• Journal of Chest Surgery
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• v.32 no.11
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• pp.1049-1051
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• 1999

We performed a reoperation of failed tricuspid mechanical valve in a 63-year-old female patient because the overgrown endothelial pannus had entrapped the prosthetic leaflets. Four years ago, the patient underwent mitral and tricuspid valve replacements with 31 and 33 mm Carbomedics, respectively. The patient showed symptoms of neck vein distention, abdominal distention and peripheral edema. The chest film, echocardiography and cineangiography confirmed the diagnosis of tricuspid valve. During the operation, we found the entrapped leaflets of the tricuspid valve in a partially closed state and the endothelial pannus had overgrown into the leaflets. Carpentier-Edward bovine pericardial valve was inserted and the patient was discharged with no significant events.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1151-1163
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• 2020

Purpose This study aimed to evaluate changes of subprosthetic pannus on cardiac CT and determine its relationship to echocardiographic findings in patients with mechanical aortic valve replacement (AVR). Materials and Methods Between April 2011 and November 2017, 17 AVR patients (56.8 ± 8.9 years, 12% male) who showed pannus formation on CT and had undergone both follow-up CT and echocardiography were included. The mean interval from AVR to the date of pannus detection was 10.5 ± 7.1 years. In the initial and follow-up CT and echocardiography, the pannus extent and echocardiographic parameters were compared using paired t-tests. The relationship between the opening angle of the prosthetic valve and the pannus extent was evaluated using Pearson correlation analysis. Results The pannus extent was significantly increased on CT (p < 0.05). The peak velocity (3.9 ± 0.8 m/s vs. 4.2 ± 0.8 m/s, p = 0.03) and mean pressure gradient (36.4 ± 15.5 mm Hg vs. 42.1 ± 15.8 mm Hg, p = 0.03) were significantly increased. The mean opening angles of the mechanical aortic leaflets were slightly decreased, but there was no statistical significance (73.1 ± 8.3° vs. 69.4 ± 12.1°, p = 0.12). The opening angle of the prosthetic leaflets was inversely correlated with the pannus extent (r = -0.57, p < 0.001). Conclusion The pannus extent increases over time, increasing transvalvular peak velocity and the pressure gradient. CT can be used to evaluate the pannus extent associated with hemodynamic changes that need to be managed by surgical intervention.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2001.11a
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• pp.14-20
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• 2001

Rheumatoid arthritis (RA) is one of the most typical rheumatic diseases, and is characterized by chronic inflammation, cartilage destruction and joint deformity ［1,2］. During this process, profound hypertrophic changes of the synovium with infiltration of immune cells, increased vascularity, and hyperplasia result in the formation of a synovial pannus that invades cartilage and bone ［3］. In early stages of RA, the synovial membrane begins to invade the cartilage. In established RA, the synovial membrane becomes transformed into inflammatory tissue, the pannus (Fig. 1). The cell types that occupy cartilage-pannus junctions include synovial macrophages, fibroblasts, mast cells, polymorphonuclear lymphocytes (PMNs), and displaced, probably differentiated condrocytes ［4-6］. Recent studies of rheumatoid synovial tissue have demonstrated localized accumulations of mast cells and evidence of their activation/degranulation［7］.

• Journal of Chest Surgery
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• v.34 no.1
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• pp.91-93
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• 2001

기계판막의 비구조적 기능이상은 판막 치환 후 생길 수 있는 심각한 합병증 중의 하나이다. 이러한 기계판막의 비구조적 기능이상은 일반적으로 1) pannus나 조직 혹은 봉합물질에 의한 장애 2) 치환 판막 주위의 틈 3) 부적절한 판막의 크기나 위치, 판막 삽입시의 잘못 등에 의해 생긴다. 저자들은 상대적으로 작은 판막륜을 가진 환자에서 치환 판막의 잘못된 위치로 야기된 pannus 형성에 의한 판막의 기능부전을 경험하였으며, 이 환자에 대해 pannus 제거 후 판막륜 확장술(닉스 술식, Nicks procedure)을 포함한 판막 재치환술을 성공적으로 시행하여 이를 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• v.62 no.6
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• pp.661-670
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• 2019

Objective : Rheumatoid arthritis (RA) is known to involve the cervical spine up to 86%. It often causes cervical instability like atlantoaxial subluxation (AAS), subaxial subluxation, and vertical subluxation (VS). In order to find the relation between RA and cord compression, we will evaluate the characteristics and risk factors of basilar invagination (BI) and cervicomedullary junction (CMJ) compression. Methods : From January 2007 to May 2015, 12667 patients administrated to Hanyang University Medical Center. Four thousand three hundred eighty-six patients took cervical X-ray and 250 patients took cervical computed tomography or magnetic resonance imaging. Radiologic parameters, medication records were obtained from 242 patients. Multivariate logistic regression analysis was performed with correlation of CMJ compression, basin-dental interval (BDI), basin-posterior axial line interval (BAI), pannus formation, BI, and AAS. Results : In the point of CMJ compression, atlantodental interval (ADI), posterior-atlantodental interval, BAI, AAS, and BI are relatively highly correlated. Patients with BI have 82 times strong possibility of radiologic confirmed CMJ compression, while AAS has 6-fold and pannus formation has the 3-fold possibility. Compared to the low incidence of BI, AAS and pannus formation have more proportion in CMJ compression. Furthermore, wrist joint erosion was correlated with VS and AAS. Conclusion : BI has a very strong possibility of CMJ compression, while AAS and pannus formation have a high proportion in CMJ compression. Hence bilateral wrist joint erosion can be used as an indicator for the timing of screening test for cervical involvement. We suggest the early recommendation of cervical spine examination for the diagnosis of cervical involvement in order to prevent morbidity and mortality.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.849-851
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• 2005

Mitral stenosis was developed after Duran ring annuloplasty in two growing children during follow up period of 8 years and 5 years respectively, which may be due to pannus overgrowth and patient's growing. Only removal of pannus and prosthetic ring has resulted in complete relieving of Mitral stenosis. With time, even adult-sized an-nuloplasty ring may induce stenosis in growing children.

• The Journal of Korean Medicine
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• v.23 no.4
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• pp.98-104
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• 2002

Objectives: Calpain, a calcium-dependent cysteine proteinase, may be one of the proteolytic enzymes that mediate cartilage degradation associated with rheumatoid arthritis. The object of this study is to ascertain immunohistochemically whether calpain is present in the inflamed joints of collagen-induced arthritis of rats, and examine the effect of Cortex Acanthopanacis Senticosi on the expression of calpain. Methods: Male Lewis rats, around 200g of body weight, were immunized with bovine type II collagen. After 3 weeks from first immunization, rats were divided into arthritic control (n=6) group and Cortex Acanthopanacis Senticosi-treated (n=6) group. Non-immunized rats served as the normal (n=6) group. All animals were sacrificed at 15 days post-treatment and tibiotarsal joints were removed. Calpain immunohistochemistry was performed on the midsagittal section of the tibiotarsal joint. Results: All animals of the control and treated groups showed ankylosing osteoarthritis. However, the animals of the treated group showed alleviation in the fibrous ankylosis, destruction of articular cartilage and destruction of subchondral bony tissue compared with the animals of the control group. Calpain was expressed in the chondrocyte lacunae of growing articular cartilage, in the skeletal muscle fibers, in the peripheral nerves, and in the vessel walls around the joints of all groups. In the control and treated groups, calpain was also expressed in proliferating synovial epithelia, subsynovial stroma cells, surface of articular cartilage, and fibrous pannus around destructive subchondral bony tissue. However, the expression density of calpain in the treated group was diminished compared with the control group, especially in surface of articular cartilage and fibrous pannus. Conclusions: These observations indicated that calpain plays an important role in the destruction of cartilage and bone in collagen-induced arthritis of rats, and also indicated that Cortex Acanthopanacis Senticosi inhibits the development of arthritis by decreasing the expression of calpain.

• The Journal of Korean Academy of Prosthodontics
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• v.15 no.1
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• pp.34-42
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• 1977

The author attempted to observed the histological changes of the temporomandibular joints of rabbits by including malocclusion. Thirth-two healthy male rabbits were devided into two groups; control and experimental group. Eight rabbits were kept as control group, while metal crowns were seated on unilateral lower molar teeth of twenty-four rabbits as experimental group. And the interocclusal distance of the incisal edge was kept 1.5mm from the begining to the end of the experimental periods. Rabbits of each group, one of control group and three of the experimental gorup, were killed at the intervals of one day, three days, one week, two weeks, four weeks, six weeks, eight weeks, and twelve weeks after experiment. The temporomandibular joint including condyle head, articular disc and glenoid fossa were excised and decalcified. The decalcified sections were made histologic sections. The results obtained were as follows. 1. The regressive changes of the condylar head were the main reaction in this experiment that consist of decreasing or increasing thickness of the fibrocartilage zone with hyaline degeneration, decreasing of the cellularity of the proliferative zone, and the irregularity of the arrangement of chondrocytes and size of the lacunae of cartilage cells with chondroclasia and osteoclasia in hypertrophic zone. 2. The regressive changes of the condylar surface of the crown seated side were persisted to the end of the experiment. 3. On the non-crown seated side, severe aggressive changes occurred in initial stage, but hyperplastic changes of the condylar surface noted in the middle of the experimental periods. 4. Although aggressive changes occurred in initial stage of experiment on the non-crown seated side, hyperplastic changes of the condylar surface were noted in the middle of the experimental periods, and remodeling appeared at the termination of the experimental periods. 5. The articular disc exhibited pannus formation on both crown seated and non crown seated side from the beginning of the experiment. The pannus persisted throughout the experiment on the crown seated side, but on the non-crown seated side it disappeared from six week group.

• Biomolecules & Therapeutics
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• v.7 no.4
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• pp.347-353
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• 1999

Osteoarthrosis was induced in rabbit knees through resecton of anterior cruciate ligament. Sodium hyaluronate (1%) was administerated into articular space at the dose levels of 0.1 mg/kg once a week using 1ml sylinge and 26G needle for test groups. Saline was administrated for control groups. After 6 and 12 weeks, animals were sacrificed to conduct macroscopic observation and histopathologic examination. The articular lesions were evaluated and test groups were compared with control groups. No significant differencies were showed between test groups and control groups at macroscopic observation in both 6- and 12- week groups. In histopathologic examination, control groups showed higher osteoarthrosis than test groups. The articular surfaces of control groups showed fibrillation, denudation, pannus formation and hypocellularity. The articular surfaces of test groups showed fibrillaton and hypercellularity. These indicate that sodium hyaluronate has inhibitory effects on osteoarthrosis at least in rabbit and could be used for treatment of osteoarthrosis.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.14 no.2
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• pp.16-24
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• 2008

Anatomy: Advanced knowledges of cellular and molecular biology led to the development of therapies of rheumatoid arthritis(RA). Rheumatoid arthritis (RA) is a chronic, recurrent, systemic inflammatory disease and results in major deformity or dysfunction of joints. Etiology: Rheumatoid arthritis is now concevied as autoimmune disease. There have been many trials to define the immunological changes in rheumatoid arthritis. But now pathogenesis and significance of immunoglobulin complement and rheumatoid factor are not full accepted. Syndrome: Joints are characteristically involved with early inflammatory changes in the synovial membrane, peripheral portions of the articular cartilage, and lation tissue(pannus) forms, covers, and erodes the articular cartilage, bone and ligaments within the jiont capsule. Inflammatory changes also occur in tendon sheaths(tenosynovitis), and if subjected to a lot of friction, the tendons may fray or rupture. Extra-articular pathological changes sometimes occur, these include rheumatoid nodules, atrophy and fibrosis of muscles, and mild cardiac changes. Treatment: Tumor necrosis factor(TNF) inhibitor for the treatment of rheumatoid arthritis(RA) induces not only significant improvement of symptoms and signs of RA but also substantial inhibition of progressive joint damage.