• Journal of Korean Medicine Rehabilitation
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• v.24 no.2
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• pp.65-81
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• 2014

Objectives This study was carried out to find out the anti-osteoarthritic effects of Mahwangbujaseshin- tang (Mahuangfuzixixintang ) on the monosodium iodoacetate (MIA)-induced osteoarthritis rats. Methods Osteoarthritis was induced by injecting MIA ($50{\mu}l$) into the knee joint of rats. Rats were divided into a 3 groups (n=7). The injection did not fit the normal group. A week later, after the injection of MIA, while control group took normal saline 2 ml, the extract of Mahwangbujaseshin-tang (Mahuangfuzixixintang ) (MBST) (200 mg/kg) was injected to treated group. After that, we examined hind paw weight bearing ability, functions of liver and kidney, serum TNF-$\alpha$, IL-$1{\beta}$, IL-6, $PGE_2$, $LTB_4$, TIMP-1, MMP-9 and hematology. Volume of cartilage was measured by micro CT arthrography. Injury of synovial tissue was measured by H & E, Safranin-O immunofluorescence. Results 1) DPPH and ABTS free radical scavenging activity of MBST was increased according to concentration of MBST and total phenolic contents were in high level. 2) In RAW 264.7 cells, ROS production was significantly decreased in MBST (at 10, $100{\mu}g/ml$) and NO was also decreased but meaningless in MBST (at $100{\mu}g/ml$). 3) In RAW 264.7 cells, IL-6 production was significantly decreased in MBST (at $100{\mu}g/ml$) and TNF-$\alpha$ and IL-$1{\beta}$ production were also decreased but meaningless in MBST (at $100{\mu}g/ml$). 4) In hind legs weight-bearing measurement, level of weight-bearing was increased. 5) Functions of liver and kidney were not affected. 6) TNF-$\alpha$, IL-$1{\beta}$, IL-6, $PGE_2$, $LTB_4$, MMP-9 and TIMP-1 production were significantly decreased. 7) In hematology, the levels of neutrophils, monocytes were significantly decreased and the levels of white blood cells, lymphocytes were also decreased but meaningless. 8) In micro CT-arthrography, cartilage volume was significantly increased. 9) Histopathologically, injury on cartilage and synovial membrane of MBST group was decreased. Conclusions Based on all results mentioned above, Mahwangbujaseshin-tang (Mahuangfuzixixintang) is believed to be meaningful for suppressing the progress of osteoarthritis. And it is related to inhibiting the activity of inflammatory cytokine and injury of volume in cartilage.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.39-57
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• 2013

Objectives The purpose of this study is to prove the effect of Kyejakjimotangkami(KMK) on osteoarthritis. Methods We checked antioxidant activity and measured production of $IL-1{\beta}$, IL-6, TNF-${\alpha}$ in RAW 264.7 cell after treat by KMK. Then we measured hind paw weight of Wister Rat with arthritis induced by MIA after KMK oral administration, checked Prostaglandin E2, IL-$1{\beta}$, IL-6, TNF-${\alpha}$, Osteocalcin, TIMP-1, MMP-9, LTB-4 in serum, ran histopathological test and ${\mu}CT$-arthrography. Results 1. DPPH radical Scavenging was increased depend on concentration of KMK ethanol extract in RAW 264.7 cell. 2. Production of NO was significantly decreased by KMK ethanol extract on concentration of $200{\mu}g/ml$ in RAW 264.7 cell. 3. Production of IL-$1{\beta}$ was significantly decreased by KMK ethanol extract on concentration of $200{\mu}g/ml$. And Production of IL-6, TNF-${\alpha}$ were significantly decreased KMK ethanol extract of every concentration in RAW 264.7 cell. 4. Result of checking hind paw weight when administered KMK ethanol extract to Wister Rat with arthritis induced by MIA was significantly higher than control group and similar to normal group. 5. Production of Prostaglandin E2, IL-$1{\beta}$, Osteocalcin, TIMP-1, MMP-9 and LTB-4 in serum was significantly decreased by KMK ethanol extract after administerd to Wister Rat with arthritis induced by MIA. 6. In Hematoxylin & Eosin staining and Safranin-O staining, we could find inflammation of synovial cell, infiltration of macrophage and granulocyte and degeneration of cartilage and bone were decreased in comparison with control group. 7. When checked cartilage volume to examine degree of cartilage degeneration using ${\mu}CT$-arthrography, volume of cartilage was increased in comparison with control group. Conclusions Comparison of the results for this study showed that KMK ethanol extract have anti-inflammatory effectiveness and can protect cartilage and bone. So we expect that KMK can be used as a effective drugs for osteoarthritis.

• Journal of Korean Foot and Ankle Society
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• v.7 no.2
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• pp.208-217
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• 2003

Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.221-225
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• 1989

Arthrography is one of highly accurate diagnostic tools for internal derangements of the temporomandibular joint (TMJ). Both TM joints are connected by the mandible and one may have influence upon the other. We performed bilateral TMJ arthrograms in 42 patients with TMJ disorders to evaluate the bilaterality of internal derangements of the TMJ. The results were as follows : 1. We could not find any specificity in clinical symptoms according to each state of internal derangements of the TMJ. 2. The bilaterality of internal derangements of the TMJ was 61%. 3. Statistically, significant correlation was found in the aspects of the presence of arthrographic abnormality in both TMJ and each state of internal derangements in them. Therefore, the patients, who are diagnosed as any internal derangement of the TMJ, need to have assured examination in the contralateral joint.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.40-49
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• 2008

Hip joint is one of the most deeply located joint in human body. Moreover, most clinical symptoms of various hip diseases are vague and confusing. In these reasons, the imaging modalities of hip have been extensively studied and developed. From a plain radiograph to more complex MR arthrography, various techniques are now available. In this brief review, the long and short of imaging modalities and clinical examples of common hip diseases will be introduced. The most important significance of diagnostic imaging is its clinical relevance. It is because when we know the characteristics of the imaging modalities and the disease itself, the optimal approach to a patient can be achieved, but when we do not know, the expensive images can only be a meaningless picture.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.134-137
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• 2018

Background: In a previous study undertaken to quantify capsular volume in rotator cuff interval or axillary pouch, significant differences were found between controls and patients with instability. However, the results obtained were derived from two-dimensional cross sectional areas. In our study, we sought correlation between three-dimensional (3D) capsular volumes, as measured by magnetic resonance arthrography (MRA), and multidirectional instability (MDI) of the shoulder. Methods: The MRAs of 21 patients with MDI of the shoulder and 16 control cases with no instability were retrospectively reviewed. Capsular areas determined by MRA were translated into 3D volumes using 3D software Mimics ver. 16 (Materilise, Leuven, Belgium), and glenoid surface area was measured in axial and coronal MRA views. Then, the ratio between capsular volume and glenoid surface area was calculated, and evaluated with control group. Results: The ratio between 3D capsular volume and glenoid surface area was significantly increased in the MDI group ($3.59{\pm}0.83cm^3/cm^2$) compared to the control group ($2.53{\pm}0.62cm^3/cm^2$) (p<0.01). Conclusions: From these results, we could support that capsular volume enlargement play an important role in MDI of the shoulder using volume measurement.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.1
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• pp.31-45
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• 2014

Objectives This study intends to clarify how Leejung-tang (here in after reffered to LJT) affect Wistar Rat whose osteoarthritis was induced by MIA. Methods Osteoarthritis was induced into rat by injecting MIA in its knee joint. Rats are divided into a total of 4 groups (n=6). Normal group are not treated at all without inducing osteoarthritis whereas control group were induced for osteoarthritis by MIA and oral medicated with 2 ml of physiological saline per day. Positive comparison group (Indomethacin) was injected with MIA and after 7 days, 2 mg/kg of Indomethacin was medicated. Experimental group (LJT) was injected with MIA and after 7 days that was medicated with 23 mg/kg of LJT. Indomethacin and LJT were oral medicated for each substance a total of 4 weeks with one time per day. After experiments (from 1 week after injection of MIA to 4 weeks elapsed), Hind paw weight bearing ability, Functions of liver and kidney, Serum prostaglandin $E_2$, TNF-${\alpha}$, IL-1${\beta}$, IL-6, Osteocalcin, TIMP-1, MMP-9, LTB4 and amount of cartilage were measured and histopathological variations for knee joint structures were observed. Results 1) Hind paw weight bearing ability of LJT administration group was increased but there was no statistical significance. 2) Functions of liver and kidney were not affected. 3) Serum prostaglandin $E_2$, IL-1${\beta}$, Osteocalcin, MMP-9 were significantly decreased and TNF-$\alpha$, IL-6, TIMP-1, LTB4 were also decreased but there were no statistical significance. 4) In H&E staining and Safranin-O staining, there were small histopathological changes in LJT administration group than control group. 5) In micro CT (computed tomography)-arthrography, cartilage destruction was more suppressed in LJT administration group than control group. Conclusions Based on all results mentioned above, Leejung-tang (LJT) is believed to be meaningful for suppressing the progress of osteoarthritis and its treatments because of its anti-inflammatory effects and alleviation of pain with histopathological effective efficacy.

• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.1-6
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• 2004

Purpose: We studied the diagnostic value of ultrasonography to confirm the presence of the syndesmosis injuries in the ankle. Materials and Methods: Pre-operative ultrasonography were taken in 42 cases of ankle fractures to determine injury of syndesmosis between February 2000 and August 2003. Tear of syndesmosis was confirmed when they met the following criteria; widening of distal tibiofibular clear space greater than 7 mm on pre-operative AP X-rays, leakage of contrast dye during intra-operative arthrography, and operative findings revealing syndesmosis rupture. We compared these diagnoses with those made by pre-operative ultrasonography. Results: Syndesmosis injuries were confirmed in 23 cases among the total 42 cases. Ultrasonography revealed syndesmosis tear in 25 cases, with 20 cases corresponding with confirmed tear and 5 cases without tear in confirm. Syndesmoses were found to be intact in 17 cases of ultrasonograph, but 3 cases were actually confirmed tear. In ankle ultrasonography, the sensitivity was 90.9%, the specificity was 75.0%. Conclusion: Preoperative ultrasonography is a non-invasive and useful study to determine the syndesmosis injury in ankle fractures.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.30-34
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• 2004

Purpose: To report our experience of treatment of rotator cuff tear and evaluate the mid-term outcome. Materials and Methods: We have performed 50 cases of mini-open rotator cuff repair from March 1996 to March 1999. Male to female ratio was 34：16, the average age 46.5(23∼57) years old, mean follow-up period was 78(62∼93) months. All-arthroscopic repair and open repair cases were excluded. Mean symptomatic period was 12.5(6∼38) months, operation was indicated in cases of no improvement by 6 months of conservative management. Preoperative simple radiographs and Magnetic resonance arthrography were obtained in all cases. We also observed the inflammation, synovitis, thickness of tear and associated pathology intraoperatively. We evaluated pain, function, and range of motion by UCLA score. Results: Overall UCLA score was mean 29.5 points. Excellent 25, good 18, poor 7 cases. Mean pain score was improved 2.6 to 7.5, 44 cases(88%) were improved and 6 cases(12%) were not improved. Mean functional score was improved 3.4 to 8.5, and activity at follow up, 25 cases(50%) were same, 8 cases(14%) were above, 17 cases(34%) were below compared with preoperative level. Mean active forward flexion was preoperative 112° to postoperative 160°, forward flexion strength was improved 3.8 to 4.7. 43 cases(86%) of patients were satisfied at the result, 7 cases(14%) were not satisfied or aggravated. Results: Mini-open rotator cuff repair was effective method in treating rotator cuff tear.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.2
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• pp.212-224
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• 2013

This study intends to clarify how Sayeok-tang(here in after reffered to SYT) affect C57BL/10 mice whose osteoarthritis was induced by papain. Osteoarthritis was induced by injecting papain in the knee joint of 3 groups(n=6) of mice. Normal group was non-treatment group and was not injected papain, whereas control mice were orally administered with $200{\mu}{\ell}$ of physiological saline. Positive comparison group was medicated with 100 mg/kg of Joins$^{(R)}$ mixed with $200{\mu}{\ell}$ of physiological saline. Experimental group was medicated with 400 mg/kg of SYT mixed with $200{\mu}{\ell}$ of physiological saline. Both Positive and experimental comparison groups were orally medicated once per day for 4 weeks. After the experiment, the functions of liver and kidney, inflammation cytokine values within serum, degree of revelation for inflammation cytokine genes, immune cells within blood, metabolism of arachidonic acid and amount of cartilage were measured and histopathological changes in the knee joint structures were observed. As results, SYT had no significant effect on the liver and kidney functions. Interleukin-$1{\beta}$(IL-$1{\beta}$), interleukin-6(IL-6), monocyte chemo attractant protein-1(MCP-1) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) were significantly decreased. Inflammation cytokines in joints were all significantly decreased. Prostaglandin $E_2(PGE_2)$, thromboxane $B_2(TXB_2)$ were significantly decreased. Destruction of cartilage on micro computed tomography(CT)-arthrography was meaningfully decreased. In terms of histopathology, infiltration of inflammation, proliferation of synovial membrane, subsidence of cartilage and bone due to penetration of excessive formation of synovial cell and destruction of cartilage were small. Based on all results mentioned above, Sayeok-tang(SYT) is believed to be meaningful for suppressing the progress of osteoarthritis and its treatments because of its anti-inflammatory effects and alleviation of pain with histopathological effective efficacy.