The sacroiliac joints connect the base of the sacrum to the ilium. When inflamed, they are suspected to cause low back pain. Inflammation of the sacroiliac joints is called sacroiliitis. The severity of the pain varies and depends on the degree of inflammation. Sacroiliitis is a hallmark of seronegative spondyloarthropathies. The presence or absence of chronic sacroiliitis is an important clue in the diagnosis of low back pain. This article aims to provide a concise overview of the anatomy, physiology, and molecular biology of sacroiliitis to aid clinicians in the assessment and management of sacroiliitis. For this narrative review, we evaluated articles in English published before August 2019 in PubMed. Then, we selected articles related to the painful manifestations of the sacroiliac joint. From the retrieved articles, we found that chronic sacroiliitis may be caused by various forms of spondyloarthritis, such as ankylosing spondyloarthritis. Sacroiliitis can also be associated with inflammatory bowel disease, Crohn's disease, gout, tuberculosis, brucellosis, and osteoarthritis, indicating common underlying etiological factors. The pathophysiology of sacroiliitis is complex and may involve internal, environmental, immunological, and genetic factors. Finally, genetic factors may also play a central role in progression of the disease. Knowing the genetic pre-disposition for sacroiliitis can be useful for diagnosis and for formulating treatment regimens, and may lead to a substantial reduction in disease severity and duration and to improved patient performance.
Objective: Bisphosphonate related osteonecrosis of the jaw (BRONJ) is reported in patients taken bisphosphonate for a long time, however, the mechanism of osteonecrosis in BRONJ was not clarified yet. This study was designed to investigate the effect of short administraion zoledronate on the healing pattern of periosteum and sinus membrane after iliac bone graft into maxillary sinus. Methods: In this study, 18 Newzeland rabbits were used. The animals were divided into 2 group. In the experimental group, rabbits were treated with weekly peritoneal injection (0.06 mg/kg/week) of zoledronate for three times. In the control group, rabbits were treated with saline solution injection instead of zoledronate. Periosteum and sinus membrane were harvested from one rabbit of the experimental group and one of the control group in the fourth week. The autogeneous bone was harvested from ilium and grafted into maxillary sinus. The rabbits were sacrificed at 1, 2, 4 and 8 weeks after bone graft. The healing pattern of periosteum and sinus membrane were evaluated histologically. Results: Inflammatory reaction in the periosteum was less conspicuous and healing process appeared earlier in experimental group compared with control group at 1, 2, 4 weeks. There were no differences of microscopic findings of sinus membrane between both groups at any weeks. Conclusion: Short-term use of zoledronate decreased the inflammatory reaction and enhanced healing process in the periosteum. These findings suggest the possibility that zoledronte suppress the function of macrophages.
Choi, Ho Yong;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
Journal of Korean Neurosurgical Society
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v.61
no.1
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pp.75-80
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2018
Objective : Among the various sacropelvic fixation methods, S2 alar-iliac (S2AI) screw fixation has several advantages compared to conventional iliac wing screw. However, the placement of S2AI screw still remains a challenge. The purpose of this study was to describe a novel technique of free hand S2AI screw insertion using a K-wire and cannulated screw, and to evaluate the accuracy of the technique. Methods : S2AI screw was inserted by free hand technique in sixteen consecutive patients without any fluoroscopic guidance. The gearshift was advanced to make a pilot hole passing through the sacroiliac joint and directing the anterior inferior iliac spine. A K-wire was placed through the pilot hole. After introducing a cannulated tapper along with the K-wire, a cannulated S2AI screw was installed over the K-wire. Results : Thirty-three S2AI screws were placed in sixteen consecutive patients. Thirty-two screws were cannulated screws, and one screw was a conventional non-cannulated screw. Thirty out of 32 (93.8%) cannulated screws were accurately positioned, whereas two cannulated screws and one non-cannulated screw violated lateral cortex of the ilium. Conclusion : The technique using K-wire and cannulated screw can provide accurate placement of free hand S2AI screw.
The purpose of this study is to effectively treat low back pain for the out patients who have been treated at the oriental hospital. Sorting the low back pain patients into four types based on scapular and ilium tilting hyper/hypo mobility characteristics, it has used several kinds of acupuncture stimuli on the 4 motor points of limb skeletal muscles, analyzing the acupuncture treatment on the 12 acupuncture points with which oriental hospitals has given to the low back pain patients and comparing with this effect. It has been analyzed how effectively the acupuncture stimuli has been contributed to the low back pain patients who suffered from skeletal muscles of spinal limb thorax abdominal and spinal skeletal system. The results are as follows. 1. There has been changes after treatment in both the control and experimental groups for low back pain patients, but the latter has been more increased in changes than the former. 2. There were much effects on the balanced restorations for spinal skeletal muscle in both the control group and experimental one, but on terms of restoration degree, the degree of the experimental group was higher than that of the control group. 3. Both the contrastive treatment and the experimental one have been contributed to the balanced restoration for all of the limb thorax abdominal muscles, but there were a few differences in terms of the way for restoration and the effects for improvement according to body types. 4. On both the control and the experimental group, spinal skeletal system has been restored with balance, but the experimental group has been higher effective on the balanced restoration than the one of the control group. Considering these results both the control and the experimental treatments have been contributed to the balanced restorations for all of low back pain patients who were suffering from skeletal muscles of spinal limb thorax abdominal and spinal skeletal system, but the contribution degree for the experimental group has been higher than that of the control group.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.5
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pp.340-345
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2009
Purpose: The purpose of this study was to evaluate the surgical success of bone reconstruction of the severely atrophic maxilla using autogenous block bone onlay graft from the ramus and ilium prior to dental implantation. And we measured the amount of vertical height change Material and Methods: 26 partially edentulous patients(32 case) who needed block onlay bone graft before implant placement in posterior maxillary area from 2002 to 2009 were selected for this study. Patients consisted of 20 males & 6 females and the average of their age was 54.2. Patients who were treated with ramal bone were 19 case and patients who were treated with iliac bone were 11 case. Digital panoramic X-ray was taken at the day of surgery, 3 months and 6 months later after the surgery. Vertical height change & resorption rate of grafted bone were measured with the same X-rays and compared Results: Two out of 32 bone grafts had to be removed because of inflamation at the grafts area(97.3%). The mean of radiographic vertical height change(change rate) of post-op. 3 month was 0.54mm(8.5%)and 6 month was 0.99mm(15.9%). Compairing to intraoral donor site(ramus), iliac bone had more vertical height change(1.18mm) at 6 month after surgery. Conclusions: Within the limit of this study, autogenous block onlay grafts can be considered a promising treatment for severely atrophic maxilla.
Kim, In Chul;Minn, Kyoung Won;Kim, Chin Whan;Park, Chul Gyoo;Lee, Yoonho;Kim, Suk Wha;Kwon, Sung Tack;Kim, Ji Hyuk;Lee, Min Goo
Archives of Reconstructive Microsurgery
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v.9
no.1
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pp.6-14
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2000
Reconstruction of the composite mandibular defect resulting from ablative resection of tumor involved jaw has been challenging task to the plastic surgeon. A wide variety of different techniques were used with limited success until the advent of microsurgery. The high success rate of microsurgical procedures has allowed for significant improvement in both functional and aesthetic results. A variety of free flap donor sites have been used successfully for mandibular reconstruction. Between April of 1991 and August of 1998, 20 mandibular reconstructions were performed for oncologic defects. 4 patients underwent mandibular reconstruction with pectoralis major flap, 3 patients with free nonvascularized bone graft, 1 patient with metal plate. 12 patients underwent microvascular mandibular reconstruction(8: fibula, 4: ilium). The type of free flap was determined by the requirements of the defect. Satisfactory aesthetic and functional results were achieved in all cases without significant complications. So microvascular mandibular reconstruction should be considered as primary choice in all mandibular defect without hesitation.
Objectives The aim of this study was to investigate pelvic insufficiency and its correlation with lumbago side. Methods 72 cases of patients who received treatment from March 2010 to February 2013 for lumbago were analyzed. Their pelvic insufficiency parameters were estimated by x-ray analysis and lumbago sides were considered. The data were analyzed to find out correlation of pelvic insufficiency parameters and correlation between parameters and lumbago sides. Pearson correlation and two-by-k cross tabulation analysis were used. Results 1) Iliac height difference had significant correlation with femur height difference and the result was alike previous studies' results. 2) Femur height difference and iliac height difference had no significant correlation with iliac width difference. 3) Posterior rotation malposition ilium side and inflare side had no significant correlation with lumbago side. Conclusions Iliac height difference had significant correlation with femur height difference and sides of pelvic insufficiency had no significant correlation with lumbago sides.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.3
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pp.158-163
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2009
Objective : Recently, we are interested in bisphosphonate related osteonecrosis of the jaw (BRONJ). Most of patients with osteonecrosis have taken medicine bisphosphonate for a long time. But the mechanism of osteonecrosis in BRONJ was not clarified yet. The aim of this study is to evaluate the difference of bone healing effect after bone graft from ilium to maxillary sinus in rabbits between zoledronate-treated and zoledronate-not treated groups. Method : The subjects was divided into two groups. The experimental group was 9 rabbits, treated with intraperitoneal administration of zoledronate(0.06mg/kg) once per week for 3 weeks. In control group, same procedure was applied but administerd saline instead of zoledronate. After 4 weeks, surgical operation under local anesthesia (ketamine 3.0cc, xylazine 1.0cc) was done. At postoperative 1, 2, 4, 8 weeks later, each rabbits were sacrificed and removed the bone grafted area. Gross, radiologic and histopathologic exminations of bone grafted area were performed. Result : There were no conspicuous differences of radiological findings between experimental and control groups in any experimental weeks. In experimental group, new bone formation appeared earlier than control group at 1 week after operation, and maturation of bony tissue were more conspicuous at 2 and 4 weeks after operation, compared with control group. In 8 weeks after operation, similar microscopic findings were noted in both groups. Conclusion : In the bisphosphonate-treated rabbits, new bone formation in the bone grafted area appeared earlier and bony maturation was more concpicuous, even though there were no significant differences of gross and radiological findings. These findings suggest that bisphosphonate might be promotive effect in the healing process in early stage after administration.
The turnover time of the mucosal epithelium in the small intestine(jejunum and ilium) and large interstine(cecum), and the cells in the lamina propria of the small intestine was investigated with the radioautography in mice at various times after single injection of $^3H$-thymidine. Twenty suckling mice were sacrified at each of the following time intervals after injection ; 2 hrs, 1, 3, 5. 7, 14 and 17 days. 1. The labeled index of the epithelial cells in the crypt and the villus of the small intestine averaged 98.7% and 1.3% at 2 hrs, 982% and 1.8% at 1 day, 18.7% and 81.3% at 3 days, 6.3% and 93.7% at 5 days, respectively. The labeled index of the epithelial cells of the crypt-base, the upper-crypt and the mucosal surface in the large intestine averaged 71.8%, 28.2% and 0% at 2 hrs, 45%. 54.2% and 0% at 1 day, 17.2%, 54.5% and 28.2% at 3 days, 10.2%, 32.4% and 57.4% at 5 days, respectively. This result suggested that the turnover time of all the epithelial cells migrating from crypts to villi in the direction of the villus tips was calculated to be less than 5 days, and also the longest turnover time was calculated to be no longer than 7 day. 2. The labeled index of the total cells in the lamina propria of the small intestine averaged 6.2-7% at 2 hrs to 5 days, 4.7% at 7 days 2.6% at 17 days and this index is tend to be decreased moderately at 7 days and severely at 17 days. So this result suggested that the turnover time of the cells with the shorter cycle duration in the lamina propria of the small intestine were less than 5 days and that of the cells with the longer cycle duration more than 17 days.
Journal of Korean Academy of Fundamentals of Nursing
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v.9
no.3
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pp.412-423
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2002
Currently, health promotion is an important issue in health policy for world citizens. Aerobic workout may be one way to attain health promotion. In recent years, there ave been many studies to evaluate the effects of exercise on obese people and various patients. However, there are few studies in which both physiological and psycho-perceptual aspects of health romotion for healthy people have been evaluated. Purpose: This study focused on evaluating the holistic effect of an 8 week aerobic workout for health promotion in young women. Method: This quasi-experimental study was designed as a nonequivalent control group pre-post test study. Forty healthy college women, aged between 20 and 25 volunteered for the study. Twenty women took 30 minutes of exercise a day for five days a week over 8 weeks with Jane Fonda's aerobic workout program. Twenty women participated as controls. The aerobic workout program consisted of warm-up for arms, waist, abdominal, leg, hips, buttocks and cool down exercises. Result: After the eight weeks of aerobic exercise, changes in health related fitness components through the In Body Test, skin fold, circumference of body, Body image, Self concept, Mood and Self-efficacy were compared. The results areas follows ; 1. Following the 8 week aerobic workout, health related body components, and fitness scores, increased significantly (P < 0.05) and skin fold for four sites (right upper arm, scapular, abdomen, supra ilium), and circumference of mid thigh decreased significantly (P<0.05, p<0.005, P<0.001) compared to the control group. 2. Following the 8 week aerobic workout, there was a significant increase in Self-concept and Mood (P<0.005 and 0.001) compared to the control group. Conclusion: According to these results, it is concluded that 8 weeks of aerobic workout have a positive effect on young women's holistic health promotion.
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