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- 저자 : 나종명 ( Jong Myoung Nah ) (검색결과 2 건)
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무릎 골관절염 환자에서 초음파로 평가된 위중도와 연골 및 활막의 생화학적 지표 간의 상관관계
정영옥 ( Young Ok Jung ),김해림 ( Hae Rim Kim ),강효종 ( Hyo Jong Kang ),유승아 ( Seung Ah Yoo ),나종명 ( Jong Myoung Nah ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ),김완욱 ( Wan Uk Kim ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.1
Objective: Ultrasonography has benefit in detecting soft tissue abnormalities within the joints, which cannot be assessed by conventional X-ray. In this study, we investigated the relationship between soft tissue and/or bony abnormalities on ultrasonography and biochemical markers of synovium and cartilage in knee osteoarthritis (OA) patients Methods: Fifty-one knee OA patients who fulfilled the ACR criteria were enrolled in this study. Knee ultrasonography was performed in affected knee joints with a 12 MHz linear probe to assess the presence of effusion, synovial proliferation, capsular distension, length of osteophytes, and thickness of cartilage. At the same time, the serum levels of hyaluronic acid (HA) and cartilage oligomeric protein (COMP) were measured by ELISA and serum osteocalcin levels were determined by RIA. Results: The patients with longer medial osteophytes showed higher levels of serum HA and COMP than those with shorter ones. Serum HA levels were significantly higher in patients with larger amount of effusion and/or synovial proliferation, suggesting inflammatory changes within the joint, than those without. In addition, the severity of capsular distention was also correlated well with serum HA and COMP levels. However, the length of lateral osteophytes and thickness of femoral cartilage were not correlated with serum HA or COMP levels. Serum osteocalcin levels did not show any association with above ultrasonographic parameters, either. Conclusion: Using knee ultrasonography, we demonstrated that serum HA and COMP levels were elevated in more severe OA patients than less severe patients. This result suggests that detailed pathologic changes in the soft tissue and/or bone of OA joints on ultrasonography are being directly reflected to biochemical markers measured in the peripheral blood.
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무릎 골관절염에서의 초음파 소견에 따른 소염진통제와 아세트아미노펜의 유효성 비교
도주호 ( Ju Ho Do ),허성은 ( Sung Eun Hur ),백승인 ( Seung In Paek ),나종명 ( Jong Myoung Nah ),김충현 ( Choong Hyun Kim ),이상헌 ( Sang Heon Lee ),박성환 ( Sung Hwan Park ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ),김완욱 ( 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.1
Objective: To compare the clinical efficacy between nonsteroidal antiinflammatory drugs (NSAIDs) and acetaminophen in knee osteoarthritis according to ultrasonographic findings. Methods: We administered 12 mg of NSAIDs (lornoxicam) plus misoprostol 300μg or 1,950 mg of acetaminophen in 40 randomly selected patients who fulfilled the ACR criteria for knee osteoarthritis. The effectiveness of these drugs on osteoarthritis was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. In addition, we performed ultrasonography of the knee joints and assessed length of capsular distension, length of medial and lateral osteophyte, amount of joint effusion, and the presence of synovial proliferation. Results: There were significant correlations between WOMAC score and length of capsular distension and length of medial/lateral osteophyte. At 6 weeks, both lornoxicam and acetaminophen-treated patients had significant lower levels of WOMAC score compared to the entry into the trial (p<0.01 and p<0.05, respectively). As compared the clinical efficacy between the two groups, the lornoxicam-treated patients showed a greater decrease in WOMAC score than patients treated with acetaminophen (p=0.026). When we further divided the patients into the subgroups according to the sonographic severity, the patients with severe capsular distension (≥0.7 cm) or severe medial osteophyte (length of osteophytes ≥0.4 cm) showed better responses to lornoxicam than to acetaminophen in terms of the reduction of WOMAC score (p=0.008 for severe capsular distension, p=0.03 for severe medial osteophyte). However, in the subgroup with mild forms of capsular distension (<0.7 cm) or medial osteophytes (<0.4 cm), no difference was found in the reduction of WOMAC score 6 weeks after treatment with lornoxicam versus acetaminophen. Conclusion: Patients with osteoarthritis of the knee had significantly greater improvements in pain score over 6 weeks with lornoxicam than with acetaminophen, particularly in patients with severe forms of capsular distension and medial osteophyte on joint ultrasonography. Ultrasonography could be an useful tool to determine the usage of NSAIDs versus acetaminophen in knee osteoarthritis patients.
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