• Title/Summary/Keyword: 만성 관절염

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Endoscopic-Assisted Curettage of Brodie Abscess in Proximal Tibia - A Case Report - (경골 근위부에 발생한 Brodie 농양에서 내시경을 이용한 소파술 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Choi, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.134-138
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    • 2007
  • Brodie abscess is a localized form of subacute or chronic osteomyelitis which is common in children but may also occur in adulthood. When Brodie abscess is located in the posterior metaphysis of the proximal tibia, open biopsy and curettage have a difficulty in approach to the lesion and can cause neurovascular injury or soft tissue contamination. We report a case wherein a novel surgical technique was used to treat a Brodie abscess in the posterior proximal tibial metaphysis in 48 year-old-male with endoscopic-assisted curettage by commercial anterior cruciate ligament targeting device(Rigid Fix; Mitek, Johnson & Johnson, Norwood, MA). Two portals were created toward the abscess site and, through each portal interchangeably, the granulation tissue and sclerotic bone could be excised. We believe that endoscopic-assisted curettage presents safe technique, decreased morbidity, accurate assessment of the extent of the abscess and possible improvement in long-term outcomes.

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Two Cases of Severe Pancytopenia Associated with Low-Dose Methotrexate Therapy in Patients with Chronic Kidney Disease and Rheumatoid Arthritis (류마티스 관절염을 가진 만성신질환 환자에서 저용량 methotrexate 투여 후 발생한 중증 범혈구 감소증 2예)

  • Kim, Hong-Ik;Lee, Woo-Hyun;Oh, Jang-Seok;Hong, Hyo-Rim;Lee, In-Hee
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.60-69
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    • 2011
  • Due to its efficacy and tolerability, low dose oral methotrexate (MTX) therapy has been widely used for treatment of rheumatoid arthritis (RA). However, it can rarely cause serious, life-threatening hematologic toxicities, such as pancytopenia. We report here on two patients with chronic kidney disease (CKD), who developed severe pancytopenia after 5 years (cumulative dose 1,240 mg) and 4 years (cumulative dose 1,320 mg) of low dose MTX therapy for treatment of RA, respectively. Both patients presented with renal insufficiency, hypoalbuminemia, concurrent use of nonsteroidal anti-inflammatory drugs, and elevated mean corpuscular volume of red blood cells (RECs), all of which are known as risk factors of MTX-induced pancytopenia. Despite receiving treatment, which included REC and platelet transfusions, antibiotic therapy, granulocyte colony stimulating factor, and leucovorin rescue, one patient died of sepsis. Based on our case study, prompt investigation of risk factors associated with MTX toxicity is required for all patients receiving MTX therapy. MTX treatment, even at a low dose, should be discontinued in patients with advanced CKD.

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Extracorporeal Shock Wave Therapy (ESWT) in Patients with Chronic Proximal Plantar Fasciitis (체외 충격파를 이용한 만성 근위부 족저 근막염의 치료)

  • Kim, Byung-Soo;Lee, Keun-Bae;Choi, Jin;Park, Yu-Bok;Baik, Long-Bin
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.163-167
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    • 2006
  • Purpose: To evaluate the results of extracorporeal shock wave therapy (ESWT) for patients with chronic proximal plantar fascitis. Materials and Methods: Between April 2005 and April 2006, 35 cases (24 patients) who were followed more than 6 months were evaluated. By $EvoTron^{(R)}$, 2 sessions of ESWT (Group 1: 1200 and Group 2: 1500 shock waves / session of $0.12\;mJ/mm^2$) were performed at 2 weeks interval. The mean age was 40.0 (range, 15-59) years. 13 patients were male and 11 patients were female. Visual analogue scale (VAS) on daily activity and a 100-point scoring system including 70 points for pain and 30 points for function were used. The clinical outcomes were rated as follows: excellent, no pain on daily activity; good, less than 50% of previous VAS; fair, 50-75% of previous VAS; or poor, more than 75% of previous VAS. Excellent and good were graded as satisfactory results. We compare clinical results between groups and evaluate the relationships between clinical results and duration of symptom, fascial thickening and previous steroid injection were evaluated. Results: Overall satisfactory rate were 71.4%. There was no significant difference of clinical results between groups. And there were no significant difference between clinical results and duration of symtom, preoperative fascial thickening and previous steroid injection. Conclusions: ESWT for recalcitrant chronic proximal plantar fascitis is useful treatment method with high patient satisfaction and pain relief, but more long-term study must be needed.

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Current Guidelines for Non-Steroidal Anti-Inflammatory Drugs (비스테로이드 소염제의 최신 사용 지침)

  • Park, Min-Gyue;Yoo, Jae-Doo;Lee, Kyu-Ho
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.9-28
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    • 2020
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used drugs worldwide for chronic pain, such as arthritis, and there are many different types depending on their composition and mechanism. After long-term use, various side effects can occur, such as gastrointestinal and cardiovascular complications. With a similar analgesic effect to that of traditional non-selective NSAIDs, cyclooxygenase-2-selective NSAIDs have been highly anticipated, because they could complement gastrointestinal tolerance. On the other hand, because of concerns about cardiovascular safety in 2004 and 2005, and the license withdrawals of rofecoxib and valdecoxib, the interest in the side effects of NSAIDs is increasing. Therefore, it is important to use the necessary drugs at a minimum, considering the side effects and interactions of each drug. This study examined the side effects and characteristics of each NSAID that may occur and reviewed the recent research and guidelines related to the use of non-selective NSAIDs and cyclooxygenase-2-selective NSAIDs.

A Boy With Blau Syndrome Misdiagnosed as Refractory Kawasaki Disease

  • Kyungwon Cho;Yoonsun Yoon;Joon-sik Choi;Sang Jin Kim;Hirokazu Kanegane;Yae-Jean Kim
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.166-172
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    • 2022
  • Blau syndrome is a systemic autoinflammatory disease presenting with non-caseating granulomatous dermatitis, chronic uveitis, and arthritis. It is caused by a gain-of-function variant of the nucleotide-binding oligomerization domain protein 2 gene, which leads to the overactivation of inflammatory cytokines and eventually causes autoinflammation. Since the symptoms of Blau syndrome are nonspecific and usually do not appear simultaneously, it is challenging to differentiate Blau syndrome from other inflammatory disorders. This is a case report of a 13-month-old boy who had suffered from recurrent skin rash and fever. The patient was previously misdiagnosed as refractory Kawasaki disease twice and was treated with intravenous immunoglobulin and systemic glucocorticoid, which only resulted in transient improvement of the symptoms. He was eventually diagnosed with Blau syndrome.

Comparison of the health behavior and nutrition status of young-old women according to the vitality in their quality of life: based on the 2019, 2021 Korea National Health and Nutrition Examination Survey (전기노인 여성의 삶의 질 중 기운에 따른 건강행태와 영양상태 비교: 2019년, 2021년 국민건강영양조사 자료를 이용하여)

  • Jiyoung Jeong;Yoon Jung Yang
    • Journal of Nutrition and Health
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    • v.56 no.5
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    • pp.496-509
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    • 2023
  • Purpose: This study aimed to identify the general characteristics, chronic diseases, health behavior, mental health, and nutritional status of young-old women based on their vitality. Methods: This study used data from the 2019 and 2021 Korea National Health and Nutrition Examination Survey (KNHANES). The subjects were 1,113 young-old women aged 65 to 74 years old. The health-related quality of life concept with an 8-item questionnaire was used to measure the quality of life. Subjects were categorized into 4 groups (always, often, sometimes, never) based on their vitality. General characteristics, chronic diseases, health behavior, dietary behavior, food intake, and nutrient intake were compared among the groups. Results: Age, education level, household income, employment, fruit intake, dietary supplements, abundance of food, and nutrition labeling recognition were associated with the vitality of the subjects. Young-old women with arthritis, diabetes, and osteoporosis displayed lower vitality. Moreover, subjective health status, exercise, activity restrictions, and average daily sitting hours were related to vitality, while no significant difference was found in vitality between smoking and drinking. In terms of mental health factors, higher vitality was associated with 6-8 hours of sleep, lower stress levels, and reduced depression. The high-vitality group exhibited a higher intake of potatoes, starch, mushrooms, fruits, meat, milk, animal oils, and beverages than the low-vitality group. Additionally, the group with higher levels of vitality showed a higher intake of protein, fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, n-6 fatty acids, dietary fiber, sugars, phosphorous, potassium, magnesium, iron, zinc, and riboflavin. Conclusion: This study suggests that the vitality of young-old women is related to socioeconomic factors, health behavior, mental health, and food intake. To maintain a vibrant lifestyle in elderly women, it is necessary to have social and economic stability, prevent arthritis, diabetes, and osteoporosis, exercise regularly, get sufficient sleep, maintain mental health, and have a balanced diet.

Disease, Accident and Health Behavior of in Farmers and Fishermen (농림어업인의 상병실태 및 건강행태 분석)

  • Kim, Kyung-Ran;Choi, Jeong-Wha
    • Journal of agricultural medicine and community health
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    • v.30 no.3
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    • pp.279-292
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    • 2005
  • Objectives: The purpose of this study is to analyze agricultural accident and disease using statistical data and materials about National Survey for Health & Nutrition in 2001 and to provide fundamental materials for studies about farmers' health and safety, decision of priority about research and policy. Results: Diagnosed chronic disease prevalence is 72.4% in farmer/fisher group, 49.8% in non farmer/fisher group. The chronic disease prevalence of musculoskeletal disease, circulatory disease, and gastroenteric disease is 46.5%, 18.2%, and 17.9% in farmer/fisher group respectively. The prevalence of musculoskeletal disease in farmer/fisher is 2.4 times higher than non farmer/fisher. This result shows that it need to evaluation for risk factors of musculoskeletal disease preferentially. Lifetime accident/poisoning rate is 18.2% In farmer/fisher group and 13.3% in non farmer/fisher group. The types of accidents were fracture>sprain>contusion and the reasons of accidents were traffic accident>falling/sliding. Conclusions: "Bad or very bad" response of farmer/fisher is almost 2 times higher than non farmer/fisher group. The rate of smoking and no exercising in farmer/fisher group is higher than non farmer/fisher group.

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Effects of health promotion education experience on present health status of elderly (건강증진 보건교육 경험이 노인의 현재 건강상태에 미치는 영향)

  • Lee, Heung Hun;Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.106-114
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    • 2019
  • This study aims to identify the effects of experiencing health promotion education on the present health status of elderly people. The subjects of this study were a total 10,532 elderly people (aged 65 years or older), and who were selected from the data of the '2017 Community Health Survey'. The health promotion education experience consisted of handwashing education/campaign, a non-smoking campaign and non-smoking education. The chronic disease control education experience consisted of education on hypertension, diabetes mellitus and arthritis. Psychiatric counseling consisted of consultations on stress, depression and suicide. The present health status consisted of the patients' ability to exercise, their self-care ability, their activities of daily living, their pain/discomfort and their anxiety/depression. The data was analyzed utilizing the chi-square test, the Mann-Whitney test and multivariate logistic regression analysis. The general characteristics of the subjects were 4,075 males (38.69%) and 6,457 females (61.31%). The average age was 73.71(±6.18) years old. The significant factors influencing the elderly peoples' present health status were age (OR=0.909, 95% CI=0.886-0.933), handwashing education/campaign (OR=2.463, 95% CI=1.703-3.563), a stop smoking campaign (OR=1.624, 95% CI=1.146-2.301) and consultation for mental problems (OR=0.533, 95% CI=0.359-0.791). In conclusion, to modify the personal habits that the elderly have had for a long time and to show the effects of education, long-term continuous education that focuses on the characteristics of the people will be effective.

The Influence of Individual-Level Social Capital on Depression (개인수준의 사회적 자본이 우울증에 미치는 영향)

  • Lee, Jin-Hyang;Park, Ki-Soo;Kim, Rock-Bum;Kim, Bong-Jo;Chun, Jin-Ho
    • Journal of agricultural medicine and community health
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    • v.36 no.2
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    • pp.73-86
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    • 2011
  • Objectives: This study was performed to investigate the relationship between individual-level social capital and depression. Methods: Data from the 2009 Community Health Survey were analyzed for this study. We used chi-square tests and hierarchical logistic regression analyses to determine the relationship between individual-level social capital and depression. The Korean version of the Center for Epidemiological Studies-Depression Scale was used to measure depression. Results: After controlling for socio-demographic factors such as, health behavior and chronic illness morbidity, that are associated with individual-level social capital, trust and informal participation significantly affected depression. Respondents with "be trust"(0.536, 95% CI 0.419-0.685) and who participate in "informal groups"(0.657, 95% CI 0.516-0.836) had significantly lower odds ratios of depression. Conclusions: Considering and introducing measures to increase the social capital of residents, need reduce depression. It is especially necessary to enhance resident empowerment.

Treatment Results of Capitellum Fractures (상완골 소두 골절의 치료결과)

  • Park, Jin-Soo;Chung, Yung-Khee;You, Jung-Han;Noh, Gyu-Cheol;Chung, Kook-Jin;Jung, Sung-Ook
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.116-121
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    • 2005
  • Purpose: Isolated capitellar fractures are rare, intra-articular fractures requiring an aggressive management regimen. Review the outcome after open reduction and internal fixation of the capitellar fractures. Materials and Methods: From 1998 to 2004, 4 patients with displaced fractures of the humeral capitellum were treated by open reduction and internal fixation of the capitellar fragments with cannulated screws. By use of the criteria of Bryan and Morrey et al, there were 3 type I fractures, 1 type III fracture. A lateral approach was used. The elbows were immobilized postoperatively for 4 to 28 days We evaluated the range of motion, stability, and pain using the criteria of Mayo score. Results: The follow-up period ranged from 12 to 36 months (mean, 15months). Three patients had a stable, pain-free elbow with good range of motion at follow-up. One patient with a neglected capitellar fracture have felxtion cpontracture of 40 degrees with 100 degrees of further felxion(total arc: 60) due to poor compliance to the postoperative rehabilitation. All fractures healed, and there was no evidence of avascular necrosis or degenerative change. Conclusion: Capitellar fractures, rare in case, gave a good result after open reduction and simple internal fixation with cannulated screws without any problem.

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