• 건강소식
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• v.30 no.1 s.326
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• pp.6-9
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• 2006

관절염은 관절에 염증을 일으키는 현상을 말하며, 염증이란 병든 부위에 부종, 홍조, 발열, 동통과 같은 병리학적인 반응을 특징으로 한다. 관절염은 그 자체가 병명이 아니고 어떤 질환의 한결과로서 나타난다. 그러므로 관절염이 발생하면 그 원인 질환이 무엇인지 찾아보아야 한다. 관절염의 종류는 무려 100여 가지가 넘으며 퇴행성 관절염, 류머티스 관절염, 통풍성 관절염, 루푸스, 통풍 등이 일반적으로 흔한 종류이다.

• Pediatric Infection and Vaccine
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• v.11 no.2
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• pp.208-211
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• 2004

The patient with group A beta-hemolytic streptococcal infection and articular disease who does not fulfill the modified Jones criteria for a diagnosis of acute rheumatic fever(ARF) have been classified as poststreptococcal reactive arthritis/arthralgia. A 10-year-old girl had presented with fever and arthralgia. She had pain in her left knee for 7 days but no swelling. A throat culture showed no growth but antistreptolysin O titer and C-reactive protein were elevated. A clinical follow up one month later showed neither arthralia nor sequelae as acute rheumatic fever. Poststreptococcal reactive arthritis/arthralgia seems to be part of the disease spectrum of ARF and to prevent subsequent development of ARF and carditis in these patient, it is recommended that antistreptococcal prophylaxis should be administered for 1 year and then could be discontinued if there is no evidence of cardiac involvement.

• Journal of the Korean Arthroscopy Society
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• v.4 no.2
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• pp.144-147
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• 2000

Purpose : The purpose of this study is to evaluate the usefulness of arthroscopy in the management of septic coxitis in adults. Materials and Methods : The subjects were 9 patients ranging from 46 to 61 years of age. All patients were diagnosed to have septic coxitis by arthrocentesis and laboratory tests. Operative arthroscopy of the hip has been performed on the patients under supine position. All patients had a follow-up period of more than 12 months by checking ESR and CRP, and by evaluating the function with Harris hip scoring system. Results : The laboratory abnormalities returned to normal level in average of 11.9 days after the surgery. Twelve months after the surgery, all patients showed normal functional hip without any discomfort. Conclusion : Arthroscopic debridement and irrigation technique seem to have more advantages than open drainage in the management of septic coxitis minimizing the morbidity of the hip joint, while it obtains the same results as open technique.

• Journal of Acupuncture Research
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• v.21 no.1
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• pp.211-225
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• 2004

목적 : 류마티스 관절염 환자의 골 파괴에 중요한 역할을 하는 것으로 알려진 Matrix Metalloproteinase-1(MMP-1) 유전자의 단일 염기 다형성을 분석하고, 나아가 봉독약침 치료에 대한 반응과의 연관성을 조사하기 위하여 본 연구를 시행하였다. 방법 : 미국류마티스학회의 류마티스 관절염 기준에 해당하는 122명의 한국인 류마티스 관절염 환자와 건강한 92명의 대조군을 대상으로 pyrosequencing 방법을 이용하여 MMP-1 유전자의 -519 위치의 다형성을 비교 분석하였으며, 류마티스 관절염 환자군을 다시 유전자 유형에 따라 동통 관절수, 종창 관절수, 조기 강직, 통증 강도, 삶의 질 평가도구인 HAQ, 환자 및 의사의 전반적 질병상태 평가, ESR, CRP 등의 항목을 치료 전후 평가하여 비교 분석하였다. 결과 : 1. 류마티스 환자군과 건강한 대조군간에 MMP-1 유전자의 단일 염기 다형성의 유전자형의 분포와 대립유전자 발현 빈도에 통계적으로 유의한 차이가 나타났으며, 이는 MMP-1 유전자 다형성이 한국인 류마티스 관절염 환자의 질병 감수성과 관련이 있음을 추정할 수 있다. 2. 각 유전자형 그룹간 치료전 질병의 중증도 평가에서 임상 평가와 혈액의 급성 염증 반응물질 평가에서 통계적으로 유의한 차이는 없었다. 3. 급성 염증 반응의 지표인 ESR과 CRP level의 봉독약침 치료 전후 변화는 MMP-1의 유전자 다형성과 유의한 연관이 없었다. 4. 각 유전자형 그룹간의 치료 전후 질병 호전도 비교에서, AA 유전자형이 종창 관절수 평가에서 더나은 호전을 보였으며, 다른 모든 평가에서는 통계적으로 유의한 차이가 없었으며, 향후 관련 유전자와의 연관성 연구가 필요하다고 사료된다.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.155-170
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• 2002

면역억제와 면역항진의 작용을 지닌 녹용(鹿茸)약침의 실험쥐에서의 type II collagen(CII)으로 유발된 관절염(CIA)에 대한 효과를 연구하였다. 본 실험에서 녹용(鹿茸)약침군과 생리식염수군을 대조군으로 하여 실험쥐에게 약침시술을 하였다. 녹용(鹿茸)약침이 CII에 작용하는 세포반응에 대한 효과를 검정하였는데, 대조군에서는 CII 유발주사 후 24일에 관절염이 관찰되었고, CIA의 정도가 점차적으로 심해졌다. 생리식염수 처리군과 비교해 24일 동안 하루에 한번 $50{\mu}g/kg$ 이상 용량의 녹용(鹿茸)약침은 CII 처리 T cell의 interleukin 2(IL-2)와 interferon-${\gamma}$($IFN-{\gamma}$) 생산능력을 억제했다. 또한 녹용(鹿茸)약침은 CII처리 임파절과 대식세포의 tumor necrosis facter ${\alpha}$($TNF-{\alpha}$)의 생산을 억제했다. 한편 CIA에 대한 약침효능의 지표는 녹용(鹿茸)약침을 14일간 하루에 한번씩 처리하면서, 소의 CII로 3주 간격으로 2번 유발접종을 실시하여 검정하였다. 첫 CII 유발접종과 동시에 일일 투여량 $100{\mu}g/kg$으로 14일간의 녹용(鹿茸)약침이 항체형성과 CII에 대한 지연형 과민성 뿐만 아니라 관절염의 증가도 막아주었다. 녹용(鹿茸)약침을 관절염 유발성 CII의 2차 접종과 동시에 시술한 결과, 관절염과 CII에 대한 면역반응을 억제하였다. 이에 저자는 CII로 유발된 관절염에 대한 녹용(鹿茸)약침의 억제효과에 대하여 보고하는 바이다.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.155-158
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• 1999

Recently arthroscopic procedure was introduced into an effective method when chronic gouty arthritis associated with acute inflammation is unresponsive to conservative treatment. The purpose of this study is to cvaluate the efficacy of tophi excision during this procedure. We tried to excise tophi which were known as one of causative materials of acute inflammation as much as possible. We report one case of chronic tophaceous gouty arthritis of the right knee which was satisfactorily treated without recurrence during more than one year after this arthroscopic procedure.

• Journal of Acupuncture Research
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• v.20 no.3
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• pp.104-116
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• 2003

목적 : 시스테인 단백분해 효소인 cathepsin는 인간과 생쥐의 항원제시세포에서 II형 주적합항원 불변사슬(MHC class II invariant chain)의 분해에 관여한다. 본 연구는 녹용 약침액이 류마티스 관절염 생쥐 모델의 골조직(연골과 활액) 유래 cathepsin 활성에 미치는 영향을 검정하였다. 방법 : 관절염 동물모델은 BALb/c계 생쥐를 생후 3일에 흉선 적출(3d-Tx)을 하여 만들었다. 동물모델의 골조직, 임파절세포, 비장 등을 녹용처치군과 대조군으로 나누어 cathepsin의 활성도 및 자가항원 특이(C-II-specific) T-세포의 활성도를 비교 분석하였다. 결과 : 각 장기에서 cathepsin S의 활성은 녹용약침 처치군에서 농도 의존적으로 유의성 있게 억제되었고, T-세포 특이 자가항원반응은 녹용약침 처치군의 임파절 세포에서 유의성있게 억제되었다. 그리고 T-세포 특이 자가항원 반응의 불활성화에는 녹용 10~20ug/ml의 용량으로 충분하였다. 결론 : 이러한 실험결과는 녹용 약침액이 cathepsin S를 선택적으로 억제시켜 류마티스 관절염과 같은 자가면역 질환에 유효한 치료약물로 사용될 수 있음을 시사한다.

• Pediatric Infection and Vaccine
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• v.12 no.2
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• pp.149-156
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• 2005

Purpose : Acute septic arthritis and acute osteomyelitis are not rare diseases in pediatric population. But when the diagnosis is delayed or inappropriate treatments are given, permanent disabilities of joint or bone can be followed. We analysed clinical manifestations, laboratory findings, X-ray findings, causative microorganisms and antibiotic susceptibility results of the two diseases in children. Methods : During January 1992 and May 2002, we conducted a retrospective study of 103 children who were diagnosed as acute septic arthritis and acute osteomyelitis. We selected out 34 children who had positive culture results in the blood or involved sites. Results : 19 cases were diagnosed as acute septic arthritis and 15 cases were acute osteomyelitis. These diseases were most common in preschool children and next in neonates. Hip joints and tibia were the most common sites in each disease. X-ray findings showed abnormalities in 6 cases(36%) of acute septic arthritis and 7 cases(50%) of acute osteomyelitis on admission. The most common microorganism isolated from the involved sites was Staphylococcus aureus; 12 out of 14 cases in acute septic arthritis and 6 out of 13 cases in acute osteomyelitis. Conclusion : It is difficult to make a clear initial diagnosis of the two diseases. We could not find any differences between these two diseases on clinical manifestations such as fever, swelling, tenderness and limitation of movements in joint and bone. The most common microorganism was Staphylococcus aureus.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1124-1127
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• 2003

We evaluated the clinical and laboratory characteristics of five children with Kawasaki disease who had showed arthritis after responding to intravenous immunoglobulin(IVIG) treatment. Age distribution was between 13 months and six years of age(mean $3.2{\pm}1.6$ years). There were two males and three females. Arthritis occurred when acute symptoms were subsiding, with the average onset on day $5.8{\pm}1.8$ after final IVIG treatment. Arthritis was pauciarticular in three, and polyarticular in two. Regarding laboratory findings, one child was positive in rhematoid factor and changed to negative after two months. Three patients were examined for HLA B27 and all showed negative results. High dose aspirin(two cases), anti-inflammatory drug(ibprofen, three cases), and corticosteroids(methyprednisolon pulse therapy, one case) were used for this type of arthritis. Symptoms and signs of arthritis in all patients were improved by these therapies. There was no relapse or complications within six months. Arthritis after responding to IVIG therapy was rarely observed in children with Kawasaki disease. This type of arthritis responded well to anti-inflammatory drugs including corticosteroids, and showed no relapses.

• Journal of the Korean Orthopaedic Association
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• v.56 no.4
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• pp.310-316
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• 2021

Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm³ (32,400-203,904/mm³), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.