• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.153-157
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• 2024

Septic arthritis of the manubriosternal joint is a rare condition, especially in adolescents, who often present with nonspecific symptoms that can mimic more common conditions such as musculoskeletal chest pain, costochondritis. Here, we report a case of septic arthritis in a 17-year-old girl and highlight the challenges in diagnosing and managing this condition in adolescents. Initially presenting with acute chest pain diagnosed as transient nonspecific chest pain, the patient's subsequent visits to the emergency department unveiled escalating symptoms, including high fever, prompting advanced imaging. Ultimately, the diagnosis of septic arthritis of the manubriosternal joint was confirmed, with blood culture growth revealing Methicillin-sensitive Staphylococcus aureus. Diagnostic delays have been attributed to the absence of typical symptoms and patient reluctance to be hospitalized. Our case emphasizes the importance of considering rare infectious etiologies in adolescents with chest pain and emphasizes the need for heightened suspicion in unusual anatomical sites. Further research is required to elucidate the pathogenesis and risk factors associated with this condition to aid in prompt diagnosis and treatment.

• Journal of Acupuncture Research
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• v.21 no.4
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• pp.177-196
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• 2004

Objective : Rheumatoid arthritis is an autoimmune disease that pathogenesis is not fully understood and one of the most intractable musculoskeletal diseases. The concern in the immunopathogenesis of rheumatoid arthritis has been increased since 1980's and many immunotherapeutic agents including disease-modifying antirheumatic drugs (DMARDs) were developed and became the mainstay of treatment of rheumatoid arthritis. However, the cure of the disease has hardly been achieved. In oriental medicine, rheumatoid arthritis is related to Bi-Zheng(痺證), that presents pain, swelling, andlor loss of joint function as major clinical manifestations, and also known to be deeply involved in suppression of immune function related to weakness of Jung-Ki(正氣). The herbal medicine, empirically used, could be a potential resource of development of new immunotherapeutic agents for rheumatoid arthritis. Methods : We developed a search strategy using terms to include "rheumatoid arthritis and herbal medicine" combined with "Chinese medicine" and/or "Oriental medicine". The search was focused on experimental studies of herbal medicine (January 1999 to May 2004), which is known to have effects on immune function of patients with rheumatoid arthritis. Computerized search used Internet databases including KISS and RISS4U (Korea), CNKI (China), MOMJ (Main Oriental Medicine Journal, Japan), and PubMed. The articles were selected from journals of universities or major research institutes. Results : The literature search for experimental studies on effects of herbal medicine on immunity of rheumatoid arthritis retrieved a total of 21 articles (Korea; 8, China ; 12, Japan ; 1). Of 21 articles, 10 were related to single-drug formula, 2 to drug interaction, and 9 to multi-drug formula. Single-drug formula was mainly used for aqua-acupuncture and researches on active components. Studies of drug interaction emphasized harmony of Ki-Hyul(氣血) and balance of Han-Yeul(寒熱). Multi-drug regimen was mainly found among formulas for Bo-Ki-Hyul(補氣血) and Bo-Sin(補腎). Conclusion : Studies on rheumatoid arthritis were performed both in vitro and in vivo in vitro study, LPS-stimulated splenocytes and synoviocytes were treated with herbal medicine, resulting in proliferation and activation of immune cells and suppression of cytokine activities in vivo study CIA animal model demonstrated that herbal medicine decreased antibody production and improved function of immune cells. In cellular and molecular study herbal medicine showed profound effects on the level of mRNA expression of certain cytokines related to immune function. This study revealed that herbal medicine has significant immune modulatory action and could be used for recovery of immune dysfunction of rheumatoid arthritis patients.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.9
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• pp.1187-1194
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• 2009

This study was performed to estimate the prevalence and the risk factors of arthritis in Andong rural area in 2003. The subjects were 1,462 people (544 males, 818 females) aged 45 years and over. The arthritis group was composed of 322 people (72 males, 250 females), diagnosed by doctor or self-diagnosed by the symptoms. Prevalence of arthritis was higher in female (27.2%) compared to male (13.2%). Mean age of arthritis group was significantly higher than that of normal group (male 66.2 vs 62.8, female 62.6 vs 60.1, p<0.001). The anthropometric measurements, such as % body fat, body mass index (BMI), and waist circumference, and the biochemical measurements, such as plasma triglyceride and total cholesterol level, were significantly higher only in female (not in male) arthritis group than those in normal group. Health related lifestyle factors, such as smoking, alcohol drinking, and exercise, were not different between both groups. The risk factors for arthritis were analyzed using the multiple logistic regression method and expressed as odds ratio (OR). The results showed that female compared to male (OR=1.983), over 65 years compared to 45$\sim$64 years (male OR=2.769 and female OR=1.461), and obese female subjects (not for male) by % body fat ($\geq$32% OR=2.035) or BMI ($\geq$25 kg/$m^2$ OR=1.556) showed significantly higher risk factors for arthritis. Regarding nutrient intakes, higher intakes of fat (OR=1.443), calcium (OR=1.503), iron (OR=1.518) and vitamin A (OR=1.390) in female seemed to be risk factors. In contrast to female, higher intakes of vitamin A (OR=0.526) and riboflavin (OR=0.582) seemed to decrease the risk for arthritis in male. This study revealed that the prevalence of arthritis was significantly higher in female and aged individuals. Also, in order to decrease the prevalence and/or prevention of arthritis, female should prevent overfatness and decrease some nutrient intakes, while male should increase their intakes.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.431-451
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• 2000

In this paper, I will examine the variables influencing the Quality of Life of arthritis patients and present basic materials which help arthritis patients have positive thinking in life and ultimately lead a satisfactory life. The subjects for this study are 231 inpatients and outpatients with arthritis living in J and K city in Chonbug Province. For the analysis of collected data I employed the SAS program. The variables for characteristics and the quality of life were analysed by descriptive statistics, T-test and ANOVA, and the relations among variables were analysed through Pearson Correlation; the Regression method was employed to predict the factors affecting quality of life. For the validity of reliance on measuring equipment Cronbach Alpha was used. The results of the study are as follows : (1) The mean score of quality of life of arthritis patients is 3.09(5 in the maximum). The general characteristics which affect the quality of life are age(F=5.13, p=0.0006), standard of education(F=6.49, p=0.0003), marriage status(F=7.77, p=0.0005), monthly pay(F=4.37, p=0.0020), medical benefits (F=4.85, p=0.0087), and supports(F=4.39, p=0.0050). For the disease-related characteristics, there is a significant difference in the 6 items: pain control method(F=5.92, p= 0.0002), physical therapy(F=3.25, p=0.013), whethere or not patients exercise(F=4.62, p=0.0000), regularity of exercise(F=4.79, p=0.0000), frequency of exercise(F=6.29, p=0.0001), and amount of exercise(F=4.62, p=0.0043). Depending on the type of arthritis, there is also a significant difference in the degree of pain felt. The patients with infectious arthritis suffer from pain the most, followed by those with gout, rheumatism and degenerative arthritis, in that order. Although statistics don't show any convincing evidence, those with gout perceive that they are in best health condition, followed by those with rheumatism, degenerative arthritis, and infectious arthritis, in that order(F=2.23, p=0.0669). (2) The quality of life of arthritis patients is correlated positively with perceived health status(r=0.56, p=0.0001), health promoting behavior(r=0.53, p=0.0001), family support (r=0.46, p=0.0001), amount of exercise (r=0.36, p=0.0001), ADL(r=0.36, p=0.0001), HLOC(r=0.32, p=0.0001), frequency of exercise(r=0.32, p=0.0001)in that order, while correlated negatively with the degree of pain felt(r=-0.32, p=0.0001), the number of pain regions(r=-0.19, p= 0.0041), and the duration of pain(r=-0.14, p=0.0279). (3) Regression analysis reveals that the most powerful predictor of the quality of life is perceived health status, which account for 31.11%. The other predictors of the quality of life, which account for 60.22%, are health promoting behavior(16.51%), family support(3.81%), ADL(2.52%), gender(1.86%), the number of family members(1.36%), level of pain(1.24%), duration of pain (1.08%), and level of education(0.67%). The results of the study show that perceived health status and health promoting behavior are the two most important variables. However, considering that the perceived health condition is difficult to control by nursing intervention, it is suggested that the level of expectation for patients, must be decided first, and the health promoting behavior and the family support influencing the quality of life must be taken into account as targets for nursing intervention. As a way of controlling the quality of life, I think that a more comprehensive approach comprising the above important variables along with demographic and general characteristics is needed. I also suggest that we must continue to explore the variables affecting the quality of life and include those variables in nursing intervention.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.4
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• pp.871-877
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• 2008

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to various stresses and mediators of inflammation. HO-1 has been recently implicated in regulation of angiogenesis via expression of VEGF. The purpose of this study was to determine the effects of HO-1 modulation on the collagen-induced arthritis (CIA) model and on angiogenesis via up- regulation of VEGF expression in human synovial fibroblast. DBA/1J mice were treated with an inhibitor of HO-1, tin protoporphyrin IX (SnPP), or with an inducer of HO-1, cobalt protoporphyrin IX (CoPP), from day 1 to day 35 after CIA induction. The clinical evolution of disease was monitored visually. At the end of the experiment, histopathologic changes were examined on the joints. VEGF expression in paws were measured by immunohistochemical stain. mRNA expression of HO-1 and VEGF stimulated with various concentration of $TNF-{\alpha}$, CoPP accessed on human synovial fibroblast by RT-PCR. Effects of pretreatment with SnPP on mRNA expression of HO-1 and VEGF in the presence of CoPP and $TNF-{\alpha}$ in synovial fibroblast was accessed by Real-time RT-PCR. Administration of cobalt protoporphyrin IX significantly induced the inflammatory response, with increased arthritis index and expression of VEGF in the paws of the arthritis models. Treatment with SnPP significantly reduced the severity of CIA through inhibition of joint inflammation and cartilage destruction. The expression of VEGF were also significantly reduced by SnPP treatment in the paw. CoPPIX as inducer of HO-1, increased HO-1 and VEGF expression dose dependently in synovial fibroblast. In contrast, inhibition of HO-1 activity by SnPPIX abrogated CoPPIX-induced HO-1 and VEGF production in synovial fibroblast. Stimulation with $TNF-{\alpha}$ increased HO-1 and VEGF expression itself and showed additive effect on HO-1 and VEGF expression when it treated with CoPP. When SnPP was treated with CoPP and $TNF-{\alpha}$, it abrogated the CoPP induced HO-1 and VEGF expression and also abrogated $TNF-{\alpha}$ induced HO-1 and VEGF expression in synovial fibroblast. The effects of HO-1 induction in rheumatoid arthritis results in aggravation of arthritis via up-regulation of VEGF. I concluded that inhibition of the expression or activity of HO-1 could be a therapeutic target of rheumatoid arthritis.

• Journal of Acupuncture Research
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• v.24 no.6
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• pp.45-61
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• 2007

Objectives : The purpose of this study is to observe the effects of Carthami Flos herbal-acupuncture (CF-HA) at Joksamni($ST_{36}$) on arthritis in mice induced by Collagen II. Methods : The author performed several experimental items, including arthritis evaluation, change in weight, spleen size and stenosis rate, change in cytokine level, IgG, IgM and anti-collagen II, change of immunocyte count and histological change of the CIA mouse joint. Conclusions are as follows: Results : 1. In the CF-HA, the arthritis index and rate and the incidence of arthritis were decreased as the experiment proceeded. 2. In the CF-HA, spleen swell and stenosis, joint edema and change were decreased. 3. In the CF-HA, the level of $IL-1{\beta}$, IL-6, $TNF-{\alpha}$ and $IFN-{\gamma}$ in blood serum were significantly decreased. 4. In the CF-HA, the level of IgG, IgM and anti-collagen II were decreased. 5. In the CF- HA, $IFN-{\gamma}$, $IFN-{\gamma}/IL-4$, IL-10 of the culture fluid was decreased. 6. In the CF-HA, the cell rate of $CD3e^+$ and $CD45R^+$, $CD4^+$ and $CD8^+$, $CD4^+/CD25^+$ in spleen was similar to the cell rate of the normal group. 7. In the CF-HA, the cell rate of $CD4^+/CD25^+$, $CD45R^+/CD69^+$ in a lymph node was decreased as in the normal group. 8. In the CF-HA, the cell rate of $CD3^+/CD69^+$, $CD11b^+/Gr-1^+$ in joints was decreased as in the normal group. 9. In the CF-HA, the cartilage destruction and the inflammation cell growth in the H&E stain were decreased. The collagen fiber in the M&T stain were less destructed, therefore the result was similar to the normal group. Conclusions : These results suggest that CH-HA at $ST_{36}$ has an effect in controlling immune reaction and suppressing inflammation in rheumatoid arthritis therefore, the continuous flow of the following study is expected.

• Physical Therapy Korea
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• v.10 no.2
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• pp.45-59
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• 2003

The purpose of this study was to assess the effects of ultrasound on adjuvant-induced arthritis in rats. Adjuvant arthritis was induced in 26 female Sprauge-Dawley rats by the subcutaneous injection of a single dose of .1 mL of Complete Freund's Adjuvant (CFA) (1 mg of Mycobacterium Butyricum suspended in .1 $m{\ell}$ paraffin oil) into the right hind paw. After confirming inflammatory edema and arthritis in the paw 2 weeks later, the arthritic rats were divided into 3 groups, i.e., a control group, a pulsed ultrasound group (Group A), and a continuous ultrasound group (Group B) with 8 rats placed in each group. The rats in Group A were treated with pulsed ultrasound at 1 MHz frequency with .5 $W/cm^2$ intensity in 1 : 4 mode for 3 minutes. The rats in Group B were treated with continuous ultrasound at 1 MHz frequency with 2 $W/cm^2$ intensity in the continuous mode for 3 minutes. The ultrasound treatment was done in the left and right ankles for 2 weeks. Clinical, radiographic and histopathologic findings were then evaluated before and after treatment and yielded the following results. 1. No significant difference was present in body weight between the control group and the treated groups. 2. A statistically significant decrease in the edema of the paw was seen in the rats in Group A that was treated with pulsed ultrasound by 26~29 days after the treatment started (p<.05). 3. According to radiological examination, Group A showed the lowest score in arthritis scale which means it showed a tendency to suppress arthritic inflammation of the left and right hind paws. However, no statistically significant difference was present in the score between the control group, Group A and Group B. 4. According to histopathologic findings, the degree of infiltration by inflammatory cells and hypertrophy of the synovium were less in Group A compared with the control group and Group B. The results of the study show that rats that were treated with the pulsed ultrasound effectively suppressed adjuvant arthritis. However, more effort is needed to objectively prove the effectiveness of ultrasound by developing more sensitive testing methods that could quantitatively evaluate the treatment effects of acute rheumatoid arthritis and by trying out different ultrasound treatment methods.

• Journal of Acupuncture Research
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• v.18 no.2
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• pp.27-36
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• 2001

Objectives : In order to study the effects of Harpagophyti Radix Aqua -acupuncture in rats with arthritis induced by Freund's complete adjuvant, performed several experimental items : that is edema rate, number of WBC, hemazocrit, platelet, total protein and albumin. Methods : In this study rats were divided into five groups : Normal group (non treated group), Control group (non-injected group in rats with arthritis induced by FCA), ST group (0.2cc normal Saline-injected group at right Chok-Samni(Zusanli,$ST_{36}$) once in every two days during the two weeks in rats with arthritis induced by FCA), HRS group (0.2cc Harpagophyti Radix-subcutaneous injected group once in every two days during the two weeks in rats with arthritis induced by FCA), HRST group (0.2cc Harpagophyti Radix-injected group at Chok-Samni($ST_{36}$) once in every two days during the two weeks in rats with arthritis induced by FCA). Results : 1. In the right plantar edema, HRS group showed a decrease with statistical significance on the 2 weeks and HRST group showed a decrease with statistical significance on the 1 weeks as compared with control group. 2. In the WBC, HRST group showed a meaningful decrease with statistical significance and also HRS group showed a decrease with statistical significanae as compared with control group. 3. In the platelet, HRST group showed a decrease with statistical significance as compared with control group. 4. In the hematocrit, HRS group showed a increase with statistical significance as compared with control group. 5. In the serum total protein and albumin, HRS group showed a increase with statistical significance as compared with control group. Conclusions : According to the above result, it is concluded that Harpagophyti Radix Aqua-acupuncture showed the therapeutic effect of antiinflammation in adjuvant arthritis and it is suggested that further studies and researchs for clinical use be needed.

• The Journal of Traditional Korean Medicine
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• v.15 no.1
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• pp.113-127
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• 2006

Objectives: This study was produced to examine the effects of moxibustion that had been played important role to traditional oriental medical treatment on disease. Recently, it was reported that moxi-tar which is generated in the process of moxibustion as burning combustibles decreased nitric oxide(NO) and inducible NO synthase (iNOS) generation in cellular experiments. Methods: Carrageenan-induced arthritis rat model was used to test the effect of moxi-tar as a chronic pain model. Diluted moxi-tar was single injected in several acupoints or combined with electroacupuncture (l ms, 2 Hz, and 2 mA) into contralateral ST36 acupoint for 30 min to assess the synergic effects. After the treatment, behavioral tests measuring stepping force were periodically conducted during the next 12 hours. Endogenous NO and iNOS, cyclooxygenase-2 (COX-2), and c-Fos protein expression in the spinal cord were examined on a rat model of carrageenan-induced arthritis. Results : After the induction of arthritis, rats subsequently showed a reduced stepping force of the affected limb for at least the next 4 days. The reduced stepping force of the limb was presumably due to a painful knee, since oral injection of indomethacin produced temporary improvement of weight bearing. Maxi-tar produced significant improvement of stepping force of the hindlimb affected by the arthritis lasting at least 9 hours. The magnitude of this improvement was equivalent to that obtained after an oral injection of 3 mg/kg of indomethacin and this improvement of stepping force was interpreted as an analgesic effect. Maxi-tar produced the improvement of stepping force of the affected hindlimb in a dose-dependent manner. Both NO production and iNOS, COX-2 protein expression increased by arthritis were suppressed by maxi-tar. Moxi-tar on combination with electroacupuncture (EA) produced more powerful and longer lasting improvement of stepping force of the hindlimb affected by the arthritis than either moxi-tar or EA did. Conclusion : The present study suggest that maxi-tar produces a potent analgesic effect on the chronic knee arthritis pain model in the rat and that moxi-tar-induced analgesia modulate endogenous NO through the suppression of iNOS/COX-2 protein expression.

• Journal of Digital Convergence
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• v.19 no.8
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• pp.351-359
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• 2021

This study was conducted to analyze the relationship between the practice of aerobic exercise and the prevalence and risk of arthritis with comorbid chronic diseases. For this study, the National Health and Nutrition Examination Survey 2017-2019 data were used and 17,356 people were selected as subjects. The relationship between the practice of aerobic exercise and the prevalence and risk of arthritis according to demographic characteristics and chronic diseases was analyzed by the chi-square independence test and Breslow-Day test. While the rate of aerobic exercise was low among women, the elderly, the low-income group, the low-education group, and people living in rural areas, the prevalence and risk of arthritis were relatively high. And in the chronic disease-positive group, those who practiced aerobic exercise had a relatively lower prevalence and risk of arthritis than those who did not. In particular, the practice of aerobic exercise was an effective complement in reducing the prevalence and risk of arthritis in people with high blood pressure, diabetes, and dyslipidemia. Therefore, the practice of aerobic exercise such as walking, slow running, and aerobic dance should be recommended in terms of the preventive medicine and health care to people who are in the group with a high prevalence of arthritis in demographic characteristics and people who have comorbid chronic diseases.