• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.472-486
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• 2020

Rheumatoid arthritis is a systemic disease with chronic progress, but the recent rapid developments of drug treatments have led many patients to gain control of their disease activity. As a result, surgery has been performed less commonly on the wrist or hand than in the past. On the other hand, surgical treatment is still essential to patients who do not respond to those medications. For the successful treatment of symptomatic deformed joints or functional disability, surgeons should understand that the pathology of rheumatoid arthritis proceeds differently in every patient. Furthermore, because rheumatoid arthritis often invades multiple joints in the hand and wrist, the patients often require multiple operations simultaneously. This paper summarizes the current concepts of surgical treatment of rheumatoid arthritis in the hand and wrist based on more than 30 years' experience of our senior surgeon and a literature review.

• Journal of muscle and joint health
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• v.19 no.2
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• pp.161-172
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• 2012

Purpose: This study was to identify the factors influencing depression among patients with degenerative arthritis after total knee arthroplasty. Methods: The subjects were 108 patients who admitted or visited K hospital in K city after total knee arthroplasty. Data were analyzed using SPSS WIN 18.0 program. Results: The level of depression was 2.72 with a possible range of 1 to 5. Social support was 3.71 out of a total score 5. Self-efficacy was 64.47 ranged from 10 to 100. Self-esteem was 2.59 ranged from 1 to 5. The associated factors with depression were marital status, length of illness, perceived health status, pain, social support, self-efficacy, and self-esteem. Marital status, length of illness, and perceived health status accounted for 5.8% of depression. Next, all variables including pain, social support, self-efficacy and self-esteem accounted for 66.4% of depression. Conclusion: The level of depression among the subjects significantly be related to marital status, length of illness, perceived health status, pain, social support, self-efficacy and self-esteem. It indicates a need to develop nursing interventions for them to decrease depression and develop quality of life during recovery.

• Journal of muscle and joint health
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• v.2 no.2
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• pp.168-184
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• 1995

This deductive-survey study was undertaken in order to examine if there were relationship between causal perceptions, expectation for the cure and compliance. The sampling method was a non-probability, purposive sampling technique. The participants of this study was 195 volunteers 1) who have been diagnosed as having chronic arthritis and 2) who were at the rheumatis center of one university hospital in Seoul between September 18th to September 25th 1989. This instruments used for this study were the compliance scale developed by Choi and causal perception scale developed by the researcher. Analysis of data was done using pass analysis, Pearson correlation coefficient. The result of study were as follow : Hypothesis 1 : "It's correlated that causal perception, expectation for cure and compliance" was accepted. (F=4.85, p< .05) Hypothesis 2 : "It's correlated that causal perception, expectation for cure and with depression" was partially accepted. Total age group-worry and anxiety (r=.1580, p<.001) After 40-function of immunity (r=.1731, p<.05) warry and anxiety (r=.1730, p<.001). In the relationship between general characteristics and the variables, age group correlated with compliance and causal perception.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.122-140
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• 2001

The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.

• Journal of agricultural medicine and community health
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• v.48 no.2
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• pp.81-90
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• 2023

Objectives: This study analyzed the decline in quality of life according to age in the chronic disease patient group, quantified it as a quantitative index, and compared it by sex and chronic disease. Methods: In the 2017-2019 Korea National Health and Nutrition Examination Survey database, 11,473 adults aged 19 years or older, excluding cancer patients, were analyzed for age-specific changes in the EQ-5D Index by chronic disease. The decline in quality of life according to age in patients with chronic diseases was analyzed by linear regression analysis while controlling for general characteristics. Then, linear regression analysis was performed according to sex. Results: In the case of the control group, the quality of life decreased by 0.0004 for every 1-year increase in age(P<0.001). By chronic disease, asthma(β=0.0019, P<0.001), arthritis(β=0.0017, P=0.002), thyroid dis- ease(β=0.0016, P=0.015), dyslipidemia(β=0.0011, P=0.020), and hypertension(β=0.0009, P=0.027) mostly showed a greater decrease in quality of life than the control group. In addition, when divided into two groups by sex, hypertension(β=0.0012, P=0.029), thyroid disease(β=0.0041, P=0.038), and arthritis(β=0.0022, P<0.001) showed a significant decrease in quality of life only in male. Diabetes(β=0.0056, P=0.038), dyslipi- demia(β=0.0022, P=0.001) significantly decreased quality of life only in female. Conclusions: Chronic disease had a negative impact on patients perception of quality of life, and the more severe the pain and activity limitation due to the chronic disease, the more severe it was. It also showed different patterns according to sex. Therefore, it is necessary to allocate more medical resources and provide policy support to prevent chronic diseases, which are serious social problems.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.160-166
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• 1998

The purpose of this study was to assess the results of arthroscopic subacromial decompression in patients with chronic impingement and to evaluate the results according to the rotator cuff pathology. We evaluated the clinical results of treatment for chronic impingement syndrome in 28 patients from Feb 1996 to Feb 1997. There were twenty men and eight women in age from 24 to 72 years (mean age 51) with dominant arm involvement in sixteen patients. Follow up evaluations averaged 15(range 12-24)months. The average duration of symptoms were 15(range 6­60)months. The final diagnoses which were based on the physical examination, plain radiographs and arthroscopic findings, were stage II impingement in 16 patients and stage ill impingement in 12 patients. We excluded the patients with acromioclavicular arthritis or glenohumeral instability in this study. All patients were managed non-operatively a minimum of six months. During the operation we performed contouring and smoothing the acromial undersurface and only resecting of the anterolateral band of the coracoacromial ligament. The clinical results were quantitated using UCLA shoulder rating score. Satisfactory results were obtained in 23(80%) patients. Unsatisfactory results were obtained in 5(18%) patients with posterior cuff tear. The average UCLA pain score showed significant improvement from 2.8(constant pain) to 7.2(present during heavy activities) at final follow up. The function and active forward flexion scores also increased from their preoperative value. There was no significant differences according to the surface and severity of tear and NeeI' stage (P>0.05). These results compared favorably with those reported following open acromioplasty. While arthroscopic subacromial decompression is a demanding technique with a learning curve, it is a reliable treatment for chronic impingement syndrome. A less aggressive approach to subacromial decompression and preserving the posteromedial band of the coracoacromialligament does not appear to compromise results.

• Journal of agricultural medicine and community health
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• v.21 no.2
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• pp.209-220
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• 1996

This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

• Journal of Nutrition and Health
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• v.45 no.6
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• pp.531-540
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• 2012

This study was carried out in order to investigate the status of food and nutrient intakes depending on the types of chronic disease of the elderly at welfare centers in Seoul. The total number of subjects was 299 elderly over the age of 60 (82 men and 217 women); they were grouped by the disease status: normal, cardiovascular disease (CVD), diabetes mellitus (DM) and arthritis patients groups. The dietary intakes were obtained by a 24-hour recall and analyzed by CAN-Pro 4.0; they were then compared with the dietary reference intakes for the Korean (KDRIs). In the results of anthropometric data according to chronic disease, the waist circumference of the normal group in males and females was lower than the other groups; in particular, the normal female group showed a lower level of waist-hip ratio, body mass index (BMI) and body fat % than those of the other groups. The arthritis group showed a higher intake of milk products than the other groups (p < 0.05); consequently, calcium intake was significantly higher than that of the other groups (p < 0.001). Vitamin A intake in the arthritis group was significantly higher than the intake in the normal and DM groups (p < 0.01). Normal and arthritis groups showed significantly higher intake of zinc and copper than the CVD group (p < 0.01). In general, about 80% of the subjects in this study revealed insufficient intakes of riboflavin, vitamin C, calcium, dietary fiber, vitamin D, biotin and potassium, compared with the estimated average requirement (EAR) or adequate intake (AI). However, sodium intake of all groups was higher than the AI of KDRIs. In conclusion, nutrient intake, according to the chronic disease, showed significant difference in some of the micronutrients, vitamin A, Ca, Zn and Cu. Therefore, we suggest that dietary guidelines, such as reducing the intake of salty foods and sweet drinks and increasing the intake of foods with sufficient calcium, vitamin D and vitamin C, are necessary to the improvement of eating habits for the elderly.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.7-10
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• 2006

Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

• Journal of muscle and joint health
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• v.6 no.1
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• pp.85-99
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• 1999

Chronic disease such as rheumatoid arthritis is believed to induce a significant psychosocial stressors. The concept of illness intrusiveness-illness induced life style disruptions-was hypothesized to affect psychosocial status. And demographic, socioeconomic, disease and social characteristics were hypotehsized to affect illness intrusiveness. Hierarchial multiple regression analyses were used. As a result, among the demographic factors gender was identified as contributor to directly increase the psychosocial stress and education level was identified to affect the psychosocial stress through illness intrusiveness. Among socioeconomic factors, the burden about the cost of medical treatment was found to indirectly affect the psychosocial stress through the illness intrusiveness. Also income and job were found to affect directly the psychosocial status. Among the disease characteristics, only the pain level was identified to increase the psychosocial stress through the illness intrusiveness. Among the social characteristics, perceived social support is identified to increase the psychosocial stress through the illness intrusiveness. Based upon these results, some suggestions were made for minimizing illness intrusiveness in rheumatoid arthritis and future research.