• Journal of Korean Medicine Rehabilitation
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• v.28 no.1
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• pp.175-184
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• 2018

The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.

• IMMUNE NETWORK
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• v.14 no.1
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• pp.45-53
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• 2014

Osteoarthritis (OA) is a degenerative joint disease characterized by a progressive loss of cartilage. And, increased oxidative stress plays a relevant role in the pathogenesis of OA. Ursodeoxycholic acid (UDCA) is a used drug for liver diseases known for its free radical-scavenging property. The objectives of this study were to investigate the in vivo effects of UDCA on pain severity and cartilage degeneration using an experimental OA model and to explore its mode of actions. OA was induced in rats by intra-articular injection of monosodium iodoacetate (MIA) to the knee. Oral administration UDCA was initiated on the day of MIA injection. Limb nociception was assessed by measuring the paw withdrawal latency and threshold. Samples were analyzed macroscopically and histologically. Immunohistochemistry was used to investigate the expression of interleukin-$1{\beta}$ (IL-$1{\beta}$), IL-6, nitrotyrosine and inducible nitric oxide synthase (iNOS) in knee joints. UDCA showed an antinociceptive property and attenuated cartilage degeneration. OA rats given oral UDCA significantly exhibited a decreased number of osteoclasts in subchondral bone legion compared with the vehicle-treated OA group. UDCA reduced the expression of IL-$1{\beta}$, IL-6, nitrotyrosine and iNOS in articular cartilage. UDCA treatment significantly attenuated the mRNA expression of matrix metalloproteinase-3 (MMP-3), -13, and ADAMTS5 in IL-$1{\beta}$-stimulated human OA chondrocytes. These results show the inhibitory effects of UDCA on pain production and cartilage degeneration in experimentally induced OA. The chondroprotective properties of UDCA were achieved by suppressing oxidative damage and inhibiting catabolic factors that are implicated in the pathogenesis of cartilage damage in OA.

• Journal of Acupuncture Research
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• v.26 no.2
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• pp.125-145
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• 2009

Objectives : To analyze the inclusion criteria of participants, control group interventions, and the results of prior studies of acupuncture for OA. Also to identify aspects of the procedure that are associated with positive outcomes in order to establish ideal acupuncture treatment model. And to assess the methodological quality of the trials with modified Jadad score and FEAS in order to evaluate the quality of prior studies and find out whether or not acupuncture has a positive effect in treating OA. Methods : Articles up to the date of November 2008 were searched via computerized databases of PubMed, Journal of Korean Oriental Medicine, The Journal of Korean Acupuncture & Moxibustion Society and Journal of Oriental Rehabilitation Medicine. Bibliographies of reviewed papers were also searched and reviewed. Only randomized controlled trials (RCTs) and systematic reviews concerning the effects of acupuncture or electroacupuncture (EA) on symptoms of osteoarthritis of the human knee, published in English and Korean were included. The acupuncture treatment methods of the reviewed trials were assessed based on STRICTA. And the methodological quality of the trials was assessed by modified Jadad score and FEAS. Results : Twenty one trials of acupuncture for OA were analyzed. Based on the results of this review the following factors might contribute to optimal results from acupuncture treatment. 1) Usage of $ST_{35}$, $GB_{34$, $EX_{32}$, $ST_{36}$ and $SP_9$ acupuncture points. 2) More than four acupuncture points should be used. 3) More than 15 minutes of needle retention time. 4) Needle length-40mm and diameter-0.30mm 5) Usage of EA 6) more than 10 times treatment 7) Treatment frequency of more than once a week, 8) Treatment duration longer than 6 to 8 weeks. Conclusions : High quality clinical trials of Acupuncture for OA is still in lack. Future investigators must concentrate their attentions on the quality of acupuncture treatment itself used in the trials as well as the methodological quality of trials.

• Journal of Korean Clinical Nursing Research
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• v.25 no.3
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• pp.275-284
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• 2019

Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.53-57
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• 2008

Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.5
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• pp.631-640
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• 2014

The inhibitory effects of Boswellia serrata (BW) extracts on degenerative osteoarthritis were investigated in primary-cultured rat cartilage cells and a monosodium-iodoacetate (MIA)-induced osteoarthritis rat model. To identify the protective effects of BW extract against $H_2O_2$ ($800{\mu}M$, 2 hr) in vitro, cell survival was measured by MTT assay. Cell survival after $H_2O_2$ treatment was elevated by BW extract at a concentration of $20{\mu}g/mL$. In addition, BW extract treatment significantly reduced and normalized the productions of pro-inflammatory factors, nuclear transcription factor ${\kappa}B$, cyclooxygenase-2, tumor necrosis factor-${\alpha}$, and interleukin-6 at a concentration of $20{\mu}g/mL$. Treatment of chondrocytes with BW extract significantly reduced 5-lipoxygenase activity and production of prostaglandin E2, especially at a concentration of $10{\sim}20{\mu}g/mL$. For the in vivo animal study, osteoarthritis was induced by intra-articular injection of MIA into knee joints of rats. Consumption of a diet containing BW extract (100 and 200 mg/kg) for 35 days significantly inhibited the development and severity of osteoarthritis in rats. To determine the genetic expression of arthritic factors in articular cartilage, real-time PCR was applied to measure matrix metalloproteinases (MMP-3, MMP-9, and MMP-13), collagen type I, collagen type II, and aggrecan, and BW extract had protective effects at a concentration of 200 mg/kg. In conclusion, BW extract was able to inhibit articular cartilage degeneration by preventing extracellular matrix degradation and chondrocyte injury. One can consider that BW extract may be a potential therapeutic treatment for degenerative osteoarthritis.

• Genomics & Informatics
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• v.9 no.3
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• pp.121-126
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• 2011

Osteoarthritis (OA) is the most common degenerative joint disorder in the elderly population. To identify OA-associated genetic variants and candidate genes, we conducted a genome-wide association study (GWAS). A total 3,793 samples (476 cases: wrist + knee and 3317 controls) from a community-based epidemiological study were genotyped using the Affymetrix SNP 5.0. An intronic SNP (rs4789934) in the TIMP2 (tissue inhibitor of metalloproteinase-2) showed the most significance with OA (odd ratio [OR] = 2.06, 95% confidence interval [CI] = 1.52-2.81, p = $4.01{\times}10^{-6}$). Furthermore, a poly-morphism (rs1352677) in the NKAIN2 ($Na^+/K^+$ transporting ATPase interacting 2) was suggestively associated with OA (OR = 1.43, CI = 1.22-1.66, p = $7.01{\times}10^{-6}$). The present study provides new insights into the identification of genetic predisposing factors for OA.

• Korean Journal of Computational Design and Engineering
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• v.18 no.6
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• pp.385-398
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• 2013

Opening wedge high tibial osteotomy (OWHTO) is widely used to treat unicompartmental osteoarthritis of the knee caused by degenerative deformations of the anatomical axes of the leg. However, since it is difficult to accurately plan the surgical degrees of adjustment such as coronal correction angle and tibial posterior slope angle to align the axes before the actual procedure, a number of studies have proposed analytical models to solve this problem. While previous analytical models for OWHTO were limited to specific cases, this study proposes an analytical osteotomy model (AOM) and a surgical planning system (SPS) that are suitable for a wide range of tibial morphologies and tibia conditions. The validity and generality of the model were verified in a total of 60 OWHTO cases. Results of the test showed that, as predicted, surgical degrees are affected quite significantly by tibia shape and slope of the resected surface. Comparison of the required surgical degrees and the degrees estimated from virtual surgery simulations using AOM showed a very small average difference of $0.118^{\circ}$. SPS, based on AOM, allows the operating surgeon to easily calculate surgical parameters needed to treat a patient.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.2
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• pp.9-17
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• 2017

Objectives This study was aimed to evaluate the effects of Daeyoungjeon (hereinafter referred to DYJ) treatment on the injury of articular cartilage induced by monosodium iodoacetate in rats. Methods Twenty-four male rats were divided into normal, osteoarthritic control and DYJ group. Rats of normal group were injected with 0.1 ml physiological saline, rats of control and DYJ groups were injected with 0.1 ml monosodium iodoacetate (3 mg/ml) into each left and right knee joint cavities. Rats of DYJ group were administrated extracts of DYJ during 60 days per orally. At 60 days after treatment, gross lesions, area and proteoglycan contents of articular cartilage, histopathological lesions, immunohistochemistry on matrix metalloproteinases (MMP-2, MMP-3, MMP-7) were evaluated. Results Grossly, degenerative changes of articular cartilages were observed weak in DYJ group. The areas of articular cartilages were broader significantly in DYJ group. The proteoglycan contents in articular cartilages were lesser significantly in DYJ group. Histopathologically, the chondrocyte score was lesser significantly in DYJ group. MMP-3 expression in articular cartilages was observed weak in DYJ group. Conclusions From above results, DYJ treatment has inhibitory effects on the injuries of articular cartilage induced by monosodium iodoacetate in rats, and it's effects may be related with down regulation of MMP-3.

• The Korean Journal of Pain
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• v.22 no.3
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• pp.216-223
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• 2009

Background: There have been limited reports on the effectiveness of 5% lidocaine patches (L5Ps) for treating a few types of chronic pain. We utilized L5Ps for chronic pain patients with various diagnoses and who had incompletely responded to their current treatment regimen. This study aimed at describing the results of a retrospective review of an open-label L5P trial to assess L5Ps' effectiveness and safety for treating various chronic pain patients. Methods: The chronic pain patients with pain lasting longer than 6-month duration were offered a 2-week L5P treatment trial. The patients were maintained on their other analgesic regimens. The treatment effect was measured according to the change from the baseline visual analog scale (VAS) to the week 2 VAS. After a 2-week trial, the patients were asked if they perceived pain improvement with L5Ps by using a four-item Pain Relief Scale (1 = a lot of relief, 2 = slight relief, 3 = no change, 4 = worse pain). Results: In the combined patient population (n = 177), 2-week treatment with the L5Ps significantly improved the week 2 VAS (P = 0.000). Significant improvement in the VAS was reported by the chronic pain patients with postherpetic neuralgia, intercostal neuralgia, degenerative osteoarthritis at knee joint, and other maladies. A higher proportion of the chronic pain patients reported improving their pain by the L5Ps. Seven patients experienced mild or moderate patch-related adverse events. Conclusions: The L5P provided clinically meaningful pain relief in some refractory chronic pain patients without any severe adverse events.