• The Journal of Korean Medicine
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• v.41 no.1
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• pp.55-83
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• 2020

Objectives: The purpose of this study was to evaluate the efficacy and safety of pharmacopuncture and bee venom acupuncture for knee osteoarthritis. Methods: We searched for randomized controlled trials that investigated the effects of pharmacopuncture and bee venom acupuncture on knee osteoarthritis through the electronic databases including Pubmed, EMBASE, Cochrane, CiNii, CNKI, KMBASE, KISS, NDSL, and OASIS. Meta-analysis was performed by Review Manager software and the quality of included studies were assessed by the Cochrane risk of bias tool. Results: A total of 20 articles with 1536 participants were identified. 12 trials about phamacopuncture and 8 trials about bee venom acupuncture showed significant improvement than sham treatment, western medicine treatment, and other Korean medicine treatment such as acupuncture in diverse scales. Six trials reported adverse events. Conclusions: These findings showed certain efficacy and safety of pharmacopuncture and bee venom acupuncture. It would be helpful for patients and Korean medicine doctors in the choice of the treatment for knee osteoarthritis. Well-designed studies with long term follow up and more number of participants should be conducted to strengthen the evidence of the use of pharmacopuncture and bee venom acupuncture.

• Journal of Korean Physical Therapy Science
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• v.11 no.1
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• pp.36-42
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• 2004

Evidence based physical therapy interventions for this patient was applied in 15 clinical sessions. Considering the patient's two main impairments, two physical therapy interventions were delivered with WOMAC index outcome measurement. From this case report, I observed that a combined physical therapy interventions consisting of manual therapy, therapeutic exercise, and TENS Unit in patients with knee osteoarthritis may result in decreased pain, stiffness and increased physical function.

• IMMUNE NETWORK
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• v.24 no.3
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• pp.15.1-15.18
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• 2024

Osteoarthritis (OA) involves cartilage degeneration, thereby causing inflammation and pain. Cardiovascular diseases, such as dyslipidemia, are risk factors for OA; however, the mechanism is unclear. We investigated the effect of dyslipidemia on the development of OA. Treatment of cartilage cells with low-density lipoprotein (LDL) enhanced abnormal autophagy but suppressed normal autophagy and reduced the activity of transcription factor EB (TFEB), which is important for the function of lysosomes. Treatment of LDL-exposed chondrocytes with rapamycin, which activates TFEB, restored normal autophagy. Also, LDL enhanced the inflammatory death of chondrocytes, an effect reversed by rapamycin. In an animal model of hyperlipidemia-associated OA, dyslipidemia accelerated the development of OA, an effect reversed by treatment with a statin, an anti-dyslipidemia drug, or rapamycin, which activates TFEB. Dyslipidemia reduced the autophagic flux and induced necroptosis in the cartilage tissue of patients with OA. The levels of triglycerides, LDL, and total cholesterol were increased in patients with OA compared to those without OA. The C-reactive protein level of patients with dyslipidemia was higher than that of those without dyslipidemia after total knee replacement arthroplasty. In conclusion, oxidized LDL, an important risk factor of dyslipidemia, inhibited the activity of TFEB and reduced the autophagic flux, thereby inducing necroptosis in chondrocytes.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.49-54
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• 2016

PURPOSE: The purpose of this study was to determine the effect of different frequencies (4Hz and 100Hz) of transcutaneous electrical nerve simulation (TENS) on pain relief using c-fos expression in the spinal cord of rat osteoarthritis to investigate the appropriate frequency for pain relief. METHODS: Total of 30 Sprague-Dawley rats was used and randomly divided 2 groups according TENS frequency and applicate the TENS during 3 period (3 days, 7 days, 10 days). The induction of osteoarthritis by 3mg monosodium iodoacetat was injected into the right knee joint of rats. Three days later, commercially available TENS unit was used for stimulation was set to 20minutes on 3, 7, 10 days after surgery. Western blot analysis system was used to detect immunoreactive proteins. The thickness of the bands were photographically measured by Scion Image. RESULTS: When investigating the c-fos expression of TENS on spinal cord in OA knee over 10 days, between-groups differences in c-fos expression reached a significant level by day 10. For within-groups comparisons, the c-fos expression decreased significantly across days in low- and high-frequency TENS groups. CONCLUSION: Whether at low- and high-frequency, the TENS as a therapy obtained beneficial effects of pain relief and TNES at high-frequency is more beneficial effects on the pain relief when TENS applied at injury site.

• Journal of Veterinary Clinics
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• v.37 no.5
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• pp.261-269
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• 2020

The purpose of this study is to investigate the clinical effects of carboxymethyl chitosan (CMC) and adipose-derived mesenchymal stem cells (MSCs) on osteoarthritis (OA). Thirty New Zealand white rabbits were used as cranial cruciate ligament transection and partial meniscectomy models. The rabbits were divided into five groups (n = 6) according to the intra-articular injection materials: the control group with PBS, the HA group with hyaluronic acid, the CMC group with CMC, the MSC group with MSCs emerged in PBS, and the MSC+CMC group with CMC and MSCs. Knee thickness, extension angle, gross morphology, histopathology and immunohistochemistry were performed to evaluate the effects of CMC and MSCs on rabbit OA. On the morphologic and histologic examination, the articular surfaces of the femur and tibia were markedly damaged in control group with higher Mankin score and lower cartilage surface thickness. However, OA related cartilage defects were alleviated by the treatment of MSC and/or CMC. The expressions of apoptotic and inflammatory cytokines were decreased and cartilage extracellular matrix (ECM) related collagens I and II were enhanced by the treatment of MSC and/or CMC. In conclusion, this study showed that CMC and MSC treatments have a beneficial effects on OA via the protection of cartilage damage, the stimulation of ECM, and the inhibition of inflammatory and apoptotic reaction.

• The Korea Journal of Herbology
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• v.29 no.4
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• pp.45-52
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• 2014

Objectives : The purpose of this study was to evaluate the efficacy of HT008 on pain relief and functional improvement in participants with mild knee osteoarthritis (OA) in comparison with that of glucosamine sulfate. Methods : This randomized double-blind trial was conducted at Kyung Hee University Medical Center in Seoul where participants with knee pain for more than 6 months and degenerative osteoarthritis were enrolled. The 100 participants were received either HT008 or glucosamine sulfate 750 mg twice daily for 8 weeks and evaluated at baseline, 4 and 8 weeks after the treatment. We primarily evaluated the differences between two groups with respect to changes in the visual analogue score (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score from baseline to week 8. Secondarily the difference between and within two groups with respect to changes in WOMAC stiffness and physical function score, and Lequesne Functional Severity Index (LFI) were also evaluated. Results : At week 8, treatment with HT008 resulted in a significant reduction of the VAS for pain and WOMAC pain scores compared to the glucosamine sulfate (both p=0.003). Patients receiving HT008 experienced statistically significantly greater improvements in WOMAC physical function scores and LFI (p = 0.014 and p=0.016, respectively) than glucosamine sulfate-treated group. The within-group change in WOMAC physical function and stiffness, and LFI during the 8-week intervention revealed significant improvements in HT008-treated group. Conclusions : HT008 treatment allows significant pain reduction and functional improvement compared with glucosamine sulfate. These data confirm HT008 as an effective and safe symptomatic drug for knee OA.

• The Journal of Korean Physical Therapy
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• v.26 no.2
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• pp.82-89
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• 2014

Purpose: This study was conducted in order to develop an instrument for the Korean Osteoarthritis Impact Measurement scale (KAIMS) in hip and knee osteoarthritis patients. Methods: A sample of 426 subjects was recruited in Ulsan metropolitan city (six hospitals and clinics) and Andong city (five hospitals and clinics) from June 2010 to May 2011. Item internal consistency and item discriminant validity were analyzed on the item-level, and floor (%) and ceiling (%) effect were analyzed on the scale-level. Exploratory factor analysis was performed for construction of items in the KAIMS instrument; confirmative factor analysis was also performed to test the fit of the model. Results: In 426 respondents, age was 64.3 years. The reliability for r coefficient 0.90 (mobility) and 0.89 (pain and stiffness) (Cronbach's alpha 0.95, 0.95 respectively) was high in the test-retest, and there was no significant difference in paired t-test (p>0.05). Item internal consistency (${\alpha}=0.92$, ${\alpha}=0.87$ respectively) was also high. It was constructed of two factors (mobility, pain and stiffness dimension) and nine items in explanatory factor analysis; results of confirmatory factor analysis also indicated that the dimensional structure model was fitted well in the test of model fit (${\chi}^2=83.83$, df=26, p=0.000; RMR=0.05; GFI=0.96; AGFI=0.83). Conclusion: In conclusion, the results of this study showed that the KAIMS that was developed was a reliable and valid instrument for measurement of osteoarthritis (OA) patients. We recommend further research for additional development of the instrument on OA in Korea.

• Korean Journal of Acupuncture
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• v.33 no.4
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• pp.204-212
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• 2016

Objectives : The aim of the study is to investigate the effects of moxibustion on the pain behavior and expression of TRPM8 in the dorsal root ganglion(DRG) in the rat model of ambient cold(AC) exposed osteoarthritis(OA). Methods : OA was induced by the injection of $50{\mu}l$ of 2% monosodium iodoacetate(MIA) into the knee joint cavity. To examine the level of pain, weight bearing forces(WBFs) of affected limb was measured. For the AC exposure, the animals were housed in 6 h/day at $4^{\circ}C$ for 14 days after MIA injection. Moxibustion treatment was performed at EX-LE4 and EX-LE5 with 5 cons(1, 7 or 10 mg) per day for 13 days from 5 days after MIA injection. The expressions of TRPM8 in DRG were measured by western blotting analysis. Results : The WBFs of MIA-AC group were decreased significantly compared to MIA group at 2, 3, 6, 7, 8 and 9 days after arthritis induction. After the first 6 h-AC exposure, expressions of TRPM8 in MIA-AC group were increased significantly compared to those of naive group. After moxibustion treatment, only the WBFs of 7 mg treated group were restored significantly. Moreover, the over-expressions of TRPM8 were attenuated by the moxibustion treatment in AC exposed rats. Conclusions : The data suggest that AC can increase arthritic knee pain via up-regulated TRPM8 and moxibustion treatment improve the arthritic pain via modulation of TRPM8 expression in DRG in the rat model of AC exposed MIA induced arthritis.

• The Journal of Korean Medicine
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• v.27 no.4
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• pp.225-232
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• 2006

Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

• Investigative Magnetic Resonance Imaging
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• v.25 no.3
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• pp.141-155
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• 2021

Purpose: To develop a 3D magnetic resonance fingerprinting (MRF) method for application in high resolution knee cartilage PD, T₁, T₂ mapping. Materials and Methods: A novel 3D acquisition trajectory with golden-angle rotating radial in k_xy direction and interleaved echo planar imaging (EPI) acquisition in the k_z direction was implemented in the MRF framework. A centric order was applied to the interleaved EPI acquisition to reduce Nyquist ghosting artifact due to field inhomogeneity. For the reconstruction, singular value decomposition (SVD) compression method was used to accelerate reconstruction time and conjugate gradient sensitivity-encoding (CG-SENSE) was performed to overcome low SNR of the high resolution data. Phantom experiments were performed to verify the proposed method. In vivo experiments were performed on 6 healthy volunteers and 2 early osteoarthritis (OA) patients. Results: In the phantom experiments, the T₁ and T₂ values of the proposed method were in good agreement with the spin-echo references. The results from the in vivo scans showed high quality proton density (PD), T₁, T₂ map with EPI echo train length (N_ETL = 4), acceleration factor in through plane (R_z = 5), and number of radial spokes (N_spk = 4). In patients, high T₂ values (50-60 ms) were seen in all transverse, sagittal, and coronal views and the damaged cartilage regions were in agreement with the hyper-intensity regions shown on conventional turbo spin-echo (TSE) images. Conclusion: The proposed 3D MRF method can acquire high resolution (0.5 mm³) quantitative maps in practical scan time (~ 7 min and 10 sec) with full coverage of the knee (FOV: 160 × 160 × 120 mm³).