• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.241-243
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• 2008

Polymyalgia rheumatica is characterized by bilateral shoulder or pelvic girdle pain, morning stiffness of greater than 45 minutes' duration, constitutional symptoms, an elevated erythrocyte sedimentation rate and a rapid response to prednisolone (${\leq}20mg/day$). Although it is not a rare disease, many cases might be neglected and treated inappropriately in pain clinics. We describe here two cases of polymyalgia rheumatica that was neglected and treated inappropriately.

• Journal of muscle and joint health
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• v.2 no.2
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• pp.185-196
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• 1995

The purposes of this study are to identify effectiveness of the hospital-based home care project, to manage patients' problems in comprehensive way, to decrease the patients' economical burden to the arthritis patients. The design is nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients were assigned in each of the experimental and control groups in Seoul, Kyunggi, Kangwon and Kwangju. Before the experiment and after 3-month period of experiment of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self-efficacy and depression were measured. Nine patients were excluded from the control group because of denial of participation. Contents of home care provided to the experimental group include distribution of prescribed drugs, assessment of patient's condition and side-reactions of drug, pain control, depression control, nutrition guide, exercise teaching, and family counselling. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie Index, ADL, self-efficacy, depression and duration of morning stiffness did not significantly different between two groups as expected. In the experimental group, level of pain, ADL, Richie Index and duration of morning stiffness changed to the positive direction from the pretest to the posttest. However, level of depression and self-efficacy did not show any changes. Ninety percent of patients in the experimental group satisfied with the home care provided to them. Since this is the intermediate report, more detailed and long-term report will be prepared.

• PNF and Movement
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• v.2 no.1
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• pp.1-12
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• 2004

Purpose : The purpose of this study is to demonstrate the correlation of pain, stiffness, and physical function by analyizing the KWOMAC socre of the patients with degenerative knee OA, is the most common disease among senior population. Method : 100 degenerative knee OA patients, diagnosed at the hostpital or clinic located in Degu and Kyung-buk province were participated in the study. Result : This study results in following conclusions. 1. Degenerative knee OA patients complained the pain going up or down stairs, stiffness after getting up in the morning. immediately. 2. They also had significant difficulty ascending or decending stairs, getting in or out of car, rising from sitting, doing chores. 3. There was the high correlation among pain, stiffness, physical function. Conclusions : It may provide information to assess the ADL of knee OA patients and the exercise, outcome for their independent life effectly.

• Journal of Acupuncture Research
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• v.20 no.2
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• pp.77-84
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• 2003

Objective : In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods : Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender joint counts, swollen joint counts, Visual analog scale(VAS), morning in stiffness, ESR, C-reactive protein(CRP) were analyzed before and after BV therapy. Results : The results as follows: 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy($9.0{\pm}7.9$ vs $15{\pm}11.4$, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy ($5.0{\pm}6.1$ vs $1.5{\pm}2.3$, p=0.001). 3. VAS in patients after BV therapy was significantly lower than before BV therapy($60.8{\pm}17.6$ vs $38.0{\pm}15.9$, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy($119.1{\pm}112.6min$ vs $59.0{\pm}89.7min$, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions: BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed in log-term effect of BV therapy.

• The Korean Journal of Pharmacology
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• v.15 no.1_2 s.25
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• pp.39-43
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• 1979

Piroxicam is known to be a new nonsteroidal anti-inflammatory drug which has anti-inflammatory, antiedema, antigranuloma and analgesic activities through the mechanism of inhibition of prostaglandin synthetase. Clinical survey for piroxicam was carried cut on 40 cases of rheumatoid arthritis and 30 cases of degenerative arthritis who visited University Hospital from Feb. to June, 1979. Following results could be obtained: 1) In rheumatoid and degenerative arthritis, the effect of piroxicam was significant in decrease of joint pain, shortening of duration of morning stiffness, decrease in number of swollen joints, improvement of joint stiffness, decrease of E.S.R., increase of mean grip strength and decrease of articular index. 2) Side effects, almost all in G-I troubles were encountered in 6 cases in 40 cases of rheumatoid arthritis and 4 cases in 30 cases of degenerative arthritis.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.138-142
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• 1998

Fibromyalgia syndrome is defined as a diffuse, aching musculoskeletal pain associated with multiple and discrete predictable tender points along with stiffness. A primary form associated without any disease is uncommon compared to the secondary diffuse fibrositis. We witnessed a case of a primary fibromyalgia syndrome. A 28-year-old woman was suffering from pain on posterior neck, right shoulder, upper back, left hand and arm for two years. She also complained of morning stiffness, fatigue, and headache. We treated her with stellate ganglion block with 0.25% bupivacaine, medication that included amitriptyline, TENS and superlizer. We also recommended aerobic exercise.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.234-246
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• 2002

Objective : Ankylosing spondylitic is a chronic inflammatory disease which most frequently the sacro-iliac joints of young men and known as rare disease. There was no clinical report on functional assessment of ankylosing spondylitis. In order to evaluate the effect of clinical treatment, it was necessary to apply valuable and useful of assessment. Methods : We evaluate 1 cases of diagnosed patient with askylosing spondylitis by AIMS2, M-HAQ, K-HAQ, BASFI, and BASDAI after a series of herbal acupuncture treatment.(Solution of herbal acupuncture is made of vaporizing extraction method from the prescription Sineumheo 1.) Results : Herbal acupuncture had relieved pain and morning stiffness successfully and recovered ankylosing spondylitis functionally. Conclusion : 1. Herbal acupuncture had relieved pain and morning stiffness of ankylosing spondylitis. 2. AIMS2 was not useful to evaluate ankylosing spondylitis because of long evaluation time and low specificity. 3. Although there is no translation version of them, BASFI, and BASDAI are clinically useful of assessment, because of short evaluation time and high specificity. 4. K-HAQ with M-HAQ is useful to evaluate the treatment of ankylosing spondylitis because of snort evaluation time and high specificity.

• The Journal of Pediatrics of Korean Medicine
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• v.24 no.1
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• pp.57-64
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• 2010

Objectives This study is to examine case that has an significant result on treating Polyarticular Type Juvenile Idiopathic Arthritis(JIA) the patient who did not response to DMARDs and NSAIDs with oriental medicine. JIA is the most common form of persistent arthritis in children before age 16. The symptoms of JIA is pain and edema of joints, fever, lethargy, reduced physical activity, and poor appetite. But the symptoms vary. Methods The patient felt pain and had limitation of mobility on his joints, but the DMARDs and NSAIDs were not effective. Therefore, he was treated with oriental medicine and withdrew from DMARDs and NSAIDs. The patient took DMARDs and NSAIDs from May 2007 to November 2008(He did not took DMARDs and NSAIDs from December 2007 to June 2008), and took oriental medicine from November 2008 until now. Results The patient's pain and limited mobility on his joints, edema, morning stiffness, fatigue was gone, and could maintain the condition. He doesn't have DMARDs or any other western medicine anymore. Conclusions This study shows that a Polyarticular Type Juvenile Idiopathic Arthritis patient who had ineffective response to DMARDs and NSAIDs can reach to the clinical remission by oriental medicine treatment. His morning stiffness, fatigue, pain of joints, edema was gone and ESR was in normal range with Oriental medicine treatment.

• Journal of muscle and joint health
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• v.3 no.1
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• pp.4-22
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• 1996

Purposes of this study were to identify a hospital-based home care model and to improve the physical, emotional and economical effectiveness of arthritic patients through medical and nursing team approach. The design in nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients in each group were assigned in Seoul, Kyunggi, Kangwon and Kwangju. Before and after 6-month period of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self efficacy, depression, cost expenditure were measured. Nine patients were excluded from the control group in the period of study because of denial of participation. Contents of home care provided to the experimental group include mainly distribution of prescribed drugs, 'assessment of patients' condition and side-reactions of drug. All of the information related to the home care patient were reported to the physician. On the bases of these data, the physician prescribe the specific drugs to each patient. Each patient visited the physician every 2 or 3 month for laboratory test. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie index, ADL, self-efficacy, depression, duration of morning stiffness and direct medical cost were the home care provided to them. If a family member accompany in a home care group can save 10,676 Won/month in Seoul, 34,000 Won/month in other districts. Other in-direct cost for transportation and meal can also be saved. In conclusion, those patients with low level of ADL, high level of pain and Richie index, living in the remote area definitely need the home care.