• The Journal of Korean Physical Therapy
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• v.15 no.4
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• pp.151-179
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• 2003

The purpose of this study was to examine the influence of total knee replacement to arthritis patients in pain intensity and functional impairment. For this study, over 50-year-old 30 patients who had osteoarthritis and 69 patients who got total knee replacement at the one of the departments of orthopedics in Daegu were interviewed from June, 2002 to March, 2003. The results of this study were as follows : First, pain intensity was decreased to experimental group after operation than control group(P<.01) And the presence of crepitation was also decreased to them(P<.05). On the other hand there's no significant difference was noted in the presence of stiffness, degree of flexion contracture and extension contracture between two groups. Second, over 91 days group after operation and visitor's group of physiotherapy unit were better than others in Level of knee function(P<.01). Third, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Barthel Index of knee function(P<.01). Forth, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Level of IADL(P<.05). Fifth, over 91 days group after operation and visitor‘s group of physiotherapy unit were higher than others in Katz Index of knee function(P<.01). Sixth, although Old Ages' Activity Index seemed to get better as time goes by, there's no statistical difference. Seventh, over 91 days group after operation and visitor's group of physiotherapy unit were higher than admission group and under 30 days group after operation in Social Activity Index(P<.05). Eighth, the function of the knee was connected with the abilities in the activity of the old and the social skill. The Barthel index was connected with the function of the knee joint and the activities of the old and Katz index. IADL function was connected with the activities of the old and the social activity. The Katz index was connected with the Barthel index. The activity of the old was connected with the Barthel index, the functional score of the knee joint andthe IADL score. The ability of social skill was connected with the activity of the old, IADL score and the function of the knee.

• IMMUNE NETWORK
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• v.6 no.1
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• pp.33-42
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• 2006

Background: Calcineurin plays a crucial role in T cell activation, cell growth, apoptosis, and angiogenesis, and its over-expression has been implicated in the pathogenesis of cardiomyopathy and stroke. However, the expression and function of calcineurin in the pathologic lesion of chronic inflammatory diseases, like rheumatoid synovium, remain to be defined. This study was aimed to determine the role of calcineurin in inflammatory arthritis and investigate the expression and function of calcineurin in the rheumatoid synovium and synoviocytes, the actual site of chronic inflammation. Methods: Immuno-histochemical staining using specific antibody to calcineurin was perfomed in the synovium of rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLS) from RA and osteoarthritis (OA) patients were isolated from RA and OA patients, and cultured with IL-1${\beta}$ and TNF-${\alpha}$ in the presence or absence of cyclosporin A, a calcineurin inhibitor. The calcineurin expression was assessed by phosphatase assay and Western blotting analysis. IL-6, -10, -17, matrix metalloproteinase (MMP)-1, -2, -3, and -9 released into the culture supernatants were measured by ELISA. After transfection with GFP-Cabin 1 gene into synoviocytes, the levels of IL-6 and MMPs were measured by ELISA. Results: Calcineurin was highly expressed in the lining layer of synovium and cultured synoviocytes of RA patients. The elevated calcineurin activity in the rheumatoid synoviocytes was triggered by proin flammatory cytokines such as IL-1${\beta}$ and TNF-${\alpha}$. In contrast, IL-10, an anti-inflammatory cytokine, failed to increase the calcineurin activity. The targeted inhibition of calcineurin by the over-expression of Cabin 1, a natural calcineurin antagonist, inhibited the production of IL-6 and MMP-2 by rheumatoid synoviocytes in a similar manner to the calcineurin inhibitor, cyclosporin A. Conclusion: These data suggest that abnormal activation of calcineurin in the synoviocytes may contribute to the pathogenesis of chronic arthritis, and thus provide a potential target for controlling inflammatory arthritis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.440-449
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• 2020

This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

• Reproductive and Developmental Biology
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• v.35 no.2
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• pp.151-157
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• 2011

Clinical arthritis is typically divided into rheumatoid arthritis (RA) and osteoarthritis (OA). Arthritis-induced muscle weakness is a major problem in aged people, leading to a disturbance of balance during the gait cycle and frequent falls. The purposes of the present study were to confirm fiber type-dependent expression of muscle atrophy markers induced by arthritis and to identify the relationship between clinical signs and expression of muscle atrophy markers. Mice were divided into four experimental groups as follows: (1) negative control (normal), (2) positive control (CFA+acetic acid), (3) RA group (CFA+acetic acid+type II collagen), and (4) aging-induced OA group. DBQA/1J mice (8 weeks of age) were injected with collagen (50 ${\mu}g/kg$), and physiological (body weight) and pathological (arthritis score and paw thickness) parameters were measured once per week. The gastrocnemius muscle from animals in each group was removed, and the expression of muscle atrophy markers (MAFbx and MuRF1) and myosin heavy chain isoforms were analyzed by reverse transcription-polymerase chain reaction. No significant change in body weight occurred between control groups and collagen-induced RA mice at week 10. However, bovine type II collagen induced a dramatic increase in clinical score or paw thickness at week 10 (p<0.01). Concomitantly, the expression of the muscle atrophy marker MAFbx was upregulated in the RA and OA groups (p<0.01). A dramatic reduction in myosin heavy chain (MHC)-$I{\beta}$ was seen in the gastrocnemius muscles from RA and OA mice, while only a slight decrease in MHC-IIb was seen. These results suggest that muscle atrophy gene expression occurred in a fiber type-specific manner in both RA- and OA-induced mice. The present study suggests evidence regarding why different therapeutic interventions are required between RA and OA.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.213-217
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• 2006

Purpose: To evaluate the clinical and radiological results of tibio-talo-calcaneal arthrodesis using ipsilateral distal fibula buttress which had advantages of extended operative field and release of contracted soft tissue. Materials and Methods: We retrospectively reviewed 4 postraumatic compartment syndrome, 2 residual poliomyelitis, 1 posttraumatic osteoarthritis with subtalar joint infection and 1 posttarumatic sciatic nerve palsy patients who underwent a tibio-talo-calcaneal arthrodesis from April, 1996 to March, 2002. Each of the cases was notable for a severe rigid equinovarus, persistent pus drainage of calcaneal area and paralytic foot. The mean duration of follow up was 18 months (range, $13{\sim}42$ months). The pain, function and alignment were evaluated by the modified ankle hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) and patients satisfaction clinically. The radiological union were evaluated by plain AP and lateral radiographs. Results: The AOFAS score improved from 58 points (range, $47{\sim}78$) preoperatively to 82 (range, $60{\sim}89$) postoperatively. Patents satisfaction checked at 12 months after operation had favorable results (excellent and good 80%). Union rate was 100% radiographically and the mean duration of union was 12.5 weeks (range $8{\sim}22$ weeks). There was 2 cases of superficial pin tract infection and one protrusion of screw. Conclusion: Tibio-talo-calcaneal arthrodesis using ipsilateral distal fibula buttress was good modality of arthrodesis which provides wide operative field and release of contracted soft tissue in some cases of contracted foot.

• The Journal of Korean Physical Therapy
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• v.14 no.4
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• pp.183-203
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• 2002

To know the effect of index of social ability (ISA) and function of social life (FSL) with activities of daily living (ADL) and instrumental activities of daily living (IADL), we carried out a study on the elderly with osteoarthritis daily living in Daegu city for 4 months, from April to July 2002. The followings were observed: 1. The score of functional disability of knee, ADL and ISA were better at lower age (p < 0.01). 2. The younger they are, the better FSL they have. The lower age group has good FSL (p < 0.01). 3. Weight affects more to the under 49Kg group than 50-59Kg group and 60-69Kg group in functional disability of knee, while it doesn't make much difference for the other groups (p > 0.05) and other assessment index doesn't show any relationship with weight. 4. Regarding relat ionship with height , taller group has better knee functions: it's proved by post hock examination that the over 160cm group has much higher knee function than the other groups (p < 0.05). In case of ADL, the over 160cm group and under 149cm group were better than 150$\∼$159cm group. (p < 0.01) . 5. ISA was also different depending on height . It was proved that FSL was the better for the over 160cm group than for the others as a result of post hock examination (p < 0.05). 6. In regard of how many months have passed since the attack of functional disability of knee, knee joint function was better for the 12mon$\∼$36mon group than for the others and the score of ADL was lower for the 12mon$\∼$36mon group than for the others (p < 0.01). ISA was lower for the 12mon$\∼$36mon group and the under 6mon group than for the other groups (p < 0.01). FSL was lower for the 12mon$\∼$36mon group and the under 6mon group than the other groups. (p < 0.01). 7. Comparing left knee with right one, the problem with left knee has lower score of functional disability in all items (p < 0.01). 8. Considering friction noise, knee joint function was slightly better for non-friction noise-group, but it's not statistically significant though. ADL and ISA were better for non-friction noise-group (p < 0.01), while no statistical significance was found in FSL, 9. Knee joint function was better for the group who doesn't have limitation on range of knee flexion motion (p,0.05) but no other difference was found in other items from this group. 10. Limitation on range of knee flexion motion has no statistical difference in ADL and FSL. However, ISA was better for the non-limitation group (p < 0.05) . 11. Knee joint function score has high correlation with ISA (r=0.812, p < 0.01) and FSL (r=0.732, p < 0.01) , which shows the better knee joint function, the higher the score. 12. ISA and FSL were highly correlated: the better ISA, the better FSL (r=0.893, p < 0.01), while ADL has no correlation with either knee joint function or ISA or FSL.

• Journal of muscle and joint health
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• v.9 no.1
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• pp.18-27
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• 2002

Introduction : Exercise has been suggested as an important nursing strategy in which to help elderly maintain functional performance and to enhanced quality of life. Most of exercise study has been reported on fitness exercise such as walking, swimming, dance etc for health of elderly. There have been few reports about exercise on the promotion of small and fine movement of elderly. The purpose of this pilot study was to determine an effect of 6 weeks hand and finger exercise in home to improve hand muscle strength such as grip strength and finger pinch pressure. Materials and Methods Design: This pilot study was used one group pre and post-test design. Sample: Twelve elderly women above 60 years of age or older living in community were selected by convenient sampling. Procedure: Signed informed consent was obtained prior to participate in this study. The authors met elderly and taught hand and finger exercise, daily a week for 6 weeks, within 30 minutes per session. But exercise frequency and strength were not same. Instruments: Left and right grip strength were measured by Bulb Dynamometer(made in USA) and left and right pinch pressure were measured by Baseline Hydraulic Pinch Gauge(made in USA). Data analysis: Discriptive data analyses were performed on all variables. Wilcoxon matched-pairs Signed-Ranks test were used to find difference of grip strength and pinch pressure between pre and post exercise using SPSS 10.0 for Window. Results: Samples age ranged from 60 to 73, Mean age was 65.3. All were women. Ten elderly were diagnosed osteoarthritis and one had DM. After six weeks hand and finger exercise, Left and right grip strength were higher than those of before exercise(Z=-2.667, P<0.01 ; Z=-3.065, p<0.01). And left pinch pressure after hand and linger exercise were higher than that of before pinch pressure (Z=-2.315, p<0.05). But Right pinch pressure was not shown significant change(Z=-1.099, p>0.05). Conclusions: Although this study was limited by the sample size and design, the findings provide some important implications for community based exercise nursing intervention. Short term (six weeks) exercise of hand and linger is shown to be useful as nursing intervention to maintain routine daily activities such as eating, writing, grip something for elderly.

• Journal of muscle and joint health
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• v.9 no.1
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• pp.5-17
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• 2002

The purpose of this one group pre and post test study was to evaluate the effect of self-help programs(SHP) which has been conducted from 1997 to 2000. The SHP was held by Korean Rheumatology Health Professionals Society(KRHP) once a week for 6 weeks for chronic arthritis patients in Korea. Eight hundred fifty five subjects completed the program at 43 sites. The effect of SHP were evaluated by flexibility, pain, activities of daily living(ADL), fatigue, depression and self-efficacy. After SHP, followings were found: 1. Participants' characteristics of SHP were most common in living in Seoul, women, sixties, high school graduates, house wifes, osteoarthritis, completed in 1999. 2. The flexibility of arm, knee, ankle joint were significantly increased, but the flexibility of the shoulder was not changed. 3. Level of pain was decreased significantly from 5.21 to 3.99, and the number of painful joints were decreased from 4.96 to 4.18 significantly. 4. The score of ADL was increased from 53.74 to 54.97 significantly. 5. The score of depression and self-efficacy was not changed. In conclusion, SHP was clearly proved to be an effective nursing intervention to Increase the flexibility of arm, knee, ankle joint and enhanced ADL. Also SHP decreased pain and fatigue. More research is needed to determine the role of self-efficacy and depression in the SHP, use of a randomized design and longer follow up period to understand more about the effects of the program.

• Journal of Preventive Medicine and Public Health
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• v.35 no.1
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• pp.1-12
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• 2002

Objective : To estimate the socioeconomic costs of obesity in Korea,1998. Methods : The 1998 National Health and Nutrition Examination Survey(1998 NHNES) data was used and 10,880 persons who had taken health examinations were selected for study. Essential hypertension, NIDDM(non insulin-dependent diabetes mellitus), dyslipidemia, osteoarthritis, coronary heart disease, stroke were included as obesity related disease. The data of direct costs of obesity was obtained from the National Federation of Medical Insurance. The category of indirect costs was the loss of productivity caused by premature death and admission, time costs, traffic costs, nursing fees due to obesity. Multiple logistic regression model was developed to estimate prevalence odds ratio by obesity class adjusted demographic and socio-ecnomic factors and calculate PAF(Population Attributable Fraction) of obesity on obesity related disease. And we finally calculated the socioeconomic costs of obesity in relation to BMI with PAF. Results : The direct costs of obesity were 2,126 billion${\sim}965$ billion Won in considering out of pocket payment to uninsured services, and the indirect costs of obesity were 2,099 billion${\sim}1,086$ billion Won. Consequently, in considering out of pocket payment to uninsured services, the socioeconomic costs of obesity were 4.225 billion${\sim}2,050$ billion Won, which corresponded to about $0.094%{\sim}0.046%$ of GDP and $1.88%{\sim}0.91$ of total health care costs in Korea. Conclusions : Obesity represents a major health problem with significant economic implications for the society. This results are conservative estimates as far as all obesity related disease and all health care and indirect costs were not included due to missing information. further studies are needed to caculate socioeconomic costs of obesity more exactly.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.90-101
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• 2003

Gait analysis can provide a better understanding of how the alignment of the lower limb and foot can contribute to force observed at the knee. Anatomic and mechanical factors that affect loading in the knee pint can contribute to pathologic change seen at the knee in degenerative pint disease and should be considered in treatment plan. The purpose of this study is to present the gait analysis data and to determine whether there is any relationships between alignment of the lower limb, foot progression angle and knee pint moments in elderly healthy women with 3-dimensional motion analyzer. The results were as follows; 1. Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04 m, Step length was 0.56 m. 2. According to the parameters of kinematics, the maximal knee flexion angle through swing phase showed left $46.82^{\circ}$, right $40.19^{\circ}$ and the maximal knee extension angle showed left $-1.32^{\circ}$, right $2.01^{\circ}$. knee varus showed left $26.90^{\circ}$, right $30.93^{\circ}$. 3. Moment, one of kinetic parameters of knee pint the maximal flexion moment showed left 0.363. Nm/kg, right 0.464 Nm/kg and maximal extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximal. adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg and the maximal internal rotatory moment showed left 0.13 Nm/kg, right 0.140 Nm/kg. 4. On sagittal plane, the maximal power of knee joint showed left 0.571 J/kg, right 0.629 J/kg. On coronal plane, the maximal power of knee joint showed left 0.11 J/kg, right 0.12 J/kg. On transverse plane, the maximal power of knee joint showed left 0.058 J/kg, right 0.072 J/kg. 5. The subject who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase. 6. The subject who had large foot progression angle had statistically lower in knee adduction moment in late stance phase. A relationship was observed between the alignment of the lower extremity and the adduction moment of the knee joint during stance phase. Hence, we need some research to figure, out the change of adduction moment according to the sort of knee joint osteoarthritis and the normal geriatrics as well. And we also require more effective, specific therapeutic program by making use of those background of researches.