Journal of Korean Academy of Fundamentals of Nursing
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v.6
no.2
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pp.198-210
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1999
This study is to investigate sleep patterns of rheumatoid arthritis patients through a survey research. The subjects for this study were 97 patients registered in Hanyang University Hospital Rheumatoid Arthritis Center, and the period of data collection was from July 15, 1998 to August 30, 1998. The research instruments used in this study were the measures of sleep, pain, and fatigue, and SPSSWIN 8.0 Program was used for data analysis. The research results are as follows ; The patients went to bed between 11 and 12 p.m., but many of them found difficulty in falling asleep within 5 minutes. They woke up quite early at around 4 to 6 o'clock in the morning and remained in bed about 1 hour. Only 39 percent of the subjects reported satisfaction with their sleep. Fifty six percent of the subjects took a nap, generally did in the afternoon and 22.7 percent of them napped for half an hour. They suffered sleep disturbance, but their sleep environments were calm and comfortable, and they turn off the light when they went to sleep. As for the quality of sleep, over 50 percent of the subjects reported not being able to sleep deeply, 30 percent of the subjects woke up frequently during sleep, 60 percent experienced frequent arousal after sleep onset. Over 90 subjects slept for 6 to 8 hours. This shows that even though they had rheumatoid arthritis, the patients remained in bed for a sufficient period of time. They also reported waking up or turning frequently during sleep. The sense of fatigue from sleep disturbance scored a relatively high 35.84 points on average against the possible score of 64 points. Behavior for sleep promotion was very active. Sleep disturbance occurred in proportion to the sense of fatigue and pain, and was negatively correlated with quality of sleep. The pain had positive correlations with the illness duration, sleep disturbance and had a negative correlation with the quality of sleep.
Purpose: We assess the mid to long term follow up results of arthrodesis of the first metatarso-phalangeal (MTP) joint and resection arthroplasty of the lesser toes in rheumatoid arthritic forefoot deformity. Materials and Methods: Between 1998 to 2001 year, 25 cases (18 patients) rheumatoid forefoot deformities were surgically corrected. Follow up period was 83 months (range, 63 to 90 months). The clinical outcome was evaluated using subjective satisfaction and AOFAS score. The radiological measurements were hallux valgus angle, first and second intermetatarsal angle, second metatarso-phalangeal angle (MTP-$2^{nd}$ angle). Results: Subjective satisfaction was 76%. AOFAS score improved from 37 to 73. The hallux valgus angle improved from preoperative $39^{\circ}$ ($27{\sim}64^{\circ}$) to $14^{\circ}$ ($4{\sim}34$) at the last follow up. The intermetatarsal angle were preoperative $13^{\circ}$ ($6{\sim}22^{\circ}$) to $11^{\circ}$ ($3{\sim}13^{\circ}$) at the last follow up, The MTP-$2^{nd}$ angle were preoperative $24^{\circ}$ ($9{\sim}47$) to last follow up $15^{\circ}$ ($2{\sim}39^{\circ}$) respectively (p>0.05). Complication was intractable callus 10 cases, Interphalangeal arthritis 5 cases. Conclusion: Mid to long term outcomes rheumatoid forefoot reconstruction by first MTP arthrodesis and resection arthroplasty of lesser toes results a satisfaction and pain relief.
This study attempts to provide the rudimentary data that might help patients with Rheumatoid Arthritis manage an independent life by the analysis of their activities of daily living(ADL). The subjects were forty patients who had been diagnosed Rheumatoid Arthritis and under drug therapy from RA clinics of the two university hospitals in Pusan. Data were collected by performing an individual interview for each of them during June 15th through July 15th 1998. Questionaires were imployed to investigate the general characteristics of patients. the traits of Rheumatoid Arthritis, and actual conditions of their activities of daily living. The questionaires utilized especially for the study of ADL is the version of Lee Eun Ok's tool which modified and complemented Katz scale (Katz, Down, Cogh and Grots 1970) and Bathel index(Bathel. 1973). It's consisted of 31 questions that each question is measured by 0-3points. The high score in the questionaire signifies the high independency in the ADL. The data were analyzed by SPSS/Win in terms of frequency, percentage, mean, and standard deviation, close connection with the contents of the personal interview. Total mean of the ADL shows $1.55{\pm}0.68$, indicating the overall activities of daily living is generally dependent. It also indicates that patients, in the condition of dependent activity. tends either to have recourse to drugs or to take negative strategy, getting help from inside or outside family member. Hence, it is necessary that patients are exposed to the introduction and instruction of self-help devies that might help them manage a comparatively independent ADL, easing their paychological burden.
Rheumatoid arthritis (RA) is a chronic inflammatory disease, which is mainly characterized by disease of joints affected with synovial hyperplasia, pathological immune response, and progressive destruction; all of which represent an important social health problem. These provide new insights in its pathogenesis of rheumatoid arthritis diagnosis and disease progression in molecular changes. This review focuses on new serological and immunological markers which seem to be useful in early diagnosis and prognosis of rheumatoid arthritis. Therefore, such tests are widely conducted for serological biomarkers and the developments with such immunological factors to identify patients who are at risk for disease progression. This evidence of the disease based on laboratory medicine could provide the best outcome for patients. Finally, data from recent studies will help to refine the ultimate usefulness of this novel approach for early diagnosis, treatment, and helping clinicians to optimize therapy by using this approach.
Kim Gye Yeop;Cho Kyoung Oh;Kim Myung Hee;Cheong Hyun Woo
Journal of Physiology & Pathology in Korean Medicine
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v.18
no.5
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pp.1301-1308
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2004
The purpose of this study was to observe the effects of far-infrared on rheumatoid arthritis induced rats by type ⅡI collagen with the change of arthritis index, hind paw volume, TNF-α and histopathologic findings. Thirty-six Sprauge-Dawley rats which were divided into four group. Group Ⅰ : Normal group, Group Ⅱ : Collagen-Induced Arthritis group, Group Ⅲ : Far-Infrared 25㎝ radiation group, Group Ⅳ : Far-Infrared 35㎝ radiation group. The results of this study were as follows: In arthritis index, far-infrared radiation group(Ⅲ, Ⅳ) are more decreased than collagen-induced arthritis group(Ⅱ). Group Ⅲ and Ⅳ showed the most significant effect at 14 day(p<0.05). In hind paw, far-infrared 25㎝ radiation group(Ⅲ) significantly decreased more than only collagen-induced arthritis group on day 14(p<0.05). Far-infrared 35㎝ radiation group(Ⅳ) significantly decreased more than collagen-induced arthritis group on day 3, 7 and 14(p<0.05). In the ELISA study of TNF-α concentration, collagen-induced arthritis group significantly increased in the concentration more than normal group. Far-infrared radiation group(Ⅲ, Ⅳ) decreased in TNF-α concentration more than collagen-induced arthritis group(Ⅱ) on day 14. In histopathologic findings, collagen-induced arthritis(Ⅱ) and far-infrared 25㎝ radiation group(Ⅲ) increased in synovial membrane thickness on 3 day. Far-infrared 35 em radiation group(Ⅳ) decreased in the concentration more than collagen-induced arthritis group on day 14. The above results suggest that far-infrared radiation effectively reduced in rheumatoid arthritis. It would be considered that far-infrared has an effects on relieving rheumatoid arthritis.
Journal of the Korean Academy of Clinical Electrophysiology
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v.5
no.2
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pp.85-93
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2007
Summary of background data: It is researched until now and the researches against the effect of position cold treatment the effect which pain threshold, change of skin temperature, researches the effective stiffness, the coldness in the patient it applied and relax an inflammation do the researches against were insufficient. Purpose: This project was to see how much it gives effect by using the cold air therapy an inflammation relief of rheumatoid arthritis patient. Methods: The medical subjects were 10 people from standard to diagnosis category of American College of Rheumatology(ACR) who had rheumatoid arthritis and to inspect informations about inflammation relief, have inspected ESR(erythrocyte sedimentation rate) and WBC(white blood cells). The experiment method was to let the patient bend the joint and lay down flat and treat with cold air from 10 cm away from joint line repeating 5 minutes treatment 1 minute rest and 3 minutes treatment. ESR and WBC cold air therapy reported with 5 days gap and each patient has been applied for 3 times. Result: The 5th day and 10th days ESR and WBC value shows when using cold air therapy, there was a reduction on rejected group but didn't last long, but 15th day it showed only on WBC it had its attention. Conclusions: So the cold air therapy shows it has positive effects on inflammation relief of rheumatoid arthritis patient.
Background: Intraarticular local anesthetic injection has been therapeutically applied for pain control in various arthritis patients. However, little physiologic effects of local anesthetics on their tissue were known. This study was conducted to determine its effects on the cell proliferation and matrix metalloproteinases (MMP) production of cultured fibroblast like synoviocytes (FLS) derived from synovial tissues of rheumatoid arthritis patients. Methods: Bupivacaine with varying concentrations 0 (control), 0.1, 0.25, 0.5% was applied to experimental cell groups growing as monolayers in culture plates for varying durations 0 (control), 30, 90, 180 seconds in the presence and absence of interleukin-$1\beta$. Results: No statistical significances were noted in thymidine incorporation between 0, 30, 90 and 180 seconds exposure groups with 0.5% bupivacaine after 1 day and 2 days. Thymidine incorporation between 0, 0.1, 0.25, 0.5% exposure groups 1 day and 2 days after 90 seconds exposure did not show any differences. After exposure to bupivacaine, there were statistically significant increases in MMP-1 (p=0.025) and MMP-3 productions (p=0.000) of FLS in the absence of IL-$1\beta$, but no differences among the groups in the presence of IL-$1\beta$. Conclusion: We concluded that in this short-term in vitro study, bupivacaine does not have injurious effect on cultured rheumatoid arthritic joint tissues. The long-term effect cannot be known from this investigation.
Objectives: This study was conducted to investigate the effects of mastery on appraisal of uncertainty in women patients with rheumatoid arthritis. Methods : The study subjects consisted of 168 patients who were recruited from the outpatient clinic of a rheumatic center in Seoul. Self report questionnaires were used to measure the study variables that included uncertainty, mastery, danger appraisal of uncertainty, and opportunity appraisal of uncertainty. Cronbach's alpha reliabilities of these instruments ranged from .72 to .93. For data analysis. the SPSSWIN 10.0 program was utilized to exam descriptive statistics. Pearson's correlation. and regression analysis. Results: The results were as follows.: 1) The uncertainty scores of the subjects ranged from 33 to 87 with the mean score of 63.27. 2) The mastery scores of the subjects ranged from 10 to 27 with a mean score of 18.70. 3) The danger appraisal of uncertainty scores of the subjects ranged from 8 to 32 with a mean score of 20.22. 4) The opportunity appraisal of uncertainty scores of the subjects ranged from 7 to 28 with a mean score of 17.80. 5) Significant factors that explained the danger appraisal of uncertainty were mastery (=-.444. p<.001), and education level (=-.184. p<.05). 6) Significant factor that explained the opportunity appraisal of uncertainty was level of uncertainty (=-.328. p<.001). Conclusion: Among the independent variables. the most significant factor that explained the danger appraisal of uncertainty in the women patients with rheumatoid arthritis was mastery. Therefore, a nursing intervention with strategies to improve sense of mastery should be developed for women patients with rheumatoid arthritis.
Na, Min-Kyun;Chun, Hyoung-Joon;Bak, Koang-Hum;Yi, Hyeong-Joong;Ryu, Je Il;Han, Myung-Hoon
Journal of Korean Neurosurgical Society
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v.59
no.6
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pp.590-596
/
2016
Objective : Rheumatoid arthritis (RA) is a systemic disease that can affect the cervical spine, especially the atlantoaxial region. The present study evaluated the risk factors for atlantoaxial subluxation (AAS) development and progression in patients who have undergone surgical treatment. Methods : We retrospectively analyzed the data of 62 patients with RA and surgically treated AAS between 2002 and 2015. Additionally, we identified 62 patients as controls using propensity score matching of sex and age among 12667 RA patients from a rheumatology registry between 2007 and 2015. We extracted patient data, including sex, age at diagnosis, age at surgery, disease duration, radiographic hand joint changes, and history of methotrexate use, and laboratory data, including presence of rheumatoid factor and the C-reactive protein (CRP) level. Results : The mean patient age at diagnosis was 38.0 years. The mean time interval between RA diagnosis and AAS surgery was $13.6{\pm}7.0$ years. The risk factors for surgically treated AAS development were the serum CRP level (p=0.005) and radiographic hand joint erosion (p=0.009). The risk factors for AAS progression were a short time interval between RA diagnosis and radiographic hand joint erosion (p<0.001) and young age at RA diagnosis (p=0.04). Conclusion : The CRP level at RA diagnosis and a short time interval between RA diagnosis and radiographic hand joint erosion might be risk factors for surgically treated AAS development in RA patients. Additionally, a short time interval between RA diagnosis and radiographic hand joint erosion and young age at RA diagnosis might be risk factors for AAS progression.
Park, Ki-Bum;Baek, Seung-Tae;Lee, Seung-Deok;Kim, Kyung-Ho;Kim, Kap-Sung
Journal of Acupuncture Research
/
v.23
no.6
/
pp.103-115
/
2006
Objectives : Rheumatoid arthritis(RA) is a systemic & a chronic inflammatory autoimmune disease . A chronic , locally destructive inflammmatory reaction in human is examplified by the synovitis present in some connective tissue disorder. The presence of a number of cytokines, $TNF-{\alpha}$, iNOS & expression of nitric oxide, NF-kB p65 activation implies an important role of cellular immune response in RA inflammatory reaction. This study was designed to evaluate on the effects of the Homnis Placenta herbal acupuncture on EX-LE201 & ST 35 reducing expression of LPS-induced arthritis model in mice. Materials and Methods : Homnis Placenta herbal acupuncture was inserted into 10 rats induced rheumatoid arthritis. The acupunctures were injected into the EX-LE201 and ST35 points. Such indexes were measured the inhibition of inducible nitric oxide synthase(iNOS) expression, nitric oxide(NO) production in vitro experiment and Tumor Necrosis $Factor-{\alpha}(TNF-{\alpha})$ & Nuclear Factor kappa $B(NF-{\kappa}B)$ p65 activation, synovial hyperplasia, angiogenesis and fibrosis in synovial membrane of knee joint of mice in vivo experiment. Results : 1.Homnis Placenta Herbal acupuncture inhibited iNOS mRNA and NO in RAW 264.7 cell of LPS-induced rheumatoid arthritis in a dose dependent manner. 2.Homnis Placenta Herbal acupuncture also showed significant inhibition of $TNF-{\alpha}$ & $NF-{\kappa}B$ p65, activation, synovial hyperplasia, angiogenesis and fibrosis in synovial membrane of knee joint of mice. Conclusion : These results suggest that Homnis Placenta Herbal acupuncture has an therapeutic effects on LPS induced-rheumatoid arthritis by inhibiting $TNF-{\alpha}$ activation.
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