• The Korean Journal of Pain
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• 제37권1호
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• pp.3-12
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• 2024

One of the most common sources of spinal pain syndromes is the facet joints. Cervical, thoracic, and lumbar facet joint pain syndromes comprise 55%, 42%, and 31% of chronic spinal pain syndromes, respectively. Common facet joint disorders are degenerative disorders, such as osteoarthritis, hypertrophied superior articular process, and facet joint cysts; septic arthritis; systemic and metabolic disorders, such as ankylosing spondylitis or gout; and traumatic dislocations. The facet pain syndrome from osteoarthritis is suspected from a patient's history (referred pain pattern) and physical examination (tenderness). Other facet joint disorders may cause radicular pain if mass effect from a facet joint cyst, hypertrophied superior articular process, or tumors compress the dorsal root ganglion. However, a high degree of morphological change does not always provoke pain. The superiority of innervating nerve block or direct joint injection for diagnosis and treatment is still a controversy. Treatment includes facet joint injection in facet joint osteoarthritis or whiplash injury provoking referred pain or decompression in mass effect in cases of hypertrophied superior articular process or facet joint cyst eliciting radicular pain. In addition, septic arthritis is treated using a proper antibiotic, based on infected tissue or blood culture. This review describes the diagnosis and treatment of common facet joint disorders.

• Tuberculosis and Respiratory Diseases
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• 제71권6호
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• pp.464-469
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• 2011

Adalimumab is a full human monoclonal antibody that inhibits tumor necrosis factor-alpha (TNF-${\alpha}$). This has recently been shown to be effective in the treatment of rheumatoid arthritis (RA), ankylosing spondylitis, and other conditions. Sacoidosis is known to be the target for adalimumab but we describe a patient who has developed sarcoidosis with lung involvement during adalimumab therapy for RA. A 48-year-old woman, who was treated with adalimumab for 5 months, was admitted because of chronic cough and both hilar lymphadenopathy on chest radiography. Chest computed tomography revealed the enlargement of multiple lymph nodes in the right supraclavicular, subcarinal, both hilar and right axillary area. She was diagnosed with sarcoidosis based on the biopsy of supraclavicular lymph node, skin and lung through video-associated thoracoscopic surgery, which was non-caseating epitheloid cell granuloma and excluded from a similar disease. She was treated for sarcoidosis with prednisolone and methotrexate instead of adalimumab.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권2호
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• pp.143-153
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• 2006

Temporomandibular joint(TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation. Ankylotic block formation causes reduction of mandibular mobility, particularly hindering mouth opening, due to a mechanical block of the condylar head in its roto-transfatory motion. Surgery in TMJ ankylosis treatment entails complete ankylotic block removal and subsequent arthroplasty, possibly with autologous tissue between articular surfaces or heterologous material to restore the anatomic structure and normal function. Temporalis myofascial flap holds great promise for the reconstruction of various maxillofacial defects. In more recent years, a pedicled temporalis myofascial flap has been advocated in TMJ ankylosis surgery. Advantages of the temporalis myofascial flap in TMJ reconstruction include close proximity to the TMJ, adequate blood supply from the internal maxillary artery, and its attachment to the coronoid process, which provides movement of the flap during function, simulating physiologic action of the disc. This study evaluated 8 patients(11 TMJs) affected by TMJ ankylosis. All patients underwent surgical treatment of the removal of the ankylotic block and subsequent interpositional arthroplasty with temporalis myofascial flap. Bilateral TMJ ankylosis was observed in 3 patients(6 TMJs), right-sides in 3 patients, left-sided in 2 patients. Epipathogenesis was traumatic in 6 patients(8 TMJs), ankylosing spondylitis in 2 patients(3 TMJs). In 3 patients coronoidotomy was underwent. Average follow-up was 16.8 months after surgery, with a range of 7 to 28 months. No patients underwent additional TMJ procedures after the temporalis myofascial flap. All patients showed a distinctive improvement both in articular functionality and symptoms. We found that temporalis myofascial flap is very valuable in reconstruction of TMJ ankylosis.

• Journal of muscle and joint health
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• 제10권1호
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• pp.54-61
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• 2003

Due to the development in computer mediated communication, there are many homepages on the web, which provide medical on health counseling and education. The internet is becoming increasingly important and essential in medicine. But little was known about what problems can be counseled and what difficulties are met during the computer mediated counseling. This study was performed to investigate the content and purpose of health counseling on the web. The data were collected from March 1st, 2002 to February 28th, 2003, from 199 questioners visited one rheumatic center homepage questionary/answering(Q/A) site. Most of the questioners consulted health problems of their own or their families. The 51.3% of them were diagnosed medically Rheumatoid arthritis was the most frequent disease and followed systemic lupus erythematosus, gout and ankylosing spondylitis. Most of the questioners needed to know treatment principles, diagnosing process, and information regarding the clinic. During the one-year period, the average number of users questioning was 29.4 cases and answering was 44.8 cases. Above findings suggest that computer mediated health counseling of rheumatic patients may be useful supplement of health education for them. Communication using internet has become popular, but this kind of approach needs a proper guideline. It is highly recommended that nurses be familiar with the e-health and e-medicine.

• Tuberculosis and Respiratory Diseases
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• 제67권5호
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• pp.454-457
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• 2009

Infliximab, a TNF-${\alpha}$ antagonist, has been used to treat refractory rheumatoid arthritis, ankylosing spondylitis, Crohn's disease and Behcet's disease. Tuberculosis (TB) is a well-known opportunistic infection in patients receiving infliximab. Therefore, patients should be screened and treated for latent or active TB infection before being administered infliximab. Recently, we encountered a case of military TB during infliximab therapy in a patient suffering from Behcet's disease and uveitis. We report this case with a review of the relevant literature.

• The Korean journal of internal medicine
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• 제33권6호
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• pp.1241-1251
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• 2018

Background/Aims: To estimate the level of agreement and positivity rates of latent tuberculosis infection (LTBI) tests prior to the use of tumor necrosis factor (TNF) inhibitors in relation to underlying rheumatic diseases and endemic tuberculosis levels. Methods: The Ovid-Medline, Embase, and Cochrane Libraries were searched for articles before October 2013 involving LTBI screening in rheumatic patients, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), juvenile idiopathic arthritis (JIA), and psoriatic arthritis. Results: In pooled analyses, 5,224 rheumatic patients had undergone both a tuberculin skin test (TST) and an interferon-gamma release assay (IGRA) before TNF inhibitors use. The positivity of TST, QuantiFERON-TB Gold In Tube (QFT-GIT), and T-SPOT.TB (T-SPOT) tests were estimated to be 29%, 17%, and 18%, respectively. The agreement percentage between the TST and QFT-GIT, and between the TST and T-SPOT were 73% and 75%. Populations from low-to-moderate endemic TB presented with slightly less agreement (71% between TST and QFT-GIT, and 74% between TST and T-SPOT) than patients from high endemic countries (73% between TST and QFT-GIT, and 81% between TST and T-SPOT). By underlying disease stratification, a lower level of agreement between TST and QFT-GIT was found among AS (64%) than among JIA (77%) and RA patients (73%). Conclusions: We reaffirm the current evidence for accuracy of LTBI test done by TST and IGRA among rheumatic patients is inconsistent. Our stratified analysis suggests different screening strategies might be needed in clinical settings considering the endemic status in the patient's country of origin and the precise nature of underlying diseases.

• Journal of the Korean Society of Physical Medicine
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• 제16권3호
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• pp.1-14
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• 2021

PURPOSE: This study aims to reveal the prevalence, therapeutic efficacy and undesirable side effects of cupping therapy all over the world from past to present. METHODS: This meta-analysis is based on the data obtained by scanning the keyword "cupping therapy" from the Pub-Med system, which is an international database. The date range has been set as 1950-2019. Local databases were not included. Cupping therapy studies combined with other complementary therapies such as acupuncture, moxa and hirudotherapy are also included in the meta-analysis. RESULTS: A total of 381 scientific studies were found on cupping therapy. Of these studies 127 wererandomized controlled trials (RCSs). Cupping treatment has been found effective in studies of painful conditions such as herpes zoster pain, fibromyalgia, back pain, neck pain, headache and acute injury pain. In addition, the effectiveness of cupping therapy was found to be high in studies related to bone / muscular system diseases such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, carpal tunnel syndrome, cervical spondylosis. In addition, cupping treatment is also promising in studies on skin diseases, neurological diseases, respiratory system diseases and cardiovascular system diseases. CONCLUSION: Recently, there has been an increase in the number of RCSs related to cupping therapy. The vast majority of this increase has been made in European and American countries rather than in Far Eastern countries. Studies on cupping therapy, which have been and will be carried out in the future, will provide evidence-based indication of whether cupping therapy is effective. and it will allow more patients to benefit from this treatment, which has a very low rate of side effects and complications.

• Journal of Periodontal and Implant Science
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• 제47권5호
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• pp.328-338
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• 2017

Purpose: Chronic periodontitis is an inflammatory disease induced by pathogenic bacterial accumulation. A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. It is advantageous for data processing and analysis because it can be treated as a continuous variable to quantify periodontal inflammation. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. Methods: This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. Results: PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P<0.01) and with periodontal indexes, such as BOP and the plaque index (PI) (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test). Porphyromonas gingivalis expression and the presence of serum P. gingivalis antibodies were significant factors affecting PISA values in a simple linear regression analysis, together with periodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease. Conclusions: PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.

• The Korean Journal of Nuclear Medicine
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• 제16권2호
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• pp.63-70
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• 1982

To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.

• Journal of Korean Foot and Ankle Society
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• 제12권2호
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• pp.197-202
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• 2008

Purpose: Haglund's disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown, painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of retrocalcaneal space for Haglund's disease. Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53 years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of more than $75^{\circ}$ and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months). Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle were decreased from preoperative 8.7 and $82^{\circ}$ to postoperative 2.3 and $57^{\circ}$, respectively. One patient with ankylosing spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion or abnormal heel sensation. Conclusion: The endoscopic decompression for Haglund's disease was demonstrated to have several advantages including low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a comparative study is needed to determine the value of endoscopic decompression and particular caution should be exerted for the enthesiopathy.