• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.167-172
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• 2005

Purpose: We report our results of arthroscopic treatment of symptomatic avulsion fracture of the malleolus in chronic ankle pain, and also analyzed the clinical and radiological features for evaluating the good candidate for arthroscopic treatment. Materials and Methods: Fourteen patients who were diagnosed with intra-articular avulsion fractures of the malleolus received arthroscopic surgery and were followed up for at least a year. The clinical and radiological characters including MRI and arthroscopic findings were reviewed. Clinical assessments were done according to the AOFAS score system. Results: There was a history of inversion type of the injury in most cases and local tenderness of lesion site was a unique. MRI study showed thickened anterior talofibular ligament (ATFL) in 8 cases (57%) and discontinued ATFL in 3 cases (21%). Enhanced signal surrounding soft tissue corresponding to synovial inflammation and impingement was found in 12 cases (86%). Preoperative score of all patients were $74.0{\pm}5.5$, which improved to $89.3{\pm}6.7$ at the follow-up after the treatment (P<0.001). Conclusion: Most patients had history of injury and localized tenderness in the area coinciding with radiological findings. Thickened ATFL and contrast enhancement around the ossicle were frequently found. Symptomatic avulsion fractures of the malleolus associated with the clinical and radiological findings above could be a good candidate for arthroscopic treatment.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.5
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• pp.1233-1242
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• 2007

Rheumatoid arthritis (RA) is a systemic autoimmune disease with chronic inflammation characterized by hyperplasia of synovial cells in affected joints, which might be mediated by the altered activation of Immune system, ultimately leading to the destruction of cartilage and bone. To examine effects of GHS on rheumatoid arthritis DBA/1J mice were immunized with bovine type II collagen to induced arthritis and then treated with GHS once a day for 7 weeks. Oral administration of GHS (200 mg/Kg) significantly suppressed the progression of CIA, which extend is comparable to that of methotrexate (MTX, 0.3 mg/Kg), a positive control. The severity of arthritis within the knee joints, which was evaluated by histological assessment of cartilage destruction and pannus formation, was also lowered by GHS. The production of TNF-and IL-6 in serum was significantly suppressed. The levels of IFN-g in the culture supernatant of splenocytes stimulated with CD3/CD28 or collagen were dramatically decreased, while those of IL-4 was increased. The levels of IgG and IgM RA factor were also decreased in the serum. FACS analysis indicated that B cells (in DLN), CD3+ T cells (in spleen, and paw joint), CD11b+Gr-1+ cells (in paw joint), CD3+CD49b(DX5) (in PBMC) were decreased and there was increased proportion of CD3+, CD4+, CD8+, CD4+CD25+ T cells in DLN. In conclusion, our results demonstrates that GHS significantly suppressed the progression of CIA and this action was characterized by the decreased production of TNF-a, IL-6, and rheumatoid factors, and modulations of immune cell populations.

• The Journal of Korean Medicine
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• v.31 no.4
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• pp.63-78
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• 2010

Objectives: This study was carried out to know the effects of Gwan-Jul-Bang-7 (hereafter referred to GJB-7) on the inhibition of arthritis induced by collagen on the mouse. Methods: To assess the effects of GJB-7 on mouse with arthritis induced by collagen II, we conducted several experiments such as analysis of cytotoxicity, hepatotoxicity, arthritis index, total cell number of draining lymph nodes and paw joints, value of immunocyte in PBMC (peripheral blood mononuclear cell), DLN (draining lymph node) and paw joint, measurement of cytokine and anti-collagen II, observation of the histological changes of joint. Results: 1. Cytotoxicity against HFC (human fibroblast cells) was not observed in any concentration and hepatotoxicity was not observed in the GJB-7 treated group. 2. The incidence of arthritis significantly decreased. 3. Total cell number of draining lymph nodes significantly increased and total cell number of paw joints significantly decreased. 4. The percentage of $CD8^+$ cells in PBMC (peripheral blood mononuclear cell) significantly increased. The percentage of $CD3^+/CD69^+$, and $CD3^+/CD49b^+$ cells in PBMC significantly decreased. 5. The percentage of $CD19^+,\;CD3^+$, and $CD4^+/CD25^+$ cells in DLN (draining lymph nodes) significantly increased. The percentage of $B220^+/CD23^+$ cells in DLN significantly decreased. 6. The percentage of $CD3^+,\;CD4^+$, and $CD11b^+/Gr-1^+$ cells in paw joints significantly decreased. 7. The production of TNF-$\alpha$, IL-6, and MCP-1 significantly decreased. 8. Anti-collagen II in serum significantly decreased. 9. With the hematoxylin and eosin stain, inflammation of joint decreased. Under Masson's trichrome stain, the cartilage destruction and synovial cell proliferation and the expression of collagen fibers decreased. Conclusions: Comparison of the results for this study showed that GJB-7 had immunomodulatory effects. So we expect that GJB-7 could be used as an effective drug for not only rheumatoid arthritis but also another auto-immune diseases.

• The Journal of Korean Medicine
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• v.38 no.4
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• pp.11-40
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• 2017

Objectives: We investigated whether a mixture of the main component of pomegranate concentrated powder (PCP) with appropriate proportions of Eucommiae Cortex (EC) and Achyranthis Radix (AR) could act synergistically as an effective treatment for osteoarthritis (OA). Methods: In order to evaluate the effects of PCP, EC, and AR against OA, knee thicknesses, maximum extension angle of each knee, anti - inflammation effects, the transcript levels of chondrogenic genes mRNA expressions in femur and tibia articular cartilage (AC) with synovial membrane (SM) were analyzed. In addition, the histopathology and immunohistochemistry of the femur and tibia AC or SM were performed. Results: The surgically-induced OA signs in rats were significantly inhibited by 28 days of continuous treatment of PCP, EC and AR single formulas, and PCP with EC:AR mixed formulas. Especially, PCP with EC:AR 4:1, 2:1 and 1:1 mixed formula treatment constantly showed significantly more favorable inhibitory activities, as compared with those of single formula of PCP, EC and AR treated rats. Conclusion: PCP and EC:AR 4:1 mixed formula showed similar OA refinement effects through potent anti-inflammatory pathways as compared with those of diclofenac treatment, and showed additional chondrocyte proliferating effects on the both femur and tibia AC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.3
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• pp.140-146
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• 2014

Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.23-37
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• 2013

Objectives This study was performed to investigate the effects of Saengkanggamchotang (SKT) on the monosodium iodoacetate (MIA) induced osteoarthritis in rats. Methods Osteoarthritis was induced by injection of MIA (50 ul, 60 mg/ml) into knee joints of rats. Rats are divided into a total of 4 groups (normal, control, positive comparison group, SKT treated group, each n=6). Normal group are not treated at all without inducing osteoarthritis whereas control group were induced for osteoarthritis by MIA and oral medicated with 20 ml of distilled water per day. Positive comparison group was injected with MIA and after 7 days, that was taken indomethacin (30 mg/kg/mouse). SKT treated group was injected with MIA and after 7 days that was taken SKT (30 mg/kg/mouse). Positive comparison group and SKT treated group were oral medicated for each substance a total of 4 weeks with one time per day. After experiments (from 1 week after injection of papain to 4 weeks elapsed), the functions of liver and kidney, Prostaglandin E2, inflammatory cytokine (IL-$1{\beta}$, IL-6, TNF-${\alpha}$), osteocalcin, TIMP-1, MMP-9 within serum. Knee joint structures were observed by H&E, safranin-O staining method, and amount of cartilage were measured by ${\mu}CT$-arthrography. Results 1) Hind paw weight bearing ability was significantly improved. 2) Functions of liver and kidney were not affected. 3) Prostaglandin E2, osteocalcin, TIMP-1, MMP-9 in serum were significantly decreased. 4) Inflammatory cytokine IL-$1{\beta}$ was significantly decreased, and IL-6, TNF-${\alpha}$ were decreased but had not significant. 5) In terms of histopathology, significantly reduced subsidence of cartilage and bone in H&E staining. And in Safranin O staining, proteoglycan content in synovial membrane was significantly increased compared with control group. 6) Destruction of cartilage on ${\mu}CT$-arthrography was significantly reduced. Conclusions Based on all results mentioned above, Saengkanggamchotang (SKT) is believed to be meaningful for suppressing the progress of osteoarthritis and its treatments.

• Genomics & Informatics
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• v.7 no.1
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• pp.20-25
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• 2009

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that is characterized by inflammation of the synovial tissue and deterioration of the joint and bone. A recent study reported a potential gene-environment interaction between HLA-DR and smoking. The present study investigated whether a specific gene was related to the association between smoking and the severity of RA (rheumatoid factor levels > 20 IU/ml). We used the resources of the NARAC family collection of GAW 15 databases, and 1139 subjects with RF>20 IU/ml were included in the current analysis. The linkage panel contained 5858 SNP markers, and 5744 SNPs passed quality control criteria. Linear regression analyses, using PLINK software and generalized estimating equation regression models, were used to test for associations between the SNPs and the severity of RA according to smoking groups. Two major findings were established. First, the severity of RA in smokers was associated with rs703618 (p=$6{\times}10^{-5}$), which lies in the intronic region of the stabilin 2 (STAB2) gene on chromosome 12. Second, there were significant differences in the levels of RF between 'ever smokers' and 'never smokers' according to the rs703618 genotype (G/G, A/G, A/A). We investigated whether a specific gene acts as a mediator between smoking and the severity of RA and found that the STAB2 gene could affect this relationship. Our finding indicates that smoking may mediate RA severity by affecting the expression level of a specific gene.

• BMB Reports
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• v.51 no.4
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• pp.165-166
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• 2018

Osteoarthritis (OA) is the most common form of arthritis and is a leading cause of disability with a large socioeconomic cost. OA is a whole-joint disease characterized by cartilage destruction, synovial inflammation, osteophyte formation, and subchondral bone sclerosis. To date, however, no effective disease-modifying therapies for OA have been developed. The estrogen-related receptors (ERRs), a family of orphan nuclear receptor transcription factors, are composed of $ERR{\alpha}$, $ERR{\beta}$, and $ERR{\gamma}$, which play diverse biological functions such as cellular energy metabolism. However, the role of ERRs in OA pathogenesis has not been studied yet. Among the ERR family members, $ERR{\gamma}$ is markedly upregulated in human and various models of mouse OA cartilage. Adenovirus-mediated overexpression of $ERR{\gamma}$ in the mouse knee joint tissue caused OA pathogenesis. Additionally, cartilage-specific $ERR{\gamma}$ transgenic (Tg) mice exhibited enhanced experimental OA. Consistently, $ERR{\gamma}$ in articular chondrocytes directly caused expression of matrix metalloproteinase (MMP) 3 and MMP13, which play a crucial role in cartilage destruction. In contrast, genetic ablation of Esrrg or shRNA-mediated Esrrg silencing in the joint tissues abrogated experimental OA in mice. These results collectively indicated that $ERR{\gamma}$ is a novel catabolic regulator of OA pathogenesis and can be used as a therapeutic target for OA.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.174-182
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• 2020

Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

• Biomolecules & Therapeutics
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• v.28 no.5
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• pp.414-422
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• 2020

Fangchinoline (FAN) is a bisbenzylisoquinoline alkaloid that is widely known for its anti-tumor properties. The goal of this study is to examine the effects of FAN on arthritis and the possible pathways it acts on. Human fibroblast-like synovial cells (FLS), carrageenan/kaolin arthritis rat model (C/K), and collagen-induced arthritis (CIA) mice model were used to establish the efficiency of FAN in arthritis. Human FLS cells were treated with FAN (1, 2.5, 5, 10 µM) 1 h before IL-1β (10 ng/mL) stimulation. Cell viability, reactive oxygen species measurement, and western blot analysis of inflammatory mediators and the MAPK and NF-κB pathways were performed. In the animal models, after induction of arthritis, the rodents were given 10 and 30 mg/kg of FAN orally 1 h before conducting behavioral experiments such as weight distribution ratio, knee thickness measurement, squeaking score, body weight measurement, paw volume measurement, and arthritis index measurement. Rodent knee joints were also analyzed histologically through H&E staining and safranin staining. FAN decreased the production of inflammatory cytokines and ROS in human FLS cells as well as the phosphorylation of the MAPK pathway and NF-κB pathway in human FLS cells. The behavioral parameters in the C/K rat model and CIA mouse model and inflammatory signs in the histological analysis were found to be ameliorated in FAN-treated groups. Cartilage degradation in CIA mice knee joints were shown to have been suppressed by FAN. These findings suggest that fangchinoline has the potential to be a therapeutic source for the treatment of rheumatoid arthritis.