• The Journal of the Korean bone and joint tumor society
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• v.16 no.2
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• pp.95-98
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• 2010

Synovial chondromatosis is a benign nodular cartilaginous proliferation arising in the synovium of joints. The radiolographic features of this condition are variable. Rarely, it would be confused with malignancy such as chondrosarcoma, osteosarcoma or synovial sarcoma. We report a case of primary synovial chondromatosis of the posterior aspect of the proximal tibia mimicking a parosteal osteoarcoma on the radiography, which showed a homogeneously radiopaque juxtacortical mass. However, subsequent computed tomography (CT) showed multiple intra-articular masses containing chondroid mineralization, suggesting synovial chondromatosis.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.264-267
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• 2009

Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the synovium of joints. It occurs most commonly in the knee joint. The disease is composed of 2 different forms: diffuse and localized. The localized form is less frequent than the diffuse one. Most cases of localized PVNS involve the anterior compartment of the knee and can be usually easily diagnosed and treated with arthroscopy. We experienced a patient of localized PVNS developed on the posterior cruciate ligament, whose main symptom was persistent pain after trauma. This case occurs rarely and complete removal of the lesion was performed arthroscopically, using posterior trans-septal portal. We report this case with review of literatures.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.250-254
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• 2021

Diffuse-type tenosynovial giant cell tumor (D-TSGCT), previously known as pigmented villonodular synovitis, is a locally aggressive neoplasm that may arise from the synovium, bursa, or tendon sheath. D-TSGCT is usually monoarticular and can be classified into intra- and extra-articular forms, the latter of which is rarer. Here, we report a case of D-TSGCT in a 64-year-old female that involved the entire flexor and extensor tendon sheaths of both wrists. We describe the ultrasonography and MRI findings, as well as review the relevant literature.

• IMMUNE NETWORK
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• v.8 no.1
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• pp.29-37
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• 2008

Interleukin-23 (IL-23) is a novel pro-inflammatory cytokine which has been implicated to play a pathogenic role in rheumatoid arthritis (RA). This study was undertaken to investigate the IL-23 inductive activity of the proinflammatory cytokine IL-17, $IL-1{\beta}$ and tumor necrosis factor (TNF-${\alpha}$) in RA synovial fluid mononuclear cells (SFMC). Expression of IL-23p19, IL-17, $IL-1{\beta}$ and TNF-${\alpha}$ in joint was examined by immunohistochemistry (IHC) of patients with RA and osteoarthritis (OA). The effects of IL-17 and $IL-1{\beta}$ on expression of IL-23p19 in human SFMC from RA patients were determined by reverse transcriptase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). IL-23p19 was expressed in the RA fibroblast like synoviocyte (FLS), but not from OA FLS. Similar to the protein expression, IL-23p19 mRNA could be detected by RT-PCR in RA SFMC. IL-17 and $IL-1{\beta}$ could induce RA SFMC to produce the IL-23p19. The effects of IL-17 were much stronger than $IL-1{\beta}$ or TNF-${\alpha}$. These responses were observed in a doseresponsive manner. In addition, IL-17 or $IL-1{\beta}$ neutralizing antibody down-regulated the expression of IL-23p19 induced by LPS in RA-SFMC. Our results demonstrate that IL-23p19 is overexpressed in RA synovium and IL-17 and $IL-1{\beta}$ appears to upregulate the expression of IL-23p19 in RA-SFMC.

• Journal of Acupuncture Research
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• v.23 no.3
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• pp.129-142
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• 2006

Objectives : The purpose of this study is to observe the effects of Eucomiae Cortex herbal-acupuncture solution(EC-HAS) at Joksamni(ST36) on arthritis of mice induced by Collagen II. Methods : The author performed several experimental items. First, it is the cell survival rate of mice lung fibroblasts. Second, it is the incidence rate of arthritis and arthritis index of CIA. Third, it is the levels of IL-6, $TNF-{\alpha}$, $IFN-{\gamma}$, $IL-{\beta}$, IgG, IgM and anti-collagen II in serum and the level of IFN-y,$IFN-{\gamma}$/IL -4 ratio in CIA mouse spleen cell culture. Fourth, it is histological analysis of the mice joint. Fifth, it is expression ratio of $CD3e^+$ to $CD19^+$+ cell, $CD4^+$ to $CD8^+$ cell, $CD69^+/CD3e^+$/cells, $CD11a^+/CD19^+$/cells, $CD11b^+/Gr-1^+$ cells and $CD4^+/CD25^+$ cells. Results & Conclusion : 1. In the EC-HA, the incidence of arthritis and arthritis index were significantly decreased. 2. In EC-HA, the levels of IL-6, $IFN-{\gamma}$, $TNF-{\alpha}$, $IL-1{\beta}$, IgG, IgM and anti-collagen II in serum of CIA mice and the level of $IFN-{\gamma}$, IL-4, $IFN-{\gamma}$/lL-4 ratio in CIA mouse spleen cell culture were significantly decreased. 3. In the histological study, the cartilage destruction and synovial cell proliferation were decreased in the EC-HA, and the collagen fiber expressions in the EC-HA were similar with that of the Normal group. 4. In the EC-HA, the expression ratio of $CD3e^+$ to $CD19^+$ cell and $CD4^+$ to $CD8^+$ cell were similarly maintained as Normal group in lymph nodes, and $CD69^+/CD3e^+$ cells and $CD11a^+/CD19^+$ cells were decreased in lymph nodes, and $CD11b^+/Gr-1^+$ cells and $CD4^+/CD25^+$ cells were decreased in synovium. These results suggest that EC-HA at ST36 has an effect to control synovial cell proliferation and cartilage destruction in rheumatoid arthritis, and to be put to practical use in the future rheumatoid arthritis clinic.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.138-142
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• 2012

Pigmented villonodular synovitis (PVNS) is a rare benign proliferative disorder that results in villous hyperplasia and nodule formation in the synovium, tendon sheath and bursa. That most commonly affects the knee and the hip joint in adult. PVNS of the hand, the wrist, the shoulder and the elbow is rare and that of the elbow in children is particularly rarer. An eight-year-old boy had his left elbow pain and a lesion like benign bone tumor in the left fossa olecrani on plain x-ray. During the operation, abnormal synovial hyperplasia in his left elbow joint led us to diagnose PVNS. Therefore, open curettage of the lesion and radical synovectomy was performed. The specimen of the synovectomized tissue revealed PVNS. The left elbow pain subsided after the operation and the child restored a full range of motion of his left elbow. We reported this rare case of PVNS in a child's elbow joint mimicking the bone tumor together with a review of the literature.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.121-126
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• 1999

Diagnosis of localized pigmented villonodular synovitis (PVNS) is difficult because of its rarity and indistinctive symptoms. This study presented 11 cases of localized PVNS of the knees, which were diagnosed and treated by arthroscopic technique. There were 6 males and 5 females between the age of 15 and 59 years (mean 34.6 years). The interval from the onset of symptoms to treatment ranged from 2 months to 3 years (average 29.9 months). All patients complained knee pain and 7 patients complained palpable mass. Four of the 11 patients had trauma history. The most common involved site was anteromedial synovium near the anterior horn of medial meniscus (5 patients). The remaining cases were identified on anterior fat pad (2 cases), suprapatellar pouch, posteromedial compartment, medial gutter and the anterior horn of the lateral meniscus, respectively. Nine cases had 1 mass and the remaining cases each had 2 or 3 masses. There was no evidence of recurrence during the follow-up period (average 29.9 months). Arthroseopy is effective in the diagnosis of localized PVNS with minimal morbidity and in the definitive treatment for PVNS.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.69-73
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• 2008

Synovial chondromatosis is an uncommon condition, and the involvement of the shoulder joint is rare. A 15 year old female patient presented to author's institution for right shoulder pain. We checked the plain radiographs and MRI. And they showed that a diagnosis of synovial chondromatosis in the shoulder, and they also demonstrated that the disease involved the bicipital tendon sheath as well as glenohumeral joint. We removed all loose bodies with total synovectomy by arthroscopic procedure, and a miniopen procedure for the lesions of biceps tendon sheath. Arthroscopic treatment affords excellent visualization of the shoulder joint with less morbidity. However, with current arthroscopic techniques, it is difficult to manage the synovial chondromatosis of biceps tendon in bicipital groove. The authors suggest that the complete elimination of synovial chondromatosis involving shoulder requires a mini-open procedure for the lesions of biceps tendon sheath in addition to the arthroscopic resection of the affected synovium and loose body removal in the glenohumeral joint.

• IMMUNE NETWORK
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• v.3 no.4
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• pp.310-319
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• 2003

Inflammatory mediators has been recognized as an important role in the pathogenesis of rheumatoid arthritis (RA). IL-17 is increasingly recognized as an important regulator of immune and inflammatory responses, including induction of proinflammatory cytokines and osteoclastic bone resorption. Evidence of the expression and proinflammatory activity of IL-17 has been demonstrated in RA synovium and in animal models of RA. However, the signaling pathways that regulate IL-17 production remain unknown. In the present study, we investigated the role of the phosphatidylinositol 3 kinase (PI3K)-Akt pathway in the regulation of IL-17 production in RA. PBMC were separated from RA (n=24) patients, and stimulated with various agents (anti CD3, anti CD28, PHA, ConA, IL-15). IL-17 levels were determined by sandwich ELISA and RT-PCR. The production of IL-17 was significantly increased in cells treated with anti-CD3 antibody, PHA, IL-15 or MCP-1 (P<0.05). ConA also strongly induced IL-17 production (P<0.001), whereas TNF-alpha, IL-1beta, IL-18 or TGF-beta did not. IL-17 was detected in the PBMC of patients with osteoarthritis (OA) but their expression levels were much lower than those of RA PBMC. Anti-CD3 antibody activated the PI3K-Akt pathway and activation of the PI3K-Akt pathway resulted in a pronounced augmentation of nuclear factor kappaB ($NF-{\kappa}B$). IL-17 production by activated PBMC in RA is completely or partially blocked in the presence of $NF-{\kappa}B$ inhibitor PDTC and PI3K-Akt inhibitor, wortmannin and LY294002, respectively. Whereas the inhibition of AP-1 and extracellular signal-regulated kinase (ERK)1/2 did not affect IL-17 production. These results provide new insight into that PI3K/Akt and $NF-{\kappa}B$ dependent signal transduction pathway could be involved in the overproduction of key inflammatory cytokine, IL-17 in rheumatoid arthritis.

• Journal of Acupuncture Research
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• v.23 no.6
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• pp.29-44
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• 2006

Objectives : The purpose of this study is to observe the effects of Mori Ramulus herbal-acupuncture solution(MR-HAS) on arthritis of mice induced by Collagen II at Joksamni(ST36). Methods : The author performed several experimental items. First, it is the cell survival rate of mice lung fibroblasts. Second, it is the incidence rate of arthritis and arthritis index of CIA. Third, it is the levels of IL-6, $TNF-{\alpha}$, $IFN-{\gamma}$, $IL-1{\beta}$, IgG, IgM and anti-collagen II in serum and the level of $IFN-{\gamma}$, $IFN-{\gamma}/IL-4$ ratio in CIA mouse spleen cell culture. Fourth, it is histological analysis of the mice joint. Fifth, it is expression ratio of CD3e+ to CD19+ cell, CD4+ to CD8+ cell, CD69+/CD3e+ cells, CD11a+/CD19+ cells and CD11b+/Gr-l+ cells and CD4+/CD25+ cells. Results : 1. In the MR-HA, the incidence of arthritis and the arthritis index were significantly decreased. 2. In MR-HA, the levels of IL-6, $IFN-{\gamma}$, $TNF-{\alpha}$, $IL-1{\beta}$, IgG, IgM and anti-collagen II in serum of CIA mice and the level of $IFN-{\gamma}$, IL-4, $IFN-{\gamma}$, IL-4 ratio in CIA mouse spleen cell culture were significantly decreased. 3. In histology, the cartilage destruction and synovial cell proliferation were decreased in the MR-HA, and the collagen fiber expressions in the MR-HA were similar with that of the Normal group. 4. In the MR-HA, the expression ratio of CD3e+ to CD19+ cell and CD4+ to CD8+ cell were similarly maintained as Normal group in lymph nodes, and CD69+/CD3e+ cells and CD11a+/CD19+ cells were decreased in lymph nodes, and CD11b+/Gr-1+ cells and CD4+/CD25+ cells were decreased in synovium. Conclusion : These results suggest that MR-HA at ST36 has an effect to control synovial cell proliferation and cartilage destruction in rheumatoid arthritis, as well as prophylaxis is important to treat rheumatoid arthritis in clinic.