• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.153-157
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• 2024

Septic arthritis of the manubriosternal joint is a rare condition, especially in adolescents, who often present with nonspecific symptoms that can mimic more common conditions such as musculoskeletal chest pain, costochondritis. Here, we report a case of septic arthritis in a 17-year-old girl and highlight the challenges in diagnosing and managing this condition in adolescents. Initially presenting with acute chest pain diagnosed as transient nonspecific chest pain, the patient's subsequent visits to the emergency department unveiled escalating symptoms, including high fever, prompting advanced imaging. Ultimately, the diagnosis of septic arthritis of the manubriosternal joint was confirmed, with blood culture growth revealing Methicillin-sensitive Staphylococcus aureus. Diagnostic delays have been attributed to the absence of typical symptoms and patient reluctance to be hospitalized. Our case emphasizes the importance of considering rare infectious etiologies in adolescents with chest pain and emphasizes the need for heightened suspicion in unusual anatomical sites. Further research is required to elucidate the pathogenesis and risk factors associated with this condition to aid in prompt diagnosis and treatment.

• The Korean Journal of Food And Nutrition
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• v.11 no.2
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• pp.171-178
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• 1998

K14 patient with chronic dyspnea, who is senile female, early had suffered from radical mastectomy, radiotherapy, autoplastic transplantation, and knee arthritis. Abnormalities of cardiopulmonary function such as obesita, hypertension, mild left ventricular hypertrophy, and chronic pulmonary disease were found from K14 patient's clinical datas, which based on medical history and diagnosis, as well as evaluation of blood pressure, obesity, clinical diagnosis, chest PA, electrocardiogram, ultrasonocardiograph, and spirometery test. Diagnostic results were exactly analyzed, also long-term cares of K14 patient were discussed with related to the clinical literatures.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.55-61
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• 2001

Purpose: To evaluate the clinical and functional results of ankle arthroplasty and to analyze the complications in total ankle arthroplasty. Materials and Methods: Between October 1988 and October 1991, the total ankle arthroplasty had been performed in eight ankle joints of seven patients.. There were five patients with rheumatoid arthritis, one with osteoarthritis and one with traumatic arthritis. One patient had bilateral replacement. New Jersey type of prosthesis was used in six patients and one patient was performed with Odland type of prosthesis. The average age at surgery was 42.3 years (range, 33-54 years). The average follow-up period was 8.2 years (range, 6-10.5 years). Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The average score was 81.4 (range, 76 - 90) at the most recent follow-up. All patients were satisfied with their clinical results. Relief of pain was excellent in most patients, but postoperatively there was no significant improvement in range of motion. One patient had arthrodesis at three year six months after total ankle arthroplasty due to deep infection. Conclusion: This study shows total ankle arthroplasty is a good alternative treatment in selected cases of osteoarthritis and rheumatoid arthritis.

• Clinical and Experimental Pediatrics
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• v.53 no.2
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• pp.262-266
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• 2010

Tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) is a major proinflammatory cytokine involved in the pathophysiology of juvenile rheumatoid arthritis. Etanercept is an effective inhibitor of $TNF-{\alpha}$ and has shown a beneficial effect in patients with JRA. However, the most important cause of concern related to etanercept administration is infection. We report a case of encephalitis in a JRA patient receiving long-term treatment with etanercept. The patient was a 4-year-old boy with refractory JRA, and he received etanercept subcutaneously at a dose of $0.4\;mg\;kg^{-1}\;day^{-1}$ twice a week for 14 months, along with non-steroidal anti-inflammatory drugs, methotrexate, oral steroids, and sulfasalazine. The patient presented with sudden fever, headache, vomiting, a generalized tonic seizure, and changes in mental status. We suspected a central nervous system infection, and simultaneously administered antibiotics, an antiviral agent, and steroids. After 2 days of hospitalization, his mental function returned to normal, and he showed no further seizure-like movements. Brain magnetic resonance imaging scan of the patient showed a multifocal cortical lesion on both sides of the temporoparietooccipital lobe, which indicated encephalitis. Although we were unable to identify the causative organism of encephalitis, we think that the encephalitis may be attributed to infection, and the use of etanercept may have increased the risk of severe infection. Therefore, etanercept was discontinued and the patient recovered shortly after. To the best of our knowledge, this is the first case of encephalitis in a juvenile rheumatoid arthritis patient treated with etanercept.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.180-184
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• 2012

Fungal arthritis is a rare joint infection that occurs in immunosuppressant patient, intravenous drug abuser and long term antibiotics user, and is especially rare in a healthy adult. Two case reports of fungal arthritis have been demonstrated in the country, but those in healthy adults have not been reported yet. Here, we experienced an antifungal treatment following successful arthroscopic debridement of fungal arthritis with a popliteal cyst in a healthy adult who got repetitive intraarticular steroid injections and report the case with review of relevant literatures. Surgeons should consider the possibility of fungal arthritis although it is rare and demonstrates nonspecific clinical features.

• Journal of Korean Foot and Ankle Society
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• v.26 no.3
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• pp.143-147
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• 2022

Past research has reported that the common causes of ankle arthritis include trauma, congenital deformity, and degeneration. Among them, fracture-induced post-traumatic arthritis is most common. For patients with ankle fractures, an anatomical reduction is performed through surgical treatment. However, insufficient reduction or malunion of the fracture site may change the alignment of the ankle joint, resulting in valgus or varus deformities. Currently, most operative options for valgus arthritis aim to either restore joint alignment and/or reduce the uneven load on the cartilage. In this report, we would like to share our clinical experience of a patient with posttraumatic valgus ankle arthritis caused by severely comminuted fracture and dislocation. A satisfactory outcome could be obtained with combined fibular lengthening osteotomy and medial displacement calcaneal osteotomy.

• Proceedings of the Korean Society of Applied Pharmacology
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• 2001.11a
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• pp.41-76
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• 2001

Rheumatoid arthritis is an incurable chronic inflammatory and destructive arthopathy that affects 1% of the population world-wide. It has substantial personal, social and economic costs. The long-term prognosis is poor: 80 percent of affected patients will become disabled within 20 years after onset of disease. Medical costs of rheumatoid arthritis average ∼$ 6000 (US) per patient (1), Current antirheumatic drugs have limited efficacy and many side effects and more importantly they do not improve the long-term prognosis of rheumatoid arthritis (2). After a decade of few notable advances in therapy, several biological response modifiers that target pathophysiological processes in the disease have now emerged in the clinic. These new drugs are termed biological agents, and although information about their use in the clinic is still limited to short term treatment, they appear to have the ability to modify disease progress. In addition, COX-2 selective agents have now been approved that have comparable efficacy with standard NSAIDs, but fewer gastrointestinal side effects (3). Thus today many more therapeutic options are suddenly open to patients that even five years ago had little hope of relief from chronic pain and inflammation.

• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.1-7
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• 2018

Ankle arthrodesis is a common and standard treatment for patients with end-stage ankle arthritis. The surgical goals of ankle arthrodesis are to obtain bony union between the tibia and talus with adequate alignment, and provide a pain-free plantigrade foot for weightbearing activities. To achieve successful fusion, the surgeon should closely examine the patient's factors before surgery, particularly the following: adjacent arthritis and deformity, infection, avascular necrosis of talus, Charcot arthropathy, and rheumatoid arthritis. Recently, ankle arthroplasty has been reported to provide satisfactory clinical results. On the other hand, long-term follow-up results are still lacking, and considering the various complications of arthroplasty, ankle arthrodesis is still the primary surgical treatment for advanced arthritis of the ankle joint.

• Journal of Korean Foot and Ankle Society
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• v.17 no.4
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• pp.329-333
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• 2013

Controversies exist regarding the treatment options for the end-stage arthritic change in the lateral tarsometatarsal joints. Arthrodesis has been frequently performed, but has a disadvantage of sacrificing a mobile joint. Resection arthroplasty also gained its popularity, especially in the patients with Rheumatoid arthritis, but possible hypermobility can lead to deformity. We report a successful clinical outcome of a patient with Rheumatoid arthritis in the 4th, 5th tarsometatarsal joints treated with tendon interpositional arthroplasties.

• Journal of Yeungnam Medical Science
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• v.20 no.1
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• pp.79-84
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• 2003

Pyoderma gangrenosum is uncommon neutrophilic dermatosis characterized by richness of the mature neutrophilic polynuclear dermal infiltrate. Pyoderma gangrenosum is associated with variable diseases, most commonly inflammatory bowel disease, hematological diseases, malignancies, but it is reported rarely in rheumatoid arthritis. We report a case of pyoderma gangrenosum in rheumoid arthritis patient. A 50-year-old woman admitted to our hospital due to painful pretibial ulcerative skin lesions. She had been treated as rheumatoid arthritis for 8 years. At admission, body temperature was $36.5^{\circ}C$ and other vital sign was unremarkable. Physical examination revealed right pretibial ulceration, multiple pustules on left pretibial area and both palms. Laboratory studies revealed WBC count 7,600/uL (neutrophils 60.3%, eosinophil 3.2%), hemoglobin 11.4 g/dL, platelet count 319,000/uL, ESR 65 mm/hour. Other lab findings were also unremarkable. Skin biopsy was done, which showed dense dermal infiltrate of neutrophils and wound culture were negative. By 8 weeks after systemic high dose corticosteroid (1 mg/kg/day), cyclosporine A (5 mg/kg/day), sulfasalazine 2 g therapy, symptoms and skin ulceration were being improved. Without skin relapse, she is followed up our hospital with low dose corticosteroid and sulfasalazine.