• 근관절건강학회지
• /
• 제10권2호
• /
• pp.131-141
• /
• 2003

The purpose of this study was to examine the effects of self-help program on patients with chronic arthritis. This study was performed from 13th of August to 29th of October 2002. 30 arthritis patients with an average age of 56 years were participated in the self-help program. At the completion of 6 weeks, 23 patients completed both pretest and posttest, overall dropout rate was 23%. Outcome measures were status of daily living, self-care activities, flexibility, grip strength and depression. Data were analysed by percentage, paired t-test, Pearson's correlation coefficient. There were statistically significant in self-care activities, flexibility, grip strength after the self-help program. However no significant differences were found in daily living and depression. There were significant relationships between daily living and depression. There were significant relationships between right flexibility & left flexibility and right and left grip strength. In conclusion self-help program was proved to be an effective nursing intervention to increase the self-care activities, flexibility and grip strength. These results of this study suggested that the follow-up program after the self-help program should be run to help the physical psychological wellbeing of arthritis patients.

• 대한예방한의학회지
• /
• 제19권1호
• /
• pp.95-107
• /
• 2015

Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

• Journal of Korean Neurosurgical Society
• /
• 제37권3호
• /
• pp.201-206
• /
• 2005

Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.

• 대한임상검사과학회지
• /
• 제39권1호
• /
• pp.42-48
• /
• 2007

This study was carried out to review and evaluate anti-CCP ELISA assay for diagnostic in RA patients from an early arthritis clinic (EAC). The subjects were obtained from patients visiting the outpatient clinic of the Dept. of Rhumatology med.of P hospital in Daegu, during 6 months from July 1, 2006 to December 31, 2006. The subjects were 140 cases : 80 cases from RA patients (60 women and 20 men; mean age 58 years; range, 32-68 years) confirmed by clinical diagnostic. 39 cases of these RA patients were classified as having early RA (EAC). 50 cases (non-RA) did not fulfill the criteria for RA, and 10 cases were from healthy individuals. We performed the analysis with solid phase-ELISA method (ETI-max3000, Diasorin; Italy) for anti-CCP and Nephelometry assay (Roche/Hitachi 902 analyzer; USA) for RF. The results obtained were summarized as follows ; anti-CCP ELISA is more specific than RF Nephelometry assay (specificity 94% vs 90%) to diagnose RA patients with suspected EAC (early arthritis clinic). The combination test "anti-CCP and RF" had a very high specificity (specificity 98.3%, PPV; RA group 96%, EAC 95%), the difference was statistically significant (p<0.05). Anti-CCP ELISA had more sensitivity in EAC (Early arthritis clinic) patients than chronic RA patients (sensitivity 64% vs 24%, respectively), anti-CCP of RA group and EAC group was more specific than RF (anti-CCP PPV; 92%, 89% vs 89%, 81% respectively), the difference was statistically significant (p<0.05). The difference of antibody concetration between anti-CCP and RF for RA and the control group is statistically significant (p<0.05). In conclusion, anti-CCP ELISA testing may be useful if performed concomitantly with RF Nephelometry assay to diagnose RA patients with suspected EAC (early arthritis clinic).

• The Korean journal of internal medicine
• /
• 제39권4호
• /
• pp.668-679
• /
• 2024

Background/Aims: This cross-sectional study aimed to investigate biologics treatment disparities in rheumatoid arthritis (RA) patients based on socioeconomic status (SES). Methods: Data from the KOrean Observational Study Network for Arthritis (KORONA) database were analyzed to assess various factors associated with SES, health behaviors, and biologics use. Logistic regression and structured equation modeling (SEM) were utilized for data analysis. Results: Among 5,077 RA patients included, 393 (7.7%) patients were identified as biologics users. Within the entire cohort, 31.8% of the participants were in the low-income and low-education groups, and 39.3% of the participants were in the high-income and high-education groups. Despite the patients with low income or low education experienced higher disease activity at diagnosis, had more comorbidities, exhibited higher medication compliance, underwent more check-ups, and had more hospital admissions than their counterparts, the odds of patients with low-income receiving biologics were 34% lower (adjusted odds ratio = 0.76, 95% confidence interval: 0.60-0.96, p = 0.021) after adjustment for demographics and comorbidities. SEM and pathway analyses confirmed the negative impact of low SES on biologics use. Conclusions: The findings suggest that SES plays a significant role in biologics use among RA patients, indicating potential healthcare inefficiencies for low SES patients. Moreover, adverse healthcare habits negatively affect biologics use in RA patients. The study highlights the importance of considering socioeconomic factors while discussing biologics use and promoting equitable access to biologics for optimal RA management.

• Clinical and Experimental Pediatrics
• /
• 제46권11호
• /
• pp.1124-1127
• /
• 2003

저자들은 가와사끼병으로 IVIG 치료로 해열을 보인 후, 급격히 발병한 관절염을 보인 5명의 환아에 대해 임상적 경과, 실험실 소견 등을 조사하였다. IVIG 치료에 반응 후 평균 5.8일 후에 관절염 증상이 나타났으며, 임상적 분류상 소수 관절형 형이 3례, 다수관절형이 2례로 나타났다. 검사실 소견에서 류마토이드 인자는 1례에서 양성을 보였으나 이 후 음성으로 전환되었다. 3명에서 조사된 HLA B27은 모두 음성을 보였다. 치료로는 고용량 아스피린(2례), 비스테로이드성 소염제(이부프로펜, 3례), 스테로이드제(메틸프레드니솔론, 1례)를 사용하였다. 가와사끼병의 경과 중 정맥용 면역글로불린 치료 후 관절염이 드물게 관찰된다. 이러한 관절염은 스테로이드제를 비롯한 항염증제에 양호한 반응을 보였고 재발은 관찰되지 않았다.

• 근관절건강학회지
• /
• 제6권1호
• /
• pp.136-152
• /
• 1999

The purposes of this study were to identify the prevalence of fatigue. and factors influencing fatigue in women with rheumatoid arthritis. The subjects were 124 patients with rheumatoid arthritis. Most of all patients felt fatigue and mean score measured by Multidimensional Assessment of Fatigue was relatirely high. Fatigue was positively correlated with pain intensity, the number of pain sites, functional disability, depression. and sleep quality. A hierachical regression model was used to determine the variance which accounts for fatigue. Pain intensity, depression. sleep quality accounted for fatigue significantly. This finding indicates that pain influences fatigue through depression and sleep quality ; depression through sleep quality. The causative factors could be identified by further study of structural eqation model.

• 한국응용약물학회:학술대회논문집
• /
• 한국응용약물학회 2001년도 추계학술대회 및 정기총회
• /
• pp.41-76
• /
• 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.

• 근관절건강학회지
• /
• 제7권1호
• /
• pp.131-147
• /
• 2000

Almost all patients with rheumatic disease experience fatigue. The fatigue affects the patient's life extensively at home and at work, therefore it is necessary to investigate the nature of the fatigue which the patients perceive. The purpose of this study is to explore the nature and pattern of fatigue of the patients with rheumatic diseases. Rheumatoid arthritis is typical disease for its joint involvement which leads to deformity. Whereas lupus is a characteristic systemic autoimmune disease and the fibromyalgia is characterized by the general bodyache and multiple local tenderness. The prevalence of these diseases and the fatigue was known to be higher in women than men. Therefore the subjects were woman patient diagnosed as rheumatoid arthritis, lupus or fibromyalgia, and they were recruited from the H-Rheumatic Disease Hospital. The two instruments, the Multidimensional Assessment of Fatigue by Belza(1995) and the Piper Fatigue Scale by Piper, et al(1995) were used to explore the nature and pattern of self-reported fatigue. In total, the data from 157 patients were analysed by the SPSS-PC program for statistical analysis. The results were as follows: 1. Most patients with rheumatic disease experienced fatigue and the degree of fatigue was at the middle range by the scores of the two instruments. 2. The degree of fatigue of the patients with fibromyalgia was the highest and the next was that of the patients with lupus and the fatigue of the patients with rheumatoid arthritis. But there were no statistically significant differences among the patients with three rheumatic diseases, except the subcategory, the meaning of fatigue of the Piper Fatigue Scale. 3. Even when the period of the symptom and pain were covariated, there were no statistically significant differences among patients with three rheumatic diseases. The fatigue of the patients with lupus and fibromyalgia is rarely investigated in Korea and this study can be the base for the further understanding of the patients with rheumatic diseases. Therefore repeated studies are required to identify the factors to affect the fatigue and to understanding the nature of the diseases and to develop the nursing interventions to alleviate the fatigue.

• Clinics in Shoulder and Elbow
• /
• 제17권4호
• /
• pp.197-200
• /
• 2014

Reports of osteomyelitis in the proximal humerus with pyogenic glenohumeral arthritis of adjacent joints mostly involve pediatric patients. Nowadays, osteomyelitis that is secondary to adjacent pyogenic glenohumeral arthritis is extremely rare, even more so in adults than in pediatrics. We report a rare case of the pyogenic glenohumeral arthritis followed by osteomyelitis of the proximal humerus in an elderly patient. Initially, we diagnosed a case of pyogenic glenohumeral arthritis only, which, despite arthroscopic synovectomy, did not resolve and severe pain continued. Subsequent radiological imaging, performed after our suspicion of a secondary involvement, allowed us to diagnose osteomyelitis combined with the pyogenic glenohumeral arthritis, which we had overlooked because of the extreme rarity of the condition in adults since the antibiotic era began.