• 제목/요약/키워드: osteoarthritis

검색결과 1,062건 처리시간 0.025초

KL-Grade의 정도와 슬관절 통증의 한의학적 치료 효과의 상관성 연구 (The Study on Correlation between the KL-Grade and Improvement of Knee Pain Treated by Korean Medicine Therapy)

  • 이기언;허석원;이현호;정성현;조경상;한시훈;최지훈;노지애
    • 한방재활의학과학회지
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    • 제27권3호
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    • pp.137-146
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    • 2017
  • Objectives The purpose of this study is to compare the effects between the KL-Grade and improvement of knee pain treated by Korean Medicine therapy. Methods 114 patients who received inpatient treatment from July 2014 to May 2017 in the Daejeon Jaseng of Korean Medicine Hospital were divided into 5 groups by the KL-Grade. All patients received a combination of treatment including acupunture, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, KL-Grade 0 group's Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) improvement was $2.02{\pm}1.69$, $7.50{\pm}9.67$ and $0.11{\pm}0.15$ respectively. KL-Grade 1 group's improvement was $2.09{\pm}1.23$, $11.75{\pm}13.99$ and $0.12{\pm}0.13$ respectively. KL-Grade 2 group's improvement was $1.60{\pm}1.07$ and $14.70{\pm}14.19$ respectively. But In this group, EQ-5D Index has decreased by $0.01{\pm}0.10$. KL-Grade 3 group's improvement was $1.88{\pm}1.31$, $7.81{\pm}13.35$ and $0.13{\pm}0.20$ respectively (p<0.034). In the case of KL-Grade 4, the population was not statistically significant (N=2) and therefore excluded from statistical significance. And there was no statistically significance between 4 group's improvement after treatment (p>0.05). Conclusions The above study showed that Korean medicine treatments showed significant therapeutic effects on knee pain and degenerative knee joints, but there was no significant difference in the effectiveness of degenerative arthritis (KL-Grade).

Indomethacin으로 유발된 흰쥐의 위장장애에 ChondroT가 미치는 영향 (The Inhibitory Effect of ChondroT on Indomethacin-Induced Gastric Mucosal Injury in Rats)

  • 김주일;김선길;김지훈;윤찬석;최지민;최찬헌;김선종
    • 한방재활의학과학회지
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    • 제30권3호
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    • pp.57-69
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    • 2020
  • Objectives The aim of this study was to investigate the inhibitory effect of ChondroT in indomethacin-induced gastric mucosal injury rat model. Methods Sprague-Dawley rats were randomly assigned to intact, control Joins, Celebrex, ChondroT50 and ChondroT200. Indomethacin (25 mg/kg) was used to induce damage to the gastric mucosal injury. ChondroT was administered by orally to inhibit the indomethacin-induced gastric mucosal injury. At the end of the experiment, pH level in stomach, stomach contents volume, tumor necrosis factor-α (TNF-α) level, interleukin-1β (IL-1β) level, prostaglandin E2 (PGE2) level, myeloperoxidase (MPO) activity, erythrocytes, and thrombocytes were measured. Ophthalmologic and histopathological examination was also analyzed. Results pH level in stomach and Stomach contents volume had no difference between Control, PC-Joins, PC-Cele, ChondroT50 and ChondroT200 group. TNF-α level was decreased in PC-Joins, PC-Cele, ChondroT50 and ChondroT200 group and there were no significant difference. IL-1β level was decreased in PC-Joins group and ChondroT200 group compared to control group. PGE2 level had no significant difference between Control, PC-Joins, PC-Cele, ChondroT50 and ChondroT200 group. MPO level and complete blood count level were decreased in PC-Joins, PC-Cele, ChondroT50 and ChondroT200. Symptom score of ophthalmologic examination was decreased in ChondroT50 and ChondroT200 group compared to control group. Conclusion Based on these results, It could be suggested that ChondroT was effective in reducing damage to the gastric mucosal injury. And further study is needed to conduct a rigorous clinical research.

관절염 환자의 운동행위 결정요인 (Determinant factors of Exercise behaviors in Patients with Arthritis)

  • 서길희;임난영
    • 근관절건강학회지
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    • 제7권1호
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    • pp.102-130
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    • 2000
  • The aims of this study were to understand and to predict the determinant factors affecting the exercise behaviors and physical fitness by testing the Ponder's health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continuous exercise program, and to help them maximize the physical effect such as muscle strength. endurance, and fuctional status and mental effects including self efficacy and quality of life, and improve the physical and mental wellbeing, and to provide a basis for the nursing intervention strategies. We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul between October 5, 1999 and October 24, 1999. Data were composed of self reported questionnaire and good of fitness score which were obtained by pedalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. 24 Of 54 hypothetical paths were supported in modified model, which was considered as a proper model with improved fit index. The physical fitness was directly influenced by exercise participation behavior and education level, and indirectly by physical fitness, while fatigue, physical disability, pastexercise behavior, life-style, self-efficacy, which explained 20% of physical fitness. The exercise participation were directly influenced by perceived benefits and self-efficacy, and indirectly influenced by life-style, fatigue and physical disability, and directly and indirectly by past exercise behavior, which explained 53% of exercise participation. Exercise score were directly affected by perceived health status, perceived benefits, self efficacy, and past exercise behavior, and were indirectly affected by fatigue, physical disability, and life-style, which explained 50%. Perceived health status were directly influeced by level of education, depression, sleep disorder, and physical disability, which explained 34% of perceived health status. Perceived benefit was directly influenced by fatigue, sleep disorder, physical disability, and life-style, which explained 45%. Perceived barriers was directly influenced by fatigue, sleep disorder, and lifestyle, which explained 9%. Self- efficacy was directly influenced by fatigue, physical disability, past exercise behavior, and level of education, which explained 61%. In conclusion, important variables for physical fitness were exercise participation and level of education, and variables affecting exercise participation were perceived self-efficacy, benefits, and past exercise behavior. Perceived self-efficacy of exercise was a significant predictor of exercise participation. Life-style, fatigue, and physical disability showed direct effects on perceived benefit, perceived barriers, and self-efficacy, and indirect effects on exercise behavior. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be soaked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved.

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A Novel COMP Gene Mutation in a Korean Kindred with Multiple Epiphyseal Dysplasia

  • Ko, Jung-Min;Kwack, Kyu-Sung;Baek, Kum-Nyeo;Cho, Dae-Yeon;Kim, Hyon-Ju
    • Journal of Genetic Medicine
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    • 제6권1호
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    • pp.81-86
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    • 2009
  • 다발성 골단이형성증은 임상적 및 유전학적으로 이질적인 연골이형성증으로, 골화 중심의 발달 지연, 골단만을 침범하는 사지의 변형 및 경한 저신장을 보이는 질환이다. 원인으로는 COMP 유전자의 돌연변이가 가장 흔히 발견되고 있으며, 돌연변이의 대부분은 칼모듈린 유사 반복(calmodulin-like repeats)부분과 C-말단에 위치한다. 저자들은 4대에 걸쳐 12명의 가족구성원에서 다발성 골단이형성증을 보인 한 가계에서 COMP 유전자 분석으로 새로운 돌연변이를 발견하여 보고하는 바이다. 이 가계는 젊은 나이에 퇴행성 관절염이 발생하고, 추후 관절치환술이 요구되는 상염색체 우성 유전 방식을 보이는 질환을 가지고 있었다. 방사선학적 검사상 양측 무릎 관절의 내측 대퇴돌기에 골연골 결손을 보였으며, 양측 무릎과 엉덩이 관절은 다양한 정도의 퇴행성 변화가 관찰되었다. 계보발단자 및 5명의 다른 이환된 가족들에서 시행한 COMP 유전자 분석에서, 12번째 엑손에서 현재까지 보고되지 않은 새로운 돌연변이인 c.1280G>C (p.Gly427Ala)을 확인하였다. 이 돌연변이는 다른 3명의 이환되지 않은 가족들에서는 발견되지 않았다. 상염색체 우성 방식을 보이는 다발성 골단이형성증 환자들에서 COMP 유전자의 직접 염기서열 분석법은 질병의 원인이 되는 돌연변이를 찾는데 도움이 되며, 고위험 가족들에서 보인자를 찾아낼 수 있고, 질병의 합병증이 발생하기 이전에 조기 진단 및 중재를 가능케 하는 유전 상담의 기회를 제공해 줄 수 있다.

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Anti-apoptotic Activity of Ginsenoside Rb1 in Hydrogen Peroxide-treated Chondrocytes: Stabilization of Mitochondria and the Inhibition of Caspase-3

  • Na, Ji-Young;Kim, Sok-Ho;Song, Ki-Bbeum;Lim, Kyu-Hee;Shin, Gee-Wook;Kim, Jong-Hoon;Kim, Bum-Seok;Kwon, Young-Bae;Kwon, Jung-Kee
    • Journal of Ginseng Research
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    • 제36권3호
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    • pp.242-247
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    • 2012
  • Chondrocyte apoptosis has been recognized as an important factor in the pathogenesis of osteoarthritis (OA). Hydrogen peroxide ($H_2O_2$), which produces reactive oxygen species, reportedly induces apoptosis in chondrocytes. The ginsenoside $Rb_1$ (G-$Rb_1$) is the principal component in ginseng and has been shown to have a variety of biological activities, such as anti-arthritis, anti-inflammation, and anti-tumor activities. In this study, we evaluated the effects of G-$Rb_1$ on the mitochondrial permeability transition (MPT) and caspase-3 activity of chondrocyte apoptosis induced by $H_2O_2$. Cultured rat articular chondrocytes were exposed to $H_2O_2$ with or without G-$Rb_1$ and assessed for viability, MPT, Bcl-xL/Bax expression, caspase-3 activity, and apoptosis. The co-treatment with G-$Rb_1$ showed an inhibition of MPT, caspase-3 activity, and cell death. Additionally, the levels of the apoptotic protein Bax were significantly lower and the levels of the anti-apoptotic protein Bcl-xL were higher compared with $H_2O_2$ treatment alone. The results of this study demonstrate that G-$Rb_1$ protects chondrocytes against $H_2O_2$-induced apoptosis, at least in part via the inhibition of MPT and caspase-3 activity. These results demonstrate that G-$Rb_1$ is a potentially useful drug for the treatment of OA patients.

슬관절전치환술 환자의 일상생활동작 수행력에 관한 연구 (A Study of ADL Performance on Elderly Total Knee Replacement Patients)

  • 박창곤;박래준
    • The Journal of Korean Physical Therapy
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    • 제15권4호
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    • pp.151-179
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    • 2003
  • The purpose of this study was to examine the influence of total knee replacement to arthritis patients in pain intensity and functional impairment. For this study, over 50-year-old 30 patients who had osteoarthritis and 69 patients who got total knee replacement at the one of the departments of orthopedics in Daegu were interviewed from June, 2002 to March, 2003. The results of this study were as follows : First, pain intensity was decreased to experimental group after operation than control group(P<.01) And the presence of crepitation was also decreased to them(P<.05). On the other hand there's no significant difference was noted in the presence of stiffness, degree of flexion contracture and extension contracture between two groups. Second, over 91 days group after operation and visitor's group of physiotherapy unit were better than others in Level of knee function(P<.01). Third, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Barthel Index of knee function(P<.01). Forth, over 91 days group after operation and visitor's group of physiotherapy unit were higher than others in Level of IADL(P<.05). Fifth, over 91 days group after operation and visitor‘s group of physiotherapy unit were higher than others in Katz Index of knee function(P<.01). Sixth, although Old Ages' Activity Index seemed to get better as time goes by, there's no statistical difference. Seventh, over 91 days group after operation and visitor's group of physiotherapy unit were higher than admission group and under 30 days group after operation in Social Activity Index(P<.05). Eighth, the function of the knee was connected with the abilities in the activity of the old and the social skill. The Barthel index was connected with the function of the knee joint and the activities of the old and Katz index. IADL function was connected with the activities of the old and the social activity. The Katz index was connected with the Barthel index. The activity of the old was connected with the Barthel index, the functional score of the knee joint andthe IADL score. The ability of social skill was connected with the activity of the old, IADL score and the function of the knee.

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류마티스 관절염에서 칼시뉴린의 발현과 기능 (Expression and Function of Calcineurin in Inflammatory Arthritis)

  • 박보형;유승아;홍경희;형복진;황유나;조철수;박원;김완욱
    • IMMUNE NETWORK
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    • 제6권1호
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    • pp.33-42
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    • 2006
  • Background: Calcineurin plays a crucial role in T cell activation, cell growth, apoptosis, and angiogenesis, and its over-expression has been implicated in the pathogenesis of cardiomyopathy and stroke. However, the expression and function of calcineurin in the pathologic lesion of chronic inflammatory diseases, like rheumatoid synovium, remain to be defined. This study was aimed to determine the role of calcineurin in inflammatory arthritis and investigate the expression and function of calcineurin in the rheumatoid synovium and synoviocytes, the actual site of chronic inflammation. Methods: Immuno-histochemical staining using specific antibody to calcineurin was perfomed in the synovium of rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLS) from RA and osteoarthritis (OA) patients were isolated from RA and OA patients, and cultured with IL-1${\beta}$ and TNF-${\alpha}$ in the presence or absence of cyclosporin A, a calcineurin inhibitor. The calcineurin expression was assessed by phosphatase assay and Western blotting analysis. IL-6, -10, -17, matrix metalloproteinase (MMP)-1, -2, -3, and -9 released into the culture supernatants were measured by ELISA. After transfection with GFP-Cabin 1 gene into synoviocytes, the levels of IL-6 and MMPs were measured by ELISA. Results: Calcineurin was highly expressed in the lining layer of synovium and cultured synoviocytes of RA patients. The elevated calcineurin activity in the rheumatoid synoviocytes was triggered by proin flammatory cytokines such as IL-1${\beta}$ and TNF-${\alpha}$. In contrast, IL-10, an anti-inflammatory cytokine, failed to increase the calcineurin activity. The targeted inhibition of calcineurin by the over-expression of Cabin 1, a natural calcineurin antagonist, inhibited the production of IL-6 and MMP-2 by rheumatoid synoviocytes in a similar manner to the calcineurin inhibitor, cyclosporin A. Conclusion: These data suggest that abnormal activation of calcineurin in the synoviocytes may contribute to the pathogenesis of chronic arthritis, and thus provide a potential target for controlling inflammatory arthritis.

웃음요법이 퇴행성 슬관절염 노인의 관절통증, 관절기능상태, 우울에 미치는 효과 (Effects of Laughter Therapy on Joint Pain, Functional Status of Knee Joint and Depression in Elderly with Degenerative Knee Arthritis)

  • 이임선;박효정
    • 한국산학기술학회논문지
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    • 제21권9호
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    • pp.440-449
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    • 2020
  • 본 연구는 웃음요법이 퇴행성 관절염 노인 환자의 관절 통증, 관절기능 이상, 우울에 주는 효과를 확인하기 위해 시도되었다. 단일맹검, 무작위 배정을 통해 S시의 경로당 및 복지관을 이용중인 65세 이상 퇴행성 슬관절염 노인을 대상으로 실험군 26명, 대조군 26명을 선정하였다. 2019년 1월 8일부터 3월 11일까지 주 2회, 회당 60분, 8주, 총 16회의 웃음요법을 적용하고 그 효과를 VAS, 압통역치, WOMAC, 한국형 노인 우울 단축형 척도로 측정하였다. 연구결과 퇴행성 슬관절염 노인의 통증 역치(p=.012)와 통증, 관절경직, 신체기능을 측정하는 관절기능상태(p<.001), 우울(p<.001)은 대조군에 비해 실험 후 개선되어 웃음요법이 효과가 있음이 확인되었다. 웃음요법은 육체적 또는 지적 활동을 통해 웃음을 경험할 수 있는 치료적 개입으로 침습적인 시술이 이루어지지 않고 약간의 훈련으로 간호사들이 쉽게 적용할 수 있는 장점이 있으므로 웃음요법을 지역사회 및 임상 현장에서 퇴행성 슬관절염 노인의 통증을 완화시키고 우울을 개선하는 중재방법으로 활용할 수 있을 것으로 사료된다.

Rheumatic Arthritis-induced Alteration of Morphology and Function in Muscles

  • Hong, Yun-Kyung;Kim, Joo-Heon;Javaregowda, Palaksha Kanive;Lee, Sang-Kil;Lee, Sang-Rae;Chang, Kyu-Tae;Hong, Yong-Geun
    • Reproductive and Developmental Biology
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    • 제35권2호
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    • pp.151-157
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    • 2011
  • Clinical arthritis is typically divided into rheumatoid arthritis (RA) and osteoarthritis (OA). Arthritis-induced muscle weakness is a major problem in aged people, leading to a disturbance of balance during the gait cycle and frequent falls. The purposes of the present study were to confirm fiber type-dependent expression of muscle atrophy markers induced by arthritis and to identify the relationship between clinical signs and expression of muscle atrophy markers. Mice were divided into four experimental groups as follows: (1) negative control (normal), (2) positive control (CFA+acetic acid), (3) RA group (CFA+acetic acid+type II collagen), and (4) aging-induced OA group. DBQA/1J mice (8 weeks of age) were injected with collagen (50 ${\mu}g/kg$), and physiological (body weight) and pathological (arthritis score and paw thickness) parameters were measured once per week. The gastrocnemius muscle from animals in each group was removed, and the expression of muscle atrophy markers (MAFbx and MuRF1) and myosin heavy chain isoforms were analyzed by reverse transcription-polymerase chain reaction. No significant change in body weight occurred between control groups and collagen-induced RA mice at week 10. However, bovine type II collagen induced a dramatic increase in clinical score or paw thickness at week 10 (p<0.01). Concomitantly, the expression of the muscle atrophy marker MAFbx was upregulated in the RA and OA groups (p<0.01). A dramatic reduction in myosin heavy chain (MHC)-$I{\beta}$ was seen in the gastrocnemius muscles from RA and OA mice, while only a slight decrease in MHC-IIb was seen. These results suggest that muscle atrophy gene expression occurred in a fiber type-specific manner in both RA- and OA-induced mice. The present study suggests evidence regarding why different therapeutic interventions are required between RA and OA.

동측 원위 비골 지주를 이용한 경-거-종골 관절 유합술 (Tibiotalocalcaneal Arthrodesis Using Ipsilateral Distal Fibula Buttress)

  • 조세현;이정수;정순택;박형빈;황선철;정재헌;차민석
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.213-217
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    • 2006
  • Purpose: To evaluate the clinical and radiological results of tibio-talo-calcaneal arthrodesis using ipsilateral distal fibula buttress which had advantages of extended operative field and release of contracted soft tissue. Materials and Methods: We retrospectively reviewed 4 postraumatic compartment syndrome, 2 residual poliomyelitis, 1 posttraumatic osteoarthritis with subtalar joint infection and 1 posttarumatic sciatic nerve palsy patients who underwent a tibio-talo-calcaneal arthrodesis from April, 1996 to March, 2002. Each of the cases was notable for a severe rigid equinovarus, persistent pus drainage of calcaneal area and paralytic foot. The mean duration of follow up was 18 months (range, $13{\sim}42$ months). The pain, function and alignment were evaluated by the modified ankle hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) and patients satisfaction clinically. The radiological union were evaluated by plain AP and lateral radiographs. Results: The AOFAS score improved from 58 points (range, $47{\sim}78$) preoperatively to 82 (range, $60{\sim}89$) postoperatively. Patents satisfaction checked at 12 months after operation had favorable results (excellent and good 80%). Union rate was 100% radiographically and the mean duration of union was 12.5 weeks (range $8{\sim}22$ weeks). There was 2 cases of superficial pin tract infection and one protrusion of screw. Conclusion: Tibio-talo-calcaneal arthrodesis using ipsilateral distal fibula buttress was good modality of arthrodesis which provides wide operative field and release of contracted soft tissue in some cases of contracted foot.

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