• Title/Summary/Keyword: 관절염환자

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The Clinical and Radiographic Features of Temporomandibular Joint Dysfunction in Patients with Rheumatoid Arthritis (류마티스성 관절염 환자에서 나타나는 측두하악관절장애의 임상적 및 방사선학적 특징)

  • Al-Mehdi, Aslam;Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.237-243
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    • 2006
  • The aims of this study was to investigate the clinical and radiographic features of temporomandibular dysfunction in the patients with RA to elucidate whether the RA patients would be a risk group for TMD. The 35 patients with temporomandibular joint dysfunction were included for this study, of which 15 had rheumatoid arthritis diagnosed by a rheumatologist, and other 20 was control group and they didn't have any history or clinical signs related to it. Clinical symptoms and signs of temporomandibular joint disorders, radiographic and MRI findings of temporomandibular joint were investigated. The results were compared between two groups. In RA group bilateral pain, morning stiffness, reduced opening range, and crepitations were more frequently reported than control group. Radiologic findings such as sclerosis and flattening of condylar head, marginal proliferation, and erosion of glenoid fossa were more frequently observed in RA group than control group. Disk destruction, cortical bone erosion, and intraarticular enhancement were more prominenet in RA group. From theses results, it can be concluded that many RA patients will develop TMD symptoms and the structural changes of TMJ is more extensive than the usual TMD cases.

Clinical Utility of Bone Scan in the Diagnosis of Temporomandibular Disorders (측두하악장애의 진단에서 Bone Scan의 유용성)

  • Kim, In-Joo;Kang, Yang-Ho;Son, Seok-Man;Lee, Kyoung-Seog;Lee, Jae-Bok;Kim, Yong-Ki;Seo, Bong-Jik;Park, June-Sang;Ko, Myung-Yun;Son, Seong-Pyo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.511-517
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    • 1995
  • Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement(13 unilaterally affected, 8 bilaterally affected), 25 patients with TMJ arthritis(23 unilateral, 3 bilateral), and 39 volunteers with no signs, symtoms, or history of TMJ disease. TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in 99mTc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were $1.673{\pm}0.606$ in TMJs affected with arthritis, $1350{\pm}0.351$ in TMJs affected with disc displacement, and $1.084{\pm}0.172$ in TMJs of controls. Significant differences were demonstrated among them(p<0.01) Difference of bith TMJ SUR was highest in patients with unilateral TMJ arthritis($0.608{\pm}$0.533, p<001), and there is no significant difference between that of controls and that of unilateral TMJ dist displacement patients($0.062{\pm}0.063$ vs $0.122{\pm}0.100$). TMJ SUR of Joint with bone change on X-ray finding was not significantly different from that of joint with normal X-ray finding. Those in patients with unilateral TMJ disc displacement(696% and 87% vs 23.1% and 23%). The proportions of patients with increased TMJ SUR and difference of both TMJ SUR(>mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan nay help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

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Response to Bee Venom Acupuncture and Polymorphism of Matrix Metalloproteinase-1 Gene in Korean Patients with Rheumatoid Arthritis (한국인 류마티스 관절염 환자의 봉독약침 치료반응과 Matrix Metalloproteinase-1의 유전자 다형성 연구)

  • Lee, Sang-hoon;Choi, Do-young;Lee, Yun-ho
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.211-225
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    • 2004
  • 목적 : 류마티스 관절염 환자의 골 파괴에 중요한 역할을 하는 것으로 알려진 Matrix Metalloproteinase-1(MMP-1) 유전자의 단일 염기 다형성을 분석하고, 나아가 봉독약침 치료에 대한 반응과의 연관성을 조사하기 위하여 본 연구를 시행하였다. 방법 : 미국류마티스학회의 류마티스 관절염 기준에 해당하는 122명의 한국인 류마티스 관절염 환자와 건강한 92명의 대조군을 대상으로 pyrosequencing 방법을 이용하여 MMP-1 유전자의 -519 위치의 다형성을 비교 분석하였으며, 류마티스 관절염 환자군을 다시 유전자 유형에 따라 동통 관절수, 종창 관절수, 조기 강직, 통증 강도, 삶의 질 평가도구인 HAQ, 환자 및 의사의 전반적 질병상태 평가, ESR, CRP 등의 항목을 치료 전후 평가하여 비교 분석하였다. 결과 : 1. 류마티스 환자군과 건강한 대조군간에 MMP-1 유전자의 단일 염기 다형성의 유전자형의 분포와 대립유전자 발현 빈도에 통계적으로 유의한 차이가 나타났으며, 이는 MMP-1 유전자 다형성이 한국인 류마티스 관절염 환자의 질병 감수성과 관련이 있음을 추정할 수 있다. 2. 각 유전자형 그룹간 치료전 질병의 중증도 평가에서 임상 평가와 혈액의 급성 염증 반응물질 평가에서 통계적으로 유의한 차이는 없었다. 3. 급성 염증 반응의 지표인 ESR과 CRP level의 봉독약침 치료 전후 변화는 MMP-1의 유전자 다형성과 유의한 연관이 없었다. 4. 각 유전자형 그룹간의 치료 전후 질병 호전도 비교에서, AA 유전자형이 종창 관절수 평가에서 더나은 호전을 보였으며, 다른 모든 평가에서는 통계적으로 유의한 차이가 없었으며, 향후 관련 유전자와의 연관성 연구가 필요하다고 사료된다.

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Pain, perceived exercise barriers, and related factors in arthritis patients (관절염 환자의 통증 및 운동 장애성 지각과 관련 요인)

  • An, Eun-Jeong;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.10
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    • pp.4588-4597
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    • 2012
  • This study aimed to investigate pain, perceived exercise barriers, and related factors in arthritis patients. The study was conducted on 140 arthritis patients (89 rheumatoid arthritis patients and 51 osteoarthritis patients) who visited C University Hospital in Daejeon due to arthritis and agreed to participate in a survey. The self-administered survey was conducted from February 2011 to September 2011. The results are as follow. The perceived exercise barriers increased in both groups as the education level and monthly household income decreased. In the rheumatoid arthritis group, the pain became more intense as the self-rated health status became poorer while the perceived exercise barriers became more significant as the self-rated health status became poorer and the patients had other diseases besides arthritis. In the osteoarthritis group, the pain was greater as the duration of arthritis was longer and the self-rated health status became poorer. In both groups, the perceived exercise barriers became more significant as the exercise stage approached the pre-planning stage. The results of the multiple linear regression analysis showed that the most influential factor on pain in both groups was the 'very bad' self-rated health status. In the rheumatoid arthritis group, influential factors on the perceived exercise barriers were the exercise stage and the education level while for the osteoarthritis group, they were the exercise stage and the monthly household income. In conclusion, the results of this study showed that the pain and perceived exercise barriers of arthritis patients were associated with various factors such as the education level, monthly household income, self-rated health status, and exercise stage, which suggests that these factors should be considered in the planning of exercise programs.

Surgical Treatment for Hand and Wrist Problems in Rheumatoid Arthritis (류마티스 관절염에서 손과 손목에 대한 수술적 치료)

  • Lee, Chang-Hun;Lee, Kwang-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.472-486
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    • 2020
  • Rheumatoid arthritis is a systemic disease with chronic progress, but the recent rapid developments of drug treatments have led many patients to gain control of their disease activity. As a result, surgery has been performed less commonly on the wrist or hand than in the past. On the other hand, surgical treatment is still essential to patients who do not respond to those medications. For the successful treatment of symptomatic deformed joints or functional disability, surgeons should understand that the pathology of rheumatoid arthritis proceeds differently in every patient. Furthermore, because rheumatoid arthritis often invades multiple joints in the hand and wrist, the patients often require multiple operations simultaneously. This paper summarizes the current concepts of surgical treatment of rheumatoid arthritis in the hand and wrist based on more than 30 years' experience of our senior surgeon and a literature review.