• Title/Summary/Keyword: 관절염환자

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A Case of Hypersensitivity Pneumonitis Caused by Methotrexate (Methotrexate에 의한 약제 유발 과민성 폐렴 1례)

  • Suh, Hyun Joo;Chung, Man Pyo;Park, Eun Ha;Shin, Sung Chul;Jeon, Kyeong Man;Yu, Chang Min;Pyun, Yu Jang;Lee, Kyung Soo;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.203-209
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    • 2004
  • Background : Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.

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

  • Lee, Yim Sun;Park, Hyo Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.440-449
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    • 2020
  • This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

Treatment Results of Capitellum Fractures (상완골 소두 골절의 치료결과)

  • Park, Jin-Soo;Chung, Yung-Khee;You, Jung-Han;Noh, Gyu-Cheol;Chung, Kook-Jin;Jung, Sung-Ook
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.116-121
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    • 2005
  • Purpose: Isolated capitellar fractures are rare, intra-articular fractures requiring an aggressive management regimen. Review the outcome after open reduction and internal fixation of the capitellar fractures. Materials and Methods: From 1998 to 2004, 4 patients with displaced fractures of the humeral capitellum were treated by open reduction and internal fixation of the capitellar fragments with cannulated screws. By use of the criteria of Bryan and Morrey et al, there were 3 type I fractures, 1 type III fracture. A lateral approach was used. The elbows were immobilized postoperatively for 4 to 28 days We evaluated the range of motion, stability, and pain using the criteria of Mayo score. Results: The follow-up period ranged from 12 to 36 months (mean, 15months). Three patients had a stable, pain-free elbow with good range of motion at follow-up. One patient with a neglected capitellar fracture have felxtion cpontracture of 40 degrees with 100 degrees of further felxion(total arc: 60) due to poor compliance to the postoperative rehabilitation. All fractures healed, and there was no evidence of avascular necrosis or degenerative change. Conclusion: Capitellar fractures, rare in case, gave a good result after open reduction and simple internal fixation with cannulated screws without any problem.

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Anti-proliferative Effects of Celastrol, A Quinine Methide Triterpene Extracted from the Perennial Vine Tripterygium wilfordii, on Obesity-related Cancers (미역줄나무 뿌리 추출물인 셀라스트롤의 비만관련 암증식 억제효과)

  • Park, Sunmi;Moon, Hyun-Seuk
    • Journal of Food Hygiene and Safety
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    • v.31 no.1
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    • pp.59-66
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    • 2016
  • It has been generally accepted that obesity and overweight are associated with metabolic diseases and cancer incidence. In fact, obesity increased risks of cancers i.e. breast, liver, pancreatic and prostate. Celastrol is a pentacyclic triterpenoid isolated from Thunder god vine, was used as a Chinese traditional medicine for treatment of inflammatory disorders such as arthritis, lupus erythematosus and Alzheimer's disease. Also, celastrol has various biological properties of chemo-preventive, neuro-protective, and anti-oxidant effects. Recent studies demonstrated that celastrol has anti-proliferation effects in different type of obesity-related cancers and suppresses tumor progression and metastasis. Anticancer effects of celastrol include regulation of $NF-{\kappa}B$, heat shock protein, JNK, VEGF, CXCR4, Akt/mTOR, MMP-9 and so on. For these reasons, celastrol has shown to be a promising anti-tumor agent. In this review, we will address the anticancer activities and multiple mechanisms of celastrol in obesity-related cancers.

Analysis of Repeated Measured VAS in a Clinical Trial for Evaluating a New NSAID with GEE Method (퇴행성 관절염 환자를 대상으로 새로운 진통제 평가를 위한 임상시험자료의 GEE 분석)

  • Lim, Hoi-Jeong;Kim, Yoon-I;Jung, Young-Bok;Seong, Sang-Cheol;Ahn, Jin-Hwan;Roh, Kwon-Jae;Kim, Jung-Man;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.4
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    • pp.381-389
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    • 2004
  • Objective : To compare the efficacy between SKI306X and Diclofenac by using generalized estimating equations (GEE) methodology in the analysis of correlated bivariate binary outcome data in Osteoarthritis (OA) diseases. Methods : A randomized, double-blind, active comparator-controlled, non-inferiority clinical trial was conducted at 5 institutions in Korea with the random assignment of 248 patients aged 35 to 75 years old with OA of the knee and clinical evidence of OA. Patients were enrolled in this study if they had at least moderate pain in the affected knee joint and a score larger than 35mm as assessed by VAS (Visual Analog Scale). The main exposure variable was treatment (SKI 306X vs. Diclofenac) and other covariates were age, sex, BMI, baseline VAS, center, operation history (Yes/No), NSAIDS (Y/N), acupuncture (Y/N), herbal medicine (Y/N), past history of musculoskeletal disease (Y/N), and previous therapy related with OA (Y/N). The main study outcome was the change of VAS pain scores from baseline to the 2nd and 4th weeks after treatment. Pain scores were obtained as baseline, 2nd and 4th weeks after treatment. We applied GEE approach with empirical covariance matrix and independent(or exchangeable) working correlation matrix to evaluate the relation of several risk factors to the change of VAS pain scores with correlated binary bivariate outcomes. Results : While baseline VAS, age, and acupuncture variables had protective effects for reducing the OA pain, its treatment (Joins/Diclofenac) was not statistically significant through GEE methodology (ITT:aOR=1.37, 95% CI=(0.8200, 2.26), PP:aOR=1.47, 95% CI=(0.73, 2.95)). The goodness-of-fit statistic for GEE (6.55, p=0.68) was computed to assess the adequacy of the fitted final model. Conclusions : Both ANCOVA and GEE methods yielded non statistical significance in the evaluation of non-inferiority of the efficacy between SKI306X and Diclofenac. While VAS outcome for each visit was applied in GEE, only VAS outcome for the fourth visit was applied in ANCOVA. So the GEE methodology is more accurate for the analysis of correlated outcomes.

A Study on Burden of Middle Aged Spouses of Rheumatoid Arthritic Patients (류마티스 관절염 환자 배우자의 부담감)

  • Choi, Kyung-Sook;Eun, Young;Ham, Mee-Young
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.241-257
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    • 2000
  • Rheumatoid arthritis as one of the chronic illness requiring management in long period of time puts great burden to patients, their family and society. For patients with chronic illnesses, providing a social support is important and the most important source comes from spouses. Therefore we assessed burden of husbands of female rheumatoid arthritic patients and also found out the factors affecting burden. The sample of study was 107 female rheumatoid arthritic patients and their spouses. The tool of assessing spouses' burden was the revised version of subjective and objective parameters developed by Montgomery et al.(1985). The results are as follows: 1. General characteristics of patients and spouses: The mean age of the patients was 48 years. Educational level of patients was high school 41.1%. The mean age of the spouses was 51years. Educational level of spouses was mostly high school(40.2%) and college(29.9%) graduate. The mean marital period was 23.4years. Average income per month was 1,609,000 won. The average duration since diagnosis was 9.4years. As a therapy, 67.3% chose standard drug therapy. Average rating of discomfort by patient was 3.05(range 1-5) and that of severity was 3.48 and that of dependency was 2.58. The husband's rating of their spouses disease severity was 3.68. 2. Husbands' burden: The average burden in subjective items was 21.61(range 6-36) and objective items was 35.24(range 10-60). The average of total burden was 56.59(range 16-96). 3. Husband's total burden correlated with patient's age, educational level of patients, therapy method, patient's level of discomfort, patient's severity, patient's level of dependence, husband's recognition of level of severity in statistical level. Husband's objective burden correlated with patient's age, educational level of patient, patient's level of discomfort, husband's recognition of level of severity. Husband's subjective burden correlated with patient's age, educational level of patients, therapy method, patient's severity, patient's level of dependence, husband's recognition of level of severity. 4. Linear correlation analysis on burden: The husbands' total burden is explained in 37 7% by husband's recognition of level of severity and husband's age. The husbands' objective burden is explained in 31.2% by patient's level of dependence, husband's age, husband's recognition of level of severity. The husbands' subjective burden is explained in 26.7% by husband's recognition of level of severity and patient's age. In conclusion, husbands' level of burden is affected by many factors and therefore nursing strategy for relieving burden of middle aged husbands should be individualized taking these factors into consideration.

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Cause of Pes Anserinus Tenderness (거위발 건 압통의 원인)

  • Kim, Jung-Man;Lee, Dong-Yeob;Koh, In-Jun;Kim, Sang-Il
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.1
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    • pp.13-17
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    • 2009
  • Purpose: The purpose of this study was to know the cause of the tenderness at pes anserinus. Materials and Methods: Out of 24 patients with tenderness at pes anserinus, 23 patients were female and 1 patient was male, and their average age was 65.9 years old. We checked the tenderness at pes anserinus by history taking & physical examniation and then, checked the pes anserinus for the presence of bursitis by US in outpatient clinic. With no evidence of bursitis by US, we injected steroid-lidocaine mixture intraarticularly and checked whether the tenderness disappeared after 2~3 minutes. Results: There was no case with bursitis at pes anserinus by US. The tenderness at pes anserinus diminished in 2-3 minutes after the intraarticular injection of the steroid-lidocaine mixture. After 6 weeks follow up, 16 patients(66.7%) had little or no tenderness at pes anserinus. 8 cases had the recurrence of tenderness recurred, 4 cases underwent arthroscopic operation on the meniscal tear, and 1 case underwent total knee arthroplasty. All cases underwent any operations had the tenderness at pes anserinus disappeared. The others 3 cases did not undergo total knee arthroplasty despite of radiologic obliteration of knee joint adequate for Kellgren-Lawrence grade IV. Conclusion: Without the bursitis at Pes Anserinus, patients the osteoarthritis may have the tenderness due to the referred pain.

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A Case of Primary Pulmonary Lymphoma of Bronchus-Associated Lymphoid Tissue associated with Systemic Lupus Erythematosus (전신성 홍반성 낭창에 동반된 기관지-관련 림프양 조직의 원발성 폐 림프종 1례)

  • Kim, Seong-Kyu;Kim, Yeon-Jae;Do, Yun-Kyung;Yu, Kuong-Sul;Lee, Byung-Ki;Kim, Won-Ho;Kim, Ik-Su;Huh, Dong-Myung
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.76-85
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    • 2002
  • A primary pulmonary malignant lymphoma is a rare disease. It is thought to be a category of non-Hodgkin's lymphoma arising from the bronchous-associated lymphoid tissue (BALT). The majority of primary pulmonary lymphomas are low-grade, small B-cell lymphomas, which are associated with Sjogren's syndrome and similar autoimmune disorders. A case of primary pulmonary low-grade B-cell lymphoma arising from the BALT was encountered in a patient with systemic lupus erythematosus. A 54-year-old man was admitted to the hospital for the evaluation of left pleuritic chest pain and multiple joint pain in both hands. Serologic tests for collagen vascular disease were performed. The results of ANA and anti-ds-DNA were all positive. The computed tomography of the chest showed patchy consolidations in the left lower lobe with a pleural effusion and a video-assisted thoracoscopic biopsy was performed. Here we report a case of a low-grade B-cell lymphoma of BALT in a patient with systemic lupus erythematosus with a review of the relevant literatures.

A Study of Life Satisfaction by Chronic Arthritis Patient (만성관절염 환자의 삶의 만족도에 관한 연구)

  • Kim, Won-Sook
    • Journal of muscle and joint health
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    • v.4 no.1
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    • pp.87-97
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    • 1997
  • This study is descriptive research clarifying the relations between physical inconvenience, social aptitude and sense of satisfaction In life of the chronic arthritis patients. This research has been conducted from 115 patients by structured self-reporting questionnaires and direct interview of the adult patients over the age of 16 years old who had been under treatment in 3 University hospitals in Seoul from Oct. 4, 1996 through Oct. 24, 1996 for 20 days. The collected materials have been under t-test and F-test(ANOVA) per variables after computerizing using SPSS package and the correlation between various causes was conducted by pearson's correlation coefficient method. The results are as the follows : 1) Generally the age of starling the disease was 40-60 with 91 in female(79.0%) and male 88(76.5%), the persons who had the religion showed the high rate of being taken ill and the persons with over high school education have fallen ill by 46.1%. The monthly income has shown that 77.5% was over 1,000,000won or over, the periods of the disease in average was 4 years 3 months showing it was the chronic disease, the degree of recognizing the disease was 19.0%, spouse and children were most concerned about their disease and the part of Joint attacked was knee(73.0%), wrist(43.5%) and others which showed that they have been very inconvenient in daily life. 2) The variables affecting to physical inconvenience were by age (F=9.06, p=.000), education level(F=7.14, p=000), economic standards (F=2.18, p=.05), the period of disease(F=3.09, p=.03), hospitalized or not(F=3.23, p=.002), showing such correlations. 3) The variables affecting to the social adaptation were by age (F=3.47, p=.018), education level(F=4.98, p=.001), periods of taken ill (F=419, p:.007), hospitalized or not (F=3.23, p=.004) and the operation or not (F=1.30, p=.028) showing such correlations. 4) The variables affecting to life satisfaction were by sex(t=2.08, p=.045), economic status(F=3.15, p=.01) being able to explain statistically. Through the above correlations, they are required to receive self-management education positively to elevate the effect of rehabilitation treatment and effective nursing arbitration and also they required to be reduced physical inconvenience at the early stage and be helped to be able to lead the quality life in satisfaction by elevating the diverse adaptation to the society by correcting the transformed joint.

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Treatment of Type 2 Distal Clavicle Fracture using Wolter Plate (Wolter 금속판를 이용한 제 2형 원위부 쇄골 골절의 치료)

  • Shin, Sung-Il;Song, Kyung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Rae;Hyun, Yoon-Suk;Lee, Kwang-Nam;Lee, Eun-Soo
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.14-20
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    • 2009
  • Purpose: This study examined the clinical results of the treatment of type 2 distal clavicle fracture with using a Wolter plate. Materials and Methods: Between 2004 and 2007, 16 patient treated for type 2 distal clavicle fracture using a Wolter plate were included in this study. Their average age was 32.6 years and the postoperative mean follow-up period was 22.9 months. The reduction and union were qualified according to the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and the Constant score Results: By Kona's functional evaluation, there were 12 cases with excellent results, 3 cases with good results and 1 case of fair results and the average Constant score was 90. All 16 cases showed bony union. As complications, there was 1 case in which the protruded hook of the plate could be palpated at the skin, and 1 case showed an acromial fracture, but all the cases dispalyed successful bony union and there was no acromioclavicular joint arthritis, infection or any other complications. Conclusion: Wolter plate fixation for type 2 distal clavicle fracture is a reliable surgical method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result.