• Title/Summary/Keyword: Intraarticular injection

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Effect of Alginic Acid on Experimentally Induced Arthropathy in Rabbit Model (토끼의 관절병증에 미치는 알긴산올리고당의 치료효과)

  • Bai, Young-Hoon;An, Tae-Hun;Lim, Sung-Chul;Pak, Sok-Cheon;Lee, Jae-Chang;Kang, Nam-Hyun;Bae, Chun-Sik
    • Korean Journal of Veterinary Research
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    • v.42 no.2
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    • pp.153-162
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    • 2002
  • For the induction of arthropathy, 5% hydrogen peroxide($H_2O_2$) was injected for 5 weeks into the intraarticular space of the New Zealand white rabbits to damage articular cartilage. Alginic acid of low molecular weight (2%) made from macromolecular alginate treated with enzyme was administered into articular space at the dose of 5 mg/kg twice a week for 3 and 6 weeks using 1 ml syringe and 26 G needle. Saline was injected for the control. Tissues surrounding the articulation were obtained for the measurements of superoxide dismutase(SOD) activity as a major antioxidant enzyme and malondialdehyde (MDA) as a lipid peroxidation level. Histopathologic examination on the surface of articular cartilage was carried out. Data showed that injection of hydrogen peroxide for 5 weeks had led to the induction of free radical damage and of articular cartilage change as confirmed by microscopic observation. The application of hydrogen peroxide caused a gradual increase in the SODs and MDA. These patterns were similar after 3 and 6 weeks of alginate treatment. Furthermore, microscopic examinations revealed that hydrogen peroxide caused flaking, fibrillation, fissuring, denudation, and hypocellularity in the articular surfaces. In conclusion, lipid peroxidation was demonstrated in the articular cartilage by the administration of hydrogen peroxide in the rabbit model. This lipid peroxidation could be caused by oxygen free radicals. The histologic and enzymatic correlations on lipid peroxidation in the articulation have provided a better understanding of arthropathy. It is possible to take advantage of these findings to evaluate effective alginate dosage more efficiently.

Effect of Aralia Cordata Pharmacopuncture on Cartilage Protection and Apoptosis Inhibition In Vitro and in Collagenased-induced Arthritis Rabbit Model

  • Park, Dong-Suk;Baek, Yong-Hyeon
    • The Journal of Korean Medicine
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    • v.28 no.4
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    • pp.114-123
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    • 2007
  • Osteoarthritis is characterized by cartilage degradation and chondrocytes death. Chondrocyte death is induced by the apotosis through special mechanisms including the activation of caspase-3. On the basis of this background, this study was designed to examine the cartilage protective and anti-apototic effects of Aralia Cordata in in vtro and in collagenase-induced arthritis rabbit model. To conduct in vitro study, chondrocytes culturedfrom rabbit knee joint were treated by 5 ng/ml IL-1a.For in vivo experiment, collagenase-induced arthritis (CIA) rabbit model was made via intraarticular injection with 0.25 ml of collagenase solution. Aralia cordata pharmacopuncture (ACP) was administrated on bilateral Dokbi acupoint (ST35) of rabbits at a dosage of 150 ${\mu}g/kg$ once a day for 28 days after the initiation of the CIA induction. In the study by using CIA rabbit model in vivo, ACP showed the inhibition of cartilage degradation in histological analysis. Aralia cordata also showed anti-apoptotic effect both in vitro and in vivo study. In chondrocytes treated by IL-1a, Aralia cordata inhibited caspase-3 activity and enhanced the proliferation of IL-1a-induced dedifferentiated chondrocytes. ACP showed the inhibition effect on the caspase-3 expression and activity from CIA rabbit model. This study indicates that ACP inhibits the cartilage destruction and the chondrocyte apotosis through downregulation of caspase-3 activity. These data suggest that ACP has a beneficial effect on preventing articular cartilage destruction in osteoarthrtis.

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Comparison of international medical costs for interventional pain treatment: a focus on Korea and Japan

  • Eun Young Lee;Hyung-Sun Won;Miyoung Yang;Hyungtae Kim;Yeon-Dong Kim
    • The Korean Journal of Pain
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    • v.37 no.1
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    • pp.51-58
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    • 2024
  • Background: The rise in national health care costs has emerged as a global problem given the ever-aging population and rapid development of medical technology. The utilization of interventional pain management has, similarly, shown a continued rise worldwide. This study evaluates the differences in the medical costs in the field of interventional pain treatment (IPT) between two countries: Korea and Japan. Methods: Korean medical insurance costs for 2019 related to pain management focused on IPT were compared to those of Japan. Purchasing power parity (PPP) was used to adjust the exchange rate differences and to compare prices in consideration of the respective societies' economic power. Results: The cost of trigger point injections in Japan was 1.06 times higher than that of Korea, whereas the perineural and intraarticular injection prices were lower in Japan. The cost of epidural blocks was higher in Japan compared to Korea in both cervical/thoracic and lumbar regions. As for blocks of peripheral branches of spinal nerves, the cost of scapular nerve blocks in Japan was lower than that in Korea, given a PPP ratio 0.09. For nerve blocks in which fluoroscopy guidance is mandatory, the costs of epidurography in Japan were greater than those in Korea, given a PPP ratio 1.04. Conclusions: This is the first comparative study focusing on the medical costs related to IPT between Korea and Japan, which reveals that the costs differed along various categories. Further comparisons reflecting more diverse countries and socio-economic aspects will be required.

Clinical Results after Arthroscopic Treatment in Acute Pyogenic Arthritis of the Knee (급성 화농성 슬관절염에서 관절경적 치료 후 결과)

  • Lee, Jung-Hwan;Yoon, Kyoung-Ho;Bae, Dae-Kyung;Kim, Jeong-Weon;Park, Soo-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.53-57
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    • 2008
  • Purpose: We analyzed the clinical results after arthroscopic treatment in acute pyogenic arthritis of the knee. Materials and Methods: From July 2000 to January 2005, we reviewed 16 cases(15 patients) of acute pyogenic arthritis of the knee on which arthroscopic treatment was done. The mean age was 61.9 years and the mean follow-up period was 30.5 months. There were 8 cases with diabetes or degenerative osteoarthritis and 14 cases with acupuncture or intraarticular injection history. Results: Causative organisms were identified in 7 cases. The average postoperative antibiotics were used intravenously for 25.5 days and per orally for 22.5 days. There were 11 complications; 5 cases of partial ankylosis, 2 cases of secondary arthritis, 1 case of chronic osteomyelitis and 3 cases of death. Patients with over 3 week immobilization had higher rate of stiffness of knee joint(p=0.032) but there was no significant difference between the symptom to treatment duration and the incidence rate of complications(p=0.293). The cases of which the causative organism was detected had higher incidences of complications(p=0.034). Conclusion: The incidence of joint stiffness was higher in the patients of longer immobilization. More complications were detected in the cases of which the causative organism is detected.

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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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Short Term Outcomes and Prognostic Factors Based on Radiofrequency Thermocoagulation on Lumbar Medial Branches (요추 후지내측지에 대한 고주파열응고술의 단기 성적과 예후 인자)

  • Choi, Byung In;Kweon, Tae Dong;Park, Kyung Bae;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.116-122
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    • 2007
  • Background: Lumbar zygapophysial joints are a common source of chronic lower back pain and radiofrequency thermocoagulation (RF) of the medial branches (MB) has been shown to be effective at providing substantial pain relief for chronic low back pain. Therefore, we carried out this study to determine the short term outcomes and prognostic factors of RF on the MB of patients with lumbar facet syndrome. Methods: We performed RF in fourteen patients who showed greater than 80% pain relief up to three times after a diagnostic MB block was conducted using 0.3 ml of 0.5% bupivacaine. Using 10 cm curved electrodes with 10-mm active tip, a 60 second, $80^{\circ}C$ lesion was made after electrical stimulation at 50 Hz for sensory and 2 Hz for motor nerve testing. The degree of pain relief was then assessed after 2 weeks, and again after 3 months using a visual analog scale (VAS) and a four point Likert scale. The outcome was regarded as 'success' if at least a 50% reduction in the VAS was observed. Possible prognostic factors between the two groups were also evaluated Results: The success rate was 71.4% (10/14) after three months of follow-up. However, there were transient complications, such as neuritis like syndrome, in 4 patients. In addition, short symptom duration and low minimal voltage (< 0.4 V) for sensory stimulation were shown to be the relevant prognostic factors for a successful outcome. Conclusions: RF may be an alternative to repeated MB block or intraarticular injection for palliation of lumbar facet syndrome. For better outcomes, early diagnosis and strict patient selection should be coupled with efforts to avoid anatomically incorrect RF.