Background and Objectives: Bee venom therapy is a new acupuncture theraphy using both acupuncture effect and a medical effect that the biochemical peculiar material affects body. The bee venom theraphy is efficacious of injecting region of disease and acupoint with extracting bee venom from bee and processing it. There have been more than 20 dissertations in Korea about bee venom and the bee venom research has actively been carrying done in other countries such as US, China, Russia, Northern Europe since 1980s. This paper is to understand the trend of arthritis and bee venom, and will be contributed to further bee venom study by analyzing local and international theses. Material and Method: This paper is reported by analyzing the dissertations regarding arthritis and bee venom of Korea and other countries and referencing PubMed. The reference terminology is as follows. bee venom, bee venom therapy, apitoxin, apitherapy, bee sting, bee sing therapy, arthritis, rheumatoid, rheumatic arthritis and so on. Results and Conclusions: The following result have been obtained. 1. Bee venom has an effect on both in vivio and in vitro of arthritisthis with suppressing inflammation, fever and pain. 2. Occasionally bee venom may induce either pain or inflammation. 3. Bee venom induces acute pain in healthy condition, while it suppresses inflammation and pain in regional inflammation state. 4. Bee venom may either induce or suppress pain and inflammation according to the used dosage.
This study was conducted to investigate the affecting factors on the adaptation to uncertainty in patients having rheumatoid arthritis. Subjects of the study constituted 222 patients who visited outpatient of rheumatic center in Seoul. Self report questionnaires were used to measure the variables affecting the adaptation to uncertainty. The variables affecting the adaptation to uncertainty were uncertainty, mastery, appraisal of danger, appraisal of opportunity, emotion focused coping, problem focused coping, pain, depression and activity of daily life(ADL). Reliability coefficients of these instruments were found Cronbach's $Alpha\;=\;.70{\sim}.94$. In data analysis, SPSSWIN 10.0 program was utilized for descriptive statistics, Pearson's correlation, and multiple regression analysis. The results were as follows. 1) The range of total pain scores was from 0 to 147 and the mean score of the pain in rheumatoid arthritis patients was 72.64. 2) The range of total depression scores was from 20 to 72 and the mean score of the depression in rheumatoid arthritis patients was 39.86. 3) The range of total ADL scores was from 22 to 80 and the mean score of the ADL in rheumatoid arthritis patients was 72.56. 4) Among the independent variables, significant factors to explain the adaptation to pain in patients were danger appraisal of uncertainty(p<.05) and emotion focused coping(p<.05). 5) Among the independent variables, significant factors to explain the adaptation to depression in patients were danger appraisal of uncertainty(p<.001), opportunity appraisal of uncertainty(p<.001) and mastery(p<.005). 6) Among the independent variables, significant factors to explain the adaptation to ADL in patients were mastery(p<.001) and danger appraisal of uncertainty(p<.05).
Alternative therapy for rheumatoid arthritis has become worldwide phenomenon this decade without scientific validation. This study was undertaken to explore the prevalence, patterns of use, and perceived efficacy of alternative therapies by patients attending a rheumatology clinic. We conducted a crossectional survey of 142 RA patients with structured questionnaire at outpatient rheumatic clinic from July to August in 2001. Results of this study were summarized as follows : 1. 85.9% of subjects were woman. Mean age was 49.97years, duration of rheumatoid arthritis was 5.6years. Mean pain score was 5.29cm. 2. 74.6% of subjects perceived rheumatoid arthritis as a controllable disease. 31% of patients combined medical treatments with alternative therapies. 58.5% of patients perceived that combining medical treatments with alternative therapies is the most effective strategy in controlling disease. 3. 77.5% had used more than one alternative therapy since the diagnosis was made. The major reason of discontinuation of use was no effect for the treatment of their disease. 4. 34.5% were currently using an alternative therapies and 50.9% were going to use alternative therapies in future. 5. 42.7% reported that alternative therapies was effective and only 3.6% reported side effects. 6. The perceived effect score was 3.14cm in general expecially the physiological score 2.91cm, psychological score 4.16cm. In conclusion, our results demonstrate a high use of alternative therapies by rheumatoid arthritis patients. And the perceived effect score of physiological aspect was not higher than one of psychological aspect. Therefore it should be considered in education program for the use of alternative therapies.
Juvenile rheumatoid arthritis (JRA) is the most common rheumatic childhood disease; its onset is before 16 years of age and it persists for at least 6 weeks. JRA encompasses a heterogeneous group of diseases that is classified according to 3 major presentations: oligoarthritis, polyarthritis, and systemic onset diseases. These presentations may originate from the same or different causes that involve interaction with specific immunogenetic predispositions, and result in heterogeneous clinical manifestations. An arthritic joint exhibits cardinal signs of joint inflammation, such as swelling, pain, heat, and loss of function; any joint can be arthritic, but large joints are more frequently affected. Extra-articular manifestations include high fever, skin rash, serositis, and uveitis. The first 2 types of JRA are regarded as T helper 1 (Th1) cell-mediated inflammatory disorders, mainly based on the abundance of activated Th1 cells in the inflamed synovium and the pathogenetic role of proinflammatory cytokines that are mainly produced by Th1 cell-stimulated monocytes. In contrast, the pathogenesis of systemic onset disease differs from that of other types of JRA in several respects, including the lack of association with human leukocyte antigen type and the absence of autoantibodies or autoreactive T cells. Although the precise mechanism that leads to JRA remains unclear, proinflammatory cytokines are thought to be responsible for at least part of the clinical symptoms in all JRA types. The effectiveness of biologic therapy in blocking the action of these cytokines in JRA patients provides strong evidence that they play a fundamental role in JRA inflammation.
The purposes of this study were to examine and to predict the affecting factors on exercise participation of Rheumatoid arthritis Patients. The subjects were 161 adult out-patients who visited the hospital for rheumatic disease in H-university. Data were composed of self-reported questionnaire. The conceptual model of this study consisted of that personal characters(age, marriage, education, income), situational characters(pain intensity, fatigue, IADL, depression), behavioral characters(formerly exercise behavior, life-style), and cognitive-perceptional characters(perceived health status, perceived benefit, perceived barrier, perceived self-efficacy) affected directly to exercise participation. Logistic regression analysis was applied for testing model of this study. The results were as follows : 1. Personal characters(education), situational characters(pain intensity), behavioral characters(formerly exercise behavior, life-style), and cognitive characters(perceived barrier, perceived self-efficacy) were significant difference between current exercise participants(127subjects) and non-exercise participants(34). 2. Personal characters(income), situational characters(pain intensity), behavioral characters(life-style), and cognitive-perceptional characters(perceived barrier, perceived self-efficacy) were correlated to exercise participation. 3. Formerly exercise behavior, perceived barrier, and perceived self-efficacy were significant predictor of exercise participation. The logistic equation predicted overall 81.94% of this study subjects 161.
This study was performed to assess the nutritional status, frequency of visiting and necessity of nutrition programs for 157 elderly(male:49, female:108) visiting public health centers in Puchon. The purpose of the study was to provide the basic data for developing a nutrition service model. The subject were investigated by interviews with a questionnaire to obtain dietary data and other information related to public health center. Blood tests for analyzing biochemical status were also carried out. The elderly showed low income status. Ninety two percent of them showed their monthly income was less than 400,000 won and 72.6% was observed as having 30,000 won/month as their pocket money. The most frequent disease reported as having or being treated were hypertension(32.6%), rheumatic arthritis(28.5%), diabetes(10.2%), and stomach disease(8.2%) for males and hypertension(33.1%), diabetes(19.4%), rheumatic arthritis(16.7%), anemia(11.1%) for females. The nutrients whose daily intakes were less than 2/3 of RDA were calcium(37.5% RDA),vitamin A(49.9% RDA), iron(60.0% of RDA) and protein(62.0% RDA) for males and vitamin A(27.7% RDA), vitamin B$_2$(33.3% RDA), calcium(44.1% RDA), iron(53.3% RDA), and niacin(60.0% RDA) for females, respectively. Prevalence of anemia, assessed by hemogloben using WHO definition, were 4.1% for males and 18.5% for females. The percentage of males with hypercholesterolemia( 220 mg/dl) was 2.1% and 19.4% fir females, Two percent of males and 12.0% of females were observed as having a LDL-C higher than 165 mg/dl. The mean fasting blood glucose(FBG) level of males and female was 84.2 mg/dl and 101.7 mg/dl respectively. Two percent of males and 8.3% of females were found with a FBG higher than 140 mg/dl. Seventy one percent of elderly reported they were visiting public health centers at least once per week or more frequently. They were satisfied most with the low medical bills but showed the lowest satisfaction for the facilities of the public health centers. What the nutrition service programs wanted most was nutrition counseling and guidance.
Objectives: This study was conducted to investigate the effects of mastery on appraisal of uncertainty in women patients with rheumatoid arthritis. Methods : The study subjects consisted of 168 patients who were recruited from the outpatient clinic of a rheumatic center in Seoul. Self report questionnaires were used to measure the study variables that included uncertainty, mastery, danger appraisal of uncertainty, and opportunity appraisal of uncertainty. Cronbach's alpha reliabilities of these instruments ranged from .72 to .93. For data analysis. the SPSSWIN 10.0 program was utilized to exam descriptive statistics. Pearson's correlation. and regression analysis. Results: The results were as follows.: 1) The uncertainty scores of the subjects ranged from 33 to 87 with the mean score of 63.27. 2) The mastery scores of the subjects ranged from 10 to 27 with a mean score of 18.70. 3) The danger appraisal of uncertainty scores of the subjects ranged from 8 to 32 with a mean score of 20.22. 4) The opportunity appraisal of uncertainty scores of the subjects ranged from 7 to 28 with a mean score of 17.80. 5) Significant factors that explained the danger appraisal of uncertainty were mastery (=-.444. p<.001), and education level (=-.184. p<.05). 6) Significant factor that explained the opportunity appraisal of uncertainty was level of uncertainty (=-.328. p<.001). Conclusion: Among the independent variables. the most significant factor that explained the danger appraisal of uncertainty in the women patients with rheumatoid arthritis was mastery. Therefore, a nursing intervention with strategies to improve sense of mastery should be developed for women patients with rheumatoid arthritis.
The etiology of rheumatic arthritis (RA) is associated with a number of genetic and environmental factors, but is not definitively elucidated. Recently, more attention has been paid to the possibility of microbial etiology in the pathogenesis of RA, because many different infectious agents have been reported to precede the onset or exacerbation of RA. Adenovirus (ADV) may be one cause of persistent or recurrent inflammatory arthritis. Varicella zoster virus (VZV) arthritis is detected frequently in RA patients treated with low dose methotrexate. The demonstration of simultaneous presence of both viral agents of specific viral nucleic acid in synovial fluids from synovitis patients would provide more direct evidence for arthritis etiological relationship, but there are no confirmed results. Therefore, we studied the ability of adenovirus and VZV to establish coinfection and persistent infection in synovial fluid from synovitis patients. The presence of viral agents in the synovial fluid demonstrated by isolation of cell culture, enzyme immunoassay and nested-PCR. The synovial fluids were also investgated for the presence of viral nucleic acid by nested-PCR using specific primer. ADV produced 220 bp and VZV produced 447 bp by each nested-PCR with specific primers. We detected 4/6 cases (66.7%) with persistent infection of ADV and 5/6 cases (83.3%) of VZV with 13 synovial fluids (between 7 to 52 day intervals) from synovitis patients by monoclonal ErA and nested-PCR. 21/28 cases (75%) with coinfection of adenovirus and VZV with synovial fluids from synovitis patients by nested-PCR. ADV and VZV coinfection and persistent infection of synovial fluids may provide a chronic antigenic stimuli to the immune system therefore provoking a continuing inflammatory response and caused the possibility of synovitis and arthritis.
Kim, Seung-Hoon;Cho, Mi-La;Youn, Jeehee;Park, Sung-Hwan;Hwang, Sue-Yun;Cho, Chul-Soo;Kim, Ho-Youn
IMMUNE NETWORK
/
v.1
no.1
/
pp.61-69
/
2001
Background: To determine the molecular structure of type II collagen-specific T-cell receptors associated with rheumatoid arthritis (RA). Methods: We generated CII-specific T-cell lines of 8 RA patients by prolonged in vitro culture with bovine CII (bCII) and the immunogenic peptide (256-270) of human CII. The proliferation response towards CII stimulation was measured from the uptake of 3H-thymidine. Changes in the secretion of Th 1 and Th2 cytokines in the culture supernatent were measured by ELISA. The TCR clonotypes of these T-cells were examined by RT-PCR/SSCP analyses of all 22 $V_{\beta}$ chains. Results: T-cells from patients' tissue exhibited strong proliferation index upon CII stimulation, which was maintained up to 6 months in the culture. The secretion of INF-$\gamma$from these T-cells increased along with the duration of culture time, while the amount of IL-4 production did not show significant changes. The SSCP band patterns of patients' T-cells appear as discrete bands unlike the smeary streak produced from normal samples. Some SSCP bands, each representing selected expansion of a TCR containing certain subtype of $V_{\beta}$ peptides, appeared to be identical in more than one patients. Among these, the expansion of SSCP band representing the $V_{\beta}$ 14 CDR3 region persisted after switching the antigen to the immunogenic human peptide (256-270). Conclusion: CII-reactive T-cells expressing distinct CDR3 motifs are selectively expanded in the peripheral blood and synovial fluid of RA patients, and their persistent proliferation upon CII stimulation, as well as the production Th 1-type cytokines, may play pivotal roles in RA pathogenesis.
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.
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