• Asian Spine Journal
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• 제12권6호
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• pp.1017-1027
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• 2018

Study Design: This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015. Purpose: This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described. Methods: We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required. Results: The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto-excellent outcomes in all patients. Conclusions: ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

• Journal of Korean Neurosurgical Society
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• 제62권2호
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• pp.217-224
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• 2019

Objective : We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death. Methods : We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities. Results : During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p<0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p<0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80-2.89) and 1.66 (95% CI, 1.42-1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups. Conclusion : The incidence rates of congestive heart failure and death were increased in AS patients.

• 근관절건강학회지
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• 제26권2호
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• pp.141-154
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• 2019

Purpose: This study aimed to analyze the effects of exercise on pulmonary function in patients with ankylosing spondylitis (AS). Methods: Randomized controlled trials (RCTs) were identified by searching MEDLINE, EMBASE, CENTRAL, and CINAHL (through Jan 2019). Three reviewers independently retrieved articles, extracted data, and assessed methodological quality using the Cochrane's Risk of Bias for randomized studies. Results: Fourteen studies met the inclusion criteria with a total of 729 participants. CE (SMD 0.58, 95% CI 0.41~0.75, p<.001) and $VO_2peak$ (SMD 0.56, 95% CI 0.24~0.88, p=.001) had a significant effect on the most exercise interventions. As a secondary variable, BASFI (SMD -0.53, 95% CI -0.70~-0.37, p<.001), BASMI (SMD -0.75, 95% CI -0.92~-0.58, p<.001) showed an effect size of more than medium. However, PFT and QoL did not produce a significant results. Conclusion: Pulmonary involvement is common in patients with AS and might have disturbed functionality and exercise modality. Exercise can be an effective intervention to improve pulmonary function in patients with AS. More attention is needed to improve the chest and spinal mobility to maintain the appropriate pulmonary function. It is also necessary to consider how to construct a patient-tailored exercise program to increase performance, accuracy and safety of exercise.

• Molecules and Cells
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• 제45권6호
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• pp.365-375
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• 2022

Long non-coding RNAs (lncRNAs) may be important regulators in the progression of ankylosing spondylitis (AS). The competing endogenous RNA (ceRNA) activity of lncRNAs plays crucial roles in osteogenesis. We identified the mechanism of the differentially expressed lncRNA MALAT1 in AS using bioinformatic analysis and its ceRNA mechanism. The interaction of MALAT1, microRNA-558, and GSDMD was identified using integrated bioinformatics analysis and validated. Loss- and gain-of-function assays evaluated their effects on the viability, apoptosis, pyroptosis and inflammation of chondrocytes in AS. We found elevated MALAT1 and GSDMD but reduced miR-558 in AS cartilage tissues and chondrocytes. MALAT1 contributed to the suppression of cell viability and facilitated apoptosis and pyroptosis in AS chondrocytes. GSDMD was a potential target gene of miR-558. Depletion of MALAT1 expression elevated miR-558 by inhibiting GSDMD to enhance cell viability and inhibit inflammation, apoptosis and pyroptosis of chondrocytes in AS. In summary, our key findings demonstrated that knockdown of MALAT1 served as a potential suppressor of AS by upregulating miR-558 via the downregulation of GSDMD expression.

• 대한정형외과학회지
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• 제56권4호
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• pp.294-304
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• 2021

강직성 척추염은 천장 관절의 강직뿐만 아니라 척추체 주변의 관절막과 인대의 골화로 인해 척추 강직을 일으킨다. 이는 척추 움직임 제한을 일으키고 많은 경우에서 통증을 동반한 경추, 흉추, 요추 분절의 척추 변형을 유발한다. 방치할 경우 최종적으로는 전신 관절의 강직과 골화를 유발하게 되는 심각한 질환 중 하나이다. 일반적으로 30세 이전에 증상이 발현되며 질병의 점진적인 진행으로 신체적 기능, 환자의 직업적 능력과 삶의 질에 악영향을 끼치게 된다. 이는 우울증 같은 정신과적 질환으로 발전할 가능성을 높인다. 저자들은 이러한 심각성을 인지하고 전신 골화로 악화되기 이전에 다양한 약물 치료로 수술적 치료를 방지하고자 하는 최근의 경향과 연구를 소개하고자 하였으며, 또한 진행을 예방하지 못하여 수술적 치료에 이르게 된 환자들에서 시행되는 다양한 수술 방법과 그에 따른 합병증을 제시하고자 한다.

• 보험의학회지
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• 제31권1호
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• pp.19-28
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• 2012

Nowadays, Rheumatic diseases are increasing more and more. So, it's important knowing the pathophysiology and extra-risk of each rheumatic disease so as to do sound underwriting. Here is brief review and long-term prognosis of some rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sj$\ddot{o}$gren syndrome, antiphospholipid syndrome, systemic sclerosis, ankylosing spondylitis, Takayasu's arteritis, and Behcet syndrome.

• 성인간호학회지
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• 제12권4호
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• pp.560-572
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• 2000

This study was designed to offer descriptive data for nursing intervention for relief of fatigue and pain, and to distinguish by the characteristic difference and the symptoms such as fatigue and pain on Ankylosing Spondylitis (AS), Fibromyalgia(FM), and Systemic Lupus Erythematosus(SLE) patients. The sample consisted of 92 patients(AS 29; FM 30; SLE 33) who visited H-University Rheumatism Hospital in Seoul. The data were collected by a structured questionnaire from May 1, 1999 to April 30, 2000. The results were as follows: Patients of 95% experienced fatigue in the last week and a fatigue score of three disease groups were above average. The fatigue score of FM patients was highest in the other disease, but which was not a statistically significant difference(F=1.417, p=.248). The mean score of AS and FM patients in pain was higher than the SLE patients, and there was the statistical significance among the three groups on pain (F=8.239, p=.001). There wasn't a statistical difference among three groups on coping wtih pain(F=1.451, p=.240). There wasn't any correlation between fatigue and pain in each disease (AS: r=.008, p=.966; FM: r=.328, p=.077; SLE: r=.237,p=.185). Therefore, morning stiffness and pain management during sleeping is needed through good body alignment in the AS patients. Adequate rest for fatigue and multiple coping strategies for pain maybe basic nursing intervention in FM and SLE. According to their fatigue rhythm, a regular exercise program is needed for rheumatic disease because they complained of fatigue above average and their fatigue was repeated better and worse only during the one week.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.200-200
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• 2024

• The Korean Journal of Pain
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• 제34권1호
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• pp.114-123
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• 2021

Background: Evaluation of the effectiveness of caudal epidural injection on pain, spine mobility, disease activity, and activity of daily living in axial spondyloarthritis (SpA) patients. Methods: A total sample of 47 patients were registered in this study. They were randomly assigned into 2 groups; Group I received caudal epidural injections, ultrasound-guided, with 1% lidocaine hydrochloride mixed with triamcinolone, whereas Group II did not receive any injections. All participants fulfilled the ASAS criteria for axial SpA. Outcome measures were as follows: visual analogue scale, Oswestry disability index (ODI), modified Schober test, lateral lumbar flexion, and Ankylosing Spondylitis Disease Activity Score (ASDAS) with assessment at baseline, 2 weeks, and 8 weeks post-treatment. This clinical trial was registered on clinicaltrials.gov under the number NCT04143165. Results: There was a significant difference between both groups regarding pain, ODI, spine mobility and ASDAS scores in favor of group I. This effect was at its maximum after 2 weeks. Despite the decline of this effect after 2 months, the difference between the groups remained significant. Higher disease activity, younger age, and shorter disease duration were associated with better outcomes. Conclusions: Epidural injection of lidocaine and triamcinolone is a cost effective and a practical technique for controlling pain, as well as improving the function of the spine and disease activity scores in axial SpA patients with acceptable complications and relatively sustained effect.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.184-193
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• 2024

Background/Aims: We aimed to clarify the clinical characteristics of psoriatic arthritis (PsA) in Korean patients focusing on PsA with axial involvement. Methods: A retrospective medical chart review was performed to identify PsA patients at a single tertiary center. Cases of AS patients with psoriasis were recruited from a prospective AS registry of the same center. Demographics, laboratory findings, and radiologic characteristics were assessed. Results: A total of 69 PsA patients were identified. In PsA patients, spondylitis (46.4%) was the most common form. Compared to AS patients with psoriasis, PsA patients with radiographic axial involvement were older (50.9 vs. 32.4 years; p < 0.001) and showed greater peripheral disease activity (peripheral arthritis 78.1 vs. 12.5%, p < 0.001; enthesitis 50.0 vs. 6.3%, p = 0.003). AS patients with psoriasis presented a higher rate of HLA-B^*27 positivity (81.3 vs. 17.2%; p < 0.001) and a more frequent history of inflammatory back pain (100.0 vs. 75.0%; p = 0.039) than PsA patients with radiographic axial involvement. Significant proportions of PsA patients with radiographic axial involvement had cervical spine involvement (10/18, 55.6%) and spondylitis without sacroiliitis (10/23, 43.5%). Conclusions: We demonstrate that axial involvement is common in Korean PsA patients, and its characteristics can be distinct from those of AS.