• Journal of Korean Medicine Rehabilitation
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• v.21 no.2
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• pp.87-100
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• 2011

Objectives : This study was carried out to investigate the effects of Buja-tang treatment on the early change of the monosodium iodoacetate-induced osteoarthritis in rats. Methods : Arthritis was induced by injection of monosodium iodoacetate(MIA)(0.25 mg) into both knee joint cavities of rats. Arthritic rats were divided into control(n=8) and treated(n=8) group. The control group was taken distilled water and the treated group, extracts of Buja-tang by orally for 20 days. At the end of the experiment(20 days after MIA injection), gross and histopathological examinations on the articular structures of knee joints were performed. Proteoglycan(PG) content in articular cartilages was analyzed by safranine O staining method. And also, tumor necrosis factor-$\alpha$($TNF-{\alpha}$) and interleukin-$1{\beta}$($IL-1{\beta}$) contents in synovial fluid were measured by enzyme-linked immunosorbent assay(ELISA) method. Results : 1. Body weight(g) of the treated group was increased significantly compared with control group at 15 and 20 days after injection. 2. Grossly, the degree of osteoarthritis in the treated group was alleviated compared with the control group. 3. PG content in articular cartilage of the treated group was increased significantly compared with the control group. 4. Histopathologically, osteoarthritic score of the treated group was decreased significantly compared with the control group. 5. $TNF-{\alpha}$ content in synovial fluid of the treated group was decreased significantly compared with the control group. Conclusions : On the basis of these results, we suggest that Buja-tang have inhibiting effects on the progression of arthritis in MIA-induced osteoarthritis model. And it is related to inhibiting the activity of $TNF-{\alpha}$ in osteoarthritic chodrocytes and synovial membranes.

• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.366-369
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• 2015

A 12-year-old, castrated male, mixed-breed dog was referred to us with a history of depression, lameness, neck and multiple joints pain. Clinical signs had been deteriorating from rear limbs lameness leading to pain on all four limbs lameness for 7 days. Mild leukocytosis and increased C-reactive protein concentration were revealed in blood work. On radiography, degenerative change of humerus and cervical intervertebral space narrowing were found. The results of synovial fluid analysis revealed severe neutrophilic pleocytosis, decreased viscosity, increased turbidity and bacterial culture was negative. The antinuclear antibody test was negative and MRI results revealed mild cervical intervertebral disk disease (IVDD). Based on all tests, we diagnosed this case as idiopathic immune-mediated polyarthritis (IMPA). Prednisolone and mycophenolate mofetil were administered and clinical signs were resolved after 7 days. This case report demonstrated that clinical, diagnostic imaging and synovial fluid analysis findings and successful treatment result with prednisolone and mycophenolate mofetil in canine idiopathic IMPA.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.2
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• pp.191-199
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• 1997

Mandibular trauma is developed due to traffic accident, fall down, industrial injury, and others. TMJ disorder is usually also developed after facial traumatic injury. Many authors suggested that disc displacement or tearing, acute synovitis, TMJ ankylosis, traumatic arthritis, or effusion are developed after facial trauma. It is still very controversible what is the best treatment of TMJ injury such as condylar fracture and meniscal injury. In TMJ injury, synovial inflammation is developed and pain mediators such as prostaglandin E2 or leukotriene B4 are released from the synovial membrane. This can be a cause of TMJ disorder. I present a variety of experimental study about the condylar fracture and meniscal injury and enzyme-immunoassay of synovial fluid after mandibular trauma that have been studied since 1992 and establish the treatment criteria of traumatic TMJ injury. I think that the treatment option of condylar fracture depends upon the surgeon's criteria exclusively. There are no significant differences between conservative and surgical treatment. If the aggressive functional physical therapy and long-term followup be performed, the favorable functional recovery of TMJ can be obtained. And I think that the initial surgical management of meniscus of TMJ is unnecessary in condylar fracture. And also arthrocentesis can be available to release the patient's subjective symptoms and improve the healing of injured TMJ.

• Journal of Acupuncture Research
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• v.19 no.2
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• pp.51-64
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• 2002

We have compared(using the same series of experimental tissue samples) the levels of proteolytic enzyme activities and free radical-induced protein damage in synovial fluid from RA and CPH cases. Many protease types showed significantly increased (typically by a factor of approximately 2-3-fold) activity in RA, compared to normal rats. However, CPH significantly reduced the cytoplasmic enzyme activities of arginyl aminopeptidase, leucyl aminopeptidase, pyroglutamyl aminopeptidase, tripeptidyl aminopeptidase, and proline endopeptidase to almost about 1/10 each. For the Iysosomal proteases, synovial fluid samples from RA rats, CPH significantly reduced the enzyme activities of cathepsin B, dipeptidyl aminopeptidase I and dipeptidyl aminopeptidase II. In extracellular matrix degrading(collagenase, tissue elastase) and leukocyte as sociated proteases (leukocyte elastase, cathepsin G), CPH decreased these enzyme activities of collagenase, tissue elastase and leukocyte associated elastase in RA. In cytoplasmic and lysosomal protease activities in plasma from RA. CPH and normal plasma samples were not significantly different, suggesting that altered activity of plasma proteases (particularly those enzymes putatively involved in the immune response) is not a contributory factor in the pathogenesis of RA. In addition, the level of free radical induced damage to synovial fluid proteins was approximately twice that in RA, compared with CPH. CPH significantly decreased the level of ROS induced oxidative damage to synovial fluid proteins (quantified as protein carbonyl derivative). Therefore we conclude that both proteolytic enzymes and free radicals are likely to be of equal potential importance as damaging agents in the pathogenesis of inflammatory joint disease, and that the design of novel therapeutic strategies for patients with the latter disorder should include both protease inhibitory and free radical scavenging elements. In addition, the protease inhibitory element should be designed to inhibit the action of a broad range of protease mechanistic types (i.e. cysteine-, metallo- and serine- proteinases and peptidases). However, increased protein damage induced by ROS could not be rationalised in terms of compromised antioxidant total capacity, since the latter was not significantly altered in RA synovial fluid or plasma compared with CPH.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.304-310
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• 2001

The joint disease including osteoarthris (OA) and rheumatoid arthritis (RA) are common in the horse. Many studies have been performed to develop biochemical markers reflecting the abnormalities of cartilage and synovial membrane. However, no specific, sensitive and clinically well established assay systems have been yet available to characterize the severity of joint diseases. Indeed, radiography is still doctor's best choice of assessing joint damage in OA/RA. This review focuses on biochemical molecules such as proteoglycan, collagen, matrix metalloproteinases (MMPs), lectin and cytokine to assess their potential value for not only predicting stage of joint disease but also monitoring treatment efficacy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.4
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• pp.308-313
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• 2001

The purpose of this study is to validate the potential etiologic factors for temporomandibular disorder(TMD). TMJ arthroscopic examination was performed in upper joint compartment of 32 joints from 20 patients with mandibular fractures. Synovial fluid was collected from the upper joint space during pumping manipulation with normal saline. Cytologic smearing and histomorphologic exam of synovial fluid were performed in 15 joints. Prostaglandin $E_2(PGE_2)$ concentration was measured in 11 joints. Leukotriene $B_4(LTB_4)$ concentration was measured in 8 joints. There were several arthroscopic variables such as ecchymosis, fibrillation, and adhesion. Histomorphologic exam showed a variety of findings such as bloody smears, cellular cluster, degenerated cells and cartilage, undifferentiated crystal. Mean $PGE_2$ concentrations were 316.5 pg/ml. Mean LTB4 concentrations were 45.9pg/ml. This study demonstrated a variety of findings on inflammatory and degenerative changes of TMJ. Because acute trauma such as mandibular fracture is a major etiologic factor in cartilage degradation and biochemical and intraarticular pathology, clinicians must identify and address TMJ signs and symptoms during follow-up periods in the long term.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.23 no.1
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• pp.7-14
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• 1993

The Internal derangement of temporomandibular joint disc was evaluated by using magnetic resonance imaging and arthrogram in 5 patients having reciprocal clicking or locking and in 5 normal subjects. Parasagittal multisections on both closed and open mouth were serially obtained by using a 1.5 Tesla MR system and surface coil with CSMEMP, MPGR. MR images obtained were analized by correlating with images of arthrograms. The obtained results were as follows: 1. Displaced meniscus was clearly delineated as dark structure on MR images other than on arthrograms of closed mouth view of patient having clicking or locking. 2. The deltoid white images of synovial fluid were identified in the glenoid fossa and on the posterior surface of condyle on open mouth view and partly depicted on closed mouth view, of parasagittal sections by MPGR. 3. The greyish image of joint fluid was identified on the posterior surface of condyle on the open mouth view of parasagittal sections by CSMEMP. 4. The structural relationship among condyle, meniscus, and fluid showed the variety of images on each parasagitta1 view.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.679-685
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• 2010

Many animal models of osteoarthritis (OA) have been developed, aimed at understanding the long-term progression of OA and difficulty of identifying patients in the initial stage of the disease. In canines, coxofemoral luxation and hip dysplasia are common orthopedic ailments related to OA in the hip joint. Transecting the ligament of the head of the femur (LHF) aids in diagnosis of coxofemoral joint OA. Presently, mobility of this joint was increased by transected LHF in 10 mature, 2-3-year-old (average $2.57{\pm}0.20$ years), healthy male beagles. The animals were normally gaited 1-week post-operatively. During the experimental period, examinations including X-ray, complete blood count and serum chemistry were unremarkable. Proteomic examination revealed protein alterations in synovial fluid, with significant increases in Vitamin D-binding protein precursor (ANOVA, p < 0.004) and Kinogen-1 (ANOVA, p < 0.039). Both proteins correlated with arthritis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.5
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• pp.399-408
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• 2005

In the progression of the Temporomandibular Joint Disorder(TMD), not only deformation and perforation of disc occur. But also fibrotic adhesion and inflammatory changes to the retrodiscal tissue can be seen in addition to the condylar degenerative change (e.g. osteoarthritis). However, the correct diagnosis,?planning for appropriate treatment, and prediction of prognosis are limited, because there are no means to stage the progression of the disorder. In this study relative signal intensity of retrodiscal tissue in MRI and the synovial fluid concentration of matrix metalloproteinase-2 (MMP-2), MMP-9, and Interleukin-6(IL-6) in the 23 temporomandibular joints(TMJ), from 17 patients with TMD were evaluated as a possible diagnostic marker. The relative signal intensity of retrodiscal tissue was referenced to brain gray matter with same region of interest(ROI) size. The concentrations of MMP-2, MMP-9, and IL-6 were evaluated by Enzyme Linked Immunosorbent Assay (ELISA). The collected data were compared with condylar degenerative change, joint effusion and disc position observed in MRI. The relative signal intensity of the retrodiscal tissue was increased significantly when degenerative changes were present. In addition, there was significantly high signal intensity in the presence of a disc displaced without reduction. The concentration of IL-6 was significantly increased when condylar degenerative change was no observed. And there were no changes in the levels of IL-6 according to disc position and joint effusion measurement. Moreover, there were no significant relevance between the concentration of total MMP-2 and active MMP-9 in synovial fluid, relative to degenerative changes in the mandibular condyle, to joint effusion, and to disc position observed on MRI images. In conclusion, the relative signal intensity of the retrodiscal tissue can be regarded as a mean of diagnosing the procession of TMD in a non-invasive manner. But more additional studies are required for the levels of MMP-2. MMP-9, and IL-6 to determine their potentials as a diagnostic marker for TMD.

• Korean Journal of Veterinary Research
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• v.46 no.4
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• pp.395-398
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• 2006

A 2-month-old female Shih-tzu dog was referred because of lameness, exercise intolerance, depression, elbow and stifle joint swelling. Physical examination, complete blood counts, serum-chemistry, radiography, synovial fluid analysis, antinuclear antibody test, and rheumatoid factor measurement were initiated. On radiography, soft tissue swelling of elbow and stifle joints without erosiveness were founded. The results of synovial fluid analysis revealed severe neutrophilic pleocytosis (nondegenerative), decreased viscosity, increased turbidity, positive on mucin-clot test, and negative on bacterial culture. The results of rheumatoid factor measurement and antinuclear antibody test were negative and below 1 : 40, respectively. Based on all tests, we diagnosed this case as juvenile onset type I immune-mediated polyarthritis. Azathioprine (1 mg/kg body weight, per os q 24 h, for 4 weeks) was then administered and clinical signs improved gradually. Four weeks after azathioprine administration, clinical signs were disappeared. This report describes the clinical findings, imaging characteristics, synovial fluid findings, and other laboratory results of type I immune-mediated polyarthritis and successful management with azathioprine therapy.