BACKGROUNDRheumatoid arthritis (RA) is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine (TCM) diagnosis first, the practitioner is able to choose acupoints according to the state of each individual patient.

METHODS/DESIGNWe are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in RA.The authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of life.

DISCUSSIONThe findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture research.

TRIAL REGISTRATION NUMBERClinicalTrials.gov Identifier NCT02553005.

Acupuncture Therapy ; Arthritis, Rheumatoid ; psychology ; therapy ; Clinical Protocols ; Double-Blind Method ; Hand ; physiopathology ; Humans ; Medicine, Chinese Traditional ; Pilot Projects ; Quality of Life

OBJECTIVES: The aim of this study was to investigate hearing and outer cells function in patients with psoriatic arthritis. Our investigation was a prospective case control study. METHODS: A total of 31 psoriatic arthritis patients (62 ears) and 31 healthy control subjects (62 ears) were enrolled in the study. We investigated hearing changes of patients and controls via pure tone audiometry, speech discrimination scores, tympanometry, acoustic reflex, and transient product otoacoustic emission. RESULTS: The mean age of psoriatic arthritis patients was 36.1+/-8.5 years (range, 14 to 62 years). The average age of the control group was 37.9+/-8.1 years (range, 16 to 62 years). There were statistically significant differences between pure tone audiometry in all frequencies and right and left emission at the 4.0 and 1.0 in psoriatic arthritis patients versus controls (P<0.05). This difference was evident, especially at high frequencies. There was no statistically significant difference between the ages and genders of the patient and control groups (P>0.05). Both audiological and otoacoustic emissions were not significantly different between right and left ear (P>0.05). CONCLUSION: Based on the audiological and otoacoustic findings; it is likely that the cochlear outer hair cells become subtly damaged in psoriatic arthritis patients, consequently leading to changes in hearing thresholds. These data suggest that it is important to screen psoriatic arthritis patients for hearing changes with otoacoustic emissions and audiologic tests regularly.
Acoustic Impedance Tests ; Arthritis, Psoriatic* ; Audiometry ; Audiometry, Pure-Tone ; Audiometry, Speech ; Case-Control Studies ; Cochlea* ; Discrimination (Psychology) ; Ear ; Hair* ; Hearing* ; Humans ; Otoacoustic Emissions, Spontaneous ; Prospective Studies ; Reflex, Acoustic

OBJECTIVETo explore features of Chinese medical syndrome types in rheumatoid arthritis (RA) patients accompanied depressive symptoms.

METHODSThe degree of depressive symptoms was assessed in 263 RA patients using self-rating depression scale (SDS). The correlation between depressive symptoms and modified Disease Activity Score (DAS28) were analyzed. The features of Chinese medical syndrome types of RA patients accompanied with depressive symptoms were also assessed.

RESULTSThe percentage of these patients of sputum-stasis obstruction syndrome (SSOS) was 47.2% and that of qi-blood deficiency syndrome (QBDS) was 45.8%, obvious higher than that of other groups (P < 0.05). DAS28 score was higher and their course of the disease was longer in RA patients accompanied with depressive symptoms. But there was no obvious difference in age. There were more RA patients with depressive symptoms holding higher levels of certificate than those holding lower levels of certificate.

CONCLUSIONSThere was certain correlation between Chinese medical syndrome types and depressive symptoms in RA patients. RA patients of SSOS and QBDS were easier to suffer from depressive symptoms. Higher DAS28, longer course of the disease, and holding higher levels of certificate might be three risk factors for RA patients accompanied with depressive symptoms.

Adult ; Arthritis, Rheumatoid ; complications ; diagnosis ; psychology ; Depression ; complications ; diagnosis ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Risk Factors

Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.
Arthritis ; Blister ; Calcaneus ; Handling (Psychology) ; Heel ; Necrosis ; Organic Chemicals ; Prevalence ; Sural Nerve ; Tendons

Calcaneal fractures account for 2% of all fractures and approximately 60 to 70% of tarsal fractures. These fractures typically are the result of high-energy injury, such as a motor vehicle accident or a fall from a height. The potential for disabling malunion following intrarticular displaced calcaneal fracture is high, regardless of treatment. Fracture displacement typically results in loss of hindfoot height, varus and widening of the hindfoot, with possible subfibular impingement and irritation of the peroneal tendon and/or sural nerve. Frequently, subtalar joint develops posttraumatic arthritis. In symptomatic patients with calcaneal malunion, systemic evaluation is required to determine the source of pain. Nonsurgical treatment, such as activity and shoe modification, bracing, orthoses, and injection, is effective in many patients. Surgical treatment may involve simple ostectomy, subtalar arthrodesis with or without distraction, or corrective calcaneal osteotomy. A high rate of successful arthrodesis and of patient satisfaction has been reported with surgical manamgent.
Arthritis ; Arthrodesis ; Braces ; Calcaneus ; Displacement (Psychology) ; Humans ; Motor Vehicles ; Organic Chemicals ; Orthotic Devices ; Osteotomy ; Patient Satisfaction ; Shoes ; Subtalar Joint ; Sural Nerve ; Tendons

PURPOSE: The purpose of this predictive study was to identify factors affecting health related quality of life (HRQoL) in patients with rheumatoid arthritis (RA). METHODS: The participants in this study were 131 patients with RA who were recruited from the outpatient clinic of a university hospital in Seoul. Disease activity in rheumatoid arthritis was evaluated by calculating the Disease Activity Score 28. Disability in activities of daily living (ADL) was assessed with the Korean Health Assessment Questionnaire, and depression with The Center for Epidemiologic Studies Depression Scale. HRQoL was evaluated using The Short Form 36 Health Survey. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression. RESULTS: Pain, disability in ADL, disease activity, and depression correlated negatively with physical and mental dimensions of HRQoL. But hierachical multiple regression analysis revealed that disability in ADL and depression were the only variables negatively influencing physical and mental QoL after adjustment for influences of sociodemographic variables. CONCLUSION: Results of this study suggest that disability in ADL and depression, rather than disease activity and pain have profound effects on HRQoL in patients with RA. Further studies are needed to assess the predictive ability of disease activity and pain on HRQoL in this population.
*Activities of Daily Living ; Adaptation, Psychological ; Adult ; Aged ; Arthritis, Rheumatoid/pathology/*psychology ; *Depression ; Female ; Health Status ; Hospitals, University ; Humans ; Male ; Middle Aged ; Pain ; *Quality of Life ; Questionnaires ; Republic of Korea

This study was conducted to estimate the socioeconomic costs of overweight and obesity in a sample of Korean adults aged 20 yr and older in 2005. The socioeconomic costs of overweight and obesity include direct costs (inpatient care, outpatient care and medication) and indirect costs (loss of productivity due to premature deaths and inpatient care, time costs, traffic costs and nursing fees). Hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, stroke, colon cancer and osteoarthritis were selected as obesity-related diseases. The population attributable fraction (PAF) of obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation (NHIC) cohort data and the 2005 Korea National Health and Nutrition Examination Survey (KNHANES) data. Direct costs of overweight and obesity were estimated at approximately U$1,081 million equivalent (men: U$497 million, women: U$584 million) and indirect costs were estimated at approximately U$706 million (men: U$527 million, women: U$178 million). The estimated total socioeconomic costs of overweight and obesity were approximately U$1,787 million (men: U$1,081 million, women: U$706 million). These total costs represented about 0.22% of the gross domestic product (GDP) and 3.7% of the national health care expenditures in 2005. We found the socioeconomic costs of overweight and obesity in Korean adults aged 20 yr and older are substantial. In order to control the socioeconomic burden attributable to overweight and obesity, effective national strategies for prevention and management of obesity should be established and implemented.
Adult ; Aged ; Arthritis/economics ; Cardiovascular Diseases/economics ; *Cost of Illness ; Diabetes Mellitus/economics ; Dyslipidemias/economics ; Female ; Health Care Costs/statistics & numerical data ; Health Expenditures ; Hospitalization/economics ; Humans ; Male ; Middle Aged ; Neoplasms/economics ; Nutrition Surveys ; Obesity/*economics/*psychology ; Republic of Korea ; Socioeconomic Factors

The posterior cruciate ligament (PCL) is a central stabilizer of the knee joint and it contributes to anteroposterior, valgus/varus and rotational stability. The PCL guides femoral rollback if it is preserved with proper tension during total knee arthroplasty. Maintenance of the joint line position, more conservation of bone and the possibility of reduced wear by absorption of shear forces are the potential advantages of posterior cruciate ligament retention. But an overly tensioned PCL increases polyethylene wear and on the other hand a lax PCL induces paradoxical femoral rollback and instability during knee flexion. So careful attention is needed in order to achieve the proper tension of the PCL during total knee arthroplasty, and sacrificing the PCL is considered in cases of severe deformity of the knee joint or progressive rheumatoid arthritis.
Absorption ; Arthritis, Rheumatoid ; Arthroplasty ; Congenital Abnormalities ; Hand ; Joints ; Knee ; Knee Joint ; Polyethylene ; Posterior Cruciate Ligament ; Retention (Psychology)

PURPOSE: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. MATERIALS AND METHODS: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. RESULTS: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. CONCLUSION: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.
Arthritis ; Clavicle ; Debridement ; Edema ; Follow-Up Studies ; Humans ; Osteomyelitis ; Recurrence ; Retention (Psychology) ; Sternoclavicular Joint ; Sternum

PURPOSE: This study was to investigate the prevalence of depressive symptoms and risk factors in elderly people (old vs oldest-old) with arthritis. METHODS: The Korean Longitudinal Study of Aging (KLoSA) was used with a sample of 1,084 elderly people with arthritis aged 65 or above. RESULTS: We found that the prevalence of depressive symptom was greater for oldest-old people (66.7%) compared to old people (56%). Significant differences between old people and oldest-old people were found for education, living with spouse, number of generation, regular exercise, body mass index (BMI), ADL limitation, self-rated health, and depression. Significant differences existed between depression and non-depression in terms of all variables except region and BMI among old people. But, among the oldest people, ADL limitation and self-rated health showed differences. The Logistic regression analysis revealed that religion, medical comorbidity, ADL limitation, self-rated health were significantly associated with depressive symptoms in old people. But, in oldest-old people, none of the variables were associated with depressive symptoms. CONCLUSION: The findings show that there are age differences in depression and related factors in elderly people with arthritis. Longitudinal studies, which covered depressive symptom severity and which are controlled for a large number of potential confounders, will need to complement the results of this study in the future.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Arthritis/*psychology ; Body Mass Index ; Comorbidity ; Depression/*psychology ; Female ; Health Status ; Humans ; Interviews as Topic ; Longitudinal Studies ; Male ; Risk Factors ; Socioeconomic Factors