Correlation between expression of interleukin-1β, interleukin-6, interleukin-8 and tumor necrosis factor α in knee joint fluid and histopathology / 第二军医大学学报

Objective To study the correlation between the expression levels of four inflammatory factors (interleukin [IL]-1β, IL-6, IL-8 and tumor necrosis factor α [TNF-α]) in knee joint fluid and the related histopathology. Methods Before the joint surgery, the knee joint fluid was extracted from 31 patients. The expression levels of IL-1β, IL-6, IL-8 and TNF-α in knee joint fluid were examined by cytometric bead array, and the pathological feature of synovial tissues was analyzed. According to the histopathological diagnosis, the patients were divided into osteoarthritis (OA), revision after prosthesis replacement (RPR), pigmented villonodular synovitis (PVNS) and rheumatoid arthritis (RA) groups. According to the content of hemosiderin in the synovial tissue, they were divided into hemosiderin deposition group and non-hemosiderin deposition group. According to the infiltration of inflammatory cells in synovial tissue, they were divided into inflammatory cell infiltration group and noninflammatory cell infiltration group. According to the color of knee joint fluid, they were divided into blood joint fluid group and non-blood joint fluid group. Results There were nine male and 22 female patients with an average age of (63.60±9.19) years, including 12 left knees and 19 right knees. There were 18 cases with OA, five with RPR, five with PVNS and three with RA. The levels of four inflammatory factors in the knee joint fluid of OA group were the lowest, which were significantly different from the other three groups (all P0.05). The level of IL-6 in knee joint fluid of RA group was significantly higher than that of PVNS group, but significantly lower than that of RPR group, and the differences between the three groups were significant (all P0.05). Conclusion IL-1β, IL-6, IL-8 and TNF-α are expressed in various joint diseases and the expressions are related to their pathological features, which can help further understand the pathogenesis and development of some joint diseases, so as to provide a reference for clinical diagnosis, treatment and basic research.

Electro-acupuncture promotes repair of rotator cuff injury in rats / 南方医科大学学报

OBJECTIVE@#To observe the therapeutic effect of electro-acupuncture on tendon healing and functional recovery of rotator cuff injury in rats and explore the therapeutic mechanism of electro-acupuncture.@*METHODS@#Ninety SD rats were randomly divided into electro-acupuncture group, model group and blank control group, and models of rotator cuff injury were established in the former two groups.The rats in electro-acupuncture group was treated with electro-acupuncture after the operation, and those in the other two groups received no treatment.The right forefoot thermal withdrawal latency (TWL), the contents of IL-1β, IL-6 and TNF-α in the synovial fluid and the maximum tension load of supraspinatus tendon were measured at 2, 4 and 8 weeks after the operation.@*RESULTS@#TWL in the model group was significantly lower than that in the blank control group and electro-acupuncture group at 2, 4 and 8 weeks after the operation (@*CONCLUSIONS@#Electro-acupuncture treatment not only effectively reduces the expression of inflammatory factors to relieve pain, but also promotes the repair of damaged tissue to improve the biomechanical properties of rotator cuff in the rat models.

The Effect of Human Joint Fluid in the Surviviorship and Proliferation of Bone-Marrow Derived Progenitor Cell / 대한정형외과연구학회지

PURPOSE: To investigate the effect of human joint fluid media on the survival and proliferation of bone marrow derived precusor cell, and to provide the basic data of the intraarticular injection with scaffold-free progenitor cell in advanced degenerative osteoarthritis (OA). MATERIALS AND METHODS: We obtained the joint fluid and bone marrow from 15 patients who had total knee arthroplasty due to degenerative OA, and isolated the mesenchymal progenitor cells (MPCs) from bone marrow by washing and ten times subculture. We devided the control and experiment groups according to the addition of joint fluid at various ratios (1/100, 1/10, 1, 10, 100, 1000 microliter), and statistically analyzed the numbers of mesenchymal progenitor cell proliferated according to the culture period. RESULTS: The experiments using joint fluid without centrifuge showed the increase of MPCs as the culture poriod was extended and was independent to the existence of fetal bovine serum, the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid, and statistically significant increase MPCs in 10, 100, 1000 microliter of serum contained groups, 1000 microliter of serum-free groups (p=0.039, p=0.017, p=0.077, p=0.004). The experiments using joint fluid with centrifuge showed the increase of MPCs as the culture period was extended and was independent of fetal bovine serum, and the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid, and statistically significant increase MPCs in 1000 microliter of both serum contained and serum-free groups (p=0.006, p=0.024). CONCLUSION: MSCs not only can survive, but also proliferate in human joint fluid. The rate of proliferaton is increased faster by the adding of joint fluid than only using common media in cell culture. And the experiment shows the dose dependent pattern in the increase of MPCs in proportion to the dose of joint fluid.

Detection of Tropheryma whipplei DNA in Joint Fluid of Patients with Arthritis by Polymerase Chain Reaction

BACKGROUND: Whipple's disease is a chronic systemic infection caused by Tropheryma whipplei which chiefly involves gastrointestinal tract and joints. Because arthritis is often the first sign of Whipple's disease, Whipple's disease may be misdiagnosed in the early stage of illness as non-infectious inflammatory arthritis. Rheumatoid arthritis may also be caused by infectious agents, including T. whipplei. To elucidate the relationship between T. whipplei infection and various arthritis, we examined T. whipplei DNA in Korean patients by polymerase chain reaction (PCR). MATERIALS AND METHODS: With two T. whipplei-specific primers dervied from the partial heat shock protein 65 gene sequence, PCR was performed on 56 joint fluid samples:33 samples from RA patients, 18 samples from OA patients, and 5 samples from patients with other unflammatory arthritis. In addition, the same method was applied to find out the DNA of T. whipplei in 8 normal adults' saliva and 22 patients' gastric juice. Due to the difficulty in obtaining the reference strain of T. whipplei, the PCR was performed without the positive control. RESULTS: The PCR method did not reveal T. whipplei in joint fluid from 56 patients with arthropathies, 8 samples from saliva, and 22 samples from gastric juice. CONCLUSION: Though technical errors can not be excluded as a cause of absence of a positive case, our results suggest that T. whipplei infection may not be a common cause of various arthritis in Korea; T. whipplei may be associated with inflammatory arthritis indirectly by immune-mediated mechanism rather than by direct joint invasion. The examination of specimens other than joint fluid could be helpful and the study of larger number of patient is highly desirable.

Detection of Tropheryma whipplei DNA in Joint Fluid of Patients with Arthritis by Polymerase Chain Reaction

BACKGROUND: Whipple's disease is a chronic systemic infection caused by Tropheryma whipplei which chiefly involves gastrointestinal tract and joints. Because arthritis is often the first sign of Whipple's disease, Whipple's disease may be misdiagnosed in the early stage of illness as non-infectious inflammatory arthritis. Rheumatoid arthritis may also be caused by infectious agents, including T. whipplei. To elucidate the relationship between T. whipplei infection and various arthritis, we examined T. whipplei DNA in Korean patients by polymerase chain reaction (PCR). MATERIALS AND METHODS: With two T. whipplei-specific primers dervied from the partial heat shock protein 65 gene sequence, PCR was performed on 56 joint fluid samples:33 samples from RA patients, 18 samples from OA patients, and 5 samples from patients with other unflammatory arthritis. In addition, the same method was applied to find out the DNA of T. whipplei in 8 normal adults' saliva and 22 patients' gastric juice. Due to the difficulty in obtaining the reference strain of T. whipplei, the PCR was performed without the positive control. RESULTS: The PCR method did not reveal T. whipplei in joint fluid from 56 patients with arthropathies, 8 samples from saliva, and 22 samples from gastric juice. CONCLUSION: Though technical errors can not be excluded as a cause of absence of a positive case, our results suggest that T. whipplei infection may not be a common cause of various arthritis in Korea; T. whipplei may be associated with inflammatory arthritis indirectly by immune-mediated mechanism rather than by direct joint invasion. The examination of specimens other than joint fluid could be helpful and the study of larger number of patient is highly desirable.

Expression of RANKL/OPG in Joint Fluids of Periprosthetic Osteolysis / 대한정형외과학회잡지

PURPOSE: This study evaluated the expression level of Receptor Activator of NF-kappaB Ligand (RANKL), Osteoprotegerin (OPG)and other pro-inflammatory cytokines in the osteoarthritic and periprosthetic joint fluid in order to characterize the role of these regulatory proteins in periprosthetic osteolysis. MATERIALS AND METHODS: Joint fluid specimens taken from 47 patients undergoing hip or knee reconstructive surgery were analyzed by enzyme-linked immunoassay (ELISA)in order to determine the relative protein expression level of RANKL, OPG, IL-1beta, IL-6 and TNF-alpha. The fluid from joints with osteoarthritis (15 cases, Group I), implants revised without associated osteolysis (15 cases, Group II)and failed implants with radiographically moderate to severe osteolysis (17 cases, Group III) were compared. The fluids from all cases with implants (Group II and III) was combined (Group IV)and compared with the osteoarthritic joint fluids. RESULTS: RANKL was present in all the fluids at similar concentrations. The OPG levels were significantly lower (2.2-3.9 fold)in Groups II and III than in Group I (p<0.0001). The IL-1beta concentration was significantly higher in Groups II, III and IV and with Group III being the highest (12.1 fold)(p<0.0001). The IL-6 expression level was significantly higher in Group III (2.0 fold)than in Groups I and II (p<0.0001). The TNF-alpha levels were 2.0 times higher in Group III and significantly higher in all implant cases (Group IV)are analyzed (p=0.03). CONCLUSION: Permissive RANKL protein expression coupled with suppressed OPG levels and enhanced osteoclastogenic cytokine expression results in periprosthetic osteolysis.

Observe the clinical effect on ankylosing spondylitis by hip joint fluid relax operation / 中国实用内科杂志

Objective To observe the clinical effect on hip involvement on patients with ankylosing spondylitis by hip joint fluid relax operation.Methods 112 patients with ankylosing spondylitis and hip involvement were selected from the Department of Rheumatology and Immunology,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology from 2003 to 2004.The patients were randomly assigned into curative group of 60 patients and control group of 52 patients.The patients in both groups took medication,and those in the curative group were treated with hip joint 'fluid relax operation besides the drug treatment.Compare the change of the following index(the hip joint function,CT staging of hip joint involvement,VAS point,erythrocyte sedimentation and plasma reactive protein)assessment between the two groups before treatment and after treatment of one year and two years.Results Score of hip joint function and VAS point were obviously higher before treatment than after treatment of one year and two years in both groups(P

Ultrasonographic Evaluation of the Painful Hemiplegic Shoulder

OBJECTIVE: The aim of this study is to know the usefulness of ultrasonographic evaluation of hemiplegic shoulder pain. METHOD: For 20 hemiplegic patients with shoulder pain, the shoulder was evaluated by simple radiographic findings, physical examinations, visual analogue scale (VAS), manual muscle test (MMT), and finally the ultrasonographic examination to define shoulder pain nature. The ultrasonographic results were compared to the simple radiography, physical examination, VAS, and MMT. RESULTS: The ultrasonographic findings were variable. The positive ultrasonographic findings were 10 joint fluid collections, 3 tendinous thickenings, 4 high echogenic findings, 4 tendon surface defects, 2 tendinous gracilings, and 1 joint surface irregularity. The ultrasonographic interpretative conclusion included 6 tendon (or muscle) tears, 2 degenerative changes, 5 nonspecific simple joint fluid collections, and 7 normal shoulder joints. In comparison of ultrasonographic findings and subluxation, VAS, and fluid collection, VAS showed relatively higher correlation. CONCLUSION: The ultrasonography is very useful as a non-invasive, inexpensive, painless, and rapid screening diagnostic method for the evaluation of painful hemiplegic shoulder.

The Study of beta-Glucuronidase Activity in Selected Orthopaedic Disease / 대한류마티스학회지

OBJECTIVES: The purpose of this study was to get help in order to diagnose orthopaedic disease, measure its activity and determine treatment plan by measuring the beta-glucuronidase activity in urine, serum and joint fluid. METHODS: The beta-glucuronidase activity was determined in the serum, urine and joint fluid of the patients with degenerative arthritis, rheumatoid arthritis, osteomyelitis and osteogenic sarcoma, and some other disease to study the change of the enzyme activity. These values of each specimen were calculated by standard curve and treated by statistical analysis. RESULTS: The results obtained were summarized as follows. 1. The beta-glucuronidase activity in the serum, urine and joint fluid was increased in patients with degenerative arthritis, rheumatoid arthritis, osteomyelitis and osteogenic sarcoma etc. 2. The increased beta-glucuronidase activity in the serum and joint fluid of each disease does not show a specific finding about respective disease, but the increased beta-glucuronidase activity was statistically significant in the urine of all disease groups(male:p=0. 0041, female:p=0. 0001). CONCLUSIONS: On the basis of these results, it was suggested that beta-glucuronidase activity was affected by the orthopaedic disease and differed according to each specimen.

Study on LD Isoenzyme Activity in Synovial Fluid of Joint Diseases / 대한정형외과학회잡지

The authors investigated LD activity and isoenzyme of total serum and joint fiuid in 18 cases of rheumatoid arthritis, 11 cases of degenerative arthritis, 6 cases of traumatic arthritis, and 10 cases of healthy control. The samples of serum examined were obtained from the anterior cubital vein and joint fluid from the knee joint except 2 cases of the rheumatoid arthritis, which were obtained from the wrist joint, in Busan National University Hospital from the April to July 1981. Total serum LD activity was measured by method of Caboud-Wroblewski and isoenzyme fractions were analysed by cellulose acetate electrophoresis. The results obtained were as follows: l. In the patients with joint diseases, total serum LD activity was significantly increased than that of healthy control. 2. The LD1 isoenzyme of joint fiuid was increased in degenerative arthritis than that in rheumatoid arthritis, and LD3 and LD5 isoenzymes were significantly increased in rheumatoid arthritis than that in degenerative arthritis. 3. In correlation between total LD and LD isoenzymes activities in joint fluid, total LD activity of rheumatoid arthritis was correlated with decrease of LD1 isoenzyme and increase of LD5 isoenzyme activity, and total LD activity of the degenerative arthritis was correlated with increase of LD1 isoenzyme activity. 4. In correlation between isoenzyme activity and gamma globulin of joint fluid, LD3 and LD5 isoenzyme activity in rheumatoid arthritis and LD4 in degenerative arthritis was correlated with increase of gamma globulin.