Effect of Pulsed Electromagnetic Fields in the Treatment of Knee Osteoarthritis. Report of Double-blind, Placebo-controlled, Randomized Trial / 대한류마티스학회지

OBJECTIVE: To determine the effectiveness of pulsed electromagnetic fields (PEMF) in the treatment of knee osteoarthritis (OA). MEHTODS: In this randomized, placebo-controlled, double-blind trial, 51 patients with knee OA, diagnosed according to the criteria of the American College of Rheumatology, were treated with PEMF or placebo. Eleven patients failed to attend after screening and were excluded from analysis. Treatment consisted of 3 half-hour periods of exposure per week over 6 weeks in a specially designed cylindrical device that emits low-frequency pulsed electromagnetic fields (25 gauss, 12 Hz). The primary outcome measure was reduction in pain on movement using a 10 cm visual analog scale. Secondary outcome measures included joint swelling and tenderness, the Lequesne index, and overall evaluations of improvement by the patient and examining physician. Evaluations were made at baseline, 3 week and 6 week during treatment and 4 weeks after finishing treatment. RESULTS: There were no significant differences between PEMF and placebo groups in respect of any outcome measures after treatment. Range of motion and knee swelling tended to be improved in the PEMF group. There were no clinically relevant adverse effects attributable to PEMF treatment. CONCLUSION: These results suggest that the PEMF treatment has no clinically significant benefits in patients with knee OA resistant to conventional treatment. The larger studies are needed to confirm the efficacy of PEMF therapy in knee OA.

Prevalence of Osteoarthritis and Rheumatoid Arthritis in Two Communities in Korea / 대한류마티스학회지

OBJECTIVE: To estimate the prevalence of osteoarthritis (OA) and rheumatoid arthritis (RA) in Korean. METHODS: Those who participated arthritis/allergy field study in Icheon, Kyunggi Province and Goesan, Chungbuk Province in 2001 were evaluated for the prevalence of arthritis. Diagnosis of OA and RA were made using American College of Rheumatology criteria. RESULTS: Among the 983 participants (mean age+/-SD, 49.9?14.0 years), 498 participants were male (mean age 49.9+/-13.1 years) and 485 participants were female (mean age 49.9+/-15.0 years), and there was no difference of mean age between male and female. There were 153 cases of OA (15.6%, mean age, 61.6+/-9.5), which consisted of 44 male cases (mean age, 58.9+/-10.7) and 109 female cases (mean age, 62.7+/-9.5). Prevalence of OA was significantly higher in female compared to male (22.5% vs 8.8%, p<0.0001). Prevalence of OA in the 4th to the 8th decade was 1.1, 7.5, 19.4, 34, 37.2%, respectively and showed increasing trend in the ascending order of age in decade (p<0.001). Localization of OA was knees (77.1%), knees and hands (17.6%), and hands (5.2%). RA was detected in 14 cases (1.4%, mean age, 58.8+/-14.6, male to female 1:13). Prevalence of RA was significantly higher in female compared to male (2.7% vs 0.2%, p<0.01). CONCLUSION: The prevalence of knee or hand OA and RA were 15.6% and 1.4% in Korean, respectively. The prevalence of OA was significantly higher in female and aged individuals. The prevalence of RA was also significantly higher in female.

Electrical Cardioversion of Atrial Fibrillation after Successful Percutaneous Balloon Mitral Valvuloplasty

Objectives: There was no previous report about the electrical cardioversion for the patients with atrial fibrillation after successful percutaneous ballon mitral valvuloplasty (PBMV). We performed electrical cardioversion after PBMV to evaluate the effectiveness of this procedure in the view of conversion to and maintenance of the sinus rhythm. METHODS: 28 patients who had persistent atrial fibrillation after successful PBMV were included in this study. All patients were anticoagulated with warfarin. Amiodarone was loaded and maintained before cardioversion. The PBMV procedures were guided by transesophageal echocardiography in all patients. Transthoracic echocardiography was done before and after PBMV and cardioversion, and was followed. RESULTS: The number of patients were 28 (male 9 and female 19) within the mean age of 50.3+/-12.0 years (24-66). Initially 24 patients (86%) succeeded in electrical cardioversion. The energy required for successful conversion was 230+/-75J, on average. There were no complications except for the transient sinus bradycardia in 2 cases. The mean follow-up duration was 357+/-144 days and when followed-up, the sinus rhythm was maintained in 15 patients out of 24 with initial success (63%). No factor was significantly related to the success of cardioversion, but left atrial dimension after 1 month of PBMV was significantly related to the maintenance of the sinus rhythm. CONCLUSIONS: This study suggests that electrical cardioversion of atrial fibrillation after successful PBMV is favorable and recommendable treatment modality of chronic valvular atrial fibrillation with high conversion rate (88%) and good maintenance rate (63%).