• Journal of Rheumatic Diseases
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• 제26권4호
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• pp.219-220
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• 2019

• Journal of Periodontal and Implant Science
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• 제42권1호
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• pp.3-12
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• 2012

Purpose: Anti-rheumatic agents target common molecular pathways of inflammation in rheumatoid arthritis (RA) and periodontitis. The purpose of this study was to determine the relative effect of anti-rheumatic agents on the levels of inflammatory biomarkers and periodontal inflammation in RA patients with periodontitis. Methods: A systematic review and meta-analysis were conducted of studies comparing periodontal parameters of inflammation, such as bleeding on probing, and biomarkers of inflammation in RA patients with periodontitis and healthy adults with and without periodontitis. The search included the electronic databases MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar, inclusive through October 2011, with no language restrictions. Hand searches were conducted of the bibliographies of related journals and systematic reviews. Observational and interventional studies assessing the effects of antirheumatic therapy qualified for inclusion. Two reviewers performed independent data extraction and risk-of-bias assessment. Of the 187 identified publications, 13 studies fulfilled the inclusion criteria. Results: When compared to healthy adults without periodontitis, RA subjects were found to have significantly higher levels of bleeding on probing and limited evidence of higher levels of interleukin-$1{\beta}$ and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in gingival crevicular fluid and saliva. No consistent differences were found in periodontal parameters and inflammatory biomarkers between RA subjects and adults with periodontitis. Studies evaluating the effect of anti-TNF-${\alpha}$ therapy in RA subjects with periodontitis have yielded inconsistent results. Conclusions: There are limited data, however, to suggest that anti-TNF-${\alpha}$ agents can reduce local production of inflammatory cytokines and periodontal inflammation in RA patients with periodontitis.

• Clinical and Experimental Reproductive Medicine
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• 제31권3호
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• pp.149-154
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• 2004

Objective: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. Methods: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. Results: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. Conclusions: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.

• 한국임상약학회지
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• 제25권4호
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• pp.246-253
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• 2015

Background & Object: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes ankylosis and deformation of axial joints. Since current medicine cannot cure the disease yet, alleviating pain and preventing deformation with medications are the main therapy for patients with AS. The key medications for these purposes include nonsteroidal anti-inflammatory drugs (NSAIDs), and tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$) inhibitors. This study aims to analyze prescribing patterns of AS patients in South Korea. Method: National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 was analyzed. Patients with AS were identified with Korean Standard Classification of Diseases code-6, which was M45. The rates of prescription, discontinuation, and switching ingredients were calculated for each medication during 2013. Results: Total number of patients was 655, and most of them were male (n = 514, 78.5%). Of all age groups, the proportion of 30-40 year old patients was the greatest (35.1%). The most utilized drug class was NSAIDs (82.4%). Less than half of patients were prescribed $TNF-{\alpha}$ inhibitors (n = 212, 32.4%). Meloxicam, aceclofenac, and celecoxib were the most frequently prescribed NSAIDs. In case of $TNF-{\alpha}$ inhibitors, adalimumab, etanercept and infliximab were the top three most prescribed drugs. Although not recommended by the current practice guideline, significant proportions of patients were identified using disease modifying anti-rheumatic drugs (DMARDs). Conclusion: Considering the current practice guideline and previous studies about the efficacy, the use of DMARDs should be reduced and medical insurance term in South Korea should be re-examined.

• IMMUNE NETWORK
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• 제3권3호
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• pp.201-210
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• 2003

Objective: The role of prostaglandin $E_2$ (PGE2) in the etiopathogenesis of immune and inflammatory diseases has become the subject of recent debate. To determine the role of PGE2 in rheumatoid arthritis (RA), we tested the effect of exogenous PGE2 on the production of cyclooxygenase-2 (COX-2) by rheumatoid synoviocytes. Methods: Fibroblast-like synoviocytes (FLS) were prepared from the synovial tissues of RA patients, and cultured in the presence of PGE2. The COX-2 mRNA and protein expression levels were determined by RT-PCR and Western blot analysis, respectively. The PGE2 receptor subtypes in the FLS were analyzed by RT-PCR. Electrophoretic mobility shift assay (EMSA) was used to measure the NF-${\kappa}B$ binding activity for COX-2 transcription. The in vivoeffect of PGE2 on the development of arthritis was also tested in collagen induced arthritis (CIA) animals. Results: PGE2 ($10^{-11}$ to $10^{-5}M$) dose-dependently inhibited the expression of COX-2 mRNA and the COX-2 protein stimulated with IL-$1{\beta}$, but not COX-1 mRNA. NS-398, a selective COX-2 inhibitor, displayed an additive effect on PGE2-induced COX-2 downregulation. The FLS predominantly expressed the PGE2 receptor (EP) 2 and EP4, which mediated the COX-2 suppression by PGE2. Treatment with anti-IL-10 monoclonal antibodies partially reversed the PGE2-induced suppression of COX-2 mRNA, suggesting that IL-10 may be involved in modulating COX-2 by PGE2. Experiments using an inducer and an inhibitor of cyclic AMP (cAMP) suggest that cAMP is the major intracellular signal that mediates the regulatory effect of PGE2 on COX-2 expression. EMSA revealed that PGE2 inhibited the binding of NF-${\kappa}B$ in the COX-2 promoter via a cAMP dependent pathway. In addition, a subcutaneous injection of PGE2 twice daily for 2 weeks significantly reduced the incidence and severity of CIA as well as the production of IgG antibodies to type II collagen. Conclusion: Our data suggest that overproduced PGE2 in the RA joints may function as an autocrine regulator of its own synthesis by inhibiting COX-2 production and may, in part, play an anti-inflammatory role in the arthritic joints.

• Journal of Chest Surgery
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• 제16권4호
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• pp.444-451
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• 1983

Valve replacement in children and adolescents, aging below 20 years [Mean 15 years 4 months], has been done at Seoul National University Hospital from March 1977 to September 1982 . Seventy-Seven patients have received 91 artificial valves 4 prosthetic valves and 87 bioprosthetic valves. 63 patients had acquired valve lesions and 14 patients had congenital valve lesions. Among the patients with acquired valve lesion, 32 patients had the history of rheumatic fever. Seventy-five patients survived operation: 12 patients [ 15.6%] died within one month postoperatively and 3 patients [3.9%] during the follow-up period with the overall mortality rate of 19.5% Thromboembolic complication occurred in 3 patients with 2 deaths: 3.9% embolic rate or 3.74% emboli per patient-year. One patient who had been on coumadin anticoagulation died from cerebral hemorrhage. Actuarial survival rate was 77.6% at 1 years after surgery, after then there were no death.

• 농촌의학ㆍ지역보건
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• 제25권2호
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• pp.275-292
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• 2000

본 연구는 류마티스 관절염 환자들을 대상으로 지식, 자기효능감 및 삶의 질과의 관계를 파악하고 류마티스 관절염 환자의 삶의 질을 증진시킬 수 있는 간호중재를 위한 기초자료를 얻고자 본 연구를 시도하였다. 자료수집은 1999년 3월 2일부터 3월 22일까지 광주광역시에 위치한 1개 대학병원과 K 류마티스 내과 개인 병원에 등록된 광주 광역시 주변 농천지역에 거주하는 류마티스 관절염 환자 100명을 임의표출하여 자료를 수집하였다. 연구도구는 구조화된 질문지로서, 김순봉(1998)이 개발한 류마티스 관절염에 대한 지식 측정도구와 Lorig 등1989) 이 개발한 도구를 근거로 김종임(1994)이 수정 보완한 자기 효능감 측정도구 및 노유자(1988)가 개발한 삶의 질 측정도구를 이용하였다. 자료분석은 SAS를 이용하여 전산처리하였으며, 일반석 특성과 지식, 자기효능감 및 삶의 질과의 관계는 t-test, ANOVA로, 지식, 자기효능감 및 삶의 질과의 상관관계 Peason's Correlation Coefficient로, 삶의 질에 영향을 미치는 예측인자는 Stepwise Multiple Regression을 이용하여 분석하였다. 본 연구의 결과는 다음과 같다. 1. 대상자의 지식 정도는 평균 15.01점, 자기효능감 정도 평균 1030.40점, 삶의 질 정도 총 평균 135.19점으로 나타났다. 2. 일반적 특성과 지식과의 관계에서는 성별(t=19.03, p=.00), 직업 (F=2.34, p=.03), 운동종류(F=2.95, p=.03), 운동시간(F=3.20, p=.02)에서 유의한 차이가 있었다. 3. 일반적 특성과 자기효능감과의 관계에서는 월수입(F=3.64, p=.01), 직업(F=2.30, p=.03), 관절염 앓은 기간(F=2.70, p=.03), 운동시간(F=3.77, p=.01), 운동효과(F=4.56, p=.01)에서 유의한 차이가 있었다. 4. 일반적 특성과 삶의 질과의 관계에서는 연령(F=3.36, p=01), 월수입(F=3.11, p=.02), 주거형태(t=4.93, p=.02). 운동시간(F=3.03, p=.03)에서 유의한 차이가 있었다. 5. 대상자의 지식과 삶의 질과의 관계에서는 유의한 상관관계가 없는 것으로 나타났다(r=.154, p>.05). 6. 대상자의 자가효능감과 삶의 질과의 관계에서는 유의한 상관관계가 있는 것으로 나타났다(r=.462, p<.001). 7. 대상자의 삶의 질에 영향을 미치는 요인은 자기효능감으로 삶의 질을 21.4% 설명하는 것으로 나타났다.

• 대한물리치료과학회지
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• 제5권4호
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• pp.845-850
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• 1998

The purpose of those study is to estimate grip and hand activity of RA patients and find that the evaluation is very a valuable to the RA patients. The term of the evaluation was from June 25. 1998.. to July 30. 1998 and researched at Hanyang university Rheumatic Hospital. This study researched 100 normal people and 85 RA patients and analyzed the results and averaged those with t-test by Excel data. The results of those study are as follows. 1. The highest percent of those results of the dynamometer, pinch research was the people who are on 40s. 2. The results of all RA patients marked lower than those of normal people. 3. It's difficult to do hard work such as washing, opening can, transferring boxes to the patients. 4. The above research is effective to RA patients.

• 기본간호학회지
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• 제8권2호
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• pp.210-219
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• 2001

Purpose: To examine the effects of the GEAP on pain, fatigue, self-esteem, perceived health status and self-efficacy in patients with chronic arthritis. Methods: One group Pre- & post-test design was used. Outcome domains included pain, number of painful joints, fatigue, self-esteem, perceived health status and self-efficacy. Thirty-four patients were recruited over four times from a rheumatic clinic affiliated to a university medical center in Seoul, Korea The GEAP is an exercise program modified by the investigators from PACE program which developed by Arthritis Foundation. The program duration is about 60 minutes, three times a week for 6 weeks. Participants were predominantly women (68%) ; on average 57.3 years old; and diagnossed with RA (58.8), osteoarthritis (29.4) or other (11.8). Results: After completing the GEAP, subjects showed significant improvement in pain (p=.02), number of painful joints (P= .04), fatigue (p= .0001), and perceived health status (P=.006). There were no improvements in self-esteem and self-efficacy score for adults with chronic rheumatic diseases. Conclusion: This study showed that the GEAP is an effective exercise intervention for improving outcomes for patients with chronic arthritis. More sample and research are needed to 1) accurately evaluate on self-esteem and self-efficacy; 2) understand and improve adherence. And also a longer follow up period is recommended to evaluate long-term effects of the PACE program.

• Journal of Chest Surgery
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• 제39권9호
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• pp.681-691
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• 2006

배경: 본 연구에서는 류마티스성 승모판막질환과 동반된 만성 심방세동의 치료에서 냉동절제술을 이용한 변형 maze 술식들의 동율동 회복률 및 중기 결과에 대해 알아보고자 하였다. 대상 및 방법: 2000년 3월부터 2004년 2월까지 류마티스성 승모판막질환과 동반된 만성 심방세동 환자에서 승모판막수술과 동시에 냉동절제술을 이용하여 변형 maze술을 받은 177명의 환자를 대상으로 Cox-maze III (CM군, n=88), Kosakai-maze (KM군, n=63), 그리고 Left atrial maze (LA군, n=26) 세 군으로 분류하여 수술 전, 후 결과 및 동율동 회복률과 중기 결과에 대해 후향조사하였다. 결과: 술 후 병원 사망은 CM군 2명(2.3%)과 KM군 1명(1.6%)을 포함한 3명(1.7%)에서 있었으며 술 후 합병증 발생률에서 세군 간에 차이는 없었다. 총 체외순환 및 대동맥차단 시간은 CM군에서 다른 두 군에 비해 유의하게 길었다(p<0.0001). 생존자 174명에서 평균 $22.4{\pm}15.1$개월($1\sim52.6$개월)을 추적조사한 결과 만기 사망은 CM군 1명(0.6%)에서 있었다. 마지막 추적조사에서 동율동 회복률은 전체환자의 79.9%, CM군 77.9%, KM군 80.7% 그리고 LA군에서는 84.6%였다(p=0.743). 술 후 4년 동안 뇌졸중으로부터의 자유도는 CM군 $84.6{\pm}9.4%$, KM군 $95.0{\pm}:4.9%$ 그리고 LA군에서는 $92.9{\pm}6.9%$였다(p=0.916). 결론: 류마티스성 승모판막질환과 동반된 만성 심방세동 치료에서 승모판막수술과 동반하여 시행하는 냉동절제술을 이용한 변형 maze 술식들은 비교적 안전하게 시행될 수 있으며 심방세동 치료에 효과적이다.