• Title/Summary/Keyword: Rheumatic disease

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Double Valve Replacement: A Report of 23 Cases (중복판막이식: 23 치험예)

  • 김용진
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.535-540
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    • 1978
  • Between January 1974 and November 1978, 23 cases of double valve replacement were done in the Department of Thoracic Surgery, Seoul National university Hospital. All had symptoms of rheumatic valvular heart disease and belonged to functional class III or IV according to NYHA classification. Among 23 cases, mitral and aortic valves were replaced in 14, and mitral and tricuspid valves in 9 cases. Six operative deaths [26%] and 4 late deaths [23%] were found. In the former group 5 and in latter one operative death were noted. Main cause of operative death was low cardiac output syndrome due to myocardial failure. Among 4 late deaths, 2 were caused by thromboembolism, one by bacterial endocarditis, and one by arrhythmia.

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Association with Autoimmune Disease in Patients with Premature Ovarian Failure (조기 난소기능 부전증 환자에서 자가면역 질환과의 상관관계)

  • Park, Joon-Cheol;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.3
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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.

Effect of Inhibition Macrophage Migration Inhibitory Factor Activation by Hominis Placenta Herbal Acupuncture on Rheumatic Arthritis (자하차약침(紫河車藥鍼)의 MIF 활성 억제를 통한 LPS 유발 류마티스성 관절염의 치료 효과)

  • Hwang, Ji-Hye;Cho, Hyun-Seok;Lee, Hyun-Jin;Lee, Dong-Gun;Jeong, Won-Je;Jung, Chan-Yung;Kim, Kyung-Ho
    • Journal of Acupuncture Research
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    • v.25 no.3
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    • pp.41-51
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    • 2008
  • Objectives : This study is to evaluate Effect of Inhibition Macrophage Migration Inhibitory Factor(MIF) activation by Hominis Placenta Herbal Acupuncture(HPA) on Rheumatic Arthritis(RA). Hominis Placenta is the placenta of healthy human, which is vital-strengthening medical stuff. In recent years, Hominis Placenta applied to chronic diseases because it makes us more resistance to diseases. Therefore it is supposed that HPA is effective on RA, a kind of autoimmune disease. When RA is induced, MIF is activated, too. MIF affects the process of inflammatory disease including RA. Methods : In order to investigate the effect of Hominis Placenta extraction on MIF(early RA inducing cytokine) and MMP(Matrix Metallo Proteinase)-9 mRNA expression by means of Reverse Transcriptase- Polymerase Chain Reaction(RT-PCR). In this study, we investigated the effect of Hominis Placenta extraction on MIF(early RA inducing cytokine) and MMP-9 mRNA expression by means of RT-PCR. Besides we investigated changing of MIF in synovial membrane and, Interleukin-6 receptor(IL-6R)-$\alpha$(pro-inflammatory cytokine), Signal transducers and activators of transcription(STAT)-3, MMP-9 after treating mouse, which is artificially attacked with RA, with HPA on its $ST_{35}$, LE201 in vivo. Results : 1. As a result of treating Lipopolysaccharide(LPS)-stimulated Raw246.7cell with HPA, MIF(RA related cytokine) and MMP-9 mRNA expression is reduced in vitro. And this reaction is concentration-dependatant. 2. In synovial membrane of the mice treated with HPA, inhibition of MIF, IL-6R-$\alpha$, STAT3 & MMP-9 activation is observed in vivo. Conclusions : From the above results, it might be suggested that HPA mitigate tissue damage originated from RA, because it intercepts the early process of by inhibition MIF activity.

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Pediatic Valve Replacement (15세 이하 소아에서의 판막치환술)

  • 박재홍
    • Journal of Chest Surgery
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    • v.27 no.12
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    • pp.984-988
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    • 1994
  • Between 1981 and 1992, 22 children from 1 to 15 years of age have undergone cardiac valve replacements at National medical center. The patients were composed of 14 males and 8 females and 7 patients had congenital heart disease and 15 patients had rheumatic heart disease. Three of these 15 patients have had second valve replacement due to prosthetic valve failure[PVF]. Single valve replacement were 20[Aortic 3 cases, Mitral 17 cases] and double valve replacments were 2. The overall mortality was 22.7 %. Actuarial survival rate was 77.28 $\pm$ 8.92 % and Complication free rate was 67.68$\pm$15.56%. The pediatric valve replacements can now be performed at a low operative risk although various problems are still remained and the choice of valve is prosthetic valve mainly due to its durability at the present time.

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Immunological benefits by ginseng through reciprocal regulation of Th17 and Treg cells during cyclosporine-induced immunosuppression

  • Heo, Seong Beom;Lim, Sun Woo;Jhun, Joo Yeon;Cho, Mi La;Chung, Byung Ha;Yang, Chul Woo
    • Journal of Ginseng Research
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    • v.40 no.1
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    • pp.18-27
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    • 2016
  • Background: It is not clear whether ginseng affects cyclosporine A (CsA)-induced desirable immunosuppressive action. In this study, we evaluated the immunological influence of combined treatment of ginseng with CsA. Methods: Using CD4+ T cells from mouse spleens stimulated with the T cell receptor (TCR) or allogeneic antigen-presenting cells (APCs), we examined the differentiation of naïve T cells into T helper 1 (Th1), Th2, Th17, and regulatory T cells (Tregs), and their cytokine production during treatment by Korean Red Ginseng extract (KRGE) and/or CsA. The influence of KRGE on the allogeneic T cell response was evaluated by mixed lymphocyte reaction (MLR). We also evaluated whether signal transducer and activator of transcription 3 (STAT3) and STAT5 are implicated in this regulation. Results: Under TCR stimulation, KRGE treatment did not affect the population of CD4+interferon gamma ($IFN{\gamma}$)+ and CD4+interleukin (IL)-4+ cells and their cytokine production compared with CsA alone. Under the Th17-polarizing condition, KRGE significantly reduced the number of CD4+IL-17+ cells and CD4+/phosphorylated STAT3 (p-STAT3)+ cells, but increased the number of CD4+CD25+forkhead box P3 (Foxp3)+ cells and CD4+/p-STAT5+ cells compared with CsA alone. In allogeneic APCs-stimulated CD4+ T cells, KRGE significantly decreased total allogeneic T cell proliferation. Consistent with the effects of TCR stimulation, KRGE reduced the number of CD4+IL-17+ cells and increased the number of CD4+CD25+Foxp3+ cells under the Th17-polarizing condition. Conclusion: KRGE has immunological benefits through the reciprocal regulation of Th17 and Treg cells during CsA-induced immunosuppression.

A Literature Study of Samguchup - Based on the Traditional Chinese Medical Journal - (삼구첩(三九貼)에 관한 문헌적 고찰 - 중의학 잡지를 중심으로 -)

  • Lee, Sun Haeng;Kim, Cho Young;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.26 no.4
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    • pp.1-9
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    • 2012
  • Objectives: The Samguchup is a plaster therapy in winter to prevent and treat diseases occurring frequently in the winter. Studies on samguchup published in China were analyzed for our study in order to utilize in Korea. Methods: 15 studies with keywords such as 'Sanjiutie' or 'Dongbingdongzhi' published in CAJ (China Academic Journal) until July 31, 2012 were compared, in terms of clinical effects, herbs, acupoints, attatching time, and accompanying treatment. Results: Treatment rate ranged from 65% to 92.65%, in recurrent respiratory infection, cough, allergic rhinitis, asthma, chronic bronchitis, chronic obstructive pulmonary disease, sleep apnea, and rheumatic arthritis. The herbs used more than 5 times were Semen Sinapis Albae, Herba Asari, Ginger juice, Radix Kansui, and Rhizoma Corydalis. The acupoints used more than 5 times were BL13, BL23, GV14, CV17, CV22, and EX-B1. The attaching time were usually 4 hours, but shorter for child. The Sambokchup, Korean medicine, moxibustion on ginger, drug(western medicine), injection, and inhalation were used as accompanying treatment. Conclusions Appropriate use of Samguchup is necessary to treat or prevent diseases in winter.

Rheumatiod Arthritis: An Updated Overview of Latest Therapy and Drug Delivery

  • Kesharwani, Disha;Paliwal, Rishi;Satapathy, Trilochan;Paul, Swarnali Das
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.210-224
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    • 2019
  • Rheumatoid arthritis is a severe autoimmune disorder, related to joints. It is associated with serious cartilage destruction. This causes disability and reduces the excellence of life. Numerous treatments are existed to combat this disease, however, they are not very efficient and possess severe side effects, higher doses, and frequent administration. Therefore, newer therapies are developed to overcome all these limitations. These include different monoclonal antibodies, immunoglobulins, small molecules used for immunotherapy and transgenes for gene therapy. One of the main goals of these new generation therapeutics is to address the underlying distressing biological processes by specifically targeting the causative agents with fewer systemic side effects and greater patient console. It is very fortuitous that loads of progressive investigations are going on in this field and many of them have entered into the successful clinical trial. But till date, a limited molecule has got FDA clearance and entered the market for treating this devastating disease. This review highlights the overview of conventional therapy and advancements in newer therapeutics including immunotherapy and gene therapy for rheumatoid arthritis. Further, different novel techniques for the delivery of these therapeutics of active and passive targeting are also described.

Left atrial thrombus in mitral valve disease (좌심방혈전증을 동반한 승모판막질환의 임상적 고찰)

  • Kim, Won-Gon;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.666-671
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    • 1984
  • During a fire-year period from March 1979 to February 1984, 559 patients underwent surgical treatment for rheumatic mitral valve disease at Seoul National University Hospital. Left atrial thrombus was found at surgery in 74 of these patients, an incidence of 13.2%. This report outlines the surgical experience with these seventy-four patients. They were 32 men and 42 women, and their age ranged between 23 and 57 with mean of 42 years old. All except one had the findings of atrial fibrillation on the preoperative electrocardiogram. Ten [13.5%] had experienced embolic events before surgery. A history of one or more episodes of cardiac failure requiring digitalis and diuretics was noted in all patients Nineteen were associated with the aortic and/or tricuspid valve disease and closed mitral commissurotomy had been performed previously in four patients. The average cardiac index was 2.68L/min/M2 [1.59 to 3.47 L/min/M2] The mean systolic pulmonary artery pressure was 57mmHg [26 to 120 mmHg]and pulmonary capillary wedge pressure 21.5 mmHg [12 to 40 mmHg]. There were no significant hemodynamic findings to suggest the presence of the left atrial thrombus. Operative mortality was acceptable with two early deaths [2.7%]. The follow-up of the hospital survivors has shown excellent functional status.

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Recent Advances in Cell Therapeutics for Systemic Autoimmune Diseases

  • Youngjae Park;Seung-Ki Kwok
    • IMMUNE NETWORK
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    • v.22 no.1
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    • pp.10.1-10.17
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    • 2022
  • Systemic autoimmune diseases arise from loss of self-tolerance and immune homeostasis between effector and regulator functions. There are many therapeutic modalities for autoimmune diseases ranging from conventional disease-modifying anti-rheumatic drugs and immunosuppressants exerting nonspecific immune suppression to targeted agents including biologic agents and small molecule inhibitors aiming at specific cytokines and intracellular signal pathways. However, such current therapeutic strategies can rarely induce recovery of immune tolerance in autoimmune disease patients. To overcome limitations of conventional treatment modalities, novel approaches using specific cell populations with immune-regulatory properties have been attempted to attenuate autoimmunity. Recently progressed biotechnologies enable sufficient in vitro expansion and proper manipulation of such 'tolerogenic' cell populations to be considered for clinical application. We introduce 3 representative cell types with immunosuppressive features, including mesenchymal stromal cells, Tregs, and myeloid-derived suppressor cells. Their cellular definitions, characteristics, mechanisms of immune regulation, and recent data about preclinical and clinical studies in systemic autoimmune diseases are reviewed here. Challenges and limitations of each cell therapy are also addressed.