• Title/Summary/Keyword: Rheumatic diseases.

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Chiral Separation of Non-Steroidal Inflammatory Drugs as Dual Diastereomeric Derivatives with (R)-and (S)-Phenylethylamines

  • Lee, Yoon-Suk;Paik, Man-Jeong;Kim, Kyoung-Rae
    • Proceedings of the PSK Conference
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    • 2003.04a
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    • pp.282.2-283
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    • 2003
  • The carboxylated acidic non-steroidal antiinflammatory drugs (NSAIDs) constitute the principal class of agents for controlling the pain and inflammation of the rheumatic diseases. It is mostly administered as a racemic mixture like most other drugs with asymmetric carbon atoms. However enantiomers of many racemic drug substances have been shown to posses different pharmacological toxicological properties. (omitted)

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A Case of Child with Poststreptococcal Reactive Arthritis (베타 용혈성 연구균 감염 후 발생한 반응성 관절염 1례)

  • Park, Dong-Kyun;Kim, Young-Min;Chung, Sa Jun;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.208-211
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    • 2004
  • The patient with group A beta-hemolytic streptococcal infection and articular disease who does not fulfill the modified Jones criteria for a diagnosis of acute rheumatic fever(ARF) have been classified as poststreptococcal reactive arthritis/arthralgia. A 10-year-old girl had presented with fever and arthralgia. She had pain in her left knee for 7 days but no swelling. A throat culture showed no growth but antistreptolysin O titer and C-reactive protein were elevated. A clinical follow up one month later showed neither arthralia nor sequelae as acute rheumatic fever. Poststreptococcal reactive arthritis/arthralgia seems to be part of the disease spectrum of ARF and to prevent subsequent development of ARF and carditis in these patient, it is recommended that antistreptococcal prophylaxis should be administered for 1 year and then could be discontinued if there is no evidence of cardiac involvement.

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Newly Synthesized Phosphodiesterase 4 (PDE4) Inhibitor, DWP205505, Inhibits TNF-$\alpha$ Secretion and mRNA Expression

  • Lee, Suk-Kyeong;Lee, Sun-A;Byun, Hye-Sin;Cho, Mi-La;Kim, Wan-Uk;Park, Sung-Hwan;Cho, Chul-Soo;Joo, Young-Shil;Lee, Shin-Seok;Yoo, Eun-Sook;Son, Ho-Jung;Kim, Ho-Youn
    • Journal of Microbiology and Biotechnology
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    • v.9 no.1
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    • pp.106-112
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    • 1999
  • The therapeutic potential of phosphodiesterase 4(PDE4) inhibitors in inflammatory diseases including some autoimmune diseases has been explored recently with some hopeful results. These PDE4 inhibitors are thought to show their anti-inflammatory effect by down-regulating tumor necrosis factor-a (TNF-$\alpha$) production in lymphocytes and macrophages. A high concentration of TNF-$\alpha$has been found in rheumatoid arthritis (RA) synovium and reducing TNF-$\alpha$using biological agents was proven to be an effective RA treatment. To test the possibility of using PDE4 inhibitors for RA treatment, the effects of a newly synthesized PDE4 inhibitor, DWP205505, on TNF-$\alpha$ and IL-10 production was tested in cells isolated from normal peripheral blood and rheumatoid arthritis synovial fluid. Cytokine production was assayed at the protein level by sandwich enzyme-linked immunosorbent assay (ELISA) and at the mRNA expression level by semi-quantitative RT-PCR. Another PDE4 inhibitor, RP73401, was used for comparison. DWP205505 and RP73401 had no harmful effect on cell viability up to 10 $\mu$M concentration during the 24 h culture period. DWP205505 as well as RP73401 significantly reduced TNF-$\alpha$ secretion from lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (pBMC) and synovial fluid mononuclear cells (SFMC). The effect of DWP205505 or RP73401 treatment on the mRNA expression of TNF-$\alpha$ was also studied in LPS-stimulated PBMC and SFMC. TNF-$\alpha$ mRNA expression was increased by LPS stimulation and both of the PDE4 inhibitors suppressed TNF-$\alpha$ mRNA expression. For interleukin-l0 (IL-l0), a little different results were obtained from PBMC and SFMC; IL-l0 secretion was unaffected by LPS stimulation and only minimally affected by both of the PDE4 inhibitors in PBMC. In unstimulated SFMC, DWP205505 and RP73401 slightly enhanced IL-10 secretion, while they reduced IL-l0 secretion from LPS-stimulated SFMC where IL-l0 secretion was a lot higher than unstimulated SFMC. These results suggest that the newly synthesized PDE4 inhibitor DWP205505 may have anti-rheumatoid arthritis activity.

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INTERPRETING A SINGLE ANTISTREPTOLYSIN O TEST: A COMPARISON OF THE 'UPPER LIMIT OF NORMAL' AND LIKELIHOOD RATIO METHODS

  • Gray Gregory C.;Struewing Jeffery P.;Hyams Kenneth C.;Escamilla Joel;Tupponce Alan K.;Kaplan Edward L.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.164-168
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    • 1994
  • Single serologic tests may occasionally influence clinicians in making diagnoses. The antistreptolysin O (ASO) test is a frequently used tool for detecting recent Streptococcus pyogenes infection and is helpful in the diagnosis of diseases like rheumatic fever. Using data from a 1989 prospective study of 600 healthy male military recruits, in which 43% experienced S. pyogenes upper respiratory tract infection (2-dilution rise in ASO), this report compared two methods of interpreting a single ASO titer. Using the 'upper limit of normal' (80 percentile) method, recruits with an ASO titer of greater than 400 showed evidence of recent S. pyogenes infection. This method had a sensitivity and specificity of only 65.9 and 81.9% respectively. In contrast to the 'yes-no'. dichotomy of the 'upper limit of normal' method. the likelihood ratio method statistics were ASO value specific, more consistent with clinical judgment, and better emphasized the caution clinicians must use in interpreting a single ASO test.

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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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Clinical experience of open heart surgery -70 cases- (개심술 70예의 임상경험)

  • 조광현
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.644-662
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    • 1986
  • Seventy cases of open heart surgery were performed in the department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, Inje College, from Oct. 1985 to Oct. 1986. And the results were summarized as follows. 1. Among the 70 cases, there were 48 cases of congenital heart anomalies and 22 cases of acquired rheumatic valvular heart diseases. Age range of the congenital patients was 7 months to 31 years with the mean age of 10 years, and the acquired patients was 18 to 62 years with the mean age of 40 years. 2. The heart-lung machine used for cardiopulmonary bypass was Sarns 7000, 5-head roller pump, and the number and type of oxygenators were 5 of membrane type and 65 of bubble type. For all cases GIK [glucose-insulin-potassium] solution was used as cardioplegic solution for myocardial protection during operation. 3. Among the 48 congenital anomalies, there were 12 cases of ASD group, 29 of VSD group, 3 of ECD, 3 of TOF and one of PDA + MR, and to all of which the appropriate radical operations were applied. 4. Among the 22 acquired valvular diseases, there were 11 cases of mitral valve diseases [MS; 4, MSr; 3, MRs; 4], 3 cases of aortic valve diseases [AR:1, ARs;1, ASr;1], 4 cases of double valve diseases [MRs+TR; 3, MRs+ARs; 1] and 4 cases of triple valve diseases [MSr+ASr+TR; 3, MSr+Ar+TR; 1]. To all the diseased mitral and aortic valves, artificial valve replacement was applied except one [As], in which valve plication was applied. And to all the diseased tricuspid valve, DeVega annuloplasty was applied. 5. The number of replaced artificial valves were 29 in 25 patients [congenital; 3, acquire; 22]. In MVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 15 of tissue valves [Carpentier-Edward valve; 11, lonescu-Shiley valve; 4] were used. In AVR, 6 of mechanical valves [St. Jude Medical valve; 6] and 2 of tissue valves [Carpentier-Edward valve; 2] were used. 6. Postoperative complications were occurred in 12 cases. Among them 11 cases were recovered with intensive cares, but one patient [VSD + Fistula of Valsalva sinus] was expired with low cardiac out put syndrome.

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Analysis of Drug Utilization for Patients with Ankylosing Spondylitis (강직성 척추염 환자에 대한 약물사용 현황 분석)

  • Kang, Han-Bin;Je, Nam Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.4
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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.

Effects of the Ground Exercise for Arthritis Program(GEAP) on Pain, Fatigue, Self-esteem, Perceived Health Status and Self-efficacy in Patients with Chronic Arthritis (만성관절염 환자의 통증, 피로, 자아존중감, 건강상태지각과 자기효능감에 대한 관절염 체조의 효과)

  • Sohng Kyeong-Yae;Kang Sung-Sil;Kim Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.2
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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.

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Inhibition of Heat-induced Denaturation of Albumin by Nonsteroidal Antiinflammatory Drugs (NSAIDs): Pharmacological Implications

  • Luciano-Saso;Giovanni-Valentini;Casini, Maria-Luisa;Eleonora-Grippa;Gatto, Maria-Teresa;Leone, Maria-Grazia;Bruno-Silvestrini
    • Archives of Pharmacal Research
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    • v.24 no.2
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    • pp.150-158
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    • 2001
  • The activity of nonsteroidal antiinflammatory drugs (NSAIDs) in rheumatoid arthritis is not only due to the inhibition of the production of prostaglandins, which can even have beneficial immunosuppressive effects in chronic inflammatory processes. Since we speculated that these drugs could also act by protecting endogenous proteins against denaturation, we evaluated their effect on heat-induced denaturation human serum albumin (HSA) in comparison with several fatty acids which are known to be potent stabilizers of this protein. By the Mizushimas assay and a recently developed HPLC assays we observed that NSAIDs were slightly less active [$EC_{50}~10^{-5}-10^{-4}$ M] than FA and that the HPLC method was less sensitive but more selective than the turbidimetric assay, i.e. it was capable of distinguishing true antiaggregant agents like FA and NSAIDs from substances capable of inhibiting the precipitation of denatured protein aggregates. In conclusion, this survey could be useful for the development of more effective agents in protein condensation diseases like rheumatic disorders, cataract and Alzheimers disease.

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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.