• 대한근관절건강학회:학술대회논문집
• /
• 1997.05a
• /
• pp.134-146
• /
• 1997

Sixty-nine articles were reviewed to understand the depression in patients with rheumatoid arthritis. Among these articles, forty seven were the studies that dealt with depression in rheumatoid disease, nineteen studied the depression in patients with other chronic disease or in normals, and three were the studies that compared the depression in the patients with rheumatic disease and in the other subjects. Specifically, the articles were analyzed (1) to determine whether the patients with rheumatic arthritis were more depressed than normal population or subjects with other chronic diseases ; (2) to test whether the measurement problems exit ; (3) to identify the disease related, personal, psychologic, and demographic variables to affect the depression and (4) to identify the nursing interventions which improve the depression in rheumatoid arthritis. Based upon these results, some suggestion were made for future research and practice.

• Journal of muscle and joint health
• /
• v.10 no.1
• /
• pp.54-61
• /
• 2003

Due to the development in computer mediated communication, there are many homepages on the web, which provide medical on health counseling and education. The internet is becoming increasingly important and essential in medicine. But little was known about what problems can be counseled and what difficulties are met during the computer mediated counseling. This study was performed to investigate the content and purpose of health counseling on the web. The data were collected from March 1st, 2002 to February 28th, 2003, from 199 questioners visited one rheumatic center homepage questionary/answering(Q/A) site. Most of the questioners consulted health problems of their own or their families. The 51.3% of them were diagnosed medically Rheumatoid arthritis was the most frequent disease and followed systemic lupus erythematosus, gout and ankylosing spondylitis. Most of the questioners needed to know treatment principles, diagnosing process, and information regarding the clinic. During the one-year period, the average number of users questioning was 29.4 cases and answering was 44.8 cases. Above findings suggest that computer mediated health counseling of rheumatic patients may be useful supplement of health education for them. Communication using internet has become popular, but this kind of approach needs a proper guideline. It is highly recommended that nurses be familiar with the e-health and e-medicine.

• Journal of Chest Surgery
• /
• v.31 no.4
• /
• pp.346-352
• /
• 1998

Rheumatic valvulitis produces at least three distinct pathologic changes, the degree varying widely among the patients: fusion of the valve leaflets at the commissures; fusion and shortening of chordae tendinae: and fibrosis of the leaflets with subsequent stiffening, contraction and calcification. The most extensive changes usually are seen in patients with recurrent attacks of rheumatic fever. We studied on outcome of the surgical treatments of rheumatic valvular diseases that have been experienced for 12 years since 1982 at Pusan National University Hospital. The diagnoses were made by rheumatic fever history, echocardiographic findings, gross operative findings and microscopic findings. Total 502 patients were performed surgery for valvular heart diseases and 440 patients of rheumatic origin have bene analysed. There were more female than male patients as 1.3:1, and the mean age was 37.8 years old. 96.3% of them affected to the mitral valve, 19.8% to aortic valve, 16.3% affected to the tricuspid valve. Most of them underwent valve replacement, and valve repair was done in 3.9% of patients. There were 36 hospital deaths(8.2%) mainly from low cardiac output syndrome, and 15 late deaths equally due to embolism and hemorrhage. Follow up was 90.1% completed(2890 patient- year). Linealized rates of late complication events are follows : thromboembolism 1.3% per patient year; anticoagulant related hemorrhage 0.8% per patient year. Overall actuarial survival including hospital mortality was 92.7＋/-2.9% in 1 year, 88.0＋/-4.5% in 5 year, 82.3＋/-7.7% in 10 year. We conclude that the rheumatic disease is still the most frequent and the most important cause of heart valve disease. So more intensive study is needed in spite of the abrupt decreasing rate of rheumatic fever in U.S.A. and other industrial country.

• Journal of Chest Surgery
• /
• v.20 no.2
• /
• pp.300-308
• /
• 1987

Clinical and pathologic data were reviewed in 20 patients who had have surgery for isolated aortic valvular heart disease between April 1978 and April, 1987. Hospital mortality was 10%, with no additional late mortality during a mean follow-up period of 24.1 months. Prosthetic valve failure developed in 3 patients and two had reoperation. Niety four percent of the survivors who were in NYHA Funtional class III or IV before operation are now in class I or II. Ninety percent of all patients are still alive at a maximum follow up of 9 years. The clinical histories, gross and histologic examination of valves estabilished the causes for isolated aortic valve disease: 3 rheumatic, 2 congenital bicuspid, 2 hypertention, 2 aortitis and each one case of floppy valve, medial cystic necrosis of aorta, bacterial endocarditis. But etiology was unknown in 8 cases. Sixteen patietns had myxoid degeneration, defined as significant disruption of the valve fibrosa and its replacement by acid mucosaccharides and cystic changes. Myxoid degeneration was also the primary pathologic abnormality in the patients with 2 hypertention, 2 rheumatic, 1 aortitis, 1 bacterial endocarditis, 1 floppy valve, 1 congenital bicuspid. The patients with myxoid degeneration of uncertain origin were 8. Histologic finding of all of them revealed nonspecific patients with myxoid degeneration of uncertain orgin were 8. Histologic finding of all of them revealed nonspecific chronic valvulitis with myxoid degeneration. This finding may indicate that the etiology w uld be infectious.

• Journal of Korean Foot and Ankle Society
• /
• v.23 no.3
• /
• pp.91-99
• /
• 2019

Purpose: This retrospective study reports the intermediate-term clinical outcomes including the practical function in daily and sports activities after total ankle arthroplasty for end-stage rheumatoid arthritis, as well as the effects of modification of perioperative anti-rheumatic medications. Materials and Methods: Twelve patients were followed for a minimum of 2 years after total ankle replacement for end-stage rheumatoid arthritis. Perioperative anti-rheumatic medications in all patients were modified based on a specific guideline. Clinical evaluations consisted of American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores. Periodic radiographic evaluation was conducted to detect changes in ankle alignment and postoperative complications. Results: Mean AOFAS, FAOS, and FAAM scores improved significantly from 37.5 to 81.2, 39.1 to 72.4, and 33.8 to 64.0 points at final follow-up, respectively (p<0.001). Functional outcomes in daily and sports activities at final follow-up were found to be 76.5 and 55.8 points for the FAOS and 70.5 and 57.5 points for the FAAM, respectively. As early postoperative complications, there was one case of local wound necrosis, one case of medial malleolar fracture, and one case of deep peroneal nerve injury. Radiological evaluation revealed two cases of asymptomatic heterotopic ossification and one case of progressive arthritis in the talonavicular joint. Reoperation was performed in only one patient (8.3%) with a medial soft tissue impingement at a mean of 35.6 months follow-up. Conclusion: Total ankle arthroplasty appears to be an effective surgical option for end-stage rheumatoid arthritis. Practical functions in daily and sports activities were significantly improved at intermediate-term follow-up. Modification of perioperative anti-rheumatic medications can be one of the solutions to reduce the postoperative complication rate.

• Korean Journal of Clinical Pharmacy
• /
• v.8 no.1
• /
• pp.1-12
• /
• 1998

Rheumatoid arthritis (RA) is a common systemic inflammatory disease which DMARDS have been widely used as a treatment modality both as monotherapy and combination therapy Bucillamine, one of newer DMARDS, has recently proven its efficacy as monotherapy in the treatment of RA. The objective of this study was to compare the efficacy and the safety of bucillamine monotherapy and bucillamine plus methotrexate combination therapy in the treatment of rheumatoid arthritis. Forty-nine mild RA patients were enrolled in this prospective, open-trial and were assigned to receive bucillamine 200 mg/day (n=18) or bucillamine 200 mg/day and methotrexate 7.5-15 mg/week (n=31) orally for 16 weeks. Concomitant use of NSAID and prednisolone <5 mg/day or equivalent dose of steroid were allowed. Both monotherapy group and combination therapy group have shown significant improvement in disease activities (Ritchie index, painful joints, swollen joints, morning stiffness, grip strength, ESR, RF, CRP, patient's self assessment of pain, physician's global assessment of disease activity) from the baseline. However, there was no statistically significant difference between two groups. The adverse effects were more frequently shown in combination therapy group than monotherapy group. In conclusion, in patients with mild RA monotherapy has shown to be equally efficacious as combination therapy with less side effects.

• Korean Journal of Radiology
• /
• v.22 no.10
• /
• pp.1671-1679
• /
• 2021

Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1-S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion: Spinal FF may help assess both AS disease activity and chronicity.

• Journal of Chest Surgery
• /
• v.21 no.2
• /
• pp.276-282
• /
• 1988

Surgery is now the usual mode of therapy in patients with severe valvular heart disease. Until recently, clinicians and pathologists attributed nearly all acquired valvular heart diseases to a rheumatic origin, except some obviously resulting from acute infection and syphilis. Although many clinicians and pathologists describe that the origin of aortic valvular disease is a nonrheumatic origin, we recognize the major origin of aortic valvular disease in Korea as a rheumatic origin. We excised 47 cardiac valves from valvular heart diseased patients and performed anatomical and pathological analysis for its origin and underlying pathology. The purpose of this article is to provide an update for the clinicians of evolving issues related to the pathology of valvular heart disease. But myxomatous origin and infective endocarditis valvulitis will not be covered in detail.

• 대한예방의학회:학술대회논문집
• /
• 2004.10a
• /
• pp.65.2-65.2
• /
• 2004

• Journal of Rheumatic Diseases
• /
• v.26 no.4
• /
• pp.219-220
• /
• 2019