• Journal of Periodontal and Implant Science
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• v.42 no.1
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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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• 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.

• 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.

• IMMUNE NETWORK
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• v.3 no.3
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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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• v.16 no.4
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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.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.275-292
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• 2000

The purpose of this study was to analyze the relationship between knowledge, self-efficacy and quality of life of patients suffering from rheumatic arthritis. The data were collected from 100 rheumatic arthritis patients 1 university hospital, K rheumatic clinic in kwang-ju city for 20 days from March 2 to March 22, 1999, by means of questionnaires. The instruments used in this study were the knowledge scale developed by Kim, the self-efficacy scale developed by Long et al and the quality of life scale developed by Rho. The data were analyzed by t-test, ANOVA, Pearson's Correlation Coefficient, and Stepwise Multiple Regression by using the SAS program. The results of this study were summarized as follows : 1. The total mean score of knowledge was 15.01(SD${\pm}$3.08), In self-efficacy, the total mean score was 1030.40(SD${\pm}$233.42), In quality of life, the total mean score was 135.19(SD${\pm}$11.07). 2. The relationship between general characteristics and knowledge were significant difference in sex(t=19.03, p=.00), occupation(F=2.34, p=.03), types of exercise (F=2.95, p=.0.3), and time of exercise(F=3.20, p.=02). 3. The relationship between general characteristics and self-efficacy were significant difference in religion(F=2.75, p=.04), in monthly salary(F=3.64, p=.01), in occupation(F=2.30, p=.03), in period of rheumatic arthritis(F=2.70, F=.03), in time of exercise(F=3.77, P=.01), and in effectiveness of exercise (F=4.56, p= .02). 4. The relationship between general characteristics and quality of life were significant difference in age(F=3.36, p=.01), monthly income(F=3.11, p=.02), types of housing(t=4.93, p=.02), arid time of exercise(F=3.03, p=.03). 5. There was not significant correlation between the subjects knowledge and quality of life. 6. There was significant correlation between the self-efficacy and quality of life(r=462, p<.011). 7. The main factor influencing on quality of life was self-efficacy(21.4%).

• Journal of Korean Physical Therapy Science
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• v.5 no.4
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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.

• 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.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.681-691
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• 2006

Background: The aim of this study was to investigate the mid-term outcomes of our modifications to the maze procedure using cryoablation for treating atrial fibrillation associated with rheumatic mitral valve disease. Material and Method: Between March 2000 and February 2004, 177 consecutive patients underwent the modified maze procedure with the use of cryoablation concomitant with mitral valve surgery for atrial fibrillation associated with rheumatic mitral valve disease, and were divided into three groups: (1) modified Cox-maze III (CM group, n=88): (2) modified Kosakai-maze (KM group, n=63): and (3) left atrial maze procedure (LA group, n=26). The postoperative and follow-up results were analyzed and compared between the groups. Result: There were three hospital deaths (1.7%) and no significant differences in the incidence of postoperative complications between the three groups. The operative time, such as the cardiopulmonary bypass and aortic crossclamp time, were significantly longer in the CM group than in the KM and LA groups, respectively (p<0.0001). The mean follow-up was $22.4{\pm}15.1$ months ($1\sim52.6$ months) for all patients. One late death developed in the CM group (0.0%). At last follow-up, 139 patients exhibited sinus rhythm (79.9%), which was also regained in 67 patients (77.9%) in the CM group, 50 (80.7%) in the KM group and 22 (84.6%) in the LA group (p=0.743). The actuarial freedom from stroke at 4 years was $84.5{\pm}9.4%$ in the CM group, $95.0{\pm}4.9%$ in the KM group, and $92.9{\pm}6.9%$ in the LA group (p=0.916). Conclusion: The modified maze procedure using cryoablation is safe and effective in treating chronic atrial fibrillation associated with rheumatic mitral valve disease.

• Journal of Chest Surgery
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• v.33 no.1
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• pp.32-37
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• 2000

Background: Reconstruction surgery of mitral valve regurgitation is now considered as an effective operative technique and has shown good long-term results. Although reconstructive surgery of mitral valve has been performed since 1970s, we have started only in early 1990s in full scale because of small number of the mitral regurgitation compared to mitral stenosis and lack of knowledge from the viewpoint of patients and physicians. Material and Method: From January 1992 to December 1996, 100 patients underwent repair of the mitral valve for mitral regurgitation with or without mitral stenosis in Seoul National University Hospital. 45(45%) of the patients were men and 55(55%) were women. The mean age was 39.9$\pm$14.4 years. The causes of the mitral regurgitation were rheumatic in 61, degenerative in 28 and others in 11. According to the Carpentier's pathological classification of mitral regurgitation 5 patients were type I. 55 patients were type II and 40 patients were type III. 7 patients underwent concomitant aortic valvuloplasty and 8 patients underwent aortic valve replacement. 7 patients underwent Maze operation or pulmonary vein isolation. Result: There were no operative death but 3 major operative complications: 2patients were postoperative low cardiac output syndrome(needed intra-aortic ballon pump support) and 1 patient was postoperative bleeding. There was one late death(1.0%) The cause of death was sepsis secondary to acute bacterial endocarditis. 3 patients required reoperation for recurred mitral regurgitation. There were no statistically significant risk factors for reoperation. The other 96 patients showed no or mild degree of mitral regurgitation 99 survivors were in NYHA functional class I or II. There were two throumboembolisms but no anticoagulation-related complications. Conclusion: We concluded that mitral valve repair could be performed successfully in most cases of mitral regurgitation even in the rheumatic and combined lesions with very low operative mortality and morbidity. The early results are very promising.