• Title/Summary/Keyword: Rheumatic patients

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Pharmacoepidemiology and clinical characteristics of medication-related osteonecrosis of the jaw

  • Son, Hyo-Jeong;Kim, Jin-Woo;Kim, Sun-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.26.1-26.7
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    • 2019
  • Background: The aim of this study was to investigate clinical and pharmacoepidemiologic characteristics of medicationrelated osteonecrosis of the jaw. Methods: The study population is comprised of 86patients who were diagnosed with ONJ at Ewha Womans University Mokdong Hospital from 2008 to 2015. Factors for epidemiologic evaluation were gender, age, location of lesion, and clinical history. The types of bisphosphonates, duration of intake, and the amount of accumulated dose were evaluated for therapeutic response. Clinical symptoms and radiographic images were utilized for the assessment of prognosis. Results: Among the 86 patients, five were male, whereas 81 were female with mean age of 73.98 (range 45-97). Location of the lesion was in the mandible for 58 patients and maxilla in 25 patients. Three patients had both mandible and maxilla affected. This shows that the mandible is more prone to the formation of ONJ lesions compared to the maxilla. ONJ occurred in 38 cases after extraction, nine cases after implant surgery, six cases were denture use, and spontaneously in 33 cases. Seventy-six patients were taking other drugs aside from drugs indicated for osteoporosis. Most of these patients were diagnosed as osteoporosis, rheumatic arthritis, multiple myeloma, or had a history of cancer therapy. Higher weighted total accumulation doses were significantly associated with poorer prognosis (P < 0.05). Conclusion: Dose, duration, route, and relative potency of bisphosphonates are significantly associated with treatment prognosis of osteonecrosis of the jaw.

Detection of Coinfection and Persistent Infection of Adenovirus and Varicella-Zoster Virus in Synovial Fluids from Synovitis Patients by Nested-PCR (Nested 중합효소연쇄반응을 이용하여 활막염 환자의 관절액으로부터 아데노바이러스와 대상포진바이러스의 이중감염과 지속감염의 검출)

  • Park, Hae-Kyung;Woo, So-Youn;Kim, Hyun-Jin
    • The Journal of Korean Society of Virology
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    • v.30 no.3
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    • pp.179-187
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    • 2000
  • The etiology of rheumatic arthritis (RA) is associated with a number of genetic and environmental factors, but is not definitively elucidated. Recently, more attention has been paid to the possibility of microbial etiology in the pathogenesis of RA, because many different infectious agents have been reported to precede the onset or exacerbation of RA. Adenovirus (ADV) may be one cause of persistent or recurrent inflammatory arthritis. Varicella zoster virus (VZV) arthritis is detected frequently in RA patients treated with low dose methotrexate. The demonstration of simultaneous presence of both viral agents of specific viral nucleic acid in synovial fluids from synovitis patients would provide more direct evidence for arthritis etiological relationship, but there are no confirmed results. Therefore, we studied the ability of adenovirus and VZV to establish coinfection and persistent infection in synovial fluid from synovitis patients. The presence of viral agents in the synovial fluid demonstrated by isolation of cell culture, enzyme immunoassay and nested-PCR. The synovial fluids were also investgated for the presence of viral nucleic acid by nested-PCR using specific primer. ADV produced 220 bp and VZV produced 447 bp by each nested-PCR with specific primers. We detected 4/6 cases (66.7%) with persistent infection of ADV and 5/6 cases (83.3%) of VZV with 13 synovial fluids (between 7 to 52 day intervals) from synovitis patients by monoclonal ErA and nested-PCR. 21/28 cases (75%) with coinfection of adenovirus and VZV with synovial fluids from synovitis patients by nested-PCR. ADV and VZV coinfection and persistent infection of synovial fluids may provide a chronic antigenic stimuli to the immune system therefore provoking a continuing inflammatory response and caused the possibility of synovitis and arthritis.

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Prevalence, Patterns of Use, and Perceived Efficacy of Alternative Therapies in Patients with Rheumatoid Arthritis (류마티스 관절염 환자의 대체요법에 대한 이용율, 이용행태 및 지각된 효과에 대한 연구)

  • Lee, Eun-Nam
    • Journal of muscle and joint health
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    • v.8 no.2
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    • pp.250-261
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    • 2001
  • Alternative therapy for rheumatoid arthritis has become worldwide phenomenon this decade without scientific validation. This study was undertaken to explore the prevalence, patterns of use, and perceived efficacy of alternative therapies by patients attending a rheumatology clinic. We conducted a crossectional survey of 142 RA patients with structured questionnaire at outpatient rheumatic clinic from July to August in 2001. Results of this study were summarized as follows : 1. 85.9% of subjects were woman. Mean age was 49.97years, duration of rheumatoid arthritis was 5.6years. Mean pain score was 5.29cm. 2. 74.6% of subjects perceived rheumatoid arthritis as a controllable disease. 31% of patients combined medical treatments with alternative therapies. 58.5% of patients perceived that combining medical treatments with alternative therapies is the most effective strategy in controlling disease. 3. 77.5% had used more than one alternative therapy since the diagnosis was made. The major reason of discontinuation of use was no effect for the treatment of their disease. 4. 34.5% were currently using an alternative therapies and 50.9% were going to use alternative therapies in future. 5. 42.7% reported that alternative therapies was effective and only 3.6% reported side effects. 6. The perceived effect score was 3.14cm in general expecially the physiological score 2.91cm, psychological score 4.16cm. In conclusion, our results demonstrate a high use of alternative therapies by rheumatoid arthritis patients. And the perceived effect score of physiological aspect was not higher than one of psychological aspect. Therefore it should be considered in education program for the use of alternative therapies.

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Mitral Annuloplasty Using Carpentier Ring: Report of 5 Cases (Carpentier Ring 을 이용한 승모판윤 성형술 [5례 보고])

  • Chang, Bung-Chul;Jo, Seung-Yeon;Cho, Bum-Koo
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.33-39
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    • 1981
  • In the presence of severe non-calcific mitral regurgitation, a dilated mitral annulus, absence of severe subvalvular chordal thickening, and no major loss of leaflet substance, reconstructive surgery for mitral regurgitation is a reasonable approach. Between March, 1980 to November, 1980, 5 patients underwent mitral annuloplasty using Carpentier Ring for severe mitral regurgitation. All 5 cases were of rheumatic in origin. There were no ruptured chorda tendinae or ruptured papillary muscles except slight thickening of the leaflet. There was no operative or late death. As is Carpentier`s report, in patient with severe mitral regurgitation who meet above criteria, mitral annuloplasty using Carpentier Ring is preferable to valve replacement.

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Ankylosing spondylitis associated with balanced reciprocal X-1 translocation (X염색체와 1번 염색체간 균형전위와 동반된 강직척추염)

  • Kim, Young Hoon;Lee, Jung Ouk
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.80-83
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    • 2017
  • A number of research papers have reported more frequent occurrence of rheumatic/autoimmune disease among patients with hypogonadism or a chromosomal anomaly with potential X-chromosome defects. A 30-year-old female patient came to the hospital with a main cause of bilateral buttock pain, which began two years ago and worsened seven days ago. Ankylosing spondylitis with invasion of both sacral-iliac joints was observed. On magnetic resonance imaging, although the uterus was observed normally, an ovary was not observed. In a chromosome test, balanced reciprocal X-1 translocation of 46,X,t(X;1)(p10;q10) was diagnosed. Here, we report on the first case involving ankylosing spondylitis accompanied by balanced reciprocal X-1 translocation.

Evaluation of a Pretreatment Method for Two-Dimensional Gel Electrophoresis of Synovial Fluid Using Cartilage Oligomeric Matrix Protein as a Marker

  • Kong, Min-Kyung;Min, Byoung-Hyun;Lee, Pyung-Cheon
    • Journal of Microbiology and Biotechnology
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    • v.22 no.5
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    • pp.654-658
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    • 2012
  • Osteoarthritis (OA) is the most common rheumatic pathology. One of the major objectives of OA research is the development of early diagnostic strategies such as those using proteomic technology. Synovial fluid (SF) in OA patients is a potential source of biomarkers for OA. The efficient and reliable preparation of SF proteomes is a critical step towards biomarker discovery. In this study, we have optimized a pretreatment method for twodimensional gel electrophoresis (2DE) separation of the SF proteome, by enriching low-abundance proteins and simultaneously removing hyaluronic acid, albumin, and IgG. SF samples pretreated using this optimized method were then evaluated by 1DE and 2DE separation followed by immunodetection of cartilage oligomeric matrix protein (COMP), a known OA biomarker, and by the identification of 3 proteins (apolipoprotein, haptoglobin precursor, and fibrinogen D fragment) that are related to joint diseases.

A Case Report of Primary Sjögren's Syndrome Presenting Oral Mucosal Pain

  • Lee, Ji-Young;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.46 no.2
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    • pp.54-62
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    • 2021
  • Sjögren's syndrome (SS) is an autoimmune rheumatic disease characterized by the presence of lymphocytic infiltration of exocrine glands and other organs. Due to the rarity of SS, it is frequently overlooked by dentists as a cause of xerostomia. Clinicians should be aware that patients may have oral complications from SS including oral mucosal pain caused by frictional damage. Use of the latest diagnostic criteria approved by the American College of Rheumatology/European League against Rheumatism in 2016 for SS diagnosis provides the advantage of early identification of patients who have not yet developed dry mouth symptoms. A case of primary SS with the chief complaint of oral mucosal pain caused by mucosal damage associated with dry mouth is presented here. This case represents the importance of recognizing oral complications of xerostomia caused by SS, and illustrates use of the latest diagnostic criteria to diagnose the suspected symptoms by dental clinicians, who typically might be the first medical professional to encounter these symptoms.

A Study on the Impact of Mastery on Appraisal of Uncertainty in Women Patients with Rheumatoid Arthritis (극복력(Mastery)이 여성 류마티스 관절염 환자가 자각하는 불확실성 인지에 미치는 효과)

  • Yoo, Kyung-Hee
    • Research in Community and Public Health Nursing
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    • v.13 no.2
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    • pp.249-259
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    • 2002
  • Objectives: This study was conducted to investigate the effects of mastery on appraisal of uncertainty in women patients with rheumatoid arthritis. Methods : The study subjects consisted of 168 patients who were recruited from the outpatient clinic of a rheumatic center in Seoul. Self report questionnaires were used to measure the study variables that included uncertainty, mastery, danger appraisal of uncertainty, and opportunity appraisal of uncertainty. Cronbach's alpha reliabilities of these instruments ranged from .72 to .93. For data analysis. the SPSSWIN 10.0 program was utilized to exam descriptive statistics. Pearson's correlation. and regression analysis. Results: The results were as follows.: 1) The uncertainty scores of the subjects ranged from 33 to 87 with the mean score of 63.27. 2) The mastery scores of the subjects ranged from 10 to 27 with a mean score of 18.70. 3) The danger appraisal of uncertainty scores of the subjects ranged from 8 to 32 with a mean score of 20.22. 4) The opportunity appraisal of uncertainty scores of the subjects ranged from 7 to 28 with a mean score of 17.80. 5) Significant factors that explained the danger appraisal of uncertainty were mastery (=-.444. p<.001), and education level (=-.184. p<.05). 6) Significant factor that explained the opportunity appraisal of uncertainty was level of uncertainty (=-.328. p<.001). Conclusion: Among the independent variables. the most significant factor that explained the danger appraisal of uncertainty in the women patients with rheumatoid arthritis was mastery. Therefore, a nursing intervention with strategies to improve sense of mastery should be developed for women patients with rheumatoid arthritis.

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The Health Status of Arthritis Patients at Home in K City Using Aims 2 Instrument (재가 관절염환자의 건강상태 장애정도에 관한 연구)

  • Suh, Moon-Ja;Kim, Keum-Soon;Lee, Eun-Ok;Noh, Kook-Hee;Jheong, Seung-Hee;Kim, Eun-Man
    • Journal of muscle and joint health
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    • v.8 no.2
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    • pp.302-322
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    • 2001
  • This study was carried out in order to examine the health status of arthritis patients living in K city of southern part of Korea. The data were collected with AIMS2 instrument from 56 subjects who were asked to complete the questionnaire by the trained surveyor. The AIMS2 has been approved useful instrument for assessing the outcome of various treatments and programs in rheumatic diseases. The component variables of the AIMS2 are Mobility, Walking and Bending, Hand and finger function, Arm function, Self-care tasks, Household tasks, Social activity, Support from family and friends, Arthritis pain, Work, Mood, Level of tension, The total number of items of AIMS 2 are 78. The results are as follows: The average age of the subjects was 58 years old and no gender difference. The mean scores of the 12 sub-concepts of AIMS2 are 15.0 of mobility, 12.16 of walking and of bending, 9.32 of hand and finger function, 9.03 of arm function, 13.53 of self-care tasks, 10.19 of household tasks, 15.09 of social activity, 19.58 support from family and friends, 13.82 of arthritis pain, work, 14.85 of level of tension, 15.12 of mood. The Cronbach Cronbach $\alpha$. is 0.72-91 for RA patients and 0.74-96 for OA patients. This results showed that the health status of Arthritis patients at home in K-city was almost not so serious, but the level of tension and mood were quite higher than the average score. Considering the results of this particular subjects, an appropriate rehabilitation program should be developed and implemented.

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Active Coping Strategy Model for Chronic Arthritis : Appling Internal Model of World and Coping Resource (내적모형과 대응자원을 이용한 만성관절염 환자의 적극적 대응전략모형)

  • Mun, Mi-Sook;Lim, Nan-Young
    • Journal of muscle and joint health
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    • v.6 no.1
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    • pp.100-135
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    • 1999
  • Typical symptoms of rheumatic disease affect overall daily living and cause severe stress. Individuals afflicted with rheumatic disease have many illness-related stresses. Pain was the predominantly perceived stress followed by limitation in mobility, difficulties in carrying out activities of daily living. helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships. difficulties performing at work, and discomfort of the treatment. Patients with chronic arthritis are subjected to long periods of continuous stress, which may require the management by the health care provider. In these cases, the purpose of the nursing is helping to promote health through supporting patient's coping. Therefore, for the nursing intervention to be effective, it is critical to build a theoretical framework that describes stress-coping for chronic arthritis. Thus, the purpose of this dissertation is to present a theoretical framework which describes the stress-coping processes and to empirically test pathos of this framework for the people with chronic arthritis. The foundation upon which this framework is built in the Erickson, Tomlin, and Swain(1983) theory of Modeling and role-Modeling. The subjects were 275 patients with rheumatoid arthritis or osteoarthritis who visited the outpatient clinic. A hypothetical model of stress-coping was tested by covariance structure analysis with PC-LISREL 8.12 program. As a result, the overall fit was good(Chi-square=94.49, P=0.00, RMR=0.067, GFI=0.95, AGFI=0.91, NNFI=0.93, NFI=0.91) for the hypothetical model. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on coping resources. However, independent variables(basic need satisfaction, internal health locus of control, illness-related experience, emotional stress and coping resource) did not have significantly influence on coping. And then, the hypothetical model was modified by considering both the theoretical implication and statistical significance of the parameter estimates. The revised model had a better fit to the data(Chi-square=83.11(P=0.00), RMR=0.061, GFI=0.96, AGFI=0.92, NNFI=0.95, NFI=0.92). Hypothesis emerged from the revised model was tested. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on illness-related experience and coping resources. Internal health locus of control, illness-related experience, emotional stress and coping resources had a significantly influence on coping. According to the results of this dissertation, basic need satisfaction and internal health locus of control play a central role in appraisal of illness-related experience and coping resources. And illness related-experience, emotional stress, and coping resources affect on coping activities. In summary, nursing interventions to enhance basic need satisfaction and internal health locus of control will decrease illness related experience and emotional stress and increase coping resources. Increased coping resources will prompt coping activities.

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