• 제목/요약/키워드: rheumatic diseases

검색결과 88건 처리시간 0.025초

Use of Quantitative Vertebral Bone Marrow Fat Fraction to Assess Disease Activity and Chronicity in Patients with Ankylosing Spondylitis

  • Ga Young Ahn;Bon San Koo;Kyung Bin Joo;Tae-Hwan Kim;Seunghun Lee
    • Korean Journal of Radiology
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    • 제22권10호
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    • pp.1671-1679
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    • 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.

류마티스 관절염 환자에서 발생한 피하조직 석회화 (Subcutaneous tissue calcification in a patient with rheumatoid arthritis)

  • 김동현;김경진;권성민;차성욱;이정욱
    • Journal of Yeungnam Medical Science
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    • 제33권2호
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    • pp.120-124
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    • 2016
  • Subcutaneous tissue calcification in rheumatic diseases usually occurs in connective tissue diseases, such as systemic lupus erythematosus, scleroderma, and dermatomyositis. Domestic cases of calcification in rheumatoid arthritis have not been reported. The mechanism of subcutaneous tissue calcification may differ depending on the cause and it can develop on all parts of the body. Calcification occurring in rheumatic diseases is a major mechanism of tissue damage caused by chronic inflammation. No standard therapy for calcification has been established; however, many studies have reported on medical and surgical treatment. We report on subcutaneous tissue calcification in a rheumatoid arthritis patient tissue calcification on both sides of the buttocks, the upper limbs, and the lower limbs.

관절염 환자의 우울 (Depression in Patients with Rheumatoid Arthritis)

  • 김인자
    • 대한근관절건강학회:학술대회논문집
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    • 대한근관절건강학회 1997년도 제6회 춘계학술대회
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    • pp.134-146
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    • 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.

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The Significance of the Mast Cell in Rheumatic Disease

  • Kim, Hyung-Min
    • 한국응용약물학회:학술대회논문집
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    • 한국응용약물학회 2001년도 추계학술대회 및 정기총회
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    • pp.14-20
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    • 2001
  • Rheumatoid arthritis (RA) is one of the most typical rheumatic diseases, and is characterized by chronic inflammation, cartilage destruction and joint deformity [1,2]. During this process, profound hypertrophic changes of the synovium with infiltration of immune cells, increased vascularity, and hyperplasia result in the formation of a synovial pannus that invades cartilage and bone [3]. In early stages of RA, the synovial membrane begins to invade the cartilage. In established RA, the synovial membrane becomes transformed into inflammatory tissue, the pannus (Fig. 1). The cell types that occupy cartilage-pannus junctions include synovial macrophages, fibroblasts, mast cells, polymorphonuclear lymphocytes (PMNs), and displaced, probably differentiated condrocytes [4-6]. Recent studies of rheumatoid synovial tissue have demonstrated localized accumulations of mast cells and evidence of their activation/degranulation[7].

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심장판막의 병리 (Pathology of the Cardiac Valve Disease)

  • 임창영
    • Journal of Chest Surgery
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    • 제21권2호
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    • pp.276-282
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    • 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.

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류마티스성 심장판막질환의 외과적 치료에 대한 임상적 연구 (A Clinical Study on the Surgical Treatment of the Rheumatic Cardiac Valve Disease)

  • 김종원;정황규;이성광;김병준;신영우
    • Journal of Chest Surgery
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    • 제31권4호
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    • pp.346-352
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    • 1998
  • 심장 초음파에 의한 류마티스성의 심장판막질환은 판첨이 융합되고 건삭이 짧아져 판막운동이 제한되는데 융합이 심하면 협착이되고 퇴축이 심하면 폐쇄부전이 일어난다. 이러한 초음파적인 소견과 수술시야에 직접 관찰되는 교련융합과 판엽의 비후, 건삭의 융합과 단축 심하면 석회침착 등의 소견 및 병리조직학적인 소견으로 확인된 류마티스성 심장판막질환에 대한 외과적 치료를 시행한 환자 440명을 대상으로 임상적성적을 분석하였다. 기간내의 총판막수술은 502명에서 시행되었으며 이중 87.3%인 440명이 류마티스성판막증으로 분류되었으며, 여자가 1.3배 많았고 평균년령은 37.8세 였다. 96.3%가 승모판을 침범하였고 대동맥판 19.8%, 삼첨판 16.3%를 침범하였으나 승모판 단독 침범례는 62.5%, 대동맥판 단독은 3.6%, 삼첨판막의 기질적 변화를 보여 외과적 치료를 가한 예는 1.8%에 불과하였다. 수술의 방법으로는 3.9%에서는 판막의 보존적 치료가 가능하였고 96.1%인 323례에서 1개 이상의 인조판막이 사용되었다. 승모판막치환술이 275례, 대동맥판 18례, 70례의 다중판막치환술을 시행하였다. 조기사망율은 보존적치료 예에서 5.9%, 판막치환례에서는 대동맥 5.9%, 승모판 6.0%, 다중판막 19.4%를 기록하였다. 생존례의 90.1%인 364명이 추시관찰이 가능하였는데 총 2890환자년의 추적기간중 뉴욕심장협회기능적 분류상 수술로 평균 2.9도에서 1.3의 상태호전을 보였으며 합병증은 혈전전색 1.3%/환자/년, 출혈성합병증 1.8%환자/년으로 나타났다. 누적생존율은 술 후 1년에 92.7+/-2.8%, 5년에 88.0+/- 4.5%, 10년에 82.3+/-7.7%였다. 류마티스성질환은 선진국에서는 최근 급격히 감소하고 있다고 하나 저자들의 예에서는 전체판막질환에 대한 수술례의 87.3%를 차지하고 있어 아직도 깊은 관심을 갖고 깊은 연구가 있어야 할 것으로 생각된다.

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사망신고자료(死亡申告資料)에 의한 사인분석(死因分析) (An Analysis of Cause of Death from the Reported Death Certificates in Korea)

  • 이동우
    • Journal of Preventive Medicine and Public Health
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    • 제14권1호
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    • pp.39-42
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    • 1981
  • Recent changes in the cause of death among the Korean population seem to be systematic and significant. Data on cause of death from the medically certified death certificates provide at least four types of evidence: a sudden increase in recent years in the numbers of death due to cerebrovascular disease or circulatory diseases including rheumatic fever and chronic heart diseases and atherosclerosis; increasing steadily in the numbers of death due to malignant neoplasm of various sites, and death due to accident; decreasing steadily in the numbers of death due to communicable diseases or parasite diseases; and a large number of deaths with unspecified symptoms and ill-defined conditions. The lack of complete registration of the deads occurred or the incomplete description on the cause of death reported suggests that statistical information of cause of death from the medically certified death records is meaningful in interpreting changing patterns.

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근골격계 질환에서 진단의학검사의 활용 (Application of Clinical Laboratory Tests in Musculoskeletal Diseases)

  • 하원배;금지혜;신선호;이정한
    • 척추신경추나의학회지
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    • 제13권2호
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    • pp.109-125
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    • 2018
  • Objectives : It is difficult to make accurate diagnosis of musculoskeletal disease because of its multiple, subjective and non-specific symptoms. It is possible to reduce errors of differential diagnosis through detailed history taking and physical examination in parallel with laboratory tests based on clinical decision. Methods : Korean and foreign on-line databases(Pubmed, Cochran Library, NDSL, KISS and OASIS) were researched for articles discussing laboratory tests in musculoskeletal diseases. Results : Laboratory tests could be applied usefully for various musculoskeletal diseases, In this review, available laboratory components in these musculoskeletal diseases are summarized, and then significance and usefulness of disease-specific laboratory examination are described. Conclusions : When examining musculoskeletal patients, it needs to accurate differential diagnosis by full interview and physical examination, to select required tests by understanding laboratory tests thoroughly, and to judge the prognosis precisely.