BACKGROUND: Patients with non-Q wave myocardial infarction tend to have smaller infarcts and less degree of ventricular function impairment initially, however, uncomplicated non-Q wave infarctions are known to be as serious as Q wave myocardal infarction due to residual myocardal ischemia and higher reinfarction rate. METHODS: Inorder to compare the clinical and coronary angiographic findings of Q wave infarction with those of non-Q wave infarction. 58 partients with acute myocardial infarction were reviewed retrospectively. Patients were classified into Q wave(n=45) and non-Q wave infarction(n=13) according to electrocardiographic findings. RESULTS: 1) There were no significant differences between the two groups in risk factors of coronary artery disease such as hypertension, hypercholesterolemia, smoking and diabets mellitus. 2) The peak myocardial enzyme levels of CPK, CPK-MB were significantly higher in the Q wave MI group, and the percentage of wall motion abnormality on two-dimensional echocardiography was significantly higher in Q wave MI than in the non-Q wave MI group. 3) The number of involved vessel, degree of stenosis and collateral circulation were not different but high degree of stenosis of infarct-related artery was more frequent in Q wave MI group. 4) There were no significant differences between the two groups in the incidence of arrhythmia and in-hospital mortality. CONCLUSION: There were some differences in clinical and angiographic findings, but in-hospital mortality was not significant different between two groups. Futher prospective studies should be performed to clarify the long term prognosis.
Arrhythmias, Cardiac ; Arteries ; Collateral Circulation ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Electrocardiography ; Hospital Mortality ; Humans ; Hypercholesterolemia ; Hypertension ; Incidence ; Infarction ; Ischemia ; Myocardial Infarction* ; Prognosis ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Ventricular Function

Myeloid-related protein (MRP)8/MRP14 is an endogenous Toll-like receptor 4 (TLR4) ligand and is abundant in synovial fluid (SF) of rheumatoid arthritis (RA) patients. Belonging to damage-associated molecular patterns, it amplifies proinflammatory mediators and facilitates a wide range of inflammatory and autoimmune diseases. Interleukin (IL)-17-producing T-helper (Th)17 cells have a crucial role in RA pathogenesis, and IL-6 is the key factor promoting Th17 differentiation. We investigated whether the level of MRP8/MRP14 is positively associated with IL-6 and IL-17 levels in RA SF and found that MRP8/MRP14 level had a significant correlation with IL-6 and IL-17 levels in RA SF. We also observed that MRP8-induced IL-17 production by peripheral blood mononuclear cells but MRP14 did not. Upon stimulation with MRP8, IL-6 production was enhanced by RA fibroblast-like synoviocytes (FLS) and was further elevated by coculturing RA FLS with activated CD4+ T cells. Moreover, we demonstrated that MRP8-activated IL-6 production by RA FLS promoted differentiation of Th17 cells using the coculture system consisting of CD4+ T cells and RA FLS. In addition, IL-6 blockade attenuated Th17 polarization of CD4+ T cells in the cocultures. Inhibitor studies revealed that MRP8 increased IL-6 production in RA FLS via TLR4/phosphoinositide 3-kinase/nuclear factor-kappaB and mitogen-activated protein kinase signaling pathways. Our results show that MRP8 has a crucial role in stimulating IL-6 expression by RA FLS, and subsequently promotes Th17 differentiation in RA, suggesting that neutralizing MRP8 level in RA synovium may be an effective therapeutic strategy in RA treatment.
ATP-Binding Cassette Transporters/*metabolism ; Adult ; Aged ; Arthritis, Rheumatoid/*pathology ; CD4-Positive T-Lymphocytes/metabolism ; Calgranulin B/metabolism ; Cell Differentiation/*immunology ; Fibroblasts/*metabolism/pathology ; Humans ; Inflammation Mediators/metabolism ; Interleukin-17/metabolism ; Interleukin-6/*biosynthesis ; Middle Aged ; Signal Transduction/immunology ; Synovial Fluid/cytology ; Synovial Membrane/metabolism/pathology ; Th17 Cells/*pathology ; Toll-Like Receptor 4/metabolism ; *Up-Regulation

OBJECTIVE: Methotrexate is the first-line drug in treatment of rheumatoid arthritis (RA) exhibiting higher efficacy and better tolerability than most other DMARDs. To have a better understanding of the anti-arthritic mechanism of methotrexate, we investigated the effect of methotrexate on suppressing the autoimmune inflammatory and destructive arthritis in collagen-induced arthritis (CIA) mice. METHODS: The effects of methotrexate on joint inflammation were assessed by clinical scoring and histologic analysis. Levels of cytokines and autoreactive antibodies were analyzed by immunohistochemistry and ELISA. The population of TH17 and Foxp3+ regulatory T (Treg) cells and phosphorylation of their critical transcription activators, STAT3 and STAT5, were examined by fluorescence microscopy and flow cytometry, respectively. RESULTS: Treatment with methotrexate significantly alleviated joint inflammation and cartilage destruction in CIA. Serum levels of total immunoglobulins G, G1, G2a specific to type II collagen were also reduced considerably in methotrexate-treated mice. The drug inhibited the expression of proinflammatory cytokines such as IL-1beta, TNF-alpha, IL-6 and IL-17 in arthritic joints ex vivo as well as by splenocytes in vitro. Moreover, methotrexate treatment resulted in reciprocal modulation of TH17 cells and Foxp3+ regulatory T (Treg) cells in spleen tissues, in which TH17 cells were decreased and Treg cells in number were increased. Subsequent analysis of CD4+T cells showed that phosphorylation of STAT3 was decreased whereas phosphorylation of STAT5 was increased in methotrexate-treated mice. CONCLUSION: Methotrexate treatment effectively suppressed autoimmune arthritis and restored homeostasis of the immune system by reciprocal regulation of TH17 and Treg cells in a mouse model of collagen-induced arthritis.
Animals ; Antibodies ; Antirheumatic Agents ; Arthritis ; Arthritis, Experimental ; Arthritis, Rheumatoid ; Cartilage ; Collagen Type II ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Homeostasis ; Immune System ; Immunoglobulins ; Immunohistochemistry ; Inflammation ; Interleukin-17 ; Interleukin-6 ; Joints ; Methotrexate ; Mice ; Microscopy, Fluorescence ; Phosphorylation ; Spleen ; T-Lymphocytes, Regulatory ; Th17 Cells ; Tumor Necrosis Factor-alpha

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin

Recently the change in medical informatics enabled us to use medical information whenever we want and wherever we are. There are many homepages on the web, which provide hospital information, medical counseling. Our multimedia center began its service as a internet Hospital in MIDAS Dongailbo, one of the major daily newspaper in Korea, on March 25th, 1997. The aim of this study is to examine the content and purpose of medical counseling on the web. The subjects consisted of 1,000 counsellings which were called 'Dongailbo Internet Hospital' for March, 25th, 1997 through October 30th, 1997. Many questioners wanted to know treatment principles, to make a diagnosis, and to know specific medical knowledges. The most common questions are as follows: general and unspecified, musculoskeletal, skin, digestive, respiratory, neurological problems.
Computer Communication Networks ; Counseling* ; Diagnosis ; Internet ; Korea ; Medical Informatics ; Multimedia ; Periodicals* ; Skin