Rheumatoid arthritis is a chronic inflammatory disease and afflicts approximately 1% of general population. Once considered as a benign non-fatal disease, rheumatoid arthritis is a debilitating condition with a serious physical, emotional, and economic consequences. Life expectancy is reduced among patients with rheumatoid arthritis, and survival rates are comparable to those for three-vessel coronary disease Hodgkin's disease, and diabetes mellitus. For the past 20 years the treatment of rheumatoid arthritis has been developed on pyramid approach, which has had limited success. This led to a move towards using disease modifying antirheumatic drugs early in the disease. Future of rheumatoid arthritis tensive induction therapy, and treatment for resistant disease. This review will be focused on current principles and general guidelines of drugs for the treatment of rheumatoid arthritis.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Coronary Disease ; Diabetes Mellitus ; Hodgkin Disease ; Humans ; Life Expectancy ; Survival Rate

No abstract available.
Adult* ; Humans

No abstract available.
Adult* ; Humans

No abstract available.
Endometriosis* ; Female ; Humans

Scleroderma is a systemic disorder with multiorgan involvement. About 90% of patients with scleroderma has Raynaud's phenomenon and microvascular involvement is well recognized in scleroderma, but macrovascular involvement is not recognized. We experienced 2 cases of scleroderma with peripheral vascular occlusions that had been diagnosed by fernoral angiography. The one patient with limited scleroderma had anticentromere antibody and angiography of both fernoral arteries showed nonvisualization of posterior tibial artery. The other patient with diffuse scleroderma had anti-Scl-70 antibody and angiography of right fernoral artery showed occlusion of both anterior and posterior tibial arteries and stenosis of distal portion of peronial artery. Both patients didn't have the risk factors of atherosclerosis such as hypertension, hypercholesterolemia, obesity, and smoking. In recent years, there have been reports that scleroderma is associated with macrovascular disease. In the future, the study on the freguency, prevention and treatment of macrovasular disease in scleroderma is necessary. We report 2 cases of scleroderma with peripheral vascular occlusions that had been diagnosed by fernoral angiography with review of literatures.
Angiography ; Arteries ; Atherosclerosis ; Constriction, Pathologic ; Humans ; Hypercholesterolemia ; Hypertension ; Obesity ; Peripheral Vascular Diseases* ; Risk Factors ; Scleroderma, Diffuse ; Scleroderma, Limited ; Smoke ; Smoking ; Tibial Arteries

OBJECTIVE: To investigate soluble Fas (sFas) protein in the sera of patients with systemic lupus erythematosus (SLE). METHODS: sfas protein was measured by sandwich ELISA METHOD: in the sera of 30 patients with SLE (mean age : 27.4+/-8.46, F:M=29:1) and 11 patients with fibromyalgia (mean age 35.8+/-11.5, F:M-11:0) as a control group. RESULTS: sfas was elevated in 6 (20%) patients of SLE and I (9%) of patients with fibromyalgia (p=0.41). sfas level was correlated with a shorter duration, lower dosage of systemic steroid and higher disease activity in patients with elevated sfas levlel compared to patients with normal serum levels of sfas. All patients with elevated sfas had been diagnosed with SLE for less than 1 month. Fifty % (6 out of 12)patients with SLE for less than I month showed elevated sfas in serum. There was no difference of in the age between patients with elevated and normal levels of sfas. CONCLUSION: These data indicate that elevated sera levels of sfas was associated with the early active phase of disease in some patients with SLE and may play a role in defective apoptosis.
Apoptosis ; Enzyme-Linked Immunosorbent Assay ; Fibromyalgia ; Humans ; Lupus Erythematosus, Systemic*

Porokeratosis is a specific disorder of keratinization characterized histologically by the presence of a cornoid lamella. Clinically, the basic lesion is a sharply demarcated hyperkeratotic plaque which may be linear, punctated, or annular with central atrophy. The etiology of the various types of porokeratosis is unknown. However, heredity, UV radiation, immunosuppression, trauma, burns, and occult infection are known to be precipitating or exacerbating factors. A 32-year-old female was burnt on her right arm and chest at the age of 12. Several years later, brownish plaques developed in these burn areas. Seven years prior to visiting our clinic, nu- merous match-head sized, peripherally elevated macules developed on the forearms and have gradually spread to the other areas of her upper and lower extremities. The histological findings of two lesions from the burn areas showed the same features including cornoid lamellae in the epidermis and fibrosis in the dermis. Howerer, the histological finding of a lesion from a non-burn area showed cornoid lamellae in the epidermis without evidence of dermal fibrosis. We believe our case is the first to be reported in Korea in which porokeratosis arose in previous burn areas.
Adult ; Arm ; Atrophy ; Burns* ; Dermis ; Epidermis ; Female ; Fibrosis ; Forearm ; Heredity ; Humans ; Immunosuppression ; Korea ; Lower Extremity ; Porokeratosis* ; Thorax

Postpartum hemorrhage is a common cause of maternal mortality; its main cause is placenta accreta. Therapeutic hypothermia is a generally accepted means of improving clinical signs in postcardiopulmonary resuscitation patients. A 41-year-old pregnant woman underwent a cesarean section under general anesthesia at 37 weeks of gestation. After the cesarean section, the patient experienced massive postpartum bleeding, which led to cardiac arrest. Once spontaneous circulation returned, the patient underwent an emergency hysterectomy and was placed under therapeutic hypothermia management. The patient recovered without neurological complications.
Adult ; Anesthesia, General ; Cesarean Section ; Emergencies ; Female ; Heart Arrest* ; Hemorrhage ; Humans ; Hypothermia ; Hypothermia, Induced* ; Hysterectomy* ; Maternal Mortality ; Placenta Accreta ; Postpartum Hemorrhage* ; Postpartum Period* ; Pregnancy ; Pregnant Women ; Resuscitation

Hypertensive left ventricular hypertrophy(LVH) was considered to be a physiologic adaptation to the increased afterload of left ventricle, but recent studies revealed that LVH was one of the most important target organ damage in essential hypertensive patients & cardiovascular morbidity was increased in patients with hypertensive LVH. Hypertensive LVH could be classified into three types : concentric LVH, disproportionate septal thickening(DST), and left ventricular dilatation. Relatively high incidence of DST in hypertension has bee reported after clinical introduction of echocardiogram. But, the mechanisms for the development of DST and its clinical significance have not been elucidated exactly. In order to assess left ventricular diastolic function in hypertensives with DST, the authors performed phonocardiogram, M-mode, and pulsed Doppler echocardiogram in 15 normotensive control(group A : 5 male, 10 female, 44.4+/-7.7 years), 15 hypertensives without LVH(group B : 5 male, 10 female, 45.5+/-8.6 years), 85 hypertensives with DST(group C : 9 male, 16 female, 47.5+/-8.6 years) and 15 hypertensives with concentric LVH(group D : 8 male, 7 female, 47.7+/-6.1 years). The obtained results were as follows : 1) Left ventricular ejection fraction was 71.6+/-6.3% in group A, 71.9+/-7.5% in group B, 731+/-7.0% in group C, and 70.3+/-10.3% in group D. Ejection fraction was not significantly different in each other group. 2) Left ventricular mass index(LVMI) by echocardiogram was 87.8+/-20.6g/m
Adaptation, Physiological ; Bees ; Deceleration ; Dilatation ; Female ; Heart Ventricles ; Humans ; Hypertension ; Hypertrophy ; Incidence ; Male ; Relaxation ; Stroke Volume

Osteoarthritis(OA) is the most common arthritis of human joint diseases and a major cause of morbidity and disability in the elderly. Current treatment of OA is to control symptoms because there are no disease-modifying OA drugs yet. The goals of management are to control pain and maintain/improve joint mobility and minimize disability. The treatment modalities consist of nonpharmacologic, pharmarcologic therapies and surgical treatment. A pyramid approach is recommended. The layers of the pyramid are added one to another in a stepwise fashion, although treatment should be individualized based on the distribution and severity of joint involvement as well as the presence of comorbid conditions. First use nonpharmacologic modalities and acetoaminophen for pain and symptom control. If response is inadequate, use nonsteroidal antiinflammatory drug(NSAID) (with gastrointestinal protective drug) During the course of managing the OA patients intraarticular hyaluronic acid and topical capsaicin cream can be given to patients already on acetoaminophen or NSAID. If effusion is present, do aspiration and injection of intraarticular steroids. If response is inadequate despite of nonpharmacological and pharmacoogic therapies, surgery can be considered. Novel agents for OA are being investigated and will be available in the future. So it is expected that the prognosis and quality of life of patients with OA will be improved.
Aged ; Arthritis ; Capsaicin ; Humans ; Hyaluronic Acid ; Joint Diseases ; Joints ; Osteoarthritis* ; Prognosis ; Quality of Life ; Steroids