Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:2.7.10.1 (ERK)
95,504 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of surgical treatment of 195 metacarpo-phalangeal joints in 132 rheumatoid patients were evaluated. The indications for each of three operative methods were presented with clinical assessment and Larsen, Dahle, Eek scale of radiological changes taken into consideration. The results of 137 synovectomies, 32 joint replacements and 24 arthroplasties in 88% were rated as good and fair. The advantages of early synovectomy as well as joint replacement in advanced arthritis were underlined.
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PMID:[Surgical treatment of metacarpo-phalangeal joints in patients with rheumatoid arthritis]. 136 57

The elbow joint is a key joint for positioning of the hand. Four operations have to be considered for the rheumatoid elbow: removal of rheumatoid nodules and bursectomy, resection of the radial head, synovectomy, and arthroplasty. Synovectomy and arthroplasty are carefully analyzed, both from the point of view of recent international literature as well as personal experience. Synovectomy of the elbow is highly effective even when performed relatively late (stage 3 according to Larsen-Dahle-Eek) insofar as pain relief and swelling are concerned. In long-term disease, deterioration as assessed by radiology can usually not be prevented, but clinical improvement may be the reason for the relatively rare indication for arthroplasty. According to recent literature, the results of elbow arthroplasty vary greatly. Fully constrained hinges should no longer be used, and no decision has been made so far on whether semiconstrained or nonconstrained surface replacement is preferred. We use the semiconstrained GSB Mark II prosthesis, which has provided results in nearly 50 cases that rank among the best reported from the point of view of pain relief, improvement of ROM, and low complication rate. Use of our so-called transtricipital approach to the elbow has proved particularly valuable, especially with regard to lack of extension and muscle strength.
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PMID:[Elbow joint]. 376 20

The aim of this prospective study was to evaluate the efficiency of radiation synovectomy with rhenium-186 or erbium-169 in rheumatoid arthritis. In the control groups articulosynovitis was treated by injection of triamcinolonhexacetonid. Follow-up time was 3 years. Patients of the study had to fulfill the following criteria: rheumatoid arthritis (ARA criteria 1988), patient age above 40 years, standardized medical treatment with methotrexate, (started at least 6 month prior to injection therapy, given for the entiry study time), prednisolon < or = 7.5 mg/d and diclofenac < or = 150 mg/ d, and no previous surgery or injection therapy on this/these joint/s. Shoulder, elbow, wrist, and ankle joints were treated in group 1 by injection of rhenium-186 combined with triamcinolonhexacetonid, in group 2 by injection of triamcinolonhexacetonid alone. Each treatment group included 50 joints. Digital joints underwent injection of erbium-169 combined with triamcinolonhexacetonid (group 3 = 131 joints) or triamcinolonhexacetonid (group 4 = 86) alone. During the follow up period, the joints were assessed for pain, synovial swelling, joint motion, and stage of radiological destruction (Larsen-Dale-Eek). After 3 years follow-up, 228 joints met the above named criteria: group 1 = 41 joints, group 2 = 21 joints, group 3 = 131 joints, group 4 = 53 joints. Significantly better clinical results were achieved with the combined injection of rhenium-186 or erbium-169 and triamcinolonhexacetonid. Results for PIP joints were worse than for other joints, which is explained by better immobilization of the latter ones after injection. The progression in radiological joint destruction according to the stages of Larsen-Dale-Eek during the follow-up time of 3 years (= stage at 3 years minus stage prior to treatment) corresponded to the clinical results and was significantly slower in groups 1 and 3: group 1 = 0.62; group 2 = 1.7; group 3 = 0.75; group 4 = 1.43 Therefore, we recommend radiosynovectomy with erbium-169 or rhenium-168 in combination with triamcinolonhexacetonid and consequent immobilization after injection.
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PMID:[Chronic polyarthritis and radiosynoviorthesis: a prospective, controlled study of injection therapy with erbium 169 and rhenium 186]. 941 61

In rheumatoid arthritis of the knee joint good results are obtained using arthroscopic synovectomy or radiation synovectomy. Aim of our study was to investigate, whether the combination of these two minimal invasive interventions achieves better results. First we performed arthroscopic synovectomy of the knee joint followed by radiation synovectomy with application of 111-222 MBq Yttrium-90 6 weeks later. In a prospective randomised clinical trial between 1987 and 1991 we performed radiation synovectomy on 22 knee joints and combined arthroscopic and radiation synovectomy on 26 knee joints. We explored the patients preoperatively, 6 weeks and 6 months postoperatively. In 1996 we evaluated 141 knee joints in a retrospective clinical trial. 90 Knee joints had been treated with the combined therapy, 39 only with radiation synovectomy and 12 only with arthroscopic synovectomy. Depending on the three different therapeutic interventions, the patients were classified into midterm (3-5 years) and long-term (6-8 years) observation groups. The trials are based on the standardized ARO-Questionnaire of the knee joint, the modified ARO Knee-Score and the radiological grading according to Larsen, Dale and Eek. In the prospective clinical trial we found significant better results for patients treated with the combined therapy than for patients treated with radiation synovectomy only regarding the parameter swelling, effusion, range of motion, pain and Knee-Score. In the long-term results of the retrospective clinical trial the patients treated with the combined therapy showed a significant better outcome for the parameters pain, swelling and Knee-Score, than the patients treated with radiation synovectomy. Although no statistically significant difference was found comparing the results of the combined therapy with arthroscopic synovectomy, an improvement of the clinical outcome can be observed performing arthroscopic synovectomy followed by radiation synovectomy. In the treatment of rheumatoid arthritis of the knee joint a better outcome is achieved performing combined arthroscopic and radiation synovectomy than performing only one of the methods.
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PMID:[Combined arthroscopic and radiation synovectomy in rheumatoid arthritis]. 958 28

Bisphosphonate-related osteonecrosis of the jaws (BON), first described in 2003, is gaining importance due to the increasing indication spectrum of bisphosphonate therapy [S. Takeyama, M. Ito, H. Shinoda, A novel bisphosphonate, TRK-530, for periodontitis, Bone 38 (2006) 31-31; M. Tagil, A. W-Dahl, J. Astrand, D. Little, S. Toksvig-Larsen, Decreasing the catabolic response by a single bisphosphonate infusion shortens the healing time in hemicallotasis operations, Bone 38 (2006) 84-85; E. Rodriguez, M.C. Duran, L.M. Rodriguez, R. Ros, M.R. Aleman, M. Rodriguez-Gaspar, A.M. Lopez, E. Garcia-Valdecasas, F. Santolaria, Intravenous (IV) bisphosphonates for osteopenic cancer survivor women: an alternative treatment, Bone 38 (2006) 72-73; D.G. Little, K. Ward, P. Kiely, M.C. Bellemore, J. Briody, C.T. Cowell, Bisphosphonate rescue in distraction osteogenesis: a case series, Bone 38 (2006) 80-80; R. Marx, Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic, J. Oral Maxillofac. Surg. 61 (2003) 1115-1118]. BON patients suffering from varying bony defects and symptoms are extremely restricted in their quality of life. Due to a limited knowledge of the aetiology of BON efficient evidence-based treatment strategies are lacking. Until now 23 patients with bisphosphonate-related osteonecrosis have been admitted to the Department of Cranio-Maxillofacial Surgery of the University of Zurich. A complete history has been recorded. All patients underwent clinical and radiographic examination. CT scans and MRI have been performed in selected cases. All patients had in common that, before signs of BON were observed, a local traumatic incidence had occurred. All patients showed signs of infection which could be remarkably reduced by antibacterial treatment. Furthermore, the period of bisphosphonate treatment was found to be one of the significant factors causing bisphosphonate-related osteonecrosis of the jaws. The aetiology of BON appears to depend on multiple factors: period and type of bisphosphonate therapy and trauma paving the way for an invasion of pathogens. Because evidence based therapy protocols for complete remodelling of bone defect are still missing, prevention in bisphosphonate-treated patients seems to be of utmost importance. A close interdisciplinary collaboration is required.
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PMID:Jaw osteonecrosis related to bisphosphonate therapy: a severe secondary disorder. 1723 37

The authors investigated the prevalence and predictors of subjective well-being (SWB) in a particular Middle Eastern culture: that of Lebanon. The authors examined personality constructs of self-esteem, optimism, and positive affect in relation to SWB. The authors surveyed a sample of 689 individuals between the ages of 17 and 24 by using four instruments with established cross-cultural validity: (a) the Satisfaction with Life Scale (SWLS; E. Diener, R. Emmons, R. J. Larsen, & S. Griffin, 1985), (b) the Positive and Negative Affect Schedule (PANAS; D. Watson, L. A. Clark, & A. Tellegen, 1988), (c) the Rosenberg Self-Esteem Scale (RSE; M. Rosenberg, 1965), and (d) the revised Life Orientation Test (LOT-R; M. F. Scheier, C. S. Carver, & M. W. Bridges, 1994). The results indicated that college youth's SWB was positively correlated with self-esteem, optimism, and positive affect. Examining the demographic variable of gender, the authors found that men had higher scores on positive affect than did women. A trend emerged that suggested that language dominance and socioeconomic status were associated with SWB levels. The results suggest that internal personality constructs are more predictive of satisfaction with life than are demographic variables.
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PMID:Predictors of subjective well-being among college youth in Lebanon. 1770 89

The wrists are affected in the long-term in 90% of people with rheumatism and are often (42%) the first manifestation of a destructive disease. The functionality of the wrist and the whole hand is of great importance because in many cases loss of function of the wrists leads to severe limitations. Local and operative treatment of the wrist in rheumatoid arthritis (RA) is one of the main duties in rheuma-orthopaedics. For operative treatment there is a finely tuned differential therapeutic spectrum available. The diagnostic indications take the local and total pattern of affection, the current systemic therapy as well as patient wishes and patient compliance into consideration. In the early stages according to LDE (Larsen, Dale, Eek), soft tissues operations such as articulo-tenosynovectomy (ATS) are most commonly carried out. In further advanced stages osseus stabilisation must often be performed. At this point a smooth transition from partial arthrodesis to complete fixation is possible. After initial euphoria, arthroplasty of the wrist is being increasingly less used for operative treatment due to the unconvincing long-term results and high complication rate. With reference to the good long-term results of all operative procedures, in particular early ATS with respect to pain, function and protection of tendons, after failure of medicinal treatment and persistence of inflammatory activity in the wrist, patients should be transferred to an experienced rheuma-orthopaedic surgeon.
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PMID:[Operative differential therapy of rheumatic wrists]. 1771 75

Inflammatory rheumatic ankle joint destruction endangers the mobility of the rheumatic patient by pain and loss of function. In the presented patient population, 29 patients with a mean preoperative history of 14.3 years of rheumatoid arthritis and 7.6 years manifestation of ankle arthritis underwent open synovectomy of the ankle joint optionally combined with accompanying tenosynovectomy. Disease duration and the prevalence of radiological alterations (81% LDE 2-3) characterize the procedures as late synovectomies. The rate of 93% of additional tenosynovectomies and the prevalence of radiological alteration in the adjacent rear foot joints indicate a panarticular pathology of the rheumatic disease. A progression of the Larsen, Dale and Eek (LDE) grade was found in 62% of the ankle joints. The significant gain in the Kofoed ankle score (42.4 versus 55.9 points, p=0.042) was mainly caused by pain reduction and gain of mobility, whereas a decline of function was detected. Both genders showed comparable outcomes. The mean pain level on a visual analogue scale decreased from 7.6 to 3.3 (p<0.001) and 81.5% of the patients assessed the results of the synovectomy as good or very good.
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PMID:[Long-term results of synovectomy in the rheumatoid ankle joint]. 1792 51

Abstract One of the wrist orthoses, the Senami Wrist Supporter (SWS), was applied to 203 rheumatoid wrists in 112 patients who had persistent wrist pain and restricted forearm rotation due to synovitis and instability at the distal radioulnar joint (DRUJ). The study was performed by sending out a questionnaire to the patients about the use of the SWS at home, and examining grip strength and forearm rotation with and without the use of the SWS. The average age of the patients was 61 years, and the average follow-up period was 18 months. The rate of compliance of wearing the SWS at home was 73% on average. It was higher in wrists of Larsen-Dale-Eek (LDE) grades 0, I, and II (normal, slight, and definite early abnormality) than in those of grades III, and IV (medium and severe destructive abnormality). Decreased pain was noted in 52% of the wrists at the time of applying the SWS. The SWS was not used in 10% of the wrists because of remission of pain at follow-up. Grip strength increased significantly (P < 0.01) and so did forearm rotation (P < 0.05) by the stabilizing effect of the SWS on the unstable DRUJ. The use of the SWS was confirmed to be an efficient measure to treat painful rheumatoid wrists with early stages of disease at the DRUJ.
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PMID:The Senami Wrist Supporter for patients with rheumatoid arthritis. 2438 93

In rheumatoid arthritis of the knee joint good results are obtained using arthroscopic synovectomy or radiation synovectomy. Aim of our study was to investigate, wether the combination of these two minimal invasive interventions achieves better results. First we performed arthroscopic synovectomy of the knee joint followed by radiation synovectomy with application of 111-222 MBq Yttrium-90 6 weeks later. In a prospective randomised clinical trial between 1987 and 1991 we performed radiation synovectomy on 22 knee joints and combined arthroscopic and radiation synovectomy on 26 knee joints. We explored the patients preoperatively, 6 weeks and 6 months postoperatively. In 1996 we evaluated 141 knee joints in a retrospective clinical trial. 90 Knee joints had been treated with the combined therapy, 39 only with radiation synovectomy and 12 only with arthroscopic synovectomy. Depending on the three different therapeutic interventions, the patients were classified into mid-term (3-5 years) and long-term (6-8 years) observation groups. The trials are based on the standardized ARO-Questionnaire of the knee joint, the modified ARO Knee-Score and the radiological grading according to Larsen, Dale and Eek. In the prospective clinical trial we found significant better results for patients treated with the combined therapy than for patients treated with radiation synovectomy only regarding the parameter swelling, effusion, range of motion, pain and Knee-Score. In the long-term results of the retrospective clinical trial the patients treated with the combined therapy showed a significant better outcome for the parameters pain, swelling and Knee-Score, than the patients treated with radiation synovectomy. Although no statistically significant difference was found comparing the results of the combined therapy with arthroscopic synovectomy, an improvement of the clinical outcome can be observed performing arthroscopic synovectomy followed by radiation synovectomy. In the treatment of rheumatoid arthritis of the knee joint a better outcome is achieved performing combined arthroscopic and radiation synovectomy than performing only one of the methods.
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PMID:Combined arthroscopic and radiation synovectomy in rheumatoid arthritis. 2824 20


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