No abstract available.

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

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*

No abstract available.
Antibodies* ; Arthritis, Rheumatoid* ; Diagnosis ; Prognosis

OBJECTIVE: To investigate the lumbar movement and chest expansion in healthy Koreans. METHODS: Sch6ber test, modified schSer test, lateral flexion, finger to ground distance and chest expansion were measured in 573 healthy Koreans. They were analysed according to age, sex and height. RESULTS: 1) Mean length of Sch ber test in total subjects was 15.7+/-0.1 cm (male 16.1+/-0. 1 cm, female 14.6+/-0. 1 cm) and mean length of chest expansion in total subjects was 4.8+/-0. 1 cm(male 5.1+/-0.1 cm, female 3.9+/-0.2 cm). 2) Mean length of Sch ber test, modified Sch ber test, lateral flexion, finger to ground distance and chest expansion were longer in male than in female. 3) As the age increased, mean length of Sch er test, modified Sch ber test and lateral flexion revealed the trend to decrease but mean length of chest expansion did not revealed the trend to increase or decrease(each r=-0.25, p<0. 001, r=-0.21, p<0. 001, r=-0. 17, p<0. 001, r=-0. 04, p<0.35). 4) As the height increased, mean length of Sch er test, modified Sch ber test, lateral flexion and chest expansion revealed the trend to increase(each r=0. 39, p<0. 001, r=0. 39, p<0. 001, r=0. 29, p<0. 001, r=0.28, p<0. 001). CONCLUSION: Length of Sch ber test and chest expansion in healthy Koreans were 15.7+/-0.1 cm and 4.8+/-0.1 cm and they were longer in male than in female. As the age increased, length of Sch er test and lateral flexion had the tendency to decrease and as the height increased, length of Sch ber test, lateral flextion and chest expansion had the tendency to increase. Therefore it is needed that length of lumbar sex and height to length of lumbar movement and chest expansion were applied according to age, sex and height to detect early disorder of lumbar motility.
Female ; Fingers ; Humans ; Male ; Thorax*

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

OBJECTIVE: To examine the relationship of serum/plasma YKL-40 levels with rheumatoid arthritis (RA) and their correlation with RA activity and rheumatoid factor (RF) level. METHODS: We performed a meta-analysis comparing the serum/plasma YKL-40 levels between patients with RA and controls and examined the correlation coefficients of the circulating YKL-40 level with the RF level and RA activity based on the 28-joint disease activity score (DAS28), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level. RESULTS: Nine studies (707 patients with RA and 1,041 controls) were included in the meta-analysis. The YKL-40 levels were significantly higher in the RA group than in the control group (standardized mean difference [SMD]=1.071, 95% confidence interval [CI]=0.726~1.417, p<0.001). Stratification by ethnicity showed significantly elevated YKL-40 levels in the RA groups from European, Asian, North American, and Arab populations. The YKL-40 level was significantly higher in the RA group than in the control group in both age- and sex-matched and only age-matched populations (SMD=0.937, 95% CI=0.554~1.320, p<0.001; SMD=2.951, 95% CI=1.389~4.512, p<0.001, respectively). Subgroup analysis by sample size showed significantly increased YKL-40 levels in the RA group in both small (n<100) and large (n>100) populations. Meta-analysis of correlation coefficients showed a significant positive correlation between the YKL-40 levels and DAS28, ESR, CRP level, and RF level (DAS28: correlation coefficient=0.381, 95% CI=0.044~0.640, p=0.028; RF level: correlation coefficient=0.341, 95% CI=0.176~0.487, p<0.001). CONCLUSION: The circulating YKL-40 levels are high in patients with RA and positively correlate with RA activity and RF level.
Arabs ; Arthritis, Rheumatoid ; Asian Continental Ancestry Group ; Blood Sedimentation ; C-Reactive Protein ; Humans ; Rheumatoid Factor ; Sample Size

OBJECTIVE: This study examined the all-cause and sex-specific standardized mortality ratios (SMRs) in patients with spondyloarthropathy. METHODS: Studies examining the all-cause and/or cause-specific SMRs in patients with psoriatic arthritis (PsA) and ankylosing spondylitis (AS) compared to the general population were surveyed using MEDLINE, EMBASE, and Cochrane databases and manual searches. A meta-analysis of the all-cause and sex-specific SMRs in patients with rheumatic diseases was then performed. RESULTS: In total, 7 comparisons (5 PsA and 2 AS) from 6 reports met the inclusion criteria. Disease-specific meta-analysis showed that the pooled SMR was 1.299 (95% confidence interval [CI] 1.092–1.605, p=0.015) for PsA and 1.784 (95% CI 1.576–2.020, p < 0.001) for AS. Meta-analysis showed that the SMRs of PsA and AS were significantly higher (1.299 to 1.784 times) than those in the general population. The age- and sex-adjusted SMR was highest for AS (1.784), followed by PsA (1.299). Moreover, sex-specific meta-analysis showed that the all-cause SMRs were increased in female and male patients with PsA. On the other hand, mortality increased in male patients with AS (SMR 1.834), whereas there was no significant increase in female patients with AS. CONCLUSION: All-cause mortality is higher in patients with PsA and AS compared to the general population. On the other hand, the mortality was higher in males with AS but not in females.
Arthritis, Psoriatic* ; Female ; Hand ; Humans ; Male ; Mortality* ; Rheumatic Diseases ; Spondylarthropathies ; Spondylitis, Ankylosing*

OBJECTIVE: This study aimed to examine whether rheumatoid arthritis (RA) is causally associated with type 2 diabetes (T2D). METHODS: We performed a two-sample Mendelian randomization (MR) analysis using the inverse-variance weighted (IVW), weighted median, and MR-Egger regression methods. We used the publicly available summary statistics datasets from a genome-wide association studies (GWAS) meta-analysis of 5,539 autoantibody-positive individuals with RA and 20,169 controls of European descent, and a GWAS dataset of 10,247 individuals with T2D and 53,924 controls, overwhelmingly of European descent as outcomes. RESULTS: We selected 10 single-nucleotide polymorphisms from GWAS data on RA as instrumental variables to improve the inference. The IVW method supported a causal association between RA and T2D (β=0.044, standard error [SE]=0.022, p=0.047). The MR-Egger analysis showed a causal association between RA and T2D (β=0.093, SE=0.033, p=0.023). In addition, the weighted median approach supported a causal association between RA and T2D (β=0.056, SE=0.025, p=0.028). The association between RA and T2D was consistently observed using IVW, MR Egger, and weighted median methods. Cochran's Q test indicated no evidence of heterogeneity between instrumental variable estimates based on individual variants and MR-Egger regression revealed that directional pleiotropy was unlikely to have biased the results (intercept=−0.030; p=0.101). CONCLUSION: MR analysis supports that RA may be causally associated with an increased risk of T2D.
Arthritis, Rheumatoid ; Bias (Epidemiology) ; Dataset ; Genome-Wide Association Study ; Mendelian Randomization Analysis ; Methods ; Population Characteristics ; Random Allocation