Background/Aims: Systemic sclerosis (SSc) is associated with a wide range of gastrointestinal (GI) changes. The University of California–Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract (UCLA SCTC GIT 2.0) instrument is a self-administered GI assessment instrument for patients with SSc. We developed a Korean version of the UCLA SCTC GIT 2.0 instrument and evaluated its reliability and internal consistency. Methods: The participants were 37 Korean patients with SSc. Translation and cross-cultural adaptation of the UCLA SCTC GIT 2.0 were performed according to international standardized guidelines. We evaluated reproducibility by calculating the intraclass correlation coefficients and assessed the internal consistency of the Korean version of the UCLA SCTC GIT 2.0. We assessed its construct validity by evaluating its correlations with the Short Form Health Survey version 2 and EQ-5D scores by means of Spearman correlation analyses. Results: Patients with SSc were mostly women (89.19%) with a mean age of 52.2 years, median disease duration of 24 months, and median modified Rodnan total skin score of 4. The median total GIT score on the UCLA SCTC GIT 2.0 was 0.3. The UCLA SCTC GIT 2.0 Korean version showed excellent internal consistency (Cronbach’s α of total GIT score = 0.863). Most domains of the ULCA SCTC GIT 2.0 were correlated with those of the EuroQol (EQ)-5D score. Conclusions The Korean version of the UCLA SCTC GIT 2.0 has acceptable internal consistency, reliability, and validity. Therefore, it can be used to assess GIT involvement in Korean patients with SSc.

Primary Sjögren's syndrome (pSS) is a chronic autoimmune inflammatory disorder characterized by lymphocytic infiltration of exocrine organs. Since 1965, several sets of classification criteria for pSS have been proposed by single experts or groups of multidisciplinary specialists. In 2002, the American-European Consensus Group proposed new classification criteria, which have been widely used in both clinical trials and routine clinical practice. In 2012, updated classification criteria were approved by the American College of Rheumatology (ACR). The existence of two different sets of criteria emphasized the need for an international consensus. Using methods consistent with those employed to develop recent ACR/European League Against Rheumatism (EULAR)-approved criteria, new ACR/EULAR classification criteria for pSS were developed and endorsed in 2016. Salivary gland ultrasonography (SGUS) is a new imaging tool used to detect salivary gland abnormalities in pSS patients. Several reports on the utility of SGUS for pSS diagnosis have appeared. This review focuses on the new 2016 ACR/EULAR classification criteria for pSS and the clinical application of SGUS in patients with pSS.
Classification* ; Consensus ; Diagnosis ; Humans ; Rheumatic Diseases ; Rheumatology ; Salivary Glands* ; Specialization ; Ultrasonography*

In the article cited above, there was an error in the title.

BACKGROUND/AIMS: Magnetic resonance imaging (MRI) is a sensitive and useful method for the detection of synovitis and joint destruction in rheumatoid arthritis (RA) patients. However, the patterns of MRI-detected bone erosion, bone marrow edema (BME), synovitis, and tenosynovitis have received insufficient attention. Therefore, this study evaluated the patterns of bone erosion, BME, synovitis, and tenosynovitis, and calculated the RA-MRI score (RAMRIS) of patients with RA at the carpal and metacarpophalangeal (MCP) joints using MRI. METHODS: MRI datasets from 43 RA patients were analyzed. All patients had undergone MRI of one wrist. In addition, 36 patients had MCP joint images taken, and three had also received MRI of the contralateral wrist and MCP joints. The MR images were evaluated for bone erosion, BME, and synovitis in consensus by two blinded readers according to the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RAMRIS. The MRI-detected tenosynovitis was evaluated based on Haavardsholm's tenosynovitis score. RESULTS: The capitate, lunate, triquetrum, and hamate bones were the most common sites of erosion and BME and showed the highest RAMRIS erosion and BME scores. Moreover, MRI-detected tenosynovitis was present in 78.3% of all patients with RA, and the extensor compartment 4 and flexor digitorum profundus and superficialis were frequently affected. CONCLUSIONS This study identified the distribution and prevalence of MRI-detected bone erosion, BME, synovitis, and tenosynovitis of the wrist and MCP joints in RA patients. The patterns of the MRI-detected abnormalities may help to select sites for the application of MRI protocols in clinical trials and practice.

BACKGROUND/AIMS: This study aimed to determine the regulatory role of N-acetyl-l-cysteine (NAC), an antioxidant, in interleukin 17 (IL-17)-induced osteoclast differentiation in rheumatoid arthritis (RA). METHODS: After RA synovial fibroblasts were stimulated by IL-17, the expression and production of receptor activator of nuclear factor κ-B ligand (RANKL) was determined by real-time polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA). Osteoclastogenesis was also determined after co-cultures of IL-17-stimulated RA synovial fibroblasts, Th17 cells and various concentrations of NAC with monocytes. After human peripheral CD4⁺ T cells were cultured with NAC under Th17 condition, IL-17, interferon γ, IL-4, Foxp3, RANKL, and IL-2 expression and production was determined by flow cytometry or ELISA. RESULTS: When RA synovial fibroblasts were stimulated by IL-17, IL-17 stimulated the production of RANKL, and NAC reduced the IL-17-induced RANKL production in a dose-dependent manner. NAC decreased IL-17-activated phosphorylation of mammalian target of rapamycin, c-Jun N-terminal kinase, and inhibitor of κB. When human peripheral blood CD14⁺ monocytes were cultured with macrophage colony-stimulating factor and IL-17 or RANKL, osteoclasts were differentiated, and NAC reduced the osteoclastogenesis. After human peripheral CD4⁺ T cells were co-cultured with IL-17-pretreated RA synovial fibroblasts or Th17 cells, NAC reduced their osteoclastogenesis. Under Th17 polarizing condition, NAC decreased Th17 cell differentiation and IL-17 and RANKL production. CONCLUSIONS: NAC inhibits the IL-17-induced RANKL production in RA synovial fibroblasts and IL-17-induced osteoclast differentiation. NAC also reduced Th17 polarization. NAC could be a supplementary therapeutic option for inflammatory and bony destructive processes in RA.
Acetylcysteine* ; Arthritis, Rheumatoid* ; Coculture Techniques ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Flow Cytometry ; Humans ; Interferons ; Interleukin-17 ; Interleukin-2 ; Interleukin-4 ; JNK Mitogen-Activated Protein Kinases ; Macrophage Colony-Stimulating Factor ; Monocytes ; Osteoclasts ; Osteogenesis ; Phosphorylation ; RANK Ligand ; Real-Time Polymerase Chain Reaction ; Sirolimus ; T-Lymphocytes ; Th17 Cells

Mycophenolate mofetil (MMF) is an immunosuppressive agent used to treat severe lupus, including lupus nephritis. Common adverse effects of MMF include gastrointestinal and hematological manifestations; however, cardiac toxicity in association with MMF has not been reported. We present a 21-year-old woman with lupus nephritis who developed ventricular tachycardia 2 hours after an overdose of MMF (34 g). Ventricular bigeminy was documented 12 hours after the MMF overdose. Transthoracic echocardiography showed no evidence of structural heart disease. The ventricular arrhythmia was successfully treated with potassium replacement, hydration, and cholestyramine. This case suggests that an overdose of MMF can induce ventricular tachycardia, and electrocardiogram monitoring is critical to identify this rare cardiac complication of MMF.
Arrhythmias, Cardiac ; Cardiotoxicity ; Cholestyramine Resin ; Echocardiography ; Electrocardiography ; Female ; Heart Diseases ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Mycophenolic Acid ; Potassium ; Tachycardia, Ventricular ; Young Adult

Mycophenolate mofetil (MMF) is an immunosuppressive agent used to treat severe lupus, including lupus nephritis. Common adverse effects of MMF include gastrointestinal and hematological manifestations; however, cardiac toxicity in association with MMF has not been reported. We present a 21-year-old woman with lupus nephritis who developed ventricular tachycardia 2 hours after an overdose of MMF (34 g). Ventricular bigeminy was documented 12 hours after the MMF overdose. Transthoracic echocardiography showed no evidence of structural heart disease. The ventricular arrhythmia was successfully treated with potassium replacement, hydration, and cholestyramine. This case suggests that an overdose of MMF can induce ventricular tachycardia, and electrocardiogram monitoring is critical to identify this rare cardiac complication of MMF.

OBJECTIVES: This study was conducted to evaluate the association of cumulative exposure to organic solvent with liver function. METHODS: We conducted a cross sectional study. 461 male workers who perform painting job at a shipyard and use organic solvents routinely and 125 workers of the same shipyard who never have been exposed to organic solvents were studied. All subjects who were confirmed not having HBsAg surveyed their age, BMI(body mass index), alcohol drinking and smoking history, and examined liver function test (SGOT, SGPT, gamma-GTP, Total protein, albumin, total bilirubin, direct bilirubin). The amount of cumulative exposure (CE) to mixed organic solvents were measured by biological monitoring method using their metabolites in urine. RESULTS: The CE was observed as a significant variable with logistic regression analysis on abnormality of SGOT(>35IU/L), SGPT(>40IU/L) and gamma-GTP(>63IU/L), their odds ratio were 1.10 (95 %CI, 1.02-1.20), 1.10 (95 %CI, 1.01-1.19), and 1.10 (95 %CI, 1.01-1.19) each. CONCLUSIONS: Therefore we suggest that the cumulative exposure to mixed organic solvents might be a significant variable on abnormal liver function indices (SGOT, SGPT,gamma-GTP) in male shipyard workers
Alanine Transaminase ; Alcohol Drinking ; Bilirubin ; Environmental Monitoring ; Hepatitis B Surface Antigens ; Humans ; Liver Function Tests ; Liver* ; Logistic Models ; Male ; Odds Ratio ; Paint ; Paintings ; Smoke ; Smoking ; Solvents*