Recently, gout prevalence is increasing, but in Vietnam the knowledge of gout is not enough. Objectives: (1) Describe clinical X-ray manifestations of bone and joint damage related to chronic gout. (2) Identify suggestive factors to make diagnosis of bone and joint damage related to chronic gout. Methods: The cross-study included 54 patients with chronic gout presented in the Rheumatology Department of Bach Mai Hospital from March-2003 to June-2004. All of them were diagnosed gout according to the criteria of Bennett and Wood-1968 and had tophi nodules. Results: The common findings are polyarthritis (79.6%), lower limbs are involved more common than upper limbs (75-80% of patients had ankle, knee, first metatarsophalangeal joint arthritis) and symmetric arthritis (60% to 70%). All patients had a history of acute gout. 80% of patients had chronic gout presented in X-ray images, including joint space narrowing, erosion, new bone formation at the edge of a gradually expanding tophus. Important factors can be considered of chronic gout were male, middle age, symmetric arthritis of lower limbs, tophi nodules. Conclusions: Suggestive factors and X-ray of bone and join contribute to earlier diagnosis of bone and joint damage in chronic gout.
Gout ; Arthritis ; Juvenile Rheumatoid ; Bone and Bones

Background: Gougerot-Sj\xf6gren syndrome is an autoimmune disorder with two remarkable symptoms such as dry eyes and dry mouth. Objective: To study the symptoms of dry mouth of Gougerot-Sj\xf6gren syndrome after rheumatoid arthritis; To evaluate clinical and subclinical manifestations of dry mouth. Subjects and method: A prospective, descriptive, cross-sectional study included 160 patients with rheumatoid arthritis, who treated at Department of Rheumatology of Bach Mai hospital, from 1998 to 2003. The patients were divided into 2 groups: 60 patients with Gougerot-Sj\xf6gren syndrome and 100 patients without Gougerot-Sj\xf6gren syndrome. Results: The average age of patients with Gougerot-Sj\xf6gren syndrome was 54.55 \xb1 10.91 years. The mean time of having dry mouth was 8.65 \xb1 8.39 months. Clinical manifestations of dry mouth were sensation of dry mouth (90%), lost of saliva (80%), drink a lot of water while eating (58.3%), enlargement of parotid glands (15%). Degrees of dry mouth were mild and moderate (36.7%), severe (53.3%). 93.3% of patients decreased total salivary flow.82% of patients had 3 and 4 anatomopathologic stages according to Chilsom classification. Conclusion: Incidence of symptoms of dry mouth was higher significantly in the rheumatoid arthritis patients with Gougerot-Sj\xf6gren syndrome than those without Gougerot-Sj\xf6gren syndrome.
Arthritis ; Rheumatoid/ pathology ; diagnosis ; Sjogren's Syndrome/ pathology ; diagnosis ; Xerostomia/ pathology ; diagnosis

Background: Tophi gout refers to the condition, where consistently high level of uric acid in the body causes the deposition of uric acid or monosodium urate crystals on the joints. Objective: To describe clinical and subclinical features of tophi gout. Subjects and method: A study conducted in 51 patients with tophi gout (according to Bennett-Wood criteria - 1968) in Department of Rheumatology, Bach Mai hospital, from February 2005 to February 2006. This was a cross-sectional prospective study. Results: The average time of tophi appearance lasted 5.3 \xb1 5.7 years. The average number of tophi was 4.5 \xb1 3.9. The most common positions of tophi were tarso - metatarsal - phalangeal joints and elbow joints (43-47%). 100% had gouty arthritis (in which 66.6% > 4 joints), 50-55% involved tarso - metatarsal - phalangeal joints (43.1% had deforming joints). On X-ray, 62.7% cases has injuries, para-articular erosions and overhanging margins (62.5%), joints space narrowing (71.9%), proliferation osseous change (43.8%). Renal stones examined by ultrasound were 41%, renal failure 24.6%. Blood analysis showed hyperuricemia (88.2%), hypertriglyceridemia (54.9%), hyperglycaemia (13.6%). Conclusions: Common features tophi gout were injuries in tarso - metatarsal - phalangeal joints; gouty polyarthritis over 4 joints. X-ray images showed para-articular erosions, joints space narrowing, proliferation osseous changes.
Gout/ pathology ; diagnosis

Background: Multiple myeloma is a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance to plasma cell leukemia. Objective: To evaluate the effectiveness in treatment of multiple myeloma with VAD. Subjects and method: A study included 26 patients with multiple myeloma diagnosed according to Tubiana - 1993 criteria, who treated by VAD at Bach Mai Hospital, from January 1998 to December 2006. This was a retrospective combined to longitudinal follow-up examination study. Results: Response rate to treatment was 75%, complete response rate was 41.7%. Remission rate was 91.67%, complete remission rate was 66.7%. The parameters such as hemoglobin, speed of blood precipition in the first hour, globulin, and creatinine changed statistically significant after treatment. The average survival time of the patients was 30.13 \xb1 4.8 months. Survival rate of 1 year after diagnosis was 80%, at 3 years after diagnosis was 26.67% and more than 5 years after diagnosis was 6.67%. Conclusion: VAD had relatively good results in treatment of multiple myeloma.
Multiple Myeloma/ therapy

Background: In Vietnam the juxta-articular soft tissue diseasesare very popular, but they have not been studied yet. Objectives: (1) Describe clinical feature of some juxta-articular soft tissue diseases (tendinopathy) (except periarthritis of the shoulder). (2) Determine the risk factors of these diseases. Subjects and method:118 patients with juxta-articular soft tissue diseases. Diagnosed following the standard criteria and treated in Rheumatology Department Bach Mai hospital (Hanoi - Vietnam) in the period from December 2005 to August 2006 There was a prospective descriptive method of study.Results:(1) Clinical feature of some juxta-articular soft tissue diseases: average age: 50.2 \xb1 10.4 years, female/male ration: 4:1, the most frequent clinical forms: Tendinosis of the Elbow (Tennis Elbow) (25.4%), de Quervain\u2019s tenosynovitis (22.9%), trigger finger (17.8%), Pes Anserine Bursitis (23.7%). Clinical symtoms: pain intensity: average VAS score: 5,8 \xb1 1,3 mild and moderate limitation of movement, inflammatory signs were not evident: Mild swelling (55%), redness, increase of local temperature (4-5%), pain character: Tendinosis of the Elbow and Pes Anserine Bursitis: permanent mild pain (73.6% and 68%), de Quervain\u2019s tenosynovitis and trigger finger: pain with irrdiation along the tendon (100%). (2)The risk factors ofthese diseases: manual and repetitive work, care of children (74%), middle age (73%), female (80,5%), osteoarthritis (21.2%), diabetes associated with trigger finger (19%).Conclusion: (1) The juxta-articular soft tissue diseases were seen at middle age, with feminine preponderance, moderate pain, not evident inflammation. Clinical forms: the prevalence of each group odd diseases (Tendinosis of the Elbow, de Quervain\u2019s tenosynovitis, trigger finger, Pes Anserine Bursitis) are quite eqiuvalent. (2) The risk factors of these diseases: manual and repetitive work, care of children, middle age, female, osteoarthritis, diabetes.
Soft Tissue Neoplasms/epidemiology ;

Background: Sciatic neuralgia syndrome is a quite common condition in clinical of internal medicine diseases. The syndrome is not life threatening but reduce the ability to work and activities of the patients. The disease is more common in men than women and most of working age.\r\n', u'Objectives: To define the clinical characteristics of sciatic neuralgia syndrome. \r\n', u'Subjects and methods: The cross sectional study was carried out on 48 sciatic neuralgia patients aged from 16 to 70, treated at Bach Mai hospital. The research indices were clinical and traditional medicine characteristics of sciatic neuralgia syndrome.\r\n', u'Results: Sciatic neuralgia was common in the 20-39 year old (87.5%) age group. The male to female ratio was 1.7 (p<0.01). The sciatic neuralgia syndrome rose after excessive exercise (50%). In almost hernia cases of vertebral disc on spinal column was detected by MRI (83.3%). The impaired nerve root was L5 (64.6%). Acupuncture sites were on gallbladder meridian (50.0%), bladder meridian (20.8%) and coordinated (29.2%)\r\n', u'Conclusion: The sciatic neuralgia syndrome causing hernia on spinal column was common at 20-59 year old age. The male number was higher than female. Almost sciatic neuralgia patients had noticed pain on the gallbladder meridian (p<0.05).\r\n', u'\r\n', u'
sciatic neuralgia syndrome ; clinical characteristic

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation and deformity of the joints. Objectives: The study have two purposes: (1) Identify the sensitivity of anti - CCP2 antibodies in rheumatoid arthritis. (2) Identify the correlation between anti - CCP2 antibodies and clinical manifestations, laboratory features of rheumatoid arthritis. Subjects and method: The study was carried out on 70 patients with rheumatoid arthritis from March to July 2006 in rheumatology department at Bach Mai hospital. All they were diagnosed according to the criteria of American College of Rheumatology 1987. Results: Results of study showed that: (1) The sensitivity of anti - CCP2 antibodies is 67.1% (2) The sensitivity of anti - CCP2 antibodies in patients with rheumatoid arthritis is 67.1 % and is as high as the sensitivity of rheumatoid factor. In early stage of disease (the duration of disease under 12 months) the sensitivity of anti - CCP2 antibodies is higher than rheumatoid factor (70% versus 57.5%). There are no significant differences between the group having anti - CCP2 antibodies and the group who did not have anti - CCP2 anti- bodies in any stages of disease about Ritchie index, DAS - 28 index, X - rays, erythrocyte sedimentation rate in the first hour, CRP ratio. Conclusions: The sensitivity of anti - CCP2 antibodies in patients with rheumatoid arthritis is 67.1 %. There is the relation between anti - CCP2 antibodies and the severity of the inflammation and the severity of X - rays.
Arthritis ; Rheumatoid/ pathology ; epidemiology ; Antibodies/ adverse effects

Background: Wrist joint damage is early, common symptom and in diagnostic criteria of rheumatoid arthritis. Objective: to describe characteristics of MRI of the wrist in rheumatoid arthritis. Subjects and methods: This was a describe study. The study included 41 patients who were diagnosed rheumatoid arthritis according to the criteria of American College of Rheumatology- 1987 from January to October - 2006. Results: The average disease duration was 16.4 \xb114.71months. According to Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) 2002, damages on MRI included: 100% of patients had synovitis (5.9 \xb1 2.20), 100% of patients had bone erosions (15.3 \xb1 11.06) and 90% of patients had bone edema (7.3 \xb1 5.86), total score 28.6 \xb1 16.58. The correlative coefficient between synovitis and bone edema: r=0.43, P<0.01, between synovitis and bone erosions:r=0.61, P<0.01, between bone erosions and bone edema: r=0.55, P<0.01. MRI revealed bone erosions in 100% of patients having rheumatoid arthritis less six months after symptom onset compared with 0% of patients on radiography. In patients with over 2 years of disease duration, this rate on MRI was 100% of patients compared with 87.5% of patients on radiography. Conclusions: The specific damages of the wrist on MRI have value in diagnosis of early rheumatoid arthritis. \r\n', u'\r\n', u'\r\n', u'
Arthritis ; Rheumatoid ; Magnetic Resonance Imaging ;

Background: FISH can detect number and structural chromosome aberrations in DNA. FISH is new technique in Vietnam, we combine FISH with chromosome analysis to prenatal diagnosis Down syndrome and turner syndrome that are high rate in birth defect.Objectives: To detect Down syndrome and turner syndrome by using FISH technique with chromosome analysis from amniotic cell.Subjects and method: 14amniotic cells samples 15th - 20th week with high risk of birth defects. Advance using FISH and chromosome analysis from amniotic cell. Results: We obtained results as follow: - 14/14 samples: correspondence between FISH and chromosome analysis. \ufffd?Detected 2 Down syndrome (female. Trisomi 21) and 4 Turner syndrome (45, X). Conclusion: Detected Down syndrome and Turner syndrome by using FISH technique with chromosome analysis from amniotic cell.
Down Syndrome/ diagnosis ; Turner Syndrome/ diagnosis ; Predictive Value of Tests ; Prenatal Diagnosis ; In Situ Hybridization ; Fluorescence ;

Background: Sodium bicarbonate is highly alkaline and may be helpful in relieving symptoms of gout. Sodium bicarbonate helps to adjust your body's pH level, slightly creating an alkaline-forming state that lessens the likelihood of gout attacks. We can prepare sodium bicarbonate in several ways to treat gout symptoms. Objective: To examine the efficacy of sodium bicarbonate for treatment of gout. Subjects and method: A study was conducted in 54 patients with gout at Department of Rheumatology of Bach Mai hospital, from September 2006 to March 2007. Patients were divided into two groups, group 1 included 29 patients treated with intravenous sodium bicarbonate and group 2 included 25 patients treated with oral sodium bicarbonate. This was a descriptive, cross-sectional study. Results: No significant changes showed between serum uric acid level, 24-hour urine uric acid level at before and after treatment in 2 groups. Gout patients with renal failure had increased level of 24-hour urine uric acid after treatment (p < 0.05). There were significantly increased level of urine volume, urine pH and decreased level of urine specific gravity after treatment. The effect of sodium bicarbonate was not different between intravenous usage and oral usage. Conclusion: Sodium bicarbonate could change urine environment, limit crystallization of urine uric acid of gout patients.
Gout/ therapy