BACKGROUND: The purpose of this study was to identify the characteristics of appendicular lean mass (ALM) associated with rheumatoid arthritis (RA) and to analyze appendicular tissue components in patients with RA. METHODS: We prospectively reviewed of patients with RA who underwent dual energy X-ray absorptiometry in a single center. From data of 28 patients, ALM was calculated. Regression analysis was used to investigate the association between ALM and RA. Using propensity score matching, patients with RA were compared to the control group from 18,698 patients of Korea National Health and Nutrition Examination Surveys data. RA and control group were matched in a 1: 5, respectively. RESULTS: In regression model, there was significantly negative association between disease activity score and ALM index in patients with RA in unadjusted (β=−0.387, 95% confidence interval [CI], −0.729 to −0.045) and model adjusted for age, sex, and body mass index (β=−0.227, 95% CI, −0.451 to −0.003). In matching with age and sex, the arms fat mass and fat fraction of RA group were significantly lower than that of control group. In matching with age, sex, and body mass index, the ALM index and legs lean mass of RA group were significantly higher than control group. CONCLUSIONS Patients with RA have a lower ALM with higher disease activity. In addition, we found that patients with RA had different tissue component in arms and legs compared to general population.

Sarcoidosis is an idiopathic, systemic, noncascating, granulomatous disease with protean clinical manifestations. Although the first description of sarcoidosis is attributed to Hutchinson, its ocular features received little attention until 1936 when Heerfordt's syndrome of uveitis, salivary gland enlargement, and cranial nerve palsies was recognized as a sign of sarcoidosis. The incidence and prevalence of sarcoidosis vary widely between countries and among ethnic groups within a country. The types of ocular abnormalities encountered were classified into three categories (1) anterior segment disease (2) posterior segment disease (3) orbital and other disease. Anterior segment structures were affected most often. Chronic granulomatous uveitis was the most common ocular manifestation of sarcoidosis. We have experienced a 25 year old male who had uveitis, vitreous hemorrhage over the optic disc and peripheral retina and hilar lymphadenopathy. In the course of corticosteroid treatment, uveitis and vitreous hemorrhage were subsided gradually, leaving the peripapillary glial proliferations.
Adult ; Cranial Nerve Diseases ; Ethnic Groups ; Humans ; Incidence ; Lymphatic Diseases ; Male ; Orbit ; Prevalence ; Retina ; Salivary Glands ; Sarcoidosis* ; Uveitis* ; Vitreous Hemorrhage*

Giant cell arteritis (GCA) is categorized as vasculitis of the large and medium-sized vessels. Visual loss is one potential consequence of cranial arteritis. Temporal artery biopsies are performed frequently to demonstrate the involvement of arteritis. On the other hand, cerebral artery involvement with pathological findings is not well documented in patients with GCA. We report a rare case of GCA with cerebral vessel involvement in a 76-year-old woman.
Aged ; Arteritis ; Biopsy* ; Brain* ; Cerebral Arteries ; Female ; Giant Cell Arteritis* ; Giant Cells* ; Hand ; Humans ; Temporal Arteries ; Vasculitis

BACKGROUND: Patients with non-Q wave myocardial infarction tend to have smaller infarcts and less degree of ventricular function impairment initially, however, uncomplicated non-Q wave infarctions are known to be as serious as Q wave myocardal infarction due to residual myocardal ischemia and higher reinfarction rate. METHODS: Inorder to compare the clinical and coronary angiographic findings of Q wave infarction with those of non-Q wave infarction. 58 partients with acute myocardial infarction were reviewed retrospectively. Patients were classified into Q wave(n=45) and non-Q wave infarction(n=13) according to electrocardiographic findings. RESULTS: 1) There were no significant differences between the two groups in risk factors of coronary artery disease such as hypertension, hypercholesterolemia, smoking and diabets mellitus. 2) The peak myocardial enzyme levels of CPK, CPK-MB were significantly higher in the Q wave MI group, and the percentage of wall motion abnormality on two-dimensional echocardiography was significantly higher in Q wave MI than in the non-Q wave MI group. 3) The number of involved vessel, degree of stenosis and collateral circulation were not different but high degree of stenosis of infarct-related artery was more frequent in Q wave MI group. 4) There were no significant differences between the two groups in the incidence of arrhythmia and in-hospital mortality. CONCLUSION: There were some differences in clinical and angiographic findings, but in-hospital mortality was not significant different between two groups. Futher prospective studies should be performed to clarify the long term prognosis.
Arrhythmias, Cardiac ; Arteries ; Collateral Circulation ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Electrocardiography ; Hospital Mortality ; Humans ; Hypercholesterolemia ; Hypertension ; Incidence ; Infarction ; Ischemia ; Myocardial Infarction* ; Prognosis ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Ventricular Function

Background: YouTube has become an increasingly popular educational tool and an important source of healthcare information. We investigated the reliability and quality of the information in Korean-language YouTube videos about gout. Methods: We performed a comprehensive electronic search on April 2, 2021, using the following keywords—“gout,” “acute gout,” “gouty arthritis,” “gout treatment,” and “gout attack”—and identified 140 videos in the Korean language. Two rheumatologists then categorized the videos into three groups: “useful,” “misleading,” and “personal experience.”Reliability was determined using a five-item questionnaire modified from the DISCERN validation tool, and overall quality scores were based on the Global Quality Scale (GQS). Results: Among the 140 videos identified, 105 (75.0%), 29 (20.7%), and 6 (4.3%) were categorized as “useful,” “misleading,” and “personal experience,” respectively. Most videos in the “useful” group were created by rheumatologists (70.5%). The mean DISCERN and GQS scores in the “useful” group (3.3 ± 1.0 and 3.8 ± 0.7) were higher than those in the “misleading” (0.9 ± 1.0 and 1.9 ± 0.6) and “personal experience” groups (0.8 ± 1.2 and 2.0 ± 0.8) (P < 0.001 for both the DISCERN and GQS tools). Conclusion Approximately 75% of YouTube videos that contain educational material regarding gout were useful; however, we observed some inaccuracies in the medical information provided. Healthcare professionals should closely monitor media content and actively participate in the development of videos that provide accurate medical information.

Objectives: ：The purpose of this study was to identify the change in the reasons for referrals before and after the COVID-19 outbreak among students who were referred to the one hospital-linked Wee center in Dalseo-gu, Daegu. Methods: ：324 students who were referred to one hospital-linked Wee center for personal counseling from January 1, 2019 to December 31 were included. In the initial session of individual counseling, 3 of the chief reasons among 27 emotional and/or behavioral problems were indicated. This reason was divided into before and after COVID-19 to determine whether there is a difference, and whether there is a difference between before and after COVID-19 depending on the school level. Results: ：The most frequent emotional and/or behavioral problem was ‘interpersonal problems’ in both pre- COVID-19 and post- COVID-19 groups. In post- COVID-19 group, ‘anxiety’ was significantly increased, whereas ‘conduct problems,’ ‘impulsivity’ and ‘inattention’ were significantly decreased. In elementary students group, only ‘conduct problems’ was significantly decreased after COVID-19 and the same result was shown in middle and high school students group. Conclusions ：The study showed that after COVID-19 pandemics in Daegu the difference of students’ problems was noted, and internalizing problems seem to increase rather than externalizing problems. This result calls upon schools to plan for students’ further mental health care measures.

Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1–S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion Spinal FF may help assess both AS disease activity and chronicity.

Objective: We quantitatively measured the fat fraction (FF) in the vertebrae of patients with ankylosing spondylitis (AS) using magnetic resonance imaging (MRI) and investigated the role of FF as an indicator of both active inflammation and chronicity. Materials and Methods: A total of 52 patients with AS who underwent spinal MRI were retrospectively evaluated. The FF values of the anterosuperior and anteroinferior corners of the bone marrow in the L1–S1 spine were assessed using the modified Dixon technique. AS activity was measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), AS Disease Activity Score (ASDAS), and serum inflammatory marker levels. AS disease chronicity was assessed by AS disease duration and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Univariable and multivariable regression analyses were conducted to investigate the correlation between FF and other clinical characteristics. Results: The mean FF ± standard deviation of the total lumbar spine was 43.0% ± 11.3%. At univariable analysis, spinal FF showed significant negative correlation with BASDAI (β = -0.474, p = 0.002) and ASDAS with C-reactive protein (ASDAS-CRP; β = -0.478, p = 0.002) and a significant positive correlation with AS disease duration (β = 0.440, p = 0.001). After adjusting for patient age, sex, and total mSASSS score, spinal FF remained significantly negatively correlated with BASDAI (β = -0.543, p < 0.001), ASDAS-CRP (β = -0.568, p < 0.001), and ASDAS with erythrocyte sedimentation rate (β = -0.533, p = 0.001). Spinal FF was significantly lower in patients with very high disease activity (ASDAS-CRP > 3.5) than in those with only high disease activity (2.1 ≤ ASDAS-CRP ≤ 3.5) (p = 0.010). Conclusion Spinal FF may help assess both AS disease activity and chronicity.

Background/Aims: Biologics are very effective drugs for patients with ankylosing spondylitis (AS). However, there are patients who are not responding to biologics. This study aimed to evaluate the level of tumor necrosis factor α (TNF-α), interleukin (IL)-23, and IL-17 from synovial fluid in patients with AS and rheumatoid arthritis (RA) and differences of the level of those cytokines according to drugs. Methods: Synovial fluid was obtained from 34 patients (42 samples) with AS and 45 patients (47 samples) with RA with active arthritis of the knee, and the cytokine levels were measured. The differences in the levels between patients treated with and without biologics (biologics and non-biologics groups, respectively) were analyzed in AS and RA. The correlations between cytokines were examined in the non-biologics and biologics groups. Results: The TNF-α level in AS was significantly lower than that in RA (p = 0.016). The IL-17 and IL-23 levels were not different between AS and RA (p = 0.409 and p = 0.562, respectively). In AS and RA, TNF-α, IL-17, and IL-23 showed good correlation among each other in the non-biologics group. However, there was no significant correlation in biologics group. In some patients in the AS group, the IL-17 or IL-23 level was markedly elevated in the biologics group. Conclusions Treatment with biologics affects the cytokine profile in inflammatory synovial fluid in patients with both AS and RA. Furthermore, IL-23 and IL-17 cytokine might be an important factor in some patients who are unresponsive to biologics in AS.

OBJECTIVE: Uveitis is the most common extra-articular manifestation occurring in patients with ankylosing spondylitis (AS). This study examined the characteristics of uveitis in patients with AS using a questionnaire survey. METHODS: A questionnaire-based survey was given to patients enrolled in an AS registry at a rheumatology clinic in a tertiary hospital between September 2015 and December 2015. The patients responded to several questions and sub-questions related to uveitis. RESULTS: A total of 750 patients participated in the survey. The number of patients diagnosed with uveitis in the ophthalmology department was 218 (29%). The most common symptoms in patients with uveitis were ocular injection (61%), eye pain (54%), and decreased visual acuity (51%). Interestingly, 91 of the 532 patients (17%) who had not been diagnosed with uveitis before also experienced similar symptoms, such as tearing, ocular injection, and eye pain. The number of patients who experienced a flare of uveitis more than once a year was 109 (50%), and 124 patients with uveitis responded that the treatment of AS had no significant effect on the prevention of uveitis recurrence. CONCLUSION: The clinical characteristics of uveitis that patients experience was investigated through surveys. Because uveitis in patients with AS is not well diagnosed and treated, active screening for suspected symptoms and the prevention of a recurrence is needed.
Eye Pain ; Humans ; Korea ; Mass Screening ; Ophthalmology ; Recurrence ; Rheumatology ; Spondylitis, Ankylosing ; Surveys and Questionnaires ; Tears ; Tertiary Care Centers ; Uveitis ; Visual Acuity