BACKGROUND: H. pylori-associated gastrointestinal diseases have been widely recognized. The aim of this study was to investigate the seropositivity of H. pylori in health check-up subjects and to find out the relating factors. METHODS: From November 2004 through June 2005, total 7,676 health check-up subjects (age > or =20) responded to the self administered questionnaires. The prevalence of H. pylori was assessed by measuring anti-H. pylori IgG antibodies. RESULTS: The overall seropositivity was 56.7% in 7,676 and 1,137 (14.8%) has been found to have history of H. pylori eradication therapy. The seropositivity rate of H. pylori was 61.3% (2,653) in 4,328 subjects without history of H. pylori eradication and current gastrointestinal symptoms. Seroprevalence of H. pylori was significantly lower in 20~29 years old, female, high income and subjects from Seoul respectively. CONCLUSIONS: The seropositivity of H. pylori in 2004~2005 is found to be 61.3% in subjects without history of H. pylori eradication and current gastrointestinal symptoms. This seems to be lower than 66.9%, the seroprevalence rate in asymptomatic Korean population in the age of > or =16 years in 1998. This decrease might be caused by improvement of socioeconomic status.
Antibodies ; Female ; Gastrointestinal Diseases ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Prevalence ; Seoul ; Seroepidemiologic Studies* ; Social Class ; Surveys and Questionnaires

Overlap syndrome is used to describe patients who have two or more well-defined connective tissue diseases. Although a variety of overlap syndromes are now recognized, the coexistence of the progression of juvenile rheumatoid arthritis (JRA) to systemic lupus erythematosus (SLE) is uncommon. We describe a patient who had typical deforming polyarthritis, who years later developed SLE.
Arthritis ; Arthritis, Juvenile* ; Connective Tissue Diseases ; Humans ; Lupus Erythematosus, Systemic*

BACKGROUND: Leflunomide, a novel immunoregulatory drug, has been shown to be effective in rheumatoid arthritis (RA) as monotherapy and as combination therapy with methotrexate (MTX). The aims of this study were to investigate the efficacy and safety of combination therapy with leflunomide and MTX in active RA patients and to identify the patients with a better response to this combination. METHODS: The patients received a maintenance dose of 20 mg of leflunomide with or without a loading dose. Parameters for disease activity in RA were measured at baseline and at 12 and 24 weeks after initiation of leflunomide. At 24 weeks, the baseline data from the patients classified as leflunomide responders were compared with data from nonresponders and analyzed to determine the potential predisposing factors for treatment response. RESULTS: A total of 103 patients with RA were included and 93 (90.3%) patients received leflunomide for 24 weeks. At 24 weeks, 67 (65.1%) patients were DAS28 responders; 14 (13.6%) were good responders and 53 (51.5%) moderate responders. At 12 weeks, significant improvements were noticeable in the individual efficacy measures of diseases activity. There were also significant improvements between 12 and 24 weeks in swollen joint count, tender joint count, HAQ disability index, and patients' and physicians' global assessments of diseases activity; but no further improvements in ESR or CRP could be seen after the first 12 weeks. When comparing the baseline data from responders with the nonresponders, patients on a higher MTX dose and patients with a higher disease activity at baseline responded better to leflunomide. However, age, sex, disease duration of RA, functional status, loading dosage of leflunomide, and previous number of DMARDs used did not affect the patients' response to leflunomide. CONCLUSION: Combination therapy with leflunomide and MTX is effective and safe across a wide range of patients, especially those with a high disease activity in spite of treatment with other traditional DMARDs.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Causality* ; Humans ; Joints ; Methotrexate*

OBJECTIVE: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. METHODS: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. RESULTS: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p= 0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. CONCLUSION: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
Adult ; Bone Marrow* ; Cartilage ; Cell Survival ; Collagen ; Connective Tissue ; Flow Cytometry ; Humans* ; Informed Consent ; Mesenchymal Stromal Cells ; Receptors, Transforming Growth Factor beta ; Statistics as Topic ; Stromal Cells* ; Tissue Donors ; Transforming Growth Factor beta

In clinical practice a serious sciatic nerve injury may result from an errornous injection of commonly used antibiotics and other therapeutic or prophylactic agents into the gluteal region which can occur at any age, especially common in infants, children and small debilitated patients. Although many isolated cases and several large series of injuries have been reported, the pathogenesis, pathology and its physiology of injection injury of the peripheral nerves in man have been poorly studied. This experimental study was conducted in order to observe the changes and degree of the functional disability of the sciatic nerve following injection of various drugs such as Rheumapyrine, Chloromycetin, Penicillin and physiological normal saline solution. Fourty-three normal adult rabbits were divided into four groups depending on injected materials and also divided into two groups of acute and chronic stages. The drugs were injected into the right sciatic nerve intraneurally and around the left sciatic nerve perineurally. For the functional study in the nerve, contractability of the calf muscle was recorded on a physiograph at intervals of 1, 3, 5, 15 and 30 minutes after the injection of the drugs. Rheobase, chronaxie and strength-duration curve of both extensor and flexor muscles of fet were recorded and measured on a chronaxie meter at intervals of 1, 2, 3 and 4 weeks after the injection. The physiogram showed the greatest reduction in contractability of the muscles in Rheumapyrine, moderate reduction in Penicillin and the least reduction in Chloromycetin group. In the measurements of rheobase and chronaxie there were marked increase of values in group of Rheumapyrine injection. There was no significant differences in values among the group of Penicillin, Chloromycetin and saline injections in comparison with those in the control group. In the analysis of strength-duration curve, it showed a pattern of complete denervation in 3 cases and a pattern of partial denervation in 3 out of 8 cases with Rheumapyrine injection, and a pattern of partial denervation in 3 out of 6 cases with Penicillin and 2 out of 8 cases with Chloromycetin injection. There was no significant differences in values of rheobase, chronaxie and strength-duration curve as time elapsed following the injury. It was postulated the functional and physiological disabilities were developed after the injection when there was a severe degree of nerve damages on the basis of histopathological study.
Adult ; Anti-Bacterial Agents ; Buttocks ; Child ; Chloramphenicol ; Chronaxy ; Denervation ; Humans ; Infant ; Muscles ; Pathology ; Penicillins ; Peripheral Nerves ; Physiology ; Rabbits ; Sciatic Nerve* ; Sodium Chloride

The majority of patients with scleroderma have gastrointestinal involvement, and a few experience gastrointestinal hemorrhage, however, gastrointestinal hemorrhage due to Mallory-Weiss syndrome is very rare. We report upon a 24-year-old pregnant woman with scleroderma who had gastrointestinal hemorrhage due to Mallory-Weiss syndrome.
Adult ; Female ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Human ; Mallory-Weiss Syndrome/*diagnosis/*etiology ; Pregnancy ; Pregnancy Complications/*diagnosis ; Scleroderma, Systemic/*complications

Relapsing polychondritis (RP) is a rare multisystem disorder. Myelodysplastic syndrome (MDS) with erythroid hypoplasia/aplasia is a rare form of myelodysplasia. Several cases of RP associated with MDS have recently been described. However, RP associated with MDS with erythroid hypoplasia/aplasia has never been reported. There was only one case report of polymyalgia rheumatica associated with MDS with erythroid hypoplasia/aplasia. In this study, we report a 79-year-old patient with RP, who developed MDS subtype refractory anemia (RA) with erythroid hypoplasia/aplasia, a very characteristic subtype of MDS.
Aged ; Biopsy ; Human ; Male ; Myelodysplastic Syndromes/*complications ; Polychondritis, Relapsing/*complications/*diagnosis/pathology ; Red-Cell Aplasia, Pure/*complications/pathology

Up to 70% of patients with systemic lupus erythematosus (SLE) are afflicted with neurologic manifestations. However, there are only a few reports documenting acute leukoencephalopathy in SLE. We describe a 20-year-old woman who was recently diagnosed as SLE, suffering from headache, fever and arthritis. She developed an acute onset of consciousness disturbance with seizure followed by prolonged coma, which recovered completely after 1 month of steroid therapy. Her brain MRI showed diffuse high signal intensity in the periventricular and subcortical white matter on T2-weighted and FLAIR images, whereas cerebral cortex, basal ganglia, and thalamus were spared. Acute leukoencephalopathy may be recognized as a subtype of lupus involving the central nervous system.
Arthritis ; Basal Ganglia ; Brain ; Central Nervous System ; Cerebral Cortex ; Coma ; Consciousness ; Female ; Fever ; Headache ; Humans ; Leukoencephalopathies* ; Lupus Erythematosus, Systemic* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Seizures ; Thalamus ; Young Adult

An "overlap syndrome" is used to describe patients who have two or more well-defined connective tissue diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and polymyositis. Their coexistence is defined clinically and often by specific serologic tests. We report a case of dermatomyositis associated with IgA nephropathy that had overlapping features of Sjogren's syndrome. This dermatomyositis and Sjogren's overlap is a rarely reported overlap syndrome worldwide.
Arthritis, Rheumatoid ; Connective Tissue Diseases ; Dermatomyositis* ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Lupus Erythematosus, Systemic ; Polymyositis ; Scleroderma, Systemic ; Serologic Tests ; Sjogren's Syndrome*

Sweet syndrome is an unusual disease characterized by the sudden onset of fever, leukocytosis, and painful erythematous plaques, and the dermal infiltration of neutrophils at the site of skin lesions. Although Sweet syndrome can also present with extra-cutaneous manifestations, involvement of the central nervous system (CNS) is rarely reported. We describe a case of Sweet syndrome involving the CNS in a 46-year-old male with a disturbance of consciousness following fever and erythematous skin plaques in the extremities. Cerebrospinal fluid examination disclosed neutrophilic pleocytosis without decreased glucose and protein levels. HLA typing showed B54, which is frequently seen in Sweet syndrome. Brain magnetic resonance imaging showed abnormal signal intensity lesions in the left temporal lobe. Skin biopsy revealed a dense dermal infiltration of neutrophils, which is compatible with Sweet syndrome. The confused mentality, fever, and erythematous skin plaques resolved after the administration of systemic corticosteroids.
Biopsy ; Brain ; Central Nervous System ; Consciousness ; Extremities ; Fever ; Glucose ; Histocompatibility Testing ; Humans ; Leukocytosis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neutrophils ; Skin ; Sweet Syndrome ; Temporal Lobe