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Systemic Lupus Erythematosus And Thymic Hyperplasia: A Case Report.

Doo Seop MOON ; Tae Hwan KIM ; Seung Young KIM ; Pyung Nam KIM ; Jae Bun JUN ; Sung Soo JUNG ; In Hong LEE ; Sang Cheol BAE ; Dae Hyun YOO ; Woong Hwan CHOI ; Seong Yoon KIM ; Moon Hyang PARK

The Journal of the Korean Rheumatism Association.1995;2(1):98-105.

Possible association between systemic lupus erythematosus and disorders of thymus has been shown in several reposrts. But the association is clearly not common as judged by fewer than 20 case reports in the world literature. One case of systemic lupus erythematosus in a patient with thymic hyperplasia is described. The woman had been suffered from purpura, dry mouth and dry eyes and complained of chest discomfort. In this case, thymectomy did not modify the course of systemic oupus erythematosus. Systemic lupus erythematosus with thymic disorder is very rare so we report this case with a review of literatures.
Female ; Humans ; Lupus Erythematosus, Systemic* ; Mouth ; Purpura ; Thorax ; Thymectomy ; Thymus Gland ; Thymus Hyperplasia*

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A Case Of Primary Biliary Cirrhosis Anteceded By Rheumatoid Arthritis.

Pyoung Nam KIM ; Tae Hwan KIM ; Seong Yoon KIM ; Jae Bum JUN ; Dong See HAN ; Sung See JUNG ; In Hong LEE ; Sang Cheol BAE ; Dae Hyun YOO ; Kyung Bin JOE ; Seung Young KIM

The Journal of the Korean Rheumatism Association.1995;2(1):92-97.

Primary biliary cirrhosis is a chronic, progressive liver disease characterized by inflammatory destruction of septal and intralobular bile ducts which results in intrahepatic cholestasis. Although the cause remains obscure, it is frequently associated with a variety of disorders presumed to be autoimmune in nature. We report a case of early primary biliary cirrhosis which was anteceded by rheumatoid arthritis. The patient was a 54-year-old female who was admitted due to arthralgia and joint deformity. She had been diagnosed as having rheumatoid arthritis 10 years before. On admission, she had elevated serum ALT, AST, alkaline phosphatase, gamma-GTP and positive serum antimitochondrial antibody test. Microscopic findings of the liver were consistent with the early stage of primary bi]iary cirrhosis.
Alkaline Phosphatase ; Arthralgia ; Arthritis, Rheumatoid* ; Bile Ducts ; Cholestasis, Intrahepatic ; Congenital Abnormalities ; Female ; Fibrosis ; Humans ; Joints ; Liver ; Liver Cirrhosis, Biliary* ; Liver Diseases ; Middle Aged

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A Case Of D-Penicillamine Induced Polymyositis.

Seung Young KIM ; Tae Hwan KIM ; Pyoung Nam KIM ; Jae Bum JUN ; Sung Soo JUNG ; In Hong LEE ; Sang Cheol BAE ; Dae Hyun YOO ; Seong Yoon KIM

The Journal of the Korean Rheumatism Association.1995;2(1):87-91.

Polymyositis can develop infrequently as one of the autoimmune complications of D-penicillamine treatment, but its exact pathogenesis remains unclear. Suspicion of D-penicillamine induced polymyositis should be followed by immediate drug withdrawal and confirmation of diagnosis by determination of muscle enzymes, EMG and biopsy. Most patients recover from polymyositis completely within 6 months after drug withdrawal, even though steroid may be used in severe conditions. Suspicion of pre-existing low-grade myopathy or myositis should possibly be regarded as a relative contraindication to D-penicillamine treatment and analysis of muscle enzymes should be followed regularly. We experienced a case of rheumatoid arthritis who developed polymyositis after treatment of D-penicillamine for about 5 weeks(total dosage 3500mg) in a 47-year-old female and report this with a review of literature.
Arthritis, Rheumatoid ; Biopsy ; Diagnosis ; Female ; Humans ; Middle Aged ; Muscular Diseases ; Myositis ; Penicillamine* ; Polymyositis*

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A Case Of Dermatomyositis Associated With Uterine Cervical Cancer.

Kwae Soo KYUNG ; Young Soo SONG ; Jung Su KIM ; Seong Hun HAN ; Hye Kyung LEE ; Yun Woo LEE

The Journal of the Korean Rheumatism Association.1995;2(1):82-86.

Dermatomyositis is a group of connective tissue disorders characterized by non-suppurative inflammation of the skeletal muscle and skin lesions. It is associated with malignancy, especially of the stomach, lung, overy and breast. we report a case of dermatomyositis with uterine cervical concer. A 78 year old female patient was admitted because of progressive proximal muscle weakness, skin rashes, and vaginal spotting. She was bedridden because of severe proximal muscle weakness and atrophy, unable to elevate her head, and suffered from dysphagia. Gottron's patches were found on the knuckles of the hands, scaly erythematous rashes on the extensor surfaces of bilateral elbows, wrists and knees. The serum concentrations of muscle enzymes were elevated, the biopsy of quadriceps muscle showed the features comparable with myositis, and the uterine cervical biopsy revealed squamous cell carcinoma, which was determined to be in stage lib by pelvic CT. Radiotherapy(total 3240 cGy) was done for the cervical cancer and prednisolone (initially 60mg/day) was given for the dermatomyositis. The muscle power improved only a little although the concentrations of serum muscle enzmes returned to normal. She deceased of aspiration pneumonia 43 days after the admission.
Aged ; Atrophy ; Biopsy ; Breast ; Carcinoma, Squamous Cell ; Connective Tissue ; Deglutition Disorders ; Dermatomyositis* ; Elbow ; Exanthema ; Female ; Hand ; Head ; Humans ; Inflammation ; Knee ; Lung ; Metrorrhagia ; Muscle Weakness ; Muscle, Skeletal ; Myositis ; Pneumonia, Aspiration ; Prednisolone ; Quadriceps Muscle ; Skin ; Stomach ; Uterine Cervical Neoplasms* ; Wrist

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The Effect Of Cytokines And Local Growth Factors In The Expreession Of Fil-Integrin And Icam-1 On Cultured Chondrocyte.

Gwan Gyu SONG ; Young Moo RO ; Dae Hyun YOO ; Seong Yoon KIM

The Journal of the Korean Rheumatism Association.1995;2(1):69-81.

OBJECTIVE: The cell-cell and cell-extracellular matrix interactions are critical to the embryogenesis, morphogenesis, maintenance of tissue integrity, and function of cells. This interactions are mediated by membrane glycoproteins called adhesion molecules. fil-integrins are heteredimeric transmembrane glycoproteins which play critical roles in the ability of cells to elaborate and maintain extracellular matrix. ICAM-1 is a sialylated glycoprotein and mediates various cell-cell interactions in immunity and inflammation. Articular cartilage consists of chondrocytes embedded in an extensive extracellular matirx. In normal tissue, the chondrocytes actively effect the stable equili-brium between the synthesis and degradation of matrix components, so that a constant concentration of these components is maintained. In osteoarthritis, the stable equilibrium is disrupted and the rate of loss of proteoglycan exceeds the rate of depositon of newly synthesized moleclues. This equilibrium is influenced by cytok{nes and growth factors such as IL-1, TNF-alpha, IGF-1 and TGF-beta. Integrins and their ligands may mediate some of the interactions of chondrocytes and cellular matrix, and the cytokines and local growth factors may affect the expression of integrins on chondrocytes. ICAM-1 may mediate interactions with other cells in osteoarthritic joint, and also may be modulated by cytokines and growth factors. The effect of IL-1, TNF-alpha, IGF-1 and TGF-beta in the expression of fil-integrin(CD29) and ICAM-l(CD54) on chondrocytes was investigated. METHODS: Cultured chondrocytes(3rd passages) from 2 osteoarthritc patient were used. Cells were incubated for 24hours with and without IL-lfi 25U/ml, IL-l 50U/ml, TNF-alpha lng/ml, TNF-alpha 10ng/ml, IFN-gamma 100U/ml, IGF-1 10ng/ml, IGF-1 50ng/ml, IGF-1 100ng/ml, TGF-beta 10ng/ml, and TGF-beta 30ng/ml. Chondrocytes were stained with monoclonal antibodies against beta1-integrin(CD29) and ICAM-1 (CD54), and positve cells were counted under the light microscpe. RESULTS: 1) Cultured chondrocytes readily expressed fi1-integrin(82. 9%). 2) filintegrin was down-regulated by IL-1beta(75.4%), TNF-alpha(61.2%), and TGF-beta (77.0%), and was slightly up-regulated by IFN-gamma(85.0%) and IGF-1 (88.9%). 3) ICAM-1 was presented in only 18.0% of cells. 4) Expression of ICAM-1 was readily up-regulated by IL-1beta(84.0%) and TNF-alpha(80.3%), and mildly up-regulated by IFN-gamma(33.0%), IGF-1 (35.0%), and TGF-beta(29.3%). CONCLUSIONS: The presence of fil-integrin and ICAM-1 on chondrocytes and the modulation of their expression by cytokines and local growth factors suggest that they have important roles in the interaction of chondrocytes with cartilage matrix and with other cells of osteoarthritic joints. Their roles should be elucidated by further researches.
Antibodies, Monoclonal ; Cartilage ; Cartilage, Articular ; Chondrocytes* ; Cytokines* ; Embryonic Development ; Extracellular Matrix ; Female ; Glycoproteins ; Humans ; Inflammation ; Insulin-Like Growth Factor I ; Integrins ; Intercellular Adhesion Molecule-1* ; Intercellular Signaling Peptides and Proteins* ; Interleukin-1 ; Joints ; Ligands ; Membrane Glycoproteins ; Morphogenesis ; Osteoarthritis ; Pregnancy ; Proteoglycans ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha

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Serum Uric Acid Levels In Korean Adult Population And Their Correlates.

Bin YOO

The Journal of the Korean Rheumatism Association.1995;2(1):60-68.

OBJECTIVE: To investigate the distribution of serum uric acid levels among 20000 Korean people who visited health screening center and relationships between serum uric acid and a number of biological variables. METHODS: By descriptive analysis on obesity index, blood pressures and various chemical measurements. Serum uric acid levels were measured by uricase method. Stepwise regression analysis of serum uric acid levels on various host variables selected on the basis of univariate analysis was perfomed. Logistic regression analysis was performed for the odds ratios for hyperuricemia. RESULTS: The mean serum uric acid level and prevalence of hyperuricemia were 5.9+/-1.3 mg/dl, 16.6% respectively in men and 4.2+/-l.0mg/dl, 1.69% in women. Serum creatinine concentration was by far the most important correlate with serum uric acid level. Obesity index, serum calcium, triglycerid were also significantly associated with serum uric acid in both sexes. Contributing factors for hyperuricema were calcium, serum GPT and obesity index in both sexes, and serum trig]yceride level, age, hypertension in men only. CONCLUSIONS: The mean serum uric acid level in men is higher than in women throughout all ages and the uric acid level arised after 5th decade in women. There are differences in contributing factors for serum uric acid level between sexes as well as in risk factor for hyperuricemia.
Adult* ; Calcium ; Creatinine ; Epidemiology ; Female ; Humans ; Hypertension ; Hyperuricemia ; Logistic Models ; Male ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Obesity ; Odds Ratio ; Prevalence ; Risk Factors ; Urate Oxidase ; Uric Acid*

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Clinical Analysis Of Adult Onset Still's Disease: 22 Cases In Korea.

Eun Bong LEE ; Yeong Wook SONG

The Journal of the Korean Rheumatism Association.1995;2(1):52-59.

OBJECTIVE: To investigate the clinical manifestations of adult onset Still's disease in Korea. METHODS: 22 patients who were diagnosed at Seoul National University Hospital during 10 years from March, 1984 to June, 1994 were reviewed. RESULTS: Age of onset was evenly distributed between 16 and 45 years in most of the patients. Fever and arthralgia were present in all cases. Arthritis and skin rash were developed in 91% and 77% of the patients respectively. Laboratory tests showed accelerated ESR in 95~o, increased serum ferritin in 79%, leukocytosis in 68%, anemia in 32%, hypoalbuminemia in 32%, and abnormal liver function test in 36% of the patients. Commonly affected joints were knees, wrists, proximal interphalangeal joints, ankles, elbows and shoulders in order. Bone marrow biopsy in 7, lymph node biopy in 2 cases revealed reactive hyperplasia. Nonsteroidal anti-inflammatory drugs (NSAID) were effective in 73% of the patients, corticosteroid with or without NSAID in 50% of the patients. Toxic hepatitis was developed in 2, acute renal failure in 1 and drug rash in 1 case during NSAID treatment, which resolved after discontinuance or switching to another NSAID. CONCLUSIONS: The clinical manifestations of AOSD in Korea generally resemble those previously reported in other countries except that lymphadenopathy, splenomegaly, joint deformity, pleurisy, leukocytosis and anemia were significantly less frequent in our cases.
Acute Kidney Injury ; Adult* ; Age of Onset ; Anemia ; Ankle ; Arthralgia ; Arthritis ; Biopsy ; Bone Marrow ; Congenital Abnormalities ; Drug-Induced Liver Injury ; Elbow ; Exanthema ; Ferritins ; Fever ; Humans ; Hyperplasia ; Hypoalbuminemia ; Joints ; Knee ; Korea* ; Leukocytosis ; Liver Function Tests ; Lymph Nodes ; Lymphatic Diseases ; Pleurisy ; Seoul ; Shoulder ; Splenomegaly ; Still's Disease, Adult-Onset* ; Wrist

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Clinical Characteristics and Joint Involvement of Rheumatoid Arthritis.

Bo Young YOON ; Chan Hee LEE ; Seong Hoon HAN ; Yun Woo LEE

The Journal of the Korean Rheumatism Association.2004;11(3):227-234.

OBJECTIVE: To investigate the clinical, laboratory, radiologic characteristics, and joint involvement of rheumatoid arthritis (RA) in Korean. METHODS: We retrospectively reviewed initial medical records of 210 patients diagnosed as rheumatoid arthritis in Seoul, Sanggye, and Ilsan Paik Hospital, Inje University. Evaluation included age, sex, disease duration, duration of morning stiffness, joint involvement, the number of tender and swollen joints, rheumatoid factor, erythrocyte sedimentation rate (ESR), C- reactive protein (CRP), and bony erosion in simple X-ray. RESULTS: In total 210 patients, mean age was 50.1+/-13.5 years, and male to female ratio was 1 to 5.6. Mean duration of arthritis was 51.8+/-72.6 months and positive rate of rheumatoid factor was 66.7%. Mean time interval between symptom onset and first visit was 14.1+/-19.1 months. Bony erosion rate was 15.3% in early RA patients, who had been diagnosed as RA within 1 year. The order of frequency of joint involvement was as the follows; metacarpophalangeal (MCP) joints, wrist joints, proximal interphalangeal (PIP) joints, metatarsophalangeal (MTP) joints, ankle joints, and knee joints. It was noted that the joints on the right and left sides behaved in like fashion. This pattern was not different with early RA. The titer of rheumatoid factor showed poor correlations with variables of clinical activity (ESR, CRP, duration of morning stiffness, and number of tender and swollen joints). CONCLUSION: In Korea, clinical manifestations and joint involvement of RA patients were not different from other published studies. The most commonly involved joints are MCP joints, wrist joints, PIP joints, and MTP joints.
Ankle Joint ; Arthritis ; Arthritis, Rheumatoid* ; Blood Sedimentation ; Female ; Humans ; Joints* ; Knee Joint ; Korea ; Male ; Medical Records ; Metatarsophalangeal Joint ; Retrospective Studies ; Rheumatoid Factor ; Seoul ; Wrist Joint

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Catalase and PPAR-gamma Polymorphisms of Rheumatoid Arthritis in Korean.

Chan Bum CHOI ; Ahmed El SOHEMY ; Sang Seokg SEONG ; Yong Wook PARK ; Hye Soon LEE ; Wan Sik UHM ; Tae Hwan KIM ; Jae Bum JUN ; Dae Hyun YOO ; Sang Cheol BAE

The Journal of the Korean Rheumatism Association.2004;11(3):217-226.

OBJECTIVE: To investigate the association between a single nucleotide polymorphism in the catalase and peroxisome proliferator activated receptor- gamma (PPAR-gamma) genes with risk and severity of rheumatoid arthritis (RA) in Korea. METHODS: DNA was isolated from blood samples collected from 473 Korean patients with RA and 400 Korean controls. Genotyping for the C-262T polymorphism of catalase and the Pro12Ala polymorphism of PPAR-gamma was performed by PCR-RFLP (restriction fragment length polymorphism) analysis. Subjects were classified according to ACR criteria for RA, KHAQ, and radiological severity classification by Steinbroker. RESULTS: In patient group, catalase C/T and T/T polymorphism was seen in 23 (4.9%) and 0 patients while Pro/Ala and Ala/Ala PPAR-gamma polymorphism was seen in 42 (8.9%) and 1 (0.2%) patients. In control group, catalase C/T and T/T polymorphism was seen in 25 (6.3%) and 1 (0.2%) controls while Pro/Ala and Ala/Ala PPAR-gamma polymorphism was seen in 34 (8.5%) and 4 (1%) controls. Catalase and PPAR-gamma polymorphism showed no association with the susceptibility to RA individually but, when combined association was found although it had no statistical significance, which was possibly due to its low frequency. Catalase and HLA-DRB1 polymorphism showed significant interaction on development of RA but, no interaction was found between PPAR-gamma and HLA-DRB1. Catalase and PPAR-gamma polymorphism showed no association with the severity or functional status of RA. CONCLUSION: Our results show that genetic polymorphisms of catalase and PPAR-gamma has no association with the susceptibility to RA. Catalase and HLA-DRB1 polymorphism showed significant interaction on development of RA.
Arthritis, Rheumatoid* ; Catalase* ; Classification ; DNA ; HLA-DRB1 Chains ; Humans ; Korea ; Peroxisomes ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

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Arthrodesis of the First Metatarsophalangeal Joint for Rheumatoid Hallux Valgus, using 2 Crossed Screws.

Il Hoon SUNG ; Sung Wook CHOI ; Choong Hyeok CHOI ; Ye Soo PARK

The Journal of the Korean Rheumatism Association.2004;11(3):212-216.

OBJECTIVE: To investigate the clinical results of the first metatarsophalangeal arthrodesis for treating the hallux valgus deformity of the rheumatoid arthritis, using the fixation method with 2 crossed screws. METHODS: 19 cases of the rheumatoid hallux valgus deformity were tried to treat with the first metatarsophalangeal arthrodesis, using 2 crossed screws. The follow-up period was averaged in 16 months. The subjective and objective findings were evaluated. Radiologically measurements for the hallux valgus angle, 1, 2 intermetatarsal angle and dorsiflexion angle were measured. RESULTS: Cases, of which the first metatarsophalangeal joint successfully fixated with 2 crossed screws, were 14 (73.7%). 5 failed fixations with 2 crossed screws due to breakage of the cortical bone were immediately refixed with fixation methods (the dorsal plating for three cases, additional K-wire fixation for one, and threaded Steinmann pins fixation for one case). After the arthrodesis of the first metatarsophalangeal joint, the subjective signs in pain, function and alignment were improved as all above fair grade. The radiological fusion was observed at average 8 weeks after the operation in all cases. The hallux valgus angle and 1, 2 intermetatarsal angle were reduced from 45.6+/-7.5degrees and 16.2+/-5.2degrees to 14.2+/-2.0degrees and 10.9+/-2.5degrees respectively. The dorsiflexion angle was measured in 20.5+/-2.2degrees after the fusion. CONCLUSION: To correct the rheumatoid hallux valgus deformity, the arthrodesis of the first metatarsophalangeal joint with 2 crossed screws is a method for the satisfactory results, once the fixation is achieved. However, other fixation procedures should be prepared in case of the failed fixation, which could be happened intraoperatively.
Arthritis, Rheumatoid ; Arthrodesis* ; Congenital Abnormalities ; Follow-Up Studies ; Hallux Valgus* ; Hallux* ; Metatarsophalangeal Joint*

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