Background/Aims: To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods: This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results: The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

BACKGROUND/AIMS: To determine the efficacy and safety of low-dose tacrolimus in Korean rheumatoid arthritis (RA) subjects with an inadequate response to methotrexate (MTX). METHODS: This was a multicenter, open-label study conducted at five Korean sites. Fifty-six patients with active RA, despite treatment for ≥ 1 month with a stable, maximally tolerated dosage of oral MTX (median dosage, 15 mg/wk), were enrolled and received 1.5 mg/day of tacrolimus as a single oral dose once per day for 16 weeks while continuing to receive MTX. All other disease-modifying anti-rheumatic drugs were discontinued, whereas stable dosages of nonsteroidal anti-inflammatory drugs and oral corticosteroids (≤ 10 mg/day of prednisone or an equivalent corticosteroid) were allowed. The primary clinical response criterion was the American College of Rheumatology's definition of 20% improvement (ACR20) at the end of treatment. RESULTS: The ACR20 response rate was 42.9% (24 of 56 patients) in patients who had received tacrolimus at least once. The overall ACR50 and ACR70 responses at the end of treatment for all patients were 30.4% and 10.7%, respectively. Throughout the treatment period, 37 patients experienced 71 adverse events (AEs) in total, and four patients left the study because of AEs. In addition, 15 patients in total experienced treatment-related AEs. Throughout the treatment period, two patients were reported to experience two serious AEs, and one patient left the study because of a serious AE. CONCLUSIONS: In patients whose active RA persists despite treatment with MTX, low-dose tacrolimus in combination with MTX appears to be safe and well tolerated, and provides clinical benefit.
Adrenal Cortex Hormones ; Antirheumatic Agents ; Arthritis, Rheumatoid* ; Humans ; Methotrexate* ; Prednisone ; Tacrolimus*

OBJECTIVE: The 2010 New American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for rheumatoid arthritis (RA) was raised to identify patients with early RA and replaced the 1987 ACR classification criteria. The aims of this study are to assess the availability of new classification criteria and to evaluate its potential limitation. METHODS: A total of 408 patients with newly diagnosed RA were included from 13 secondary or tertiary hospitals in South Korea. The symptom duration was less than 12 months before the diagnosis of RA. RA was defined as either 1987 ACR classification criteria or new 2010 ACR/EULAR criteria. We compared the full details of both classification criteria. RESULTS: The mean symptom duration was 5.1 months. The majority (76.2%) of the patients were female. Two hundred and seventy three patients (66.9%) fulfilled both of the 2010 and 1987 classification criteria. Forty-seven (14.7%) of the 320 patients fulfilling the 1987 criteria did not fulfill the new classification criteria. On the other hand, eighty-eight (24.4%) of the 361 patients fulfilling the 2010 ACR/EULAR classification criteria did not fulfill the 1987 ACR criteria. Thirty-six (55.4%) of the 65 patient with seronegative RA failed to meet the 2010 classification criteria. In case of seropositive RA (n=343), 85 additional patients (24.8%) could be diagnosed as RA using new classification criteria. CONCLUSION: The new 2010 ACR/EULAR classification criteria enable physicians to diagnose more patients with early RA via the help of serology. However, the sensitivity for the diagnosis of seronegative RA is projected to decrease.
Arthritis, Rheumatoid ; Female ; Hand ; Humans ; Republic of Korea ; Rheumatic Diseases ; Tertiary Care Centers

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.
Dermatitis, Atopic ; Erythema ; Humans ; Light ; Pruritus ; Salicylamides ; Skin ; Weights and Measures

BACKGROUND: Atopic dermatitis (AD) is associated with severe pruritus, but there are only a few effective treatment modalities. Previous studies have demonstrated that infrared light inhibited the development of atopic dermatitis. OBJECTIVE: This study is to evaluate the efficacy and safety of StoneTouch(R) infrared device in reducing pruritus associated with atopic dermatitis. METHODS: A total of 92 patients with atopic dermatitis with mild to moderate AD were enrolled in the randomized single-blind, placebo-controlled study. Randomly assigned StoneTouch(R) or sham device was irradiated three times daily for 14 days trial. Efficacy was evaluated by visual analogue scales and investigator's assessments. RESULTS: Pruritus scores using VAS evaluated by patients revealed greater improvement in the StoneTouch(R) infrared treatment group. Assessment of treated skin lesion by physicians showed significant improvement of skin findings in treated group. Transient erythema and mild irritation on the treated site were reported in a few patients. These symptoms were diminished within 1~2 days of treatment. CONCLUSION: StoneTouch(R) infrared device is safe and effective in reducing pruritus in patients with atopic dermatitis.
Dermatitis, Atopic ; Erythema ; Humans ; Light ; Pruritus ; Salicylamides ; Skin ; Weights and Measures

It is important to identify therapeutic compounds with no adverse effects for use in the chemotherapy of patients with bone-related diseases. The aim of this study was to identify a new compound that inhibits osteoclast differentiation and bone resorption. Herein, we examined the effects of 1',2'-dihydrorotenone on osteoclast differentiation and bone resorption in vitro and in vivo. 1',2'-dihydrorotenone inhibited receptor activator of NF-kappaB ligand (RANKL)-induced osteoclast differentiation of cultured bone marrow macrophages (BMMs) in a dose-dependent manner. However, 1',2'-dihydrorotenone did not exert cytotoxic effect on BMMs. 1',2'-dihydrorotenone suppressed the expression of c-fos and NFATc1 as well as osteoclast-specific genes in BMMs treated with RANKL. Treatment with RANKL inhibited the expression of inhibitors of differentiation/DNA binding (Id)1, 2, and 3; however, in the presence of 1',2'-dihydrorotenone, RANKL did not suppress the expression of Id1, 2, and 3. Furthermore, 1',2'-dihydrorotenone inhibited bone resorption and considerably attenuated the erosion of trabecular bone induced by lipopolysaccharide treatment. Taken together, these results suggest that 1',2'-dihydrorotenone has the potential to be applied in therapies for bone-related diseases.
Bone Marrow ; Bone Resorption ; Humans ; Macrophages ; Osteoclasts ; Receptor Activator of Nuclear Factor-kappa B ; Rotenone

BACKGROUND: Atopic dermatitis is a chronic inflammatory skin disease. It is caused by immunological abnormalities, abnormalities of the skin barrier, environmental factors and genetic factors. Atopic dermatitis destroys the skin barrier and passes through the skin, triggering an immune response. To treat atopic dermatitis, we anticipate use of hypoallergenic cures to hydrate skin that has been dried by destruction of the skin barrier. OBJECTIVE: We did a preclinical trial to identify inhibitory effects of the StoneTouch(R) infrared scanner on atopic dermatitis. We conducted skin safety tests, comparing the use of infrared energy to drug treatment. We then confirmed the effects of the StoneTouch(R) infrared scanner through animal tests using Nc/Nga mice as a model of atopic dermatitis in order to identify any inhibition of the immune response in atopic dermatitis. METHODS: We irradiated Nc/Nga mice using a StoneTouch(R) infrared scanner under a variety of conditions. During skin safety tests of the StoneTouch(R) infrared scanner on hairless mice, we assessed immune response and burn risk in irradiated mouse skin. We identified any inhibitory effects on atopic dermatitis using Dermoscope assessments, measurements of transepidermal water loss (TEWL) and IgE levels, measurements of pro-inflammatory cytokines, H&E staining and immunofluorescence staining (IF) of substance P and CGRP as neurotransmitters on the backs and ears of Nc/Nga mice irradiated by the StoneTouch(R) infrared scanner. RESULTS: We did not observe any skin abnormalities after using the StoneTouch(R) infrared scanner on Nc/Nga mice. We confirmed the inhibitory effect of the StoneTouch(R) infrared scanner irradiation on atopic dermatitis. We found that irradiated epidermis was thinner than that of the epidermis in Nc/Nga mice in which atopic dermatitis was induced. We observed no significant between groups differences in expression level of substance P. The expression of CGRP in mice with atopic dermatitis was decreased, but, the increased irradiation led to greater expression of CGRP in irradiated skin. CONCLUSION: The StoneTouch(R) infrared scanner does not as a function of irradiation dosage. It inhibits the development of atopic dermatitis.
Animals ; Burns ; Cytokines ; Dermatitis, Atopic ; Ear ; Epidermis ; Fluorescent Antibody Technique ; Immunoglobulin E ; Mice ; Mice, Hairless ; Neurotransmitter Agents ; Skin ; Skin Abnormalities ; Skin Diseases ; Substance P

Right sided aortic arch is an uncommon congenital anomaly. It can be classified into three types, depending on the left aortic arch's degenerating pattern and the branching pattern of the great vessels. It can be associated with major congenital heart disease, depending on the type of right sided aortic arch. We report a case of an 18-years-old female who has right sided aortic arch with atrial septal defect (ASD). In our case, the patient had a right sided aortic arch and aberrant left subclavian artery, also she had ASD (ostium secundum) and moderate tricuspid regurgitation with pulmonary hypertension. The patient was successfully performed patch closure of ASD and tricuspid valve annuloplasty via midline sternotomy. The patient had uneventful postoperative course.
Aneurysm ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Deglutition Disorders ; Female ; Heart Diseases ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Sternotomy ; Subclavian Artery ; Tricuspid Valve ; Tricuspid Valve Insufficiency

BACKGROUND: Inflammatory response on LPS and IFN-gamma induced Macrophage Raw 264.7 cells was secreted NO (nitric oxide) and PGE2 (prostaglandin E2) though expression of iNOS and COX-2. And many pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6 etc.) was secreted on LPS and IFN-gamma induced Macrophage Raw 264.7 cells, too. Atopy dermatitis was inflammatory skin disease with pruritus, xeroderma and specific eczema. OBJECTIVE: We sought to effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. METHODS: The immune response of Raw 264.7 cells were induced by LPS and IFN-gamma. Then LPS and IFN-gamma induced Raw 264.7 cells was measured NO, PGE2 production after treatment of different concentrations for AF-343. The related genes (iNOS, COX-2) for NO, PGE2 production were detected using Western blot in LPS and IFN-gamma induced Raw 264.7 cells after treatment of different concentrations for AF-343. Pro-inflammatory cytokines were detected, too. NC/Nga mice as Atopy dermatitis model was induced atopy dermatitis. Then NC/Nga mice with atopy dermatitis were performed oral administration of AF-343 for 1weeks. After oral administration of AF-343, TEWL was measured on skin tissues of NC/Nga mice with atopy dermatitis according to whether were performed oral administration of AF-343 or not. And pro-inflammatory cytokines and IgE was measured in serum, protein of skin tissues of NC/Nga mice. Skin tissues of NC/Nga mice were performed H&E staining, immunohistochemical staining for PCNA, Involucrin and filaggrin. RESULTS: LPS and IFN-gamma induced Raw 264.7 cells was decreased NO, PGE2 production in dose-dependent after treatment of different concentrations for AF-343. The expression level of iNOS, COX-2 protein was decreased in dose-dependent, too. The related pro-inflammatory cytokines in media with LPS and IFN-gamma induced Raw 264.7 cells were decreased after treatment of different concentrations for AF-343. TEWL level of NC/Nga mice skin (back, ear) with atopy dermatitis according to whether were performed oral administration of AF-343 or not was decreased in NC/Nga mice with atopy dermatitis group was performed oral administration by AF-343. When NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343, induced pro-inflammatory cytokines and IgE expression in serum, protein of back, ear skin tissues of each NC/Nga mice group was decreased. H&E stained Skin tissues of NC/Nga mice was confirmed that thickness of epidermis, dermis were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis. The expression of PCNA, involucrin and filaggrin were decreased in NC/Nga mice group with atopy dermatitis was performed oral administration by AF-343 than NC/Nga mice group with atopy dermatitis as results of immunihistochemical staining using specific antibodies such as PCNA as cell proliferation marker, involucrin and filaggrin as keratinocytes differentiation markers for skin tissues (back, ear) of NC/Nga mice. CONCLUSION: We confirmed effect of anti-inflammation and skin hydration of AF-343 on Macrophage Raw 264.7 cells and NC/Nga mice with Atopic Dermatitis. In conclusion, AF-343 is expecting as therapeutics for atopic dermatitis.
Administration, Oral ; Animals ; Antibodies ; Antigens, Differentiation ; Blotting, Western ; Cell Proliferation ; Cytokines ; Dermatitis ; Dermatitis, Atopic ; Dermis ; Dinoprostone ; Ear ; Eczema ; Epidermis ; Ichthyosis ; Immunoglobulin E ; Inflammation ; Interleukin-6 ; Intermediate Filament Proteins ; Keratinocytes ; Macrophages ; Mice ; Proliferating Cell Nuclear Antigen ; Protein Precursors ; Pruritus ; Skin ; Skin Diseases ; Taraxacum

BACKGROUND: Dermatological diseases can occur with atopic dermatitis. OBJECTIVE: The purpose of this study was to analyze diseases associated with atopic dermatitis in Koreans. METHODS: From November, 2007, to May, 2008, 948 patients with atopic dermatitis who visited the department of dermatology at 19 hospitals were evaluated for associated diseases. RESULTS: Of 948 patients, 53.8% (510) had symptoms associated with other dermatological diseases. In order of frequency, diseases associated with atopic dermatitis included acne, hand/foot eczema, seborrheic dermatitis, urticaria, warts, and recurrent herpes simplex. The number of associated diseases did not change significantly with the severity of atopic dermatitis. However, the incidence of hand/foot eczema and eczema herpeticum correlated significantly with the severity of atopic dermatitis. CONCLUSION: There is a distinct pattern of diseases associated with atopic dermatitis in Koreans.
Acne Vulgaris ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Dermatology ; Eczema ; Herpes Simplex ; Humans ; Incidence ; Kaposi Varicelliform Eruption ; Methylmethacrylates ; Polystyrenes ; Urticaria ; Warts