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Yoo DH, Sohn CH, Kang HS, Cho YD, Kim KM. Arterial Spin-Labeling MR Imaging for the Differential Diagnosis of Venous-Predominant AVMs and Developmental Venous Anomalies. AJNR Am J Neuroradiol 2023; 44:916-921. [PMID: 37385682 PMCID: PMC10411836 DOI: 10.3174/ajnr.a7922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND AND PURPOSE Venous-predominant AVMs are almost identical in appearance to developmental venous anomalies on conventional MR imaging. Herein, we compared and analyzed arterial spin-labeling findings in patients with developmental venous anomalies or venous-predominant AVMs, using DSA as the criterion standard. MATERIALS AND METHODS We retrospectively collected patients with either DVAs or venous-predominant AVMs, each available on both DSA and arterial spin-labeling images. Arterial spin-labeling imaging was visually assessed for the presence of hyperintense signal. CBF measured at the most representative section was normalized to the contralateral gray matter. The temporal phase of developmental venous anomalies or venous-predominant AVMs was measured on DSA as a delay between the first appearance of the intracranial artery and the lesion. Correlation between the normalized CBF and the temporal phase was evaluated. RESULTS Analysis of 15 lesions (13 patients) resulted in categorization into 3 groups: typical venous-predominant AVMs (temporal phase, <2 seconds), intermediate group (temporal phase between 2.5 and 5 seconds), and classic developmental venous anomalies (temporal phase, >10 seconds). Arterial spin-labeling signal was markedly increased in the typical venous-predominant AVM group, while there was no discernible signal in the classic developmental venous anomaly group. In the intermediate group, however, 3 of 6 lesions showed mildly increased arterial spin-labeling signal. The normalized CBF on arterial spin-labeling and the temporal phase on DSA were moderately negatively correlated: r(13) = 0.66, P = .008. CONCLUSIONS Arterial spin-labeling may predict the presence and amount of arteriovenous shunting in venous-predominant AVMs, and using arterial spin-labeling enables confirmation of typical venous-predominant AVMs without DSA. However, lesions with an intermediate amount of shunting suggest a spectrum of vascular malformations ranging from purely vein-draining developmental venous anomalies to venous-predominant AVMs with overt arteriovenous shunting.
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Affiliation(s)
- D H Yoo
- From the Departments of Radiology (D.H.Y., C.-H.S., Y.D.C.)
| | - C-H Sohn
- From the Departments of Radiology (D.H.Y., C.-H.S., Y.D.C.)
| | - H-S Kang
- Neurosurgery (H.-S.K., K.M.K.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Y D Cho
- From the Departments of Radiology (D.H.Y., C.-H.S., Y.D.C.)
| | - K M Kim
- Neurosurgery (H.-S.K., K.M.K.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Yoo DH, Cho YD, Lee HS, Kim SH, Jang D, Lee SH, Cho WS, Kang HS, Kim JE, Han MH. Suspected Metallic Embolization Distal to Coiled Intracranial Aneurysms Detectable by Susceptibility-Weighted MR Imaging. AJNR Am J Neuroradiol 2020; 41:619-623. [PMID: 32273325 PMCID: PMC7144647 DOI: 10.3174/ajnr.a6506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/19/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE After endovascular coiling of intracranial aneurysms, round dark parenchymal lesions believed to be particulate metal are sometimes encountered in MR imaging studies of the brain. We used SWI to assess the frequency of such occurrences, in addition to exploring likely causes and clinical implications. MATERIALS AND METHODS We reviewed 700 MR imaging studies performed between September 2018 and March 2019 at our institution as follow-up monitoring of coiled intracranial aneurysms. Any sizeable (>5 mm) rounded dark-signal lesions encountered were presumed to be metallic. The magnitudes and locations of such lesions were recorded. In patients with these lesions, pertinent procedural documentation was screened for devices used, including coils, microcatheters, microguidewires, and stents. Medical records were also examined to determine whether any related symptoms ensued. RESULTS Twenty patients (2.8%) exhibited a total of 25 lesions on SWI. Diameters ranged from 5 to 11 mm (median, 8 mm). All except 2 lesions were located in brain regions downstream from aneurysms, but all lesions occupied vascular territories of vessels used to place guiding catheters. Other than the Synchro 14, which was routinely deployed, no device was regularly used in patients with SWI-detectable lesions; and none of the affected patients developed focal neurologic symptoms as a consequence. CONCLUSIONS Although the origins remain unclear, distal embolization of particulate metal distal to coiled cerebral aneurysms is occasionally observed on follow-up MR imaging studies. Such lesions, however, seem to have no apparent clinical impact.
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Affiliation(s)
- D H Yoo
- From the Departments of Radiology (D.H.Y., Y.D.C., H.S.L., S.H.K., M.H.H.), and
| | - Y D Cho
- From the Departments of Radiology (D.H.Y., Y.D.C., H.S.L., S.H.K., M.H.H.), and
| | - H S Lee
- From the Departments of Radiology (D.H.Y., Y.D.C., H.S.L., S.H.K., M.H.H.), and
| | - S H Kim
- From the Departments of Radiology (D.H.Y., Y.D.C., H.S.L., S.H.K., M.H.H.), and
| | - D Jang
- Neurosurgery (D.J., S.H.L., W.-S.C., H.-S.K., J.E.K.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - S H Lee
- Neurosurgery (D.J., S.H.L., W.-S.C., H.-S.K., J.E.K.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - W-S Cho
- Neurosurgery (D.J., S.H.L., W.-S.C., H.-S.K., J.E.K.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - H-S Kang
- Neurosurgery (D.J., S.H.L., W.-S.C., H.-S.K., J.E.K.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - J E Kim
- Neurosurgery (D.J., S.H.L., W.-S.C., H.-S.K., J.E.K.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - M H Han
- From the Departments of Radiology (D.H.Y., Y.D.C., H.S.L., S.H.K., M.H.H.), and
- Department of Neurosurgery and Radiology (M.H.H.), Veterans Health Service Medical Center, Seoul, Korea
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Kwon HJ, Cho YD, Lim JW, Koh HS, Yoo DH, Kang HS, Han MH. Contralateral Approach to Coil Embolization of Proximal A1 Aneurysms Using the Anterior Communicating Artery. AJNR Am J Neuroradiol 2018; 39:2297-2300. [PMID: 30442700 DOI: 10.3174/ajnr.a5875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 09/28/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Aneurysms arising from the proximal A1 segment of the anterior cerebral artery are rare, and their distinctive configurations often pose technical challenges during endovascular embolization. Herein, we present 11 patients with proximal A1 aneurysms requiring a contralateral approach (via the anterior communicating artery) to coil embolization. MATERIALS AND METHODS From a prospectively collected data repository, we retrieved records of 11 patients consecutively treated for proximal A1 aneurysms between January 2011 and March 2018. In each instance, coil embolization was performed by the contralateral route. Outcomes were analyzed in terms of morphologic features and clinical status. RESULTS Aneurysms in all 11 patients were directed posteriorly and were small (<5 mm). A contralateral approach (via the anterior communicating artery) was used after ipsilateral attempts at aneurysm selection failed in each instance, despite using a variety of microcatheters. Single punctures and single guiding catheters sufficed in 9 patients, but 2 patients required dual punctures and 2 guiding catheters. All endovascular treatments ultimately yielded excellent outcomes. Although 1 symptomatic infarct was manifested in the course of ipsilateral treatment, no morbidity or mortality resulted from the contralateral access. CONCLUSIONS Due to angio-anatomic constraints, a contralateral strategy for coil embolization of proximal A1 aneurysms is acceptable if ipsilateral access is technically prohibitive and the vessels (contralateral A1 and anterior communicating artery) are amenable to the passage of microdevices.
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Affiliation(s)
- H-J Kwon
- From the Department of Neurosurgery (H.-J.K., J.W.L., H.-S. Koh), Regional Cerebrovascular Center, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Y D Cho
- Departments of Radiology (Y.D.C., D.H.Y., M.H.H.)
| | - J W Lim
- From the Department of Neurosurgery (H.-J.K., J.W.L., H.-S. Koh), Regional Cerebrovascular Center, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - H-S Koh
- From the Department of Neurosurgery (H.-J.K., J.W.L., H.-S. Koh), Regional Cerebrovascular Center, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - D H Yoo
- Departments of Radiology (Y.D.C., D.H.Y., M.H.H.)
| | - H-S Kang
- Neurosurgery (H.-S. Kang), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - M H Han
- Departments of Radiology (Y.D.C., D.H.Y., M.H.H.)
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Choi HH, Ha EJ, Lee JJ, Yoo DH, Cho WS, Kim JE, Cho YD, Han MH, Kang HS. Comparison of Clinical Outcomes of Intracranial Aneurysms: Procedural Rupture versus Spontaneous Rupture. AJNR Am J Neuroradiol 2017; 38:2126-2130. [PMID: 28860217 DOI: 10.3174/ajnr.a5344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/09/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Procedural rupture of an intracranial aneurysm is a devastating complication in endovascular treatment. The purpose of this study was to evaluate the clinical outcomes of patients with procedural rupture of unruptured saccular intracranial aneurysms compared with those with spontaneously ruptured aneurysms. MATERIALS AND METHODS A retrospective review was performed for 1340 patients with 1595 unruptured saccular intracranial aneurysms that underwent endovascular coil embolization between February 2010 and December 2014. The clinical outcomes of patients with procedural rupture of unruptured saccular intracranial aneurysms were compared with those of 198 patients presenting with spontaneously ruptured aneurysms. RESULTS In this series, procedural rupture developed in 19 patients (1.4% per patient and 1.2% per aneurysm), and the morbidity related to procedural rupture was 26.3% (95% confidence interval, 8.5%-61.4%) with no mortality. Hunt and Hess scale grades and hospitalization days of patients with procedural rupture were equivalent to those of patients presenting with spontaneous aneurysm rupture. Subsequent treatment procedures after hemorrhage (including lumbar drainage, extraventricular drainage, decompressive craniectomy, and permanent shunt) showed no difference between the 2 groups. The hemorrhage volumes were smaller in the procedural-rupture group (P = .03), and the endovascular vasospasm therapies tended to be more frequently required in the spontaneous aneurysm-rupture group (P = .08). At postictus 6 months, the proportion of modified Rankin Scale scores of ≥2 were lower in the procedural-rupture group (5.3% versus 26.8%, P = .049). In multivariate analysis, spontaneous aneurysm rupture was a significant risk factor for worse clinical outcome (OR = 14.9; 95% CI, 1.2-193.1; P = .039). CONCLUSIONS This study showed better clinical outcomes in the procedural-rupture group. Even though there is a potential chance of aneurysm rupture during treatment, the clinical outcomes after procedural bleeds seem to be more favorable than those of spontaneous rupture.
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Affiliation(s)
- H H Choi
- From the Departments of Neurosurgery (H.H.C.), Dongguk University College of Medicine, Dongguk University Hospital, Ilsan, Korea
| | - E J Ha
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
| | - J J Lee
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - D H Yoo
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - W-S Cho
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
| | - J E Kim
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
| | - Y D Cho
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - M H Han
- Radiology (J.J.L., D.H.Y., Y.D.C, M.H.H.), Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - H-S Kang
- Departments of Neurosurgery (E.J.H., W.-S.C., J.E.K., H.-S.K.)
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Jeon JP, Cho YD, Yoo DH, Moon J, Lee J, Cho WS, Kang HS, Kim JE, Han MH. Risk Factor Analysis of Recanalization Timing in Coiled Aneurysms: Early versus Late Recanalization. AJNR Am J Neuroradiol 2017; 38:1765-1770. [PMID: 28619836 DOI: 10.3174/ajnr.a5267] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 04/10/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Long-term documentation of anatomic and angiographic characteristics pertaining to the timing of recanalization in coiled aneurysms has been insufficient. Our intent was to analyze and compare early and late-phase recanalization after coiling, identifying respective risk factors. MATERIALS AND METHODS A total of 870 coiled saccular aneurysms were monitored for extended periods (mean, 30.8 ± 8.3 months). Medical records and radiologic data were also reviewed, stratifying patients as either early (n = 128) or late (n = 52) recanalization or as complete occlusion (n = 690). Early recanalization was equated with confirmed recanalization within 6 months after the procedure, whereas late recanalization was defined as verifiable recanalization after imaging confirmation of complete occlusion at 6 months. A multinomial regression model served to assess potential risk factors, the reference point being early recanalization. RESULTS Posterior circulation (P = .009), subarachnoid hemorrhage at presentation (P = .011), second attempt for recanalized aneurysm (P < .001), and aneurysm size >7 mm (P < .001) emerged as variables significantly linked with early recanalization (versus complete occlusion). Late (versus early) recanalization corresponded with aneurysms ≤7 mm (P = .013), and in a separate subanalysis of lesions ≤7 mm, aneurysms 4-7 mm showed a significant predilection for late recanalization (P = .008). However, the propensity for complete occlusion in smaller lesions (≤7 mm) increased as the size diminished. CONCLUSIONS Although long-term complete occlusion after coiling was more likely in aneurysms ≤7 mm, such lesions were more prone to late (versus early) recanalization, particularly those of 4-7 mm in size. Long-term follow-up imaging is thus appropriate in aneurysms >4 mm to detect late recanalization of those formerly demonstrating complete occlusion.
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Affiliation(s)
- J P Jeon
- From the Department of Neurosurgery (J.P.J.), Hallym University College of Medicine, Chuncheon, Korea
| | - Y D Cho
- Departments of Radiology (Y.D.C., D.H.Y., J.M.)
| | - D H Yoo
- Departments of Radiology (Y.D.C., D.H.Y., J.M.)
| | - J Moon
- Departments of Radiology (Y.D.C., D.H.Y., J.M.)
| | - J Lee
- Neurosurgery (J.L., W.-S.C., H.-S.K., J.E.K., M.H.H.), Seoul National University College of Medicine, Seoul, Korea
| | - W-S Cho
- Neurosurgery (J.L., W.-S.C., H.-S.K., J.E.K., M.H.H.), Seoul National University College of Medicine, Seoul, Korea
| | - H-S Kang
- Neurosurgery (J.L., W.-S.C., H.-S.K., J.E.K., M.H.H.), Seoul National University College of Medicine, Seoul, Korea
| | - J E Kim
- Neurosurgery (J.L., W.-S.C., H.-S.K., J.E.K., M.H.H.), Seoul National University College of Medicine, Seoul, Korea
| | - M H Han
- Neurosurgery (J.L., W.-S.C., H.-S.K., J.E.K., M.H.H.), Seoul National University College of Medicine, Seoul, Korea
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Goh TW, Kim BO, Do SH, Kim HS, Yoo DH, Kim YY. 202 Various levels of milk by-products in weaning pig diet on growth performance, blood profiles, intestinal morphology, muscle fiber diameter, and diarrhea incidence in weaning pigs. J Anim Sci 2017. [DOI: 10.2527/asasmw.2017.12.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Jeon JP, Cho YD, Rhim JK, Yoo DH, Cho WS, Kang HS, Kim JE, Han MH. Fate of Coiled Aneurysms with Minor Recanalization at 6 Months: Rate of Progression to Further Recanalization and Related Risk Factors. AJNR Am J Neuroradiol 2016; 37:1490-5. [PMID: 26965468 DOI: 10.3174/ajnr.a4763] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/28/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Minor recanalization in coiled aneurysms may remain stable with time or may progress to major recanalization. Our aim was to monitor the aneurysms displaying minor recanalization in imaging studies at 6 months, gauging major recanalization rates and related risk factors through extended follow-up. MATERIALS AND METHODS Sixty-five aneurysms (in 65 patients) showing minor recanalization in follow-up imaging at 6 months were reviewed retrospectively. Medical records and radiologic data accruing during extended monitoring (mean, 24.8 ± 8.2 months) were assessed. Univariate and multivariate analyses were conducted to identify risk factors for progression from minor-to-major recanalization. RESULTS Progression to major recanalization was observed in 24 (36.9%) of the initially qualifying aneurysms during a follow-up of 112.5 aneurysm-years, for an annual rate of 17.84% per aneurysm-year. Progression was determined chronologically as follows: 14 (58.3%) at 6 months, 8 (33.3%) at 18 months, and 2 (8.4%) at 30 months. Stent deployment significantly decreased the occurrence of major recanalization (OR = 0.22, P = .03), whereas antiplatelet therapy (OR = 0.82, P = .75), posterior location (OR = 0.24, P = .20), and second coiling for recanalized aneurysms (OR = 0.96, P = .96) were unrelated. CONCLUSIONS Our analysis determined a 36.9% rate of major recanalization during a follow-up of 112.5 aneurysm-years in coiled aneurysms showing minor recanalization at 6 months. Stent deployment alone conferred a protective effect, preventing further recanalization without additional treatment. Given the fair probability of late major recanalization, aneurysms showing minor recanalization at 6 months should be monitored diligently, particularly in the absence of stent placement.
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Affiliation(s)
- J P Jeon
- From the Department of Neurosurgery (J.P.J.), Hallym University College of Medicine, Chuncheon, Korea
| | - Y D Cho
- Departments of Radiology (Y.D.C., J.K.R., D.H.Y., M.H.H.)
| | - J K Rhim
- Departments of Radiology (Y.D.C., J.K.R., D.H.Y., M.H.H.)
| | - D H Yoo
- Departments of Radiology (Y.D.C., J.K.R., D.H.Y., M.H.H.)
| | - W-S Cho
- Neurosurgery (W.s.C., H.-S.K., J.E.K.), Seoul National University College of Medicine, Seoul, Korea
| | - H-S Kang
- Neurosurgery (W.s.C., H.-S.K., J.E.K.), Seoul National University College of Medicine, Seoul, Korea
| | - J E Kim
- Neurosurgery (W.s.C., H.-S.K., J.E.K.), Seoul National University College of Medicine, Seoul, Korea
| | - M H Han
- Departments of Radiology (Y.D.C., J.K.R., D.H.Y., M.H.H.)
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Jeon JP, Cho YD, Rhim JK, Yoo DH, Kang HS, Kim JE, Cho WS, Han MH. Do Contrast-Fill Patterns Immediately After Coil Embolization of Small Saccular Aneurysms Impact Long-Term Results? Clin Neuroradiol 2015; 27:205-211. [PMID: 26608741 DOI: 10.1007/s00062-015-0485-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/12/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE It is generally accepted that filling of a saccular aneurysm with contrast immediately after coil embolization predisposes to later recanalization. However, not all such scenarios evolve similarly over time. We investigated outcomes of small (≤ 7 mm) aneurysms with contrast-filled sacs immediately after coil embolization, evaluating the impact of pattern and degree of filling on subsequent recanalization. METHODS Between January, 2008 and December, 2010, 186 small (≤ 7 mm) saccular aneurysms that retained contrast after coil embolization accrued for this study. Lesions were categorized by pattern (eccentric vs. concentric) and degree of filling on working projections. Clinical and morphologic factors were also analyzed to assess impact on subsequent recanalization. Morphologic outcomes at 6 months or more were assessed. RESULTS In 93.5 % (174/186) of aneurysms with visible contrast retention, complete occlusion was evident on follow-up imaging studies at 6 months. Multiple logistic regression analysis indicated that eccentric (vs. concentric) contrast filling carried greater risk of subsequent recanalization (p = 0.020). Stent placement and progressive occlusion were also linked, falling short of statistical significance (p = 0.089). Of 166 progressively occluded aneurysms followed for more than 12 months (mean, 30.8 ± 7.3 months), 158 (95.2 %) exhibited stable occlusion. CONCLUSION Small (≤ 7 mm) aneurysms that retain contrast immediately after coil embolization are more likely to become completely occluded over time through progressive thrombosis. However, an eccentric fill pattern may predispose to recanalization.
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Affiliation(s)
- J P Jeon
- Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea
| | - Y D Cho
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu Seoul, Seoul 110-744, Seoul, Korea.
| | - J K Rhim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu Seoul, Seoul 110-744, Seoul, Korea
| | - D H Yoo
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu Seoul, Seoul 110-744, Seoul, Korea
| | - H-S Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - J E Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - W S Cho
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - M H Han
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu Seoul, Seoul 110-744, Seoul, Korea.,Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Kim HC, Yoo DH, Kim HJ, Jeon YT, Hwang JW, Park HP. A prospective randomised comparison of two insertion methods for i-gel placement in anaesthetised paralysed patients: standard vs. rotational technique. Anaesthesia 2014; 69:729-34. [PMID: 24773470 DOI: 10.1111/anae.12680] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2014] [Indexed: 11/30/2022]
Abstract
In this prospective randomised study, we compared two techniques for i-gel(™) insertion. One hundred and eighty-one anaesthetised, paralysed adult patients were randomly allocated into one of two groups. In the standard group (n = 91), the i-gel was inserted using the standard technique. In the rotation group (n = 90), the i-gel was rotated 90° anticlockwise in the mouth and re-rotated in the hypopharynx to the original alignment. The success rate, insertion time, air leak pressure and complications were assessed. The success rate for insertion at the first attempt was lower for the standard technique, 78 (86%) vs. 87 (97%; p = 0.016). The mean (SD) insertion time was longer (26.9 (14.5) s vs. 22.4 (10.2) s; p = 0.016) and air leak pressure was lower (22.5 (10.4) cm H2O vs. 27.1 (9.4) cm H2O; p = 0.002) in the standard group. The incidence of bloodstaining was higher with the standard technique (8 (9%) vs. 1 (1%); p = 0.034). This study suggests that the rotational technique is superior to the standard technique for i-gel insertion.
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Affiliation(s)
- H C Kim
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Jung KH, Kim JJ, Lee JS, Park W, Kim TH, Jun JB, Yoo DH. Interleukin-18 as an efficient marker for remission and follow-up in patients with inactive adult-onset Still’s disease. Scand J Rheumatol 2013; 43:162-9. [DOI: 10.3109/03009742.2013.824023] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bang SY, Joo YB, Choi JY, Kang YM, Kim HA, Suh CH, Kim TJ, Park YW, Lee J, Park SY, Yoo DH, Lee HS, Bae SC. FRI0317 Predictor of renal survival in lupus nephritis in korea. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yoo DH, Racewicz A, Brzezicki J, Yatsyshyn R, Tobias Arteaga E, Baranauskaite A, Abud-Mendoza C, Navarra S, Eullaran R, Kadinov V, Goecke Sariego I, Byrne P, Park W, Lee SJ, Kim HU, Müller-Ladner U. OP0068 A Phase 3 Randomised Controlled Trial to Compare CT-P13 with Infliximab in Patients with Active Rheumatoid Arthritis: 54 Week Results from the Planetra Study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.273] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Park W, Jaworski J, Brzezicki J, Gnylorybov A, Kadinov V, Goecke Sariego I, Abud-Mendoza C, Otero Escalante WJ, Kang SW, Andersone D, Blanco F, Yoo DH, Ahn C, Kim HU, Braun J. FRI0421 A randomised, double-blind, parallel-group, phase 1 study comparing the pharmacokinetics, safety and efficacy of ct-p13 and infliximab in patients with active ankylosing spondylitis: 54 week results from the planetas study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1548] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kim JJ, Na KS, Kim TH, Yoo DH. THU0466 Pilot Trial of Tocilizumab for Refractory Patients with Adult Onset Still’s Disease. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yoo DH, Shevchuk S, Ramiterre E, Kovalenko V, Tee M, Tobias Arteaga E, Morales Olazabal L, Baranauskaite A, Bukauskiene L, Lim MJ, Lee YA, Rednic S, Ahn C, Kim H, Park W. FRI0164 Local tuberculosis incidence affects the rate of positive conversion in the quantiferon®-tb gold test among patients receiving infliximab or ct-p13 therapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lee ES, Lee JM, Kim WS, Choi SH, Joo I, Kim M, Yoo DH, Yoo RE, Han JK, Choi BI. Multiple-electrode radiofrequency ablations using Octopus® electrodes in an in vivo porcine liver model. Br J Radiol 2012; 85:e609-15. [PMID: 22422385 DOI: 10.1259/bjr/61619687] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES The objective of this study was to determine the in vivo efficacy of radiofrequency ablation (RFA) in porcine liver using Octopus® electrodes for creating a large coagulation compared with RFA using clustered electrodes. METHODS A total of 39 coagulations were created using a 200-W generator and clustered electrodes or Octopus electrodes during laparotomy in 19 pigs. Radiofrequency was applied to the livers using four protocols: (1) Group A-1, monopolar mode using a clustered electrode (n=11); (2) Group A-2, monopolar mode using an Octopus electrode (n=11); (3) Group B-1, consecutive monopolar mode using three, clustered electrodes (n=8); and (4) Group B-2, switching monopolar mode using two Octopus electrodes (n=9). The energy efficiency, shape, diameters (D) and volume (V) of the coagulation volume were compared in each of the two groups. RESULTS The mean maximum D and V of the coagulations in Group A-2 (4.7 cm and 33.1 cm(3), respectively) were significantly larger than those in Group A-1 (4.1 cm and 20.3 cm(3), respectively) (p<0.05). Furthermore, the mean minimum D, maximum D and V of the coagulations in Group B-2 were significantly larger than those in Group B-1, i.e. 5.3 vs 4.0 cm, 6.6 vs 4.9 cm and 66.9 vs 30.2 cm(3), respectively (p<0.05). The energy efficiencies were also significantly higher in Groups A-2 and B-2 than in Groups A-1 and B-1 (p<0.05). CONCLUSION The Octopus electrodes were more efficient for creating a large ablation zone than clustered electrodes, and the efficacy of RFA with Octopus electrodes can be amplified in the switching monopolar mode.
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Affiliation(s)
- E S Lee
- Department of Radiology, Seoul NationalUniversity College of Medicine, Seoul, Republic of Korea
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Santos-Moreno P, Bello J, Palomino A, Villarreal L, Zambrano D, Amador L, Andrade O, Urbina A, Guzman C, Cubides M, Arbelaez A, Valle-Onate R, Galarza-Maldonado C, Brickmann K, Furst F, Kielhauser S, Hermann J, Brezinsek HP, Graninger W, Ziaee V, Sadghi P, Moradinejad MH, Yoo DH, Woo JH, Kim YJ, Kim JJ, Choi CB, Sung YK, Kim TH, Jun JB, Bae SC, Park W, Joo K, Lim MJ, Kwon SR, Jung. KH, Choi CB, Bang SY, Park SR, Lee KW, Kim TH, Bae SC, Donmez S, Pamuk ON, Pamuk GE, Aksoy A, Almoallim H, Almasari A, Khadawardi H, Haroyan A, Petrova M, Shah D, Bhatnagar A, Wanchu A, Okada M, Ardakani FE, Owlia M, Hesami S, Owlia MB, Soleimani H, Saleh-Abadi HS, Lotfi M, Owlia MB, Dehghan A, Saberir B, Moradinejad MH, Zamani G, Aghamohammadi A, Soheili H, shahinpour S, Abolhassani H, Hirbod A, Arandi N, Tavassoli M, Parvaneh N, Rezaei N, Rezaieyazdi Z, Hatef MR, Sedighi S, Ah Kim H, Chung CK, Martinez Perez R, Leon M, Uceda J, Rodriguez Montero S, Munoz A, Velloso M, Marenco J, Tsiliakou N, Giotakos O, Koutsogeorgopoulou L, Kassimos D, Fernandes N, Silva V, Hernandez Sanchez R, Gonzalez Moreno P, Uceda Montanes J, Marenco de la Fuente J, Aytekin E, Demir SE, Okur SC, Caglar NS, Tutun S, Eroglu Demir S, Rezvani A, Ozaras N, Rezvani A, Eroglu Demir S, Ozaras N, Poyraz E, Guneser M, Demir SE, Asik Celik HK, Rezvani A, Ozaras N, Poyraz E, Batmaz I, Sariyildiz M, Dilek B, Yildiz I, Ayyildiz O, Nas K, Cevik R, Gunay T, Garip Y, Bodur H, Baykal T, Seferoglu B, Senel K, Baykal T, Seferoglu B, Senel K, Kara M, Tiftik T, Kaya A, Engin Tezcan M, Akif Ozturk M, Ozel S, Akinci A, Ozcakar L, Saliha Eroglu D, Ebru A, Ilhan K, Teoman A, Gulis D, Ileana F, Linda G, Cristina P, Laura D, Simona S, Simona R, Kaya A, Kara M, Tiftik T, Engin Tezcan M, Akif Ozturk M, Ataman S, Akinci A, Ozcakar L, Venkatesan S, Ng L, Carbone C, Jaeggi E, Silverman E, Kamphuis S, Mak N, Carbone C, Lim L, Levy D, Silverman E, Kamphuis S, Ciobanu E, Mazur M, Mazur-Nicorici L, Ah Kim H, Jin Park S, Cheon EJ, Chung CK, Tugnet N, Dixey J, Cheng C, Schmidt S, Stoy K, Seisenbayev A, Togizbaev G, Santos-Moreno P, Bello J, Gonzalez F, Cubides M, Arbelaez A, Palomino A, Villareal L, Urbina A, Valle-Onate R, Galarza C, Nikiphorou E, MacGregor A, Morris S, James D, Young A, Alomari MA, Shammaa R, Shqair DM, Alawneh K, Khabour OF, Namey TC, Kolahi S, Haghjoo AG, Lee MJ, Suh CH, Park YW, Bae SC, Lee HS, Bang SY, Kang YM, Shim SC, Lee WK, Park H, Lee J, Wong RH, Huang CH, Cheng-Chung Wei J, Chiou SP, Tu YC, Lee HS, Eroglu Demir S, Rezvani A, Ok S, Kim JO, Lee JS, Sung IH, Kim JH, Kim TH, Lee SH, Choi J, Kim S, Song R, Lee YA, Hong SJ, Yang HI, Lee YA, Lee SH, Matsui K, Yoshida K, Oshikawa H, Kobayashi T, Nakano H, Utsunomiya M, Kimura M, Rezvani A, Seniz O, Eroglu Demir S, Yoon J, Yoon N, Lee S, Kim Y. Poster Presentations (PP01-PP67). Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kim SK, Jang WC, Park SB, Park DY, Bang KT, Lee SS, Jun JB, Yoo DH, Chang HK. SLC11A1 gene polymorphisms in Korean patients with Behçet's disease. Scand J Rheumatol 2009; 35:398-401. [PMID: 17062442 DOI: 10.1080/03009740600704221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the potential susceptibility to the solute carrier family 11 member 1 (SLC11A1) gene polymorphisms of Korean patients with Behçet's disease (BD). METHODS Ninety-nine patients with BD and 98 controls were recruited. Analyses of three polymorphisms of the SLC11A1 gene [the 5'-promoter (GT)n, D543N and A318V] were performed, either by denaturing high-performance liquid chromatography for D543N and A318V or by using automatic DNA sequencing for the (GT)n. The genotypes and alleles between patients with BD and the controls were compared using the chi2 test and Yate's correction test. RESULTS No significant differences were found in the distribution of genotypes and alleles of the (GT)n polymorphism between BD patients and the controls. However, subjects with the allele 3 or the genotype allele 3/allele 3 of this polymorphism had a significantly lower risk of developing BD than those without this allele or genotype [allele: p = 0.029, pc = 0.039, odds ratio (OR) = 0.60, 95% confidence interval (CI) 0.37-0.95; genotype: p = 0.036, pc = 0.048, OR = 0.54, 95% CI 0.31-0.96]. In addition, the distributions of genotypes and alleles of D543N were similar between BD patients and controls (p>0.05). In the case of A318V, all of the BD patients and controls had a wild-type genotype. CONCLUSION The allele 3 and the genotype allele 3/allele 3 of the 5'-promoter (GT)n in the SLC11A1 gene may have a protective effect for the development of BD in the Korean population. Further studies in other populations are required to confirm our results.
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Affiliation(s)
- S K Kim
- Department of Internal Medicine, Dankook University, Cheonan, South Korea
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Kim BS, Lee SR, Hyun BH, Shin MJ, Yoo DH, Lee S, Park YS, Ha JH, Ryoo ZY. Effects of gonadotropins on in vitro maturation and of electrical stimulation on parthenogenesis of canine oocytes. Reprod Domest Anim 2008; 45:13-8. [PMID: 19144021 DOI: 10.1111/j.1439-0531.2008.01128.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The objective of this study was to determine the effects of gonadotropins on in vitro maturation (IVM) and electrical stimulation on the parthenogenesis of canine oocytes. In experiment I, cumulus oocyte complexes were collected from ovaries at a random phase of the oestrus cycle and cultured on maturation medium treated with hCG or eCG for 48 or 72 h. There were no significant differences in the effects on the metaphase II (MII) rate between the hCG and eCG treatment groups over 48 h (5.4% vs 5.5%). The MII rate in the co-treatment group of hCG and eCG for 48 h was higher than in each hormone treated group (15.5%, p < 0.05). In experiment 2, the parthenogenetic effect on oocyte development, at various electrical field strengths (1.0, 1.5, 2.0 kV/cm DC) for 60 or 80 mus with a single DC pulse after IVM on the co-treatment of hCG and eCG, was examined. The rate of pronuclear formation (37.1%) in electrical activation at 1.5 kV/60 mus without cytochalasin B (CB) was higher than that of oocytes activated in the other groups (p < 0.05). However, we did not observe the cleavage stages. Also, CB did not influence parthenogenesis of canine oocytes. The results showed that the pronucleus formation rate, indicative of the parthenogenesis start point, could be increased by electrical stimulation. Therefore, these results can provide important data for the parthenogenesis of canine oocytes and suggest the probability of parthenogenesis in canines.
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Affiliation(s)
- B S Kim
- School of Life Science and Biotechnology, Kyungpook National University, Buk-ku, South Korea
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Abstract
Polymorphisms of FcgammaR have been proposed as genetic factors that influence susceptibility to SLE. FcgammaRIIIB polymorphism in systemic lupus erythematosus (SLE) have been studied in various populations, but the results were inconsistent. The aim of this study was to determine the association of FcgammaRIIIB polymorphism in Korean lupus patients. One-hundred and eighty-three SLE patients (166 female, 17 male) meeting 1982 ACR criteria and 300 Korean disease-free controls were enrolled. Genotyping for the FcgammaRIIIB NA1/NA2 was performed by PCR of genomic DNA using allele-specific primers. There was no significant skewing in the distribution of the three FcgammaRIIIB genotypes, and alleles between SLE and the controls. The frequency of FcgammaRIIIB genotypes in SLE patients and controls was FcgammaRIIIB NA1/NA1 27.9% versus 26%, NA1/NA2 55.2% versus 51.7%, NA2/NA2 16.9% versus 22.3%, respectively. The gene frequencies of NA1 allele were 0.56 in the SLE and 0.52 in controls, respectively. Among clinical manifestations, thrombocytopenia was more common in FcgammaRIIIB NA2/NA2 genotype (P = 0.04, OR 2.4, 95% CI 1.0-5.4), and NA2 allele (P = 0.03, OR 1.7, 95% CI 1.1-2.8). Although FcgammaRIIIB polymorphism was not associated with the development of SLE in Korean, thrombocytopenia was associated with FcgammaRIIIB NA2/NA2 genotype, and NA2 allele.
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Affiliation(s)
- C H Hong
- Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea
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Abstract
We report a case with protruding inguinal masses for 6 months, in whom muscular amyloidoma was not suspected before muscle biopsy. On pelvic magnetic resonance imaging (MRI), round masses showing peripheral rim enhancement with gadolinium were observed in iliopsoas and iliacus muscles of both inguinal areas. The same lesions were also observed in gluteus muscles. The biopsy showed Congo red positive materials in a dense fibrous background. Serum and urine electrophoresis showed Bence Jones protein, lambda type. In bone marrow section, myeloma cells were found. Peripheral blood stem cell transplantation (PBSCT) following four cycles of VAD (vincristine, adriamycin, dexamethasone) chemotherapy was performed and the result was satisfactory. Amyloidoma lesions decreased in size and number on the following MRI.
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Affiliation(s)
- C I Joung
- Department of Rheumatology, Konyang University Hospital, Daejeon, Korea
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Kim SK, Park IK, Park BH, Park W, Lee HS, Kim TH, Jun JB, Bae SC, Yoo DH, Uhm WS. A case report: isolated a heavy chain monoclonal gammopathy in a patient with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin change syndrome. Int J Clin Pract 2005:26-30. [PMID: 15875614 DOI: 10.1111/j.1368-504x.2005.00343.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A 45-year-old South-Korean man presented with abdominal distension, progressive paresthesia and motor weakness of both lower extremities. Our case was identified as polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin change (POEMS) syndrome based on diagnostic criteria. Circulating M components of POEMS syndrome consist mainly of IgG or IgA-lambda and rarely IgM-lambda, IgG-kappa or isolated light chains. In this case, the M-band on serum protein electrophoresis and isolated IgA heavy chain on serum immunofixation electrophoresis were demonstrated, but there was no abnormal light chain. We suggest that this case may be associated with a pattern of abnormal secretion of monoclonal protein or a coincidence of a heavy chain disease in POEMS syndrome, even though the latter possibility may be very rare.
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Affiliation(s)
- S K Kim
- Department of Internal Medicine, The Hospital for Rheumatic Diseases, Seoul, South Korea
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Abstract
Macrophagic myofasciitis (MMF) is known to be closely associated to vaccination containing aluminium as an adjuvant. Here we describe a case of MMF unrelated to vaccination, and presented as focal tender muscle in a 59-year-old woman. Magnetic resonance imaging showed evidence of unilateral myofasciitis involving muscles and fascias of the vastus lateralis. Open biopsy showed a unique pathological pattern of MMF. Our case suggests that other causes unrelated to vaccination need to be investigated in the pathogenesis of MMF, and MMF could be considered in the differential diagnosis of patients with focal muscle tenderness.
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Affiliation(s)
- J H Park
- Department of Internal Medicine, Division of Rheumatology, Hanyang University College of Medicine, Hospital for Rheumatic Diseases, Seoul, Korea
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Kang CP, Lee KW, Yoo DH, Kang C, Bae SC. The influence of a polymorphism at position -857 of the tumour necrosis factor gene on clinical response to etanercept therapy in rheumatoid arthritis. Rheumatology (Oxford) 2005; 44:547-52. [PMID: 15695296 DOI: 10.1093/rheumatology/keh550] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We aimed to test whether polymorphisms in the etanercept target genes TNFA and LTA are associated with clinical responses to etanercept therapy in RA patients. METHODS Clinical responses of 70 patients treated with etanercept were determined according to the ACR criteria. We genotyped 13 single-nucleotide polymorphisms (SNPs) within TNFA and LTA and tested whether they influenced the responses to 12 weeks of etanercept therapy. Univariate and multivariate analyses were performed to compare allele, genotype and haplotype distributions between responders and non-responders. RESULTS Association of the -857C/T SNP at the TNFA promoter was marginally significant when patients were divided into responders and non-responders according to improvement criteria ACR20 or ACR70. When ACR70 responders (the best responders) were compared with ACR20 non-responders (the worst responders), however, the association was prominent [odds ratio (OR) = 12, 95% confidence interval (CI) = 1.4-105, P = 0.0077, P(corrected) = 0.054], as the frequency of the T allele was 5% in the ACR20 non-responders but 39% in the ACR70 responders. Moreover, the ratio of ACR70 responder number to ACR20 non-responder number among T-allele carriers was >10-fold higher than in the C-allele homozygotes (OR = 12, 95% CI = 1.2-120, P = 0.033). CONCLUSIONS RA patients with the T allele of TNFA -857C/T SNP respond better to etanercept therapy than homozygotes for the C allele, indicating that, when the results have been confirmed, this SNP could become a useful genetic marker for predicting responses.
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Affiliation(s)
- C P Kang
- Department of Biological Sciences, Korea Advanced Institute of Science and Technology, Yuseong-gu, Daejeon, Korea.
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Park YW, Ji JD, Lee JS, Ryang DW, Yoo DH. Actinomycin D renders cultured synovial fibroblasts susceptible to tumour necrosis factor related apoptosis-inducing ligand (TRAIL)-induced apoptosis. Scand J Rheumatol 2004; 32:356-63. [PMID: 15080267 DOI: 10.1080/03009740410005025] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the expression of tumour necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) receptors in cultured synovial fibroblasts from rheumatoid arthritis (RA) and osteoarthritis (OA) patients, and to examine their susceptibility to TRAIL-induced apoptosis in the presence or absence of metabolic inhibitors. METHODS The expression of TRAIL receptors in synovial fibroblasts was examined by Western blot and immunohistochemistry. Expression of TRAIL-receptor 1 (TRAIL-R1), FLICE-inhibitory protein (Fas-associating protein with death domain-like interleukin-1-converting enzyme), and Bcl-2 was assessed by Western blot. Synovial cell viability was measured by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide assay (XTT), and apoptosis was determined both by DNA content analysis after propidium iodide staining and Annexin V stain. RESULTS TRAIL-R1 was constitutively expressed on cultured synovial fibroblasts from RA and OA, however, expression of TRAIL-R2 and TRAIL-R3 was not observed by immunohistochemistry and Western blot. Cultured synovial fibroblasts were resistant to apoptosis by TRAIL alone, but combined treatment of TRAIL with actinomycin D (ActD: 200 ng/mL), cycloheximide (CHX: 10 microg/mL), or proteasome inhibitor (MG132: 20 microM) induced apoptosis in a dose-dependent manner. The apoptosis was completely or partially inhibited by various caspase inhibitors, implicating an involvement of caspase pathway in TRAIL-induced apoptosis in the presence of these metabolic inhibitors. Expression of TRAIL-R1, FLIPL, and Bcl-2 did not account for the apoptosis by the combined treatment of TRAIL with ActD. CONCLUSIONS Although TRAIL-R1 was constitutively expressed; cultured synovial fibroblasts were resistant to apoptosis by TRAIL. ActD, CHX, and MG132 rendered cultured synovial fibroblasts susceptible to TRAIL-induced apoptosis by a caspase-dependent mechanism. However, the exact mechanism of sensitization by these metabolic inhibitors remains to be determined.
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Affiliation(s)
- Y W Park
- Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Yim SY, Lee IY, Lee JH, Jun JB, Kim TH, Bae SC, Yoo DH. Quality of marital life in Korean patients with spondyloarthropathy. Clin Rheumatol 2004; 22:208-12. [PMID: 14505212 DOI: 10.1007/s10067-003-0700-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2002] [Accepted: 11/16/2002] [Indexed: 01/28/2023]
Abstract
The objectives of this study were to assess the quality of marital life (QML) in patients with spondyloarthropathy (SpA) in Korea and to identify possible gender differences in QML in patients with SpA. This was a case-control study at the outpatient unit of a tertiary care medical centre. Subjects were the patient group, composed of 47 married patients with SpA, and a comparison group composed of 47 healthy married adults with similar demographic characteristics. QML was measured using the Marital Satisfaction Inventory, Revised. As a result, QML was similar for both the male patients and the healthy men. However, the female patients had higher scores on the global distress scale (59.8 +/- 6.3 vs. 53.8 +/- 5.6, P=0.021) and the aggression scale (50.5 +/- 7.9 vs. 44.3 +/- 5.4, P=0.016) than the female comparison group. At the same time, the female patients demonstrated higher scores on the global distress scale (59.8 +/- 6.3 vs. 54.7 +/- 7.2, P=0.035) than the male patients. In conclusion, QML in Korean males with SpA was not greatly different from that of the male comparison group. However, QML in the female patients was characterised by higher global distress and a higher probability of aggression from their partner, but no significant sexual dissatisfaction.
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Affiliation(s)
- S Y Yim
- Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea
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Chang HK, Kim JU, Lee SS, Yoo DH. Lack of association between angiotensin converting enzyme gene polymorphism and Korean Behçet's disease. Ann Rheum Dis 2004; 63:106-7. [PMID: 14672905 PMCID: PMC1754730 DOI: 10.1136/ard.2003.011007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jang IS, Ko YH, Yang HY, Ha JS, Kim JY, Kim JY, Kang SY, Yoo DH, Nam DS, Kim DH, Lee CY. Influence of Essential Oil Components on Growth Performance and the Functional Activity of the Pancreas and Small Intestine in Broiler Chickens. Asian Australas J Anim Sci 2004. [DOI: 10.5713/ajas.2004.394] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lee HS, Chung YH, Kim TG, Kim TH, Jun JB, Jung S, Bae SC, Yoo DH. Independent association of HLA-DR and FCgamma receptor polymorphisms in Korean patients with systemic lupus erythematosus. Rheumatology (Oxford) 2003; 42:1501-7. [PMID: 12867584 DOI: 10.1093/rheumatology/keg404] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine the distribution of HLA-DR type and FcgammaRIIa/IIIa polymorphisms, and to analyse the combined effects of these genes for susceptibility in Korean systemic lupus erythematosus (SLE) patients. METHODS A total of 299 SLE patients meeting 1982 ACR criteria and 144 Korean disease-free controls were enrolled. Genotyping for the FcgammaRIIa 131 R/H and FcgammaRIIIa 176 F/V was performed by polymerase chain reaction (PCR) of genomic DNA using allele-specific primers. HLA-DRB1 typing was performed by the PCR-SSOP method. RESULTS There was significant skewing in the distribution of the three FcgammaRIIa genotypes between the SLE patients and the controls [P = 0.002 for R/R131 vs R/H131 and H/H131, relative risk (RR) 2.6 (95% CI 1.3-5.2)], but not in FcgammaRIIIa genotypes. HLA-DRB1*15 allele was significantly more prevalent among SLE patients than the control population [P < 0.02, RR = 1.7 (1.1-2.6)]. HLA-DRB1 genotypes or allele frequencies of the SLE patients with nephritis did not differ significantly from those of the SLE patients without nephritis. We analysed the combined effects of the two candidate genes on SLE susceptibility. HLA-DRB1*15 allele was a significant predictor of SLE in individuals who were not homozygous for FcgammaRIIa-R/R131 [RR = 2.1 (1.2-3.7), P < 0.008], and the FcgammaRIIa-R/R131 genotype vice versa [RR = 5.3 (1.9-15.4), P < 0.001]. However, an additive or synergistic effect of both susceptible genes on relative risk for SLE was not evident. CONCLUSIONS Our results suggest that FcgammaRIIa-R/R131 homozygote and HLA-DRB1*15 allele are independent risk factors in Korean SLE patients without additive or synergistic effects.
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Affiliation(s)
- H S Lee
- Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Joung CI, Lee HS, Lee SW, Kim CG, Song YH, Jun JB, Chung WT, Choe JY, Kim TG, Yoo DH. Association between HLA-DR B1 and clinical features of adult onset Still's disease in Korea. Clin Exp Rheumatol 2003; 21:489-92. [PMID: 12942703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVE To determine whether HLA-DR alleles are associated with the development and clinical features of Adult Onset Still's Disease (AOSD) in Korea. METHODS Forty-seven patients (41 women, 6 men, mean age at diagnosis 31.6 yr) meeting Yamaguchi's criteria for AOSD and 144 healthy controls were enrolled in this study. The patients with AOSD were subdivided into groups according to their chronicity: monocyclic systemic, polycyclic systemic, and chronic destructive type, and were furthermore classified as non-articular, oligoarticular or polyarticular types (having arthritis involving 5 or more joints) according to the extent of articular involvement. HLA-DRB1 genotypes were assessed by PCR-SSOP. RESULTS Patients with AOSD had more frequent DRB1*12 (p = 0.028, relative risk (RR) = 2.27, 95% confidence interval (CI): 1.08-4.80) and DRB1*15 (p = 0.013, RR = 2.16, 95% CI: 1.17-4.00). They had less frequent DRB1*04 (p = 0.006, RR = 0.35, 95% CI: 0.16-0.75) compared to controls. DRB1*14 (p = 0.011, RR = 3.80, 95% CI: 1.27-11.31) were associated with the monocyclic systemic type. CONCLUSION Korean AOSD patients had more frequent DRB1*12 and DRB1*15, and less frequent HLA-DRB1*04. The patients with the monocyclic systemic type had more frequent DRB1*14 alleles. This study suggests that Korean AOSD patients have distinct immunogenetic profiles, and that it would be valuable to assess the relationships between HLA-DRB1 genes and polymorphisms of proinflammatory cytokines in the pathogenesis of AOSD.
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Affiliation(s)
- C I Joung
- Division of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Uhm WS, Lee HS, Chung YH, Kim TH, Bae SC, Joo KB, Kim TY, Yoo DH. Angiotensin-converting enzyme gene polymorphism and vascular manifestations in Korean patients with SLE. Lupus 2003; 11:227-33. [PMID: 12043886 DOI: 10.1191/0961203302lu174oa] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Systemic lupus erythematosus (SLE) is an inflammatory multisystem disease of unknown etiology with immunologic aberrations. Many studies have shown that genetic and environmental factors are implicated in the development of SLE. Angiotensin-converting enzyme (ACE) affects various immune phenomena through the renin-angiotensin and kallikrein-kininogen systems by creating angiotensin II and inactivating bradykinin. We investigated the correlation between insertion/ deletion polymorphism of the ACE gene and the clinical manifestations of SLE, especially vascular involvement and lupus nephritis. Two-hundred and eleven Korean patients fulfilling the ACR criteria and 114 healthy subjects were enrolled. The ACE genotype was determined by polymerase chain reaction using genomic DNA from peripheral blood. The nephritis patients were classified by the WHO classification. In addition, the activity and chronicity index were used to assess the severity of renal involvement. We evaluated vascular involvement by the presence or absence of hypertension, Raynaud's phenomenon, livedo reticularis, antineutrophil cytoplasmic antibody and the SLICC/ACR Damage Index. The gene frequency of ACE gene polymorphism was as follows: II 39 vs 34%, ID 41 vs 50%, DD 20 vs 16% in SLE patients and controls, respectively. There was no difference in genotype frequency between both groups. There were no significant differences between the distribution of ACE gene genotypes and lupus nephritis and its related parameters, including WHO classification, activity index, chronicity index, renal dysfunction and amount of 24 h urinary protein. The ACE genotypes and alleles did not affect the presence of vascular manifestations evaluated, but the frequency of DD genotype was significantly low in SLE patients with Raynaud's phenomenon compared to those without Raynaud's phenomenon (P = 0.002 for ACE ID vs DD and II, OR 2.7, 95% CI 1.43-5.09; P=0.023 for ACE DD vs ID and II, OR 0.33, 95% CI 0.12-0.89). Also skewing from DD to II genotype was noted in patients with anti-Sm antibody compared to those without anti-Sm antibody (P = 0.025 for ACE DD vs ID and II, OR 0.21, 95% CI 0.05-0.93). The onset age of serositis was older in patients with the ID genotype than the others (ID= 34.5+/-10.8, II + DD = 25.6+/-10.2, P= 0.002). Also the onset age of malar rash was older in patients with II genotype than the others (II=26.7+/-8.4, ID+DD=21.3+/-9.0; P=0.021). The patients with I allele showed a significantly higher frequency of serositis (P = 0.022). Taken together, the I/D polymorphisms of ACE gene did not affect susceptibility of SLE, lupus nephritis and the vascular manifestations, including Raynaud's phenomenon, in Korean SLE patients, although the DD genotype was negatively associated with Raynaud's phenomenon among SLE patients. However, it would be valuable to evaluate the role of other genes potentially related to vascular events, such as endothelin, nitric oxide or angiotensin II receptor as well as ACE gene.
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Affiliation(s)
- W S Uhm
- The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Cheon H, Yu SJ, Yoo DH, Chae IJ, Song GG, Sohn J. Increased expression of pro-inflammatory cytokines and metalloproteinase-1 by TGF-beta1 in synovial fibroblasts from rheumatoid arthritis and normal individuals. Clin Exp Immunol 2002; 127:547-52. [PMID: 11966774 PMCID: PMC1906321 DOI: 10.1046/j.1365-2249.2002.01785.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Transforming growth factor (TGF)-beta1 is expressed abundantly in the rheumatoid synovium. In this study, the inflammatory effect of TGF-beta1 in rheumatoid arthritis (RA) was investigated using cultured fibroblast-like synoviocytes (FLS) from RA and osteoarthritis (OA) patients, as well as non-arthritic individuals. mRNA expressions of IL-1beta, tumour necrosis factor (TNF)-alpha, IL-8, macrophage inflammatory protein (MIP)-1alpha and metalloproteinase (MMP)-1 were increased in RA and OA FLS by TGF-beta1 treatment, but not in non-arthritic FLS. Enhanced protein expression of IL-1beta, IL-8 and MMP-1 was also observed in RA FLS. Moreover, TGF-beta1 showed a synergistic effect in increasing protein expression of IL-1beta and matrix metalloproteinase (MMP)-1 with TNFalpha and IL-1beta, respectively. Biological activity of IL-1 determined by mouse thymocyte proliferation assay was also enhanced by 50% in response to TGF-beta1 in the culture supernatant of RA FLS. DNA binding activities of nuclear factor (NF)-kappaB and activator protein (AP)-1 were shown to increase by TGF-beta1 as well. These results suggest that TGF-beta1 contributes for the progression of inflammation and joint destruction in RA, and this effect is specific for the arthritic synovial fibroblasts.
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Affiliation(s)
- H Cheon
- Department of Biochemistry, Korea University College of Medicine, Sungbuk-Gu, Seoul
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Yun JE, Lee SW, Kim TH, Jun JB, Jung S, Bae SC, Kim TY, Yoo DH. The incidence and clinical characteristics of Mycobacterium tuberculosis infection among systemic lupus erythematosus and rheumatoid arthritis patients in Korea. Clin Exp Rheumatol 2002; 20:127-32. [PMID: 12051389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVES The aim of this study was to describe the incidence and clinical characteristics of Mycobacterium tuberculosis infection in SLE and RA patients in Korea where the prevalence rate of active pulmonary tuberculosis in a general population is relatively higher than in Western countries. PATIENTS We reviewed the medical records of 283 SLE and 284 RA patients retrospectively and then assessed the incidence, risk factors, and clinical characteristics of active tuberculous infection. We then compared the results for the two different groups. RESULTS Tuberculosis was documented in 15 SLE and 7 RA patients with an incidence rate of 7.9/1,000 patient-years and 2.3/1,000 patient-years, respectively (p = 0.003). SLE-associated tuberculosis cases included 3 of miliary tuberculosis, 7 of pulmonary tuberculosis (including 1 case of diffuse pulmonary involvement with meningitis) predominantly involving two or more lobes at the mid-/lower lungfield, and 5 extra-pulmonary forms (joint, bone, kidney, larynx, pleura). All of the RA-associated tuberculosis cases were pulmonary forms with the majority being localized to single lobe, and only one case had a past history of tuberculosis, whereas a past history of tuberculosis and a longer duration of the underlying disease were significantly correlated with the development of tuberculosis in the SLE patients. Major organ involvement, the mean daily dosage of prednisolone, and a history of over 30 mg of daily prednisolone were not related to the development of tuberculosis. However, when we took only those patients taking corticosteroid until the diagnosis of tuberculosis for analysis, SLE patients with tuberculosis showed a higher daily dosage of prednisolone than those without tuberculosis. CONCLUSION Taken together, the characteristics of tuberculosis in SLE patients were: (1) a higher incidence rate, (2) more frequent extra-pulmonary involvement, (3) more extensive pulmonary involvement, and (4) a higher relapse rate than in rheumatoid arthritis. Thus, the contributory role of M. tuberculosis infection in the morbidity and mortality of patients with SLE must be emphasized, especially in areas in which this bacteria is endemic.
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MESH Headings
- Adolescent
- Adult
- Aged
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/epidemiology
- Arthritis, Rheumatoid/microbiology
- Female
- Humans
- Incidence
- Korea/epidemiology
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/epidemiology
- Lupus Erythematosus, Systemic/microbiology
- Male
- Middle Aged
- Mycobacterium Infections, Nontuberculous/complications
- Mycobacterium Infections, Nontuberculous/diagnosis
- Mycobacterium Infections, Nontuberculous/epidemiology
- Retrospective Studies
- Risk Factors
- Tuberculosis, Pulmonary/complications
- Tuberculosis, Pulmonary/diagnosis
- Tuberculosis, Pulmonary/epidemiology
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Affiliation(s)
- J E Yun
- The Hospital for Rheumatic Diseases, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
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Abstract
This case illustrates a young man with an 11 y history of systemic lupus erythematosus who developed lupus flare after a 9-month use of growth hormone (GH) for the treatment of growth retardation. The course of disease was improving after GH cessation and treatment with high dose corticosteroids and intravenous cyclophosphamide pulse therapy.
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Affiliation(s)
- Y S Bae
- Department of Internal Medicine, Hanyang University College of Medicine and the Hospital for Rheumatic Diseases, Seoul, Korea
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Yun HR, Koh HK, Kim SS, Chung WT, Kim DW, Hong KP, Song GG, Chang HK, Choe JY, Bae SC, Salmon JE, Yoo DH, Kim TY, Kim SY. FcgammaRIIa/IIIa polymorphism and its association with clinical manifestations in Korean lupus patients. Lupus 2002; 10:466-72. [PMID: 11480843 DOI: 10.1191/096120301678416015] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this study was to determine the distribution of the FcgammaRlla and FcgammaRIIIa polymorphisms and their association with clinical manifestations in Korean lupus patients. Three hundred SLE (systemic lupus erythematosus) patients (48 male, 252 female) meeting 1982 ACR criteria and 197 Korean disease-free controls were enrolled. Genotyping for FcgammaRlla 131 R/H and FcgammaRIIIa 176 F/V was performed by PCR of genomic DNA using allele-specific primers and the FcgammaRIIIa genotype was confirmed by direct sequencing of PCR product in some cases. There was significant skewing in the distribution of the three FcgammaRIIa genotypes between the SLE and the controls (P=0.002 for R/R131 vs R/H131 and H/H131, OR 2.5 (95% Cl 1.4-4.5), but not in FcgammaRIIIa genotypes. FcgammaRIIa-R allele was a significant predictor of lupus nephritis, as compared with SLE patients without nephritis (P=0.034 for R131 vs H131, OR 1.4 (95% Cl 1.03-1.9)), but proliferative nephritis (WHO class III and IV) was less common in patients with FcgammaRlla-R/R131 and in FcgammaRIIa-R allele. In 300 SLE patients, high binding allele combination H131/V176 was less common in SLE with nephritis than in SLE without nephritis. Hemolytic anemia was less common in R131/F176 allele combination among four FcgammaRIIa/FcgammaRIIIa allelic combinations. Male SLE patients showed a higher frequency of renal involvement, serositis, thrombocytopenia, malar rash and discoid rash than female SLE, and male SLE had a higher frequency of FcgammaRIIa-R/R131 or R131-allele than male controls, but FcgammaRIIa or FcgammaRIIIa genotypes had no association with renal involvement in male SLE patients. FcgammaRIIa-H/H131 showed a higher frequency of hemolytic anemia and less pulmonary complications in male SLE. Female SLE patients showed higher frequency of any hematologic abnormality, lymphopenia, anticardiolipin antibody (+) and anti-Ro antibody (+) than male SLE, and had earlier onset of first symptoms. There was no skewing in FcgammaRIIa or FcgammaRIIIa genotypes between female SLE and female controls, but FcgammaRIIa-R131 allele showed skewing between female SLE with nephritis and female SLE without nephritis. The age at onset of thrombocytopenia was earlier in FcgammaRIIa R/R131 among three FcgammaRIIa genotypes, and serositis in FcgammaRIIIa-F/F176 among three FcgammaRIIIa genotypes. FcgammaRIIa-R131 homozygote was a major predisposing factor to the development of SLE and FcgammaRIIa-RI31 homozygote and R131 allele were a predisposing factor, and H131/V176 was a protective allele combination in lupus nephritis. In contrast to other ethnic patients, in our study cohort, clinical manifestation was different between male and female, and FcgammaRIIa and FcgammaRIIIa showed somewhat different clinical associations between the genders.
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Affiliation(s)
- H R Yun
- Division of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Ji JD, Cheon H, Jun JB, Choi SJ, Kim YR, Lee YH, Kim TH, Chae IJ, Song GG, Yoo DH, Kim SY, Sohn J. Effects of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) on the expression of inflammatory cytokines and apoptosis induction in rheumatoid synovial fibroblasts and monocytes. J Autoimmun 2001; 17:215-21. [PMID: 11712859 DOI: 10.1006/jaut.2001.0542] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study was performed to investigate whether peroxisome proliterator-activated receptor-gamma (PPAR-gamma) exerted an anti-inflammatory effect on rheumatoid synovial cells and inhibited dysregulated proliferation. The expression of PPAR-gamma mRNA in cultured human synoviocytes and THP-1 cells was analysed by RT-PCR. PPAR-gamma was expressed in normal, osteoarthritis (OA), rheumatoid arthritis (RA) synovial cells as well as a human monocytic cell line, THP-1. In RA and OA synoviocytes, the induction of inflammatory cytokine mRNA expression such as TNF-alpha and IL-1beta was significantly inhibited by the natural PPAR-gamma agonist, 15 deoxy-Delta(12,14)prostaglandin J(2)(15d-PGJ(2)). The effect of PPAR-gamma on the nuclear factor (NF)-kappaB activity was tested by electrophoretic mobility shift assay (EMSA). Both troglitazone and 15d-PGJ(2)markedly inhibited TNF-alpha-induced NF-kappaB activation at 30 microM. However, PPAR-gamma agonist neither reduced proliferation nor induced apoptosis in RA synoviocytes when measured by XTT assay and fluorescence activated cell sorter (FACS) analysis. In contrast, it induced apoptosis in a dose-dependent manner in THP-1 cells and augmented TNF-related apoptosis-inducing ligand (TRAIL)-induced apoptosis as well. In conclusion, these data demonstrate that PPAR-gamma is expressed in human synoviocytes and THP-1 cells, and the PPAR-gamma activation inhibits expression of inflammatory cytokines in RA synoviocytes. Furthermore, PPAR-gamma activation induces apoptosis by itself and augments TRAIL/Apo2L-induced apoptosis in THP-1 cells. These results suggest that PPAR-gamma agonists may provide a new therapeutic approach for RA.
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Affiliation(s)
- J D Ji
- Department of Biochemistry, Korea University College of Medicine, Sungbuk-Gu, Seoul, Korea
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Bae SC, Lee HS, Yun HR, Kim TH, Yoo DH, Kim SY. Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis Cartilage 2001; 9:746-50. [PMID: 11795994 DOI: 10.1053/joca.2001.0471] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Our aims were to translate WOMAC and Lequesne osteoarthritis (OA) indices into Korean (KWOMAC, KLequesne) and confirm their reliability, validity, and responsiveness. DESIGN The WOMAC and Lequesne indices were translated into Korean by three translators and translated back into English by three different translators. Fifty consecutive patients with OA were asked to rate the comprehensibility of the questions on a 4-point scale. The comprehensibility (responding with 'good' and 'very good') ranged from 78% to 99%. Test-retest was performed in another 47 patients with knee OA. The final 53 patients with knee OA, within the context of a clinical trial of two non-steroidal antiinflammatory drugs for 4 weeks, were studied to assess the internal consistency, construct validity, and responsiveness of the Korean versions. RESULTS The test-retest reliability of the KWOMAC 3 subscales and the KLequesne yielded intraclass correlation coefficients of 0.79-0.89 and 0.87. The Cronbach standardized alphas were 0.81-0.96 and 0.75, respectively. For the construct validity, the correlation coefficients of both the KWOMAC subscales and the KLequesne with patient pain assessment and patient global assessment were between 0.30 and 0.70 and the KWOMAC subscales correlated with the KLequesne (0.41-0.55). For responsiveness, the KWOMAC and KLequesne scores significantly improved by 4-week post-treatment compared with pre-treatment; effect size values were between 0.41 and 0.69 for the KWOMAC subscales and 0.70 for the KLequesne; and the relative efficiency values of the KWOMAC subscales vs the KLequesne were between 0.87 and 0.90. CONCLUSIONS The reliability, validity, and responsiveness of the KWOMAC and the KLequesne are confirmed.
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Affiliation(s)
- S C Bae
- The Department of Internal Medicine, Division of Rheumatology, Hanyang University College of Medicine and The Hospital for Rheumatic Diseases, Seoul, Korea.
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Chang DK, Yoo DH, Kim TH, Jun JB, Lee IH, Bae SC, Kim IS, Kim SY. Induction of remission with intravenous immunoglobulin and cyclophosphamide in steroid-resistant Evans' syndrome associated with dermatomyositis. Clin Rheumatol 2001; 20:63-6. [PMID: 11254245 DOI: 10.1007/s100670170107] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Evans' syndrome is characterised by the simultaneous or sequential occurrence of Coombs'-positive haemolytic anaemia (AIHA) and immune thrombocytopenia without underlying aetiology. It has been found to be associated with collagen vascular diseases, especially systemic lupus erythematosus (SLE) and scleroderma. However, Evans' syndrome with dermatomyositis is very rare. A 59-year-old woman, who had been taking high-dose prednisolone for a month and cyclosporin for 10 days for dermatomyositis, developed purpura on the left popliteal fossa. The platelet and haemoglobin levels decreased to 77,000/mm3 and 9.8 g/dl, respectively. Antiplatelet antibody was positive. Thrombocytopenia responded to intravenous immunoglobulin (IVIG) for a short time, but further decreased in a week. Her blood film showed features of haemolytic anaemia. Laboratory findings showed reticulocytosis and a positive direct Coombs' test. Bone marrow examination showed a mild hyperplasia of erythroid precursors and megakaryocytes. The patient was successfully treated with cyclophosphamide in addition to oral prednisolone. AIHA in connective tissue disease may develop gradually and show a benign clinical course in most patients. Therefore, we suggest that patients with dermatomyositis and anaemia should always be checked for haemolysis if there is no other explanation.
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Affiliation(s)
- D K Chang
- Hospital for Rheumatic Diseases, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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Chang DK, Yoo DH, Kim TH, Kim IS, Jun KY, Park MH, Kim SY. Burkitt's lymphoma presenting as ileocaecal intussusception in systemic lupus erythematosus. Clin Rheumatol 2001; 18:253-6. [PMID: 11206354 DOI: 10.1007/s100670050095] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Patients with systemic lupus erythematosus (SLE) are reported to have an increased risk of malignancy, especially lymphoproliferative disorders. We decribe the occurrence of ileocaecal intussusception secondary to Burkitt's lymphoma in a patient with SLE. A 23-year-old woman, who had been diagnosed with SLE 2 years ago, developed intermittent abdominal pain with a palpable mass. Computed tomography and a double-contrast barium enema showed a lobulated mass with intussusception at the ileocaecal junction. Right hemicolectomy and splenectomy was performed after histopathological examinations on colonoscopic biopsy revealed Burkitt's lymphoma. Fourteen months after chemotherapy, there is no evidence of recurrence of the Burkitt's lymphoma. When a patient with SLE has abdominal complaints, besides serositis, lupus enteritis such as peptic ulcer disease, mesenteric vasculitis with or without complications and pancreatitis, we have to consider intussusception secondary to gastrointestinal lymphoma as one of the differential diagnoses. Therefore, we should thoroughly investigate patients with SLE presenting with abdominal pain and not simply consider it afeature of lupus enteritis until other causes have been ruled out.
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Affiliation(s)
- D K Chang
- The Hospital for Rheumatic Diseases, Division of Rheumatology, Hanyang University College of Medicine, Seoul, Korea
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Abstract
We undertook this study to demonstrate the pattern of onset and the course of arthritis on the traumatised joint in spondyloarthropathy (SpA) initiated by physical trauma. Among 288 patients with SpA, 12 (4.2%) whose arthropathies were associated with trauma were reviewed retrospectively. There were seven patients with ankylosing spondylitis (AS), three with juvenile onset AS and two undifferentiated SpA. The type of trauma was direct injury to the joint and injuries at other sites, except in spinal surgery, for example. In eight cases the initial evidence of disease was peripheral arthritis. The disease first occurred in traumatised joints in five cases. Only three cases showed recurrent inflammatory episodes in the traumatised joints throughout the disease course. SpA initiated by trauma initially manifested as peripheral arthritis at the traumatised joints in about half of the cases. Inflammatory episodes preferentially involved other joints apart from the traumatised joints throughout the whole course of the disease.
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Affiliation(s)
- J B Jun
- Division of Rheumatology, The Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea.
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Oh YB, Jun JB, Kim CK, Lee CW, Park CK, Kim TY, Yoo DH, Kim SY. Mixed connective tissue disease associated with skin defects of livedoid vasculitis. Clin Rheumatol 2001; 19:381-4. [PMID: 11055828 DOI: 10.1007/s100670070032] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 21-year-old woman who had a 2-year history of mixed connective tissue disease (MCTD) developed rapidly evolving ulcers consistent with livedoid vasculitis (LV) in all distal extremities. She presented clinically with Raynaud's phenomenon, polyarthritis and swollen hands; serologically with high titres of ANA and anti-nRNP; and immunogenetically with HLA-DR4 and HLA-DR53. Although there was initial success in treatment except for the skin defects over the ankles, the patient died from disseminated intravascular coagulation. We suggest that LV may be a poor prognostic manifestation in MCTD.
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Affiliation(s)
- Y B Oh
- Department of Rheumatic diseases, Tong-inchon Ghil Hospital, Inchon, Korea
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Yun HR, Yoo DH, Lee HS, Kim TH, Ahn MH, Min DY, Park MH, Kim SY. Fatal strongyloides hyper-infection in a patient with rheumatoid arthritis. Clin Exp Rheumatol 2001; 19:224. [PMID: 11326491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Jeong YS, Jun JB, Kim TH, Lee IH, Bae SC, Yoo DH, Park MH, Kim SY. Successful treatment of protein-losing enteropathy due to AA amyloidosis with somatostatin analogue and high dose steroid in ankylosing spondylitis. Clin Exp Rheumatol 2000; 18:619-21. [PMID: 11072606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Secondary amyloidosis is an occasional complication of ankylosing spondylitis (AS) and in most cases renal amyloidosis presents with proteinuria, nephrotic syndrome and decreased renal function. We describe a 32-year-old male patient with AS manifested by frequent diarrhea, intermittent abdominal pain and low serum albumin levels. He has suffered from severe inflammatory back pain for 14 years with multiple peripheral joint involvement. Protein-losing enteropathy due to gastrointestinal amyloidosis was diagnosed with 99mTc-human albumin scintigraphy, fecal alpha-1 antitrypsin clearance and colonoscopic biopsy with Congo red staining. Somatostatin analogue octreotide and prednisolone were introduced with successful result.
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Affiliation(s)
- Y S Jeong
- Division of Rheumatology, Hospital for Rheumatic Diseases, Seoul, Korea
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Oh YB, Bae SC, Jung JH, Kim TH, Jun JB, Jung SS, Lee IH, Yoo DH, Park MH, Kim SY. Secondary renal amyloidosis in adult onset Still's disease: case report and review of the literature. Korean J Intern Med 2000; 15:131-4. [PMID: 10992726 PMCID: PMC4531753 DOI: 10.3904/kjim.2000.15.2.131] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We report a 25-year-old Korean woman with Adult onset Still's disease (AOSD) presented with renal amyloidosis, which had developed four years after disease onset. We successfully treated her with prednisolone, colchicine and cyclophosphamide. A review of the literature uncovered about 10 cases, most of which were treated by various regimens that resulted in poor outcomes. Renal amyloidosis should be suspected in patients with AOSD who have unexplained proteinuria. Although the mechanism of renal amyloid deposition is not well known, earlier histopathologic diagnosis and choice of regimen may affect prognosis.
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Affiliation(s)
- Y B Oh
- Department of Rheumatology, Tong-Inchon Ghil Hospital, Gachon Medical School, Korea
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Jung JH, Jun JB, Shim SC, Kim TH, Jung SS, Lee IH, Bae SC, Yoo DH, Joo KB, Kim SY. A case of parasymphyseal and associated insufficiency fractures of pubic rami in a patient with mixed connective tissue disease. Korean J Intern Med 2000; 15:160-3. [PMID: 10992733 PMCID: PMC4531757 DOI: 10.3904/kjim.2000.15.2.160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Parasymphyseal insufficiency fractures are uncommon. Furthermore, none have been reported in systemic rheumatic diseases other than rheumatoid arthritis. In this article we report on parasymphyseal insufficiency fractures in a patient with mixed connective tissue disease.
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Affiliation(s)
- J H Jung
- Department of Internal Medicine, Eulji University School of Medicine Hospital, Daejon, Korea
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Abstract
Gold salts have been used for many years in the treatment of rheumatoid arthritis. The common side effects are mucocutaneous reactions, but hepatotoxic reaction and isolated neutropenia are rare complications. We report a 62-year-old woman with rheumatoid arthritis who had developed hepatitis and neutropenia simultaneously after receiving 137.5 mg of sodium aurothiomalate.
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Affiliation(s)
- W S Uhm
- Hospital for Rheumatic Diseases, Hanyang University, Seoul, Korea
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Jung JH, Jun JB, Yoo DH, Kim TH, Jung SS, Lee IH, Bae SC, Kim SY. High toxicity of sulfasalazine in adult-onset Still's disease. Clin Exp Rheumatol 2000; 18:245-8. [PMID: 10812499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Sulfasalazine (SSZ) is an anti-rheumatic drug that has been used to treat chronic arthritis. In many reports, the use of SSZ in children with systemic onset juvenile rheumatoid arthritis (JRA) revealed frequent side effects which required discontinuation of the drug. We examined whether there were frequent side effects of SSZ in patients with adult-onset Still's Disease (AOSD). METHODS From July 1990 to April 1998, we followed 41 AOSD patients. Ten were given SSZ for the treatment of arthritis and the side effects were studied. We also studied 109 consecutive patients with RA who had been given SSZ, as a control group. In addition, we retrospectively studied the side effects and efficacy of SSZ in both groups through their medical records. RESULTS Six patients (60%, p < 0.01) with AOSD experienced side effects ranging from mild ones like abdominal pain, nausea and vomiting, urticaria, and facial flushing to severe ones such as high fever, hypotension, and severe myelosuppression as well as fulminant hepatitis, which led to the death of one patient. However, 16 patients (14.7%) with RA stopped using SSZ due to mild side effects such as rash, urticaria, gastrointestinal troubles, mild leukopenia, and fever. Three AOSD patients (30%, p = 0.053) and 15 RA patients (13.8%) stopped using SSZ due to its inefficacy. CONCLUSION We conclude that SSZ appears to have frequent severe side effects in AOSD, as in systemic onset JRA. These potential adverse effects of SSZ should be considered when it is used to treat chronic arthritides with systemic symptoms. Further study of SSZ in the treatment of AOSD in a multi-center, placebo-controlled environment is needed.
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Affiliation(s)
- J H Jung
- Department of Internal Medicine, Eulji Medical College Hospital, Taejon, Korea
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Abstract
Baker's cysts are rare cause of peripheral nerve entrapment and only a few cases of tibial nerve entrapment resulting from the popliteal cyst in the calf muscle have been reported in the literature. We present a case of rheumatoid arthritis complicated by a Baker's cyst with a tibial nerve entrapment. It is important to diagnose a Baker's cyst early and to differentiate it from thrombophlebitis, a popliteal aneurysm, tumor or muscle tear to effect optimal therapy and to obviate a potential neuropathy. Prompt recognition of these cases may save the patients unnecessary procedures and delay in treatment.
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Affiliation(s)
- J H Lee
- Hospital for Rheumatic Diseases, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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Salmon JE, Ng S, Yoo DH, Kim TH, Kim SY, Song GG. Altered distribution of Fcgamma receptor IIIA alleles in a cohort of Korean patients with lupus nephritis. Arthritis Rheum 1999; 42:818-9. [PMID: 10211900 DOI: 10.1002/1529-0131(199904)42:4<818::aid-anr28>3.0.co;2-j] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- J E Salmon
- Hospital for Special Surgery and New York Hospital, Cornell Medical Center, NY, USA
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