The Roles of Intercellular Adhesion Molecule I in T Cell Adhesion Tosynovial Cell in Patients with Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: It has previously been shown that cellular interaction between infiltrating mononuclear cells and synoviocyte are important in the initiation and perpetuation of autoimmune processes in the synovial tissue of patients with rheuamtoid arthritis. Thus, we have investigated the molecular basis of T cell-synovial cell interaction in the cultured synoviocytes from patients with rheumatoid arthritis. METHODS: Using an immunohistochemical staining technique and inhibition study with monoclonal antibody, we studied the expression and the function of intercellular adhesion molecule 1 (ICAM-1) in T cell-synovial cell interaction in the cultured synoviocytes. RESULTS: Expression of ICAM-1 was diffusely observed in most components of rheumatoid synovium and readily up-regulated by IL-1. T cell-synovial cell interaction was inhibited by monoclehal antibody aganinst ICAM-1. CONCLUSION: These results showed that ICAM-1 was involed in the cellular interaction between T lymphocytes and synovial cells in patients with rheumatoid arthritis.

The Effect of Bucillamine of Trace Element Levels of Hair in Patients with Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVES: We investigated the changes of trace element levels in hair of patients with rheumatoid arthritis after bucillamine treatment. METHODS: We performed inductively coupled plasma atomic emission spectrometry in determination of trace element levels in hair of patients with rheumatoid arthritis. RESULTS: The results were as follows: 1) There was a significant increase of copper concentration, but no change in zinc level after bucillamine treatment. 2) There were no significant changes in copper and zinc concentrations between the proximal and distal portions of hair after long-term bucillamine treatment. CONCLUSIONS: Our results showed the significant increase of copper level and no significant change of zinc level in hair after bucillamine treatment, but, although statistically not significant, copper and zinc levels were decreased on experiment with divided hair. So, our findings do not permit any conclusion on the influence of bucillamine on trace element levels in hair. Further studies in large samples and comparison with the effect of D-penicillamine will be necessary to clarify the association of trace element levels in hair of rheumatoid arthritis patients and bucillamine treatment.

A Case Of D-Penicillamine Induced Polymyositis / 대한류마티스학회지

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

A Case Of Primary Biliary Cirrhosis Anteceded By Rheumatoid Arthritis / 대한류마티스학회지

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

Trace Element Levels In Hair As An Indicator For Disease Activity Of Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: Zinc and copper are the second and third most abundant trace elements following iron in the human body. Zinc and copper have important effects on humoral and cell-mediated immunity. In patients with rheumatoid arthritis, it has been reported that serum zinc level is decreased and seurm copper level increased. But no reports are available for the trace element level of hair in patients with rheumatoid arthritis. We studied to investigate the significance of trace element level of hair in rheumatoid arthritis patients, particularly its relation to disease activity. METHODS: The trace element level of hair was estimated in 50 patients with rheumatoid arthritis and 22 osteoarthritis patients by inductively coupled plasma atomic emission spectrometry and was investigate the correlation to various disease activity indices of rheumatoid arthritis. RESULTS:The results were as follows: 1) There was no significant difference in either the zinc or copper level in hair between patients with rheumatoid arthritis and osteoarthritis. 2) No correlation was observed between the zinc or copper level in hair and age or disease duration for rheumatoid arthritis patients. 3) Zinc and copper levels of hair did not correlate with various indices of disease activity in rheumatoid arthritis patients. CONCLUSIONS: Zinc and copper levels of hair in rheumatoid arthritis patients were not different from those of osteoarthritis and did not correlate with disease activity indices. Studies on the effect of antirheumatic drug therapy on trace element level of hair are necessary.

Lymphedema Associated with Rheumatoid Arthritis / 대한류마티스학회지

OBJECTIVE: To investigate the clinical manifestations and causes of upper limb edema in 8 patients with rheumatoid arthritis. METHODS: Eight patients with upper limb edema in association with rheumatoid arthritis were investigated for their clinical manifestations and assessment of lymphatic function with lymphoscintigrphy. In lymphoscintigraphy, 99mTc-Human serum albumin((0.3ml, 1.0mci) was injected subcutaneously into the second web space of each hand. Images were obtained over injetion site and both axillary regions at Ohr and 2hr post-injection. The visualization of axillary lymph node and the percentage uptake of isotope in the axillary regions were evaluated. RESULTS: All patients except one have unilateral upper limb edema and showed no relation between lymphedema and either activity or duration of arthritis. Six of eight cases were found to have impaired lymph drainage and two cases showed normal lymphatic function. CONCLUSION: This study describes lymphedema in patients with rheumatoid arthritis due to impaired lymphatic function and a relatively rapid production of interstitial fluid.