Relationship between Red Blood Cell Distribution Width and Severity of Rheumatiod Arthritis / 现代检验医学杂志

Objective To investigate the relationship between red blood cell distribution width(RDW) and disease degree of aheumatiod arthritis(RA).Methods Selected 102 RA patients in Department of Rheumatology,the First Affilicated Hospital of Yangtze University from January 2013 to December 2016,and collected the clinical datas and the levels of RDW,erythrocyte sedimentation rate (ESR),high-sensitivity C-reactive protein (hs-CRP) and rheumatoid factor (RF).The patients were divided into high inflammatory and low inflammatory groups on the basis of ESR (40 mm/h) and hs-CRP (5 mg/L),and also were divided into nonanemic and anemic groups on the basis of HB (110 g/L).The differences of various factors among groups were evaluated by t test and relations between various factors were evaluated by Spearman correlation analysis.Results ①The levels of ESR,hs-CRP and RF were very high in RA patients.②RDW and RF levels were higher but HB and RBC were lower in high inflammatory groups than in low inflammatory (P＜0.05).RDW,RF,ESR and hs-CRP levels in anemic groups were higher than in nonanemic groups (P＜0.05).③RDW was significantly associated with ESR,hs CRP and RF in all RA patients,but was no associated with ESR,hs-CRP and RF in nonanemic groups.Conclusion RDW was associated with the severity of disease and inflammatory factors in RA,but the relationship may be affected by anemia.

Comparison of the Disease Activity Score-28 Based on the Erythrocyte Sedimentation Rate and C-reactive Protein in Rheumatoid Arthritis

OBJECTIVE: Assessing the disease activity is a key part of clinical decision-making in rheumatology. In particular, a high disease activity, which is represented by a disease activity score-28 (DAS28) score >5.1, is used as a cutoff value for the use of biologics in many countries, including Korea. This study compared the DAS28-erythrocyte sedimentation rate (ESR) and DAS28-C-reactive protein (CRP) to determine if these indices can be used interchangeably in patients with high disease activity. METHODS: This cross-sectional study enrolled 1,117 patients with rheumatoid arthritis and examined the initial registration data from the Korean Biologics Registry. RESULTS: In general, DAS28-CRP showed an excellent correlation with DAS28-ESR (r2=0.889, p <0.001). On the other hand, DAS28-CRP tended to underestimate the disease activity in those with moderate-to-high disease activity. The best agreement between DAS28-ESR and DAS28-CRP for defining a high disease activity was achieved using a cutoff value of 4.5 for the latter (kappa, 0.68; sensitivity, 85.9%; specificity, 88.1%). CONCLUSION: DAS28-CRP correlates well with DAS28-ESR; however, the cutoff value of the former needs to be reduced to 4.5 if these two indices are to be used interchangeably to define a high disease activity.

The Cementless Total Knee Arthroplasty in Osteoarthritis & Rheumatoid Arthritis / 대한정형외과학회잡지

The results of cementless total knee arthroplasty(TKA) have improved steadly during the past decade due to development of design, fixation and surgical technique. We analyzed the results of 45 total knee arthroplasties performed with Anatomic Modular Knee(AMK) prosthesis at the department of Orthopedic Surgery, Yonsei University College of Medicine between June 1989 and December 1991 and compared their results of rheumatoid arthritis(RA) and osteoarthritis(OA) patients. The follow up ranged from 2 years to 4 years and 2 months (average 2 years and 8 months). Using the Hospital for Special Surgery(H.S.S.) rating system and Knee Society(K.S.) clinical rating system, we found that the clinical results were similar for RA group(Average; H.S.S. 86.1, K.S. 81.2/74.4) and OA group(Average; H.S.S. 88, K.S. 87.8/77.1) even though the preoperative knee score was lower in RA group(Average;H.S.S.42.8) than OA group(Average;H.S.S. 57.7). The average age of RA patients was 14 years younger than that of OA patients. The improvement of range of motin and preoperative flexion contracture after TKA was remarkable in RA group. The radiologic evaluation based on Knee Society roentgenographic evaluation system revealed proper alignment of all component and no definite radiologic loosening except 1 case in which postoperative deep infection had occurred. On the basis of this prospective clinical and radiologic review, we concluded that uncemented implantation of AMK prosthsis both in RA and OA patients was encouraging.

Total Wrist Arthroplasty (Three Cases Report) / 대한정형외과학회잡지

We have performed three total wrist arthroplasty of Meuli type on the dominant wrist of three female patients who have been suffering from the classical rheumatoid arthritis for more than two years, and after follow them for average twenty months postoperatively, we have found, even the complications and reoperation rate after total wrist arthroplasty are reported high in literature, three patients have reasonably satisfied with the remarkable relief of pain and the functional abilities of their wrists. It is our belief, even if the total wrist arthroplasty is also still in controversy, that in those patients with bilateral wrist involvement by the rheumatoid arthritis in whom arthrodesis was done on one wrist, then a total wrist arthroplasty on dominant wrist is a most prefer way to reconstruct the disabled wrists.