A case of rheumatoid arthritis with Sjogren's syndrome presenting as a tonic pupil / 대한내과학회지

Sjogren's syndrome is an autoimmune disease that presents mainly as dry eyes and mouth, and occasionally with extra-glandular symptoms. A peripheral neuropathy is present in 10~30% of the cases with extra-glandular symptoms, although a tonic pupil caused by destruction of the ciliary ganglion is rare. We report a case of rheumatoid arthritis with Sjogren's syndrome presenting as a tonic pupil. A 29-year-old woman was admitted for evaluation of polyarthralgia and a tonic pupil. On physical examination, she had polyarthritis involving the jaws, shoulders, wrists, and hands. Her pupils were anisocoric and did not react to light, but constricted promptly to pilocarpine. Biopsy of the minor salivary gland showed lymphocyte infiltration. Rose-Bengal stain was positive. She was diagnosed with rheumatoid arthritis with Sjogren's syndrome and treated with prednisolone and hydroxychloroquine. Three months later, her polyarthritis had improved markedly, but she still had a tonic pupil.

Gene transfer using liposome-complexed adenovirus seems to overcome limitations due to coxsackievirus and adenovirus receptor-deficiency of cancer cells, both in vitro and in vivo

Use of adenoviruses as vehicle for gene therapy requires that target cells express appropriate receptors such as coxsakievirus and adenovirus receptor (CAR). We show here that CAR-deficiency in cancer cells, that limits adenoviral gene delivery, can be overcome by using adenovirus complexed with the liposome, Ad-PEGPE [1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(poly-ethylene glycol)-2000]. We first confirmed that CT-26 mouse colon cancer cells are deficient in CAR by RT-PCR, and then showed that CT-26 cells infected with Ad-GFP/PEGPE exhibited highly enhanced expression of green fluorescent protein (GFP), compared with those infected with Ad-GFP. GFP expression depends on the dose of liposome and adenovirus. Luciferase expression in livers treated with Ad-luc/PEGPE was about 1,000-fold less than those infected with Ad-luc. In a liver metastasis mouse tumor model developed by intrasplenic injection of CT-26 cells, luciferase expression following i.v. injection of Ad-luc/PEGPE was significantly higher in tumors than in adjacent non-neoplastic liver. Following systemic administration of Ad-GFP/PEGPE, GFP expression increased in tumors more than in adjacent liver while the reverse was true following administration of Ad-GFP. In the latter case, GFP expression was higher in liver than in tumors. This study demonstrates that systemic delivery of PEGPE-adenovirus complex is an effective tool of adenoviral delivery as it overcomes limitation due to CAR deficiency of target cells while reducing hepatic uptake and enhancing adenoviral gene expression in tumors.

Prevalence of Osteoarthritis and Rheumatoid Arthritis in Two Communities in Korea / 대한류마티스학회지

OBJECTIVE: To estimate the prevalence of osteoarthritis (OA) and rheumatoid arthritis (RA) in Korean. METHODS: Those who participated arthritis/allergy field study in Icheon, Kyunggi Province and Goesan, Chungbuk Province in 2001 were evaluated for the prevalence of arthritis. Diagnosis of OA and RA were made using American College of Rheumatology criteria. RESULTS: Among the 983 participants (mean age+/-SD, 49.9?14.0 years), 498 participants were male (mean age 49.9+/-13.1 years) and 485 participants were female (mean age 49.9+/-15.0 years), and there was no difference of mean age between male and female. There were 153 cases of OA (15.6%, mean age, 61.6+/-9.5), which consisted of 44 male cases (mean age, 58.9+/-10.7) and 109 female cases (mean age, 62.7+/-9.5). Prevalence of OA was significantly higher in female compared to male (22.5% vs 8.8%, p<0.0001). Prevalence of OA in the 4th to the 8th decade was 1.1, 7.5, 19.4, 34, 37.2%, respectively and showed increasing trend in the ascending order of age in decade (p<0.001). Localization of OA was knees (77.1%), knees and hands (17.6%), and hands (5.2%). RA was detected in 14 cases (1.4%, mean age, 58.8+/-14.6, male to female 1:13). Prevalence of RA was significantly higher in female compared to male (2.7% vs 0.2%, p<0.01). CONCLUSION: The prevalence of knee or hand OA and RA were 15.6% and 1.4% in Korean, respectively. The prevalence of OA was significantly higher in female and aged individuals. The prevalence of RA was also significantly higher in female.

A Case of Systemic Lupus Erythematosus Presented with Clinical Feature Resembling Multiple Sclerosis / 대한류마티스학회지

Systemic lupus erythematosus is a connective tissue disease which can affect every organ system. Neurologic abnormalities are common, occuring in approximately half of all patients at some time during the course of their illness. But symptoms of nervous system as the sole presenting symptoms occur in less than 1% of lupus patients. In patients initially presenting with neurologic symptoms and signs, differential diagnosis is difficult and sometimes it may be misdiagnosed. Therefore extensive laboratory investigations should be carried out in all patients with unusual neurological symptoms, since early diagnosis of lupus can help in providing effective treatment. We report a patient with systemic lupus erythematosus who presented with dysarthria and dysphagia resembling multiple sclerosis.