Arthroscopic Synovectomy in a Patient with Primary Hypertrophic Osteoarthropathy / 대한류마티스학회지

No abstract available.

Two Cases of Mucosa-Associated Lymphoid Tissue Lymphoma of Lung in Patients with Sjogren's Syndrome / 대한류마티스학회지

Sjogren's syndrome is an autoimmune exocrinopathy characterised by decreased lacrymal and salivary gland function, resulting in keratoconjunctivitis sicca and dry mouth. The occurrence of malignant lymphoma is the most serious complication of Sjogren's syndrome. Recent reports have found that MALT lymphoma accounts for 46~56% of the malignant lymphoma that develop in patients with Sjogren's syndrome. The most common site of MALT lymphoma in patients of Sjogren's syndrome is parotid gland, but we experienced two cases of MALT lymphoma of lung in patients with Sjogren's syndrome. We report these cases with review of literature.

Effect of Hypoxia on Cytokine Production in Rheumatoid Fibroblast-Like Synoviocytes / 대한류마티스학회지

OBJECTIVE: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by increased production of cytokines, proliferation of fibroblast-like synoviocytes (FLS) and joint destruction. It is well known that the involved joints in RA are hypoxic. Hypoxia may play a role in the pathogenesis of RA. We thought that hypoxia might alter the production of cytokines by FLS and these changes could affect the biologic behaviors of FLS. Based on that, we investigated whether hypoxia affects the production of cytokines in FLS and the effect of these changes on matrix metalloproteinases (MMPs) expression. METHODS: Fibroblast-like synoviocytes from human rheumatoid synovial tissue obtained duringjoint replacement surgery were cultured in vitro. Hypoxic culture was performed by incubating cells in BBL? Gaspak pouchTM anaerobic system. After incubation under hypoxic condition for 24 hr, the concentrations of various cytokines in culture supernatants were determined by ELISA. To determine the effect of highly expressed cytokines on MMP expression, we performed ELISA of MMP-1, MMP-2 and MMP-3 in cultured FLS, after stimulation with respective cytokines. RESULTS: In hypoxic state, IL-6, IL-8 and vascular endothelial growth factor (VEGF) concentrations were significantly increased compared to those in normoxic condition. However, there were little differences in IL-1, IL-2, IL-4, TNF-alpha and TGF-beta. Stimulation of FLS with IL-6 and IL-8 showed the increased concentrations of MMP-1, MMP-2 and MMP-3. CONCLUSION: Hypoxic environment of rheumatoid synovium might affect FLS to produce proinflammatory and proangiogenic cytokine such as IL-6 and IL-8. These cytokines again could stimulate MMPs production in FLS leading to joint destruction.

Idiopathic Calcium Pyrophosphate Dihydrate (CPPD) Crystal Deposition Disease in a Young Male Patient: A Case Report

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is a disease of the elderly and extremely rare in young individuals. If young people develop CPPD crystal deposition disease, it may be associated with metabolic diseases such as hemochromatosis, hyperparathyroidism, hypophosphatasia, hypomagnesemia, Wilson's disease, hypothyroidism, gout, acromegaly, and X-linked hypophosphatemic rickets. Therefore, in young-onset polyarticular CPPD crystal deposition disease, investigation for predisposing metabolic conditions is warranted. We report a case of a young male patient with idiopathic CPPD crystal deposition disease, who did not have any evidences of metabolic diseases after thorough evaluations. As far as we know, this is the first report of a young male patient presented with idiopathic CPPD crystal deposition disease.

Clinical Implication of Magnetic Resonance Imaging in the Idiopathic Inflammatory Myopathies / 대한류마티스학회지

OBJECTIVE: The purpose of the study is to describe the magnetic resonance imaging (MRI) findings and to investigate useful sequences of MRI in inflammatory myopathies. A third goal is to correlate MRI findings with the grade of histopathologic severity. METHODS: Sixteen patients (13 women, 3 men), aged 21-74 years (median age of 49) with inflammatory myositis (examined with both MRI and muscle biopsy) were studied. Ten patients were diagnosed with polymyositis and 6 with dermatomyositis. Conventional T1-weighted (SE 366/12) and T2-weighted (SE 4766/90) fast spin-echo and fat-suppressed T1-weighted MR images with contrast enhancement (FSAT T1 CE) were obtained. Ratios between the signal intensities of a muscle and the signal intensities of subcutaneous fat in the same tomographic sections were calculated to objectively represent the degree of signal intensities. Semi-quantitative grading of severities in muscle biopsy specimen was examined based on invasion of inflammatory cells and necrosis, degeneration and regeneration of muscle fiber by a neuromuscular pathologist. RESULTS: FSAT T1 CE could objectively describe the severity of involvement in inflammatory myopathies. The quadriceps muscle group, especially the vastus muscle tended to be most severely and frequently involved in inflammatory myositis with FSAT T1 CE (statistically insignificant). The vastus intermedius muscle was more severely involved in dermatomyositis than polymyositis. The signal intensity of abnormal muscle sampled by biopsy correlated positively with the grade of muscle biopsy. CONCLUSION: MRI shows promise in identifying pathologic muscle in patients suspected of having one of the inflammatory myopathies. The degree of signal intensity on MRI may reflect the severity of grade in muscle biopsy.

A Case of Intestinal Pseudo-Obstruction in a Patient with Systemic Lupus Erythematosus / 대한류마티스학회지

Intestinal pseudo-obstruction is an uncommon and poorly understood complication of systemic lupus erythematosus. It is characterized by acute or chronic symptoms suggestive of the obstruction of small or large intestine without any radiologic, surgical or endoscopic evidence of mechanical obstruction. Although the exact pathogenesis of intestinal pseudo-obstruction in SLE remains unknown, it can be caused by derangement of the visceral smooth muscle, enteric nerves or visceral autonomic nervous system. Concomitant involvement with dilatation of gastrointestinal and genitourinary tract highly suggests of intestinal pseudo-obstruction in systemic lupus erythematosus. There is an apparent association between lupus-related intestinal pseudo-obstruction and ureterohydronephrosis. The management of intestinal pseudo-obstruction consists of high dose corticosteroid, adequate nutrition, hydration and prokinetics. Early recognition of intestinal pseudo-obstruction in systemic lupus erythematosus and the use of adequate dose of corticosteroid are important. We report a case of systemic lupus erythematosus presenting as intestinal pseudo-obstruction.