• The Korean Journal of Pain
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• 제25권3호
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• pp.173-182
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• 2012

Background: Fibromyalgia (FM) is characterized by chronic widespread pain with a low pain threshold. The aim of this study was to compare two criteria for the diagnosis and assessment of FM and to analyze the correlation and agreement between the 1990 and 2010 American College of Rheumatology (ACR) preliminary diagnostic criteria for FM. Methods: We studied 98 patients who had already been diagnosed as having FM using the 1990 criteria or 2010 preliminary criteria. Tender point examination, FM impact questionnaire (FIQ) and pain visual analog scale (VAS) were obtained. According to the preliminary criteria, FM was quantified as WPI (widespread pain index) and the SS scale (symptom severity) and the two criteria were compared. Results: Among 98 patients, 78.6% of the patients were diagnosed with the 1990 ACR criteria and 93.9% of the patients were diagnosed with the ACR preliminary diagnostic criteria, and there was also significant agreement between the two criteria (P < 0.01). There was a correlation with the WPI and the tender point, with the SS and the FIQ, and with the sum of the WPI and SS and the FIQ. Conclusions: The ACR preliminary diagnostic criteria for FM were in agreement with the 1990 ACR criteria during the disease course. The preliminary criteria were the more sensitive method than the 1990 criteria. In addition, the 2010 criteria might have advantages since it is easy to assess the physical and psychological symptoms and can be quantified. Therefore, the ACR preliminary diagnostic criteria for FM could be used more conveniently for clinical diagnosis and follow up evaluation after starting management of FM.

• Journal of Acupuncture Research
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• 제34권3호
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• pp.121-130
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• 2017

Objectives : The purpose of this study was to report the clinical effects of the Graston Technique and Chuna manual therapy, combined with Korean Medical Treatment for fibromyalgia. Methods : We treated a patient diagnosed with fibromyalgia. We used acupuncture, the Graston Technique, Chuna manual therapy, pharmacopuncture, herbal medicine, moxibustion and physical therapy. Outcomes were evaluated using the American College of Rheumatology Preliminary Diagnostic Criteria (ACR), the Fibromyalgia Impact Questionnaire (FIQ), and the Numeric Rating Scale (NRS). Results : The widespread pain index (WPI) scale score of the ACR decreased from 12 to 9, and the symptom severity scale (SS) score of the ACR decreased from 8 to 6. The FIQ score decreased from 63.69 to 50.15. On the NRS, lower back pain & lower limb pain decreased from 6 to 2; neck pain from 6 to 3; muscle tenderness & morning stiffness from 6 to 4; fatigue from 6 to 3; urticaria from 6 to 2. Conclusion : This case study suggests that the Graston Technique and Chuna manual therapy combined with Korean Medical Treatment may be effective treatments for fibromyalgia. However, further studies are needed.

• 한국임상약학회지
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• 제25권1호
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• pp.9-17
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• 2015

Background: Biologic disease-modifying antirheumatic drugs (bDMARDs) extend the treatment choices for rheumatoid arthritis patients with insufficient response or intolerance to conventional DMARDs (cDMARDs). These agents have considerable efficacy compared with conventional DMARDs, but only a few head-to-head comparisons among these agents have been performed. The objective of this systematic review and network meta-analysis (NMA) was to compare the relative efficacy of Certolizumab with conventional DMARD to licensed bDMARD with cDMARD therapy for patients who failed to prior cDMARD treatment under the condition of the reimbursement coverage criteria in Korea. Methods: A systematic review was conducted using MEDLINE and Cochrane library. Key endpoints were the American College of Rheumatology (ACR) responses of 20/50/70 at six months. Bayesian outcomes were calculated as median of treatment effect, probability of the best, Odds Ratio (OR) and probability that OR was greater than one. Results: Compared with other bDMARDs, Certolizumab were associated with higher or comparable ACR response rates; in ACR20, the OR (probability of OR>1) was 2.08 (92.6%) for Adalimumab, 1.86 (85.7%) for Etanercept, 1.89 (79.5%) for Golimumab, 2.36 (92.1%) for Infliximab, 1.79 (87.0%) for Abatacept, 1.74 (80.8%) for Rituximab and 1.82 (86.8%) for Tocilizaumab. In ACR50 and ACR70, the ORs did not present significant differences. Conclusion: Certolizaumab with cDMARD was more effective or comparable than other bDMARDs in patients who failed prior cDMARD treatment.

• Clinical and Experimental Pediatrics
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• 제50권12호
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• pp.1180-1187
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• 2007

Systemic lupus erythematosus (SLE) is an episodic, multi-system, autoimmune disease characterized by widespread inflammation of blood vessels and connective tissues and by the presence of antinuclear antibodies (ANAs), especially antibodies to native (double-stranded) DNA (dsDNA). Its clinical manifestations are extremely variable, and its natural history is unpredictable. Untreated, SLE is often progressive and has a significant fatality rate. The most widely used criteria for the classification of SLE are those of the American College of Rheumatology (ACR), which were revised in 1982 and modified in 1997. The presence of four criteria have been diagnosed as a SLE. Rashes are common at onset and during active disease. The oral mucosa is the site of ulceration with SLE. Arthralgia and arthritis affect most children and these symptoms are short in duration and can be migratory. Lupus nephritis may be more frequent and of greater severity in children than in adults. The initial manifestation of nephritis is microscopic hematuria, followed by proteinuria. The most common neuropsychiatric symptoms are depression, psychosis(hallucination and paranoia) and headache. CNS disease is a major cause of morbidity and mortality. Pericarditis is the most common cardiac manifestation. Libman-Sacks endocarditis is less common in children. The most frequently described pleuropulmonary manifestations are pleural effusions, pleuritis, pneunonitis and pulmonary hemorrhage. During the active phase ESR, CRP, gamma globulin, ferritin and anti-dsDNA are elevated. Antibodies to dsDNA occur in children with active nephritis. Antibodies to the extractable nuclear antigens (Sm, Ro/SS-A, La/SS-B) are strongly associated with SLE. Specific treatment should be individualized and based on the severity of the disease. Sepsis has replaced renal failure as the most common cause of death.

• 한국컴퓨터산업학회논문지
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• 제2권4호
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• pp.547-564
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• 2001

본 논문에서는 EPRCA(Enhanced Proportional Rate Control Algorithm) 스위치 방식과 EMRCA(Explicit Max_min Rate Control Algorithm) 스위치 방식의 성능을 평가하기 위하여 시뮬레이션을 수행하였다. 시뮬레이션의 평가 기준으로 과도상태와 정상상태에서 각 송신원에서의 전송률(ACR)의 변화, 큐 길이, 링크 대역폭 이용률과 전송률의 공평성 여부를 사용하였다. 실험 결과 EMRCA 스위치 방식은 EPRCA 스위치 방식보다 더 안정적이며 스위치의 버퍼 크기도 줄였으며 더 높은 링크 이용률을 보였다. 이 방식은 스위치에서 MACR(Mean Allowed Cell Rate)의 계산을 위한 부동소수점 연산을 제거하여 EPRCA 스위치 방식이나 기존의 다른 폭주 제어 방식들보다 훨씬 낮은 하드웨어 복잡도를 갖는다.

• 한방재활의학과학회지
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• 제26권4호
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• pp.127-136
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• 2016

The purpose of this study is to report a clinical progress of fibromyalgia syndrom patient treated by Korean Medicine treatment. The patient was treated with acupuncture, acupotomy, pharmacopuncture (Bee venom, Hwangryun, Hominis Placental), herbal medicine, moxibustion, cupping treatment. We measured Visual Analogue Scale (VAS), American College of Rheumatology Preliminary Diagnostic Criteria (ACR, 2010), Fibromyalgia Impact Qustionnaire (FIQ), and observed the change in body temperature using Digital Infrared Thermal Imaging (DITI). After Korean Medicine treatment, pain was controlled and VAS, ACR, FIQ were decreased. The result showed that Korean Medicine treatment is effective in fibromyalgia syndrome.

• 대한한방내과학회지
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• 제42권5호
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• pp.863-871
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• 2021

Objective: The purpose of this study was to investigate the effects of Korean medical treatment on a fibromyalgia patient with gastrointestinal symptoms, using herbal medicines selected according to new rather than existing standards. Method: A 52-year-old female patient with fibromyalgia was treated with Odu-tang and acupuncture, cupping, and moxibustion for 22 days. To evaluate the treatment, we used the Numerical Rating Scale (NRS), American College of Rheumatology's Preliminary Diagnostic Criteria (ACR), and Korean Gastrointestinal Symptom Rating Scale (KGSRS). Result: Following treatment, pantalgia diminished, NRS, and ACR scores improved, and the GSRS score decreased from 29 to 11. Conclusion: This study suggests that Korean medical treatment could effectively reduce pain and improve digestive symptoms in patients with fibromyalgia. It also presents a new method that considers individual characteristics when choosing herbal medicine.

• The Korean Journal of Pain
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• 제32권2호
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• pp.120-128
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• 2019

Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

• 한국정보과학회논문지:정보통신
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• 제27권1호
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• pp.98-107
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• 2000

본 논문에서는 멀티캐스트 가용비트율 (Available Bit Rate: ABR) 서비스를 위해 현재 ATM 포럼 등을 통해 제안되고 있는 신속한 폭주 통지 (fast overload indication) 기능을 기존 피드백통합 알고리즘들에 적용하여 이들의 성능을 시뮬레이션을 통해 비교 분석하였다. 성능 분석의 지표로 송신원의 허용된 셀률 (Allowed Cell Rate: ACR), 스위치에서의 큐 길이, 링크 이용 효율, 공평성, 역방향 자원관리 셀 (Backward Resource Management: BRM) 셀의 오버헤드 등을 사용하였다. 분석 결과, 신속한 폭주 통지 기능이 추가된 피드백 통합 알고리즘들은 망에 심각한 폭주가 발생한 경우에 매우 효과적임을 알 수 있었다. 신속한 폭주 통지 기능은 기본적인 피드백 통합 알고리즘에 관계없이 쉽게 추가될 수 있는 반면에, 이러한 기능이 추가된 알고리즘들의 성능은 기본적인 피드백 통합 알고리즘들의 성능에 매우 의존적임을 알 수 있었다.

• Childhood Kidney Diseases
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• 제24권2호
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• pp.107-114
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• 2020

Purpose: The purpose of this study was to evaluate the prevalence, clinical characteristics, and long-term clinical effects of hypertension in Korean childhood-onset systemic lupus erythematous (SLE) patients. Methods: The medical records of SLE patients, diagnosed by 2019 SLE European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria, who visited Samsung Medical Center from January 2009 to May 2019 were reviewed. Disease activity and long-term damage were evaluated using the Modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and the Pediatric Systemic Lupus International Collaborating Clinics/ACR Damage Index (Ped-SDI), respectively. The sex-, age- and height-blood pressure standards recommended by the American Academy of Pediatrics 2017 guideline was used to define hypertension. Results: A total of 32 patients were enrolled in this study. The median follow-up duration was 7.3 years and females were predominant. The median ages at SLE and hypertension diagnoses were 14.2 and 14.3 years, respectively. The biopsy-proven lupus nephritis was detected in 90.6% and 37.5% were class IV. During the follow-up, 12 patients (37.5%) had hypertension. Among them, 2 patients had 3 episodes of posterior reversible encephalopathy syndrome and 5 patients had left ventricular hypertrophy (LVH). Univariate analysis showed baseline hypertension was significantly correlated with a lower estimated glomerular filtration rate, higher body mass index and SLEDAI at baseline. The development of hypertension during the follow-up was significantly correlated with obesity, LVH, and higher Ped-SDI. Conclusion: Our study revealed that hypertension in pediatric SLE is associated with obesity and renal function at SLE diagnosis and could affect long-term damage.