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A Case of Miliary Tuberculosis in a Patient with Behcet's Disease and Uveitis Receiving Infliximab (베체트병 포도막염 환자에서 Infliximab 사용 중 발생한 속립성 결핵 1예)

  • Yoo, Jung-Wan;Roh, Jae Hyung;Park, Jin Wook;Kim, Yong Giun;Jang, Ji Woong;Na, Soo Young;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.5
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    • pp.454-457
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    • 2009
  • Infliximab, a TNF-${\alpha}$ antagonist, has been used to treat refractory rheumatoid arthritis, ankylosing spondylitis, Crohn's disease and Behcet's disease. Tuberculosis (TB) is a well-known opportunistic infection in patients receiving infliximab. Therefore, patients should be screened and treated for latent or active TB infection before being administered infliximab. Recently, we encountered a case of military TB during infliximab therapy in a patient suffering from Behcet's disease and uveitis. We report this case with a review of the relevant literature.

Systematic review: agreement between the latent tuberculosis screening tests among patients with rheumatic diseases

  • Pyo, Junhee;Cho, Soo-Kyung;Kim, Dam;Sung, Yoon-Kyoung
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1241-1251
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    • 2018
  • Background/Aims: To estimate the level of agreement and positivity rates of latent tuberculosis infection (LTBI) tests prior to the use of tumor necrosis factor (TNF) inhibitors in relation to underlying rheumatic diseases and endemic tuberculosis levels. Methods: The Ovid-Medline, Embase, and Cochrane Libraries were searched for articles before October 2013 involving LTBI screening in rheumatic patients, including rheumatoid arthritis (RA), ankylosing spondylitis (AS), juvenile idiopathic arthritis (JIA), and psoriatic arthritis. Results: In pooled analyses, 5,224 rheumatic patients had undergone both a tuberculin skin test (TST) and an interferon-gamma release assay (IGRA) before TNF inhibitors use. The positivity of TST, QuantiFERON-TB Gold In Tube (QFT-GIT), and T-SPOT.TB (T-SPOT) tests were estimated to be 29%, 17%, and 18%, respectively. The agreement percentage between the TST and QFT-GIT, and between the TST and T-SPOT were 73% and 75%. Populations from low-to-moderate endemic TB presented with slightly less agreement (71% between TST and QFT-GIT, and 74% between TST and T-SPOT) than patients from high endemic countries (73% between TST and QFT-GIT, and 81% between TST and T-SPOT). By underlying disease stratification, a lower level of agreement between TST and QFT-GIT was found among AS (64%) than among JIA (77%) and RA patients (73%). Conclusions: We reaffirm the current evidence for accuracy of LTBI test done by TST and IGRA among rheumatic patients is inconsistent. Our stratified analysis suggests different screening strategies might be needed in clinical settings considering the endemic status in the patient's country of origin and the precise nature of underlying diseases.

Analytical Approach to the Literature of Cupping Therapy

  • Koran, Serhat;Irban, Arzu
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.3
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    • pp.1-14
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    • 2021
  • PURPOSE: This study aims to reveal the prevalence, therapeutic efficacy and undesirable side effects of cupping therapy all over the world from past to present. METHODS: This meta-analysis is based on the data obtained by scanning the keyword "cupping therapy" from the Pub-Med system, which is an international database. The date range has been set as 1950-2019. Local databases were not included. Cupping therapy studies combined with other complementary therapies such as acupuncture, moxa and hirudotherapy are also included in the meta-analysis. RESULTS: A total of 381 scientific studies were found on cupping therapy. Of these studies 127 wererandomized controlled trials (RCSs). Cupping treatment has been found effective in studies of painful conditions such as herpes zoster pain, fibromyalgia, back pain, neck pain, headache and acute injury pain. In addition, the effectiveness of cupping therapy was found to be high in studies related to bone / muscular system diseases such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, carpal tunnel syndrome, cervical spondylosis. In addition, cupping treatment is also promising in studies on skin diseases, neurological diseases, respiratory system diseases and cardiovascular system diseases. CONCLUSION: Recently, there has been an increase in the number of RCSs related to cupping therapy. The vast majority of this increase has been made in European and American countries rather than in Far Eastern countries. Studies on cupping therapy, which have been and will be carried out in the future, will provide evidence-based indication of whether cupping therapy is effective. and it will allow more patients to benefit from this treatment, which has a very low rate of side effects and complications.

Characteristics of patients with psoriatic arthritis in Korea: focusing on axial involvement

  • Hanna Park;Ji Hyun Lee;Seung-Ki Kwok;Ji Hyeon Ju;Wan-Uk Kim;Sung-Hwan Park;Jennifer Jooha Lee
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.184-193
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    • 2024
  • Background/Aims: We aimed to clarify the clinical characteristics of psoriatic arthritis (PsA) in Korean patients focusing on PsA with axial involvement. Methods: A retrospective medical chart review was performed to identify PsA patients at a single tertiary center. Cases of AS patients with psoriasis were recruited from a prospective AS registry of the same center. Demographics, laboratory findings, and radiologic characteristics were assessed. Results: A total of 69 PsA patients were identified. In PsA patients, spondylitis (46.4%) was the most common form. Compared to AS patients with psoriasis, PsA patients with radiographic axial involvement were older (50.9 vs. 32.4 years; p < 0.001) and showed greater peripheral disease activity (peripheral arthritis 78.1 vs. 12.5%, p < 0.001; enthesitis 50.0 vs. 6.3%, p = 0.003). AS patients with psoriasis presented a higher rate of HLA-B*27 positivity (81.3 vs. 17.2%; p < 0.001) and a more frequent history of inflammatory back pain (100.0 vs. 75.0%; p = 0.039) than PsA patients with radiographic axial involvement. Significant proportions of PsA patients with radiographic axial involvement had cervical spine involvement (10/18, 55.6%) and spondylitis without sacroiliitis (10/23, 43.5%). Conclusions: We demonstrate that axial involvement is common in Korean PsA patients, and its characteristics can be distinct from those of AS.

Effects of Catalpa Ovata on the Collagen-induced Arthritis in Lewis Rats (개오동이 흰쥐의 Collagen 유발 관절염에 미치는 영향)

  • Kim, Sun-Jung;Seo, Il-Bok;Yoon, Je-Pil
    • The Journal of Korea CHUNA Manual Medicine
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    • v.4 no.1
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    • pp.75-88
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    • 2003
  • Objectives : The purpose of this study is to find out the effects of Catalpa Ovata on the collagen-induced arthritis in the lewis rats. and we infere the effects of Catalpa Ovata on the rheumatoid arthritis in the human body. Methods : We investigated the effect of Catalpa Ovata on the Collagen-induced arthritis in Lewis rats via morphology, histology and serology as an experimental group, a control group, and a normal group. We feed Catalpa Ovata. only to an experimental group. Results : According to this research, the abnormal finding In Moire topography was 53.7% (1,018 students), and students needed X-ray re-examination were 11.2% (213 students). Students diagnosed scoliosis by X-ray re-examination were 1.8%. According to statistical analysis, interval between vertical base line of pelvis and vertical base line of neck, gap between left distance and right distance to the vertical base line of pelvis and difference of contour lines have strong correlations with deformity degree of the body surface examined by Moire. Conclusions : 1. The weight of an experimental group were lower than control group with statistically significant at 15 days later. 2, The paw edema volume of an experimental group were lower than control group at 10 days, 15 days later. but couldn't be found meaning. 3. The size of the tarsal joint of an experimental group were lower than control group at 5 days, 10 days, 15 days later, but couldn't be found meaning. 4. The volume of tumor necrosis factor-a at an experimental group were lower than control group with statistically significant. 5. The volume of interleukin-$1{\beta}$ at an experimental group were lower than control group with statistically significant. 6. An experimental group and a control group were showed ankylosing osteoarthritis, but an experimental group compared with a control group, alleviated In the fibrous ankylosis, destruction of articular cartilage and destruction of subchondral bony tissue. According to the above results, it might be considered that Catalpa Ovata has the suppression of the advance of the Collagen-induced arthritis and that result were presumed to bo connected with suppression of volume of the tumor necrosis $factor-{\alpha}$ and $interleukin-1{\beta}$ in the blood.

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Periodontal inflamed surface area as a novel numerical variable describing periodontal conditions

  • Park, Shin-Young;Ahn, Soyeon;Lee, Jung-Tae;Yun, Pil-Young;Lee, Yun Jong;Lee, Joo Youn;Song, Yeong Wook;Chang, Yoon-Seok;Lee, Hyo-Jung
    • Journal of Periodontal and Implant Science
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    • v.47 no.5
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    • pp.328-338
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    • 2017
  • Purpose: Chronic periodontitis is an inflammatory disease induced by pathogenic bacterial accumulation. A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. It is advantageous for data processing and analysis because it can be treated as a continuous variable to quantify periodontal inflammation. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. Methods: This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. Results: PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P<0.01) and with periodontal indexes, such as BOP and the plaque index (PI) (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test). Porphyromonas gingivalis expression and the presence of serum P. gingivalis antibodies were significant factors affecting PISA values in a simple linear regression analysis, together with periodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease. Conclusions: PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.

Sacroiliac Joint/Sacrum Uptake Ratio Measured by Quantitative Sacroiliac Joint Scintigraphy (골(骨)스캔을 이용(利用)한 천장관절(薦腸關節)/천골섭취비(薦骨攝取比)의 정량적(定量的) 측정(測定))

  • Lee, Young-Yiul;Park, Seon-Yang;Lee, Myung-Chul;Choi, Sung-Jae;Cho, Bo-Youn;Choe, Kang-Won;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.2
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    • pp.63-70
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    • 1982
  • To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.

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The Results of the Endoscopic Decompression for the Treatment of Haglund's Disease (Haglund씨 병에서 시행한 내시경적 감압술의 결과)

  • Ahn, Su-Han;Cho, Hyung-Lae;Hong, Seong-Hwak;Wang, Tae-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.197-202
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    • 2008
  • Purpose: Haglund's disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown, painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of retrocalcaneal space for Haglund's disease. Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53 years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of more than $75^{\circ}$ and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months). Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle were decreased from preoperative 8.7 and $82^{\circ}$ to postoperative 2.3 and $57^{\circ}$, respectively. One patient with ankylosing spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion or abnormal heel sensation. Conclusion: The endoscopic decompression for Haglund's disease was demonstrated to have several advantages including low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a comparative study is needed to determine the value of endoscopic decompression and particular caution should be exerted for the enthesiopathy.

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Systematic Review of High Frequency of Acupuncture Point and Self Exercise Therapy for Lower Back Pain (요통 치료의 빈용 경혈과 자가 운동 요법에 대한 체계적 문헌 고찰)

  • Nam, Dae-Jin;Huh, Gun;Lee, Hyung-Eun;Choi, Bo-Mi;Lee, Jung-Min;Lee, Eun-Jung;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.59-71
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    • 2013
  • Objectives The aim of this review is to figure out which acupoints are frequently used to treat low back pain and which exercises are effective to low back pain. Methods We searched the three electronic database (RISS, KISS, KTKP) and manually checked related Korean journals and reference lists up to June 2013. We investigated the frequency of acupoints for using treatment of low back pain. We Introduce exercise therapies we can do easily at home without professional skills for treatment low back pain. Results We included 72 articles in this study. The most frequently adopted acupoints were BL25, BL23, BL24, GB30, BL40, BL26, BL60, GB34, BL52, BL57, GB39. The most frequently adopted meridian pathways were BL, GB, GV, ST. The most frequently adopted disease causing low back pain were HIVD (Herniated intervertebral disc), Lumbar sprain, Spinal stenosis, Compression fracture, Cauda equina syndrome, Spondylolisthesis, Ankylosing spondylitis. There are many exercise therapies (Lumbar stabilizing exercise, Resistance exercise, Bareunmom physical exercise, Mckenzie exercise, Williams exercise, Emblass exercise, Swiss ball exercise, Thera band exercise, Yoga) for treatment low back pain. Conclusions These results suggest that most frequently adopted acupoints were foot taeyang urinary bladder channel acupoints. Beacuse foot taeyang urinary bladder channel is passes through the waist, it will be effective for treatment of low back pain. Also exercise therapy is effective for enhance Muscular strength. In order to treatment of low back pain, Acupuncture treatment is also important, as well as exercise therapy.

HLA-B27 DNA Typing using Group Specific Polymerase Chain Reaction (중합효소연쇄반응을 이용한 HLA-B27 유전자분석)

  • Kyung Ok Lee;Sung Hoi Hong;Moom Ju Oh;Kyung In Kim;Min Jung Kim
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.223-229
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    • 1996
  • HLA-B27 gene, one of the HLA-class I molecule, is strongly associated with ankylosing spondylitis. It has been most frequently used as a disease-correlated HLA gene by clinicians. In most laboratories, conventional HLA-B27 typing is still performed by cell cytotoxicity tests or fluorescence serology with specific antibodies. In this study, DNA typing method for HLA-B27 was developed by using group specific Polymerase Chain Reaction (PCR). Four HLA-B27 cell lines (HOM-2, JESTHOM, WT24 and BTB) and fifty six B27 Korean individuals defined by serology were used. The results of control cell and B-27 positive individual samples were correlated well with the data which was performed by serological method. All of B27 positive PCR products gave positive signals on Southern blot hybridization with B27 specific probe. This study shows that the HLA-B27 DNA typing is a relatively simple, fast and practical tool for the determination of the HLA-B27 gene in routine clinical laboratory work.

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