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Background/Aims To compare the effects of abatacept and conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) on the progression and development of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods This multi-center retrospective study included RA patients receiving abatacept or csDMARDs who underwent at least two pulmonary function tests and/or chest high-resolution computed tomography (HRCT). We compared the following outcomes between the groups: progression of RA-ILD, development of new ILD in RA patients without ILD at baseline, 28-joint Disease Activity Score with the erythrocyte sedimentation rate (DAS28-ESR), and safety. Longitudinal changes were compared between the groups by using a generalized estimating equation. Results The study included 123 patients who were treated with abatacept (n = 59) or csDMARDs (n = 64). Nineteen (32.2%) and 38 (59.4%) patients treated with abatacept and csDMARDs, respectively, presented with RA-ILD at baseline. Newly developed ILD occurred in one patient receiving triple csDMARDs for 32 months. Among patients with RA-ILD at baseline, ILD progressed in 21.1% of cases treated with abatacept and 34.2% of cases treated with csDMARDs during a median 21-month follow-up. Longitudinal changes in forced vital capacity and diffusing capacity for carbon monoxide were comparable between the two groups. However, the abatacept group showed a more significant decrease in DAS28-ESR and glucocorticoid doses than csDMARDs group during the follow-up. The safety of both regimens was comparable. Conclusions Abatacept and csDMARDs showed comparable effects on the development and stabilization of RA-ILD. Nevertheless, compared to csDMARDs, abatacept demonstrated a significant improvement in disease activity and led to reduced glucocorticoid use.

Background/Aims To define standard reference values for musculoskeletal ultrasonography (MSUS) in Korea. Methods A total of 251 healthy adults were recruited for this study. Ultrasonography was performed by experienced rheumatologists who had undergone four appropriate training programs in Korea. A General Electric LOGIQ electronic ultrasound device fitted with a 12 MHz linear transducer was employed. Mean values ± standard deviations (SDs) were defined as standard reference values. Intraclass correlation coefficients was employed to evaluate the extent of inter- and intraobserver agreement when MSUS measurements were made. Results The 251 study participants included 122 males. Mean subject age was 28.6 years. The average bone-to-capsule distance of the right-side second and third metacarpophalangeal (MCP) joints were 0.68 and 0.72 mm respectively, and those of the left-side joints 0.62 and 0.68 mm. The cartilage thicknesses of the right-side second and third MCP joints were 0.55 and 0.55 mm, and those of the left-side joints were 0.55 and 0.56 mm, respectively. The bone-to-capsule distances of the right and left wrists were 0.80 and 0.82 mm. In 12.4% of participants (31/251), the erosion score of the humeral head was 1.71. In the right-side knee joint, mean cartilage thicknesses of the medial and lateral condyles were 1.86 and 2.03 mm in longitudinal scans. High overall interobserver agreement was evident after appropriate training that included instruction on standard MSUS methodology. Conclusions We defined standard reference values for MSUS in healthy Korean adults. The reliabilities of interobserver agreements were high after appropriate training program.

Almost 50% of patients with inflammatory bowel disease (IBD) exhibit at least one extra-intestinal manifestation in their lifetime. Extra-intestinal manifestations of IBD are often associated with the intestinal disease activity, reducing the quality of life of the patient but rarely leading to fatal complications. Musculoskeletal involvement is the most frequent extra-intestinal manifestation of patients with IBD but this rarely occurs before IBD is diagnosed. They are manifested in various forms, such as arthropathy, fibromyalgia, and osteoporosis. Therefore, a multidisciplinary team approach including gastroenterologists and rheumatologists are necessary for optimal treatment. This review focuses on the diagnosis and treatment of musculoskeletal manifestations of IBD from the perspectives of rheumatologists who can assist gastroenterologists.

Objectives Celecoxib is a selective cyclooxygenase (COX)-2 inhibitor that is commonly used to reduce the incidence of gastrointestinal (GI) complications in patients with rheumatoid arthritis (RA). CELBESTA® is a generic equivalent to CELEBREX®, a celecoxib preparation. This study compared the efficacy and safety of CELBESTA® and CELEBREX® in patients with RA. Methods This was a multicenter, double-blind, double-dummy, active-controlled, randomized, parallel-group, non-inferiority clinical trial. The primary endpoint was a change from baseline in self-assessed pain intensity determined using a 100-mm visual analog scale after 6 weeks of treatment. Results After a washout period, 119 eligible subjects were randomized to one of two groups (CELBESTA® group, n = 61; CELEBREX® group, n = 58). CELBESTA® was not inferior to CELEBREX® because the upper limit of two-sided 95% confidence interval (CI) for the difference between the two groups (difference in the least square [LS] mean, −8.68 mm; two-sided 95% CI −16.59 mm to −0.77 mm) was less than the non-inferiority margin (10 mm). There were no significant differences in GI complications and renal toxicity. Conclusions CELBESTA® was not inferior to CELEBREX® with regard to the pain relief efficacy in RA patients, and the tolerability and safety profiles were excellent and at similar levels for both preparations.

Abstract Background Occupational exposure to crystalline silica is a potential risk factor for various systemic autoimmune diseases including systemic sclerosis. The etiology of systemic sclerosis is not conclusively known, but there are epidemiological studies that show the relationship between exposure to crystalline silica and risk of systemic sclerosis. Here we report, for the first time, two cases of crystalline silica-related systemic sclerosis in patients who worked in crystal processing in the jewelry-manufacturing field. Case presentation Case 1 is a 57-year-old man who had worked mainly in crystal processing for multiple jewelry-processing companies for 17 years, since the age of 15 years. He contracted tuberculosis at the age of 25 years and showed Raynaud’s phenomenon of both the hands and feet at age 32 years. Digital cyanosis and sclerosis developed at approximately age 41 years. The patient was diagnosed with systemic sclerosis at age 48 years. Case 2 is a 52-year-old man who worked in crystal processing for various jewelry-processing companies for 7 years, since the age of 23 years. He first showed signs of cyanosis in the third and fourth digits of both hands at age 32 years, was diagnosed with Raynaud’s syndrome at age 37 years, and was diagnosed with systemic sclerosis at age 38 years. Crystal processing is a detailed process that involves slabbing and trimming the selected amethyst and quartz crystals, which requires close proximity of the worker’s face with the target area. In the 1980s and 1990s, the working hours were 12 h per day, and the working environment involved 15 workers crowded into a small, 70-m2 space with poor ventilation. Conclusion Two workers who processed crystals with a maximum crystalline silica content of 56.66% developed systemic sclerosis. Considering the epidemiological and experimental evidence, exposure to crystalline silica dust was an important risk factor for systemic sclerosis. An active intervention is necessary to reduce exposure in similar exposure groups in the field of jewelry processing.

Objective: Gout is a chronic inflammatory disease that is associated with a high prevalence of atherosclerotic cardiovascular mortality. Oxidized low-density lipoprotein (ox-LDL) is considered to play a critical role in the progression of atherosclerosis. Design: Gout patients were divided into five clinical subsets and ox-LDL were checked. Materials and Methods: They were divided into five clinical subsets. We compared clinical and laboratory parameters among the inflammatory status groups. Results: In a comparison of the four inflammatory status groups, with the exception of one asymptomatic hyperuricemia patient, ox-LDL was significantly higher in acute arthritis, and it was lowest in the well-controlled group. In post hoc analysis, ox-LDL was significantly different between acute arthritis and well-controlled status, between subacute arthritis and well-controlled status, and between chronic tophaceous gout and well-controlled status. Discussions: Ox-LDL is considered to be a key factor in the pathogenesis of atherosclerotic disease. Its levels were significantly different among the four inflammatory status groups; it was highest in acute arthritis, where the most active inflammation seems to occur, and lowest in the well-controlled status group. Conclusion: The present study emphasized that ox-LDL is associated with gout inflammatory status and may be a useful biomarker indicating a correlation of inflammation with atherosclerosis progression in gout patients. [ABSTRACT FROM AUTHOR]

In this paper, the efficiency and power factor performance of improved power factor correction (PFC) topologies suitable for a high density and efficient design are compared. Several topologies, including a conventional average current mode control boost PFC, an interleaved boost PFC, a back-to-back bridgeless boost PFC, and a semi-bridgeless boost PFC, are assessed through loss analysis and simulation using whole height 1 U and 2 kW class prototypes. Based on this, an optimal topology is selected for which an additional comparative analysis involving input line measure improvement control is conducted. The results of these experiments can be adapted for use in the circuit selection of high-performance converters with power factor improvement circuits. [ABSTRACT FROM AUTHOR]

Most eco-friendly cars can adopt the concept of an integrated battery charger (IBC), which uses currently available motor drive systems. The IBC has a lot of strong points such as low cost and minimum space for the high voltage battery charger. On the other hand, it also has some defects caused by its structure. In this paper, the shortcomings of the conventional IBC for PHEVs with interior permanent magnet motors are discussed, and two advanced IBCs with improved performance are presented. Compared with the conventional IBC, the two advanced IBCs have plenty of strengths such as low common noise, high efficiency, simple sensing methods, etc. Then, the digital control algorithm is modified and a power loss calculation is carried out with simulation software. Finally, experimental results are provided to show the performance of the IBC systems. [ABSTRACT FROM AUTHOR]

This paper describes the application of a quasi-one-demensional (1D) network, bubble model to simulate the filtration of a microfine cement suspension injected through a column of sand. The bubble model represents the soil column as a series of homogeneous sites linked through bundles of cylindrical bonds that characterize the distribution of pores. The model captures mechanisms of particle sieving at the inlet sites and infiltration within each of the bonds under the action of hydrodynamic and gravitational forces. The behavior of each bond is based on numerical simulations of particle transport, collection, mounding, and clogging within a cylindrical model pore. Two empirical parameters are introduced to account for uncertainties in particle attachment at the pore wall and observed mechanisms of resuspension of hindered particles. In principal, these parameters can be calibrated from measurements of effluent concentrations. The bubble model provides useful physical insights to explain the transient dynamics of filtration processes. The model is able to provide consistent predictions of pore pressures measured in 1D column injection tests reported in the literature. [ABSTRACT FROM AUTHOR]

The article presents a study about the biological evaluation of neopeptins which are isolated from a Streptomyces strain. The authors mentioned that microbial secondary metabolites were a good source of antifungal agents and they can also function as alternatives to synthetic fungicides. They identified the lipopeptide antibiotic neopeptins from the culture broth of Streptomuces sp. to develop disease control agents against powdery mildew. They evaluated the in vivo control efficacy of the said compounds on cucumber plants in glasshouse conditions. They also found out that neopeptin solutions separated from Streptomyces sp. KNF2047 showed potent disease control activity against the powdery mildew cultivation on cucumber plants.

Creep tests were conducted to measure the creep rates of pure Ni, Ni/7wt%Ni3Al, and Ni/5wt%Ni3Al/5wt%Cr anodes for MCFCs. The resulting creep rates were well modeled by a creep rate equation. During the initial stage of sintering, the creep mechanism was affected by the microstructure, and geometry referred to the macroscopic shapes of the porous anodes. For the Ni/7wt%Ni3Al and Ni/5wt%Ni3Al/5wt%Cr anodes the creep rate varied nonlinearly with time, obeying a power law with an exponent of n < 1, in contrast to the behavior of high-density materials, which exhibit linear Nabarro-Herring or Coble creep when subjected to an applied load. Compared to the pure Ni anode, the anodes containing Ni3Al showed considerably increased creep resistance due to the impeding of mass transport of nickel particles in the anode when it was subjected to a compressive load. Collectively, the present results suggest that Ni/7wt%Ni3Al and Ni/5wt%Ni3Al/ 5wt%Cr anodes simultaneously have high creep resistance, and thus may represent a viable alternative porous anode for use in MCFC. [ABSTRACT FROM AUTHOR]

Unilateral pedicle stress fracture accompanying spondylolytic spondylolisthesis is rare even in the elderly. Most are associated with major trauma, previous spine surgery, or stress-related activity. Here, the authors describe an unique case of unilateral pedicle fracture associated with spondylolytic spondylolisthesis at the L5 level, which was successfully treated by posterior lumbar interbody fusion with screw fixation at the L5-S1 level. As far as the authors' knowledge, no such case has been previously reported in the literature. The pathophysiological mechanism of this uncommon entity is discussed and a review of relevant literature is included. [ABSTRACT FROM AUTHOR]

Synovial cysts are recognized as an uncommon cause of radicular and myelopathic symptoms. They are most frequently found in the lumbar region. The cervical spine or cervicothoracic junction is a rare location for a degenerative intraspinal synovial cyst as compared with the lumbar spine. At given cervical spinal levels, synovial cysts probably share clinical features with disc herniation and stenosis. However, the pathogenesis of synovial cysts remains still controversial. Here, we report a rare case of a synovial cyst in the lower cervical spine presented as Brown-Séquard syndrome and include a brief review of the literature. To the best of our knowledge, no previous report has been issued in the English literature on a synovial cyst presenting with Brown-Séquard syndrome. Neurologic function recovered completely after complete removal of the cyst and expansive laminoplasty. [ABSTRACT FROM AUTHOR]

PURPOSE Developmental disabilities often result in decreased physical fitness and problematic behaviors. Participating in regular physical activity and exercise is one of the main ways to improve problems associated with developmental disabilities. In this study, we aimed to develop an evidence-based exercise program tailored to the characteristics, disability level, and functional level of children with developmental disabilities. METHODS The development process is composed of the following nine steps: preliminary literature review, survey of physical activity participation, first expert group discussion, development of the first exercise program, feasibility study, focus group interview, second expert group discussion, development of the evidence-based exercise program, the validation of the developed exercise program. RESULTS Participating in the evidence-based exercise program developed in this study was found to significantly improve cardiovascular fitness (6-minute walk), agility (standing long jump), and muscular function (sit-ups), but did not yield significant results in terms of flexibility (sit-and-reach). Additionally, the exercise program showed significant results in terms of reducing problem behaviors. The parents of children with developmental disabilities were all satisfied with the exercise program and its outcomes. CONCLUSIONS The evidence-based exercise program developed in this study had positive effects on the physical fitness and behavior of children with developmental disabilities. This study provides a basis for the development of exercise programs through a safe and effective means for children with developmental disabilities.

The article describes the case of a 41-year-old man diagnosed with bead-like gouty tophi in the hand and foot, along with information on the three-dimensional computed tomography done on the patient.