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The aim of this study was to determine the significance of bone scan findings in Korean polymyositis/dermatomyositis (PM/DM) patients. The participants in this study were 26 PM/DM patients who fulfilled the proposed criteria for definite or probable PM/DM. All patients had been examined by bone scan. The results were analyzed visually and quantitatively using the uptake ratios. Correlations between the bone scan parameters of six proximal muscle groups (trapezius, deltoid, biceps, iliopsoas, quadriceps, and gluteus medius and maximus) and clinical parameters (laboratory values and manual muscle test) representing disease activities were assessed. Based on visual analyses of their bone scans, 10 of 14 (71.4 %) patients with active PM/DM had abnormal muscle uptake. Visual grading of the bone scans had a sensitivity and specificity of 74 and 90.9 %, respectively, for the assessment of muscle inflammation. Maximal proximal muscle uptake ratios, as determined on the bone scans, were significantly higher in patients with active PM/DM than in those with inactive disease (median 1.97 vs. 1.02, p = 0.046). Maximal proximal uptake ratios correlated significantly with creatine kinase ( r = 0.394, p = 0.046), lactate dehydrogenase (LDH, r = 0.473, p = 0.015), aldolase ( r = 0.428, p = 0.029), erythrocyte sedimentation rate ( r = 0.412, p = 0.036), C-reactive protein ( r = 0.454, p = 0.002), and manual muscle test results ( r = −0.399, p = 0.044). Mean proximal muscle uptake ratios correlated significantly with LDH ( r = 0.438, p = 0.025) and aldolase ( r = 0.572, p = 0.002). Visually assessed proximal muscle uptake grades and maximal proximal muscle uptake ratios as determined by bone scan correlated significantly with the levels of known PM/DM disease activity markers. The findings of this study suggest that bone scan is a useful imaging technique for the evaluation of PM/DM patients. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Numerous epidemiologic data have shown that smoking may play a role in the disease manifestations or severity of chronic musculoskeletal pain. The authors of the present study investigated the effect of smoking on clinical features such as pain, fatigue, functional impairment, and psychiatric features in the Korean population with fibromyalgia syndrome (FMS). Methods: A total of 336 patients with FMS were consecutively enrolled from 10 medical centers which participated in the Korean national fibromyalgia survey. Smoking was divided into current smokers and non-smokers. Instruments of FMS assessment included tender points, Fibromyalgia Impact questionnaire (FIQ), 36-item Medical Outcomes Study Short-Form Health Survey (SF-36), Brief Fatigue Inventory (BFI), Brief Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI)-1 and STAI-2, and social family support and social friend support. Statistical analyses included Chi-square test, Fisher''s exact test, Mann-Whitney U test, and multivariate logistic regression analysis. Results: Thirty-three patients (9.8%) out of 336 participants were current smokers. The number of tender points (P =0.037), BFI (P =0.026), general health of SF-36 (P =0.028), BDI (P =0.014), syncope (P =0.024), and reflex sympathetic dystrophy (P =0.003) showing significance between current smokers and non-smokers were not associated with smoking habits after adjustment. The significance of the number of tender points (P =0.009), scores of total tender points (P =0.032), BDI (P =0.038), general weakness (P =0.047), and reflex sympathetic dystrophy (P =0.011) was observed between randomized non-smokers (n =55) and smokers (n =33). In addition, the number of tender points (P =0.027, OR=1.379) was associated with smoking status after adjustment. The analysis between randomized non-smokers (n =45) and smokers (n =22) in female FMS patients showed that BDI in FMS was associated with smoking status (P =0.023, OR=1.077) after logistic regression analysis. Conclusions: This study revealed that smoking habits may, in part, influence pain or functional and psychiatric features in FMS patients. The impact of smoking on clinical features in FMS should be assessed in a larger study population. [Copyright &y& Elsevier]

We have investigated the clinical utility of antichromatin antibodies for the diagnosis of SLE and as a marker of disease activity in Korean SLE patients. Blood samples were collected from SLE patients, lupus syndrome patients having only two or three of ACR classification criteria for SLE and normal controls. The level of antichromatin antibody was measured by enzyme linked immunosorbent assay and expressed as arbitrary unit. The antichromatin antibody levels of the SLE and lupus syndrome patients were higher than NC. The antichromatin antibody levels were significant higher in SLE patients with arthritis. A significant correlation was found between the level of antichromatin antibodies and each of anti-dsDNA antibody, leukopenia, complement and SLEDAI. The change of antichromatin antibody levels showed a positive correlation with the change of SLEDAI in serial samples. These data suggest that the antichromatin antibodies appear to be a useful laboratory test that can help in the diagnosis and assessment of SLE.

Background: Although baker's asthma (BA) is a common occupational asthma, there have been few reports on this disease in Korean subjects., Objectives: We evaluated the prevalence of serum-specific IgE, IgG1, and IgG4 antibodies in relation to work-related respiratory symptoms in a single industrial bakery., Methods: Three hundred and ninety-two bakery workers were administered and taken a questionnaire regarding respiratory symptoms. For symptomatic workers, the methacholine bronchial challenge test and specific bronchoprovocation tests with wheat extracts were carried out. Skin prick tests were performed and serum-specific IgE, IgG1, and IgG4 antibodies to wheat flour were detected. The IgE- and IgG4-binding components were identified by immunoblotting., Results: Sixty-seven workers (17.1%) complained of work-related upper and lower respiratory symptoms. The prevalence of BA based on positive bronchoprovocation test results was 1.5%. The sensitization rate to wheat flour was 5.9% by skin prick test and 6.5% by ELISA, and was closely associated with the presence of atopy and work-related lower respiratory symptoms (P<0.001 for both). IgE immunoblotting revealed six major IgE-binding components (27, 31, 36, 43, 54, and 72 kDa). The presence of wheat-specific IgG1 and IgG4 antibodies was found to be significantly associated with exposure intensity (P<0.05 for both)., Conclusions: The overall prevalence of wheat sensitization in a Korean bakery was 5.9%. We confirmed that an IgE-mediated response is the major pathogenic mechanism for the induction of work-related symptoms in wheat-exposed workers. Wheat-specific IgG antibodies may represent current or previous exposure to wheat dust.

Clinically important myocarditis is an unusual feature in systemic lupus erythematosus (SLE). We describe the clinical characteristics, management and outcomes of five SLE patients who developed severe left ventricular dysfunction. Four patients were female with mean age of 36.4 years. Three patients had both lupus myocarditis and lupus nephritis. Four patients had raised anti-dsDNA antibody titer and low complement level and two patients had positive IgG anticardiolipin antibody. Three patients were treated by high-dose corticosteroids, one patient by intravenous pulse methylprednisolone, and one patient by intravenous immunoglobulin and pulse cyclophosphamide with high dose corticosteroids. Left ventricular function improved markedly in four patients and all of them had no recurrence of lupus myocarditis up to follow-up of 33 months. However, one patient, who showed no improvement of left ventricular function, was expired due to sudden cardiac arrest. Lupus myocarditis should be treated by immunosuppressive therapy with high-dose corticosteroids and mostly the prognosis might be good with early treatment.