Han Joo Baek

Gachon University, Sŏngnam, Gyeonggi-do, South Korea

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Publications (43)113.44 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: AimTo describe the prevalence and characteristics of fibromyalgia (FM) in patients with underlying rheumatic disease, and to compare it by three different measures.Methods We studied 546 patients with chronic rheumatic diseases who attended our rheumatology clinic. If patients answered all of a screening questionnaire with yes, then we considered patients to be having widespread pain as assessed by the fibromyalgia impact questionnaire (FIQ), widespread pain index (WPI), and symptom severity (SS). A physician administered the tender point (TP) exam and clinician's judgment of FM. We collected demographics, clinical and laboratory features.ResultsOne hundred and sixty-four (30.0%) patients among 546 cases had a further exam. The male-to-female count was 25 : 139. The mean age was 49.7 years, disease duration 3.7 years, TP counts 4.2, FIQ score 47.0 and WPI with SS score was 11.1. We classified 17 patients (10.4%) with concomitant FM with widespread pain by tender point exam, 56 patients (34.2%) by WPI with SS, and 36 patients (22.0%) by a clinician's judgment. A total of 70.6% (n = 12) of those classified as FM by 1990 American College of Rheumatology (ACR) criteria wee categorized as FM by clinician's judgment, while 33.3% by clinician's judgment were classified by 1990 ACR criteria.Conclusions We found a 10.4~34.2% prevalence of concomitant FM in the patients with chronic widespread pain. The 1990 ACR criteria were the most restrictive except for SLE. Although The 2010 ACR criteria had a wide spectrum, it can be used for FM diagnosis even in the patient with underlying rheumatic diseases.
    International Journal of Rheumatic Diseases 05/2015; DOI:10.1111/1756-185X.12678
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    ABSTRACT: The object of this study was to evaluate the seasonality of gout in Korea. We retrospectively examined data from 330 patients seen at nine rheumatology clinics, treated with urate lowering therapy (ULT) more than one year after stopping prophylactic medication. Demographic data, clinical and laboratory features, and seasonality of gout onset and flares were collected. Season was classified in three-month intervals. The mean age was 52.2 yr and mean disease duration was 26.8 months. The male to female count was 318:12. The onset of acute gouty attacks was obtained in 256 patients. Gout developed most commonly in summer season (36.7%) (P<0.001) and in June (15.6%, P=0.002). During ULT, there were 147 (male 97.3%) gout flares. Although there was no statistically significant difference, gout flares were more common in summer (30.6%). Aggravating factors were identified in 57 flares: alcohol (72.0%) was most common. In the patients who attained target serum uric acid (<6 mg/dL) at the end of prophylaxis, gout flares were high in fall (35.8%) and September (17.0%). In Korea, the summer is most common season of gout onset and there is a tendency for gout flares to increase during ULT in summer/fall season. Graphical Abstract
    Journal of Korean Medical Science 03/2015; 30(3):240-4. DOI:10.3346/jkms.2015.30.3.240
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    ABSTRACT: T helper 17-related cytokines have been implicated in rheumatoid arthritis (RA) pathogenesis. The study aimed to identify cytokines associated with the treatment response of RA patients to tocilizumab (TCZ), a humanized monoclonal antibody against the interleukin- (IL-) 6 receptor. As an independent substudy of the 24-week, randomized, double-blinded CWP-TCZ301 trial of TCZ in RA patients with an inadequate response to disease-modifying antirheumatic drugs, serum levels of cytokines including tumor necrosis factor-alpha, IL-17A, IL-21, IL-23, IL-6, and soluble IL-6 receptor were measured. Baseline IL-17A levels were significantly lower in RA patients who achieved disease activity score 28 (DAS28) remission at 12 weeks of TCZ treatment, compared to patients not in remission. Patients were stratified into IL-17A low group and IL-17A high group. Significantly more patients in the IL-17A low group achieved remission as compared to the IL-17A high group (47.6 versus 17.4%, ). DAS28 improvement was significantly better in the IL-17A low group than in the IL-17A high group at 12 weeks and 24 weeks after adjustment. Other baseline cytokines were not associated with treatment response to TCZ. The data demonstrate that low baseline IL-17A levels are associated with better clinical response to TCZ treatment in RA patients.
    Journal of Immunology Research 01/2015; 2015:1-7. DOI:10.1155/2015/487230
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    ABSTRACT: Purpose: Pulmonary arterial hypertension (PAR) is an orphan disease showing poor prognosis. The purpose of study was to evaluate clinical factors influencing outcomes in PAR. Materials and Methods: Patients who were diagnosed with PAR at a single center were reviewed retrospectively. Forty patients (34.9 +/- 14.5 years, 80% of female) were enrolled. Results: Causes were congenital heart disease in 24 (60%), connective tissue disease in 8 (20%) and idiopathic PAR in 6 (15%). Sixteen patients (40%) were WHO functional class ifi or IV at the time of diagnosis. Twenty seven patients (67.5%) received molecular targeted therapy. During follow-up (53.6 +/- 45.5 months), 10 patients (25%) died and 1-, 2-, and 8 year survival rates were 91.3%, 78.7%, and 66.8%, respectively. As expected, median survival of patients with functional class I or If were significantly longer than patients with DT or IV (p=0.041). Interestingly, patients with molecular targeted therapy showed longer survival than conventional therapy (p=0.021). Conclusion: WHO functional class at the time of diagnosis was the strong predictor of survival, and molecular targeted therapy could significantly improve the survival. Therefore, early screening and intensive management would be crucial to improve the prognosis in the patient with PAH.
    Yonsei Medical Journal 11/2014; 55(6):1526-32. DOI:10.3349/ymj.2014.55.6.1526
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    ABSTRACT: The diagnosis of spondyloarthritis (SpA) has a lengthy delay; we investigated the outcomes and factors associated with the delayed diagnosis of SpA. This was a cross-sectional study on patients with SpA who visited a rheumatology clinic at a single tertiary centre. The data were collected from face-to-face interviews, physician assessments of disease status and reviews of medical records. In total, 105 patients with SpA were consecutively enrolled. Of the included patients, 94 had axial SpA and 11 had peripheral SpA. The median diagnostic delay was 8 years (interquartile range, 3-14) for axial SpA. Comparisons between the early and late diagnosis groups were performed to identify the factors related to delayed diagnosis in axial SpA. A definite diagnosis of SpA led to proper management and clinical improvements. The patients with delayed diagnosis showed worse outcomes in disease activity, function, spinal mobility and/or radiographic damage. These patients also demonstrated a less favourable treatment response according to the Bath Ankylosing Spondylitis Disease Activity Index and the rate of radiographic progression. Multivariate analysis indicated that a prior diagnosis of mechanical back pain was an independent factor associated with diagnostic delay. The diagnosis of SpA is often delayed. Delayed diagnosis is associated with worse outcomes and poor treatment responses in SpA patients. Physician and patient awareness of inflammatory back pain are essential for the early diagnosis of SpA, and a referral guideline for patients with suspected SpA is needed.
    Clinical Rheumatology 09/2014; DOI:10.1007/s10067-014-2768-y
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    ABSTRACT: Recurrent oral ulcer (ROU) is a common condition that significantly impacts quality of life. It is often related to systemic diseases, such as Behçet’s disease (BD), Crohn’s disease, and ulcerative colitis. Treatment of ROU depends on its severity: from topical agents for mild cases to systemic agents, such as corticosteroids, azathioprine, or other immunosuppressants for severe cases. Recently, good results have been reported with infliximab in refractory ROU. However, the optimal dosage and treatment duration have not been determined and the cost and potential side effects should be considered. We report on four patients who received a single-dose infliximab for refractory ROU. Two patients had refractory ROU with no underlying disease; one of them had soft palate perforation accompanied by severe oral ulcers. The two other patients had ROU of BD without major organ involvement. All patients received a single infusion of infliximab and an additional infusion was given on demand in one patient. Infliximab showed a rapid, good response in three patients and was also effective in improving the acute inflammation in the perforation of the soft palate, which had been resistant to conventional therapies. These effects diminished over a few weeks, but the ROU were tolerable and it was not necessary to increase steroids or add another medicine for about 1 year. We suggest that a single infusion of infliximab can be considered for refractory ROU.
    American Journal of Otolaryngology 09/2014; 35(5). DOI:10.1016/j.amjoto.2014.04.014
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    ABSTRACT: AimTo evaluate treatment patterns and clinical factors affecting gout flare in South Korea.Methods We retrospectively examined data from 401 patients seen at nine rheumatology multicenter clinics, under urate lowering therapy (ULT) more than 6 months after stopping prophylactic medication. Demographic data, clinical and laboratory features were collected at the initiation of ULT, upon stopping prophylaxis, and 6 months after.ResultsThe mean age was 52.2 years and mean disease duration was 25.0 months. The male-to-female count was 387 : 14. The most common ULT starting agent was allopurinol 83.8%. Colchicine (62.3%) was the most commonly prescribed prophylactic agent. During ULT, 134 of the 401 patients (33.4%) experienced at least one gouty attack in the period from stopping prophylaxis to 6 months later. The duration of prophylaxis was different between those with serum uric acid levels below 6 mg/dL and those over 6 mg/dL (P = 0.001). Of the 179 patients (44.6%) who attained target serum uric acid (SUA) levels (6 mg/dL) at the end of prophylaxis, those taking < 6 months of prophylaxis suffered more frequent flares than those taking it ≥ 6 months (42.9% vs. 26.3%, P = 0.041). The time interval to the first attack after stopping prophylaxis was shorter in the < 6 months group than the ≥ 6 months group (13.5 weeks vs. 22.5 weeks, P = 0.007).Conclusions Prophylaxis more than 6 months from initiation of ULT, and achieving target SUA (< 6 mg/dL) at the time of stopping prophylaxis is associated with fewer gout flares during ULT.
    International Journal of Rheumatic Diseases 08/2014; DOI:10.1111/1756-185X.12422
  • Annals of the Rheumatic Diseases 06/2014; 73(Suppl 2):610-611. DOI:10.1136/annrheumdis-2014-eular.5095
  • Annals of the Rheumatic Diseases 06/2014; 73(Suppl 2):805-805. DOI:10.1136/annrheumdis-2014-eular.3438
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is one of the causes of cor pulmonale. Cor pulmonale patients with pulmonary hypertension have a significant lower survival rate than patients without. However, there is no conclusive treatment options in cor pulmonale and pulmonary hypertension associated with COPD until now. We report a patient with cor pulmonale and pulmonary hypertension associated with severe form of COPD and tuberculous destroyed lung who achieved marked clinical, functional and echocardiographic hemodynamic improvements with inhaled iloprost for six months.
    Journal of cardiovascular ultrasound 06/2014; 22(2):95-7. DOI:10.4250/jcu.2014.22.2.95
  • Annals of the Rheumatic Diseases 01/2014; 71(Suppl 3):670-670. DOI:10.1136/annrheumdis-2012-eular.562
  • Han Joo Baek
    01/2014; 21(6):279. DOI:10.4078/jrd.2014.21.6.279
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    ABSTRACT: Vasculitis that involves the gastrointestinal (GI) tract often occurs as part of a systemic inflammatory process. It is a well-recognized manifestation of the small and medium sized vessel vasculitides. Vasculitis of the GI tract may occur in isolation; although it can progress to a systemic illness. It usually involves the arterioles, venules, and capillaries; however, it is very rare for only the venules to be affected. Enterocolic lymphocytic phlebitis is a localized vasculitis, typically affecting the small and medium-sized intramural and mesenteric veins of the intestines. We report a case of enterocolic lymphocytic phlebitis of the colon. A 38-year-old woman was presented with hematochezia and severe abdominal pain on the day of admission. She had no history of intestinal disease or systemic disease. Computed tomography showed an extremely thickened wall of the colon, along with several air bubbles in the colon with diffuse subcutaneous emphysema in the abdominal wall. An emergency exploration laparotomy and extended right hemicolectomy was performed. The patient recovered completely after surgery and remains well without further therapy.
    01/2014; 21(2):101. DOI:10.4078/jrd.2014.21.2.101
  • 01/2013; 20(1):17. DOI:10.4078/jrd.2013.20.1.17
  • Mi Ryoung Seo, Han Joo Baek
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    ABSTRACT: The spondyloarthritis (SpA) is a group of chronic inflammatory rheumatic diseases in association with HLA-B27. They share the clinical features including sacroiliitis, spondylitis, oligoarthritis, enthesitis and extra-articular involvement. Recently ASAS proposed new classification criteria sets of axial and peripheral SpA. They were designed to include non-radiographic SpA, thus can guide the early diagnosis of disease before the structural damage occurs. SpA has a strong genetic predisposition. Non-MHC genes, such as IL23R and ERAP1, as well as HLA-B27 were confirmed as susceptibility genes through several GWAS. Major pathology in SpA is entheseal inflammation and new bone formation. Intrinsic ability of HLA-B27 to trigger innate immune response and several proinflammtory cytokines may contribute to the inflammation in SpA. New bone formation could be explained by a mechanism, partly or completely independent of the inflammatory process.
    01/2013; 85(3):229. DOI:10.3904/kjm.2013.85.3.229
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    ABSTRACT: OBJECTIVES: To identify non-major histocompatibility complex susceptible genes that might contribute to Behçet's disease (BD). METHODS: We performed a genome-wide association study using DNA samples from a Korean population consisting of 379 BD patients and 800 controls. A replication study was performed in a Japanese population (363 BD patients and 272 controls). To evaluate the functional implication of the target single nucleotide polymorphisms (SNP), gene expression levels in peripheral T cells, allele-specific modulation of promoter activity and biological effect of mRNA knockdown were investigated. RESULTS: We found a novel association of BD to the GIMAP locus, mapped to chromosome 7q36.1 (rs1608157, p=6.01×10(-8) in a minor allele dominant model; rs11769828, allele based p=1.60×10(-6)). A fine mapping study identified an association with four additional SNP: rs1522596 (OR=1.45, p=7.70×10(-6)) in GIMAP4; rs10266069 (OR=1.32, p=2.67×10(-4)) and rs10256482 (OR=1.27, p=5.27×10(-4)) in GIMAP2; and rs2286900 (OR=1.61, p=3.53×10(-5)) in GIMAP1 areas. Replication study using DNA samples from the Japanese population validated the significant association between BD and the GIMAP locus. The GIMAP4 promoter construct plasmid with the minor allele of rs1608157 displayed significantly lower activity than one with the major allele. Moreover, CD4 T cells from BD patients showed a lower level of GIMAP4 mRNA, and GIMAP4 knockdown was protective against Fas-mediated apoptosis. CONCLUSIONS: These results suggest that a GIMAP cluster is a novel susceptibility locus for BD, which is involved in T-cell survival, and T-cell aberration can contribute to the development of BD.
    Annals of the rheumatic diseases 10/2012; DOI:10.1136/annrheumdis-2011-200288
  • Han Joo Baek
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    ABSTRACT: The practice of medicine today is beset with unprecedented challenges which include public distrust in medical profession, increasing market force and strengthened management. Recently medical professional societies in UK & USA are overcoming these challenges in the way that medical professionalism is modernized in a changing society. They set 'a physician charter' and new definition of medical professionalism as a partnership. The principles of new medical professionalism are patient welfare, patient autonomy and social justice. It describes doctors' commitment to integrity, compassion, altruism, continuous improvement, excellence, working in partnership, just distribution of finite resources, maintaining trust by managing conflicts of interest and others. New professionalism support improvement of health care system for the welfare of society and the collective human dignity. Experience of rebuilding medical professionalism in UK and USA will give a lesson to Korean medical profession when they seek for solution to restore public confidence and take the leadership in Korean healthcare system.
    01/2012; 19(6):316. DOI:10.4078/jrd.2012.19.6.316
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    ABSTRACT: Behçet's disease (BD) is a chronic systemic inflammatory disease with unknown etiology. A number of clinical and laboratory findings suggest a strongly polarized Th1 immune response in BD. T-bet is a newly identified Th1 specific T-box transcription factor selectively expressed in Th1 cells. However, it is not yet clear whether the T-bet protein is involved in the proposed Th1-mediated pathogenesis of BD at the transcriptional level. Therefore, this study investigated the potential associations of two single nucleotide polymorphisms (SNPs) at positions -99 (C/G) and -1993 (T/C) in the exon and promoter regions of the TBX21 gene with susceptibility to BD in the Korean population.
    The Journal of the Korean Rheumatism Association 12/2010; 17(4):360. DOI:10.4078/jkra.2010.17.4.360
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    ABSTRACT: The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed using the Bath ankylosing spondylitis disease activity index. Five hundred and five patients were recruited. The male to female ratio was 6.1:1. Average age at symptom onset was 25.4+/-8.9 yr and average disease duration was 9.6+/-6.8 yr. Males manifested symptoms at a significantly earlier age. HLA-B27 was more frequently positive in males. Hips were more commonly affected in males, and knees in females. When spinal mobility was measured using tragus-to-wall distance and the modified Schober's test, females had significantly better results. Radiographic spinal changes, including bamboo spine and syndesmophytes, were more common in males after adjustment of confounding factors. In conclusion, we observed significant gender differences in radiographic spinal involvement as well as other clinical manifestations among Korea patients with adult-onset ankylosing spondylitis. These findings may influence the timing of the diagnosis and the choice of treatment.
    Journal of Korean medical science 04/2010; 25(4):532-5. DOI:10.3346/jkms.2010.25.4.532
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    ABSTRACT: Matrix metalloproteinase (MMP)-9 expression is reported to be upregulated in several primary vasculitides. The -1562C>T and -91 [CA](n) repeat polymorphisms can affect MMP-9 promoter activity. We investigated the distributions of these functional polymorphisms in 122 patients with Behçet's disease (BD) and in 122 gender- and age-matched healthy controls. Plasma levels of MMP-9 were analyzed. The frequency of "L" alleles with [CA](n) <21 was significantly lower in all BD patients (vs controls, odds ratio (OR) = 0.371 [95% confidence interval 0.152-0.905]) and male patients (vs male controls, OR = 0.117 [0.019-0.737]). Furthermore, the frequency of "H/H" homozygote with [CA](n) > or = 21 was significantly higher in BD patients than controls (OR = 2.677 [1.065-6.729]). Moreover, the frequency of CL haplotype with lower promoter activity was significantly lower in BD patients (vs controls, OR = 0.374 [0.149-0.939]) and in BD patients with visceral involvement (OR = 0.202 [0.044-0.916]). Although plasma MMP-9 levels were not different between controls and BD patients, concentrations of this substance were significantly higher in male patients (vs male controls, p = 0.044) or patients with visceral involvements (vs patients without visceral involvement, p = 0.027). These results suggest that MMP-9 is a novel susceptibility gene and its promoter polymorphisms can affect the development of visceral involvement in BD.
    Human immunology 04/2010; 71(7):717-22. DOI:10.1016/j.humimm.2010.03.009

Publication Stats

377 Citations
113.44 Total Impact Points

Institutions

  • 2007–2015
    • Gachon University
      • Department of Rheumatology
      Sŏngnam, Gyeonggi-do, South Korea
    • Incheon St. Mary’s Hospital, Catholic Medical Center
      Bucheon, Gyeonggi Province, South Korea
  • 1998–2012
    • Seoul National University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2005
    • Chungnam National University
      • Department of Internal Medicine
      Daiden, Daejeon, South Korea
  • 1998–2000
    • Seoul National University
      • • Department of Internal Medicine
      • • Institute of Molecular Biology and Genetics
      Sŏul, Seoul, South Korea