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- 저자 : ( Mie Jin Lim ) (검색결과 45 건)
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( Mie Jin Lim ),( Seong Ryul Kwon ),( Kowoon Joo ),( Min Jung Son ),( Shin Goo Park ),( Won Park ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.6
Background/Aims: Our aim was to assess whether short-term treatment with soluble tumor necrosis factor (TNF) receptor affects circulating markers of bone metabolism in rheumatoid arthritis (RA) patients. Methods: Thirty-three active RA patients, treated with oral disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids for > 6 months, were administered etanercept for 12 weeks. Serum levels of bone metabolism markers were compared among patients treated with DMARDs at baseline and after etanercept treatment, normal controls and naive RA patients not previously treated with DMARDs (both age- and gender-matched). Results: Bone-specific alkaline phosphatase (BSALP) and serum c-telopeptide (CTX)-1 levels were lower in RA patients treated with DMARDs than in DMARD- naive RA patients. After 12 weeks of etanercept treatment, serum CTX-1 and sclerostin levels increased. In patients whose DAS28 improved, the sclerostin level increased from 1.67 ± 2.12 pg/mL at baseline to 2.51 ± 3.03 pg/mL, which was statistically significant (p = 0.021). Increases in sclerostin levels after etanercept treatment were positively correlated with those of serum CTX-1 (r = 0.775), as were those of BSALP (r = 0.755). Conclusions: RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients. Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.
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( Mie Jin Lim ),( Seong Ryul Kwon ),( Kyong-hee Jung ),( Won Park ) 대한류마티스학회 2016 대한류마티스학회지 Vol.23 No.6
Objective. This study examines the effects of tumor necrosis factor (TNF) blockade on markers of bone metabolism in peripheral blood from active rheumatoid arthritis (RA) patients. Methods. Eighteen patients (16 women, 2 men) aged 50 years (range 37-63 years), with persistently active RA (mean disease duration 7 years) were studied. Most took methotrexate (mean dose 12.5 mg) and all except one received corticosteroid (mean dose 5.7 mg). Four were treated with etanercept, eight received adalimumab and six received infliximab. Before and six months after taking TNF blockers, blood was sampled to obtain peripheral blood mononuclear cells (PBMCs), and serum bone turnover markers and acute phase reactants were measured. PBMCs were seeded and cultured to produce osteoblastic lineage cells and osteoclasts. Results. The formation of calcified nodules by osteoblastic lineage cells from PBMC increased from 205.7±196.3 μmol/well at the baseline to 752.5±671.9 μmol/well after TNF blockade (p<0.024). The serum levels of bone formation markers, including bone specific alkaline phosphatase and osteocalcin also increased. The number of circulating osteoclasts and area of bone resorption pits made by osteoclasts were reduced after TNF blockade. Conclusion. The activity of circulating osteoblastic lineage cells increased after TNF blockade, whereas peripheral osteoclastogenesis tended to be suppressed. This is the first study of cultured human peripheral osteoblastic lineage cells in RA patients. Given that peripheral bone formation is difficult to study using radiologic methods, culture of these cells may provide a new modality for studying bone metabolism in RA. (J Rheum Dis 2016;23:356-362)
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Mie Jin Lim,Kyong-Hee Jung,Seong-Ryul Kwon,Won Park 대한내과학회 2023 The Korean Journal of Internal Medicine Vol.38 No.6
Background/Aims: We investigated the effect of rituximab on systemic bone metabolism in patients with seropositive rheumatoid arthritis (RA). Methods: Twenty seropositive patients with RA were enrolled and administered one cycle of rituximab. If RA became active for > 6 months after the first rituximab cycle, a second cycle was initiated; otherwise, no additional treatment was administered. Patients were divided into two groups according to the number of rituximab treatment cycles. Results: In patients treated with a second cycle, the total hip bone mineral density (BMD) was clinically low, whereas the serum levels of receptor activator of nuclear factor kappa-B ligand (RANKL) were increased at 12 months. BMD in patients treated with one cycle did not change at 12 months, whereas serum RANKL levels decreased at all time points. DAS28 activity improved in both groups from baseline to 4 months; however, from 4 to 12 months, DAS28 activity worsened in the develgroup with the second cycle but remained stable in the group with one cycle. Conclusions: Systemic inflammation, reflected by increased disease activity, may be responsible for the increase in RANKL levels, which causes systemic bone loss in rituximab-treated patients with RA. Although rituximab affects inflammation, it does not seem to alter systemic bone metabolism in RA.
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( Mie Jin Lim ),( Seong Ryul Kwon ),( Kyong Hee Jung ),( Kowoon Joo ),( Won Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Raynaud`s phenomenon (RP) is characterized by a three-phase color change after cold exposure. We supposed that infrared thermography could be used as screening tool as cold-induced vasoconstriction of distal extremities in RP lowers skin temperature which could be easily detected by thermography. Methods: fifty-seven patients with RP (primary RP, n=33; secondary RP, n=24) and 146 healthy volunteers were recruited. After acclimation to temperature of 24 ℃, thermal imaging of palmar aspect of hands and dorsal aspect of feet were taken. A fi nger with lowest temperature among 2nd, 3rd and 4th fi nger was chosen as ‘thecoolest fi nger’. The temperature difference of the coolest fi nger/fi rst toe was defi ned as temperature of palm/dorsum was subtracted by temperature of the coolest fi nger/ 1st toe, respectively. Results: Temperature differences of both coolest fi ngers and fi rst toes signifi cantly differed between patients with RP and controls. They successfully distinguished male patients with RP from male controls but temperature difference of the coolest fi nger from non-dominant hand did not differ between female patients with RP and female controls. The area under curve analysis showed that temperature difference of the coolest finger (cutoff value: 2. 2 ℃) differentiated patients with RP from controls (sensitivity/specifi city : 65-68 %/ 57-62 %, respectively). Temperature differences of fi rst toe (cutoff value: 3. 11 ℃) discriminated patients with RP (sensitivity/specifi city : 72-74 %/ 64-68 %). Thermographic assessment of the coolest fi nger and fi rst toe combined was highly effective (sensitivity/ specifi city : 88-90 % / 44-45 %), especially in men (sensitivity/ specifi city : 88 %/ 58-62 %). However, in women, thermographic assessment of fi rst toe was solely suffi cient (sensitivity/specifi city : 88-90 % / 31-36 %). Conclusions: Thermographic assessment of the coolest fi nger and fi rst toe is useful as the screening tool for RP.
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AVP 자극검사 양성 양측성 거대결절성 부신피질 증식증
김현진,김세화,이유미,김성은,안철우,차봉수,김경래,이현철,허갑범,임승길 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4
저자들은 임상증상과 기초호르몬 검사 및 저용량 덱사메타손 억제 검사에서 쿠싱증후군으로 진단된 환자에서, 낮음 ACTH 수치 및 고용량 덱사메타손 억제 검사상 억제되지 않는 코티솔 수치, 방사선학적 검사로 ACTH 비의존성 양측성 거대결절성 부신피질 증식증으로 진단하였고 양측성 부신절제술을 시행하였다. 또한 AVP 자극검사에서 양성을 보여 정상적으로 부신에 존재하는 V1-AVP 수용체의 활성도가 비정상적으로 항진되어 있음을 간접적으로 추정할 수 있었기에 이를 문헌고찰과 함께 보고하는 바이다. Adrenocorticotropin (ACTH) independent bilateral macronodular adrenal hyperplasia (AIMAH) is a rare form of Cushing's syndrome, in which unique endocrinological, clinical and histopathological features have been describe. In AIMAH, cortisol secretion is autonomous and independent of ACTH, thus plasma ACTH levels are persistently suppressed. Various etiological mechanisms have been proposed to explain the development of AIMAH, the development of aberrant adrenal sensitivity to gastric inhibitory polypeptide (GIP), vasopressin, β-adrenergic receptor agonists or the presence of circulating adrenal stimulating immunoglobulins have been suggested. We report on a 46-year-old female who had Cushing's syndrome, due to AIMAH, with a positive response to vasopressin (J Kor Soc Endocrinol 17:603∼609, 2002).
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김형진(Hyeung Jin Kim),배상운(S. W. Pae),김대중(Dae Jung Kim),김수경(Soo Kyung Kim),김세화(Se Hwa Kim),이유미(Yu Mie Rhee),정상수(Sang Su Chung),안철우(Chul Woo Ahn),차봉수(Bong Soo Cha),송영득(Young Duk Song),임승길(Sung Kil Lim),김경 대한내과학회 2002 대한내과학회지 Vol.63 No.1
N/A Background: High sensitivity C-reactive protein (hsCRP) is more sensitive than standard CRP assay for evaluation of risk of coronary heart diseases and other atherosclerotic events. But, there were no data of association of serum hsCRP with risk factors of cardiovascular diseases and nonalcoholic fatty liver in Korean type 2 diabetic and nondiabetic subjects. Methods: A hundred type 2 diabetic subjects (51 men and 49 women) from Severance Hospital and 200 nondiabetic subjects participating medical checkup in Health Promotion Center (105 men and 95 women) were recruited and subjects with acute illnesses and chronic inflammatory diseases such as upper respiratory infection, rheumatoid arthritis, osteoarthritis, or viral hepatitis were excluded. A standardized interview was conducted by trained personnel; detailed information was collected on medical history, dietary habits and lifestyle characteristics, including smoking, alcohol and physical activity. Body mass index (BMI) was computed and biochemical study were undergone using fasting blood. All subjects were done abdominal ultrasonography for evaluation of fatty liver. Serum hsCRP concentration was measured by Nephelometer AnalyzerⅡ (Behring Co.) and a lower detection limit of test was 0.18 mg/L. Results: There was no difference in sex, BMI, presence of fatty liver, concentration of total cholesterol, triglyceride, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and uric acid between diabetic and nondiabetic subjects. Age, total colesterol/HDL-C ratio, fasting blood glucose and incidence of hypertension were higher in diabetic than nondiabetic subjects, but a rate of smoking was higher in nondiabetic than diabetic subjects. The mean concentration of serum hsCRP was remarkably increased in type 2 diabetic subjects than nondiabetic subjects (1.34±1.87 vs 0.71±0.80 mg/L, p<0.05). After adjustment of different variables between both groups, there was significantly difference of the concentration of serum hsCRP (p<0.05). In nondiabetic subjects, by univariate analysis, there was a positive correlation between hsCRP and age (r=0.26, p<0.05), BMI (r=0.34, p<0.05), systolic blood pressure (r=0.21, p<0.05), diastolic blood pressure (r=0.16, p<0.05), triglyceride (r=0.27, p<0.05), total cholesterol/HDL-C ratio (r=0.22, p<0.05), uric acid (r=0.15, p<0.05) and a negative correlation between serum hsCRP and HDL-C (r=-0.16, p<0.05). Interestingly, subjects with fatty liver had shown increased serum hsCRP concentration than subjects without fatty liver (0.99±0.96 vs 0.58±0.69 mg/L, p<0.05). But there were no correlation of serum hsCRP with the history of smoking, sex, physical activity, fasting plasma glucose and presence of hypertension. After multiple regression analysis, only BMI and age were associated with serum hsCRP. In diabetic subjects, there were significant correlation of serum hsCRP with HDL-C and fasting plasma glucose, but other risk factors of cardiovascular diseases and fatty liver were not. When we compared serum hsCRP according to numbers of risk factors of cardiovascular diseases in nondiabetic subjects, group without risk factors had 0.41±0.55 mg/L, group with one risk factor had 0.48±0.40 mg/L, group with two risk factors had 0.75±0.88 mg/L, group with three risk factors had 1.08±0.87 mg/L and group with four risk factors had 1.55±1.21 mg/L. There was significant difference of serum hsCRP according to numbers of risk factors of cardiovascular diseases (p<0.05). Conclusion: Serum hsCRP is correlated with risk factors of cardiovascular diseases and may be useful tool for prediction of accelerated, atherosclerotic process in nondiabetic subjects. Although there is association of serum hsCRP with few risk factors of cardiovascular diseases, serum hsCRP is elevated in diabetic subjects. Therefore it is necessary to evaluate usefulness of serum hsCRP using carefully selected diabetic subjects. In addition, our study had show
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