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Inhibition of Osteoclast formation from cultured synovial cells by Dexamethasone
( Yeong Shil Joo ),( Myeong A. Cheong ),( Jae Il Park ),( Min Ju Kang ),( Byoung Joon Kim ),( Kyu Jeung Ahn ),( Sung Woon Kim ),( Jin Woo Kim ),( Yeong Seol Kim ),( Young Kil Choi ) 대한내과학회 2001 대한내과학회 추계학술대회 Vol.61 No.-
주영실 ( Yeong Shil Joo ),이신석 ( Shin Seok Lee ),김완욱 ( Wan Uk Kim ),민준기 ( Jun Ki Min ),박성환 ( Sung Hwan Park ),홍연식 ( Yeon Sik Hong ),이상헌 ( Sang Heon Lee ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.1
Objectives: To assess the extent of generalized osteoporosis in Korean rheumatoid arthritis patients and evaluate the importance of disease activity, duration of disease, menopausal status, corticosteroid use and markers of bone metabolism. Methods: Bone mineral density was measured by dual energy x-ray absorptiometry (DEXA) at 3 locations in 134 rheumatoid arthritis patients, aged 21~80 (57 premenopausal and 66 postmenopausal patients). Markers of bone metabolism were measured and assessed in relation to the disease activity and corticosteroid use. Results: The mean age of the study population was 49 years and mean age of the menopause was 48.1±3.6 years. Decreased bone mineral density was observed at all 3 locations measured in the study population (Z-score -0.36, -0.14 and -0.66 for BMD of L-spine, femoral neck and femur Ward`s triangle respectively). Fifty nine percent of the patients showed osteopenia (T-score <-1) and 13.4% showed Tscore lower than -2.5. The best independent predictors of bone mass (stepweise multiple regression analysis) was body mass index, cortocosteroid use, and CRP in premenopausal patients and years post menopause, age, alkaline phosphatase and rheumatoid factor in postmenopausal patients. Urinary excretion of deoxypyridinoline was increased in both pre- and postmonopausal RA patients while serum osteocalcin level was normal in both groups. Deoxypyridinoline level was significantly correlated with CRP in premenopausal RA patients. Conclusion: Generalized osteoporosis is also prevalent in Korean rheumatoid arthritis patients. Bone metabolism appears to be uncoupled. Deoxypyridinoline correlated best with CRP and thus can provide a rational approach for selecting and treating patients with RA to reduce the risk of osteoporotic fracture.
류마티스관절 활막세포에서의 Receptor Activator of NF-kB Ling (RANKL)의 발현 및 파골세포 생성
주영실 ( Yeong Shil Joo ),정명아 ( Myeong A Cheong ),신동혁 ( Dong Hyuk Sheen ),임미경 ( Mi Kyoung Lim ),심승철 ( Seung Cheol Shim ),정덕환 ( Duke Whan Chung ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.4
Objective: A number of soluble factors which play important role in the pathophysiology of rheumatoid synovitis are also known to be involved in osteoclast differentiation and activation through RANKL (Receptor activator of NF-κB ligand). To investigate the importance of RANKL in the pathogenesis of bone erosion in rheumatoid arthritis (RA) patients, we analyzed the expression of RANKL and Osteoprotegerin (OPG) and examined the formation of osteoclasts in rheumatoid synovial fibroblasts under the influence of various osteotropic factors. Methods: Primary culture synoviocytes or fibroblast-like synoviocytes isolated from synovial tissues of 8 RA patients were cultured and treated with IL-1β (2 ng/ml), TNF-α(2 ng/ml), INF-γ (1000 /ml), IL-15 (10 ng/ml), IL-12 (10 ng/ml), dexamethasone (10(-9) M), PMA (10 ng/ml) or 1,25 (OH)2D3 (10(-9) M) for 18 hours. Expression RANKL or OPG mRNA was measured by semiquantitative RT-PCR within linear amplification condition. TRAP (+) MNC (tartrate resistant acid phosphatase-positive multinucleated cell) formation was induced from primary culture synoviocytes or in coculture system of synovial fibroblasts with PBMCs in the presence of M-CSF and 1,25 (OH)2D3. Results: 1. The intensity of base-line expression was different from patient to patient. Primary culture synoviocytes and synovial fibroblasts express RANKL and OPG mRNA with decreasing intensity when they are passaged. 2. Expresssion of RANKL mRNA was significantly increased by 1,25 (OH)2D3 and IL-1β (158.8±21% and 197.2±17% of controls, p<0.05 and p<0.005, respectively), while decreased significantly by dexamethasone (25.6±4.6% of controls, p<0.005). Expression of RANKL mRNA was significantly increased by IL-1β and decreased by dexamethasone, in a dose- and time-dependant manner. 3. TRAP (+) MNCs are formed from primary culture synoviocytes or in coculture system of synovial fibroblasts and PBMC in the presence of M-CSF and 1,25 (OH)2D3. Dexamethasone clearly inhibited TRAP (+) MNCs formation from synovial cells. Conclusion: The regulatory mechanism for the expression of RANKL or OPG in rheumatoid synoviocytes might be different from that in bone marrow cells. Modulating the expression of these molecules could have potential therapeutic implication targeting bone destruction in RA.
동맥혈 칼슘 자극 검사로 진단된 국소성 췌도 세포 증식증 1예
윤진훈,안규정,주영실,김병준,김성훈,권계형,정명아,양진수,정인수,김충현,조성범,이태석,김은경 대한내분비학회 2001 Endocrinology and metabolism Vol.16 No.4
We report a 40-year-old female patient with clinical findings suggestive of insulinoma. Although imaging studies did not reveal any tumors in the pancreas, a selective arterial calcium stimulation test (SACI), procedurally simpler and more effective than transhepatic pancreatic venous sampling, was performed. And then near total pancreatectomy was carried out because the possibility of small insulinoma could not be completely excluded. Grossly, the surgically removed pancreas did not reveal any tumors. However, the pancreas exhibited islets cell hyperplasia. To our knowledge, this is the first reported authentic case in a Korean adult of islet-cell hyperplasia diagnosed by selective arterial calcium stimulation test
슬관절 골관절염 환자에서 Hyruan(R)(Sodium Hyaluronate)의 유효성 및 안정성 평가
이신석 ( Shin Seok Lee ),주영실 ( Yeong Shil Joo ),김완욱 ( Wan Uk Kim ),박성환 ( Sung Hwan Park ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ),김현정 ( Hyon Jeong Kim ),김성재 ( Sung Jae Kim ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
Objectives: To assess the clinical efficacy and safety of Hyruan(R)(sodium hyaluronate) in patients with osteoarthritis of the knee. Methods: A 12-week open study of Hyruan(R) was conducted in 48 patients with osteoarthritis(OA) of the knee. Hyruan(R) was injected into knee joints weekly for 5 weeks. Clinical evaluations were performed using visual analog scale(VAS) for pain, Lequesne`s index, tenderness and swollen joint counts weekly for the first 5 weeks and then monthly up to 3 months post-injection. Results: Significant improvements in VAS, Lequesne`s index, tenderness and swollen joint counts were noted from the first week and maintained until the end of 3 month follow-up period. At 3 months post-injection, 68.8% of patients had ≥20mm reduction in the VAS. The patients with Kellgren stage III showed significant response in VAS and Lequesne`s index as patients with Kellgren stage I and II. The clinical improvement after treatment was slower in patients(n=16) with late(≥5 years) OA than in patients(n=32) with early(<5 years) OA, but it was statistically significant in either groups, compared to baseline. There were no severe adverse reactions to Hyruan(R) therapy and laboratory examinations revealed no evidence of toxicity. Conclusion: Hyruan(R) has been shown to be effective and safe in the treatment of patients with osteoarthritis of the knee.