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이정욱 ( Joung Wook Lee ),박영은 ( Young Eun Park ),조미라 ( Mi Ra Cho ),백승훈 ( Seung Hoon Baek ),김근태 ( Geun Tae Kim ),이준희 ( Jun Hee Lee ),김성일 ( Sung Il Kim ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.2
Objective: Rheumatoid arthritis (RA) is associated with an increased cardiovascular events. These may be related to insulin resistance (IR). We evaluated status of IR and analyzed the relationship between IR and clinical and laboratory characteristics in patients with RA. Methods: We examined 52 RA patients (43 females) and 52 age and sex matched healthy controls. We measured Homeostasis model assessment (HOMA) IR, calculated according to fasting serum glucose and insulin. Results: In patients, age was 50.8±10.2 years old, disease duration was 42.1±30.9 months. In controls, HOMA IR was 0.62±0.30 and in patients, it was 1.28±0.50. This difference was highly significant (p<0.001). Patients with early RA (disease duration is less than 36 months) were 28, and established RA (more than 36 months) were 24. HOMA IR was significantly higher in patients with established RA (1.42±0.45) than those with early RA (1.16±0.45) (p=0.03), and significantly correlated with disease duration (r=0.36, p=0.01), BMI (r=0.36, p<0.001), total cumulative prednisolon dose (r=0.34, p=0.01). Disease duration and BMI were independent predictors for HOMA IR (p<0.01, p=0.03). Conclusion: In patients with RA, IR measured by HOMA IR was more significantly increased than that of healthy control and significantly correlated with disease duration, BMI, and total cumulative prednisolon dose; however, the determinants of HOMA IR in RA patients were disease duration and BMI.
제1형 신경 섬유종증 (Neurofibromatosis Type 1)에 병합된 미세 변화성 신증후군
이정욱 ( Joung Wook Lee ),정현철 ( Hyun Chul Jung ),이수봉 ( Soo Bong Lee ),곽임수 ( Ihm Soo Kwak ),나하연 ( Ha Yeon Rha ) 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.6
Neurofibromatosis type 1 is the most common neurocutaneous disorders and affects between 1/2,000 and 1/4,500 people. This occurs at any age and is hereditary disease with autosomal dominant fashion.. Renovascular hypertension is major form of renal manifetation of the disease. There are few reported cases in Japan and Hungary of Recklinghausen`s neurofibromatosis with several glomerular lesions but their relationship is not apparent. A 21-year-old man was admitted to the hospital because of general edema. On admission, the blood pressure was 130/80 ㎜Hg and general edema was noted. He had a plexiform neuroma on right flank and multiple cafe-au-lait spots on chest and extremites. Laboratory findings were as follows; Hemoglobin 14.2 g/dL, AST 28 IU/L, ALT 12 IU/L, albumin 1.2 gm/dL, total cholesterol 533 ㎎/dL, urinary protein 4.0 gm/day, C3 86.6 ㎎/dL, C4 19.9 ㎎/dL, HBs Ag/Ab (+/-), HBe Ag/Ab (+/-), HCV Ab (-), HBV DNA probe 6,000 pg/mL. Renal biopsy was performed and the histological findings were compatible with minimal change disease. The immunohistochemical method revealed that HBsAg was negative. We experienced a case of minimal change disease concurrent with Neurofibromatosis type 1, but their relationship is not clear. We report this case with a brief review.
류마티스 관절염에서 발생한 Cerebral Aspergillosis
이태근 ( Tae Kun Lee ),최재훈 ( Jae Hoon Choi ),최철웅 ( Cheul Woong Choi ),이상용 ( Sang Yong Lee ),이준희 ( Jun Hee Lee ),이정욱 ( Joung Wook Lee ),김상수 ( Sang Soo Kim ),김성일 ( Sung Il Kim ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.4
We report a case of aspergillosis of the central nervous system in patient with rheumatoid arthritis (RA). A 46-year-old woman with 20-year history of RA and on treatment with corticosteroid, hydroxychloroquine and methotrexate, was admitted because of drowsiness, dizziness and dysarthria. On admission, physical examination and laboratory data showed, among other findings, disappearance of pupil reflex, positive Babinski and Chaddock reflex. Magnetic resonance imaging (MRI) of brain showed multiple high signal intensity lesion on medulla, pons, midbrain, basal ganglia, internal capsule, thalamus and hypothalmus. Stereotactic brain biopsy was performed and biopsy specimen revealed an invasive Aspergillus.
특발성 염증성 근육병증에서 Toll-Like Receptor의 발현
김근태 ( Geun Tae Kim ),이준희 ( Jun Hee Lee ),백승훈 ( Seung Hoon Paek ),이정욱 ( Joung Wook Lee ),조미라 ( Mi Ra Cho ),김주인 ( Ju In Kim ),이선희 ( Sun Hee Lee ),김대성 ( Dae Seong Kim ),김성일 ( Sung Il Kim ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.2
Objective: To investigate the expression of toll-like receptor (TLR)-2, 4 and 9 in idiopathic inflammatory myopathies (IIMs). Methods: The expression of TLR-2, 4 and 9 was measured by real-time RT-PCR and immunohistochemical stain (IHS) from muscle tissues in patients with IIMs and controls. Results: The expression levels of TLR-2, 4 and 9 in IIMs were significantly higher than controls. TLR-2, 4 and 9 were mainly expressed on sarcolemma of muscle fibers, perimysial vascular endothelium and infiltrating inflammatory cells in dermatomyositis, whereas, they were mainly expressed on sarcolemma of muscle fibers, destructed muscle fibers, and enodmysial infiltrating inflammatory cells in polymyositis. Conclusion: TLR-2, 4 and 9 were highly expressed in muscle tissue of IIMs. These results suggest that TLR-2, 4 and 9 play a role in pathogenesis of IIMs.
특발성 염증성 근육병증 환자에서 IL-17 발현의 증가
백승훈 ( Seung Hoon Baek ),이준희 ( Jun Hee Lee ),김근태 ( Geun Tae Kim ),이정욱 ( Joung Wook Lee ),조미라 ( Mi Ra Cho ),김주인 ( Ju In Kim ),이선희 ( Sun Hee Lee ),김대성 ( Dae Seong Kim ),김성일 ( Sung Il Kim ) 대한류마티스학회 2008 대한류마티스학회지 Vol.15 No.2
Objective: Idiopathic inflammatory myopathies (IIMs) are systemic autoimmune diseases characterized by infiltration of T lymphocytes, monocytes, and macrophages in muscle tissues. Interleukin-17 (IL-17), a Th17 cytokine, has potent pro-inflammatory actions and plays a role in autoimmune diseases. We investigated the expression of IL-17 in muscle tissues of patients with IIMs. Methods: We measured the IL-17 mRNA level of muscle tissues from 14 patients with IIMs (9 patients with dermatomyositis and 5 patients with polymyositis) by real-time RT-PCR and compared with controls. We also performed an immunohistochemical stain to detect IL-17 expression. Results: The expressions of IL-17 were significantly enhanced in IIMs than controls. In immunohistochemistry, IL-17 was expressed in perimysial, endomysial and perivascular infiltrating inflammatory cells. Conclusion: These results suggest that IL-17 plays a role in the immunopathogenesis of IIMs.
전신경화증에서 Multi-Detector Computed Tomography로 측정한 관상동맥 석회화
조미라 ( Mi Ra Cho ),박영은 ( Young Eun Park ),백승훈 ( Seung Hoon Baek ),이정욱 ( Joung Wook Lee ),김근태 ( Geun Tae Kim ),이준희 ( Jun Hee Lee ),추기석 ( Ki Seok Choo ),정연주 ( Yeon Ju Jeong ),이선희 ( Sun Hee Lee ),김성일 ( Su 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.3
Objective: There is some controversy regarding the early onset or high incidence of coronary atherosclerosis in patients with systemic sclerosis (SSc). Measurements of the coronary calcification score (CCS) by multi-detector computed tomography (MDCT) is an accurate and non-invasive method for detecting coronary atherosclerosis, and a high level of CCS (≥160) can predict coronary events. This study examined the CCS using MDCT and evaluated the risk of coronary events in patients with SSc. Methods: The clinical and laboratory characteristics of 35 patients with SSc were examined. The CCS was measured by MDCT, and the risk of coronary events were evaluated by CCS and the Framingham risk score (FRS). Results: In 35 patients (2 males and 33 females, 20 with limited and 15 with diffuse type), the mean age was 52±12 years and the disease duration was 8±7 years. The mean CCS was 10.1±30.8, the CCS of 28 patients (80%) was 0, and all patients had a CCS<160. The CCS had no significant correlation with the clinical and laboratory characteristics. The FRS was evaluated in 29 patients. Twenty eight patients were categorized into the low-risk group (FRS<10%) and only one was classified into the moderate-risk group (FRS=13%). Conclusion: These results suggest that the risk of coronary events due to coronary atherosclerosis might not be high in patients with SSc.
증례 : C형 간염 환자의 페그인터페론과 리바비린 병합요법 중 발생한 항CCP항체 양성 류마티스 관절염 1예
김동현 ( Dong Hyun Kim ),김영환 ( Young Hwan Kim ),이순일 ( Soon Ii Lee ),하병길 ( Byung Kil Ha ),최성호 ( Sung Ho Choi ),김성일 ( Sung Ii Kim ),이정욱 ( Joung Wook Lee ) 대한내과학회 2012 대한내과학회지 Vol.83 No.2
만성 C형 간염으로 페그인터페론과 리바비린 병합 치료시작 16주 후 다발성 관절통이 발생하여, 류마티스관절염 진단하에 NSAID와 DMARD를 투약하여 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Combination therapy with pegylated interferon (IFN) and ribavirin is the mainstay of treatment for chronic hepatitis C. An important side effect of IFN is the induction of an autoimmune disease such as autoimmune thyroid disease or, rarely, rheumatoid arthritis. However, the introduction of pegylated formulations of IFN can minimize the risk of autoimmune induction by reducing immunogenicity. Detection of anti-cyclic citrullinated peptide (anti-CCP) antibodies can help distinguish rheumatoid arthritis from hepatitis C-related arthritis. Here, we report the first Korean case of a 48-year-old female who developed anti-CCP antibody-positive rheumatoid arthritis following peginterferon alpha-2a therapy for hepatitis C.
이트라코나졸(itraconazole)액의 첨가물에 의해 발생한 지연형 두드러기 및 혈관부종 1예
김수영 ( Soo Young Kim ),최길순 ( Gil Soon Choi ),김희규 ( Hee Kyoo Kim ),김제훈 ( Je Hun Kim ),김철수 ( Cheol Su Kim ),양정욱 ( Joung Wook Yang ),유가인 ( Ga In You ),이진영 ( Jin Young Lee ) 대한천식알레르기학회(구 대한알레르기학회) 2014 Allergy Asthma & Respiratory Disease Vol.2 No.2
Itraconazole, new triazole agent with a broader antifungal spectrum than fluconazole, has been prescribed widely in the treatment and prophylaxis for fungal infection. Itaconazole has been reported to have gastrointestinal disturbance (4%) and headache (1%) as its most common side-effects. However, allergic reactions caused by this drug are rare. A 53 year-old woman with myelodysplastic syndrome received prophylactic antibiotic therapy including itraconazole solution before chemotherapy. She complained of hive on the face with angioedema at 6 hours after taking them. The symptoms were more aggravated on the next day and reversed by stopping itraconazole solution and injection of antihistamine and steroids. Skin prick tests with itraconazole solution, itraconazole tablet, and ketoconazole showed all the negative responses. The oral challenge test with itraconazole solution was performed and resulted in urticaria and angioedema 6 hours later. Next, the oral challenge test with intraconazole tablet was performed and showed negative response. The patient was finally diagnosed as adverse reaction by additives contained intraconazole solution. We report, a case of delayed onset urticaria and angioedema caused by components of itraconazole solution. (Allergy Asthma Respir Dis 2014;2:138-141)
류마티스관절염에 동반된 만성 골수성 백혈병 환자에서 Imatinib Mesylate 효과 보고 1예
전혜경 ( Hye Kyung Jeon ),박영은 ( Young Eun Park ),김성일 ( Sung Il Kim ),박성후 ( Seong Hu Park ),백승훈 ( Seung Hoon Baek ),이정욱 ( Joung Wook Lee ),하동우 ( Dong Woo Ha ),이혜원 ( Hye Won Lee ),정주섭 ( Joo Seop Chung ),이승 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.2
Rheumatoid arthritis is associated with an increased risk of hematological malignancy as a result of the RA itself or its treatment. We report here on an unusual case of a 55-year-old female with long-standing rheumatoid arthritis and who was treated with low dose methotrexate and hydrochloroquine. She was diagnosed with chronic myelogenous leukemia that manifested with severe thrombocytosis and basophilia, and this was treated with imatinib mesylate. After 6 months, she achieved a complete cytogenetic response of the CML and a complete resolution of all the RA symptoms without DMARDs.