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증례 : 류마티스 ; 강직성 척추염 환자에서 발생한 갑상선자극호르몬(TSH) 분비 뇌하수체 선종 1예
박지혜 ( Ji Heh Park ),이승근 ( Seung Geun Lee ),박은경 ( Eun Kyoung Park ),구동완 ( Dong Wan Koo ),김보현 ( Bo Hyun Kim ),김인주 ( In Joo Kim ),김근태 ( Geun Tae Kim ) 대한내과학회 2015 대한내과학회지 Vol.88 No.6
저자들은 강직성 척추염을 진단받고 외래에서 추적관찰중인 환자에서 동반된 갑상선자극호르몬 분비 뇌하수체 선종을 TRH 자극검사, 갑상선자극호르몬 α-아단위 측정 및 자기공명영상으로 진단하고 수술로 치료하여서 호전된 드문증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. 두질환과의 상호 연관성에 대해서는 추가적인 연구가 필요할 것으로 판단된다. A thyrotropin (TSH)-secreting pituitary adenoma is a rare cause of hyperthyroidism, with an incidence of one case per million. Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease of the axial skeleton. Extra-articular manifestations, such as anterior uveitis, may also be prominent features in AS but little is known about the association between AS and thyroid diseases including TSH-secreting pituitary adenomas. We present a case study of a 26-year-old male AS patient who was diagnosed with a TSH-secreting pituitary adenoma using a thyrotropin releasing hormone stimulation test, measurement of the TSH α-subunit, and magnetic resonance imaging, and subsequently treated with a transsphenoidal tumor resection. (Korean J Med 2015;88:737-741)
A Case of a Central Retinal Artery Occlusion in a Patient with Rheumatoid Arthritis
( Eun-kyoung Park ),( Seung-geun Lee ),( Dong-wan Koo ),( Ji-heh Park ),( Young-mi Seol ),( Shinwon Lee ),( Sun-hack Lee ),( In-su Kim ),( Sungwho Park ) 대한류마티스학회 2016 대한류마티스학회지 Vol.23 No.5
A 50-year-old woman, who had been treated for rheumatoid arthritis (RA) over a 10-year period, suddenly presented with mon-ocular vision loss while the RA had a stable course over many years. She was diagnosed with central retinal artery occlusion (CRAO) based on ophthalmologic examinations including optical coherence tomography and fluorescein angiography. There was no evidence of atherosclerosis, infection, and malignancy that can cause CRAO. Considering the association between CRAO and other rheumatic diseases, such as systemic vasculitis and systemic lupus erythematous in previous reports, it was presumed that her RA might have contributed to the development of CRAO. Although cases of CRAO in patients with RA are extremely rare, these findings suggest that physicians need to be aware of the possibility of CRAO in patients with RA who expe-rience decreased visual acuity. (J Rheum Dis 2016;23:326-331)
Eun-Young Park,이승근,Eun-Kyoung Park,Dong-Wan Koo,Ji-Heh Park,Geun-Tae Kim,Hee Sang Tag,Hyun-Ok Kim,Young-Sun Suh 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.1
Background/Aims: To investigate the drug survival rate of tacrolimus (TAC) and analyze the potential predictors of this rate in patients with rheumatoid arthritis (RA) in routine care. Methods: In this retrospective longitudinal study, we enrolled 102 RA patients treated with TAC from April 2009 to January 2014 at a tertiary center in South Korea. The causes of TAC discontinuation were classified as lack of efficacy (LOE), adverse events (AEs), and others. The drug survival rate was estimated using the Kaplan-Meier method and the predictors of this rate were identified by Coxregression analyses. Results: TAC was discontinued in 27 of 102 RA patients (26.5%). The overall 1-, 2-, 3-, and 4-year TAC continuation rates were 81.8%, 78.4%, 74.2%, and 69.1%, respectively and the median follow-up period from the start of TAC was 32.5 months. The number of TAC discontinuations due to LOE, AEs, and others were 15 (55.6%), 11 (40.7 %), and 1 (3.7%), respectively. The baseline high disease activity was a significant risk factor for TAC discontinuation after adjusting for confounding factors (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.16 to 5.35; p = 0.019). In addition, underlying interstitial lung disease was significantly associated with TAC withdrawal due to AEs (HR, 3.49; 95% CI, 1.06 to 11.46; p = 0.039). Conclusions: In our study, TAC showed a good overall survival rate in patients with RA in real clinical practice. This suggests that the long-term TAC therapy has a favorable efficacy and safety profile for treating RA.
( Jong Man Park ),( Seung Geun Lee ),( Eun Kyoung Park ),( Dae Sung Lee ),( Sung Min Baek ),( Kyung Lim Hwang ),( Joong Keun Kim ),( Ji Heh Park ),( Geun Tae Kim ),( Seon Yoon Choi ) 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.3
Objective. The present study determined if vitamin D deficiency is a potential risk factor for increased carotid intima- media thickness (CIMT) in patients with rheumatoid arthritis (RA). Methods. This cross-sectional study analyzed 50 consecutive female RA patients without cardiovascular disease history at the Pusan National University Hospital between September and December of 2013. CIMT was measured using a high-resolution ultrasonography. Serum 25-hydroxy vitamin D (25-OHD) levels were assessed by radioimmunoassay, and vitamin D deficiency was defined as serum 25-OHD levels <20 ng/mL. Stepwise multivariable linear regression analyses were performed to evaluate the association between vitamin D deficiency and increased CIMT. Results. The median 25-OHD level (inter-quartile range) was 14.0 (11.0∼20.7) ng/mL, and 74% of patients had vitamin D deficiency. The mean±standard deviation of CIMT was 0.58±0.08 mm. RA patients with vitamin D deficiency had significantly higher CIMT than those without this feature (0.59±0.07 vs 0.54±0.05, p=0.028). In univariable linear regression models, vitamin D deficiency (β(SE)=0.047 (0.021), p=0.028), older age (β(SE)=0.003 (7.2-4), p<0.001) and higher disease activity score 28-erythrocyte sedimentation rate (β(SE)=0.021 (0.010), p=0.034) and Korean version of health assessment questionnaire score (β(SE)=0.051 (0.015), p=0.002) were significantly associated with increased CIMT. Vitamin D deficiency remained statistically significant in multivariable regression models after adjusting for confounders. Conclusion. Vitamin D deficiency was associated with increased CIMT in female RA patients. Our finding suggests that hypovitaminosis D can be a risk factor for atherosclerosis in RA patients.
Heh-Ran Choi,Hee Kwon Lee,Ji-Young Song,Hee-Jeon Park,Sang-Eun Lee,Pill Jae Park,In Sok Lee,Dong-Hee Rhew,Song-Joong Yun 한국작물학회 2010 한국작물학회 학술발표대회 논문집 Vol.2010 No.04
In order to breed the useful mutants in black raspberry, cultivated in Gochang-gun, leaf-petiol explants from shoot-proliferating culture was regenerated after irradiated with 30, 50 and 70 Gy gamma-ray. The LD50 dose of leaf-petiol explants was identified as 30Gy after two months. Morphological characteristics of the variants were observed such as stem variation, existence and nonexistence of spine, spine color, anthocyanin content, width of leaf, thick of leaf compared with donor cultivar. Of the 701 mutants, 14 lines with the useful mutant characters were selected and random amplified polymorphic DNA(RAPD) was carried out to confirm mutation state at the molecular level with 20 primers. There are many bands be revealed only in mutants and disappear in mutants reversely. RAPD analysis revealed a high level of genetic diversity among Control and mutants. Compared to Control, No. 14 mutant showed the highest genetic diversity. Also, the co-dominant SSR markers have allowed the evaluation of heterozygosity. Valuable mutants obtained will be useful for developing new cultivars and studying gene function in molecular level.
박희전 ( Hee Jeon Park ),송지영 ( Ji Young Song ),채규서 ( Kyu Seo Chea ),이희권 ( Hee Kwon Lee ),최혜란 ( Heh Ran Choi ) 한국산업식품공학회 2012 산업 식품공학 Vol.16 No.1
To promote the utilization of Rubus coreanus Miquel as a functional food, its physicochemical properties were examined during maturation and new beverage was developed based on the results of sugar content and acidity. The sugar content was ranged from 12-18 oBx and the acidity was 0.4 to 0.9%. This study showed that the optimal sugar content was 13-14 oBx and the acidity was 0.5-0.7% for developing Black raspberry beverage. Black raspberry beverage had higher contents of amino acid and mineral and greater antioxidant activity than orange and grape juices.
Kweon, Seong-Min,Sohn, Dong Hyun,Park, Ji-Heh,Koh, Jung Hee,Park, Eun-Kyoung,Lee, Han-Na,Kim, Keunyoung,Kim, Yunkyung,Kim, Geun-Tae,Lee, Seung-Geun Wolters Kluwer Health 2018 Medicine Vol.97 No.24
<P><B>Abstract</B></P><P>Most previous research investigating osteoporosis in rheumatoid arthritis (RA) has focused on female patients and there is a lack of data regarding clinical characteristics of osteoporosis in male patients with RA.</P><P>The aim of this study was to compare the frequency of osteoporosis between male patients with RA and healthy patients, and to identify the risk factors for osteoporosis and low bone mineral density (BMD) in male patients with RA.</P><P>We conducted a retrospective, cross-sectional study including 76 South Korean male patients with RA aged over 50 years and 76 age-matched male healthy individuals. BMD was measured at the lumbar spine (L1-4) and left hip (femoral neck and total hip) using dual energy X-ray absorptiometry. Osteoporosis was defined as a <I>T</I>-score of ≤ −2.5 according to the World Health Organization (WHO) classification.</P><P>The frequency of osteoporosis at either the spine or the hip among male patients with RA was significantly higher than that among controls (22.4% vs 10.5%, <I>P</I> = .049) and RA patients had a significantly lower total hip BMD than healthy individuals (0.92 ± 0.14 vs 0.96 ± 0.1 g/cm<SUP>2</SUP>, <I>P</I> = .027). For male RA patients, the mean 28-joint Disease Activity Scores using erythrocyte sedimentation rate (DAS28-ESR) and body mass index (BMI) were 3.28 and 22 kg/m<SUP>2</SUP>, respectively. In multivariable logistic regression models, BMI ≤ 22 kg/m<SUP>2</SUP> (odds ratio = 3.43, <I>P</I> = .043) and DAS28-ESR > 3.2 (odds ratio = 3.85, <I>P</I> = .032) were independent risk factors for osteoporosis at either site in male patients with RA.</P><P>Our data demonstrate that male patients with RA had a 2.1 times higher risk for osteoporosis compared with healthy individuals. This suggests that appropriate management of osteoporosis in patients with RA is crucial not only for postmenopausal women but also for men aged over 50 years, especially those with low BMI and higher disease activity.</P>
원발쓸개관경화증에서 발생한 갑상샘유두암과 혼합결합조직병 1예
구동완 ( Dong-wan Koo ),이승근 ( Seung-geun Lee ),박은경 ( Eun-kyoung Park ),박지혜 ( Ji-heh Park ),이규민 ( Kyu-min Lee ) 대한내과학회 2017 대한내과학회지 Vol.92 No.1
A 40-year-old female previously diagnosed with primary biliary cirrhosis was referred to the hospital complaining of muscle weakness, arthralgia, Raynaud`s phenomenon, and thick skin. After work-up, she was diagnosed with both mixed connective tissue disease (MCTD) and papillary thyroid cancer (PTC), based on the Alarcon-Segovia criteria and pathological examination, respectively. High-dose glucocorticoid and azathioprine were introduced to treat active myositis of MCTD, and total thyroidectomy was performed to treat PTC. This report highlights the possible association between MCTD and thyroid cancer, and suggests that MCTD is associated with PTC, similar to other autoimmune diseases including Sjogren`s syndrome, systemic sclerosis, and systemic lupus erythematosus. (Korean J Med 2017;92:103-107)
Case of Raynaud Syndrome after the Use of Methimazole
( Yunkyung Kim ),( Hee-sang Tag ),( Geun-tae Kim ),( Seung-geun Lee ),( Eun-kyung Park ),( Ji-heh Park ),( Seong-min Kweon ),( Song-i Yang ),( Jeong-hoon Kim ) 대한류마티스학회 2018 대한류마티스학회지 Vol.25 No.3
Raynaud syndrome is a medical condition that causes pain, numbness, and changes in skin color at the distal extremities. Raynaud syndrome can be subdivided into primary Raynaud's and secondary Raynaud's. The former is diagnosed when the cause is unknown and the latter is caused by an underlying condition, such as connective tissue diseases, injury, smoking, or certain medications. Both cancer chemotherapy and β-blockers are relatively common causes of Raynaud syndrome but there are no reports of its association with methimazole administration. The authors encountered a 43-year old woman with hyperthyroidism who developed digital ulcers associated with Raynaud syndrome after a methimazole treatment. Her digital ulcers and Raynaud syndrome were improved after methimazole was replaced with propylthiouracil and conventional therapy. This paper reports this case along with a review of the relevant literature. (J Rheum Dis 2018;25:203-206)