인류의 신장 혈관간세포에서 유착분자 발현과 Chemokine 발현에 미치는 Th1 Cytokine과 Th2 Cytokine의 상호 작용

나경선 ( Kyoung Sun Na ),강태영 ( Tae Young Kang ),이진숙 ( Jin Sook Lee ),박용욱 ( Yong Wook Park ),이혜순 ( Hye Soon Lee ),엄완식 ( Wan Sik Uhm ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),배상철 ( Sang Cheol Bae ),이춘용 ( 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.2

Purpose: Predominance of IFN-γ over Th2 cytokines is evident in proliferative lupus nephritis. Th2 cytokines such as IL-10, or IL-4 have been known to suppress Th1 cytokine driven pro-inflammatory responses. However a combination of cytokines can exert variable effects during the evolution of autoimmune diseases depending on the various factors, such as the stage of diseases or local versus systemic expression. To determine whether Th2 cytokines play a pro- or anti-inflammatory role in the local glomerular inflammation induced by IFN-γ, we studied the effect of IL-10 and IL-4 on the expression of chemokines and adhesion molecules in human mesangial cells stimulated with IFN-γ. Methods: Human mesangial cells were obtained from 3 patients undergoing nephrectomy. MCP-1, RANTES, ICAM-1, and CD40 expressions were examined in response to various cytokine stimulation; IFN-γ, IL-10, IL-4, IFN-γ+IL-10, IFN-γ+IL-4, and IFN-γ+IL-10+IL-4, respectively. Expression of MCP-1 mRNA was analyzed by RT-PCR and the levels of MCP-1 and RANTES in the culture supernatants were measured using an enzyme immunoassay. ICAM-1 and CD40 surface expressions were analyzed by flow cytometry. Results: IFN-γ increased basal mRNA expression of MCP-1, and IL-10 strongly enhanced the level of MCP-1 mRNA and protein expressions induced by IFN-γ. IL-4 did not affect significantly on the MCP-1 expression induced by IFN-γ. Although IFN-γ increased the concentration of RANTES, IL-10 and IL-4 did not affect IFN-γ induced RNTES expression. Increased expression of ICAM-1 and CD40 induced by IFN-γ were not down-regulated by IL-10 or IL-4. Conclusion: Taken together, IL-10 appears to augment local inflammatory reaction though the up-regulation of MCP-1 from mesangial cells in the presence of IFN-γ rather than inhibit inflammatory response in the pathogenesis of proliferative glomerulonephritis.

난치성 전신성 홍반성 루푸스 환자에 대한 자가조혈모세포이식

나경선 ( Kyoung Sun Na ),최정혜 ( Jung Hae Choi ),유대현 ( Dae Hyun Yoo ),김신규 ( Think You Kim ),안명주 ( Myung Ju Ahn ),배상철 ( Sang Cheol Bae ) 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.2

Objective: To determine the safety and efficacy of immune ablation followed by autologous hematopoietic stem cell transplantation (HSCT) in refractory systemic lupus erythematosus (SLE). Methods: Three patients who had been refractory to steroid and one or more immunosuppressive drug were included. Peripheral blood stem cells were mobilized with cyclophosphamide (CTX, 3 g/m2), followed by granulocyte-colony stimulating factor (5μg/kg/day). T lymphocytes were depleted from the graft by selection of CD34 positive cells. Conditioning regimens composed of high dose CTX (total dose 200 mg/kg) and anti-thymocyte globulin (total dose 90 mg/kg) in 2 patients and BEAM (BCNU 300 mg/m2, etoposide 200 mg/m2, cytarabine 200 mg/m2, melphalan 200 mg/m2) in 1 patient. Stored stem cells were reinfused 48 hours after conditioning. Results: Among 3 patients, first patient had lupus nephritis, second patient had overlap syndrome combined with rheumatoid arthritis (rhupus) and the last patient had severe thromobocytopenia and intractable polyserositis. No life threatening complications were observed during the treatment. All patients demonstrated rapid and marked improvement in organ function and quality of life just after HSCT. Previous massive proteinuria in first patient was decreased to less than 500 mg/day with 6 months follow up. Rhupus patient satisfied American college of rheumatology 70% response criteria with 3 months follow up. But third patient improved polyserositis dramatically 1 month after HSCT and relapsed at 9 weeks. Conclusion: In refractory SLE patients, HSCT can be performed safely with marked improvement and sustained withdrawal of all immunosuppressive medication. A further randomized trial is needed to confirm the efficacy and durability of remission.

초음파 유도하 관절내 주사

나경선 ( Kyoung Sun Na ) 대한내과학회 2015 대한내과학회지 Vol.89 No.6

Ultrasonography (US) is being used increasingly to guide diagnostic and therapeutic musculoskeletal injections. Intra-articular injection is an important mainstay in the treatment of joint diseases, including rheumatoid arthritis (RA) and osteoarthritis (OA). However, blind or palpation-based injection can result in inaccurate needle placement and can be challenging for small joints or difficult-to-access joints such as the hip joint. The correct position of the needle with guidance in the target area would improve the efficacy of the procedure and greatly improve the outcome. Compared to conventional fluoroscopic guidance, the advantages of US are that it avoids radiation exposure and the equipment is readily available and less expensive. Knowledge of anatomy and probe positioning, as well as the ability to coordinate the probe and needle are necessary when injecting patients under US guidance. This review describes the general considerations for intra-articular injections under US guidance and includes practical suggestions for the injection of individual joints. (Korean J Med 2015;89:654-662)

국내 각막굴절교정학용 렌즈의 처방 현황에 대한 첫 설문조사 보고

박신혜,나경선,권형구,이현수,주천기,Shin Hae Park,Kyoung Sun Na,Hyoung Gu Kwon,Hyun Soo Lee,Choun-Ki Joo 대한안과학회 2009 대한안과학회지 Vol.50 No.4

Purpose: To investigate the current trends in the prescription of orthokeratologic lenses in Korea. Methods: We sent out an online survey to the members of the Korean ophthalmological Society in December 2007 and March 2008. We received responses from 139 ophthalmologists and analyzed the results of each question. Results: Easy fitting (34.5%) was selected as a major factor in the selection of orthokeratologic lenses. Children between the ages of 10 and 15 years with myopia less than 5 diopter, astigmatism less than 1.5 diopter, and 42 to 45-diopter keratometric value were preferred by most respondents. Decentration (n=74, 59%), corneal erosion (n=35, 25.2%), undercorrection (n=18, 12.9%), and allergy (n=11, 7.9%) were the most frequently encountered problems. 54.7% (n=76) of respondents needed to be fitted twice for trial lenses. The time required for the lens prescription in one patient was more than 30 minutes in 83.5% (n=116) of respondents. 59.7% of the respondents agreed that the lenses had an inhibitory potential on myopic progression, and 81.3% of the respondents said that orthokeratology could substitute for refractive surgery. Conclusions: There is a possibility of future growth in the use of orthokeratology. It is necessary to provide guidelines and teaching programs for the safe and effective fitting of orthokeratologic lenses. J Korean Ophthalmol Soc 2009;50(4):505-509

펨토초레이저를 이용한 각막이식술과 일반적인 전층각막이식술의 임상결과 비교

정경인,최진아,나경선,정소향,차흥원,김응권,주천기,Kyoung In Jung,Jin A Choi,Kyung Sun Na,So Hyang Chung,Hungwon Tchah,Eung Kweon Kim,Choun-Ki Joo 대한안과학회 2010 대한안과학회지 Vol.51 No.8

Purpose: To compare the outcomes of IntraLase femtosecond laser-enabled keratoplasty (IEK) versus conventional penetrating keratoplasty (C-PKP). Methods: This retrospective study included 18 eyes of 17 patients who underwent C-PKP and 26 eyes of 25 patients who underwent IEK. Postoperative clinical results were compared between two groups. Results: The mean logMAR best spectacle-corrected visual acuity (BSCVA) was 0.70, 0.58, and 0.61 in the IEK group, and 1.06, 1.01, and 0.90 in the C-PKP group at postoperative 2, 4, and 6 months respectively. The difference between the two groups was statistically significant at 2 and 4 months postoperatively (p=0.033, 0.011). The mean refractive cylinder was 4.08 diopters (D), 4.01D, and 4.44D in the IEK group, while 5.75D, 5.75D, and 5.21D in the C-PKP group for each month, and the difference between the groups was statistically significant at 2 and 4 months postoperatively (p=0.037, 0.027). The complication rate showed no significant differences up to 6 months of follow-up between the two groups. Conclusions: The IEK showed better results in BSCVA and refractive astigmatism in the early postoperative period, in comparison with the C-PKP, and can be considered as a valuable method in penetrating keratoplasty. J Korean Ophthalmol Soc 2010;51(8):1054-1063

임상화보 : 고관절 통증으로 발현된 유골 골종 1예

정경희 ( Kyong Hee Jung ),나경선 ( Kyoung Sun Na ),이승훈 ( Seung Hun Lee ),김태환 ( Tae Hwan Kim ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.3

안검 모낭충 감염군과 안구건조증 환자 중 비감염군에서의 마이봄샘 소실 비교

윤영채(Young Chae Yoon),조수연(Soo Yeon Cho),박선경(Sun Kyoung Park),유영식(Young Sik Yoo),황웅주(Woong Joo Whang),나경선(Kyung Sun Na),김은철(Eun Chul Kim),김현승(Hyun Seung Kim),황호식(Ho Sik Hwang) 대한안과학회 2022 대한안과학회지 Vol.63 No.1

목적: 비접촉 마이봄샘촬영술을 이용하여 눈꺼풀 모낭충 감염 여부에 따른 마이봄샘 소실 정도를 비교하고자 하였다. 대상과 방법: 저자들은 눈꺼풀 모낭충에 감염된 24명의 성인 환자와 감염되지 않은 40명의 환자를 대상으로 적외선 디지털 카메라를 사용하여 비접촉 마이봄샘촬영술을 시행하였다. 마이봄샘의 소실을 기준으로 오른쪽 눈의 위눈꺼풀과 아래눈꺼풀의 마이봄점수를 합하여 각 피험자에 대한 전체 마이봄점수를 구했다. 각 그룹의 눈꺼풀 모낭충 감염 여부 및 성별에 따라 마이봄점수를 평가하였다. 결과: 64명 64안이 연구에 등록되었으며, 평균 나이는 67.9세(40-79세, 남자 65.2세, 여자 69.1세)였다. 눈꺼풀 모낭충 감염과 총 마이봄점수, 위 및 아래눈꺼풀 마이봄점수 사이에 유의한 연관성이 있었다(각각, p=0.000, p=0.002, p=0.004). 마이봄점수는 남자와 여자 사이에 유의한 차이가 없었다. 연령과 마이봄점수 사이에 양의 상관 관계가 시사되었으나, 본 연구에서는 집중된 연령 분포로 인해 R2 값이 낮았다. 결론: 비접촉 마이봄샘촬영술을 이용한 검사에서 눈꺼풀 모낭충 감염이 마이봄샘 변화와 유의한 관련이 있었다. Purpose: To compare the degree of meibomian gland drop-out associated with Demodex infestation using non-contact meibography. Methods: We performed noncontact meibography using an infrared digital camera on 24 adult subjects infested by Demodex and 40 without infestation. The right upper and lower lids were scored based on the loss of meibomian glands, and the scores of the upper and lower eyelids were summed to obtain the total meiboscore for each subject. Meiboscores were evaluated according to Demodex infestation and gender in each group. Results: Sixty-four eyes of 64 people were enrolled in this study. The study subjects had an average age of 67.9 years (range, 40-79 years; men, 65.2 years; women, 69.1 years). There was a significant association between Demodex infestation and total meiboscore and upper and lower eyelid meiboscores (p = 0.000, p = 0.002, p = 0.004, respectively). There was no significant difference in the meiboscores between men and women. Age and meiboscore suggested a weak positive correlation; however, the R2 value was low, due to the concentrated age distribution of the study population. Conclusions: Based on noncontact meibography, the authors concluded that the prevalence of changes in the meibomian glands was significantly related to Demodex infestation; however, there was no significant difference between men and women.

급성 용혈성 빈혈과 전격성 간염 양상으로 증상발현을 보인 Wilson씨 병 1례

김진영,나경선,김성훈,김인순 大韓血液學會 2000 大韓血液學會誌 Vol.35 No.2

Autologous Peripheral Blood Stem Cell Transplantation in Rapidly Progressive Systemic Sclerosis : Case Report

Ahn, Myung-Ju,Choi, Jung-Hae,Shim, Sung-Gon,Na, Kyoung-Sun,Kim, Think-You,Bae, Sang-Cheol 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.2

Systemic sclerosis (SSc) is a devastating systemic disease with diffuse scleroderma and visceral organ involvement is associated with high morbidity and mortality. Autologous hematopoietic stem cell transplantation (AHSCT) has been developed as a potential treatment for autoimmune disease based on the animal model and clinical evidence. Here, we report a case of 31-year-old patient with rapidly progressive diffuse scleroderma successfully treated with autologous HSCT. Peripheral blood stem cells were mobilized with cyclophosphamide (CTX, 3 g/㎡), followed by granulocyte-colony stimulating factor (G-CSF, 5μg/kg/day). The CD34 positive selected numbers were 4.33×10^(6) cells/kg. Conditioning regimen was high dose CTX (total dose 200 mg/kg) and antithymocyte globulin (ATG, total dose 90 mg/kg). The patient tolerated this regimen well with manageable toxicity. The neutrophil count (>500μ/L) was recovered by day 9. Only transient thrombocytopenia occurred on day 4. Two months after HSCT, the patient's total skin score was decreased by 55% accessed by the modified Rodnan skin thickness score (from 27 to 12). The health-related quality of life, which was measured by Korean Short Form Health Survey-36 (KSF-36) and EuroQol-5 Dimensions (KEQ-5D), was improved. And the functional disability, which was assessed by the Korean Health Assessment Questionnaire-20 (KHAQ-20), also showed an improvement.

호중구성 복수를 동반한 위막성 대장염 1예

박은주,장우영,한동수,손주현,전용철,은창수,전대원,나경선 대한소화기내시경학회 2000 Clinical Endoscopy Vol.21 No.1

Antibiotic associated colitis due to Clostridium difficile is a common infection associated with significant morbidity. In severe cases, Pseudomembranous colitis (PMC) may be associated with intraperitoneal fluid accumulation. Howwver, the characteristics of the liquid are seldom described. This case report describes PMC patients who were presented with low serum-ascites albumin gradients (SAAG)and neutrocytic ascites, without evidence of infectious, malignant, or inflammatory peritoneal disease. The characteristics of their fluid specimens and the possible pathogenic mechanisms are discussed. These findings suggest that PMC without bowel perforation or spontaneous bacterial peritonitis.