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골관절염 연골세포에서 진행성당화종말생성물에 의한 기질단백분해효소 발현의 증가
나성수 ( Seong Su Nah ),최인영 ( In Young Choi ),문세환 ( Se Hwan Mun ),김용길 ( Yong Gil Kim ),문희범 ( Hee Bom Moon ),유빈 ( Bin Yoo ),이창근 ( Chang Keun Lee ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.1
Objective: Although increased expression of receptor for advanced glycation end products (AGE) in osteoarthritis (OA) has been reported, little is known concerning the role of AGEs in the pathogenesis of OA. This study was undertaken to determine the effect of AGEs on the regulation of matrix metalloproteinase (MMP) expressions and activities in human OA chondrocytes Methods: OA chondrocytes were treated with increasing doses of AGE-bovine serum albumin (AGE-BSA). The expressions of MMPs were determined by both enzyme-linked immunosorbent assay (ELISA) and immunoblot analysis. The activities of MMPs were evaluated by both gelatin and casein zymography assays. In addition, electrophoretic mobility shift assay (EMSA) was employed to investigate the DNA binding activity of nuclear factor-kappa B (NF-κB) by AGE-BSA treatment. Results: The productions of MMP-1, -3, and -13 were significantly elevated by AGE-BSA in a dose dependent manner. The elevated activities of MMP-1, -3, and -13, and TNF-α by AGE-BSA were also observed. DNA binding activity of NF-κB was markedly increased by AGE-BSA treatment implicating possible involvement of NF-κB mediated pathway in the AGE-BSA induced MMP-1, -3, and -13, and TNF-α productions in OA chondrocytes. Taken together, this study demonstrates the stimulatory effect of AGE-BSA on the productions of MMPs and TNF-α and suggests the possible involvement of NF-κB mediated pathway in OA chondrocytes. Conclusion: These results suggest that AGE may play a role in pathogenesis of OA.
베체트병의 심혈관 침범 환자의 재발에서 면역억제제의 효과
나성수 ( Seong Su Nah ),이창근 ( Chang Keun Lee ),오지선 ( Ji Seon Oh ),김용길 ( Yong Gil Kim ),전찬홍 ( Chan Hong Jeon ),문희범 ( Hee Bom Moon ),고은미 ( Eun Mi Koh ),유빈 ( Bin Yoo ),홍석찬 ( Seok Chan Hong ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.4
Objective: Despite the high risk for disease-related morbidity and mortality in Behcet`s disease (BD) with cardiovascular (CV) manifestations, only a few studies concerning BD with CV involvements are available. We conducted study to evaluate the clinical manifestations of CV BD (cardiovascular Behcet`s disease) and the clinical outcome according to the different treatment modalities, especially focusing on the immunosuppressive agents. Methods: We retrospectively reviewed 1,812 patients diagnosed with BD at tertiary hospital. All patients with vascular involvements were classified into three groups by lesion site. We assessed clinical characteristics, treatments, outcome and recurrence in each group. Results: Of 1,812 patients, 79 patients showed CV involvements. Male to female ratio was 65 (82.3%) to 14 (17.7%). Venous involvements occurred in 57 cases (72.2%), arterial lesions in 22 (27.8%), cardiac involvements 16 (20.3%). In clinical manifestation, only hypertension and arthritis were more frequently found in cardiac lesion than in venous lesion (p=0.01, p=0.01, respectively). CV lesions recurred in 16 patients (20.3%), mostly at the same sites as previous involvements. There was no association of recurrence with site of lesion (p=0.49). Recurrent rate was significant different in three medication group (p=0.028). Recurrences were more frequent in patients treated with no immunosuppressive agent and colchicines only or colchicines with prednisolone than in patients treated with additional immunosuppressive agent (p=0.024, R.R, 7.16 (95% CI, 1.55 to 32.99)). Conclusion: Recurrence rate was lower in patients with aggressive immunosuppressive treatment. Although most of patients improved, more efforts to decrease the relatively high rate of the recurrence (20.3%) would be needed.
담도성 동통을 주소로 내원한 제 3형 오디괄약근 기능이상
변대근 ( Dae Keun Pyun ),김명환 ( Myung Hwan Kim ),나성수 ( Seong Su Nah ),최정민 ( Jung Min Choi ),김미영 ( Mi Young Kim ),송문희 ( Moon Hee Song ),서동완 ( Dong Wan Seo ),이상수 ( Sang Soo Lee ),이성구 ( Sung Koo Lee ),윤인자 ( 대한소화기기능성질환·운동학회 2004 Journal of Neurogastroenterology and Motility (JNM Vol.10 No.2
Sphincter of Oddi dysfunction (SOD) is a disease of severe episodic abdominal pain caused by stenosis or dyskinesia and develops months or years after a cholecystectomy in many cases. There are three clinical classifications of SOD according to objective
오지선 ( Ji Seon Oh ),권귀영 ( Gui Young Kwon ),소민욱 ( Min Wook So ),최성호 ( Seong Ho Choi ),김용길 ( Yong Gil Kim ),나성수 ( Seong Su Nah ),이창근 ( Chang Keun Lee ),문희범 ( Hee Bom Moon ),유빈 ( Bin Yoo ) 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.4
Plasma cell granuloma, a form of inflammatory pseudotumor, is a rare nonneoplastic lesion that is characterized by cellular proliferation composed predominantly of polyclonal plasma cells with other inflammatory cells in fibrovascular background. We have experienced an unusual case of plasma cell granuloma of skull that developed in a patient with systemic lupus erythematosus (SLE). A 42-year-old female diagnosed with SLE 13 years ago has complained of palpable scalp mass and headache beginning ten days previously. A brain magnetic resonance imaging showed intensely enhanced soft tissue mass with focal bone defect in right parietal bone and whole body positron emission tomography suggested high possibility of malignancy. Surgical tumor removal was performed. Biopsy specimen revealed inflammatory proliferation predominantly with mature plasma cells which were determined to be polyclonal in immunostaining. Currently, 4 months after surgery, the patient are on regular follow-up with oral medications (prednisolone, hydroxychloroquine) for SLE without evidence of recurrence.
이경훈 ( Kyoung Hoon Rhee ),정창희 ( Chang Hee Jung ),배정호 ( Jung Ho Bae ),소민욱 ( Min Wook So ),오지선 ( Ji Seon Oh ),김세희 ( Sai Hui Kim ),나성수 ( Seong Su Nah ),이창근 ( Chang Keun Lee ),유빈 ( Bin Yoo ),문희범 ( Hee Bom 대한류마티스학회 2006 대한류마티스학회지 Vol.13 No.2
Dermatomyositis (DM) is an inflammatory myopathy of unknown etiology, which involves predominantly the muscles and skin, but also produces pulmonary manifestations in approximately 10% of the patients. Increasing attention has been paid to progressive interstitial pneumonitis as an important pulmonary manifestation of DM that can sometimes have a serious influence on the prognosis. Pneumomediastinum has been reported as a rare complication of DM. In this report, we present a case of 40-year-old woman with DM and interstitial lung disease who developed spontaneuous pneumomediastinum and was successfully treated with cyclosporin A.
김기원 ( Ki Won Kim ),정혜경 ( Hye Kyoung Chung ),이한민 ( Han Min Lee ),조아라 ( A Ra Cho ),이세환 ( Se Whan Lee ),나성수 ( Seong Su Nah ),모상일 ( Sang Il Mo ),이혁규 ( Hyeok Gyu Lee ),고규봉 ( Gyu Bong Ko ),강병일 ( Byong Il Ka 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.1
Klinefelter`s syndrome (KFS) is a gonosomal aberration disease that occurs in males, and is characterized by 47, XXY karyotype, hypogonadism and a lack of secondary sexual characteristics. A potential link between this hormonally deficient syndrome and autoimmune disease, particularly systemic lupus erythematosus (SLE), has been reported. On the other hand, KFS is rarely reported to be accompanied by rheumatoid arthritis (RA), and there are no Korean cases reported. We report the first Korean case of a KFS patient with sero-positive RA and discuss the role of the pathogenesis of RA with KFS.
일차성 Sjogren씨 증후군에서 발생한 림프구성 간질성 폐렴 증례보고와 국내문헌고찰
모상일 ( Sang Il Mo ),이혁규 ( Hyeok Gyu Lee ),조아라 ( A Ra Cho ),정혜경 ( Hye Kyoung Chung ),이호성 ( Ho Sung Lee ),최재성 ( Jae Sung Choi ),서기현 ( Ki Hyun Seo ),나성수 ( Seong Su Nah ),김용훈 ( Yong Hoon Kim ),나주옥 ( Ju Ock 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.5
Lymphoid interstitial pneumonia (LIP) is a rare benign lymphoproliferative interstitial lung disease. LIP has been associated with autoimmune disorders, HIV, viral infections, and so on. Once underlying systemic diseases have been excluded, a diagnosis of idiopathic LIP can be made. Although 6 cases of pathologically confirmed LIP have occurred in Korea, thus far none has been associated with primary Sjogren`s syndrome. A 44-year-old man was admitted to hospital due to a dry cough and dypsnea on exertion that had been ongoing for 2 months. A chest radiography showed multiple and variable-sized cystic lesions, on both lungs and both interstitial infiltration and consolidation in both lower lung fields. Tests for autoantibody showed positive results of anti-nuclear antibody and anti-Ro/La antibody. The patient underwent a video assisted thoracoscopic surgery biopsy and pathologically confirmed LIP. We report the first known case of LIP-associated with primary Sjogren`s syndrome in Korea.
병원획득 Klebsiella pneumoniae 균혈증 분석을 통해 본 Ciprofloxacin 내성과 Extended-Spectrum β-Lactamase생성 간의 연관성
김미영,추은주,곽이경,송문희,나성수,송태준,김성혜,전재범,최상호,정진용,김남중,김양수,우준희,류지소 대한감염학회 2004 감염과 화학요법 Vol.36 No.5
목적 : K. pneumoniae는 ciprofloxacin내성 증가가 전세계적으로 문제가 되고있는 extended-spectrum beta-lactamase (ESBL)를 생성하는 대표적인 세균으로 최근 외국에서 ciprofloxacin 내성과 ESBL 생성사이에 관련이 있다는 2-3편의 보고들이 있었다. 본 연구에서는 병원획득 K. pneumoniae 패혈증이 있었던 환자들을 대상으로 ciprofloxacin 내성과 관련된 인자를 알아보고자 하였다. 재료 및 방법 : 2001년 1월 부터 2002년 12월 사이에 2200병상의 3차 의료기관인 한 대학병원에서 입원 후 72시간 이후에 나간 혈액배양에서 K. pneumoniae가 배양된 입원환자를 대상으로 의무기록과 전산기록을 분석하여 환자의 성별, 나이, 병동, 기저질환, 이전의 항생제 사용력, 패혈증 발생당시까지의 재원기간, 이전 입원력, 원인균의ESBL 생성유무 등을 파악하였고 이들 변수가 ciprofloxacin 내성과 관련이 있는지를 분석하였다. 재발성 패혈증의 경우는 첫 번째 경우만을 분석에 포함하였다. 결과 : 연구대상 환자는 총154명이었고 K. pneumoniae의 ciprofloxacin에 대한 내성률은 28.6% (44/154)였다. Ciprofloxacin 내성균주 중 ESBL 생성균주의 비율은 95.5% (42/44)였고 ciprofloxacin 감수성균주에서 ESBL 생성균주의 비율은 24.5% (27/110)였다(P<0.001). ESBL생성외에 단변량 분석에서 유의한 관련을 보인 변수로는 남자, 나이가 많은 경우, 패혈증 당시 중환자실 재원, 기저질환이 고형암, 혈액암, 담도계 질환인 경우, 패혈증 발생이전 1달 이내의 항생제 사용력, 3세대 cephalosporin, metronidazole, fluroquinolone, carbapenem 투여력이 있었다. 다변량 로지스틱 분석을 시행 하였을 때는 나이가 많은 경우(Adjusted odds ratio[A0R]; 1.04, 95%confidence interval[CI]; 1.01-1.06)와 ESBL 생성(AOR; 81.35, 95% CI; 17.76-372.53)이 유의하게 ciprofloxacin 내성과 관련이 있었다. 결론 : 패혈증을 일으킨 병원획득 K. pneumonias에서의 ciprofloxacin 내성은 ESBL 생성과 유의한 관련을 보였고 향후 이에 관련된 원인이나 기전을 분석하기위한 분자역학적·분자생물학적 연구가 필요하겠다. Background : Strains of ciprofloxacin-resistant Klebsiella pneumoniae have emerged worldwide. We investigated the epidemiology of ciprofloxacin resistance and its relationship to ESBL production in nosocomial K. pneumoniae bacteremia. Materials and Methods : Using the computerized database of clinical microbiology, we identified all patients whose blood culture had yielded K. pneumoniae between January 2001 and December 2002 at a 2200-bed university-affiliated tertiary-care hospital. During the study period, total of 392 episodes of K. pneumoniae bacteremia were documented of which 163 episodes were acquired nosocomially. 9 cases of recurrent episodes were excluded. Results : The resistance rates to ciprofloxacin was 28.6% (44/154). ESBL-production was significantly more common in ciprofloxacin-resistant isolates than in ciprofloxacin-susceptible isolates (95.9% [42/44] vs. 24.5% [27/110], P<0.001). In univariate analysis, following factors were significantly associated with resistance to ciprofloxacin: older age, male sex, ICU admission at the time of bacteremia, prior use of antibiotics within 1 month before bacteremia, solid tumor, hematological malignancy, or biliary disease as underlying disease, and ESBL-production. The prior use of 3^(rd)-generation cephalosprins, metronidazole, fluroquinolone, or carbapenem were also risk factors. Independent risk factors for ciprofloxacin resistance were older age (adjusted odds ratio [AOR]; 1.04, 95% confidence interval [CI]; 1.01-1.06) and ESBL production (AOR; 81.35, 95% CI; 17.76-372.53). Conclusion : The close relationship between ciprofloxacin resistance and ESBL production was documented in nosocomial K. pneumoniae bacteremia. Further epidemiological and molecular studies to determine factors and mechanisms involved in the relationship are needed.