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척추 골관절염 환자에서의 골밀도와 골다공증성 척추골절의 빈도와의 관계
박준섭 ( Jun Sup Park ),주영실 ( Yeong Shil Joo ),최윤선 ( Yun Sun Choi ),정명아 ( Myeong A Cheong ),하형근 ( Hyung Keun Ha ),정인수 ( In Su Jung ),김시민 ( Si Min Kim ),김병준 ( Byoung Joon Kim ),안규정 ( Kyu Jeung Ahn ),최영길 ( 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.1
Objective: To investigate the association between bone mineral density (BMD) and osteoporotic compression fractures in radiographic spinal osteoarthritis (OA) patients. Methods: Subjects were 382 female patients (ages 45 to 85) from outpatient clinic for osteoporosis and rheumatic diseases. BMD was measured at lumbar spine and hip by dual X-ray absorptiometry (Hologic QDR 2000). The standard anteroposterior and lateral plain radiographs of thoracic and lumbar spine were taken to define spinal OA and vertebral compression fractures. Radiographic spinal OA was defined by grade of disc degeneration and facet joint degeneration. Frequency of vertebral fractures was compared between spinal OA and control patients in relation to their BMD, age, weight, body mass index (BMI) and years post menopause. Results: Higher proportion of fracture cases were observed in spinal OA patients than non-spinal OA patients (34.1%, 44/129 vs. 18.2%, 46/253, p<0.001) despite comparable mean BMD (0.836±0.152 vs. 0.834±0.185, p=0.89) and older mean age (65.8±8.5 vs. 57.8±10.3, p<0.001). In subjects of ages from 65 to 74, spinal OA patients showed significantly higher BMD than non-spinal OA patients (0.784±0.125 vs. 0.719±0.119, p=0.007), but the frequency of fractures seems to be higher than that of non-spinal OA patients (44.9%, 22/50 patients vs. 34%, 19/55 patients, p=0.58). When all study subjects were stratified according to their spine BMD (normal, osteopenia, and osteoporosis), significantly higher proportion of vertebral compression fractures was noted in spinal OA than non-spinal OA patients in osteopenia group (38.5% vs. 13.5%, p<0.001). Conclusion: Higher BMD does not seem to be translated directly into decreased risk of osteoporotic compression fractures in spinal OA patients. Careful assessment of risk factors for osteoporotic fractures and newer methods for assessing bone strength in this group of patients are needed.
젊은 여자에서 당뇨병과 여포성 갑상선암이 동반된 궤양성 대장염
양진수 ( Jin Su Yang ),박영숙 ( Young Sook Park ),김시민 ( Si Min Kim ),박준섭 ( Jun Sup Park ),이현석 ( Hyun Seok Lee ),전재석 ( Jae Seok Jeon ),김은경 ( Eun Kyung Kim ) 대한소화기학회 2003 대한소화기학회지 Vol.41 No.1
Ulcerative colitis is a chronic intestinal mucosal inflammatory disease of unknown etiology. Recent epidemiological and molecular studies have provided strong evidence that the inherited predisposition is important in the pathogenesis of chronic inflammatory bowel disease. The model consistent with the epidemiological data suggests that ulcerative colitis is related to polygenic diseases. We exprienced a 27-year-old woman with ulcerative colitis combined with follicular thyroid cancer and gestational diabetes mellitus. These diseases were developed consecutively within one and half year. She has a family history of thyroid disease and diabetes mellitus. We report this case with a review of literature. (Korean J Gastroenterol 2003;41:70-73)
크론병에서 Infliximab 치료에 의해 발생한 건선
좌윤정 ( Yoon Jung Jwa ),김남훈 ( Nam Hoon Kim ),박혜진 ( Hai Jin Park ),박준섭 ( Jun Sup Park ),배원기 ( Won Ki Bae ),김경아 ( Kyung Ah Kim ),이준성 ( June Sung Lee ),문영수 ( Young Soo Moon ) 대한소화기학회 2010 대한소화기학회지 Vol.56 No.5
Infliximab, the monoclonal antibody to tumor necrosis factor, is indicated for refractory luminal and fistulizing Crohn`s disease and rheumatoid arthritis. Infliximab treatment has adverse events including infusion reactions, opportunistic infections, and the potential for the event such as reactivation of latent tuberculosis. Cutaneous adverse reactions of TNF-α agents include skin rash, urticaria, pruritus, lupus-like eruption, and injection site reactions. Most of all, psoriasis or psoriasiform dermatitis induced by infliximab treatment for Crohn`s disease is rarely reported in Korea. We report a case of psoriasis induced by infliximab treatment for Crohn`s disease with a review of world literature. (Korean J Gastroenterol 2010;56:324-328)
고용량 스테로이드로 치유된 Henoch-Schonlein 자반증의 회장 말단부 궤양 1예
최원호 ( Won Ho Choi ),김남훈 ( Nam Hoon Kim ),정은숙 ( Eun Sook Jung ),윤상구 ( Sang Goo Yoon ),박준섭 ( Jun Sup Park ),배원기 ( Won Ki Bae ),김경아 ( Kyung Ah Kim ),이준성 ( June Sung Lee ),문영수 ( Young Soo Moon ),김한성 ( Han 대한소화기학회 2007 대한소화기학회지 Vol.50 No.5
Henoch-Schonlein purpura (H-S purpura) is a systemic small-vessel vasculitis involving skin, joint, gastrointestinal tract, and kidney. It is characterized by the classic tetrad of abdominal pain, arthralgia, typical rash, and renal involvement. All of these clinical findings can occur in any order and at any time over several days to weeks. Gastrointestinal manifestations such as abdominal pain, melena, or hematochezia occur in 45-85% and preceed skin lesions upto 40% in H-S purpura. However, endoscopically proven gastrointestinal lesion is rare because majority of involved sites are small intestine. We report a case of Henoch-Schonlein purpura with terminal ileal ulcer, healed after treatment with high dose steroid, proven by colonoscopy. (Korean J Gastroenterol 2007;50:324-327)
서유승,최재웅,송창섭,조용범,양진수,박준섭,정인수 대한내과학회 2003 대한내과학회지 Vol.65 No.2
관상동맥 동정맥루 기형은 매우 드문 질환으로 치료가 불필요한 경우가 대부분이나 coronary steal 현상으로 인해 증상이 발생하거나 합병증이 발생한 환자에 대해선 치료를 요한다. 최근에는 시술에 적합한 누공을 가진 선택된 환자군을 대상으로 카테터를 이용한 중재적 시술이 시행되어 수술적 치료와 유사한 결과를 얻고 있다. 저자들은 젊은 남자에서 관상동맥 동정맥루 기형과 동반된 급성 심근 경색증을 진단하여 비 수술적 방법인 카테타 코일 색전술로 성공적 치료 후 증상 및 심근 재관류에 호전을 보인 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. We report a case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute non-Q wave myocardial infarction. A 27-year-old man visited emergency department because of severe chest pain lasting two hours. The electrocardiogram showed ST segment elevation in precordial leads V3~6. Cardiac enzymes were as follows;CK-MB:36.44 IU/L T-T:0.489 ng/mL, CPK:542 IU/L, and LDH:475 IU/L. The thallium-201 dipyridamole stress perfusion scan showed perfusion defect and reversed redistribution in the anteroseptal wall. The coronary angiogram revealed coronary artery fistula between the proximal left anterior descending artery and main pulmonary artery without significant stenoses of coronary arteries. The result of ergonovine test was negative. After micro-coil embolization to the coronary fistula, symptoms were improved. Follow-up thallium-201 scan showed normalized blood flow in the left anteroseptal wall.
정명아,서유승,양진수,박준섭,윤진훈,이중건,이준승,이영규,김동희,조성범,주종은 대한신장학회 2002 Kidney Research and Clinical Practice Vol.21 No.2
Pelvic actinomycosis is a chronic granulomatous suppurative disease caused by an anaerobic grampositive organism Actinomyces israelii. It is com-monly associated with an intrauterine device(IUD) and can mimick pelvic or intra-abdominal malignant neoplasm. Ureteral obstruction leading to hydronephrosis is a rare complication of tubo-ovarian abscess. We experienced a case of hydronephrosis as a complication of pelvic actinomycotic abscess. The patient was a 46-year-old women presenting with fever and right flank pain. Leukocytosis and pyuria were present and a hydronephrosis was diagnosed by intravenous pyelography. Ultrasonography and a computerised tomography revealed a mass in right adnexum compressing the right ureter. Removal of retroperitoneal abscess and salphingo-oophorectomy were done and the diagnosis of actinomycosis was made by pathologic finding of resected mass. Postoperatively, the patient was treated with second-generation cephalosporin successfully. (Korean J Nephrol 2002;21(2):337-340)