http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Mie Jin Lim,Kyong-Hee Jung,Seong-Ryul Kwon,Won Park 대한내과학회 2023 The Korean Journal of Internal Medicine Vol.38 No.6
Background/Aims: We investigated the effect of rituximab on systemic bone metabolism in patients with seropositive rheumatoid arthritis (RA). Methods: Twenty seropositive patients with RA were enrolled and administered one cycle of rituximab. If RA became active for > 6 months after the first rituximab cycle, a second cycle was initiated; otherwise, no additional treatment was administered. Patients were divided into two groups according to the number of rituximab treatment cycles. Results: In patients treated with a second cycle, the total hip bone mineral density (BMD) was clinically low, whereas the serum levels of receptor activator of nuclear factor kappa-B ligand (RANKL) were increased at 12 months. BMD in patients treated with one cycle did not change at 12 months, whereas serum RANKL levels decreased at all time points. DAS28 activity improved in both groups from baseline to 4 months; however, from 4 to 12 months, DAS28 activity worsened in the develgroup with the second cycle but remained stable in the group with one cycle. Conclusions: Systemic inflammation, reflected by increased disease activity, may be responsible for the increase in RANKL levels, which causes systemic bone loss in rituximab-treated patients with RA. Although rituximab affects inflammation, it does not seem to alter systemic bone metabolism in RA.
( Mie Jin Lim ),( Seong Ryul Kwon ),( Kyong-hee Jung ),( Won Park ) 대한류마티스학회 2016 대한류마티스학회지 Vol.23 No.6
Objective. This study examines the effects of tumor necrosis factor (TNF) blockade on markers of bone metabolism in peripheral blood from active rheumatoid arthritis (RA) patients. Methods. Eighteen patients (16 women, 2 men) aged 50 years (range 37-63 years), with persistently active RA (mean disease duration 7 years) were studied. Most took methotrexate (mean dose 12.5 mg) and all except one received corticosteroid (mean dose 5.7 mg). Four were treated with etanercept, eight received adalimumab and six received infliximab. Before and six months after taking TNF blockers, blood was sampled to obtain peripheral blood mononuclear cells (PBMCs), and serum bone turnover markers and acute phase reactants were measured. PBMCs were seeded and cultured to produce osteoblastic lineage cells and osteoclasts. Results. The formation of calcified nodules by osteoblastic lineage cells from PBMC increased from 205.7±196.3 μmol/well at the baseline to 752.5±671.9 μmol/well after TNF blockade (p<0.024). The serum levels of bone formation markers, including bone specific alkaline phosphatase and osteocalcin also increased. The number of circulating osteoclasts and area of bone resorption pits made by osteoclasts were reduced after TNF blockade. Conclusion. The activity of circulating osteoblastic lineage cells increased after TNF blockade, whereas peripheral osteoclastogenesis tended to be suppressed. This is the first study of cultured human peripheral osteoblastic lineage cells in RA patients. Given that peripheral bone formation is difficult to study using radiologic methods, culture of these cells may provide a new modality for studying bone metabolism in RA. (J Rheum Dis 2016;23:356-362)
( Mie Jin Lim ),( Seong Ryul Kwon ),( Kyong Hee Jung ),( Kowoon Joo ),( Won Park ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Raynaud`s phenomenon (RP) is characterized by a three-phase color change after cold exposure. We supposed that infrared thermography could be used as screening tool as cold-induced vasoconstriction of distal extremities in RP lowers skin temperature which could be easily detected by thermography. Methods: fifty-seven patients with RP (primary RP, n=33; secondary RP, n=24) and 146 healthy volunteers were recruited. After acclimation to temperature of 24 ℃, thermal imaging of palmar aspect of hands and dorsal aspect of feet were taken. A fi nger with lowest temperature among 2nd, 3rd and 4th fi nger was chosen as ‘thecoolest fi nger’. The temperature difference of the coolest fi nger/fi rst toe was defi ned as temperature of palm/dorsum was subtracted by temperature of the coolest fi nger/ 1st toe, respectively. Results: Temperature differences of both coolest fi ngers and fi rst toes signifi cantly differed between patients with RP and controls. They successfully distinguished male patients with RP from male controls but temperature difference of the coolest fi nger from non-dominant hand did not differ between female patients with RP and female controls. The area under curve analysis showed that temperature difference of the coolest finger (cutoff value: 2. 2 ℃) differentiated patients with RP from controls (sensitivity/specifi city : 65-68 %/ 57-62 %, respectively). Temperature differences of fi rst toe (cutoff value: 3. 11 ℃) discriminated patients with RP (sensitivity/specifi city : 72-74 %/ 64-68 %). Thermographic assessment of the coolest fi nger and fi rst toe combined was highly effective (sensitivity/ specifi city : 88-90 % / 44-45 %), especially in men (sensitivity/ specifi city : 88 %/ 58-62 %). However, in women, thermographic assessment of fi rst toe was solely suffi cient (sensitivity/specifi city : 88-90 % / 31-36 %). Conclusions: Thermographic assessment of the coolest fi nger and fi rst toe is useful as the screening tool for RP.
( Mie Jin Lim ),( Seong Ryul Kwon ),( Kowoon Joo ),( Min Jung Son ),( Shin Goo Park ),( Won Park ) 대한내과학회 2014 The Korean Journal of Internal Medicine Vol.29 No.6
Background/Aims: Our aim was to assess whether short-term treatment with soluble tumor necrosis factor (TNF) receptor affects circulating markers of bone metabolism in rheumatoid arthritis (RA) patients. Methods: Thirty-three active RA patients, treated with oral disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids for > 6 months, were administered etanercept for 12 weeks. Serum levels of bone metabolism markers were compared among patients treated with DMARDs at baseline and after etanercept treatment, normal controls and naive RA patients not previously treated with DMARDs (both age- and gender-matched). Results: Bone-specific alkaline phosphatase (BSALP) and serum c-telopeptide (CTX)-1 levels were lower in RA patients treated with DMARDs than in DMARD- naive RA patients. After 12 weeks of etanercept treatment, serum CTX-1 and sclerostin levels increased. In patients whose DAS28 improved, the sclerostin level increased from 1.67 ± 2.12 pg/mL at baseline to 2.51 ± 3.03 pg/mL, which was statistically significant (p = 0.021). Increases in sclerostin levels after etanercept treatment were positively correlated with those of serum CTX-1 (r = 0.775), as were those of BSALP (r = 0.755). Conclusions: RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients. Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.
항 Ro/SS-A 항체 양성인 일차성 쇼그렌증후군 환자에서 침샘 초음파의 유용성
박원 ( Won Park ),김영욱 ( Young Wook Kim ),권성렬 ( Seong Ryul Kwon ),임미진 ( Mie Jin Lim ),김환철 ( Hwan Cheol Kim ) 대한내과학회 2009 대한내과학회지 Vol.77 No.4
Background/Aims: This study sought to evaluate the diagnostic value of salivary gland ultrasonography in primary Sjogren`s syndrome with anti-Ro/SS-A antibody. The secondary goal was to assess the relationship between the grade of parenchymal inhomogeneity and the anti-Ro/SS-A antibody titer or clinical manifestations. Methods: The parotid and submandibular glands were examined ultrasonographically in 30 patients having primary Sjogren`s syndrome with anti-Ro/SS-A antibody and 30 control subjects with no evidence of Sjogren`s syndrome. The ultrasonographic definition of parenchymal inhomogeneity of the salivary glands was blurred glandular borders, multiple hyperechoic bands, and hypoechoic areas. The parenchymal inhomogeneity of the glands was categorized into four grades. Results: Parenchymal inhomogeneity of the parotid gland was seen in 25 (83.3%) patients with primary Sjogren`s syndrome and 2 (6.7%) control subjects. Of these cases, the submandibular gland showed parenchymal inhomogeneity in 24 (80%) patients with primary Sjogren`s syndrome and 2 (6.7%) control subjects. The sensitivity and specificity of parenchymal inhomogeneity of the parotid gland were 83.3% and 93.3%, respectively, and 80% and 93.3% for the submandibular gland. The grade of ultrasonographic parenchymal inhomogeneity was related to a diagnosis of Sjogren`s syndrome (p<0.001) and the time of dissolution of the wafer, but had no relationship with the anti-Ro/SS-A antibody titer. A high degree of interobserver agreement was found in the assessment of parenchymal abnormalities of the salivary gland (parotid gland: κ=0.859; submandibular gland: κ=0.837). Conclusions: Salivary gland ultrasonography is a useful method for visualizing glandular structural changes and making a diagnosis of primary Sjogren`s syndrome. (Korean J Med 77:480-487, 2009)