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슬골관절염 환자에서 시행한 초음파 소견과 통증과의 상관관계
강효종 ( Hyo Jong Kang ),이상배 ( Sang Bae Lee ),이명수 ( Myeung Su Lee ),홍승재 ( Seung Jae Hong ),박경수 ( Kyung Su Park ),윤종현 ( Chong Hyeon Yoon ),김완욱 ( Wan Uk Kim ),민도준 ( Do June Min ),민준기 ( Jun Ki Min ),이상헌 ( S 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.2
Objective: To investigate the ultrasonographic findings in knee OA patients and to examine the possible causes of pain in osteoarthritis by ultrasonography. Methods: Ultrasonography was performed with 7.5 MHz linear probe in 64 knee OA patients who fulfilled the ACR criteria. All patients were graded according to the Kellgren-Lawrence grades and then classified into group 1 (K/L I and II) and Group 2 (K/L III and IV). Also WOMAC score, BMI, laboratory finding (ESR, CRP) were checked. Ultrasonographic findings was examined; effusion, thickening of synovium, vertical length of medial and lateral osteophyte (longitudinal view), length of capsular distension (medial longitudinal view), evidence of bursitis and articular cartilage. Results: 50.0% of patients had effusion, among whom 68.7% patients also had synovial thickening. In all patients, the severity of pain was correlated with 4 variables; the presence of effusion, disease duration, the length of medial osteophyte, the length of capsular distension (r=0.279, r=0.415, r=0.537, r=0.608, respectively, p<0.05). The length of medial osteophyte, the degree of capsular distension and disease duration were significantly correlated with WOMAC pain score in Group 1 (p<0.05). After multiple regression analysis, the length of medial osteophyte alone had correlation with the pain severity in Group 1 (r2=0.396 p<0.05) and the only length of capsular distension was significantly correlated with WOMAC pain score in Group 2 (r=0.609, p<0.05). Conclusion: The length of osteophyte may be more related with pain severity in mild cases (K/L score I and II) while capsular distension could be an important factor causing knee pain in more advanced knee OA (K/L score III and IV).
김민수,이종석,남상범,강효종,김지은 대한의학회 2015 Journal of Korean medical science Vol.30 No.8
Size selection of the laryngeal mask airway (LMA) Classic based on actual body weight remains a common practice. However, ideal body weight might allow for a better size selection in obese patients. The purpose of our study was to compare the utility of ideal body weight and actual body weight when choosing the appropriate size of the LMA Classic by a randomized clinical trial. One hundred patients with age 20 to 70 yr, body mass index ≥ 25 kg/m2, and the difference between LMA sizes based on actual weight and ideal weight were allocated to insert the LMA Classic using either actual body weight or ideal body weight in a weight-based formula for size selection. After insertion of the device, several variables including insertion parameters, sealing function, fiberoptic imaging, and complications were investigated. The insertion success rate at the first attempt was lower in the actual weight group (82%) than in the ideal weight group (96%), even it did not show significant difference. The ideal weight group had significantly shorter insertion time and easier placement. However, fiberoptic views were significantly better in the actual weight group. Intraoperative complications, sore throat in the recovery room, and dysphonia at postoperative 24 hr occurred significantly less often in the ideal weight group than in the actual weight group. It is suggested that the ideal body weight may be beneficial to the size selection of the LMA Classic in overweight patients (Clinical Trial Registry, NCT 01843270).
윤재영,민선양,박주이,홍승권,강효종 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.4
A previously healthy 44-year-old woman who was diagnosed as having dermatomyositis suddenly developed severe dyspnea while being in the state of improved condition of muscle weakness. Interstitial lung disease was found on high resolution computed tomography (HRCT). In spite of the treatment with the immune-modulating agent (high dose steroid, cyclophosphamide, immunoglubulin and cyclosporine), her condition deteriorated further and rapidly, leading to death. More intensive agent such as FK506 would be necessary in those cases of dermatomyositis-related interstitial lung disease that have poor prognostic factors.
홍승재,양형인,윤휘중,이명수,강효종,김완욱,이상헌,조철수,김호연,Hong, Seung-Jae,Yang, Hyung-In,Yoon, Hwi-Joong,Lee, Myoung-Soo,Kang, Hyo-Jong,Kim, Wan-Uk,Lee, Sang-Heon,Cho, Chul-Soo,Kim, Ho-Youn 대한면역학회 2003 Immune Network Vol.3 No.1
Background: Celecoxib, a COX-2 specific inhibitor, has recently been used for the treatment of rheumatoid arthritis. However, the molecular and cellular mechanisms of celecoxib against RA inflammation remain to be defined. To elucidate the action mechanism of celecoxib on inflammatory cells, we investigated the effect of celecoxib on the production of two important mediators of inflammation, nitric oxide and PGE2 Methods: RAW 264.7 cells stimulated with LPS were preincubated with various concentrations of celecoxib (from $10^{-8}$ to $10^{-5}$ M) and $10{\mu}M$ hydrocortisone, respectively. The production of NO and PGE2, the end products of iNOS and COX-2 genes, were estimated in culture supernatants by Greiss method and EIA, respectively. The expression of iNOS gene, COX-2 gene, $NF-{\kappa}B$, and $I-{\kappa}B$ were determined by RT-PCR and western blot analysis. Results: Celecoxib and hydrocortisone inhibited the production of NO and PGE2 in dose dependent manner, when RAW 264.7 cells were stimulated with LPS. The expression of iNOS was also down-regulated by celecoxib and hydrocortisone. Interestingly, COX-2 gene differentially expressed according to the dose of celecoxib, a decrease with lower dose ($10^{-8}$ M) but an increase with higher dose ($10^{-5}$ M). $NF-{\kappa}B$ binding activity was decreased by lower dose of celecoxib, whereas was not affected by higher dose of it. The expression of $I-{\kappa}B$ was suppressed by higher dose of celecoxib. Conclusion: The celecoxib strongly suppressed the production of NO and PGE2 in LPS-stimulated RAW264.7 cells. The decrease of NO seems to be linked to the inhibition of iNOS by celecoxib. The lower and higher dose of celecoxib differentially regulated the COX-2 expression and $NF-{\kappa}B$ activity.
류마티스 관절염 환자의 혈중 아연 및 구리 농도와 질병 활성도와의 관계
이명수 ( Myeung Su Lee ),강효종 ( Hyo Jong Kang ),홍승재 ( Seung Jae Hong ),도주호 ( Ju Ho Do ),윤종현 ( Chong Hyeon Yoon ),김완욱 ( Wan Uk Kim ),민도준 ( Do June Min ),윤지희 ( Jee Hee Youn ),박성환 ( Sung Hwan Park ),조철수 ( Ch 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.4
Objective: To investigate the relationship between serum trace element levels with disease activity in Korean patients with rheumatoid arthritis (RA). Methods: The serum levels of zinc, copper and ceruloplasmin were measured by inductively coupled plasma atomic emission spectrometers in 80 patients with RA, 26 osteoarthritis (OA), and 30 healthy controls (HC). We also measured the levels of zinc and copper in the synovial fluid (SF) of patients with RA. We investigated the clinical parameters simultaneously obtained at sampling of serum and analyzed correlation between serum levels of trace elements and disease activity in RA. Results: In RA, the levels of serum zinc were significantly lower than that of HC, and the levels of serum copper and ceruloplasmin were significantly higher than those of HC. In active RA, the levels of serum zinc were more decreased, and the levels of serum copper and ceruloplasmin were more increased than those of inactive group of RA. The levels of both copper and ceruloplasmin showed positive correlation with the levels of serum ESR and CRP. On the other hand, the levels of serum zinc showed negative correlation with the levels of serum ESR and CRP. Conclusion: Serum zinc levels are significantly lower and serum copper levels significantly higher in patients with active RA and these trace elements were useful parameter of disease activity in RA.
신진,전용덕,최원규,안병진,문석준,김철우,권재구,백인석,강효종,채민수 대한신장학회 1996 Kidney Research and Clinical Practice Vol.15 No.4
Doxylamine is an antihistamine commonly used as an over-the-counter medication to relieve insomnia and frequently involved in overdoses. Its overdoses are dominated by anticholinergic effects, including central and peripheral effects in clinical course. Recently it was revealed that doxylamine has a direct toxic effect on muscle, while the exact mechanism is not clear yet. We report a case of young adult who was complicated by rhabdomyolysis and acute renal failure after ingestion of about 6250mg of doxylamine for suicide attemps. He was camed to emergency department due to generalized tonic clonic seizure. He developed a elevated muscle enzyme and showed generalized, multiple uptake in damaged muscle with image of Tc-99m MDP bone scan. He was treated with hydration, urine alkalinization and supportive care during hospitalization. On considering the cause of this rhabdomyolysis, we could not regard the seizure as a main cause in view of plasma creatine kinase level and suppose that direct toxic effect of doxylamine may play a role to some extents. In all case of where such overdosages are suspected, we should make consideration of obtaining creatine kinase level in tbe early periods to prevent the possibility of rhabdomyolysis and subsequent acute renal failure, especially in the presence of dehydration and acidosis.
무릎 골관절염 환자에서 초음파로 평가된 위중도와 연골 및 활막의 생화학적 지표 간의 상관관계
정영옥 ( Young Ok Jung ),김해림 ( Hae Rim Kim ),강효종 ( Hyo Jong Kang ),유승아 ( Seung Ah Yoo ),나종명 ( Jong Myoung Nah ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ),김완욱 ( Wan Uk Kim ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.1
Objective: Ultrasonography has benefit in detecting soft tissue abnormalities within the joints, which cannot be assessed by conventional X-ray. In this study, we investigated the relationship between soft tissue and/or bony abnormalities on ultrasonography and biochemical markers of synovium and cartilage in knee osteoarthritis (OA) patients Methods: Fifty-one knee OA patients who fulfilled the ACR criteria were enrolled in this study. Knee ultrasonography was performed in affected knee joints with a 12 MHz linear probe to assess the presence of effusion, synovial proliferation, capsular distension, length of osteophytes, and thickness of cartilage. At the same time, the serum levels of hyaluronic acid (HA) and cartilage oligomeric protein (COMP) were measured by ELISA and serum osteocalcin levels were determined by RIA. Results: The patients with longer medial osteophytes showed higher levels of serum HA and COMP than those with shorter ones. Serum HA levels were significantly higher in patients with larger amount of effusion and/or synovial proliferation, suggesting inflammatory changes within the joint, than those without. In addition, the severity of capsular distention was also correlated well with serum HA and COMP levels. However, the length of lateral osteophytes and thickness of femoral cartilage were not correlated with serum HA or COMP levels. Serum osteocalcin levels did not show any association with above ultrasonographic parameters, either. Conclusion: Using knee ultrasonography, we demonstrated that serum HA and COMP levels were elevated in more severe OA patients than less severe patients. This result suggests that detailed pathologic changes in the soft tissue and/or bone of OA joints on ultrasonography are being directly reflected to biochemical markers measured in the peripheral blood.
Erythropoietin 투여 후 나타난 투석막 재사용 투석효율 및 임상지표의 변화에 관한 연구
신진,전용덕,이성은,이승복,안병진,윤광식,문도호,도승경,정안철,최장균,정예경,강효종 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.2
The use of erythropoietin for correction of anemia in maintenance hemodialysis patients affects dialyzer reuse, dialysis efficacy and other clinical pararneters. This study showed the change of Kt/fVurea, nPCR, pre-dialysis BUN, body weight, ultrafiltration volume, pre-dialysis blood pressure, heparin dosage, the number of dialyzer reuse caused by the administration of erythropoietin in reuse(n=ll) and first use(n=9) patients who were started erythropoietin since January, 1995. 1) In 20 all patients, hematocrit increased significantly after EPO treatment 20.7±0.8%, 27.8±0.7%, ultrafiltration volume increased from 2.0±0.3L to 2.5±0.2L(P$lt;0.05). However no significant changes were noted in Kt/Vurea, nPCR and other parameters 2) In patients of dialysis reuse, the number of reuse was not affected by EPO treatment(8.4±1.7, 9.6±1.5, P=0.67). No significant differences were observed in all parameters except hematocrit in case of first use and reuse. 3) Entire patients were reclassified into low baselitein intake group(nPCR$lt;1.0g/kg/day) and high baseline protein intake group(nPcR$gt;1.0/kg/ day) and then pretreatment versus posttreatment nPCR, pre-dialysis BUN and ultrafiltration volume were compared. In low baseline protein intake group, significant increases of ultrafiltration volume, nPCR were observed. However, pre-dialysis BUN were not changed significantly. In high protein intake group, nPCR, pre-dialysis BUN, ultrafiltration volume were changed without significance. In conclusion, EPO treatment did not affect Kt/ Vurea, dialyzer reuse, nPCR, predialysis blood pressure, heparin dosage. But ultrafiltration volume increased significantly after EPO treatment. Maybe increased appetite in low baseline protein intake group caused the increased posttreatment ultrafiltration volume.