경남 지역 농업인의 상지 근골격계 질환 유병률과 위험인자

서영선 ( Young Sun Suh ),천윤홍 ( Yun Hong Cheon ),김현옥 ( Hyun Ok Kim ),김록범 ( Rock Bum Kim ),박기수 ( Ki Soo Park ),양현수 ( Hyun Su Yang ),박형빈 ( Hyung Bin Park ),나재범 ( Jae Bum Na ),윤철호 ( Chul Ho Yoon ),이상일 ( Sang 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.6

Objective. To evaluate the prevalence and risk factors of upper extremity musculoskeletal diseases (MSDs) among Korean farmers. Methods. The study was carried out from June 2013 to August 2015 on 850 farmers and 203 non-farmers (controls) in Gyeongnam Province. Physical examinations were performed by rheumatologists, orthopedists, and rehabilitation specialists. Plain radiography, a nerve conduction examination, and magnetic resonance imaging were performed, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was used to assess upper extremity function. Results. Thirty-four different types of upper extremity MSDs were detected in the 1,053 study subjects. The prevalence of any MSD in farmers was 8.96-fold higher than in control (p<0.001). The most obvious difference in prevalence between farmers and non-farmers was hand osteoarthritis (48.2% vs. 4.9%). Mean total DASH score was higher for farmers than non-farmers (14.29±13.66 vs. 10.03±10.85, p<0.001). Among farmers, myofascial pain syndrome, rotator cuff tear, and epicondylitis were more prevalent among overhead workers (growing persimmons, pears, and grapes) than in non-overhead workers (growing rice and upland crops). The following factors were associated with a rotator cuff tear; older age, overhead work, high waist circumference, and lower level of education. Hand osteoarthritis was found to be associated with older age, a female gender, high waist circumference, and longer total work time. Conclusion. The prevalence of upper extremity MSDs is much higher in farmers than non-farmers and greater still for farmers doing overhead work. Various factors contribute to the occurrence of upper extremity MSDs, and thus, the authors suggest an efficient preventive strategy, which involves consideration of type of work and risk factors, be established for farmers to reduce upper extremity MSDs. (J Rheum Dis 2015;22:366-373)

성상신경절 차단후 총경동맥, 액와동맥, 상완동맥 요골동맥의 혈류속도변화

서영선(Young Sun Suh) 대한통증학회 1995 The Korean Journal of Pain Vol.8 No.1

N/A Stellate ganglion block(SGB) is applicated frequently to increase the blood flow and to re- duce the pain in head, neck and upper extremity. The effects of SGB are able to be estimated by clinical signs and symptoms of Horners syndrome, skin warmth, anhydrosis, etc. The ef- fects are also estimated by sympathetic function and the blood flow. Blood flow velocities and pulsatility indices of common carotid,d axillary, brachial and radial artery were measured by Doppler flowmeter after SGB with 1% lidocaine at C6 level. Blood velocities of all arteries were increased and pulsatility indices of all arteries were de- creased. This results suggest that SGB increase the blood flow of head and upper extremity and Doppler flowmeter is a good indicator of the effects of SGB

Alcohol농도에 따른 내장신경 차단효과

윤덕미,서영선,오흥근,Yoon, Duck-Mi,Suh, Young-Sun,Oh, Hung-Kun 대한통증학회 1990 The Korean Journal of Pain Vol.3 No.1

Three hundred and eighty-nine cases of splanchnic nerve block were retrospectively divided into 3 groups according to the change of alcohol concentration. In Group 1 (26 cases), about 7 ml of 1% lidocaine was used bilaterally as test block followed by an injection of 20 ml of 50% alcohol bilaterally. In Group 2 (286 cases) the same test block was followed by the same amount of pure and 50% alcohol. In Group 3 (77 cases) and used 30 ml of 75% alcohol bilaterally. The overall success rate of the first alcohol block in group 1, 2 and 3 was 73.1%, 92.0% and 84.4% respectively. From the above results, that splanchnic nerve block by pure alcohol was the most reliable method for upper abdominal cancer patients.

Alcohol 농도에 따른 내장신경 차단효과

윤덕미(Duck Mi Yoon),서영선(Young Sun Suh),오흥근( 대한통증학회 1990 The Korean Journal of Pain Vol.3 No.1

N/A Three hundred and eighty-nine cases of splanchnic nerve block were retrospectively divided into 3 groups according to the change of alcohol concentration. In Group 1 (26 cases), about 7 ml of 1% lidocaine was used bilaterally as test block followed by an injection of 20 ml of 50% alcohol bilaterally. In Group 2 (286 cases) the same test block was followed by the same amount of pure and 50% alcohol. In Group 3 (77 cases) and used 30 ml of 75% alcohol bilaterally. The overall success rate of the first alcohol block in group 1, 2 and 3 was 73.1%, 92.0% and 84.4% respectively. From the above results, that splanchnic nerve block by pure alcohol was the most reliable method for upper abdominal cancer patients.

대상포진후 신경토에 적용한 경막외 Phenol 주입법

문봉기(Bong Kee Moon),서영선(Young Sun Suh),윤덕미 대한통증학회 1994 The Korean Journal of Pain Vol.7 No.2

N/A Postherpetic neuralgia is one of the most troublesome disease in pain clinic. Nine patients who suffered from postherpetic neuralgia for 1.5 to 8 month, has been treated with the epidural block for prognostic or therapeutic purpose. Epidural catheter was inserted as close to the involved neural roots as possible, and tip of ep- idural catheter was confirmed under fluroscopic guide. Epidural neurolysis was performed out intermittent injection of 1-3 ml of 6% phenol in sa- line and repeated 2-6 times over one or 7 days interval. Two patients reported satisfactory pain relief and 3 patients reported some pain relief. But 4 patients unchanged after phenol block. The overall duration of pain relief was not studied. Validity and safety of epidural phenol block was not confined. Further study will be necessary before application of epidural phenol block to postherpetic neuralgia.

콜라겐 유도성 관절염 마우스모델에서 레스베라트롤 식이요법의 류마티스관절염 완화효과

천윤홍 ( Yun Hong Cheon ),김현옥 ( Hyun Ok Kim ),서영선 ( Young Sun Suh ),허재형 ( Jae Hyung Hur ),조원용 ( Won Yong Jo ),임혜송 ( Hye Song Lim ),하영술 ( Young Sool Hah ),성미정 ( Mi Jeong Sung ),권대용 ( Dae Young Kwon ),이상일 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.2

Objective. Resveratrol is well-known for its anti-inflammatory, anti-oxidant effects on several diseases. We investigated whether dietary supplementation with resveratrol may suppress joint inflammation and destruction in a mouse model of collagen-induced arthritis (CIA). Methods. Mice were randomly divided into two groups; CIA mice with normal diet-fed and CIA mice fed a 0.05% resveratrol diet. The effect of resveratrol on arthritis was assessed by clinical scoring system. The plain radiographs of paws were obtained to evaluate the effects on preventing bone destruction. Joint inflammation, cartilage damage, and osteoclastic bone resorption were checked by staining with H&E, Safranin-O, and tartrate resistant acid phosphatase (TRAP). Levels of pro-inflammatory cytokines were checked by enzyme-linked immunosorbent assay. The level of expression of nuclear factor (NF)-κB was measured by electrophoretic mobility shift assay (EMSA). Results. Dietary supplementation with resveratrol led to mitigated severity of arthritis compared to the normal diet group (6.7±0.8 vs. 2.7±0.6, p<0.01). Resveratrol-fed mice showed decreased bone destruction on radiograph (3.4±0.3 vs. 2.0±0.2, p<0.01), and showed significantly inhibited pathological changes (inflammation 2.0±0.3 vs.3.2±0.2, p<0.01; cartilage damage 1.5±0.3 vs. 3.2±0.2, p<0.01; pannus formation 1.4±0.3 vs. 3.0±0.3, p<0.01; erosion; 1.4±0.2 vs. 3.3±0.3, p<0.01). Generation of TRAP-positive osteoclasts was inhibited in the resveratrol-fed mice (55.3±12.7 vs. 3.27±0.8, p<0.01). Resveratrol-fed mice showed decreased levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-6,monocyte chemoattractant protein 1, and the soluble receptor activator of NF- κB ligand in joint tissues and sera. Expression of NF-κB, measured by EMSA, was decreased in resveratrol-fed mice. Conclusion. Dietary supplementation with resveratrol mitigates inflammation and bone destruction in CIA mice. (J Rheum Dis 2015;22:93-101)

Adalimumab으로 치료된 스테로이드 및 메소트렉세이트 저항성 호산구성 근막염 1예

이상수 ( Sang Su Lee ),김현옥 ( Hyun Ok Kim ),나재범 ( Jae Boem Na ),이종실 ( Jong Sil Lee ),서영선 ( Young Sun Suh ),천윤홍 ( Yun Hong Cheon ),강민규 ( Min Gyu Kang ),김유은 ( Yu Eun Kim ),이상일 ( Sang Il Lee ) 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.4

호산구성 근막염은 원인과 병인이 잘 알려지지 않은 미만성 근막염과 호산구 증가증을 보이는 드문 질환이다. 스테로이드 제제가 일차적인 치료제로 알려져 있으며 치료에 반응이 없는 경우 MTX와 같은 항류마티스 제제를 투여 할 수 있다. 하지만 이러한 약제에도 저항성을 보이는 경우 종양괴사인자 억제제가 치료에 사용될 수 있으며 치료 후 반응을 평가 하기 위해 자기공명영상이 유용할 수 있다. 이에 저자들은 스테로이드와 항류마티스 제제에 저항성을 보이는 호산구성 근막염 환자에게 종양괴사인자 억제제를 사용하여 치료 호전된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Eosinophilic fasciitis (EF) is a rare fibrosing disorder characterized by painful swelling and induration of the limbs and trunk, characteristic histology with sclerosis and lymphocytic inflammation affecting the fascia. The cause and pathogenesis of EF are still unknown and current therapies include glucocorticoids with or without use of immunosuppressive agents. Recently, there have been several case reports documenting the efficacy of a TNF alpha inhibitor in EF following a steroid-resistant disease course. However, there has been no report on the experience in treatment of EF with a TNF alpha inhibitor in Korea. Hence, we report a case of steroid and methotrexate-resistant EF which was successfully treated with adalimumab, along with a review of the relevant articles.