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슬관절 골관절염 환자에 대한 Meloxicam의 유효성 및 안전성 평가를 위한 Diclofenac과의 공개 비교 무작위 다기관 임상 시험
송정식 ( Jung Sik Song ),박용범 ( Yong Beom Park ),이수곤 ( Soo Kon Lee ),안홍준 ( Hong Joon Ahn ),이윤우 ( Yun Woo Lee ),이창근 ( Chang Keun Lee ),고재현 ( Jae Hyun Koh ),고은미 ( Eun Mi Koh ),이은영 ( Eun Young Lee ),이충기 ( Ch 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.4
Objective: To assess the clinical efficacy and safety of meloxicam 7.5mg versus diclofenac 100mg slow release (SR) in the Korean patients with osteoarthritis of the knee. Methods: Ninety-one patients of four university hospitals in 1999 were randomized to receive once daily oral meloxicam 7.5mg (N=45) or diclofenac 100mg SR (N=46) for 8 weeks. Clinical efficacy was evaluated using 100mm Visual Analogue Scale (VAS) for pain, Lequesne index after 4, 8 weeks of treatment as well as the physician`s and patient`s global assessment at the end of treatment. Evaluations for clinical safety were performed using the incidence of adverse events, physical examinations, laboratory finding and total ingestion of antacid during the treatment. Results: After 8 weeks of therapy, both groups had significant improvement in 100mm VAS and Lequesne index than baseline although the difference between two groups did not reach statistical significance. The physician`s and patient`s global assessment were similar in two groups. The incidence of gastrointestinal adverse events was significantly lower in meloxicam group (24.4%) than diclofenac group (50.0%) (p<0.05). Conclusion: Meloxicam 7.5mg is comparable to diclofenac 100mg SR in the treatment of Korean patients with osteoarthritis of the knee. Furthermore meloxicam 7.5mg was well tolerated for 8 weeks and has safe advantage of a significantly lower incidence of gastrointestinal adverse events.
송정식 ( Jung Sik Song ),박용범 ( Yong Beom Park ),이준구 ( Jun Gu Lee ),권기환 ( Ki Hwan Kwon ),이원기 ( Won Ki Lee ),서창희 ( Chang Hee Suh ),이찬희 ( Chan Hee Lee ),송창호 ( Chang Ho Song ),이지수 ( Ji Soo Lee ),이수곤 ( Soo Ko 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1
Spontaneous pneumomediastnum has been reported only recently as a rare complication of dermatomyositis. We are reporting two cases of spontaneous pneumomediastinum in dermatomyositis. The diagnosis of dermatomyositis was based on the diagnostic criteria requiring symmetric weakness of limb-girdle muscles and anterior neck flexors, elevation of serum skeletal muscle enzymes, electromyograpic findings of inflammatory myopathy, positive findings on muscle biopsy and dermatologic features including heliotrope rash and Gottron`s papule. Vasculitis may be the common denominator leading to the association of dermatomyositis and pneumomediasinum. In reported cases, the prognosis of pneumomediastinum seems unfavorable. Interestingly the 2 cases we are reporting resolved spontaneously without any recurrence.
이준구,고시환,송정식,황재하,백용한,장윤수,김대중,배상욱,박중원,홍천수 ( Jun Gu Lee,Shi Hwan Ko,Jung Sik Song,Jae Ha Hwang,Yong Han Park,Yoon Soo Jang,Dae Jung Kim,Sang Wook Bae,Jung Woon Park,Chein Soo Hong ) 대한천식알레르기학회 1998 천식 및 알레르기 Vol.18 No.3
Human seminal fiuid (HSP) hypersensitivity is rare, but possibly a life-threatening disease. The pathogenesis of seminal plasma hypersensitivity and the exact nature of the HSP allergens remains to be clarified. We report a case of 25-year-old female patient who complained of severe itching sensation, flushing and edema of external genitalia, facial edema and dyspnea after sexual intercourse. The diagnosis was established by skin pr ick test with her husbands diluted semen. Intravaginal desensitization was performed by modified Matloffs method. Dilutions was made with sterile human serum albumin(0.2%) and 0.4% pheno1-0.9% saline solution. Two ml each of progressively greater concentrations of semen dilutions(1: 100,000 v/v, 1: 10,000 v/ v, 1:1,000 v/v, 1:100 v/v, 1:10 v/v) were inserted intravaginally at 45-min intervals, followed by an undiluted specimen. The patient was successfully desensitized and could have unprotected intercourse without anaphylaxis.
류마티스 관절염의 초치료와 불응성 류마티스 관절염의 치료에 있어 Bucillamine의 효과
송창호 ( Chang Ho Song ),이지수 ( Ji Soo Lee ),이찬희 ( Chan Hee Lee ),이충원 ( Choong Won Lee ),송정식 ( Jung Sik Song ),이수곤 ( Soo Kon Lee ),( Chang Hee Suh ) 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1
저자들은 DMARD를 사용한 경험이 없는 류마티스 관절염의 초치료 환자 10명과 DMARD에 반응이 없는 불응성 류마티스 관절염 환자 9명을 대상으로 bucillamine을 투여하여 다음의 결과를 얻었다. 1. 치료 종료시 초치료군에서 조조강직의 지속시간, VAPS, 압통관절의 수, 종창관절의 수, ESR 및 CRP가 치료전에 비하여 유의하게 감소 하였으나 불응성 환자군에서는 대부분의 지표가 감소하지 않았다. 2. 치료약제와 관련된 부작용은 초치료군에서 4예, 불응성 환자군에서 5예에서 발생하였으며, 상부위장관 장애가 양군을 합하여 5예로 가장 흔하였다. 이상의 결과로 bucillamine은 류마티스 관절염의 초치료에 효과적이며 비교적 안전한 약제임을 알 수 있었다. Objective: To assess the clinical effect of bucillamine in rheumatoid arthritis (RA), we performed an open clinical trial for 3 months. Methods: 10 out of 12 patients completed bucillamine trial(200mg/day) for their initial treatment against arthritis, and 9 out of 11 patients with refractory RA completed the bucillamine trial. Disease activity was assessed by the duration of morning stiffness(MS), visual analogue pain scale(VAPS), functional capacity(FC), tender joint counts(TJC), swollen joint counts(SJC), ESR, and CRP every month. Adverse effects were monitored monthly. Results: At the end of trial, all parameters were decreased in the initial treatment group except of CRP. No parameters were decreased in the refractory group. Gastrointestinal disturbance was the most common adverse effect. Skin rash, stomatitis, proteiuria and elevated hepatic enzyme were minor adverse effects. Conclusion: Bucillamine was effective in the initial treatment of rheumatoid arthritis, but not effective in the patients with refractory rheumatoid arthritis. Bucillamine is relatively safe in the treatment of rheumatoid arthritis in both groups.
전신성 홍반성 루푸스에 동반된 폐동맥 고혈압과 좌측 성대마비
김도영 ( Do Young Kim ),서정훈 ( Jung Hoon Suh ),강신명 ( Shin Myung Kang ),김창오 ( Chang Oh Kim ),나호균 ( Ho Guun Na ),김중선 ( Joong Sun Kim ),송정식 ( Jung Sik Song ),박용범 ( Yong Beom Park ),이원기 ( Won Ki Lee ),최홍식 ( H 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.3
There have been few case reports on the association of vocal cord palsy and pulmonary hypertension in a systemic lupus erythematosus (SLE) patient. Most cases had left vocal cord palsy caused by compression of left recurrent laryngeal nerve secondary to pulmonary hypertension, and only two cases in the literature were caused by vasculitis or inflammation of the right recurrent laryngeal nerve not related to pulmonary hypertension. Recently, we have experienced a 23-year-old female patient who presented hoarseness and multiple joint pain. She was diagnozed as SLE and left vocal cord palsy, and echocardiographic examination demonstrated enlargement of right atrium, right ventricle, and elevated right ventricular pressure (systolic pressure 47mmHg). She took high-dose glucocorticoid and calcium channel blocker. About one month later, there was significant improvement of hoarseness, arthritis, and cardiomegaly, and showed improvement of the left vocal cord palsy on the laryngoscopic examination. We report a case of left vocal cord palsy and pulmonary hypertension accompanied by SLE who experienced improvement of hoarseness after steroid treatment.
류마티스 다발근육통증 환자의 전형적 18-FDG-PET/CT 소견 1예
박진수 ( Jin Su Park ),표정윤 ( Jung Yoon Pyo ),박희진 ( Hee Jin Park ),이향선 ( Hyang Sun Lee ),강윤 ( Yoon Kang ),강미일 ( Mi Il Kang ),송정식 ( Jung Sik Song ),박용범 ( Yong Beom Park ),이수곤 ( Soo Kon Lee ),이상원 ( Sang Won 대한류마티스학회 2013 대한류마티스학회지 Vol.20 No.2
PMR의 병태생리는 명확히 밝혀져 있지 않지만, 염증을 시사하는 병리학적 소견이나 ESR의 상승은 염증이 주된 병인기전임을 시사한다. 최근 PMR 환자에서 시행한 18-FDG-PET에서 윤활막염과 윤활낭염 및 혈관염 등의 특징적인 소견이 관찰되고 있다. 이 증례는 PMR 환자에서 18-FDG-PET/CT를 시행하였고, 전형적인 윤활막염, 윤활낭염, 무증상의 큰 혈관염 등이 관찰된 첫 번째 증례이다. 향후 한국인 PMR 환자의 진단시, 18-FDG-PET의 유용성에 대한 정확한 자료를 얻기 위해서 표준화된 방법을 통한 여러 환자에서의 시행이 필요할 것이다. Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by generalized pain and morning stiffness in the shoulders, hip girdle, and neck. Since the pathogenesis of PMR is still uncertain, the diagnosis of PMR depends on clinical features. There have been several studies regarding radiological tools for the diagnosis of PMR. Recent studies using 18-FDG-PET showed bursitis, synovitis, uptake in the spinous process and asymptomatic large-vessel vasculitis in PMR patients. However, there was no report on the efficacy of 18-FDG-PET for diagnosis of PMR in Korea. Here, we are first reporting a case of a Korean patient with PMR, who had radiological findings including bursitis, synovitis, uptake in the spinous process and asymptomatic large-vessel vasculitis on 18-FDG-PET/CT.
이두희 ( Doo Hee Lee ),조영준 ( Young Jun Cho ),송정식 ( Jung Sik Song ),서창희 ( Chang Hee Seo ),이지수 ( Ji Soo Lee ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
Amyopathic dermatomyositis is defined by characteristic cutaneous manifestation of dermatomyositis without evidence of muscle involvement. There is no clinical difference between dermatomyositis and amyopathic dermatomyositis. Pulmonary involvement of dermatomyositis is so frequent than aggressive dianostic and therapeutic approach is needed. Early steroid or immunosuppresive treatment in pulmonary involvement of dermatomyositis gets better prognosis. Intravenous immunoglobulin treatment is an effective and safe alternative when the steroid or immunosuppresive treatment is ineffective or intolerable. We are reporting a case of amyopathic dermatomyositis with interstitial lung disease. This patient was improved with intravenous immunoglobulin treatment.
박무석 ( Moo Suk Park ),박민찬 ( Min Chan Park ),송정식 ( Jung Sik Song ),박용범 ( Yong Beom Park ),이수곤 ( Soo Kon Lee ),김세훈 ( Se Hoon Kim ),양우익 ( Woo Ick Yang ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.3
Systemic lupus erythematosus (SLE) is an autoimmune disease with a loss of the control over B lymphocytes which is normally exerted by T-suppressor cell. The thymus play a central role in regulating and controlling immune reaction through its effects on T cell differentiation of both T helper and T suppressor cells. Tumors of the thymus are rare but have been reported in concur rence with a variety of autoimmune diseases, including most frequently myasthenia gravis and rarely SLE and other disorders. The association of thymoma and SLE is very rare, fewer than 10 case reports in the world literature. The woman had been thymectomized because of incidental thymoma. After two years, she was diagnosed as SLE with features of arthritis, leukopenia, high titer of ANA, positivity of anti-dsDNA and hypocomplementemia. We report here one case of concurrent SLE and thymoma.
호산구증다증을 동반한 P-ANCA 양성 괴사성 사구체신염
신장열 ( Jang Yel Shin ),강이화 ( Ea Wha Kang ),류동렬 ( Dong Ryeol Ryu ),송정식 ( Jung Sik Song ),이원기 ( Won Ki Lee ),박용범 ( Yong Beom Park ),김루시아 ( Lucia Kim ),정현주 ( Heun Ju Jung ),이수곤 ( Soo Kon Lee ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.1
Antineutrophil cytoplasmic antibodies (ANCAs) are now regarded as a serologic marker for pauci-immune crescentic necrotizing glomerulonephritis either in renal-limited form or in association with systemic vasculitis, such as Wegener`s granulomatosis, microscopic polyarteritis, and Churg-Strauss syndrome. Two major ANCA antigens have been indentified: proteinase3, which produces a cytoplasmic staining pattern termed C-ANCA, and myeloperoxidase, which produces a perinuclear pattern termed P-ANCA on ethanol-fixed neutrophils by indirect immunofluorescence. In ANCA- associated diseases, eosinphilia in excess of 1.5×10(9)/L has been proposed to be characteristic of Churg-Strauss syndrome and is rare in other forms of ANCA-associated systemic vasculitis and crescentic necrotizing glomerulonephritis. Recently, there were two cases of P-ANCA positive crescentic necrotizing glomerulonephritis with peripheral blood eosinophilia and extrarenal microscopic vasculitis without asthma or granulomas. We experienced a patient with P-ANCA positive pauci-immune necrotizing glomerulonephritis with few eosinophilic infiltration and eosinophilia. He improved with oral prednisolone along with combination of intravenous cyclophosphamide. So we report this case with the review of literature.