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중증 류마티스 관절염 환자에 대한 Methylprednisolone Minipulse Therapy의 효과
정성욱,김재연,최진우,안진철,한성훈,김동욱,문정섭,이윤우 인제대학교 1997 仁濟醫學 Vol.18 No.2
1994년 3월부터 1996년 4월까지 인제대학교 서울백병원에 입원한 류마티스 관절염 환자 13예를 대상으로 methylprednisolone 100mg을 3일간 정맥 주사하는 '소충격요법(minipulse therapy)'을 실시하여 치료전과 치료후 3일, 1개월 그리고 3개월에 환자의 주관적인 평가(환자의 질병 활성도 평가, visual analogue pain scale, 조조 강직), 객관적인 이학적 검사(압통과 종창 관절의 수, standard grip strength)와 혈액학적 검사(ESR, CRP, 류마티스인자)를 시행하여 모든 측정치가 조사 기간동안 호전되었으며 부작용은 발견되지 않았다. 이에 저자들은 methyl-prednisolone 소충격 요법이 disease modifying antirheumatic drugs의 치료 효과가 나타날 때까지 증상의 일시적인 호전을 위해 유효한 치료 방법이 될 수 있을 것으로 사료된다. Objective: Methylprednisolone megadose pulse therapy (1.0 g I.V for 1 to 3 days) has been known effective for the patients with severe rheumatoid arthritis, and lately there were few reports that minipulse therapy (100 mg I.V. for 3 days) was also effective. We have done prospective study to evaluate the effectiveness of methylprednisolone minipulse therapy against Korean patients wish severe rheumatoid arthritis. Methods: Methylprednisolone minipulse therapy (100mg I.V for 3 days) had been given to 13 patients with severe rheumatoid arthritis from March 1994 to April 1996. Each patient was evaluted about the subjective patient's self assessed conditions (patient's assessement of overall disease activity, visual analogue pain scale and duration of morning stiffness), the objective observer's physical examinations (the number of tender and swollen joints, standard grip strength), and laboratory analyses (ESR, CRP and rheumatoid factor). The evaluations were done before therapy, on day 3 after therapy. 1 and 3 months after therapy. Results: 1.The subjective patient's self assessed conditions and the objective observer's physical examinations improved significantly after minipulse therapy. 2.The laboratory analyses improved after minipulse therapy. 3. Any significant clinical complication wasn't found during 3 months of follow-up peroid. Conclusion : Methylprednisolone minipulse therapy could be used for temporary improvement of severe rheumtoid arthritis, while the treatment with disease modifying antirheumatic drugs gets effectiveness.
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이봉춘,이혜경,최수전,염호기,김주인,김정수,안진철,전우기 대한내과학회 1996 대한내과학회지 Vol.51 No.5
The leiomyosarcoma is uncommon tumor and commonly arise from retroperitoneum or mesentery. But leiomyosarcoma arised from mediastinum is very rare and only incidental case report is present. Mediastinal leiomyosarcoma may originate from superior vena cava, pulmonary artery, small vessels of alveoli, esophagus and cardiac muscle. Common symptoms related with leiomyosarcoma of mediastinum are cough and dyspnea. And dysphagia, chest pain, hemoptysis and pleural effusion can be rarely produced. Although complete resection of tumor was the choice of treatment, there was no effective therapy in patients who had disseminated disease or huge tumor mass. We report a case of posterior mediastinal leiomyosarcoma confirmed by immunohistochemical staining and electron microscopic finding with a review of literature.
ScienceON
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