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RISS 인기검색어
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- 저자 : 장대국(Dae Kuk Chang) (검색결과 4 건)
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류마티스 관절염 환자에서 Hydroxychloroquine 이 혈중지질에 미치는 영향
장대국(Dae Kuk Chang),전재범(Jae Bum Jun),정성수(Sung Soo Jung),이인홍(In Hong Lee),배상철(Sang Cheol Bae),유대현(Dae Hyun Yoo),김성윤(Seong Yoon Kim) 대한내과학회 1994 대한내과학회지 Vol.47 No.5
N/A Objectives: Antimalarial drug have been used in the treatment of rheumatoid arthritis and systemic lupus erythematosus. They are inhibitors of platelet aggregation and adhesion whose prophylactic effects in thromboembolism have been demonstrated. Recently, profound decreases in serum cholesterol levels were reported in rheumatoid arthritis patients treated with chloroquine. The mechanism by which hydoxychloroquine may lower serum lipid is not clear, although chloroquine has multiple effects on hepatic cholesterol metabolism. We investigated the effects of hydroxychloroquine on serum lipid levels. Methods: We studied 62 female patients diagnosed as rheumatoid arthritis from Feburary 1993 to August 1993, prospectively. Patients were excluded from the study if they were diabetic, had nephrotic syndrome, or were taking antihyperlipidemic agents. A total of 62 female wer divided into following treatment groups: Group A; HCQ(n=46) Group B; sulfasalazine (n=16) We measured the lipid profile before therapy and after 3 months. Results: The hydoxychloroquine-treated group had lower cholesterol and LDL-cholesterol levels than those receiving sulfasalazine. The significant changes in lipid profile including lowering of serum cholesterol and LDL-cholesterol, were especially evident in the middle aged(age 41 to 60 years) group of patients. Conclusions: The lipid lowering effects of hydroxychloroquine on serum lipid levels may have a good reference for selection of antirheumatic drugs in patients with rheumatoid arthritis.
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남자 류마티스 관절염 환자에서 Androgen 보충요법의 치료 효과
심승철(Seung Cheol Shim),장대국(Dae Kuk Chang),김종필(Jong Phil Kim),정성수(Sung Soo Jung),이인홍(In Hong Lee),배상철(Sang Cheol Bae),유대현(Dae Hyun Yoo),최웅환(Woong Hwan Choi),김성윤(Seong Yoon Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.2
N/A Objectives: Recently, attention has been focused on the androgenic status of male rheumatoid arthritis patients. A hypogonadic condition, which is characterized by low serum testosterone concentration. seems to be associated at least with the activity of rheumatoid arthritis. Methods: We reviewed 46 cases of male RA patients who were admitted or visited to Hanyang University Hospital since Jannuary 1992 and five male RA patients who had low serum testosterone levels were treated for 24 weeks with testosterone in an attempt to evaluate the role of sex hormone in rheumatoid arthritis. Overall clinical and laboratorial results were obtained. Result: 1) The average serum testosterone level was 5.56 ng/ ml in male RA patients and 6.99 ng/ml in male OA patients. 2) In male RA patients, the range of serum testosterone concentration was 2.2~7.3 ng/ml and the range of serum DHEA-S concentration was 134~2313ng/ml. Both data were within normal limits. 3) Male RA patients who had low serum testosterone level were treated with testosterone and significant hormonal changes were not found. 4) After androgen replacement therapy there were no signficant changes in Ritchie articular index, grip strength of hands, global assessement of patients and physician, ESR etc. 5) During androgen replacement therapy only one case completed 24 weeks of this trial and another 3 cases were stopped due to abnormal liver function and the other one was stopped for aggravation of symptoms. Conclusion: Laboratory parameters of disease activity and overall clinical status not improved significantly with androgen replalcement in male rheumatoid arthritis patient having low testosterone.
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D-Penicillamine 에 의한 중증 근무력증 1 예
김명호,유대현,윤석진,김성윤,이인홍,배상철,장대국,장대일 대한내과학회 1992 대한내과학회지 Vol.43 No.2
In the D-penicillamine induced myasthenia gravis, ptosis and diplopia may occur usually six to seven months after starting therapy. Muscular weakness is usually improved two to three months after discointinuing D-penicillamine without any treatment. The pathogenesis of drug induced myasthenia is not clear. The antiacetylcholine receptor antibody is noticed to be increased presumably due to altered immunological reactivity. The patient was a 52-year-old woman who had had rheumatoid arthritis for 5years. After four months of D-penicillamine therapy (500mg/day), she began to be suffered from diplopia and left ptosis. A tensilon test was positive. HLA DR1 was positive. Electromyographic finding was normal. No antibody to acetylcholine receptor was detected. Four months after cessation of D-penicillamine therapy symptoms and signs disappered without any treatment. We experienced a case of rhematoid arthritis with D-penicillamine induced myasthenia gravis in a 52-year-old female and report this with a review of literature.
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부갑상선 절제술 후 골밀도의 증가를 보인 만성 신부전증에 병발된 신성 골 이영양증 1 예
박한철,김호중,안유헌,박찬현,정파종,박문향,강경원,강종명,장대국,채현기 대한내과학회 1995 대한내과학회지 Vol.48 No.4
$quot;Renal osteodystrophy$quot;, a term introduced over 51 years ago, is still used to describe any bone disease occuring in a patient with renal disease. In actually, a very wide spectrum of bone disease can occur in renal failure patients, ranging from states of makedly impaired bone formation and mineralization (such as low-turnover bone disease, osteomalacia) to states of markedly increased bone turnover (hyperparathyroidism). We had experienced one case of renal osteodystrophy and secondary hyperaparathyroidism, especially combined with advanced renal failure, who was admitted to Hayang University Hospital due to severe bone pain on both lowe extremites. Skull X-ray showed decreased bone density with so called $quot;salt and pepper$quot; appearance. Subperiosteal bone resorptions along the ribs and the proximal medial tibial metaphysis were noted on chest PA and both knee X-rays. Serum calcium level was 8.9mg/ dl, serum phosphorous level was 5.6mg/dl, serum alkaline phosphatase was 1872IU/L, serum parathyroid hormone level was 6.54ng/dl(normal; 0.22-0.66ng/dl). Dual photon bone densitometry showed marked decreased total body bone density. Renal osteodystrophy(osteitis fibrosa) was confirmed by bone biopsy stained with Haematoxylin & Eosin and double tetracycline labelling, and secondary hyperparathyroidism was confirmed by parathroid gland biopsies. She was treated with CaCO3, Al(OH)3, Cholecalcitriol after parathyroidectomy.
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