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정승혜 ( Seung Hie Chung ),이진배 ( Jin Bae Lee ),임상혁 ( Sang Hyuk Lim ),김채기 ( Chae Gi Kim ),최정윤 ( Jung Yoon Choe ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.4
Overlap syndrome is used to describe patients who have two or more well-defined connective tissue diseases. Although a variety of overlap syndromes are now recognized, the coexistence of the progression of juvenile rheumatoid arthritis (JRA) to systemic lupus erythematosus (SLE) is uncommon. We describe a patient who had typical deforming polyarthritis, who years later developed SLE.
사람골수줄기세포가 연골조직으로 분화되는 과정에 나타나는 세포표지자의 표현
김상경 ( Sang Gyung Kim ),최정윤 ( Jung Yoon Choe ),김채기 ( Chae Gi Kim ),정승혜 ( Seung Hie Chung ),신임희 ( Im Hee Shin ),서헌석 ( Hun Suk Suh ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.1
Objective: Multipotent bone marrow stromal cells have the ability to differentiate toward a variety of connective tissue lineages including cartilage. The future use of adult mesenchymal stem cells (MSCs) for human therapies depends on the establishment of preclinical studies. Therefore, in this preclinical study we demonstrated the expression of MSC surface markers CD29, CD105, and CD44 on human bone marrow derived stromal cells during chondrogenic differentiation. Methods: Adult human bone marrow was collected from the iliac crest of 7 donors following informed consent. Mononuclear cells were isolated, incubated in monolayers, and embedded in alginate beads for three-dimensional cultures. Cellualr viability was assessed by MTT assay. Flow cytometry of alginate bead cultures was performed on days 0, 7, 14, 21, and 28 using monoclonal antibody against surface molecules, CD105, CD29, CD44, CD34 and CD45. Total contents of collagen and glycosaminoglycan (GAG) of the alginate beads was measured. SPSS 11.0 was used for data analysis. Results: After 7 days of culture, 89% of the cells expressed the human integrin beta 1 antibody, CD29. The CD29-positive cells remained elevated at 83% on days 28. However, while only 18% expressed the type II TGF-beta receptor endoglin, CD105 on day 7, the CD105-positive cells increased abruptly 65% on day 14 remaining elevated up to day 28. The expression of CD44 was maximal in the first passage cell (63%). High concentration of TGF-beta 3 (10 ng/mL) was more favorable for sustaining cell viability than a low concentration (0.5 ng/mL)(n=4, p=0.002, day 21). The total contents of collagen and GAG in the MSC-alginate beads increased during the three-dimensional culture (n=4, p=0.02, p=0.006) suggesting its differentiation into a chondrogenic lineage. Conclusion: CD29 was expressed earlier than CD105 during chondrogenic differentiation of human bone marrow MSC. CD44 expression was highest in the first passage cells and gradually decreased afterwards.
IgA 신병증을 동반한 쇼그렌증후군과 피부근염의 중복증후군
신진향 ( Jin Hyang Shin ),박근우 ( Keun Woo Park ),조자경 ( Ja Kyoung Cho ),한석재 ( Seok Jae Han ),정승혜 ( Seung Hie Chung ),김채기 ( Chae Gi Kim ),최정윤 ( Jung Yoon Choe ),김상경 ( Sang Gyung Kim ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.4
An overlap syndrome is used to describe patients who have two or more well-defined connective tissue diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and polymyositis. Their coexistence is defined clinically and often by specific serologic tests. We report a case of dermatomyositis associated with IgA nephropathy that had overlapping features of Sjogren`s syndrome. This dermatomyositis and Sjogren`s overlap is a rarely reported overlap syndrome worldwide.
중추신경계 침범을 보인 Sweet 증후군 1예: Neuro-Sweet disease
정현영 ( Hyun Young Jung ),김수경 ( Soo Kyoung Kim ),박근우 ( Keun Woo Park ),박철연 ( Cheol Yeon Park ),정승혜 ( Seung Hie Chung ),박성훈 ( Sung Hoon Park ),최정윤 ( Jung Yoon Choe ) 대한내과학회 2008 대한내과학회지 Vol.75 No.4
Sweet 증후군은 급성 발열, 백혈구 증가, 발적을 동반한 압통성 피부 병변을 특징으로 하며, 피부병변의 진피 조직에서 중성구의 피하침윤이 관찰된다. Sweet 증후군의 피부 외 발현으로 근골격계 증상이 흔하게 나타나지만 중추 신경계의 침범은 매우 드물어 국내에서는 보고된 바가 없다. 이에 저자들은 의식 혼탁으로 내원하여 중추 신경계를 침범한 Sweet 증후군으로 진단한 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Sweet syndrome is an unusual disease characterized by the sudden onset of fever, leukocytosis, and painful erythematous plaques, and the dermal infiltration of neutrophils at the site of skin lesions. Although Sweet syndrome can also present with extra-cutaneous manifestations, involvement of the central nervous system (CNS) is rarely reported. We describe a case of Sweet syndrome involving the CNS in a 46-year-old male with a disturbance of consciousness following fever and erythematous skin plaques in the extremities. Cerebrospinal fluid examination disclosed neutrophilic pleocytosis without decreased glucose and protein levels. HLA typing showed B54, which is frequently seen in Sweet syndrome. Brain magnetic resonance imaging showed abnormal signal intensity lesions in the left temporal lobe. Skin biopsy revealed a dense dermal infiltration of neutrophils, which is compatible with Sweet syndrome. The confused mentality, fever, and erythematous skin plaques resolved after the administration of systemic corticosteroids. (Korean J Med 75:463-466, 2008)
한석재 ( Seok Jae Han ),조자경 ( Ja Kyung Jo ),조윤영 ( Yoon Young Cho ),김학준 ( Hak Jun Kim ),김상현 ( Sang Hyon Kim ),정승혜 ( Seung Hie Chung ),김채기 ( Chae Gi Kim ),김지언 ( Ji Eun Kim ),최정윤 ( Jung Yoon Choe ) 대한류마티스학회 2005 대한류마티스학회지 Vol.12 No.2
Up to 70% of patients with systemic lupus erythematosus (SLE) are afflicted with neurologic manifestations. However, there are only a few reports documenting acute leukoencephalopathy in SLE. We describe a 20-year-old woman who was recently diagnosed as SLE, suffering from headache, fever and arthritis. She developed an acute onset of consciousness disturbance with seizure followed by prolonged coma, which recovered completely after 1 month of steroid therapy. Her brain MRI showed diffuse high signal intensity in the periventricular and subcortical white matter on T2-weighted and FLAIR images, whereas cerebral cortex, basal ganglia, and thalamus were spared. Acute leukoencephalopathy may be recognized as a subtype of lupus involving the central nervous system.
류마티스 관절염 환자에서 Methotrexate 사용 중 발생한 악성 림프종
김무곤 ( Moo Gon Kim ),이준엽 ( Juhn Yeob Lee ),배종석 ( Jong Seok Bae ),서영진 ( Young Jin Seo ),임경진 ( Kyung Jin Lim ),정승혜 ( Seung Hie Chung ),윤현대 ( Hyun Dae Yoon ),김은영 ( Eun Young Kim ),윤원찬 ( Wern Chan Yoon ),류 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.1
Rheumatoid arthritis (RA) is a multisystemic inflammatory disease with a prevalance of approximately 1% of the population. The use of disease modifying anti-rheumatic drug (DMARD) is an essential regimen for the treatment of RA. Among DMARDs, methotrexate (MTX) is used worldwide with confirmed effectiveness. However, cytopenia, pulmonary injury, and hepatic toxicity are a few side effects limiting its use. In addition, although the oncogenic potential of MTX is low, several cases have been reported. Recently an increased risk of developing lymphoproliferative disorders has been reported in patients with RA. The incidence is higher in elderly individuals with severe longstanding seropositive RA, those with Sjoren`s or Felty`s syndrome, and in patients with RA treated with prolonged low dose MTX. We describe a case of RA who developed non-Hodgkin`s lymphoma during low dose MTX therapy.
저세포성 골수를 보인 환자에서 저용량 Ara-C 치료 후 급성골수성백혈병으로 진단된 1예
정승혜,박성훈,정성창,진명인,박민식,류헌모,김상경,조창호,이재련 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1
저세포성 급성골수성백혈병은 골수 검사 결과 세포충실도가 5~40%이면서 백혈구 아세포가 30% 이상이 되는 경우를 말하며 급성백혈병 중 5~10%를 차지한다. 저세포성 급성골수성백혈병에서 low-dose Ara-C는 골수양 분화를 항진시킴으로 치료 효과를 가진다고 알려져 있다. 저자들은 저세포성 급성골수성백혈병 또는 저세포성 골수이형성증후군이 의심되어 low-dose Ara-C를 투여한 후 세포충실도의 증가를 보이며, 후에 급성골수성백혈병으로 진행하는 증례를 경험하였다. 본 증례에서는 low-dose Ara-C 투여 후 골수의 세포충실도의 증가를 확인할 수 있어 low-dose Ara-C의 분화 유도 효과를 뒷받침해 준다고 볼 수 있다. 환자는 idarubicin과 Ara-C 병용 요법으로 관해유도요법을 시행한 후 완전관해에 도달하여 공고요법 중이다. Hypocellular AML occurs in 5 to 10% of patients with AML, and has been described as a subset of AML with a cellularity between 5 and 40% when the blast % exceeds 30% of all the nucleated bone marrow (BM) cells. Low-dose cytosine arabinoside (Ara-C) in patients with hypocellular AML is known to be an effective regimen with some clinical benefits through the action of myeloid differentiation. We experienced a 56- year-old female with pancytopenia in the peripheral blood and a hypocellular marrow. She was diagnosed of having either hypocellular AML or hypocellular MDS and chemotherapy with low- dose Ara-C was started. Her BM cellularity increased to 10%. Two months later she was admitted again with thrombocytopenia with a BM cellularity of 75% and was diagnosed of AML (FAB M2). The increase in BM cellularity supported the myeloid differentiation effect of low-dose Ara-C. She achieved complete remission after receiving a combination regimen of idarubicin and Ara-C and is presently undergoing postremission therapy.
류마티스 관절염 환자에서 발생한 Mycobacterium intracellulare에 의한 관절염 1예
박근우,권현희,정승혜,김경찬,최정윤,이영환 대한감염학회 2007 감염과 화학요법 Vol.39 No.1
비정형 항산균에 의한 근골격계 감염은 매우 드물며, 진단이 지연되는 경우가 많다. 저자들은 류마티스 관절염환자에서 수차례 스테로이드 주사 후에 생긴 M. intracellulare에 의한 관절염을 진단하고 수술적 치료없이 약물 치료만으로 좋은 결과를 보인 예를 경험하였기에 보고하는 바이다. Nontuberculous mycobacteria are ubiquitous organisms that are frequently present in the water, soil and animal reservoirs. Nontuberculous mycobacterial infections of the musculoskeletal system are rare and usually associated with predisposing factors, such as prior joint disease, trauma, use of intraarticular or oral corticosteroids, or an immunocompromised state. A sixty five-year-old patient with rheumatoid arthritis was hospitalized due to swelling on the left wrist. M. intracellulare was cultured from the aspirated joint fluid. The patient was successfully treated with clarithromycin, ethambutol, and rifampin. We report this case with review, emphasizing high suspicion for nontuberculous mycobacterial infection in patients with predisposing risk factors.
박성훈,이진배,박민식,임상혁,진명인,정성창,정승혜,류헌모,박소윤,김미숙,이태성,이영환,이재련 대한내과학회 2002 대한내과학회지 Vol.63 No.5
Wilms' tumor is the most common malignant abdominal tumor in the adolescent and pediatric period, whereas adult Wilms' tumor is uncommon. Wilms' tumor often originates in the kidney. Extrarenal Wilms' tumor is rare and has been considered "unstageable". Therefore, treatment and long-term survival have not been uniformly reported. We report a 24 year-old female who developed extrarenal Wilms' tumor, in the retroperitoneal space. She was misdiagnosed for ovarian neoplasm and underwent debulking operation, by which Wilms' tumor was confirmed. Palliative chemotherapy and radiotherapy were performed.