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Propylthiouracil에 의한 중증 급성간염 1예
임종주,심미령,이명수,김태현,오석규,안선호,박무림,김남호,박병현,조성구 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2
PTU에 의한 간염의 발생은 매우 드물게 발생하는 것으로 알려져 있으나 저자들은 Graves씨 병으로 진단 받고 propylthiouracil 투여를 받고있던 환자에서 중증의 급성 간염이 발생한 1예를 경험하였기에 보고하는 바이다. Propylthiouracil is widely used to treat patients with hyperthyroidism. This drug has been associated with severe hepatotoxicity rarely. We presented the case of jaundice and profound liver dysfunction from a 23-year old woman treated with propylthiouracil for hyperthyroidism. Viral, metabolic, and autoimmune liver disease could be excluded and liver biopsy revealed a pattern of acute hepatitis. After discontinuing the drug, there was a progressive resolution of hepatic symptoms and decrease in biochemical data of the liver. Despite propylthiouracil induced hepatitis in rare case, patients receiving propylthiouracil are exposed to develope severe hepatotoxicity. Therefore it might be advisable to monitor level of the transaminase on regular base from patients receiving propylthiouracil.
( Myeung-su Lee ),( Chang Hoon Lee ),( Hye Soon Lee ),( Yoon-kyoung Sung ),( Jung Ran Choi ),( Kyungsu Park ),( Mi-kyoung Lim ),( Byoong Yong Choi ),( Hyoun-ah Kim ),( Seung Won Choi ),( Yusun Lee ),( 대한류마티스학회 2021 대한류마티스학회지 Vol.28 No.2
Objective. Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune disorder that impairs patients’ overall health-related quality of life (HRQOL). In this study, we evaluated the effect of adalimumab in Korean patients with active RA on HRQOL. Methods. Patients included in the study had moderate to severe active RA that did not respond to conventional drugs with a Disease Activity Score of 28 joints >3.2 and were biologics-naïve. All patients received adalimumab 40 mg subcutaneously every other week and were followed for 24 weeks. The primary endpoint was the change in baseline Health Assessment Questionnaire Disability Index (HAQ-DI) score at week 24. Secondary endpoints were changes in the EuroQol 5-dimension 3-Level (EQ-5D-3L) baseline score and Short Form 36-Item Health Survey (SF-36) domain scores at weeks 12 and 24 and change in baseline HAQ-DI score at week 12. Results. In total, 91 Korean patients were included. Ninety-three percent of patients were in high disease activity with a baseline mean DAS28 value of 6.1 within all patients. The mean change from baseline in HAQ-DI scores were -0.46 at week 12 and∼0.67 at week 24 (p<0.0001). Additionally, EQ-5D-3L score at weeks 12 and 24 had significantly improved (p<0.0001) compared to baseline. SF-36 at weeks 12 and 24 had significantly improved (p<0.0001, p=0.0001) compared to baseline. Conclusion. Treatment with adalimumab resulted in significant improvement in HAQ-DI, EQ-5D-3L, and SF-36 scores at 12 and 24 weeks in Korean RA patient. (J Rheum Dis 2021;28:68-75)
(Myeung Su Lee),(Seon Ho Ahn),(Ju Jung Song) 대한내과학회 2002 The Korean Journal of Internal Medicine Vol.17 No.3
N/A Background : Recombiant human erythropoietin (epoetin) has greatly contributed to improvement of the anemia of chronic renal failure patients on hemodialysis. However, the reduced erythropoietic effect to epoetin and its high cost have induced lots of supplementary treatments. Therefore, we performed a prospective study to evaluate the effects of adjuvant low-dose androgen therapy in patients using a lower-dose of epoetin than the commonly recommended dose on anemia and the nutritional parameters. Methods : 17 patients of hemoglobin (Hgb) less than 9 g/dL even after being treated with 1,000 U epoetin subcutaneously (s.c.) 3 times per week on a stable status for more than 6 months, who were on hemodialysis at our institution were examined. They were injected with the same dose of epoetin s.c. and nandrolone decanoate 100 mg intramuscularly (i.m) weekly for another 6 months. Blood test was performed every month before therapy for 6 months and after therapy for 6 months and the mean values were reviewed for comparison. Results: Hgb (7.75±0.9vs8.99±1.39 g/dL, p 0.01) and hematocrit (Hct) (23.68±2.85vs26.66±3.91%, p 0.01) were apparently changed before and after adjuvant therapy. Hgb and Hct, weekly dose of epoetin were not statistically different in 9 male patients before and after adjuvant therapy. The weekly dose of epoetin was not statistically different in 8 female patients, but Hgb and Hct (8.02±0.6vs9.72±1.31 g/dL, 24.54±1.7vs28.74±3.06%, p 0.01) were statistically different before and after adjuvant therapy. In comparison between male and female groups, weekly doses of epoetin and nandrolone decanoate were significantly greater in the female group than the male group (epoetin; 50.66±6.23 vs 61.18±8.76 U/kg/week, nandrolone decanoate; 1.69±0.2vs2.04±0.29 mg/kg/week, p 0.05). Conclusion : Our data show that the adjuvant androgen therapy is effective for the anemia of hemodialysis patients who did not recover from anemia even after being continuously treated with low-dose epoetin.
섬유근통증후군 환자의 질병관련 특성과 일상생활장애의 상관관계
이명수(Myeung-Su Lee),황은희(Eun-Hee Hwang) 한국콘텐츠학회 2011 한국콘텐츠학회논문지 Vol.11 No.7
본 연구는 섬유근통증후군 환자의 질병관련 특성과 일상생활 장애의 정도를 파악하고, 그 상관관계를 확인하기 위하여 시도되었다. 대상자는 I시에 소재한 1개 대학병원 류마티스 내과 외래 방문 환자 중 섬유근통증후군 진단을 받은 45명으로, 구조화된 설문지를 이용하여 자료를 수집하였다. 대상자의 압통점은 평균 15.00, 피로는 8.67, 수면의 질은 12.94, 우울은 23.70점이었고, 이들은 평균 대략 6년간의 유병기간을 가지고 있었다. 42.2%의 대상자들이 질병으로 인해 직업이나 학업을 중단하였으며, 지난 3개월동안 평균 41.79일 일상생활 장애를 경험하였다. 일상생활 장애 정도는 압통점, 우울과 양의 상관관계가 있었고, 피로와 우울, 수면의 질과 양의 상관관계가, 수면의 질은 우울과 양의 상관관계가 있었다. 결론적으로 섬유근통 증후군 환자들은 질병과 관련한 다양한 증상을 동반하며, 이로 인한 일상생활 장애를 경험하고 있었다. 따라서 이들이 일상생활을 유지하면서 보다 나은 삶을 유지할 수 있도록 관련 요인을 반영한 중재프로그램을 개발할 필요가 있다. The purpose of this study was to identify the correlations between disease related factors and disturbance of daily living in patients with fibromyalgia. A descriptive survey study design was used. Data were collected from 45 out patients diagnosed of fibromyalgia according to the conditions by American College of Rheumatology in I-city. The mean score of tender points were 15.00, fatigue was 8.67, quality of sleep was 12.94 and depression was 23.70. They have struggled with fibromyalgia for 6 years on an average. Among patients, 42.2% had to discontinue their job/learning due to their disease, and experienced a disturbance of daily living for 41.79 days during last 3 months. There were significant positive correlations between disturbance of daily living and tender points, depression, between fatigue and depression, quality of sleep, between quality of sleep and depression. As a result, fibromyalgia patients suffered from various disease related factors and disturbance of daily living. Therefore, it can be suggested that the consideration of these related factors is important to develope intervention program for the better qualified life of the patients.
류마티스 관절염 환자의 혈중 아연 및 구리 농도와 질병 활성도와의 관계
이명수 ( Myeung Su Lee ),강효종 ( Hyo Jong Kang ),홍승재 ( Seung Jae Hong ),도주호 ( Ju Ho Do ),윤종현 ( Chong Hyeon Yoon ),김완욱 ( Wan Uk Kim ),민도준 ( Do June Min ),윤지희 ( Jee Hee Youn ),박성환 ( Sung Hwan Park ),조철수 ( Ch 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.4
Objective: To investigate the relationship between serum trace element levels with disease activity in Korean patients with rheumatoid arthritis (RA). Methods: The serum levels of zinc, copper and ceruloplasmin were measured by inductively coupled plasma atomic emission spectrometers in 80 patients with RA, 26 osteoarthritis (OA), and 30 healthy controls (HC). We also measured the levels of zinc and copper in the synovial fluid (SF) of patients with RA. We investigated the clinical parameters simultaneously obtained at sampling of serum and analyzed correlation between serum levels of trace elements and disease activity in RA. Results: In RA, the levels of serum zinc were significantly lower than that of HC, and the levels of serum copper and ceruloplasmin were significantly higher than those of HC. In active RA, the levels of serum zinc were more decreased, and the levels of serum copper and ceruloplasmin were more increased than those of inactive group of RA. The levels of both copper and ceruloplasmin showed positive correlation with the levels of serum ESR and CRP. On the other hand, the levels of serum zinc showed negative correlation with the levels of serum ESR and CRP. Conclusion: Serum zinc levels are significantly lower and serum copper levels significantly higher in patients with active RA and these trace elements were useful parameter of disease activity in RA.
저용량 Erythropoietin 을 투여받고 있는 혈액 투석환자에서 빈혈과 영양지표에 대한 안드로겐 병용투여의 효과
이명수(Myeung Su Lee),안선호(Seon Ho Ahn),송주흥(Ju Hung Song) 대한내과학회 2001 대한내과학회지 Vol.61 No.6
N/A Background: Recombinant human erythropoietin (rHuEPO) has become attractive option of anemia therapy in chronic hemodialysis patients, but the use of rHuEPO is primarily limited by its high cost. So, the current cost-containment policy renders valuable any strategies that enhances the erythropoietic response to rHuEPO, thus resulting in lower rHuEPO dosing. Before the widespread availability of rHuEPO, androgen was the mainstay of nontransfusional therapy for the anemia of end-stage renal failure. However, previous studies that used androgen to enhance the response to rHuEPO showed variable results. Methods: We carried out a prospective study to examine the effect of adjuvant androgen on anemia and nutritional parameters in chronic hemodialysis patients using low-dose rHuEPO. Studies were performed in seventeen hemodialysis patients previously treated with low-dose rHuEPO (1,000 U rHuEPO subcutaneously three times a week), mean hemoglobin < 9.0 g/dL for 6 months (group A: before adjuvant androgen therapy). Same patients received the same dose of rHuEPO plus nandrolone decanoate 100 mg intramuscularly weekly for 6 months (group B: after adjuvant androgen therapy). Results: Transferrin saturation, serum ferritin, intact serum parathyroid hormone, plasma aluminium, ALT, ESR, albumin, PCRn and Kt/V were not significantly changed before and after adjuvant androgen therapy. The increase in hemoglobin and hematocrit in the group B was statistically greater than in the group A, respectively (8.99±1.39 g/dL vs 7.75±0.90 g/dL; p=0.001, 26.66±3.91% vs 23.68±2.85%; p= 0.003, respectively). With the exception of mild discomfort at the injected site, there were no significant side effects from nandrolone decanoate. Conclusion: Adjuvant androgen in patients treated with low-dose rHuEPO is effective treatment for the anemia of poor responsive patients to low-dose rHuEPO and lower the economical cost compared with the higher dose rHuEPO treatment alone.(Korean J Med 61:641-649, 2001)