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류마티스 관절염환자의 건강상태와 자기효능, 강인성, 가족지지 및 통증과의 관련성
백광미,심승철,김종임 대한류마티스 건강전문학회 2000 근관절건강학회지 Vol.7 No.2
This study was conducted to find out the relationship among several variables such as health status, self-efficacy, health related hardiness, family support and pain in patients with rheumatoid arthritis. The subjects were 108 patients with rheumatoid arthritis who visited the out patient department of Rheumatism at E university hospital in Teajon. Data were collected by questionnaire from November 26, 1999 to January 14, 2000. The instrument used in this study were health status developed by Bae et at(1998), self-efficacy scale developed by KRHPS, health related hardiness modified by Suh(1988), family support scale developed by Kang(1984), Pain with graphic rating scale. Data were analyzed by descriptive statistics, one-way ANOVA, Pearson Correlation Coefficient, multiple regression using the SPSS Win Program. The results were as follows; 1.There were no statistically significant differences between general characteristics and variables such as health status, self-efficacy, health related hardiness and family support respectively. 2.Statistically significant differences were not found between clinical characteristic and variables such as health status, self-efficacy, health related hardiness and family support respectively. 3.Significant correlations were found between health status and self-efficacy, self- efficacy and hardiness, hardiness and family support, health status and pain, self-efficacy and pain respectively(P<0.01), and health status and hardiness, self-efficacy and family support, hardiness and pain respectively(P<0.05). 4.Self-efficacy and pain were significant affecting factors of a health status. In these results, it is suggested that nursing intervention to increase self-efficacy and to reduce pain was very important for patients with rheumatoid arthritis.
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.
Breakdown of the vaginal ecosystem in patients with rheumatoid arthritis
심승철 ( Seung Cheol Shim ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( Sang Cheol Bae ),황정혜 ( Jung Hye Hwang ),문영진 ( Young Jin Moon ),조수현 ( Soo Hyun Cho ),최태 대한내과학회 1998 대한내과학회 추계학술대회 Vol.1998 No.1
Systemic Lupus erythematosus initially presented with moyamoya disease
심승철 ( Seung Cheol Shim ),김태환 ( Tae Hwan Kim ),장대국 ( Dae Kook Chang ),고희관 ( Hee Kwan Koh ),전재범 ( Jae Bum Jun ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),김성윤 대한내과학회 1998 대한내과학회 추계학술대회 Vol.1998 No.1
류마티스관절염 환자의 활막세포에서 Stat 단백의 발현에 관한 연구
심승철 ( Seung Cheol Shim ),이인홍 ( In Hong Lee ),정자헌 ( Ja Hun Jung ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),송강원 ( Kang Won Song ),배상철 ( Sang Cheol Bae ),유대현 ( Dae Hyun Yoo ),김성윤 ( Seong Yoon Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.1
Objective: To characterize Stat activity in synovial tissue in rheumatoid arthritis (RA) in order to see if Stat molecule contributes to the pathogenesis of RA by regulatory expression of genes that play an important role in inflammation and tissue destruction. Methods: Synovial tissue were obtained immediately after operative excision. Immuno-histochemistry was done with the antibodies for Stat 3 and Stat 5. Cells were stimulated with interleukin 6 (IL-6) and soluble interleukin 6 receptor (sIL-6R) or steroid using chambered slide. In supershift experiment, cell extracts were incubated with 0.5ng of 32P-labelled double-stranded oligonucleotide probe. Samples were resolved on 4.5% polyacrylamide gels, which was transferred to polyvinylidene fluoride membranes. Anti-phosphotyrosine Stat 3 antibody was used for Western blotting. Results: Stat 3 was not shown on the synovial tissue section done by immuno-histochemistry. However, activated Stat 3 was expressed on cultured synovial cell stimulated with IL-6 and sIL-6R, and also with IL-6 and dexamethasone using chambered slide. In contrast to Stat 3, activated Stat 5 was expressed on the synovial tissue section, especially around blood vessel. Conclusion: Stat is activated in cultured synovial cells as shown in other immune associated cells, and IL-6 is the strong activator of Stat 3. Further analysis of the regulation of Stats in synovitis and the role of Stats in driving synovial inflammation will yield insight into the pathogenesis of RA and the development of novel therapeutic modality.
심승철(Seung Cheol Shim),전재범(Jae Bum Jun),정성수(Sung Soo Jung),이인홍(In Hong Lee),배상철(Sang Cheol Bae),유대현(Dae Hyun Yoo),김성윤(Seong Yoon Kim),정화순(Wha Soon Chung),정낙은(Nak Eun Chung) 대한내과학회 1994 대한내과학회지 Vol.47 No.6
N/A Objectives : Anemia is the most common extra-articular manifestation of rheumatoid arthritis (RA). However neither the frequency of anemia in the patients of RA nor the role of erythroid abnormalities in various types of anemia have been reported previously in Korean population. Methods : To establish the frequency of anemia and the role of erythropoietin in the pathophysiology of anemia, 500 patients with RA were selected randomly from the patients who were diagnosed at Rheumatism center of Hanyang university hospital from January 1993. Results : 1) In the series of 500 RA patients, 196 patients (39.2%) had anemia, and 127 of 196 patients with anemia had mild anemia (Hb more than 10.0 g/dl), the other 69 patients (35%) had moderate to severe anemia. 2) 92 (77.3%) of 120 patients with anemia had anemia of chronic disease (ACD) and iron deficiency anemia (IDA) was observed in 26 patients (22.7%). Other types of anemia were also found: one case had vitamin B12 deficiency anemia, the other case had autoimmune hemolytic anemia. 3) 17 patients with ferritin between 20~100 ng/ml were examined bone marrow aspiration and biopsy. The results of bone marrow biopsy were identical with that of Iron index (=-0.00446×TIBC+1.22765×Log ferritin-0.07824) except one case, 4) ACD had higher value of Ritchie index, ESR, functional class than IDA (p<0.01), Serum iron had no significant differences between ACD and IDA, but TIBC and ferritin had significant differences between two groups (p<0.01). 5) Ritchie index versus Hb (r=-0.38. p<0.01)'and ESR versus Hb (r=-0.53, p<0.01) were negatively related but there were no significant differences in disease duration. 6) Serum erythropoietin was 17.27±1.3 mu/ml in ACD and 35.64±1.7 mu/ml in IDA, and there were significant differences between these two groups (p<0.01). Conclusions : Iron index is a useful method for differential diagnosis between ACD and IDA. In ACD, erythropoietin may be effective in rheumatoid arthritis with moderate to severe anemia.