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슬골관절염 환자에서 시행한 초음파 소견과 통증과의 상관관계
강효종 ( Hyo Jong Kang ),이상배 ( Sang Bae Lee ),이명수 ( Myeung Su Lee ),홍승재 ( Seung Jae Hong ),박경수 ( Kyung Su Park ),윤종현 ( Chong Hyeon Yoon ),김완욱 ( Wan Uk Kim ),민도준 ( Do June Min ),민준기 ( Jun Ki Min ),이상헌 ( S 대한류마티스학회 2003 대한류마티스학회지 Vol.10 No.2
Objective: To investigate the ultrasonographic findings in knee OA patients and to examine the possible causes of pain in osteoarthritis by ultrasonography. Methods: Ultrasonography was performed with 7.5 MHz linear probe in 64 knee OA patients who fulfilled the ACR criteria. All patients were graded according to the Kellgren-Lawrence grades and then classified into group 1 (K/L I and II) and Group 2 (K/L III and IV). Also WOMAC score, BMI, laboratory finding (ESR, CRP) were checked. Ultrasonographic findings was examined; effusion, thickening of synovium, vertical length of medial and lateral osteophyte (longitudinal view), length of capsular distension (medial longitudinal view), evidence of bursitis and articular cartilage. Results: 50.0% of patients had effusion, among whom 68.7% patients also had synovial thickening. In all patients, the severity of pain was correlated with 4 variables; the presence of effusion, disease duration, the length of medial osteophyte, the length of capsular distension (r=0.279, r=0.415, r=0.537, r=0.608, respectively, p<0.05). The length of medial osteophyte, the degree of capsular distension and disease duration were significantly correlated with WOMAC pain score in Group 1 (p<0.05). After multiple regression analysis, the length of medial osteophyte alone had correlation with the pain severity in Group 1 (r2=0.396 p<0.05) and the only length of capsular distension was significantly correlated with WOMAC pain score in Group 2 (r=0.609, p<0.05). Conclusion: The length of osteophyte may be more related with pain severity in mild cases (K/L score I and II) while capsular distension could be an important factor causing knee pain in more advanced knee OA (K/L score III and IV).
홍승재,양형인,윤휘중,이명수,강효종,김완욱,이상헌,조철수,김호연,Hong, Seung-Jae,Yang, Hyung-In,Yoon, Hwi-Joong,Lee, Myoung-Soo,Kang, Hyo-Jong,Kim, Wan-Uk,Lee, Sang-Heon,Cho, Chul-Soo,Kim, Ho-Youn 대한면역학회 2003 Immune Network Vol.3 No.1
Background: Celecoxib, a COX-2 specific inhibitor, has recently been used for the treatment of rheumatoid arthritis. However, the molecular and cellular mechanisms of celecoxib against RA inflammation remain to be defined. To elucidate the action mechanism of celecoxib on inflammatory cells, we investigated the effect of celecoxib on the production of two important mediators of inflammation, nitric oxide and PGE2 Methods: RAW 264.7 cells stimulated with LPS were preincubated with various concentrations of celecoxib (from $10^{-8}$ to $10^{-5}$ M) and $10{\mu}M$ hydrocortisone, respectively. The production of NO and PGE2, the end products of iNOS and COX-2 genes, were estimated in culture supernatants by Greiss method and EIA, respectively. The expression of iNOS gene, COX-2 gene, $NF-{\kappa}B$, and $I-{\kappa}B$ were determined by RT-PCR and western blot analysis. Results: Celecoxib and hydrocortisone inhibited the production of NO and PGE2 in dose dependent manner, when RAW 264.7 cells were stimulated with LPS. The expression of iNOS was also down-regulated by celecoxib and hydrocortisone. Interestingly, COX-2 gene differentially expressed according to the dose of celecoxib, a decrease with lower dose ($10^{-8}$ M) but an increase with higher dose ($10^{-5}$ M). $NF-{\kappa}B$ binding activity was decreased by lower dose of celecoxib, whereas was not affected by higher dose of it. The expression of $I-{\kappa}B$ was suppressed by higher dose of celecoxib. Conclusion: The celecoxib strongly suppressed the production of NO and PGE2 in LPS-stimulated RAW264.7 cells. The decrease of NO seems to be linked to the inhibition of iNOS by celecoxib. The lower and higher dose of celecoxib differentially regulated the COX-2 expression and $NF-{\kappa}B$ activity.
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.
무릎 골관절염 환자에서 초음파로 평가된 위중도와 연골 및 활막의 생화학적 지표 간의 상관관계
정영옥 ( Young Ok Jung ),김해림 ( Hae Rim Kim ),강효종 ( Hyo Jong Kang ),유승아 ( Seung Ah Yoo ),나종명 ( Jong Myoung Nah ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ),김완욱 ( Wan Uk Kim ) 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.1
Objective: Ultrasonography has benefit in detecting soft tissue abnormalities within the joints, which cannot be assessed by conventional X-ray. In this study, we investigated the relationship between soft tissue and/or bony abnormalities on ultrasonography and biochemical markers of synovium and cartilage in knee osteoarthritis (OA) patients Methods: Fifty-one knee OA patients who fulfilled the ACR criteria were enrolled in this study. Knee ultrasonography was performed in affected knee joints with a 12 MHz linear probe to assess the presence of effusion, synovial proliferation, capsular distension, length of osteophytes, and thickness of cartilage. At the same time, the serum levels of hyaluronic acid (HA) and cartilage oligomeric protein (COMP) were measured by ELISA and serum osteocalcin levels were determined by RIA. Results: The patients with longer medial osteophytes showed higher levels of serum HA and COMP than those with shorter ones. Serum HA levels were significantly higher in patients with larger amount of effusion and/or synovial proliferation, suggesting inflammatory changes within the joint, than those without. In addition, the severity of capsular distention was also correlated well with serum HA and COMP levels. However, the length of lateral osteophytes and thickness of femoral cartilage were not correlated with serum HA or COMP levels. Serum osteocalcin levels did not show any association with above ultrasonographic parameters, either. Conclusion: Using knee ultrasonography, we demonstrated that serum HA and COMP levels were elevated in more severe OA patients than less severe patients. This result suggests that detailed pathologic changes in the soft tissue and/or bone of OA joints on ultrasonography are being directly reflected to biochemical markers measured in the peripheral blood.