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Behcet`s 환자에서 합병된 우측 총 장골동맥 동맥류에서 Stent-graft를 이용한 치료
김예리 ( Ye Ree Kim ),최성재 ( Seong Jae Choi ),이영호 ( Young Ho Lee ),지종대 ( Jong Dae Ji ),송관규 ( Gwan Gyu Song ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.1
Behcet`s disease is characterized by recurrent orogenital ulcers and ocular and cutaneous inflammatory lesions. It is a multisystem disorder affecting the skin, mucous membrane, eyes, joints, CNS and blood vessels. The vascular involvements consist of thrombophlebitis, arterial occlusion and arterial aneurysm. Rupture of large artery aneurysm is the leading cause of death in patients with Behcet`s disease and surgical treatment is necessary. But, surgical treatment is often difficult and may lead to formation of further false aneurysms at the site of vascular anastomosis. Endovascular stent-graft placement emerged as an alternative treatment that is less invasive with a lower risk. We report a case of the aneurysm of right common iliac artery associated with Behcet`s disease. Percutaneous stent-graft placement was attempted and successfully controlled aneurysmal manifestations.
류마티스 관절염 환자에서 대체의학의 이용실태 및 유용성
김예리 ( Ye Ree Kim ),유태석 ( Tae Seok Yoo ),박훈기 ( Hoon Ki Park ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),정성수 ( Sung Soo Jung ),유대현 ( Dae Hyun Yoo ),배상철 ( Sang Cheol Bae ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.3
Objective: The use of Complementary and Alternative Medicine (CAM) is common especially among patients with chronic conditions. The aim of this study was to investigate the percentage and characteristics of patients who make use of CAM and analyse the effect of CAM in RA. Methods: Two hundreds and twelve patients with RA were interviewed by a trained nurse according to structured questionnaire about sociodemographic features and type, effect and cost of CAM which was used. Results: Among 212 patients with RA, 73 patients had used CAM (34.4%). There was no difference in sociodemographic features between the user and non-user of CAM. The chinese medicine containing herbal medicine and acupuncture (43.8% and 24.7%) was most commonly used. There was no difference in the score of Korean Health Assessment Questionnaire (KHAQ) between the user and non-user of CAM. In the user group, the scores of the subjective effect and satisfaction for CAM were higher than those for the hospital services. The average yearly cost for CAM was 790,000 Won/person and it was about 67.5% of the one for hospital services. Conclusion: In patients with RA, the percentage of using CAM was 34.4%. Herbal medicine was most commonly used. CAM did not affect the outcome of the patients with RA. However, the scores of the subjective effect and satisfaction for CAM were higher than those for the hospital services. For the proper management of patients with RA, it is necessary to know further data about the effectiveness and side effects of CAM through experimental and clinical research.
전신성 홍반성 루푸스 환자에서 Fas Promoter 유전자 다형성에 대한 연구
최성재 ( Seong Jae Choi ),김예리 ( Ye Ree Kim ),이영호 ( Young Ho Lee ),지종대 ( Jong Dae Ji ),송관규 ( Gwan Gyu Song ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.4
Objective: To investigate whether the polymorphism of Fas promoter gene is associated with susceptibility to systemic lupus erythematosus (SLE) and its clinical features. Methods: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using MvaI was used to determine genotypes of the Fas promoter in 87 SLE patients and 87 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. Results: The genotype distribution of the Fas promoter did not differ between SLE patients and control subjects (AA, GA, GG genotypes 31.0%, 54.0%, 14.9% in SLE patients vs. 29.9%, 55.2%, 14.9% in controls respectively, χ2=0.03, 2 degrees of freedom, p=0.99). No significant differences were also found in allele frequencies between the groups. Clinically in the lupus patients according to the Fas promoter polymorphism, there were no significant differences in age at onset, anti-ds DNA titer, C3, C4 level, renal involvement, number of ACR (American College of Rheumatology) criteria presented, SLE Disease Activity Index, SLICC/ACR (The Systemic Lupus international Collaborating Clinics/American College of Rheumatology) damage index, and autoantibody profiles except for anti-RNP antibody. The frequency of anti-RNP antibody in the lupus patients was increased in AA group (71.4%) compared to GA and GG groups (26.2% and 30.0%, p=0.007). Conclusion: The Fas promoter polymorphism does not seem to confer susceptibility to SLE, but seems to have some influence on the development of certain autoantibody like anti-RNP antibody, suggesting that the Fas promoter polymorphism is functional.
전신성 홍반성 루푸스와 류마티스 관절염에서 CTLA-4 exon 1과 promoter 유전자 다형성에 대한 연구
이영호 ( Young Ho Lee ),최성재 ( Seong Jae Choi ),김예리 ( Ye Ree Kim ),지종대 ( Jong Dae Ji ),송관규 ( Gwan Gyu Song ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.1
Objective: Strong genetic evidence has shown an association between cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and autoimmune diseases. This study was set out to determine whether the polymorphisms of the CTLA-4 exon 1 and promoter are associated with susceptibility to systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and their clinical features. Methods: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using Bst E II and Tru9 I was used to determine genotypes of the CTLA-4 exon 1 and promoter in 80 SLE, 86 RA patients and 86 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. Results: The genotype frequency of the CTLA-4 exon 1 differed between SLE patients and controls (chi-squared=6.74, 2 degrees of freedom (df), p=0.03). The CTLA-4 AG genotype occurred more frequently in patients with SLE (46.3% vs. 33.7% controls). On the other hand, the CTLA-4 AA genotype as well as the CTLA-4 GG genotype was less frequent among SLE patients than among control subjects (1.3% vs. 9.3% and 52.5% vs. 57.0% respectively). The genotype distribution of the CTLA-4 promoter differed between SLE patients and control subjects (CT, TT, CC genotypes 27.5%, 0%, 72.5% vs. 16.3%, 4.7%, 79.1% controls respectively, chi-squared=6.36, 2 df, p=0.04). When the association was analyzed with respect to sex, the distribution of the CTLA-4 exon 1-promotor genotypes was significantly different between female SLE patients and females in the control group (chi-squared=8.16, 3 df, p=0.04). The frequencies of the CTLA-4 exon 1 and promoter genotypes, allele and phenotypes and exon 1-promotor genotypes were not significantly different between RA patients and control subjects. Clinically, there were no significant differences in patients with SLE and RA according to the CTLA-4 polymorphisms. Conclusion: The polymorphisms within the CTLA-4 exon 1 and promoter appear to play a role in susceptibility to SLE, but not to be associated with clinical features of SLE, susceptibility to RA and its clinical features.
소화성 궤양에서 삼제 병합 요법의 저용량에 의한 Helicobacter pylori 제균률과 궤양 치유효과
김예리,박봉안,이재동,이종혁,김인숙,박형석,진춘조,김상윤,박의우 건국대학교 의과학연구소 2000 건국의과학학술지 Vol.10 No.-
Helicobacter pylori is the major cause of histologic chronic gastritis and is strongly associated with peptic ulcer disease, gastric cancer and lymphoma. Several recommendations for the management of the Helicobacter pylori infection have been developed. However, there has been no clear therapeutic regimen for the optimal treatment of Helicobacter pylori infection. This study was desinged to evaluate the eradication rate and the ulcer healing rate of the triple regimen with low-dose clarithromycin(0.5g/day) in peptic ulcer patients. Forty three patients with gastric ulcer(n=15) and duodenal ulcer(n=28) were enrolled. The patients were treated either with omeprazole 20mg b.i.d. amoxicillin 0.5g b.i.d. and clarithromycin 250mg b.i.d. (low-dose regimen group, n=29) or with omeprazole 20mg b.i.d., amoxicillin 1.0g b.i.d. and clarithromycin 0.5g b.i.d.(high-dose regimen group, n= 14) for 2 weeks. After 4 weeks, the patients were evaluated for the eradication of Helicobacter pylori and the healing of ulcer. And gastritis scores according to the Sydney system were evaluated before and after 4 weeks from the end of the triple regimen. There was no significant difference in the eradication rate and the ulcer healing rate between the low-dose regimen group, group and the high-does regimen group. In the low-does regimen group, the mean initial scores of chronic inflammation and activity were decreased after the eradication of Helicobacter pylori. In conclusion, the low-dose triple regimen is as effective as the high-dose triple regimen on the eradication of Helicobacter pylori and the ulcer healing rate in peptic ulcer disease.
윤성욱,김예리,정상만 건국대학교 의과학연구소 1998 건국의과학학술지 Vol.8 No.-
Pulmonary thromboembolism is the impaction of material into branches of the pulmonary arterial bed. The clinical manifestations are similar to those of other cardiopulmonary disorders, and thus, the diagnosis of pulmonary embolism may be delayed even in patients presenting with characteristic symptoms. Accurate early diagnosis and treatment are important because untreated in-hospital mortality is up to 30 percent whereas it is only 8 percent if appropriately treated. The confirmation of a pulmonary embolus depends on performing either a ventilation-perfusion scan or angiography. But, ventilation-perfusion scans are not sufficiently sensitive, and angiography is invasive and associated with complications. Also, both of these tests are time consuming. Therefore, a noninvasive method of early detecting pulmonary thromboembolism is important to carry out further invasive diagnostic tests. We experienced a case of pulmonary thromboembolism that had been treated successfully after early diagnosis by noninvasive method of transthorathic echocardiography, and presented it with a review of literature.
윤성욱,김예리,김석,유광하,정상만 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-
Trousseau's syndrome refers to an association of thrombosis with visceral malignancy. The thrombophlebitis is usually recurrent and migratory. An episode of thrombosis may precede clinical recognition of malignancy by weeks or months and in many cases, the underlying malignancy was occult. Patients with a recurrent deep venous thrombophlebitis without a known predisposing factors for hypercoagulable state deserves a consideration for underlying malignancy. We report a patients with lung cancer who initially demonstrates the clinical features of the Trousseau's syndrome.