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콜라겐 유도성 관절염 마우스모델에서 레스베라트롤 식이요법의 류마티스관절염 완화효과
천윤홍 ( Yun Hong Cheon ),김현옥 ( Hyun Ok Kim ),서영선 ( Young Sun Suh ),허재형 ( Jae Hyung Hur ),조원용 ( Won Yong Jo ),임혜송 ( Hye Song Lim ),하영술 ( Young Sool Hah ),성미정 ( Mi Jeong Sung ),권대용 ( Dae Young Kwon ),이상일 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.2
Objective. Resveratrol is well-known for its anti-inflammatory, anti-oxidant effects on several diseases. We investigated whether dietary supplementation with resveratrol may suppress joint inflammation and destruction in a mouse model of collagen-induced arthritis (CIA). Methods. Mice were randomly divided into two groups; CIA mice with normal diet-fed and CIA mice fed a 0.05% resveratrol diet. The effect of resveratrol on arthritis was assessed by clinical scoring system. The plain radiographs of paws were obtained to evaluate the effects on preventing bone destruction. Joint inflammation, cartilage damage, and osteoclastic bone resorption were checked by staining with H&E, Safranin-O, and tartrate resistant acid phosphatase (TRAP). Levels of pro-inflammatory cytokines were checked by enzyme-linked immunosorbent assay. The level of expression of nuclear factor (NF)-κB was measured by electrophoretic mobility shift assay (EMSA). Results. Dietary supplementation with resveratrol led to mitigated severity of arthritis compared to the normal diet group (6.7±0.8 vs. 2.7±0.6, p<0.01). Resveratrol-fed mice showed decreased bone destruction on radiograph (3.4±0.3 vs. 2.0±0.2, p<0.01), and showed significantly inhibited pathological changes (inflammation 2.0±0.3 vs.3.2±0.2, p<0.01; cartilage damage 1.5±0.3 vs. 3.2±0.2, p<0.01; pannus formation 1.4±0.3 vs. 3.0±0.3, p<0.01; erosion; 1.4±0.2 vs. 3.3±0.3, p<0.01). Generation of TRAP-positive osteoclasts was inhibited in the resveratrol-fed mice (55.3±12.7 vs. 3.27±0.8, p<0.01). Resveratrol-fed mice showed decreased levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-6,monocyte chemoattractant protein 1, and the soluble receptor activator of NF- κB ligand in joint tissues and sera. Expression of NF-κB, measured by EMSA, was decreased in resveratrol-fed mice. Conclusion. Dietary supplementation with resveratrol mitigates inflammation and bone destruction in CIA mice. (J Rheum Dis 2015;22:93-101)
경남 지역 농업인의 상지 근골격계 질환 유병률과 위험인자
서영선 ( Young Sun Suh ),천윤홍 ( Yun Hong Cheon ),김현옥 ( Hyun Ok Kim ),김록범 ( Rock Bum Kim ),박기수 ( Ki Soo Park ),양현수 ( Hyun Su Yang ),박형빈 ( Hyung Bin Park ),나재범 ( Jae Bum Na ),윤철호 ( Chul Ho Yoon ),이상일 ( Sang 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.6
Objective. To evaluate the prevalence and risk factors of upper extremity musculoskeletal diseases (MSDs) among Korean farmers. Methods. The study was carried out from June 2013 to August 2015 on 850 farmers and 203 non-farmers (controls) in Gyeongnam Province. Physical examinations were performed by rheumatologists, orthopedists, and rehabilitation specialists. Plain radiography, a nerve conduction examination, and magnetic resonance imaging were performed, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was used to assess upper extremity function. Results. Thirty-four different types of upper extremity MSDs were detected in the 1,053 study subjects. The prevalence of any MSD in farmers was 8.96-fold higher than in control (p<0.001). The most obvious difference in prevalence between farmers and non-farmers was hand osteoarthritis (48.2% vs. 4.9%). Mean total DASH score was higher for farmers than non-farmers (14.29±13.66 vs. 10.03±10.85, p<0.001). Among farmers, myofascial pain syndrome, rotator cuff tear, and epicondylitis were more prevalent among overhead workers (growing persimmons, pears, and grapes) than in non-overhead workers (growing rice and upland crops). The following factors were associated with a rotator cuff tear; older age, overhead work, high waist circumference, and lower level of education. Hand osteoarthritis was found to be associated with older age, a female gender, high waist circumference, and longer total work time. Conclusion. The prevalence of upper extremity MSDs is much higher in farmers than non-farmers and greater still for farmers doing overhead work. Various factors contribute to the occurrence of upper extremity MSDs, and thus, the authors suggest an efficient preventive strategy, which involves consideration of type of work and risk factors, be established for farmers to reduce upper extremity MSDs. (J Rheum Dis 2015;22:366-373)
유방의 종괴로 발현된 항호중구세포질항체 음성 육아종 다발혈관염
김민교 ( Min Gyo Kim ),허재형 ( Jae Hyeong Huh ),천윤홍 ( Yun Hong Cheon ),조상영 ( Sang Yeong Cho ),고경혁 ( Gyung Hyuck Ko ),김현옥 ( Hyun Ok Kim ),김지은 ( Ji Eun Kim ),최혜영 ( Hye Yeong Choi ),이상일 ( Sang Il Lee ) 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.4
Granulomatosis with polyangiitis (GPA) is a disease characterized by a granulomatous necrotizing vasculitis of the small vessels, along with the presence of antineutrophil cytoplasmic antibody (ANCA), serologically. GPA is a multisystem disease, in which the diagnosis is frequently based on respiratory and renal manifestations, with rare breast invasion. To date, several cases of breast invasion by GPA have been published, and most cases have been positive for ANCA. However, ANCA-negative forms of breast invasion by GPA are extremely rare and have not been reported in Korea thus far. Therefore, we report a case of ANCA-negative GPA in a 70-year-old woman, who was initially presented with a localized palpable mass in the left breast.
증례 : 감염 ; 보존적 치료로 호전된 시력소실을 동반한 급성 A형 간염 1예
임민희 ( Min Hee Lim ),허상택 ( Sang Taek Heo ),김차영 ( Cha Young Kim ),배인규 ( In Gyu Bae ),김재희 ( Jae Hee Kim ),천윤홍 ( Yun Hong Cheon ),하창윤 ( Chang Yoon Ha ) 대한내과학회 2011 대한내과학회지 Vol.80 No.2S
Hepatitis A is usually a mild, self-limiting illness, but in certain cases it can develop into a severe or fatal disease. The most common symptoms of acute hepatitis A virus (HAV) infection are fever, myalgia, nausea, vomiting, jaundice, and abdominal pain. Extrahepatic symptoms are rare, especially neurologic manifestations. We investigated a 34-year-old male who presented after suffering two days of fever, chills and general myalgia. His condition gradually deteriorated and he developed sudden blindness on day nine. This blindness lasted for 20 min and at this point abnormal brain images were observed. Initial tests for immunoglobulin M anti HAV were negative. These tests were repeated, later confirming acute HAV infection. After conservative management, the individual fully recovered. We report this extremely rare acute HAV infection case with metabolic encephalopathy exhibiting transient blindness. (Korean J Med 2011;80:S305-S309)
Adalimumab으로 치료된 스테로이드 및 메소트렉세이트 저항성 호산구성 근막염 1예
이상수 ( Sang Su Lee ),김현옥 ( Hyun Ok Kim ),나재범 ( Jae Boem Na ),이종실 ( Jong Sil Lee ),서영선 ( Young Sun Suh ),천윤홍 ( Yun Hong Cheon ),강민규 ( Min Gyu Kang ),김유은 ( Yu Eun Kim ),이상일 ( Sang Il Lee ) 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.4
호산구성 근막염은 원인과 병인이 잘 알려지지 않은 미만성 근막염과 호산구 증가증을 보이는 드문 질환이다. 스테로이드 제제가 일차적인 치료제로 알려져 있으며 치료에 반응이 없는 경우 MTX와 같은 항류마티스 제제를 투여 할 수 있다. 하지만 이러한 약제에도 저항성을 보이는 경우 종양괴사인자 억제제가 치료에 사용될 수 있으며 치료 후 반응을 평가 하기 위해 자기공명영상이 유용할 수 있다. 이에 저자들은 스테로이드와 항류마티스 제제에 저항성을 보이는 호산구성 근막염 환자에게 종양괴사인자 억제제를 사용하여 치료 호전된 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Eosinophilic fasciitis (EF) is a rare fibrosing disorder characterized by painful swelling and induration of the limbs and trunk, characteristic histology with sclerosis and lymphocytic inflammation affecting the fascia. The cause and pathogenesis of EF are still unknown and current therapies include glucocorticoids with or without use of immunosuppressive agents. Recently, there have been several case reports documenting the efficacy of a TNF alpha inhibitor in EF following a steroid-resistant disease course. However, there has been no report on the experience in treatment of EF with a TNF alpha inhibitor in Korea. Hence, we report a case of steroid and methotrexate-resistant EF which was successfully treated with adalimumab, along with a review of the relevant articles.