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Azathioprine에 반응을 보인 류마티양 관절염에 의한 경막염(Pachymeningitis)1예
배광봉,이정호,이정찬,곽상혁,강정현,김철희,김현수,김종숙,조덕연,김삼용 충남대학교 의과대학 지역사회의학연구소 1999 충남의대잡지 Vol.26 No.1
Rheumatoid arthritis frequently involves the cervical spine and may lead to neurologic impairement. However, direct involvement of CNS structures by inflammatory cells has been reported infrequently. The prevalence of this complication of rheumatoid arthritis is unknown. Inflammatory CNS involvement in rheumatoid arthritis reportedly occurs in the setting of longstanding, active, erosive articular disease and is accompanied by extracranial and extraspinal nodules and vasculitis. This is diagnosed by radiologic finding of CNS nodules or meningeal thickening and by biopsy or autopsy. Treatment with corticosteroid, cytotoxic agent or surgical decompression is helpful. But the majority of patients die within several months of onset of neurologic symptom. Recently, we experienced a case of pachymeningitis caused by rheumatoid arthritis, which resolved repeatedly with azathioprine treatment.
Interdialytic Weight Gain and Cardiovascular Outcome in Incident Hemodialysis Patients
Lee, Mi Jung,Doh, Fa Mee,Kim, Chan Ho,Koo, Hyang Mo,Oh, Hyung Jung,Park, Jung Tak,Han, Seung Hyeok,Yoo, Tae-Hyun,Kim, Yong-Lim,Kim, Yon Su,Yang, Chul Woo,Kim, Nam-Ho,Kang, Shin-Wook S. Karger AG 2014 American journal of nephrology Vol.39 No.5
<P>Abstract</P><P><B><I>Background:</I></B> Interdialytic weight gain (IDWG) has been regarded as a surrogate of volume overload, but also as a marker of a better nutritional status in end-stage renal disease (ESRD) patients on hemodialysis (HD). This paradoxical meaning of IDWG requires further investigation, particularly in adverse cardiovascular outcomes. <B><I>Methods:</I></B> A prospective cohort of 1,013 incident HD patients from 36 HD centers of the Clinical Research Center for ESRD in Korea was included. Patients were categorized into five groups according to the IDWG%, a ratio of absolute IDWG to dry weight: <1.0, ≥4.0, and every 1.0 increment in between. Primary outcome was major adverse cardiac and cerebrovascular events (MACCE). <B><I>Results:</I></B> During a mean follow-up of 18.7 months, primary outcome was observed in 104 patients (10.3%). In multivariate analysis, compared to patients with IDWG% of 1.0-1.9 (reference group), the hazard ratios (HRs) for primary outcome in the IDWG% <1.0, 2.0-2.9, 3.0-3.9, and ≥4.0 groups were 1.10 [95% confidence interval (CI) 0.55-2.20, p = 0.80], 1.15 (95% CI 0.59-2.27, p = 0.68), 1.80 (95% CI 0.95-3.41, p = 0.07), and 1.93 (95% CI 1.02-3.64, p = 0.04), respectively. Furthermore, even when residual renal function and 24-hour urine volume were adjusted, IDWG% ≥4.0 remained as a significant predictor of primary outcome (HR 2.03, 95% CI 1.02-4.02, p = 0.04). <B><I>Conclusion:</I></B> Increased IDWG% is a significant independent predictor of MACCE in incident HD patients. It could be helpful to prevent excessive IDWG for improving clinical outcomes in incident HD patients.</P><P>© 2014 S. Karger AG, Basel</P>
Oh, Hyung Jung,Nam, Bo Young,Lee, Mi Jung,Kim, Chan Ho,Koo, Hyang Mo,Doh, Fa Mee,Han, Jae Hyun,Kim, Eun Jin,Han, Ji Suk,Park, Jung Tak,Yoo, Tae-Hyun,Kang, Shin-Wook,Han, Dae-Suk,Han, Seung Hyeok International Society for Peritoneal Dialysis 2015 Peritoneal dialysis international Vol.35 No.1
<P>♦ <I>Introduction:</I> It has been reported that klotho deficiency is associated with oxidative stress and inflammation in experimental kidney disease models. Patients with endstage renal disease (ESRD) are particularly characterized by increased oxidative stress and inflammation. However, little is known about the relationship between these features and klotho in patients with ESRD.</P><P>♦ <I>Methods:</I> We conducted a single-center, cross-sectional study of 78 patients receiving peritoneal dialysis (PD). Serum concentrations of klotho, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and 8-isoprostane were measured by enzyme-linked immunosorbent assay. To define factors independently associated with klotho, we determined Spearman’s correlation coefficients for between co-variates and conducted multiple linear regression analyses.</P><P>♦ <I>Results:</I> Patients were classified by median concentration of klotho. In patients with klotho levels > 329.6 pg/mL, serum 8-isoprostane and IL-6 levels were significantly higher than in those with klotho levels < 329.6 pg/mL. In correlation analyses, log 8-isoprostane (γ = –0.310, <I>p</I> = 0.006) and log IL-6 (γ = –0.343, <I>p</I> = 0.002) were inversely correlated with log klotho. After adjustment for age, gender, mean arterial pressure, log intact parathyroid hormone, and log IL-6, log 8-isoprostane was independently associated with log klotho (β = –0.158, <I>p</I> = 0.040). However, the significant relationship between klotho and IL-6 was not seen in an adjusted model.</P><P>♦ <I>Conclusions:</I> This study showed that circulating klotho levels were significantly associated with 8-isoprostane levels in patients undergoing PD, suggesting a potential link between klotho deficiency and enhanced oxidative stress in ESRD patients.</P>
Jung, Kijung,Kim, Kunsoon,Sung, Jong-Chan,Ahmed, Tonia S.,Hong, Soon Hyeok,Grubbs, Robert H.,Choi, Tae-Lim American Chemical Society 2018 Macromolecules Vol.51 No.12
<P>Ru-based metathesis catalysts employed in cyclopolymerization (CP) of 1,6-heptadiyne derivatives have promoted regioselective α-addition to alkynes, forming various conjugated polyenes containing exclusively five-membered repeat units. Recently, we discovered that a new chelated Ru catalyst could promote regioselective β-addition to produce analogous polyenes containing six-membered rings with moderate to good β-selectivity. Since then, we have focused our research on pursuing more active and β-selective regiocontrol to produce conjugated polymers with excellent β-selectivity, with a much broader range of monomers. Herein, we demonstrate highly β-selective CP by combining a new dithiolate-chelated Ru-based catalyst with weakly coordinating pyridine additives, which significantly enhance the conversion and β-selectivity. An in-depth mechanistic investigation by <SUP>1</SUP>H NMR revealed a prominent role for the additives, which improve the stability of the propagating carbene.</P> [FIG OMISSION]</BR>
Jung-Jin Lee,Dae-Hyeok Kim,Sung-Su Byun,Woong-Gil Choi,Chan-Woo Lee,Seung-Min Yi,Jun Kwan,Keum-Soo Park,Woo-Hyung Lee 연세대학교의과대학 2009 Yonsei medical journal Vol.50 No.1
Coronary anomalies are rare angiographic findings. Moreover, there are few reports of cases of an anomalous origin of the right coronary artery from the left sinus of Valsalva and of the left coronary artery from the posterior sinus of Valsalva. Here, we report a case with an anomalous origin of the right coronary artery from the ascending aorta above the left sinus of Valsalva and the left coronary artery from the posterior sinus of Valsalva. This was observed in a patient who was treated for a myocardial infarction of the inferior wall caused by a thrombus in the proximal right coronary artery. The patient was treated successfully with the implantation of a stent in the anomalous origin of the right coronary artery using a 6Fr Amplatz left 1 catheter.