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항 TNF 차단제로 치료한 고령에서 발생한 강직성척추염 증례
이지선 ( Ji Sun Lee ),방소영 ( So Young Bang ),유대현 ( Dae Hyun Yoo ),변영상 ( Young Sang Byun ),박수역 ( Soo Yuk Park ),김태환 ( Tae Hwan Kim ) 대한류마티스학회 2010 대한류마티스학회지 Vol.17 No.1
고령에서 발생한 강직성척추염은 일반적으로 젊은 연령에 비하여 비전형적인 증상들과 고령에서의 퇴행성 변화 및 다른 근골격계 질환의 동반으로 진단이 어렵다. 본원에서 고령에서 다양한 증상으로 발현하여 강직성척추염으로 진단된 4개의 증례들의 임상 양상 및 검사 소견을 이전 연구들과 비교하였으며, NSAIDs, 부신피질호르몬제, DMARDs로 증상과 검사소견의 호전이 없었으나, TNF 차단제를 사용 후 뚜렷한 부작용 없이 호전을 보여 보고하는 바이다. Ankylosing spondylitis is a disease that shows a young age of onset (less than 40 years old), inflammatory back pain, sacroiliitis and a strong association with HLA-B27. Yet some recently reported cases have presented with a late age of onset (more than 55 years old), atypical clinical presentations and a low response to NSAIDs, and this has also been named late onset spondyloarthropathy (LOSPA). As compared with early onset spondyloarthropathy (EOSPA), the LOSPA patients more frequently suffer with combined peripheral arthritis and inflammatory systemic symptoms and a high ESR and CRP level, but they lack the typical axial symptoms. Yet there have been few reports about late onset ankylosing spondylitis (LOAS). The previous cases of LOSPA and LOAS were managed with NSAIDs, steroids, methotrexate and sulfasalazine, but none were managed with TNF antagonists. LOAS is rare and difficult for management because of the patients` older age and the lack of experiences with this malady, so we report here on the four cases of LOAS that were successfully treated by TNF antagonists.
Kang, Myung-Ji,Kwon, Eun-Bin,Yuk, Heung Joo,Ryu, Hyung Won,Kim, Soo-Yeon,Lee, Mi-Kyeong,Moon, Dong-Oh,Lee, Su Ui,Oh, Sei-Ryang,Lee, Hyun-Sun,Kim, Mun-Ock Informa UK (TaylorFrancis) 2017 Bioscience, Biotechnology, and Biochemistry Vol.81 No.12
<P>In the course of screening to find a plant material decreasing the activity of triacylglycerol and cholesterol, we identified Tripterygium regelii (TR). The methanol extract of TR leaves (TR-LM) was shown to reduce the intracellular lipid contents consisting of triacylglycerol (TG) and cholesterol in HepG2 cells. TR-LM also downregulated the mRNA and protein expression of the lipogenic genes such as SREBP-1 and its target enzymes. Consequently, TR-LM reduced the TG biosynthesis in HepG2 cells. In addition, TR-LM decreased SREBP2 and its target enzyme HMG-CoA reductase, which is involved in cholesterol synthesis. In this study, we evaluated that TR-LM attenuated cellular lipid contents through the suppression of de novo TG and cholesterol biosynthesis in HepG2 cells. All these taken together, TR-LM could be beneficial in regulating lipid metabolism and useful preventing the hyper-lipidemia and its complications, in that liver is a crucial tissue for the secretion of serum lipids.</P>