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김성동 ( Seong Dong Kim ),류동환 ( Dong Hwan Ryu ),이정훈 ( Jeong Hoon Lee ),권창모 ( Chang Mo Kwon ),홍영훈 ( Young Hoon Hong ),이충기 ( Choong Ki Lee ) 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.3
Objective: To investigate the prevalence of autonomic dysfunction and to evaluate the relationship between autonomic dysfunction and clinical parameters in patients with systemic lupus erythematosus (SLE). Methods: Fifty-eight patients with SLE who met the American College of Rheumatology criteria for SLE and forty-five healthy controls were selected at our hospital. Cardiovascular autonomic nervous function (CAN) test, including heart rate variation in deep breathing, Valsalva maneuver and orthostatic change and blood pressure response to standing, handgrip, was done in patient group and controls. Erythrocyte sedimentation rate (ESR), antinuclear antibody, anti-dsDNA antibody, complete blood count, complement and disease duration of patients were retrospectively reviewed and disease activity was assessed by Mexican SLE disease activity index (MEX-SLEDAI). Results: The frequency of parasympathetic damage was 51.7% in patients with SLE and 15.6% in controls. There was significant difference between 2 groups in heart rate variation in deep breathing. No significant correlations were observed between autonomic dysfunction and ESR, antinuclear antibody, anti-dsDNA antibody, thrombocytopenia, complement, disease duration of patients, but there was slightly positive correlation between number of abnormal parasympathetic function test and MEX-SLEDAI (r=0.32, p<0.05). Conclusion: The prevalence of autonomic dysfunction was high in SLE patients and there was high frequency in patients with high disease activity. Prospective studies are needed to determine the clinical significance of autonomic dysfunction in the morbidity and mortality of SLE.
류동환,권창모,이정훈,홍영훈,이충기 영남대학교 의과대학 2003 Yeungnam University Journal of Medicine Vol.20 No.1
Pyoderma gangrenosum is uncommon neutrophilic dermatosis characterized by richness of the mature neutrophilic polynuclear dermal infiltrate. Pyoderma gangrenosum is associated with variable diseases, most commonly inflammatory bowel disease, hematological diseases, malignancies, but it is reported rarely in rheumatoid arthritis. We report a case of pyoderma gangrenosum in rheumoid arthritis patient. A 50-year-old woman admitted to our hospital due to painful pretibial ulcerative skin lesions. She had been treated as rheumatoid arthritis for 8 years. At admission. body temperature was 36.5℃ and other vital sign was unremarkable. Physical examination revealed right pretibial ulceration, multiple pustules on left pretibial area and both palms. Laboratory studies revealed WBC count 7,600/uL (neutrophils 60.3%, eosinophil 3.2%), hemoglobin 11.4 g/dL, platelet count 319,000/uL, ESR 65 mm/hour. Other lab findings were also unremarkable. Skin biopsy was done, which showed dense dermal infiltrate of neutrophils and wound culture were negative. By 8 weeks after systemic high dose corticosteroid (1 mg/kg/day), cyclosporine A (5 mg/kg/day), sulfasalazine 2 g therapy, symptoms and skin ulceration were being improved. Without skin relapse, she is followed up our hospital with low dose corticosteroid and sulfasalazine.
여자 전신성 홍반성 낭창 환자에서 발생한 천장골염 1례
박기도,김성동,류동환,이충기,홍영훈 영남대학교 의과대학 2000 Yeungnam University Journal of Medicine Vol.17 No.2
저자들은 17세 여자환자로 심한 전신성 홍반성 낭창과 동반되어 발생한 유증상의 천장골염을 보고한다. 이 환자는 HLA-B27이나 DR3와 연관성이 없이 천장골염이 발생하였으며, 남자 전신성 홍반성 낭창 환자에서는 종종 천장골염이 보고된바는 있으나 여자환자에서 천장골염이 보고된 경우는 드물어 보고하며, 저자들의 견해로는 전신성 홍반성 낭창에서 천장골염의 동반은 희귀한 유전학적 표지자의 조합만으로 설명하기 힘들며 드문 전신성 홍반성 낭창의 임상양상으로 추정된다. We report a case of 17-year-old female with juvenile onset systemic lupus erythematosus who developed symptomatic unilateral sacreiliitis. She had neither HLA-DR3 nor B27 antigens. Though sacroiliitis have been reported in male SLE patients, it has been rarely reported in female patients. The rare coexistence of SLE and sacroiliitis, described in this case, may not be determined soley by genetic factors ; sacroiliitis may be just an infrequent manifestation of SLE.