http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
자가조혈모세포이식을 이용한 불응성 류마티스 관절염의 치료
민도준 ( Do June Min ),민창기 ( Chang Ki Min ),양동원 ( Dong Won Yang ),윤종현 ( Chong Hyeon Yoon ),김완욱 ( Wan Uk Kim ),이상헌 ( Sang Heon Lee ),김동욱 ( Dong Wook Kim ),이종욱 ( Jong Wook Lee ),조철수 ( Chul Soo Cho ),김호연 ( 대한류마티스학회 2002 대한류마티스학회지 Vol.9 No.1
Objective: To investigate the safety and efficacy of immunoablation and subsequent autologous hematopoietic stem cell transplantation (HSCT) in refractory rheumatoid arthritis (RA). Methods: Three patients with severe, refractory RA were treated. We mobilized autologous hematopoietic stem cells (HSCs) with cyclophosphamide (Cy) and granulocyte colony-stimulating factor. HSCs were collected and enriched ex vivo using CD34-positive immunoselection. Two different immunoablative conditioning regimens were employed; fludarabine-Cy-anti-thymoayte glonulin (ATG) in patients whose disease activity was transiently ameliorated in response to Cy used in stem cell mobilization, or fludarabine-busulfan-ATG in those who didn`t show any response to that. Results: Median time to engraftment with an absolute neutrophil count greater than 500/μl and nontransfused platelet count greater than 20,000/μl was 15 days (range 12-16) and 9 days (range 7-13), respectively. Regimen-related toxicity was minimal. Two patients were markedly improved at 2 or 3 months after HSCT, repectively. In another patient, disease activity was transiently subsided, but relapsed at 2 months after HSCT, which led to reinstitution of anti-rheumatic medications. This resulted in subsequent marked improvement of disease activity whereas her disease had been refractory to these medications. Conclusions: These results underscore the feasibility and potential efficacy of intensive immunosuppression followed by autologous HSCT for treatment of refractory rheumatoid arthritis. The durability of remission remains to be clarified.
민준기 ( Jun Ki Min ),민도준 ( Do June Min ),홍연식 ( Youn Sik Hong ),이상헌 ( Sang Heon Lee ),박성환 ( Sung Hwan Park ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.4
Objective: To determine the causative organisms and predisposing factors of bacteremia in patients with systemic lupus erythemaosus (SLE). Methods: We retrospectively evaluated medical records of 358 patients with SLE who were followed in Kangnam St. Mary`s Hospital from 1992 to 1997. Bacteremic SLE patients were compared to non-bacteremic SLE patients in terms of laboratory and clinical variables. Results: Twenty-nine episodes of bacteremia in 27 patients with SLE (26 women, 1 man) were identified. The episode of community acquired bacteremia (n=21, 72.4%) was more frequent than that of hospital acquired bacteremia (n=8, 27.6%). Isolated bacterial organisms from blood were as follows: gram negative organisms (n=14); Salmonella species (n=8), E. coli (n=4), P. mirabilis (n=1), K. pneumonia (n=1). gram positive organisms (n=15); S. aureus (n=6) , Streptococcus pneumoniae (n=2), coagulase negative Staphylococci(n=2), Bacillus species (n=1), Streptococcus viridans (n=1), Streptococcus pyogenes (n=1), Entero-coccus faecalis (n=1), Listeria monocytogenes (n=1). SLE was the most common underlying condition among Salmonella bacteremic patients. One of twenty seven bacteremic SLE patients (3.8%) died in spite of antibiotic therapy. Logistic regression analysis of the laboratory and clinical variables between bacteremic SLE patients and non-bacteremic SLE patients (n=140) showed that bacteremic SLE patients were more frequently associated with thrombocytopenia (p=0.008, odds ratio (OR)=7.8, 95% confidence interval (CI), 1.7 to 35.9), lupus nephritis (p=0.023, OR=5.3, 95% CI, 1.1 to 26.8), and high dose steroid therapy (prednisolone >0.5mg/kg/day, p=0.008, OR=12.1, 95% CI 2.5 to 58.6) than non-bacteremic SLE patients. Conclusion: Our data suggested that Salmonella was the single most frequent isolate from the blood of SLE patients. Lupus nephritis and high dose steroid therapy were independent predisposing factors for the development of bacteremia in SLE patients.
류마티스 질환에서 혈청 Soluble Fas Ligand (sFasL), FasL-Fas 복합체, FasL-IgG 복합체 측정
민준기 ( Jun Ki Min ),민소연 ( So Youn Min ),조미라 ( Mi Ra Cho ),정재연 ( Jae Yeon Jeong ),주대명 ( Dae Myung Jue ),민도준 ( Do June Min ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.4
Objective: To quantify the soluble Fas ligand (sFasL) and to measure FasL-Fas complex and FasL-IgG complex in the sera of patients with various rheumatic diseases: systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), and adult onset Still`s disease (AOSD). Methods: Serum samples were obtained from 37 patients with SLE, 40 with RA, 30 with SSc, 20 with AOSD, and 40 healthy controls. The serum sFasL, FasL-Fas complex, and FasL-IgG complex were measured using a sandwich enzyme-linked immunoabsorbent assay. Hospital medical records were retrospectively reviewed for clinical and laboratory characteristics in patients with SLE. Disease activity in SLE patients was assessed by the SLE Disease Activity Index (SLEDAI) score. Results: In patients with SLE, serum sFasL levels (383.1±208.9pg/ml) were significantly higher (p<0.001) than those of healthy controls (192.0±84.7pg/ml). sFasL levels in patients with RA (150.8±30.7pg/ml, p=0.014), SSc (115.4±13.5pg/ml, p<0.001), and AOSD (137.5±12.9pg/ml, p=0.001) were significantly lower compared with healthy controls. The frequencies of positive FasL-Fas complex and FasL-IgG complex were higher in patients with SLE (56.8%, 56.8% respectively) than in healthy controls (2.5%, 0% respectively) (p<0.001). All patients with RA or AOSD were negative for FasL-Fas complex and FasL-IgG complex. No patients with SSc were positive for FasL-Fas complex. On the other hand, the positive frequency of FasL-IgG complex was greater in patients with SSc (16.7%) than in healthy controls (0%) (p=0.012). Serum levels of FasL-IgG complexes in active SLE patients (OD 0.467±0.050) were tended to be lower than those in inactive SLE patients (OD 0.509±0.055) (p=0.060). SLEDAI score was tended to be negatively correlated with the serum levels of FasL-IgG complex in patients with SLE (r=-0.308, p=0.068). Conclusion: These results suggest that FasL may possibly play a role in the pathogenesis of SLE.
비스테로이드성 항염제 유발 위장관 부작용에 대한 rebamipide의 효과
서영일 ( Young Il Seo ),박성환 ( Sung Hwan Park ),민도준 ( Do June Min ),김완욱 ( Wan Uk Kim ),민준기 ( Jun Ki Min ),이상헌 ( Sang Heon Lee ),홍연식 ( Yeon Sik Hong ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.2
Objectives: To investigate protective effect of rebamipide against nonsteroidal anti-inflammatory drugs (NSAIDs) induced gastroduodenal mucosal injury. Methods: Randomized eight patients with rheumatic disease starting NSAIDs underwent pre-treatment gastroduodenoscopy, and degree of mucosal injury and several gastrointestinal (GI) symptoms were graded by Lanza score scale (rating from 0 to 4) and symptom score scale (rating from 0 to 3). Eight weeks after the subjects had received concomitant rebamipide 100mg bid and NSAIDs they underwent post-treatment gastroduodenoscopy and degree of mucosal injury and GI symptoms were graded. Randomized previous NSAIDs-used 20 patients with rheumatic disease were also investigated. Eight weeks after 100mg bid with concomitant NSAIDs, they underwent gastroduodenoscopy and degree of mucosal injury and GI symptoms were graded. Results: All eight patients who received concomitant rebamipide and NSAIDs had no interval changes between pre and post-treatment mucosal injury scores and had little interval changes between pre and post-treatment symptom scores. In previous NSAIDs-used patients with rheumatic disease, incidence of each gastric ulcer and duodenal ulcer were 16.7% and 11.1% and all mean symptom scores were lower than 1.0. No special adverse effect was developed during the study. Conclusion: Rebamipide seems to have a good protective effect against NSAIDs induced mucosal injury and GI symptoms and probably have rare adverse effect.
조병식 ( Byoung Sik Cho ),곽승기 ( Seung Ki Kwok ),서영일 ( Young Il Seo ),민도준 ( Do June Min ),김완욱 ( Wan Uk Kim ),이숙경 ( Suk Kyoung Lee ),박성환 ( Sung Hwan Park ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.4
Rheumatoid arthritis(RA) is occasionally associated with variable extra-articular involvement and the chronic inflammatory process can affect the gastrointestinal system. The gastrointestinal involvement in RA may present in many causes: drug induced colitis, vasculitis and amyloidosis involved in the gut, association with certain bowel diseases such as collagenous colitis or infectious colitis. Ulcerative colitis(UC) is a chronic inflammatory bowel disease and is commonly associated with peripheral joint disease which correlates with the disease activity and extent of the bowel inflammation. The arthritis is usually presented in pauciarticular, generally asymmetric, transient, and nondestructive pattern. However, the chronic and destructive peripheral arthritis has been reported in a few cases and RA has not been observed in association with UC. We experienced a case of RA patient with recurrent abdominal pain, hematochezia, and tenesmus who was diagnosed as UC by endoscopic and histologic finding. We herein report the case with literature.