Disentangling Diagnosis and Management of Fibromyalgia

( Ji-hyoun Kang ),( Sung-eun Choi ),( Dong-jin Park ),( Shin-seok Lee ) 대한류마티스학회 2022 대한류마티스학회지 Vol.29 No.1

Fibromyalgia (FM) is a chronic pain condition characterized by widespread pain accompanied by symptoms such as fatigue, sleep disturbance, cognitive dysfunction, and mood disorder. The pathophysiology of FM has been unclear, leading to inconsistent diagnosis and ineffective management. Several diagnostic criteria for FM have been proposed in recent years, including the revised 2016 American College of Rheumatology (ACR) criteria, the criteria of the ACTTION-American Pain Society Pain Taxonomy (AAPT) group, and the modified 2019 Fibromyalgia Assessment Status (FAS) criteria. Despite the appearance of newer criteria for FM diagnosis, the 2016 ACR criteria demonstrate the best performance. Many randomized controlled studies and systematic reviews have shown the therapeutic efficacies of pharmacological and non-pharmacological treatments of FM. Nevertheless, further research is needed to develop better treatment options. (J Rheum Dis 2022;29:4-13)

Comparative population genetic analyses of the burrowing mayfly, Ephoron shigae (Ephemeroptera: Polymitarcyidae), in South Korea and Japan: Implications for mayfly mass emergence

Ji Hyoun Kang,Jeong Mi Hwang,Soon-Jik Kwon,Kazuki Sekine,Sun-Jae Park,Min Jeong Baek,Wongyu Lee,Wooseong Kim,Yeon Jae Bae 한국응용곤충학회 2023 한국응용곤충학회 학술대회논문집 Vol.2023 No.04

A Case of Sarcoidosis That Improved upon Discontinuation of Etanercept

( Ji Hyoun Kang ),( Joon Ho Ahn ),( Ji Eun Yu ),( Ji Eun Kim ),( Yi Rang Yim ),( Jeong Won Lee ),( Kyung Eun Lee ),( Dong Jin Park ),( Lihui Wen ),( Yong Wook Park ),( Shin Seok Lee ) 대한류마티스학회 2016 대한류마티스학회지 Vol.23 No.3

A 31-year-old man who had been prescribed etanercept over a 3-year period for treatment of ankylosing spondylitis presented with newly developed dry cough, chills, myalgia, and weight loss. Chest computed tomography showed multiple reticulonodular pulmonary infiltrates and bilateral mediastinal, hilar, and peribronchial lymphadenopathy. Biopsy of a paratracheal lymph node revealed chronic granulomatous inflammation without necrosis, and the serum angiotensin-converting enzyme level was elevated. Sarcoidosis was diagnosed. His laboratory and radiological findings, and clinical symptoms improved only after discontinuation of etanercept without treatment. Although etanercept-induced sarcoidosis is rare, this case report suggests that sarcoidosis should be considered in the differential diagnosis of patients treated with the tumor necrosis factor inhibitor. (J Rheum Dis 2016;23:187-192)

Poster Session : PS 1503 ; Rheumatology : Drug Survival Rates of Tumor Necrosis Factor Inhibitors in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

( Ji Hyoun Kang ),( Dong Jin Park ),( Jeong Won Lee ),( Kyung Eun Lee ),( Lihui Wen ),( Tae Jong Kim ),( Yong Wook Park ),( Shin Seok Lee ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: We investigated the compliance of Korean patients using tumor necrosis factor (TNF) inhibitors to treat rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and identified potential predictors associated with treatment discontinuation. Methods: The study population comprised 114 RA and 310 AS patients treated with TNF inhibitors at a single tertiary center for at least 1 year from December 2002 to November 2011. Results: Of the 114 RA patients, 64 (56.1%) discontinued their first TNF inhibitors with a mean duration of 18.1 months. By contrast, 65 of 310 patients (21.0%) with AS discontinued their first TNF inhibitors, with a mean duration of 84 months. Although the survival rate did not differ among the three TNF inhibitors in the AS patients, the etanercept group had a lower discontinuation rate than the infiiximab group in the RA patients. In addition, RA patients who received corticosteroids in combination with TNF inhibitors were more likely to discontinue their TNF inhibitors. The independent predictors of drug discontinuation in AS patients were male gender and complete ankylosis on radiographs of the sacroiliac joint. Conclusions: Our results provide further evidence that real-life treatment outcomes of RA and AS patients may be different from those observed in randomized clinical trials.

[PE-0056] Natural variation in total phenol and total flavonoid content of maize varieties cultivated under different environment conditions

Hyoun-Min Park(Hyoun-Min Park),Myeong-Ji Kim(Myeong-Ji Kim),So Ra Jin(So Ra Jin),Min Ho Lee(Min Ho Lee),Yun-Young Kang(Yun-Young Kang),Oh Suk Yu(Oh Suk Yu),Eun-Ha Kim(Eun-Ha Kim),Sang-Gu Lee(Sang-Gu L 한국육종학회 2022 한국육종학회 공동학술발표집 Vol.2022 No.-

Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report

( Ji-hyoun Kang ),( Donghyun Lee ),( Yunchul Park ) 대한외상학회 2021 大韓外傷學會誌 Vol.34 No.4

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

한국멸종위기담수어종열목어(Brachymystax lenok tsinlingensis)의유전적 다양성과집단구조: 미래복원을위한보존의미a

Ji Eun Jang,Jae Hwan Kim,Ji Hyoun Kang,Song Yi Baek,Hwang Goo Lee,Jun Kil Choi,Jae Seok Choi,Hyuk Je Lee 한국환경생태학회 2016 한국환경생태학회 학술대회지 Vol.2016 No.1

Brachymystax lenok tsinlingensis (family Salmonidae), cold freshwater fish, is endemic to Asia. This species is currently distributed throughout Russia, Mongolia, China and the Korean Peninsula. B. lenok tsinlingensis in South Korea was severely affected by anthropogenic activities such as habitat destruction, agricultural run-off and water pollution, and hence this fish has recently been dramatically decreased in its population sizes and become now critically endangered. To recover the number of individuals of B. lenok tsinlingensis, stocking or translocation programs have been conducted continuously by local governments since 1970s. However, these programs made little effort to clarify populations that may have originated from stocked, translocated or introduced fish. An understanding of genetic characteristics of endangered populations is critical to develop effective conservation and restoration plans especially because genetic diversity ensues their future fate. Therefore, we assessed the “conservation status” of this species by estimating the level of genetic diversity and genetic structure among ten geographic populations including restored populations via reinforcement and supplementation. Also, we aimed to trace the genetic origins of the newly translocated population (Chiak) through a restoration practice program. Moreover, we inferred the phylogenetic relationships among Korean lenok populations as well as across the Northeast Asia. Two hundred eighteen individuals of B. lenok tsinlingensis were sampled from ten localities (Yanggu, Injae, Seorak, Bangtae and Hongcheon: North Han River basin; Pyeongchang, Chiak and Jeongseon: South Han River basin; Taebaek and Bonghwa: Nakdong River basin in South Korea). Based on mitochondrial DNA (mtDNA) control region and eight nuclear microsatellite loci, we found extremely low levels of within-population genetic diversity, which suggests small effective population sizes (Ne) within populations. For mtDNA control region, each population housed one, or at most, two haplotypes that are restricted to the respective localities, meaning that these ‘genetically unique’ lineages will be lost permanently if the local populations undergo extinction. The overall values of haplotype diversity (h) and nucleotide diversity (π) for the entire Korean population were 0.703 ± 0.024 and 0.021 ± 0.010, respectively. In the case of microsatellites, average number of alleles across the eight loci for the entire population was 9.1 and allelic richness (AR) per population ranged from 2.375 to 4.144 (mean = 3.104). The values of observed heterozygosity (HO) and expected heterozygosity (HE) were similar to each other [HO: 0.400 ~ 0.590 (mean = 0.518); HE: 0.407 ~ 0.608 (mean = 0.504)]. The inbreeding coefficient (FIS) values were generally low, ranging from 0.048 to 0.279. Consequently, the majority of the populations (except Yanggu and Pyeongchang) were not significantly deviated from Hardy-Weinberg equilibrium (HWE), suggesting random mating at these loci tested. In addition, we found that Korean lenok populations were significantly genetically isolated from each other, with private mtDNA haplotypes and microsatellite alleles, indicating limited gene flow among populations, strong effects of genetic drift due to small Ne, or a combination of both. The Mantel test of microsatellites revealed a significant correlation (r = 0.414, P = 0.04) between genetic and geographic distances for pairwise comparisons among the ten populations, while that of mtDNA showed a lack of correlation. Given the shared identical mtDNA haplotype and similar microsatellite allelic distributions between Chiak and Hongcheon populations, we suggest that the restored (introduced) Chiak population would be inferred to be genetically originated from Hongcheon population. Phylogenetic relationships among Northeast Asian populations showed that South Korean lineages have more recently diverged from China (Yellow River), than between North Korea and Russia. Although the phylogenetic relationship would be expected to be associated with geography, South-North Korea and China populations with a similar latitude was more phylogenetically closely related. These findings may suggest a possible scenario for the historical movements of B. lenok tsinlingensis in Northeast Asia during Last Glacial Maximum (LGM). It would be supported by the line of evidence that most lenok populations migrated to southward from Northern Asia such as Russia and Mongolia during LGM because the Korean Peninsula was landlocked as inland epoch and functioned as a southern shelter with Yellow River. For this reason, the Korean Peninsula is suggested to be an important geographical region for better understanding phylogenetic relationships and evolutionary histories of B. lenok tsinlingensis across the Northeast Asia. Despite large efforts made to develop several restoration programs in South Korea for B. lenok tsinlingensis, it is still unknown whether these past restoration efforts were successful or fruitless, mainly because of little attention paid to post-restoration monitoring research. Hence, there was a lack of their published official records. In the future, conservation and restoration projects of the Korean lenok populations should consider the genetic data for a better understanding of their ecological and evolutionary trajectories. And finally, we hope that our findings here can help inform on the future effective conservation and restoration plans for B. lenok tsinlingensis populatio ns in South Korea.

견정(肩井), 곡지(曲池), 족삼리(足三里) 시침(시鍼)이 뇌졸중(腦卒中) 환자(患者)의 혈압(血壓)과 두통(頭痛)에 미치는 효과

윤현민 ( Hyoun Min Youn ),강귀염 ( Kwi Yeum Kang ),이지원 ( Ji Won Lee ) 대한경락경혈학회 2005 Korean Journal of Acupuncture Vol.22 No.3

Objective: The purpose of this study was to verify the effect of pressing at Kyeun-Jung(G21), Gok-Ji(LI11) and Zok-Sam-Li(S36) with Si-acupuncture on the decreasing of blood pressure and headache on the stroke patients. Methods: This study was one-group pretest-posttest experimental design. The subjects of this study were 30 patients who were hospitalized in stroke center of hospital located in Ulsan from September 27, to November 12, 2004. They had over 160/90mmHg blood pressure but didn`t take any hypotensive drugs. The instruments were the Si-acupuncture, the blood pressure and headache scale using Visual Analogue Scale(VAS). Results: 1. With administration of Si-acupuncture, the blood pressure intensity decreased statistical significantly(systolic blood pressure: t=13.310, p=0.000, diastolic blood pressure: t=11.788, p=0.000). After 30 minutes with administration of Si-acupuncture, the blood pressure intensity decreased statistical significantly(systolic blood pressure: t=15.130, p=0.000, diastolic blood pressure: t=12.479, p=0.000). 2. With administration of Si-acupuncture, the headache intensity not decreased statistical significantly"(t=0.372, p=0.712). After 30 minutes with administration of Si-acupuncture, the headache intensity decreased statistical significantly"(t=7.370, p=0.000). Conclusion: According to above, it was verified that the pressing at Kyeun-Jung, Gok-Ji and Zok-Sam-Li with Si-acupuncture was effective in decreasing of blood pressure and headache on the stroke patients.

미국의 연속적인 케어 정책을 통해서 본 한국의 연속적인 케어 방향에 관한 연구

강지현(Ji Hyoun Kang) 명지대학교 여성가족생활연구소 2002 여성가족생활연구 Vol.7 No.-

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Osteoporosis Is Associated with an Increased Risk of Colorectal Adenoma and High-Risk Adenoma: A Retrospective, Multicenter, Cross-Sectional, Case-Control Study

Nam Ji Hyung,Koh Myung,Kang Hyoun Woo,Ryu Kum Hei,Lee Dong Seok,Kim Su Hwan,Jang Dong Kee,Jeong Ji Bong,Kim Ji Won,Lee Kook Lae,Oh Dong Jun,Lim Yun Jeong,Koh Seong-Joon,Im Jong Pil,Kim Joo Sung 거트앤리버 소화기연관학회협의회 2022 Gut and Liver Vol.16 No.2

Background/Aims: The protective effects of vitamin D and calcium on colorectal neoplasms are known. Bone mineral density (BMD) may be a reliable biomarker that reflects the long-term anticancer effect of vitamin D and calcium. This study aimed to evaluate the association between BMD and colorectal adenomas including high-risk adenoma. Methods: A multicenter, cross-sectional, case-control study was conducted among participants with average risk of colorectal cancer who underwent BMD and screening colonoscopy between 2015 and 2019. The main outcome was the detection of colorectal neoplasms. The variable under consideration was low BMD (osteopenia/osteoporosis). The logistic regression model included baseline demographics, components of metabolic syndrome, fatty liver disease status, and aspirin and multivitamin use. Results: A total of 2,109 subjects were enrolled. The mean age was 52.1±10.8 years and 42.6% were male. The adenoma detection rate was 43%. Colorectal adenoma and high-risk adenoma were both more prevalent in subjects with low BMD than those with normal BMD (48.2% vs 38.8% and 12.1% vs 9.1%). In the univariate analysis, old age, male sex, smoking, metabolic components, fatty liver, and osteoporosis were significantly associated with the risk of adenoma and high-risk adenoma. In the multivariate analysis, osteoporosis was independently associated with risk of colorectal adenoma (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.11 to 2.46; p=0.014) and high-risk adenoma (OR, 1.94; 95% CI, 1.14 to 3.29; p=0.014). Conclusions: Osteoporosis is an independent risk factor of colorectal adenoma and high-risk adenoma.