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내과적 질환에 병발된 반사성 교감신경계 위축 증후군 20 예의 분석
송소향(So Hyang Song),이정득(Jeong Deuk Lee),이상헌(Sang Heon Lee),홍연식(Yeon Sik Hong),조철수(Chul Su Cho),박동준(Dong Joon Park),정수교(Soo Kyo Chung),김호연(Ho Yun Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.5
N/A Reflex sympathetic dystrophy syndrome (RSDS) is an distinct symptom complex characterized by diffuse distal-limb pain, edema, vasomotor skin change and dystrophic skin change. It has been associated with limb-trauma, acute stoke, myocardial ischemia, peripheral neuropathy, phamacological agents such as phenobarbital and antituberculosis agents and malignancy. We report the clinical and radiological features of 20 patients who were diagnosed of RSDS at Kangnam Saint Mary's Hospital between January 198S and May 1991. The results were as fo1lows: 1)According to Kozin's criteria, seven (35%) are diagnosed of definite RSDS, eight (40%) of probable RSDS, and five (25%) of doubtful RSDS. 2) Disorders associated with RSDS were cerebrovascular disease (7 patients), malignancy (4 patients), myocardial ischemia (4 patients) and antituberculosis drug (2 patients). The remaining 6 padtients (30%) had no specific precipitating events. 3) Review of the Three phase bone scitigraphy (TPBS) for 20 patients indicated that nineteen of twenty patients (95%) has asymmetric and abnormal blood flow in TPBS. 4) Most patients were diagnosed early, therefore, had symptomatic relief without sequele such as flexion contracture of skin or subcutaneous atrophy by analgesics, steroid, calcitonin and physical therapy. In summary, the TPBS is a potentially sensitive and specific test to corroborate the diagnosis of RSDS and we can expect to have symptomatic relief without sequence if this disorder could be diagnased and treated, early.
Elevated Serum Levels of Both TH1 1 and TH2 Cytokines in Patients with Adult Still`s Disease
민준기 ( Jun Ki Min ),조미라 ( Mi Ra Cho ),민소연 ( So Yeon Min ),김선준 ( Sun June Kim ),김완욱 ( Wan Uk Kim ),홍연식 ( Yeon Sik Hong ),박성환 ( Sung Hwan Park ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한내과학회 1999 대한내과학회 추계학술대회 Vol.57 No.-
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.
The Role of Interleukin-12 in Inflammatory Activity of Patients with Rheumatoid Arthritis
김완욱 ( Wan Uk Kim ),민소연 ( So Youn Min ),조미라 ( Mi La Cho ),민준기 ( Jun Ki Min ),홍연식 ( Yeon Sik Hong ),이상헌 ( Sang Heon Lee ),박성환 ( Sung Hwan Park ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한내과학회 1999 대한내과학회 추계학술대회 Vol.57 No.-
류마티스 활막세포에서 비스테로이드성 항염제에 의한 Vascular Endothelial Growth Factor 생성의 억제
김용주 ( Yong Ju Kim ),박종서 ( Jong Seo Park ),최진정 ( Jin Jung Choi ),민소연 ( So Youn Min ),조미라 ( Mi La Cho ),김완욱 ( Wan Uk Kim ),박성환 ( Sung Hwan Park ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.4
Objective: Vascular endothelial growth factor (VEGF), a potent angiogenic, permeability-enhancing cytokine plays an important role in chronic inflammatory process of rheumatoid arthritis (RA). Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used drugs for the treatment of RA. However, the effect of NSAIDs on angiogenesis in rheumatoid synovium is unclear. In this study, we investigated the effects of NSAIDs such as indomethacin (IDC) on TGF-β-induced VEGF production in rheumatoid synoviocytes. Methods: Fibroblast-like synoviocytes (FLS) from RA were stimulated with TGF-β (10 ng/ml) for 24hr in the presence of the various concentrations of IDC. The levels of VEGF were measured in culture supernatant by ELISA. In addition, COX-2 and VEGF mRNA expression of cultured FLS were evaluated by RT-PCR. Results: VEGF production from FLS was significantly increased in the presence of TGF-β. IDC exerted a dose-dependent inhibitory effect on the production of VEGF induced by TGF-β. RT-PCR analysis showed that IDC also inhibited TGF-β-induced COX-2 and VEGF mRNA expression in cultured FLS by a dose-dependent manner. Conclusion: Our results demonstrate that NSAIDs inhibit VEGF production and the expression of its mRNA and COX-2 mRNA in synovial cells of RA patients. These findings suggest that NSAIDs may suppress progression and perpetuation of rheumatoid synovitis by anti-angiogenic activity.
Hydroxychloroquine이 T 세포의 Fas Ligand 대사에 미치는 영향
민준기 ( Jun Ki Min ),이희진 ( Hee Jin Lee ),이원선 ( Won Sun Lee ),박상희 ( Sang Hee Park ),민소연 ( So Youn Min ),조미라 ( Mi La Cho ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ) 대한류마티스학회 2000 대한류마티스학회지 Vol.7 No.2
Objective: Hydroxychloroquine (HCQ) is a drug that has been used to treat autoimmune disorders such as rheumatoid arthritis arid systemic lupus erythematosus. However, the specific mechanism for its pharmacologic action has been largely unknown. It has been reported that dysregulation of lymphocytic apoptosis mediated by Fas ligand (FasL) and Fas is associated with the development of autoimmune diseases and HCQ induces apoptosis in peripheral blood lymphocytes. These reports suggest that HCQ may exert its pharmacologic effects through the modulation of FasL and Fas. Therefore, we are intended to investigate the effects of HCQ on the regulation of FasL and Fas. Methods: Jurkat cells or peripheral blood mononuclear cells (PBMNC) were treated with varying concentrations of HCQ. Semiquantative reverse transcription-polymerase chain reaction, Western blotting, flow cytometry, and ELISA were used for this study. Results: HCQ at nontoxic concentrations(50~150μM) caused a dose dependent increase of FasL mRNA expression and FasL in cell lysates. HCQ inhibited the release of intracellular 40 kDa FasL by Jurkat cells which were pulse-stimulated with PHA (50㎍/㎖). Jurkat cells activated with PHA increased membrane bound FasL (mFasL) expression (24.5±4.3%), however Jurkat cells pretreated with HCQ(150μM) followed by PHA administration did not further increase mFasL expression (26.8±1.6%). Addition of different concentrations of HCQ to the cultured PBMNC stimulated with PHA for 24 hours showed increase of soluble FasL (sFasL). The levels of sFasL treated with HCQ zero, 50, 150 and 300μM for 24hours were 38.6±3.0, 43.4±5.1, 77.0±3.6(P<0.05) and 72.3±8.lpg/㎖(P<0.05) respectively. However, fas metabolism was not affected by HCQ. Conclusion: These results suggest that HCQ may exhibit its pharmacological effects by upregulation of FasL gene expression and increased production sFasL without any influence on the Fas metabolism of T cells.
류마티스 관절염 환자에서 Methotrexate와 관련된 간질성 폐렴
김지연 ( Ji Yeon Kim ),김완욱 ( Wan Uk Kim ),김성일 ( Sung Il Kim ),류완희 ( Wan Hee Yoo ),박성환 ( Sung Hwan Park ),홍연식 ( Yeon Sik Hong ),김석찬 ( Seok Chan Kim ),조철수 ( Chul Soo Cho ),김호연 ( Ho Youn Kim ),이연수 ( Youn So 대한류마티스학회 1998 대한류마티스학회지 Vol.5 No.1
The use of oral methotrexate in a low dose given once weekly has become the mainstay of therapy for active and sustained rheumatoid arthritis. Pneumonitis can be expected to occur in patients taking low doses of methotrexate for rheumatoid arthritis. The pathology suggests that methotrexate pneumonitis is a hypersensitivity reaction although arguments have been put forth that it is idiosyncratic. Treatment of presumed methotrexate pneumonitis, even while waiting for special stains, cultures, or tissue sections from bronchoscopic biopsy, should be glucocorticoids given intravenously or by mouth. Empirical antibiotic treatment can be used until infectious causes are ruled out. In recent years there has been an increase in the number of reports of pulmonary complications associated with low-dose methotrexate therapy for rheumatic diseases. Among these complications interstitial pneumonitis has been most often reported (more than 35 cases since the first report in 1983). We report a case of methotrexate-associated pulmonary complication in rheumatoid arthritis confirmed by trans-bronchoscopic lung biopsy, which resolved by treatment of corticosteroid therapy.
고환염, 부고환염 및 척수수막염을 동반한 Behcet 씨 병 1 예
박수헌,박동준,송소향,한제호,조철수,김호연,김동집 대한내과학회 1991 대한내과학회지 Vol.41 No.2
$quot;The major feature of Behcet`s syndrome is characterized by recurrent oral and genital ulcers and ocular lesion. Other manifestations of the syndrome include pyoderma, erythema nodosum, thrombophlebitis, pericarditis, arthritis, hepatomegaly, epididymitis, ulcers of the gastrointestinal tract, and central nervous system disease. Recently, we experienced a case of Neuro-Behcet syndrome associated with epididymitis and orchitis. A 30-year-old man was admitted with paraplegia and dysuria. Multiple aphthous ulcers, erythema nodosum, uveitis and epididymitis had developed during his hospital course. Cerebrospinal fluid examination showed 17 white blood cell/㎣ and a total protein level of 56mg/dl. A search for viral, bacterial and fungal agents by culture and the serolagy of the cerebrospinal fluid had been serially checked, always with negative results. There was a gradual improvement in his neurologic symptoms. Hence we present a case of Neuro-Behcet`s disease with literature. $quot;