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한국인 류마티스 관절염과 Catalase와 PPAR-γ유전자 다형성의 연관성
최찬범,김태환,전재범,유대현,배상철,Ahmed El-Sohemy,성상석,박용욱,이혜순,엄완식 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.3
Objective: To investigate the association between a single nucleotide polymorphism in the catalase and peroxisome proliferator activated receptor-γ (PPAR-γ) genes with risk and severity of rheumatoid arthritis (RA) in Korea. Methods: DNA was isolated from blood samples collected from 473 Korean patients with RA and 400 Korean controls. Genotyping for the C-262T polymorphism of catalase and the Pro12Ala polymorphism of PPAR-γ was performed by PCR-RFLP (restriction fragment length polymorphism) analysis. Subjects were classified according to ACR criteria for RA, KHAQ, and radiological severity classification by Steinbroker. Results: In patient group, catalase C/T and T/T polymorphism was seen in 23 (4.9%) and 0 patients while Pro/Ala and Ala/Ala PPAR-γ polymorphism was seen in 42 (8.9%) and 1 (0.2%) patients. In control group, catalase C/T and T/T polymorphism was seen in 25 (6.3%) and 1 (0.2%) controls while Pro/Ala and Ala/Ala PPAR-γ polymorphism was seen in 34 (8.5%) and 4 (1%) controls. Catalase and PPAR-γ polymorphism showed no association with the susceptibility to RA individually but, when combined association was found although it had no statistical significance, which was possibly due to its low frequency. Catalase and HLA-DRB1 polymorphism showed significant interaction on development of RA but, no interaction was found between PPAR-γ and HLA-DRB1. Catalase and PPAR-γ polymorphism showed no association with the severity or functional status of RA. Conclusion: Our results show that genetic polymorphisms of catalase and PPAR-γ has no association with the susceptibility to RA. Catalase and HLA-DRB1 polymorphism showed significant interaction on development of RA.
Safety and Clinical Responses in Ankylosing Spondylitis after Three Months of Etanercept Therapy
최찬범,엄완식,전재범,배상철,유대현,김태환,김태종,박희진 대한의학회 2008 Journal of Korean medical science Vol.23 No.5
We aimed to evaluate the safety and clinical responses in Korean ankylosing spondylitis(AS) patients after three months of etanercept therapy. AS patients satisfyingthe Modified New York Criteria were enrolled. They were assessed for safety andclinical responses at enrollment and after three months of etanercept therapy. Atotal of 124 patients completed the study. After three months, the rate of ASsessmentin AS International Working Group 20% improvement (ASAS 20) responsewas 79.8%. The rates of ASAS 40 and ASAS 5/6 responses were 58.5 and 62.8%,respectively. Significant improvement of Korean version of Bath AS Disease ActivityIndex (KBASDAI) (p<0.0001), Bath AS Functional Activity Index (BASFI) (p<0.0001), and Bath AS Metrology Index (BASMI) (p=0.0009) were achieved afterthree months. Quality of life was also significantly improved after three months, asdemonstrated by scores for SF-36 (p<0.0001) and EQ-5D (p<0.0001). Erythrocytesedimentation rate and C-reactive protein were significantly decreased (p<0.0001, p<0.0001, respectively). None of the patients developed tuberculosis andthere were no serious adverse event. AS patients with inadequate response toconventional therapy showed significant clinical improvement without serious adverseevents after three months of etanercept therapy.
Eosinophilic Granulomatosis with Polyangiitis: Experiences in Korean Patients
최찬범,박용범,이상원 연세대학교의과대학 2019 Yonsei medical journal Vol.60 No.8
Eosinophilic granulomatosis with polyangiitis (EGPA) is one form of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Identical to what has been called Churg-Strauss syndrome, EGPA exhibits both allergic and vasculitis features. EGPA was firstdescribed as a syndrome consisting of asthma, fever, eosinophilia, and organ involvement including heart failure, neuropathy, andkidney damage, by Churg and Strauss in 1951. On the basis of the 2012 Chapel Hill Consensus Conferences Nomenclature of Vasculitis,EGPA comprises three typical allergic components, including asthma, peripheral eosinophilia, and eosinophil-rich granulomaof the respiratory tracts. EGPA has three clinical and histological stages. The first is an allergic stage composed of asthma and sinusitis,and the second is an eosinophilic stage characterised by peripheral hypereosinophilia and intra-organ infiltration of eosinophils. The last is a vasculitic stage, including necrotising inflammation of small vessels and end-organ damage. In this review, we describethe classification criteria for EGPA and recommendations for the evaluation and management of EGPA with conventional andnewly suggested drugs for EGPA. Also, we discuss a variety of clinical aspects such as predictive values for prognosis and associationswith other Th2-mediated diseases and hepatitis B virus.
강준구,김동선,최찬범,김태종,김종표,이창범,박용수,안유헌,김태화,배상철,박찬금 대한내분비학회 2002 Endocrinology and metabolism Vol.17 No.4
Acquired hypophosphatemic rickets, or osteomalacia, requires the recognition of the typical clinical and radiological features of osteomalacia in association with hypophosphatemia, which is caused by the decrease in intestinal absorption or impaired renal tubular phosphate reabsorption. The latter form may either be hereditary or acquired. Acquired hypophosphatemic osteomalacia includes oncogenic osteomalacia, neurofibromatosis, fibrous dysplasia, renal tubular acidosis and sporadic nonfamilial hypophosphatemic osteomalacia.A 33-year-old man presented with bone pain, progressive severe muscle weakness and a height loss of more than 10 cm over a 5 year period. The familiy history was negative for bone disease or other renal tubular defects. He was found to have hypophosphatemia, impaired phosphate reabsorption, normocalcemia, normal vitamin D metabolite levels, normal PTH and elevated alkaline phophatase. A bone biopsy showed thickened unmineralized osteoid compared to pelvic bone in control cases. Clinical symptoms, such as bone pain and muscle weakness, were improved after supplementation of oral phosphorus and calcitriol, although the serum phosphorus level did not normalize (J Kor Soc Endocrinol 17:610~616, 2002). 저자 등은 근력약화와 골통증을 주소로 내원하여, 신세뇨관의 인산재흡수장애에 의한 저인산염혈증 골연화증을 진단하였고, 비타민 D와 경구 인산염제제를 투여한 후 증상의 호전을 보인 1예를 경험하여, 문헌고찰과 함께 보고하는 바이다. 골연화증의 특별한 원인 종양을 발견하지 못하여 산발성 비가족성 저인산염혈증 골연화증으로 진단하였으나 후에 종양성 골연화증으로 진단되는 경우가 종종 보고되고 있어, 약물치료와 함께 원인 종양을 계속하여 확인 하고자 한다.
Congenital Hypoplasia of the Medial Hallucial Sesamoid with Avascular Necrosis: A Case Report
송윤아,이승훈,최찬범,주경빈,류정아,배지윤 대한영상의학회 2013 대한영상의학회지 Vol.69 No.4
Avascular necrosis of the hallucial sesamoids is an uncommon cause of metatarsalgia, and the congenital absence of the medial sesamoid is also a rarely reported condition in the podiatric literature. It must be distinguished from other painful conditions of the sesamoid due to the opposite direction of treatment. To our knowledge, there is no reported case of congenital hypoplasia of the medial sesamoid with osteonecrosis. We report a case of nontraumatic metatarsal pains with progressive sclerosis and fragmentation of the medial sesamoid on serial radiographs, magnetic resonance imaging, and ultrasonography with an incidental finding for the absence of contralateral medial sesamoid in a 33-year-old female.
한국인 류마티스관절염 환자의 특성-단일 기관 코호트 연구
김윤정 ( Yun Jung Kim ),최찬범 ( Chan Bum Choi ),성윤경 ( Yoon Kyoung Sung ),이혜선 ( Hye Seon Lee ),배상철 ( Sang Cheol Bae ) 대한류마티스학회 2009 대한류마티스학회지 Vol.16 No.3
Objective: The aim of this study is to describe the general characteristics and potential susceptibility genes of a large cohort of Korean rheumatoid arthritis (RA) patients. Methods: After giving consent, the patients were invited to undergo a structured interview and clinical examination that were performed by rheumatologists and a specially trained research nurse. When appropriate, the information obtained by interview was supplemented by information from the patient`s medical record. We reviewed the genetic studies for the subjects in the Hanyang RA cohort to investigate the genetic characteristics of Korean RA patients. Results: The mean age of the Hanyang RA cohort was 51.6±12.4 years, and 88.1% were women. The unemployment rate was 19.6%, and 52.2% of the patients had limitation of everyday life or their work life. The mean age at the time of disease onset was 41.0±12.9 years and the duration from disease onset to initiation of treatment was 23.6±57.1 months. The smoking rate of the Hanyang RA cohort was 16.8%, and 30.8% of the patients were exposed to passive smoking. Total joint arthroplastys were performed in 158 (10.3%) patients, and the most common operation site was the knee. On the review of the genetic studies for the Hanyang RA cohort, the representative susceptibility genes for the development of RA were HLA-DRB1, PADI4, STAT4 and TRAF1-C5. Conclusion: This data of Korean RA patients can be used as the preliminary data for important studies. Establishment of a large prospective, multicenter cohort is imperative to determine the characteristics of Korean RA, and the Hanyang RA cohort is expected to play a lead role for this.