Multiple approaches of assessing stress in rheumatoid arthritis (초)

( Hyoun Ah Kim ),( Jeong Moon Yun ),( Ja Young Jeon ),( Mu Jeong Kim ),( Jun Mo Sung ),( Sat Byul Park ),( Chang Hee Suh ) 대한내과학회 2008 대한내과학회 추계학술대회 Vol.2008 No.-

Case Report : An Antinuclear Antibody-Negative Patient With Lupus Nephritis

Hyoun Ah Kim,Jae Wook Chung,Han Jung Park,Dai Yeol Joe,Hyun Ee Yim,Hae Sim Park,Chang Hee Suh 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.1

Systemic lupus erythematosus (SLE) is a typical autoimmune disease that`s characterized by various autoantibodies to nuclear and cytoplasmic antigens. The presence of antinuclear antibodies (ANA) in serum is generally considered a decisive diagnostic sign of SLE. However, a small subset of SLE patients who had the typical clinical features of SLE was reported to show persistently negative ANA tests. Our report describes a 16-yr-old female who presented with the clinical manifestations of SLE such as malar rash, photosensitivity, arthritis, lymphopenia, pericarditis and proteinuria. The serum autoantibodies were all negative and renal biopsy showed that the histopathological changes of immune complex mediated the focal segmental necrotizing glomerulonephritis with crescent formation. She was treated with monthly pulse cyclophosphamide along with corticosteroids. During the 2-yr follow-up period, the proteinuria was markedly decreased and all of the ANA and anti-double stranded DNA antibody tests were negative. This case suggests that ANA may not be required in the pathogenesis of lupus nephritis. (Korean J Intern Med 2009;24:76-79)

Multiple approaches of assessing stress in rheumatoid arthritis (초)

( Hyoun Ah Kim ),( Jeong Moon Yun ),( Ja Young Jeon ),( Mu Jeong Kim ),( Jun Mo Sung ),( Sat Byul Park ),( Chang Hee Suh ) 대한내과학회 2008 대한내과학회지 Vol.75 No.1S

Poster Session : PS 0752 ; Rheumatology ; Role of Bone Scan in the Assessment of Polymyositis/ Dermatomyositis

( Hyoun Ah Kim ),( Young Sil An ),( Ju Yang Jung ),( Chang Hee Suh ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Previous studies have reported the results of bone scan in infi ammatory myositis patients; however, they are not consistent. Therefore, in this study, we investigated the clinical signifi cance of bone scan with a quantitative method for the global assessment of uptake in the proximal muscles in KoreanPM/DM patients. Methods: The 26 PM/DM patients fulfi lled the previously proposed criteria for either defi nite or probable PM/DM. The patients had undergone bone scan. The results were retrospectively analyzed visually and quantitatively using uptake ratios. The correlation between clinical parameters (laboratory and manual muscle test [MMT]) representing disease activity and fi nding of bone scan was assessed. Results: Visual analysis determined that 10 (71. 5%) active PM/DM patients had abnormal muscle uptake in bone scan. Visual grade of bone scan gave a sensitivity and specifi city value of 74% and 90. 9%, respectively in assessing infi ammation of muscle. Maximal proximal muscle uptake ratios of bone scan weresignificantly greater in active PM/DM patients than inactive patients (median 1. 97 vs 1. 02, p=0. 046). Maximal proximal uptake ratio signifi cantly correlated with creatine kinase (r=0. 394, p=0. 046), lactate dehydrogenase (LDH, r=0. 473, p=0. 015), aldolase (r=. 0428, p=0. 029), erythrocyte sedimentation rate (r=0. 412, p=0. 036), C reactive protein (r=0. 454, p=0. 002), and corresponding MMT (r=-0. 399, p=0. 044). Mean proximal muscle uptake ratio signifi - cantly correlated with LDH (r=0. 438, p=0. 025) and aldolase (r=0. 572, p=0. 002). Conclusions: Visual grade and maximal proximal uptake ratio on bone scan signifi cant correlated with known disease activity markers. The data suggest that bone scan may be a useful imaging technique for evaluation of PM/DM patients.

남자 청소년 쉼터의 경험적 독서 프로그램 효과에 관한 연구

지현아(Hyoun-Ah Ji) 한국독서교육연구학회 2018 한국독서교육학회지 Vol.5 No.1

이 연구는 쉼터에 거주하는 청소년들에게 다양한 독서의 경험을 제공함으로써 독서가 즐거운 활동이라는 것을 인식시키고, 독서 경험이 청소년들에게 미치는 영향을 알아보고자 하였다. 연구 결과, 참여자들은 책 속 주인공과 공감하는 것을 즐겁게 받아들였다. 또한 과거의 트라우마와 열등감에서 벗어남으로써 자아를 확립하고, 현재보다 발전 된 자아를 찾는 긍정적인 변화를 나타냈다. 후속 연구에서는 쉽터의 유형과 거주 학생의 다양한 문제를 고려하여 신중하게 개발할 필요가 요구된다. The purpose of this study is to understand the effect of reading experience on adolescents by recognizing that reading is a pleasant activity by providing various reading experiences to youths living in shelter. As a result of the study, the participants happily accepted sympathy with the hero in the book. In addition, it showed a positive change by establishing self by deviating from past trauma and inferiority sense, and looking for self developed than present. In subsequent research, it is necessary to develop carefully considering the types of the facilitator and various problems of the resident students.

Clinical Characteristics of Patients With Psoriatic Spondylitis Versus Those With Ankylosing Spondylitis: Features at Baseline Before Biologic Therapy

Kim Hyoun-Ah,Lee Eunyoung,Park So Young,Lee Shin-Seok,Shin Kichul 대한의학회 2022 Journal of Korean medical science Vol.37 No.33

Background: Clinical characteristics and manifestations of psoriatic arthritis (PsA) have been extensively studied in western countries, yet data of Korean patients with PsA are very limited. We aimed to investigate the clinical traits of patients with PsA and dissect the characteristics of those with axial involvement. Methods: In this observational study, we analyzed clinical data of 109 patients with PsA who were enrolled in the Korean College of Rheumatology Biologics and Targeted Therapy registry between December 2012 and March 2022 at the time point of initiating or switching to a biologic agent. Data from 2,221 patients with ankylosing spondylitis (AS) registered during the same period were also analyzed. We divided patients with PsA into patients with or without axial involvement and then added AS patients with psoriasis (total three subgroups) for comparative analyses. Results: Asymmetric oligoarthritis was the most common clinical manifestation in patients with PsA, followed by symmetric polyarthritis and spondylitis. Our analysis indicated that methotrexate and sulfasalazine were the two most prescribed disease-modifying antirheumatic drugs for patients with PsA before starting biologic therapy. The patients with psoriatic spondylitis had more peripheral joint involvement (P = 0.016), less prior uveitis (P < 0.001), and lower human leukocyte antigen B27 (HLA-B27) positivity (P < 0.001) than the AS patients with psoriasis. Furthermore, syndesmophytes and radiographic sacroiliitis were prevalent among patients with PsA and AS patients with psoriasis who had the HLA-B27 gene. Conclusion: Our study shows that the degree of peripheral arthritis is less severe in Korean patients with PsA who require biologics and reestablishes that psoriatic spondylitis is a common and important clinical pattern in Korean patients with PsA.

Determining a BMDL of Blood Lead Based on ADHD Scores Using a Semi-Parametric Regression

Kim, Ah-Hyoun,Ha, Min-A,Kim, Byung-Soo 한국통계학회 2012 응용통계연구 Vol.25 No.3

This paper derives a benchmark dose(BMD) and its 95% lower confidence limit(BMDL) using a semi-parametric regression model for small lead based changes in attention-deficit hyperactivity disorder(ADHD) scores in the first wave of the Children's Health and Environment Research(CHEER) survey data, which have been regularly collected in South Korea since 2005. Ha et al. (2009) showed that the appearance of ADHD symptoms had a borderline trend of increasing with the blood lead concentration. Butdz-J${\o}$rgensen (EFSA, 2010a) derived the BMDL of lead corresponding to a benchmark region of 1 full intelligent quotient (IQ) score using the raw data in Lanphear et al. (2005, EHP). European Food Safety Authority (EFSA, 2010b) determined the BMDL of $1.2{\mu}g/dl$ as a reference point for the characterization of lead when assessing the risk of the intellectual deficit measured by IQ scores. Kim et al. (2011) indicated that an even lower BMDL could be obtained based on the ADHD score; however, the BMDLs depended heavily upon the model assumptions. We show in this paper that a semi-parametric approach resolves the model dependence of BMDLs.

TLR4 Endogenous Ligand S100A8/A9 Levels in Adult-Onset Still’s Disease and Their Association with Disease Activity and Clinical Manifestations

Kim, Hyoun-Ah,Han, Jae Ho,Kim, Woo-Jung,Noh, Hyun Jin,An, Jeong-Mi,Yim, Hyunee,Jung, Ju-Yang,Kim, You-Sun,Suh, Chang-Hee MDPI 2016 INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES Vol.17 No.8

<P>S100A8/A9 has been suggested as a marker of disease activity in patients with adult-onset Still’s disease (AOSD). We evaluated the clinical significance of S100A8/A9 as a biomarker and its pathogenic role in AOSD. Blood samples were collected prospectively from 20 AOSD patients and 20 healthy controls (HCs). Furthermore, skin and lymph node biopsy specimens of AOSD patients were investigated for S100A8/A9 expression levels via immunohistochemistry. Peripheral blood mononuclear cells (PBMCs) of active AOSD patients and HCs were investigated for S100A8/A9 cell signals. S100A8/A9, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) levels in active AOSD patients were higher than those of HCs. S100A8/A9 levels correlated positively with IL-1β, TNF-α and C-reactive protein. The inflammatory cells expressing S100A8/A9 were graded from one to three in skin and lymph node biopsies of AOSD patients. The grading for S100A8/A9 was more intense in the skin lesions with karyorrhexis, mucin deposition, and neutrophil infiltration. Like lipopolysaccharide (LPS), S100A8/A9 induced phosphorylation of p38 and c-Jun amino-terminal kinase (JNK) in PBMCs, suggesting that S100A8/A9 activates Toll-like receptor 4 signaling pathways. These findings suggest that S100A8/A9 may be involved in the inflammatory response with induction of proinflammatory cytokines and may serve as a clinicopathological marker for disease activity in AOSD.</P>

The Liver X Receptor Is Upregulated in Monocyte-Derived Macrophages and Modulates Inflammatory Cytokines Based on LXR <i>α</i> Polymorphism

Kim, Hyoun-Ah,Baek, Wook-Young,Han, Mi-Hwa,Jung, Ju-Yang,Suh, Chang-Hee Hindawi 2019 MEDIATORS OF INFLAMMATION Vol.2019 No.-

<P>Liver X receptors (LXRs) have emerged as important regulators of inflammatory gene expression. Previously, we had reported that an LXR<I>α</I> gene promoter polymorphism (-1830 T > C) is associated with systemic lupus erythematosus (SLE). Therefore, we assessed cytokine expression in relation to LXR<I>α</I> polymorphism in monocyte-derived macrophages from patients with SLE. Macrophages were obtained after 72 hours of culture of human monocytes supplemented with phorbol 12-myristate 13-acetate. Cells were transfected with LXR<I>α</I> promoter constructs. Additionally, peripheral blood mononuclear cell- (PBMC-) derived macrophages from the patients were evaluated for proinflammatory cytokines in relation to the genotypes of LXR<I>α</I> -1830 T > C. The expression of LXR<I>α</I> was increased in macrophages; levels of proinflammatory cytokines were decreased with LXR<I>α</I> expression. Production of proinflammatory cytokines varied depending on LXR<I>α</I> -1830 T > C genotype. In particular, expression of LXR<I>α</I> was decreased and that of proinflammatory cytokines was increased for LXR<I>α</I> -1830 TC genotype compared to that for TT genotype. The data were consistent in PBMC-derived macrophages from patients with SLE. Increased proinflammatory cytokines is related to TLR7 and TLR9 expression. These data suggest that the expression levels of LXR<I>α</I>, according to LXR<I>α</I> -1830 T > C genotype, may contribute to the inflammatory response by induction of inflammatory cytokines in SLE.</P>

Therapeutic responses and prognosis in adult-onset Still's disease.

Kim, Hyoun-Ah,Sung, Jun-Mo,Suh, Chang-Hee Springer International 2012 Rheumatology international Vol.32 No.5

<P>To date, the treatment of adult-onset Still's disease (AOSD) has been largely empirical; therefore, this study was conducted to investigate the response to therapy and prognostic factors of AOSD. Fifty-four Korean patients with AOSD were enrolled based on Yamaguchi's criteria. We retrospectively analyzed the treatments and prognosis. Thirty-nine patients (72.2%) were female, and the average age at disease onset was 37.3 years. Twenty-nine patients had a monocyclic disease (53.7%), five had a polycyclic (9.3%) and fifteen had a chronic articular disease (27.7%) and five died (9.3%). The elevated ESR and corticosteroids refractoriness were associated with poor prognosis (P = 0.023 and P = 0.009, respectively). The patients that died were older than those survived (49.2 ± 11.8 vs. 42.2 ± 14 year old, P = 0.024). Forty-two patients were treated with non-steroidal anti-inflammatory drugs; however, they also needed corticosteroids and intravenous immunoglobulin (IVIG). Among 50 patients treated with high-dose corticosteroids, 21 patients (42%) were resistant to corticosteroids and treated with IVIG or anti-tumor necrosis factor (TNF) agents. Of the 23 patients medicated with IVIG, the prognosis was better in IVIG-responsive patients, indicating a therapeutic effect. Methotrexate was the most commonly used disease modifying anti-rheumatic drugs (27 patients, 50%), and the corticosteroid requirements were lower in the methotrexate-responsive patients. Approximately half of AOSD patients had a poor prognosis and were corticosteroids resistance. An elevated ESR and non-response to corticosteroids were associated with poor prognosis. Patients who died were older than those survived.</P>