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고희관 ( Hee Kwan Koh ),안명주 ( Myung Ju Ahn ),김태환 ( Tae Hwan Kim ),이은영 ( Eun Young Lee ),유태석 ( Tae Seok Yoo ),이제경 ( Je Kyung Lee ),장대국 ( Dae Kook Chang ),심승철 ( Seung Cheol Shim ),전재범 ( Jae Bum Jun ),정성수 ( 대한류마티스학회 1999 대한류마티스학회지 Vol.6 No.1
연구배경: 류마티스 관절염은 활막세포의 비정상적인 증식과 단핵세포의 침윤으로 인한 종양처럼 활막의 증식 등을 특징으로 하는 질환이다. Telomerase가 류마티스 관절염 환자에서 활성화되어 류마티스 관절염의 병인에 관여하는지 알아보기 위해 본 연구를 시행하였다. 방법: 류마티스 관절염 환자와 대조군으로 퇴행성 관절염 환자에서 얻은 활막조직, 배양된 활막세포, 활액에서 추출한 단핵세포 등에서의 telomerase의 활성도를 TRAP(telomeric repeat amplification protocol) assay를 이용하여 비교 관찰하였다. 결과: Telomerase 활성도는 류마티스 관절염의 활막에서 높은 활성도를 보였고(70.6%: 12/17), 퇴행성 관절염 환자의 일부(30%: 3/10)에서도 역시 관찰되었다. 그러나 배양된 활막세포는 류마티스 관절염 환자의 일부에서만(50%: 2/4) 관찰되었다. 또한 류마티스 관절염 환자의 활액에서 추출한 단핵세포는 모두 telomerase 활성도가 관찰되었다. 결론: Telomerase 활성도는 류마티스 관절염의 병인에 관여할 수 있으리라 사료되며 앞으로 류마티스 관절염에서 telomerase의 생물학적 기능과 활성기전에 대해서도 보다 많은 연구가 있어야 할 것으로 사료된다. Objective: Rheumatoid arthritis(RA) is a disease characterized by infiltration of mononuclear cells into synovium and abnormal proliferation of synovial cells leading to pannus formation, which shows tumor-like growth. To determine whether telomerase is activated in RA and telomerase might be involved in the pathogenesis of RA, we measured telomerase activity in patients with RA. Methods: Telomerase activity was measured by using TRAP(telomeric repeat amplification protocol) assay in synovial tissues obtained from 17 patients with RA and 10 patients with osteoarthritis(OA), in cultured synovial cells from 4 patients with RA and 2 patients with OA, and in extracts of mononuclear cells from synovial fluid of 6 patients with RA. Results: Twelve of synovial tissues from 17 patients with RA(70.6%) showed telomerase activity, where three of synovial tissues from 10 patients with OA(30%) showed telomerase activity with low activity. Telomerase activity was detected in two of the cultured synoviocytes from 4 patients with RA(50%), but synoviocytes from patients with OA did not reveal any telomerase activity, if any. Telomerase acivity was detected in mononuclear cells extracted from synovial fluid of all patients with RA. Conclusion: Telomerase activity is highly positive in RA synovial tissues than OA synovial tissues and in RA synoviocytes as in mononuclear cells from synovial fluid. Taken together, these findings indicate that telomerase may playa role in the pathogenesis of RA.
류마티스 관절염과 HLA-B27과의 연관성에 관한 연구
고희관 ( Hee Kwan Koh ),오광택 ( Kwang Taek Oh ),송용호 ( Yong Ho Song ),정자헌 ( Ja Hun Jung ),김태환 ( Tae Hwan Kim ),김동욱 ( Dong Yook Kim ),전재범 ( Jae Bum Jun ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( Sang 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.1
Objective: In rheumatoid arthritis(RA) patients, HLA-B27 has been mainly found with the same frequency as in the normal population. An increased frequency of HLA-B27 in RA has, however, repeatedly been found in northern Sweden and in Filand. The results concerning the association of HLA-B27 to the outcome of the disease have been contradictory in RA. In RA, the presence of HLA-B27 has shown to be a prognostic index for cervical spine subluxation. There has been no report regarding the association between RA and HLA-B27 in the Korean population. Methods: 188 patients with RA were randomly selected from the patients who were diagnosed at Rheumatism Center of Hanyang University Hospital from October 1994 to June 1995 to establish the frequency of HLA-B27 in RA and to investigate the possible influence and prognostic significance on clinical outcome including atlantoaxial subluxations. Results: The results were as follows: 1) HLA-B27 was present in 12.2% of the RA patients studied. The relative risk (RR) and etiologic fraction (EF) of HLA-B27 were 5.99 and 0.1019 respectively. 2) The rheumatoid factor was positive in 79.8% of the total patients, 73.9% in HLA-B27 positive patients, and 80.6% in HLA-B27 negative patients. HLA-B27 was not associated with the presence of rheumatoid factor in this study. 3) HLA-B27 was not associated with the duration of morning stiffness, Ritchie index, extraarticular manifestations, the number of swollen joints, ARA functional class, ESR. C-reactive protein, or hemoglobin. HLA-B27 was not associated with the positivity of ANA and antiperinuclear factor. 4) HLA-B27 was not associated with the positive rate of erosion and Steinbrocker class in peripheral joints. 5) Atlantoaxial subluxation was present in 13% of HLA-B27 positive patients and 17% of HLA-B27 negative patients. The involvement of atlantoaxial joint including narrowing of lateral facet joints was 26.1% in HLA-B27 positive patients and 20.6% in HLA-B27 negative patients. Subaxial subluxation was presented in only 1 case in HLA-B27 negative group of total patients. HLA-B27 was not associated with the cervical changes in RA. Conclusions: An increased freuency of HLA-B27 in RA patients was significantly found in Korea (RR=5.99, EF=0.1019). However, patients with HLA-B27 had a similiar clinical profile to patients without HLA-B27 and HLAB27 positivity did not further contribute to the severity with respect to clinical and laboratory variables or to radiological progression in peripheral joints or cervical spine.
전신성 홍반성 루푸스에서 발생한 만성 결절성 통풍 2예
조영신 ( Young Shin Cho ),양종태 ( Jong Tae Yang ),고희관 ( Hee Kwan Koh ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.4
Gout and systemic lupus erythematosus(SLE) are relatively common diseases in rheumatism. But the case of coexistent gout and SLE is extremely rare. The rarity is that may be due to misdiagnosis and disparity of the epidemiology. It is suggested that immulonogic milieu in SLE and therapy for SLE may have a negative effect on the manifestations of gout. Especially, hyperuricemia that not caused by nephritis, renal failure, use of diuretics, alcohol drinking and other risk factors in premenopausal women is extremely rare. We experienced two cases of chronic tophaceous gout in female patients with SLE who did not have other hyperuricemic risk factors.
윤형란 ( Hyun Ran Yun ),정성수 ( Sung Soo Jung ),고희관 ( Hee Kwan Koh ),유태석 ( Tae Seok Yoo ),이제경 ( Je Kyung Lee ),황관표 ( Kwan Pyo Hong ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),이인홍 ( In Hong Lee ),배상철 ( Sang 대한류마티스학회 1997 대한류마티스학회지 Vol.4 No.2
SAPHO(synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome designates a group of articular and osseous manifestations frequently combined with skin disorders. It`s fundamental component is inflammatory, pseudoinfectious, and sterile osteitis. The anterior chest wall is the most frequent localization and all the components of this structure may be involved. Palmoplantar pustulosis, psoriasis, acne conglobata, acne ulcerans, acne fulminans, pyoderma gangrenosum can be associated with the characteristic bone lesions. We report two cases of SAPHO syndrome: A 40-year-old female presented with both buttock pain with hyperostosis, costochondritis, synovitis and pustulosis palmaris and a 23-year-old male presented with migrating polyarthritis with costochondritis, synovitis, acne, Pustulosis.
Does Sulfasalazine have Frequent side Effects in Adult - onset Still`s Disease ?
정자훈(Ja Hun Jung),전재범(Jae Bum Jun),유대현(Dae Hyun Yoo),고희관(Hee Kwan Koh),정성수(Sung Soo Jung),이인홍(In Hong Lee),배상철(Sang Cheol Bae),김성윤(Seong Yoon Kim),(Seung Cheol Shim),(Dae Kook Chang),(Tae Hwan Kim) 대한내과학회 1998 대한내과학회 추계학술대회 Vol.55 No.-
Does sulfasalazine have frequent side effects in adult-onset Still`s disease?
정자훈 ( Ja Hun Jung ),전재범 ( Jae Bum Jun ),유대현 ( Dae Hyun Yoo ),고희관 ( Hee Kwan Koh ),심승철 ( Seung Cheol Shim ),장대국 ( Dae Kook Chang ),김태환 ( Tae Hwan Kim ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( S 대한내과학회 1998 대한내과학회 추계학술대회 Vol.1998 No.1