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전신성 홍반성 루푸스의 신경,정신병적 증상과 자가항체와의 관계
민준기 ( Jun Ki Min ),오은숙 ( Eun Sook Oh ),정명선 ( Myoung Seon Chung ),박성환 ( Sung Hwan Park ),홍연식 ( Yeon Sik Hong ),이상헌 ( Sang Heon Lee ),조철수 ( Chul Soo Cho ),김호연 ( Ho Yeon Kim ) 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.2
Objective: To explore the association between neruopsychiatric manifestations and auto-antibodies in patients with neruopsychiatric lupus. Methods: 233 patients with systemic 1upus erythematosus (SLE) who were admitted or visited Kangnam St. Mary`s Hospital from January 1993 to March 1996 were included in this study. The medical records of this group were reviewed in detail according to a predefined protocol with special emphasis upon any neruopsychiatric manifestations of the illness. Results: 1) Among patients with SLE, 45 (20.1%) had neruopsychiatric manifestations during the course of the disease. 2) The positivity of anticardiolipin antibody and antiribosomal P antibody is more frequent in neruopsychiatric group than that of non-neruopsychiatric lupus (56.3% vs. 22.9%, 44.1% vs. 21.5%, respectively, p<0.05). 3) The frequency of anticardiolipin antibody and lupus anticoagulant is more frequent in thrombotic group than that of non-thrombotic group (69.2% vs. 26.3%, 50.0% vs. 12.1%, respectively, p<0.05). Conclusions: Our findings suggest that investigation of the autoantibodies such as anticardiolipin antibody, antiribosomal P antibody, and lupus anticoagulant may be useful for early detection and management of SLE patients who have neruopsychiatric manifestations.
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류마티스관절염 환자의 활액 세포에서 IL-17과 $IL-1{\beta}$에 의한 IL-23p19의 발현 증가
조미라,허유정,오혜좌,강창민,이선영,홍연식,김호연,Cho, Mi-La,Heo, Yu-Jung,Oh, Hye-Jwa,Kang, Chang-Min,Lee, Seon-Yeong,Hong, Yeon-Sik,Kim, Ho-Youn 대한면역학회 2008 Immune Network Vol.8 No.1
Interleukin-23 (IL-23) is a novel pro-inflammatory cytokine which has been implicated to play a pathogenic role in rheumatoid arthritis (RA). This study was undertaken to investigate the IL-23 inductive activity of the proinflammatory cytokine IL-17, $IL-1{\beta}$ and tumor necrosis factor (TNF-${\alpha}$) in RA synovial fluid mononuclear cells (SFMC). Expression of IL-23p19, IL-17, $IL-1{\beta}$ and TNF-${\alpha}$ in joint was examined by immunohistochemistry (IHC) of patients with RA and osteoarthritis (OA). The effects of IL-17 and $IL-1{\beta}$ on expression of IL-23p19 in human SFMC from RA patients were determined by reverse transcriptase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). IL-23p19 was expressed in the RA fibroblast like synoviocyte (FLS), but not from OA FLS. Similar to the protein expression, IL-23p19 mRNA could be detected by RT-PCR in RA SFMC. IL-17 and $IL-1{\beta}$ could induce RA SFMC to produce the IL-23p19. The effects of IL-17 were much stronger than $IL-1{\beta}$ or TNF-${\alpha}$. These responses were observed in a doseresponsive manner. In addition, IL-17 or $IL-1{\beta}$ neutralizing antibody down-regulated the expression of IL-23p19 induced by LPS in RA-SFMC. Our results demonstrate that IL-23p19 is overexpressed in RA synovium and IL-17 and $IL-1{\beta}$ appears to upregulate the expression of IL-23p19 in RA-SFMC.
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정명선 ( Myung Sun Chung ),오은숙 ( Eun Suk Oh ),조은주 ( Eun Ju 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 ) 대한류마티스학회 1997 대한류마티스학회지 Vol.4 No.1
SLE is an acute and/or chronic disease of a complex autoimmune nature affecting the skin, joints, serous membranes, kidney, central nervous system, cardiovascular system, and other organs of the body. Cardiac abnormalities are one of the most important clinical manifestations of SLE, contributing significantly to the morbidity and morality of the disease. We report a woman, a 30-year-old with SLE, who developed symptoms and echocardiographic signs of dilated cardiomyopathy. She had a history of acute myocardial infartion 7 months ago and has taken cyclophosphamide pulse therapy owing to lupus nephritis. The diagnosis of the condition was based only on clinical and echocardiographic grounds without coronary angiography or endomyocardial biopsy. She received high dose steroid (methylprednisolone pulse therapy: Img/kg for 3 days) and conservative therapy for heart failure. The association of SLE with dilated cardiomyopathy has not been described with review of previous literatures. For the probable causes of her dilated cardiomyopathy, we suggest that they are due to coronary arteritis or cyclophosphamide-induced myocarditis with regard to her past history of myocardial infartion and cyclophosphamide therapy for lupus nephritis. The incidence of dilated cardiomyopathy, complicated with SLE is rare, but it has an increased risk for untavorable outcome. It reserves to pioneer the method of early diagnosis and management which will improved the morbidity and mortality of the disease.
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극소 저출생 체중아에서 미숙아 망막증의 발생 빈도, 첫 검진 시기 및 발생 위험인자
라은영 ( Eun Young Ra ),방호일 ( Ho Ill Bang ),오연균 ( Yeon Kyun Oh ),양연식 ( Yeon Sik Yang ) 대한주산의학회 2002 Perinatology Vol.13 No.4
연구목적: 1,500gm 미만의 극소 저출생 체중아에서 미숙아 망막증의 발병 빈도와 적절한 첫 검진시기, 그리고 발병에 관련되는 많은 위험인자 중 cryotherapy 또는 lasertherapy 시행에 영향을 미치는 위험인자를 알아보고자 본 연구를 시도하였다. 방법:1997년 7월부터 2002년 6월까지 5년 동안 원광대학교 병원 신생아 중환자실에서 치료받은 1,500gm 미만의 극소 저출생 체중아를 대상으로 후향적으로 조사하였으며, 생후 4주 이내 사망하거나 안저 검사를 시행하지 않은 경우를 제외한 130명을 대상으로 미숙아 망막증의 유무, 첫 검진시기, cryo therapy 또는 lasertherapy 시행여부, 미숙아 망막증 발생관련 위험인자 등을 조사하고 이를 통계 분석하였다. 결과:1,500gm 미만에서 미숙아 망막증의 발병빈도는 36.9%(48/130명)이었으며, 평균 재태주령은 29.1±1.99주, 출생체중은 1,153±209gm 이었다. stage II 이상의 심한 미숙아 망막증을 보인 경우는 총 환아 중 15.4%, 미숙아 망막증 발생 환아 중 41.7%이었으며, 문턱병으로 cryotherapy 또는 laser therapy가 시행된 환아는 미숙아 망막증 환아 중 27.1% 이었다. 재태주령 및 출생체중으로 구분시 26주 이하, 750gm 미만에서는 100%에서 stage II 이상의 미숙아 망막증 발생과 cryotherapy 또는 la sertherapy가 시행되었다. 미숙아 망막증 진단은 가장 빠른 경우 역연령 3주, 수태 후 연령 30주이었으며, cryotherapy 또는 lasertherapy가 필요했던 문턱병 진단은 빠른 경우 역연령 5주, 수태 후 연령 33주이었다. cryotherapy 또는 lasertherapy 시행에 관련된 인자로는 재태주령, 출생체중, 1, 5분 Apgar 점수, 그리고 수혈회수에서 의의를 보였으며, cryotherapy 또는 lasertherapy가 시행되지 않은 경증 미숙아 망막증 환아의 자연회복 경과는 평균 13.4±8.8주 이었다. 결론:1,500gm 미만의 극소 저출생 체중아에서 미숙아 망막증의 발생 빈도는 36.9% 이었고, 첫 안과 검진은 cryotherapy 또는 lasertherapy가 시행된 환아의 첫 진단 시기인 역연령 5주, 수태 후 연령 33주 이전 모두를 고려하여 이중 빠른 시기를 기준으로 시행되어져야 하며, cryotherapy 또는 laserthe rapy 시행에 의미 있는 위험인자로는 재태주령, 출생체중, 1,5분 Apgar 점수, 수혈회수로 조사되었다. Objective: This study was conducted to evaluate the incidence, the optimal timing of screening examinations for retinopathy of prematurity (ROP) and to analyze perinatal risk factors associated with cryotherapy or lasertherapy (CT/LT) in ROP. Methods: Medical records of 130 very low birth weight (VLBW) infants who admitted to the NICU of Wonkwang University Hospital from July 1997 to June 2002 were reviewed retrospectively. We evaluated the incidence and severity of ROP by gestational age (GA) and birth weight (BW) . And the comparisons of perinatal risk factors between ROP with and without CT/LT have been made. Results: Incidence of ROP was 36.9% and mean GA and BW were 29.1 ±1.99 weeks, 1,153±209 gin in VLBW infants respectively. ROP Stage II or greater was 15.4% of VLBW infants, 41.7% of ROP infants, and 27.1% of ROP infants were treated with CEILT. All infants with BW <750gm or GA <26 weeks were developed ROP with stage II or greater and treated with CT/LI First detection of ROP was performed at chronologic age (CA) 3 weeks, postconceptional age (PCA) 30 weeks, and first identification of threshold ROP needed with CT/LT were at CA 5 weeks and PCA 33 weeks. The perinatal risk factors with CT/LT for ROP were significant in GA, BW, Apgar score at` and 5 minutes and number of blood transfusion. The mean time of spontaneous regression is 13.4±8.8 weeks in the mild ROP infants without CT/LI Conclusion: The incidence of ROP is 36.9% and the optimal timing of screening for ROP should be selected by earlier time in 2 guidelines of at 5 weeks of CA and 33 weeks of PCA in VLBW infants. And the related risk factors with CT/LT for threshold ROP were GA, BW and Apgar score at 1 and 5 minutes and number of blood transfusions.
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