• Title/Summary/Keyword: 반응변화도

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Influence of Age on The Adenosine Deaminase Activity in Patients with Exudative Pleural Effusion (연령의 증가가 삼출성 흉수 Adenosine Deaminase 활성도에 미치는 영향)

  • Yeon, Kyu-Min;Kim, Chong-Ju;Kim, Jeong-Soo;Kim, Chi-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.530-541
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    • 2002
  • Background : Pleural fluid adenosine deaminase (ADA) activity can be helpful in a differntial diagnosis of an exudative pleural effusion because it is increased in a tuberculous pleural effusion. The ADA activity is determined mainly by the lymphocyte function. Age-associated immune decline is characterized by a decrease in T-lymphocyte function. For that reason, the pleural fluid ADA level would be lower in older patients with exudative pleural effusion. This study focused on the influence of age on the pleural fluid ADA activity in patients with exudative pleural effusion. Methods : A total of 81 patients with exudative pleural effusion were enrolled in this study. In all patients, the pleural fluid ADA activity was measured using an automated kinetic method. Results : The mean age of the patients was $52.7{\pm}21.2$ years. In all patients with exudative pleural effusion, the pleural fluid ADA activity revealed a significant difference between young patients (under 65 years of age) and old patients (p<0.05), and showed a negative correlation with age (r=-0.325, p<0.05). In the 60 patients with a tuberculous pleural effusion, the pleural fluid ADA activity revealed a significant difference between the young and older patients : $103.5{\pm}36.9$ IU/L in young patients Vs. $72.2{\pm}31.6$ IU/L in old patients (p<0.05), and showed a negative correlation with age (r=-0.384, p<0.05). In the 21 patients with non-tuberculous exudative pleural effusion, the pleural fluid ADA activity of the young patients and old patients was similar : $23.7{\pm}15.3$ IU/L in young patients Vs. $16.1{\pm}10.2$ IU/L in old patients (p>0.05), and did not show any correlation with age (r=-0.263, p>0.05). The diagnostic cutoff value of pleural fluid ADA activity for tuberculous pleural effusion was lower in the older patients (25.9 IU/L) than in the younger patients (49.1 IU/L) or all patients (38.4 IU/L) with exudative pleural effusion. Conclusion : Tuberculous pleural effusion is an important possibility to consider in older patients with a clinical suspicion of a tuberculous pleural effusion, although no marked increase in the pleural fluid ADA activity is usually detected. For a diagnosis of a tuberculous pleural effusion in old patients, the cutoff for the pleural fluid ADA activity should be set lower.

Study of Animation 3-Dimensional Motion Picture (애니메이션 입체 영화에 대한 연구)

  • Min, Kyung-Mi
    • Cartoon and Animation Studies
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    • s.9
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    • pp.127-142
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    • 2005
  • Not only in Korea but throughout the entire world millions of people are in contact with images. Images have become a medium through which to transmit anything from simple visualizations of moving images to knowledge and information. The age of the internet has arisen thanks to scientific development, and the internet generation's acquisition of information is continuously becoming faster. The spectators, ufo must choose amongst the excessive amount of available information, are changing along with it just as quickly. The method of visual transmission has changed to match the demands of the fast-changing pace of the new generation. In order to receive an instantaneous selection amongst much information, the primary requisite is attracting one's attention, and then presenting a corresponding feeling of satisfaction. The early stages of film arose from the desire to capture one's actual situation as it realty is. Unsatisfied with the still picture, people developed the motion picture. Research has succeeded in reproducing 3-dimensional images more realistic than the actual image we perceive as a result of the difference in visual perspective of both eyes and their response to rays of light From color film to 3-dimensional pictures, people enjoy the magnificent results of this. All fields within the category of film are continuously studying the human desire to pursue their visual side, namely the pursuit of visual images with a maximum sense of reality. The images that millions of people around the world see now are flat. The screen's depth and optical illusions effectively give a sense of reality while conveying information. However, although the flat screen is able to create a sense of depth using the different visual perspective of each eye for the realization of a cubic effect, there are limitations. Entering the 21s1 century, there is a quickly-arising branch within the field of image media which seeks to overcome these limitations Although 3-dimensional images began in films, entering the latter half of the 20th century, due to development of 3-dimensional images using the mediums of the animation field, cellular phones, advertisement screens, television etc., without restriction is designated as 'image.'. With research having started around 1900 and continuing for over 100 years, we are now able to witness the popularization of 3-dimensional films happening before our very eyes. Within our own country, we can frequently see them at amusement parks and museums. In the future, through the popularization of HDTV etc., there is a good outlook for practical use of 3-dimensional images in televisions with advanced picture qualify as well as in other areas. Together with the international current, research on 3-dimensional films has been activated in Korea and is rising as a main current in the film industry. Within this context, the contents and understanding of 3-dimensional images must keep in step with the pace of technical advancements. In order to accelerate of development of film contents to keep in pace with technical developments, this dissertation presents the techniques and technical aspects of future developments, and shows the need to prepare in advance to make the field grow- and thereby avoid having a lack of experts and being conquered by other nations in the field - rather than only advancing the technical aspects and importing the contents. This dissertation aims to stimulate interest and continual research by progressive-thinking people related to the film industry. Part II looks into the definition and types of 3-dimensional motion pictures, the terminology, the fundamentals of image formation, current market fluctuations, and looks into 3-dimensional techniques which can be borrowed and introduced in 3-dimensional animations. Part III concerns 3-dimensional animated films. It analyzes 3-dimensional production techniques while using the introduction of specific animation techniques in the 2004 production Lee Sun Shin and Nelson - Naval Heroes 3-dimensional animation produced in 2004 by Clay & Puppet Stop-Motion Animation & Computer Graphic. Original Korean title: 해전영웅 이순신과 넬슨. as an example, and it also looks into how current film techniques used in animations can be applied in 3-dimensional films. Additionally, the actual stages of the various fields of 3-dimensional animations are presented. Given the current direction and advancement of 3-dimensional films making use of animations and the possible realization of this field, the author plans to weigh the development of this yet unexploited new market Not looking at the current progress of the field, but rather the direction of the hypothetical types of animation techniques, the author predicts the marketability and possibility of development of each area.

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Gene Expression Profiles in Cervical Cancer with Radiation Therapy Alone and Chemo-radiation Therapy (자궁경부암의 방사선치료 및 방사선항암화학 병용치료에 따른 유전자발현 조절양상)

  • Lee Kyu Chan;Kim Meyoung-kon;Kim Jooyoung;Hwang You Jin;Choi Myung Sun;Kim Chul Yong
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.54-65
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    • 2003
  • Purpose : To analyze the gene expression Profiles of uterine ceulcal cancer, and its variation after radiation therapy, with or without concurrent chemotherapy, using a CDNA microarray. Materials and Methods :Sixteen patients, 8 with squamous ceil carcinomas of the uterine cervix, who were treated with radiation alone, and the other 8 treated w14h concurrent chemo-radiation, were Included in the study. Before the starling of the treatment, tumor biopsies were carried out, and the second time biopsies were peformed after a radiation dose of 16.2$\~$27 Gy. Three normal cervix tissues were used as a control group. The microarray experiments were peformed with 5 groups of the total RNAs extracted individually and then admixed as control, pre-radiation therapy alone, during-radiation therapy alone, pre-chemoradiation therapy, and during-chemoradlation therapy. The 33P-iabeled CDNAS were synthesized from the total RNAs of each group, by reverse transcription, and then they were hybridized to the CDNA microarray membrane. The gene expression of each microarrays was captured by the intensity of each spot produced by the radioactive isotopes. The pixels per spot were counted with an Arrayguage, and were exported to Microsoft Excel The data were normalized by the Z transformation, and the comparisons were peformed on the Z-ratio values calculated. Results : The expressions of 15 genes, including integrin linked kinase (ILK), CDC28 protein kinase 2, Spry 2, and ERK 3, were increased with the Z-ratio values of over 2.0 for the cervix cancer tissues compared to those for the normal controls. Those genes were involved In cell growth and proliferation, cell cycle control, or signal transduction. The expressions of the other 6 genes, Including G protein coupled receptor kinase 5, were decreased with the Z-ratio values of below -2.0. After the radiation thorapy, most of the genes, with a previously Increase expressions, represented the decreased expression profiles, and the genes, with the Z-ratio values of over 2.0, were cyclic nucleotlde gated channel and 3 Expressed sequence tags (EST). In the concurrent chemo-radiation group, the genes involved in cell growth and proliferation, cell cycle control, and signal transduction were shown to have increased expressions compared to the radiation therapy alone group. The expressions of genes involved in anglogenesis (angiopoietln-2), immune reactions (formyl peptide receptor-iike 1), and DNA repair (CAMP phosphodiesterase) were increased, however, the expression of gene involved In apoptosls (death associated protein kinase) was decreased. Conclusion : The different kinds of genes involved in the development and progression of cervical cancer were identified with the CDNA microarray, and the proposed theory is that the proliferation signal stalls with ILK, and is amplified with Spry 2 and MAPK signaling, and the cellular mitoses are Increased with the increased expression oi Cdc 2 and cell division kinases. After the radiation therapy, the expression profiles demonstrated 4he evidence of the decreased cancer cell proliferation. There was no sigificant difference in the morphological findings of cell death between the radiation therapy aione and the chemo-radiation groups In the second time biopsy specimen, however, the gene expression profiles were markedly different, and the mechanism at the molecular level needs further study.

Evaluation of the Fruit Quality Indices during Maturation and Ripening and the Influence of Short-term Temperature Management on Shelf-life during Simulated Exportation in 'Changjo' Pears (Pyrus pyrifolia Nakai) (배 신품종 '창조'의 성숙 중 품질 요인 변화 및 수송온도 환경에 따른 반응성)

  • Lee, Ug-Yong;Choi, Jin-Ho;Ahn, Young-Jik;Chun, Jong-Pil
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.378-385
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    • 2017
  • In this study, we evaluated the changes of fruit quality indices during fruit development and ripening in Korean new pear cultivar 'Changjo', developed from a cross between 'Tama' and '81-1-27' ('Danbae' ${\times}$ 'Okusankichi') in 1995 and named in 2009, to determine appropriate harvest time and to enhance the market quality and broaden the cultivation area. The fruits of 'Changjo' pears harvested from 132 days after full bloom (DAFB) to 160 DAFB. Fruit growth and quality indices were monitored at 1 week interval by measuring fruit weight, length, diameter, firmness, and taste related quality indices. The calculated fruit fresh weight increased continuously with fruit development and reached to an average of 594g on Sep. 20 (160 DAFB). The ratio of length to diameter declines as fruit maturation progress, resulting in 0.898 for ripe fruit stage as a round oblate shape. Flesh firmness of 'Changjo' pears showed over 30N until 153 DAFB and then decreased abruptly with fruit ripening, reaching a final level of about 26.44N on 160 DAFB. Starch content of fruit sap was also decreased abruptly after 146 DAFB which decreased almost half of the fruits harvested at 139 DAFB. In parallel with the decrease of flesh firmness, ethanol insoluble solids (EIS) content decreased sharply with fruit ripens, only 50% of EIS was detected on the fruits harvested on 160 DAFB when compared to that of the fruits harvested on 139 DAFB (Aug. 30). The maximum value of soluble solids contents was observed in the fruits harvested on 153 DAFB, resulting in $14.2^{\circ}Brix$. The changes of skin color difference $a^*$ which means loss of green color occurred only after 139 DAFB, coincide with the decrease of SPAD value of the fruit skin. The sugars of the 80% ethanol soluble fraction consisted mainly of fructose, sorbitol, glucose and sucrose, also increased during maturation and ripening. Fructose and sucrose contents were larger than those of glucose and sorbitol in flesh tissues. These results were explained that stored starch is converted to soluble sugars during fruit maturation, mainly in fructose and sucrose increasing the sweetness of this cultivar. Total polyphenols were increased up to middle of fruit maturation (146 DAFB) and then decreased continuously until the end of fruit maturation. Consequently, our results suggested that the commercial harvest time of 'Changjo' pears should not be passed 153 DAFB and late harvest of this cultivar would not good for quality maintenance during shelf-life. As a result of the post-harvest low-temperature acclimation experiment during the short-term transportation period, fruits harvested at 146 DAFB tended to maintain higher firmness after 14 days of simulated marketing at $25^{\circ}C$ compared to fruits harvested at 153 DAFB regardless of temperature set. And, the slower the rate of decrease to the final transport temperature of $5^{\circ}C$, the higher the incidence of internal browning and ethylene production. Therefore, in order to suppress the physiological disorder and to maintain the fruit quality when exporting to Southeast Asia in the 'Chanjo' pears, it is desirable to lower the temperature of the fruits within a short time after harvest and to set the harvest time before 146 days after full bloom.

Effect of Exercise on Antioxidant Enzyme Activities of Skeletal Muscle and Liver in STZ-diabetic Rats (STZ-당뇨쥐에서 운동부하가 골격근 및 간의 항산화효소 활성도에 미치는 영향)

  • Seok, Kwang-Ho;Lee, Suck-Kang
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.21-30
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    • 2000
  • Background: The purpose of the present study was to investigate the effect of exercise on the activities of antioxidant enzymes, super oxide dismutase(SOD), glutathione peroxidase(GPX) and catalase(CAT) of skeletal muscle(gastrocnemius) and liver in streptozotocin(STZ) induced diabetic rats. The malondialdehyde(MDA) concentration was also measured as an index of lipid poroxidation of tho tissues by exercise-induced oxidative stresses in diabetic rats. Material and Methods: Male Sprague-Dawley rats were randomly divided into control and STZ-induced diabetic rats. The STZ in citrate buffer solution was injected twice at S days intervals intraperitoneally(50, 70 mg/kg respectively). On the 28th day after the first STZ injection, the diabetic animals were randomly divided into pre- and post-exercise groups, The exercise was introduced to the rats of post-exercise group by treadmill running until exhaution with moderate intensity ($V_{O2max}$: 50-70%) of exercise. The duration of average running time was 2 hours and 19 minutes. Results: The blood glucose concentration was increased(p<0.001) and plasma insulin concentration was decreased(p<0.001) in the diabetic rats. The glycogen concentration in the muscle and liver was decreased by exhaustive exercise in the diabetic rats(p<0.001), In the skeletal muscle, the activities of GPX was increased(p<0.05) and the activities of SOD and CAT were not changed in the diabetic rats compare to those of the control rats. The activities of GPX was not changed by exercise but the activities of SOD(p<0.01) and CAT(p<0.01) were decreased by exercise in the diabetic rats, The concentration of MDA was not changed by exercise in diabetic rats, and the values of pre-exercise and post-exercise diabetic rats were not different from the value those of control rats, In the liver, the activities of SOD was decreased(p<0.01), and the activities of GPX and CAT were not changed in diabetic rats compared to the values of control rats, The activities of SOD, GPX and CAT were not changed by exercise in diabetic rats but the activity of SOD seemed to decrease slightly, The MDA concentration was increased in the diabetic rats compared to the values of control rats(p<0.001), but there was no change of MDA concentration by exercise in diabetic rats, Conclusions: In summary, exhaustive physical exercise did not seem to impose oxidative stress on the skeletal muscle because of due to oxygen free radicals, regardless of the decrease in SOD and CAT in the diabetic rats, In liver tissue, the tissue damage by oxidative stress was observed in diabetic rats but the additional tissue damage by exhaustive physical exercise was not observed.

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The Roles of Service Failure and Recovery Satisfaction in Customer-Firm Relationship Restoration : Focusing on Carry-over effect and Dynamics among Customer Affection, Customer Trust and Loyalty Intention Before and After the Events (서비스실패의 심각성과 복구만족이 고객-기업 관계회복에 미치는 영향 : 실패이전과 복구이후 고객애정, 고객신뢰, 충성의도의 이월효과 및 역학관계 비교를 중심으로)

  • La, Sun-A
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.1-36
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    • 2012
  • Service failure is one of the major reasons for customer defection. As the business environment gets tougher and more competitive, a single service failure might bring about fatal consequences to a service provider or a firm. Sometimes a failure won't end up with an unsatisfied customer's simple complaining but with a wide-spread animosity against the service provider or the firm, leading to a threat to the firm's survival itself in the society. Therefore, we are in need of comprehensive understandings of complainants' attitudes and behaviors toward service failures and firm's recovery efforts. Even though a failure itself couldn't be fixed completely, marketers should repair the mind and heart of unsatisfied customers, which can be regarded as an successful recovery strategy in the end. As the outcome of recovery efforts exerted by service providers or firms, recovery of the relationship between customer and service provider need to put on the top in the recovery goal list. With these motivations, the study investigates how service failure and recovery makes the changes in dynamics of fundamental elements of customer-firm relationship, such as customer affection, customer trust and loyalty intention by comparing two time points, before the service failure and after the recovery, focusing on the effects of recovery satisfaction and the failure severity. We adopted La & Choi (2012)'s framework for development of the research model that was based on the previous research stream like Yim et al. (2008) and Thomson et al. (2005). The pivotal background theories of the model are mainly from relationship marketing and social relationships of social psychology. For example, Love, Emotional attachment, Intimacy, and Equity theories regarding human relationships were reviewed. As the results, when recovery satisfaction is high, customer affection and customer trust that were established before the service failure are carried over to the future after the recovery. However, when recovery satisfaction is low, customer-firm relationship that had already established in the past are not carried over but broken up. Regardless of the degree of recovery satisfaction, once a failure occurs loyalty intention is not carried over to the future and the impact of customer trust on loyalty intention becomes stronger. Such changes imply that customers become more prudent and more risk-aversive than the time prior to service failure. The impact of severity of failure on customer affection and customer trust matters only when recovery satisfaction is low. When recovery satisfaction is high, customer affection and customer trust become severity-proof. Interestingly, regardless of the degree of recovery satisfaction, failure severity has a significant negative influence on loyalty intention. Loyalty intention is the most fragile target when a service failure occurs no matter how severe the failure criticality is. Consequently, the ultimate goal of service recovery should be the restoration of customer-firm relationship and recovery of customer trust should be the primary objective to accomplish for a successful recovery performance. Especially when failure severity is high, service recovery should be perceived highly satisfied by the complainants because failure severity matters more when recovery satisfaction is low. Marketers can implement recovery strategies to enhance emotional appeals as well as fair treatments since the both impacts of affection and trust on loyalty intention are significant. In the case of high severity of failure, recovery efforts should be exerted to overreach customer expectation, designed to directly repair customer trust and elaborately designed in the focus of customer-firm communications during the interactional recovery process to affect customer trust rebuilding indirectly. Because it is a longer and harder way to rebuild customer-firm relationship for high severity cases, low recovery satisfaction cannot guarantee customer retention. To prevent customer defection due to service failure of high severity, unexpected rewards as a recovery will be likely to be useful since those will lead to customer delight or customer gratitude toward the service firm. Based on the results of analyses, theoretical and managerial implications are presented. Limitations and future research ideas are also discussed.

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Research and Development Trends on Omega-3 Fatty Acid Fortified Foodstuffs (오메가 3계 지방산 강화 식품류의 연구개발 동향)

  • 이희애;유익종;이복희
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.26 no.1
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    • pp.161-174
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    • 1997
  • Omega-3 fatty acids have been major research interests in medical and nutritional science relating to life sciences since after the epidemiologic data on Green3and Eskimos reported by several researchers clearly showed fewer per capita deaths from heart diseases and a lower incidence of adult diseases. Linolenic acid(LNA) is an essential fatty acid for human beings as well as linoleic acid(LA) due to the fact that vertebrates lack an enzyme required to incorporate a double bond beyond carbon 9 in the chain. In addition the ratio of omega-6 and 3 fatty acids seems to be important in terms of alleviation of heart diseases since LA and LNA competes for the metabolic pathways of eicosanoids synthesis. High consumption of omega-3 fatty acids in seafoods may control heart diseases by reducing blood cholesterol, triglyceride, VLDL, LDL and increasing HDL and by inhibiting plaque development through the formation of antiaggregatory substances like PGI$_2$, PGI$_3$ and TXA$_3$ metabolized from LNA. Omega 3 fatty acids also play an important role in neuronal developments and visual functioning, in turn influence learning behaviors. Current dietary sources of omega-3 fatty acids are limited mostly to seafoods, leafy vegetables, marine and some seed oils and the most appropriate way to provide omega-3 fatty acids is as a part of the normal dietary regimen. The efforts to enhance the intake of omega-3 fatty acids due to several beneficial effects have been made nowadays by way of food processing technology. Two different ways can be applied: one is add Purified and concentrated omega-3 fatty acids into foods and the other is to produce foods with high amounts of omega-3 fatty acids by raising animals with specially formulated feed best for the transfer of omega-3 fatty acids. Recently, items of manufactured and marketed omega-3 fatty acids fortified foodstuffs are pork, milk, cheese, egg, formula milk and ham. In domestic food market, many of them are distributed already, but problem is that nutritional informations on the amounts of omega-3 fatty acids are not presented on the labeling, which might cause distrust of consumers on those products, result in lower sales volumes. It would be very much wise if we consume natural products, result in lower sales volumes. It would be very much wise if we consume natural products high in omega-3 fatty acids to Promote health related to many types of adult diseases rather than processed foods fortified with omega-3 fatty acids.

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Spatio-temporal Fluctuations with Influences of Inflowing Tributary Streams on Water Quality in Daecheong Reservoir (대청호의 시공간적 수질 변화 특성 및 호수내 유입지천의 영향)

  • Kim, Gyung-Hyun;Lee, Jae-Hoon;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.45 no.2
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    • pp.158-173
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    • 2012
  • The objectives of this study were to analyze the longitudinal gradient and temporal variations of water quality in Daecheong Reservoir in relation to the major inflowing streams from the watershed, during 2001~2010. For the study, we selected 7 main-stream sites of the reservoir along the main axis of the reservoir, from the headwater to the dam and 8 tributary streams. In-reservoir nutrients of TN and TP showed longitudinal declines from the headwater to the dam, which results in a distinct zonation of the riverine ($R_z$, M1~M3), transition ($T_z$, M4~M6), and lacustrine zone ($L_z$, M7) in water quality, as shown in other foreign reservoirs. Chlorophyll-a (CHL) and BOD as an indicator of organic matter, were maximum in the $T_z$. Concentration of total phosphorus (TP) was the highest (8.52 $mg\;L^{-1}$) on March in the $R_z$, and was the highest (165 ${\mu}g\;L^{-1}$) in the $L_z$ on July. Values of TN was the maximum (377 ${\mu}g\;L^{-1}$) on August in the $R_z$, and was the highest (3.76 $mg\;L^{-1}$) in the $L_z$ on August. Ionic dilution was evident during September~October, after the monsoon rain. The mean ratios of TN : TP, as an indicator of limiting factor, were 88, which indicates that nitrogen is a surplus for phytoplankton growth in this system. Nutrient analysis of inflowing streams showed that major nutrient sources were headwater streams of T1~T2 and Ockcheon-Stream of T5, and the most influential inflowing stream to the reservoir was T5, which is located in the mid-reservoir, and is directly influenced by the waste-water treatment plants. The key parameters, influenced by the monsoon rain, were TP and suspended solids (SS). Empirical models of trophic variables indicated that variations of CHL in the $R_z$ ($R^2$=0.044, p=0.264) and $T_z$ ($R^2$=0.126, p=0.054) were not accounted by TN, but were significant (p=0.032) in the $L_z$. The variation of the log-transformed $I_r$-CHL was not accounted ($R^2$=0.258, p=0.110) by $I_w$-TN of inflowing streams, but was determined ($R^2$=0.567, p=0.005) by $I_w$-TP of inflowing streams. In other words, TP inputs from the inflowing streams were the major determinants on the in-reservoir phytoplankton growth. Regression analysis of TN : TP suggested that the ratio was determined by P, rather than N. Overall, our data suggest that TP and suspended solids, during the summer flood period, should be reduced from the eutrophication control and P-input from Ockcheon-Stream should be controlled for water quality improvement.

Association Between Temporomandibular Disorders and Cervical Muscle Pressure Pain (측두하악장애와 경부근육 압통 간의 상관성)

  • Im, Yeong-Gwan;Kim, Jae-Hyeong;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.339-352
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    • 2008
  • Aims: The aims of this study were to identify the association between cervical muscle pain and TMD by pressure pain response, and to find cervical muscles showing moderate to severe pressure pain that are correlated with masticatory muscle pain. Methods: Patients(n=129, female 65.9%, mean age 28.8 years) answered a TMD questionnaire asking about headache, neck pain, emotional stress, sleep disturbance, parafunction habits, and pain intensity. A clinical examination of the masticatory system was performed. Of the neck muscles, (1) the upper sternocleidomastoid, (2) the middle sternocleidomastoid, (3) the upper trapezius, (4) the splenius capitis, (5) the semispinalis capitis, (6) the scalene medius, and (7) the levator scapulae muscles were examined by palpation. Pressure pain or tenderness of all palpation sites was scored from 0 to 3 according to the pain response. The variables of sum of pressure pain scores were calculated from pressure pain scores and were used for statistical analyses. Results: Eighty patients(62.0%) answered that they suffer from neck pain in the TMD questionnaire. More than 40% of sternocleidomastoid and upper trapezius examination sites showed moderate to severe tenderness in the cervical muscles, and 36% of middle masseter in the masticatory muscles. For the 129 patients, the sum of cervical muscle pain scores(mean=12.88, SD=8.06) and the sum of TMD pain scores(mean=5.36, SD=5.10) were moderately correlated($\rho$ = 0.502, P < 0.001). The sum of TMD pain scores tends to increase as the sum of cervical muscle pain scores increases(Y = 0.395${\cdot}$X, $R^2$ = 0.659, P < 0.001). In the patients with masticatory muscle disorders, the sum of sternocleidomastoid and upper trapezius pain scores(mean = 8.67, SD = 4.95) and the sum of temporalis and masseter pain scores(mean = 3.37, SD = 3.56) showed moderate correlation($\rho$ = 0.375, P < 0.001). Those two variables were in a proportionate relationship(Y = 0.359${\cdot}$X, $R^2$ = 0.538, P < 0.001). In a partial correlation analysis of the sum of unilateral pain scores, the sum of right cervical muscle pain scores and the sum of left cervical muscle pain scores showed the highest correlation(r = 0.802, P < 0.001). The sum of right TMD pain scores and the sum of left TMD pain scores were moderately correlated(r = 0.481, P < 0.001). For the twenty patients with unilateral TMD pain, the partial correlation coefficient between the sum of ipsilateral cervical muscle pain scores and the sum of contralateral cervical muscle pain scores was the largest(r = 0.597, P = 0.009). A partial correlation between the sum of primary TMD side pain scores and the sum of ipsilateral cervical muscle pain scores was 0.564(P = 0.015). Conclusions: TMD is associated with cervical muscle pain on condition of pressure pain response to palpation. Of the cervical muscles, sternocleidomastoid and upper trapezius frequently exhibit moderate to severe pressure pain, and they are closely related to the masticatory muscle pain. The characteristic of symmetric involvement of pain is prominent in cervical muscles; however, TMD can affect the level of cervical muscle pain to modify its symmetric nature.

Predicting Oxygen Uptake for Men with Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD환자에서 6분 보행검사를 이용한 최대산소섭취량 예측)

  • Kim, Changhwan;Park, Yong Bum;Mo, Eun Kyung;Choi, Eun Hee;Nam, Hee Seung;Lee, Sung-Soon;Yoo, Young Won;Yang, Yun Jun;Moon, Joung Wha;Kim, Dong Soon;Lee, Hyang Yi;Jin, Young-Soo;Lee, Hye Young;Chun, Eun Mi
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.433-438
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    • 2008
  • Background: Measurement of the maximum oxygen uptake in patients with chronic obstructive pulmonary disease (COPD) has been used to determine the intensity of exercise and to estimate the patient's response to treatment during pulmonary rehabilitation. However, cardiopulmonary exercise testing is not widely available in Korea. The 6-minute walk test (6MWT) is a simple method of measuring the exercise capacity of a patient. It also provides high reliability data and it reflects the fluctuation in one' s exercise capacity relatively well with using the standardized protocol. The prime objective of the present study is to develop a regression equation for estimating the peak oxygen uptake ($VO_2$) for men with moderate to very severe COPD from the results of a 6MWT. Methods: A total of 33 male patients with moderate to very severe COPD agreed to participate in this study. Pulmonary function testing, cardiopulmonary exercise testing and a 6MWT were performed on their first visits. The index of work ($6M_{work}$, 6-minute walk distance [6MWD]${\times}$body weight) was calculated for each patient. Those variables that were closely related to the peak $VO_2$ were identified through correlation analysis. With including such variables, the equation to predict the peak $VO_2$ was generated by the multiple linear regression method. Results: The peak $VO_2$ averaged $1,015{\pm}392ml/min$, and the mean 6MWD was $516{\pm}195$ meters. The $6M_{work}$ (r=.597) was better correlated to the peak $VO_2$ than the 6MWD (r=.415). The other variables highly correlated with the peak $VO_2$ were the $FEV_1$ (r=.742), DLco (r=.734) and FVC (r=.679). The derived prediction equation was $VO_2$ (ml/min)=($274.306{\times}FEV_1$)+($36.242{\times}DLco$)+($0.007{\times}6M_{work}$)-84.867. Conclusion: Under the circumstances when measurement of the peak $VO_2$ is not possible, we consider the 6MWT to be a simple alternative to measuring the peak $VO_2$. Of course, it is necessary to perform a trial on much larger scale to validate our prediction equation.