• Title/Summary/Keyword: 염증성 등통증

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Response to Bee Venom Acupuncture and Polymorphism of Matrix Metalloproteinase-1 Gene in Korean Patients with Rheumatoid Arthritis (한국인 류마티스 관절염 환자의 봉독약침 치료반응과 Matrix Metalloproteinase-1의 유전자 다형성 연구)

  • Lee, Sang-hoon;Choi, Do-young;Lee, Yun-ho
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.211-225
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    • 2004
  • 목적 : 류마티스 관절염 환자의 골 파괴에 중요한 역할을 하는 것으로 알려진 Matrix Metalloproteinase-1(MMP-1) 유전자의 단일 염기 다형성을 분석하고, 나아가 봉독약침 치료에 대한 반응과의 연관성을 조사하기 위하여 본 연구를 시행하였다. 방법 : 미국류마티스학회의 류마티스 관절염 기준에 해당하는 122명의 한국인 류마티스 관절염 환자와 건강한 92명의 대조군을 대상으로 pyrosequencing 방법을 이용하여 MMP-1 유전자의 -519 위치의 다형성을 비교 분석하였으며, 류마티스 관절염 환자군을 다시 유전자 유형에 따라 동통 관절수, 종창 관절수, 조기 강직, 통증 강도, 삶의 질 평가도구인 HAQ, 환자 및 의사의 전반적 질병상태 평가, ESR, CRP 등의 항목을 치료 전후 평가하여 비교 분석하였다. 결과 : 1. 류마티스 환자군과 건강한 대조군간에 MMP-1 유전자의 단일 염기 다형성의 유전자형의 분포와 대립유전자 발현 빈도에 통계적으로 유의한 차이가 나타났으며, 이는 MMP-1 유전자 다형성이 한국인 류마티스 관절염 환자의 질병 감수성과 관련이 있음을 추정할 수 있다. 2. 각 유전자형 그룹간 치료전 질병의 중증도 평가에서 임상 평가와 혈액의 급성 염증 반응물질 평가에서 통계적으로 유의한 차이는 없었다. 3. 급성 염증 반응의 지표인 ESR과 CRP level의 봉독약침 치료 전후 변화는 MMP-1의 유전자 다형성과 유의한 연관이 없었다. 4. 각 유전자형 그룹간의 치료 전후 질병 호전도 비교에서, AA 유전자형이 종창 관절수 평가에서 더나은 호전을 보였으며, 다른 모든 평가에서는 통계적으로 유의한 차이가 없었으며, 향후 관련 유전자와의 연관성 연구가 필요하다고 사료된다.

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Case Report : Non-surgical Treatment of Inferior Alveolar Nerve Injury as a Result of Overinstrumented Root Canal Treatment (근관 충전제의 과충전에 의한 하치조 신경손상에 관한 비수술적 치료 증례)

  • Bae, Kook-Jin;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Cho, Young-Gon;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
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    • v.36 no.3
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    • pp.199-205
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    • 2011
  • During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).

The Neurotransmitter Pathway of Itching (가려움증의 신경전달 경로)

  • Jo, Jeong Won;Kim, Chi-Yeon
    • Journal of Life Science
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    • v.27 no.5
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    • pp.600-610
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    • 2017
  • It was common that the classification of itching was classified into four categories according to the neurophysiological mechanisms of pruritoceptive itching, neuropathic itching, neurogenic itching and psychogenic itching. Recently it was classified by clinical criteria. The neurotransmission pathway of itch is divided into histamine-dependent pathway and histamine-independent pathway. Different receptors and neuropeptides act on each itch mediator. Itch mediators such as histamine, BAM8-22, and chloroquine are transmitted through the histamine-dependent pathway. Cowhage spicule, protease, and TSLP (Thymic stromal lymphopoietin) have been reported to be related to the histamine-independent pathway. These itch mediators, receptors, and neuropeptides are the targets of treatment for itching. Although itching and pain are typical noxious stimuli, and in the past, it was argued that two senses were transmitted through one noxious stimulus receptor. It has recently been shown that itching and pain have an independent neurotransmitter system and both neuronal systems inhibit each other. In addition, the mutual antagonism between itching and pain is explained by various mechanisms. Recently, many new mediators and receptors are being studied. The studies on histamine 4 receptor (H4 receptor) have been actively conducted. And the H4 receptors are expressed in immune cells such as T cells. The therapeutic agent for blocking the H4 receptor can inhibit the inflammatory reaction itself, which is important for the itching and chronicization. Understanding the underlying mechanisms of itching and studying new itch mediators will lead to the development of effective therapies, and this is what I think the itching study will go on.

Cauda Equina Syndrome Occurred by Adhesive Arachnoiditis of the Lumbar Spine with an Unknown Cause (원인 미상의 요추의 유착성 지주막염에 의해 발생한 마미 증후군)

  • Jeon, Ho-Seung;Hwang, Seok-Ha;Suh, Seung-Pyo;Kim, Jae-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.361-365
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    • 2019
  • Spinal adhesive arachnoiditis is an inflammation and fibrosis of the subarachnoid space and pia mater caused by infection, trauma, spinal vascular anomalies, and iatrogenic (surgery and/or puncture). Adhesive arachnoiditis develops various symptoms and signs (gait disturbances, radiating pain, paralysis, and incontinence). On the other hand, adhesive arachnoiditis associated with cauda equina syndrome has not been reported in Korea until now. The authors experienced cauda equina syndrome caused by adhesive arachnoiditis of the lumbar spine with satisfactory results following decompression. We report this case with a review of the relevant literature.

Osteomyelitis of Mandibular Condyle : A Case Report in 9-year-old Child (9세 소아에서 발생한 하악과두의 골수염)

  • Lee, Kyung-Eun;Choi, Soon-Jeong;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.34 no.3
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    • pp.333-340
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    • 2009
  • Osteomyelitis means inflammation of the bone marrow. It usually begins in the medullary cavity, involving the cancellous bone; then it extends and spreads to the cortical bone and eventually to the periosteum. The cause is usually thought to be microbiological. But there still are factors that predispose to produce a possible bone infection such as injuries, syphilis, actionomycosis, chronic kidney failure, alcoholism, malnutrition, radiotherapy, and chemotherapy. Treatment of modalities have been directed toward eradicating microbes and improving circulation in the early stage. In the case presented, surgical debridement and IV antibiotics were the treatment of choice. Osteomyelitis in children is mainly affected in the mandible. And in childhood, the mandibular condyle is regarded as an important center of mandibular growth. Therefore, in young patients, osteomyelitis involving this region may cause a restraint of mandibular development, resulting in facial asymmetry. So diagnosis in the early stage is important in child with osteomyelitis. Recently, we have encountered an interesting case of osteomyelitis of the mandibular condyle in 9-year-old boy. So we present the case and review the literature about osteomyelitis.

Azoospermia Following Mumps Orchitis:2 Case (볼거리 고환염에 따른 무정자증: 2례)

  • Sim, Hyun-Sun
    • The Journal of the Korea Contents Association
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    • v.16 no.11
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    • pp.767-775
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    • 2016
  • Mumps is an acute viral disease that affects the entire body, including inflammation of the salivary glands. Mumps is accompanied by unilateral or bilateral parotid gland swelling and pain. Mumps virus is spread to others by air, saliva, direct contact, and urine, and occurs in high-density population places such as schools, army, etc. Bilateral testicular involvement is seen in 10-60% of cases. If mumps orchitis affect post-pubertal men, approximately 50% of the infected people are said to experience severe testicular atrophy within 1-2 months as a complication. Mumps orchitis can alter the count, morphology, and motility of sperm and result in oligozoospermia and infertility caused by a rare azoospermia. When suspected of mumps orchitis, active initial symptomatic treatment can prevent infertility due to azoospermia in future adults. A case of mumps orchitis report two cases with references to the ultrasonnography and semen.

Expression Pattern of T Lymphocyte Regulatory Factors in Unstimulated Whole Saliva of Erosive Oral Lichen Planus and Recurrent Aphthous Stomatitis Patients (미란형 구강편평태선과 재발성 아프타성 구내염 환자들의 비자극성 전타액내 T림프구 조절인자들의 발현 양상)

  • Yoon, Seon-Hack;Ko, Hyun-Mi;Park, Ji-Il;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.363-369
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    • 2009
  • Erosive oral lichen planus (EOLP) and recurrent aphthous stomatitis (RAS) are T-cell mediated inflammatory immune disorders. It was investigated mRNA expression pattern of several regulatory factors, such as, CD28, CD45, CD152, CD154, CD279, which influence T lymphocyte in unstimulated whole saliva (UWS) of EOLP and RAS patients. It was collected unstimulated whole saliva during 10 minute in EOLP 18 people, RAS patients 12 people, healthy control 8 people. We investigated mRNA expression of T lymphocyte regulatory factors, such as, CD28, CD45, CD152, CD154, CD279, with real time reverse transcription polymerase chain reaction. In EOLP group, CD45, CD279 expressed higher and CD154 expressed lower than control. In RAS, CD45, CD270 expressed higher and CD28, CD154 expressed lower than control. In addition CD152 salivary mRNA expression of EOLP is higher than that of RAS. The above results were suggested that the mRNA expression of T lymphocyte regulatory factors in unstimulated whole saliva of EOLP and RAS contributes to diagnosis of diseases.

Video-assisted Thoracoscopic Surgery for Mediastinal Lesions (종격동 질환의 비디오 흉강경 수술)

  • 김연수;김광택;손호성;김일현;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.40-45
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    • 1998
  • Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

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Osteoarthritis of the Temporomandibular Joint (측두하악관절의 골관절염)

  • Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.87-95
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    • 2013
  • Osteoarthritis (OA) of the temporomandibular joint (TMJ) is a severe form of temporomandibular disorders (TMDs), presenting gradual breakdown of articular cartilage and subchondral bone by the functional load sustained to exceed the physiologic tolerance of the joint. In such a joint loaded, offensive bioactive materials such as matrix degrading proteins, cytokines, and free radicals increase in concentration to shift the tissue response in the joint to degeneration from regeneration or remodeling. Recently, it has been issued that obesity can play an offensive role in pathogenesis of OA in a metabolic way. Adipokines released by adipose cells are present at higher concentration in the arthritic joint and joints of obese individuals. However, because of conflicting data reported, further scientific study should be performed to elucidate the practical role of adipokines in pathogenesis of TMJ OA. As far as the clinical signs and symptoms of TMJ OA are not much different from those of other forms of TMD and any definitive treatment modality to control directly the bone resorptive activity is not available yet, the treatment of TMJ OA should be directed to reduce the physical load and enhance the physiologic tolerance of the joint by means of conservative treatment such as physical therapy, medication, and occlusal splint therapy for sufficient period and, if needed after that, supplementary surgical procedure such as intra-articular injection, arthrocenthesis, and arthroscopic surgery that have turned out to be effective to control OA signs and symtpoms. Enthusiastic reassurance and motivation for patients to control behaviors for themselves to reduce unnecessary functional load in daily life is very important for the joint to reach to more favorable orthopedic stability of the TMJ more quickly, guaranteeing more successful management TMJ OA.

Diagnosis and Treatment of Gastric MALT Lymphoma (위 MALT 림프종의 진단 및 치료에 대한 고찰)

  • Tae Ho Kim
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.82-88
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    • 2015
  • Gastric lymphoma comprises 1-6% of all gastric malignant neoplasms and among them 50% is gastric MALT lymphoma. The 60-70% of MALT lymphomas is diagnosed at early, localized diseased state. Gastric MALT lymphoma is assumed that it progress slowly with indolent course. It presents nonspecific symptoms such as epigastric pain, dyspepsia, nausea and vomiting. It is rarely associated with serious complication such as gastrointestinal bleeding or perforation. The definite diagnosis of gastric MALT lymphoma should be made with histopathologically. Wotherspoon score is used to differential diagnosis with Helicobacter pylori associated gastric inflammatory change. Gastric MALT lymphoma is associated with Helicobacter pylori infection with supported by epidemiologic and histopathologic studies. Gastric MALT lymphoma is characterized with genetic aberrations such as trisomy 3, trisomy 18, chromosomal translocations t(11;18), t(1;14), t(14;18), t(3;14). Appropriate clinical staging is essential to determine the optimal treatment strategy for gastric MALT lymphoma. Lugano International Conference classification has been applied widely. Helicobacter pylori eradication is used as the first line treatment for gastric MALT lymphoma independent of the stage. The complete remission has been achieved in 60-90% of the stage I/II1 patients with Helicobacter pylori eradication only. The treatment options for the patients with refractory to eradication are radiotherapy, chemotherapy and/or immunotherapy with the complete remission rate of 75% to 100%. The incidence of gastric MALT lymphoma can be expected to down by virtue of the decrease of Helicobacter pylori infection rate. Further basic and clinical research is necessary to advance in determine the pathogenesis and management.

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