• Title/Summary/Keyword: Clinical Disease Activity Index

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The Roles of the TSH Receptor Antibodies in Autoimmune Thyroid Diseases (자가면역성 갑상선질환에서 TSH 수용체 항체의 역활에 관한 연구)

  • Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.85-100
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    • 1986
  • To evaluate the clinical and pathogenetic roles of TSH receptor antibodies in autoimmune thyroid diseases, TBII were measured by TSH-radioreceptor assay methods in 352 patients with Graves' disease, 108 patients with other thyroid diseases and 69 normal persons. The normal range of TBII activity was less than 15%. The frequencies of detectable TBII in 169 patients with untreated Graves' disease, 31 patients with hyperthyroidism under treatment and 70 patients with euthyrodism under treatment were 92.4%, 87.1% and 54.3% respectively. However 12 (21.8%) out of 55 patients who have been in remission more than one year after discontinuation of antithyroid drugs treatment had detectable TBII activities in their sera. In 196 patients with untreated Graves' disease, the frequency of TBII increased by increasing size of goiter and the frequency of proptosis was significantly high in patients whose TBII activities were more than 60%. TBII activities were roughly correlated with total $T_3,\;T_4$ and free $T_4$ index but low $\gamma^2$ value(less than 0.1). In 67 patients with Graves' disease who were positive TBII before antithyroid drugs treatment, TBII activities began to decrease from the third months and it was converted to negative in 35.8% of patients at 12 months after treatment. There were no significant differences of the declining and disappearing rates of TBII activities between high dose and conventional dose groups. TBII activities were significantly increased initially (2-4 months) and then began to decrease from 5-9 months after $^{131}I$ treatment. There were two groups, one whose TBII activities decreased gradually and the other did not change untill 12 months after subtotal thyroidectomy. Although preoperative clinical and laboratory findings of both groups were not different, TBII activities of non-decreasing group were significantly higher than those of decreasing group$(74.6{\pm}18.6%\;vs\;39.2{\pm}15.2%;\;P<0.01)$. Thirty three(55.9%) out of 59 patients with Graves' disease relapsed within 1 year after discontinuation of antithyroid drugs. The positive rate of TBII at the end of antithyroid drug treatment in relapse group(n=33) was significantly higher than those in remission group (n=26) (63.6% vs 23.1%; P < 0.05). The mean value of TBII activities at the end of antithyroid drug treatment in relapse group was significantly elevated $(29.7{\pm}21.4%\;vs\;14.7{\pm}11.1%,\;P<0.05)$. Positive predictive value of TBII for relapse was 77.8%, which was not different from those of TRH nonresponsiveness(78.6%). The frequencies of detectable TBII in 68 patients with Hashimoto's thyroiditis, 10 patients with painless thyroiditis and 5 patients subacute thyroiditis were 14.7%, 20% and 0%, respectively. However in 25 patients with primary nongoitrous myxedema, 11 patients(44%) showed TBII activities in their sera. 9 out of 11 patients who had TBII activities in their sera showed high TBII activities(more than 70% binding inhibition) and their IgG concentrations showing 50% binding inhibition of $^{125}I-bTSH$ to the TSH receptor were ranges of 0.1-2.6 mg/dl. One patient who had high titer of TBII in her serum delivered a hypothyroid baby due to transplacental transfer of maternal TBII. These findings suggested that 1) TSH receptor antibodies are closely related to a pathogenetic factor of Graves' hyperthyroidism and of some patients with primary non-goitrous myxedema, 2) measurement of TSH receptor antibodies is helpful in evaluating the clinical outcome of patients with Graves' disease during antithyroid drug treatment and in predicting the neonatal transient hypothyroidism of baby delivered from primary myxedema patients. 3) there are 2 or more different types of TSH receptor antibodies in autoimmune thyroid diseases including one which stimulates thyroid by binding to the TSH receptor and another which blocks adenylate cyclase stimulation by TSH.

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Differential Excretion of Urinary Eosinophil Protein X after Methacholine Challenge Test in Children with Asthma (천식 환아에서 요중 Eosinophil Protein X의 메타콜린 기관지 유발 시험 전·후의 변화)

  • Shin, Su-A;Oh, Jae-Won;Lee, Ha-Baik
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.495-499
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    • 2003
  • Purpose : Eosinophil is one of the important inflammatory cell involved in the airway inflammation in childhood asthma. It has been demonstrated that markers of eosinophil activation, including eosinophil cationic protein or eosinophil protein X(EPX), are increased in childhood asthma. Furthermore, they are related to disease activity and are assumed to be helpful in monitoring the treatment effect as urinary EPX(U-EPX) can be obtained easily and in a noninvasive way in children of all ages. Methods : Twenty-five children(22 male and three female) aged $11.87{\pm}3.82$ years with stable asthma were challenged with methacholine and urine was collected from each child during the following periods; before methacholine challenge test(MCT); 0-3 hr after the end of MCT; 4-7 hr after the end of MCT; and 8-24 hr after the end of MCT. Bronchial reactivity was determined by using Dosimeter( Jeager, Germany) with serially diluted methacholine from 0.05 to 25.0 mg. The $FEV_1$ less than 80% of baseline value were classified into positive MCT. U-EPX was measured with a sensitive and specific radioimmunoassay(Pharmacia & Upjohn AB, Uppsala, Sweden). Results were expressed as ${\mu}gEPX/mmol$ creatinine. Results : An early airway response after MCT was associated with an increase of U-EPX excretion for 0-3 hr after methacholine inhalation in comparison with beseline values. Most subjects showed a small increase in U-EPX excretion during late asthmatic response for 4-7 hr, which then decreased to normal level in 8-24 hr. Also, a tendency for a higher increase of U-EPX was associated with a lower threshold of methacholine challenge and a longer duration of asthma. Conclusion : Measurement of EPX in urine is a noninvasive and easy method to assess the severity of airway inflammation in asthmatic children. It may be a helpful index of the events underlying the airway inflammatory responses during nonspecific bronchial challenge, and in monitoring asthma management.

Anti-inflammatory effects of mulberry twig extracts on dextran sulfate sodium-induced colitis mouse model (상지추출물이 Dextran Sulfate Sodium으로 유도된 대장염 마우스 모델에 미치는 항염증 효능)

  • Cui, Xuelei;Kim, Eunjung
    • Journal of Nutrition and Health
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    • v.52 no.2
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    • pp.139-148
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    • 2019
  • Purpose: Ulcerative colitis is a common inflammatory bowel disease. Prolonged colitis can be a risk factor for the development of colorectal cancer. Mulberry twig (MT, Sangzhi), a dry branch of Morus alba L., which is widely distributed throughout East Asia, has been shown to have anti-inflammatory activities in the cells. However, the effects of MT extracts on colitis in in vivo are limited. Therefore, in this study, we investigated the anti-inflammatory effects of MT extracts in the dextran sulfate sodium (DSS)-induced mouse colitis model. Methods: Six week-old, male ICR mice were divided into 3 groups: Control (n = 5), DSS (n = 7), and DSS+MT (n = 7) groups. Mice in the DSS and DSS+MT groups were administrated 3% DSS in drinking water for 5 days to induce colitis. At the same time, water extracts of MT (5 g/kg body weight/day) were orally administered to mice in the DSS+MT groups for 5 days. Results: The MT extracts significantly reduced the clinical and pathological characteristics of colitis. Disease activity index, mucosal thickness, and colonocyte proliferation were significantly reduced in the DSS+MT group compared with the DSS group. Furthermore, MT administration reduced the levels of plasma $TNF-{\alpha}$, IL-6, and the colonic myeloperoxidase activity as well as mRNA expression of $TNF-{\alpha}$, IL-6, Cox-2, and iNOS. Conclusion: Taken together, these results suggest that MT water extracts have potent anti-colitis activities in the mouse colitis model.

Is catechol-o-methyltransferase gene polymorphism a risk factor in the development of premenstrual syndrome?

  • Deveci, Esma Ozturk;Incebiyik, Adnan;Selek, Salih;Camuzcuoglu, Aysun;Hilali, Nese Gul;Camuzcuoglu, Hakan;Erdal, Mehmet Emin;Vural, Mehmet
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.2
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    • pp.62-67
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    • 2014
  • Objective: The objective of this study was to investigate whether there was a correlation between catechol-o-methyltransferase (COMT) gene polymorphism, which is believed to play a role in the etiology of psychotic disorders, and premenstrual syndrome (PMS). Methods: Fifty-three women with regular menstrual cycles, aged between 18 and 46 years and diagnosed with PMS according to the American Congress of Obstetrics and Gynecology criteria were included in this study as the study group, and 53 healthy women having no health problems were selected as the controls. Venous blood was collected from all patients included in the study and kept at $-18^{\circ}C$ prior to analysis. Results: There was no significant difference between the groups in terms of demographic features such as age, body mass index, number of pregnancies, parity, and number of children. No statistically significant difference was observed in terms of COMT gene polymorphism (p=0.61) between women in the PMS and the control groups. However, a significant difference was found between arthralgia, which is an indicator of PMS, and low-enzyme activity COMT gene (Met/Met) polymorphism (p=0.04). Conclusion: These results suggested that there was no significant relationship between PMS and COMT gene polymorphism. Since we could not find a direct correlation between the COMT gene polymorphism and PMS, further studies including alternative neurotransmitter pathways are needed to find an effective treatment for this disease.

Constitution Therapy of Adolescent Ulcerative Colitis: A Case Report (청소년궤양성 대장염 환자의 사상체질요법에 대한 증례보고)

  • Park, Se-gi;Kim, Geun-yeob;Shin, Seon-mi;Ko, Heung
    • The Journal of Internal Korean Medicine
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    • v.38 no.4
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    • pp.531-540
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    • 2017
  • Objectives: This study discusses the effects of constitution therapy on adolescent ulcerative colitis. Methods: A 12-year-old male patient was treated with western medication for six months and herbal medicine for one year and six years; however, his abdominal pain, mucousy stool, bloody stool, and diarrhea persisted. He was diagnosed as having Taeumin according to Sasang constitution classification and treated with Sasang constitutional medicine (i.e., Yeuldahanso-tang and food restrictions based on constitutional medicine theory). Before the first treatment, his Pediatric Ulcerative Colitis Activity Index (PUCAI) score was 35, but this score decreased to 15 within six months and was maintained at 10 by 18 months of treatment. He took the herbal medication for 38 months, and his PUCAI score was 0 at the end of treatment. His liver functioned normally despite long-term drug use, and a follow-up colonoscopy showed no ulcerative colitis except melanosis, which was presumed to be caused by the herbal medicine. Ulcerative colitis in pediatric adolescents requires treatment with pharmacotherapy and dietary control based on constitutional medicine to maintain disease remission. Conclusions: Constitutional therapy is effective for treating adolescent ulcerative colitis. More clinical data are needed for patients with ulcerative colitis.

Experimental Research of Baecksunpijibujabokhap-banng(BJBB) on Atopic Dermatitis Treatment (백선피지부자복합방(白鮮皮地膚子複合方)의 항아토피피부염 효능에 관한 실험적 연구)

  • Sim, Boo-Yong;Ji, Joong-Gu;Lee, Won-Yung;Kim, Su-Jung;Kim, Hyo-Young;Lee, Ji-Young;Kim, Dong-Hee
    • Journal of Haehwa Medicine
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    • v.22 no.2
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    • pp.67-79
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    • 2014
  • In order to investigate the efficacy of BJBB on atopic dermatitis, various immune related factors were studied. The results and conclusions are as follows. Atopic dermatitis symptoms were improved in BJBB treated group and significant decrease in dermatitis index were observed in 13 weeks. ALT, AST and BUN, Cr levels were all with in the normal ranges in BJBB treated group, indicating no induced toxicity. BJBB treated group showed significant decrease in CD4+, CD11b+/Gr-1+ immune cell ratio in dorsal skin by 33% and 62% respectively. BJBB treated group showed significant decrease in the expression of IL-4, IL-5, IL-13 and histamine by 83%, 62%, 53% and 61% respectively. Also the group showed decrease in the transcription of IL-4, IL-5 and IL-13 mRNA in spleen by 41%, 52% and 50% respectively. BJBB treated group showed decrease in the expression of IgE by 57% respectively. The results above indicated that treatment of BJBB improved atopic dermatitis symptoms by immune modulation activity a clinical evidence. thus, BJBB has a potential use as a composition of medicinal plants for treatment against inflammation related disease.

Effect of vitamin C on azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced colitis-associated early colon cancer in mice

  • Jeon, Hee-Jin;Yeom, Yiseul;Kim, Yoo-Sun;Kim, Eunju;Shin, Jae-Ho;Seok, Pu Reum;Woo, Moon Jea;Kim, Yuri
    • Nutrition Research and Practice
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    • v.12 no.2
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    • pp.101-109
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    • 2018
  • BACKGROUD/OBJECTIVES: The objective of this study was to investigate the effects of vitamin C on inflammation, tumor development, and dysbiosis of intestinal microbiota in an azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced inflammation-associated early colon cancer mouse model. MATERIALS/METHODS: Male BALB/c mice were injected intraperitoneally with AOM [10 mg/kg body weight (b.w)] and given two 7-d cycles of 2% DSS drinking water with a 14 d inter-cycle interval. Vitamin C (60 mg/kg b.w. and 120 mg/kg b.w.) was supplemented by gavage for 5 weeks starting 2 d after the AOM injection. RESULTS: The vitamin C treatment suppressed inflammatory morbidity, as reflected by disease activity index (DAI) in recovery phase and inhibited shortening of the colon, and reduced histological damage. In addition, vitamin C supplementation suppressed mRNA levels of pro-inflammatory mediators and cytokines, including cyclooxygenase-2, microsomal prostaglandin E synthase-2, tumor necrosis $factor-{\alpha}$, Interleukin $(IL)-1{\beta}$, and IL-6, and reduced expression of the proliferation marker, proliferating cell nuclear antigen, compared to observations of AOM/DSS animals. Although the microbial composition did not differ significantly between the groups, administration of vitamin C improved the level of inflammation-related Lactococcus and JQ084893 to control levels. CONCLUSION: Vitamin C treatment provided moderate suppression of inflammation, proliferation, and certain inflammation-related dysbiosis in a murine model of colitis associated-early colon cancer. These findings support that vitamin C supplementation can benefit colonic health. Long-term clinical studies with various doses of vitamin C are warranted.

Protaetia brevitarsis extract ameliorates the severity of DSS-Induced Ulcerative Colitis in vivo (굼벵이 추출물의 DSS유도 궤양성 대장염 조절효능 탐색)

  • Park, Bog-Im;Jeon, Yong-Deok;Sim, Hyeon-Jae;Lee, Hoon-Yeon;Kim, Seong-Oh;kim, Dong-Keun;Jo, Mi-Na;Cho, Yong-Jin;Kim, Chong-Tai;Kim, Tae-Eun;Jin, Jong-Sik
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2019.04a
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    • pp.122-122
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    • 2019
  • Protaetia brevitarsis (PB) extracts has been traditionally used as medicinal stuff to treat blood stasis, occlusion of menstruation, tetanus and liver cancer in Asian countries (Korea, Japan, China, Taiwan, India and Myanmar). Especially, Donguibogam, which is traditional korean medicinal book, described the PB extracts as traditional medicine to treat hepatic diseases and vascular disorders. The PB extracts has been considered as highly nutritional food. The major constituents of PB extracts are rich in protein, healthy fats, iron, calcium. Recent studies announced that PB extracts has hepatoprotective effect and anti-microbacterial effect. However, the effect of PB on ulcerative colitis has not been uncovered yet. The aim of this study was to examine the anti-inflammatory effect of PB extracts in dextran sulfate sodium (DSS)-induced colitis mice model. Cytotoxicity of PB was determined by MTT assay and the antiinflammatory effect of PB extract was investigated by measuring nitric oxide (NO) production. PB extracts did not show any cytotoxicity. AIso, PB extracts supressed NO production in LPS-stimulated mice peritoneal macrophages. To determine whether PB could be an effective treatment on ulcerative colitis, DSS was administered in BALB/c mice for 10 days. PB extract significantly improved the clinical signs of DSS-induced UC, including body weight loss, colon length shortening, and disease activity index increase, with histological markers of colon injury. These findings indicated the possibility of PB as a therapeutic agent on ulcerative colitis.

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Research Trend of Joint Mobilization Type on Shoulder : A scoping review (어깨관절 질환에 대한 관절가동술 유형의 연구 동향 : 주제범위 문헌고찰)

  • Jeong-Woo Lee;Nam-Gi Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.3
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    • pp.171-183
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    • 2023
  • Purpose : This study sought to investigate research trends regarding joint mobilization type among patients with shoulder joint diseases. Methods : A scoping review was conducted according to the five steps outlined by Arskey and O'Malley and PRISMA-ScR. We searched six domestic databases (ScienceOn, DBpia, Riss, Kmbase, Kiss, KCI) and three international databases (CINAHL, Pubmed, Cochrane central) between 2013 and June 2023. The keyword terms used were 'joint mobilization', 'Kaltenborn', 'Maitland', 'Mulligan', and 'shoulder joint'. Results : There were a total of 44 studies that investigated the topic, and these were divided into quantitative analysis and topic analysis. In terms of publication year, the number of studies within the last five years has increased more than compared to the previous five years, with most of them being randomized clinical trials. In shoulder joint diseases, it was found that the majority of joint movement studies focused on adhesive joint cystitis and shoulder collision syndrome. The Mulligan concept was the most commonly studied type of joint motion. The dependent variables used included pain, joint function (disability), and muscle function. The visual analog scale was the most commonly used for the pain variable, followed by the numeric rating scale. For joint function and disability variables, range of motion was the most commonly used, followed by shoulder pain and disability index, and disabilities of the arm, shoulder, and hand. For muscle function, variables such as muscle tone, strength, and activity were used. Conclusion : We believe that findings of this scoping review can serve as valuable mapping data for joint mobilization research on shoulder joint diseases. Further studies including systematic reviews and meta-analyses based on these results are recommended.

The Usefulness of Dyspnea Rating in Evaluation for Pulmonary Impairment/Disability in Patients with Chronic Pulmonary Disease (만성폐질환자의 폐기능손상 및 장애 평가에 있어서 호흡곤란정도의 유용성)

  • Park, Jae-Min;Lee, Jun-Gu;Kim, Young-Sam;Chang, Yoon-Soo;Ahn, Kang-Hyun;Cho, Hyun-Myung;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.204-214
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    • 1999
  • Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, $VO_2$max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of $VO_2$max(ml/kg/min) and $VO_2$max(%), the parameters of resting PFTs, except $FEV_1$ were not significantly different between non-severe and severe(p>0.05). According to focal score($FEV_1$(%), FVC(%), MW(%), $FEV_1/FVC$, and $VO_2$max were significantly lower in the severe group(p<0.01). However, in the more severe dyspneic group(focal score<5), only $VO_2$max(ml/kg/min) and $VO_2$max(%) were low(p<0.01). $FEV_1$(%) was correlated with $VO_2$max(%)(r=0.52;p<0.01), but not predictive of exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. Conclusion : According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than $VO_2$max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

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