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'Lumbar Degenerative Kyphosis' Is Not Byword for Degenerative Sagittal Imbalance : Time to Replace a Misconception

  • Lee, Chang-Hyun;Chung, Chun Kee;Jang, Jee-Soo;Kim, Sung-Min;Chin, Dong-Kyu;Lee, Jung-Kil;Korean Spinal Deformity Research Society
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.125-129
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    • 2017
  • Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name "primary degenerative sagittal imbalance" (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK.

Molecular Analysis of Alternative Transcripts of the Equine Cordon-Bleu WH2 Repeat Protein-Like 1 (COBLL1) Gene

  • Park, Jeong-Woong;Jang, Hyun-Jun;Shin, Sangsu;Cho, Hyun-Woo;Choi, Jae-Young;Kim, Nam-Young;Lee, Hak-Kyo;Do, Kyong-Tak;Song, Ki-Duk;Cho, Byung-Wook
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.6
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    • pp.870-875
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    • 2015
  • The purpose of this study was to investigate the alternative splicing in equine cordon-bleu WH2 repeat protein-like 1 (COBLL1) gene that was identified in horse muscle and blood leukocytes, and to predict functional consequences of alternative splicing by bioinformatics analysis. In a previous study, RNA-seq analysis predicted the presence of alternative spliced isoforms of equine COBLL1, namely COBLL1a as a long form and COBLL1b as a short form. In this study, we validated two isoforms of COBLL1 transcripts in horse tissues by the real-time polymerase chain reaction, and cloned them for Sanger sequencing. The sequencing results showed that the alternative splicing occurs at exon 9. Prediction of protein structure of these isoforms revealed three putative phosphorylation sites at the amino acid sequences encoded in exon 9, which is deleted in COBLL1b. In expression analysis, it was found that COBLL1b was expressed ubiquitously and equivalently in all the analyzed tissues, whereas COBLL1a showed strong expression in kidney, spinal cord and lung, moderate expression in heart and skeletal muscle, and low expression in thyroid and colon. In muscle, both COBLL1a and COBLL1b expression decreased after exercise. It is assumed that the regulation of COBLL1 expression may be important for regulating glucose level or switching of energy source, possibly through an insulin signaling pathway, in muscle after exercise. Further study is warranted to reveal the functional importance of COBLL1 on athletic performance in race horses.

Shoes from Pinet to the Present

  • June, Swann
    • Proceedings of the Korea Society of Costume Conference
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    • 2001.08a
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    • pp.11-13
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    • 2001
  • For those unfamiliar with the shoe world, Pinet (1817-1897) was a contemporary of Worth, the great Parisian couturier. So I look at the glamour shoes and the world of haute couture, and indeed the development of the named designer. That is a concept we are all familiar with now. So it is not easy to comprehend the lack of names for the exquisite work before 1850. Straightway I have to say that the number of noted shoe designers is far fewer than famous dress designers, but I will introduce you to some of them, against the background of contemporary shoe fashions. Franc;ois Pinet was born in the provinces (probably Touraine) in 1817, two years after the end of the Napoleonic Wars. His father, an ex-soldier, settled to shoemaking, a comparatively clean and quiet trade. It had a tradition of literacy, interest in politics, and was known as the gentle craft, which attracted intelligent people. We should presume father would be helped by the family. It was usual for a child to begin by the age of 5-6, tying knots, sweeping up, running errands and gradually learning the job. His mother died 1827, and father 1830 when he was 13, and at the time when exports of French shoes were flooding world markets. He went to live with a master shoemaker, was not well treated, and three years later set out on the tour-de- France. He worked with masters in Tours and Nantes, where he was received as Compagnon Cordonnier Bottier du Devoir as Tourangeau-Ia rose dAmour (a name to prove most appropriate). He went on to Bordeaux, where at 19 he became president of the local branch. In 1841 he went to Paris, and in 1848, revolution year, as delegate for his corporation, he managed to persuade them not to go on strike. By now the shoemakers either ran or worked for huge warehouses, and boots had replaced shoes as the main fashion. In 1855 Pinet at the age of 38 set up his own factory, as the first machines (for sewing just the uppers) were appearing. In 1863 he moved to new ateliers and shop at Rue ParadisPoissoniere 44, employing 120 people on the premises and 700 outworkers. The English Womans Domestic Magazine in 1867 records changes in the boots: the soles are now wider, so that it is no longer necessary to walk on the uppers. There is interest in eastern Europe, the Polonaise boots with rosette of cord and tassels and Bottines Hongroises withtwo rows of buttons, much ornamented. It comments on short dresses, and recommends that the chaussure should correspond to the rest of the toilet. This could already be seen in Pinets boots: tassels and superb flower embroidery on the higher bootleg, which he showed in the Paris Exposition that year. I think his more slender and elegant Pinet heel was also patented then or 1868. I found little evidence for colour-matching: an English fashion plate of 1860 shows emerald green boots with a violetcoloured dress.

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The Antiallodynic Effect and the Change of the α2 Adrenergic Receptor Subtype mRNA Expression by Morphine Administration in a Spinal Nerve Ligation Rat Model (백서의 척수신경결찰모델에서 Morphine의 투여가 항이질통 효과와 척수 α2 아드레날린계 수용체 아형 mRNA 발현에 미치는 영향)

  • Chung, Kyu Yeon;Shin, Sang Wook;Kwon, Su Ah;Kim, Tae Kyun;Baek, Seung Hoon;Baik, Seong Wan
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.21-27
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    • 2009
  • Background: The neuropathic pain arising from nerve injury is difficult to treat and the therapeutic effects of opioid drugs remain debatable. Agonists acting at the ${\alpha}_2$ adrenergic and opioid receptors have analgesic properties and they act synergistically when co-administered in the spinal cord. The lack of subtype-selective pharmacological agents has previously impeded the synergistic effects that are mediated by the adrenergic receptor subtypes. Methods: We created neuropathic pain model by ligating the L5 spinal nerve in Sprague-Dawley rats (n = 18). We divided the rats into three groups (n = 6 for each group), and we administered intraperitoneal morphine (1 mg/kg, 3 mg/kg, 5 mg/kg) and then we measured the mechanical allodynia with using von-Frey filaments for 8 hours. We then injected morphine (5 mg/kg) intraperitoneally, twice a day for 2 weeks. We measured the tactile and cold allodynia in the morphine group (n = 9) and the saline group (n = 9). After 2 weeks, we decapitated the rats and harvested the spinal cords at the level of lumbar enlargement. We compared the ${\alpha}_2$ subtype mRNA expression with that of control group (n = 6) by performing real time polymerase chain reaction (RTPCR). Results: Intraperitoneal morphine reduced the neuropathic pain behavior in the dose-dependent manner. Chronic morphine administration showed an antiallodynic effect on the neuropathic pain rat model. The rats did not display tolerance or hyperalgesia. The expression of the mRNAs of the ${\alpha}_{2A}$, ${\alpha}_{2B}$, ${\alpha}_{2C}$ subtypes decreased, and morphine attenuated this effect. But we could not get statistically proven results. Conclusions: Systemic administration of morphine can attenuate allodynia during both the short-term and long-term time course. Morphine has an influence on the expression of ${\alpha}_2$ receptor subtype mRNA. Yet we need more research to determine the precise effect of morphine on the ${\alpha}_2$ subtype gene expression.

A Basic Study on the Differential Diagnostic System of Laryngeal Diseases using Hierarchical Neural Networks (다단계 신경회로망을 이용한 후두질환 감별진단 시스템의 개발)

  • 전계록;김기련;권순복;예수영;이승진;왕수건
    • Journal of Biomedical Engineering Research
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    • v.23 no.3
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    • pp.197-205
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    • 2002
  • The objectives of this Paper is to implement a diagnostic classifier of differential laryngeal diseases from acoustic signals acquired in a noisy room. For this Purpose, the voice signals of the vowel /a/ were collected from Patients in a soundproof chamber and got mixed with noise. Then, the acoustic Parameters were analyzed, and hierarchical neural networks were applied to the data classification. The classifier had a structure of five-step hierarchical neural networks. The first neural network classified the group into normal and benign or malign laryngeal disease cases. The second network classified the group into normal or benign laryngeal disease cases The following network distinguished polyp. nodule. Palsy from the benign laryngeal cases. Glottic cancer cases were discriminated into T1, T2. T3, T4 by the fourth and fifth networks All the neural networks were based on multilayer perceptron model which classified non-linear Patterns effectively and learned by an error back-propagation algorithm. We chose some acoustic Parameters for classification by investigating the distribution of laryngeal diseases and Pilot classification results of those Parameters derived from MDVP. The classifier was tested by using the chosen parameters to find the optimum ones. Then the networks were improved by including such Pre-Processing steps as linear and z-score transformation. Results showed that 90% of T1, 100% of T2-4 were correctly distinguished. On the other hand. 88.23% of vocal Polyps, 100% of normal cases. vocal nodules. and vocal cord Paralysis were classified from the data collected in a noisy room.

Iron Intake During Pregnancy on Serum Concentrations of Trace Minerals in Mothers and Neonates (임신기간 중 철 섭취가 모체와 제대 혈청의 미량 무기질 농도에 미치는 영향)

  • Kim, Hye-Ra;Lim, Hyeon-Sook
    • Journal of Nutrition and Health
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    • v.41 no.3
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    • pp.242-253
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    • 2008
  • It is a common clinical practice to recommend taking iron supplements for pregnant women during gestation. Although it is required to ensure adequate iron stores during pregnancy, there has been some debate over the interference effects of excessive iron load, because it is possible to compete in the transport in the intestine and placenta and in binding to serum proteins of other trace minerals. In this study, maternal and neonatal serum concentrations of Fe, Zn, Cu, Se, Cr, Mn, and Co were assessed along with maternal Fe intakes. A total of 124 pregnant women and their term neonates participated voluntarily in this research. The women were divided into one of the three groups {high Fe intake (HFI), median Fe intake (MFI), and low Fe intake (LFI)} by their total Fe intakes and one of the two groups (Anemic and Normal) by their Fe nutritional status. All the data were compared among the three groups and between the two groups also. Total Fe intakes of HFI, MFI, and LFI groups were 140.8 ${\pm}$ 76.1, 68.0 ${\pm}$ 11.2, and 30.2 ${\pm}$ 8.6 mg/day, respectively. Those of Anemic and Normal groups were 90.1 ${\pm}$ 74.8 and 86.6 ${\pm}$ 46.8 mg/day, respectively. Maternal Hb concentration and Hct were not significantly different among HFI, MFI, and LFI groups but those were significantly different between Anemic and Normal groups. However, neonatal Hb concentration was not significantly different among HFI, MFI, and LFI groups and between Anemic and Normal groups either. Maternal serum Fe concentrations of the three groups, HFI, MFI, and LFI, were similar but that of Anemic group was significantly lower compared to Normal group. However, there was no significant difference in neonatal serum Fe concentrations among the three groups and between the two groups either. Serum concentrations of the other trace minerals in both mothers and neonates were not significantly different among HFI, MFI, and LFI groups and between Anemic and Normal groups. In addition, in the maternal serum, Fe concentration was positively correlated to Zn and Se concentration, respectively. As for the neonatal serum, Fe concentration showed a positive correlation to Zn, Cu, Mn, Se, and Co concentration, respectively. No trace mineral concentration was found to correlate negatively to Fe concentration in both maternal and neonatal serum, The results in this study indicate that Fe intakes of pregnant women, even if it is considerably above the level of estimated average requirement (EAR), may not affect serum Fe concentration in both mothers and neonates. In addition it might not influence adversely on the availability of other trace minerals including Zn and Cu in both mothers and neonates.

Pathogenesis and pathogenicity for the porcine circovirus 2 Korean isolates in weaned pigs (국내 분리 porcine circovirus 2의 이유자돈에 대한 병원성 시험연구)

  • Roh, In-Soon;Lee, Kyung-Woo;Kim, Jae-Hoon;Han, Jeong-Hee;Jean, Young-Hwa
    • Korean Journal of Veterinary Research
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    • v.47 no.2
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    • pp.175-185
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    • 2007
  • This study was carried out to investigate the pathogenesis and pathogenicity of the porcine circovirus type 2 (PCV2) Korean isolate from weaned pigs. Twenty four weaned pigs, PCV2, porcine reproductive and respiratory syndrome virus (PRRSV) and porcine parvovirus (PPV) antibodies free, were allocated to 4 groups (n = 6). Six pigs were inoculated intranasally with PCV2 alone, 6 with PCV2 and PRRSV, 6 with the combined PCV2/PRRSV/PPV inoculum, and 6 were remained as a uninoculated negative control. Pigs were killed 3 and 6 weeks after inoculation and tissue samples examined for gross and microscopic lesions and for the presence of PCV2 antigens and nucleic acids. Experimentally inoculated pigs were evaluated for 3 considerations: 1. development of postweaning multisystemic wasting syndrome (PMWS), 2. distribution of viral antigens by immunohistochemistry and polymerase chain reaction (PCR), and 3. cytokine mRNA levels in lymph nodes. Pigs inoculated with PCV2/PRRSV/PPV showed typical clinical signs, gross findings, and histopathologic characteristics of PMWS. In the PCV2/PRRSV/PPV inoculated group, the PCV2 antigen was widely distributed in various parenchymal organs such as brain, spinal cord, tonsil, lymph nodes, lung, heart, liver, kidney, spleen, and peyer's patch. Lymph node mRNA expression of IL-$1{\alpha}$, IL-2R and IL-8 was determined by real-time PCR. The pigs of PCV2/PRRSV and PCV2/PRRSV/PPV inoculation group, the mRNA expression was characterized by a decrease of IL-$1{\alpha}$, IL-2R and IL-8. The decrease of cytokine mRNA represent the state of T cell immuno-suppression in pig, and nicely support the evidence for the impairment of immune system in pigs with PMWS. In conclusion, PCV2 infection and some additional infectious causes such as PRRSV and/or PPV are warranted for the presence of PMWS in weaned pigs in Korea.

Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas (척추 경막외 출혈에 대한 수술적 치료성적 분석)

  • Cho, Young-Hyun;Park, Jin-Hoon;Kim, Ji-Hoon;Roh, Sung-Woo;Kim, Chang-Jin;Jeon, Sang-Ryong
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.163-169
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    • 2010
  • Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

The Effect of Therapy Oriented CT in Radiation Therapy Planning (치료 계획용 전산화 단층촬영이 방사선 치료계획에 미치는 효과)

  • Kim, Sung-Kyu;Shin, Sei-One;Kim, Myung-Se
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.149-155
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    • 1987
  • The success of radioation therapy depends on exact treatment of the tumor with significant high dose for maximizing local control and excluding the normal tissues for minimizing unwanted complications. To achieve these goals, correct estimation of target volume in three dimension, exact dose distribution in tumor and normal critical structures and correction of tissue inhomogeneity are required. The effect of therapy oriented CT (plannng CT) were compared with conventional simulation method in necessity of planning change, set dose, and proper distribution of tumor dose. Of 365 new patients examined, planning CT was performed in 104 patients $(28\%)$. Treatment planning was changed in $47\%$ of head and neck tumor, $79\%$ of intrathoracic tumor and $63\%$ of abdmonial tumor. in breast cancer and musculoskeletal tumors, planning CT was recommended for selection of adequate energy and calculation of exact dose to critical structures such as kidney or spinal cord. The average difference of tumor doses between CT planning and conventional simulation was $10\%$ in intrathoracic and intra-abdominal tumors but $20\%$ in head and neck tumors which suggested that tumor dose may be overestimated in conventional simulation Although some limitations and disadvantages including the cost and irradiation during CT are still criticizing, our study showed that CT Planning is very helpful in radiotherapy Planning.

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Phloroglucinol Inhibits the in vitro Differentiation Potential of CD34 Positive Cells into Endothelial Progenitor Cells

  • Kwon, Yi-Hong;Lee, Jun-Hee;Jung, Seok-Yun;Kim, Jae-Won;Lee, Sang-Hun;Lee, Dong-Hyung;Lee, Kyu-Sup;Lee, Boo-Yong;Kwon, Sang-Mo
    • Biomolecules & Therapeutics
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    • v.20 no.2
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    • pp.158-164
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    • 2012
  • Inhibiting the bioactivities of circulating endothelial progenitor cells (EPCs) results in significant inhibition of neovessel formation during tumor angiogenesis. To investigate the potential effect of phloroglucinol as an EPC inhibitor, we performed several in vitro functional assays using $CD34^+$ cells isolated from human umbilical cord blood (HUCB). Although a high treatment dose of phloroglucinol did not show any cell toxicity, it specifically induced the cell death of EPCs under serum free conditions through apoptosis. In the EPC colony-forming assay (EPC-CFA), we observed a significant decreased in the small EPC-CFUs for the phloroglucinol group, implying that phloroglucinol inhibited the early stage of EPC commitment. In addition, in the in vitro expansion assay using $CD34^+$ cells, treatment with phloroglucinol was shown to inhibit endothelial lineage commitment, as demonstrated by the decrease in endothelial surface markers of EPCs including $CD34^+$, $CD34^+/CD133^+$, $CD34^+/CD31^+$ and $CD34^+/CXCR4^+$. This is the first report to demonstrate that phloroglucinol can inhibit the functional bioactivities of EPCs, indicating that phloroglucinol may be used as an EPC inhibitor in the development of biosafe anti-tumor drugs that target tumor angiogenesis.