Objectives : The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. Methods : Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. Results : The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. Conclusion : Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.
Objective : This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods : A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with a femur allograft, and 51 patients (64 segments) were treated with a fibular allograft. The mean follow-up period was 16.0 (range, 12-25) months in the femur group and 19.5 (range, 14-39) months in the fibular group. Cage fracture and breakage, subsidence rate, fusion rate, segmental angle and height and disc height were assessed by using radiography. Clinical outcomes were assessed using a visual analog scale and neck disability index. Results : At 12 months postoperatively, cage fracture and breakage had occurred in 3.4% (2/58) and 7.4% (4/58) of the patients in the femur group, respectively, and 21.9% (14/64) and 31.3% (20/64) of the patients in the fibular group, respectively (p<0.05). Subsidence was noted in 43.1% (25/58) of the femur group and in 50.5% (32/64) of the fibular group. No difference in improvements in the clinical outcome between the two groups was observed. Conclusion : The femur allograft showed good results in subsidence and radiologic parameters, and sustained the original cage shape more effectively than the fibular allograft. The present study suggests that the femur allograft may be a good choice as a fusion substitute for the treatment of cervical DDD.
Park, Un-Chul;Cho, Myung-Soo;Park, Jung-Hyun;Kim, Sang-Jin;Ku, Seung-Yup;Choi, Young-Min;Moon, Shin-Yong;Yu, Hyeong-Gon
Clinical and Experimental Reproductive Medicine
/
제38권4호
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pp.216-221
/
2011
Objective: To differentiate the human embryonic stem cells (hESCs) into the retinal pigment epithelium (RPE) in the defined culture condition and determine its therapeutic potential for the treatment of retinal degenerative diseases. Methods: The embryoid bodies were formed from hESCs and attached on the matrigel coated culture dishes. The neural structures consisting neural precursors were selected and expanded to form rosette structures. The mechanically isolated neural rosettes were differentiated into pigmented cells in the media comprised of N2 and B27. Expression profiles of markers related to RPE development were analyzed by reverse transcription-polymerase chain reaction and immunostaining. Dissociated putative RPE cells ($10^5$ cells/5 ${\mu}L$) were transplanted into the subretinal space of rat retinal degeneration model induced by intravenous sodium iodate injection. Animals were sacrificed at 1, 2, and 4 weeks after transplantation, and immnohistochemistry study was performed to verify the survival of the transplanted cells. Results: The putative RPE cells derived from hESC showed characteristics of the human RPE cells morphologically and expressed molecular markers and associated with RPE fate. Grafted RPE cells were found to survive in the subretinal space up to 4 weeks after transplantation, and the expression of RPE markers was confirmed with immunohistochemistry. Conclusion: Transplanted RPE cells derived from hESC in the defined culture condition successfully survived and migrated within subretinal space of rat retinal degeneration model. These results support the feasibility of the hESC derived RPE cells for cell-based therapies for retinal degenerative disease.
Parkinson's disease is a degenerative disease of a cranial nerve and has a main symptoms of irregular movement of muscle, stiffening, trembling which occurred by about 1% of population in the age of over 65. Moreover, the and prevalence rate and attack rate are soaring according to increase of elderly population. However, allopathy and surgery were done through dopamine and anticholinergic medicine for treatment but it developed a lot of complications due to medicine and progress since it makes slow progress or can't stop the treatment. Hereupon, I report that there is a case on one of the patients Young Jin Oriental Medical Clinic. The patient who is in state of treatment termination who doesn't need any further remedy and no worsening of symptoms after conduction of therapies of dialectic and 5 upright life cure regulations. 5 upright life cure regulations means five practive way for improvement of nature healing power. Upon undertaking the 5 upright life cure regulations, there were found significant results in such tests as Unified Parkinson Disease Rating Scale (UPDRS), Hoehn & Yahr Staging Scale, and Activity of Daily Living (ADL), and the ingestion of Benztropine 1mg and Requip 0.25mg was decreased from 3 times to 0 times. The study offers objective clinical data on Oriental Medicine treatment for Parkinson's disease which is one of representative neuro-degenerative diseases and thus broadens the application range of Oriental Medical treatment and presents the fundamental data on the clinical research on Parkinson's disease by adopting evidence-based medicine (EBM).
Crataegii Fructus is commonly used as a improving digestion, removing retention of food, promoting blood circulation and resolving blood stasis agent in East Asia. Cadmium (Cd) is widely distributed in the environment due to its use in industry. An exposure to Cd causes dysuria, polyuria, chest pain, hepatic and renal tubular diseases. The liver is the most important target organ when considering Cd-induced toxicity because Cd primarily accumulates in the liver. This study investigated the protective effect of Crataegii Fructus water extract against cadmium ($CdCl_2$, Cd)-induced liver toxicity in H4IIE cells, a rat hepatocyte-derived cell line and in rats. Cell viability was significantly reduced in Cd-treated H4IIE cells in a time and concentration-dependent manner. However, Crataegii Fructus water extract (CFE) protected the cells from Cd-induced cytotoxicity via inhibition of PARP cleavage. To induce acute toxicity in rats, Cd (4 mg/kg body weight) was dissolved in normal saline and intravenously injected into rats. The rats then received either a vehicle or silymarin (as a positive control) or CFE (50, 100 mg/kg/day) for 3 days, and were subsequently exposed to a single injection of Cd. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were significantly increased by Cd treatment. In contrast, pretreatment with CFE reduced ALT, AST and LDH. In histopathological analysis, CFE reduced the hepatic degenerative regions and the number of degenerative hepatocytes. These are considered as direct evidences that Crataegii Fructus has favorable inhibitory effects on the Cd-intoxicated liver damages. The efficacy of Crataegii Fructus shows slight lower than that of silymarin in the present study.
In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.
Tenti, Sara;Fioravanti, Antonella;Guidelli, Giacomo Maria;Pascarelli, Nicola Antonio;Cheleschi, Sara
셀메드
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제4권1호
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pp.3.1-3.8
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2014
Spa represents a treatment widely used in many rheumatic diseases (RD). The mechanisms by which immersion in mineral or thermal water ameliorates RD are not fully understood. The net benefit is probably the result of a combination of factors, among which the mechanical, thermal and chemical effects are most prominent. Buoyancy, immersion, resistance and temperature play important roles. According to the gate theory, pain relief may be due to the pressure and temperature of the water on skin; heat may reduce muscle spasm and increase the pain threshold. Mud-bath therapy increases plasma ${\beta}$-endorphin levels and secretion of corticotrophin, cortisol, growth hormone and prolactin. It has recently been demonstrated that thermal mud-bath therapy induces a reduction in circulating levels of prostaglandin E2, leukotriene B4, interleukin-$1{\beta}$ and tumour necrosis factor-${\alpha}$, important mediators of inflammation and pain. Furthermore, balneotherapy has been found to cause an increase in insulin-like growth factor-1, which stimulates cartilage metabolism, and transforming growth factor-${\beta}$. Beneficial anti-inflammatory and anti-degenerative effects of mineral water were confirmed in chondrocytes cultures, too. Various studies in vitro and in humans have highlighted the positive action of mud-packs and thermal baths, especially sulphurous ones, on the oxidant/antioxidant system. Overall, thermal stress has an immunosuppressive effect. Many other non-specific factors may also contribute to the beneficial effects observed after spa therapy in some RD, including effects on cardiovascular risk factors (e.g. adipokines) and changes in the environment, pleasant surroundings and the absence of work duties.
As the average life span have been lengthened and the rate of senile population have been raised, chronic degenerative diseases incident to aging has been increased rapidly and become a social problem. With this social background, recently, the facts that oxygen radicals(OR) have toxic effects on Central Nervous System and Peripheral Nervous System and cause neuropathy such as Parkinson's Disease, Alzheimer Disease have been turned out, and accordingly lots of studies on the mechanism of the toxic effects of OR on nerves, the diseases caused by OR and the approaches to curing the diseases have been made. The purpose of this study is to examine the toxic effects caused by Glucose Oxidase(GO) and the effects of herbal extracts such as Chilbokyeum(CBY), Chilbokyeumga Acori Rhizoma(CAR), Acori Rhizoma(AR) on the treatment of the toxic effects. For this purpose, experiments with the cultured cell from the cerebrums of new born mice were done. The results of these experiments were as follows. 1. GO, a oxygen radical, decreased the survival rate of the cultured cells on NR assay, MTT assay and amount of neurofilaments and increased the amount of total protein, lipid peroxidation and the amount of LDH. 2. CBY have efficacy of increasing the amount of neurofilaments and total protein and decreasing lipid peroxidation and the amount of LDH. 3. CAR have efficacy of increasing the amount of neurofilaments and total protein and decreasing lipid peroxidation and the amount of LDH. 4. AR have efficacy of increasing the amount of neurofilaments and total protein. From the above results, It is concluded that Chilbokyeumgamibang has marked efficacy as a treatment for the damages caused in the GO-mediated oxidative process. And Chilbokyeumgamibang is thought to have certain pharmacological effects on controlling over aging and treating Dementia. Further clinical study of this pharmacological effects of Chilbokyeumgamibang should be complemented.
As the elderly population has increased in recent years in Korea chronic degenerative diseases prevalent in the aged have garnered attention in relation to food behavior. In general, dietary intakes of elderly Koreans were inadequate in quality as well as in quantity. Especially, intakes of Ca, vitamin A, and riboflavin along with total energy were insufficient. They tended to consume high carbohydrate and low fat energy rates which may be resulted from long standing vegetable-based flood patterns. Relationships between dietary intakes and indices of cardiovascular diseases revealed that blood pressures and serum lipids patterns tended to be poor in individuals having high abdominal fat accumulations which seemed to be related with dietary consumption of high carbohydrate and insufficient intake of many nutrients. These results suggested that a nutritionally balanced diet including animal sources floods is needed in order to prevent an abdominal obesity and cardiovascular diseases. The bone health status of the Korean elderly appeared poor. It was more serious in women recording a higher prevalence rate of osteopenia and osteoporosis than in men. There were strong associations between dietary factors and bone health status. Bone mineral density was found to be higher with higher intakes of protein energy rate, the total amount of feeds, and many nutrients including Ca and p, indicating that a good quality diet is essential in maintaining healthy bone status in later life. mental health condition of the elderly as measured by cognitive function and the degree of depression was also inadequate and had strong association with dietary consumption. The positive results were obtained in individuals having an adequate dict. Therefore, it could be summarized that the physical as well as mental health in elderly Koreans are highly related with their dietary patterns. Thus, the older adults need te consume nutritionally well balanced diet in sufficient amount, which contains various flood items including significant amounts of animal source floods in a daily diet in order to maintain healthy condition.
Selenium is a strong antioxidant trace mineral, scavenging free radicals. The prevalence of chronic degenerative diseases is increasing in Korean adults with increasing age. The increased cell damage from free radicals has been implicated in the etiology of these diseases, and evidence is accumulating that the low selenium status that comes with advanced aged is involved in the prevalence of age-associated diseases. However, little is known about the selenium status of Koreans, its age-related change and its relationship to dietary nutrient intake. In this study, the serum selenium levels of healthy adult females according to life cycle and its association with blood albumin levels and nutrient intake were examined. Serum selenium level was measured with the Huwo research reactor using the neutron activation analysis method (NAA). The overall proportion of women with selenium deficiency, serum selenium concentrations below 7.0 $\mu\textrm{g}$/dl, was 9.4%. The average serum selenium levels were 12.39 $\mu\textrm{g}$/dl, 9.45 $\mu\textrm{g}$/dl and 9.16 $\mu\textrm{g}$/dl in the young adult, middle-aged and elderly groups, respectively, showing a reduction of selenium status with advancing age. Selenium deficiency was seen only in the elderly group. Generally, serum selenium levels positively or negatively correlated with nutrient intake, but these association patterns differed depending on the age. The nutrients that showed positive correlations with selenium levels were proteins and phosphate in the young adult group (p < 0.05, p < 0.05), and total calcium, potassium and vegetable-origin calcium in the middle-aged group. Vitamin C and fiber were the negative correlated nutrients with serum selenium levels in the elderly group (p < 0.05, p < 0.05). Multiple stepwise regression analysis of the determining factors responsible for selenium status showed that age and serum albumin levels were important factors which explained up to 26.9% variances in serum selenium levels. The average selenium concentrations of Korean adult female subjects were above the deficiency levels in all three age groups. There was a tendency toward decreasing selenium levels as the age of the subjects increased. The factors with the strongest in-fluence on selenium status in healthy adult Korean females were age and serum protein status. (Korean J Nutrition 36(5): 491~499, 2003)
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