• 제목/요약/키워드: Disc Disease

검색결과 284건 처리시간 0.023초

A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy

  • Kang, Suk-Hyung;Seo Yang, Jin;Cho, Steve Sungwon;Cho, Yong-Jun;Jeon, Jin Pyeong;Choi, Hyuk Jai
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.806-813
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    • 2020
  • Objective : Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated. Methods : Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery. Results : Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months. Conclusion : RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.

Rotavirus VP6 유전자의 감자식물체내로의 도입과 형질전환체의 발현분석 (Introduction of VP6 Gene into Potato Plant by Agrobacterium-mediated Transformation and Analysis of VP6 Expression in Transgenic Potatoes)

  • 염정원;전재흥;정재열;이병찬;강원진;김미선;김철중;정혁;김현순
    • Journal of Plant Biotechnology
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    • 제29권2호
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    • pp.93-98
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    • 2002
  • 바이러스 설사병의 원인인 VP6유전자를 감자에 형질전환 시키기 위하여 CaMV 35S promoter와 kanamycin 항생제 내성을 갖는 식물발현벡터 pMBP-1에 subcloning하고, 이 재조합 벡터를 A. tumefaciens LBA4404에 도입시킨 후, freeze haw방법을 이용하여 감자에 형질전환 시켰다. 공동배양된 감자의 잎절편은 2,4-D가 2.0 mg/L첨가된 배지에서 2일간 배양 후, 0.01 mg/L NAA, 0.1 mg/L GA$_3$, 2.0 mg/L Zeatin, 100.0 mg/L kanamycin, 500.0 mg/L carbenicillin이 첨가된 선발배지에서 재분화시켰다. 이 때 유도된 신초는 100.0 mg/L의 kanamycin이 포함된 배지에 옮겨준 후, 왕성한 생육을 위해 MS 기본배지에서 다시 배양하였다. 기내배양시 외부유전자의 도입에 의한 외형적인 변화는 찾을 수 없었으며, 형질전환체는 NPT primer를 사용한 PCR방법으로 1차선별 하였다. DIG 표지된 probe를 이용하여 total RNA를 분석한 결과 개체별로 발현양의 차이는 있었으나, 95% 이상의 안정성을 보였고, genomic DNA를 추출해 Southern blot hybridization했을 경우 1~3개의 copy수를 보임으로써 형질전환 식물체에 외래유전자인 VP6유전자가 안정적으로 도입되었음이 확인되었다.

Occurrence and antibiotic susceptibility of fish bacteria isolated from Oreochromis niloticus (Nile tilapia) and Clarias gariepinus (African catfish) in Uganda

  • Wamala, S.P.;Mugimba, K.K.;Mutoloki, S.;Evensen, O.;Mdegela, R.;Byarugaba, D.K.;Sorum, H.
    • Fisheries and Aquatic Sciences
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    • 제21권2호
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    • pp.6.1-6.10
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    • 2018
  • The intention of this study was to identify the bacterial pathogens infecting Oreochromis niloticus (Nile tilapia) and Clarias gariepinus (African catfish), and to establish the antibiotic susceptibility of fish bacteria in Uganda. A total of 288 fish samples from 40 fish farms (ponds, cages, and tanks) and 8 wild water sites were aseptically collected and bacteria isolated from the head kidney, liver, brain and spleen. The isolates were identified by their morphological characteristics, conventional biochemical tests and Analytical Profile Index test kits. Antibiotic susceptibility of selected bacteria was determined by the Kirby-Bauer disc diffusion method. The following well-known fish pathogens were identified at a farm prevalence of; Aeromonas hydrophila (43.8%), Aeromonas sobria (20.8%), Edwardsiella tarda (8.3%), Flavobacterium spp. (4.2%) and Streptococcus spp. (6.3%). Other bacteria with varying significance as fish pathogens were also identified including Plesiomonas shigelloides (25.0%), Chryseobacterium indoligenes (12.5%), Pseudomonas fluorescens (10.4%), Pseudomonas aeruginosa (4.2%), Pseudomonas stutzeri (2.1%), Vibrio cholerae (10.4%), Proteus spp. (6.3%), Citrobacter spp. (4.2%), Klebsiella spp. (4.2%) Serratia marcescens (4.2%), Burkholderia cepacia (2.1%), Comamonas testosteroni (8.3%) and Ralstonia picketti (2.1%). Aeromonas spp., Edwardsiella tarda and Streptococcus spp. were commonly isolated from diseased fish. Aeromonas spp. (n = 82) and Plesiomonas shigelloides (n = 73) were evaluated for antibiotic susceptibility. All isolates tested were susceptible to at-least ten (10) of the fourteen antibiotics evaluated. High levels of resistance were however expressed by all isolates to penicillin, oxacillin and ampicillin. This observed resistance is most probably intrinsic to those bacteria, suggesting minimal levels of acquired antibiotic resistance in fish bacteria from the study area. To our knowledge, this is the first study to establish the occurrence of several bacteria species infecting fish; and to determine antibiotic susceptibility of fish bacteria in Uganda. The current study provides baseline information for future reference and fish disease management in the country.

한, 일 고려인삼 심포지움 (Studies on Selective Modulators and Anti-anorexigenic Agents in Korean Red Ginseng)

  • Hiromichi Okuda;Keizo Sekiya;Hiroshi Masuno;Takeshi Takaku;Kenji Kameda
    • Journal of Ginseng Research
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    • 제11권2호
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    • pp.145-252
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    • 1987
  • Isolated rat adipocytes are well known to possess opposite pathways of lipid metabolism: lipolysis and ipogenesis. Both of the metabolism respond to various biologically active substances such as epinephrine, ACTH and insulin. Epinephrine and ACTH stimulate lipolysis and insulin accelerates lipogenesis. Recently, Korean red ginseng powder was found to contain adenosine and an acidic poptide which inhibited epinephrine-induced lipolysis and sl imulated insulin-mediated lipogenesis from added glucose. The acidic peptide is consisted mainly of glutamic acid and glucose. Ginsenosides Rb1 and Re inhibited ACTH-induced lipolysis in isolated rat adipocytes, while they did not affect insulinstimulated lipogenesis, Thus, all these substances extracted from Korean red ginseng exhibited selective modulations toward the opposite metabolic pathways in rat adipocyte; They inhibited the lipolysis but not the lipogenesis. We call these substances"selective modulators". Recently, we isolated a toxic substance named "toxohormone-L " from ascites fluid of patients with various malignant tumors. The toxohormone-L stimulated lipolysis in rat adipocytes and induced anorexia in rats. Both the lipolytic and the anorexigenic actions of toxohormone-L were found to be inhibited by ginsenoside Rb2 in Korean red ginseng. Based on these results, physiological signifi¬cances of these substances in Korean red ginseng were discussed. Pan ax ginseng is a medicinal plant long used in treatment of various pathological states including general complaints such as head ache, shoulder ache, chilly constitution and anorexia in cancer patients, There have been many pharmacological studies on Panax ginseng roots. Petkovllreported that oral administration of an aqueous alcoholic extract of ginseng roots decreased the blood sugar levtl of rabbits. Saito2lreported that Panax ginseng suppressed hyperglycemia induced by epinephrine and high carbohydrate diets. These findings suggest that Panax ginseng roots contain insulin-like substances. Previously, we demonstrated that gin¬seng roots contain an insulin-like peptide which inhibits epinephrine-induced lipolysis and stimulated insulin-mediated lipogenesis. In 1984, we suggested that such an insulin-like substance should be called a selective modulator4). Present investigation describes the details of the selective modulators in ginseng roots. During progressive weight loss in patients with various neoplastic disease, depletion of fat stores have been observed. The depletion of body fat during growth of neoplasms is associated with increase in plasma free fatty acids. Recently, we found that the ascites fluid from patients with hepatoma or ovarian tumor and the pleural fluid from patients with malignant lymphoma elicited fatty acid release in slices of rat adipose tissue in vitro. The lipolytic factor, named"toxohormone-L". was purifed from the ascites fluid of patients with hepatoma. The isolated preparation gave a single band on both disc gel electrophoresis and sodium dodecyl sulfate(SDS)-acrylamide gel electrophoresis in the presence of ${\beta}$-mercaptoethanol. Its molecular weight was determined to be 70,000-75,000 and 65,000 by SDS-acrylamide gel electrophoresis and analytical ultracentrifugation, respectively. Injection of toxohormone-L into the lateral ventricle of rats significantly suppressed food and water intakes. There was at least 5 hr delay between its injection and appearance of its suppressive effect. In the present study, we also tried to find a inhibitory substance toward toxohormone-L from root powder of ginseng.

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요추추간판탈출증군과 단순요통군간의 Current Perception Threshold상의 차이에 관한 연구 (The study of difference between HIVD group and simple low back pain group by Current Perception Threshold test)

  • 김철홍;이병훈;권혜연;임춘우;서정철;윤현민;송춘호;장경전;안창범
    • Journal of Acupuncture Research
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    • 제18권6호
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    • pp.59-69
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    • 2001
  • Objective : The aim of this study is to assess the ability of the CPT test to dignosis radiculopathy in Korean with NeuvalTM CPT database. Method : Electrical stimulation(at 2000, 250, and 5Hz) using Neurometer was applied to the 19 patients who felt back and sciatic pain with herniated intervertevral disc(HIVD) of L-spine, dignosisd by lumbar CT or MRI, and the 33 patients who felt only back or hip or leg pain without HIVD, stenosis, spondylolisthesis which causing radiculopathy. The test sites were toe1, toe3 and toe5 related to L4, L5 and S1 nerve roots. Results : The mean values of the CPT of HIVD group was stiatically lower than LBP group at toe1-250Hz, toe3-2000Hz, 250Hz and toe5-250Hz, 5Hz. The grading CPT score of HIVD group was stastically higher than LBP group at the toe3(L5). The VAS of HIVD group was stastically higher than LBP group. Conclusion : These results suggest that the CPT test can be a valuable testing for diagnosing radiculopathy in Korean. In using CPT test further study is needed for the diagnosis and evaluation of sensory nerve dysfunction in the musculoskeletal disease.

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울릉도 자생식물인 섬괴불나무(Lonicera morrowii A.Gray) 잎 추출물의 생리활성 (Physiological activities of leaf extract of Lonicera morrowii A.Gray, a plant native to Ulleungdo)

  • 이은호;박혜진;홍은진;술타노브 아크마존;김병오;정희영;강인규;조영제
    • Journal of Applied Biological Chemistry
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    • 제63권4호
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    • pp.443-449
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    • 2020
  • 본 연구에서는 섬괴불나무 잎으로부터 phenol성 화합물의 생리활성 탐색을 통하여 기능성 소재로 활용 가능성을 살펴보았다. 인체에 무해한 용매인 열수와 ethanol로 추출 했을 때 열수는 3.53 mg/g, 40% ethanol은 2.82 mg/g의 TPC를 나타내었으며, 추출물을 이용하여 항산화 활성, xanthine oxidase (XOase), angiotensin converting enzyme (ACE), α-glucosidase 억제효과 및 항균 활성을 검정하였다. 그 결과 섬괴불나무 잎의 열수와 ethanol 추출물 50-200 ㎍/mL TPC에서 농도의존적으로 DPPH 유리라디칼 소거활성 및 PF가 증가하는 경향을 보였고, 50 ㎍/mL의 저농도에서도 모두 매우 높은 활성을 나타내었다. XOase 저해효과에서는 200 ㎍/mL TPC에서 열수와 ethanol 추출물이 각각 76.35, 99.83%의 높은 저해효과 나타냈으며, ACE 저해효과 또한 200 ㎍/mL TPC에서 열수와 ethanol 추출물 각각 79.06, 87.14%의 저해효과를 확인하였다. α-Glucosidase 저해효과를 측정한 결과 200 ㎍/mL TPC에서 열수와 ethanol 추출물 각각 80.45, 63.58%의 저해효과를 보였다. 생육저해환으로 항균활성을 측정 결과 열수 추출물 200 ㎍/100 μL TPC에서 H. pylori, P. acne균에 대해 각각 11.5, 18.5 mm의 clear zone을 형성 하였고, ethanol 추출물 200 ㎍/100 μL 농도에서는 P. acne균에 대해 10 mm의 clear zone을 형성하였다. 따라서 본 연구를 통하여 섬괴불나무 잎 추출물의 항산화 활성, xanthine oxidase (XOase), angiotensin converting enzyme (ACE), α-glucosidase 억제효과 및 항균 활성이 있다고 판단되었다.

A Prospective, Multi-Center, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of the Synthetic Bone Graft Material DBM Gel with rhBMP-2 versus DBM Gel Used during the TLIF Procedure in Patients with Lumbar Disc Disease

  • Hyun, Seung-Jae;Yoon, Seung Hwan;Kim, Joo Han;Oh, Jae Keun;Lee, Chang-Hyun;Shin, Jun Jae;Kang, Jiin;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • 제64권4호
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    • pp.562-574
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    • 2021
  • Objective : This study is to evaluate the efficacy and safety of demineralized bone matrix (DBM) gel versus DBM gel with recombinant human bone morphogenetic protein-2 (rhBMP-2) used in transforaminal lumbar interbody fusion (TLIF). Methods : This study was designed as a prospective, multi-center, double-blind method, randomized study. All randomized subjects underwent TLIF with DBM gel with rhBMP-2 group (40 patients) as an experimental group or DBM gel group (36 patients) as a control group. Post-operative observations were performed at 12, 24, and 48 weeks. The spinal fusion rate on computed tomography scans and X-rays films, Visual analog scale pain scores, Oswestry disability index and SF-36 quality of life (QOL) scores were used for the efficacy evaluation. The incidence rate of adverse device effects (ADEs) and serious adverse device effects (SADEs) were used for safety evaluation. Results : The spinal fusion rate at 12 weeks for the DBM gel with rhBMP-2 group was higher with 73.68% compared to 58.82% for the DBM gel group. The 24 and 48 weeks were 72.22% and 82.86% for the DBM gel with rhBMP-2 group and 78.79% and 78.13%, respectively, for the DBM gel group. However, there were no significant differences between two groups in the spinal fusion rate at 12, 24, and 48 weeks post-treatment (p=0.1817, p=0.5272, p=0.6247). There was no significant difference between the two groups in the incidence rate of ADEs (p=0.3836). For ADEs in the experimental group, 'Pyrexia' (5.00%) was the most common ADE, followed by 'Hypesthesia', 'Paresthesia', 'Transient peripheral paralysis', 'Spondylitis' and 'Insomnia' (2.50%, respectively). ADEs reported in control group included 'Pyrexia', 'Chest discomfort', 'Pain', 'Osteoarthritis', 'Nephropathy toxic', 'Neurogenic bladder', 'Liver function analyses' and 'Urticaria' (2.86%, respectively). There was no significant difference between the two groups in the incidence rate of SADEs (p=0.6594). For SADE in the experimental group, ''Pyrexia' and 'Spondylitis' were 2.50%. SADE reported in the control group included 'Chest discomfort', 'Osteoarthritis' and 'Neurogenic bladder'. All SADEs described above were resolved after medical treatment. Conclusion : This study demonstrated that the spinal fusion rates of DBM gel group and DBM gel with rhBMP-2 group were not significantly different. But, this study provides knowledge regarding the earlier postoperative effect of rhBMP-2 containing DBM gel and also supports the idea that the longer term follow-up results are essential to confirm the safety and effectiveness.

Full-Endoscopic versus Minimally Invasive Lumbar Interbody Fusion for Lumbar Degenerative Diseases : A Systematic Review and Meta-Analysis

  • Son, Seong;Yoo, Byung Rhae;Lee, Sang Gu;Kim, Woo Kyung;Jung, Jong Myung
    • Journal of Korean Neurosurgical Society
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    • 제65권4호
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    • pp.539-548
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    • 2022
  • Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

라이프케어를 위한 추간판성 통증 치료의 최신중재기법 기술적 윤리적 문제들에 관하여 (Recent Interventional Procedures for Spinal Discogenic Pain for Life Care : Technical and Ethical Issues)

  • 홍영기
    • 한국엔터테인먼트산업학회논문지
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    • 제13권4호
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    • pp.311-320
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    • 2019
  • 척추 추간판의 퇴화과정에서 발생하는 추간판성 통증은 근골격계의 난치성 질환이다. 이 질환은 현대 의학이 다루는 일반적 질환들과는 달리 객관적인 영상학적, 임상병리학적 지표로 확진되지 않는다. 그리고 현재의 기술로는 근본적인 치료법도 존재하지 않는다. 이 연구는 추간판성 통증치료를 위해 실시되는 신경차단술, 추간판 내열치료술, 수핵성형술 등 여러 중재시술법들의 치료적 근거가 타당성이 있는지, 그리고 각 기법들의 개발과정에서 전임상적 시험과 같은 안전성 검토가 충실히 이행되었는지를 문헌검토를 통해 분석하였다. 그 결과 치료적 근거가 객관적으로 검증된, 추간판성 통증의 중재시술 방법은 아직 없는 것으로 추정된다. 그리고 기술 개발과정에서 시술의 안전성에 대한 검토를 위해 필요한 전임상적 시험의 단계를 적절히 갖추지 않은 중재시술법의 사례들도 발견된다. 결론적으로, 아직까지 선명한 치료적 근거를 가진, 추간판성 통증에 대한 중재시술법은 없으므로, 임상에서 시술여부를 판단할 때는 보다 신중한 접근이 필요하다는 인식이 필요하며, 안전성에 대한 검토를 충실히 갖추지 않은 채 실시되어온 것으로 판단되는 일부 중재시술법들에 대해선 의료윤리적 문제가 제기될 수 있다.

단순 Fogarty 혈전색전 제거술의 효과 (The Effect of the Simple Fogarty Thromboembolectomy)

  • 오중환;박일환;이종국
    • Journal of Chest Surgery
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    • 제42권4호
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    • pp.480-486
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    • 2009
  • 배경: Fogarty 카테터는 원위부 동맥 색전을 제거하기 위하여 고안되었으며 1960년대 이래로 급성혈전색전의 치료에 획기적인 치료법이 되었다. 그러나 지난 30년동안 동맥폐쇄의 주원인이 심장에서 비롯하는 색전으로부터 죽상동맥경화증으로 변화하였으며 이런 맥락에서 단순 Fogarty 혈전색전제거술이 여전히 효과가 있는지 의문점이 생긴다. 대상 및 방법: 1990년 3월부터 2008년 8월까지 본원에서 Fogarty 혈전제거술을 시행한 156명을 대상으로 하였다. 환자를 혈전제거술만 시행한 79명(제 1 군)과 혈관우회수술을 같이 시행한 77명(제 2 군)으로 나누어 증상의 기간, 혈전의 원인, 응급실 내원 여부, 한방치료 및 오진경험, 동반질환, 주발생부위, 사망원인 등을 후향적으로 T 검증, 교차분석, 카이제곱 및 Kaplan-Meier을 이용하여 비교분석 비교하였다. 결과: 두군 모두 환자의 나이는 평균 64$\pm$10세로 비슷하였다. 제1군과 2군의 다리 통증 기간은 평균 12$\pm$4일 vs 71$\pm$14일(p=0.001), 응급실 내원한 경우는 50명(63%) vs 18명(23%) (p=0.005), 디스크로 오인하여 치료를 받거나 침을 맞은 경우가 20명(25%) vs 30명(39%), 내원전 항응고제 치료 받은 경우는 22명(28%) vs 11명(14%), 혈전원인은 심장질환 24명(30%) vs 6명(8%) (p=0.001), 동맥경화증 46예(58%) vs 67명(87%) (p=0.001), 외상 9명(11%) vs 6명(8%)이었다. 동반질환으로는 뇌졸증, 고혈압 당뇨가 주를 이루었으며(22$\sim$37%), 막힌 부위는 대부분 장골 및 대퇴동맥이었다 우회수술은 58명(75%)에서 대퇴-대퇴 및 대퇴-슬와동맥간 우회수술을 시행했다. 내막절제술은 각각 7명(9%) vs 18명(23%)에서 동반시술이 이루어졌다(p=0.012). 수술의 성공율은 27명(34%) vs 40명(52%) (p=0.019), 다시 막힌 경우는 37명(47%) vs 20명(26%) (p=0.000), 하지절단 4명(5%) vs 12명(16%) (p=0.012), 사망 10명(13%) vs 3명(4%) (p=0.044)으로 의의있는 차이를 보였다. 결론: 최근 급성동맥폐쇄증의 원인이 류마티스 심장질환에서 동맥경화성 질환으로 변화함으로서 단순한 Fogarty 혈전색전 제거술의 효과가 줄어들고 있어 이러한 단순 시술 대신에 부가적인 우회수술법이 고려되어야 할 것이다.