• Title/Summary/Keyword: Local circulation

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Photoimmunology -Past, Present and Future-

  • Daynes, Raymond A.;Chung, Hun-Taeg;Roberts, Lee K.
    • The Journal of the Korean Society for Microbiology
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    • v.21 no.3
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    • pp.311-329
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    • 1986
  • The experimental exposure of animals to sources of ultraviolet radiation (UVR) which emit their energy primarily in the UVB region (280-320nm) is known to result in a number of well-described changes in the recipient's immune competence. Two such changes include a depressed capacity to effectively respond immunologically to transplants of syngeneic UVR tumors and a markedly reduced responsiveness to known inducers of delayedtype (DTH) and contact hypersensitivity (CH) reactions. The results of experiments that were designed to elucidate the mechanisms responsible for UVR-induced immunomodulation have implicated: 1) an altered pattern of lymphocyte recirculation, 2) suppressor T cells(Ts), 3) deviations in systemic antigen presenting cell (APC) potential. 4) changes in the production of interleukin-1-like molecules, and 5) the functional inactivation of epidermal Langerhans cells in this process. The exposure of skin to UVR, therefore, causes a number of both local and systemic alterations to the normal host immune system. In spite of this seeming complexity and diversity of responses, our recent studies have established that each of the UVR-mediated changes is probably of equal importance to creating the UVR-induced immunocompromised state. Normal animals were exposed to low dose UVR radiation on their dorsal surfaces under conditions where a $3.0\;cm^2$ area of skin was physically protected from the light energy. Contact sensitization of these animals with DNFB, to either the irradiated or protected back skin, resulted in markedly reduced CH responses. This was observed in spite of a normal responsiveness following the skin sensitization to ventral surfaces of the UVR-exposed animals. Systemic treatment of the low dose UVR recipients with the drug indomethacin (1-3 micrograms/day) during the UVR exposures resulted in a complete reversal of the depressions observed following DNFB sensitization to "protected" dorsal skin while the altered responsiveness found in the group exposed to the skin reactive chemical through directly UVR-exposed sites was maintained. These studies implicate the importance of EC as effective APC in the skin and also suggest that some of the systemic influences caused by UVR exposure involve the production of prostaglandins. This concept was further supported by finding that indomethacin treatment was also capable of totally reversing the systemic depressions in CH responsiveness caused by high dose UVR exposure (30K joules/$m^2$) of mice. Attempts to analyze the cellular mechanisms responsible established that the spleens of all animals which demonstrated altered CH responses, regardless of whether sensitization was through a normal or an irradiated skin site, contained suppressor cells. Interestingly, we also found normal levels of T effector cells in the peripheral lymph nodes of the UVR-exposed mice that were contact sensitized through normal skin. No effector cells were found when skin sensitization took place through irradiated skin sites. In spite of such an apparent paradox, insight into the probable mechanisms responsible for these observations was provided by establishing that UVR exposure of skin results in a striking and dose-dependent blockade of the efferent lymphatic vessels in all peripheral lymph nodes. Therefore, the afferent phases of immune responses can apparently take place normally in UVR exposed animals when antigen is applied to normal skin. The final effector responses, however, appear to be inhibited in the UVR-exposed animals by an apparent block of effector cell mobility. This contrasts with findings in the normal animals. Following contact sensitization, normal animals were also found to simultaneously contain both antigen specific suppressor T cells and lymph node effector cells. However, these normal animals were fully capable of mobilizing their effector cells into the systemic circulation, thereby allowing a localization of these cells to peripheral sites of antigen challenge. Our results suggest that UVR is probably not a significant inducer of suppressor T-cell activity to topically applied antigens. Rather, UVR exposure appears to modify the normal relationship which exists between effector and regulatory immune responses in vivo. It does so by either causing a direct reduction in the skin's APC function, a situation which results in an absence of effector cell generation to antigens applied to UVR-exposed skin sites, inhibiting the capacity of effector cells to gain access to skin sites of antigen challenge or by sequestering the lymphocytes with effector cell potential into the draining peripheral lymph nodes. Each of these situations result in a similar effect on the UVR-exposed host, that being a reduced capacity to elicit a CH response. We hypothesize that altered DTH responses, altered alloresponses, and altered graft-versus-host responses, all of which have been observed in UVR exposed animals, may result from similar mechanisms.

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Dispersion of Air Pollutants from Ship Based Sources in Incheon Port (인천항의 선박오염원에서 배출된 대기오염물질의 확산)

  • Kim, Kwang-Ho;Kwon, Byung Hyuk;Kim, Min-Seong;Lee, Don-Chool
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.23 no.5
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    • pp.488-496
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    • 2017
  • Emissions of pollutants from ship-based sources are controlled by the International Maritime Organization (IMO). Since pollutants emitted from ship may be dispersed to the land, controlling emissions from ships is necessary for efficient air quality management in Incheon, where exposure to ship-based pollution is frequent. It has been noted that the ratios of air pollutant emissions from coastal areas to inland areas are about 14% for NOx and 10% for SOx. The air quality of coastal urban areas is influenced by the number of ships present and the dispersion pattern of the pollutants released depending on the local circulation system. In this study, the dispersion of pollutants from ship-based sources was analyzed using the numerical California Puff Model (CALPUFF) based on a meteorological field established using the Weather Research and Forecasting Model (WRF). Air pollutant dispersion modeling around coastal urban regions such as Incheon should consider point and line sources emitted from both anchored and running ships, respectively. The total average NOx emissions from 82-84 ships were 6.2 g/s and 6.8 g/s, entering and leaving, respectively. The total average SOx emissions from 82-84 ships, entering and leaving, were 3.6 g/s and 5.1 g/s, respectively. The total average emissions for NOx and SOx from anchored ships were 0.77 g/s and 1.93 g/s, respectively. Due to the influence of breezes from over land, the transport of pollutants from Incheon Port to inland areas was suppressed, and the concentration of NOx and SOx inland were temporarily reduced. NOx and SOx were diffused inland by the sea breeze, and the concentration of NOx and SOx gradually increased inland. The concentration of pollutants in the area adjacent to Incheon Port was more influenced by anchored ship in the port than sea breezes. We expect this study to be useful for setting emission standards and devising air quality policies in coastal urban regions.

The Effect of Hyperthermia Combined with Radiation on Crypts of the Mouse Jejunum (마우스공장 소낭선의 방사선 효과에 온열요법의 병용이 미치는 영향에 관한 실험적 연구)

  • Bae, Hoon-Sik;Park, Charn-Il;Kim, Jung-Jin
    • Radiation Oncology Journal
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    • v.5 no.1
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    • pp.13-21
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    • 1987
  • The effect of local hyperthermia of 41 to $43^{\circ}C$ for 30 minutes on radiosensitivity of normal tissue was studied utilizing jejunal crypt microcolony assay. Hyperthermia of this range enhanced the radiation effect and the effect was mainly additive without significant effect on the slopes of cell survival curves. At the isoeffect level of 20 microcolony formation, the thermal enhancement ratio was 1.02, 1.10 and 1.39 for $41^{\circ},\;42^{\circ}\;and\;43^{\circ}C$, respectively. The distribution of microcolony formation along the circumference of jejunum was not uniform, having more colonies around the mesenteric border, and this suggests the effect of uneven cooling by blood circulation.

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The Effect of 6 Weeks of Treatment with Inhaled Budesonide on Bronchial Hyperresponsiveness and Adrenal Function in Asthmatic Patients (흡입용 스테로이드인 Budesonide 6주 치료가 기관지 천식환자의 기관지 과민반응과 부신피질기능에 미치는 영향)

  • Kim, Kwan-Hyoung;Oh, Yong-Seok;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.219-227
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    • 1992
  • Background: Acute and chronic airway inflammation are important in the pathogenesis of bronchial asthma. Corticosteroids have proved to be very effective in the management of asthma. Although the mechanism by which they produce this effect is still debated, suppression of the inflammatory response is thought to be the most likely. Although inhaled steroids are known to be safe and have less side effects than oral steroids, the extent which inhaled steroids have beneficial and the detrimental effects in the treatment of asthma has remained open to question. Budesonide is a recently developed corticosteroid for inhalation treatment with a strong local effect combined with rapid inactivation in the systemic circulation. We set out to look in more detail at the time course of change in bronchial reactivity, clinical symptoms and the effects on the adrenal function during 6 weeks of treatment with budesonide (800 ug per day). Methods: Clinical symptoms, pulmonary function test, histamine $PC_{20}$, serum ACTH and cortisol (8 AM and 4 PM) were measured in 23 allergic asthmatic patients before and after 6 weeks of treatment with budesonide. Results: 1) Pulmonary function test; PEFR, FEV1 and FVC after 6 weeks of treatment with budesonide were higher than those before treatment. 2) Clinical symptoms; Clinical symptoms were significantly improved after 3 weeks and 6 weeks of treatment with budesonide. 3) Histamine provocation; Histamine $PC_{20}$ after 6 weeks of treatment with budesonide was significantly higher than that before treatment. 4) Adrenal function; 6 weeks of budesonide therapy did not significantly affect the level of serum ACTH and cortisol. Conclusion: From these results, it is concluded that budesonide therapy improved the clinical symptoms, pulmonary function and bronchial hyperreactivity after 3 weeks of treatment and the improvement after 6 weeks of treatment was higher than that after 3 weeks of treatment. During 6 weeks of treatment with budesonide, the inhibitory effect on the adrenal function was not obvious.

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Korean Ocean Forecasting System: Present and Future (한국의 해양예측, 오늘과 내일)

  • Kim, Young Ho;Choi, Byoung-Ju;Lee, Jun-Soo;Byun, Do-Seong;Kang, Kiryong;Kim, Young-Gyu;Cho, Yang-Ki
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.18 no.2
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    • pp.89-103
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    • 2013
  • National demands for the ocean forecasting system have been increased to support economic activity and national safety including search and rescue, maritime defense, fisheries, port management, leisure activities and marine transportation. Further, the ocean forecasting has been regarded as one of the key components to improve the weather and climate forecasting. Due to the national demands as well as improvement of the technology, the ocean forecasting systems have been established among advanced countries since late 1990. Global Ocean Data Assimilation Experiment (GODAE) significantly contributed to the achievement and world-wide spreading of ocean forecasting systems. Four stages of GODAE were summarized. Goal, vision, development history and research on ocean forecasting system of the advanced countries such as USA, France, UK, Italy, Norway, Australia, Japan, China, who operationally use the systems, were examined and compared. Strategies of the successfully established ocean forecasting systems can be summarized as follows: First, concentration of the national ability is required to establish successful operational ocean forecasting system. Second, newly developed technologies were shared with other countries and they achieved mutual and cooperative development through the international program. Third, each participating organization has devoted to its own task according to its role. In Korean society, demands on the ocean forecasting system have been also extended. Present status on development of the ocean forecasting system and long-term plan of KMA (Korea Meteorological Administration), KHOA (Korea Hydrographic and Oceanographic Administration), NFRDI (National Fisheries Research & Development Institute), ADD (Agency for Defense Development) were surveyed. From the history of the pre-established systems in other countries, the cooperation among the relevant Korean organizations is essential to establish the accurate and successful ocean forecasting system, and they can form a consortium. Through the cooperation, we can (1) set up high-quality ocean forecasting models and systems, (2) efficiently invest and distribute financial resources without duplicate investment, (3) overcome lack of manpower for the development. At present stage, it is strongly requested to concentrate national resources on developing a large-scale operational Korea Ocean Forecasting System which can produce open boundary and initial conditions for local ocean and climate forecasting models. Once the system is established, each organization can modify the system for its own specialized purpose. In addition, we can contribute to the international ocean prediction community.

Objectives and Contents of Basic Medical Sciences in Nursing Education (간호학 교육에서 기초의과학 교과목별 목표와 내용에 대한 연구)

  • 최명애;신기수
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1455-1468
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    • 1999
  • The purpose of this study was to investigate the objectives and contents of basic medical sciences at department of nursing in college of nursing, and junior college of nursing, thus ultimately providing the basic data to standardize the curriculum of the basic medical sciences in nursing education. Seventy eight professors who were in charge of teaching basic medical sciences to at 22 colleges of nursing/ department of nursing, and 20 junior colleges of nursing responded to the questionnaires that consisted of the questions regarding objectives and contents, of basic medical sciences. Based on the description of objectives, the description related to nursing, nurse, nursing science was cathegorized as on objective applicable to nursing science, the description related to medicine or clinical medicine as medical model, the description without description related to medicine was cathegorized as knowledge acquisition. The number of schools corresponding to each category were summerized in descending order. The objectives of basic medical sciences were categorized by concepts and number of schools corresponding to the categorized concept. The findings of the study are as follows ; 1. The subjects of basic medical science identified were physiology, anatomy, biochemistry, pathology, microbiology, and pharmacology in most colleges of nursing and junior colleges. Two colleges of nursing/department of nursing (9.1%) and 19 junior colleges of nursing(95%) did not offer biochemistry, 1 college of nursing /department of nursing(5%) did not offer pathology & pharmacology. 2 junior colleges of nursing (10%) did not offer pharmacology, 1 junior college of nursing(5%) did not offer pathology. The other 1 junior college of nursing did not offer microbiology. 2. Objectives of physiology were to acquire knowledge and understanding on human function in both 6 (50%) colleges and 5 junior colleges. Objectives of anatomy were to acquire knowledge on human structure in both 4 (57%) colleges and 2 (50%) junior colleges; knowledge applicable to nursing sciences in both 3 (42.8%) colleges and 2 (50%) junior colleges. Objectives of biochemistry was to obtain knowledge and understanding on biochemistry, and understanding of basic concepts about biochemistry. Objectives of pathology were to obtain knowledge and understanding on pathology in both 4 (57.1%) colleges and 5(62.5%) junior colleges. Objectives of microbiology were to acquire knowledge and understanding on microbiology in both 5(83.8%) colleges and 6(85.7%) junior colleges. Objectives of pharmacology were to acquire knowledge on pharmacology in both 7(100%) colleges and 8(100%) junior colleges. 3. Contents of physiology in 19 (100%) schools were membrane transport, digestion, circulation, nervous system and respiration. In 16(84.2%) were kidney and muscle, that in 13(68.4%) were endocrine physiology. In 11(57.9%) were introduction and that in 9(47.4%) were structure and function of cells. Contents of anatomy in 11(100%) schools were skeletal system, muscle system, digestive system, circulatory system, concepts regarding human structure. In 10(90.9%) schools were endocrine system and nervous system, and in 5(45.5%) schools were blood, urinary system and cell. Contents of biochemistry in 6(100%) schools were history of biochemistry, body regulating factor, bioenergy, health and nutrition, nutrition of cell, energy production system. In 5(83.3%) schools were metabolism of protein and carbohydrate and enzyme, and in 3(50%) schools were metabolism of energy and fat. Contents of microbiology in 13(100%) schools were environment and influenc of bacteria, virus, G(-) rods, purulent cocci, G(+) rods. In 10 (76.9%) were immunity, diphtheria, enterobacteria, and in 9(69.2%) were spirochete, rickettsia and clamydia, and that in 6(46.2%) were sterilization and disinfection. Contents of pathology in 14(100%) schools were cell injury and adaptation, inflammation, respiratory diseases, circulatory diseases. In 10(71.4%) were neurological disorders, in 8(57.1%) were immunity and disease, and in 7 (50%) were tumor and progressive changes. Contents of pharmacology in 15(100%) were cardivascular drugs, introduction to pharmacology, hypnotics, analgesics, local anesthetics, an ticonvulsants. In 12(80%) were drugs activity on sympathetic and parasympathetic nervous system, and in 11(73%) were sulfa drugs, antibiotics, drug abuse and addiction.

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Hydrogeochemical and Environmental Isotope Study of Groundwaters in the Pungki Area (풍기 지역 지하수의 수리지구화학 및 환경동위원소 특성 연구)

  • 윤성택;채기탁;고용권;김상렬;최병영;이병호;김성용
    • Journal of the Korean Society of Groundwater Environment
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    • v.5 no.4
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    • pp.177-191
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    • 1998
  • For various kinds of waters including surface water, shallow groundwater (<70 m deep) and deep groundwater (500∼810 m deep) from the Pungki area, an integrated study based on hydrochemical, multivariate statistical, thermodynamic, environmental isotopic (tritium, oxygen-hydrogen, carbon and sulfur), and mass-balance approaches was attempted to elucidate the hydrogeochemical and hydrologic characteristics of the groundwater system in the gneiss area. Shallow groundwaters are typified as the 'Ca-HCO$_3$'type with higher concentrations of Ca, Mg, SO$_4$and NO$_3$, whereas deep groundwaters are the 'Na-HCO$_3$'type with elevated concentrations of Na, Ba, Li, H$_2$S, F and Cl and are supersaturated with respect to calcite. The waters in the area are largely classified into two groups: 1) surface waters and most of shallow groundwaters, and 2) deep groundwaters and one sample of shallow groundwater. Seasonal compositional variations are recognized for the former. Multivariate statistical analysis indicates that three factors may explain about 86% of the compositional variations observed in deep groundwaters. These are: 1) plagioclase dissolution and calcite precipitation, 2) sulfate reduction, and 3) acid hydrolysis of hydroxyl-bearing minerals(mainly mica). By combining with results of thermodynamic calculation, four appropriate models of water/ rock interaction, each showing the dissolution of plagioclase, kaolinite and micas and the precipitation of calcite, illite, laumontite, chlorite and smectite, are proposed by mass balance modelling in order to explain the water quality of deep groundwaters. Oxygen-hydrogen isotope data indicate that deep groundwaters were originated from a local meteoric water recharged from distant, topograpically high mountainous region and underwent larger degrees of water/rock interaction during the regional deep circulation, whereas the shallow groundwaters were recharged from nearby, topograpically low region. Tritium data show that the recharge time was the pre-thermonuclear age for deep groundwaters (<0.2 TU) but the post-thermonuclear age for shallow groundwaters (5.66∼7.79 TU). The $\delta$$\^$34/S values of dissolved sulfate indicate that high amounts of dissolved H$_2$S (up to 3.9 mg/1), a characteristic of deep groundwaters in this area, might be derived from the reduction of sulfate. The $\delta$$\^$13/C values of dissolved carbonates are controlled by not only the dissolution of carbonate minerals by dissolved soil CO$_2$(for shallow groundwaters) but also the reprecipitation of calcite (for deep groundwaters). An integrated model of the origin, flow and chemical evolution for the groundwaters in this area is proposed in this study.

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Difference in the practice of COVID-19 prevention according to the reliability of COVID-19 response among high school students in Korea (일부 고등학생들의 학교와 학원 코로나19 대응방역 신뢰도에 따른 코로나19 예방행동 실천의 차이)

  • Lee, Hocheol;Yoon, Hyejin;Kim, Ji Eon;Nam, Eun Woo
    • Journal of agricultural medicine and community health
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    • v.46 no.3
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    • pp.131-143
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    • 2021
  • Objectives: This study aimed 1) to investigate high school students' reliability on COVID-19 responses in schools and private academies and 2) to identify the differences in COVID-19 prevention practice. Methods: This cross-sectional survey collected data from 200 high school respondents, using an anonymous online questionnaire designed by the Yonsei Global Health Center, from July 2 to 17, 2020 in this study. Chi-square tests were conducted to analyze the differences in preventative practices and practice rates between schools and private academies. Binary logistics regression analysis was conducted to identify the factor affecting the reliability of COVID-19 response. Results: These high school students reliabilityed the schools' COVID-19 response more than the private academy. In addition, students who studied only at school did more COVID-19 prevention practices than students who studied both at school and academy. There was a significant difference in avoiding public transportation (p=.028), sitting in one row while having a meal (p=.011) in the practice rates depending on the schools' COVID-19 response. A significant difference in Covering the mouth when coughing and sneezing (p-.041) was also found in the practice rates depending on the private academies' COVID-19 response. Conclusion: The reason why schools were more reliable than private academies was that there are health teachers. Because schools are supervised by the ministry of education, the Ministry of education and local government need to work together to manage and monitor the COVID-19 response in the academies through cooperation between two organizations. In addition, it is necessary to arrange a temporary circulation health teacher who will provide the COVID-19 prevention education at the academies.

A Study on Oriental Medical Diagnosis of Musculoskeletal Disorders using Moire Image (Moire 영상을 이용한 근골격계 질환의 한의학적 진단에 관한 연구)

  • Lee Eun-Kyoung;Yu Seung-Hyun;Lee Su-Kyung;Kang Sung-Ho;Han Jong-Min;Chong Myong-Soo;Chun Eun-Joo;Song Yung-Sun;Lee Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.72-92
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    • 2000
  • This research has conducted studies on an Oriental medicine-based method of diagnosing of occupational musculoskeletal system diseases. This researcher has searched through existing relevant medical literature. Also, this researcher has worked on a moire topography using moire topography. In this course, this researcher has reached the following conclusion in relation to the possibility of using a moire topography as a diagnosing device of musculoskeletal system diseases under Oriental medicine . 1 The Western medicine outlines its criteria of screening occupational musculoskeletal system diseases as follows A. The occupational musculoskeletal diseases must clearly include one or more of the subjective symptoms characterized by pain, hypoesthesia dysaesthesia, anaesthesia. etc . B, There should be clinically admitted objective observations and diagnosis outlining that the disease concerned shows symptoms such as tenderness, induration. and edema that can appear with occupational musculoskeletal system diseases. dyscinesia should be admitted with the disease concerned, or there should be observations and diagnosis outlining that abnormality exists in electric muscular or nervous diagnosis and examination . C. It should be admitted that prior to the occurrence of symptoms or observations and diagnosis on musculoskeletal system-related diseases, a patient has been engaged in works with conditions requiring improper work posture or work movement. That is, this is an approach whereby they see abnormality in the musculoskeletal system come from material and structural defect, and adjust and control abnormality in the musculoskeletal system and secreta . 2. The Oriental medicines sees that a patient develops the pain of occupational musculoskeletal diseases as he cannot properly activate the flow of his life force and blood thus not only causing formation of lumps in the body and blocking the flow of life force and blood in some parts of the body. Hence, The Oriental medicine focuses on resolving the cause of weakening the flow of life force and blood, instead of taking material approach of correcting structural abnormality Furthermore , Oriental medicine sees that when muscle tension builds up, this presses blood vessels and nerves passing by, triggering circulation dyscrasia and neurological reaction and thus leading to lesion. Thus, instead of taking skeletal or neurophysiological approach. it seeks to fundamentally resolve the cause of the flow of the life force and blood in muscles not being activated. As a result Oriental medicine attributes the main cause of musculoskeletal system diseases to muscle tension and its build-up that stem from an individual's long formed chronicle habit and work environment. This approach considers not only the social structure aspect including companies owners and work environment that the existing methods have looked at, but also individual workers' responsibility and their environmental factors. Hence, this is a step forward method. 3 The diagnosis of musculoskeletal diseases under Oriental medicine is characterized by the fact that an Oriental medicine doctor uses not only photos taken by himself, but also various detection devices to gather information and pass comprehensive judgment on it. Thus, it is the core of diagnosis under Oriental medicine to develop diagnosing devices matching the characteristics of information to be induced and to interpret information so induced from the views of Oriental medicine. Diagnosis using diagnosing devices values the whole state of a patient and formal abnormality alike, and the whole balance and muscular state of a patient serves as the basis of diagnosis. Hence, this method, instead of depending on the information gathered from devices under Western medicine, requires devices that provide information on the whole state of a patient in addition to the local abnormality information that X-ray. CT, etc., can offer. This method sees muscle as the central part of the abnormality in the musculoskeletal system and thus requires diagnosing devices enabling the muscular state. 4. The diagnosing device using moire topography under Oriental medicine has advantages below and can be used for diagnosing musculoskeletal system diseases with industrial workers . First, the device can Provide information on the body in an unbalanced state. and thus identify the imbalance and difference of height in the left and right stature that a patient can not notice at normal times. Second, the device shows the twisting of muscles or induration regions in a contour map. This is not possible with existing shooting machines such as X-ray, CT, etc., thus differentiating itself from existing machines. Third, this device makes it possible for Oriental medicine to take its unique approach to the abnormality in the musculoskeletal system. Oriental medicine sees the state and imbalance state in muscles as major factors in determining the lesion of musculoskeletal system, and the device makes it possible to shoot the state of muscles in detail. In this respect, the device is significant. Fourth, the device has an advantage as non-aggression diagnosing device.

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Soluble IL-2R, IFN-$\gamma$ and Neopterin as Immunologic Markers in Patients with Tuberculosis (결핵 환자에서 면역학적 지표로서의 sIL-2R, IFN-$\gamma$, Neopterin에 관한 연구)

  • Ryu, Yon-Ju;Ryu, Kum-Hei;Kim, Su-Hyun;Lee, Jong-Soo;Cheon, Seon-Hee;Seoh, Ju-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.294-308
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    • 2002
  • Background : The cell-mediated immune response plays an important role in tuberculosis. After being activated by mycobacterial antigens, T lymphocytes express a high affinity receptor (IL-2R) for interleukin-2 (IL-2) on their own surface and release a soluble fraction of the IL-2 receptor (sIL-2R) from the cell membrane into the circulation. Neopterin is a metabolite of guanosine-triphosphate, which is produced by stimulated macrophages under the influence of IFN-$\gamma$ with a T lymphocyte origin. Therefore, the utility of sIL-2R, IFN-$\gamma$ and the neopterin levels as immunologic indices of the cell-mediated immune response and severity of disease in patients with pulmonary tuberculosis was assessed. Methods : The serum sIL-2R, IFN-$\gamma$ and neopterin levels were measured in 39 patients with pulmonary tuberculosis, 6 patients with tuberculous lymphadenitis prior to treatment and 10 healthy subjects. The serum and pleural sIL-2R, neopterin and ADA levels were measured in 22 patients with tuberculous pleurisy. The patients with pulmonary tuberculosis were divided into a mild, moderate and severe group according to the severity by ATS guidelines. To compare the results from these patients with those of the pretreatment levels, the sIL-2R, IFN-$\gamma$ and neopterin levels were measured in 36 of the 39 patients(1 patient, expired; 2 patients were referred to a sanitarium) with pulmonary tuberculosis after 2 months of treatment. Results : 1) the serum sIL-2R and IFN-$\gamma$ levels were elevated in patients with tuberculosis when compared to those of healthy subjects (p>0.05). The neopterin concentration in the serum was significantly lower in patients with pulmonary tuberculosis($2967{\pm}2132.8$ pg/ml) than in healthy controls($4949{\pm}1242.1$ pg/ml)(p<0.05). 2) In the pulmonary tuberculosis group, the serum sIL-2R and IFN-$\gamma$ levels were higher in patients with severe disease than those in patients with mild and moderate disease. However, the neopterin levels declined as the pulmonary tuberculosis became more severe (p<0.01). 3) The mean serum sIL-2R and IFN-$\gamma$ levels declined from $1071{\pm}1139.4$ U/ml to $1023{\pm}1920.9$ U/ml(p>0.05), $41{\pm}52.8$ pg/ml to $22{\pm}23.9$ gm/ml(p<0.05), respectively, after 2 month of treatment. The mean serum neopterin levels increased from $3158{\pm}2272.6$ pg/ml to $3737{\pm}2307.5$ pg/ml(p>0.05) after a 2 month of treatment. These findings were remarkable in the severe group of pulmonary tuberculosis with a clinical correlation. 4) In the patients with tuberculous pleurisy, the serum sIL-2R and ADA were significantly higher than those in the pleural fluid, However, the neopterin levels in the sera and pleural effusion were similar. Conclusion : On the basis of this study, sIL-2R, IFN-$\gamma$ and neopterin measurements may not only provide an insight into the present state of the cell-mediated immune response, but also serve as parameters monitoring of the prognosis of the disease, particularly in patients with severe pulmonary tuberculosis. In addition, an assay of the pleural sIL-2R levels might signal a stimulated local immunity including T cell activation in the tuberculous pleural effusion.