• Journal of Oral Medicine and Pain
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• 제40권1호
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• pp.3-9
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• 2015

The etiopathogenesis of burning mouth syndrome (BMS) seems to be complex and many patients probably involves interactions among local, systemic, and/or psychological factors in the pathophysiologic mechanism. Although there are controversies over whether the psychological factor is a cause or a result of BMS, several studies have supported strong relationships between psychological factors and chronic pain. It has been suggested that somatic complaints from unfavorable life experiences may influence both individual personality and mood changes; however, initiation of BMS symptoms is not necessarily correlated with stressful life events despite their elevated psychological stress. If the psychological distress is not a causal factor of BMS, it seems that BMS patients may be particularly vulnerable to psychological problems, primarily depression, anxiety, and hostility due to the characteristic entities of BMS such as chronic persistent pain itself. It seems likely that both physiological and psychological factors play a role in causing, perpetuating and/or exacerbating BMS; therefore, both two components of the patient's symptoms must be addressed. The acceptance of psychological factors by the patient is often an important element of BMS, management. The evaluation of psychological and emotional status of BMS patient enables clinicians to recognize prolonged negative and subclinical factors which can complicate the management of pain or indirectly perpetuate other physical factors. This evaluation improves the doctor-patient relationships, motivation, and compliance through a correct understanding of the clinical problem. Appropriate emotional and psychological evaluation may be required prior to developing a treatment plan in order to gain the successful treatment outcome.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1140-1146
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• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• Archives of Plastic Surgery
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• 제41권4호
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• pp.325-329
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• 2014

Background Liposuction is a procedure to reduce the volume of subcutaneous fat by physical force. Intracellular storage fat is composed of triglyceride, whereas circulating fat particles exist as cholesterol or triglycerol bound to carrier proteins. It is unavoidable that the storage form of fat particles enters the circulation system after these particles are physiologically destroyed. To date, however, no studies have clarified the fatal characteristics of fat embolism that occurs after the subclinical phase of free fat particles. Methods A mixture of human lipoaspirate and normal saline (1:100, 0.2 mL) was injected into the external jugular vein of rats, weighing 200 g on average. Biopsy specimens of the lung and kidney were examined at 12-hour intervals until postoperative 72 hours. The deposit location and transport of the injected free fat particles were confirmed histologically by an Oil Red O stain. Results Inconsistent with previous reports, free fat particles were transported from the intravascular space to the parenchyma. At 24 hours after infusion, free fat particles deposited in the vascular lumen were confirmed on the Oil Red O stain. At 72 hours after infusion, free fat particles were accumulated compactly within the parenchymal space near the perivascular area. Conclusions Many surgeons are aware of the fatal results and undiscovered pathophysiologic mechanisms of free fat particles. Our results indicate that free fat particles, the storage form of fat that has been degraded through a physiological process, might be removed through a direct transport mechanism and phagocytotic uptake.

• 대한한의학회지
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• 제18권1호
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• pp.25-39
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• 1997

Shoulder hand syndrome is characterized by pain, vasomotor instability, and tenderness, mainly in the distal upper extremity. The pathophysiologic mechanism of this syndrome is not yet proved. The purpose of this study is to evaluate the usefulness of thermographic imaging on shoulder hand syndrome after stroke for early diagnosis and its clinical pattern analysis including acupuncture and electroacupuncture therapy. This study was performed from June to September in 1996 on 46 stroke patients who were admitted at Oriental hospital of Kyung Hee Medical Center. The study group were 23 patients with shoulder hand syndrome. The control group were 23 patients without shoulder hand syndrome. Skin temperatures on the both upper extremities were measured by Digital Infrared Thermographic Imaging(D.I.T.I.) before the study and 3 weeks later again. The results were as follows; 1. The shoulder hand syndrome group were significantly more restricted in shoulder passive range of motion than the control group. 2. The shoulder hand syndrome group showed significant temperature difference of both dorsal hands. 3. The electroacupunture therapy group were significantly more improved on the temperature difference of both dorsal hands than acupuncture therapy group in 3 weeks later. 4. Both posterior arms showed the biggest temperature difference from 11 to 30 days in shoulder hand syndrome group. 5. The lesser passive ROM(range of motion) of shoulder group showed significantly increased temperature difference of both hands. The above results show that measurement of shoulder passive range of motion and D.I.T.I. is a useful method for early diagnosis on shoulder hand syndrome and its clinical pattern analysis including evaluation of acupuncture and electroacupuncture therapy. Continuous study will be needed for more clinical application and evaluation on shoulder hand syndrome.

• Journal of Obesity & Metabolic Syndrome
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• 제27권4호
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• pp.233-237
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• 2018

Background: Obesity is a complex, medical condition causally contributing to many chronic diseases and a number of efforts have been made to find the associated markers for novel prevention and treatment of obesity. Our study was to evaluate the relationship between gut immune response and obesity and overweight with use of fecal calprotectin (FC) both in adult and children groups. Methods: Fecal samples were obtained from 74 subjects: 14 non-obese and overweight children (PN), 13 obese and overweight children (PO), 20 non-obese and overweight adults (AN), and 27 obese and overweight adults (AO). FC was measured using a commercial Legend Max quantitative enzyme-linked immunosorbent assay (BioLegend). Mann-Whitney U-test was used for statistical analysis. Results: Median FC concentration was $7.9{\mu}g/g$ (range, $1.9-28.9{\mu}g/g$) for PN, $5.0{\mu}g/g$ (range, $2.6-29.6{\mu}g/g$) for PO, $9.5{\mu}g/g$ (range, $0.8-28.9{\mu}g/g$) for AN, and $10.0{\mu}g/g$ (range, $1.6-25.6{\mu}g/g$) for AO, respectively. In both adults and children age groups, the FC showed no statistically significant difference between AO and AN or PO and PN. However, FC showed statistically significant difference (P<0.05) between AO and PO while not significant between AN and PN. Conclusion: FC level in AO was significantly higher than that in PO, suggestive of different pathophysiologic mechanism between children obesity and adults obesity.

• Biomolecules & Therapeutics
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• 제31권5호
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• pp.484-495
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• 2023

Idiopathic pulmonary fibrosis (IPF) can be defined as a progressive chronic pulmonary disease showing scarring in the lung parenchyma, thereby resulting in increase in mortality and decrease in the quality of life. The pathophysiologic mechanism of fibrosis in IPF is still unclear. Repetitive microinjuries to alveolar epithelium with genetical predisposition and an abnormal restorative reaction accompanied by excessive deposition of collagens are involved in the pathogenesis. Although the two FDA-approved drugs, pirfenidone and nintedanib, are under use for retarding the decline in lung function of patients suffered from IPF, they are not able to improve the survival rate or quality of life. Therefore, a novel therapeutic agent acting on the major steps of the pathogenesis of disease and/or, at least, managing the clinical symptoms of IPF should be developed for the effective regulation of this incurable disease. In the present review, we tried to find a potential of managing the clinical symptoms of IPF by natural products derived from medicinal plants used for controlling the pulmonary inflammatory diseases in traditional Asian medicine. A multitude of natural products have been reported to exert an antifibrotic effect in vitro and in vivo through acting on the epithelial-mesenchymal transition pathway, transforming growth factor (TGF)- β-induced intracellular signaling, and the deposition of extracellular matrix. However, clinical antifibrotic efficacy of these natural products on IPF have not been elucidated yet. Thus, those effects should be proven by further examinations including the randomized clinical trials, in order to develop the ideal and optimal candidate for the therapeutics of IPF.

• International Journal of Stem Cells
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• 제16권1호
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• pp.108-116
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• 2023

γδ T cells are a rare and unique prototype of T cells that share properties with natural killer cells in secondary lymphoid organs. Although many studies have revealed the function and importance of adult-derived γδ T cells in cancer biology and regenerative medicine, the low numbers of these cells hamper their application as therapeutic cell sources in the clinic. To solve this problem, pluripotent stem cell-derived γδ T cells are considered alternative cell sources; however, few studies have reported the generation of human pluripotent stem cell-derived γδ T cells. In the present study, we investigated whether lymphoid lineage γδ T cells were successfully generated from human pluripotent stem cells via hemogenic endothelium under defined culture conditions. Our results revealed that pluripotent stem cells successfully generated γδ T cells with an overall increase in transcriptional activity of lymphoid lineage genes and cytolytic factors, indicating the importance of the optimization of culture conditions in generating lymphoid lineage γδ T cells. We uncovered an initial step in differentiating γδ T cells that could be applied to basic and translational investigations in the field of cancer biology. Based on our result, we will develop an appropriate method to purify γδ T cells with functionality and it helpful for the study of basic mechanism of γδ T cells in pathophysiologic condition as well as clinic application.

• Natural Product Sciences
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• 제5권3호
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• pp.113-120
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• 1999

Nitric oxide (NO) is a free radical synthesized from L-arginine by nitric oxide synthase (NOS). It is believed that NO is an important mediator in numerous physiological and inflammatory responses. Particularly, a large amount of NO released from the inducible nitric oxide synthase (iNOS) is mostly associated with inflammatory processes. Overproduction of NO in these processes including sepsis and autoimmune diseases can have deleterious consequences and pathophysiologic relevance. Therefore, for the discovery of new inhibitory agents against iNOS activity, we have evaluated about 100 kinds of natural products after partition into three layers (n-hexane, ethyl acetate and aqueous) from 100% methanol extracts to study inhibitory effects on iNOS activity induced by lipopolysaccharide (LPS) in RAW264.7 cells culture system. As a positive control, curcumin, which is known as an anti-tumor promoter, anti-inflammatory agent as an iNOS inhibitor, was used and showed the dose-dependent inhibitory effect $(IC_{50},\;2.5\;{\mu}g/ml)$. Among tested fractions, the n-hexane fraction of Cimicifuga heracleifolia $(IC_{50}:\;9.65\;{\mu}g/ml)$, Forsythiae fructus $(IC_{50}:\;6.36\;{\mu}g/ml)$, Saposhnikovia divaricata $(IC_{50}:\;5.92\;{\mu}g/ml)$, and the ethyl acetate fraction of Chrysanthemum sibiricum $(IC_{50}:\;2.56\;{\mu}g/ml)$, Gastrodia elata $(IC_{50}:\;3.46\;{\mu}g/ml)$, and the aqueous fraction of Dianthus chinensis $(IC_{50}:\;6.73\;{\mu}g/ml)$, Euonymus alatus $(IC_{50}:\;6.78\;{\mu}g/ml)$, Mechania urticifoloria $(IC_{50}:\;8.01\;{\mu}g/ml)$ showed strong inhibitory activity against LPS-stimulated iNOS. Especially, the ethyl acetate fraction of Chrysanthemum sibiricum $(IC_{50}:\;2.56\;{\mu}g/ml)$, which exhibited the strongest inhibition against iNOS, was fractionated with silica-gel column chromatography. These subfractions exhibited dose-dependent inhibition against iNOS activity in the range of $2.59-5.6\;{\mu}g/ml$ except for fraction No. 3, 4, 5, 6, 8, 9, and 16. Our study shows that Chrysanthemum sibiricum has the strongest inhibitory effect against iNOS activity and has similar effect to curcumin. Therefore, further studies for the identification of active principles from Chrysanthemum sibiricum and investigation for the mechanism of the inhibition of iNOS by active principles will be performed.

• Childhood Kidney Diseases
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• 제13권2호
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• pp.189-196
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• 2009

목적 : 신증후군에서 사구체 단백 투과성이 증가하는 것은 전신적인 순환 인자와 관련되어 있는 것으로 여겨진다. 전신적인 순환 인자의 사구체 외 기관에서의 영향과 관련하여, 본 연구에서는 복막 투석 중인 steroid resistant nephrotic syndrome (SRNS) 환자에서의 복막투석을 통한 단백 소실 정도를 파악하고자 하였다. 방법 : 2001년부터 2009년까지 복막 투석 중인 신증후군 환자 12명(SRNS)과 대조군 14명을 대상으로 후향적 환자-대조군 연구를 시행하였다. 성별, 투석 시작 시 연령, 체중, 신장, 투석 방법, 투석양, 투석 시작 시 검사 소견(혈액 요소 질소, 혈청 크레아티닌, 혈청 단백, 혈청 알부민, 24시간 투석액 부피, 24시간 투석액 단백, Kt/V)과 1년 뒤 투석 시 검사 소견(24시간 투석액 단백)을 조사하였다. 단백질 섭취 정도를 평가하기 위해 nPNA (normalized protein equvalent of total nitrogen appearance)를 측정하였다. 결과 : SRNS군과 대조군은 nPNA를 비롯한 다른 지표에 의미 있는 차이를 보이지 않았으나, SRNS군에서 혈청 알부민이 $3.7{\pm}0.3$ g/dL로 대조군($4.0{\pm}0.4$ g/dL, P=0.021)보다 낮았다. 복막액을 통한 단백 소실량은 SRNS군에서 대조군보다 통계학적으로 의미 있게 높았으며($3,044.4{\pm}837.6\;mg/m^2$/day vs. $1,791.6{\pm}1,244.0\;mg/m^2$/day, P=0.007), 혈장 단백에 대한 복막의 투과성은 SRNS군에서 대조군보다 2배 가량 높았다($1.06{\pm}0.46%$ vs. $0.58{\pm}0.43%$, P=0.010). SRNS군과 대조군 모두 초기와 1년 뒤 복막 단백 소실량이 증가하였으나 대조군에서 더 큰 차이를 보였으며 복막 단백 소실량의 시간 경과에 따른 변화는 두 군(SRNS군 vs. 대조군)간에 의미있게 차이가 있었다(P=0.023). 결론 : 신증후군을 앓고 있는 소아 환자에서 복막 투석을 시행할 때는 이들의 영양상태, 성장 및 발달에 평가가 보다 적극적으로 이루어져야 하고, 복막을 통한 단백 소실을 모니터링하여 이를 보충하려는 노력 또한 필요하리라 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제44권5호
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• pp.1114-1124
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• 1997

연구배경 : Endothelin(이하 ET로 약함)은 폐혈관 내피세포에서 생산되며 강한 혈관 수축작용이 있는 peptide이다. 일차성 폐동맥고혈압과 급성 폐동맥색전증 환자의 혈장내 ET이 증가하고 이들 질환에서의 심폐기능장애에 ET이 중요한 역할을 하리라고 추측되나 ET증가의 기전에 대해서는 알려진 바 없다. 이들 두 질환은 모두 혈전증이 중요한 병태생리 소견이므로 저자들은 혈소판과 활성화된 혈소판에서 유리된 매개체들이 폐혈관 내피세포에서 ET 생산을 증가시킬 것이라고 가정하고 이를 확인하기 위하여 연구를 시행하였다. 방 법 : 소 폐동맥내피세포 배양배지에 혈소판, thrombin(0.1~10u/ml), transforming growth factor-${\beta}1$(TGF-${\beta}1$, 1-1000pM), serotonin(1-100uM), 및 내독소(1ug/ml)를 첨가한 후 18시간 배양하여 배지내로 유리된 immunoreactive ET(이하 ir-ET로 약함)을 방사선면역측정법으로 정량분석 하였다. 결과 : 소 폐동맥내피세포 배양 상청액내 ir-ET은 배양 시간에 비례하여 증가하였으며 혈소판 $10^8/ml$을 첨가한 군에서는 배양 8시간 및 18시간 후에 대조배지군에 비해 유의하게 높았다(p<0.05). 혈소판 첨가군에서 배양 상청액내 ir-ET은 혈소판의 수가 증가함에 따라 증가하는 경향을 보였고 $10^8/ml$에서는 대조배지군에 비해 유의하게 높았다 (0<0.05). Ir-ET를 증가시키지 않는 혈소판 ($10^7/ml$)에 ir-ET을 유의하게 증가시키지 않는 농도의 thrombin (0.1u/ml) 또는 내독소(1ug/ml)를 각각 첨가한 군에서 배양 상청액내 ir-ET은 배지 대조군과 단독 첨가군 (thrombin 0.1u/ml, 내독소 1ug/ml)에 비해 각각 유의하게 높았다(p<0.05). 소 폐동맥내피세포 배양 상청액내 ir-ET은 thrombin(1-10ug/ml), TGF-${\beta}1$(100-1000pM) 첨가군에서 각각 대조배지군에 비해 유의하게 높았으며 (p<0.05), serotonin(1-100uM) 첨가군은 대조배지군파 유의한 차이가 없었다. 결 론 : 소 폐동맥 내피세포에서 ET 생산을 자극하며 그 기전은 혈소판과 활성화된 혈소판에서 유리되는 TGF-${\beta}1$ 등의 매개물에 의한 내피세포의 자극으로 생각되며 이외에 혈소판에 의한 내피세포의 ET 생산 반응 조절(priming) 가능성도 추측할 수 있다.