• Title/Summary/Keyword: common pathophysiology

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Etiopathogenesis of sacroiliitis: implications for assessment and management

  • Baronio, Manuela;Sadia, Hajra;Paolacci, Stefano;Prestamburgo, Domenico;Miotti, Danilo;Guardamagna, Vittorio A.;Natalini, Giuseppe;Bertelli, Matteo
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.294-304
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    • 2020
  • The sacroiliac joints connect the base of the sacrum to the ilium. When inflamed, they are suspected to cause low back pain. Inflammation of the sacroiliac joints is called sacroiliitis. The severity of the pain varies and depends on the degree of inflammation. Sacroiliitis is a hallmark of seronegative spondyloarthropathies. The presence or absence of chronic sacroiliitis is an important clue in the diagnosis of low back pain. This article aims to provide a concise overview of the anatomy, physiology, and molecular biology of sacroiliitis to aid clinicians in the assessment and management of sacroiliitis. For this narrative review, we evaluated articles in English published before August 2019 in PubMed. Then, we selected articles related to the painful manifestations of the sacroiliac joint. From the retrieved articles, we found that chronic sacroiliitis may be caused by various forms of spondyloarthritis, such as ankylosing spondyloarthritis. Sacroiliitis can also be associated with inflammatory bowel disease, Crohn's disease, gout, tuberculosis, brucellosis, and osteoarthritis, indicating common underlying etiological factors. The pathophysiology of sacroiliitis is complex and may involve internal, environmental, immunological, and genetic factors. Finally, genetic factors may also play a central role in progression of the disease. Knowing the genetic pre-disposition for sacroiliitis can be useful for diagnosis and for formulating treatment regimens, and may lead to a substantial reduction in disease severity and duration and to improved patient performance.

NEURODEVELOPMENTAL PERSPECTIVE OF ATTENTION-DEFICIT/HYPERACTIVITY DISORDER(ADHD) (주의력결핍-과잉행동장애의 신경발달학적 고찰)

  • Ahn, Dong-Hyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.160-172
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    • 2005
  • Attention-Deficit/Hyperactivity Disorder(ADHD) is the most common neurodevelopmental disorder in child psychiatry. The etiology or ADHD is not completely understood, but involved in genetical and/or neurocognitive deficits. This article reviews the current state of the literature pertaining to the neurodevelopmental aspects of ADHD. Although the neurodevelopment of ADHD remains unclear, emerging evidence documents its genetic and neurobiologic underpinnings. A pathophysiology of ADHD has not been fully characterized, although genetic, neurobiologic, neuroimaging, and neuropsychological studies of ADHD consistently implicates dysfunction in the fronto-subcortical network and abnormality in the dopaminergic and noradnergic systems. Furthermore some suggests that the timing of aberrant brain development in ADHD could be in early gestation and genetic and/or early environmental influences on brain development in ADHD are fixed, nonprogressive. Although many studies provide evidences for the important or psychosocial or environmental adversities in ADHD, they may be not specific predictors of ADHD but nonspecific triggers of an underlying predisposition or modifiers of the course of disorder.

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Literature Review of Postoperative Delirium in Geriatric Patients After Elective Gastrointestinal Cancer Surgery

  • Park, Da-In;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.20 no.3
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    • pp.177-186
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    • 2018
  • Purpose: Increasing number of older adults are receiving cancer surgeries especially for gastrointestinal cancers, which brings forth attention to age-related postoperative complication prevention. Postoperative delirium (POD) is a common complication that rises after surgical procedures involving general anesthesia, largely in the elderly population. Due to its sudden onset and fluctuating symptoms, POD often goes underdiagnosed and undertreated even though it may lead to various adverse outcomes. POD in GI cancer surgical elderly patients is poorly understood in terms of prevalence, pathophysiology, assessment, treatment and nursing management. We aimed to identify available literature and investigate study results to broaden our understanding of geriatric GI cancer POD. Methods: The search process involved six databases to identify relevant studies abided by inclusion criteria. Results: Eleven studies were selected for this review. Geriatric POD is closely related to frailty and surgical complications. Frailty increases vulnerability to surgical stress and causes cerebral changes that affect stress-regulating neurotransmitter proportions, brain blood flow, vascular density, neuron cell life and intracellular signal transductions. These conditions of frailty result in increased risks of surgical complications such as blood loss, cardiovascular events and inflammation, which all may lead to the POD. Mini Metal State Examination (MMSE), Confusion Assessment Method (CAM) and Delirium Rating Scale-revised-98 (DRS-R-98) are recommended for POD assessment to identify high-risk patients. Conclusion: The POD prevalence ranged from 8.2% to 51.0%. The multifactorial causative mechanism suggests nurses to identify highrisk elderly GI-cancer surgical patients by reviewing patient-specific factors and surgery-specific factors.

Replication of Early B-cell Factor 1 (EBF1) Gene-by-psychosocial Stress Interaction Effects on Central Adiposity in a Korean Population

  • Kim, Hyun-Jin;Min, Jin-Young;Min, Kyoung-Bok
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.5
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    • pp.253-259
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    • 2016
  • Objectives: Central obesity plays a major role in the development of many chronic diseases, including cardiovascular disease and cancer. Chronic stress may be involved in the pathophysiology of central obesity. Although several large-scale genome-wide association studies have reported susceptibility genes for central adiposity, the effects of interactions between genes and psychosocial stress on central adiposity have rarely been examined. A recent study focusing on Caucasians discovered the novel gene early B-cell factor 1 (EBF1), which was associated with central obesity-related traits via interactions with stress levels. We aimed to evaluate EBF1 gene-by-stress interaction effects on central adiposity traits, including visceral adipose tissue (VAT), in Korean adults. Methods: A total of 1467 Korean adults were included in this study. We selected 22 single-nucleotide polymorphisms (SNPs) in the EBF1 gene and analyzed their interactions with stress on central adiposity using additive, dominant, and recessive genetic modeling. Results: The four SNPs that had strong linkage disequilibrium relationships (rs10061900, rs10070743, rs4704967, and rs10056564) demonstrated significant interactions with the waist-hip ratio in the dominant model ($p_{int}$<0.007). In addition, two other SNPs (rs6556377 and rs13180086) were associated with VAT by interactions with stress levels, especially in the recessive genetic model ($p_{int}$<0.007). As stress levels increased, the mean values of central adiposity traits according to SNP genotypes exhibited gradual but significant changes (p<0.05). Conclusions: These results suggest that the common genetic variants for EBF1 are associated with central adiposity through interactions with stress levels, emphasizing the importance of managing stress in the prevention of central obesity.

Familial Gastric Dysmotility in Monozygotic Twins with Functional Dyspepsia and Their Mothers and the Effect of Korean Traditional Medicine on Symptoms and Gastric Dysmotility in Twins (기능성 소화불량증의 일란성 쌍생아와 이들 모친의 가족적 위 운동성 장애와 한방치료가 쌍둥이의 임상증상과 위 운동성에 미친 영향)

  • Yoon, Sang-hyub
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.772-783
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    • 2018
  • The aims of this study were to use the Rydoraku test, electrogastrography, and enterotachography to examine the presence of familial gastric dysmotility among monozygotic twins and their mothers; to determine the relationship between the symptoms and the indexes of the Rydoraku test, electrogastrography, and enterotachography; and to observe the therapeutic reaction for each differential treatment between twins with familial gastric dysmotility. The same herbal medication (Banhasasim-tang extract three times/day and Sojuckkunbi-tang extract three times/day) was given to each twin, but the younger twin also underwent manual acupuncture on the CV 10, 12, and 13 points of the abdominal wall and electrical stimulation of both ST 36 points of the lower leg 2-3 times per week. Evaluation of the therapeutic effect was followed after six weeks. The presence of familial gastric dysmotility was shown in the autonomic nerve system and gastric muscle and was thought to be a common pathophysiology induced by genetic co-ownership. Only the younger twin showed any marked relief of the dyspeptic symptoms associated with improvement of pyloric sphincter function, which was induced by acupuncture treatment. The Rydoraku test, electrogastrography, and enterotachography results showed the presence of familial gastric dysmotility. Although Korean traditional medicine had no effect on the familiar gastric dysmotility associated with genetic influences, the acupuncture treatment had a beneficial effect on the secondary disorder of pyloric sphincter function, which is associated with the relief of dyspeptic symptoms.

Difference of Gene Expression in Venous Malformation (정맥기형 환자에 있어서의 유전자 발현 차이)

  • Kim, Taek Kyun;Oh, Eun Jung;Cho, Byung Chae;Chung, Ho Yun
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.671-678
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    • 2007
  • Purpose: Venous malformation(VM) which often causes pain and discomfort is the most common type of vascular malformations. Although it is presented with disfigured appearance and associated soft tissue or skeletal hypertrophy, the molecular bases of VMs are poorly understood. Differentially expressed genes(DEGs) of VMs were investigated to illuminate the molecular mechanism of the disease entity. Methods: Gene expressions of VM patients' subcutaneous tissue were studied in comparison with normal persons' by $GeneFishing^{TM}$ technique using the annealing control primers (ACPs) to identify DEGs. Candidate genes were sequenced and screened by basic local alignment search tool (BLAST) afterwards. Results: Among seventy DEGs identified, forty DEGs which had shown significantly different expression pattern were sequenced. Twenty eight out of 40 were up-regulated while 12 were down-regulated. BLAST searches revealed that 37 were known genes and 3 were unknown genes. Many genes were involved in the differentiation and remodeling of smooth muscle cells, opposed to the previous hypothesis that a lot of angiogenetic genes would be involved. Furthermore, several transcription factors and related genes, as well as cell signaling and metabolism regulators, were up regulated. Conclusion: It suggests that analysis of DEGs in VMs provide basic knowledge about its pathophysiology. and new therapeutic approaches.

Clinical and Neurobiological Relevance of Current Animal Models of Autism Spectrum Disorders

  • Kim, Ki Chan;Gonzales, Edson Luck;Lazaro, Maria T.;Choi, Chang Soon;Bahn, Geon Ho;Yoo, Hee Jeong;Shin, Chan Young
    • Biomolecules & Therapeutics
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    • v.24 no.3
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    • pp.207-243
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    • 2016
  • Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social and communication impairments, as well as repetitive and restrictive behaviors. The phenotypic heterogeneity of ASD has made it overwhelmingly difficult to determine the exact etiology and pathophysiology underlying the core symptoms, which are often accompanied by comorbidities such as hyperactivity, seizures, and sensorimotor abnormalities. To our benefit, the advent of animal models has allowed us to assess and test diverse risk factors of ASD, both genetic and environmental, and measure their contribution to the manifestation of autistic symptoms. At a broader scale, rodent models have helped consolidate molecular pathways and unify the neurophysiological mechanisms underlying each one of the various etiologies. This approach will potentially enable the stratification of ASD into clinical, molecular, and neurophenotypic subgroups, further proving their translational utility. It is henceforth paramount to establish a common ground of mechanistic theories from complementing results in preclinical research. In this review, we cluster the ASD animal models into lesion and genetic models and further classify them based on the corresponding environmental, epigenetic and genetic factors. Finally, we summarize the symptoms and neuropathological highlights for each model and make critical comparisons that elucidate their clinical and neurobiological relevance.

A study on the development of 64 channels computerized cardiac mapping system (64채널 심장전기도 시스템 구현에 관한 연구)

  • Chang, Byung-Chul;Kim, Nam-Hyun;Jung, Sung-Hun;Ra, Sang-Weon;Cho, Bum-Koo
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.88-91
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    • 1994
  • It is well known that multipoint and computerized intraoperative mapping systems improve the results of surgery for Wolff-Parkinson-White syndrome and show tremendous potential for opening an entirely new era of surgical intervention for the more common and lethal types of supraventricular tachyarrhythmias such as atrial flutter and atrial fibrillation. In addition, the ability to map and ablate the sometimes fleeting automatic atrial tachycardia is greatly enhanced by computerized mapping systems. In this study, we have developed 64 channel computerized data analysis system using microcomputer (Macintosh IIx) for basic research of electrophysiology and electrical propagation. The bipolar electrogram information is acquired from 64 cardiac sites simultaneously at a sampling rate of 1ksamples/sec with continuous and total data storage of up to 30 seconds. When the reference electrogram is selected and reference point is picked up, delay time from the reference point in displayed on two dimensional diagram of the heart. System design permits easy expansion to almost 256 simultaneous sites, This system is expected to enable us to study pathophysiology of cardiac arrhythmia and to improve the results of diagnosis and surgical treatment for cardiac arrhythmia.

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Type-specific Prevalence of Human Papillomavirus by Cervical Cytology among Women in Brasov, Romania

  • Moga, Marius Alexandru;Irimie, Marius;Oanta, Alexandru;Pascu, Alina;Burtea, Victoria
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6887-6892
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    • 2014
  • The oncogenic role of human papillomavirus (HPV) in triggering cervical cancer, the second most common cancer in women worldwide, is well established. Romania ranks in first place in Europe in terms of the incidence of cervical cancer. Geographical widespread data on HPV type-distribution are essential for estimating the impact of HPV vaccines and cervical cancer screening programmes. In this study we aimed to identify the prevalence of HPV genotypes and to establish correlations with abnormal cervical cytology among the female population of Brasov County, Romania. A total of 1,000 women aged 17.3-57 years, attending routine cervical examination in the Obstetrics and Gynecology Hospital of Brasov, Romania, and undergoing both cytological examination and HPV genotyping were screened. Infection with 35 different HPV genotypes was detected in 39.6% of cytological specimens. Overall HPV infections were highest in young women under 25 years (p<0.0001), in which cervical cytological abnormalities also reached the highest prevalence. Patients infected by HPV-16 or HPV-18 showed the highest prevalence of cervical cytological abnormalities. Some 48.2% of women with abnormal cytology were infected with high-risk HPV types whereas less than 3% of them were infected only with low-risk HPV types. Our study showed that the prevalence of high-risk HPV infection among Romanian women is higher compared to other studies in other geographic areas. Thus, we consider that in areas where there is an increased prevalence of high-risk HPV infections, HPV genotyping should be performed in all women aged between 18 and 45 years, and Pap test should be performed every 6 months in women with high-risk HPV infection, even those with previous normal cervical cytology.

ESOPHAGEAL DYSMOTILITY IN PATIENTS WITH GLOBUS SENSATION (인두 이물감 환자의 식도 운동성 장애)

  • Lee, Heung-Man;Oh, Seung-Cheol;Lee, U-Seob;Kim, Kyung-Hyun;Choi, Geon;Bak, Young-Tae
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.232-237
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    • 1996
  • Burning and lump sensation in the throat is a common disorder in middle aged woman. It is generally considered to be a neurotic origin but its pathophysiology is still remained unknown. The purpose of this study was to evaluate the prevalence of the Pharyngoesophageal structural lesions and the esophageal motility disorders among the patients with globus pharyngeus and to elucidate whether any specific manometric abnormality might have any causative role in the pathogenesis of the globus sensation, and we also wanted to know whether such tests were necessary in evaluating those patients. Structural lesions were demonstrated in 21 cases(17.5 %) among 120 patients. But among 44 controls, there were also Two cases(4.5 %) of structural lesions, and there was less significantly difference in the prevalence of the structural lesions between the patients and controls(p=0.0625) Manometric abnormalities over the lower esophageal sphincter and the lower esophageal body were demonstrated in 28 cases (23.3 %) of the patients, while only one case (2.3 %) of the controls revealed such abnormality ( p=0.0037). Various manometric parameters of the upper esophageal sphincter and pharynx showed no difference between the patients and controls except the upper esophageal sphincter pressure at lateral sides which was lower in patients than in controls (p=0.0034). Globus sensation is a kind of symptom of esophageal dysmotility, and esophageal manometry is necessary to detect such abnormality in patients with globus sensation, Careful physical examination is also necessary to detect structural lesions in the pharynx and esophagus.

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