• Title/Summary/Keyword: degenerative disease

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Mitral Reconstruction Using Prosthetic Ring in Mitral Valvular Heart Disease (승모판막질환에 있어서 인공판륜을 이용한 승모판막재건술의 임상적 고찰)

  • 나명훈;황경환
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.598-606
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    • 1997
  • Among 136 patients having undergone mitral valve surgery from September of 1994 through August of 1995 in Sejong Heart Institute, forty four patients(18 males, 26 females) underwent mitral valve reconstruction using prosthetic rings and their clinical results were evaluated. Patients'ages ranged from 5 to 63 years(mean age 38.2 years). Mitral valvular diseases were due to rheumatic origin in 30 patients(68%), degenerative in 13(30%), and congenital in one patient(2%). Mitral regurgitation(MR) was in 33 patients(76%), mitral stenosis 2(5%), and mitral stenoinsufaciency 9 patients(19%). The patients were divided into Carpentier's functional groups : type I, 5 patients(11%) : type I, 24 patients(55%) ; type III, 4 patients (9%) i and mixed(II + III), 11 patients(25%). Average number of anatomic lesions of mitral valve per patient was 3.7. The techniques included prosthetic ring amluloplasty(44 patients, 32 Carpentier ring and 12 Duran ring), leaflet mobilization(24, 55%), chordae shortening(23, 52%), chordae transposition(23, 52%), commissurotomy(16, 35%), leaflet resection(9, 20%), papillary muscle splitting(8, 18%), and chordae reimplantation(1, 2%). Average 3.4 surgical procedures were applied on mitral valve per patient. There were two hospital mortality and one reoperation due to development of MR(grade III) after 2 weeks. During the mean follow up of 12 months, patients improved in terms of functional class of the New York Heart Association, which was mean 3.0 preoperatively and 1.3 postoperatively. Doppler echocardiographic studies showed adequate valve area(2.07$\pm$0.11 cm2 mean $\pm$standard error), improved ventricular contractiliy in 41 patients(93%), ab ence of MR in 23(53%), trace MR in 18(42%), and garde II MR in 2 patients(5%).

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The Characteristics of Dietary Habits of Obese, Overweight or Normal Subjects in Seoul (서울지역 중년에 있어서 정상체중군과 과체중군의 식생활 특성 비교)

  • 이미숙
    • Korean Journal of Community Nutrition
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    • v.9 no.2
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    • pp.161-172
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    • 2004
  • The dietary habits of middle-aged obese, overweight and normal subjects were evaluated for the purpose of providing the background information of the degenerative disease control. A survey was conducted with 293 subjects (121 males and 172 females) between the ages 40-64 and they were divided into three groups of normal (BMI 18.5-22.9), overweight (BMI 23-24.9) and obese ($BMI\geq25$) based on the criteria of Korean Obesity Association (2000). The mean age of the subjects was $52.0\pm7.3(male)\;and\;51.9\pm6.9$ (female). Socioeconomic levels of subjects belong to the mid-upper class, since 71.9% of the males and 39.5% of the females received above a college education. More than 40% (44.6%) of males and 22.1% of females were obese, and educational background did not affect the obesity rate in males, whereas in females those who received lower education had a higher rate of obesity (p < 0.001). The subjects had a similar degree of drinking to the national average value. but had a lower degree of smoking. The obese group had the higher rate of drinking (p < 0.01) and smoking (p < 0.01). The annual increase in weight, more than 4 kg, was 8.8% for normal group and 30.9% for obese group. However, there were no differences in the mean annual increase in weight among the three groups. In females there were greater tendencies of weight changes in obese group (p < 0.05). About 44.9% of subjects responded that they were exercising regularly, and the obese group appeared to put into practice less than the other groups and to use more strenuous exercise. There was the greater rate of skipping dinner in the obese female group (p < 0.05). The unbalanced dietary pattern was found more with normal group than the other groups (p < 0.01). The food consumption frequency by food groups was not different among the groups. The obese group consumed less frequently meats, vegetables and fruits and had higher frequency in fish, legumes and their products, instant or fast food. In all subjects the higher rate of obesity was found with males than females and with those of heavier smoking and drinking, and in females the higher rate of obesity was found with lower education levels, skipping meals and having an unbalanced diet. In middle-aged subjects of this study with higher educational and socioeconomic background factors contributing to the effects of obesity may include smoking, drinking, educational background, skipping meals or unbalanced dietary pattern. The predictable characteristics for the development of obesity can be defined as sudden fluctuation of weights, exercise regularity and intakes of vegetables and fruits.

A Study on the Tinnitus of Huangdi's Internal Classic $\ll$황제내경(黃帝內經)$\gg$ ($\ll$소문(素問).영추(靈樞)$\gg$에 나타난 이명(耳鳴)에 대한 연구(硏究))

  • Byun, Seok-Mi;Tark, Myoung-Rim;Kang, Na-Ru;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.1
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    • pp.224-252
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    • 2010
  • Objective : The purpose of this study is to investigate tinnitus of Plain Questions $\ll$素問$\gg$ and Miraculous Pivot $\ll$靈樞$\gg$. Methods : We conducted a study on the original text paragraphs of Internal Classic $\ll$內經$\gg$ containing the tinnitus and analysis of Yang, Ma, Zhang, Wang etc. We drew a parallel between tinnitus from Internal Classic $\ll$內經$\gg$ and matching diagnoses from western medicine. Results : The results were as follows. 1. Tinnitus in Plain Questions $\ll$素問$\gg$Tong Pyeong Heo Sil Ron <通評虛實論> was similar to the symptoms of diabetes mellitus complication and schizophreniform disorder in western medicine. 2. Liver fire tinnitus in Plain Questions $\ll$素問$\gg$ Yuk Won Jeong Gi Dae Ron <六元正紀大論> was similar to the symptoms of psychological distress in western medicine. 3. Phlegm fire tinnitus in Plain Questions $\ll$素問$\gg$ Ji Jin Yo Dae Ron <至眞要大論> was similar to the symptoms of meniere's disease and malfunction of autonomic nervous system in western medicine. 4. Blood deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Sa Gi Jang Bu Byeong Hyeong <邪氣藏府病形> was similar to the symptoms of anemia in western medicine. 5. Tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gyeong Geun <經筋> was similar to the myofacial pain syndrome of the sternocleidomastoid muscle and the masseter muscle in western medicine. 6. Gallbladder deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gwol Hyeong <厥病> was similar to the symptoms of otitis media and labyrinthitis in western medicine. 7. Kidney deficiency tinnitus in Miraculous Pivot $\ll$靈樞$\gg$ Gyeol Gi <決氣> and Hai Ron <海論> was similar to the symptoms of degenerative auditory organ in western medicine. 8. Tinnitus in Internal Classic $\ll$內經$\gg$ showed close relations with the symptoms of the wind character. Conclusion : We analyzed the original text paragraphs of Internal Classic $\ll$內經$\gg$ and explanations about tinnitus. Further studies are needed to compare oriental medicine and western medicine diagnoses to develop better treatments for tinnitus.

Neuroprotective effects of phenolic compounds isolated from Spiraea prunifolia var. simpliciflora (조팝나무(Spiraea prunifolia var. simpliciflora)로부터 분리한 페놀 화합물의 신경세포 보호효과)

  • Oh, Seon Min;Choi, Doo Jin;Kim, Hyoung-Geun;Lee, Jae Won;Lee, Young-Seob;Lee, Jeong-Hoon;Lee, Seung-Eun;Kim, Geum-Soog;Baek, Nam-In;Lee, Dae Young
    • Journal of Applied Biological Chemistry
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    • v.61 no.4
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    • pp.397-403
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    • 2018
  • The leaves of Spiraea prunifolia were extracted with 80% aqueous MeOH and the concentrates were partitioned into EtOAc, n-BuOH, and $H_2O$ fractions. The repeated $SiO_2$ or ODS column, and medium pressure liquid chromatographies for the n-BuOH fraction led to isolation of two phenolic glucosides. The chemical structures of these compounds were determined as isosalicin (1) and crenatin (2) based on spectroscopic analyses including Nuclear magnetic resonance and MS. Extracts were analyzed using UPLC-MS/MS providing a short analysis time within 5 min using MRM technique. The concentration of crenatin was higher as 9.53 mg/g and isosalicin was lower as 0.65 mg/g. Neuroprotective effects of these compounds against hydrogen peroxide ($H_2O_2$)-induced neurotoxicity were evaluated. The results showed that exposure to $H_2O_2$ induced morphological changes, cell death and neurotoxicity in SK-N-MC cells. However, pretreatment with crenatin resulted in inhibition of morphological change, reduction of loss of cell viability and attenuation of neuronal damage. These results suggested that neuroprotective effect of crenatin isolated from S. prunifolia can be a good candidate for the development of health beneficial foods which can ameliorate the degenerative neuronal disease caused by oxidative stress.

Salicylate Can Enhance Osteogenic Differentiation of Human Periosteum-derived Mesenchymal Stem Cells (Salicylate가 성체줄기세포의 골분화에 미치는 영향)

  • Kim, Bo Gyu;Lee, A ram;Lee, Bo Young;Shim, Sungbo;Moon, Dong kyu;Hwang, Sun-Chul;Byun, June-Ho;Woo, Dong Kyun
    • Journal of Life Science
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    • v.28 no.12
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    • pp.1455-1460
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    • 2018
  • Due to a rapidly expanding aging population, the incidence of degenerative bone disease has increased, and efforts to handle the issue using regenerative medicine have become more important. In order to control various bone diseases such as osteoarthritis and osteoporosis, regenerative medicine utilizing adult stem cells has been extensively studied. And it is now clear that the mitochondrial energy metabolism, oxidative phosphorylation, is important for the process of stem cell differentiation. Interestingly, a recent study reported that salicylate promotes mitochondrial biogenesis by regulating the expression of $PGC-1{\alpha}$ in murine cells. However, the possible effects of salicylate on osteogenic differentiation through increased mitochondrial biogenesis in stem cells remain unknown. Thus, here we investigated whether salicylate could influence osteogenic differentiation and mitochondrial biogenesis of periosteum-derived mesenchymal stem cells (POMSCs). We found that salicylate treatments of POMSCs undergoing osteogenic differentiation increased the activity of alkaline phosphatase, a well-known early marker of bone cell differentiation. In addition, we observed that mitochondrial mass was increased by salicylate treatments in POMSCs. Together, these results indicate that salicylate can enhance osteogenic differentiation and mitochondrial biogenesis in POMSCs. Therefore, the findings in this study suggest that small molecules augmenting mitochondrial function such as salicylate can be a novel modulator for osteogenic differentiation and regenerative medicine.

"Post-Decompressive Neuropathy": New-Onset Post-Laminectomy Lower Extremity Neuropathic Pain Different from the Preoperative Complaint

  • Boakye, Lorraine A.T.;Fourman, Mitchell S.;Spina, Nicholas T.;Laudermilch, Dann;Lee, Joon Y.
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1043-1052
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    • 2018
  • Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

Risk Factors of Allogenous Bone Graft Collapse in Two-Level Anterior Cervical Discectomy and Fusion

  • Woo, Joon-Bum;Son, Dong-Wuk;Lee, Su-Hun;Lee, Jun-Seok;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.450-457
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    • 2019
  • Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

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

  • Hong, Young-Ki
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.311-320
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    • 2019
  • Discogenic pain which develops during the degenerative process of intervertebral disc is an intractable disease of musculoskeletal system. Unlike other diseases in modern medical science, it is not clinically confirmed through objective imaging and clinicopathologic index. Moreover, current technology has been facing difficulties finding fundamental treatment. This study examined through reviewing literature whether the therapeutic rationales of interventional procedures for the discogenic pain, such as nerve block, intradiscal electrothermal therapy and nucleoplasty, are valid and whether safety reviews such as preclinical tests are carried out faithfully during the technology development process. As a result, it is presumed that there is not yet an interventional treatment for discogenic pain, whose therapeutic rationale has been objectively verified. And there are some cases of interventional treatment that have not been adequately equipped with the preclinical test steps necessary to review the safety of the procedure during the technology development process. In conclusion, since there is still no interventional treatment for discogenic pain which has clear therapeutic rationale, it is necessary to recognize that a more careful approach is needed to judge whether the procedure is performed in clinical settings. And medical ethical issues may arise for some interventional treatment that are deemed to have been carried out without a thorough review of safety.

Pathophysiology and MRI Findings of Infectious Spondylitis and the Differential Diagnosis (감염성 척추염과 감별질환의 병태생리와 MRI 소견)

  • Sunjin Ryu;Yeo Ju Kim;Seunghun Lee;Jeongah Ryu;Sunghoon Park;Jung Ui Hong
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1413-1440
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    • 2021
  • On MRI, abnormal signals of the intervertebral disc, destruction of the upper and lower vertebral body endplate around the disc, and bone marrow edema around the endplate are considered typical findings of infectious spondylitis. These findings can also appear in various non-infectious spinal diseases, such as degenerative changes, acute Schmorl's node, spondyloarthropathy, synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO), chronic recurrent multifocal osteomyelitis, and calcium pyrophosphate dihydrate crystal deposition disease. The imaging findings of infectious spondylitis that can be differentiated from these non-infectious spinal diseases on MRI are high signal intensity and abscess of the disc space, an abscess in the paraspinal soft tissue, and the loss of the linear low signal intensity on T1-weighted images of the bony endplate. However, these differentiation points do not always apply since there are many similarities in the imaging findings of infectious and non-infectious diseases. Therefore, for an accurate diagnosis, it is important to know the imaging characteristics related to the pathophysiology of not only infectious spondylitis but also non-infectious spinal diseases, which requires differentiation from infection.

Current Status and Prospects of Community Nutrition in Korea (한국 지역사회영양의 현황과 전망)

  • 채범석;한정호
    • Korean Journal of Community Nutrition
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    • v.1 no.1
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    • pp.9-27
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    • 1996
  • The nutritional status is strictly related with flood production, flood processing, and distribution along with habits, education and technological achievement, adapted and adjusted to socio-economic conditions. All these factors are independently affecting the nutritional status of populations. In addition to the above mentioned factors launch of it is useful to consider two points ; unification of the South and the North Korea and WTO. The present study gives and overview of basic knowledge about nutritional status of Korean by using availab1e data in relation to nutrition. The basic characteristics of Korean diet with proportions high in carbohydrate and low in fat, have been relatively constant for the past two decades. The average daily flood intake in terms of weight of flood per person is relatively constant throughout the years. Although the proportion of animal food intake tends to increase recently, the Korean diet is still insufficient in meat, eggs, milk, and fish. Moreover because milk has not been accustomed flood with the general population and not much used in traditional flood preparation in Korea, milk consumption was especially low in comparison with western countries. The total energy intake was relatively constant throughout the years from 1969 to 1993. However, changes in the composition have occurred in the past two decades. The amount and proportions of fat have been s1ightly increasing while the total amount of carbohydrate has been decreasing. The nutrition preblems of Korea have changed over the past severa1 decades. The general adequacy of protein and energy existing after Korean War(1950) was resolved now. Since then the average diet appears to be nearly desirable in terms of rapid rates of growth during childhood and attainment of progressively stature and body weight at maturity. The dietary habits of some young people in these days seem to be taking a more western style diets. This trends if established by habit may lead to a marked change in the traditional diet and health. I think Korean nutritional experiences have potential values for tole other countries in Asia and in western countries. Korean diet illustrates a high level of nutritional status and health attainable will a largely vegetable diet : high in complex carbohydrates, and dietary fibre, and low in tat, and reasonable amount of total protein. This is significant for developing and developed countries that must select specific goals fir adequate nutrition for the people. Compared to the western countries, Koreas different incidence of coronary heart disease and malignancy demonstrates the significance of environment and probably the prominent role of diet in the development of these diseases. The changes occurring in the Korean diet of fir the unusual opportunity to assess the effect of diet upon chronic degenerative disease. In the future, the Korean diet might be continue to change significantly These changes are being influenced by socioeconomic factors that have been emerging and growing stronger since mid-l980 and that probably continue to be potent. The expanded purchasing power of the consumer results in increased discretionary purchases. In the case of foodstuffs, the consumer demands appear to be directed toward items of higher protein content, which, being primarily animal products, are inevitably accompanied by an increased consumption of fat. The continued availability of these more expensive flood items depends upon the balance of foreign trade favouring their importation and domestic production. A regression of foreign trade could result in a decreased supply for the consumer, whereas continued growth of trade iou]d provide freedom for increasing availability to the consumer. In this latter situation the exact choice of foodstuffs is depending upon comsumer tastes and the pressures that may influence it.

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