• The Korean Journal of Physiology and Pharmacology
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• 제15권1호
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• pp.31-36
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• 2011

To understand the roles of purinergic receptors and cellular molecules below the receptors in the vascular inflammatory response, we determined if extracellular nucleotides up-regulated chemokine expression in vascular smooth muscle cells (VSMCs). Human aortic smooth muscle cells (AoSMCs) abundantly express $PSY_1$, $PSY_6$, and $PSY_{11}$ receptors, which all respond to extracellular nucleotides. Exposure of human AoSMCs to $NAD^+$, an agonist of the human $PSY_{11}$ receptor, and $NADP^+$ as well as ATP, an agonist for $PSY_1$ and $PSY_{11}$ receptors, caused increase in chemokine (C-C motif) ligand 2 gene (CCL2) transcript and CCL2 release; however, UPT did not affect CCL2 expression. CCL2 release by $NAD^+$ and $NADP^+$ was inhibited by a concentration dependent manner by suramin, an antagonist of P2-purinergic receptors. $NAD^+$ and $NADP^+$ activated protein kinase C and enhanced phosphorylation of mitogen-activated protein kinases and Akt. $NAD^+$- and $NADP^+$-mediated CCL2 release was significantly attenuated by SP6001250, U0126, LY294002, Akt inhibitor IV, RO318220, GF109203X, and diphenyleneiodium chloride. These results indicate that extracellular nucleotides can promote the proinflammatory VSMC phenotype by up-regulating CCL2 expression, and that multiple cellular elements, including phosphatidylinositol 3-kinase, Akt, protein kinase C, and mitogen-activated protein kinases, are involved in that process.

• The Korean Journal of Physiology and Pharmacology
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• 제13권3호
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• pp.153-159
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• 2009

We investigated whether deficiency of inducible nitric oxide synthase (iNOS) could prevent isoproterenol-induced cardiac hypertrophy in iNOS knockout (KO) mice. Isoproterenol was continuously infused subcutaneously (15 mg/kg/day) using an osmotic minipump. Isoproterenol reduced body weight and fat mass in both iNOS KO and wild-type mice compared with saline-infused wild-type mice. Isoproterenol increased the heart weight in both iNOS KO and wild-type mice but there was no difference between iNOS KO and wild-type mice. Posterior wall thickness of left ventricle showed the same tendency with heart weight. Protein level of iNOS in the left ventricle was increased in isoproterenol-infused wild-type mice. The gene expression of interleukin-6 (IL-6) and transforming growth factor-${\beta}$ (TGF-${\beta}$) in isoproterenol-infused wild-type was measured at 2, 4, 24, and 48-hour and isoproterenol increased both IL-6 (2, 4, 24, and 48-hour) and TGF-${\beta}$ (4 and 24-hour). Isoproterenol infusion for 7 days increased the mRNA level of IL-6 and TGF-${\beta}$ in iNOS KO mice, whereas the gene expression in wild-type mice was not increased. Phosphorylated form of extracellular signal-regulated kinases (pERK) was also increased by isoproterenol at 2 and 4-hour but was not increased at 7 days after infusion in wild-type mice. However, the increased pERK level in iNOS KO mice was maintained even at 7 days after isoproterenol infusion. These results suggest that deficiency of iNOS does not prevent isoproterenol-induced cardiac hypertrophy and may have potentially harmful effects on cardiac hypertrophy.

• 대한정형외과 초음파학회지
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• 제1권1호
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• pp.31-39
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• 2008

초음파을 통하여 신생아 고관절의 형태와 안정성 여부를 관찰 할 수 있음이 알려진 이후 2개의 상반된 견해가 형성되었다. 신생아기에 관찰되는 관절 불안정이 치료를 필요로 하는 중요 병리라는 의견은 신생아기 비구이형성이 중요한 역할을 한다는 의견과 상충되어 왔다. Graf방법같이 신생아 비구이형성을 포함하여 치료의 필요성 여부를 판단하면 고관절 불안정성만을 기준으로 한 경우보다 치료와 추시를 하는 빈도가 훨씬 더 높았었다. 현재는 기술적 검사 방법의 발달과 질환의 적절한 이해로 그 차이는 크지 않은 것으로 여겨지고 있어 여러 방법은 유사한 결과를 보이고 있다. 중요한 것은 방법의 선택이 아니라 표준화한 검사를 할 수 있는 충분한 경험과 이해를 가지고 있어야 한다는 것이다. 이를 위하여 고관절 이형성증(DDH)의 진단에서의 여러 초음파 검사 방법과 의의, 치료시의 유용성에 대하여 논의 하였다.

• The Korean Journal of Pain
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• 제21권1호
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• pp.38-43
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• 2008

Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.

• 대한물리치료과학회지
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• 제9권3호
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• pp.67-75
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• 2002

The purpose of this study was to evaluate the effects of quadriceps femoris flexibility exercise which would improve the degree of knee flexion range of motion, extension torque, and the activities of daily living (ADL) in elderly subjects with degenerative knee arthritis. Fourteen elderly patients (two men and twelve women) with degenerative knee arthritis participated and had a quadriceps femoris flexibility exercise intervention program in this study. The mean age of the patients was 70.00 years for men and 71.16 years for women. This study carried out the experimental study of one group pretest-posttest design, which evaluated the degree of knee flexion range of motion, extension torque, the ADL ability of the patients before and after applying the exercise intervention for five weeks. The results of this study are as follow: 1. The knee flexion ranges of motion of the patients were measured before and after the intervention and the ranges increased significantly both in the left and right knee flexion range of motion (p < 0.05). 2. The peak torque of the knee muscle, the peak torque/body weight, and average power of the patients showed significant increases in both in the left and right knee after applying the intervention (p < 0.05). 3. The intervention produced a significant reduction in pain of the patients (p < 0.05). Their functional activities of ADL improved significantly compared with before the intervention (p < 0.05). It has been shown that the quadriceps femoris flexibility exercise intervention program increased significantly the knee flexion range of motion, and extension torque, as well as an increase in performance of functional activities of ADL of the patients. Thus, the quadriceps femoris flexibility exercise should be considered as one of the therapeutic exercises for the elderly patients with degenerative knee arthritis applied.

• 대한물리치료과학회지
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• 제22권1호
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• pp.43-48
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• 2015

Background : The purpose of this study was find out more effective method for improving muscle strengthening in lower extremities according squatting exercise method among knee joint angle 45, 60, 90 degree and between gym ball behind back and wall. Methods : Participants were 21 university students(males 10, females 11) who didn't have any problem with orthopedic surgery. We divided participants to two groups with gym ball group and wall group. Gym ball group were performance squatting exercise with gym ball behind back. Each group had performance squatting exercise according knee joint angle 45, 60, 90 degree. We collected data from E.M.G of Biceps femoris, Gastrocnemius, Vastus medialis and lateralis, Tibialis anterior in lower extremity according knee joint angle 45, 60, 90 degree of each groups. We analyzed data using by ANOVA and ANCOVA of SPSS PC ver. 12.0 in order to determine more effective method according various squatting exercise. Results : Each groups show significantly difference value of biceps femoris, vastus lateralis and medialis, tibialis anterior, gastrocnemius lateralis and medialis among knee joint angle 45, 60, 90 degree. But there was no significantly difference value between gym ball group and wall group according knee joint angle. Conclusions : We suggested that squatting exercise with gym ball was more effective method improving lower extremity muscle strengthening, and changing knee joint angle was more effective compared than continued knee joint angle.

• 대한정형외과스포츠의학회지
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• 제4권1호
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• pp.6-11
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• 2005

관절 연골 손상은 급성 손상과 만성 손상인 퇴행성 관절염으로 구분되며, 급성 손상은 연골 손상의 깊이에 따라서 미세 손상, 연골 골절, 골연골 골절의 세 종류로 구분할 수 있고 각 손상의 종류별로 서로 다른 양상의 치유 반응과 예후를 보인다. 만성 관절 연골 손상은 다양한 원인으로 인해서 발생하며 관절 연골의 전반적인 퇴행성 관절염의 형태를 보인다. 관절 연골 손상 시 초기 손상의 정도가 예후를 결정짓는데 가장 중요하고 이외에도 손상의 크기, 부위, 나이, 활동성, 비만 정도, 하지 정렬 상태등도 예후를 결정하는 중요한 요소들이다. 본 논문에서는 관절 연골 손상 시 발생하는 관절 연골 내의 병태 생리적 변화에 대하여 기술하고 비수술적인 치료 방법을 생역학적인 측면과 생물학적인 측면으로 구분하여 그 효과를 알아보고자 한다.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.168-172
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• 2007

Objective : Hirabayashi's open-door laminoplasty is a good procedure to use to treat patients with myelopathy of the cervical spine; however, the authors have experienced problems in maintaining an open-window in cervical spines after the surgery. The authors developed a modified method of the expanded open-door laminoplasty and compared the radiological and clinical results with those of the classical method. Methods : In the modified method, wiring fixation with lateral mass screws on the contra lateral-side instead of fixing the paraspinal muscle or facet joint, as in the classical methods, was used in the open window of the cervical spine. Fifteen patients with cervical myelopathy were treated using the classical method and 12 patients were treated using the modified method. Preoperative and postoperative clinical conditions were assessed according to the Japanese Orthopedic Association (JOA) score. The radiological results were compared with the preoperative and postoperative computed tomography (CT) findings. Results : In both methods, the clinical results revealed a significant improvement in neurological function (p<0.001). Image analysis revealed that the cervical canals were continuously expanded in patients treated using the modified methods. However, authors have observed restenosis during the follow-up periods in 4 patients treated using the original method. Progression to deformity and spinal instability were not observed in any of the patients in the radiological results. Conclusion : Although analysis with a larger population and a longer follow-up period needs to be undertaken, our modified open-door laminoplasty has shown an advantage in better maintaining an open window in comparison with the Hirabayashi's open-door laminoplasty.

• Journal of Korean Neurosurgical Society
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• 제52권2호
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• pp.126-132
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• 2012

Objective : The purpose of this study was to present the MRI and CT findings of solitary spinal bone lesions (SSBLs) with the aims of aiding the differential diagnoses of malignant tumors and benign lesions, and proposing a diagnostic strategy for obscure SSBLs. Methods : The authors retrospectively reviewed the imaging findings of 19 patients with an obscure SSBL on MRI at our hospital from January 1994 to April 2011. The 19 patients were divided to benign groups and malignant groups according to final diagnosis. MRI and CT findings were evaluated and the results of additional work-up studies were conducted to achieve a differential diagnosis. Results : At final diagnoses, 10 (52.6%) of the 19 SSBLs were malignant tumors and 9 (47.4%) were benign lesions. The malignant tumors included 6 metastatic cancers, 3 multiple myelomas, and 1 chordoma, and the benign lesions included 4 osteomyelitis, 2 hemangiomas, 2 nonspecific chronic inflammations, and 1 giant cell tumor. No MRI characteristics examined was found to be significantly different in the benign and malignant groups. Reactive sclerotic change was observed by CT in 1 (10.0%) of the 10 malignant lesions and in 7 (77.8%) of the 9 benign lesions (p=0.005). Conclusion : Approximately half of the obscure SSBLs were malignant tumors. CT and MRI findings in combination may aid the differential diagnosis of obscure SSBLs. In particular, sclerotic change on CT images was an important finding implying benign lesion. Finally, we suggest a possible diagnostic strategy for obscure SSBLs on MRI.

• Journal of Korean Neurosurgical Society
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• 제48권1호
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• pp.46-52
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• 2010

Objective : In cervico-thoracic junction (CTJ), the use of strong fixation device such as pedicle screw-rod system is often required. Purpose of this study is to analyze the anatomical features of C7 and T1 pedicles related to screw insertion and to evaluate the safety of pedicle screw insertion at these levels. Methods : Nineteen patients underwent posterior CTJ fixation with C7 and/or T1 included in fixation levels. Seventeen patients had tumorous conditions and two with post-laminectomy kyphosis. The anatomical features were analyzed for C7 and T1 pedicles in 19 patients using computerized tomography (CT). Pedicle screw and rod fixation system was used in 16 patients. Pedicle violation by screws was evaluated with postoperative CT scan. Results : The mean values of the width, height, stable depth, safety angle, transverse angle, and sagittal angle of C7 pedicles were $6.9{\pm}1.34\;mm$, $8.23{\pm}1.18\;mm$, $30.93{\pm}4.65\;mm$, $26.42{\pm}7.91$ degrees, $25.9{\pm}4.83$ degrees, and $10.6{\pm}3.39$ degrees. At T1 pedicles, anatomic parameters were similar to those of C7. The pedicle violation revealed that 64.1% showed grade I violation and 35.9% showed grade II violation, overall. As for C7 pedicle screw insertion, grade I was 61.5% and grade II 38.5%. At T1 level, grade I was 65.0% and grade II 35.0%. There was no significant difference in violation rate between the whole group, C7, and T1 group. Conclusion : C7 pedicles can withstand pedicle screw insertion. C7 pedicle and T1 pedicle are anatomically very similar. With the use of adequate fluoroscopic oblique view, pedicle screw can be safely inserted at C7 and T1 levels.