• Title/Summary/Keyword: Neurologic

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Exendin-4 Improves Nonalcoholic Fatty Liver Disease by Regulating Glucose Transporter 4 Expression in ob/ob Mice

  • Kim, Seok;Jung, Jaehoon;Kim, Hwajin;Heo, Rok Won;Yi, Chin-Ok;Lee, Jung Eun;Jeon, Byeong Tak;Kim, Won-Ho;Hahm, Jong Ryeal;Roh, Gu Seob
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.4
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    • pp.333-339
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    • 2014
  • Exendin-4 (Ex-4), a glucagon-like peptide-1 receptor (GLP-1R) agonist, has been known to reverse hepatic steatosis in ob/ob mice. Although many studies have evaluated molecular targets of Ex-4, its mechanism of action on hepatic steatosis and fibrosis has not fully been determined. In the liver, glucose transporter 4 (GLUT4) is mainly expressed in hepatocytes, endothelial cells and hepatic stellate cells (HSCs). In the present study, the effects of Ex-4 on GLUT4 expression were determined in the liver of ob/ob mice. Ob/ob mice were treated with Ex-4 for 10 weeks. Serum metabolic parameters, hepatic triglyceride levels, and liver tissues were evaluated for hepatic steatosis. The weights of the whole body and liver in ob/ob mice were reduced by long-term Ex-4 treatment. Serum metabolic parameters, hepatic steatosis, and hepatic fibrosis in ob/ob mice were reduced by Ex-4. Particularly, Ex-4 improved hepatic steatosis by enhancing GLUT4 via GLP-1R activation in ob/ob mice. Ex-4 treatment also inhibited hepatic fibrosis by decreasing expression of connective tissue growth factor in HSCs of ob/ob mice. Our data suggest that GLP-1 agonists exert a protective effect on hepatic steatosis and fibrosis in obesity and type 2 diabetes.

The Eastern and Western Medical Investigation on the Relation with I.I.C.P and Kwul (두개내압상승(頭蓋內壓上昇)과 궐의(厥) 상관성(相關性)에 대(對)한 동서의학적(東西醫學的) 고찰(考察))

  • Jung, Seung-Hyun;Park, Seong-Sik;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.3
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    • pp.237-267
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    • 1994
  • The purpose of this study is the approach to I.I.C.P. centered on the meaning of consciousness disorder and the pathological aspect of Kwul (Jose consciousness ; faint, fall into a coma). The meaning of consciousness disorder and apoplexy is evidently involved the definition of Kwul. 1. It is found that the etymological interpretation on Kwul which the energy rises back to go through blocked space and the meaning interpretation of regarding Kwul as apoplexy with medical viewpoint, are related with consciousness disorder and motor disturbance in IICP in the aspect of the rise of Kwul and the abnormal rising of vital energy and blood, In addtion, the overall of meaning of Kwul is showed in table <1-1> by reference to doctors of many generations, 2. The pathology of Kwul includes abnormal rising, sthenia-syndrome in the upper part and asthenia in the lower, the origin of Kwul, the lower, looking like Yin by too sthenic Yang and looking like Yang by too sthenic Yin. The headache, vomiting, papilledema, paralysis of nervi craniales, coma, blood pressure rising, tachycardia by I.I.C.P can be regarded as a conception of trouble of vital energy, sthenia-syndrome of Kwul. The pulse pressure, brachycardia, bradypnea can be regarded as the conception of looking like Yin by too sthenic Yang. 3. In the emergency of Kwul, the abnormal ternimal reversion of the Kwulyin channel, Kuyang channel, and three Yins are related with the phenomenon in I.I.C.P. It is considered that the reverse movement of materials, I.I.C.P. can be closely observed by giving meaning on the meridian of Kwul in Somunkwulron. And the content of phrases of Naelyung which includes consciousness disorder refered in the chapter of Kwul, is compared with I.I.C.P. 4. The followings should be considered; examination of optic symptom and abnormal posture in cerebral herniation ; understanding and working out counterplans of factors and symptoms of consciousness disorder by the observation of vital sign, check of general stages, neurologic inverstigation, clinical diagnosis, and subsidiary diagnosis; application of morphological change of opinion; addtion of the conception of demonstration centered on Yunkyung, Samyinkwulruk, asthenia and thenia of healthy energy in oriental medicine. 5. The similarity of Kwul and I.I.C.P. can be found from etiology and pathotenic factor. The similarity is clearly found by investigation of etiology, pathotenic factor, symptoms and thrapy of Kwul, disease symptom ar.d other symptoms.

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Difference of Knowledge and Attitudes toward HIV/AIDS between Genders of Physical Therapists and Physical Therapy Students (물리치료사와 물리치료과 학생의 성별에 따른 HIV/AIDS 에 대한 지식과 태도)

  • Ahn, So-Youn;Kim, Jong-Soon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.11 no.2
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    • pp.26-39
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    • 2005
  • The purpose of this descriptive study is to investigate the general knowledge and attitude about HIV/AIDS among gender in physical therapists and physical therapy students. AIDS a clinical syndrome that involves progressive immune deficiency and consequent development of opportunistic infection, tumors, neurologic disease and systemic wasting with chronic trends. Many medical specialists are afraid of AIDS patients because they have a little information of AIDS and fear of HIV infection from AIDS patients at work site. This study surveyed 649 physical therapists and physical therapy students by means of a self-administered questionnaire. This study was carried out from April, 2003 to October, 2003 for collecting data. The findings of this study can be summarized as follows. 1) The male and female physical therapist and physical therapy students who have an experience of educational program for HIV/AIDS show higher general knowledge about HIV/AIDS. 2) The male physical therapist and physical therapy students were conscious of the need for physical therapeutic intervention for the complication of HIV/AIDS. 3) The male who has higher general knowledge about HIV/AIDS are conscious of the need for educational program about HIV/AIDS. 4) The male and female want to have the choice to accept or reject the HIV/AIDS patients for treatment. 5) The knowledge of transmission mode in sexual intercourse of HIV/AIDS influence the attitude of male and female to patients with HIV/AIDS. 6) The knowledge of prevention of HIV/AIDS influence the attitude of male and female to patients with HIV/AIDS. 7) The knowledge of regarding symptom of HIV/AIDS influence the attitude of female to patients with HIV/AIDS. 8) The knowledge of general transmission mode of HIV/AIDS influence the attitude of male and female to patients with HIV/AIDS. 9) The knowledge of transmission risk factors in work site of HIV/AIDS influence the attitude of male and female to patients with HIV/AIDS. 10) The knowledge of needs for prevention in work site of HIV/AIDS influence the attitude of male and female to patients with HIV/AIDS. In conclusion, male and female with more knowledge of HIV/AIDS could positively treat HIV/AIDS patients.

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Comparison of Peripheral Blood Flow in Post-Stroke Hemiparetic Patients and Normal Person with Doppler Ultrasonography (도플러 초음파 기기를 이용한 편측 부전마비성 뇌졸중 환자와 정상인의 말초 혈류 비교 연구)

  • Han, Deok-Jin;Bang, Chang-Ho;Kim, Sergey;Bae, Young-Min;Shin, Sae-Ron;Yang, Chung-Yong;Lee, In
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1491-1496
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    • 2009
  • Stroke is usually associated with the cerebral blood flow of the central nervous system. However, studies concerning the effects of neurologic sysmptoms induced from stroke on the peripheral blood flow has not taken place sufficiently. To ascertain the feasibility of a blood flow meter adopting to use doppler ultrasonogrphy, under the prospect that hemiparesis induced from stroke may have effect on the peripheral blood flow, the peripheral blood flow velocity was observed. The control group made up of healthy people without any factors capable of effecting the peripheral blood flow velocity, and patient group which consist of hemiparetic people induced from stroke, were recruited. Volumes of recruitment are 21 persons in the patient group, and 29 persons in the control group, but the final numbers of people are 17 and 21 respectively because of the inconsistancy in the method of the test. The non-invasive method of Doppler effect of Ultrasound was used to measure the blood flow velocity. The blood flow velocity in the peripheral part of left and right fourth fingers:dorsal branches of proper palmar digital artery to dorsum of distal phalanges, was measured in the control group and patient group through Doppler Ultrasound. In comparison of the control group and the patient group, the systolic blood flow velocity from the peripheral part of the upper extremity was lower in the patient group than that of the control group. According to such results, it is concluded that hemiparesis induces the reduction of the peripheral blood flow velocity in the systolic phase.

The Assessment of Risk of Bias on Randomised Controlled Trials of Oriental Medicine in Korea (한의학 관련 무작위배정비교임상연구의 비뚤림 위험 평가)

  • Lee, Yoon-Jae;Jang, Bo-Hyoung;Go, Ho-Yeon;Hyun, Min-Kyung;Park, Sun-Young;Lee, Chang-Hoon;Kim, Jin-Sung;Cho, Ki-Ho
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.4
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    • pp.105-113
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    • 2011
  • Objectives: To examine the current status of clinical research in oriental medicine, and to assess 'risk of bias'(ROB) of randomized clinical trials(RCTs) in oriental medicine in Korea. Methods: Special committee for EBM, KOMS(Korean Oriental Medicine Society) reviewed 17 journals related to oriental medicine in Korea (from the first issue to May 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 2, 2010), and PubMed (1966 to May 2010). Then we selected eligible RCTs in terms of oriental medicine, and assessed 'risk of bias'. Results: We reviewed 12,653 articles from the 17 journals, and 41 articles from CENTRAL and PubMed. After non-clinical articles were excluded, 1,004 articles were left. Among them, the number of eligible studies in terms of oriental medicine was 306. In these eligible studies, 130 were RCTs. Of RCTs, 69 were on acupuncture, 25 on herbal medicine. The proportion of 'unclear' is high in the criteria of 'Allocation concealment', 'Blinding of participants and personnel', 'Blinding of outcome assessment' and 'Other bias'. On the other hand, 'low' has high in the criteria of 'Incomplete outcome data' and 'Selective reporting'. Conclusions: Risk of bias on oriental medicine is unclear in terms of 'allocation concealment' and 'blinding'. For high-quality research in oriental medicine, further research should be needed on randomization and blinding in the RCTs.

Treatment of Aplasia Cutis Congenita on Scalp using Hyalomatix$^{(R)}$: A Case Report (하이알로매트릭스를 이용한, 두개골결손을 동반한 선천성피부무형성증의 치료: 1례 보고)

  • Rhee, Suk-Hyun;Hong, Jong-Won;Roh, Tai-Suk;Kim, Young-Seok;Rah, Dong-Kyun
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.469-472
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    • 2010
  • Purpose: Aplasia Cutis Congenita (ACC) is a rare disease characterized by the focal defect of the skin at birth, frequently involving scalp, but it may affect any region of the body. There are no etiology known but some conditions such as intrauterine vascular ischemia, amniotic adherences and viral infections are associated. The ideal treatment for the ACC is not known. Superficial and relatively small sized defects (< $3{\times}5\;cm$) may heal spontaneously and large defects related with risks of infection and bleeding may require aggressive surgical treatment. Hyalomatrix$^{(R)}$ is a bilayer of an esterified hyaluronan scaffold beneath a silicone membrane. It has been used as a temporary dermal substitute to cover deep thickness skin defect and has physiological functions derive from the structural role in extracellular matrix and interaction with cell surface receptor. This material has been used for the wound bed pre-treatment for skin graft to follow and especially in uncooperative patient, like a newborn, this could be a efficient and aseptic way of promoting granulation without daily irritative wound care. For this reason, using Hyalomatrix$^{(R)}$ for the treatment of ACC was preferred in this paper. Methods: We report a case of a newborn with ACC of the vertex scalp and non-ossified partial skull defect. The large sized skin and skull defect ($6{\times}6\;cm$) was found with intact dura mater. No other complications such as bleeding or abnormal neurologic sign were accompanied. Escharectomy was performed and Hyalomatrix$^{(R)}$ was applied for the protection and the induction of acute wound healing for 3 months before the split-thickness skin graft. During the 3 months period, the dressing was renewed in aseptic technique for every 3 weeks. The skin graft was achieved on the healthy granulation bed. Results: The operative procedure was uneventful without necessity of blood transfusion. Postoperative physical examination revealed no additional abnormalities. Regular wound management was performed in out-patient clinic and the grafted skin was taken completely. No other problems developed during follow-up. Conclusion: Hyalomatrix$^{(R)}$ provides protective and favorable environment for wound healing. The combination of the use of Hyalomatrix$^{(R)}$ and the skin graft will be a good alternative for the ACC patients with relatively large defect on vertex.

Surgical Management of Multidrug Resistant Pulmonary Tuberculosis (다제내성 폐결핵 환자에서의 수술적 치료)

  • 성숙환;강창현;김영태;김주현
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.287-293
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    • 1999
  • Background: Medical treatment of multiple drug resistant(MDR) pulmonary tuberculosis has been quite unsuccessful. We analyzed our experience to identify the benefits and complications of the pulmonary resection in MDR pulmonary tuberculosis. Material and Method: A retrospective review was performed in 27 patients who unerwent pulmonary resection for MDR pulmonary tuberculosis between January 1994 and March 1998. Mean age was 40 years and the average history of diagnosis prior to surgery was 3.1 years. All had resistance to an average of 4.4 drugs, and received second line drugs selected according to the drug sensitivity test. Most patients (93%) had cavitary lesions as the main focus. Bilateral lesions were identified in 19 patients (70%), however, the main focus was recognized in one side of the lung. Eleven patients (41%) were converted to negative sputum smear and/or culture before surgery. Result: Pneumonectomy was performed in 9 patients, lobectomy in 16 and segmentectomy in 2. There was no operative mortality. Morbidity had occurred in 7 patients (26%), prolonged air leak in 3 patients, reoperation due to bleeding in 2, bronchopleural fistula in 1, and reversible neurologic defect in 1. Median follow up period was 15 months (3-45 months). Sputum negative conversion was initially achieved in 22 patients (82%), and with continuous postopertive chemotherapy negative conversion was achieved in other 4 patients (14%). Only one pneumonectized patient (4%) failed due to considerable contralateral cavity. Conclusion: For patients with localized MDR pulmonary tuberculosis and with adequate pulmonary reserve function, surgical pulmonary resection combined with appropriate pre and postoperative anti-tuberculosis chemotherapy can achieve high success rate with acceptable morbidity.

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Surgical Treatment with Extracorporeal Circulation for Acute Dissection of Descending Thoracic Aorta (체외순환을 이용한 흉부 하행대동맥의 급성 박리증 수술)

  • 최종범;정해동;양현웅;이삼윤;최순호
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.481-487
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    • 1998
  • The surgical management of acute type B dissection is controversial. The complexity of the repair usually requires a period of aortic cross-clamping exceeding 30 minutes, which can cause ischemic injury of the spinal cord. Several forms of distal perfusion have been considered for use to prevent this injury. To determine the safety and efficacy of a graft replacement with cardiopulmonary bypass in reparing acute dissection of descending thoracic aorta, we retrospectively reviewed our surgical experience treating 8 patients who had aortic dissection secondary to atherosclerosis, trauma, and carcinoma invasion. Cardiopulmonary bypass was performed with two aortic cannulas for simultaneous perfusion of the upper and lower body and one venous cannula for draining venous blood from the right atrium or inferior vena cava. Although aortic cross-clamp time was relatively long (average, 117.8 minutes; range, 47 to 180 minutes) in all cases, there was no neurologic deficit immediately after graft replacement for the aortic lesion. Two patients(25%) of relatively old age died on the postoperative 31st and 41st days, respectively, because of delayed postoperative complications, such as pulmonary abscess and adult respiratory distress syndrome. Although any of several maneuvers may be appropriate in managing dissection of the descending aorta, graft replacement with cardiopulmonary bypass during aortic cross-clamping may be a safe and effective method for the treatment of acute dissection of the descending thoracic aorta.

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Equine Motor Neuron Disease in a Jeju Pony (제주 조랑말에서의 말운동신경세포질환 일례)

  • Lee, Sang-Kyu;Han, Jae-Ik;Kang, Hyun-Gu
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.142-145
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    • 2013
  • Equine motor neuron disease (EMND) is a spontaneous neurologic disorder of horses, which results from the degeneration of motor neurons in the spinal cord and brain stem. An 8-year-old Jeju pony gelding presented with weight loss, muscle tremors, frequent recumbence, low head carriage, sweating, and standing with four limbs close together. The gelding has been on the same stable and limited access to pasture for several years. The gelding has been fed with dried hays and commercial concentrated feeds. Laboratory test revealed very low serum vitamin E level (0.14 ${\mu}g/mL$; reference range > 1.5 ${\mu}g/mL$), mildly elevated creatine kinase (402 IU/L; reference range 119-287 IU/L) and aspartate aminotransferase (876 IU/L; reference range 226-336 IU/L). Oral glucose absorption test showed decreased glucose absorption. Histopathologic examination using a biopsy specimen from sacrocaudalis dorsalis medialis muscle revealed atrophic and hypertrophic muscle fiber, centralization of nucleus, degenerating and necrotic muscle fibers. Taken together, the gelding was diagnosed as EMND. After oral vitamin E administrated for 5 weeks, the gelding showed normally improved stance, decreased periods of recumbency, improved head carriage and weight gain except consistent tremors. This is the first report that successfully treated EMND case occurred in a Jeju pony in Korea.

Event-related Potentials of Pre- and Post-Hemodialysis in Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석 전후의 P300 인지유발전위검사)

  • Bae, Jae-Chun;Lee, Sang-Moo
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.136-142
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    • 2001
  • Background : Nervous system dysfunction is a major complication of end stage renal disease. Although severe neurologic symptoms are partially or completely reversed by adequate hemodialysis, even optimally dialyzed patients will usually not return to normal neurocognitive function. To investigate the influence of chronic renal failure and hemodialysis on higher cognitive function electrophysiologically, we studied auditory P300 event-related potentials in 14 hemodialysis patients and 14 age- and sex-matched normal healthy controls. Methods : The subjects consisted of 14 patients(M: 6, F: 8) with chronic renal failure(CRF) for 1 to 10 years and 14 age- and sex-matched healthy controls(M: 5, F: 9). For the reliability of study, patients with diabetes mellitus, abnormal brain CT findings, or low mini-mental state score(below 20) were excluded. Event related potentials(ERPs) for hemodialysis patients were performed at pre- and post-hemodialysis. To obtain ERPs, subjects underwent 2-tone auditory discrimination test(oddball paradigm). Results : Although the age(control: $48.79{\pm}10.31years$, CRF: $51.21{\pm}7.61years$) and mini-mental state score(control: $27.00{\pm}1.71points$, predialysis CRF: $25.07{\pm}3.58points$) were not different in normal control and CRF groups significantly(P>0.05), P300 latencies at Cz(control: $288.11{\pm}17.36msec$, predialysis CRF: $332.35{\pm}42.34msec$) were significantly delayed(P<0.05)and the duration of Trail making test A was significantly prolonged(control: $64.2{\pm}24.2sec$, CRF: $118.9{\pm}101sec$) in CRF group. P300 latencies between pre- and post-hemodialysis CRF patients(predialysis CRF: $332.35{\pm}42.34msec$, postdialysis CRF: $325.82{\pm}38.69msec$) were not significantly different. The P300 latency was not related with the duration of CRF(Spearman's correlation test, r=0.25, P>0.05) and the frequency of hemodialysis(Spearman's correlation test, r=0.28, P>0.05). Conclusions : From these results, we suggest that P300 latency is valuable in evaluating cognitive brain dysfunction in patients with CRF and hemodialysis does not have a significant effect on cognitive brain dysfunction in patients with CRF.

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