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Evaluation of Multiple System Atrophy and Early Parkinson's Disease Using $^{123)I$-FP-CIT SPECT ($^{123)I$-FP-CIT SPECT를 이용한 다중계위축증 및 조기 파킨슨병에서의 평가)

  • Oh, So-Won;Kim, Yu-Kyeong;Lee, Byung-Chul;Kim, Bom-Sahn;Kim, Ji-Sun;Kim, Jong-Min;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.10-18
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    • 2009
  • Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.

A New Approach to Automatic Keyword Generation Using Inverse Vector Space Model (키워드 자동 생성에 대한 새로운 접근법: 역 벡터공간모델을 이용한 키워드 할당 방법)

  • Cho, Won-Chin;Rho, Sang-Kyu;Yun, Ji-Young Agnes;Park, Jin-Soo
    • Asia pacific journal of information systems
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    • v.21 no.1
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    • pp.103-122
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    • 2011
  • Recently, numerous documents have been made available electronically. Internet search engines and digital libraries commonly return query results containing hundreds or even thousands of documents. In this situation, it is virtually impossible for users to examine complete documents to determine whether they might be useful for them. For this reason, some on-line documents are accompanied by a list of keywords specified by the authors in an effort to guide the users by facilitating the filtering process. In this way, a set of keywords is often considered a condensed version of the whole document and therefore plays an important role for document retrieval, Web page retrieval, document clustering, summarization, text mining, and so on. Since many academic journals ask the authors to provide a list of five or six keywords on the first page of an article, keywords are most familiar in the context of journal articles. However, many other types of documents could not benefit from the use of keywords, including Web pages, email messages, news reports, magazine articles, and business papers. Although the potential benefit is large, the implementation itself is the obstacle; manually assigning keywords to all documents is a daunting task, or even impractical in that it is extremely tedious and time-consuming requiring a certain level of domain knowledge. Therefore, it is highly desirable to automate the keyword generation process. There are mainly two approaches to achieving this aim: keyword assignment approach and keyword extraction approach. Both approaches use machine learning methods and require, for training purposes, a set of documents with keywords already attached. In the former approach, there is a given set of vocabulary, and the aim is to match them to the texts. In other words, the keywords assignment approach seeks to select the words from a controlled vocabulary that best describes a document. Although this approach is domain dependent and is not easy to transfer and expand, it can generate implicit keywords that do not appear in a document. On the other hand, in the latter approach, the aim is to extract keywords with respect to their relevance in the text without prior vocabulary. In this approach, automatic keyword generation is treated as a classification task, and keywords are commonly extracted based on supervised learning techniques. Thus, keyword extraction algorithms classify candidate keywords in a document into positive or negative examples. Several systems such as Extractor and Kea were developed using keyword extraction approach. Most indicative words in a document are selected as keywords for that document and as a result, keywords extraction is limited to terms that appear in the document. Therefore, keywords extraction cannot generate implicit keywords that are not included in a document. According to the experiment results of Turney, about 64% to 90% of keywords assigned by the authors can be found in the full text of an article. Inversely, it also means that 10% to 36% of the keywords assigned by the authors do not appear in the article, which cannot be generated through keyword extraction algorithms. Our preliminary experiment result also shows that 37% of keywords assigned by the authors are not included in the full text. This is the reason why we have decided to adopt the keyword assignment approach. In this paper, we propose a new approach for automatic keyword assignment namely IVSM(Inverse Vector Space Model). The model is based on a vector space model. which is a conventional information retrieval model that represents documents and queries by vectors in a multidimensional space. IVSM generates an appropriate keyword set for a specific document by measuring the distance between the document and the keyword sets. The keyword assignment process of IVSM is as follows: (1) calculating the vector length of each keyword set based on each keyword weight; (2) preprocessing and parsing a target document that does not have keywords; (3) calculating the vector length of the target document based on the term frequency; (4) measuring the cosine similarity between each keyword set and the target document; and (5) generating keywords that have high similarity scores. Two keyword generation systems were implemented applying IVSM: IVSM system for Web-based community service and stand-alone IVSM system. Firstly, the IVSM system is implemented in a community service for sharing knowledge and opinions on current trends such as fashion, movies, social problems, and health information. The stand-alone IVSM system is dedicated to generating keywords for academic papers, and, indeed, it has been tested through a number of academic papers including those published by the Korean Association of Shipping and Logistics, the Korea Research Academy of Distribution Information, the Korea Logistics Society, the Korea Logistics Research Association, and the Korea Port Economic Association. We measured the performance of IVSM by the number of matches between the IVSM-generated keywords and the author-assigned keywords. According to our experiment, the precisions of IVSM applied to Web-based community service and academic journals were 0.75 and 0.71, respectively. The performance of both systems is much better than that of baseline systems that generate keywords based on simple probability. Also, IVSM shows comparable performance to Extractor that is a representative system of keyword extraction approach developed by Turney. As electronic documents increase, we expect that IVSM proposed in this paper can be applied to many electronic documents in Web-based community and digital library.

Multicenter clinical study of childhood periodic syndromes that are common precursors to migraine using new criteria of the International Classification of Headache Disorders (ICHD-II) (편두통의 전 단계인 소아기주기성증후군의 다기관 임상 연구: 국제두통질환분류 제2판 제1차 수정판 적용)

  • Park, Jae Yong;Nam, Sang-Ook;Eun, So-Hee;You, Su Jeong;Kang, Hoon-Chul;Eun, Baik-Lin;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.557-566
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    • 2009
  • Purpose : To evaluate the clinical features and characteristics of childhood periodic syndromes (CPS) in Korea using the new criteria of the International Classification of Headache Disorders (ICHD)-II. Methods : The study was conducted at pediatric neurology clinics of five urban tertiary-care medical centers in Korea from January 2006 to December 2007. Patients (44 consecutive children and adolescents) were divided into three groups (cyclic vomiting syndrome [CVS], abdominal migraine [AM], and benign paroxysmal vertigo of childhood [BPVC]) by recurrent paroxysmal episodes of vomiting, abdominal pain, dizziness, and/or vertigo using the ICHD-II criteria and their characteristics were compared. Results : Totally, 16 boys (36.4%) and 28 girls (63.6%) were examined (aged 4-18 yr), with 20 CVS (45.5%), 8 AM (18.2%), and 16 BPVC (36.4%) patients. The mean age at symptom onset was $6.3{\pm}3.6$ yr, $8.5{\pm}2.7$ yr, and $8.5{\pm}2.9$ yr in the CVS, AM, and BPVC groups, respectively, showing that symptoms appeared earliest in the CVS group. The mean age at diagnosis was $8.0{\pm}3.4$ yr, $10.5{\pm}2.6$ yr, and $10.1{\pm}3.2$ yr the CVS, AM, and BPVC groups, respectively. Of the 44 patients, 17 (38.6%) had a history of recurrent headaches and 11 (25.0%) showed typical symptoms of migraine headache, with 5 CVS (25.0%), 2 AM (25.0%), and 4 BPVC (25.0%) patients. Family history of migraine was found in 9 patients (20.4%): 4 in the CVS group (20.0%), 2 in the AM group (25.0%), and 3 in the BPVC group (18.8%). Conclusion : The significant time lag between the age at symptom onset and final diagnosis possibly indicates poor knowledge of CPS among pediatric practitioners, especially in Korea. A high index of suspicion may be the first step toward caring for these patients. Furthermore, a population-based longitudinal study is necessary to determine the incidence and natural course of these syndromes.

The meaning based on Yin-Yang and Five Elements Principle in Semantic Landscape Composition of 'the Forty Eight Poems of Soswaewon' ('소쇄원(瀟灑園) 48영'의 의미경관 구성에 있어서 음양오행론적(陰陽五行論的) 의미(意味))

  • Jang, Il-Young;Shin, Sang-Sup
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.31 no.2
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    • pp.43-57
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    • 2013
  • The purpose of this study is to identify potential semantic landscape makeup of "the Forty Eight Poems of Soswaewon" according to Yin-Yang and Five Elements Principle(陰陽五行論). that speculation system between human's nature and cosmical universal order. Existing academic discussions made so far concerning this topic can be summed up as follows: 1. Among Yin-Yang-based landscape makeups of the Forty Eight Poems of Soswaewon, poetic writings for embodiment of interactions between nature and human behaviors focused on depicting dynamic aspects of a poetic narrator when he appreciates or explores hills and streams as of to live free from worldly cares. Primarily, many of those writings were created on the east and south primarily through assignment of yang. On the other hand, poetic writings for embodiment of nature and seasonal scenery - as static landscape makeup of yin - were often created on or near the north and west for many times. Those writings focusing on embodiment of nature and artificial scenery as a work are divided into two categories: One category refers to author Kim In-hu's expression of semantic landscape from seasonal scenery in nature. The other refers to his depiction of realistic garden images as they are. In the Forty Eight Poems of Soswaewon, the poetic writings show that author Kim focused on embodying seasonal scenery rather than expressing human behaviors. In addition, both Poem No. 1 and Poem No. 48(last poem; titled 'Jangwon Jeyeong') were created in a same place, which author Kim sought to understand the place as a space of beginning and end where yin and yang - i.e. the principle of natural cycle - are inherent. 2. According to construction about landscape in the Forty Eight Poems of Soswaewon on the basis of Ohaeng-ron (five natural element principle), it was found that tree(木) and fire(火) are typical examples of a world combined by emanation. First, many of poetic writings depicting the sentiments of tree focused on embodying seasonal scenery and were located in the place of Ogogmun(五曲門) area in the east, from overall perspective of Soswaewon. The content of these poems shows generation and curve / straightness in flexibility and simplicity. Many of poems depicting the sentiments of fire(火) focused on embodying human behaviors, and they were created in Aeyangdan area on the south of Soswaewon over which sun rises at noon. These poems are all on a status of side movement that is characterized by emanation and ascension which belong to attributes of yang. 3. With regard to Ohaeng-ron's interpretation about landscape in the Forty Eight Poems of Soswaewon, it was found that metal(金) and water(水) are typical examples of world combined by convergence. First, it was found that all of poems depicting sentiments of metal focused on embodying seasonal scenery, and were created in a bamboo grove area on the west from overall perspective of Soswaewon. They represent scenery of autumn among 4 seasons to symbolize faithfulness vested in a man of virtue(seonbi) with integrity and righteousness. Poems depicting sentiments of water were created in vicinity of Jewoldang on the north, possibly topmost of Soswaewon. They were divided into two categories: One category refers to poems embodying actions of welcoming the first full moon deep in the night after sunset, and the other refers to poems embodying natural scenery of snowscape. All of those poems focused on expressing any atmosphere of turning into yin via convergence. 4. With regard to Ohaeng-ron's interpretation of landscape in the Forty Eight Poems of Soswaewon, it was found that poems depicting sentiments of earth(土), a complex body of convergence and emanation, were created in vicinity of mountain stream around Gwangpunggak which is located in the center of Soswaewon. These poems focused on carrying actions of author Kim by way of natural phenomena and artificial scenery.

Growth and Yield Characteristics of Foxtail Millet, Comon Millet Cereal Crops on Marginal Agricultural Lands (조건 불리 한계농경지에서의 조, 수수, 기장의 생육 및 수량)

  • Yoon, Seong-Tak;Lee, Myung-Cheol;Kim, Jeong-Soon;Zhang, Qingyu;Xu, Zhen-Yu;Kim, Young-Bok;Kim, Tae-Ho;Nam, Jung-Chang;Nam, Min-Hee;Lee, Young-Hawn;Hwang, Jae-Bok;Shim, Sang-In;Kim, Seong-Min
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.55 no.4
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    • pp.350-356
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    • 2010
  • This experiment was conducted to select optimum minor cereal crop and variety for the marginal agricultural lands so that they would be used to increase the agricultural land use rate in mountainous areas. This experiment used three different marginal agricultural lands, that is, slope land, barren land and gravelly land. Soil pH of control field was 7.85, slightly alkali, whereas gravelly land showed strong acid(pH 5.1). EC of marginal agricultural lands was generally lower compared to the control, especially barren land showed 0.05dS $m^{-1}$ which was the lowest among marginal agricultural lands. Foxtail millet showed no significant difference of heading and ripening date among marginal agricultural lands. Foxtail millet of slope land showed the highest culm length(169.5 cm) and grains per ear(4913.9 grains) among marginal agricultural lands except control field. Growth duration of three varieties was varied from 112 to 113days, which was not different statistically. In grains per ear of common millet, slope land showed 787.1 grains which was the highest among marginal agricultural lands except control field. Among varieties, Byorukgijang showed the highest grains per ear(827.2 g/ear), whereas 1000 grain weight was 5.5 g which was lower compared to that of Hwanggijang(6.2 g). In sorghum, slope land showed the highest grains(2563.8 grains) per ear and ears per 3.3 $m^2$(26.0 ears) except control field. Growth duration of three sorghum varieties almost the same from 122 to 123 days, whereas the highest grains per ear was obtained from Moktaksusu(2357.6 grains). Jangmoksusu showed the highest 1000 grain weight(23.8 g) among three sorghum varieties. In yield of three foxtail millets, the highest yield was obtained from slope land(282.0 kg/10a) among marginal agricultural lands and Mongdangjo showed the highest yield(252.3 kg/10a) among three varieties. In yield of three common millets, the highest yield was obtained from slope land(196.0 kg/10a) among marginal agricultural lands and Byorukgijang showed the highest yield(173.8 kg/10a) in three varieties. In three sorghum varieties, the highest yield was obtained from slope land(301.7 kg/10a) among marginal agricultural lands and Moktaksusu showed the highest yield(236.5 kg/10a) among three varieties.

Effect of Bronchial Artery Embolization(BAE) in Management of Massive Hemoptysis (대량 객혈환자에서 기관지 동맥색전술의 효과)

  • Yeo, Dong-Seung;Lee, Suk-Young;Hyun, Dae-Seong;Lee, Sang-Haak;Kim, Seok-Chan;Choi, Young-Mee;Suh, Ji-Won;Ahn, Joong-Hyun;Song, So-Hyang;Kim, Chi-Hong;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak;Kim, Ki-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.53-64
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    • 1999
  • Background : Massive and untreated hemoptysis is associated with a mortality of greater than 50 percent. Since the bleeding is from a bronchial arterial source in the vast majority of patients, embolization of the bronchial arteries(BAE) has become an accepted treatment in the management of massive hemoptysis because it achieves immediate control of bleeding in 75 to 90 percent of the patients. Methods: Between 1990 and 1996, we treated 146 patients with hemoptysis by bronchial artery embolization. Catheters(4, 5, or 7F) and gelfoam, ivalon, and/or microcoil were used for embolization. Results: Pulmonary tuberculosis and related disorders were the most common underlying disease of hemoptysis(72.6%). Immediate success rate to control bleeding within 24hours was 95%, and recurrence rate was 24.7%. The recurrence rate occured within 6 months after embolization was 63.9%. Initial angiographic findings such as bilaterality, systemic-pulmonary artery shunt, neovascularity, aneurysm were not statistically correlated with rebleeding tendency(P>0.05). Among Initial radiographic findings, only pleural lesions were significantly correlated with rebleeding tendency(P<0.05). At additional bronchial artery angiograpy done due to rebleeding, recanalization of previous embolized arteries were 63.9%, and the presence of new feeding arteries were 16.7%, and 19.4% of patients with rebleeding showed both The complications such as fever, chest pain, headache, nausea and vomiting, arrhythmia, paralylytic ileus, transient sensory loss (lower extremities), hypotension, urination difficulty were noticed at 40 patients(27.4%). Conclusion: We conclude that bronchial artery embolization is relatively safe method achieving immediate control of massive hemoptysis. At initial angiographic findings, we could not find any predictive factors for subsequent rebleeding. It may warrant further study whether patients with pleural disease have definetely increased rebleeding tendency.

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Comparison of Naphthalene Degradation Efficiency and OH Radical Production by the Change of Frequency and Reaction Conditions of Ultrasound (초음파 주파수 및 반응조건 변화에 따른 나프탈렌 분해효율과 OH 라디칼의 발생량 비교)

  • Park, Jong-Sung;Park, So-Young;Oh, Je-Ill;Jeong, Sang-Jo;Lee, Min-Ju;Her, Nam-Guk
    • Journal of Korean Society of Environmental Engineers
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    • v.31 no.2
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    • pp.79-89
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    • 2009
  • Naphthalene is a volatile, hydrophobic, and possibly carcinogenic compound that is known to have a severe detrimental effect to aquatic ecosystem. Our research examined the effects of various operating conditions (temperature, pH, initial concentration, and frequency and type of ultrasound) on the sonochemical degradation of naphthalene and OH radical production. The MDL (Method detection limit) determined by LC/FLD (1200 series, Agilient) using C-18 reversed column is measured up to 0.01 ppm. Naphthalene vapor produced from ultrasound irradiation was detected under 0.05 ppm. Comparison of naphthalene sonodegradion efficiency tested under open and closed reactor cover fell within less than 1% of difference. Increasing the reaction temperature from $15^{\circ}C$ to $40^{\circ}C$ resulted in reduction of naphthalene degradation efficiency ($15^{\circ}C$: 95% ${\rightarrow}$ $40^{\circ}C$: 85%), and altering pH from 12 to 3 increased the effect (pH 12: 84% ${\rightarrow}$pH 3: 95.6%). Pseudo first-order constants ($k_1$) of sonodegradation of naphthalene decreased as initial concentration of naphthalene increased (2.5 ppm: $27.3{\times}10^{-3}\;min^{-3}\;{\rightarrow}$ 10 ppm : $19.3{\times}10^{-3}\;min^{-3}$). Degradation efficiency of 2.5 ppm of naphthalene subjected to 28 kHz of ultrasonic irradiation was found to be 1.46 times as much as when exposed under 132 kHz (132 kHz: 56%, 28 kHz: 82.7%). Additionally, its $k_1$ constant was increased by 2.3 times (132 kHz: $2.4{\times}10^{-3}\;min^{-1}$, 28 kHz: $5.0{\times}10^{-3}\;min^{-1}$). $H_2O_2$ concentration measured 10 minutes after the exposure to 132 kHz of ultrasound, when compared with the measurement under frequency of 28 kHz, was 7.2 times as much. The concentration measured after 90 minutes, however, showed the difference of only 10%. (concentration of $H_2O_2$ under 28 kHz being 1.1 times greater than that under 132 kHz.) The $H_2O_2$ concentration resulting from 2.5 ppm naphthalene after 90 minutes of sonication at 24 kHz and 132 kHz were lower by 0.05 and 0.1 ppm, respectively, than the concentration measured from the irradiated M.Q. water (no naphthalene added.) Degradation efficiency of horn type (24 kHz) and bath type (28 kHz) ultrasound was found to be 87% and 82.7%, respectively, and $k_1$ was calculated into $22.8{\times}10^{-3}\;min^{-1}$ and $18.7{\times}10^{-3}\;min^{-1}$ respectively. Using the multi- frequency and mixed type of ultrasound system (28 kHz bath type + 24 kHz horn type) simultaneously resulted in combined efficiency of 88.1%, while $H_2O_2$ concentration increased 3.5 times (28 kHz + 24 kHz: 2.37 ppm, 24 kHz: 0.7 ppm.) Therefore, the multi-frequency and mixed type of ultrasound system procedure might be most effectively used for removing the substances that are easily oxidized by the OH radical.

Genetic Polymorphisms of the $\beta_2$-Adrenergic Receptor in the Severity of Bronchial Asthma (기관지 천식 환자에서 천식 증상의 정도에 따른 $\beta_2$ 교감신경 수용체의 유전자 다형성)

  • Shim, Jae-Jeong;Kim, Jei-Hyung;Lee, Seung-Yong;Kwan, Young-Hwan;Lee, So-Ra;Lee, Sang-Youb;Kang, Se-Yong;Kang, Yong-Koo;Cho, Jae-Youn;In, Kwang-Ho;Won, Nam-Hee;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.77-89
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    • 1998
  • Background: Genetic and environmental factors are known to affect the incidence and severity of asthma. Stimulation of $\beta_2$-Adrenergic Receptor ($\beta_2$AR) results in smooth muscle relaxation, leading to decrease in resistance of airflow. The gene encoding the $\beta_2$AR has recently been seguenced. The $\beta_2$AR genotype at the polymorphic loci of codons 16, 27, 34, and 164 was known to cause changes in the amino acids. The relationships between the structure of the $\beta_2$AR and its functions are being elucidated. Purpose : The gene encoding the $\beta_2$AR was carried out to assess the frequency of polymorphisms in bronchial asthma, to determine wheather these polymorphisms have any relation to the severity, or nocturnal symptoms in bronchial asthma. Methods: The subjects studied were 103 patients with bronchial asthma, which consisted of 30 mild episodic, 32 mild persistent, 17 moderate, and 24 severe asthma patients. The polymorphisms of the $\beta_2$AR gene were detected by mutated allele specific amplification (MASA) method at the codons 16,27,34, and 164. Results: The most frequent polymorphism was arginine 16 to glycine. The other two polymorphisms, valine 34 to methionine and glutamine 27 to glutamic acid occured in 11 and 6 patients respectively. The polymorphism of threonine 164 to isoleucine was not found in our enrolled patients. The homozygous polymorphism of $\beta_2$AR gene was found in only arginine 16 to glycine (12.6%). The heterozygous polymorphisms of $\beta_2$AR gene were in arginine 16 to glycine, valine 34 to methionine, and glutamine 27 to glutamic acid, as 65.1 %,10.7%, and 5.8% respectively in asthma patients. The presence of agrginine 16 to glycine heterozygous or/and homozygous polymorphism was associated in severe asthma (p=0.015), but there was no association between the other three polymorphisms and the severity of asthma. The frequency of the $\beta_2$AR gene polymorphisms was no relation in nocturnal asthma as compared with non-nocturnal asthma. Conclusion: The arginine 16 to glycine polymorphism of the $\beta_2$AR gene is the most frequently found in asthma patients and association with severe asthma. But there was no association between the polymorphism of the $\beta_2$AR gene and nocturnal asthma.

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The Bronchial Biopsies and Steroid Response in Unexplained Chronic Non-Productive Cough (원인을 알 수 없는 만성 기침의 기관지 생검소견과 경구 스테로이드의 효과)

  • Lee, Sang-Yeub;Jeong, Hye-Cheol;Kim, Kyung-Kyu;Kim, Je-Hyeong;Kwan, Young-Hwan;Lee, Sung-Yong;Lee, So-Ra;Cho, Hyun-Deuk;Lee, Sin-Hyung;Shim, Jae-Jeong;Cho, Jae-Yun;Kim, Han-Gyum;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.372-385
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    • 1999
  • Background: The purpose of this study was to examine the causes and pathologic process of chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph by investigating clinicopathologic findings. Method: We studied 25 adults with chronic non-productive cough over a 3-week period with a normal chest radiograph and pulmonary function tests without any other symptoms. Clinical assessment, cough score, chest and sinus radiograph, pulmonary function tests, methacholine challenge, allergic skin prick test, and bronchoscopy for bronchial biopsies were performed. Subjects were then treated with prednesolone 20 to 30 mg/day for 1 to 2 weeks. Results: The experimental group was divided into two subgroups-those infiltrated with eosinophils, and those infiltrated with lymphocytes depending on eosinophil and lymphocyte counts, both of which were respectively higher than those of the control group. Eosinophils infiltrated group had mean numbers of eosinophil of 89.8 $cells/mm^3$ while control group's mean was 0.4 $cells/mm^2$(p=0.005). Lymphocyte infiltrated group was 4 patients whose mean was 84.3 $cells/mm^2$ with 28.4 $cells/mm^2$ of control group(P=0.026). In addition, the mean thickness of the basement membrane of experimental group was $14.20{\pm}5.20{\mu}m$ in contrast of control group whose mean was $3.50{\pm}1.37{\mu}m$(P=0.001). With the methacholine challenge test, 7 of the 21 eosinophil infiltrated subjects were diagnosed with cough variant asthma ; the other 14 with eosinophilic bronchitis. Three subjects with eosinophilic bronchitis were atopic positive (21.4%) with the skin prick test In the lymphocyte dominant group, all four subjects were diagnosed with lymphocytic bronchitis. Cough score was improved after steroid treatment in 22 of 25 subjects in the experimental group (88.0%). Conclusion: These results suggest chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph was associated with airway inflammation by eosinophil and lymphocyte infiltration. The causes for chronic non-productive cough were eosinophilic bronchitis, cough variant asthma, and lymphocytic bronchitis(written in frequency). They further suggest that therapeutic treatment with steroids can provide effective symptomatic relief.

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Effects of HapKok (LI-4) , SamUmGyo (SP-6) Acupuncture on Uterine Motility and Cyclooxygenase-2 Manifestation in Rats (합곡(合谷), 삼음교(三陰交) 자침(刺鍼)이 백서(白鼠) 자궁(子宮) 운동(運動) 및 Cyclooxygenase-2 발현(發現)에 미치는 영향(影響))

  • Lee, Byung-Chul;Lee, Ho-Sub;Kim, Kyung-Sik;Lee, Geon-Mok;Na, Chang-Soo;Kim, Jung-Sang;Hwang, Woo-Jun
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.187-208
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    • 2000
  • By the activation of ovary hormone, many morphological changes occur in the epithelial cell lines and muscle cells in rat uterus. These two cells in uterus are important to the implantation of embryo, maintaining pregnancy and starting parturition. One important change associated with the morphological change of these two cells in uterus is the change on prostaglandin(PG) metabolism. Its presence and synthesis in endometriurn and myometrium in uterus affects estrous cycle and the start of embryo implantation in uterus. It also performs as an important modulator in parturition. So the abnormally weak expression of PG causes difficulty during labor and over-expression causes pre-term labor. PG biosynthesis starts from either free or liberated arachidonic acids from membrane phospholipid by phospholipase. Such arachidonic acids are converted into PG catalyzed by Cyclooxygenase. Under normal physiological condition, Cyclooxygenase-1(COX-1) having 602 units of amino acids controls the synthesis of PG. It acts as a local hormone regulating vasomodulation of blood flow, flexible muscle movement, increasing the blood permeability and contributing the protective role in preserving integrity of the stomach lining and Cyclooxygenase-2 (COX-2) is induced by the inflammation, pregnancy and increased its expression until parturition. Lipid metabolite like PG is located in uterine and expression of COX-2 increased with pregnancy. Increased expression of COX proteins in epithelial cells and myometrial cells are told to increase the muscle contractility in uterus but decreased right after the labor in rat. It is a good sign indicating that COX proteins are deeply related to the start of labor. Currently, Several studies report the use of PG and COX-2 inhibitor as medication for controlled abortion or to prevent pre-term labor but they entail various side-effects. Our study proposed to suggest use of acupuncture as an another mediator to control abortion or pre-term labor without causing unnecessary side-effects by those medicines. Two acupuncture sites, LI-4 & SP-6 were selected due to their known efficacy. From the immunohistochemical staining of COX-2, normal expression of COX-2 protein in nonpregnant SD rat's uterus revealed that COX-2 protein was primarily detected in the lumina epithelial lining and in the epithelial cell lining contacting the stromal cells. High resolution optical microscopic scanning revealed distinguishable staining in the myometrial mucosa. LI-4 acupuncture administered nonpregnant rat's uterus showed strong expression for COX-2 in endometrium contacted with lumina epithelial lining of rat uterus and in myometrial mucosa. Stromal cells showed more staining than untreated nonpregnant rat's uterus and stronger staining in stromal cells contacting myometrial layer compared to untreated nonpregnant rat's uterus. SP-6 acupuncture administered nonpregnant rat's uterus showed weak expression for COX-2 in myometrial layers and stromal cells but no staining was visible in lumina epitheliai and glandular epithelial cells. Few stromal cells and myometrial mucosa were positively stained for COX-2. Pregnant SD rat's uterus was also immunostained for COX-2 expression after 18 days of pregnancy. Unlike to untreated nonpregnant rat's uterus, luminal epithelial cells were not positively stained for COX-2 but stronger staining for COX-2 was revealed in stromal cells. LI-4 acupunctured SD rat's uterus had very strong expression of COX-2 in luminal epithelial lining. Few stromal cells showed stronger positive COX-2 staining and myometrial layers also showed more expression than untreated pregnant rat. SP-6 acupuncture administered pregnant SD rat's uterus showed positive expression of COX-2 in epithelial cells of luminal mucosa layer but weaker than that of LI-4 acupuncture treatment's case. However, strong positive staining was revealed in stromal mucosa and myometrial layers. Virgin SD rat's uterus motility index during LI-4 acupuncture was 66.52 % (Prob〉T = 0.0197) compared to its motility before the acupuncture treatment but the motility index was slighdy elevated up to 79.58 % (Prob〉T = 0.1175) after the acupuncture. During the SP-6 acupuncture treatment for 30 minutes, uterus motility index was 90.52 % (Prob〉T = 0.1832) showing lesser decrement but consequently reached similar motility index decreasal to 79.95 % (Prob〉T = 0.0215) after the acupuncture treatment as LI-4 showed. LI-4 acupuncture tend to be a quick treatment to reducing the uterus motility in a virgin rat but eventually both two acupuncture administration created very similar reduction of uterus motility seeing the index after the both acupunctures. The uterus movement monitored during the LI-4 acupuncture administered for 30 minutes, Pregnant SD rat showed decreased motility down to 77.90 % (Prob〉 T = 0.0076) compared to uterus motility before the acupuncture and it continuously decreased down to 71.81 %(Prob〉T = 0.0214) after the removal of needle. The statistical analysis using paired t-test showed significance difference for both two motility indexs at =0.05. SP-6 acupuncture administered to pregnant SD rat also had similar pattern of decreasing uterus motility index down to 74.70 % (Prob〉T = 0.1730) during the initial 30 minutes acupuncture administration and it was continuously lowered to 71.52 % (Prob〉T = 0.0155) after the acupuncture. The paired t-test resuit for SP-6 suggest prompt response of uterus motility index to the SP-6 acupuncture treatment but consequently reached same level of inducing the motility reduction as LI-4 at =0.05 level.

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