• 제목/요약/키워드: multifactorial

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Modified chevron 절골술을 이용한 무지외반증의 치험 (Modified Chevron Osteotomy for the Treatment of Hallux Valgus)

  • 이범구;박홍기;위성
    • 대한족부족관절학회지
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    • 제1권2호
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    • pp.95-101
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    • 1997
  • Hallux valgus has been characterized by a valgus deformity of the great toe at the metatarsophalangeal joint, along with medial deviation of the first metatarsal, and by three components. First, there is a valgus angle more than $20^{\circ}$ at the first, metatarsophalangeal joint. Second, there is a greater angle than $9^{\circ}$ between the first. and second metatarsals. Third, there is bursal hypertrophy at the medial eminence of the first metatarsals head. The etiology is multifactorial and many procedures have been reported in the treatment of hallux valgus. Most of the procedures are directed towards pain relief, correction of deformity, and preservation of dorsiflexion in the first metatarsophalangeal joint. One such treatment is the Modified chevron osteotomy. It is technically simple, and provides greater stability than a standard osteotomy, and allows early ambulation after surgery. We a reviewed 19 cases with 13 patients of hallux valgus deformity. They were all treated with the Modified chevron osteotomy at the Department of Orthopedic Surgery, Choong ang Gil Hospital, between June 1988 and May 1994. The results of the study were as follows; 1. The mean age was 36 years. Three patients(5 case) were male and ten patients(14 cases) were female. 2. The mean value of the hallux valgus angle was $34.1^{\circ}$, and the first to second intermetatarsal angle was $12.1^{\circ}$, preoperatively. These angles were corrected to $15.8^{\circ}$ and $8.5^{\circ}$, respectively. 3. The metatarsalgia subsided in 17 cases (89.5%). avascular necrosis, non union, and dorsal angulation complicatious were nonexistant. Early bone healing occurred in all cases. 4. The Modified chevron osteotomy is technically simple. It provides excellent pain relief, early ambulation, increased mechanical stability, and many avoids many complications such as AVN, non-union, and dorsal angulation.

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Combination therapy with cilostazol, aripiprazole, and donepezil protects neuronal cells from β-amyloid neurotoxicity through synergistically enhanced SIRT1 expression

  • Heo, Hye Jin;Park, So Youn;Lee, Yi Sle;Shin, Hwa Kyoung;Hong, Ki Whan;Kim, Chi Dae
    • The Korean Journal of Physiology and Pharmacology
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    • 제24권4호
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    • pp.299-310
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    • 2020
  • Alzheimer's disease (AD) is a multi-faceted neurodegenerative disease. Thus, current therapeutic strategies require multitarget-drug combinations to treat or prevent the disease. At the present time, single drugs have proven to be inadequate in terms of addressing the multifactorial pathology of AD, and multitarget-directed drug design has not been successful. Based on these points of views, it is judged that combinatorial drug therapies that target several pathogenic factors may offer more attractive therapeutic options. Thus, we explored that the combination therapy with lower doses of cilostazol and aripiprazole with add-on donepezil (CAD) might have potential in the pathogenesis of AD. In the present study, we found the superior efficacies of donepezil add-on with combinatorial mixture of cilostazol plus aripiprazole in modulation of expression of AD-relevant genes: Aβ accumulation, GSK-3β, P300, acetylated tau, phosphorylated-tau levels, and activation of α-secretase/ADAM 10 through SIRT1 activation in the N2a Swe cells expressing human APP Swedish mutation (N2a Swe cells). We also assessed that CAD synergistically raised acetylcholine release and choline acetyltransferase (CHAT) expression that were declined by increased β-amyloid level in the activated N2a Swe cells. Consequently, CAD treatment synergistically increased neurite elongation and improved cell viability through activations of PI3K, BDNF, β-catenin and α7-nicotinic cholinergic receptors in neuronal cells in the presence of Aβ1-42. This work endorses the possibility for efficient treatment of AD by supporting the synergistic therapeutic potential of donepezil add-on therapy in combination with lower doses of cilostazol and aripiprazole.

Capsular Contracture after Breast Augmentation: An Update for Clinical Practice

  • Headon, Hannah;Kasem, Adbul;Mokbel, Kefah
    • Archives of Plastic Surgery
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    • 제42권5호
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    • pp.532-543
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    • 2015
  • Capsular contracture is the most common complication following implant based breast surgery and is one of the most common reasons for reoperation. Therefore, it is important to try and understand why this happens, and what can be done to reduce its incidence. A literature search using the MEDLINE database was conducted including search terms 'capsular contracture breast augmentation', 'capsular contracture pathogenesis', 'capsular contracture incidence', and 'capsular contracture management', which yielded 82 results which met inclusion criteria. Capsular contracture is caused by an excessive fibrotic reaction to a foreign body (the implant) and has an overall incidence of 10.6%. Risk factors that were identified included the use of smooth (vs. textured) implants, a subglandular (vs. submuscular) placement, use of a silicone (vs. saline) filled implant and previous radiotherapy to the breast. The standard management of capsular contracture is surgical via a capsulectomy or capsulotomy. Medical treatment using the off-label leukotriene receptor antagonist Zafirlukast has been reported to reduce severity and help prevent capsular contracture from forming, as has the use of acellular dermal matrices, botox and neopocket formation. However, nearly all therapeutic approaches are associated with a significant rate of recurrence. Capsular contracture is a multifactorial fibrotic process the precise cause of which is still unknown. The incidence of contracture developing is lower with the use of textured implants, submuscular placement and the use of polyurethane coated implants. Symptomatic capsular contracture is usually managed surgically, however recent research has focussed on preventing capsular contracture from occurring, or treating it with autologous fat transfer.

원인불명의 극심한 식욕부진(食慾不振)을 호소한 고령 환자 치험례 (Case of an Old-Age Patient with Ill-defined Severe Anorexia)

  • 정기용;하유군;백종우;최유경;김동우;박종형;전찬용
    • 동의생리병리학회지
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    • 제22권1호
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    • pp.256-261
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    • 2008
  • Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.

돼지 위축성 비염백신의 효과에 관한 연구 (Efficacy of atropic rhinitis vaccine in pigs)

  • 지영철;로 승;한정희;한태욱
    • 대한수의학회지
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    • 제40권4호
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    • pp.707-717
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    • 2000
  • Atropic rhinitis (AR) is one of major respiratory diseases in pigs. AR causes a great economic losses and is considered to be a multifactorial disease in which herd management, heredity, and environment. Several vaccines against have been developed commercially and used in pig farms but the efficacy of each vaccine is still questionable. In this study, one of commercial AR vaccines, which contains inactivated Bordetella bronchiseptica, Pasteurella multocida type D and their toxoid was evaluated for vaccine efficacy by challenge test. Twenty piglets were divided into four groups as follows; group I was piglets from vaccinated sows (twice before parturition); group II was piglets from vaccinated sows (same as group I) and were vaccinated at 1 day old; group III and IV were piglets without any vaccination. Groups I, II, and III were challenged by intranasal instillation of $5.3{\times}10^7$ CFU of B bronchiseptica twice and $1{\times}10^9$ CFU of P multocida five times. Group IV was control group without any vaccination and any challenge. We compared serological results, recovery rate of P multocida by polymerase chain reaction, clinical signs and pathological findings between vaccinated groups and unvaccinated groups for efficacy of the vaccine, Serological responses against B bronchiseptica and toxigenic P multocida type D were not showed evident discrepancy between vaccinated groups and unvaccinated groups assuming that the antibody responses against the vaccine is very delayed. However, growth rate, clinical signs and snout lesion grading in vaccinated groups showed more favorable than those in unvaccinated group. Therefore, AR vaccination in this study is considered to be effective in the prevention of AR in pigs.

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Study of Novel Markers for Early Diagnosis of Cardiovascular Diseases

  • Kang Jae Heon;Han Jung Soon;Kim Kyung A;Song Hong Ji
    • Journal of Community Nutrition
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    • 제6권3호
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    • pp.155-163
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    • 2004
  • In our country, cardiovascular disease (CVD) and Coronary heart diseases (CHD) are the leading causes of death. It is well known that CHD is multifactorial, involving environmental factors such as diet, level of exercise and cigarette smoking, and inherited factors. According to the statistical data in 2003, the cause of death with the highest mortality was including hypertension, ischemic heart disease and atherosclerosis, which accounted for $24.7\%$ of total mortality. In spite of, there have been few study reports on the change of biochemical markers and mechanisms concerned. The development of biochemical markers is required for an early diagnosis and treatment of cardiovascular diseases that are related with dietary habits of Korean people enjoying mixtures of traditional dietary style and westernized food-styles. Therefore, the most efficient cost-saving biochemical marker was established in this study, through analysis of biochemical markers related with dietary habits which are susceptibly being changed in association to cardiovascular diseases from the pre-disease phase, and through reanalysis and assessment of early diagnosis of and preventive effects of diagnosis of cardiovascular diseases by demographical character including sex, age, and socioeconomic level with use of biochemical markers that are identified and selected among the parameters in consideration of the effectiveness and appropriateness of early diagnosis of diseases. The appropriateness of biochemical markers was reviewed by professionals (medical, pharmaceutical area and food/ nutrition area) and CRP(C-Reactive Protein) and was identified to be possible in Korea. It is thought that these biochemical markers may be used as the basic data for early diagnosis and prevention of cardiovascular diseases (CVD) which may be used for Korean people.

저시력 환자의 삶의 질과 일상에 영향을 주는 병인에 관한 연구 (Study on the quality of life and etiological factor influenced on daily life in low vision patient)

  • 서재명
    • 한국산학기술학회논문지
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    • 제10권11호
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    • pp.3412-3417
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    • 2009
  • 본 연구는 저시력 환자와 정상인의 삶의 만족도를 상호 객관적으로 비교하고자 시행하였다. 다인성 저시력환자 20명과 그들의 나이와 유사하며 신체 건강한 정상인 20명을 대상으로 시기능설문지 NEI VFQ-25를 사용하여 구두로 평가하였다. 참가자 연령은 25세에서 78세까지 고루 분포하였으며 저시력 실험군의 평균값은 55.88$\pm$14.76이었으며 정상 대조군은 94.47$\pm$3.78로 나타났다. 저시력 실험군의 나이는 근거리 활동성과 가장 관련이 높았으며(r=-0.584) 그들의 시력은 주변시력과 관련이 가장 높은 것으로 나타났다(r=0.527). 저시력 환자의 삶의 만족도는 정상인에 비해 현저히 낮았으며 안구진탕이 일상생활에 큰 영향을 미칠 것으로 생각된다.

한의학(韓醫學)의 전망(展望)과 우리의 역할(役割) (A Personal Perspective and Our Role in Korean Oriental Medicine)

  • 강순수
    • 대한한의학방제학회지
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    • 제10권2호
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    • pp.1-4
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    • 2002
  • The development of Korean Oriental medicine is based upon the accumulation of experience and knowledge gathered over the centuries. The approaches taken are holistic and empirical. There is a need to understand their actions at molecular levels with more rational, objective and scientific studies. Today it appears that Chronic and age-associated diceases may be multifactorial and hence more complex. A different approach may be required. One claimed usage of Korean Oriental medicine is for the treatment and prevention of chronic and age-associated illnesses. Some of the botanical formulas used for this purpose were discovered thousands of years ago and continue to be used today. There are indications that these formulas may indeed be helpful in the treatment or prevention of chronic diseases. This multi-component medicine could not only be very useful meeting the unmet clinical needs but for defining a more synergistic therapy that supports and maintains the bodies natural curative abilities. The potential usefulness of Korean Oriental medicine embodies the belief of maintaining healthy homeostasis of the body through the proper balance of a mixture of chemical at different organs or tissues. This concept is different from western medicine and implies that multiple compounds may act on multiple mechanisms of action to maintain the balance of the complex web of biology. This is very important in view of sciences current direction to integrate fragmented information to develop future medicines. The western and eastern approaches to human health and disease are complementary to each other. The best approach in developing future medicines is to integrate both approaches.

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심한 우식을 동반한 골격성 전치부 개방 교합 환자의 전악 수복 증례 (Full-mouth rehabilitation of skeletal anterior open bite with severely decayed dentition: A case report)

  • 김성아;노관태;배아란;우이형
    • 대한치과보철학회지
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    • 제55권1호
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    • pp.79-87
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    • 2017
  • 전치부 개방 교합은 다양한 원인이 복합적으로 작용하고, 진단에 따라 효과적인 치료 계획과 적절한 유지 방법을 선택할 수 있다. 대부분의 경우 교정과 악교정 수술을 통해 안정적인 교합을 얻고, 기능과 심미를 회복한다. 하지만 전체 치열에서 심한 우식증이 있는 경우 광범위한 수복이 필요하게 되므로, 보철 수복을 통해서도 교합을 재형성할 수 있다. 본 증례는 심한 우식을 동반한 골격성 전치부 개방 교합 환자에서 안모 분석 및 진단 납형으로부터 가장 효과적인 치료로 전악 보철 수복을 선택하였다. 교합력을 균등하게 분산하고 심미적인 임시 수복물을 제작하였고, 악간 관계 평가, 혀 등 연조직의 적응, 입술과의 조화를 관찰하고 수정하였다. 충분한 기간 동안 사용한 임시 수복물을 CAD/CAM (Computer-aided design/computer-aided manufacturing)을 이용하여 단일구조 지르코니아 최종 보철물로 이행하였고, 치료 종결 후 3개월 간 주기적으로 관찰하였을 때 만족스러운 결과를 얻었다.

Three-dimensional morphological evaluation of the hard palate in Korean adults with mild-to-moderate obstructive sleep apnea

  • Yu, Chen;Ahn, Hyo-Won;Kim, Seong-Hun
    • 대한치과교정학회지
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    • 제48권3호
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    • pp.133-142
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    • 2018
  • Objective: The purpose of this study was to evaluate differences in three-dimensional (3D) morphology of the hard palate between Korean adults with and without mild-to-moderate obstructive sleep apnea (OSA) using cone-beam computed tomographic (CBCT) data. Methods: The protocol for the two-dimensional (2D) and 3D mathematical modeling was established by analyzing CBCT images of 30 adults with OSA and 30 matched controls without OSA, using MIMICS software. The linear and angular measurements were also determined using this software. The measurements were repeated for 30 palates, by the same operator, to assess reliability. Results: The palates of OSA patients were higher in the posterior part and narrower in the anterior-superior part than those of the control group (p < 0.05). The nasal cavities of patients with OSA were narrower (p < 0.05) than those of controls. The increasing angle of the first molar palatal root is a compensation of the upper dental arch to improve occlusion. However, for most palatal measurements, there were no significant differences between the OSA and control groups (p > 0.05). The results of 2D and 3D mathematical models were consistent for linear and angular measurements, indicating that 2D and 3D mathematical modeling of the palate is a reliable methodology. Conclusions: OSA is a multifactorial disease; the palates of adults with mild-to-moderate OSA do not have specific morphological features distinct from those of healthy controls.