• Title/Summary/Keyword: vertebral disease

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Abrogation of the Circadian Nuclear Receptor REV-ERBα Exacerbates 6-Hydroxydopamine-Induced Dopaminergic Neurodegeneration

  • Kim, Jeongah;Jang, Sangwon;Choi, Mijung;Chung, Sooyoung;Choe, Youngshik;Choe, Han Kyoung;Son, Gi Hoon;Rhee, Kunsoo;Kim, Kyungjin
    • Molecules and Cells
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    • v.41 no.8
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    • pp.742-752
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    • 2018
  • Parkinson's disease (PD) is a neurodegenerative disease characterized by progressive degeneration of dopaminergic (DAergic) neurons, particularly in the substantia nigra (SN). Although circadian dysfunction has been suggested as one of the pathophysiological risk factors for PD, the exact molecular link between the circadian clock and PD remains largely unclear. We have recently demonstrated that $REV-ERB{\alpha}$, a circadian nuclear receptor, serves as a key molecular link between the circadian and DAergic systems. It competitively cooperates with NURR1, another nuclear receptor required for the optimal development and function of DA neurons, to control DAergic gene transcription. Considering our previous findings, we hypothesize that $REV-ERB{\alpha}$ may have a role in the onset and/or progression of PD. In the present study, we therefore aimed to elucidate whether genetic abrogation of $REV-ERB{\alpha}$ affects PD-related phenotypes in a mouse model of PD produced by a unilateral injection of 6-hydroxydopamine (6-OHDA) into the dorsal striatum. $REV-ERB{\alpha}$ deficiency significantly exacerbated 6-OHDA-induced motor deficits as well as DAergic neuronal loss in the vertebral midbrain including the SN and the ventral tegmental area. The exacerbated DAergic degeneration likely involves neuroinflammation-mediated neurotoxicity. The $REV-erb{\alpha}$ knockout mice showed prolonged microglial activation in the SN along with the over-production of interleukin $1{\beta}$, a pro-inflammatory cytokine, in response to 6-OHDA. In conclusion, the present study demonstrates for the first time that genetic abrogation of $REV-ERB{\alpha}$ can increase vulnerability of DAergic neurons to neurotoxic insults, such as 6-OHDA, thereby implying that its normal function may be beneficial for maintaining DAergic neuron populations during PD progression.

The Effects of Segmental Instability and Muscle Fatigue after Applying Sabilization Exercise Program In Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.12-20
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    • 2007
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after applying program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, (-) value was increased between lumbar vertebra segment when was the load on spine. And so applying stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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Monostotic Fibrous Dysplasia in the Spine - A Case Report - (척추에 발생한 단골성 섬유 이형성증 - 증례 보고-)

  • Yang, Jun-Young;Lee, June-Kyu;Lee, Jun-Ho;Yang, Jae-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.188-193
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    • 2005
  • Fibrous dysplasia is a condition characterized by the replacement of the medullary component of predominantly long bone with fibrous tissues. The monostotic form of the fibrous dysplasia occurs more frequent than the polyostotic form. Only the twenty three previous cases of vertebral involvement in monostotic fibrous dysplasia have been reported. Authors experienced a case of monostotic fibrous dysplasia of the third lumbar vertebra, so we report this case. Report details the diagnosis and treatment of a 34 years old man with back pain from monostotic fibrous dysplasia of the third lumbar vertebra. We discuss the experience in the consideration of previous report to recommend the optimal management of this disease.

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A Case of Idiopathic Takayasu's Arteritis - Experience of Successful Treatment - (특발성 Takayasu's arteritis - 활동기의 치료경험 1례 -)

  • Na So Young;Kang Hee Gyung;Ha Il Soo;Kim In One;Cheong Hae Il;Choi Yong
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.114-119
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    • 2002
  • Takayasu's arteritis(TA) is a chronic idiopathic vasculitis mainly involving the aorta and its main branches, such as brachiocephalic, carotid, subclavian, vertebral and renal arteries, as well as coronary and pulmonary arteries The clinical features usually reflect limb or organ ischemia resulting from gradual stenosis of involved arteries. We experienced a case of idiopathic Takayasu's arteritis with negative tuberculin test involving multiple main branch arteries at active stage without pulse. We treated this patient with combined therapy of steroid and azathioprine, with remission of disease activity. (J Korean Soc Pediatr Nephrol 2002 ;6 : 114-9)

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Appropriate Block Level in Neurolytic Lumbar Sympathetic Ganglion Block (신경파괴적 요부교감신경절 차단의 적정 부위)

  • Kim, Hee-Jung;Lee, Cheol-Oh;Shin, Yang-Sik;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.14 no.2
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    • pp.199-206
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    • 2001
  • Background: The lumbar sympathetic ganglia are variable in both position and numbers. The aim of this study was to detect the appropriate lumbar vertebral level where the lumbar sympathetic ganglia primarily aggregate. Methods: Forty patients comprising of hyperhidrosis (26 cases), complex regional pain syndrome (10 cases), peripheral artery occlusion disease (3 cases) and postherpetic neuralgia (1 case) underwent lumbar sympathetic block. We randomly selected one of two (L2 or L3) levels and the L4 level. The position of the needle tip and distribution of dye was verified by injection of a mixture of radio-opaque dye (1.5 ml) and 4% lidocaine (1.5 ml) and subsequently confirmed by L-spine anteroposterior and a lateral view X-ray. We considered the response positive when the skin temperature increased more than $1^{\circ}C$ in 5 min. Results: In general, the positive response ratio was greater when the needle tip located at the L2 or L4 level vice L3 and when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space. In a right side block, the positive response ratio was greater when the drug was distributed on the lower half of the L4 body and in the L4/5 intervertebral disc space, although in a left side block there was no significant difference seen between the levels. The complications of the neurolytic block were alcohol neuritis (7.5%) and hypoesthesia (5%) on the L1 or L2 dermatome. Conclusions: The best effect with least chance of complication may be induced by spreading the drug on the lower half of the L4 body and/or into the L4/5 intervertebral disc space by placing the needle tip on the L4 body.

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Fenestration and Duplication of the Vertebrobasilar Artery Detected by Conventional Angiography and Magnetic Resonance Angiography

  • Ahn, Jae-Heung;Kim, Myoung-Soo;Lee, Hyun-Koo;Lee, Seung-Jun;Park, Hyo-Il;Lee, Chae-Heuck
    • Journal of Korean Neurosurgical Society
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    • v.39 no.5
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    • pp.355-359
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    • 2006
  • Objective : The purpose of our study is to examine the clinical significance of vertebrobasilar artery[VBA] fenestration and duplication. In addition, we review its incidence and pathogenesis. Methods : Cerebral angiography was performed in 803 patients and magnetic resonance angiography[MRA] in 880; the patients had or were suspected to have cerebrovascular disease. We retrospectively reviewed angiography and MRA. Results : Fifteen patients [eight men, seven women, 3 to 77 years of age, median age = 58 years] had a VBA fenestration and duplication. Seven [7/803 = 0.87%] of the patients undergoing cerebral angiography revealed fenestrations and one duplication of VBA. Ten patients [10/880 = 114%] among 880 patients that underwent MRA demonstrated fenestration of basilar artery[BA]. Two of 66 patients that underwent both conventional cerebral angiography and cranial MRA showed a fenestration of BA. Twelve fenestrations were located in the proximal portion of the BA and one was in the mid portion of the BA. One vertebral artery[VA] fenestration was located in the intracranial portion of the right VA, and one VA duplication was at the level of $C_{1-2}$ in the left VA. Conclusion : In addition to medial defects, flow phenomena at the proximal end of fenestrations, where hemodynamic stress and increased turbulence are present, may contribute to aneurysm formation. And arterial fenestration is a predisposing factor in vascular injury and cerebral ischemia.

A Case of Isolated Pulmonary Takayasu's Arteritis Combined with Pulmonary Thromboembolism and Hyperthyroidism (폐혈전증과 갑상선기능항진증이 동반된 타카야수 폐동맥염 1예)

  • Uhm, Jae Sun;Kwon, Jung Hyun;Kim, Tae Woo;Ji, Jeong Seon;Kim, Jin Woo;Kim, Seung Joon;Lee, Sook Young;Kim, Young Kyoon;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.188-192
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    • 2004
  • Takayasu's arteritis is a chronic inflammatory disease, involving mainly the aorta and its main branches, which can cause stenosis or occlusion. It involves the bracheocephalic, carotid, subclavian, vertebral, and renal, as well as the coronary and pulmonary arteries. The clinical manifestations range from asymptomatic to catastrophic, with dizziness, hypertension, claudication, cerebral infarction, chest pain and dyspnea. Takayasu's arteritis involving the pulmonary arteries, but not the aorta and its main branches, is very rare. Herein, a case of isolated pulmonary Takayasu's arteritis combined with pulmonary thromboembolism, and hyperthyroidism is reported, with a review of the literature.

The Effects of Segmental Instability and Muscle Fatigue after Stabilization Exercise Program in Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • Journal of Korean Physical Therapy Science
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    • v.13 no.4
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    • pp.7-16
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    • 2006
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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Correlation Study between Cervical X-ray Sagittal Parameters and Chuna Posture Analysis Results (경추 X-ray 시상면 지표와 추나체형분석 결과와의 상관성 연구)

  • Park, Joo-Sung;Lim, Hyung-Ho;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.2
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    • pp.125-137
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    • 2020
  • Objectives The purpose of this study was to examine how changes in the cervical spine correlate with body posture changes in the whole body, and to find out the significance of complementary clinical application X-ray and Chuna posture analysis. Methods From January 1, 2019 to October 31, 2019, the results of 27 patients with pain in the vertebral region were analysed in accordance with the results of cervical X-ray and Chuna posture analysis. In order to confirm the significance of Chuna posture analysis results, the survey of 187 Chuna standard curriculum instruction qualification certifiers was conducted and the responses of 47 of them were analyzed. Results The occiput-atlas cline angle increases in both hypolordosis/hyperlordosis groups based on cervical lordosis angle, and increases further than in the hyperlordosis group. There were significant correlations between the changes in the cervical spine and the body posture changes in the whole body. There were no significant differences between cervical X-ray sagittal parameters and the body posture analysis parameters based on the patient's major disease codes. Conclusions As a result of conducting a survey on the clinical importance of the body posture analysis parameters, the importance of cervical parameters was verified. Changes in the cervical spine may not only cause other changes in the cervical region, but also affect the body posture changes in the whole body. The complementary application of X-ray and Chuna posture analysis results is helpful in clinical diagnosis and treatment of musculoskeletal disorders.

Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

  • Kim, Kyoung-Tae;Cho, Dae-Chul;Sung, Joo-Kyung;Kim, Young-Baeg;Kim, Du Hwan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.30-39
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    • 2017
  • Objective : To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods : Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2-7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results : The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were $8.6{\pm}2.3$ and $8.4{\pm}2.0$, and lower level motion values were $8.4{\pm}2.2$ and $8.3{\pm}1.9$. Preoperative and postoperative FSU heights were $37.0{\pm}2.1$ and $37.1{\pm}1.8$. In the group B, upper level adjacent segment motion values were $8.1{\pm}2.6$ and $8.2{\pm}2.8$, and lower level motion values were $6.5{\pm}3.3$ and $6.3{\pm}3.1$. FSU heights were $37.1{\pm}2.0$ and $36.2{\pm}1.8$. The postoperative FSU motion and height changes were significant (p<0.05). The patient's satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion : TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient's biomechanical characteristics and economic status should be understood and treated using the optimal procedure.