어깨 근막통 증후군에서 어깨 관절운동범위에 대한 분석

김정수,김인아,이수진,김용규,박시복,고재우,송재철 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Objective: This study was carried out to investigate if the measurement of range of motion(ROM) could be applied in the diagnosis of Myofascial Pain Syndrome(MPS) and to determine the severity by analyzing ROM in MPS patients. Methods: The study subjects were 476 female telephone number information service workers. Southampton Protocol and Pittsburgh Protocol were used to diagnose MPS and to measure ROM. ROMs were measured by 2 inclinometers exercising each shoulder passively and actively in 5 directions ; abduction, forward flexion, extension, external rotation, and internal rotation. Results: Compared to the normal group (n=147), the mean of right side ROM in the subjects (n=270) with same side MPS was 2.1˚ (SD=11.5) lesser in active extension and 1.7˚ (SD=10.4) lesser in passive extension. Compared to the mild group (n=210), the mean of right side ROM in the patients with same side severe MPS (N=58) was lesser in all directions. Especially in active forward flexion, passive forward flexion, active extension, passive extension and active external rotation, ROM in the subjects with severe MPS was lesser by 6.5˚ (SD=13.1), 5.1˚ (SD=12.8), 5.9˚ (SD=11.8), 5.0˚ (SD=10.6) and 3.9˚ (SD=9.8), respectively, than those of the subjects with mild MPS. Compared to the subjects with left side mild MPS(n=172), ROM in the subjects with left side severe MPS (n=59) was 5.3˚ (SD=13.3) lesser in active forward flexion. Conclusions: In this study, ROMs in the subjects with severe MPS tended to be lesser than those in mild patients. This tendency was more prominent in the right side than the left, active range of motion than passive and forward flexion and extension than others. The results of this study are expected to help diagnose shoulder MPS and determine severity.

Phenylephrine이 토끼 유두근의 수축력과 활동전압에 미치는 영향

이영배,고인송,박종완,엄대용,이상돈 중앙대학교 의과대학 의과학연구소 1989 中央醫大誌 Vol.14 No.1

In order to clarify the receptor types and mechanisms underlying the positive inotropic effect of phenylephrie on the mammalian ventricular myocardium, the action potential, its first derivatives and isometric contraction of the rabbit papillary muscle were recorded using a free transducer and glass capillary microelectronics filled with 3M KCI, and results were analyzed. The results were as follows; l. In normal Tyrode solution, the contractile force was increased with increments of phenylephrine concentration and maximum effect was reached at the stimulation frequency of 1 Hz in 10^-5 M phenylephrine. 2. In 22 mM K^+-Tyrode solution, the maximum rate of rise (Vmax) of action potential, overshoot and the duration oction potential were significantly increased with increments of phenylephrine concentration (10^-6 ~ 10^-4 M). 3. The negative inotropic effect induced by verapamil was reversed by phenylephrine. 4. Phentolamine (3x10^-6 M) shifted the dose response curve for phenylephrine to the right more than propranolol (10^-6 M) did. The above results may be interpreted as follow; The positive inotropic effect of phenylephrine is caused by increase in slow inward current (Ca^2+influx into the myocardial cell), and is mediated through α- and β-adrengergic receptors in the rabbit pailary muscle

일부 조선업 근로자의 직업성 요통 발생실태 및 위험요인에 관한 연구

고상백,김형식,최홍렬,김지희,송인혁,박준한,박종구,장세진,차봉석 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

목적 : 이 연구에서는 한 사업장의 동일한 코호트내에서 직업성 요통의 발생 및 발생원인에 대해 조사하고자 하였다. 방법 : 연구대상은 1995년 12월 현재 한 조선업체에 종사하는 근로자 중에서 1995년 12월 31일 까지 요통이 이미 발생한 근로자와 1995년 당시 검진 미수검자를 제외한 9,784명을 연구대상으로 하였다. 요통 발생군은 1996년부터 1998년까지 3년간 추적 관찰하여 요통으로 4일 이상 통원 또는 입원치료를 받은 근로자로 하였다. 발생률은 요통발생 당시 연도를 기준으로 하여 해당 연도의 4일 이상 신규치료를 받은 중등도 이상의 요통근로자를 분자로 하였고, 해당년도 사업장의 종사하는 근로자 총수(과거 요통자 제외)를 분모로 간주하였다. 요통 발생군은 외상성 요통과 직업관련성 요통으로 대별하였으며, 위험요인과 질병 발생간의 관련성을 보기 위한 Cox모형에서 그 위험도를 파악하고자 할 때에는 직업성 요통만을 환자군으로 선정하였다. 결과 및 결론 . 요통 발생률은 근로자 천명당 1998년 3.1명, 1997년 8.8명, 1996년 7.8명이었다. 요통점유율의 범위는 10.99∼25.66이었다. 연령별 요통 발생률은 30대, 40대에서 높은 발생률을 보였다. 진단명에 따른 발생률은 추간판 탈출증, 염좌, 척추골절, 척추분리증, 척추협착증 순이었다 직업성 요통 발생자들의 직업적 요인을 알아보기 위하여 요통 발생 당시 작업형태를 알아본 결과, 물건을 들다가 66명(35.3%)이 발생하여 가장 큰 빈도를 차지하였고, 물건을 옮기는 과정에서 19명(10.2%)이 발생하여 2위를 차지하였고, 넘어지거나(8.6%), 물건을 당기는 자세(8.0%), 값자기 일어서다(7.5%) 순으로 요통이 발생하였다. 직업성 요통에 영향을 주는 일반적 특성 및 직업적 특성에 판한 상대위험도 및 95% 신뢰구간를 구한 결과, 요통발생에 영향을 주는 유의한 변수로는 체질량 지수(비만도), 교대여부, 중량물 취급여부였다. Objectives : This study was conducted to estimate the incidence rate, and to identify the risk factors for the occupational low back pain among shipyard workers. Methods : The study subjects consisted of 9,784 workers who were employed in a ship-building industry (excluded workers who had a history of low pack pain before 1995 or did not take periodic health examination in 1995) . The cases were 220 people who experienced back pain from January 1, 1996 to December 31, 1998. To assess risk factors for occupational low back pain, Cox propotional hazard model was used. Results : During the recent three years from 1996 to 1998, the incidence rate per 1,000 persons was 7.8 in 1996, 8.8 in 1997, and 3.1 in 1998. The main causes of work-related low back pawn were sprain, strain and disc herniation. Lifting was the most common cause of back pain (35.3%) , and carrying (10.2%) and pulling (8.0%) were followed. In Cox proportional harzard model, independent risk factors for back pain were body mass index(R.R. ; 1.54, 95% C.1. : 1.06-2.25), shift work(R.R. ; 1.65, 95% C.1. : 1.19-2.28), and lifting heavy material(R. R., 3.95, 95% C.1. : 2.29-6.82). Conclusions . This study suggests that the risk factors of back pawn In shipyard work-ers were body mass index, shift work and lifting.

위 유문동근 K^+ - 경축에 미치는 Vanadate의 효과

김충수,고인송,엄대용,이상돈 중앙대학교 의과대학 의과학연구소 1988 中央醫大誌 Vol.13 No.3

Effects of vanadate on the spontaneous contraction and the high K^+-induced contracture of guinea pig’s pyloric antral smooth muscles were observed in the various Na^+ and/or Ca^+ of bathing solutions. Following results were obtained; 1. Basal tension and developed tension of the spontaneous activity were increased by vanadate and the membrane potential tended to be depolarized. 2. Phasic contracture increased, tonic contracture decreased as the outside K^+ concentration increased and the both components were increased by vanadate. 3. In the case of absence of K^+ and/or Na^+, the contracture were hardly developed and the spontaneous, rhythmic contraction were sustained. 4. Effects of vanadate on the K^+-contracture and the Ca^2+-sensitivity of the Phasit and tonic components were prominent in the presence of Na^+. The above results suggested that vanadate would increase the voltage-dependent calcium current in smooth muscle cells of the pyloric antrum.

백서 소장 점막 이당류 분해 효소 순응에 대한 연구

임경욱(Kyong Wook Yim),고광철(Kwang Chul Koh),김유철(Yoo Chul Kim),임용철(Yong Chul Lim),이효석(Hyo Suk Lee),윤용범(Yong Bum Yoon),송인성(In Sung Song),김정룡(Chung Yong Kim) 대한내과학회 1988 대한내과학회지 Vol.35 No.1

N/A There is plenty of evidence that the intestinal disaccharidases such as sucrase and maltase are adaptive by their substrates. However the intestinal lactase adaptiveness is still controversial despite results which positively suggest its adaptiveness in young experimental animals. The authors designed the following experiment with six groups of adult Wistar rats, each of which consists of ten 210 g average adult rats, to investigate whether dietary lactose solutions would increase the intestinal lactase specific acitivity and to observe the effects of various dietary solutions on other intestinal enzyme specific activities at the same time. All of the animals were fed by standard rat chow ad libitum and the first group (control) was made to suck tap water the second group a 5% glucose solution, the third group a 10 sucrose solution, and the fourth, fifth, and sixth groups 5%-, 10%- and 15% lactose solutions respectively, also ad libitum as the fluid source for a six week period. At the end of the experiment, the small intestines were divided into three segments of equal length from the Treitz ligament to the terminal ileum, from each of which one tissue section was made and specific enzyme activities (lactase, sucrase, trehalase, alkaline phosphatase and aminopeptidase N) were assayed. The results were as follows: 1) There was no difference in mean body weight during the experimental period. (mean±S.D; 230±12.3) 2) No histological differences between the groups were noted in each of the three segments. 3) The intestinal trehalase, alkaline phosphatase, aminopeotidase N, and lactase, which was the key enzyme of this experiment, were not adapted by these experimental solutions. 4) The intestinal sucrase specitic activities, especially of the middle segment, from animals fed with 5% glucose, 10% sucrose, 10%-and 15%-lactose solutions, in- creased from a control group value of 41.8±18.4 to 72.1±15.1, 73.0±12.0, 71.3±24.9 and 66.4±11.0mu/mg protein (p<0.01 in all) respectively, confirming again its adaptiveness. We concluded that the intestinal lactase was not adapted by these 5-15% lactose solutions in six weeks, To the contrary, the sucrase was adapted by various carbohydrate solutions which suggested that the adaptation was substrate non-specific and was by local effect rather than distant hormonal or neural effects.

불명열 환자에서 진단된 중증 만성 활동성 Epstein-Barr virus 감염증

전경만,김응호,손준성,장현하,정숙인,오원섭,백경란,송재훈,고광철,정철원,고영혜 대한감염학회 2003 감염과 화학요법 Vol.35 No.4

최근 장기적이고 심각한 임상 증상을 유발하는 만성 활동성 EBV 감염증의 개념이 정립되면서 그 증례들이 보고되고 있다. 만성 활동성 EBV 감염증은 소아나 젊은 성인들에게서 주로 발생되며, EBV-VCA IgG, EBV-EA IgG의 수치가 높게 관찰되고, 지속적인 발열, 전신쇠약감, 광범위한 임파선비대증, 간비장비대, 범혈구감소증, 다크론성감마병증을 나타낸다. 이 질환은 환자의 임상소견, 혈액학적 소견, EBV 항체 역가 및 침범 장기의 EBV genome 검출로 확진 되며 치료로 항 바이러스 체제, 항암 치료, 골수이식술 등이 시도되고 있으나 아직 검증되어 있지 않다. 저자들은 불명열을 주소로 내원하여 중증 만성 활동성 EBV 감염증으로 진단된 증례 4례를 경험하였다. 한 례에서는 항 바이러스 제제를 추여 후 임상적, 혈액학적 호전을 보였으나 치료 20일째 발생한 세균성 복막염과 패혈증으로 사망하였고, 두 례에서 총 6회의 CHOP 항암치료와 자가조혈모세포이식을 시행 받은 후 현재까지 증상 없이 추적관찰 중이다. 지속되는 발열을 주소로 내원한 불명열 환자들에게서 EBV에 대한 검사를 시행할 경우 불명열의 원인을 규명하는데 하나의 단서를 제공할 수 있을 것으로 사료된다. Epstein-Barr virus (EBV) is one of eight human herpesvirus. Primary infection with EBV in childhood is generally asymptomatic or mild, however, often causes overt diseases such as infectious mononucleosis (IM) and lymphoproliferative disorder (LPD), the latter occursing in immunologically compromised individuals. Historically, EBV has been considered to be etiologically linked to human malignancies such as EBV genome positive Burkitt's lymphoma and nasopharyngeal carcinoma. Recently, however, another category of EBV-related disease, "chronic active EBV infection", has been made to describe persons without a clearly defined underlying disease. We report 4 cases of patients, presented with episodic fever of unknown origin (FUO), who were diagnosed as severe chronic active EBV infection. A combined application of serology for EBV and in-situ hybridization established the diagnosis of the EBV infection.

Body Height Effect on Brain Volumes in Youth Decreases in Old Age in Koreans

Koh, In-Song Korean Society for Bioinformatics 2011 Interdisciplinary Bio Central (IBC) Vol.3 No.3

The MRI (magnetic resonance imaging) volumetric analysis of the brain was performed in 59 healthy elderly Koreans (aged 62-76 years; 34 male, 25 female) to investigate whether the previously reported significant correlations between body height and brain volumes in the young aged Koreans (20's) still exist in the old aged Koreans (60's and 70's). Unlike previously reported significant correlations in the young aged Koreans, neither the correlation between whole brain volume and body height in male nor the correlation between cerebellar volume and body height in female show any significance in the old aged Koreans. The significant correlation between body height and whole brain volume was still observed when both male and female data were combined (r=0.27, P<0.05), but the correlation coef-ficient and the level of significance markedly decreased from those of previously reported Korean youth data (r=0.67, P<0.01). Simple linear regression analysis shows decrease of explanatory power of height (measured in $r^2$) from 44% in the youth group to 7% in the old age group on the variance of whole brain volume. Multiple linear regression analysis shows that age and sex, rather than height, are major explanatory variables for whole brain volume in the old aged Koreans. The loss of correlations in the aged group is suspected to be mainly due to age related brain volume changes.

류마티스 관절염과 HLA-B27과의 연관성에 관한 연구

고희관 ( Hee Kwan Koh ),오광택 ( Kwang Taek Oh ),송용호 ( Yong Ho Song ),정자헌 ( Ja Hun Jung ),김태환 ( Tae Hwan Kim ),김동욱 ( Dong Yook Kim ),전재범 ( Jae Bum Jun ),정성수 ( Sung Soo Jung ),이인홍 ( In Hong Lee ),배상철 ( Sang 대한류마티스학회 1996 대한류마티스학회지 Vol.3 No.1

Objective: In rheumatoid arthritis(RA) patients, HLA-B27 has been mainly found with the same frequency as in the normal population. An increased frequency of HLA-B27 in RA has, however, repeatedly been found in northern Sweden and in Filand. The results concerning the association of HLA-B27 to the outcome of the disease have been contradictory in RA. In RA, the presence of HLA-B27 has shown to be a prognostic index for cervical spine subluxation. There has been no report regarding the association between RA and HLA-B27 in the Korean population. Methods: 188 patients with RA were randomly selected from the patients who were diagnosed at Rheumatism Center of Hanyang University Hospital from October 1994 to June 1995 to establish the frequency of HLA-B27 in RA and to investigate the possible influence and prognostic significance on clinical outcome including atlantoaxial subluxations. Results: The results were as follows: 1) HLA-B27 was present in 12.2% of the RA patients studied. The relative risk (RR) and etiologic fraction (EF) of HLA-B27 were 5.99 and 0.1019 respectively. 2) The rheumatoid factor was positive in 79.8% of the total patients, 73.9% in HLA-B27 positive patients, and 80.6% in HLA-B27 negative patients. HLA-B27 was not associated with the presence of rheumatoid factor in this study. 3) HLA-B27 was not associated with the duration of morning stiffness, Ritchie index, extraarticular manifestations, the number of swollen joints, ARA functional class, ESR. C-reactive protein, or hemoglobin. HLA-B27 was not associated with the positivity of ANA and antiperinuclear factor. 4) HLA-B27 was not associated with the positive rate of erosion and Steinbrocker class in peripheral joints. 5) Atlantoaxial subluxation was present in 13% of HLA-B27 positive patients and 17% of HLA-B27 negative patients. The involvement of atlantoaxial joint including narrowing of lateral facet joints was 26.1% in HLA-B27 positive patients and 20.6% in HLA-B27 negative patients. Subaxial subluxation was presented in only 1 case in HLA-B27 negative group of total patients. HLA-B27 was not associated with the cervical changes in RA. Conclusions: An increased freuency of HLA-B27 in RA patients was significantly found in Korea (RR=5.99, EF=0.1019). However, patients with HLA-B27 had a similiar clinical profile to patients without HLA-B27 and HLAB27 positivity did not further contribute to the severity with respect to clinical and laboratory variables or to radiological progression in peripheral joints or cervical spine.

Effects of Recombinant Adenovirus-Mediated Uncoupling Protein 2 Overexpression on Endothelial Function and Apoptosis

Lee, Ki-Up,Lee, In Kyu,Han, Jin,Song, Dae-Kyu,Kim, Yun Mi,Song, Hai Sun,Kim, Hyoun Sik,Lee, Woo Je,Koh, Eun Hee,Song, Kee-Ho,Han, Sung Min,Kim, Min Seon,Park, In-Sun,Park, Joong-Yeol Ovid Technologies Wolters Kluwer -American Heart A 2005 Circulation research Vol.96 No.11

<P>Increased oxidative stress in vascular cells plays a key role in the development of endothelial dysfunction and atherosclerosis. Uncoupling protein 2 (UCP2) is an important regulator of intracellular reactive oxygen species (ROS) production. This study was undertaken to test the hypothesis that, UCP2 functions as an inhibitor of the atherosclerotic process in endothelial cells. Adenovirus-mediated UCP2 (Ad-UCP2) overexpression led to a significant increase in endothelial nitric oxide synthase (eNOS) and decrease in endothelin-1 mRNA expression in human aortic endothelial cells (HAECs). Moreover, UCP2 inhibited the increase in ROS production and NF-kappaB activation, and apoptosis of HAECs induced by lysophophatidylcholine (LPC) and linoleic acid. LPC and linoleic acid caused mitochondrial calcium accumulation and transient mitochondrial membrane hyperpolarization, which was followed by depolarization. UCP2 overexpression prevented these processes. In isolated rat aorta, Ad-UCP2 infection markedly improved impaired vascular relaxation induced by LPC. The data collectively suggest that UCP2, functions as a physiologic regulator of ROS generation in endothelial cells. Thus, measures to increase UCP2 expression in vascular endothelial cells may aid in preventing the development and progression of atherosclerosis in patients with metabolic syndrome.</P>

AdipoR2 is transcriptionally regulated by ER stress‐inducible ATF3 in HepG2 human hepatocyte cells

Koh, In‐,uk,Lim, Joo H.,Joe, Myung K.,Kim, Won H.,Jung, Myeong H.,Yoon, Jong B.,Song, Jihyun Blackwell Publishing Ltd 2010 FEBS JOURNAL Vol.277 No.10

<P>Adiponectin acts as an insulin‐sensitizing adipokine that protects against obesity‐linked metabolic disease, which is generally associated with endoplasmic reticulum (ER) stress. The physiological effects of adiponectin on energy metabolism in the liver are mediated by its receptors. We found that the hepatic expression of adiponectin receptor 2 (AdipoR2) was lower, but the expression of markers of the ER stress pathway, 78 kDa glucose‐regulated protein (GRP78) and activating transcription factor 3 (ATF3), was higher in the liver of <I>ob</I>/<I>ob</I> mice compared with control mice. To investigate the regulation of AdipoR2 by ER stress, we added thapsigargin, an ER stress inducer, to a human hepatocyte cell line, HepG2. Addition of the ER stress inducer increased the levels of GRP78 and ATF3, and decreased that of AdipoR2, whereas addition of a chemical chaperone, 4‐phenyl butyric acid (PBA), could reverse them. Up‐ or down‐regulation of ATF3 modulated the AdipoR2 protein levels and AdipoR2 promoter activities. Reporter gene assays using a series of 5′‐deleted AdipoR2 promoter constructs revealed the location of the repressor element responding to ER stress and ATF3. In addition, using electrophoretic mobility shift and chromatin immunoprecipitation assays, we identified a region between nucleotides −94 and −86 of the AdipoR2 promoter that functions as a putative ATF3‐binding site <I>in vitro</I> and <I>in vivo</I>. Thus, our findings suggest that the ER stress‐induced decrease in both protein and RNA of AdipoR2 results from a concomitant increase in expression of ATF3, which may play a role in the development of obesity‐induced insulin resistance and related ER stress in hepatocytes.</P>