Chronic Low Back Pain in Young Korean Urban Males : The Life-Time Prevalence and Its Impact on Health Related Quality of Life

Shim, Jae-Hyun,Lee, Kyeong-Seok,Yoon, Sang-Young,Lee, Chang-Hoon,Doh, Jae-Won,Bae, Hack-Gun The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.56 No.6

Objective : We assessed the life-time prevalence (LTP) of chronic low back pain (LBP) in young Korean males. We also evaluated the relationship between lumbar spinal lesions and their health related quality-of-life (HRQOL). Methods : A cross-sectional, self-reported survey was conducted in Korean males (aged 19-year-old) who underwent physical examinations for the conscript. We examined 3331 examinees in November 2014. We included 2411 subjects, who accepted to participate this study without any comorbidities. We interviewed using simple binary questions for their LBP experience and chronicity. HRQOL was assessed by Short-Form Health-Survey-36 (SF-36) in chronic LBP and healthy control groups. Radiological assessment was performed in chronic LBP group to determine whether there were any pathological causes of their symptoms. Results : The LTP of chronic LBP was 13.4%. Most (71.7%) of them didn't have any lumbar spinal lesions (i.e., non-specific chronic LBP). The SF-36 subscale and summary scores were significantly lower in subjects with chronic LBP. Between specific and non-specific chronic LBP group, all physical and mental subscale scores were significantly lower in specific chronic LBP group, except mental health (MH) subscale score. In MH subscale and mental component summary score, statistical significant differences didn't appear between two groups (p=0.154, 0.126). Conclusion : In Korean males 19 years of age, the LTP of chronic LBP was 13.4%, and more than two-thirds were non-specific chronic LBP. Chronic LBP had a significant impact on HRQOL. The presence of lumbar spinal pathoanatomical lesions affected mainly on the physical aspect of HRQOL. It influenced little on the mental health.

Predisposing Factors Associated With Chronic and Recurrent Rhinosinusitis in Childhood

최선희,한만용,안영민,박용민,김창근,김현희,고영률,나영호 대한천식알레르기학회 2012 Allergy, Asthma & Immunology Research Vol.4 No.2

Purpose: There is currently no information regarding predisposing factors for chronic and recurrent rhinosinusitis (RS), although these are considered to be multifactorial in origin, and allergic diseases contribute to their pathogenesis. We evaluated the predisposing factors that may be associated with chronic and recurrent RS. Methods: In this prospective study, we examined patients with RS younger than 13 years of age, diagnosed with RS at six tertiary referral hospitals in Korea between October and December, 2006. Demographic and clinical data related to RS were recorded and analyzed. Results: In total, 296 patients were recruited. Acute RS was the most frequent type: 56.4% of the patients had acute RS. The prevalences of other types of RS, in descending order, were chronic RS (18.9%), subacute RS (13.2%), and recurrent RS (11.5%). Factors associated with recurrent RS were similar to those of chronic RS. Patients with chronic and recurrent RS were significantly older than those with acute and subacute RS. The prevalences of allergic rhinitis, atopy, and asthma were significantly higher in patients with chronic and recurrent RS than those with acute and subacute RS. Conclusions: An association between atopy and chronic/recurrent RS, compared to acute and subacute RS, suggests a possible causal link.

A case of chronic graft-versus-host disease mimicking viral warts

( Jae Won Ha ),( Ji Eun Hahm ),( So Eun Park ),( Jin Yong Lee ),( Chul Woo Kim ),( Sang Seok Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

Graft-versus-host disease(GVHD) is observed in recipient of hematopoietic stem cell transplantation. GVHD is clinically classified as acute and chronic. Chronic GVHD usually presents 100 days after allogenic bone marrow transplantation. Chronic GVHD cutaneous lesions are classified into lichenoid or scleroderma-like form. But the initial lesions of chronic GVHD can be subtle and present non-specific lesions like rashs, papules and vesicles. We report a case of a 20-year-old man who presented with whitish vesiculopapules that similar to verruca on his both palms and soles. He was diagnosed with acute T-cell lymphoblastic lymphoma 3 years before. The allogenic bone marrow transplantation was done 2 years before and he was taking oral cyclosporine. 16 months post-transplantation, vesiculopapular lesions developed on his both palms and soles. A biopsy of the lesions revealed interface dermatitis with a few apoptotic keratinocytes and infiltration of lymphocytic inflammatory cells. Immunohistochemical stain, CD3(T-cell) and CD20(B-cell) was done and only CD3 stain was positive. We could not have any therapeutic intervention or medication for the skin lesions because of his general condition. This is an interesting case showing vesiculopapular lesions that mimic viral warts as a initial presentation of cutaneous chronic GVHD.

Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1?

임청호,신현근,강욱호,정승규,양형규 대한대장항문학회 2011 Annals of Coloproctolgy Vol.27 No.5

Purpose: Many kinds of substances are produced on vascular endothelial activation. The aim of this study is to confirm an increase in Endothelin-1 (ET-1), the most potent vasoconstrictor, which is produced by endothelial activation, in patients with chronic anal fissure and to infer the relationship between ET-1 and anal fissure chronicity. Methods: The study groups are divided into three different groups with 30 subjects each. Group 1 is comprised of healthy volunteers, group 2 of chronic anal fissure patients, and Group 3 of patients with higher than 3rd degree hemorrhoids. Blood samples were taken to measure the ET-1 levels in subject’s serum and to compare the results with those for the control groups. Results: Among the 90 subjects, 38 were male, and 52 were female. The average age was 36.8. The average ET-1 level marked 1.47 ± 0.78 pg/mL for male subjects and 1.16 ± 0.47 pg/mL for female subjects (P = 0.02). The average ET-1 level in the patient groups is as follow: 1.21 ± 0.44 pg/mL in group 1, 1.46 ± 0.83 pg/mL in group 2, and 1.20 ± 0.56 pg/mL in group 3 (P =0.14). Conclusion: Group 2, the chronic anal fissure patient group, showed a higher ET-1 level than groups 1 and 3, the control group and the hemorrhoid patient group, but this difference had no statistical significance.

The Molecular Signatures of Acute-immobilization-induced Antinociception and Chronic-immobilization-induced Antinociceptive Tolerance

Jing-Hui Feng,Hee-Jung Lee,서홍원 한국뇌신경과학회 2019 Experimental Neurobiology Vol.28 No.6

In the present study, the productions of antinociception induced by acute and chronic immobilization stress were compared in several animal pain models. In the acute immobilization stress model (up to 1 hr immobilization), the antinociception was produced in writhing, tail-flick, and formalin-induced pain models. In chronic immobilization stress experiment, the mouse was enforced into immobilization for 1 hr/day for 3, 7, or 14 days, then analgesic tests were performed. The antinociceptive effect was gradually reduced after 3, 7 and 14 days of immobilization stress. To delineate the molecular mechanism involved in the antinociceptive tolerance development in the chronic stress model, the expressions of some signal molecules in dorsal root ganglia (DRG), spinal cord, hippocampus, and the hypothalamus were observed in acute and chronic immobilization models. The COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus were elevated in acute immobilization stress, but were reduced gradually after 3, 7 and 14 days of immobilization stress. Our results suggest that the chronic immobilization stress causes development of tolerance to the antinociception induced by acute immobilization stress. In addition, the COX-2 in DRG, p-JNK, p-AMPKα1, and p-mTOR in the spinal cord, p-P38 in the hippocampus, and p-AMPKα1 in the hypothalamus may play important roles in the regulation of antinociception induced by acute immobilization stress and the tolerance development induced by chronic immobilization stress.

Selective Retina Therapy in Acute and Chronic-Recurrent Central Serous Chorioretinopathy

Framme, Carsten,Walter, Andreas,Berger, Lieselotte,Prahs, Philipp,Alt, Clemens,Theisen-Kunde, Dirk,Kowal, Jens,Brinkmann, Ralf S. Karger AG 2015 Ophthalmologica Vol.234 No.4

<P>Abstract</P><P><B><I>Purpose:</I></B> Selective retina therapy (SRT), the confined laser heating and destruction of retinal pigment epithelial cells, has been shown to treat acute types of central serous chorioretinopathy (CSC) successfully without damaging the photoreceptors and thus avoiding laser-induced scotoma. However, a benefit of laser treatment for chronic forms of CSC is questionable. In this study, the efficacy of SRT by means of the previously used 1.7-µs and shorter 300-ns pulse duration was evaluated for both types of CSC, also considering re-treatment for nonresponders. <B><I>Material and Methods:</I></B> In a two-center trial, 26 patients were treated with SRT for acute (n = 10) and chronic-recurrent CSC (n = 16). All patients presented with subretinal fluid (SRF) in OCT and leakage in fluorescein angiography (FA). SRT was performed using a prototype SRT laser system (frequency-doubled Q-switched Nd:YLF-laser, wavelength 527 nm) with adjustable pulse duration. The following irradiation settings were used: a train of 30 laser pulses with a repetition rate of 100 Hz and pulse durations of 300 ns and 1.7 µs, pulse energy 120-200 µJ, retinal spot size 200 µm. Because SRT lesions are invisible, FA was always performed 1 h after treatment to demonstrate laser outcome (5-8 single spots in the area of leakage). In cases where energy was too low, as indicated by missing FA leakage, energy was adjusted and the patient re-treated immediately. Observation intervals were after 4 weeks and 3 months. In case of nonimprovement of the disease after 3 months, re-treatment was considered. <B><I>Results:</I></B> Of 10 patients with active CSC that presents focal leakage in FA, 5 had completely resolved fluid after 4 weeks and all 10 after 3 months. Mean visual acuity increased from 76.6 ETDRS letters to 85.0 ETDRS letters 3 months after SRT. Chronic-recurrent CSC was characterized by less severe SRF at baseline in OCT and weaker leakage in FA than in acute types. Visual acuity changed from baseline 71.6 to 72.8 ETDRS letters after 3 months. At this time, SRF was absent in 3 out of 16 patients (19%), FA leakage had come to a complete stop in 6 out of 16 patients (38%). In 6 of the remaining chronic CSC patients, repeated SRT with higher pulse energy was considered because of persistent leakage activity. After the re-treatment, SRF resolved completely in 5 patients (83.3%) after only 25 days. <B><I>Conclusion:</I></B> SRT showed promising results in treating acute CSC, but was less effective in chronic cases. Interestingly, re-treatment resulted in enhanced fluid resolution and dry conditions after a considerably shorter time in most patients. Therefore, SRT including re-treatment if necessary might be a valuable CSC treatment alternative even in chronic-recurrent cases.</P><P>© 2015 S. Karger AG, Basel</P>

Chronic exercise improves repeated restraint stress-induced anxiety and depression through 5HT1A receptor and cAMP signaling in hippocampus

( Mun Hee Kim ),( Yea Hyun Leem ) 한국운동영양학회 2014 Physical Activity and Nutrition (Phys Act Nutr) Vol.18 No.1

[Purpose] Mood disorders such as anxiety and depression are prevalent psychiatric illness, but the role of 5HT1A in the anti-depressive effects of exercise has been rarely known yet. We investigated whether long-term exercise affected a depressive-like behavior and a hippocampal 5HT1A receptor-mediated cAMP/PKA/CREB signaling in depression mice model. [Methods] To induce depressive behaviors, mice were subjected to 14 consecutive days of restraint stress (2 hours/day). Depression-like behaviors were measured by forced swimming test (TST), and anxiety-like behavior was assessed by elevated plus maze (EPM). Treadmill exercise was performed with 19 m/min for 60 min/day, 5 days/week from weeks 0 to 8. Restraint stress was started at week 6 week and ended at week 8. To elucidate the role of 5HT1A in depression, the immunoreactivities of 5HT1A were detected in hippocampus using immunohistochemical technique. [Results] Chronic/repeated restraint stress induced behavioral anxiety and depression, such as reduced time and entries in open arms in EPM and enhanced immobility time in FST. These anxiety and depressive behaviors were ameliorated by chronic exercise. Also, these behavioral changes were concurrent with the deficit of 5HT1A and cAMP/PKA/CREB cascade in hippocampus, which was coped with chronic exercise. [Conclusion] These results suggest that chronic exercise may improve the disturbance of hippocampal 5HT1A-regulated cAMP/PKA/CREB signaling in a depressed brain, thereby exerting an antidepressive action.

Clinical Association of Thyroid Stimulating Hormone Receptor Antibody Levels with Disease Severity in the Chronic Inactive Stage of Graves' Orbitopathy

Woo, Young Jae,Jang, Sun Young,Lim, Tyler Hyung Taek,Yoon, Jin Sook The Korean Ophthalmological Society 2015 Korean Journal of Ophthalmology Vol.29 No.4

<P><B>Purpose</B></P><P>To investigate associations between serum thyroid stimulating hormone (TSH) receptor antibody (TRAb) levels and Graves' orbitopathy (GO) activity/severity in chronic-stage GO and compare the performance of two newly-developed TRAb assays (third-generation TSH-binding inhibition immunoglobulin [TBII] assay versus Mc4 thyroid-stimulating immunoglobulin [TSI] bioassay).</P><P><B>Methods</B></P><P>This study is a retrospective review of medical charts and blood tests from Korean GO patients who first visited the departments of ophthalmology and endocrinology, Yonsei University College of Medicine from January 2008 to December 2011, were diagnosed with GO and Graves' hyperthyroidism, and were followed up for ≥18 months. Third-generation M22-TBII and Mc4-TSI assays were performed in the chronic-inactive GO patients in whom euthyroidism status was restored. Patients' GO activity/severity clinical activity scores (CAS), and modified NOSPECS scores were examined for a correlation with TRAb assays.</P><P><B>Results</B></P><P>Fifty patients (mean age, 41.3 years; 41 females) were analyzed. The mean duration of Graves' hyperthyroidism symptom was 63 months (range, 18 to 401 months) and that of GO was 46 months (range, 18 to 240 months). All patients had been treated previously with anti-thyroid drugs for a median period of 52.3 months, and two patients underwent either radioiodine therapy or total thyroidectomy. Mean CAS and NOSPECS scores were 0.5 ± 0.9 (standard deviation) and 4.8 ± 3.1, respectively. Mean M22-TBII and Mc4-TSI values were 7.5 ± 10.2 IL/L and 325.9 ± 210.1 specimen-to-reference control ratio. TSI was significantly correlated with NOSPECS score (R = 0.479, <I>p</I> < 0.001); however, TBII was not associated with NOSPECS score (<I>p</I> = 0.097). Neither TSI nor TBII correlated with CAS (<I>p</I> > 0.05), because GO inflammatory activity subsided in the chronic stages of GO.</P><P><B>Conclusions</B></P><P>In chronic-inactive GO after euthyroid restoration, GO activity score did not associate with serum levels of TRAb or TBII. However, levels of the functional antibody Mc4-TSI did correlate with GO severity. Therefore, the TSI bioassay is a clinically relevant measure of disease severity even in chronic inactive GO.</P>

B 형 만성 간염 환자에서 HBeAg / anti - HBe 전환 전후에 HBV Precore 변종의 발생과 만성 간염 활동성과의 관계

고광철(Kwang Cheol Koh),이효석(Hyo Suk Lee),김정룡(Chung Yong Kim) 대한내과학회 1994 대한내과학회지 Vol.46 No.3

N/A Objectives: To determine the most common type of precore mutant of hepatitis B virus (HBV) and the relationship between the emergence of precore mutant and the severity of chronic hepatitis B, we compared the prevalence and the emerging pattern of the precore mutant during the natural course in chronic-hepatitis-B patients, with us well as without biochemical remission, along with HBeAg/anti-HBe seroconversion. Methods: A total number of 39 sera obtained serially from 12 patients with chronic hepatitis B, all of whom experienced HBeAg/anti-HBe seroconversion during natural course were studied. The patients were divded into two groups according to the subsequent biochemical remission after HBeAg/anti-HBe seroconversion; Group I included 8 patients who accompanied biochemical remission and group II 4 patient-s who showed persistent elevation of ALT. The prevalence rates of precore mutant of these two groups and the rates before and after HBeAg/anti-HRe seroconversion were compared with each other. The sera were analysed for the presence of mutation at the precore region of HBV using the direct sequencing of DNA amplified by polymerase chain reaction. Results: The precore mutants were found in 10 patients (83.3%) of a total number of 12 patients; 6 of 8 (75.0%) in group I and 4 of 4 (100%) in group II. The difference in the detection rates between the two groups was not statistically significant (p=0.52). The precore mutant having a G-A mutation at the nucleotide 1896 was most commonly found (9/10), and the precore mutant with G-A mutations both at the nucleotide 1896 and 1899 was also found in the remaining one patient. The detection rates of wild type were 75.0% (9/12) during HBeAg-positive period and 0% (0/7) during anti-HBe-positive period. In contrast, those of precore mutant were 66.7% (8/12) during HBeAg-positive period and 100g (7/7) during anti-HBe-positive period. In 2 patients, the courses of whom were closely followed up for longer period of time, wild type was the predominant population of HBV in sera during HBeAg-positive period when the values of ALT fluctuated, and precore mutant began to emerge just before the disappearance of HBeAg and was the main population after the ALT level normalized and anti-HBe became positive. Conclusion: The most common type of precore mutant of HBV in Korea was the mutant with a G-A mutation at nt 1896. The emergence of precore mutant was frequently associated with the HBeAg/anti-HBe seroconversion irrespective of ALT levels; therefore, precore mutant is unlikely to bear direct causal relation to the severity of chronic hepatitis B.

Association between the BDNF Val66Met Polymorphism and Chronicity of Depression

이유진,임신원,김수연,정재원,김진우,명우재,송지혜,김선우,Bernard J Carroll,김도관 대한신경정신의학회 2013 PSYCHIATRY INVESTIGATION Vol.10 No.1

Objective Both clinical and biological factors influence the course of depressive disorders. This study tested for associations between the brain-derived neurotrophic factor (BDNF) gene at the Val66Met locus and the course of major depressive disorder (MDD). Methods Three hundred ten Korean subjects (209 patients, 101 controls) were genotyped for rs6265 at nucleotide 196 (G/A), which produces an amino acid substitution at codon 66 (Val66Met) of the gene for BDNF. Course of illness was evaluated both by chronicity of current episode (episode duration >24 months) and by the lifetime history of recurrences. Results Patients with the Met/Met BDNF genotype had a significantly higher rate of chronic depression than all others. There was a significant dose effect of the Met allele on chronicity. Compared with the Val/Val genotype, the relative risk of chronicity was 1.67 for the Val/Met genotype, and 2.58 for the Met/Met genotype. Lifetime history of recurrent episodes was not related to BDNF genotypes but was significantly associated with younger age of onset and with a history of depression in first degree relatives. Conclusion BDNF genotyping may be informative for anticipating chronicity in major depression.