BACKGROUND: Selective lumbar nerve root block (SNRB) is generally accepted as an effective treatment method for back pain with sciatica. However, it requires devices producing radioactive materials such as C-arm fluoroscopy. This study evaluated the usefulness of the longitudinal view of transverse process and needles for medial branch block as landmarks under ultrasonography. METHODS: We performed selective nerve root block for 96 nerve roots in 61 patients under the guidance of ultrasound. A curved probe was used to identify the facet joints and transverse processes. Identifying the lumbar nerve roots under the skin surface and ultrasound landmarks, the cephalad and caudal medial branch blocks were undertaken under the transverse view of sonogram first. A needle for nerve root block was inserted between the two transverse processes under longitudinal view, while estimating the depth with the needle for medial branch block. We then injected 1.0 mL of contrast medium and checked the distribution of the nerve root with C-arm fluoroscopy to evaluate the accuracy. The visual analog scale (VAS) was used to access the clinical results. RESULTS: Seven SNRBs were performed for the L2 nerve root, 15 for L3, 49 for L4, and 25 for L5, respectively. Eighty-six SNRBs (89.5%) showed successful positioning of the needles. We failed in the following cases: 1 case for the L2 nerve root; 2 for L3; 3 for L4; and 4 for L5. The failed needles were positioned at wrong leveled segments in 4 cases and inappropriate place in 6 cases. VAS was improved from 7.6 +/- 0.6 to 3.5 +/- 1.3 after the procedure. CONCLUSIONS: For SNRB in lumbar spine, the transverse processes under longitudinal view as the ultrasound landmark and the needles of medial branch block to the facet joint can be a promising guidance.
Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Humans ; Low Back Pain/etiology/*therapy ; Lumbar Vertebrae/anatomy & histology/*ultrasonography ; Male ; Middle Aged ; Nerve Block/*methods ; Sciatica/etiology/*therapy ; Spinal Stenosis/complications/*diagnosis ; Zygapophyseal Joint/anatomy & histology/ultrasonography

Chronic neuroinflammation is an integral pathological feature of major neurodegenerative diseases. The recruitment of microglia to affected brain regions and the activation of these cells are the major events leading to disease-associated neuroinflammation. In a previous study, we showed that neuron-released alpha-synuclein can activate microglia through activating the Toll-like receptor 2 (TLR2) pathway, resulting in proinflammatory responses. However, it is not clear whether other signaling pathways are involved in the migration and activation of microglia in response to neuron-released alpha-synuclein. In the current study, we demonstrated that TLR2 activation is not sufficient for all of the changes manifested by microglia in response to neuron-released alpha-synuclein. Specifically, the migration of and morphological changes in microglia, triggered by neuron-released alpha-synuclein, did not require the activation of TLR2, whereas increased proliferation and production of cytokines were strictly under the control of TLR2. Construction of a hypothetical signaling network using computational tools and experimental validation with various peptide inhibitors showed that beta1-integrin was necessary for both the morphological changes and the migration. However, neither proliferation nor cytokine production by microglia was dependent on the activation of beta1-integrin. These results suggest that beta1-integrin signaling is specifically responsible for the recruitment of microglia to the disease-affected brain regions, where neurons most likely release relatively high levels of alpha-synuclein.
Animals ; Antigens, CD29/genetics/*metabolism ; Cell Line, Tumor ; *Cell Movement ; Cells, Cultured ; Culture Media, Conditioned/*pharmacology ; Gene Regulatory Networks ; Humans ; Mice ; Mice, Inbred C57BL ; Microglia/drug effects/metabolism/*physiology ; Neurons/*metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Toll-Like Receptor 2/metabolism ; alpha-Synuclein/*pharmacology

OBJECTIVE: The purpose of this paper is to analyze the effects of precarious employment status on the level of self-rated health, based on various criteria, by participants in the Korean Labor and Income Panel Survey. METHODS: Data were obtained from 3,268 subjects(2,057 men and 1,211 women), who participated in the 2005-2006 Korean Labor and Income Panel Survey. Group A was classified as Non-precarious employment by both the Ministry of Labor (MoLab) and the Korea Labor and Society Institute (KLSI). The group B was classified as Non-precarious employment by the MoLab and as precarious employment by the KLSI. The group C is classified as Non-precarious employment by both MoLab and KLSI. Outcome variables were self-rated health and a panel logistic regression analysis was performed on the data. RESULTS: The level of self-rated health was worse among group B males (OR: 1.45, C.I:1.00~2.11) and group C males (OR: 1.69, C.I:1.35~2.10) compared to group A males. A substantial difference(57.8%) in the level of self-rated health between groups A and B was attributed to the sociodemographic characteristics of the populations. The difference in self-rated health between groups A and C was explained by work environments(15.7%), as well as by sociodemographic characteristics(26.1%). For female workers, the level of self-rated health in group B and C was worse than in group A, but this finding was not statistically significant. CONCLUSIONS: These findings suggested that the policy to improve the working environment, as well as a more comprehensive effort to reduce the disparity, is needed for the precarious employment worker.
Employment ; Female ; Health Status ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Male

BACKGROUND: In April 6, 1996, a male researcher who has worked at a research unit at the Basic Research Building of Seoul National University(SNU) College of Medicine admitted to SNU Hospital due to persistent fever. He was diagnosed serologically as hemorrhagic fever with renal syndrome(HFRS). Another female researcher in the same unit was also diagnosed as HFRS at the same hospital several days later. Epidemic investigation of HFRS was conducted to determine the magnitude of the problems since these two cases were strongly suspected to have laboratory-acquired infections of HFRS. METHODS: All researchers and employees working at the Basic Research Building(BRB) of SNU College of Medicine as of April 1, 1996 were recruited for the study. Information on symptoms of HFRS and history of contact to experimental animals were collected by self-administered questionnaires and serological tests among study subjects were also conducted by indirect immunofluorescent antibody(IFA) to hantavirus. The experimental animals were also serologically tested for infection with hantavirus by IFA. RESULTS: Among 218 surveyed, six researchers and an animal caretaker had hantavirus antibodies above 1:20 in IFA titer. Five of seven sero-positive subjects had antibodies above 1:640 in IFA titer and had shown clinical symptoms compatible to HFRS during Jan. 1 to Apr. 20, 1996. The sero-positive persons had handled animals more frequently than sero-negative persons (OR, 19.68; 95% CI, 1.11 - 350.40) and handling animals at the animal quarter at School of Public Health(SPH) had shown consistently higher risk to get infected with hantavirus irrespective of types of animals handled (OR, 4.90 - 6.37). Sero-positivity of rats of the aniamal quarter at BRB was 30-60%, whereas 80% of rats at SPH tested were shown sero-positivity. CONCLUSION: There was a epidemic of HFRS in research units of a medical school during the period from Jan. through Apr. Further investigation is needed to determine the extent and the mode of transmission of the laboratory-acquired infection with hantavirus in other research facilities.
Animals ; Animals, Laboratory ; Antibodies ; Female ; Fever ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Male ; Surveys and Questionnaires ; Rats ; Schools, Medical* ; Seoul* ; Serologic Tests

Previous studies on life style for colorectal cancer risk suggest that serum lipids and glucose might be related to adenomatous polyps as well as to colorectal carcinogenesis. This case-control study was conducted to investigate the associations between serum lipids, blood glucose, and other factors and the risk of colorectal adenomatous polyp. Male cases with colorectal adenomatous polyp, histologically confirmed by colonoscopy (n=134), and the same number of male controls matched by age for men were selected in hospitals in Seoul, Korea between January 1997 and October 1998. Serum lipids and glucose levels were tested after the subjects had fasted for at least 12 hr. Conditional logistic regression showed that there was a significant trend of increasing adenomatous polyp risk with the rise in serum cholesterol level (Ptrend=0.07). Increasing trend for the risk with triglyceride was also seen (Ptrend=0.01). HDL-cholesterol and LDL-cholesterol had increasing trends for the risk, which were not significant. In particular, it was noted that higher fasting blood glucose level reduced the adenomatous polyp risk for men (Ptrend=0.001). This study concluded that both serum cholesterol and triglyceride were positively related to the increased risk for colorectal adenomatous polyp in Korea. Findings on an inverse relationship between serum glucose and the risk should be pursued in further studies.
Adenomatous Polyps/blood* ; Blood Glucose/analysis* ; Case-Control Studies ; Cholesterol/blood* ; Colonic Neoplasms/blood* ; Human ; Korea ; Lipids/blood ; Lipoproteins, HDL Cholesterol/blood ; Lipoproteins, LDL Cholesterol/blood ; Male ; Rectal Neoplasms/blood* ; Risk Factors ; Triglycerides/blood*

Phenotypic characteristics of complex diseases such as rheumatoid arthritis are a consequence of interactions of genetic and environmental factors. Biomolecules closely interact with other molecular components and form functional modules, resulting in significant biologic action capability. While traditional biochemical research focuses on a single disease using narrowly constrained data, systems biology aims to interpret large volumes of highly complex and multilevel data obtained from high-through-put technologies to understand how biological systems function as a whole. Such a systems approach to complex diseases, so-called network medicine, can shape our comprehensive understanding of disease mechanisms by identifying modules temporally and spatially perturbed in the context of health and diseases. Given the unmet needs for diagnosis, monitoring, and treatment in rheumatoid arthritis, systems biology is obviously an emerging powerful tool to gain insight into disease mechanisms, study comorbidities, analyze therapeutic drugs and their targets, and discover novel network-based biomarkers.
Arthritis, Rheumatoid* ; Biomarkers ; Comorbidity ; Diagnosis ; Systems Biology

BACKGROUND: Polycyclic aromatic hydrocarbons (PAH) are well known environmental pollutants. The measurement of PAH in ambient air is not commonly used, because it is quite difficult to perform and is unreliable. Using biomarkers of PAH can be an alternative approach to this problem. The PAH in ambient air is absorbed in particulate matter. Total suspended particulate(TSP) or particulate matter of less than 10 micrometer in diameter (PM10) can be easily measured. Therefore, TSP or PM10 can be used as a surrogate measurements of ambient air PAH. CONCLUSIONS: We investigated whether the urinary concentration of two biomarkers of PAH, 1-hydroxypyrene (1-OHP) and 2-naphthol, could reflect the total suspended particulate in the general population. METHODS: In order to exclude the effects of occupational exposure and smoking, first grade middle school students were included in this study. Four middle schools within a one kilometer boundary of ambient air monitoring stations were selected. Total suspended particulate was regarded as the marker of airborne PAH. Diet and smoking data were collected by self administered questionnaires, and spot urine samples were collected. Urinary 1-OHP and 2-naphthol were analyzed by high performance liquid chromatography. RESULTS: The correlation between urinary 1-OHP, 2-naphthol and passive smoking was not statistically significant. The correlation between urinary 1-OHP and TSP indices was not statistically significant. The correlations between urinary 2-naphthol and TSP of two lag days, one lag day, and zero lag days were statistically significant. The statistical significance of two lag days was the strongest (p=0.001), one lag day was the next (p=0.0275), and zero lag days was the weakest (p=0.0349). CONCLUSION: Our results imply that the urinary concentration of 2-naphthol can be applied as a PAH exposure marker for the general population with low PAH exposure.
Air Pollution ; Biomarkers ; Chromatography, Liquid ; Diet ; Environmental Pollutants ; Humans ; Occupational Exposure ; Particulate Matter ; Polycyclic Hydrocarbons, Aromatic ; Surveys and Questionnaires ; Smoke ; Smoking ; Tobacco Smoke Pollution

Due to the aging population and tremendous changes in life style over the past decades, cancer has been the leading cause of death in Korea. The incidence rate of breast cancer is the second highest in Korea, and it has shown an annual increase of 6.8% for the past 6 years. The major risk factors of breast cancer in Korean women are as follows: Early menarche, late menopause, late full-term pregnancy (FTP), and low numbers of FTP. Height and body mass index increased the risk of breast cancer in postmenopausal women only. There are ethnic variations in breast cancer due to the differences in genetic susceptibility or exposure to etiologic agent. With the epidemiological evidences on the possibility of further increase of breast cancer in Korea, the Korean Government began implementing the National Cancer Screening Program against breast cancer in 2002. Five-year survival rates for female breast cancer have improved significantly from 78.0% in early 1993-1995 to 90.0% in 2004-2008. This data indicate that improvement of the survival rate may be partially due to the early diagnosis of breast cancer as well as the increased public awareness about the significance of early detection and organized cancer screening program. The current primary prevention programs are geared towards strengthening national prevention campaigns. In accordance with the improvement in 5-year survival rate, the overall cancer mortality has started to decrease. However, breast cancer death rate and incidence rates are still increasing, which need further organized effort by the Korean Government.
Aging ; Body Mass Index ; Breast ; Breast Neoplasms ; Cause of Death ; Early Detection of Cancer ; Early Diagnosis ; Female ; Formycins ; Genetic Predisposition to Disease ; Humans ; Incidence ; Korea ; Life Style ; Menarche ; Menopause ; Pregnancy ; Primary Prevention ; Ribonucleotides ; Risk Factors ; Survival Rate

The advances in mass spectrometry-based proteomics technologies have enabled the generation of global proteome data from tissue or body fluid samples collected from a broad spectrum of human diseases. Comparative proteomic analysis of global proteome data identifies and prioritizes the proteins showing altered abundances, called differentially expressed proteins (DEPs), in disease samples, compared to control samples. Protein biomarker candidates that can serve as indicators of disease states are then selected as key molecules among these proteins. Recently, it has been addressed that cellular pathways can provide better indications of disease states than individual molecules and also network analysis of the DEPs enables effective identification of cellular pathways altered in disease conditions and key molecules representing the altered cellular pathways. Accordingly, a number of network-based approaches to identify disease-related pathways and representative molecules of such pathways have been developed. In this review, we summarize analytical platforms for network-based protein biomarker discovery and key components in the platforms.
Body Fluids ; Humans ; Proteome ; Proteomics ; Biomarkers

OBJECTIVES: To determine the prevalence of prostatitis symptoms in the general population by questionnaire survey and to measure the effect of prostatitis symptoms on quality of life(QOL). MATERIALS AND METHODS: A cross sectional community-based epidemiologic study was performed on 2,034 men, living in the Seoul metropolitan area using stepwise random sampling. Out of 2,034 interviewees, 1,356 men who were older than 40 and provided sufficient information were selected for this study. The questionnaires were completed by well trained interviewers. Contents of the questionnaires included demographic data, the Prostatitis Symptom Index(PSI), the International Prostate Symptom Score(IPSS), a general health questionnaire section and a sexual health questionnaire section. The PSI was composed of a sum of the scores from three questions about dysuria, penile pain and perineal pain and it ranged 0 to 12. Incidence of prostatitis symptoms was defined by a score of 4 or more and the reference group was defined as consisting of those with a score of 3 or less. The rate of incidence of prostatitis symptoms was assessed according to age and the difference of QOL between the prostatitis symptoms group and the reference group. RESULTS: The overall positive rate of prostatitis symptoms measured by the PSI, in men older than 40, living in the Seoul metropolitan area, was 4.5%(61/1,356), adjusted to 4.8% by the relative proportion of this age group in the general population of the Seoul metropolitan area as compared to Korea and the World. The proportion of the group with prostatitis symptoms assessed by the PSI did not increase with age although the proportion of participants with moderate to severe lower urinary tract symptoms (LUTS) did increase with age. The group with prostatitis symptoms suffered from a much greater incidence of LUTS compared to the reference group (p<0.05). The QOL scores of the IPSS, and the general health and sexual health status of the group with prostatitis symptoms, were worse than those of the reference group.(p<0.05). CONCLUSIONS: The positive rate of prostatitis symptoms in men older than 40, living in the Seoul metropolitan area, was 4.8% and it didn't increase with age. The general QOL of the group with prostatitis symptoms was much worse than that of the reference group.
Dysuria ; Epidemiologic Studies ; Humans ; Incidence ; Korea ; Lower Urinary Tract Symptoms ; Male ; Prevalence ; Prostate ; Prostatitis* ; Quality of Life* ; Surveys and Questionnaires ; Reproductive Health ; Seoul