Effect of Total Hip Arthroplasty on Ipsilateral Lower Limb Alignment and Knee Joint Space Width: Minimum 5-Year Follow-up

Choi Yun Seong,Park Jung-Wee,Kim Tae Woo,Kang Kee Soo,Lee Young-Kyun,Koo Kyung-Hoi,Chang Chong Bum 대한의학회 2023 Journal of Korean medical science Vol.38 No.20

Background: This study aimed to 1) assess the effect of total hip arthroplasty (THA) on coronal limb alignment, namely, the hip–knee–ankle angle (HKA), 2) identify factors that determine changes in the HKA, and 3) determine whether alignment changes influence the knee joint space width. Methods: We retrospectively evaluated 266 limbs of patients who underwent THA. Three types of prostheses with neck shaft angles (NSAs) of 132°, 135°, and 138° were used. Several radiographic parameters were measured in the preoperative and final radiographs (at least 5 years after THA). A paired t-test was used to confirm the effect of THA on HKA change. Multiple regression analysis was performed to identify radiographic parameters related to HKA changes following THA and changes in knee joint space width. Subgroup analyses were performed to reveal the effect of NSA change on the HKA change, and the proportion of total knee arthroplasty usage and changes in radiographic parameters between maintained joint space and narrowed joint space groups were compared. Results: The preoperative mean HKA was 1.4° varus and increased to 2.7° varus after THA. This change was related to changes in the NSA, lateral distal femoral angle, and femoral bowing angle. In particular, in the group with a decrease in NSA of > 5°, the preoperative mean HKA was largely changed from 1.4° varus to 4.6° varus after THA. The prostheses with NSA of 132° and 135° also led to greater varus HKA changes than those with an NSA of 138°. Narrowing of the medial knee joint space was related to changes in the varus direction of the HKA, decrease in NSA, increase in femoral offset. Conclusion: A large reduction in NSA can lead to considerable varus limb alignment after THA, which can have adverse effects on the medial compartment of the ipsilateral knee.

일측 폐이식 성견에서 혈역학과 체액조절 호르몬의 상관관계

서강석,박창권,송대규,배재훈,박원균 啓明大學校 醫科大學 2002 계명의대학술지 Vol.21 No.1

폐이식에 의한 체액이나 혈압의 변동 및 신경의 절단은 혈압 및 체액의 조절에 관여하는 호르몬의 분비에 영향을 미치리라 생각되어 좌일측 폐이식 시 이식폐에 분포하는 신경이 절단된 상태에서 폐이식 후 수용견의 혈역학적 변동이 ANP 및 ADH의 분비와 어떠한 상관관계가 있는지를 관찰하였다. 한국산 성견 12마리를 대상으로 좌일측 폐이식을 시행하였다. 공여폐의 보존은 low potassium dextrane glucose용액을 이용하여 10℃에서 20시간동안 보존한 다음 수용견에 이식하였다. 수용견의 좌측 폐를 적출하기 전과 후, 그리고 이식 후 재관류 30분, 2시간 후에 각각 혈역학 및 동맥혈 가스분압을 측정하였고, 동맥혈에서 ANP 및 ADH의 농도를 측정하였다. 동맥혈의 P_(O_2) 및 P_(CO_2)는 유의한 변동은 없었다. 대퇴동맥압을 재관류 후 30분에는 유의하게 감소하였고, 재관류 2시간 후에는 다소 회복세를 보이는 경향이었으며, 맥압은 비교적 유지되었다. 폐동맥압은 좌측폐 절제 시 이완기 폐동맥압은 변동이 없는 반면에 수축기 폐동맥압은 증가하였고, 재관류 시 폐동맥압은 어느 정도 회복되는 양상이었다. 심박출량은 좌측 폐절제 후에는 감소하였으며 재관류후에도 낮게 유지되는 양상이었다. 반면에 심박수는 유의한 변화없이 유지되었다. 전신혈관저항 및 폐혈관저항은 좌측 폐절제 후나 재관류 30분에 증가하였으며, 재관류 2시간 후 폐혈관저항은 회복되는 양상이나 전신혈관저항은 회복되지 못하였다. 혈중 ANP는 일측 폐절제 후 증가하였고, 재관류 후에는 점차 회복되는 양상을 보였고, ADH는 일측 폐절제 후, 30분에 증가한 후 회복되는 양상을 보였다. 동맥혈 ANP의 변동은 동맥혈 P_(O_2)및 P_(CO_2)와 상관관계를 보였고, ADH는 전신 동맥압의 변동과 상관관계가 있었다. 이상의 결과로 좌일측 폐이식 시에도 ANP 및 ADH는 혈역학적 변화와 연관하여 동맥압 및 체액의 조절에 생리적으로 관여하는 것으로 사료되며, ANP의 분비는 동맥혈의 저산소증 그리고 ADH의 분비는 동맥의 압수용기를 통한 신경성 조절의 영향을 받을 수 있는 것으로 생각된다. The purpose of this investigation was to study changes of plasma atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) in Korean mongrel dogs after a left single lung transplantation and to evaluate the correlation between hemodynamic factors and secretory responses of ANP and ADH. Arterial P_(O_2 and P_(CO_2) did not change significantly. Femoral arterial pressure decreased after 30 min of reperfusion and recovered slightly at 120 min, whereas pulse pressure did not change. After pneumonectomy, systolic pulmonary arterial pressure increased, whereas diastolic pulmonary pressure remained unchanged. Althought cardiac output fell following pneumonectomy and reperfusion, heart rate was unchanged. The secretion of plasma ANP initially increased follwoing pneumonectomy, but subsequently recoverd. In each subject, ANP values showed stronger correlation with arterial P_(O_2) than other hemodynamic parameters. The secretion of plasma ADH also initially increased (p<0.05) after 30 min of reperfusion and thereafter recoverd, showing the strongest correlation with mean femoral arterial pressure. The present results suggest that the secretion of ANP and ADH seem to be well regulated in accordance with hemodynamic changes after a single lung transplantation. Hypoxia and systemic arterial pressure are the prominent factors in the secretion of ANP and ADH, respectively.

정상인의 입각기에서 발바닥압력측정시 압력중심점의 위치

허재균,박시복,이상건,이강목,김영호,양길태,장윤희 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.2

펄스코로나 방전에서의 NOⅹ 저감 에너지 효율에 관한 실험적 연구

姜宇政,申昌均 충주대학교 산업과학기술연구소 2002 産業科學論文集 Vol.10 No.-

Rapid recent development in industry generated environmental issues. The NOx, the main cause for the air pollution, increases the Ozone-concentration and becomes a factor for the photochemical smog and acid-rain. Thus, the preventive method as well as the inhibitive technique for NOx have been demanded. The purpose of present study is to change the harmful gas using high voltage pulse system. In order to reduce the harmful NOx, experiments were done with changes in gas temperature, NOx initial concentration, C_2H_4 concentration, and the amount of pulse voltage.

산업용 Robot言語의 解析器 設計

李康鉉,朴暢均 조선대학교 동력자원연구소 1986 動力資源硏究所誌 Vol.8 No.2

This paper deals with the design of interpreter for the industrial robot systems, and then concatenated operation with other robot systems in the industrial lines. A design method of the driving circuits for the DC-servo motor is suggested an algorithm using the Digital Position Locked Loop(DPLL). Robot arms, which are used in this investigation, are 3-dimension controllable and rotationable. As the result 1) we can easily operate the system as the robot language is defined the single key format with actuated motion. 2) it is cost effective system because the system can be deleted the extra controller for each motor. 3) it is improved the system precision by using the DPLL.

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

천포창에서의 열충격단백질 70의 발현

강주형 ( Joo Hyung Kang ),조문균 ( Moon Kyun Cho ),최보라 ( Bo Ra Choi ),황규왕 ( Kyu Yang Whang ),노영석 ( Young Suck ),이창우 ( Chang Woo Lee ) 대한피부과학회 2008 대한피부과학회지 Vol.46 No.8

Background: Heat shock proteins (HSP), especially the HSP 70 family, may play certain roles in the immunophysiology of some skin diseases such as psoriasis, pemphigus, and lichen planus. HSPs generally induce down-regulation of the process of apoptosis that is considered to be one of the acantholysis-producing pathways in pemphigus. Objective: We planned to examine possible roles of HSPs 70/105 in the blistering process in pemphigus vulgaris (PV) and pemphigus foliaceus (PF), in connection with the detection results of apoptosis in local tissue specimens. Methods: Immunohistochemical stainings and Western blot analysis were performed for the detection and semiquantitation of HSPs 70/105 in skin specimens from lesional, nonlesional, and normal control sites. Hoechst 33342 staining was simultaneously carried out to examine features of apoptosis in lesional skin specimens. Results: The findings on expression of HSP were as follows. In PV, the expression of HSP 70 was minimum or negative; however, in PF, the expression was obvious and recognizable in lesional and perilesional normal skin. In contrast, HSP 105 was not detected in all cases of PV and PF. The features of apoptosis were evident at the lesional skin of all cases of pemphigus with acantholytic changes. Conclusion: PV and PF had different relative intensities of HSPs in lesional tissue stainings, especially in cases with HSP 70. This suggests that there may be subtle differences in the mechanisms causing acantholysis between PV and PF. (Korean J Dermatol 2008;46(8):1003~1010)

口眼渦斜 患者의 Gadolinium-DPTA enhanced MRI 所見에 대한 臨床的 考察

김재수,최우석,김용석,고형균,강성길,김창환 경희대학교 동서의학연구소 2001 東西醫學硏究所 論文集 Vol.2000 No.-

This study is designed to evaluate the clinical implications of Gd-DPTA (Gadolinium-diethyl - enetriamine pentacetic acid) enhanced MRI(Magnetic resonance imaging) in Bell's palsy and find it's usefulness in Oriental Medicine In this study, 25 outpatients with Bell's palsy were studied that MRI was performed. To evaluate degree of facial palsy, H-B(House-Brackmann) Grade was used. In Oriental Medical therapy, Acupuncture and Herbal medicine were treated. Subjective causes was divided into exposure to chill, fatigue, stress, mixed cases. Enhanced site was compared with symptoms which were disorder of eye, hearing, taste, and facial muscle palsy. Also, Relation between time which was performed MRI and enhancement was analyzed. The enhanced lesion in MRI was divided into five segments; Internal auditory canal, Labyrinthine segment, Geniculate ganglion, Tympanic segment, Mastoid segment. In Bell's palsy, 20 of 25 patients(80%) had abnormal contrast enhancement of the facial nerve. The H-B grade and interval performed MRI from onset were directly proportionate to enhancement. That is to say, Severe facial palsy short interval show high possibility of enhancement. There was no relation between subjective causes and enhanced site of facial nerve in MRI. Also Clinical symptoms didn't coincide with MRI findings.

Dietary Exposure to Transgenic Rice Expressing the Spider Silk Protein Fibroin Reduces Blood Glucose Levels in Diabetic Mice: The Potential Role of Insulin Receptor Substrate-1 Phosphorylation in Adipocytes

박지은,정연재,박준범,김혜영,유영현,이광식,양원태,김도훈,김종민 한국발생생물학회 2019 발생과 생식 Vol.23 No.3

Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR). T2DM is correlated with obesity and most T2DM medications have been developed for enhancing insulin sensitivity. Silk protein fibroin (SPF) from spiders has been suggested as an attractive biomaterial for medical purposes. We generated transgenic rice (TR) expressing SPF and fed it to diabetic BKS.Cg-m+/+Leprdb mice to monitor the changes in blood glucose levels and adipose tissue proteins associated with energy metabolism and insulin signaling. In the present study, the adipocyte size in abdominal fat in TR-SPF-fed mice was remarkably smaller than that of the control. Whereas the adenosine monophosphate-activated protein kinase (AMPK)-activated protein kinase and insulin receptor substrate 1 (IRS1) protein levels were increased in abdominal adipose tissues after TR-SPF feeding, levels of six-transmembrane protein of prostate 2 (STAMP2) proteins decreased. Phosphorylation of AMPK at threonine 172 and IRS1 at serine 307 and tyrosine 632 were both increased in adipose tissues from TR-SPFfed mice. Increased expression and phosphorylation of IRS1 at both serine 307 and tyrosine 632 in adipose tissues indicated that adipocytes obtained from abdominal fat in TR-SPF-fed mice were more susceptible to insulin signaling than that of the control. STAMP2 protein levels decreased in adipose tissues from TR-SPF-fed mice, indicating that STAMP2 proteins were reducing adipocytes that were undergoing lipolysis. Taken together, this study showed that TR-SPF was effective in reducing blood glucose levels in diabetic mice and that concurrent lipolysis in abdominal adipocytes was associated with alterations of AMPK, IRS1, and STAMP2. Increased IRS1 expression and its phosphorylation by TR-SFP were considered to be particularly important in the induction of lipolysis in adipocytes, as well as in reducing blood glucose levels in this animal model.

자궁내막기질인 Type I Collagen을 이용한 생쥐 배아의 착상에 관한 연구

김정훈(Chung Hoon Kim),채희동(Hee Dong Chae),강병문(Byung Moon Kang),장윤석(Yoon Seok Chang),강은희(Eun Hee Kang),전용필(Yong Pil Cheon),박견(Kyun Park) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.1

목적: Type I collagen을 이용하여 3차원적 배양체계와 유사한 구조적인 환경을 조성하여 생쥐 배아의 착상전후의 상태를 보기 위한 연구를 중심으로 하였다. 연구방법: 포배단계의 배를 획득하기 위해서 자궁과 수란관의 일부를 적출하고 배양액으로 관류하여 배를 획득한 후 실험에 사용하였다. 멸균된 centrifuge용 시험관에 collagen이 polymerization되게 하였다. 배아는 착상과정의 비교를 위하여 type I collagen군(실험군)과 대조군으로 나누었으며, 대조군에서는 type I collagen 없이 배양액만 사용하여 배아를 배양하였다. 배의 성장과 분화는 24시간 단위로 해부현미경하에서 관찰하였다. 결과: 배양 제 3일에 배아의 부착율은 차이가 없었으나, 배아의 크기는 대조군에 비하여 실험군에서 뚜렸하게 컸다. 배아의 성장이 대조군에서 배양용기의 표면을 따라 수평적으로 진행되는 것과는 달리 실험군에서는 구형을 이루며 입체적으로 성장하기 때문에 색깔이 훨씬 진하게 나타났다. 배아의 발달단계를 관찰한 결과 배양 제 4일과 5일에는 실험군에서 대조군에 비하여 유의하게 발달단계가 높았다. 결론: Type I collagen을 사용한 본 연구는 착상연구의 모델로서 실험적으로 원하는 환경을 설정할 수 있고 관찰이 용이한 장점을 보여주었으나, 생체의 자궁내막세포와 같은 dynamic milieu가 결여되어 있어, 실제의 자궁내막과 유사한 체계를 이루는 배양체계를 어느 정도 수준까지 완성하려면 지속적인 연구가 필요할 것으로 사료된다. Objectives: To examine the in vitro interactions of blastocyst attachment using type I collagen. Materials and methods: ICR mice were used and follicular growth was stimulated by pregnant mare serum gonadotropin and human chorionic gonadotropin. On day 4 of pregnancy, the uteri were removed and blastocysts were flushed. Mixtures of 1mL sterile water, 0.5mL DMEM, 2mL type collagen solution and 0.5mL 0.1M NaOH were prepared and transferred to an incubator where the collagen solution polymerized. Blastocysts were transferred to dishes previously coated with type I collagen. CMRL 1066 was used as the basic culture medium. It was supplemented with 1mM glutamine and 1mM sodium pyruvate plus 50 IU/ml penicillin and 50 mg/ml streptomycin. During the first 4 days the culture medium was supplemented with 20% fetal calf serum and thereafter with 20% heat inactivated human cord serum. All blastocysts were initially cultured for 2 days without media change. After 2 days, fresh medium was renewed daily. The stages of embryo growth were examined and recorded everyday under a dissecting microscope and classified according to the standard in vivo criteria set forth by Witschi. Results: By 48h, nearly all blastocysts had attached to the surface of collagen pad. Following adhesion to the collagen pad, the blastocysts maintained their 3-dimensional integrity in contrast to control. The embryos in collagen pad were not flattening and kept polarity and spherical shape during culture. The polar trophoblast invaded the type I collagen downward unlike the horizontal growth in control. In the developmental stage of mouse blastocyst, there were significant differences between control and type I collagen group during day 4 and 5 culture. Conclusion: Blastocyst development was better in type I collagen group than control. Therefore, in vitro culture study using type I collagen could provide improved model for the establishment of blastocyst implantation study.