High Glucose Accelerates Autophagy in Adult Rat Intervertebral Disc Cells

공재관,박종범,김만수,박은영 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.5

Study Design: In vitro cell culture. Purpose: The purpose of this study was to investigate the effect of high glucose on autophagy in adult rat intervertebral disc cells. Overview of Literature: Diabetes mellitus is considered to be an important etiologic factor for intervertebral disc degeneration, resulting in degenerative disc diseases. A glucose-mediated increase of autophagy is a major causative factor for the development of diseases associated with diabetes mellitus. However, no information is available for the effect of high glucose on autophagy in adult intervertebral disc cells. Methods: Nucleus pulposus and annulus fibrosus cells were isolated from 24-week-old adult rats, cultured and placed in either 10% fetal bovine serum (normal control) or 10% fetal bovine serum plus two different high glucose concentrations (0.1 M and 0.2 M) (experimental conditions) for one and three days, respectively. The expressions of autophagy markers, such as beclin-1, light chain 3-I (LC3-I) and LC3-II, autophagy-related gene (Atg) 3, 5, 7 and 12, were identified and quantified. Results: Two high glucoses significantly increased the expressions of beclin-1, LC3-II, Atg3, 5, 7, and 12 in adult rat nucleus pulposus and annulus fibrosus cells in a dose- and time-dependent manner. The ratio of LC3-II/LC3-I expression was also increased in a doserespectively time-dependent manner. Conclusions: The results suggest that autophagy of adult nucleus pulposus and annulus fibrosus cells might be a potential mechanism for the intervertebral disc degeneration in adult patients with diabetes mellitus. Thus, the prevention of autophagy in adult intervertebral disc cells might be considered as a novel therapeutic target to prevent or to delay the intervertebral disc degeneration in adult patients with diabetes mellitus.

Effect of High Glucose on Stress-Induced Senescence of Nucleus Pulposus Cells of Adult Rats

공재관,박종범,이동환,박은영 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.2

Study Design: In vitro cell culture model. Purpose: We investigated the effect of diabetes mellitus (DM) on senescence of adult nucleus pulposus (NP) cells. Overview of Literature: DM is a major public health issue worldwide, especially adult‑onset (type 2) DM. DM is also thought to be an important etiological factor in disc degeneration. Hyperglycemia is considered to be a major causative factor in the development of DM-associated diseases through senescence. However, little is known about the effects of DM on senescence in adult NP cells. Methods: Adult NP cells were isolated from 24-week-old rats, cultured, and placed in either 10% fetal bovine serum (FBS, normal control) and 10% FBS plus two different high glucose concentrations (0.1 M or 0.2 M; experimental conditions) for 1 or 3 days. We identified and quantified the occurrence of senescence in adult rat NP cells using senescence-associated-beta-galactosidase (SA-β-Gal) staining. We also investigated the expression of proteins related to the replicative senescence (p53–p21–pRB) and stress-induced premature senescence (p16–pRB) pathways. Results: The mean SA-β-Gal-positive percentage was increased in adult rat NP cells treated with high glucose in a dose- and timedependent manner. Both high glucose levels increased the expression of p16 and pRB proteins in adult rat NP cells. However, the levels of p53 and p21 proteins were decreased in adult rat NP cells treated with both high glucose concentrations. Conclusions: The current study demonstrated that high glucose accelerated stress-induced senescence in adult rat NP cells in a dose- and time-dependent manner. Accelerated stress-induced senescence in adult NP cells could be an emerging risk factor for intervertebral disc degeneration in older patients with DM. These results suggest that strict blood glucose control is important in prevent or delaying intervertebral disc degeneration in older patients with DM.

Conversion of anatomic TSA into RTSA

공재관 대한견주관절의학회 2022 대한견주관절학회 학술대회논문집 Vol.2022 No.11

Joint, Periarticular bone, Black bone, Minocycline, Total joint arthroplasty

곽대순,공재관,한승호,Dong-Hyun Kim,인용 대한정형외과학회 2012 Clinics in Orthopedic Surgery Vol.4 No.3

Background: Despite the importance of soft tissue balancing during total knee arthroplasty (TKA), all estimating techniques are dependent on a surgeon’s manual distraction force or subjective feeling based on experience. We developed a new device for dynamic gap balancing, which can offer constant load to the gap between the femur and tibia, using pneumatic pressure during range of motion. Methods: To determine the amount of distraction force for the new device, 3 experienced surgeons’ manual distraction force was measured using a conventional spreader. A new device called the consistent load pneumatic tensor was developed on the basis of the biomechanical tests. Reliability testing for the new device was performed using 5 cadaveric knees by the same surgeons. Intraclass correlation coefficients (ICCs) were calculated. Results: The distraction force applied to the new pneumatic tensioning device was determined to be 150 N. The interobserver reliability was very good for the newly tested spreader device with ICCs between 0.828 and 0.881. Conclusions: The new pneumatic tensioning device can enable us to properly evaluate the soft tissue balance throughout the range of motion during TKA with acceptable reproducibility

Postoperative Urinary Retention Following Anterior Cervical Spine Surgery for Degenerative Cervical Disc Diseases

정현주,박종범,공재관,김영율,Jangsu Park,김종분 대한정형외과학회 2013 Clinics in Orthopedic Surgery Vol.5 No.2

Background: Postoperative urinary retention (POUR) may cause bladder dysfunction, urinary tract infection, and catheter-related complications. It is important to be aware and to be able to identify patients at risk of developing POUR. However, there has been no study that has investigated the incidence and risk factors for the development of POUR following anterior cervical spine surgery for degenerative cervical disc disease. Methods: We included 325 patients (164 male and 161 female), who underwent anterior cervical spine surgery for cervical radiculopathy or myelopathy due to primary cervical disc herniation and/or spondylosis, in the study. We did not perform en bloc catheterization in our patients before the operation. Results: There were 36 patients (27 male and 9 female) that developed POUR with an overall incidence of 11.1%. The mean numbers of postoperative in-and-out catheterizations was 1.6 times and mean urine output was 717.7 mL. Thirteen out of 36 POUR patients (36%) underwent indwelling catheterization for a mean 4.3 days after catheterization for in-and-out surgery, because of persisting POUR. Seven out of 36 POUR patients (19%) were treated for voiding difficulty, urinary tract irritation, or infection. Chi-square test showed that patients who were male, had diabetes mellitus, benign prostate hypertrophy or myelopathy, or used Demerol were at higher risk of developing POUR. The mean age of POUR patients was higher than non-POUR patients (68.5 years vs. 50.8 years, p < 0.01). Conclusions: To avoid POUR and related complications as a result of anterior cervical spine surgery for degenerative cervical disc disease, we recommend that a catheter be placed selectively before the operation in at-risk patients, the elderly in particular, male gender, diabetes mellitus, benign prostate hypertrophy, and myelopathy. We recommend that Demerol not be used for postoperative pain control.

청소년기 축구선수에서 원위 대퇴외과 성장판 손상의 관절경하 정복 및 내고정 - 1례 보고-

이용석,정재경,공재관,신윤창,Lee, Yong-Seuk,Jung, Jae-Kyoung,Kong, Chae-Kwan,Shin, Yoon-Chang 대한정형외과스포츠의학회 2007 대한정형외과스포츠의학회지 Vol.6 No.1

청소년기에 슬관절 부위에 스포츠 관련 손상은 흔하게 발생하며 이 시기에는 생리적 특성 때문에 골절이 인대손상보다 흔하다. 저자들은 청소년기의 축구 선수에서의 대퇴 외과 성장판 손상을 관절경을 이용하여 정복 및 고정을 하였다. 술 후 2년에 내고정물 제거를 동반한 이차 관절경 검사에서 관절면은 잘 치유되어 있었고, 하지 전장 방사선 촬영소견에서 하지 정열도 변형없이 잘 유지되어 있었다. Sports-related knee injuries frequently occur in adolescent period and fractures are more common than ligamentous Injuries in this age group because of physiologic characteristics. We operated an adolescent soccer player with lateral femoral epiphyseal injury using arthroscopic assisted reduction and infernal fixation. In $2^{nd}$ look arthroscopy and metal removal at postoperative 2 years, articular cartilage was healed with good congruity and lower extremity entire long film showed normal axial alignment without residual deformity.

수부에 발생한 전이암

이승구,정도현,공재관,김정호,Rhee, Seung-Koo,Chung, Do-Hyun,Kong, Chae-Gwan,Kim, Jeong-Ho 대한근골격종양학회 2003 대한골관절종양학회지 Vol.9 No.2

1990년이래 치험한 5례의 수부 전이암은, 남자 1명, 여자 4명이었고, 원발성 종양은 폐암 2례, 유방암, 위암 및 직장암이 각 1례씩이 었으며, 근위지골 발생이 4례, 원위지골 발생이 1례 였고, 단발 수지 발생 4례, 다발 수지 발생이 1례 였다. 수부 전이암이 X-선상 진단되기 전 약 3~6개월전부터 동통과 부종 및 X-선상 수부 골조송증의 소견이 있어 이들이 수부 전이암의 초기 증상으로 판단되였다. 이들은 열 전단술 3례, 견관절 이단 및 보존적 치료를 각 1례씩 시행 하였으며, 진단이후 생존 기간은 평균 5개월 이었다. Skeletal metastasis are common in terminal malignant tumor patients over 30% of incidence, but hand acrometastasis are very rare under 0.1% in terminal cancer patients. We have reported 5 cases of hand acrometastasis herewith the review of literatures. In the preterminal malignant tumor patients, sudden painful swelling on fingers and osteoporosis on X-rays are thought to be the earliest sign of hand metastasis.

슬괵건을 이용한 후방 십자 인대 재건술시 횡고정 핀을 이용한 대퇴 터널 고정술

인용,권오수,박원종,공재관 대한슬관절학회 2003 대한슬관절학회지 Vol.15 No.1

목적 : 슬괵건을 이용한 후방 십자 인대 재건술 시행시 대퇴 터널을 횡고정 핀으로 고장하는 술식을 시행하고 그 결과를 보고자 한다. 대상 및 방법 : 2001년 9월부터 2002년 3월까지 동반손상이 없는 grade Ⅲ 이상의 후방 십자 인대 손상으로 네 겹의 슬괵건을 이용한 후방 십자 인대 재건술을 받고 1년이상 추시가 가능하였던 8예를 대상으로 하였다. 전 예에서 대퇴 터널을 횡고정 핀으로 고정하였으며 경골 터널은 Intrafix(Mitek_(?), USA)를 이용하여 고정하였다. 기능 평가는 Lysholm 점수, International Knee Documentation Committee(IKDC) 평가 기준과 KT-2000 관절계를 이용한 최대 도수 부하 검사를 이용하였다. 결과 : Lysholm 점수가 술전 평균 54점에서 술후 1년 추시상 89점으로 향상되었다. IKDC 평가 기준상 정상이 2예, 거의 정상이 5예였으며 비정상이 1예 있었다. KT-2000 관절계를 이용한 최대 도수 부하 검사상 술전 평균 12.2 ㎜에서 3.7 ㎜로 호전되었다. 결론 : 슬괵건을 이용한 후방십자인대 재건술시 횡고정 핀을 이용하는 고정방법은 좋은 술식으로 사료된다. Purpose: The purpose of this study is to introduce new fixation technique for posterior cruciate ligament (PCL) reconstruction using quadruple hamstring tendon autograft. Materials & Materials : From September 2001 to March 2002, eight patients received PCL reconstruction using quadruple hamstring autograft for PCL injury without associated procedures for posterolateral complex injures. All femoral tunnels were fixed with cross pins and all tibial tunnels were fixed with Intrafix(Mitek_(?), USA). Clinical assessments consited of Lysholm knee scores, International Knee Documentation Committee(IKDC) evaluation form and manual maximal side to side difference using KT-2000 arthrometer. Result : The average Lysholm knee score improved from 54 preoperative to 89 postoperatively. At the final IKDC evaluation, 2 cases were graded as normal, 5 nearly normal, 1 abnormal. Mean side to side difference of manual maximum posterior displacement with knee in 70° flexion using the KT-2000 arthrometer was 3.7 ㎜. Conclusion : In PCL reconstruction using quadruple hamstring autograft, cross pins are good fixation method with high strength and stiffness.

Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series

박호연,김석중,서유준,Jae Woong Jung,공재관 대한견주관절학회 2020 대한견주관절학회지 Vol.23 No.4

Background: Locked posterior fracture-dislocation of the shoulder (LPFDS) is a very rare injury that occurs predominantly in young patients following high-energy trauma. The long-term outcome of the treatment of this injury is often poor. This study sought to present the characteristics of injury, discuss the pathological anatomy, and to report the treatment outcomes of our case series. Methods: Between January 2012 and May 2018, a total of 234 patients who underwent surgical treatment for proximal humerus fractures were reviewed. Among them, six patients (mean age, 54.7 years; range, 35–76 years) with LPFDS were included in this study. Four patients were treated with open reduction and internal fixation (ORIF) with locking plates, one with hemiarthroplasty, and one with reverse total shoulder arthroplasty. Clinical results were evaluated by Constant, American Shoulder and Elbow Surgeons (ASES), and visual analog scale (VAS) scores and radiologic evaluation was conducted using follow-up radiographs. Results: The mean length of follow-up was 26.2 months (range, 12–54). The mean Constant, ASES, and VAS scores were 66.7, 65.5, and 2.2, respectively. Four patients who underwent ORIF achieved bony union, but avascular necrosis (AVN) of the humeral head was observed in two patients. No complications were observed in the patients who underwent arthroplasty surgery until final follow-up. Conclusions: In the treatment of LPFDS, replacement arthroplasty can produce predictable results. The approach of ORIF may be considered as a first choice of treatment in young patients but is sometimes correlated with postoperative complications such as AVN and the functional outcomes may be unpredictable. Therefore, patients should undergo careful diagnosis and treatment of this type of injury.

경골 과 골절과 동반된 반월상 연골 손상

인용 ( Yong In ),박원종 ( Won Jong Bahk ),권오수 ( Oh Soo Kwon ),공재관 ( Chae Gwan Kong ),김주영 ( Ju Young Kim ) 대한골절학회 2003 대한골절학회지 Vol.16 No.4