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Retrograde Intramedullary Nailing for Distal Femur Fracture with Osteoporosis
Jihyeung Kim,강승백,Kyungpyo Nam,Seung Hwan Rhee,Jong Won Won,Hyuk-Soo Han 대한정형외과학회 2012 Clinics in Orthopedic Surgery Vol.4 No.4
Background: The incidence of distal femur fracture in the elderly has been increasing recently, and commonly occurs with osteoporosis. Retrograde intramedullary nailing has been considered a good surgical option for distal femur fracture. The purpose of the present study was to present our surgical results with retrograde intramedullary nailing for distal femur fractures with osteoporosis. Methods: Thirteen patients diagnosed with extra-articular distal femur fracture and osteoporosis and managed with retrograde intramedullary nailing were retrospectively reviewed. Cement augmentation was used in four patients, shape memory alloy was used in eight patients and both were used in one patient. All patients were followed up for more than 2 years. Radiologic alignments were scored and Tegner and the Lysholm activity score was used for a functional assessment. Results: The average time to clinical union was 13 weeks (range, 10 to 15 weeks). In 12 of our cases, the total alignment scores were excellent. At the last follow-up, the mean range of motion was 116° (range, 110° to 125°). The average functional score at postoperative 1 year was 2.6 (range, 1 to 5). Conclusions: Retrograde intramedullary nailing is a good surgical option for distal femur fracture with osteoporosis. Cement augmentation and shape memory alloy can also be used for added mechanical stability. This surgical technique is very useful for distal femur fracture with osteoporosis as it promotes fracture healing and early rehabilitation.
Jihyeung Ju,Youngeun Kwak,Xingpei Hao,Chung S. Yang 한국영양학회 2012 Nutrition Research and Practice Vol.6 No.5
The aim of the study was to investigate the inhibitory effects of calcium against intestinal cancer in vitro and in vivo. We first investigated the effects of calcium treatment in HCT116 and HT29 human colon cancer cells. At the concentration range of 0.8-2.4 mM, calcium significantly inhibited cell growth (by 9-29%), attachment (by 12-26%), invasion (by 15-31%), and migration (by 19-61%). An immunofluorescence microscope analysis showed that the treatment with calcium (1.6 mM) for 24 h increased plasma membrane β-catenin but decreased nuclear β-catenin levels in HT29 cells. We then investigated the effect of dietary calcium on intestinal tumorigenesis in ApcMin/+ mice. Mice received dietary treatment starting at 6 weeks of age for the consecutive 8 weeks. The basal control diet contained high-fat (20% mixed lipids by weight) and low-calcium (1.4 ㎎/g diet) to mimic the average Western diet, while the treatment diet contained an enriched level of calcium (5.2 ㎎ calcium/g diet). The dietary calcium treatment decreased the total number of small intestinal tumors (by 31.4%; P < 0.05). The largest decrease was in tumors which were ≥ 2 ㎜ in diameter, showing a 75.6% inhibition in the small intestinal tumor multiplicity (P < 0.001). Immunohistochemical analysis showed significantly reduced nuclear staining of β-catenin (expressed as nuclear positivity), but increased plasma membrane staining of β-catenin, in the adenomas from the calcium-treated groups in comparison to those from the control group (P < 0.001). These results demonstrate intestinal cancer inhibitory effects of calcium both in human colon cancer cells and ApcMin/+ mice. The decreased β-catenin nuclear localization caused by the calcium treatment may contribute to the inhibitory action.
김지형(Jihyeung Kim),공현식(Hyun Sik Gong),백구현(Goo Hyun Baek) 대한정형외과학회 2017 대한정형외과학회지 Vol.52 No.2
척골 충돌 증후군은 척측 수근 관절 동통의 가장 흔한 원인 질환 중 하나이다. 통증은 주로 전완부가 회내전된 상태에서 수근 관절은 척측 변위시키며 강력 파악하는 동작에서 발생하게 된다. 척골 충돌 증후군의 가장 흔한 원인 인자는 손목 관절에서 척골이 요골보다 긴 척골 양성 변이이다. 하지만 척골 충돌 증후근은 척골 중성 변이 혹은 척골 음성 변이 환자에서도 발생할 수 있는데 척골 변이가 전완부 회내전 및 강력 파악 동작에서 길어지거나 두꺼운 삼각 섬유 인대 복합체가 동반될 수 있기 때문이다. 척골 충돌 증후군 환자에서 생활 습관의 개선, 약물 치료, 부목 고정 등을 이용한 보존적 치료에 실패하게 되면 wafer 술식 혹은 척골 단축술과 같은 수술적 치료를 시행해 볼 수 있다. Wafer 술식은 척골 충돌 증후군에서 효과적으로 시행할 수 있는 수술법으로 작은 절개 혹은 관절경을 이용하여 척골 경상 돌기의 골절이 발생하지 않도록 주의하며 척골 두 원위부를 2-4 mm 정도 제거하는 술식이다. Wafer 술식의 장점으로는 골유합을 위한 내고정이 필요하지 않고 삼각 섬유 인대 복합체에 대한 수술을 함께할 수 있다는 점이다. 하지만 이 술식은 기술적으로 어려우며 원위 요척 관절 불안정성이 있거나 월상-삼각골간 불안정성, 척골 음성 변이 환자, 4 mm 이상의 척골 양성 변이 환자에서는 금기이다. 척골 단축술은 척골 충돌 증후군에서 가장 많이 사용되는 수술법이다. 이 술식은 척골 충돌 증후군 증상을 효과적으로 경감시켜줄 수 있고, 원위 요척 관절을 안정화시킬 수 있다. 하지만 과도하게 척골을 단축시킬 경우에는 원위 요척 관절의 최대 압력이 증가할 수 있고, 원위 요척 관절염이 발생할 수 있다. 또한 절골 부위에서 지연 유합 혹은 불유합이 발생할 수 있다. 이를 예방하기 위해서는 절골 부위에 간격이 생기지 않도록 주의하여야 한다. 척골 단축술 이후 원위 요척 관절의 관절염이 발생할 수 있기 때문에 정기적인 외래 경과 관찰이 필요하다. Ulnar impaction syndrome is one of the common causes of ulnar-sided wrist pain. The pain is usually aggravated by ulnar deviation during a power grip, especially when the forearm is in a pronated position. The most common predisposing factor of ulnar impaction syndrome is ulnar positive variance, which is an increased ulnar length relative to the radius of the radiocarpal joint. However, it can also occur in patients with ulnar neutral or negative variance because ulnar variance can increase during functional activities, including pronation and power gripping. In these patients, the triangular fibrocartilage complex (TFCC) may be thickened. If conservative treatments-lifestyle modification, medication, or wrist splinting-are unsuccessful, surgical treatments, such as wafer procedure or ulnar shortening osteotomy can be considered. The wafer procedure is an effective treatment for ulnar impaction syndrome. It removes the distal 2 to 4 mm of the ulnar head, while preserving the ulnar styloid process from fracturing via a limited open or an arthroscopic approach. The advantages of the wafer procedure are that it does not require bone healing or internal fixation and provides direct access to TFCC. However, it is a technically demanding procedure and is contraindicated in patients with distal radio-ulnar joint (DRUJ) instability, lunotriquetral instability, ulnar minus variance, and with an ulnar positive variance of more than 4 mm. Ulnar shortening osteotomy is the most popular method for the treatment of ulnar impaction syndrome. It can effectively relieve ulnar impaction symptoms and stabilize DRUJ. However, an excessive amount of shortening may increase the peak pressure at DRUJ, which results in DRUJ arthritis. There is also a possibility of delayed union or nonunion in the osteotomy site. To prevent delayed union or nonunion, we should make an effort to decrease the gap in the osteotomy site during surgery. A serial follow-up is also recommended to evaluate the occurrence of arthritis in DRUJ after ulnar shortening.
Youngeun Kwak,Jihyeung Ju 한국영양학회 2015 Nutrition Research and Practice Vol.9 No.1
BACKGROUND/OBJECTIVES: Perilla frutescens Britton leaves are a commonly consumed vegetable in different Asian countries including Korea. Cancer is a major cause of human death worldwide. The aim of the current study was to investigate the inhibitory effects of ethanol extract of perilla leaf (PLE) against important characteristics of cancer cells, including unrestricted growth, resisted apoptosis, and activated metastasis, using human cancer cells. MATERIALS/METHODS: Two human cancer cell lines were used in this study, HCT116 colorectal carcinoma cells and H1299 non-small cell lung carcinoma cells. Assays using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide were performed for measurement of cell growth. Soft agar and wound healing assays were performed to determine colony formation and cell migration, respectively. Nuclear staining and cell cycle analysis were performed for assessment of apoptosis. Fibronectin-coated plates were used to determine cell adhesion. RESULTS: Treatment of HCT116 and H1299 cells with PLE resulted in dose-dependent inhibition of growth by 52-92% (at the concentrations of 87.5, 175, and 350 μg/ml) and completely abolished the colony formation in soft agar (at the concentration of 350 μg/ml). Treatment with PLE at the 350 μg/ml concentration resulted in change of the nucleus morphology and significantly increased sub-G1 cell population in both cells, indicating its apoptosis-inducing activity. PLE at the concentration range of 87.5 to 350 μg/ml was also effective in inhibiting the migration of H1299 cells (by 52-58%) and adhesion of both HCT116 and H1299 cells (by 25-46%). CONCLUSIONS: These results indicate that PLE exerts anti-cancer activities against colon and lung cancers in vitro. Further studies are needed in order to determine whether similar effects are reproduced in vivo.