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.

척골 충돌 증후군의 최신 지견

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.

Outcomes of Ulnar Shortening Osteotomy with an Intramedullary Bone Graft for Idiopathic Ulnar Impaction Syndrome

Kyung Wook Kim,Jihyeung Kim,Hyungryul Lim,Kee Jeong Bae,Yo Han Lee,Young Kwang Shin,Goo Hyun Baek 대한정형외과학회 2024 Clinics in Orthopedic Surgery Vol.16 No.2

Background: Although several techniques for the treatment of ulnar impaction syndrome (UIS) have been introduced, there have still been reports on various complications such as delayed union, nonunion, refracture, wrist pain, plate irritation, and chronic regional pain syndrome. This study aimed to compare the differences in radiological and clinical outcomes of patients in which intramedullary bone grafting was performed in addition to plate stabilization with those without additional bone grafting during ulnar shortening osteotomies (USOs). Methods: Between November 2014 and June 2021, 53 wrists of 50 patients with idiopathic UIS were retrospectively reviewed. Patients were divided into 2 groups according to whether intramedullary bone grafting was performed. Among the 53 wrists, USO with an intramedullary bone graft was performed in 21 wrists and USO without an intramedullary bone graft was performed in 32 wrists. Demographic data and factors potentially associated with bone union time were analyzed. Results: There was no significant difference between the 2 groups when comparing postoperative radioulnar distance, postoperative ulnar variance, amount of ulnar shortening, and postoperative Disabilities of the Arm, Shoulder and Hand score. Compared to the without-intramedullary bone graft group, bone union time of the osteotomy site was significantly shortened, from 8.8 ± 3.0 weeks to 6.7 ± 1.3 weeks in the with-intramedullary bone graft group. Moreover, there were no cases of nonunion or plate-induced symptoms. Both in univariable and multivariable analyses, intramedullary bone grafting was associated with shorter bone union time. Conclusions: USO with an intramedullary bone graft for idiopathic UIS has favorable radiological and clinical outcomes. The advantage of this technique is the significant shortening of bone union time.

주한 외국인의 한식에 대한 인식, 선호 및 교육요구도

김나영(Na Young Kim),김샛별(Saet Beol Kim),한지연(Ji Yeon Han),주지형(Jihyeung Ju) 충북대학교 생활과학연구소 2011 생활과학연구논총 Vol.15 No.2

The present study aimed to investigate recognition, preference, and educational need of foreign residents on korean foods. Subjects of this study were a total of 155 foreign residents in Chungcheong area of Korea. Major findings of this study were: 1) the general recognition of the subjects on korean foods was above moderate (scored 3∼4 points out of 5 points); 2) 81.3% of the subjects did not cook korean foods although they were interested in cooking korean foods (scored 3.5 points out of 5 points); 3) most of the subjects obtained information on korean foods from their friends or internet, and more than 80% of the subjects have no experience in participating education program on korean foods; 4) approximately half the subjects wanted to be educated on how to cook korean foods in a cooking class. The present study suggest that effective education program should be developed in order for foreign residents in Korea to improve their understanding on korean foods.

다발성 Kirschner 강선을 이용한 제 5중족골 기저부 골절의 수술적 치료

김지형,김장우,이정익,김상길,이승환,Kim, Jihyeung,Kim, Jang Woo,Lee, Jeong Ik,Kim, Sang Kil,Rhee, Seung Hwan 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.1

Purpose: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture. Materials and Methods: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) mid-foot score at six months postoperatively. Results: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively. Conclusion: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.

Inhibitory Activities of Perilla frutescens Britton Seed Extract against Cell Growth, Migration, and Adhesion in Human Cancer Cells

Sinae Kim,Boram Song,Jihyeung Ju 한국식품영양과학회 2014 한국식품영양과학회 학술대회발표집 Vol.2014 No.10

민간단체 소속 자원봉사자의 식품안전에 대한 인식 및 관련 교육에 대한 요구

김은선(Kim, Eunsun),주지형(Ju, Jihyeung) 충북대학교 생활과학연구소 2020 생활과학연구논총 Vol.24 No.3

The present study aimed to investigate the perception on food safety and the demand for related education among volunteers from private organization. The subjects were a total of 149 volunteers of private organization in Chungbuk area. The subjects with experience of being trained for food safety (46.3%) were less than the subject without such experience (53.7%), and only a few cases were formal offline-based training in safety-related organizations. The interest, trust, knowledge, and behavior score of the subjects were a moderate level (3.5 out of 5 points, 3.3 out of 5 points, 14.1 out of 20 points, 20.8 out of 30 points, respectively). The subjects perceived the ease of obtaining food safety-related information as below moderate level (2.9 out of 5 points). The demand of subjects for the food-safety related education on food safety was scored to 4.0 out of 5 points, and the score of the subjects with experience of food safety training (4.3 points) was higher than that of the subjects without such experience (3.8 points) (p<0.01). The present study suggest that effective education programs on food safety need to be developed and offered to volunteers of private organization in order to improve their understandings on food safety.

자기이방성센서를 이용한 강판의 비파괴 응력 계측에 관한 연구

김대성(Kim, Daesung),문홍득(Moon, Hongduk  ),유지형(Yoo, Jihyeung) 한국지반환경공학회 2011 한국지반환경공학회논문집 Vol.12 No.11

최근 들어 자기이방성센서를 이용한 비파괴응력계측기법은 강교나 강관 등의 건설 분야에서 적용되어지고 있다. 또한 터널건설현장에서 이용되는 강지보재에 대해서도 적용한 사례가 있다. 본 연구에서는 일본에서 개발된 자기이방성센서와 스트레인 게이지를 이용하여 국산 강재인 SS400에 적합한 응력감도곡선을 도출하기 위해 강재하중재하실험을 수행하였다. 또한 자기이방성 센서를 이용한 비파괴 응력계측기법의 적용성을 평가하기 위하여 추가 강재하중재하실험과 수치해석을 실시하였다. 본 연구의 결과, 계측위치에 따라 자기이방성센서에서 측정된 출력전압과 스트레인 게이지로 측정된 응력의 평균을 이용하여 국산 강재인 SS400에 적합한 응력감도곡선을 도출하였다. 그리고 추가 강재하중재하실험과 수치해석을 비교한 결과, 자기이방성센서의 오차범위가 약 20MPa 정도임을 알 수 있었다. 자기이방성센서를 강재의 응력상태를 파악할 목적으로 사용할 경우, 강재의 항복응력의 레벨(245MPa)을 고려하면 공학적으로 충분한 정확도를 가지고 있다고 판단된다. 특히 자기이방성센서는 계측 센서가 부착되어 있지 않은 강구조물에서 잔류응력을 고려한 현재상태의 응력을 용이하게 파악할 수 있으며, 강구조물의 유지관리에 편리하게 적용이 가능함을 확인하였다. Recently, non-destructive stress measurement method using magnetic anisotropy sensor has been applied to the construction site such as steel bridges and steel pipes. In addition, steel rib used in the tunnel construction site was found to be possible to measure the stress by non-destructive method. In this study, steel loading experiments using magnetic anisotropy sensor developed in Japan and strain gauges were conducted to derive stress sensitivity curve for domestic steel SS400. Also, additional steel loading experiments and numerical analysis were performed for evaluation of applicability for non-destructive stress measurement method using magnetic anisotropy sensor. As a result of this study, stress sensitivity curves for domestic steel SS400 were derived using output voltage measured by magnetic anisotropy sensor and average of stress measured by strain gauges depending on the measurement location. And as a result of comparing additional steel loading experiments with the numerical analysis, error level of magnetic anisotropy sensor is around 20MPa. When considering the level of the yield stress(245MPa) of steel, in case of using magnetic anisotropy sensor in order to determine the stress status of steel, it has sufficient accuracy in engineering. Especially, magnetic anisotropy sensor can easily identify the current state of stress which considers residual stress at steel structure that stress measurement sensor is not installed, so we found that magnetic anisotropy sensor can be applied at maintenance of steel structure conveniently.

들깨 추출물의 항산화 활성과 암세포 기본 특성에 대한 억제 효과

김시내(Sinae Kim),송보람(Boram Song),주지형(Jihyeung Ju) 한국식품영양과학회 2015 한국식품영양과학회지 Vol.44 No.2

본 연구에서는 들깨 에탄올 추출물의 항산화 성분 함량 및 활성을 측정하고 들깨 추출물이 암세포의 주요 특징인 성장, colony 형성, 이동, 부착성 등에 미치는 영향을 in vitro 수준에서 분석하고자 하였다. 들깨의 총 폴리페놀 함량과 총 플라보노이드 함량은 각각 222.6 mg gallic acid equivalent/100 g과 285.7 mg quercetin equivalent/100 g으로 측정되었다. 들깨 추출물(87.5~350 μg/mL)의 DPPH radical 소거 활성은 24~45%, 철 환원력은 28~62%였다. 한편 87.5~350 μg/mL 농도의 들깨 추출물은 HCT116 대장암 세포와 H1299 폐암 세포의 성장을 18~94% 억제하는 농도 의존적 활성이 있었다. 또한 175 μg/mL 농도의 들깨 추출물은 HCT116과 H1299 세포에서 모두 colony 형성을 완전히 억제하는 활성이 있었다. 또한 들깨 추출물은 87.5~350 μg/mL 농도에서 H1299 세포의 이동을 30~37% 억제하였고, 가장 높은 농도인 350 μg/mL 농도에서는 HCT116과 H1299 세포의 부착을 14~16% 억제하였다. 이상의 결과를 통하여 들깨 추출물은 항산화 활성 및 암세포의 주요 특징을 억제하는 활성을 가지는 것으로 생각되며, 향후 이러한 연구 결과가 in vivo 수준에서 재현되는지 여부와 본 활성과 관련된 세부작용기전 또한 규명되어야 할 것으로 생각된다. The aim of the study was to investigate the antioxidant activities of ethanol extract of perilla seed (PSE) and its inhibitory effects against major characteristics of cancer cells, such as unrestricted growth and activated metastasis in vitro. The total polyphenol and flavonoid levels of PSE were 222.6 mg gallic acid equivalent/100 g and 285.7 mg quercetin equivalent/100 g, respectively. The radical scavenging activity and ferric reducing antioxidant power of PSE at concentration of 87.5 to 350 μg/mL were 24∼45% and 28∼62%, respectively. Treatment of HCT116 colorectal carcinoma cells and H1299 non-small cell lung carcinoma cells with PSE dose-dependently inhibited growth by 18∼94% (at concentration range of 87.5 to 350 μg/mL) and completely abolished colony formation (at concentration of 175 μg/mL). PSE was also effective in inhibiting migration of H1299 cells (by 30∼37% at concentration range of 87.5 to 350 μg/mL) and adhesion of both HCT116 and H1299 cells (by 14∼16% at concentration of 350 μg/mL). These results indicate that PSE exerts antioxidant and anti-cancer activities in vitro. It needs to be determined whether or not similar effects can be reproduced in vivo.

충북지역 일부 대학생의 2011년 일본 원전 사고 이후 식품구매행동과 식품안전에 대한 인식 및 관련 교육에 대한 요구

김경진(Kyung Jin Kim),임유나(You Na Lim),소총총(Cong Cong Shao),주지형(Jihyeung Ju) 충북대학교 생활과학연구소 2014 생활과학연구논총 Vol.18 No.1

The present study aimed to investigate the food purchasing behavior, the perception on food safety, and the need for food safety education among college students after Japan's 2011 nuclear accident. The subjects were a total of 187 college students in Chungbuk area. Major findings of this study were as follows: 1) the interest of the subjects on food safety-related issues were below a moderate level (2.9 out of 5 points), but the interest level of the subjects with an experience of taking food science major courses was higher than that of the subjects without such an experience (p<0.05); 2) the subjects perceived the adverse effects of the nuclear accident against food safety in a moderate to high level (3.7 out of 5 points), and they tended to be reluctant to purchase marine and agricultural foods; 3) the need of the subjects for the education on food safety was scored to 3.7 out of 5 points, and the need of the subjects with an experience of taking food science major courses was higher than that of the subjects without such an experience (p<0.05); 4) the subjects considered 'dietitian' and 'medical professionals' as the most appropriate educators for food safety-related issues, and such phenomenon was more pronounced among the subjects with an experience of taking food science major courses (p<0.05). The present study suggests that more courses or programs need to be developed and offered to college students in order to improve their understandings on food safety.