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      • KCI등재

        인체 슬관절 퇴행성 관절염 환자에서 전방십자인대 노화와 관련된 세포자멸사 및 세포증식에 대한 예비조사

        현낙민(Rak Min Hyun),김기원(Ki Won Kim),정서원(Seo Won Jeong),정진화(Jin Wha Chung),이화성(Hwa Sung Lee) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.4

        목적: 고령 환자에서 노화에 의한 슬관절 전방십자인대의 세포자멸사 및 세포증식과의 연관성을 알아보고자 하였다. 대상 및 방법: 퇴행성 관절염으로 슬관절 전치환술을 받은 환자 20명을 대상으로 하였으며, 연령별로 65세 이하는 A군, 66세에서 75세까지는 B군, 76세 이상은 C군으로 분류하였다. 수술 중 채취된 전방십자인대를 이용하여 terminal deoxynucleotidyl transferase dUTP nick-end labeling 방법 및 면역조직화학염색법을 하였고, 세포자멸사 지수 및 세포증식 지수로 정량화하였다. 결과: 모든 실험군에서 세포자멸사가 발현하는 것을 확인하였으며, 세포자멸사 지수는 A군보다 B군에서 높고, B보다 C군이 높았다. 상관분석에서 연령이 1세 증가 시 평균적으로 1.49 증가하였고, 통계적으로 유의한 직선적 양의 관계를 보였다. 세포증식 지수는 A군보다 B군이 낮고, B군보다 C군에서 낮았으며, 연령이 1세 증가 시 평균적으로 1.0 감소하였고, 통계적으로 유의한 직선적 음의 상관관계를 보였다. 세포자멸사 지수와 세포증식 지수는 통계적으로 유의한 음의 상관관계를 보였으며, 세포자멸사 지수가 1.0 증가 시 세포증식 지수는 0.45 감소하였다. 결론: 슬관절 전방십자인대에서 세포자멸사를 확인할 수 있었으며, 연령이 증가함에 따라 세포자멸사가 증가되고, 세포증식은 감소하였다. Purpose: We investigated the association between aging-induced apoptosis and cell proliferation in the anterior cruciate ligament (ACL) of aged patients. Materials and Methods: Twenty patients with osteoarthritis who underwent total knee replacement arthroplasty were enrolled in the study. They were divided into three groups according to age: group A (≤65 years), group B (66-75 years), and group C (≥76 years). The ACL tissue was obtained intraoperatively and subjected to terminal deoxynucleotidyl transferase dUTP nick-end labeling staining and immunohistochemistry to quantify the apoptosis and cell proliferation indices. Results: Apoptosis occurred in all groups, with the highest apoptosis index found in group C, followed by that in groups B and A. A statistically significant positive linear correlation was observed, with a 1-year increase in age resulting in an average increase of 1.49 in the apoptotic index. The lowest cell proliferation index was observed in group C, followed by that in group B and group A, with a 1-year increase in age resulting in an average decrease of 1.0 in the cell proliferation index, which was a statistically significant negative linear correlation. Consequently, a statistically significant negative correlation was confirmed between the apoptosis and cell proliferation indices, whereby an increase of 1.0 in the apoptosis index was concurrent with a decrease of 0.45 in the cell proliferation index. Conclusion: Apoptosis occurred in the ACL of human knee joint. With increasing age, apoptosis increased and cell proliferation decreased.

      • KCI등재

        Bone Cement Augmentation Procedures for Spinal Pathologic Fractures by Multiple Myeloma

        하기용,민창기,서준영,김영훈,안주현,현낙민,김윤정 대한의학회 2015 Journal of Korean medical science Vol.30 No.1

        Efficacy and safety of bone cement augmentations for spinal pathologic fractures relatedto multiple myeloma, and usefulness of radionuclide studies for surgical decision wereretrospectively evaluated. Forty eight vertebrae from 27 patients for bone cementaugmentation procedures and 48 vertebrae from 29 patients for conservative treatmentwere enrolled. Clinical results using visual analogue scale (VAS) and Oswestry disabilityindex (ODI), and radiologic results were assessed. For clinical decisions on treatment ofspinal pathologic fracture, bone scan or single photon emission computed tomographywas done for 20 patients who underwent surgery. Mean follow-up was 16.8 months. Interms of clinical results, immediate pain relief was superior in the operated group to that inthe conservative group. ODI, maintenance of vertebral height and local kyphotic angle atthe last follow-up were superior in the operated group in comparison to the conservativegroup. At one year follow-up, cumulative survival rate were 77.4% and 74.7% in theoperated and conservative groups, respectively (log rank test > 0.05). Leakage of bonecement was noted at 10 treated vertebrae. Bone cement augmentations presented shorttermpain relief for spinal pathologic fractures by myeloma with relative safety in highlyselected patients, and radionuclide imaging studies were useful for the surgical decision onthese procedures.

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