Effect of Teriparatide on Healing of Atypical Femoral Fractures: A Systemic Review

임군일,이성현 대한골대사학회 2015 대한골대사학회지 Vol.22 No.4

Background: Bisphosphonates (BPs) are the most commonly used anti-osteoporotic drugs, which have been proven to reduce the risk of osteoporotic fractures. However, use of BPs, particularly for long periods of time, is associated with an increased risk of atypical femoral fracture (AFF). Healing of BP-associated AFF is usually delayed because of suppressed bone turnover. Teriparatide (TPTD), a recombinant form of parathyroid hormone (PTH), enhances bone healing in patients with delayed healing or non-union. Methods: In this study, we summarized and performed a systemic review of the published literature on treatment of AFF using TPTD. Results: Although there is a lack of level 1 studies on the evidence of TPTD in promoting bone union in AFFs, this systemic review of the available literature revealed that TPTD works positively in AFFs, and we put together the evidence that TPTD is a viable treatment option for enhancing fracture healing in AFFs. Conclusions: While anecdotal evidence of beneficial effects of TPTD on fracture healing offer limited guidance for clinical decision making, a better understanding of the role of TPTD in fracture healing may be elucidated with future prospective trials.

간엽줄기세포에 대하 소고

임군일 한국생체재료학회 2006 생체재료학회지 Vol.10 No.1

Mesenchymal stem cells (MSCs) exist in bone marrow and other musculoskeletal tissues. These cells contribute to the homeostasis of musculoskeletal tissue as well as support for the growth and differentiation of primitive hemopoietic cells. Recent advancements in tissue engineering and regeneratve medicine have brought MSCs to high attention as a potential source of cells which would differentiate to a variety of tissue, tailored to individual needs. In this review is briefly outlined the current status of MSCs, particularly focused on their biological characteristics

The Concept of Early Osteoarthritis and Its Significance in Regenerative Medicine

임군일 한국조직공학과 재생의학회 2022 조직공학과 재생의학 Vol.19 No.3

Osteoarthritis (OA) has been investigated as one of important target diseases for regenerative medicine. The concept of early OA has recently emerged under the assumption that if OA is detected and intervened early, progression of OA might be arrested or delayed before irreversible destruction of the joint occurs. This concept also matters in regenerative medicine for OA because new regenerative technologies can work better when joint damage is minimal. Diagnostic criteria for early OA have been suggested in this background to find a group of patients who have a higher possibility of developing full-blown OA. However, as currently suggested criteria of early OA are mostly expert opinions lacking higher level of evidence, clinical validations are necessary to prove their value in patient care. While new treatment methods that can suppress or prevent symptoms at an early stage of OA before progressive and irreversible changes occur are being developed, detailed definition and classification of early OA agreed upon by major stakeholders in OA field and validated by prospective studies are necessary to prove the efficacy of these methods. As clinical outcome of regenerative treatment is related to patient characteristics and the status of the whole joint, it is of critical significance to predict which patient will progress and who will be responsive to regenerative treatment. While diagnostic criteria for early OA should be highly sensitive and applicable without employing biomarkers or magnetic resonance imaging, a subclassification and comprehensive endotyping /phenotyping using these techniques might be needed to detect the population who would be responsive to regenerative medicine.

Emerging Concepts of Endotypes/Phenotypes in Regenerative Medicine for Osteoarthritis

임군일,Moon Jaeyeon 한국조직공학과 재생의학회 2022 조직공학과 재생의학 Vol.19 No.2

Osteoarthritis (OA) represents a broad spectrum of different conditions. Our present understanding of phenotypes and endotypes can explain the differences in clinical manifestations, etiology, and underlying pathophysiology. Although this concept was first applied in choosing the right target population for clinical trials of disease-modifying osteoarthritis drugs (DMOADs), given that the regenerative medicine so far has not delivered uniformly successful results in structural improvement in OA, it merits a consideration to introduce the concept of phenotype/endotype in the regenerative medicine for OA toward an effort to find the right patients for these expensive therapeutics. A better understanding of molecular endotypes facilitates defining clinical phenotypes more clearly. Based on this knowledge, these patients may respond better to treatments that can preserve joints, including regenerative medicine. On the other hand, patients who are not expected to benefit from these treatments may receive earlier total joint replacement surgery. This will result in a reduction of healthcare costs, as well as a more effective approach to new drug development. An understanding of phenotypes/endotypes will contribute to the selection of suitable patients for regenerative treatment of OA.

지방줄기세포를 이용한 조직재생의 현황

임군일 한국생체재료학회 2009 생체재료학회지 Vol.13 No.3

Adipose tissue provides abundant source of adult stem cells. Adipose stem cells were proven to differentiate into various musculoskeletal tissue. Their easy availability and minimal morbidity associated with procurement provoked a greate interest in the field of tissue engineering, and there has been exponetial increase in the number of publications on this subject in recent years. The adipose stem cells have different characteristics depending on the location the are harvested. They are most commonly isolated from lipoaspirates from plastic surgery. Their manifestations of surface phenotypes are similar but not totally identical to mesenchymal stem cell from bone marrow (BMMSCS), and conditions different from BMMSCs are needed for osteogenic or chondrogenic differentiations. In this review article, recent updates on the isolation method, characterization, capacity for differentiation, immune response as well as application to bone and cartilage tissue engineering are introduced.

근골격계에서 줄기세포를 이용한 재생치료의 개관

임군일 대한정형외과학회 2019 대한정형외과학회지 Vol.54 No.6

Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and the relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. On the other hand, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system, few reliable clinical studies have been published. Stem cell therapy can be applied locally for bone, cartilage, and tendon regeneration. The candidate disease modalities in bone regeneration include large bone defects, nonunion of fractures, and osteonecrosis. Focal osteochondral defect and osteoarthritis are the current targets for cartilage regeneration. For tendon regeneration, bone-tendon junction problems, such as rotator cuff tears are hot topics in clinical research. To date, the literature supporting stem cell-based therapies comprises mostly case reports or case series. 줄기세포를 임상에 이용하고자 하는 시도는 원래 종래의 치료에 반응하지 않는 치명적인 난치질환을 이용하기 위하여 시작되었다. 근골격계질환들은 그로 인하여 사망하지는 않지만 발생빈도가 높고 임상실험이 비교적 용이한 점이 있어 이 분야의 임상적용이 타분야에 비하여 많이 이루어졌다. 그러나 근골격계에서 줄기세포 치료에 의한 재생치료와 관련되어 시험관 내 연구와 전임상 연구가 많은 것과 비교하면 임상적용에 있어 신뢰할 만한 높은 신뢰도를 가진 연구결과는 드물다. 근골격계에서 골, 연골, 건의 재생을 위하여 줄기세포 치료를 적용할 수 있는데 골의 대규모 결손, 대퇴골두 무혈성괴사, 골연골결손, 골관절염, 회전근개 파열등에서 시도되고 있다. 현재까지는 주로 증례보고나 후향적 논문이 대부분이지만 향후 전향적 무작위 비교연구 등 높은 증거능력을 가진 연구결과들이 나오기를 기대한다.

마모입자가 골원세포에 미치는 영향

임군일 한국생체재료학회 2008 생체재료학회지 Vol.12 No.2

Wear particles generated from artificial joints cause biological reactions which usually lead to periprosthetic osteolysis. As the longevity of joint replacement is generally determined by the presence and progression of osteolysis, the strategy to prevent the complication is of utmost importance in joint replacement surgeries. Although macrophages are the main target of wear particles, bone forming cells and their progenitors are also directly affected by them. In this review, the results of investigations that have studied the effects of various particles on osteoblasts and menchymal stem cells are summarized.

간엽줄기세포로부터의 연골형성

임군일 한국고분자학회 2008 한국고분자학회 학술대회 연구논문 초록집 Vol.33 No.1

인공관절 치환술 후의 하지부동

임군일,신용운 대한고관절학회 2004 Hip and Pelvis Vol.16 No.2

인공관절 주위의 골용해: 마모입자에 대한 생물학적 반응

임군일 한국생체재료학회 2007 생체재료학회지 Vol.11 No.2

Although total hip arthroplasty is one of the most successful reconstructive procedure, periprosthetic osteolysis caused by the biological reaction to particulate wear debris poses the greatest challenge to the long-tem survival of the implanted prosthesis. In this review, the pathogenesis of and the pharmacological attempts to treat the biological reaction are outlined.