대퇴골두 골단분리증의 치험례

단진명,김세동 영남대학교 의과대학 1997 Yeungnam University Journal of Medicine Vol.14 No.1

저자들은 1989년 1월부터 1995년 7월까지 영남대학교 의과대학 부속병원 정형외과에서 대퇴골두 골단분리증으로 입원하여 수술적 치료를 받았던 10명(12고관절)의 환자의 치료 경험을 통하여 다음과 같은 결과를 얻었다. 1. 남녀성비는 6:4 였으며, 수술시 평균 나이는 11.8세였다. 발병부위는 좌측이 7례, 우측이 1례, 양측이 2례였다. 2. 임상적 유형별로는 급성분리가 2례(2고관절), 만성분리에 겹친 급성분리가 5례(6고관절), 만성분리가 3례(4고관절)였다. 3. 방사선 소견상 대퇴부경부에 대한 골두의 전위정도를 기준으로 하였을때, 경도의 분리가 7례(9고관절), 중등도의 분리가 1례, 고도의 분리가 2례였다. 4. 10례의 환자중 5례에서 비만에 성발육 지연을 보였고, 세장형의 환자가 2례였고, 정상 체형은 3례였다. 5. 10례중 5례에서 외상의 병력이 있었고, 1명에서 연소기 류마토이드 관절염의 병력이 있었다. 6. 내분비계 검사를 시행한 6명의 환자에서 모두 유증상 또는 무증상의 호르몬이상을 볼 수 있었다. 7. 수술적 방법으로 9례(11고관절)에서 정위치핀고정술을 실시하였고, 고도분리된 1례에서 절골술후 핀고정술을 실시하였다. 8. 환자들의 최종추시때의 고관절의 기능은 excellent가 6례(8고관절), good이 2례, failure는 2례였다. failure 2례는 술후합병증으로 대퇴골두무혈성괴사가 속발한 경우였다. 대퇴골두 골단분리증은 청소년기의 비교적 드문 고관절질환으로 치료시 연골 용해증 및 대퇴골두 무혈성 괴사등 심각한 합병증을 동반할 수 있으나, 정위치 핀고정술로 대부분 goood 이상의 결과를 얻을 수 있었다. 또한 이 질환에서 증상이 있는, 또는 이 질환에서 내분비계의 이상을 동반하는 경우가 많으므로 진단시 호르몬 이상유무를 검사해야하고, 이상이 있는 경우에는 보다 장기적인 추시관찰이 필요할 것으로 사료된다 Slipped capital femoral epiphysis (SCFE) is a disorder in which there is a gradual of acute disruption through the capital physeal plate. The pyhsiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The assocoation of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnomality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients (12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic thpe; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one ; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

Inhibition of Inducible Nitric Oxide Synthase Attenuates Monosodium Urate-induced Inflammation in Mice

Tae-Jin Ju,Jin-Myoung Dan,Young-Je Cho,So-Young Park 대한생리학회-대한약리학회 2011 The Korean Journal of Physiology & Pharmacology Vol.15 No.6

The present study elucidated the effect of the selective inducible nitric oxide synthase (iNOS) inhibitor N⁶-(1-iminoethyl)-L-lysine (L-NIL) on monosodium urate (MSU) crystal-induced inflammation and edema in mice feet. L-NIL (5 or 10 mg/kg/day) was administered intraperitoneally 4 h before injection of MSU (4 mg) into the soles of mice hindlimb feet. Twenty-four hours after MSU injection, foot thickness was increased by 160% and L-NIL pretreatment reduced food pad swelling in a dose dependent manner. Pretreatment of 10 mg/kg/day L-NIL significantly suppressed the foot pad swelling by MSU. Plasma level of nitric oxide (NO) metabolites and gene expression and protein level of iNOS in feet were increased by MSU, which was suppressed by L-NIL pretreatment. Similar pattern of change was observed in nitrotyrosine level. MSU increased the gene expression of tumor necrosis factor (TNF)-Ձ and interleukin (IL)-1Ղ and L-NIL pretreatment suppressed MSU-induced cytokines expression. The mRNA levels of superoxide dismutase and glutathione peroxidase1 were increased by MSU and L-NIL pretreatment normalized the gene expression. Phosphorylation of extracellular signal-regulated kinase 1/2 and p38 was increased by MSU, which was suppressed by L-NIL pretreatment. The mRNA levels of iNOS, TNF-Ձ, and IL-1Ղ were increased by MSU in human dermal fibroblasts, C2C12 myoblasts, and human fetal osteoblasts in vitro, which was attenuated by L-NIL in a dose dependent manner. This study shows that L-NIL inhibits MSU-induced inflammation and edema in mice feet suggesting that iNOS might be involved in MSU-induced inflammation.

Topographic prominence discriminator for the detection of short-latency spikes of retinal ganglion cells

Choi, Myoung-Hwan,Ahn, Jungryul,Park, Dae Jin,Lee, Sang Min,Kim, Kwangsoo,Cho, Dong-il Dan,Senok, Solomon S,Koo, Kyo-in,Goo, Yong Sook IOP 2017 Journal of neural engineering Vol.14 No.1

<P> <I>Objective</I>. Direct stimulation of retinal ganglion cells in degenerate retinas by implanting epi-retinal prostheses is a recognized strategy for restoration of visual perception in patients with retinitis pigmentosa or age-related macular degeneration. Elucidating the best stimulus-response paradigms in the laboratory using multielectrode arrays (MEA) is complicated by the fact that the short-latency spikes (within 10 ms) elicited by direct retinal ganglion cell (RGC) stimulation are obscured by the stimulus artifact which is generated by the electrical stimulator. <I>Approach</I>. We developed an artifact subtraction algorithm based on topographic prominence discrimination, wherein the duration of prominences within the stimulus artifact is used as a strategy for identifying the artifact for subtraction and clarifying the obfuscated spikes which are then quantified using standard thresholding. <I>Main results</I>. We found that the prominence discrimination based filters perform creditably in simulation conditions by successfully isolating randomly inserted spikes in the presence of simple and even complex residual artifacts. We also show that the algorithm successfully isolated short-latency spikes in an MEA-based recording from degenerate mouse retinas, where the amplitude and frequency characteristics of the stimulus artifact vary according to the distance of the recording electrode from the stimulating electrode. By ROC analysis of false positive and false negative first spike detection rates in a dataset of one hundred and eight RGCs from four retinal patches, we found that the performance of our algorithm is comparable to that of a generally-used artifact subtraction filter algorithm which uses a strategy of local polynomial approximation (SALPA). <I>Significance</I>. We conclude that the application of topographic prominence discrimination is a valid and useful method for subtraction of stimulation artifacts with variable amplitudes and shapes. We propose that our algorithm may be used as stand-alone or supplementary to other artifact subtraction algorithms like SALPA.</P>

Inhibition of Inducible Nitric Oxide Synthase Attenuates Monosodium Urate-induced Inflammation in Mice

Ju, Tae-Jin,Dan, Jin-Myoung,Cho, Young-Je,Park, So-Young The Korean Society of Pharmacology 2011 The Korean Journal of Physiology & Pharmacology Vol.15 No.6

The present study elucidated the effect of the selective inducible nitric oxide synthase (iNOS) inhibitor $N^6$-(1-iminoethyl)-L-lysine (L-NIL) on monosodium urate (MSU) crystal-induced inflammation and edema in mice feet. L-NIL (5 or 10 mg/kg/day) was administered intraperitoneally 4 h before injection of MSU (4 mg) into the soles of mice hindlimb feet. Twenty-four hours after MSU injection, foot thickness was increased by 160% and L-NIL pretreatment reduced food pad swelling in a dose dependent manner. Pretreatment of 10 mg/kg/day L-NIL significantly suppressed the foot pad swelling by MSU. Plasma level of nitric oxide (NO) metabolites and gene expression and protein level of iNOS in feet were increased by MSU, which was suppressed by L-NIL pretreatment. Similar pattern of change was observed in nitrotyrosine level. MSU increased the gene expression of tumor necrosis factor (TNF)-${\alpha}$ and interleukin (IL)-$1{\beta}$ and L-NIL pretreatment suppressed MSU-induced cytokines expression. The mRNA levels of superoxide dismutase and glutathione peroxidase1 were increased by MSU and L-NIL pretreatment normalized the gene expression. Phosphorylation of extracellular signal-regulated kinase 1/2 and p38 was increased by MSU, which was suppressed by L-NIL pretreatment. The mRNA levels of iNOS, TNF-${\alpha}$, and IL-$1{\beta}$ were increased by MSU in human dermal fibroblasts, C2C12 myoblasts, and human fetal osteoblasts in vitro, which was attenuated by L-NIL in a dose dependent manner. This study shows that L-NIL inhibits MSU-induced inflammation and edema in mice feet suggesting that iNOS might be involved in MSU-induced inflammation.

미세 수술 후 처치

단진명,한수홍,Dan, Jin Myoung,Han, Soo Hong 대한미세수술학회 2012 Archives of reconstructive microsurgery Vol.21 No.2

Attenuated Sympathetic Activity and Its Relation to Obesity in MSG Injected and Sympathectomized Rats

So-Young Park,Yong-Woon Kim,Jin-Myoung Dan,Jong-Yeon Kim 대한생리학회-대한약리학회 2007 The Korean Journal of Physiology & Pharmacology Vol.20 No.3

In order to characterize the role of sympathetic activity in obesity, we repeatedly assessed sympathetic activity via power spectral analyses of heart rate variability in the same subjects at 7, 11, 25, and 60 weeks, using monosodium glutamate (MSG)-induced obese and control rats. The effects of lower sympathetic activity on obesity were also evaluated. Fat mass in MSG rats was already higher at 7 weeks, but the sympathetic activity did not differ between 7 and 25 weeks. Between 25 and 60 weeks, the increase in fat mass, food efficiency, and body weight gain was higher in MSG rats. The increase in sympathetic activity between 25 and 60 weeks and sympathetic activity at 60 weeks were lower in MSG rats. Fat mass at 60 weeks was inversely correlated with changes in sympathetic activity between 25 and 60 weeks. Reduced plasma epinephrine levels by bilateral adrenal demedullation induced increase of fat mass. In summary, an attenuated increase of sympathetic activity with age may partly be responsible for aggravated obesity in MSG rats. Additionally, reduced sympathetic activity per se induced obesity in rats. These results suggest that lower sympathetic activity contributes to obesity in rats.

Attenuated Sympathetic Activity and Its Relation to Obesity in MSG Injected and Sympathectomized Rats

Park, So-Young,Kim, Yong-Woon,Dan, Jin-Myoung,Kim, Jong-Yeon The Korean Society of Pharmacology 2007 The Korean Journal of Physiology & Pharmacology Vol.11 No.4

In order to characterize the role of sympathetic activity in obesity, we repeatedly assessed sympathetic activity via power spectral analyses of heart rate variability in the same subjects at 7, 11, 25, and 60 weeks, using monosodium glutamate (MSG)-induced obese and control rats. The effects of lower sympathetic activity on obesity were also evaluated. Fat mass in MSG rats was already higher at 7 weeks, but the sympathetic activity did not differ between 7 and 25 weeks. Between 25 and 60 weeks, the increase in fat mass, food efficiency, and body weight gain was higher in MSG rats. The increase in sympathetic activity between 25 and 60 weeks and sympathetic activity at 60 weeks were lower in MSG rats. Fat mass at 60 weeks was inversely correlated with changes in sympathetic activity between 25 and 60 weeks. Reduced plasma epinephrine levels by bilateral adrenal demedullation induced increase of fat mass. In, an attenuated increase of sympathetic activity with age may partly be responsible for aggravated obesity in MSG rats. Additionally, reduced sympathetic activity per se induced obesity in rats. These results suggest that lower sympathetic activity contributes to obesity in rats.

회전근 개 완전파열 환자에서의 나이 및 성별에 따른 견관절 동반 병소의 차이

김재화,단진명,윤병호,김영웅,Kim, Jae-Hwa,Dan, Jin-Myoung,Yoon, Byung-Ho,Kim, Young-Woong 대한관절경학회 2008 대한관절경학회지 Vol.12 No.3

목적: 회전근 개 완전 파열로 관절경적 시술을 받은 환자를 대상으로 나이와 성별에 따른 견관절 동반 병소의 차이를 알아보고자 하였다. 대상 및 방법: 2003년 6월부터 2006년 3월까지 본원 정형외과에서 회전근 개 완전파열로 수술하였던 109명, 109례의 환자들을 대상으로 견관절 동반 병소의 차이를 분석하였다. 성별 분포는 남자 59명, 여자 50명이었고 나이는 최소 24세에서 최고 75세로 평균 53.3세였다. 연령대에 따른 분류는 59세 이하의 환자 군과 60세 이상의 환자 군으로 임의로 분류하였고 분석 대상은 견봉 쇄골 관절염, 상부 관절와 순 병변, 상완 이두근 염의 동반 유무를 Khai-square를 이용하여 통계학적으로 분석하였다. 결과: 전반적으로 견봉 쇄골 관절염은 60세 이상의 환자 군에서 59세 이하 군에 비해 높은 동반율을 보였고 상부 관절와 순 병변은 59세 이하의 환자 군, 특히 남자 환자에서 60세 이상의 환자 군에 비해 높은 동반 비율을 보였다. 결론: 회전근 개 파열의 진단 및 치료를 함에 있어 연령대에 따른 견관절 동반 병소를 고려하여야 하며, 특히 젊은 남자환자에서는 상부 관절와 순 병변, 고령의 환자에서 견봉 쇄골 관절염의 동반 유무를 반드시 확인하여야겠다. Purpose: This study evaluated the differences in associated shoulder lesions on complete rotator cuff tear patients regarding ages and gender. Materials and Methods: Between June 2003 and March 2006, 109 patients (59 males, 50 females) who received arthroscopic shoulder surgery for their complete rotator cuff tear were selected and their associated shoulder lesions were analyzed. Ages were between 24 years, the youngest, and 75 years, the oldest. Groups by age were under 59 years group and over 60 years group, and associated lesions of patients to be analyzed were Acromioclavicular arthritis, SLAP(shoulder labrum anterior and posterior) lesion, and biceps tendinitis, and statistic analysis were performed by Khai-square method. Results: For acromioclavicular joint arthritis, over 60 years old group showed higher association rate compared to under 59 years young group, and for SLAP lesions, under 59 years young group showed higher association rate compared to over 60 years old group only in men. Conclusion: For diagnosis and treatment of complete rotator cuff tear patient, associated shoulder lesions in different ages should be considered, especially associations of SLAP lesions in young male patients, and acromioclavicular joint arthritis in old age patients should be verified.

배측 접근을 이용한 월상골 주위 탈구 및 월상골 탈구의 수술적 치료

한수홍 ( Soo Hong Han ),단진명 ( Jin Myoung Dan ),이동훈 ( Dong Hoon Lee ),김영웅 ( Young Woong Kim ) 대한골절학회 2011 대한골절학회지 Vol.24 No.4

목적: 월상골 주위 탈구 및 월상골 탈구에 있어 배측 접근법만으로 관혈적 정복 및 내고정, 골간 인대 복원술 등을 시행하였으며, 이에 그 임상적, 방사선학적 결과를 보고하고자 한다. 대상 및 방법: 월상골 주위 탈구 및 월상골 탈구로 배측 접근법을 이용한 관혈적 정복 및 내고정, 인대 복원술을 시행하고, 1년 이상 추시가 가능했던 13명의 환자를 대상으로 하였다. 대상 중 탈구된 월상골이 손목관절을 넘어서 근위부까지 전위된 경우는 제외하였다. 임상적 결과 분석은 설문지를 통한 DASH 점수와 Mayo 손목점수를 이용하였다. 또한 방사선 사진에 의한 주상-월상골간각과 주상골 경유 탈구에서는 골절의 유합 여부를 파악하여 방사선학적 결과를 분석하였다. 결과: 최종 추시 시의 DASH 점수는 평균 16.3점 (범위, 10.8~26.7)이었고, Mayo 손목점수는 평균 79점 (범위, 65~90)으로 매우 우수 2예, 우수 7예, 양호 4예였고, 65점 미만의 불량한 결과를 보인 예는 없었다. 방사선 사진상 주상-월상골간각이 평균 49.0° (범위, 35~55°)로 전례에서 정상 범위 내로 유지되었으며, 7예의 주상골 골절도 모두 골유합되었다. 결론: 월상골 주위 탈구 및 월상골 탈구의 수술적 치료에 있어 탈구된 월상골이 손목관절을 넘어 근위부로 전위된 예외적인 경우를 제외하고는 월상골 주위 탈구 및 월상골 탈구의 치료 시 배측 접근법만으로도 좋은 결과를 기대할 수 있을 것으로 생각된다. Purpose: To evaluate the clinical and radiologic outcomes of the perilunate dislocation and the lunate dislocation which were managed surgically through a dorsal approach. Materials and Methods: Retrospective reviews of the 13 patients who had minimum 1-year follow-up after surgical treatment through isolated dorsal approach for their perilunate dislocations or the lunate dislocations were performed. The case that dislocated lunate migrated proximally through the wrist was excluded in this series. We evaluated the DASH score in questionnaire method and Mayo wrist score to analyze the clinical outcomes. Radiologic results were investigated by measurement of the scapho-lunate angle, and fracture union was also evaluated in the case of trans-scaphoid dislocation. Results: The mean DASH Score was 16.3 points (range, 10.8~26.7 points) and the mean Mayo wrist score was 79 points (range, 65~90 points) at the final follow-up. There were 2 cases of excellent, 7 cases of good and 4 cases of fair in the Mayo wrist score. On the radiologic analysis, the mean scapho-lunate angle was 49.0° (range, 35~55°) and all cases were within the normal range. All cases of the trans-scaphoid perilunate dislocation achieved bone union. Conclusion: Author`s cases showed satisfactory outcomes in clinically and radiologically. Isolated dorsal approach could give anatomical reduction and appropriate internal fixation in treatment of the perilunate dislocations and the lunate dislocations except the rare case of proximal migration of the lunate through the wrist.

추출조건에 따른 유근피 추출물의 항산화 활성

김재민(Jae-Min Kim),조명래(Myoung-Lae Cho),서규은(Kyu-Eun Seo),김예슬(Ye-Seul Kim),정태동(Tae-Dong Jung),김영현(Young-Hyun Kim),김단비(Dan-Bi Kim),신기해(Gi-Hae Shin),오지원(Ji-Won Oh),이종석(Jong Seok Lee),이진하(Jin-Ha Lee),김종예(Jon 한국식품영양과학회 2015 한국식품영양과학회지 Vol.44 No.8

본 연구는 유근피를 항산화 소재로 사용하기 위한 기초 자료를 제공하고자 에탄올의 농도(0, 40, 80% 에탄올) 및 추출시간(1, 2, 3시간)이 다른 조건에서 추출하였으며, 이들 추출물의 총 폴리페놀 및 플라보노이드 함량을 측정하였다. 또한 다양한 추출물의 DPPH 라디칼 소거능, ABTS 라디칼 소거능, 환원력, ORAC value 등의 항산화 활성을 측정하였으며, 총 폴리페놀 및 플라보노이드 함량과 항산화 활성과의 연관성을 분석하였다. 그 결과 유근피 추출물은 80% 에탄올로 3시간 추출하였을 때 가장 높은 총 폴리페놀 및 플라보노이드 함량과 항산화 활성을 보였다. 또한 DPPH 및 ABTS 라디칼 소거능, 환원력은 에탄올 함량에 따른 활성 차이는 보였으나 추출시간에 따른 항산화 활성 차이는 보이지 않았다. 하지만 ORAC는 유근피 추출물의 추출시간이 증가함에 따라 함께 증가하였다. 이상의 결과로 볼 때 유근피 추출물은 80% 에탄올을 이용하여 70°C에서 3시간 추출을 할 때 항산화 활성을 갖는 phenolic 및 flavonoid 계열의 유효성분이 가장 많이 추출되었다. 또한 유근피 80% 에탄올 3시간 추출물은 피부 섬유아세포와 3T3-L1 지방세포에서 세포독성을 나타내지 않았고 피부 섬유아세포에서 산화적 스트레스에 대한 세포 보호 효과를 가졌으며, 3T3-L1 지방세포에서 활성산소종 생성량을 감소하였다. 따라서 높은 항산화력을 가진 유근피 추출물은 천연 항산화제로 충분히 사용 가능할 것으로 사료된다. This study investigated optimal extraction conditions for application of Ulmus pumila L. as a natural antioxidant. U. pumila L. was extracted using ethanol (EtOH) at various concentrations (0, 40, and 80%) and extraction times (1, 2, and 3 h) at 70°C and then evaluated for extraction yield, total phenolic contents, total flavonoid contents, as well as antioxidant activities [2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2"-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging activity, reducing power, and oxygen radical absorbing capacity (ORAC)]. Antioxidant activities were correlated with total phenolic and flavonoid contents. Of the solvent conditions, 80% EtOH extracts for 3 h at 70°C showed the highest total phenolic and flavonoid contents with strong antioxidant activities, although there were no significant time effects on DPPH and ABTS radical scavenging activities and reducing power. However, ORAC values of all EtOH extracts remarkably increased in a time-dependent manner. In addition, 80% EtOH extract for 3 h exhibited strong antioxidant effects on HDF and 3T3-L1 cells. Therefore, the antioxidant capacity of U. pumila L., may due to phenolic and flavonoid contents, and extraction conditions were 80% EtOH for 3 h at 70°C. This extract could be a good source for natural antioxidants.