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Cho WT, Jang JH, Park SR, Sohn HS. Radiographic outcomes and non-union factor analysis in fragmentary segmental femoral shaft fractures (AO/OTA 32C3) treated with reamed antegrade nailing. Sci Rep 2024; 14:8364. [PMID: 38600312 PMCID: PMC11006881 DOI: 10.1038/s41598-024-59136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/08/2024] [Indexed: 04/12/2024] Open
Abstract
This study retrospectively assessed radiographic outcomes and risk factors associated with non-union in femoral shaft fragmentary segmental fractures (AO/OTA 32C3) treated with reamed antegrade intra-medullary nailing. Radiological outcomes, including union and alignment, were evaluated. The risk factors for non-union were investigated, including demographics and treatment-related characteristics, such as the number of interlocking screws, segmentation length, main third fragment length, distance of the main third fragment, width ratio and exposed nail length in one cortex from immediate post-operative radiographs. Multivariate logistic regression was used for statistical analysis. Among 2295 femoral shaft fracture patients from three level-1 trauma centers, 51 met the inclusion criteria. The radiological union was achieved in 37 patients (73%) with a mean union time of 10.7 ± 4.8 months. The acceptable axial alignment was observed in 30 patients (59%). Multiple logistic regression analysis identified only exposed nail length as a significant risk factor for non-union (odds ratio: 1.599, p = 0.003) and the cut-off value was 19.1 mm (sensitivity, 0.786; specificity, 0.811). The study revealed high rates of non-union (27%) and malalignment (41%). Therefore, patients who underwent intramedullary nailing with an exposed nail length greater than 19.1 mm or about twice the nail diameter should be cautioned of the potential non-union.
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Affiliation(s)
- Won-Tae Cho
- Department of Orthopaedic Surgery, School of Medicine, Ajou University Hospital, Suwon, Republic of Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Dong-eui Hospital, Busan, Republic of Korea
| | - Seung Ryeol Park
- Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju, 26426, Republic of Korea
| | - Hoon-Sang Sohn
- Department of Orthopaedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju, 26426, Republic of Korea.
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Seriramulu VP, Suppiah S, Lee HH, Jang JH, Omar NF, Mohan SN, Ibrahim NSN, Azmi NHM, Buhari I, Ahmad U. Review of MR spectroscopy analysis and artificial intelligence applications for the detection of cerebral inflammation and neurotoxicity in Alzheimer's disease. Med J Malaysia 2024; 79:102-110. [PMID: 38287765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Magnetic resonance spectroscopy (MRS) has an emerging role as a neuroimaging tool for the detection of biomarkers of Alzheimer's disease (AD). To date, MRS has been established as one of the diagnostic tools for various diseases such as breast cancer and fatty liver, as well as brain tumours. However, its utility in neurodegenerative diseases is still in the experimental stages. The potential role of the modality has not been fully explored, as there is diverse information regarding the aberrations in the brain metabolites caused by normal ageing versus neurodegenerative disorders. MATERIALS AND METHODS A literature search was carried out to gather eligible studies from the following widely sourced electronic databases such as Scopus, PubMed and Google Scholar using the combination of the following keywords: AD, MRS, brain metabolites, deep learning (DL), machine learning (ML) and artificial intelligence (AI); having the aim of taking the readers through the advancements in the usage of MRS analysis and related AI applications for the detection of AD. RESULTS We elaborate on the MRS data acquisition, processing, analysis, and interpretation techniques. Recommendation is made for MRS parameters that can obtain the best quality spectrum for fingerprinting the brain metabolomics composition in AD. Furthermore, we summarise ML and DL techniques that have been utilised to estimate the uncertainty in the machine-predicted metabolite content, as well as streamline the process of displaying results of metabolites derangement that occurs as part of ageing. CONCLUSION MRS has a role as a non-invasive tool for the detection of brain metabolite biomarkers that indicate brain metabolic health, which can be integral in the management of AD.
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Affiliation(s)
- V P Seriramulu
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - S Suppiah
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia.
| | - H H Lee
- METLiT Inc., Seoul, Republic of Korea
| | - J H Jang
- METLiT Inc., Seoul, Republic of Korea
| | - N F Omar
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - S N Mohan
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Psychiatry, 43400 Serdang, Selangor, Malaysia
| | - N S N Ibrahim
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - N H M Azmi
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - I Buhari
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Radiology, 43400 Serdang, Selangor, Malaysia
| | - U Ahmad
- Bauchi State University, Faculty of Basic Medical Sciences, Department of Anatomy, Molecular Genetics Informatics, Gadau, Nigeria
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Kwon H, Jang JH, Moon NH, Rhee SJ, Ryu DY, Ahn TY. Superior gluteal artery injury in pelvic ring injury and acetabular fracture: Single center observational study. J Orthop Sci 2023:S0949-2658(23)00279-8. [PMID: 37867061 DOI: 10.1016/j.jos.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Intrapelvic hemorrhage following pelvic fractures, including pelvic ring and acetabular fractures, originates from the venous system and the fracture. Arterial injury often causes significant bleeding and hemodynamic instability. The superior gluteal artery (SGA) is a frequently injured artery in patients with pelvic fractures. This study investigated the incidence and pattern of SGA injuries associated with pelvic fractures. METHODS We retrospectively reviewed the medical records of patients with pelvic fractures who visited our institution between January 2016 and April 2022. Patients who underwent angiography for suspected arterial injury and SGA embolization were identified. Furthermore, the demographics and patterns of pelvic fractures were evaluated. RESULTS In total, 2042 patients with pelvic fractures visited our trauma emergency department and 498 patients (24.4%) underwent embolization for arterial injuries. Of these, 30 patients (1.5% of the total and 6.0% of the patients who underwent procedures) received embolization therapy of the main trunk of the SGA. The mean age of patients was 51.2 (23-85 years), and the injury mechanisms were all high-energy injuries. There were 19 pelvic ring injuries, eight acetabular fractures, and three combined injuries. Acetabular fractures involved mostly both columns. The three combined injuries were lateral compression involving both columns, vertical shear involving both columns, and lateral compression with T-type fractures. Twelve (40.0%) occurred through the sciatic notch of different patterns. CONCLUSIONS SGA injury occurred in 1.5% of all pelvic fractures and was identified in 6% of patients receiving embolization. SGA injury occurs through various injury mechanisms and fracture patterns, even in the absence of a fracture in the sciatic notch. However, no conclusions could be drawn in this study on the association between SGA injuries, injury mechanisms, and fracture patterns. Since the prediction of SGA injury by fracture pattern is limited, angiography should be performed regardless of fracture pattern when an injury is suspected.
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Affiliation(s)
- Hoon Kwon
- Department of Radiology, Pusan National University Hospital, Busan, Republic of Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Trauma Center, Pusan National University Hospital, Busan, Republic of Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Seung Joon Rhee
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Dong Yeon Ryu
- Department of Trauma and Surgical Critical Care, Trauma Center, Pusan National University Hospital, Busan, Republic of Korea
| | - Tae Young Ahn
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
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Shin WC, Lee SM, Moon NH, Jang JH, Choi MJ. Comparison of Cephalomedullary Nails with Sliding Hip Screws in Surgical Treatment of Intertrochanteric Fractures: A Cumulative Meta-Analysis of Randomized Controlled Trials. Clin Orthop Surg 2023; 15:192-202. [PMID: 37008962 PMCID: PMC10060774 DOI: 10.4055/cios22103] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 02/01/2023] Open
Abstract
Background The primary objective of the present study was to compare surgical failures of intertrochanteric fractures of the femur through a meta-analysis of randomized controlled trials and to assess the change in surgical outcomes over time in a cumulative meta-analysis. Methods To identify studies evaluating the surgical outcomes of internal fixation using sliding hip screws (SHS) or cephalomedullary (CM) nails for the treatment of intertrochanteric fractures of the femur, all records until August 2021 in the PubMed, Embase, and Cochrane Library databases were searched. Studies with the following characteristics were considered eligible: patients who had an intertrochanteric fracture of the femur (population); patients who received surgical treatment using a CM nail (intervention); patients who received surgical treatment using SHS (comparator); surgical failures that required reoperation, including cut-out or cut-through of lag screws, varus collapse or posterior angulation of proximal fragments, loosening of lag screws or helical blades, and fracture nonunion (outcomes); and two reviewers independently reviewed the titles and abstracts of the randomized controlled trials and selected relevant studies for a full-text review (study design). Results Twenty-one studies were included in the final analysis consisting of 1,777 cases in the SHS group and 1,804 cases in the CM nail group. The cumulative standard mean difference was 0.87, indicating that CM nails had no significant effect in improving the surgical outcomes. There was no significant difference in surgical failure between SHS and CM nails for all intertrochanteric fractures (odds ratio [OR], 1.07; 95% confidence interval [CI], 0.76-1.49). Pooled data showed no significant difference between the two groups in terms of surgical failure in unstable intertrochanteric fractures (OR, 0.80; 95% CI, 0.42-1.54). Conclusions Although the use of CM nails has become a current trend in the treatment of intertrochanteric fractures, there is no literature supporting their clinical superiority when compared with SHS.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sang Min Lee
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Min Joon Choi
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
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Jang JH, Rhee SJ, Jun SB, Choi YY. Scattering and clustering the proximal screw construct in unilateral locking plate osteosynthesis of distal femoral fractures. Arch Orthop Trauma Surg 2022; 142:2193-2203. [PMID: 34018021 DOI: 10.1007/s00402-021-03912-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The importance of fixation construct in locking compression plate (LCP) is not well enlightened until recently. The aim of this study was to investigate radiological and clinical outcomes of scattering and clustering of the proximal screw fixation construct in unilateral LCP treatment of the distal femoral fractures. MATERIALS AND METHODS Patients who were treated for distal femoral fractures using unilateral LCP between January 2014 and December 2019 in our institute were included in this retrospective study. They were divided into groups 1 (35 cases, scattered proximal screw fixation) and 2 (35 cases, clustered proximal screw fixation). Mean follow-up period was 23.6 months for group 1 and 21.3 months for group 2. Medical history, patient demographics, injury characteristics, and surgical characteristics were reviewed and analyzed. Radiological findings including time to callus formation, bridging callus formation, union, and symmetry of the union were assessed and compared between the groups. Clinical outcomes included total blood loss during the operation, postoperative range of motion, and number of revision surgery. RESULTS The time for callus formation (5.8 weeks in group 1 vs. 4.1 weeks in group 2, p = 0.009) and bridging callus formation (12.5 weeks in group 1 vs. 10.7 weeks in group 2, p = 0.009) was significantly earlier in group 2. Despite similar union rates between groups, the mean time for radiological union was longer in group 2 (10.7 vs 7.4 months, p = 0.001). Though statistically insignificant, more asymmetric union was observed in group 2 (17 vs 11 cases). CONCLUSIONS Despite a delay in initial callus and bridging callus formation, scattering the proximal screws was better in achieving earlier and more balanced radiographic union than the clustered fixation. We recommend to avoid bridging more than five holes in the whole plate fixation construct to lessen the asymmetric callus formation and to prevent eventual plate breakage.
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Affiliation(s)
- Jae Hoon Jang
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Seung Joon Rhee
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea.
| | - Se Bin Jun
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan, 602-739, Korea
| | - Yoon Young Choi
- Department of Diagnostic Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Moneke I, Ögütür E, Chatterjee S, Haberecker M, Jang JH, Fähndrich S, Senbaklavaci Ö, Faccioli E, Opitz I, Passlick B, Diederichs S, Jungraithmayr W. CD26-inhibition correlates with the absence of chronic lung allograft dysfunction and decreases fibroblast activity in vitro. Br J Surg 2022. [DOI: 10.1093/bjs/znac176.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Chronic lung allograft dysfunction (CLAD) limits the survival after lung transplantation (Tx). CLAD is characterized by progressive fibrosis of small airways and lung parenchyma. No effective therapy is available that reverses or prevents CLAD. CD26 is a molecule with enzymatic activity also playing a key role in the progression of fibrotic diseases. Here, we analyzed the inhibitory effect of CD26 on fibroblast activity in vitro and the role of CD26-inhibition on allograft rejection in lung transplant patients.
Methods
Profibrogenic mRNA and protein levels were analyzed in vitro on the CD26-expressing fibroblast cell line Wi-38 using RT-qPCR and Western blot. CD26 was inhibited by Vildagliptin. Migration and proliferation activity of activated fibroblasts were analyzed by Incucyte® and Celltiter-Glo®. Characteristics of patients undergoing lung Tx between 2004 and 2021 were reviewed. Lung biopsies were analyzed by immunohistochemistry (IHC) for CD26.
Results
In vitro, the expression of profibrogenic genes (αSMA, FAPα, IGFBP7, Collagen 3 and Fibronectin) was significantly reduced in activated lung fibroblasts by Vildagliptin treatment. Also, migration and proliferation activity were attenuated by Vildagliptin. In 221 patients analyzed, CLAD was absent in 34 patients treated with the CD26-inhibitor Sitagliptin vs. an incidence of 18% in patients without Sitagliptin intake (p=0.02). Five-year survival in patients on Sitagliptin was significantly improved vs. patients without CD26-inhibitor intake (80% vs. 58%, p=0.006). Likewise, the incidence of acute cellular rejection (ACR) was significantly reduced in patients on Sitagliptin (7% vs. 35%, p=0.01). IHC of patient lung biopsies showed expression of CD26 in perifibrotic areas of CLAD lesions. Additional clinical data from University Hospital Zurich and from University Hospital Padua confirmed the finding that Sitagliptin intake correlated with the absence of acute and chronic allograft rejection.
Conclusion
CD26-inhibition attenuates key pro-fibrotic mediators and fibroblast activity in vitro. Impressively, patients on CD26-inhibitor did not show any CLAD. Moreover, ACR was significantly reduced. Gliptins which are in routine clinical use for the treatment of type II diabetes therefore seem to have great potential to be repurposed for a novel clinical application against lung allograft rejection.
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Affiliation(s)
- I Moneke
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - E Ögütür
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - S Chatterjee
- Institute for Environmental Medicine, Perelmann School of Medicine, University of Pennsylvania , Philadelphia, USA
| | - M Haberecker
- Institute of Pathology, University Hospital Zurich , Zurich, Switzerland
| | - J H Jang
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - S Fähndrich
- Department of Pneumology, University Medical Center Freiburg , Freiburg, Switzerland
| | - Ö Senbaklavaci
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - E Faccioli
- Department of Thoracic Surgery, University Hospital of Padua , Padua, Italy
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - I Opitz
- Department of Thoracic Surgery, University Hospital Zurich , Zurich, Switzerland
| | - B Passlick
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
| | - S Diederichs
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
- German Cancer Research Center RNA Biology & Cancer, , Heidelberg, Germany
| | - W Jungraithmayr
- Department of Thoracic Surgery, University Medical Center Freiburg , Freiburg, Germany
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Kim SH, Ryu D, Kim H, Lee K, Jeon CH, Choi HJ, Jang JH, Kim JH, Yeom SR. Effects of the Coronavirus Disease 2019 (COVID-19) Pandemic on Outcomes among Patients with Polytrauma at a Single Regional Trauma Center in South Korea. J Trauma Inj 2021. [DOI: 10.20408/jti.2020.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals’ service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea. Methods We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4–19 days] vs. 16 days [IQR 8–28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found. Conclusions The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.
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Kim SD, Park SJ, Jang JH, Moon J, Ha HY, Lee CH, Park H, Shin JH, Lee TH. Strain hardening recovery mediated by coherent precipitates in lightweight steel. Sci Rep 2021; 11:14468. [PMID: 34262073 PMCID: PMC8280213 DOI: 10.1038/s41598-021-93795-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/10/2021] [Indexed: 11/09/2022] Open
Abstract
We investigated the effect of κ-carbide precipitates on the strain hardening behavior of aged Fe–Mn-Al-C alloys by microstructure analysis. The κ-carbides-strengthened Fe–Mn-Al-C alloys exhibited a superior strength-ductility balance enabled by the recovery of the strain hardening rate. To understand the relation between the κ-carbides and strain hardening recovery, dislocation gliding in the aged alloys during plastic deformation was analyzed through in situ tensile transmission electron microscopy (TEM). The in situ TEM results confirmed the particle shearing mechanism leads to planar dislocation gliding. During deformation of the 100 h-aged alloy, some gliding dislocations were strongly pinned by the large κ-carbide blocks and were prone to cross-slip, leading to the activation of multiple slip systems. The abrupt decline in the dislocation mean free path was attributed to the activation of multiple slip systems, resulting in the rapid saturation of the strain hardening recovery. It is concluded that the planar dislocation glide and sequential activation of slip systems are key to induce strain hardening recovery in polycrystalline metals. Thus, if a microstructure is designed such that dislocations glide in a planar manner, the strain hardening recovery could be utilized to obtain enhanced mechanical properties of the material.
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Affiliation(s)
- Sung-Dae Kim
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Seong-Jun Park
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Jae Hoon Jang
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Joonoh Moon
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Heon-Young Ha
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Chang-Hoon Lee
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Hyungkwon Park
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Jong-Ho Shin
- Materials and Manufacturing Technology Development Center, Corporate Research and Development Institute, Doosan Heavy Industries and Construction Co. LTD, 22 Doosanvolvo-ro, Changwon, Gyeongnam, 51711, Republic of Korea
| | - Tae-Ho Lee
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea.
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O'Sullivan MJ, Jang JH, Panariti A, Bedrat A, Ijpma G, Lemos B, Park JA, Lauzon AM, Martin JG. Airway Epithelial Cells Drive Airway Smooth Muscle Cell Phenotype Switching to the Proliferative and Pro-inflammatory Phenotype. Front Physiol 2021; 12:687654. [PMID: 34295265 PMCID: PMC8290262 DOI: 10.3389/fphys.2021.687654] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022] Open
Abstract
The increased mass of airway smooth muscle (ASM) in the airways of asthmatic patients may contribute to the pathology of this disease by increasing the capacity for airway narrowing. Evidence for the airway epithelium as a participant in ASM remodeling is accruing. To investigate mechanisms by which airway epithelial cells induce ASM cell (ASMC) proliferation, we have employed a co-culture model to explore markers of ASMC proliferative phenotype. Co-culture with epithelial cells led to incorporation of bromodeoxyuridine into ASMCs, indicating augmented proliferation and an associated increase in mRNA of the pro-proliferative co-transcription factor Elk1. Although the mitogen heparin-binding epidermal growth factor (HB-EGF) was augmented in the co-culture supernatant, the ASMC epidermal growth factor receptor (EGFR), an effector of HB-EGF induced proliferation, did not mediate epithelial-induced proliferation. The co-culture increased the expression of ASMC mRNA for the pro-inflammatory cytokines IL-6 and IL-8 as well as the pro-proliferative microRNA miR-210. The transcriptional repressor Max-binding protein (Mnt), a putative target of miR-210, was transcriptionally repressed in co-cultured ASMCs. Together, these data indicate that the airway epithelium-induced proliferative phenotype of ASMCs is not driven by EGFR signaling, but rather may be dependent on miR210 targeting of tumor suppressor Mnt.
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Affiliation(s)
- M J O'Sullivan
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada.,T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - J H Jang
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - A Panariti
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - A Bedrat
- T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - G Ijpma
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - B Lemos
- T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - J A Park
- T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - A M Lauzon
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
| | - J G Martin
- Meakins-Christie Laboratories, McGill University Health Centre, Montreal, QC, Canada
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Sun HW, Kim H, Jeon CH, Jang JH, Kim GH, Park CI, Park SJ, Kim JH, Yeom SR. Incidence and Clinical Features of Urethral Injuries with Pelvic Fractures in Males: A 6-Year Retrospective Cohort Study at a Single Institution in South Korea. J Trauma Inj 2021. [DOI: 10.20408/jti.2020.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Shin WC, Lee SM, Jang JH, Kang JH, Moon NH. Importance of firm isthmic fixation in high-energy induced subtrochanteric fracture of the femur: retrospective observational study in a level I trauma center. Eur J Trauma Emerg Surg 2021; 48:1807-1815. [PMID: 34137910 DOI: 10.1007/s00068-021-01709-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study aimed to report the surgical outcomes in patients with high-energy induced subtrochanteric fracture and determine the risk factors for nonunion using statistical analysis. METHODS This study evaluated 88 patients with high-energy induced subtrochanteric fractures who underwent surgeries with indirect reduction technique and intramedullary nailing between March 2015 and December 2020. Outcome measures, including union time and nonunion incidence, were assessed by radiologic evaluation. Multiple logistic regression analyses were performed to identify the risk factors for nonunion, using age, sex, injury severity score, body mass index, preoperative mobility score, implant, and isthmic fixation as covariates. RESULTS Five nonunions and two delayed unions were identified. The average union time was 17.4 weeks. Multiple logistic regression analyses showed that poor isthmic fixation was the only risk factor for nonunion (odds ratio 15.294, 95% confidence interval 1.603-145.894, P value 0.018). Out of five nonunion cases, four were confirmed as hypertrophic, and one was confirmed as atrophic. CONCLUSION Although surgical treatment using an indirect reduction technique and intramedullary nailing showed good outcomes, hypertrophic nonunion due to distal instability could occur if a firm fixation at the level of the isthmus cannot be achieved. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Sang Min Lee
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Trauma center, Pusan National University Hospital, Busan, South Korea
| | - Jun Ho Kang
- Department of Orthopaedic Surgery, Trauma center, Pusan National University Hospital, Busan, South Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-Ro Seo-Gu, Busan, 49241, South Korea.
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12
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Cheon SJ, Ahn TY, Jung SJ, Jang JH, Kim JH, Jeon CH. Does transarterial pelvic embolization have a negative effect on perioperative outcomes in pelvic ring injury and acetabular fracture? Asian J Surg 2021; 45:239-245. [PMID: 34078580 DOI: 10.1016/j.asjsur.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 01/17/2021] [Accepted: 05/10/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The purpose of this study was to determine whether TAE negatively impacted perioperative outcomes in patients who underwent open surgery for pelvic trauma. METHODS We retrospectively reviewed the medical records and radiographs of patients who had open surgery for an acute pelvic trauma between February 2014 and May 2017. The patients were classified into two groups: those who underwent TAE and those who did not. We evaluated preoperative demographics and perioperative outcomes between the two groups. Injury type-specific comparisons were also performed. RESULTS A total of 136 patients (50 TAE and 86 non-TAE) were included in this study. There were significant differences in preoperative demographics including the type of injury, injury severity score, revised trauma score, surgical approach, initial blood pressure, and the amount of transfusion within 24 h between the two groups. However, no differences in perioperative outcomes were identified except for the amount of total transfusion. There were significant differences between the two groups in the injury type-specific comparisons, specifically in the amount of transfusion within 24 h in patients with pelvic ring injury and in the injury severity score in patients with acetabular fracture. However, there was no difference in perioperative outcomes between the groups for either injury type. CONCLUSION In the present study, we were unable to identify negative effects of TAE on perioperative outcomes. Therefore, when considering open surgery subsequent to TAE, there is no evidence of increased risk for negative perioperative outcomes, especially with respect to bone healing and deep infection.
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Affiliation(s)
- Sang Jin Cheon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Republic of Korea
| | - Tae Young Ahn
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Republic of Korea
| | - Seok Jin Jung
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Republic of Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Trauma Center, Pusan National University Hospital, Republic of Korea.
| | - Jae Hun Kim
- Department of Trauma Surgery, Trauma Center, Pusan National University Hospital, Republic of Korea
| | - Chang Ho Jeon
- Department of Radiology, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Repubilic of Korea
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Jang JH, Cho YJ, Choi YY, Rhee SJ. Hammock plating for comminuted inferior sleeve avulsion fractures of the patella: A surgical technique and clinical results. Orthop Traumatol Surg Res 2021; 107:102866. [PMID: 33677129 DOI: 10.1016/j.otsr.2021.102866] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/24/2020] [Accepted: 10/30/2020] [Indexed: 02/03/2023]
Abstract
Comminuted inferior sleeve avulsion fractures of the patella is a surgical challenge owing to the lack of directly purchasable bone fragments and the vulnerable patellar tendon below the displaced lip fragments. Despite the reports of various techniques to treat this fracture, still there is need for a new surgical technique to improve the reduction construct. The purpose of this article is to introduce Hammock plating, which is a surgical technique for comminuted inferior sleeve avulsion patella fractures that utilizes synthetic suture and a low-profile mini plate. The reduction construct provides an indirect reduction of the inferior sleeve fragments to form a hammock-like construct that embraces and lifts the lip fragments upward altogether that enables a firm bone-to-bone union. The advantages also include relatively simple and easy procedure with less injury to the fractured bone fragments and patellar tendon.
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Affiliation(s)
- Jae Hoon Jang
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University Hospital, Busan, Korea
| | - Yoon Jae Cho
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University Hospital, Busan, Korea
| | - Yoon Young Choi
- Department of Diagnostic Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung Joon Rhee
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University Hospital, Busan, Korea.
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Park SJ, Kim H, Jeon CH, Jang JH, Kim JH, Kim SH, Park CI, Lee SB, Kim SH, Park CY, Yeom SR. Relevant Clinical Findings of Patients with Extraperitoneal Bladder Injury Associated with Pelvic Fracture Who Underwent Operative Management: A 6-Year Retrospective Study. J Acute Care Surg 2021. [DOI: 10.17479/jacs.2021.1.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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15
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Jang JH, Moon NH, Rhee SJ, Jung SJ, Ahn TY. Surgical outcomes of transverse acetabular fractures and risk factors for poor outcomes. BMC Musculoskelet Disord 2021; 22:222. [PMID: 33648482 PMCID: PMC7923451 DOI: 10.1186/s12891-021-04082-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Transverse acetabular fractures, although classified as elementary, have worse outcomes than other types of acetabular fractures. Prognostic factors for this fracture type are not clearly established. This study aimed to assess the surgical outcomes of transverse acetabular fractures and subtypes thereof and to investigate the prognostic factors. Methods Between 2014 and 2019, 39 patients (39 hips) had transverse fractures or subtypes thereof. We reviewed the surgical outcomes and evaluated patient factors, injury factors, and surgical factors in relation to osteoarthritis (OA) and conversion to total hip arthroplasty (THA). Additionally, we analyzed the cutoff values for postoperative residual gaps and steps. Results Twenty-three male patients and sixteen female with a mean age of 41.7 years (range, 18–78 years) were included. There were 29 satisfactory reductions (74.4%). Eleven hips (28.2%) developed OA, and five (12.8%) of them underwent THA. Dome impaction (odds ratio [OR], 41.173; 95% confidence interval [CI], 1.804–939.814; p = 0.020) and residual gaps (OR, 4.251; 95% CI, 1.248–14.479; p = 0.021) were correlated with poor outcomes. Residual gaps (≥3 mm) and residual steps (≥1 mm) were significantly associated with OA. Conclusions Relatively poor reduction was found for transverse acetabular fractures and subtypes thereof. However, the rates of OA and conversion to THA were not high. Dome impaction and wide residual gaps were identified as risk factors for poor outcomes. The development of OA significantly increased if residual gap and step were more than 3 mm and 1 mm, respectively.
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Affiliation(s)
- Jae Hoon Jang
- Department of Orthopedic Surgery, Bio-medical Research Institute, Trauma Center, Pusan National University Hospital, 179 Gudeok-Ro Seo-Gu, Busan, 49241, Republic of Korea
| | - Nam Hoon Moon
- Department of Orthopedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro Seo-Gu, Busan, 49241, Republic of Korea
| | - Seung Joon Rhee
- Department of Orthopedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro Seo-Gu, Busan, 49241, Republic of Korea
| | - Seok Jin Jung
- Department of Orthopedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro Seo-Gu, Busan, 49241, Republic of Korea
| | - Tae Young Ahn
- Department of Orthopedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro Seo-Gu, Busan, 49241, Republic of Korea.
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16
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Shin WC, Jang JH, Moon NH, Jun SB. Is open bone graft always necessary when treating aseptic subtrochanteric nonunion with a reamed intramedullary nail? BMC Musculoskelet Disord 2021; 22:145. [PMID: 33648481 PMCID: PMC7923340 DOI: 10.1186/s12891-021-04016-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background This study aimed to compare the radiological results between closed nailing without bone graft (BG) and open nailing with BG for aseptic subtrochanteric nonunion and to determine when an open procedure with BG should be considered. Methods In this retrospective study, we investigated patients who underwent surgical intervention for subtrochanteric nonunion between January 2008 and March 2018 in two institutions. Patients with infection, large bone defect, pathologic fracture, open fracture, previous surgery using plate, and follow-up of less than 1 year were excluded. We compared the demographic details and radiological results between patients who underwent the open procedure with BG (BG group) and the closed procedure without BG (non-BG group) as a historical control, and risk factors for the failure of revision surgery were evaluated. Results Thirty-seven patients met the criteria and were divided into the following two groups: the BG group (n=19) who underwent open nailing with BG and the non-BG group (n=18) who underwent closed reamed nailing without BG. The mean degrees of correction of varus and flexion deformity were significantly different (p=0.001, respectively), 6.2° and 2.9° in the BG group and 4.1° and 0.6° in the non-BG group, respectively. Bony union was observed in 17 cases (89.5%) in an average of 7.4 months in the BG group and in 16 cases (88.9%) in 7.6 months in the non-BG group, with no significant differences. The factors that were significantly associated with failure of revision were atypical fracture, two or more previous surgeries, and varus and sagittal anterior angulation. Conclusions The radiological results of closed reamed nailing without BG for subtrochanteric nonunion were satisfactory. In the effort of percutaneous realignment, gap reduction, and intramedullary reaming, the radiological results of closed nailing without BG were not different from those of open nailing with BG; therefore, closed procedure without BG may be an acceptable option in appropriately selected patients.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Trauma Center, Bio-medical Research Institute, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, Republic of Korea.
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Se Bin Jun
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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17
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Lee CK, Jang JH, Lee NH, Song S. Traumatic Tricuspid Regurgitation Treated by the Minimally Invasive Double Orifice Technique. J Chest Surg 2021; 54:68-71. [PMID: 33046665 PMCID: PMC7946528 DOI: 10.5090/kjtcs.20.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/29/2020] [Accepted: 08/08/2020] [Indexed: 12/02/2022] Open
Abstract
A 37-year-old man was transferred to our level I trauma center after a road traffic accident, presenting with right acetabular fracture, multiple rib fractures, epidural hemorrhage, and liver contusion. Severe traumatic tricuspid regurgitation was also discovered during the work-up for surgery. Our initial attempt at acetabular surgery failed when the patient experienced near cardiac arrest during anesthetic induction. It was hence decided that tricuspid valve repair should precede orthopedic surgery. Minimally invasive tricuspid valve repair using the double orifice technique was successfully performed. Subsequently, acetabular surgery was performed and he was discharged 35 days post-trauma without any complications.
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Affiliation(s)
- Chan Kyu Lee
- Department of Trauma Surgery, Pusan National University Hospital Trauma Center, Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
| | - Jae Hoon Jang
- Department of Orthopedic Surgery, Pusan National University Hospital Trauma Center, Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
| | - Na Hyeon Lee
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
| | - Seunghwan Song
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
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18
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Choi HJ, Jang JH, Wang IJ, Ha M, Yu S, Lee JH, Kim BC. Correlations of Weather and Time Variables with Visits of Trauma Patients at a Regional Trauma Center in Korea. J Trauma Inj 2020. [DOI: 10.20408/jti.2020.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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19
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Moon NH, Jang JH, Shin WC, Jung SJ. Effects of Teriparatide on Treatment Outcomes in Osteoporotic Hip and Pelvic Bone Fractures: Meta-analysis and Systematic Review of Randomized Controlled Trials. Hip Pelvis 2020; 32:182-191. [PMID: 33335866 PMCID: PMC7724023 DOI: 10.5371/hp.2020.32.4.182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/24/2020] [Accepted: 06/27/2020] [Indexed: 12/03/2022] Open
Abstract
The primary objective of this study was to evaluate randomized controlled trials (RCTs) that have reported the effects of teriparatide on bone-healing in osteoporotic hip and pelvic bone fractures to determine the efficacy of teriparatide in lowering the rate of treatment failure. A total of 2,809 studies were identified using a comprehensive literature search (MEDLINE [n=1,061], Embase [n=1,395], and Cochrane Library n=353]). Five RCTs were included in the final analysis. Treatment failure rates at the last follow-up of osteoporotic hip and pelvic bone fractures between the teriparatide and control groups was the primary outcome. Treatment failure was defined as non-union, varus collapse of the proximal fragment, perforation of the lag screw, and any revision in cases due to mechanical failure of the implant during the follow-up period. The number of treatment failures in the teriparatide and placebo groups were 11.0% (n=20 out of 181) and 17.6% (n=36 out of 205), respectively. Although the rate of treatment failure in the teriparatide group was lower than that in the control group, this difference was not significant (odds ratio, 0.81 [95% confidence interval, 0.42–1.53]; P=0.16; I2=42%). This meta-analysis did not identify any significant differences in the rate of treatment failure between the teriparatide and control groups at final follow-up. Based on these results, we believe that there is a lack of evidence to confirm efficacy of teriparatide in reducing treatment failures in osteoporotic hip and pelvic bone fractures.
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Affiliation(s)
- Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery and Trauma Center, Pusan National University Hospital, Busan, Korea
| | - Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seok Jin Jung
- Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea
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Son JW, Choi SH, Jang JH, Koh JT, Oh WM, Hwang YC, Lee BN. Irisin promotes odontogenic differentiation and angiogenic potential in human dental pulp cells. Int Endod J 2020; 54:399-412. [PMID: 33089893 DOI: 10.1111/iej.13435] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 10/19/2020] [Accepted: 10/19/2020] [Indexed: 12/31/2022]
Abstract
AIM To determine whether irisin, a newly discovered myokine that links exercise-induced and metabolic homeostasis, is able to promote odontogenic differentiation and angiogenesis in human dental pulp cells (HDPCs). METHODOLOGY Cell viability in the presence of irisin was measured. Real-time PCR and Western blot analysis were performed to evaluate the expression levels of irisin, odontogenic and angiogenic markers. The involvement of mitogen-activated protein kinase (MAPK) and the protein kinase B (Akt) signalling pathway was evaluated by Western blot. To evaluate mineralization nodule formation, alkaline phosphatase (ALP) staining and alizarin red S staining were performed. Scratch wound assays were performed to evaluate the effects of irisin on cell migration. The data were analysed using one-way analysis of variance (anova) followed by Tukey post hoc test and Student's t-test. Statistical significance was considered at P < 0.05. RESULTS Irisin significantly promoted odontogenic differentiation as evidenced by formation of mineralized nodules, induction of ALP activity and upregulation of odontogenic and angiogenic markers (P < 0.05). Scratch wound assays revealed that irisin significantly increased migration of HDPCs (P < 0.05). Phosphorylation of both MAPK and Akt was increased by irisin. MAPK and Akt inhibitors inhibited mineralization, cell migration and the increased expression of odontogenic and angiogenic markers. CONCLUSIONS Irisin promoted odontogenic differentiation and mineralization and has the potential for angiogenesis through activation of the MAPK and Akt signalling pathways in HDPCs.
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Affiliation(s)
- J W Son
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - S H Choi
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - J H Jang
- Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - J T Koh
- Department of Pharmacology and Dental Therapeutics, Hard-tissue Biointerface Research Center, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - W M Oh
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Y C Hwang
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - B N Lee
- Department of Conservative Dentistry, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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21
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Kim H, Jeon CH, Kim JH, Sun HW, Ryu D, Lee KH, Park CI, Jang JH, Park SJ, Yeom SR. Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses. Eur J Trauma Emerg Surg 2020; 47:1661-1669. [PMID: 32949247 PMCID: PMC8629886 DOI: 10.1007/s00068-020-01497-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/08/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Transarterial embolisation (TAE) is an effective intervention for management of arterial haemorrhage associated with pelvic fracture. However, its effects on survival and clinical outcomes are unclear. METHODS Trauma patients with survival data between November 2015 and December 2019 were identified using a trauma database. Patients were divided between TAE and non-TAE groups, and a propensity score was developed using multivariate logistic regression. Survival at 28 days was compared between the groups after propensity score matching. RESULTS Among 881 patients included in this study, 308 (35.0%) were treated with TAE. After propensity score matching, 130 pairs were selected. Survival at 28 days was significantly higher among patients treated with TAE than among those treated without TAE [122 (93.9%) vs. 112 (86.2%); odds ratio = 2.45; 95% CI 1.02-5.86; p = 0.039]. CONCLUSIONS TAE use was associated with improved survival at 28 days in patients with pelvic fracture and should therefore be considered in the management of severely injured patients with pelvic fracture.
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Affiliation(s)
- Hohyun Kim
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea
| | - Chang Ho Jeon
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea.,Department of Diagnostic Radiology, Pusan National University Hospital, Busan, Korea
| | - Jae Hun Kim
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. .,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. .,Pusan National University School of Medicine, Yangsan, Korea.
| | - Hyun-Woo Sun
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Dongyeon Ryu
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kang Ho Lee
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Chan Ik Park
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Hoon Jang
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea.,Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea
| | - Sung Jin Park
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Seok Ran Yeom
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea.,Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea
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22
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Shin WC, Jang JH, Jung SJ, Moon NH. Advantages and limitations of intramedullary nailing for the surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures: a retrospective comparative study based on propensity score matching. Eur J Trauma Emerg Surg 2020; 48:1779-1786. [PMID: 32870324 DOI: 10.1007/s00068-020-01469-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/21/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The aim of the present study was to introduce surgical technique using long PFNA for the treatment of ipsilateral intertrochanteric and femoral shaft fractures, and evaluate the characteristics of this fracture by comparing its surgical outcomes with those of isolated intertrochanteric and femoral shaft fractures. MATERIALS AND METHODS Between March 2013 and December 2018, 38 patients with ipsilateral intertrochanteric and femoral shaft fracture were identified at two institutions. Twenty-eight patients with ipsilateral intertrochanteric and femoral shaft fractures were enrolled in the present study. After propensity score matching, fifty-six patients with isolated intertrochanteric (group B) and femoral shaft (group C) fractures were finally enrolled in the present study for 1:2 matching to compare surgical outcomes to that of ipsilateral intertrochanteric and femoral shaft fractures (Group A). RESULTS All 28 patients achieved union of intertrochanteric fractures, while two experienced non-union of femoral shaft fractures. The union time of intertrochanteric fractures in group A was significantly shorter than that in group B. The union time of femoral shaft fractures in group A was significantly longer than that in group C. CONCLUSIONS The surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures using long PFNA was advantageous as it allowed both fractures on the same femur to be fixed in one go and showed good surgical outcomes. However, fixation of femoral shaft fractures might be insufficient depending on the fracture level and configuration, and can be a cause of hypertrophic non-union.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, South Korea
| | - Seok Jin Jung
- Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, South Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-Ro Seo-Gu, Busan, 49241, South Korea.
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Kim HK, Ha HY, Bae JH, Cho MK, Kim J, Han J, Suh JY, Kim GH, Lee TH, Jang JH, Chun D. Nanoscale light element identification using machine learning aided STEM-EDS. Sci Rep 2020; 10:13699. [PMID: 32792596 PMCID: PMC7426414 DOI: 10.1038/s41598-020-70674-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/03/2020] [Indexed: 11/18/2022] Open
Abstract
Light element identification is necessary in materials research to obtain detailed insight into various material properties. However, reported techniques, such as scanning transmission electron microscopy (STEM)-energy dispersive X-ray spectroscopy (EDS) have inadequate detection limits, which impairs identification. In this study, we achieved light element identification with nanoscale spatial resolution in a multi-component metal alloy through unsupervised machine learning algorithms of singular value decomposition (SVD) and independent component analysis (ICA). Improvement of the signal-to-noise ratio (SNR) in the STEM-EDS spectrum images was achieved by combining SVD and ICA, leading to the identification of a nanoscale N-depleted region that was not observed in as-measured STEM-EDS. Additionally, the formation of the nanoscale N-depleted region was validated using STEM–electron energy loss spectroscopy and multicomponent diffusional transformation simulation. The enhancement of SNR in STEM-EDS spectrum images by machine learning algorithms can provide an efficient, economical chemical analysis method to identify light elements at the nanoscale.
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Affiliation(s)
- Hong-Kyu Kim
- Advanced Analysis Center, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Heon-Young Ha
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - Jee-Hwan Bae
- Advanced Analysis Center, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Min Kyung Cho
- Advanced Analysis Center, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Juyoung Kim
- Advanced Analysis Center, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Jeongwoo Han
- Advanced Analysis Center, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Jin-Yoo Suh
- Center for Energy Materials Research, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Gyeung-Ho Kim
- Advanced Analysis Center, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Tae-Ho Lee
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - Jae Hoon Jang
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea.
| | - Dongwon Chun
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea.
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Moon J, Ha HY, Kim KW, Park SJ, Lee TH, Kim SD, Jang JH, Jo HH, Hong HU, Lee BH, Lee YJ, Lee C, Suh DW, Han HN, Raabe D, Lee CH. A new class of lightweight, stainless steels with ultra-high strength and large ductility. Sci Rep 2020; 10:12140. [PMID: 32699336 PMCID: PMC7376142 DOI: 10.1038/s41598-020-69177-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/08/2020] [Indexed: 11/10/2022] Open
Abstract
Steel is the global backbone material of industrialized societies, with more than 1.8 billion tons produced per year. However, steel-containing structures decay due to corrosion, destroying annually 3.4% (2.5 trillion US$) of the global gross domestic product. Besides this huge loss in value, a solution to the corrosion problem at minimum environmental impact would also leverage enhanced product longevity, providing an immense contribution to sustainability. Here, we report a leap forward toward this aim through the development of a new family of low-density stainless steels with ultra-high strength (> 1 GPa) and high ductility (> 35%). The alloys are based on the Fe-(20-30)Mn-(11.5-12.0)Al-1.5C-5Cr (wt%) system and are strengthened by dispersions of nano-sized Fe3AlC-type κ-carbide. The alloying with Cr enhances the ductility without sacrificing strength, by suppressing the precipitation of κ-carbide and thus stabilizing the austenite matrix. The formation of a protective Al-rich oxide film on the surface lends the alloys outstanding resistance to pitting corrosion similar to ferritic stainless steels. The new alloy class has thus the potential to replace commercial stainless steels as it has much higher strength at similar formability, 17% lower mass density and lower environmental impact, qualifying it for demanding lightweight, corrosion resistant, high-strength structural parts.
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Affiliation(s)
- Joonoh Moon
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Heon-Young Ha
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Kyeong-Won Kim
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Seong-Jun Park
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Tae-Ho Lee
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Sung-Dae Kim
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Jae Hoon Jang
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Hyo-Haeng Jo
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea
| | - Hyun-Uk Hong
- Department of Materials Science and Engineering, Changwon National University, 20 Changwondaehak-ro, Uichang-gu, Changwon, Gyeongnam, 51140, Republic of Korea
| | - Bong Ho Lee
- Center for Core Research Facilities, Daegu Gyeongbuk Institute of Science and Technology, 333 Hyeonpung-eup, Dalseong-gun, Daegu, 42988, Republic of Korea
| | - Young-Joo Lee
- Advanced Metallic Materials Research Group, Research Institute of Industrial Science and Technology, 67 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 37673, Republic of Korea
| | - Changhee Lee
- Division of Materials Science and Engineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Dong-Woo Suh
- Graduate Institute of Ferrous Technology, Pohang University of Science and Technology, 77 Cheongam-ro, Nam-gu, Gyeongbuk, 37673, Republic of Korea
| | - Heung Nam Han
- Department of Materials Science and Engineering and Research Institute of Advanced Materials, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Dierk Raabe
- Max-Planck-Institut für Eisenforschung, Max-Planck-Straβe 1, 40237, Düsseldorf, Germany
| | - Chang-Hoon Lee
- Steel Department, Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondae-ro, Seongsan-gu, Changwon, Gyeongnam, 51508, Republic of Korea.
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Shin WC, Jang JH, Seo HE, Suh KT, Moon NH. Prevalence and clinical impact of sarcopenia in osteoporotic hip fracture: Single center retrospective cohort study. Acta Orthop Traumatol Turc 2020; 54:27-33. [PMID: 32175894 DOI: 10.5152/j.aott.2020.01.476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The study aimed to identify the prevalence of sarcopenia in patients with osteoporotic hip fractures, investigate the anthropometric differences between sarcopenic and non-sarcopenic patients, and evaluate and compare the surgical outcomes between the two groups. METHODS The study included 135 patients (35 men and 100 women; mean age: 74.1 years (range; 25-96)) who received surgical treatment for hip fracture between March 2014 and October 2016 and underwent whole-body dual-energy X-ray absorptiometry (DEXA). The skeletal muscle mass index (SMI) for diagnosis of sarcopenia was measured using whole-body DEXA. The following data were collected to compare the preoperative details of the sarcopenic and non-sarcopenic groups: SMI, age, sex, type of fracture, type of operation, BMI, obesity, American society of Anesthesiologists (ASA) class, pre-injury mobility score, BMD, and follow-up period. We compared clinical outcomes, including Harris Hip Score (HSS) and the walking ability at the last follow-up visit and radiologic outcomes, including non-union and the time to union. RESULTS The average HHS and Parker's mobility score at the last follow-up were 81.7 and 6.9 in the sarcopenic group, and 77.6 and 6.3 in the non-sarcopenic group, respectively (p=0.149 and 0.122). Non-union was identified 0 (0%) in sarcopenic group and 4 (10%) in non-sarcopenic group (p=0.288). The mean union timer of the patients in the sarcopenia group was 4.0 months and that of patients in the non-sarcopenic group was 4.4 months (p=0.210). Multiple regression analysis did not show any significant association between sarcopenia and postoperative surgical outcomes, including HHS, mobility score at the last follow up, non-union, and time to union. CONCLUSION Although the present study showed that the prevalence of sarcopenia in hip fracture patients was 45.9% (62/135), there was no clinical association between sarcopenia and postoperative. Based on these results, the clinical impact of sarcopenia may be confined to increased risk of hip fracture occurrence and surgical outcomes of hip fracture may not be affected by sarcopenia. LEVEL OF EVIDENCE Level III, Therapeutic Study.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University, Yangsan Hospital, Busan, Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Han Eol Seo
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kuen Tak Suh
- Department of Orthopaedic Surgery, Pusan National University, Yangsan Hospital, Busan, Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Korea
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Seong YJ, Jang JH, Jeon SB, Moon NH. Characteristics and Surgical Outcomes of Intertrochanteric or Subtrochanteric Fractures Associated with Ipsilateral Femoral Shaft Fractures Treated with Closed Intramedullary Nailing: A Review of 31 Consecutive Cases over Four Years at a Single Institution. Hip Pelvis 2019; 31:190-199. [PMID: 31824873 PMCID: PMC6892903 DOI: 10.5371/hp.2019.31.4.190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 11/27/2022] Open
Abstract
Purpose To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. Materials and Methods Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. Results A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11–25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. Conclusion Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures may be a good surgical option. However, fixation of femoral shaft fractures might not be sufficient depending on the implant design.
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Affiliation(s)
- Yoon Jae Seong
- Department of Orthopaedic Surgery, Myung Eun Hospital, Busan, Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Se Bin Jeon
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
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Shin WC, Moon NH, Jang JH, Seo HU, Suh KT. A retrospective bicenter comparative study of surgical outcomes of atypical femoral fracture: Potential effect of teriparatide on fracture healing and callus formation. Bone 2019; 128:115033. [PMID: 31398503 DOI: 10.1016/j.bone.2019.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/22/2019] [Accepted: 08/05/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The main purpose of the present study was to assess the radiologic effect of teriparatide on fracture healing, including union rate, union time, and callus formation, by quantitative measurements using serial follow-up X-ray imaging examinations in patients with complete atypical femoral fractures (AFFs) treated using closed intramedullary nailing. METHODS From January 2010 to October 2017, 58 consecutive patients with complete AFF who were treated with intramedullary nailing at two institutions were enrolled. Patients were classified into two groups: those who received teriparatide therapy (group A) and those who did not (group B). Teriparatide (Forsteo®; Eli Lily Co., Indianapolis, IN, USA) at a once-daily 20 μg dose was prescribed as continuous treatment of osteoporosis or with the expectation of better bone healing. Surgical outcomes, including union rate, union time, modified radiologic union score (mRUS), and callus formation at 3, 6, and 12 months postoperatively, were assessed to evaluate the effect of teriparatide on fracture healing. Quantitative measurement of callus formation was performed using the region of interest (ROI) tool in the picture archiving communication system (PACS). RESULTS Non-union was not observed in group A, whereas two patients had non-union in group B. Union time was 18.3 ± 4.8 (range, 12-28) weeks in group A and 23.6 ± 9.5 (range, 12-64) weeks in group B and was significantly shorter in group A than group B (p = 0.010). The average mRUSs during periods A (3-4 months postoperatively), B (6-8 months postoperatively), and C (12-14 months postoperatively) were 10.0, 13.9, and 15.9 in group A, and 8.7, 12.0, and 14.9 in group B, respectively. The average mRUSs during periods A and B were significantly different (p = 0.027 and 0.011, respectively). The medial, posterior, and total callus areas during periods A and B were also significantly greater in group A than in group B. No difference was observed in the union rate between the two groups (p = 0.492). CONCLUSION Teriparatide may improve callus formation and shorten union time in patients with complete diaphyseal AFF who underwent closed intramedullary nailing. LEVEL OF EVIDENCE Level III retrospective comparative study.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital.
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital
| | - Han Ul Seo
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital
| | - Kuen Tak Suh
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital
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Abstract
PURPOSE Tension band wiring is considered the standard treatment for patella fractures. However, it is limited for fractures with marginal involvement, comminution, and osteoporotic bone. Our experience indicates that these limitations can be overcome with the hook plate. We evaluated the radiographic and clinical outcomes in patients with patella fracture treated with hook plating. METHODS We enrolled 30 patients who underwent hook plating for patella fracture at two institutions between 2013 and 2017. Fracture classification and surgical options were reviewed. Postoperative fracture gap and time to union as radiographic measurements, and complications, range of motion, and functional outcome with the Lysholm score as clinical outcomes, were evaluated retrospectively. RESULTS Nine fractures were AO/OTA 34A1, three B1, one B2, two C1, nine C2, and six C3. All were closed fractures. There were 3 cases of revision, 4 with lateral or medial marginal fracture, 9 with isolated inferior pole fracture, and 14 with comminuted fracture. The average postoperative fracture gap was 0.4 (range, 0-2.0) mm, and bone union was achieved without additional intervention. The average time to union was 11.6 (range, 7-24) weeks. There were no complications, and no extension lag except in one case (10°). The average flexion was 138.5° (range, 110-145°). For functional outcomes, the average Lysholm score was 89.5 (range, 74-95), with 13 excellent, 14 good, 3 fair, and no poor cases. CONCLUSION This study suggests that hook plating can result in good bone union and restored knee function in marginal or comminuted fractures of the patella.
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Affiliation(s)
- Jae Hoon Jang
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Seung Joon Rhee
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Ji Wan Kim
- Department of Orthopedic Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
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Kim SD, Park JY, Park SJ, Jang JH, Moon J, Ha HY, Lee CH, Kang JY, Shin JH, Lee TH. Direct observation of dislocation plasticity in high-Mn lightweight steel by in-situ TEM. Sci Rep 2019; 9:15171. [PMID: 31645600 PMCID: PMC6811588 DOI: 10.1038/s41598-019-51586-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/01/2019] [Indexed: 11/24/2022] Open
Abstract
To gain the fundamental understanding of deformation mechanisms in an aluminum-containing austenitic high-Mn steel (Fe-32Mn-8.9Al-0.78 C (wt.%)), in-situ straining transmission electron microscopy (TEM) analysis is conducted. The in-situ observation during the deformation demonstrates that the plastic deformation is accommodated by the pronounced planar dislocation gliding followed by the formation of slip bands (SBs) and highly dense dislocation walls (HDDWs). Experimental evidences of the glide plane softening can be obtained from the interaction between the gliding perfect dislocations and the L’12 ordered precipitates in the austenite matrix. Furthermore, the observation of the localized cross-slip of dislocations at the slip band intersections enables to understand why slip bands are extensively developed without mutual obstructions between the slip bands. The enhanced strain hardening rate of the aluminum-containing austenitic high-Mn steels can be attributed to the pronounced planar dislocation glides followed by formation of extensive slip band which prevent premature failure by suppressing strain localization.
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Affiliation(s)
- Sung-Dae Kim
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Jun Young Park
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Seong-Jun Park
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Jae Hoon Jang
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Joonoh Moon
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Heon-Young Ha
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Chang-Hoon Lee
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Jun-Yun Kang
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea
| | - Jong-Ho Shin
- Materials and Manufacturing Technology Development Center, Corporate Research and Development Institute, Doosan Heavy Industries and Construction Co. LTD., 22 Doosanvolvo-ro, Changwon, Gyeongnam, 51711, Republic of Korea
| | - Tae-Ho Lee
- Advanced Metals Division, Korea Institute of Materials Science, 797 Changwondaero, Changwon, 51508, Republic of Korea.
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Shin WC, Jang JH, Jeong JY, Suh KT, Moon NH. Effect of a synthetic osteoconductive bone graft substitute with zeta potential control (geneX ®ds) in the treatment of intertrochanteric fracture: A single center experience of 115 consecutive proximal femoral nail antirotations. J Orthop Sci 2019; 24:842-849. [PMID: 30770214 DOI: 10.1016/j.jos.2019.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/25/2018] [Accepted: 01/23/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Although various clinical applications of geneX®ds have been reported, no study has reported the clinical application of geneX®ds in osteoporotic hip fracture. The present study aimed to identify the clinical effect of the application of geneX®ds in elderly patients with intertrochanteric fracture treated using proximal femoral nail antirotation (PFNA). MATERIALS AND METHODS From March 2014 to October 2017, 233 patients with intertrochanteric fracture (65 men and 168 women) were enrolled in this study. All patients received surgical treatment using PFNA. Patients were classified into two groups: those in whom geneX®ds which is synthetic osteoconductive bone graft substitute with the unique property of Zeta Potential Control (ZPC®), was use, and those in whom it was not. We compared the preoperative details and surgical outcomes, including radiologic outcome (postoperative reduction, tip apex distance, sliding distance of the helical blade, union, and union time) and clinical outcomes (Harris Hip Score and the walking ability at the last follow-up) between the groups. RESULTS In patients with unstable fracture who achieved anatomical or extramedullary type of reduction, the average sliding distance at 1, 3, and 12 months was 4.9 mm, 7.5 mmm and 8.1 mm in the geneX®ds group and 7.5 mm, 10.8 mm, and 12.1 mm in the no geneX®ds group, respectively. There were significant differences in the sliding distance at 1, 3, and 12 months between these two groups. CONCLUSION The use of this synthetic osteoconductive bone graft substitute with zeta potential control may have positive effect on the controlled sliding of the helical blade and the healing of intertrochanteric fracture.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, South Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, South Korea
| | - Jae Yoon Jeong
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, South Korea
| | - Kuen Tak Suh
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, South Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, South Korea.
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Shin WC, Moon NH, Jang JH, Jeong JY, Suh KT. Three-dimensional analyses to predict surgical outcomes in non-displaced or valgus impaction fractures of the femoral neck: A multicenter retrospective study. Orthop Traumatol Surg Res 2019; 105:991-998. [PMID: 31324521 DOI: 10.1016/j.otsr.2019.03.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 02/26/2019] [Accepted: 03/14/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of our study was to (1) report our surgical outcomes of internal fixation in patients with non-displaced or valgus impaction fractures of the femoral neck, (2) introduce our new three-dimensional assessment method using a combination of X-ray and CT imaging, and (3) determine which radiologic measurements significantly predicted fixation failure. HYPOTHESIS We hypothesized that high posterior tilt angle and retroversion angle are related to high incidence of non-union and osteonecrosis. MATERIALS AND METHODS From January 2009 to December 2016, 64 elderly patients in two institutions with non-displaced or valgus impaction fractures of the femoral neck who had internal fixation using multiple parallel cannulated screws were enrolled. To determine the independent predictors of non-union, osteonecrosis, and re-operation, various clinical variables and radiologic variables, including the valgus angle on coronal CT images, the posterior tilt angle on Lorenz images, and the retroversion angle on axial CT images, were analyzed. RESULTS Non-union was identified in nine of the 64 patients (14.1%) and nine of the 55 patients (16.4%) who achieved bony union had femoral head osteonecrosis with subsequent segmental collapse. The multiple logistic regression model showed that a low bone mineral density of the femur, a higher posterior tilt angle on Lorenz image, and a higher retroversion angle on axial CT images were independent predictors of non-union and re-operation. DISCUSSION Primary hip arthroplasty should be considered when a posterior tilt angle of more than 9 degrees on Lorenz images or a retroversion angle of more than 13 degrees on axial CT images is identified in patients with osteoporotic valgus impaction fractures. TYPE OF STUDY AND LEVEL OF PROOF III, Retrospective comparative study.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Republic of Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, 179, Gudeok-Ro Seo-Gu, 49241 Busan, Republic of Korea.
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, 179, Gudeok-Ro Seo-Gu, 49241 Busan, Republic of Korea
| | - Jae Yoon Jeong
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, 179, Gudeok-Ro Seo-Gu, 49241 Busan, Republic of Korea
| | - Kuen Tak Suh
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Republic of Korea
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Moon NH, Shin WC, Jang JH, Seo HU, Bae JY, Suh KT. Surgical Outcomes of Internal Fixation Using Multiple Screws in Femoral Neck Fractures with Valgus Impaction: When Should We Consider Hip Arthroplasty? A Retrospective, Multicenter Study. Hip Pelvis 2019; 31:136-143. [PMID: 31501762 PMCID: PMC6726869 DOI: 10.5371/hp.2019.31.3.136] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose We analyzed the surgical outcomes at two institutions after internal fixation using multiple screws in femoral neck fractures with valgus impaction to determine independent predictors and their cut-off values for nonunion and reoperation. Materials and Methods Between January 2006 and December 2016, 104 femoral neck fractures with valgus impaction that underwent internal fixation using multiple screws from two institutions were enrolled. The multiple logistic regression model and receiver operating characteristics analysis were used to determine the independent predictors and cut-off values for nonunion and reoperation. Results There were 20 reoperations (19.2%) due to 11 nonunions (10.6%) and nine cases of femoral head osteonecrosis (8.7%). Multiple logistic regression analysis revealed that independent predictors of nonunion and reoperation were age and posterior tilt angle (P<0.05). The cut-off value for age and the posterior tilt angle for reoperation were 72.5 years and 12.2°, respectively. The patients with a posterior tilt angle of greater than 13° had poorer radiological and clinical outcomes compared with those with a posterior tilt angle of less than 13°, even though they did achieve bone union. Conclusion Primary hip arthroplasty should be considered in patients older than 73 years of age with a posterior tilt angle greater than 13°.
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Affiliation(s)
- Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Won Chul Shin
- Department of Orthopedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Han Ul Seo
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jung Yun Bae
- Department of Orthopedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Kuen Tak Suh
- Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Korea
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Park WR, Jang JH. An inexpensive and rapid method for removal of multiple stripped locking screws following locking plating: A case report. Int J Surg Case Rep 2019; 57:134-137. [PMID: 30959360 PMCID: PMC6453824 DOI: 10.1016/j.ijscr.2019.03.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/18/2019] [Accepted: 03/22/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Removal of stripped or jammed locking screws involves several difficulties. Especially when two or more screws are involved, their removal is a more challenging and time-consuming process because the various reported techniques have certain limitations. CASE PRESENTATION Herein, we report a case in which five stripped screws were removed using a novel technique. DISCUSSION Many techniques to remove damaged locking head screw were introduced, however in case with multiple screws were involved, they are limited to use. In the case, screw extractor, although it is not a medical device, is helpful in terms of time and cost. CONCLUSION In case with the failure of removal of multiple locking screws, our technique using non-medical screw extractor can be a good option.
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Affiliation(s)
- Won Ro Park
- Department of Orthopaedic Surgery, Dong-Eui Medical Center, Busan, Republic of Korea
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, Trauma Center, Bio-Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
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Rhee SJ, Jang JH, Choi YY, Suh JT. Arthroscopic reduction of posterior cruciate ligament tibial avulsion fracture using two cross-linked pull-out sutures: A surgical technique and case series. Injury 2019; 50:804-810. [PMID: 30447986 DOI: 10.1016/j.injury.2018.11.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/08/2018] [Indexed: 02/02/2023]
Abstract
Surgical treatment of the posterior cruciate ligament (PCL) tibial avulsion fracture is challenging due to the deep-seated location of the lesion with complex adjacent anatomy and usually with small-sized bone fragment. We introduce a novel arthroscopic reduction technique using two cross-linked pull-out sutures (2XLPOS) through triple bone tunnels in posterior cruciate ligament (PCL) tibial avulsion fracture. Posterior trans-septal portal was established following the four standard arthroscopic portals. Bilateral margins of the PCL with 1∼2 mm margin from the border were penetrated using suture hook. Fiberwire sling tied with a No. 0 PDS knot was introduced anterior to the PCL by the two posteriorly pulled shuttle sutures. Three bone tunnels were drilled in the inferomedial, inferolateral, and apex edge of the avulsed tibial crater. Each end of the Fiberwire was drawn out through the inferomedial and inferolateral bone tunnel, respectively. Two ends of the No. 0 PDS were drawn out through the apex tunnel by the same manner. Fiberwire was tied on the anteromedial aspect of the proximal tibia with one strand of the No. 0 PDS placed underneath the Fiberwire knot. And, the No. 0 PDS loop was tied to complete cross-linking of pull-out construct. Arthroscopic reduction of PCL tibial insertion avulsion fracture using 2XLPOS technique was performed in eleven patients. Mean range of motion at the first postoperative year was 126.8°. Mean Lysholm score, Tegner activity scale, and IKDC was 69.2, 4.2, and 58.1, respectively. Posterior instability decreased from mean 12.6 mm preoperatively to 3.2 mm at 1-year postoperative follow up. Radiographic union of the fracture site was confirmed in 11 cases. Our new surgical technique yielded good clinical and radiological outcome, and we consider it is unique in utilizing two cross-linked sling type pull-out suture constructs and triple bone tunnels for their passage.
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Affiliation(s)
- Seung Joon Rhee
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
| | - Jae Hoon Jang
- Department of Orthopedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Yoon Young Choi
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Jeung Tak Suh
- Department of Orthopedic Surgery, Busan Medical Center, Busan, Republic of Korea
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Oh S, Jang JH, Kim HJ, Seo NS, Byun SH, Kim SW, Kim DS. Long-term Follow-up of Complicated Crown Fracture With Fragment Reattachment: Two Case Reports. Oper Dent 2019; 44:574-580. [PMID: 30702408 DOI: 10.2341/18-201-t] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Two cases of complicated crown fracture of the maxillary incisors were restored using the fragment reattachment technique. Root canal treatment was performed, and the fractured fragment was bonded to the tooth structure using a dentin adhesive system and a flowable composite resin, followed by the insertion of a fiber post using dual-cured resin cement. Reattached fragments have shown reliable prognosis without inflammatory signs around bonded junctions after long-term follow-up.
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Jang JH, Wu YN, Kim SJ, Zhang YH. P927Neuronal nitric oxide synthase-beta in the myofilament and maintains sarcomere structure in cardiomyocyte. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J H Jang
- Seoul National University, Seoul, Korea Republic of
| | - Y N Wu
- Seoul National University, Seoul, Korea Republic of
| | - S J Kim
- Seoul National University, Seoul, Korea Republic of
| | - Y H Zhang
- Seoul National University, Seoul, Korea Republic of
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Park JS, Jang JH, Park KY, Moon NH. High energy injury is a risk factor for preoperative venous thromboembolism in the patients with hip fractures: A prospective observational study. Injury 2018; 49:1155-1161. [PMID: 29709377 DOI: 10.1016/j.injury.2018.04.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/07/2018] [Accepted: 04/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The purpose of this study was to identify the incidence of preoperative venous thromboembolism (VTE), and determine if high energy hip fracture affects preoperative VTE occurrence. METHODS Three-hundred nine patients (244 low and 61 high energy injuries) treated between March 2015 and March 2017 were included in this study. Indirect multidetector computed tomographic venography for the detection of preoperative VTE was performed at admission. The incidence of preoperative VTE was compared between high and low energy injury hip fractures. Logistic regression analysis was used to identify independent risk factors for preoperative VTE. RESULTS The overall incidence of preoperative VTE was 18.4% (56 of 305 patients). Preoperative VTE was identified in 17 (27.9%) and 39 (16.0%) patients in the high and low energy injury groups, respectively (p = 0.034). Multivariate logistic regression analysis showed that high energy injury, history of VTE, and myeloproliferative disease were significant predictive factors of preoperative VTE (OR = 2.451; 95% CI = 1.227-4.896, OR = 11.174; 95% CI = 3.500-35.673, OR = 6.936; 95% CI = 1.641-29.321, respectively) CONCLUSION: Because high energy hip fracture is significantly associated with preoperative VTE occurrence, preoperative evaluation and proper thromboprophylaxis should be performed for patients with a high-energy hip fracture.
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Affiliation(s)
- Jin Sup Park
- Division of Cardiology, Pusan National University Hospital, Busan, Republic of Korea
| | - Jae Hoon Jang
- Trauma Center, Pusan National University Hospital, Busan, Republic of Korea
| | - Ki Young Park
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Bio-medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
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Jang JH, Moon NH, Park KY. Arthroscopic Management of Intraarticular Screw Perforation after Surgical Treatment of an Acetabular Posterior Wall Fracture: A Case Report. Hip Pelvis 2018; 30:60-64. [PMID: 29564299 PMCID: PMC5861028 DOI: 10.5371/hp.2018.30.1.60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/05/2018] [Accepted: 01/13/2018] [Indexed: 11/28/2022] Open
Abstract
Although surgical techniques for treating acetabular fracture are evolving, the use of periacetabular screws is common, and their placement in acetabular surgery is still technically demanding. For instance, intraarticular screw perforation is a serious complication that may occur during surgical treatment of an acetabular fracture. Here, we describe the case of a 50-year-old female who experienced an intraarticular screw perforation after surgical treatment of a posterior acetabular wall fracture. Removal of the perforated screw was performed arthroscopically based on its ability to offer minimally invasive access to the hip joint. One year after removal of the screw, no radiological signs of osteoarthritic changes were observed. The patient regained normal ambulation without limitations to range of motion or hip pain. To our knowledge, this is the first report on the use of arthroscopy to treat intraarticular screw perforation after surgical treatment of an acetabular fracture.
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Affiliation(s)
- Jae Hoon Jang
- Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea
| | - Ki Young Park
- Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea
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Jang JH, Moon J, Ha HY, Lee TH, Suh DW. Quantum-mechanical analysis of effect of alloying elements on ε-martensite start temperature of steels. Sci Rep 2017; 7:17860. [PMID: 29259306 PMCID: PMC5736593 DOI: 10.1038/s41598-017-18230-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 12/07/2017] [Indexed: 12/01/2022] Open
Abstract
With regard to the transformation mechanism of austenitic high manganese steel, the prediction of the ε-martensite start temperature is a critical consideration in alloy design. Evaluation of the ε-martensite start temperature makes it possible to predict the microstructure and to understand the phase transformation occurring during deformation. Here we use the quantum mechanical calculation of random alloys to understand the physics for ε-martensitic transformation in steels. We could find the linear relationship between the measured ε-martensite start temperatures and the crystal structure stability for various compositions. We also could estimate the effect of several alloying elements. It is expected that the effect of decreasing the temperatures for the same amount of alloying elements addition will be larger moving farther from Group VIII. By creating a free-energy model that reflects the temperature effect, we were able to calculate the average driving force required for the ε-martensitic transformations.
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Affiliation(s)
- J H Jang
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea.
| | - J Moon
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - H-Y Ha
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - T-H Lee
- Ferrous Alloy Department, Korea Institute of Materials Science, Changwon, 51508, Republic of Korea
| | - D-W Suh
- Graduate Institute of Ferrous Technology, POSTECH, Pohang, 37673, Republic of Korea
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Shin WC, Moon NH, Jang JH, Lee HJ, Suh KT. Comparative study between biologic plating and intramedullary nailing for the treatment of subtrochanteric fractures: Is biologic plating using LCP-DF superior to intramedullary nailing? Injury 2017; 48:2207-2213. [PMID: 28847590 DOI: 10.1016/j.injury.2017.08.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/12/2017] [Accepted: 08/13/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The objective of this study is to evaluate the outcome measures of subtrochanteric fractures between biologic plating and intramedullary nailing and determine if biologic plating is superior to intramedullary nailing. METHODS Between March 2009 and December 2015, 81 patients with subtrochanteric fractures were enrolled (52 males and 29 females; 31 treated with biologic plating and 50 with intramedullary nailing). Biologic plating was conducted consecutively between May 2011 and March 2013 and intramedullary nailing was performed for the rest of period. Perioperative outcomes including operation time and blood loss during the operation; postoperative radiologic outcomes including union, time to union, coronal alignment, and shortening of the femur; and clinical outcomes including walking ability and pain were evaluated. The biologic plating group was compared with the intramedullary nailing group as a historical control. RESULTS No significant differences were identified for bony union and time to union between the two different fixation methods Coronal alignment was significantly better in the biologic plating group than in the intramedullary nailing group (p<0.016). Postoperative coronal alignment was the only risk factor associated with the nonunion of subtrochanteric fractures (unadjusted OR: 1.915, 95% CI: 0.190 - 19.273; adjusted OR: 0.042, 95% CI: 0.000 - 21.517; p=0.320). CONCLUSION Surgical outcomes using LCP-DF are comparable to those using intramedullary nailing. Further clinical studies with a larger sample size are required to show the advantage of biologic plating for the treatment of subtrochanteric fractures.
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Affiliation(s)
- Won Chul Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, (Bio)Medical Research Institute, Pusan National University Hospital, Busan, Korea.
| | - Jae Hoon Jang
- Department of Orthopaedic Surgery, (Bio)Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hee Jin Lee
- Department of Orthopaedic Surgery, (Bio)Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kuen Tak Suh
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Han SA, Jang JH, Won KY, Lim SJ, Song JY. Prognostic value of putative cancer stem cell markers (CD24, CD44, CD133, and ALDH1) in human papillary thyroid carcinoma. Pathol Res Pract 2017; 213:956-963. [PMID: 28687160 DOI: 10.1016/j.prp.2017.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 04/17/2017] [Accepted: 05/03/2017] [Indexed: 01/06/2023]
Abstract
We hypothesized that cancer stem cells (CSCs) are responsible for the poor outcome and aggressive clinicopathological factors. We surveyed the expression of selected CSC markers that are specifically expressed in thyroid papillary carcinoma (PTC). A total of 80 patients with PTC from 2011 to 2012 were enrolled. We selected CD24, CD44, CD133, and dehydrogenase 1 (ALDH1), as they have been suggested to be candidate CSC markers. Expression of these markers was investigated by immunohistochemical (IHC) staining. IHC staining for CD24, CD44, CD133 and ALDH1 was evaluated according to staining intensity and proportion. The intensity and proportion scores were multiplied together for a total score, which was either 0-2 (negative) or 3-7 (positive). IHC for CD133 in PTC was positive in 49 (61.3%) patients, and CD24 was positive in 28 (35.0%). Seventy-eight (97.5%) patients were CD44 positive and 79 (98.8%) were ALDH1 positive. When we assessed the relationship between CSC markers and clinicopathological factors in PTC, CD24 expression was inversely correlated with multifocality (p=0.045; odds ratio [OR], 0.370; 95% confidence interval [CI], 0.138-0.991) and CD44 expression was significantly correlated with a BRAF mutation (p=0.001; OR, 7.091; 95% CI, 4.101-12.262). However, CD133 and ALDH1 were not associated with any of the clinicopathological parameters. CD24 expression was inversely correlated with multifocality, and CD44 expression was significantly correlated with a BRAF mutation. Therefore, CD24 and CD44 are related to clinicopathological aggressive features and important for determining surgical extent in patients with PTC.
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Affiliation(s)
- Sang-Ah Han
- Department of surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Hoon Jang
- Graduate School, Department of Medicine, Kyung Hee University, Korea
| | - Kyu Yeoun Won
- Department of Pathology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sung-Jig Lim
- Department of Pathology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jeong-Yoon Song
- Department of surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
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Jang JH, Ahn JM, Lee HJ, Moon NH. Surgical Outcomes of Biologic Fixation for Subtrochanteric Fracture Using Locking Compression Plates. Hip Pelvis 2017; 29:68-76. [PMID: 28316965 PMCID: PMC5352728 DOI: 10.5371/hp.2017.29.1.68] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/02/2017] [Accepted: 02/09/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose This study aimed to evaluate the surgical outcomes of biologic plating using locking compression plate-distal femur (LCP-DF) in patients with subtrochanteric fracture of the femur. Materials and Methods Between January 2010 and December 2013, 28 consecutive patients with subtrochanteric fractures of the femur, treated with biologic fixation using LCP-DF, were enrolled. Preoperative values, including patient age, sex, body mass index, fracture type, type of lung injury, and surgical timing from injury to surgery, were retrospectively evaluated. Radiologic assessments included time to union, coronal alignment, rotational alignment, and complications such as implant breakage and screw breakage. Adverse events, including postoperative fat embolism and adult respiratory distress syndrome, infection during the follow-up period, and walking ability at the last follow-up visit, were assessed. Results Union was achieved in 27 patients (96.4%) after a mean duration of 5.4 months (range, 3-14 months). No patients developed fat embolism or adult respiratory distress syndrome during the hospitalization period of this study. Conclusion Biologic fixation using locking compression plates may represent a safe surgical option which can be utilized in patients with subtrochanteric fracture regardless of injury severity, surgical timing, fracture type, and presence of lung injury.
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Affiliation(s)
- Jae Hoon Jang
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Min Ahn
- Department of Orthopaedic Surgery, Pusan Korea Hospital, Busan, Korea
| | - Hee Jin Lee
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Nam Hoon Moon
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Shin WC, Moon NH, Jang JH, Park KY, Suh KT. Anterolateral femoral bowing and loss of thigh muscle are associated with occurrence of atypical femoral fracture: Effect of failed tension band mechanism in mid-thigh. J Orthop Sci 2017; 22:99-104. [PMID: 27720510 DOI: 10.1016/j.jos.2016.09.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Revised: 08/23/2016] [Accepted: 09/10/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND The purpose of this study was to characterize anterolateral bowing of the femur using X-rays and muscular atrophy in the mid-thigh using computed tomography (CT) in patients with atypical femoral fractures (AFFs). We then compared the results with those of an intertrochanteric fracture to understand whether these measures act as causative factors of AFFs. METHODS From January 2009 to December 2015, 37 patients with complete AFF and 12 patients with incomplete AFF were enrolled in this study. Lateral femoral bowing, anterior femoral bowing, cross-sectional area (CSA), and attenuation coefficient of thigh muscles in the AFF group are measured and compare with those in the intertrochanteric fracture group. RESULTS Lateral and anterior femoral bowing in the AFF group were significantly higher than those in the intertrochanteric fracture group. The level of fracture was found to be significantly associated with lateral and anterior femoral bowing (r = 0.569, r2 = 0.324, p < 0.001; r = -0.530, r2 = 0.281, p < 0.001, respectively). Total CSA and CSA of anterior and medial compartments were significantly lower in the AFF group (p < 0.05). The attenuation coefficient of the total thigh muscle and all three compartments in the AFF group were significantly lower than those in the intertrochanteric fracture group (p < 0.05). CONCLUSIONS This study demonstrated that anterolateral femoral bowing and loss of thigh muscle were highly associated with the occurrence of AFFs.
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Affiliation(s)
- W C Shin
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea
| | - N H Moon
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, South Korea.
| | - J H Jang
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, South Korea
| | - K Y Park
- Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, South Korea
| | - K T Suh
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea
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Lee MH, Jang JH, Min HJ, Jang HI, Nah JH, Lyu CJ, Han KS, Won JH, Lee YH, Chong SY, Mun YC, Lee WS, Kim SJ, Kim I. Predictors of general discomfort, limitations in activities of daily living and intention of a second donation in unrelated hematopoietic stem cell donation. Bone Marrow Transplant 2016; 52:258-263. [PMID: 27819689 DOI: 10.1038/bmt.2016.260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 11/09/2022]
Abstract
We performed a retrospective study of 1868 consecutive unrelated donors to predict the risk factors related to general discomfort, limitations in activities of daily living (ADLs) and intention of a second donation in hematopoietic stem cell (HSC) donation. General discomfort and limitations in ADLs were assessed by numerical measurement (scores of 0-10) and donor's intention of a second donation by yes or no reply. The post-donation questionnaires were completed within 48 h after HSC collection and at 1 week, 4 weeks, and 4 months thereafter. Predictors of general discomfort included female sex (P<0.0001), bone marrow (BM) collection (P<0.0001) or PBSC collection through a central line (CL; P=0.0349), 2-day collection (P=0.0150) and negative or undetermined intention of a second donation on day 1 (P<0.0001). Predictors of limitations in ADLs included age group of 30-39 years (P=0.0046), female sex (P<0.0001), BM collection (P<0.0001) or PBSC collection through a CL (P<0.0001) and negative or undetermined intention of a second donation on day 1 (P<0.0001). The only predictor of positive intention of a second donation was male sex (P=0.0007). Age, sex and collection method and period should be considered risk factors when unrelated HSC donation is performed.
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Affiliation(s)
- M H Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - J H Jang
- Korea Marrow Donor Program, Seoul, South Korea
| | - H J Min
- Clinical Research Institute, Konkuk University Medical Center, Seoul, South Korea
| | - H I Jang
- Korea Marrow Donor Program, Seoul, South Korea
| | - J H Nah
- Korea Marrow Donor Program, Seoul, South Korea
| | - C J Lyu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - K-S Han
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - J H Won
- Department of Hematology-Oncology, Soon Chun Hyang University Hospital, Seoul, South Korea
| | - Y-H Lee
- Department of Pediatrics, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, South Korea
| | - S Y Chong
- Department of Internal Medicine, Bundang Cha Hospital, Seongnam, South Korea
| | - Y C Mun
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea
| | - W S Lee
- Department of Hematology and Oncology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - S J Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - I Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
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Jang JH, Janker F, Arni S, Yamada Y, De Meester I, Weder W, Jungraithmayr W. CD26/DPP4-inhibition suppresses lung cancer growth via increased NK cell and macrophage recruitment. Zentralbl Chir 2016. [DOI: 10.1055/s-0036-1587531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Yamada Y, Laube I, Jang JH, Maeyashiki T, Bonvini J, Inci I, Beck Schimmer B, Weder W, Jungraithmayr W. Sevoflurane preconditioning attenuates lung injury after mouse lung transplantation. Zentralbl Chir 2016. [DOI: 10.1055/s-0036-1587544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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47
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Jung YH, Jang JH, Kang H, Choi WS, Choi YK, Song WC, Song BS, Lee JH, Hong B. Properties of Dye-Sensitized Solar Cells Using Carbon Nanowall Counter Electrodes. J Nanosci Nanotechnol 2016; 16:5302-5304. [PMID: 27483920 DOI: 10.1166/jnn.2016.12215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This research investigates plasma-treated and metal-coated carbon nanowalls (CNWs) for use as counter electrodes of dye-sensitized solar cells (DSSCs). The CNWs were synthesized on a fluorine-tin-oxide (FTO) glass substrate using the microwave plasma-enhanced chemical vapor deposition (PECVD) system with methane (CH4) gas. The post-plasma treatment was performed on the CNWs with hydrogen (H2) plasma using PECVD, and the CNWs were sputter-coated with metal films using the RF magnetron sputtering system with a four-inch tungsten (W) target. Then the post-plasma-treated and metal-coated CNWs were used as counter electrodes for the fabrication of the DSSCs. Field-emission scanning electron microscopy (FE-SEM) was performed to obtain cross-sectional and planar images of the grown CNWs. The energy conversion efficiencies of the DSSCs manufactured using the post-plasma-treated and metal-layer-coated CNWs as the counter electrodes were measured.
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Abstract
The traditional techniques involving an oblique tunnel or triangular wedge resection to approach a central or mixed-type physeal bar are hindered by poor visualisation of the bar. This may be overcome by a complete transverse osteotomy at the metaphysis near the growth plate or a direct vertical approach to the bar. Ilizarov external fixation using small wires allows firm fixation of the short physis-bearing fragment, and can also correct an associated angular deformity and permit limb lengthening. We accurately approached and successfully excised ten central- or mixed-type bars; six in the distal femur, two in the proximal tibia and two in the distal tibia, without damaging the uninvolved physis, and corrected the associated angular deformity and leg-length discrepancy. Callus formation was slightly delayed because of periosteal elevation and stretching during resection of the bar. The resultant resection of the bar was satisfactory in seven patients and fair in three as assessed using a by a modified Williamson-Staheli classification.
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Affiliation(s)
- H T Kim
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
| | - K P Lim
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
| | - J H Jang
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
| | - T Y Ahn
- Pusan National University, 1Ga-10, Ami-Dong, Seo-Gu Busan, 602-739, Korea
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49
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Lee SK, Ahn KJ, Jang JH, Choi HS, Jung SL, Kim BS. Artefacts at a glance: differentiating features of artefactual stenosis from true stenosis at the genu of the petrous internal carotid artery on TOF MRA. Clin Radiol 2015; 71:e72-8. [PMID: 26652609 DOI: 10.1016/j.crad.2015.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 10/05/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
AIM To investigate the distinguishing features of artefactual stenosis from true stenosis at the genu of the petrous internal carotid artery (ICA) on time of flight (TOF) magnetic resonance angiography (MRA). MATERIALS AND METHODS Both TOF MRA and digital subtraction angiography (DSA) were performed in 65 patients with 74 vessels who demonstrated artefactual stenosis in 43 patients with 50 vessels and true stenosis in 22 patients with 24 vessels. The following findings of the signal loss were compared between the two groups: (1) margin, (2) darkness, (3) the presence of bilaterality, (4) the presence of tandem arterial stenosis, (5) the location of the epicentre, and (6) length. RESULTS In five out of the six evaluated items, statistically significant differences were present between the two groups (p<0.00 in all five items). Artefactual stenosis more frequently showed signal loss with ill-defined margins (47/50), less darkness compared to the background darkness (46/50), the absence of tandem arterial stenosis (35/50), epicentre at the genu (34/50), and shorter length (2.57 ± 0.68 mm). No significant difference was noted in the presence of bilaterality of signal loss between the two groups (p=0.706). CONCLUSION Several MRA features can be useful for suggesting artefactual stenosis rather than true stenosis at the genu of the petrous ICA on TOF MRA.
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Affiliation(s)
- S K Lee
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - K J Ahn
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea.
| | - J H Jang
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - H S Choi
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - S L Jung
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
| | - B S Kim
- Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, South Korea
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Abstract
Soft tissue reconstruction is needed to maintain the maximum length of the fingers in fingertip injury. The purpose of this study was to present an anterograde pedicle advancement flap technique, for the treatment of fingertip injuries, which involved a modification to the anterograde advancement flap by the dissection of the digital nerve and artery with a pedicle to advance the flap. This technique was used in 12 fingers in patients who had undergone soft tissue reconstruction of fingertip injuries between January 2012 and October 2013. The sizes of the flaps ranged from 8 × 7 mm to 14 × 10 mm. The mean length of advancement was 9.7 mm (range 7-13). The mean value of the static two-point discrimination test of the healed flaps was 5.1 mm (range 4-6) and the flaps survived in all the 12 cases. The modified anterograde pedicle advancement flap provides a reliable coverage of sensate soft tissue without bone shortening in fingertip injuries.Level II.
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Affiliation(s)
- S H Lee
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
| | - J H Jang
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
| | - J I Kim
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
| | - S J Cheon
- Department of Orthopaedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea
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