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Park CB, Hwang JS, Gong HS, Park HS. A Lightweight Dynamic Hand Orthosis With Sequential Joint Flexion Movement for Postoperative Rehabilitation of Flexor Tendon Repair Surgery. IEEE Trans Neural Syst Rehabil Eng 2024; 32:994-1004. [PMID: 38376979 DOI: 10.1109/tnsre.2024.3367990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
During the postoperative hand rehabilitation period, it is recommended that the repaired flexor tendons be continuously glided with sufficient tendon excursion and carefully managed protection to prevent adhesion with adjacent tissues. Thus, finger joints should be passively mobilized through a wide range of motion (ROM) with physiotherapy. During passive mobilization, sequential flexion of the metacarpophalangeal (MCP) joint followed by the proximal interphalangeal (PIP) joint is recommended for maximizing tendon excursion. This paper presents a lightweight device for postoperative flexor tendon rehabilitation that uses a single motor to achieve sequential joint flexion movement. The device consists of an orthosis, a cable, and a single motor. The degree of spatial stiffness and cable path of the orthosis were designed to apply a flexion moment to the MCP joint prior to the PIP joint. The device was tested on both healthy individuals and a patient who had undergone flexor tendon repair surgery, and both flexion and extension movement could be achieved with a wide ROM and sequential joint flexion movement using a single motor.
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Hwang JS, Ma SB, Kim J, Baek GH. Correction of Congenital Ring-Little Finger Metacarpal Synostosis Through Simultaneous Interpositional Allograft Bone After Split Osteotomy of the Synostosis Site and Distraction Lengthening of the Fifth Metacarpal. J Hand Surg Am 2024:S0363-5023(23)00688-3. [PMID: 38284955 DOI: 10.1016/j.jhsa.2023.12.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 12/09/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE We attempted a technique for patients with congenital ring-little finger metacarpal synostosis involving simultaneous interpositional allograft bone after split osteotomy of the synostosis site and distraction lengthening of the fifth metacarpal along with correction of the metacarpal joint abduction contracture. The purpose of this study was to describe the surgical technique and its outcomes. METHODS We reviewed the medical records of children with congenital ring-little finger metacarpal synostosis treated surgically at our institute. Eight hands of six children with an average age of 5.0 (range, 1.7-9.3) years were treated by simultaneous interpositional allograft bone after split osteotomy, distraction lengthening, and tenotomy of abductor digiti minimi. We measured the metacarpal head-to-capitate area ratios from serial radiographs and analyzed them according to age. We also measured the change in the intermetacarpal angle (IMA) and metacarpal length ratio during an average of 8.1 (range, 1.4-16.8) years of follow-up. These changes were compared with changes in seven hands of five children with an average age of 8.1 (range, 1.5-15.6) years treated by the same method, but without a distraction lengthening of the fifth metacarpal and followed up for an of average 12.1 (range, 4.1-19.8) years, as a control group. RESULTS Abnormal metacarpal head-to-capitate area ratio before surgery was normalized in all patients within the first 2 years after surgery. The IMA change averaged 39.8°, and the metacarpal length ratio changed by 17%. The control group showed an average IMA change of 36.6° and metacarpal length ratio change of 6%. CONCLUSIONS Simultaneous interpositional allograft bone after split osteotomy of the synostosis site and distraction lengthening of the fifth metacarpal with correction of metacarpal joint abduction contracture can restore the radiographic parameters in congenital ring-little finger metacarpal synostosis. The normalized ossification of the fifth metacarpal head indicates that the surgical procedure is probably safe. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic V.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopaedic Surgery, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea
| | - Sang Beom Ma
- Department of Orthopedic Surgery, Insung Hospital, Chuncheon, Republic of Korea
| | - Jihyeung Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea
| | - Goo Hyun Baek
- Department of Orthopaedic Surgery, Seoul National University Hospital, College of Medicine, Seoul, Republic of Korea; Yeson Orthopaedic Hospital, Bucheon-si, Republic of Korea.
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Hwang JS, Won SJ, Gong HS. How Does the Subchondral Bone Density Distribution of the Distal Humerus Change Between Early and Advanced Stages of Osteoarthritis? Clin Orthop Relat Res 2023:00003086-990000000-01417. [PMID: 37966302 DOI: 10.1097/corr.0000000000002921] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND The distribution of subchondral bone density in a joint represents stress that is applied to the joint. Knowing this information is important for understanding the pathophysiology of osteoarthritis (OA). In the elbow, however, this has not been studied before. QUESTIONS/PURPOSES (1) Is advanced-stage elbow OA associated with more radially distributed subchondral bone density than earlier stages? (2) What demographic (age and sex) and radiographic (osteophyte location and carrying angle) factors are associated with increased radial shift in subchondral bone density? METHODS Between March 2001 and December 2021, we treated 301 patients for elbow OA. We considered patients with plain radiographs and conventional CT scans as potentially eligible. Thus, 68% (206 patients) were eligible; a further 27% (80 patients) were excluded because of a history of any injury or surgery or known inflammatory joint disease, leaving 42% (126 patients) for analysis here. Their mean ± standard deviation age was 60 ± 10 years. Early OA with minimal joint space narrowing and osteophyte formation was found in 33% (42 of 126) of patients, and advanced OA was found in the remaining 67% (84 of 126). Three-dimensional distal humerus subchondral bone models were derived from CT images, and in the central intra-articulating portion, we measured the subchondral bone density in two different sites: where it articulates with the radius (SBDrad) and with the ulna (SBDulna). We further defined the SBDratio as the percent ratio of SBDrad to SBDulna. We also evaluated osteophyte severity based on its size at the radiocapitellar and ulnotrochlear joints, and alignment through measuring the carrying angle on radiographs. To assess interobserver reliability, two orthopaedic surgeons took measurements independently from each other. All measurements had excellent intraoberver and interobserver reliabilities. Then, we compared the subchondral bone parameters between early and advanced OA and performed a multivariable analysis of the factors associated with subchondral bone parameters, including age, sex, osteophyte location, and carrying angle. RESULTS Radial versus ulna subchondral bone density (SBDratio) was modestly higher in patients with advanced OA (118% ± 17%) than in patients with early OA (109% ± 17%, mean difference 9% [95% CI 2.3% to 15.3%]; p = 0.01). With increasing radial deviation in subchondral bone density, cubitus valgus had a modest association (β = 0.46 ± 0.23; p = 0.04) and severe osteophytes at the radiocapitellar joint had a large association (β = 9.51 ± 3.06; p = 0.002). CONCLUSION According to subchondral bone density distribution, stress concentration was more radially deviated in patients with the advanced stages of elbow OA than in those with the early stages. We also found that an increase in carrying angle is associated with radial deviation of stress. A future study that examines longitudinal changes in the subchondral bone density might be required to confirm changes in stress concentration with OA progression. CLINICAL RELEVANCE This study gives us insight into the potential pathophysiology of elbow OA in relation to elbow alignment. Although debridement of osteophytes in the ulnotrochlear joint is the most frequently performed procedure in patients with advanced elbow OA, our finding suggests that some patients with an increased carrying angle might benefit from management of the radiocapitellar joint as well, or from being informed of the future development of OA in the radiocapitellar joint, because stress at this site can be increased with the advancement of OA.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Samuel Jaeyoon Won
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
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Hwang JS, Lee HS, Gong HS. Three-Dimensional Analysis of the Trapezium Subchondral Bone and its Association with Trapeziometacarpal Joint Osteoarthritis. Calcif Tissue Int 2023; 112:320-327. [PMID: 36357542 DOI: 10.1007/s00223-022-01040-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/01/2022] [Indexed: 11/12/2022]
Abstract
Subchondral bone properties are associated with the pathogenesis of osteoarthritis (OA), but this relationship has not been confirmed in the trapeziometacarpal joint (TMCJ). We aimed to evaluate the thickness (SBT) and density (SBD) of three-dimensional (3D) trapezium subchondral bone models derived from computed tomography (CT) images, and their relationships with early-stage TMCJ OA. We reviewed patients with a distal radius fracture who underwent conventional CT scans and such osteoporosis evaluations as bone mineral density (BMD) and bone turnover markers (BTMs). From 3D trapezium subchondral bone models, we measured SBT and SBD according to the OA stage and performed multivariate analyses to evaluate their associations with age, sex, body mass index, BMD, and BTMs. As results, a total of 156 patients (78 men and 78 age-matched women; mean age, 67 ± 10 years) were analyzed. There were 30 (19%) with grade 0, 71 (45%) with grade 1, 13 (8%) with grade 2, and 42 (27%) with grade 3 TMCJ OA. SBT was significantly lower in patients with grade 1 OA than those with grade 0 or grade 3 OA, but SBD generally increased according to the OA severity. Low SBT was associated with low BMD, and low SBD with low BMD, high osteocalcin levels, and severe OA grades. In conclusion, patients with early-stage radiographic TMCJ OA have a lower SBT at the trapezium, which may support the potential role of subchondral bone in OA pathogenesis. This study also shows that subchondral bone properties are associated with BMD and osteocalcin levels.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Han Sang Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gumi-Ro 173, 82 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, South Korea
| | - Hyun Sik Gong
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Gumi-Ro 173, 82 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, South Korea.
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Hwang JS, Kwon HJ, Gong HS. A cross-sectional analysis of receptor for advanced glycation end-products in human skeletal muscle: a comparative analysis between patients with and without sarcopenia. Gerontology 2022; 69:526-532. [PMID: 36587609 DOI: 10.1159/000528160] [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] [Received: 04/20/2022] [Accepted: 11/15/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Animal studies suggest that advanced glycation end-products (AGEs) and their interaction with receptor for AGEs (RAGE) are involved in sarcopenia, but their relationship in human skeletal muscles has yet to be elucidated. We aimed to determine whether RAGE expression in human skeletal muscle is associated with serum AGE levels and sarcopenia-related changes. Methods We retrospectively reviewed 33 consecutive women (mean age, 65 years) with distal radius fracture who had consented to donate a sample of forearm muscle for research purposes, which was taken during surgical fracture repair. The muscle RAGE expression was measured with immunohistochemistry staining and serum AGE levels using ELISA method. We compared RAGE expression and AGE levels in patients with and without sarcopenia. We also correlated RAGE expression with such clinical parameters as demographic factors, as well as sarcopenia-related changes, including grip strength, appendicular skeletal muscle mass, and muscle cross-sectional area (CSA) ratios. Results Twelve patients (36%) were diagnosed with sarcopenia. They had a significantly higher RAGE expression (p = 0.044) and AGE level (p < 0.001) than those without sarcopenia. The RAGE expression correlated significantly with a high AGE level (r = 0.510, p = 0.011) and correlated inversely with a muscle CSA ratio (r = -0.696, p < 0.001). Discussion/Conclusion This study shows that RAGE expression increases in sarcopenic patient skeletal muscles. This expression also correlates positively with serum AGE levels and inversely with muscle CSA ratios. Further studies are necessary to determine whether targeting RAGEs can be a therapeutic option for sarcopenia.
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Lee JH, Hwang JS, Kang SY, Kim J. Postoperative evaluation of modified abductor pollicis longus suspensionplasty using two anchors: Preliminary results. Hand Surg Rehabil 2022; 41:669-674. [PMID: 36210046 DOI: 10.1016/j.hansur.2022.09.240] [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] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/06/2022] [Accepted: 09/25/2022] [Indexed: 11/29/2022]
Abstract
Among the various surgical treatments for basal joint arthritis, we modified abductor pollicis longus (APL) suspensionplasty by using two anchors. We hypothesized that this modification would prevent not only subsidence but also lateral migration of the first metacarpal. Thirteen thumbs that underwent APL suspensionplasty were investigated. Mean follow-up was 25 months (range, 12-69 months). Clinical and radiographic parameters were assessed preoperatively and postoperatively. Progression of subsidence (trapezial space) and lateral migration of the first metacarpal were investigated sequentially and with the thumb abducted or adducted against stress in a specifically designed mold. Clinical improvement was assessed by decrease in QuickDASH score (from 49.6 to 19.7). The immediate postoperative trapezial space decreased significantly by 39% (p = 0.003), and lateral migration was improved significantly by 14% (p = 0.007). At final follow-up, subsidence and lateral migration had not significantly progressed (p = 0.059 and 0.278, respectively). Under stress, the trapezial space ratio decreased significantly with the thumb in abduction (from 0.63 to 0.59, p = 0.011). APL suspensionplasty using two anchors in patients with basal joint arthritis maintained the position of the first metacarpal bone, and especially lateral subluxation. LEVEL OF EVIDENCE: IV.
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Affiliation(s)
- J H Lee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, 103, Daehakro, Jongro-gu, Seoul, 03080, Republic of Korea.
| | - J S Hwang
- Department of Orthopedic Surgery, Seoul National University Hospital, 101, Daehakro, Jongro-gu, Seoul, 03080, Republic of Korea.
| | - S Y Kang
- Department of Orthopedic Surgery, Seoul National University Hospital, 101, Daehakro, Jongro-gu, Seoul, 03080, Republic of Korea.
| | - J Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, 101, Daehakro, Jongro-gu, Seoul, 03080, Republic of Korea.
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Hwang JS, Li Q, Kim J. A quantitative measurement of trapeziometacarpal joint pressure using a cadaveric model of lateral pinch. J Orthop Res 2022; 40:1523-1528. [PMID: 34664302 DOI: 10.1002/jor.25188] [Citation(s) in RCA: 1] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/13/2021] [Accepted: 09/30/2021] [Indexed: 02/04/2023]
Abstract
Trapeziectomy is performed for trapeziometacarpal (TMC) arthritis but decreased lateral pinch strength is a major source of discomfort after the surgery. The magnitude of the decrease is unclear, however, and how the pressure changes in the TMC joint is unknown. To investigate this relationship, we designed a cadaveric study to measure TMC joint pressure using a lateral pinch model, and quantitatively evaluated the effect of trapeziectomy on the pressure measurements. For 10 cadaveric forearms, physiologic forces were applied across the thumb TMC joint by loading five tendons, thereby simulating lateral pinch. Using pressure sensors, we measured the lateral pinch pressure and TMC joint pressure, which averaged 10.1 (range, 4.2-16.2) kg/cm2 and 2.0 (range, 0.8-4.4) kg/cm2 , respectively. A significant correlation between the measurements was found, with an average ratio of 19% (range, 10%-27%). After trapeziectomy and interposition of the tendon ball using flexor carpi radialis, the pressure measurements were repeated under the same conditions. Significant changes were found, which averaged 5.1 (range, 1.7-10.7) kg/cm2 for lateral pinch pressure and 15.0 (range, 5.6-25.6) kg/cm2 for TMC joint pressure. In conclusion, TMC joint pressure could be measured as the ratio relative to lateral pinch pressure using a cadaveric model. After trapeziectomy, the lateral pinch strength decreased, whereas the TMC joint pressure increased.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Qingyuan Li
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Hand and Microsurgery, Tianjin Hospital, Tianjin, China
| | - Jihyeung Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
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Hwang JS, Kim J, Bae KJ, Lee Y, Baek GH. Rotational osteo-onychocutaneous flap for central polydactyly of the foot: A novel technique for correction of the deformity. J Plast Reconstr Aesthet Surg 2022; 75:2831-2870. [PMID: 35768289 DOI: 10.1016/j.bjps.2022.06.031] [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] [Received: 04/21/2021] [Revised: 04/20/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
Eccentric location of two nails like eyes of a bird are frequently observed in central polydactyly of the foot. A novel technique of rotational osteo-onychocutaneous (OOC) flap procedure is introduced to correct this deformity. Six children with central polydactyly of the foot who showed eccentric locations of nails were operated by this technique. Four patients were distal phalangeal type, and two middle phalangeal type. Preoperatively the angulation deformity of distal phalangeal type was average 16.8 (range, 2.3-48.0) degrees, and middle phalangeal type 10.3 (range, 2.9-17.7) degrees. The rotational OOC flap procedure was performed at average 24 (range, 12-51) months of age. Cosmetic and radiographic assessments were done after an average of 42 (range, 6-79) months of follow-up. All patients and their parents were satisfied with the cosmetic results. The angulation deformity was improved to average 4.2 (range, 0.5-11.2) degrees in distal phalangeal type, and 5.9 (range, 2.0-9.8) degrees in middle phalangeal type, respectively. Postoperative residual angulation deformity measured by simple radiographs were less than 5° in all patients. Complications such as partial necrosis of the flap were not found. In conclusion, our novel technique of rotational OOC flap procedure resulted in satisfactory outcome for patients with 'eyes of a bird' type toe nail deformity of central polydactyly of the foot. It corrected the angulation and rotational deformity of the toe nail of the main digit without causing any complications.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jihyeung Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Kee Jeong Bae
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Yohan Lee
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Goo Hyun Baek
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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Hwang JS, Lee S, Shin JW, Kim KW, Gong HS. The association of index-to-ring finger ratio with trapeziometacarpal joint osteoarthritis in an elderly Korean population. J Rheumatol Suppl 2022; 49:1152-1157. [PMID: 35705248 DOI: 10.3899/jrheum.211355] [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] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Index-to-ring finger ratio (IRFR) has been reported to be associated with joint osteoarthritis (OA). We aimed to evaluate the association between IRFR and trapeziometacarpal joint (TMCJ) OA in an elderly Korean population. METHODS A population-based sample included 604 participants with mean age of 74.8 years. IRFR was radiographically measured by the ratio of length of the right second to fourth phalangeal bones ("phalangeal IRFR") and metacarpal bones ("metacarpal IRFR"), and was visually classified as either type 1 (index finger longer than or equal to ring finger) or type 2 (index finger shorter than ring finger). Odds ratios (ORs) for the presence of OA (Kellgren-Lawrence (KL) grade > 1) and for severe OA (KL grade > 2) were analyzed using logistic regressions. RESULTS The phalangeal IRFR averaged 91.3%, the metacarpal IRFR 116.7%, and 304 out of 604 participants (50.3%) had type 2 IRFR. We found TMCJ OA in 112 participants (18.5%), and severe TMCJ OA in 37 participants (5.5%). Presence of TMCJ OA was significantly associated with age (OR 1.036; 95% CI 1.011-1.061) and metacarpal IRFR (OR 0.936; 95% CI 0.884-0.992), and severe TMCJ OA with age (OR 1.075; 95% CI 1.032-1.121) and type 2 IRFR (OR 3.057; 95% CI 1.128-8.288). CONCLUSION Radiographic, specifically metacarpal IRFR, was associated with the presence of TMCJ OA, and visual IRFR with severe TMCJ OA in both elderly Korean men and women. This study suggests that IRFR might serve as an easily measurable biomarker to identify patients vulnerable to TMCJ OA.
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Affiliation(s)
- Ji Sup Hwang
- This research was supported by a Grant from the Korean Health Technology R&D Project, Ministry of Health, Welfare, Republic of Korea (Grant No. A092077) and by the National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT) (Grant No. 2020R1A2C1005778). JS Hwang, MD; Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea; S Lee, MD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea; JW Shin, MD; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; KW Kim, MD, PhD; Department of Psychiatry, Seoul National University College of Medicine, Seongnam-si, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, South Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; HS Gong, MD, PhD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea. Address correspondence to Hyun Sik Gong, MD, PhD Department of Orthopedic surgery, Seoul National University Bundang Hospital Seoul National University College of Medicine Gumi-ro 173, 82 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea E-mail:
| | - Sanghoon Lee
- This research was supported by a Grant from the Korean Health Technology R&D Project, Ministry of Health, Welfare, Republic of Korea (Grant No. A092077) and by the National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT) (Grant No. 2020R1A2C1005778). JS Hwang, MD; Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea; S Lee, MD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea; JW Shin, MD; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; KW Kim, MD, PhD; Department of Psychiatry, Seoul National University College of Medicine, Seongnam-si, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, South Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; HS Gong, MD, PhD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea. Address correspondence to Hyun Sik Gong, MD, PhD Department of Orthopedic surgery, Seoul National University Bundang Hospital Seoul National University College of Medicine Gumi-ro 173, 82 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea E-mail:
| | - Jung Wook Shin
- This research was supported by a Grant from the Korean Health Technology R&D Project, Ministry of Health, Welfare, Republic of Korea (Grant No. A092077) and by the National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT) (Grant No. 2020R1A2C1005778). JS Hwang, MD; Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea; S Lee, MD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea; JW Shin, MD; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; KW Kim, MD, PhD; Department of Psychiatry, Seoul National University College of Medicine, Seongnam-si, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, South Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; HS Gong, MD, PhD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea. Address correspondence to Hyun Sik Gong, MD, PhD Department of Orthopedic surgery, Seoul National University Bundang Hospital Seoul National University College of Medicine Gumi-ro 173, 82 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea E-mail:
| | - Ki Woong Kim
- This research was supported by a Grant from the Korean Health Technology R&D Project, Ministry of Health, Welfare, Republic of Korea (Grant No. A092077) and by the National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT) (Grant No. 2020R1A2C1005778). JS Hwang, MD; Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea; S Lee, MD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea; JW Shin, MD; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; KW Kim, MD, PhD; Department of Psychiatry, Seoul National University College of Medicine, Seongnam-si, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, South Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; HS Gong, MD, PhD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea. Address correspondence to Hyun Sik Gong, MD, PhD Department of Orthopedic surgery, Seoul National University Bundang Hospital Seoul National University College of Medicine Gumi-ro 173, 82 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea E-mail:
| | - Hyun Sik Gong
- This research was supported by a Grant from the Korean Health Technology R&D Project, Ministry of Health, Welfare, Republic of Korea (Grant No. A092077) and by the National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT) (Grant No. 2020R1A2C1005778). JS Hwang, MD; Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea; S Lee, MD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea; JW Shin, MD; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; KW Kim, MD, PhD; Department of Psychiatry, Seoul National University College of Medicine, Seongnam-si, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, South Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea; HS Gong, MD, PhD; Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea. Address correspondence to Hyun Sik Gong, MD, PhD Department of Orthopedic surgery, Seoul National University Bundang Hospital Seoul National University College of Medicine Gumi-ro 173, 82 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea E-mail:
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Hwang JS, Kim MB, Lee YH. Radiographic and Clinical Outcomes of Non-Operative Treatment for Patients with Non-Union of Fractures of the Mid-Shaft of the Clavicle in Adults. J Hand Surg Asian Pac Vol 2022; 27:68-75. [PMID: 35135419 DOI: 10.1142/s2424835522500205] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Non-unions of clavicle fracture after conservative treatment have been treated surgically, but carry a risk of complications. The aim of this study is to report the outcomes of non-operative treatment for patients with non-union of fractures of the mid-shaft of the clavicle following initial conservative treatment. Methods: This is a retrospective study done at a single centre. Subjects with non-union after conservative treatment of clavicle mid-shaft fractures between March 2004 and February 2019 were included in this study. The exclusion criteria included follow-up period <1 year after the diagnosis of non-union and concomitant upper extremity injury. Final radiographs were assessed for fracture healing, vertical displacement, and shortening. Visual analog scale (VAS) pain scores, shoulder range of motion (ROM) and self-rated outcomes were obtained. Results: Fourteen patients (five females) with an average age of 58 (range, 29-76) years and a mean follow-up duration of 4.0 (range, 1.5-10.2) years were included in the study. The average vertical fracture displacement was 188.7 (range, 95.4-301.4) percent and the average shortening was 13.2 (range, 2.7-16.9) percent. The average VAS pain score was 0.21 (range, 0-2) points. There was no significant difference in the ROM between the injured and uninjured shoulder (p = 0.715 for forward flexion, 0.070 for abduction and 0.714 for external rotation) and the Constant shoulder score (p = 0.190). Thirteen of the 14 patients were satisfied with the treatment, and 12 returned to their pre-injury level of sports participation. Conclusions: Non-operative treatment resulted in a favourable outcome for patients with non-union of clavicle fracture after conservative treatment. Self-rated outcome score was excellent, regardless of the presence of radiographic abnormalities. Level of Evidence: Level IV (Therapeutic).
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Affiliation(s)
- Ji Sup Hwang
- Seoul National University Hospital, Seoul, Republic of Korea.,
| | - Min Bom Kim
- Seoul National University Hospital, Seoul, Republic of Korea.,
| | - Young Ho Lee
- Seoul National University Hospital, Seoul, Republic of Korea.,
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11
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Hwang JS, Shim BJ, Li Q, Kim J, Baek GH. The Natural History of Kienböck’s Disease Diagnosed at More than Fifty Years of Age. Clin Orthop Surg 2022; 14:450-457. [PMID: 36061838 PMCID: PMC9393282 DOI: 10.4055/cios22022] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/23/2022] [Accepted: 05/18/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Ji Sup Hwang
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Bum Jin Shim
- Department of Orthopaedic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Qingyuan Li
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Hand and Microsurgery, Tianjin Hospital, Tianjin, China
| | - Jihyeung Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Goo Hyun Baek
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
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Hwang JS, Lee S, Gong HS. The impact of acute fracture on interpretation of bone turnover marker measurements for patients starting anti-resorptive therapies. Bone 2022; 154:116199. [PMID: 34534710 DOI: 10.1016/j.bone.2021.116199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/24/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Bone turnover markers (BTM) are used in evaluating patients' response to anti-resorptive agents (ARA). Fracture and its healing process, however, can influence the measurements, which might make their interpretation difficult in patients with a recent fracture. We aimed to evaluate the effect of oral ARA on changes in BTM levels in patients with a recent distal radius fracture (DRF). METHODS In 143 women who had a new DRF and then received oral ARA including selective estrogen receptor modulator (SERM, n = 101), and bisphosphonate (n = 42), we measured serum cross-linked C-telopeptides of type I collagen (CTXI) and osteocalcin, at baseline and six months, as well as lumbar and total hip bone mineral density (BMD) at baseline and one year after fracture. We determined the predictive value of BTM at six months in determining one-year responses in BMD. RESULTS Both BTM levels decreased significantly at six months, with the average decrease of 27 ± 63% for CTX-I and 11% ± 37% for osteocalcin. The percent changes of BTM at six months were independent predictors of the BMD change. Cutoff points of 50.0% CTX-I decrease and 23.5% for osteocalcin decrease had the highest sensitivities and specificities for detecting BMD responders for bisphosphonate users, but cutoffs could not be found for SERM users. CONCLUSION Although a fresh fracture can influence BTM, ARA therapy significantly reduced their levels and their percent change at six months could predict BMD improvement at one year. However, adjusted cutoff points can be necessary to increase sensitivity for detecting patients responsive to ARA treatment after a new DRF.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea
| | - Sanguk Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, South Korea.
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Kim JS, Shah GM, Chae YJ, Hwang JS, Ahn JM, Gong HS. Ulnar nerve morphology on magnetic resonance imaging predicts nerve recovery after surgery for cubital tunnel syndrome. Hand Surg Rehabil 2021; 41:90-95. [PMID: 34763114 DOI: 10.1016/j.hansur.2021.10.316] [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] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
Magnetic resonance imaging (MRI) can evaluate nerve morphology in cubital tunnel syndrome (CuTS), but its value in predicting surgical outcome is unclear. The purpose of this study was to determine whether ulnar nerve morphology on MRI correlated with outcome after CuTS surgery. We reviewed 40 patients who had preoperative MRI and electrodiagnostic (EDX) examinations for CuTS and outcome evaluation 6 months and 2 years postoperatively. Using MRI, ulnar nerve cross-sectional area (UNCSA), changes in signal intensity, and any space-occupying lesion were evaluated. Other factors assessed were age, symptom duration and severity, type-2 diabetes and EDX parameters. Factors associated with unfavorable surgical outcome were identified. At 6 months postoperatively, 12 patients (30%) had excellent, 19 (47.5%) good, 8 (20%) fair and 1 (2.5%) poor results on modified Wilson-Krout criteria. On univariate analysis, unfavorable outcomes were associated with increased UNCSA, space-occupying lesion, and decreased motor nerve conduction velocity (mNCV), and on multivariate analysis with increased UNCSA 1 cm distal from the epicondyle only (model 1) or increased UNCSA 1 cm proximal from the epicondyle and decreased mNCV (model 2). At 2 years, 15 patients (37.5%) had excellent, 21 (52.5%) good, 3 (7.5%) fair and 1 (2.5%) poor results, and no factors correlated with unfavorable outcome. Increased UNCSA on MRI was associated with unfavorable outcome at 6 months but not at 2 years. This study suggests that morphologic ulnar nerve changes can predict delayed nerve recovery after surgery for CuTS.
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Affiliation(s)
- J S Kim
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
| | - G M Shah
- Department of Orthopedics and Trauma Surgery, Patan Academy of Health Sciences, Lagankhel-5, 44700 Bagmati, Nepal
| | - Y J Chae
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
| | - J S Hwang
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
| | - J M Ahn
- Department of Radiology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea
| | - H S Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
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Park JW, Hwang JS, Gong HS. Rheumatoid Hand Surgery in the Era of Biologic Therapy: A Rheumatologist-oriented Overview. J Rheum Dis 2021; 28:192-201. [PMID: 37476361 PMCID: PMC10324912 DOI: 10.4078/jrd.2021.28.4.192] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/28/2021] [Accepted: 07/12/2021] [Indexed: 07/22/2023]
Abstract
Rheumatoid arthritis (RA) can cause significant hand and wrist damage and dysfunction. The aim of medical treatment is to eradicate inflammation and prevent damage to joints and soft tissues. Advances in newer biological therapies over the last two decades have resulted in greater remission rates and lower disease activity status. Despite these improvements, surgical intervention is still indicated in cases of disability, irreversible deformities, and severe pain. However, there are large variations in the surgical rates of common rheumatoid hand procedures, which may indicate clinical uncertainty or disagreement between treating rheumatologists and hand surgeons. In this review, we provide a basic overview of common problems of the hand and wrist in RA patients. The target audience is rheumatologists for their better understanding of surgical options and for better informed patient consultation before referring to hand surgeons.
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Affiliation(s)
- Jin Woo Park
- Department of Orthopedic Surgery, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Ji Sup Hwang
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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15
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Hwang JS, Lee Y, Bae KJ, Kim J, Baek GH. In Situ Neurolysis of Ulnar Nerve for Patients With Failed Anterior Subcutaneous Transposition - A Case Series. Oper Neurosurg (Hagerstown) 2021; 21:111-117. [PMID: 34100080 PMCID: PMC8521744 DOI: 10.1093/ons/opab171] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/19/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Various surgical techniques have been attempted to treat patients with failed anterior subcutaneous transposition performed for cubital tunnel syndrome. OBJECTIVE To analyze intraoperative findings of failed anterior subcutaneous transposition and to report the outcome of in Situ neurolysis of ulnar nerve. METHODS Patients who, under diagnosis of failed anterior subcutaneous transposition of ulnar nerve, underwent in Situ neurolysis between 2001 and 2018 were included in this study. We excluded patients with follow-up of less than one year, records of traumatic ulnar nerve injury, and concomitant double crush syndrome such as cervical spondylosis causing radicular pain, ulnar tunnel syndrome, or thoracic outlet syndrome. Surgical outcomes were evaluated using visual analog scale (VAS) pain score and Disabilities of the Arm, Shoulder, and Hand (DASH) score, which were assessed before and after surgery. A total of 28 elbows in 27 patients whose average age was 58.5 (range, 31-76) yr were enrolled, and the duration of follow-up was 5.8 (range, 1.0-14.9) yr. RESULTS The most common pathologic finding identified during operation was severe adhesion of the transposed nerve in all elbows, followed by incomplete decompression of deep flexor-pronator aponeurosis in 26 elbows (93%). The average VAS pain score improved from 4.9 (range, 2-7) to 1.3 (range, 0-5), and the average DASH score from 31.7 (range, 18.1-66.7) to 14.1 (range, 5.0-46.6). Of the 28 elbows, 27 (96.4%) showed improvement of preoperative symptoms. CONCLUSION In Situ neurolysis of ulnar nerve for patients with failed anterior subcutaneous transposition resulted in satisfactory outcome.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yohan Lee
- Department of Orthopaedic Surgery, Seoul National University Boramae Hospital, Seoul, Republic of Korea
| | - Kee Jeong Bae
- Department of Orthopaedic Surgery, Seoul National University Boramae Hospital, Seoul, Republic of Korea
| | - Jihyeung Kim
- Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Goo Hyun Baek
- Department of Orthopaedic Surgery, College of Medicine, Seoul National University, Seoul, Republic of Korea
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Lee JH, Kim J, Hwang JS, Baek GH. Improvement in lunate perfusion after radial closing-wedge osteotomy in patients with Kienböck's disease. Hand Surg Rehabil 2021; 40:588-594. [PMID: 34147670 DOI: 10.1016/j.hansur.2021.06.005] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/12/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
Radial closing-wedge osteotomy is a widely accepted treatment for Kienböck's disease. However, despite favorable long-term clinical outcomes, its impact on lunate perfusion has not been documented. The purpose of this study was to determine whether radial closing wedge osteotomy improved lunate perfusion on gadolinium (Gd)-enhanced magnetic resonance imaging (MRI). We conducted a retrospective review of 12 patients with Kienböck's disease who received radial closing wedge osteotomy. Mean age at surgery was 25 years. Preoperative Gd-enhanced MRI was performed in 7 patients. After bone union, implants were removed and MRI was repeated. Two patients were classified as Lichtman stage IIIA, and 5 as stage IIIB. Percentage pre- to post-operative perfused lunate volume was compared on MRI. At last follow-up, mean QuickDASH score improved from 43.7 to 6.2. Pre- to post-operative lunate fragmentation, collapse and perfusion were compared qualitatively on MRI. On quantitative analysis, perfusion increased from 24% to 54% (p = 0.018) using our method of measuring percentage perfused lunate volume. The method showed satisfactory reproducibility. Investigation using Gd-enhanced MRI suggested that radial closing wedge osteotomy increases lunate perfusion.
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Affiliation(s)
- J H Lee
- Department of Orthopedic Surgery, Seoul National University Hospital, 101, Daehakro, Jongro-gu, Seoul, 03080, Republic of Korea.
| | - J Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, 101, Daehakro, Jongro-gu, Seoul, 03080, Republic of Korea.
| | - J S Hwang
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82, Gumiro 173, Beongil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
| | - G H Baek
- Department of Orthopedic Surgery, Seoul National University Hospital, 101, Daehakro, Jongro-gu, Seoul, 03080, Republic of Korea.
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17
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Hwang JS, Kim J, Kim S, Bae KJ, Lee Y, Baek GH. Diagnosis of Neurogenic Thoracic Outlet Syndrome Based on the Clinical Status. Ann Vasc Surg 2021; 76:454-462. [PMID: 33905846 DOI: 10.1016/j.avsg.2021.03.051] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/18/2020] [Accepted: 03/31/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES At our institute, we devised a clinical algorithm for diagnosis of neurogenic thoracic outlet syndrome (TOS). Our approach assisted in the accurate diagnosis and in detection of patients likely to benefit from surgical treatment. The purposes of this study were to propose our diagnostic approach to neurogenic TOS, and to describe the outcomes of surgical and conservative treatment. METHODS Patients (n = 91) who were suspected to have neurogenic TOS, and therefore, underwent a routine clinical protocol from January 2012 to January 2018 were reviewed. Through the clinical protocol, diagnosis of "true neurologic TOS", "symptomatic TOS", and "not likely TOS" was made. The visual analog scale (VAS) pain score and Disabilities of the Arm, Shoulder and Hand (DASH) score were used to assess the treatment outcomes. Satisfaction with surgery was assessed according to the Derkash classification as excellent, good, fair, or poor. RESULTS Among 91 patients with presumed neurogenic TOS, 25 patients were "true neurologic TOS", 61 patients were "symptomatic TOS", and five patients were "not likely TOS". Nineteen patients underwent supraclavicular decompression of the brachial plexus whose mean age at the time of surgery was 36.4 years. The VAS average pain score improved from 3.6 to 0.8, and the DASH score improved from 38.4 to 17.1. According to the Derkash classification, ten patients (53%) rated their recovery as excellent, four (21%) as good, and five (26%) as fair. Sixty-seven patients underwent conservative treatment. At the last follow-up visit, their VAS and DASH score were 2.3 and 11.8, respectively. CONCLUSIONS By using an algorithm, we diagnosed the patients suspected to have neurogenic TOS into three groups based on clinical status. We surgically treated 19 patients using supraclavicular approach, and achieved favorable outcomes.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopaedic Surgery, Seoul National University, College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Jihyeung Kim
- Department of Orthopaedic Surgery, Seoul National University, College of Medicine, Jongno-gu, Seoul, Republic of Korea.
| | - Shin Kim
- Department of Orthopaedic Surgery, Seoul National University, College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Kee Jeong Bae
- Department of Orthopaedic Surgery, Seoul National University, College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Yohan Lee
- Department of Orthopaedic Surgery, Seoul National University, College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Goo Hyun Baek
- Department of Orthopaedic Surgery, Seoul National University, College of Medicine, Jongno-gu, Seoul, Republic of Korea
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18
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Hwang JS, Kim YJ, Yoo YJ, Kim KW, Rhee JY, Chen LY, Li SR, Guo XW, Lee YP. Tunable quad-band transmission response, based on single-layer metamaterials. Opt Express 2018; 26:31607-31616. [PMID: 30650744 DOI: 10.1364/oe.26.031607] [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] [Received: 09/17/2018] [Accepted: 11/04/2018] [Indexed: 06/09/2023]
Abstract
We investigated the electromagnetically induced transparency (EIT)-like effects in planar metamaterials (MMs) at microwave (GHz) frequencies. The specific MMs that were used in this study consist of cut-wire resonator/ring resonator, which achieved the dual EIT-like effects in a single-layer through the bright- and quasi-dark-mode coupling and the lattice mode coupling. In addition, by varying the distance between the two resonators, the quad-band EIT spectral response in the microwave region was obtained, and the group refractive index at the EIT-like resonance of proposed design reached up to 4,000. This study provides the design approach to the multispectral EIT-like effects and might suggest potential applications in a variety of fields, for example, low-loss slow-light device, multiple switching sensor, and other sensing devices.
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Lee YK, Moon KH, Kim JW, Hwang JS, Ha YC, Koo KH. Remaining Loose Bodies after Arthroscopic Surgery Including Extensive Capsulectomy for Synovial Chondromatosis of the Hip. Clin Orthop Surg 2018; 10:393-397. [PMID: 30505405 PMCID: PMC6250970 DOI: 10.4055/cios.2018.10.4.393] [Citation(s) in RCA: 6] [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: 04/12/2018] [Accepted: 09/17/2018] [Indexed: 11/20/2022] Open
Abstract
Background The purpose of our study was to evaluate the usefulness of hip arthroscopy including extensive capsulectomy for synovial chondromatosis of the hip. Methods From 2008 to 2016, 13 patients with synovial chondromatosis of the hip were treated with arthroscopic removal of loose bodies and synovectomy using three arthroscopic portals. An extensive capsulectomy was performed to allow the remaining loose bodies to be out of the extracapsular space, and the excised capsule was not repaired. All patients were assessed by clinical scores and the radiographs were reviewed to determine whether the remaining loose bodies disappeared at the last follow-up. Results Eight men and two women were followed up for a minimum of 1 year (mean, 3.8 years; range, 1 to 6.8 years) after hip arthroscopy. Clinical outcomes such as modified Harris hip score, University of California Los Angeles score, and Western Ontario and McMaster Universities Osteoarthritis Index score improved at the last follow-up. Although seven hips had remaining loose bodies after arthroscopic surgery, the remaining loose bodies disappeared in five hips (71.4%) at the last follow-up. Conclusions Arthroscopic surgery was useful to treat synovial chondromatosis of the hip. In spite of limited removal of loose bodies, arthroscopic procedures including extensive capsulectomy could be effective for the treatment of synovial chondromatosis of the hip.
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Affiliation(s)
- Young-Kyun Lee
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyung Ho Moon
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jin-Woo Kim
- Department of Orthopaedic Surgery, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
| | - Ji Sup Hwang
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kyung-Hoi Koo
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Kim HJ, Kang KT, Chun HJ, Hwang JS, Chang BS, Lee CK, Yeom JS. Comparative study of 1-year clinical and radiological outcomes using robot-assisted pedicle screw fixation and freehand technique in posterior lumbar interbody fusion: A prospective, randomized controlled trial. Int J Med Robot 2018; 14:e1917. [DOI: 10.1002/rcs.1917] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 03/17/2018] [Accepted: 04/01/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Ho-Joong Kim
- Spine Center and Department of Orthopaedic Surgery; Seoul National University College of Medicine and Seoul National University Bundang Hospital; Sungnam Republic of Korea
| | - Kyoung-Tak Kang
- Department of Mechanical Engineering; Yonsei University; Seoul Republic of Korea
| | - Heoung-Jae Chun
- Department of Mechanical Engineering; Yonsei University; Seoul Republic of Korea
| | - Ji Sup Hwang
- Spine Center and Department of Orthopaedic Surgery; Seoul National University College of Medicine and Seoul National University Bundang Hospital; Sungnam Republic of Korea
| | - Bong-Soon Chang
- Department of Orthopaedic Surgery; Seoul National University College of Medicine and Seoul National University Hospital; Seoul Republic of Korea
| | - Choon-Ki Lee
- Department of Orthopaedic Surgery; Seoul National University College of Medicine and Seoul National University Hospital; Seoul Republic of Korea
| | - Jin S. Yeom
- Spine Center and Department of Orthopaedic Surgery; Seoul National University College of Medicine and Seoul National University Bundang Hospital; Sungnam Republic of Korea
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21
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Kim J, Suh BK, Ko CW, Lee KH, Shin CH, Hwang JS, Kim HS, Chung WY, Kim CJ, Han HS, Kwon NY, Cho SY, Yoo HW, Jin DK. Recombinant growth hormone therapy for prepubertal children with idiopathic short stature in Korea: a phase III randomized trial. J Endocrinol Invest 2018; 41:475-483. [PMID: 29103133 PMCID: PMC5852196 DOI: 10.1007/s40618-017-0786-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/25/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Several studies have evaluated the effects of growth hormone (GH) on auxological and biochemical parameters in children with non-GH-deficient, idiopathic short stature (ISS). This study evaluated the efficacy and safety of Growtropin®-II (recombinant human GH) in Korean patients with ISS. METHODS This was a 1-year, open-label, multicenter, phase III randomized trial of Growtropin®-II in Korean patients with ISS. In total, 70 prepubertal subjects (39 males, 31 females) between 4 and 12 years of age were included in the study. All patients were naive to GH treatment. RESULTS Annual height velocity was significantly higher in the treatment group (10.68 ± 1.95 cm/year) than the control group (5.72 ± 1.72, p < 0.001). Increases in height and weight standard deviation scores (SDSs) at 26 weeks were 0.63 ± 0.16 and 0.64 ± 0.46, respectively, for the treatment group, and 0.06 ± 0.15 and 0.06 ± 0.28, respectively, for the control group (p < 0.001). Serum insulin-like growth factor (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) increased significantly in the treatment group at week 26 compared to baseline. However, the SDS for body mass index (BMI) at 26 weeks did not change significantly in either group. Growtropin®-II was well tolerated and safe over 1 year of treatment. CONCLUSIONS One-year GH treatment for prepubertal children with ISS demonstrated increased annualized velocity, height and weight SDSs, and IGF-1 and IGFBP-3 levels, with a favorable safety profile. Further evaluations are needed to determine the optimal dose, final adult height, and long-term effects of ISS treatment.
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Affiliation(s)
- J Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - B-K Suh
- Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - C W Ko
- Department of Pediatrics, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - K-H Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Republic of Korea
| | - C H Shin
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - J S Hwang
- Department of Pediatrics, Ajou University Hospital, Suwon, Republic of Korea
| | - H S Kim
- Department of Pediatrics, Severance Hospital, Onsei University Health System, Seoul, Republic of Korea
| | - W Y Chung
- Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - C J Kim
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - H-S Han
- Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - N Y Kwon
- Data Management and Clinical Statistics Team, Dong-A ST Co., LTD, Seoul, Republic of Korea
| | - S Y Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - H-W Yoo
- Department of Pediatrics, Medical Genetics Clinic and Laboratory, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - D-K Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
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Lee YK, Yoon BH, Hwang JS, Cha YH, Kim KC, Koo KH. Risk factors of fixation failure in basicervical femoral neck fracture: Which device is optimal for fixation? Injury 2018; 49:691-696. [PMID: 29433801 DOI: 10.1016/j.injury.2018.02.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 12/18/2017] [Revised: 01/31/2018] [Accepted: 02/07/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Basicervical femur neck fracture (FNF) is a rare type of fracture, and is associated with increased risk of fixation failure due to its inherent instability. The purpose of this study was (1) to investigate the incidence of fixation failure and (2) to determine risk factors for fixation failure in basicervical FNF after internal fixation. METHODS To identify basicervical FNF with a minimum of 12 months follow-up, we retrospectively reviewed records of 3217 patients who underwent hip fracture surgery from May 2003 to March 2016. Among the identified 77 patients with basicervical FNF, 69 patients were followed up for at least 12 months. We evaluated the rate of collapse of fracture site and reoperation due to fixation failure. We performed a multivariable analysis to determine risk factors associated with fracture site collapse and fixation failure. RESULTS Among the 69 patients with basicervical FNF, 17 (24.6%) showed collapse of fracture site, and 6 (8.6%) underwent conversion to arthroplasty because of fixation failure. In the multivariable analysis, use of extramedullary plating with a sliding hip screw was an independent significant risk factor for both collapse of fracture site (odds ratio 6.84; 95% confidence interval 1.91-24.5, p = 0.003) and fixation failure (odds ratio 12.2; 95% confidence interval 1.08-137.7, p = 0.042). CONCLUSIONS Basicervical FNF treated with extramedullary plate with a sliding hip screw is more likely to fail than that treated with intramedullary nail with a helical blade. Our results suggested that intramedullary nail with a helical blade is more recommended for basicervical FNF compared with extramedullary plate with a sliding hip screw. LEVEL OF EVIDENCE III, Retrospective cohort study.
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Affiliation(s)
- Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Byung-Ho Yoon
- Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, South Korea.
| | - Ji Sup Hwang
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Yong-Han Cha
- Department of Orthopedic Surgery, Eulji University Hospital, 95, Dunsanseo-ro, Seo-gu 35233, South Korea.
| | - Ki-Choul Kim
- Department of Orthopaedic Surgery, Dankook University College of Medicine, Dongnam-gu, Cheonan-si, Chungcheongnam-do, South Korea.
| | - Kyung-Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
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Mahjoub MS, Dur G, Souissi S, Schmitt FG, Hwang JS. Multifractal anisotropic swimming: the optimal foraging behaviour of grouper larvae. J Fish Biol 2016; 88:1835-1846. [PMID: 27021375 DOI: 10.1111/jfb.12948] [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] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 02/09/2016] [Indexed: 06/05/2023]
Abstract
It was hypothesized that the Malabar grouper Ephinephelus malabaricus larvae have developed search patterns adapted to the distribution of their prey to maximise their net energy intake per unit time. Analysis of the swimming behaviour of E. malabaricus larvae in both the presence and absence of Artemia sp. nauplii is presented to test this hypothesis. A method derived from turbulence studies (the moment function of the displacements) was used to characterize the behaviour. The results revealed that larval swimming pattern was multifractal (intermittent and long-range-correlated) and isotropic (i.e. uniform in all directions) in the presence of prey, but multifractal and anisotropic (i.e. more frequent long displacement on the vertical axis) in the absence of prey. It is suggested that the search behaviour observed in the absence of prey is an adaptive response to prey distribution pattern, which is often characterised by multifractality and anisotropy (i.e. larger patches on the horizontal axes). In the presence of prey, E. malabaricus shifted to intensive search behaviour. Other possible contributors to the observed patterns are discussed. It is concluded that multifractality and anisotropy of swimming patterns observed in the experiment are mainly explained in an optimal foraging theory framework.
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Affiliation(s)
- M S Mahjoub
- Univ. Lille, CNRS, Univ. Littoral Cote d'Opale, UMR 8187, LOG, Laboratoire d'Océanologie et de Géosciences, F 62 126 Wimereux, France
- Institute of Marine Biology, National Taiwan Ocean University, 202 Keelung, Taiwan
| | - G Dur
- Institute of Marine Biology, National Taiwan Ocean University, 202 Keelung, Taiwan
| | - S Souissi
- Univ. Lille, CNRS, Univ. Littoral Cote d'Opale, UMR 8187, LOG, Laboratoire d'Océanologie et de Géosciences, F 62 126 Wimereux, France
| | - F G Schmitt
- Univ. Lille, CNRS, Univ. Littoral Cote d'Opale, UMR 8187, LOG, Laboratoire d'Océanologie et de Géosciences, F 62 126 Wimereux, France
| | - J S Hwang
- Institute of Marine Biology, National Taiwan Ocean University, 202 Keelung, Taiwan
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Lee HS, Jin HS, Shim YS, Jeong HR, Kwon E, Choi V, Kim MC, Chung IS, Jeong SY, Hwang JS. Low Frequency of MKRN3 Mutations in Central Precocious Puberty Among Korean Girls. Horm Metab Res 2016; 48:118-22. [PMID: 25938887 DOI: 10.1055/s-0035-1548938] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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] [Indexed: 10/23/2022]
Abstract
Mutations of MKRN3, the gene encoding makorin RING-finger protein 3, lead to central precocious puberty (CPP). The aim of this study was to investigate mutations of the MKRN3 gene in Korean girls with CPP. Two hundred-sixty Korean girls with idiopathic CPP were included. Auxological and endocrine parameters were measured, and the entire MKRN3 gene was directly sequenced. MKRN3 gene analysis revealed one novel nonsense mutation (p.Gln281 *) and 6 missense variants (p.Ile100Phe, p.Gly196Val, p.Ile204Thr, p.Gln226Pro, p.Lys233Asn, and p.Ser396Arg). The novel nonsense mutation (p.Gln281 *) was a heterozygous C>T nucleotide change (c.841C>T) predicted to result in a truncated protein due to a premature stop codon in the MKRN3 gene. The nonsense mutation (p.Gln281 *) was only identified in one of the girls and her younger brother. Compared to previous reports on MKRN3 mutations in familial and sporadic cases of CPP, the present study reveals a relatively low number of MKRN 3 mutations in Korean girls with CPP. Larger samples of children with CPP and MKRN3 mutations are necessary in order to clarify whether the clinical course of puberty may differ as compared to idiopathic CPP.
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Affiliation(s)
- H S Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - H-S Jin
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Y S Shim
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - H R Jeong
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - E Kwon
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - V Choi
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - M-C Kim
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - I-S Chung
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - S-Y Jeong
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - J S Hwang
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Republic of Korea
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Yoo T, Ham SA, Hwang JS, Lee WJ, Paek KS, Oh JW, Kim JH, Do JT, Han CW, Kim JH, Seo HG. Peroxisome proliferator-activated receptor δ inhibits Porphyromonas gingivalis lipopolysaccharide-induced activation of matrix metalloproteinase-2 by downregulating NADPH oxidase 4 in human gingival fibroblasts. Mol Oral Microbiol 2015; 31:398-409. [PMID: 26403493 DOI: 10.1111/omi.12137] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 02/02/2023]
Abstract
We investigated the roles of peroxisome proliferator-activated receptor δ (PPARδ) in Porphyromonas gingivalis-derived lipopolysaccharide (Pg-LPS)-induced activation of matrix metalloproteinase 2 (MMP-2). In human gingival fibroblasts (HGFs), activation of PPARδ by GW501516, a specific ligand of PPARδ, inhibited Pg-LPS-induced activation of MMP-2 and generation of reactive oxygen species (ROS), which was associated with reduced expression of NADPH oxidase 4 (Nox4). These effects were significantly smaller in the presence of small interfering RNA targeting PPARδ or the specific PPARδ inhibitor GSK0660, indicating that PPARδ is involved in these events. In addition, modulation of Nox4 expression by small interfering RNA influenced the effect of PPARδ on MMP-2 activity, suggesting a mechanism in which Nox4-derived ROS modulates MMP-2 activity. Furthermore, c-Jun N-terminal kinase and p38, but not extracellular signal-regulated kinase, mediated PPARδ-dependent inhibition of MMP-2 activity in HGFs treated with Pg-LPS. Concomitantly, PPARδ-mediated inhibition of MMP-2 activity was associated with the restoration of types I and III collagen to levels approaching those in HGFs not treated with Pg-LPS. These results indicate that PPARδ-mediated downregulation of Nox4 modulates cellular redox status, which in turn plays a critical role in extracellular matrix homeostasis through ROS-dependent regulation of MMP-2 activity.
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Affiliation(s)
- T Yoo
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
| | - S A Ham
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
| | - J S Hwang
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
| | - W J Lee
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
| | - K S Paek
- Department of Nursing, Semyung University, Chungbuk, Korea
| | - J W Oh
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
| | - J H Kim
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
| | - J T Do
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
| | - C W Han
- Department of Internal Medicine, Pusan National University School of Korean Medicine, Yangsan, Kyeongnam, Korea
| | - J H Kim
- Department of Biomedical Science, CHA University, Seongnam, Gyeonggi-Do, Korea
| | - H G Seo
- Department of Animal Biotechnology, Konkuk University, Seoul, Korea
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Abstract
AIMS To investigate the association between early menarche (menarche age < 12 years) and Type 2 diabetes mellitus in young and middle-aged Korean women. METHODS We analysed data for 4657 women aged 20-50 years from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009). RESULTS The prevalence of Type 2 diabetes was 2.8%. Women with early menarche had a higher prevalence of impaired fasting glucose than did women with later menarche (age ≥ 12 years) in the 20-30 age group (7.4% vs. 3.0%), and a higher prevalence of diabetes in the 30-40 (6.3% vs. 1.7%) and 40-50 (18.5% vs. 4.4%) age groups. The odds ratio (OR) of Type 2 diabetes in women with early menarche was 3.61 [95% confidence interval (CI), 1.90-6.88] after adjusting for age. In multivariate regression, the OR of Type 2 diabetes decreased to 2.52 (95% CI, 1.29-4.94) after further adjusting for BMI. However, the OR decreased to 2.04 (95% CI, 0.95-4.39) without significance after adjusting for HOMA-IR. CONCLUSIONS Early menarche increased the risk of Type 2 diabetes in young and middle-aged Korean women although adulthood adiposity attenuated the relationship. Knowledge of age at menarche is important in identifying women at risk for diabetes.
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Affiliation(s)
- J S Lim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
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27
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Oh SH, Lee YE, Kim DY, Lee JH, Kim D, Hwang JS, Bae SC, Ahn JH, Sung YK. Comparison of Diagnostic Strategies to Detect Prevalent Vertebral Fracture for Adults Over Age 50: Use of Vertebral Fracture Assessment or Spine Radiography. Value Health 2014; 17:A381. [PMID: 27200850 DOI: 10.1016/j.jval.2014.08.2618] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S H Oh
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Y E Lee
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - D Y Kim
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - J H Lee
- Inje University Ilsan paik Hospital, Seoul, South Korea
| | - D Kim
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - J S Hwang
- National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, South Korea
| | - S C Bae
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
| | - J H Ahn
- National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Y K Sung
- Hanyang University Hospital for Rheumatic Diseases, Seoul, South Korea
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28
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Hwang JS, Lee WJ, Kang ES, Ham SA, Yoo T, Paek KS, Lim DS, Do JT, Seo HG. Ligand-activated peroxisome proliferator-activated receptor-δ and -γ inhibit lipopolysaccharide-primed release of high mobility group box 1 through upregulation of SIRT1. Cell Death Dis 2014; 5:e1432. [PMID: 25275593 PMCID: PMC4649513 DOI: 10.1038/cddis.2014.406] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [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: 03/21/2014] [Revised: 06/25/2014] [Accepted: 07/22/2014] [Indexed: 12/24/2022]
Abstract
Peroxisome proliferator-activated receptors (PPARs) inhibit lipopolysaccharide (LPS)-primed release of high mobility group box 1 (HMGB1), a late proinflammatory mediator, but the underlying molecular mechanism is not completely understood. In this study, we demonstrated that the inhibition of HMGB1 release by PPAR-δ and -γ is associated with the deacetylase activity of SIRT1. Ligand-activated PPAR-δ and -γ inhibited LPS-primed release of HMGB1, concomitant with elevation in SIRT1 expression and promoter activity. These effects were significantly reduced in the presence of small interfering (si)RNAs against PPAR, indicating that PPAR-δ and -γ are involved in both HMGB1 release and SIRT1 expression. In addition, modulation of SIRT1 expression and activity by siRNA or chemicals correspondingly influenced the effects of PPARs on HMGB1 release, suggesting a mechanism in which SIRT1 modulates HMGB1 release. Furthermore, we showed for the first time that HMGB1 acetylated in response to LPS or p300/CBP-associated factor (PCAF) is an effective substrate for SIRT1, and that deacetylation of HMGB1 is responsible for blockade of HMGB1 release in macrophages. Finally, acetylation of HMGB1 was elevated in mouse embryonic fibroblasts from SIRT1-knockout mice, whereas this increase was completely reversed by ectopic expression of SIRT1. These results indicate that PPAR-mediated upregulation of SIRT1 modulates the status of HMGB1 acetylation, which, in turn, has a critical role in the cellular response to inflammation through deacetylation-mediated regulation of HMGB1 release.
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Affiliation(s)
- J S Hwang
- Department of Animal Biotechnology, Konkuk University, Seoul, Republic of Korea
| | - W J Lee
- Department of Animal Biotechnology, Konkuk University, Seoul, Republic of Korea
| | - E S Kang
- Department of Animal Biotechnology, Konkuk University, Seoul, Republic of Korea
| | - S A Ham
- Department of Animal Biotechnology, Konkuk University, Seoul, Republic of Korea
| | - T Yoo
- Department of Animal Biotechnology, Konkuk University, Seoul, Republic of Korea
| | - K S Paek
- Department of Nursing, Semyung University, Jecheon, Republic of Korea
| | - D S Lim
- Department of Applied Bioscience, College of Life Science, CHA University, Seongnam, Korea
| | - J T Do
- Department of Animal Biotechnology, Konkuk University, Seoul, Republic of Korea
| | - H G Seo
- Department of Animal Biotechnology, Konkuk University, Seoul, Republic of Korea
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29
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Abstract
Estrogen plays a crucial role in the development and function in reproductive physiology. Estrogens regulate cellular activity through binding to estrogen receptor α (ERα) and β (ERβ). ERα polymorphisms have been associated with changes in age at menarche, menopause onset, and fertility. The aim of this study is to investigate the relationship of ERα gene polymorphisms with central precocious puberty (CPP) in girls. Two hundred and one (201) Korean girls with idiopathic CPP were included in this study along with 100 healthy Korean female adults with pubertal maturation within normal age who served controls. Auxological and endocrine parameters were measured, and both patients and controls were genotyped for PvuII (397 T→C) and XbaI (351 A→G) polymorphisms in the ERα gene. A significantly lower incidence of the CC genotype with PvuII polymorphism were noted among CPP girls than controls (11.9% vs. 22%, P=0.021). However, the clinical parameters did not differ among the 3 genotypes. In addition, there was no significant difference in patients with the XbaI polymorphism compared to controls. The present study reveals that neither PvuII nor XbaI polymorphisms in the ERα gene are associated with onset and progression of puberty. However, further studies are needed to validate the exact function of these polymorphisms.
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Affiliation(s)
- H S Lee
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
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30
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Abstract
The hallmark of puberty is the progressive increase in gonadotropin-releasing hormone (GnRH) activity, reflected by an increase in the circulating concentration of luteinizing hormone (LH). The GnRH stimulation test is widely used in the evaluation of precocious puberty. The aim of our study was to assess the diagnostic utility of basal LH for the diagnosis of central precocious puberty (CPP) in girls. A total of 803 girls were referred to Ajou University Hospital for evaluation of precocious puberty between 2008 and 2011. All subjects underwent GnRH-stimulation tests as part of their evaluation. Serum LH and follicle stimulating hormone (FSH) were measured by immunoradiometric assay before and after the GnRH injection. Of the 803 subjects, 505 (62.9%) were included in the pubertal response group and 298 (37.1%) were in the prepubertal response group. Basal LH level was identified as a significant predictor for CPP. Based on the ROC curve, the optimal cut off point of basal LH related to 'pubertal response' was 1.1 IU/l, which was associated with 69.1% sensitivity and 50.5% specificity, with an area under the ROC curve of 0.620 (95% CI, 0.581-0.660). It is concluded that a single basal LH measurement can be used as a screening test to identify girls with CPP and to determine who should undergo GnRH stimulation test.
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Affiliation(s)
- H S Lee
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
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31
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Abstract
AIMS Childhood obesity is associated with an increased likelihood for having impaired glucose tolerance, dyslipidaemia and diabetes. The aim of the study was to evaluate HbA(1c) as a screening test for impaired glucose tolerance in obese children and adolescents and identify the optimal HbA(1c) threshold. METHODS We studied 126 obese and overweight children (BMI > 85 th percentile for age and gender) 4-17 years of age referred to the endocrine clinic at Ajou University Hospital in Korea. All subjects underwent HbA(1c) and oral glucose tolerance test. RESULTS Thirty-four patients (27%) out of 126 had impaired glucose tolerance. Silent diabetes was diagnosed in 10 adolescents (7.9%). Based on the receiver operating characteristic curve, the optimal cut point of HbA(1c) related to impaired glucose tolerance diagnosed by oral glucose tolerance test was 40 mmol/mol (5.8%), which was associated with a 64.7% sensitivity and 61.6% specificity, with an area under the receiver operating characteristic curve of 0.651 (95% CI 0.529-0.772). CONCLUSIONS Obesity is associated with an increased risk of impaired glucose tolerance. An HbA(1c) value of 40 mmol/mol (5.8%) should be used as a screening tool to identify children and adolescents with impaired glucose tolerance.
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Affiliation(s)
- H S Lee
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
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32
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Abstract
For over a decade, bisphosphonate administration has evolved and become the cornerstone of the prevention and treatment of fragility fractures. Millions of post-menopausal women have relied on, and continue to depend on, the long-acting, bone density-maintaining pharmaceutical drug to prevent low-energy fractures. In return, we have seen the number of fragility fractures decrease, along with associated costs and emotional benefits. However, with any drug, there are often concerns with side effects and complications, and this unique drug class is seeing one such complication in atypical subtrochanteric femoral fracture, counterproductive to that which it was designed to prevent. This has created concern over long-term bisphosphonate administration and its potential link to these atypical fractures. There is controversial evidence surrounding such a definitive link, and no protocol for managing these fractures. This review offers the latest information regarding this rare but increasingly controversial adverse effect and its potential connection to one of the most successful forms of treatment that is available for the management of fragility fractures.
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Affiliation(s)
- R S Yoon
- NYU Hospital for Joint Diseases, Department of Orthopaedic Surgery, 301 East 17th Street, New York, New York 10003, USA
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Hwang DH, Kang MG, Kim TG, Hwang JS, Kim DW, Whang D, Hwang SW. Fabrication and radio frequency characterization of carbon nanotube field effect transistor: evidence of quantum capacitance. J Nanosci Nanotechnol 2011; 11:7222-7225. [PMID: 22103162 DOI: 10.1166/jnn.2011.4834] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We fabricated an radio frequency (RF) carbon nanotube field effect transistor (CNTFET) whose electrode shapes were standard RF designed ground-signal-ground (GSG)-type pads. The S-parameters measured from our RF CNTFET in the frequency range up to 6 GHz were fitted with an RF equivalent circuit, and the extracted gate capacitance was shown to be the capacitance value of the series combination of the electrostatic capacitance and the quantum capacitance. The effect of the channel resistance and the kinetic inductance was also discussed.
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Affiliation(s)
- D H Hwang
- Research Center for Time-domain Nano-functional Devices and School of Electrical Engineering, Korea University, 5-1 Anam, Sungbuk, Seoul 136-701, South Korea
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Kim ES, Cho KB, Park KS, Lee KI, Jang BK, Chung WJ, Hwang JS. Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors. Endoscopy 2011; 43:573-8. [PMID: 21448852 DOI: 10.1055/s-0030-1256339] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Although perforation of the colon is known as one of the main complications of endoscopic submucosal dissection (ESD) for colorectal tumor management, factors predictive of perforation have not been fully evaluated. This study aimed to determine the factors associated with perforation during colorectal ESD. METHODS Patients with colorectal tumors undergoing ESD were enrolled and their records were reviewed retrospectively. Age, sex, co-morbidity, medication history, procedure time, resection method, tumor size, location, gross morphology, the presence of fibrosis, and histologic findings were included as possible risk factors. In the cases where perforation had occurred, factors associated with the duration of hospitalization were analyzed. RESULTS One hundred eight lesions in 108 patients were eligible for inclusion in the study (68 patients were male; mean patient age was 63.01 ± 10.71 years). Mean tumor size was 27.59 ± 10.10 mm (range: 8 - 53 mm). Laterally spreading tumor was the most common type (75 %), followed by the protruding type (25 %). Procedure time was 61.95 ± 41.90 minutes (range: 5 - 198 minutes). Complete en bloc resection was achieved for 85 lesions (78.7 %). Perforation occurred in 22 patients (20.4 %). Multivariate analysis confirmed that tumor size [odds ratio (OR): 1.084; 95 % confidence interval (CI): 1.015 - 1.158; P = 0.017] and the presence of fibrosis (OR: 4.551; 95 %CI: 1.092 - 18.960; P = 0.037) were independent risk factors for perforation. All cases of perforation were managed with nonsurgical treatment. Younger age and abdominal pain appeared to be related to prolonged hospitalization. CONCLUSION Tumor size and fibrosis are important factors related to complications during colorectal ESD. Younger age and development of abdominal pain can predict the hospital course in patients with perforation after ESD.
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Affiliation(s)
- E S Kim
- Department of Internal Medicine, Institute of Gastroenterology and Hepatology, Keimyung University School of Medicine, Daegu, South Korea
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Abstract
BACKGROUND Diabetic ketoacidosis is a metabolic disorder caused by insulin deficiency and is the most important cause of mortality and morbidity in children with Type 1 diabetes mellitus. Acute neurological complications related to diabetic ketoacidosis include cerebral oedema, cerebral infarction, brain herniation, cortical venous thrombosis and cerebral haemorrhage. Cerebral infarction is rare in juvenile diabetic ketoacidosis. CASE REPORT We report a girl with a newly diagnosed Type 1 diabetes mellitus who presented with diabetic ketoacidosis and developed cerebral infarction with transient visual loss. CONCLUSIONS Our findings emphasize the importance of prompt evaluation and proper management of intracranial crises in diabetic ketoacidosis.
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Affiliation(s)
- H S Lee
- Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea
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36
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Kim HT, Kim DW, Hwang JS, Shin JS, Whang D, Ahn D, Hwang SW. Probing the continuous radio frequency spectrum of water relaxation using a carbon nanotube. J Phys Condens Matter 2011; 23:072201. [PMID: 21411871 DOI: 10.1088/0953-8984/23/7/072201] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We have obtained the continuous radio frequency spectrum of water molecule relaxation using carbon nanotubes (CNT) as a high-speed nanoprobe. Three sets of characteristic time scales are clearly identified. Two sets are attributed to the electric-field-driven polarization of water molecules bound to CNTs and the collective relaxation of water layers in the vicinity of CNTs, respectively. The third set is appreciable only in air, and can be related to triplet oxygen relaxation.
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Affiliation(s)
- H T Kim
- Research Center for Time-domain Nano-functional Devices and School of Electrical Engineering, Korea University, 5-1 Anam, Sungbuk, Seoul 136-701, Korea
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Kim HJ, Kim MY, Hwang JS, Kim HJ, Lee JH, Chang KC, Kim JH, Han CW, Kim JH, Seo HG. PPARdelta inhibits IL-1beta-stimulated proliferation and migration of vascular smooth muscle cells via up-regulation of IL-1Ra. Cell Mol Life Sci 2010; 67:2119-30. [PMID: 20221783 DOI: 10.1007/s00018-010-0328-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 02/07/2010] [Accepted: 02/19/2010] [Indexed: 11/26/2022]
Abstract
Activation of peroxisome proliferator-activated receptor (PPAR) delta by GW501516, a specific PPARdelta ligand, significantly inhibited interleukin (IL)-1beta-induced proliferation and migration of vascular smooth muscle cells (VSMCs). This effect of GW501516 was dependent on transforming growth factor-beta, and was mediated through the up-regulation of IL-1 receptor antagonist. The inhibitory effect of GW501516 on VSMC proliferation was associated with cell cycle arrest at the G1 to S phase transition, which was accompanied by the induction of p21 and p53 along with decreased cyclin-dependent kinase 4 expression. Inhibition of cell migration by GW501516 was associated with the down-regulation of matrix metalloproteinase (MMP)-2 and MMP-9 in IL-1beta-treated VSMCs. Inhibition of extracellular signal-regulated kinase significantly reduced the GW501516-mediated inhibition of IL-1beta-stimulated VSMC proliferation. These results suggest that PPARdelta plays an important role in the pathophysiology of diseases associated with the proliferation and migration of VSMCs.
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Affiliation(s)
- H J Kim
- Department of Pharmacology, Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, 92 Chilam-Dong, Jinju, 660-751, Korea
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Koester R, Hwang JS, Durand C, Dang DLS, Eymery J. Self-assembled growth of catalyst-free GaN wires by metal-organic vapour phase epitaxy. Nanotechnology 2010; 21:015602. [PMID: 19946171 DOI: 10.1088/0957-4484/21/1/015602] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A catalyst-free method for growing self-assembled GaN wires on c-plane sapphire substrates by metal-organic vapour phase epitaxy is developed. This approach, based on in situ deposition of a thin SiN(x) layer (approximately 2 nm), enables epitaxial growth of c-oriented wires with 200-1500 nm diameters and a large length/diameter ratio (>100) on c-plane sapphire substrate. Detailed study of the growth mechanisms shows that a combination of key parameters is necessary to obtain vertical growth. In particular, the duration of the SiN(x) deposition prior to the wire growth is critical for controlling the epitaxy with the substrate. The GaN seed nucleation time determines the mean size diameter and structural quality, and a high Si-dopant concentration promotes vertical growth. Such GaN wires exhibit UV-light emission centred at approximately 350 nm and a weak yellow band (approximately 550 nm) at low temperature.
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Affiliation(s)
- R Koester
- Equipe mixte CEA-CNRS Nanophysique et semiconducteurs, CEA, INAC, SP2M, NPSC, 17 rue des Martyrs, 38054 Grenoble cedex 9, France
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Kim Y, Jo MH, Kim TC, Yang CW, Kim JW, Hwang JS, Noh DY, Kim ND, Chung JW. Coarsening kinetics of a spinodally decomposed vicinal Si(111) surface. Phys Rev Lett 2009; 102:156103. [PMID: 19518655 DOI: 10.1103/physrevlett.102.156103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Indexed: 05/27/2023]
Abstract
The coarsening kinetics of the stepped-and-terrace groove structure formed on a vicinal Si(111) surface was investigated by in-situ synchrotron x-ray scattering. The time evolution of the groove period L at various temperatures below the (1 x 1)-to-(7 x 7) transition falls onto a universal curve when the annealing time is scaled by a scale factor. Distinctive stages of spinodal decomposition, coarsening, and saturation are identified in the evolution of the groove period. L increases following a power law, L approximately t;{n} with n = 1/6 and 0.29 in the initial stage and the late stage of coarsening, respectively. The initial coarsening proceeds via collective motion of step bunches while the late stage is dominated by the diffusion of individual steps.
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Affiliation(s)
- Yongsam Kim
- Department of Materials Science and Engineering, Center for Extreme Light Applications, Gwangju Institute of Science and Technology, Gwangju, Korea
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Hwang JS, Chen JF, Yang TS, Wu DJ, Tsai KS, Ho C, Wu CH, Su SL, Wang CJ, Tu ST. The effects of strontium ranelate in Asian women with postmenopausal osteoporosis. Calcif Tissue Int 2008; 83:308-14. [PMID: 18843436 DOI: 10.1007/s00223-008-9180-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 05/12/2008] [Accepted: 09/11/2008] [Indexed: 11/26/2022]
Abstract
The aim of this study was to assess the efficacy and safety of strontium ranelate in the treatment of postmenopausal women with osteoporosis in Taiwan. In this 12-month multicenter, randomized, double-blind, placebo-controlled study, 125 women with osteoporosis were randomly given either strontium ranelate 2 g daily or placebo. Lumbar spine, femoral neck, and total-hip bone mineral density (BMD) and biochemical markers of bone turnover were measured; adverse events and tolerability were recorded and assessed. Subjects treated with strontium ranelate showed significant increases in BMD of 5.9% at the lumbar spine, 2.6% at the femoral neck, and 2.7% at the total hip, while the placebo group exhibited no significant change at 12 months. Serum level of a formation marker (bone-specific alkaline phosphatase) was also significantly increased at 6 and 12 months. Thus, although the sample size and the treatment duration of this study could not show its effect of reducing osteoprotic fractures, strontium ranelate showed bone protection effects by increasing BMD and concentrations of a bone formation marker. Safety assessment revealed adverse events were mild and not significantly different from placebo.
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Affiliation(s)
- J S Hwang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Chlayi, Kaohsiung, Taiwan, ROC.
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Hwang JS, Kim HT, Kim HK, Son MH, Oh JH, Hwang SW, Ahn D. Electronic transport characteristics of a single wall carbon nanotube field effect transistor wrapped with deoxyribonucleic acid molecules. ACTA ACUST UNITED AC 2008. [DOI: 10.1088/1742-6596/109/1/012015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Hong SH, Kang MG, Cha HY, Son MH, Hwang JS, Lee HJ, Sull SH, Hwang SW, Whang D, Ahn D. Fabrication of one-dimensional devices by a combination of AC dielectrophoresis and electrochemical deposition. Nanotechnology 2008; 19:105305. [PMID: 21817698 DOI: 10.1088/0957-4484/19/10/105305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We demonstrate a hybrid process for fabricating one-dimensional wire devices. The process is a combination of an alignment procedure using dielectrophoresis and subsequent contact metal formation utilizing electrochemical deposition with non-toxic organic-based Au electrolytes. Several devices have been successfully made from GaN nanowires or multi-walled carbon nanotubes (MWCNTs) using our hybrid technique. We demonstrate that rapid thermal annealing improves the ohmic characteristics by five orders of magnitude in the case of the GaN devices and ∼300% in the case of the MWCNT devices. One of the reasons for this improvement is enhanced gold wetting due to the reduction of grain size at the annealing temperature.
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Affiliation(s)
- S H Hong
- Research Center for Time-domain Nano-functional Devices, Korea University, 5-1 Anam, Sungbuk, Seoul 136-701, Korea. School of Electrical Engineering, Korea University, 5-1 Anam, Sungbuk, Seoul 136-701, Korea
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Fang CT, Chang YY, Hsu HM, Twu SJ, Chen KT, Lin CC, Huang LYL, Chen MY, Hwang JS, Wang JD, Chuang CY. Life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy. QJM 2007; 100:97-105. [PMID: 17277317 DOI: 10.1093/qjmed/hcl141] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Limited data are available on the life expectancy of patients with newly-diagnosed HIV infection in the era of highly active antiretroviral therapy (HAART). AIM To provide such an estimate using a semi-parametric projection. DESIGN Statistical analysis. METHODS Follow-up data for patients newly diagnosed with HIV infection in Taiwan (HIV/AIDS Cohort) from 1 May 1997 to 30 April 2003 (n = 3351, only 1% are injecting drug users) were analysed using the Kaplan-Meier method. The survival function for an age- and gender-matched reference population was generated by the Monte Carlo method from the life-table of the general population. A constant excess hazard model was used to project long-term survival of HIV-infected patients, with linear extrapolation of a logit-transformed curve of survival ratio between HIV-infected patients and the reference population. RESULTS The 5-year survival rate was 58% in patients who had already developed AIDS at diagnosis (AIDS group), and 89% in those who had not (non-AIDS group). Extrapolation yielded an expected mean survival time of 10.6 years after diagnosis for the AIDS group, and 21.5 years after diagnosis for the non-AIDS group. DISCUSSION Our results support the expansion of HIV screening programs to minimize delay in diagnosis. With continuing advances in HAART, this estimate of survival in initially asymptomatic patients may be conservative. Their long life expectancy raises questions about what kind of preventive heath services should be offered. These should be addressed through further analysis of overall benefit and cost-effectiveness.
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Affiliation(s)
- C T Fang
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung San South Road, Taipei, Taiwan
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Kim I, Lee EM, Seol KY, Yun EY, Lee YB, Hwang JS, Jin BR. The mitochondrial genome of the Korean hairstreak, Coreana raphaelis (Lepidoptera: Lycaenidae). Insect Mol Biol 2006; 15:217-25. [PMID: 16640732 DOI: 10.1111/j.1365-2583.2006.00630.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We determined the complete nucleotide sequences of the mitochondrial genome (mitogenome) of the Korean hairstreak, Coreana raphaelis (Lepidoptera: Lycaenidae). The entire mitochondrial DNA (mtDNA) molecule was 15,314 bp long. The C. raphaelis genes were in the same order and orientation as the completely sequenced mitogenomes of other lepidopteran species, except for the presence of an extra copy of tRNA(Ser)(AGN). High similarity in primary sequence and secondary structure between the two tandemly located copies of the tRNA(Ser)(AGN) suggest a recent duplication of an original single tRNA(Ser)(AGN). The DHU arm of the two copies of tRNA(Ser)(AGN) formed a simple loop as seen in many other metazoan mt tRNA(Ser)(AGN). The putative initiation codon for the C. raphaelis COI gene appears to be a tetranucleotide, TTAG, found commonly in the sequenced lepidopterans. ATPase8, ATPase6, ND4L and ND6 genes, which are next to another protein-coding gene at their 3' end all had the sequences potential to form a hairpin structure, suggesting the importance of such a structure for precise cleavage of the mature protein-coding genes.
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Affiliation(s)
- I Kim
- Department of Agricultural Biology, The National Institute of Agricultural Science and Technology, Rural Development Administration, Suwon, Republic of Korea.
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Abstract
BACKGROUND The pathogenesis of melasma has not yet been clearly demonstrated. We tried to determine whether the stem cell factor (SCF) and its receptor c-kit are involved in the mechanism of hyperpigmentation of melasma because this factor is highly implicated in the stimulation of melanocyte function in vitro and in vivo. OBJECTIVES The present study was conducted to investigate the expression of SCF and c-kit on the lesions of melasma compared with nonlesional skin. PATIENTS/METHODS Skin samples were obtained from lesional and nonlesional facial skin of 60 Korean women with melasma. Immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) analysis was performed to determine the expression of SCF and c-kit in melasma. RESULTS The expression of SCF was significantly increased at the lesional dermis compared with nonlesional dermis. However, there was no significant difference in the expression of SCF in lesional and nonlesional epidermis. The expression of c-kit was significantly increased at lesional epidermis compared with nonlesional skin. RT-PCR of SCF and c-kit mRNAs demonstrated increased expression of both types of transcripts in the lesional skin compared with nonlesional skin. CONCLUSIONS These results suggest that the increased expression of SCF in the dermis and of c-kit in the epidermis play an important role in the mechanism of hyperpigmentation in melasma.
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Affiliation(s)
- H Y Kang
- Department of Dermatology, Ajou University School of Medicine, Suwon 443-721, Korea.
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Hwang JS, Tu ST, Yang TS, Chen JF, Wang CJ, Tsai KS. Teriparatide vs. calcitonin in the treatment of Asian postmenopausal women with established osteoporosis. Osteoporos Int 2006; 17:373-8. [PMID: 16421647 DOI: 10.1007/s00198-005-2002-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [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: 03/30/2005] [Accepted: 07/26/2005] [Indexed: 10/25/2022]
Abstract
This study compared the clinical efficacy, safety, and tolerability of daily subcutaneous injections of teriparatide and salmon calcitonin in the treatment of postmenopausal women with established osteoporosis in Taiwan. This 6-month, multicenter, randomized, controlled study enrolled 63 women with established osteoporosis. They were randomized to receive either teriparatide 20 microg or calcitonin 100 IU daily in an open-label fashion. Lumber spine, femoral neck, total hip bone mineral density (BMD), and biochemical markers of bone turnover were measured, and adverse events and tolerability were recorded. The results at 6 months showed that patients using teriparatide had larger mean increases in spinal BMD than those who used calcitonin (4.5% vs. 0.1%), but the BMD changes in these two groups at the femoral neck and the total hip were not significant. There were also larger mean increases in bone markers in the teriparatide group than in the calcitonin group (bone specific alkaline phosphatase 142% vs. 37%; osteocalcin 154% vs. 23%). We conclude that teriparatide has more positive effects on bone formation than salmon calcitonin, as shown by the larger increments of lumbar spine BMD and bone formation markers, and caused only mild adverse events and no significant change in liver, kidney or hematological parameters. Compared with the published global results, teriparatide seems to be equally effective and safe to use in this Asian population.
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Affiliation(s)
- J S Hwang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taiwan, Republic of China
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Abstract
Ifosfamide is one of the most widely used alkylating chemotherapeutic agents. Before mesna was introduced, its dose-limiting toxicity was hemorrhagic cystitis, but at present, neurotoxicity is one of its most worrisome side effects. A total of 10%-15% of patients treated with ifosfamide develop an encephalopathy. The exact pathophysiologic mechanisms responsible for the development of ifosfamide-induced encephalopathy (IIE) are not known. However, accumulation of chloracetaldehyde, toxic metabolite of ifosfamide, in the central nervous system is theorized to be the cause of the neurotoxicity. No standard treatment has been available for IIE. Recently, many reports suggested that methylene blue (MB) may be an effective treatment of this lethal complication. We report two cases of IIE and their treatment outcomes. The first patient recovered completely with MB. The other patient showed slow and incomplete improvement without using MB. We suggest that MB can be used as an initial treatment for the encephalopathy related to ifosfamide infusion. Thus, we present these two cases with brief review of related literature.
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Affiliation(s)
- I S Park
- Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University Hospital, Daegu, South Korea.
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Hwang JS, Shin CH, Yang SW. Clinical implications of N epsilon-(carboxymethyl)lysine, advanced glycation end product, in children and adolescents with type 1 diabetes. Diabetes Obes Metab 2005; 7:263-7. [PMID: 15811143 DOI: 10.1111/j.1463-1326.2004.00398.x] [Citation(s) in RCA: 25] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to investigate the relationship between serum levels of the glycoxylation product N(epsilon)-(carboxymethyl)lysine (CML) and development of chronic diabetic complications and degree of diabetic control in children and adolescents with type 1 diabetes. METHODS The serum levels of CML were measured in 87 patients with uncomplicated type 1 diabetes mellitus (12.7 +/- 4.6 years of age) and in seven patients with background retinopathy, microalbuminuria or neuropathy (18.2 +/- 5.2 years of age) and compared with those in 64 normal control subjects (12.6 +/- 5.2 years of age). The mean durations of diabetes in uncomplicated and complicated patients were 5.0 +/- 3.4 years (0.1-14 years), and 8.6 +/- 5.0 years (3.1-18 years), respectively. The serum levels of CML were measured by enzyme-linked immunosorbent assay using a monoclonal anti-CML antibody (6D12). RESULTS The serum levels of CML were significantly higher in the patient group than those in the control group; 0.85 +/- 0.37 (0.37-1.93) U/ml vs. 0.56 +/- 0.23 (0.15-1.05) U/ml (p < 0.001) and significantly higher in the patient group with chronic complications than those in patient group without chronic complications; 1.06 +/- 0.39 (0.72-1.78) U/ml vs. 0.83 +/- 0.36 (0.37-1.93) U/ml (p < 0.05). Weak, but statistically significant relationship between CML levels and haemoglobin A(1c) levels at the measurement of CML was observed (r = 0.29, p < 0.05). CONCLUSIONS Our data are suggesting that higher serum levels of CML are involved in the development of chronic diabetic complications, and serum levels of CML reflect the degree of diabetic control for a long duration in type 1 diabetic children and adolescents.
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Affiliation(s)
- J S Hwang
- Department of Pediatrics, Ajou University School of Medicine, Suwon, South Korea
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Chang EJ, Lee TH, Mun KC, Kim HC, Suh SI, Bae JH, Kim SP, Cho KB, Hwang JS. Effects of polyhemoglobin-antioxidant enzyme complex on ischemia-reperfusion in kidney. Transplant Proc 2005; 36:1952-4. [PMID: 15518709 DOI: 10.1016/j.transproceed.2004.08.146] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The kidney suffers ischemia-reperfusion (I/R) injury during transplantation. The purpose of the present study was to investigate the therapeutic effect of artificials cells on renal I/R injury through biochemical assays and histological examination. METHODS We prepared artificial cells using cross-linked hemoglobin (Hb), superoxide dismutase (SOD), and catalase. Normal male Sprague-Dawley rats were divided into 6 groups: the sham-operated control group, the group treated with polyHb,and the group treated with polyHb-SOD-catalase (PSC) (per groups were subjected to ischemia for 1 hour or 2 hours). After reperfusion for 4 hours, kidney and blood samples were obtained. RESULTS The levels of SOD and catalase in the PSC group were 15 and 50 times higher than those of the control group, respectively. In the polyHb group, the levels of blood urea nitrogen (BUN), serum creatinine, renal hydrogen peroxide, and renal malondialdehyde were increased. However, their levels were significantly decreased by PSC administration. Renal SOD activity did not show any significant changes in the polyHb group, but renal catalase activity was decreased by polyHb treatment in comparison with the control group. The activities of renal SOD and catalase were increased using PSC treatment. In the histological findings, the PSC group showed no evidence of acute tubular necrosis in proximal convoluted tubules; their microvilli and cytoplasmic microorganelles were relatively well preserved. CONCLUSIONS These results show that PSC effectively reduces renal damage via diminished oxygen free radical-mediated injury after I/R.
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Affiliation(s)
- E J Chang
- Dong San Kidney Institute & Chronic Disease Research Center, Keimyung University School of Medicine, Daegu, Korea
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Chang EJ, Lee SH, Mun KC, Suh SI, Bae JH, Kim SP, Choi HJ, Cho KB, Hwang JS. Effect of artificial cells on hepatic function after ischemia–reperfusion injury in liver. Transplant Proc 2004; 36:1959-61. [PMID: 15518711 DOI: 10.1016/j.transproceed.2004.08.092] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The liver suffers from ischemia/reperfusion injury during transplantation. Reactive oxygen species generated by xanthine oxidase during reperfusion of the ischemic liver may be partially responsible for the hepatic injury. Oxygen free radicals are removed by antioxidant enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase. Using glutaraldehyde and lysine we constructed crosslinked hemoglobin, containing SOD and catalase, and assessed its ability to protect against ischemia/reperfusion injury during transplantation. METHODS In contrast to the sham-operated control groups, blood was exchanged using crosslinked hemoglobin (polyHb) a PolyHb-SOD-catalase (PSC) group. After ischemia/reperfusion injury, several parameters of hepatic damage and oxygen free radicals were measured as well as microscopic examination. RESULTS Alanine aminotransferase, aspartate aminotransferase, superoxide production, hydrogen peroxide, and malondialdehyde levels were higher among the PolyHb group than sham-operated controls. The PolyHb group revealed a few apoptotic bodies, some acute inflammatory infiltrates in the sinusoids, nuclear fragmentations, cell shrinkage, and chromatin clumping with formation of apoptotic bodies in the apoptotic cells under microscopic examination. Alanine aminotransferase, aspartate aminotransferase, superoxide production, and hydrogen peroxide levels were lower in the PSC than the PolyHb group. Hepatic structures were well preserved in the PSC group. CONCLUSIONS Reactive oxygen species contribute to hepatic dysfunction with morphologic changes. PSC is effective to reduce hepatic damage by lowering oxygen free radical-mediated injury after ischemia/reperfusion in the liver.
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Affiliation(s)
- E J Chang
- Institute for Medical Science and Chronic Disease Research Center, Keimyung University School of Medicine, Daegu, Korea
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