• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.383-396
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• 2020

Purpose: This study compared the injury mechanism, site, type, initial management approach of orthopedic injury, and outcomes according to the injury severity in moderate-to-severe injured patients. Materials and Methods: During 57-month, excluding the period when the authors' emergency/trauma center was not operating, from 2014 to 2019, a retrospective study was conducted on 778 patients with orthopedic injuries among patients with an Injury Severity Score (ISS)>9 scored. The patients were classified into moderate-injured group (group-1, 679) and severe-injured group (group-2, 99) according to the injury severity based on the ISS and physiologic parameters. The injury mechanism and non-orthopedic injury were evaluated. Orthopedic injuries were assessed according to the injury pattern and the number of anatomical regions and bone sites involved. The management approach for the orthopedic injuries in two groups was compared. Outcomes (hospital stay, systemic complications, and in-hospital mortality) were evaluated, and the risk factors for mortality were analyzed. Results: In group-2, the incidence of younger males, high-energy mechanisms, and accompanying injuries was significantly higher than in group-1. The number of anatomical regions and bone sites involved increased in group-2. The involvement of the pelvis, spine, and upper extremity was significantly higher in group-2, whereas group-1 was involved mainly by the lower extremities. Depending on the patient's condition, definitive or staged management for orthopedic injuries may be used. Group-1 was treated mainly with definite fixation after the physiological stabilization process, and group-2 was treated with staged management using temporary external fixation. The hospital stay was significantly longer in group-2. The overall systematic complications and in-hospital mortality was approximately 4.9% and 4.5%. A higher injury severity was associated with higher in-hospital mortality (2.9%, 15.2%; p<0.0001). Increasing age and high ISS are independent risk factors for mortality. Conclusion: A higher severity of injury was associated with a higher incidence of high-energy mechanism, younger, male, accompanying injuries, and the frequency and severity of orthopedic injuries. Severe polytrauma patients were treated mainly with a staged approach, such as external fixation. The hospital stay, systematic complications, and in-hospital mortality were significantly higher in severe-injured patients. Age and ISS are strong predictors of in-hospital mortality in polytrauma.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.71-77
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• 2020

Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.253-260
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• 2020

Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm² and the mean size of the donor sites was 51.9 cm². The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.495-502
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• 2020

Purpose: The aim of this study was to assess the effectiveness of domestically developed volar locking plate which has the concept of double-tiered subchondral support (DSS) in maintaining the reduction after distal radial fracture surgery. Materials and Methods: From July 2017 to December 2018, 54 patients were assessed. Plain radiographs were obtained immediately after surgery and at the last follow-up, and the radiographic parameters were measured in those images: radial length, radial inclination, volar tilt, ulnar variance, and distal dorsal cortical distance. The patients were subdivided into their age, type of fracture, and the position of the plate to evaluate the influence of each factors on the reduction maintenance. Results: Distal dorsal cortical distance in radiographs after the surgery was 5.91 mm (standard deviation, ±1.95 mm) on average. Significant differences in the radial length (p=0.038) and ulnar variance (p=0.001) were observed between immediately after surgery and at the last follow-up. When the parameters were evaluated by dividing the patients into subgroups according to the three specific factors, the ulnar variance showed a significant increase at the last follow-up when the patients were included 65-years-old or older. AO/OTA type C3 fracture, and Soong classification grade 0 plate position (p=0.007, p=0.012, p=0.046, respectively). Conclusion: Using the domestically developed DSS-type volar locking plate, significant reduction after distal radial fracture surgery could be maintained successfully. On the other hand, further study will be needed to determine about the reduction loss of the lunate facet identified in special cases that deal with fractures in elderly patients, unstable AO/OTA type C3 distal radial fractures, and Soong classification grade 0 plate position.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.46-53
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• 2020

Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.

• Journal of Food Hygiene and Safety
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• v.36 no.6
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• pp.528-536
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• 2021

The purpose of the study was to investigate the content of sinigrin, an index component, in Brassica juncea extract and to evaluate the differentiation of lipocytes, inhibition of production of reactive oxygen species (ROS) and reduction of protein production by lipogenic factors (PPARγ, C/EBPα, aP2) in the processing of Brassica juncea extract and sinigrin in 3T3-L1 preadipocytes which induces Bisphenol A (BPA), an endocrine disrupting environmental hormone. From the investigation, the content of sinigrin in Brassica juncea extract, measured by HPLC, is found to be 21.27±0.2 mg/g. The XTT assay result on BPA-derived 3T3-L1 adipocytes shows there is no cytotoxicity found from 180 µM of sinigrin and 300 ㎍/mL of Brassica juncea extract. Moreover, both intracellular lipid accumulation and ROS production during differentiation of lipocyte are significantly reduced in cells processed with Brassica juncea extract and sinigrin. Lastly, it was also found that the production of transcription factors of lipocyte differentiation, PPARγ, C/EBPα and aP2, were found to be suppressed by the application of Brassica juncea extract and sinigrin. Such results reveals that Brassica juncea is effective in not only suppressing lipid accumulation in the environmental hormone bisphenol A-derived lipocyte, but also in reducing the ROS. The sinigrin-containing Brassica juncea is highly expected to be used in natural functional supplements that prevents the lipid metabolism disorders caused by BPA. There are necessities for additional clinical research and follow-up studies on the in vivo model to verify the relevant mechanisms.

• Journal of Life Science
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• v.31 no.4
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• pp.418-424
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• 2021

Skin inflammation (dermatitis) is caused by varying skin damage due to ultraviolet radiation and microbial infection. Currently prescribed drugs for dermatitis include anti-histamine and steroid drug classes that soothe inflammation. However, incorrect or prolonged use of steroids can cause weakening of skin barriers as well as osteoporosis. Therefore, treating dermatitis with a drug that has minimal side effects is important. Statins, also known as 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, are cholesterol-lowering drugs that have been widely treated for hyperlipidemia and cardiovascular diseases. Interestingly, recent studies have shown the anti-inflammatory effects of statins in both experimental and clinical models for of osteoarthritis. This study investigated the possible anti-inflammatory effects of atorvastatin and fluvastatin in human keratinocytes (HaCaT cells), which are crucial components of skin barriers. Stimulation of HaCaT cells with IL-1β increased the expression of the COX2 protein, a major player of inflammatory responses. However, this induction of the COX2 protein was downregulated by pretreatments with atorvastatin and fluvastatin. Treatment with IL-1ß-induced the upregulation of other inflammatory genes (such as iNOS and MMP-1) and these expressions were similarly lowered by these two statin drug treatments. Taken together, these results indicated that atorvastatin and fluvastatin can reduce IL-1β-induced inflammatory responses in HaCaT cells. In conclusion, the findings suggest that atorvastatin and fluvastatin can be potential modulators for ameliorating skin inflammation.

• Korean Journal of Mineralogy and Petrology
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• v.34 no.2
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• pp.95-106
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• 2021

The SO₄ in the jarosite structure can be substituted by other oxyanions, and therefore, the transition of jarosite to goethite plays a very important role in controlling the behavior of oxyanions. In this study, the phase change according to the species of the oxyanion in jarosite and the related behavior of the oxyanion was studied by mineralogical and geochemical methods when jarosite, which is coprecipitated with various oxynions, undergoes a phase change by a reductive dissolution. Jarosite substituted by five oxyanions by 5 mol% was used in this study. The mineral phase change induced by reductive dissolution using ammonium oxalate was investigated, and the order of phase transition rate of jarosite to goethite was MoO₄-jarosite ≥ SeO₄-jarosite ≥ CrO₄-jarosite > pure jarosite > SeO₃-jarosite > AsO₄-jarosite, showing that the transition rates vary depending on the substituted oxyanion. The resultant concentration of the leached Fe was slightly different depending on the type of oxyanion and time but did not show a noticeable difference. The concentration of each oxyanion leached according to the change of the mineral phase showed that the order of concentration of oxyanions was Mo > Se(SeO₃) > As > Se(SeO₄) > Cr in general, and showed a slight increase with time. This trend was related to the species of oxyanions rather than mineral phase change. The results of this study showed that the phase transition of jarosite to goethite was affected by the species of oxyanions, but this tendency did not affect the concentrations leached oxyanions.

• Journal of the Korean Association of Geographic Information Studies
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• v.25 no.4
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• pp.94-106
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• 2022

In order to increase timber self-sufficiency, Korea's 6th Basic Forest Plan aims to increase the density of forest roads to 12.8 m ha^-1 by 2037. However, due to rapid re-forestation, current management infrastructure is insufficient, with just 4.8 m ha^-1 of forest roads in 2017. This is partly due to time and cost limitations on the process of forest road feasibility evaluation, which considers factors such as topography and forest conditions. To solve this problem, we propose an eco-friendly and efficient forest road network planning method using a geographic information system (GIS), which can evaluate a potential road site remotely based on spatial information. To facilitate such planning, this study identifies forest road construction priorities that can be evaluated using spatial information, such as topography, forest type and forest disasters. A method of predicting the optimal route to connect a forest road with existing roads is also derived. Overlapping analysis was performed using GIS-MCE (which combines GIS with multi-criteria evaluation), targeting the areas of Cheongsong-gun and Buk-gu, Pohang-si, which have a low forest-road density. Each factor affecting the suitability of a proposed new forest road site was assigned a cost, creating a cost surface that facilitates prioritization for each forest type. The forest path's optimal route was then derived using least-cost path analysis. The results of this process were 30 forestry site recommendations in Cheongsong-gun and one in Buk-gu, Pohang-si; this would increase forest road density for the managed forest sites in Cheongsong-gun from 1.58 m ha^-1 to 2.55 m ha^-1. This evaluation method can contribute to the policy of increasing timber self-sufficiency by providing clear guidelines for selecting forest road construction sites and predicting optimal connections to the existing road network.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.414-427
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• 2022

This study aims to analyze the color distribution of maxillary permanent incisors in Korean pediatric patients and determine the effects of age and root developmental stage on tooth color. The L^*a^*b^* values of 404 sound and fully erupted maxillary incisors without dental caries, restorations, trauma history or discoloration from 101 Korean patients between ages 7 and 15, with a mean age 10.0 ± 1.5, were analyzed with a spectrophotometer. CIE L^*a^*b^* values were 84.01, 0.17, and 24.07 in maxillary central incisors, and 82.33, 0.31, and 25.99 in maxillary lateral incisors. L^* values of maxillary central incisors were higher, and b^* values of maxillary central incisors were lower than those of maxillary lateral incisors (p < 0.001). The color differences among the subregions exceeded the clinical perceptibility threshold in both of the maxillary central and lateral incisors. L^* value for children at age 10 and younger was 84.13 in maxillary central incisors and 84.04 in maxillary lateral incisors, and those of older patients were 80.62 and 80.56, respectively. L^* value of maxillary incisors of children at age 10 and younger was significantly higher than that of older patients. The root developmental stage did not affect tooth color. This study suggests that the color differences between maxillary central and lateral incisors and among the subregions of a tooth and the effects of age should be considered for aesthetic restorations of permanent incisors in pediatric patients.