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Evaluation of Prosthetic Reconstruction in Lower Extremity (하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Koo, Ki-Hyoung;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.1-11
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    • 2002
  • Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

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The Effects of Prostaglandin and Dibutyryl cAMP on Osteoblastic Cell Activity and Osteoclast Generation (Prostaglandin과 Dibutyryl cAMP가 조골세포의 활성과 파골세포 형성에 미치는 영향)

  • Mok, Sung-Kyu;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.26 no.2
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    • pp.448-468
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    • 1996
  • To maintain its functional integrity, bone is continuously remodelled by a process involving resorption by osteoeclasts and formation by osteoblasts, In order to respond to changes in the physical environment or to trauma with the relevant action, this process is strictly regulated by locally synthesized or systemic fators, Prostaglandin $E_2(PGE_2$) is perhaps one of the best studied factors, having been known to affect bone cell function for several decades.$PGE_2$ has both anabolic and catabolic activities. Excess of $PGE_2$ has been implicated in a number of pathological states associated with bone loss in a number of chronic inflammatory conditions such as periodontal disease and rheumatoid arthritis. $PGE_2$ and other arachidonic acid metabolites have been shown to be potent stimulators of osteoclastic bone resorption in organ culture. The anabolic effects of $PGE_2$ were first noticed when an increase in periosteal woven bone formation was seen after the infusion of $PGE_2$ into infants in order to prevent closure of the ductus arteriosus. The cellular basis for the catabolic actions of $PGE_2$ has been well characterized. $PGE_2$increases osteoclast recruitment in bone marrow cell cultures. Also $PGE_2$ has a direct action on osteoclast serving to inhibit activity and can also indirectly activate osteoclast via other cells in the vicinity, presumably osteoblast. The cellular mechanisms for the anabolic actions of $PGE_2$ are not nearly so well understood. The purpose of this paper was to study the effects of $PGE_2$ and dibutyl(DB)cAMP on osteoblastic clone MC3T3El cells and on the generation of osteoclasts from their precursor cells. The effect of $PGE_2$ and DBcAMP on the induction of alkaline phoaphatase(AlP) was investigated in osteoblastic clone MC3T3El cells cultured in medium containing 0.4% fetal bovine serum. $PGE_2$ and DBcAMP stimulated ALP activity and MTT assay in the cells in a dose-dependent manner at concentrations of lO-SOOng/ml. Cycloheximide, protein synthesis inhibitor, inhibited the stimulative effect of $PGE_2$ and DBcAMP on ALP activity in the cells. $PGE_2$also increased the intracellular cAMP content in a dose-dependent fashion with a maximal effect at 500ng/ml. The effect of $PGE_2$ on the generation of osteoclasts was investigated in a coculture system of mouse bone marrow cells with primary osteoblastic cells cultured in media containing 10% fetal bovine serum.After cultures, staining for tartrate-resistant acid phosphatase(TRAP)-marker enzyme of osteoclast was performed. The TRAP(+) multinucleated cells(MNCs), which have 3 or more nuclei, were counted. More TRAP(+) MNCs were formed in coculture system than in control group. $PGE_2(10^{-5}10^{-6}M)$ stimulated the formation of osteoclast cells from mouse bone marrow cells in culture. $PGE_2(10^{-6}M)$ stimulated the formation of osteoclast cells from mouse bone marrow cells in coculture of osteoblastic clone MC3T3E1 cells This results suggest that $PGE_2$ stimulates the differentiation of osteoblasts and generation of osteoclast, and are involved in bone formation, as well as in bone resorption.

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Clinical Characteristics and Heart Rate Variability in Patients with Comorbid Panic Disorder and Major Depressive Disorder (주요우울장애가 동반된 공황장애 환자의 임상 특징과 심박변이도)

  • Choi, Young-Hee;Kim, Won;Kim, Min-Sook;Yoon, Hye-Young;Choi, Seung-Mi;Woo, Jong-Min
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.50-57
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    • 2005
  • Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

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Polymorphisms of GSTM1 and CYP1A1, and Susceptibility to Primary Lung Cancer in Korean Males (한국인 남성에서 GSTM1과 CYP1A1 유전자 다형성과 원발성폐암의 유전적 감수성)

  • Bae, Nack-Cheon;Lee, Su-Yeon;Chae, Po-Hee;Kang, Kyung-Hee;Kim, Kyung-Rock;Cha, Seung-Ick;Chae, Sang-Chul;Kim, Chang-Ho;Jung, Tae-Hoon;Park, Jae-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.568-578
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    • 2001
  • Background : Lung cancer is frequently cited as an example of a disease caused solely by exposure to environmental carcinogens. However, there is a growing realization that the genetic constitution is also important in determining individual's susceptibility to lung cancer. This genetic susceptibility may result from functional polymorphims of the genes involved in carcinogen metabolism. In this study, the association between GSTM1 and CYP1A1 polymorphisms and the lung cancer risk in Korean males was investigated. Materials and Method : The study population consisted of 153 male lung cancer patients and 143 healthy male controls. The GSTM1 and CYP1A1 genotypes were determined by multiplex PCR and PCR-RFLP analysis. Result : There were no significant differences in the frequency of the GSTM1 null genotype between the cases and the controls. When the cases were categorized by their histologic type, the frequency of the GSTM1 null genotype in the small cell carcinoma group was higher than those of the controls(67.2% vs 55.9%), but the difference was not statistically significant(OR=1.772 ; 95% CI=0.723-4.340). The distribution of the CYP1A1 MspI genotypes among the cases were similar to those among the controls. When the cases were grouped by their histologic type, the ml/m1, ml/m2, m2/m2 genotypes frequencies among the small cell carcinomas(23.0%, 38.5%, and 38.5%, respectively) were significantly different from those of the controls(36.4%, 46.2%, and 7.4%, respectively, p<0.05). When the m1/m1 genotype was used as a reference, the ml/m2 and m2/m2 genotypes were associated with an increased risk for small cell lung cancer(ml/m2 genotype : OR=1.337, 95% CI=0.453-3.947 ; m2/m2 genotype : OR=3.374, 95% CI=1.092-10.421). Conclusion : These results suggest that the GSTM1 and CYP1A1 genotypes may be a genetic determinant of the risk for lung cancer, particlulary small cell carcinoma. Further investigation is needed to confirm these results.

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A Study on Infant Weaning Practices Based on Maternal Education and Income Levels (양육인의 교육 및 수입정도에 따른 이유기 식생활관리에 대한 실태조사)

  • Kim, Song-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.7
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    • pp.1000-1007
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    • 2005
  • The aim of the present study was to examine the relationship of maternal factors such as knowledge, attitude and practice of weaning with infant feeding. The subjects were 103 mothers visiting a public health center in Gumi, Kyungbook who filled out self-administered Questionnaires. First of all, about $90\%$ of the participants recognized the importance of complementary foods and proper weaning practices. The response for the recognition of the importance of infant weaning process showed a significant difference by education levels. Concerning an appropriate time for the introduction of weaning foods, $53\%$ of mothers had commenced weaning at age $4\~6$ months, while $38\%$ had done so at age $6\~8$ months. Approximately $76\%$ of mothers fed their babies without the knowledge of age-related weaning method and type of weaning foods. There were no statistical differences in maternal weaning knowledges between levels of education and house income. Mothers with higher levels of education and family income tended to show high perception scores regarding possibility of food allergies caused by baby foods. A demand for reliable sources and education related to nutritious weaning foods and weaning practices were strong in the group with higher education. Knowledge of weaning method and baby foods were obtained by 59 of the 103 mothers from mass media, 35 from friends caring babies, and 9 obtained advice from health professionals or family. Advice from the heath professionals was not the main influence on their decision to introduce weaning foods. Although commercial baby foods are the most commonly used as first weaning foods, those with higher education groups considered commercial baby food are not nutritionally better than home-maid foods. The current findings suggest to us that to improve weaning process, mothers should be educated on the selection and preparation of nutritious, balanced weaning foods and on good weaning practices. It is advised that supportive health professionals from community public health centers should lead the education of infant feeding practices based on maternal characteristics and on basic food and nutritional knowledge.

Needs Assessment for the Beneficiaries of Home-Based Cancer Patients Management Project (보건소 재가암환자관리사업 대상자의 서비스 요구도 분석)

  • Lee, Ju-Hyung;Park, Jung-Im;Kang, Ji-Hoon;Youm, Jung-Ho;Koh, Dai-Ha;Kwon, Keun-Sang
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.238-250
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    • 2011
  • Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.

Marginal fidelity of zirconia core using MAD/MAM system (MAD/MAM을 이용한 치과용 지르코니아 코어의 변연 적합도)

  • Kang, Dong-Rim;Shim, June-Sung;Moon, Hong-Suk;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.1
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    • pp.1-7
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    • 2010
  • Purpose: The purpose of this study was to evaluate the fit of zirconia core using MAD/MAM system comparing to that of conventional metal-ceramic and CAD/CAM system. Materials and methods: Duplicating the prepared resin tooth, 50 improved stone dies were fabricated. These dies are classified as a group of 5 to create the core. The groups were composed of metal-ceramic, $Cercon^{(R)}$, $Ceramill^{(R)}$, $Rainbow^{TM}$, and $Zirkonzhan^{(R)}$. Each core was cemented to stone die, and then, absolute marginal discrepancy was measured with microscope at a magnification of ${\times}50$. Statistical analysis was done with one-way ANOVA test and Tukey's HSD test. Results: The mean absolute marginal discrepancy for metal-ceramic was $51.97{\pm}23.38{\mu}m$, for $Cercon^{(R)}$ was $62.16{\pm}25.88{\mu}m$, for $Ceramill^{(R)}$ was $67.64{\pm}40.38{\mu}m$, for $Rainbow^{TM}$ was $125.07{\pm}42.19{\mu}m$, and for $Zirkonzhan^{(R)}$ was $105{\pm}44.61{\mu}m$. Conclusion: 1. Fit of margin was identified as in the order of metal-ceramic, $Cercon^{(R)}$, $Ceramill^{(R)}$, $Zirkonzhan^{(R)}$, and $Rainbow^{TM}$. 2. Absolute marginal discrepancy of the zirconia core that designed by MAD/MAM system had significant differences in order of $Ceramill^{(R)}$, $Zirkonzhan^{(R)}$, and $Rainbow^{TM}$. 3. The mean absolute marginal discrepancy between $Cercon^{(R)}$ and $Ceramill^{(R)}$ did not show significant differences.

The Effect of Packing Method of Relining Material on the Flexural Strength of Denture Base Resin (첨상용 레진의 성형법이 의치상의 굴곡강도에 미치는 영향)

  • Kim, Min-Chul;Kim, Yu-Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.197-207
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    • 2011
  • The study aimed at examining how different reline resins affect flexural strength and flexural modulus of denture base. A total of 80 specimens ($64{\times}10{\times}3.3$ mm, according to ISO 1567:1999) of heat-polymerized resin, 40 specimens for (Lucitone199(Dentsply Int., NewYork, USA), SR Ivocap(Ivoclar AG, Schaan, Liechtenstein)) respectively, were polymerized according to the manufacturer's instructions and divided into eight groups(n = 10). Control group specimens remained intact. Specimens in the other groups were abraded on both sides to 2 mm thickness, and were relined in 1.3 mm thickness with 3 types of resins (Lucitone199(Dentsply), SR Ivocap(Ivoclar), and Rebase II(Tokuyama Co., Ltd, Tokyo, Japan)). All specimens were preserved in distilled water at $37^{\circ}C$ for 50 hours, and then were subjected to flexural strength testing in a universal testing machine using 3-point loading. A crosshead speed of 5 mm/min was used, and the distance between the supports was 50 mm. Data analyses included one-way analysis of variance(ANOVA) and the Tukey Honestly Significant Difference test (p=.05). Both heat-polymerized resin groups and auto-polymerized resin groups showed statistically low flexural strength and flexural modulus than control groups. Specimens relined with Lucitone 199 showed significantly higher flexural strength and flexural modulus than those relined with SR-Ivocap. Specimens relined with auto-polymerized resin showed significantly lower flexural strength and flexural modulus than those relined with heat-polymerized resin. Relining with heat-polymerized resins showed superior mechanical properties to relining with an auto-polymerized resin. Relining with the same heat-polymerized resin as the denture base does not affect mechanical properties of a denture. Lucitone199 using a compression-mould technique resulted in the highest flexural strength.

ROS Scavenging Effect and Cell Viability of Opuntia humifusa Extract on Osteoblastic MC3T3-E1 Cells (천년초 추출물이 조골세포의 증식과 ROS소거능에 미치는 영향)

  • Hwang, Hyun-Jung;Jung, Bok-Mi;Kim, Mi-Hyang
    • Journal of Life Science
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    • v.21 no.12
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    • pp.1752-1760
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    • 2011
  • In this study, the effect of the Opuntiahumifusa extracts on proliferation, alkaline phosphatase (ALP) activity, collagen synthesis and ROS level of a cell was investigated using an osteoblast. Opuntiahumifusawas separated intoOpuntiahumifusapeel (OH-P), seed (OH-Se) and stem (OH-St).These were subjected to extraction by using hot water and ethanol. The proliferation of the MC3T3-E1 osteoblastic cells that were treated with OH-Se water extract were increased by approximately 120%. Regarding the effects of OH-Se on ALP activity, the $50{\mu}g/ml$ ethanol extract group showed the highest activity. The synthesis of collagen increased significantly in response to treatment with OH-Se water extract. The ROS scavenging effects of Opuntiahumifusawere investigated for involvement of oxidativedamage, cell culture and staining. Also, when OH-Se water extract $100{\mu}g/ml$ was added, the ROS level decreased by 54%. These results indicate that Opuntiahumifusa extracts have an anabolic effect on bone through the promotion of osteoblastic differentiation, suggesting that it could be used for the treatment of common metabolic bone diseases.

Enhanced production of monacolin-K through supplement of monacolin-K precursors into production medium and cloning of SAM synthetase gene (metK) (Precursor제공 및 생합성 관련 유전자의 cloning을 통한 Monacolin-K 생산성 향상)

  • Lee, Mi-Jin;Jeong, Yong-Seob;Chun, Gie-Taek
    • KSBB Journal
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    • v.23 no.6
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    • pp.519-524
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    • 2008
  • Monacolin-K is a strong anti-hypercholesterolemic agent produced by Monascus sp. via polyketide pathway. High-yielding mutants of monacolin-K were developed through rational screening strategies adopted based on understanding of monacolin-K biosynthetic pathway. Through the experiments for investigating various amino acids as putative precursors for the monacolin-K biosynthesis, it was found that production level of monacolin-K was remarkably increased when optimum amount of cysteine was supplemented into the production medium. We suggested that these phenomena might be related to the special roles of SAM (S-adenosyl methionine), a putative methyl group donor in the biosynthetic pathway of monacolin-K, demonstrating close interrelationship between SAM-synthesizing primary metabolism and monacolin-K synthesizing secondary metabolism. Namely, increase in the intracellular amount of SAM derived from the putative precursor, cysteine which was extracellularly supplemented into the production medium might contribute to the significant enhancement in the monacolin-K biosynthetic capability of the highly mutated producers. On the basis of these assumptions derived from the above fermentation results, we decided to construct efficient expression vectors harboring SAM synthetase gene (metK) cloned from A. nidulans, with the hope that increased intracellular level of SAM could lead to further enhancement in the monacolin-K production through overcoming a rate-limiting step associated with monacolin-K biosynthesis. Hence, in order to overcome the plausible rate-limiting step associated with monacolin-K biosynthesis by increasing intracellular level of SAM, we transformed the producer mutants with an efficient expression vector harboring gpdA promoter of the producer microorganism, and metK gene. Notably, from the resulting various transformants, we were able to screen a very high-yielding transformant which showed approximately 3.3 fold higher monacolin-K productivity than the parallel nontransformed mutants in shake flask cultures performed under the identical fermentation conditions.