• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.43-50
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• 2011

Lunate revascularization with the vascularized bone grafts is a current concept in the treatment of Kienbo${\ddot{o}}$ck disease. The aim of this study is to present our experience and preliminary results of the treatment using the fourth extensor compartment artery (4 ECA) vascularized bone graft for Kienbo${\ddot{o}}$ck disease. Between May 2009 and June 2010, five patients (3 men and 2 women) with Kienbo${\ddot{o}}$ck disease were treated with 4 ECA vascularized bone grafts. The mean age was 32.8 years and mean follow-up time was 13 months. The patients were composed of two patients in stage II and three patients in stage IIIa according to Lichtman's classification. Modified Mayo wrist score including pain, grip strength, range of motion and functional status and radiographic parameters such as carpal height ratio and radioscaphoid angle were evaluated at a final follow-up. Pain was markedly diminished and modified Mayo wrist score was 82 at last follow up period. There were no or little changes in carpal height ratio and radioscaphoid angle. All patients showed satisfactory bony union and no further lunate collapse on follow-up radiographs. The 4 ECA vascularized bone graft is a reliable alternative procedures among revascularization procedures for treatment of Kienbo${\ddot{o}}$ck's disease. It is less invasive and has low risk of kinking of pedicle compared to the 4+5 ECA vascularized bone graft. However, long term follow-up and MRI evaluation at follow up period should be needed for the future.

• Journal of radiological science and technology
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• v.27 no.4
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• pp.17-21
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• 2004

With advancement of the medical imaging technology, the dynamic pelvic MRI (magnetic resonance imaging) has been introduced and used for dynamic MR defecography to improved diagnosis of the patients. At the early stage of its use, it was mostly used to diagnose enterocele or cystocele, then its use was extended to diagnose the organ prolapse and other dysfunctional pelvis organs. There now have been many reports of other diseases such as the functional constipation and others. This paper introduces the pelvis MRI and the dynamic MR defecography and reports the future trend in their clinical applications. Until recently, the studies with pelvic MRI were mostly focused on observing the movement of the pelvis in the supine position. Yang and 26 others reported good result in observing the patients with the pelvic organ prolapse by using the pubococcygeal line as the anatomical index. Using the fast gradient recalled acquisition (fast GRASS), they compared cystocoele, genitourinary prolapse, enterocoele and rectocoele with the control group. Kruyt et al. observed the posterior compartment and reported that MRI was more helpful than the fluoroscopy. Healy et al. applied the dynamic MRI test on the patients with constipation or incontinence as well as the control group without those symptoms. Since then, MRI technology has further advance by Lienemann, who was able to attain the more detailed images using the fast T2 weighted turbo spin echo technology, and others. If its limitation in diagnosing intussusception and the like, since the observation can be made only from the supine position, can be overcome with open MR or others, it is envisages that the method can eventually replace the radiological defecography.

• Archives of Reconstructive Microsurgery
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• v.1 no.1
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• pp.9-16
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• 1992

Volkmann's ischemic contracture is the end result of an untreated, delayed or Inadequately decompressed compartment syndrome in which muscle ischemia and necrosis have occurred. Once the muscle necrosis have happened, the involved muscle undergo permanent change into fibrous tissue. So secondary shortening and distal joint contracture will be a final outcome, which results in marked functional impairment of hand and forearm. Even though several procedures, such as muscle sliding operation has been attempted, overall results were far from satisfaction, compare to healthy opposite hand. The management of these unfavorable condition of the forearm and hand was regarded as one of challenging area in orthopedics. Recently new approach, using microsurgical technique which transfers functioning muscle unit, has been developed and its result was much better than any other methods in the aspect of an active motion. Among these musculocutaneous free flaps, gracilis has obtained special reputation due to its easiness to handle such as elevation of flap and reliable neurovascular pedicle. Other advantages are flexibility of flap size to adjust variable size of the defect in the forearm and minor morbidity of the donor site. Authors have performed 7 cases of functioning gracilis musulocutaneous free flap transplantation for the functional loss of forearm and hand due to Volkmann's ischemic contracture or muscle and skin defect due to severe trauma since November, 1981 till May, 1991. The results in most cases were satisfactory and acceptable.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.453-457
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• 2006

This study was designed to investigate the effect of intra-articular injection of hyaluronic acid for the treatment of internal derangements of the temporomandibular joint(TMJ). Sixteen patients with internal derangements of TMJ in 1 male and 15 females aged 68 to 18 years comprised the study material. The patients' complaint was limited mouth opening and pain during function. Patients were divided into 3 groups(articular disc displacement with reduction, articular disc displacement without reduction, osteoarthritis group). The preauricular area was disinfected anesthetized locally with 2% lidocaine hydrochloride. Arthrocentesis was performed. Hyaluronic acid(1.5 ㏄) was then injected into the superior compartment of the TMJ. Active range of motion exercises were instituted at approximately 24 hours postoperatively. Antibiotics and NSAID, three times daily by mouth, was prescribed for 3 days. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, final follow-up visit postoperatively. Pain during function was assessed using visual analog scales(VAS). Maximal mouth opening was recorded as a distance between upper incisal edge and lower incisal edge. Intra-articular injection of hyaluronic acid caused significant reduction of pain during function, significant increase of maximal opening range. These findings suggest that intra-articular injection of hyaluronic acid is useful for decreasing patient reports of pain while increasing functional mobility of the mandible in internal derangements of the TMJ.

• BMB Reports
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• v.45 no.6
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• pp.360-364
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• 2012

Uptake of circulating glucose into the cells happens via the insulin-mediated signalling pathway, which translocates the glucose transporter 4 (GLUT4) vesicles from the intracellular compartment to the plasma membrane. Rab GTPases are involved in this vesicle trafficking, where Rab GTPases-activating proteins (RabGAP) enhance the GTP to GDP hydrolysis. TBC1D4 (AS160) and TBC1D1 are functional RabGAPs in the adipocytes and the skeletonal myocytes, respectively. These proteins contain two phosphotyrosine-binding domains (PTBs) at the amino-terminus of the catalytic RabGAP domain. The second PTB has been shown to interact with the cytoplasmic region of the insulin-regulated aminopeptidase (IRAP) of the GLUT4 vesicle. In this study, we quantitatively measured the ${\sim}{\mu}M$ affinity ($K_D$) between TBC1D4 PTB and IRAP using isothermal titration calorimetry, and further showed that IRAP residues 1-49 are the major region mediating this interaction. We also demonstrated that the IRAP residues 1-15 are necessary but not sufficient for the PTB interaction.

• BMB Reports
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• v.47 no.5
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• pp.241-248
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• 2014

CD1 molecules belong to non-polymorphic MHC class I-like proteins and present lipid antigens to T cells. Five different CD1 genes (CD1a-e) have been identified and classified into two groups. Group 1 include CD1a-c and present pathogenic lipid antigens to ${\alpha}{\beta}$ T cells reminiscence of peptide antigen presentation by MHC-I molecules. CD1d is the only member of Group 2 and presents foreign and self lipid antigens to a specialized subset of ${\alpha}{\beta}$ T cells, NKT cells. NKT cells are involved in diverse immune responses through prompt and massive production of cytokines. CD1d-dependent NKT cells are categorized upon the usage of their T cell receptors. A major subtype of NKT cells (type I) is invariant NKT cells which utilize invariant $V{\alpha}14-J{\alpha}18$ TCR alpha chain in mouse. The remaining NKT cells (type II) utilize diverse TCR alpha chains. Engineered CD1d molecules with modified intracellular trafficking produce either type I or type II NKT cell-defects suggesting the lipid antigens for each subtypes of NKT cells are processed/generated in different intracellular compartments. Since the usage of TCR by a T cell is the result of antigen-driven selection, the intracellular metabolic pathways of lipid antigen are a key in forming the functional NKT cell repertoire.

• Molecules and Cells
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• v.37 no.5
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• pp.399-405
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• 2014

Autophagy targets cytoplasmic cargo to a lytic compartment for degradation. Autophagy-related (Atg) proteins, including the transmembrane protein Atg9, are involved in different steps of autophagy in yeast and mammalian cells. Functional classification of core Atg proteins in plants has not been clearly confirmed, partly because of the limited availability of reliable assays for monitoring autophagic flux. By using proUBQ10-GFP-ATG8a as an autophagic marker, we showed that autophagic flux is reduced but not completely compromised in Arabidopsis thaliana atg9 mutants. In contrast, we confirmed full inhibition of auto-phagic flux in atg7 and that the difference in autophagy was consistent with the differences in mutant phenotypes such as hypersensitivity to nutrient stress and selective autophagy. Autophagic flux is also reduced by an inhibitor of phosphatidylinositol kinase. Our data indicated that atg9 is phenotypically distinct from atg7 and atg2 in Arabidopsis, and we proposed that ATG9 and phosphatidylinositol kinase activity contribute to efficient autophagy in Arabidopsis.

• Journal of Korean Neurosurgical Society
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• v.64 no.4
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• pp.592-607
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• 2021

Objective : Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. Methods : Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. Results : The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). Conclusion : Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.40-46
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• 2012

Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.

• Nutritional Sciences
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• v.9 no.3
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• pp.212-226
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• 2006

The involvement of arachidonic acid (AA) metabolizing enzyme, lipoxygenase (LOX), in the development of particular tumors in humans has gradually been acknowledged and LOX has emerged as a novel target to prevent or treat human cancers. In the mouse skin carcinogenesis model, which provides an excellent model to study multistage nature of human cancer development, many studies have shown that some of the LOXs are constitutively upregulated in their expression. Moreover, application of LOX inhibitors effectively reduced tumor burdens, which implicates the involvement of LOX in mouse skin tumor development as well. 8S-LOX is a recently cloned LOX, which is specifically expressed in mouse skin after 12-O-tetradecanoyl-phorbol-13-acetate (TPA) treatment but not in normal skin. Unlike other members of the LOX 'family' expressed in mouse skin, this TPA-induced expression of 8S-LOX is prominent only in the skin of the TPA tumor promotion-sensitive strains of mice (SENCAR, CD-1, and NMRI) but not in the promotion-resistant C57BL/6J mice. This is a very unique phenomenon among strains of mice. Constitutive upregulation of 8S-LOX was also found in early stage papillomas and the expression was gradually reduced as the tumors became malignant. Based on these observations, it has been thought that 8S-LOX is involved in TPA-induced tumor promotion as well as in tumor conversion from papillomas to carcinomas. In accordance with this hypothesis, several studies have suggested possible roles of 8S-hydroxyeicosatetraenoic acid (HETE), an AA metabolite of 8S-LOX, in mouse skin tumor development. A clastogenic activity of 8S-HETE was demonstrated in primary keratinocytes and a close correlation between the levels of etheno-DNA adducts and 8S-HETE during skin carcinogenesis was also reported. On the other hand, it has been reported that 8S-LOX protein expression is restricted to a differentiated keratinocyte compartment Moreover, reported findings on the ability of 8S-HETE to cause keratinocyte differentiation appear to be contrary to the procarcinogenic features of the 8S-LOX expression, presenting a question as to the role of 8S-LOX during mouse skin carcinogenesis. In this review, molecular and biological features of 8S-LOX as well as current views on the functional role of 8S-LOX/8S-HETE during mouse skin carcinogenesis are presented.