Publications by authors named "Hak Jun Kim"

181 Publications

Multifunctional Tannic Acid-Alendronate Nanocomplexes with Antioxidant, Anti-Inflammatory, and Osteogenic Potency.

Nanomaterials (Basel) 2021 Jul 13;11(7). Epub 2021 Jul 13.

Department of Orthopedic Surgery and Nano-Based Disease Control Institute, Korea University Guro Hospital, #148, Gurodong-ro, Guro-gu, Seoul 08308, Korea.

In the current study, we fabricated tannic acid-alendronate (TA-ALN) nanocomplexes (NPXs) via self-assembly. These TA-ALNs were characterized by dynamic light scattering, zeta potential, transmission electron microscopy, and FT-IR spectroscopy. The TA-ALNs were evaluated for antioxidant, anti-inflammatory, and osteogenesis-accelerating abilities in osteoblast-like cells (MC3T3-E1 cells). All TA-ALNs displayed nano-sized beads that were circular in form. Treatment with TA-ALN (1:0.1) efficiently removed reactive oxygen species in cells and protected osteoblast-like cells from toxic hydrogen peroxide conditions. Moreover, TA-ALN (1:0.1) could markedly decrease the mRNA levels of pro-inflammatory mediators in lipopolysaccharide-stimulated cells. Furthermore, cells treated with TA-ALN (1:1) exhibited not only significantly greater alkaline phosphatase activity and calcium collection, but also outstandingly higher mRNA levels of osteogenesis-related elements such as collagen type I and osteocalcin. These outcomes indicate that the prepared TA-ALNs are excellent for antioxidant, anti-inflammatory, and osteogenic acceleration. Accordingly, TA-ALN can be used latently for bone renovation and regeneration in people with bone fractures, diseases, or disorders.
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http://dx.doi.org/10.3390/nano11071812DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308329PMC
July 2021

Selective and easy detection of microcystin-LR in freshwater using a bioactivated sensor based on multiwalled carbon nanotubes on filter paper.

Biosens Bioelectron 2021 Jul 24;192:113529. Epub 2021 Jul 24.

Department of Chemistry, Pukyong National University, Namgu, 48513, Republic of Korea. Electronic address:

Microcystin-LR (MC-LR) is a cyanobacterial toxin produced as a result of eutrophication in polluted water in warm weather conditions. The MC-LR could cause health problems in mammal organs such as the liver, heart, and muscle. Therefore, the World Health Organization (WHO) has stipulated a limit of <1.0 ng/mL in drinking water. Thus, detection and quantification are vital, but current techniques require complex and expensive offsite analysis. We have developed an inexpensive, sensitive, and field-deployable sensor based on bioactivated multiwalled carbon nanotubes (MWCNTs, diameter 20 nm) and micropore filter paper (0.45-μm pore size) for the detection of MC-LR. A specially designed DNA oligonucleotide (5-NH-C-AN) was used as the MC-LR targeting aptamer (MCTA). For bioactivation, MCTA was immobilized on the carboxylated MWCNTs via the formation of amide bonds. The bioactivated MWCNTs were deposited on the micropore filter paper by suction filtering. The detection of MC-LR in freshwater was possible within 1.5 h, achieved by measuring the changes in electrical resistance caused by the selective MC-LR and MCTA interactions. Despite suffering from some matrix effects, the detection limit of the sensor was 0.19 ng/mL for low-concentration MC-LR (≤0.5 ng/mL). This method is much cheaper (biosensor price: < $2.5) than liquid chromatography coupled with tandem mass spectroscopy analysis (ca. $50/sample) which is a standard method for MC-LR detection in a modern laboratory. Thus, this cheap and straightforward MC-LR sensor has applications for detection in remote locations.
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http://dx.doi.org/10.1016/j.bios.2021.113529DOI Listing
July 2021

Hypochlorite-Activated Fluorescence Emission and Antibacterial Activities of Imidazole Derivatives for Biological Applications.

Front Chem 2021 12;9:713078. Epub 2021 Jul 12.

Industry 4.0 Convergence Bionics Engineering, Pukyong National University, Busan, South Korea.

The ability to detect hypochlorite (HOCl/ClO) is of great importance to identify and visualize infection. Here, we report the use of imidazoline-2-thione ( ) probes, which act to both sense ClO and kill bacteria. The NC=S moieties can recognize ClO among various typical reactive oxygen species (ROS) and turn into imidazolium moieties ( ) desulfurization. This was observed through UV-vis absorption and fluorescence emission spectroscopy, with a high fluorescence emission quantum yield (Փ = 43-99%) and large Stokes shift (∆v∼115 nm). Furthermore, the probe, which was prepared by treating the probe with ClO, also displayed antibacterial efficacy toward not only () and () but also methicillin-resistant (MRSA) and extended-spectrum ß-lactamase-producing (ESBL-EC), that is, antibiotic-resistant bacteria. These results suggest that the probe has great potential to carry out the dual roles of a fluorogenic probe and killer of bacteria.
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http://dx.doi.org/10.3389/fchem.2021.713078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311462PMC
July 2021

Arthroscopic All-Inside Anterior Talofibular Ligament Repair with and without Inferior Extensor Retinacular Reinforcement: A Prospective Randomized Study.

J Bone Joint Surg Am 2021 Sep;103(17):1578-1587

Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan, Republic of Korea.

Background: The utility of inferior extensor retinacular (IER) reinforcement for arthroscopic repair of a lateral ankle injury is debatable. We hypothesized that the outcomes would not differ significantly between arthroscopic all-inside anterior talofibular ligament (ATFL) repair with and without IER reinforcement.

Methods: We prospectively randomized 73 patients who had arthroscopic all-inside ATFL repair into 2 groups: those who had IER reinforcement (37 patients) and those who had no IER reinforcement (36 patients). The primary outcome was the Karlsson Ankle Functional Score (KAFS). The secondary outcomes included the Foot and Ankle Outcome Score (FAOS), Tegner activity score (TAS), ankle range of motion, and radiographic parameters. The functional outcomes were evaluated preoperatively and at 6 and 12 months postoperatively. Stress radiographs were obtained preoperatively and at 12 months postoperatively.

Results: The KAFS, all FAOS subscale scores, and TAS improved significantly at 1 year postoperatively in both groups, with no significant differences between the groups with respect to the preoperative and postoperative values. Significant differences were not observed between the ankle range of motion values recorded preoperatively and at 1 year postoperatively in both groups; the preoperative and postoperative range of motion values did not differ significantly between the groups. The mean talar tilt and talar anterior translation decreased significantly at 1 year postoperatively in both groups, with no significant differences between the groups preoperatively and postoperatively. One patient in each group had neuralgia of the superficial peroneal nerve; 2 patients in the IER reinforcement group had knot irritation causing mild discomfort.

Conclusions: Arthroscopic all-inside ATFL repair with and without IER reinforcement showed comparable functional and stress radiographic outcomes at 1 year. Performing IER reinforcement in addition to all-inside arthroscopic direct ATFL remnant repair is not necessary.

Level Of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.2106/JBJS.20.01696DOI Listing
September 2021

Comparison between headless compression screws and tension band wires for the fixation of medial malleolar fractures: a prospective randomized trial.

Arch Orthop Trauma Surg 2021 Jun 23. Epub 2021 Jun 23.

Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea.

Introduction: To date, there has been no prospective randomized trial supporting the rationale of the use of headless compression screw (HCS) compared to conventional fixation methods for medial malleolar fractures. This study aimed to prospectively compare the outcomes of the HCS and tension band wire (TBW) for the fixation of medial malleolar fractures.

Material And Methods: Sixty patients were randomized to receive either an HCS or a TBW for the fixation of a medial malleolar fracture. Clinical outcomes were assessed using the Olerud-Molander ankle score (OMAS), EuroQoL five-dimensional instrument (EQ-5D) score, visual analog scale (VAS) score, patient satisfaction with implant-related symptoms, operative time, and incision length. Radiographic outcomes were assessed using the presence of nonunion, delayed union, and articular incongruity. Clinical and radiographic assessments were performed at 2 and 6 weeks and 3, 6, and 12 months postoperatively.

Results: The OMAS, EQ-5D score, VAS score, and operative time did not differ between the HCS and TBW groups; however, the HCS group had greater satisfaction with implant-related symptoms and smaller incision than the TBW group. There was no difference in the presence of nonunion, delayed union, and articular incongruity.

Conclusion: HCS fixation for medial malleolar fractures is not inferior to TBW fixation, while reducing implant-related symptoms. These findings suggest that HCS is a viable alternative for the fixation of medial malleolar fractures.
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http://dx.doi.org/10.1007/s00402-021-04003-xDOI Listing
June 2021

Tannylated Calcium Carbonate Materials with Antacid, Anti-Inflammatory, and Antioxidant Effects.

Int J Mol Sci 2021 Apr 28;22(9). Epub 2021 Apr 28.

Department of Systems Biotechnology, Chung-Ang University, Gyeonggi 17546, Korea.

Calcium carbonate (CaCO)-based materials have received notable attention for biomedical applications owing to their safety and beneficial characteristics, such as pH sensitivity, carbon dioxide (CO) gas generation, and antacid properties. Herein, to additionally incorporate antioxidant and anti-inflammatory functions, we prepared tannylated CaCO (TA-CaCO) materials using a simple reaction between tannic acid (TA), calcium (Ca), and carbonate (CO) ions. TA-CaCO synthesized at a molar ratio of 1:75 (TA:calcium chloride (CaCl)/sodium carbonate (NaCO)) showed 3-6 μm particles, comprising small nanoparticles in a size range of 17-41 nm. The TA-CaCO materials could efficiently neutralize the acid solution and scavenge free radicals. In addition, these materials could significantly reduce the mRNA levels of pro-inflammatory factors and intracellular reactive oxygen species, and protect chondrocytes from toxic hydrogen peroxide conditions. Thus, in addition to their antacid property, the prepared TA-CaCO materials exert excellent antioxidant and anti-inflammatory effects through the introduction of TA molecules. Therefore, TA-CaCO materials can potentially be used to treat inflammatory cells or diseases.
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http://dx.doi.org/10.3390/ijms22094614DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124724PMC
April 2021

Clinical and Dermoscopic Features of Fungal Melanonychia: Differentiating from Subungual Melanoma.

Ann Dermatol 2020 Dec 11;32(6):460-465. Epub 2020 Nov 11.

Department of Dermatology, Pusan National University Hospital, Busan, Korea.

Background: Fungal melanonychia (FM) is a rare nail disorder that presents as dark pigmentation in the nail plate because of fungal nail infection. The diagnosis of FM is occasionally confusing because its appearance is similar to melanonychia due to other causes including malignant melanoma. Dermoscopy could help increase the accuracy of diagnosing the cause of pigmented nail lesions. However, dermoscopic features of FM are not well elucidated.

Objective: This study aimed to investigate clinical and dermoscopic characteristics of FM.

Methods: The clinical features and dermoscopic findings of 20 patients diagnosed with FM and 14 patients diagnosed with subungual melanoma the Department of Dermatology of Pusan National University Hospitals (Busan and Yangsan) were retrospectively reviewed.

Results: FM mainly occurred as a solitary form in the toenail. Patients in the FM group were older than those in the subungual melanoma group. The most distinguishable general dermoscopic features in FM were a distal diffuse pattern, distal linear pattern, and light brown to yellowish color. FM-associated specific dermoscopic patterns such as the reverse triangular pattern, subungual hyperkeratosis, scale on the nail surface, and white or yellowish streaks were dominantly observed in the FM group compared to the subungual melanoma group.

Conclusion: FM-associated dermoscopic patterns and distal diffuse and linear patterns could be helpful diagnostic clues for differential diagnosis of FM from subungual melanoma.
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http://dx.doi.org/10.5021/ad.2020.32.6.460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875234PMC
December 2020

Risk Factors for Persistent Pain Requiring Surgical Treatment in Adult Symptomatic Accessory Navicular.

Clin J Sport Med 2021 Mar 1. Epub 2021 Mar 1.

Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Korea.

Objective: Identifying the risk factors for persistent pain despite proper conservative treatment in adult symptomatic accessory navicular may reduce the need for surgical treatment. The aim of this study was to identify any such risk factors.

Design: Cohort study.

Setting: University hospital foot and ankle clinic.

Patients: A retrospective review of 313 patients who presented with adult symptomatic accessory navicular was performed.

Assessment Of Risk Factors: Potential risk factors were identified via medical records and foot radiographs. The possible risk factors included age, gender, body mass index, smoking status, occurrence/cause of symptoms, occupation, type of accessory navicular, and radiographic foot parameters.

Main Outcome Measures: Predictors that relate to persistent pain requiring surgical treatment in adult accessory navicular were analyzed using logistic regression analysis.

Results: Of the 313 patients included, 30 (9.6%) underwent surgical treatment due to failure of conservative treatment. The odds of needing surgical treatment decreased by 0.96 per year of age at symptom onset (P = 0.030), but those odds were 8.52 times higher in patients who had a type IIB accessory navicular (P = 0.001). Other variables did not reach statistical significance.

Conclusions: Younger age at symptom onset and type IIB were the risk factors for persistent pain requiring surgical treatment in adult symptomatic accessory navicular.
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http://dx.doi.org/10.1097/JSM.0000000000000901DOI Listing
March 2021

Association of Ankle Dorsiflexion With Plantar Fasciitis.

J Foot Ankle Surg 2021 Jul-Aug;60(4):733-737. Epub 2021 Mar 6.

Associate Professor, Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, South Korea. Electronic address:

This study aimed to compare the mean ankle dorsiflexion range between individuals with and without plantar fasciitis using passive ankle dorsiflexion with consistent pressure, and to identify the prevalence of an isolated gastrocnemius and gastrocnemius soleus complex contracture in 2 groups. 91 participants were prospectively classified into the plantar fasciitis group (45 subjects) and the control group (46 subjects). Ankle dorsiflexion was measured with the knee extended and with the knee flexed 90° using a standard orthopedic goniometer while a consistent force of 2 kg was applied under the plantar surface of the forefoot using a custom-made scale. Intraclass correlation coefficients (ICC) were calculated to determine the interobserver and intraobserver reliability of the current ankle dorsiflexion measurement. The current ankle dorsiflexion measurement revealed excellent interobserver and intraobserver reliability. The mean ankle dorsiflexion in the knee extended was -9.6° ± 8.1° and -11.2° ± 8.2° in the study and control groups, respectively (p = .353). The mean ankle dorsiflexion in the knee flexed was 7.8° ± 6.5° and 5.1° ± 7.4° in the study and control groups, respectively (p = .068). In the study and control groups, 68.9% and 65.2%, respectively, had an isolated gastrocnemius contracture and 24.4% and 30.4%, respectively, had a gastrocnemius-soleus complex contracture (p = .768). The present study demonstrated that there were no significant differences in passive ankle dorsiflexion and in the prevalence of an isolated gastrocnemius or gastrocnemius soleus complex contracture between individuals with and without plantar fasciitis.
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http://dx.doi.org/10.1053/j.jfas.2021.02.004DOI Listing
July 2021

Investigation of the Effect of Bone Mineral Density on the Postoperative Outcome of Ankle Fractures in Elderly Patients.

Foot Ankle Int 2021 Jul 10;42(7):929-934. Epub 2021 Mar 10.

Department of Orthopaedic Surgery, Korea University Guro Hospital, Guro-gu, Seoul, Korea.

Background: The association between ankle fractures in elderly patients and low bone mineral density (BMD) has recently been recognized, but the effect of BMD on the postoperative outcome of these fractures is unknown. The aim of this study was to investigate the effect of BMD on the postoperative outcome of ankle fractures in elderly patients to evaluate the need for BMD screening.

Methods: We retrospectively reviewed 48 patients aged 65 years or older who had ankle fractures and underwent dual-energy x-ray absorptiometry to assess BMD after surgical treatment of the fracture. Postoperative outcomes were assessed using the Olerud-Molander Ankle Score (OMAS), visual analog scale (VAS) score for pain, Kellgren and Lawrence (K&L) grading scale score, and quality of fracture reduction. The correlation between the BMD and the outcome measures at 12 months after surgery was analyzed using the Pearson correlation coefficient.

Results: The mean absolute value of BMD was 0.6 ± 0.1 g/cm (T-score, -1.5 ± 1.2) at the femoral neck and 0.8 ± 0.2 g/cm (T-score, -1.2 ± 1.5) at the lumbar spine. Osteoporosis was present in 33% of female patients and in 11% of male patients. At 12 months after surgery, the OMAS was 70 ± 17 and the VAS score for pain was 18 ± 17. Of the patients, 20, 21, 5, 1, and 1 had K&L grades of 0, 1, 2, 3, and 4, respectively. None of the clinical and radiographic outcome measures were correlated with the BMD values of the patients.

Conclusion: The postoperative outcome of the ankle fractures in elderly patients at 12 months after surgery showed no correlation with femoral neck or lumbar spine BMD at the time of fracture.

Level Of Evidence: Level III, retrospective comparative study.
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http://dx.doi.org/10.1177/1071100721996262DOI Listing
July 2021

Role of Ultrasound in Early Diagnosis of Stress Fracture: A Case Report of Bilateral Distal Fibular Stress Fracture in a Female Recreational Badminton Player.

J Am Podiatr Med Assoc 2021 Feb;111(1)

A 34-year-old female recreational badminton player presented with left ankle pain 1 week after a recreational badminton game. She reported experiencing a similar pattern of pain in her right ankle 4 months before that had persisted for 3 months. On plain radiography, callus formation was evident on the right distal fibula, and a subtle lesion was observed on the left side. Ultrasound was performed with the clinical suspicion of bilateral, nonsimultaneous, distal fibular stress fracture. Focal hyperechoic thickening of the periosteum with irregularity and hypoechoic periosteal edema over the left distal fibula were identified. These findings were consistent with stress fracture, and an early phase of distal fibular stress fracture was diagnosed. This case report highlights that ultrasound can be an alternative modality to magnetic resonance imaging or bone scan scintigraphy for the early diagnosis of stress fracture.
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http://dx.doi.org/10.7547/19-146DOI Listing
February 2021

3D-printed, bioactive ceramic scaffold with rhBMP-2 in treating critical femoral bone defects in rabbits using the induced membrane technique.

J Orthop Res 2021 Feb 12. Epub 2021 Feb 12.

Department of Orthopaedic Surgery, Korea University Medical Center, Seoul, Republic of Korea.

Although autogenous bone grafts are an optimal filling material for the induced membrane technique, limited availability and complications at the harvest site have created a need for alternative graft materials. We aimed to investigate the effect of an rhBMP-2-coated, 3D-printed, macro/microporous CaO-SiO -P O -B O bioactive ceramic scaffold in the treatment of critical femoral bone defects in rabbits using the induced membrane technique. A 15-mm segmental bone defect was made in the metadiaphyseal area of the distal femur of 14 rabbits. The defect was filled with polymethylmethacrylate cement and stabilized with a 2.0 mm locking plate. After the membrane matured for 4 weeks, the scaffold was implanted in two randomized groups: Group A (3D-printed bioceramic scaffold) and Group B (3D-printed, bioceramic scaffold with rhBMP-2). Eight weeks after implantation, the radiographic assessment showed that the healing rate of the defect was significantly higher in Group B (7/7, 100%) than in Group A (2/7, 29%). The mean volume of new bone formation around and inside the scaffold doubled in Group B compared to that in Group A. The mean static and dynamic stiffness were significantly higher in Group B. Histological examination revealed newly formed bone in both groups. Extensive cortical bone formation along the scaffold was found in Group B. Successful bone reconstruction in critical-sized bone defects could be obtained using rhBMP-2-coated, 3D-printed, macro/microporous bioactive ceramic scaffolds. This grafting material demonstrated potential as an alternative graft material in the induced membrane technique for reconstructing critical-sized bone defects.
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http://dx.doi.org/10.1002/jor.25007DOI Listing
February 2021

Risk factors associated with failure of total ankle arthroplasty: a nationwide cohort study.

Sci Rep 2021 Feb 3;11(1):2878. Epub 2021 Feb 3.

Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea.

We conducted a nationwide population-based cohort study to identify the risk factors associated with failure of total ankle arthroplasty (TAA). We included 2,914 subjects who underwent primary TAA between January 1, 2010, and December 31, 2016, utilizing the database of the Korean National Health Insurance Service. Failure of TAA was defined as revision TAA or arthrodesis procedures. An increased risk of TAA failure was observed in the < 65 age group versus the ≥ 75 age group [adjusted hazard ratios (aHR) 2.273, 95% confidence interval (CI) 1.223-4.226 in the 60-64 age group; aHR 2.697, 95% CI 1.405-5.178 in the 55-59 age group; aHR 2.281, 95% CI 1.145-4.543 in the 50-54 age group; aHR 2.851, 95% CI 1.311-6.203 in the < 50 age group]. Conversely, the ≥ 65 age group displayed no increase in the risk of TAA failure. The risk of TAA failure was increased in the severely obese group with body mass index (BMI) of ≥ 30 kg/m versus the normal BMI group (aHR 1.632; 95% CI 1.036-2.570). This population-based longitudinal study demonstrated that age < 65 years and BMI of ≥ 30 kg/m were associated with increased risk of TAA failure.
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http://dx.doi.org/10.1038/s41598-021-82674-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859193PMC
February 2021

Comparative genetic analyses of Korean bat coronaviruses with SARS-CoV and the newly emerged SARS-CoV-2.

J Vet Sci 2021 Jan;22(1):e12

Laboratory of Veterinary Infectious Disease, College of Veterinary of Medicine, Jeonbuk National University, Iksan 54596, Korea.

Background: Bats have been considered natural reservoirs for several pathogenic human coronaviruses (CoVs) in the last two decades. Recently, a bat CoV was detected in the Republic of Korea; its entire genome was sequenced and reported to be genetically similar to that of the severe acute respiratory syndrome CoV (SARS-CoV).

Objectives: The objective of this study was to compare the genetic sequences of SARS-CoV, SARS-CoV-2, and the two Korean bat CoV strains 16BO133 and B15-21, to estimate the likelihood of an interaction between the Korean bat CoVs and the human angiotensin-converting enzyme 2 (ACE2) receptor.

Methods: The phylogenetic analysis was conducted with the maximum-likelihood (ML) method using MEGA 7 software. The Korean bat CoVs receptor binding domain (RBD) of the spike protein was analyzed by comparative homology modeling using the SWISS-MODEL server. The binding energies of the complexes were calculated using PRODIGY and MM/GBGA.

Results: Phylogenetic analyses of the entire RNA-dependent RNA polymerase, spike regions, and the complete genome revealed that the Korean CoVs, along with SARS-CoV and SARS-CoV-2, belong to the subgenus , within . However, the two Korean CoVs were distinct from SARS-CoV-2. Specifically, the spike gene of the Korean CoVs, which is involved in host infection, differed from that of SARS-CoV-2, showing only 66.8%-67.0% nucleotide homology and presented deletions within the RBD, particularly within regions critical for cross-species transmission and that mediate interaction with ACE2. Binding free energy calculation revealed that the binding affinity of Korean bat CoV RBD to hACE2 was drastically lower than that of SARS-CoV and SARS-CoV-2.

Conclusions: These results suggest that Korean bat CoVs are unlikely to bind to the human ACE2 receptor.
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http://dx.doi.org/10.4142/jvs.2021.22.e12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850784PMC
January 2021

Bone Defects After Surgery for Displaced Intraarticular Calcaneal Fractures Spontaneously Improve Without Bone Grafting.

Clin Orthop Relat Res 2021 06;479(6):1265-1272

Y. H. Park, H. W. Cho, J. W. Choi, H. J. Kim, Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Korea.

Background: Most intraarticular displaced calcaneal fractures are accompanied by bone defects after surgical treatment, but the concern about negative effects of bone defects has not been resolved yet owing to the few studies on this issue. Therefore, studies on volumetric changes in bone defects over time and the correlation between postoperative outcomes and residual bone defects will be helpful to address the controversy on the necessity of bone grafting in bone defects of calcaneal fractures.

Questions/purposes: (1) Do bone defects change in size in the first year after surgical treatment of displaced intraarticular calcaneal fractures? (2) Does the size of residual bone defects correlate with postoperative radiographic or clinical outcomes?

Methods: Between 2015 and 2019, 99 patients with displaced intraarticular calcaneal fractures visited the investigators' institution, of whom 95 received surgical treatment. Of the patients treated with surgery, 25% (24 of 95) did not undergo open reduction and internal fixation via an extensile lateral approach, and 19% (18 of 95) had multiple fractures, bilateral fractures, open fractures, or a history of previous surgery on the calcaneus; all of these patients were excluded. During the study period, CT was routinely performed for calcaneal fractures immediately after and 12 months after the surgery, but 6% (6 of 95) of the patients had insufficient CT data due to loss to follow-up before 12 months or other reasons, leaving 47 patients for evaluation in this retrospective study. Fractures were fixed with plate and screws, and bone grafting was not performed in all patients. To answer our first question, which was on the changes in bone defects over time, volumetric measurements of the bone defect were performed using CT via the ITK-SNAP software. The percentage of volumetric change was calculated as a fraction of the volumetric change over 12 months from the initial volume. The percentage of the residual bone defect was calculated as a fraction of the volume of the residual bone defect relative to the volume of the entire calcaneus. To answer our second question, which was on the correlation between residual bone defects and postoperative outcomes, we assessed the Böhler angle, Gissane angle, calcaneal height, Olerud-Molander Ankle Score (OMAS), and VAS score for pain and compared these parameters with the size of the residual bone defect using the Pearson correlation coefficient. The OMAS and VAS scores for pain were evaluated and recorded during patient visits, and we obtained the scores through a chart review. All volumetric measurements and radiographic evaluations were performed by two orthopaedic surgeons, and the intraobserver and interobserver reliability were assessed using the intraclass correlation coefficient.

Results: The mean volume of the bone defect measured using CT was 4 ± 3 cm3 immediately after surgery and 1 ± 1 cm3 12 months after surgery. During the first 12 months after surgery, the mean volume of the bone defect was reduced by 77% (95% confidence interval 73% to 80%). The mean residual bone defect in the entire calcaneus was 2% (95% CI 1% to 2%), and none of the postoperative outcomes were correlated with the residual bone defect.

Conclusion: As bone defects substantially resolve without treatment, surgeons do not need to use bone graft for the surgical treatment of displaced intraarticular calcaneal fractures. Future studies that include patients who underwent bone grafting for the treatment of calcaneal fractures are needed to confirm our findings and to further investigate whether bone grafting has additional benefits for the recovery of bone defects.

Level Of Evidence: Level III, therapeutic study.
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http://dx.doi.org/10.1097/CORR.0000000000001634DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133131PMC
June 2021

Comparison of the intraoperative efficacy of the powered rasp and conventional burr in arthroscopic resection of anterior ankle osteophytes.

Foot Ankle Surg 2020 Dec 28. Epub 2020 Dec 28.

Department of Orthopaedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea. Electronic address:

Background: The efficacy of the powered rasp, a new reciprocating motion device for arthroscopic resection of osteophytes, has not been verified. The aim of this study was to compare the intraoperative efficacy of the powered rasp in arthroscopic resection of anterior ankle osteophytes to that of the conventional burr.

Methods: A total of 49 consecutive patients who underwent arthroscopic resection of anterior ankle osteophytes (26 patients with the conventional burr and 23 patients with the powered rasp) were retrospectively reviewed. The preoperative volume of each osteophyte was measured using computerized tomography scan and three-dimensional software. The resection time was measured by review of the individual arthroscopy video, and the estimated resection rate was calculated as the volume of osteophytes/resection time.

Results: The preoperative volume of osteophytes was not different between the two groups (847.8 ± 685.3 mm in the conventional burr and 913.3 ± 605.8 mm in the powered rasp, p = 0.726). The resection time was 442.4 ± 216.6 s (seconds) in the conventional burr and 386.4 ± 186.3 s in the powered rasp, and the estimated resection rate was 1.8 ± 1.0 mm/s with the conventional burr and 2.4 ± 1.3 mm/s with the powered rasp. These measurements were not significantly different between the two groups (p = 0.340 and 0.083, respectively).

Conclusion: The intraoperative efficacy of the powered rasp did not show superiority to that of the conventional burr in arthroscopic resection of anterior ankle osteophytes.

Level Of Evidence: Level III, retrospective comparative study.
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http://dx.doi.org/10.1016/j.fas.2020.12.009DOI Listing
December 2020

How accurately can surgeons perform angle manipulation? Quantitative assessment of the accuracy of manual angle manipulation of orthopedic surgery: a cadaver study.

Arch Orthop Trauma Surg 2021 Jan 8. Epub 2021 Jan 8.

Department of Orthopedic Surgery, Guro Hospital, Korea University, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Korea.

Introduction: To date, only few studies have been performed on the accuracy of manual angle manipulation during orthopedic surgery. This cadaver study was aimed at quantitatively assessing the accuracy of manual angle manipulation performed by orthopedic surgeons according to their surgical experience and comparing it with manipulation performed with the assistance of a digital goniometer.

Materials And Methods: Six lower-leg specimens of fresh-frozen human cadavers were subjected to angle manipulation performed via Kirschner wire (K-wire) insertion. K-wires were inserted manually and with the assistance of a digital goniometer at target angles of 0°, 30°, and 60° by three operators who had different levels of experience in orthopedic surgery. The accuracy of the insertion angles at the target angles was evaluated using computed tomography.

Results: The mean angle error in the manual angle manipulation was 8.8° (standard deviation [SD] 6.0). When the target angles were set to 0°, 30°, and 60°, the identified angle errors were 6.1° (SD 4.3), 8.8° (SD 6.6), and 11.7° (SD 5.6), respectively, and each value did not show any significant difference among the operators. With the assistance of a digital goniometer, the mean (SD) angle error was significantly improved to 2.1° (1.1°) (p < 0.001). The amount of improvement in accuracy significantly increased as the target angle increased (p = 0.01).

Conclusion: This cadaver study quantified the inaccuracy of manual angle manipulation in orthopedic surgery and showed that these inaccuracies ​​can be improved using an assistive device. These results support the need to develop a device that can compensate manual angle manipulation in orthopedic surgery.
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http://dx.doi.org/10.1007/s00402-020-03702-1DOI Listing
January 2021

Lactoferrin-Anchored Tannylated Mesoporous Silica Nanomaterials for Enhanced Osteo-Differentiation Ability.

Pharmaceutics 2020 Dec 26;13(1). Epub 2020 Dec 26.

Department of Systems Biotechnology, Chung-Ang University, Gyeonggi-do, Anseong-si 17546, Korea.

In the present study, we created lactoferrin-anchored mesoporous silica nanomaterials with absorbed tannic acid (LF/TA-MSNs) and evaluated the effect of these LF/TA-MSNs on the in vitro osteo-differentiation ability of adipose-derived stem cells (ADSCs) by testing alkaline phosphatase (ALP) level, calcium accumulation, and expression of osteo-differentiation-specific genes, including osteocalcin () and osteopontin (). Both bare MSNs and LF/TA-MSNs exhibited round nano-particle structures. The LF/TA-MSNs demonstrated prolonged LF release for up to 28 days. Treatment of ADSCs with LF (50 μg)/TA-MSNs resulted in markedly higher ALP level and calcium accumulation compared to treatment with LF (10 μg)/TA-MSNs or bare MSNs. Furthermore, LF (50 μg)/TA-MSNs remarkably increased mRNA levels of osteo-differentiation-specific genes, including and , compared to MSNs or LF (10 μg)/TA-MSNs. Together, these data suggest that the ability of LF/TA-MSNs to enhance osteo-differentiation of ADSCs make them a possible nanovehicle for bone healing and bone regeneration in patients with bone defect or disease.
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http://dx.doi.org/10.3390/pharmaceutics13010030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823981PMC
December 2020

Protection of Alcohol Dehydrogenase against Freeze-Thaw Stress by Ice-Binding Proteins Is Proportional to Their Ice Recrystallization Inhibition Property.

Mar Drugs 2020 Dec 13;18(12). Epub 2020 Dec 13.

Department of Chemistry, Pukyong National University, Busan 48513, Korea.

Ice-binding proteins (IBPs) have ice recrystallization inhibition (IRI) activity. IRI property has been extensively utilized for the cryopreservation of different types of cells and tissues. Recent reports demonstrated that IRI can also play a significant role in protecting proteins from freezing damage during freeze-thaw cycles. In this study, we hypothesized that the protective capability of IBPs on proteins against freeze-thaw damage is proportional to their IRI activity. Hence we used two IBPs: one with higher IRI activity (LeIBP) and the other with lower activity (FfIBP). Yeast alcohol dehydrogenase (ADH) was used as a freeze-labile model protein. IBPs and ADH were mixed, frozen at -20 °C, and thawed repeatedly. The structure of ADH was assessed using fluorescence emission spectra probed by 1-anilinonaphthalene-8-sulfonate over the repeated freeze-thaw cycles. The activity was monitored at 340 nm spectrophotometrically. Fluorescence data and activity clearly indicated that ADH without IBP was freeze-labile. However, ADH maintained about 70% residual activity after five repeated cycles at a minimal concentration of 0.1 mg mL of high IRI-active LeIBP, but only 50% activity at 4 mg mL of low active FfIBP. These results showed that the protection of proteins from freeze-thaw stress by IBPs is proportional to their IRI activity.
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http://dx.doi.org/10.3390/md18120638DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764648PMC
December 2020

Structural and biochemical analyses of an aminoglycoside 2'-N-acetyltransferase from Mycolicibacterium smegmatis.

Sci Rep 2020 12 9;10(1):21503. Epub 2020 Dec 9.

Research Unit of Cryogenic Novel Material, Korea Polar Research Institute, Incheon, 21990, Republic of Korea.

The expression of aminoglycoside-modifying enzymes represents a survival strategy of antibiotic-resistant bacteria. Aminoglycoside 2'-N-acetyltransferase [AAC(2')] neutralizes aminoglycoside drugs by acetylation of their 2' amino groups in an acetyl coenzyme A (CoA)-dependent manner. To understand the structural features and molecular mechanism underlying AAC(2') activity, we overexpressed, purified, and crystallized AAC(2') from Mycolicibacterium smegmatis [AAC(2')-Id] and determined the crystal structures of its apo-form and ternary complexes with CoA and four different aminoglycosides (gentamicin, sisomicin, neomycin, and paromomycin). These AAC(2')-Id structures unraveled the binding modes of different aminoglycosides, explaining the broad substrate specificity of the enzyme. Comparative structural analysis showed that the α4-helix and β8-β9 loop region undergo major conformational changes upon CoA and substrate binding. Additionally, structural comparison between the present paromomycin-bound AAC(2')-Id structure and the previously reported paromomycin-bound AAC(6')-Ib and 30S ribosome structures revealed the structural features of paromomycin that are responsible for its antibiotic activity and AAC binding. Taken together, these results provide useful information for designing AAC(2') inhibitors and for the chemical modification of aminoglycosides.
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http://dx.doi.org/10.1038/s41598-020-78699-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7725843PMC
December 2020

Relationship between Hallux Valgus and Pes Planus in Adult Patients.

J Foot Ankle Surg 2021 Mar-Apr;60(2):297-301. Epub 2020 Sep 12.

Professor, Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, South Korea. Electronic address:

This study aimed to determine whether the degree of pes planus was associated with hallux valgus severity and hallux valgus surgery outcomes. A total of 122 feet were retrospectively analyzed after hallux valgus surgery. The hallux valgus angle, inter-metatarsal angle, lateral talo-first metatarsal angle, calcaneal pitch, and talonavicular coverage angle were measured. The Foot and Ankle Outcome Score and Foot Function Index were evaluated. A significant correlation between radiographic parameters of pes planus and hallux valgus severity, radiographic outcomes, Foot and Ankle Outcome Score, and Foot Function Index were not noted. The hallux valgus angle and inter-metatarsal angle changed significantly after the surgery (p < .001 and p < .001, respectively); however, a significant difference was not noted between the pes planus and non-pes planus groups (p = .279 and p = .632, respectively). A significant interaction between the time points and groups was not observed with respect to the hallux valgus angle (p = .311) and inter-metatarsal angle (p = .417). Multivariable logistic regression revealed that none of the radiographic parameters for pes planus affected hallux valgus recurrence. Pes planus in adult patients is not significantly associated with hallux valgus severity and recurrence, radiographic outcomes, or clinical scores.
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http://dx.doi.org/10.1053/j.jfas.2020.06.030DOI Listing
June 2021

Icariin-Functionalized Nanodiamonds to Enhance Osteogenic Capacity In Vitro.

Nanomaterials (Basel) 2020 Oct 20;10(10). Epub 2020 Oct 20.

Department of Orthopedic Surgery and Rare Diseases Institute, Korea University Guro Hospital, #148, Gurodong-ro, Guro-gu, Seoul 08308, Korea.

Nanodiamonds (NDs) have been used as drug delivery vehicles due to their low toxicity and biocompatibility. Recently, it has been reported that NDs have also osteogenic differentiation capacity. However, their capacity using NDs alone is not enough. To significantly improve their osteogenic activity, we developed icariin (ICA)-functionalized NDs (ICA-NDs) and evaluated whether ICA-NDs enhance their in vitro osteogenic capacity. Unmodified NDs and ICA-NDs showed nanosized particles that were spherical in shape. The ICA-NDs achieved a prolonged ICA release for up to 4 weeks. The osteogenic capacities of NDs, ICA (10 μg)-NDs, and ICA (50 μg)-NDs were demonstrated by alkaline phosphatase (ALP) activity; calcium content; and mRNA gene levels of osteogenic-related markers, including ALP, runt-related transcript factor 2 (RUNX2), collagen type I alpha 1 (COL1A1), and osteopontin (OPN). In vitro cell studies revealed that ICA (50 μg)-ND-treated MC3T3-E1 cells greatly increased osteogenic markers, including ALP, calcium content, and mRNA gene levels of osteogenic-related markers, including ALP, RUNX2, COL1A1, and OPN compared to ICA (10 μg)-NDs or ND-treated cells. These our data suggest that ICA-NDs can promote osteogenic capacity.
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http://dx.doi.org/10.3390/nano10102071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7589593PMC
October 2020

Identification of prognostic mRNAs in metastatic cutaneous melanoma.

Melanoma Res 2020 12;30(6):543-547

Biomedical Research Institute, Pusan National University Hospital.

Cutaneous melanoma is the most common cause of skin cancer-related deaths worldwide. There is an urgent need to identify prognostic biomarkers to facilitate decision-making for treatment of metastatic cutaneous melanoma. Gene expression microarrays and RNA-seq technology have recently improved or changed current prognostic and therapeutic strategies for several cancers. However, according to the current melanoma staging system, prognosis is almost entirely dependent on clinicopathological features. To identify novel prognostic biomarkers, we investigated gene expression and clinical data for patients with cutaneous melanoma from three cohorts of The Cancer Genome Atlas and Gene Expression Omnibus. Kaplan-Meier survival analysis using median values of each gene as cutoff value revealed that nine genes (ABCC3, CAPS2, CCR6, CDCA8, CLU, DPF1, PTK2B, SATB1, and SYNE1) were statistically significant prognostic biomarkers of metastatic cutaneous melanoma in all three independent cohorts. Low expression of two genes (CDCA8 and DPF1) and high expression of seven genes (ABCC3, CAPS2, CCR6, CLU, PTK2B, SATB1, and SYNE) were significantly associated with positive metastatic cutaneous melanoma prognoses. In conclusion, we suggest nine novel prognostic biomarkers for cutaneous metastatic melanoma.
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http://dx.doi.org/10.1097/CMR.0000000000000697DOI Listing
December 2020

Comparison of Outcome of Deltoid Ligament Repair According to Location of Suture Anchors in Rotational Ankle Fracture.

Foot Ankle Int 2021 Jan 19;42(1):62-68. Epub 2020 Sep 19.

Department of Orthopaedic Surgery, Korea University Guro Hospital, Guro-gu, Seoul, Korea.

Background: The suture anchors for the repair of deltoid ligament in rotational ankle fracture are inserted mostly into the medial malleolus, but sometimes are placed into the talus depending on the rupture site. This study sought to compare the radiological and clinical outcomes of deltoid ligament repair according to using these 2 locations for suture anchor placement.

Methods: The cases of 131 patients (114 patients with suture anchors on the medial malleolus and 17 patients with suture anchors on the talus) who underwent deltoid ligament repair along with ankle fracture fixation were retrospectively reviewed. Medial clear space oblique (MCSo), medial clear space perpendicular (MCSp), tibiofibular clear space (TFCS), and tibiofibular overlap (TFO) were measured as radiological outcomes, while the Olerud-Molander Ankle Score (OMAS) and visual analog scale (VAS) score for pain were calculated as clinical outcomes. The follow-up period did not differ between the 2 groups (16.8 ± 10.9 months in the medial malleolus group vs 17.9 ± 14.3 months in the talus group; = .670).

Results: There were no differences in MCSo, MCSp, TFCS, and TFO at 3 months after surgery and final follow-up. The OMAS and VAS for pain did not show intergroup differences at final follow-up.

Conclusion: The surgical outcome of deltoid ligament repair in rotational ankle fracture did not differ whether the suture anchors were inserted into the medial malleolus or into the talus.

Level Of Evidence: Level III, retrospective comparative study.
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http://dx.doi.org/10.1177/1071100720952053DOI Listing
January 2021

Enhanced tendon restoration effects of anti-inflammatory, lactoferrin-immobilized, heparin-polymeric nanoparticles in an Achilles tendinitis rat model.

Carbohydr Polym 2020 Aug 26;241:116284. Epub 2020 Apr 26.

Department of Orthopedic Surgery and Rare Diseases Institute, Korea University Guro Hospital, #80, Guro-dong, Guro-gu, Seoul, 08308, Republic of Korea. Electronic address:

Gradual wear and tear can cause a local inflammatory response in tendons. The trauma and inflammatory reaction eventually impair the biomechanical properties of the tendon. In this study, we prepared lactoferrin-immobilized, heparin-anchored, poly(lactic-co-glycolic acid) nanoparticles (LF/Hep-PLGA NPs) and evaluated their in vitro anti-inflammatory effects on interleukin-1β (IL-1β)-treated tenocytes and in vivo tendon healing effects in a rat model of Achilles tendinitis. Long-term LF-deliverable NPs (LF/Hep-PLGA NPs) remarkably decreased mRNA levels of pro-inflammatory factors [cyclooxygenase-2 (COX-2), IL-1β, matrix metalloproteinase-3 (MMP-3), MMP-13, IL-6, and tumor necrosis factor-α (TNF-α)] and increased mRNA levels of anti-inflammatory cytokines (IL-4 and IL-10) in both IL-1β-treated tenocytes and the Achilles tendons of a collagenase-induced Achilles tendinitis rat model. Interestingly, anti-inflammatory LF/Hep-PLGA NPs greatly enhanced collagen content, mRNA levels of tenogenic markers [collagen type I (COL1A1), decorin (DCN), tenascin-C (TNC)], and biomechanical properties such as tendon stiffness and tensile strength. These results suggest that anti-inflammatory LF/Hep-PLGA NPs are effective at restoring tendons in Achilles tendinitis.
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http://dx.doi.org/10.1016/j.carbpol.2020.116284DOI Listing
August 2020

Necessity of Interfragmentary Lag Screws in Precontoured Lateral Locking Plate Fixation for Supination-External Rotation Lateral Malleolar Fractures.

Foot Ankle Int 2020 07 9;41(7):818-826. Epub 2020 May 9.

Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Korea.

Background: Interfragmentary lag screws, protected by a plate, have been applied for many years in the treatment of supination-external rotation (SER) ankle fractures. Recently, similar biomechanical stability was found between fixation completed with a plate and lag screw and a plate alone. The aim of this study was to determine whether interfragmentary lag screws are necessary during precontoured lateral locking plate fixation for SER lateral malleolar fractures.

Methods: A prospective randomized controlled trial of 76 patients with unilateral Lauge-Hansen SER lateral malleolar fractures was conducted. The patients were randomly treated either with or without the use of interfragmentary lag screws with precontoured lateral locking plate fixation. Clinical outcomes were assessed using the Olerud-Molander Ankle Score and a visual analog scale for pain. Radiologic outcomes were assessed based on the Kellgren and Lawrence scale score, incongruity of the ankle joint, and type of fracture healing. Sixty-nine patients completed 12 months of follow-up.

Results: There was no significant difference between the 2 groups with regard to clinical outcomes at 3 and 12 months after surgery and radiologic outcomes at 12 months after surgery. All patients in both groups achieved primary bone healing.

Conclusion: The results of this study suggest that with precontoured lateral locking plate fixation, the use of interfragmentary lag screw is not essential in the treatment SER lateral malleolar fractures.

Level Of Evidence: Level I, prospective randomized study.
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http://dx.doi.org/10.1177/1071100720917645DOI Listing
July 2020

Percutaneous Reduction and 2.7-mm Cortical Screw Fixation for Low-Energy Lisfranc Injuries.

J Foot Ankle Surg 2020 Sep - Oct;59(5):914-918. Epub 2020 Apr 25.

Professor and Orthopaedic Surgeon, Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Korea. Electronic address:

To use the advantages of transarticular screw fixation while minimizing iatrogenic involved joint damage and screw irritation, it is important to determine the screw size. The aim of this study was to analyze the outcomes of percutaneous reduction and 2.7-mm cortical screw fixation for low-energy Lisfranc injuries and determine whether the procedure is a safe alternative to traditional screw fixation using a larger screw size. A review was performed for all patients who underwent percutaneous reduction and 2.7-mm cortical screw fixation for low-energy Lisfranc injuries at a single institution over a 6-year period. Thirty-one patients were enrolled in this study. Patients were assessed clinically and radiographically for demographics, foot function index (FFI), numerical rating scale (NRS) for pain, patient satisfaction, and complication rates. Factors affecting screw breakage and its clinical relevance were also analyzed. The FFI and NRS for pain were 17.2 ± 14.7 (range 0.8 to 57.8) and 3.1 ± 2.3 (range 0 to 8) points, respectively, at the 12-month follow-up visit. One patient (3.2%) underwent arthrodesis for the development of posttraumatic arthritis; all other patients recovered without sequelae. Screw breakage was identified in 7 patients (22.6%). There was no significant difference between patients with and without screw breakage in terms of FFI, NRS for pain, patient satisfaction, or complication rate. Body mass index (BMI) was significantly higher in patients with screw breakage than in those without screw breakage. Receiver operator characteristics curve analysis demonstrated a strong relationship between BMI and screw breakage (area under the curve = 90%, p < .001), and the potential BMI cutoff value was 27.8 kg/m. After considering the incidence of screw breakage, percutaneous reduction and 2.7-mm cortical screw fixation can be a viable option for treating low-energy Lisfranc injuries in nonobese patients, especially those with BMI <27.8 kg/m.
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http://dx.doi.org/10.1053/j.jfas.2019.10.013DOI Listing
June 2021

Dermoscopy-guided Mohs micrographic surgery in post-laser basal cell carcinomas: is dermoscopy helpful for demarcation of the surgical margin?

J Dermatolog Treat 2021 Jan 31:1-4. Epub 2021 Jan 31.

Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.

Background: Mohs micrographic surgery (MMS) in cases where the tumor margin is poorly defined to the naked eye can lead to the need to take an increased number of Mohs stages.

Objective: To evaluate the usefulness of dermoscopy in determining MMS surgical margins of BCCs with a history of ablative laser treatment.

Methods: Patients were randomly allocated to naked eye ( = 69) or dermoscopy ( = 64) groups by the surgical margin detection method. Surgical outcomes of 133 post-laser BCC patients treated with MMS were analyzed.

Results: The lateral margin involvement rate at the first MMS stage was significantly lower in the dermoscopy group than in the naked eye group (4.7% vs. 29.0%;  < .001). However, the deep margin involvement rate at the first and mean MMS stages were not significantly different between the groups. The ablative laser treatment duration correlated to the number of MMS stages ( = .026).

Conclusion: The results demonstrated that lateral margin was mostly controlled within the first MMS stage with dermoscopy. Dermatosurgeons could focus on the deep margin after the first MMS stage; thus, the performance of MMS could be improved with dermoscopic assistance in post-laser BCC patients.
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http://dx.doi.org/10.1080/09546634.2020.1762839DOI Listing
January 2021

Structural and sequence comparisons of bacterial enoyl-CoA isomerase and enoyl-CoA hydratase.

J Microbiol 2020 Jul 22;58(7):606-613. Epub 2020 Apr 22.

Unit of Research for Practical Application, Korea Polar Research Institute, Incheon, 21990, Republic of Korea.

Crystal structures of enoyl-coenzyme A (CoA) isomerase from Bosea sp. PAMC 26642 (BoECI) and enoyl-CoA hydratase from Hymenobacter sp. PAMC 26628 (HyECH) were determined at 2.35 and 2.70 Å resolution, respectively. BoECI and HyECH are members of the crotonase superfamily and are enzymes known to be involved in fatty acid degradation. Structurally, these enzymes are highly similar except for the orientation of their C-terminal helix domain. Analytical ultracentrifugation was performed to determine the oligomerization states of BoECI and HyECH revealing they exist as trimers in solution. However, their putative ligand-binding sites and active site residue compositions are dissimilar. Comparative sequence and structural analysis revealed that the active site of BoECI had one glutamate residue (Glu135), this site is occupied by an aspartate in some ECIs, and the active sites of HyECH had two highly conserved glutamate residues (Glu118 and Glu138). Moreover, HyECH possesses a salt bridge interaction between Glu98 and Arg152 near the active site. This interaction may allow the catalytic Glu118 residue to have a specific conformation for the ECH enzyme reaction. This salt bridge interaction is highly conserved in known bacterial ECH structures and ECI enzymes do not have this type of interaction. Collectively, our comparative sequential and structural studies have provided useful information to distinguish and classify two similar bacterial crotonase superfamily enzymes.
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http://dx.doi.org/10.1007/s12275-020-0089-1DOI Listing
July 2020

A comparative pilot study of oral diacerein and locally treated diacerein-loaded nanoparticles in a model of osteoarthritis.

Int J Pharm 2020 May 23;581:119249. Epub 2020 Mar 23.

Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea; Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea. Electronic address:

Diacerein (DIA) is a slow-acting drug for osteoarthritis (OA). Oral DIA administration, however, exerts side effects including diarrhea and urine discoloration. We fabricated DIA-loaded poly(d,l-lactide-co-glycolide) nanoparticles (DIA/PLGA NPs) that allow sustained release of DIA. In vitro, rat synoviocytes were used to investigate the cytotoxicity and anti-inflammatory effects of DIA-loaded NPs. In vivo, monosodium iodoacetate (MIA)-induced OA rats were divided into seven groups that included non-treated healthy control rats and rats injected with MIA alone or in combination with NPs, DIA(5%) solution, DIA(1%)/NPs, DIA(5%)/NPs, or oral DIA. The in vitro studies revealed that DIA/PLGA NPs dose-dependently suppressed mRNA levels of pro-inflammatory cytokines and enzymes, including interleukin-1 (IL-1), IL-6, tumor necrosis factor-α, matrix metalloproteinase-3 (MMP-3), MMP-13, cyclo-oxygenase-2, and a disintegrin and metalloproteinase with thrombospondin motifs-5 in synoviocytes. The in vivo studies demonstrated that intra-articular treatment of OA rat models with DIA-loaded PLGA NPs markedly decreased mRNA levels of these pro-inflammatory factors and increased those of anti-inflammatory cytokines (IL-4 and IL-10). Micro-computed tomography and histological evaluations indicated that intra-articular injection of DIA-loaded NPs was effective in protecting against cartilage degradation. Administration of DIA/PLGA NPs via intra-articular injection is promising for inhibiting inflammation and protecting against cartilage degradation in OA.
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http://dx.doi.org/10.1016/j.ijpharm.2020.119249DOI Listing
May 2020
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