Effects of RGD Protein on the Bone Resorptive Activity of Osteoclast / 대한정형외과학회잡지

Osteoclasts resorb bone by the hydrogen ions and proteolytic enzymes in the localize environment under the ruffled border. Before releasing hydrogen ion and enzymes, osteoclast should attach to bone surface very tightly and make a room to release enzymes and hydrogen ion in the center. Specialized attachment molecule in the cell membrane, such as integrin, is associated with specific noncollagenous protein in the matrix, which has specific amino acid sequence (Arginine-Glycine- Aspartic acid sequence). We may speculate that osteoclast action would be decreased if the integrin is blocked by antibody or RGD protein. In this study, the osteoclasts were cultured on the coverslip or bone slice with or without RGD protein in the culture medium, and numbers of growing giant cells were much less in group with RGD protein. The number resorption pits, formed on mineralized bone slice, was also lower in the group adding RGD protein in the medium. And we made a conclusion that the osteoclastic bone resorption was inhibited by soluble RGD protein.

Treatment of Comminuted Trochanteric Fractures with Dynamic Hip Screw and DHS Trochanter Stabilizing Plate / 대한정형외과학회잡지

It has been emphasized that the treatment of choice for the trochanteric fracture of the femur is open reduction and rigid internal fixation. Regarding the stability of the fracture, most reports were focused on the comminution of the medial cortex, but few reports were paid attention to the additional fracture of the greater trochanter. This paper was aimed to evaluate the fragment of the greater trochanter on the maintenance of reduction. We treated 23 cases of unstable trochanteric fractures in which 16 cases were treated with Dynamic Hip Screw (DHS) alone, and 7 cases were treated with DHS and additional DHS Trochanter Stabilizing Plate (TSP). We compared the two groups and the results were as follows: 1. The average lag screw slipping distance was 17.1mm in DHS Group and 10.0mm in TSP Group. 2. The average distance of lateral displacement of greater trochanter over the trochantric fractures was 11.5mm in DHS Group and no change in TSP Group. The above results suggested that the comhined use of DHS Trochanter Stabilizing Plate with Dynamic Hip Screw provided good results in the treatment of uristable intertrochanteric fractures with completely detached greater trochanter and reverse oblique fracture.

Clinical Value of Supraspinatus Outlet View and Thirty-Degree Caudal Tilt View in Rotator Cuff Disease / 대한정형외과학회잡지

Supraspinatus outlet view and thirty-degree caudal tilt view have been used for the diagnosis of rotator cuff disease. Because scapula is moving on the thoracic cage, these two views are not always easy to take. The purposes of this study were to investigate the detectability of these views, to compare both views and to observe the interobserver reliability of these views. Supraspinatus outlet views and thirty-degree caudal tilt views were taken from 66 shoulders with clinically diagnosed rotator cuff disease. The shape of the acromions was examined on the supraspinatus outlet views and the size and shape of the acromions were analyzed on the thirty-degree caudal tilt views. An orthopaedic resident, an orthopaedic staff and a radiologic staff reviewed the all films without knowing the opinions of others. Suprapinatus outlet views were not-acceptable in average 43.9% and thirty-degree caudal tilt view were not-acceptable in average 12.6%. All of the three observes had same opinions in 43.9% for the supraspinatus outlet views, and in 45.5% for in thirty-degree caudal tilt views. Disagreement among all three observes was noticed in 13.6% for the supraspinatus outlet views and in 3.0% for in thirty-degree caudal tilt views. In the supraspinatus outlet views, the hooked acromions appeared in average 12.1%. In the thirty-degree caudal tilt view, acromial spurs appeared in average 27.3%. Only 2.5% in average showed hooked acromion on supraspinatus outlet view and acromial spur on thirty-degree caudal tilt view. Thirty-degree caudal tilt view is easier to take and more reliable than supraspinatus outlet view. In is better to take both supraspinatus outlet view and thirty-degree caudal tilt view for each patients with rotator cuff diseases. Radiologic findings should be judged on the base of clinical feature.