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Osteoimmunology and Fracture Healing

Diane Nam is studying the effects of the immune system on fracture healing. Immunodeficient mice that lack T and B cells have significant alterations in the normal fracture healing pathway - inflammation followed by proliferation and remodeling. Immunodeficient mice, like immunodeficient humans, may fail to heal - developing partial or non-unions. This interesting area of osteoimmunology has important implications for fracture healing for all human patients, as five to ten percent of human fractures fail to heal satisfactorily. Cytokines associated with T cell function are altered in human patients with osteoporosis, diabetes, or those with immunodeficiency induced by chemotherapy, smoking, AIDS or trauma. "If we can use the immune response to improve the outcome in these patients, we may even be able to accelerate or guarantee union in normal patients. Immune modulators, which might be dietary supplements, T cell activators, or other pharmaceuticals may accelerate healing in normal patients as well as rescue, or strengthen those who are immunodeficient. Immune dysfunction is frequently observed after traumatic injury. Sunnybrook offers many opportunities to translate research findings into the clinical milieu."

Diane's clinical work is focused primarily on elective reconstructive surgery of the upper extremity and general orthopaedic trauma. Working with her colleagues Terry Axelrod and Robin Richards, she sees a great variety of upper extremity pathology. Diane has 75% protected time for research and 25% dedicated time for clinical work. In addition, she teaches medical students and residents. She took all of her training from medical school through fellowship at the University of Toronto. As a fellow with Terry Axelrod, she studied upper limb surgery. Her clinical work is performed at both Sunnybrook and at the Holland Orthopaedic and Arthritic Hospital. Her mentors during training include Nizar Mahomed who "sparked the orthopaedic interest during clerkship", Ben Alman for basic science training, and Terry Axelrod, who supervised her fellowship in upper extremity surgery. She was interested in research before entering medical school, earning a masters degree in pharmacology. Her father was an architect in Korea and her mother an accountant. Her parents and brother Rob, featured elsewhere in this issue, have been great supporters in her life and career. As a busy mother, she has little time now for music and the arts, though she is classically trained to play the violin. Diane is married to Mark, an attorney. They have two children, Emma, age 5, Ava, age 1. The children are frequently at their Uncle Rob and Aunt Yuna's house a stone's throw away, playing with their cousins Matthew and Amy or enjoying their uncle's gourmet barbecue cooking.

M.M.





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