• Title/Summary/Keyword: 골절위험

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폐경 후 여성의 골다공증 예방 프로그램이 골밀도 및 건강신념에 미치는 효과

  • Sin, Yong-Ae
    • 대한근관절건강학회:학술대회논문집
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    • 2002.11a
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    • pp.238-246
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    • 2002
  • 최근 경제의 발전과 의학의 발달로 인하여 인간의 수명은 점차 연장됨에 따라, 노인인구도 급격히 증가하고 있다. 40세 이상 여성 인구도 8.998천명으로 전체 여성의 38%를 차지하며 이는 매년 증가할 것이다. 그리하여 전체 인구에 대한 폐경 여성의 점유율도 급격히 증가하고 있다. 폐경 이후 $5{\sim}10$년 동안 매년 $2{\sim}4%$씩 골농도가 감소하고 있기 때문에 폐경기 여성을 위협하는 주요 질환 중 하나가 골다공증이다. 하지만 골다공증은 뚜렷한 자각증상이 없어 골 기형 및 골절이 발생하기 전에는 조기발견이 어렵다. 골다공증은 모든 중년 여성의 건강문제이므로 지역사회에서 골절 발생 위험율을 줄일 수 있도록 골다공증 예방을 위한 건강관리가 필요하다. 본 연구의 목적은 지역사회에서 적용할 수 있는 골다공증 예방 프로그램을 개발하여 그 효과를 검정한 후 지역사회 중년 여성 건강증진 프로그램으로 활용코저 함에 있다. 골다공증 예방 프로그램은 운동과 교육으로 구성하였으며, 12주 동안 점핑 동작 위주의 에어로빅과 스텝퍼 운동과 근력강화운동(최대 심박수의 $70%{\sim}80%$, $70{\sim}80$분, 3회/주)을 병행하여 실시하였고, 교육은 운동과 칼슘 섭취의 중요성을 건강 신념 이론에 근거하여 자기 효능감을 증대시키는 교육을 하여 지속적인 운동 실천과 칼슘식이 섭취를 하도록 하였다. 대상자는 서울시 일개 보건소에서 골감소증으로 진단받은 폐경 여성으로 실험군 19명과 대조군 19명이었다. 골다공증 예방 프로그램의 효과는 골밀도, DPD ratio, osteocalcin, 일일 평균 칼슘섭취량, 일일 열량 소모량, 배근력, 최대 산소 섭취량, 제지방량과 건강신념 변수로 측정하였다. 수집된 자료는 PC SPSS 8.0 프로그램을 이용하여 대상자의 일반적 특성은 실수와 백분율로 실험군과 대조군의 동질성 검사는 t-test, $x^2-test$ 및 Fisher exact test를 이용하였고, 두 집단 간 결과변수들의 중재 전후의 차이는 t-test로 분석하였다. 연구 결과는 다음과 같다. 1) $L_{2-4}$ 골밀도는 실험군이 대조군에 비하여 유의하게 높았다. 2) DPD ratio와 osteocalcin은 두 집단간 유의한 차이가 없었다. 3) 배근력은 실험군에서 대조군보다 유의하게 증가하였으나, 제지방량과 최대 산소 섭취량은 유의한 차이가 없었다.

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Risk Factors of Intracranial Hemorrhage in Skull Fracture after Pediatric Head Trauma (두부 외상 후 두개골 골절 환아의 두개내 출혈 위험요인)

  • Ji, Myoung-Hee;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.22 no.1
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    • pp.45-52
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    • 2020
  • Purpose: The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. Methods: The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using 𝓍2-test, Fisher's exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. Results: Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage. Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. Conclusion: In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.

Efficacy of Statins on BMB or Fracture Risk in Postmenopausal Women (스타틴이 폐경기 여성의 골밀도 혹은 골절위험에 미치는 효과 -보고된 임상연구결과 분석을 중심으로-)

  • Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.86-91
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    • 2006
  • There are 3 different hypotheses on how statins may affect bones, through promoting bone formation, inhibiting bone resorption or through anti-inflammatory effect. In the 3 cross-sectional studies above, one showed increase BMD at hip and spine, one showed increase BMD only at mid-forearm and one showed that the risk reduction in fractures is not explained by the changes in BMD however, all 3 studies showed a decrease in risk of fracture associated with statins. In the 2 prospective cohort studies, one showed the use of statins was not associated with BMD at any skeletal site or decreasing the risk of fracture, and the other showed statins except pravastatin decreased in risk of vertebrate fracture but not affecting lumbar spine BMD. All of case-control studies indicated reduction in fracture risk but did not provide any data regarding BMD. 2 of the randomized, controlled studies showed no significant reduction in fracture risk as well as statins' effects on BMD. Finally, one longitudinal study showed statin use reduced fracture risk and increased BMD. Among the conflicting results shown above, even when statin use was shown to increase BMD, it does not seem to account for the reduction in fracture risk. There may be different ways that statins affect bone other than those hypotheses proposed above. Many studies seem to agree that pravastatin does not have any effect on bone. Some studies suggested that the reason statins did not achieve clinically significant increases in BMD in some studies, is due to the low affinity of statins on bone; statins are designed to act in the liver therefore their effective concentration in extrahepatic tissue is low. The limitations to those studies discussed above. Many studies did not account for the change of lifestyle while subjects' were on statins. Increases in weight bearing exercise and changes in diet might affect BMD and thus reduce risk of fractures. Mental alertness and vision acuity might prevent falls from occurring; many statin-users in the studies were young so the risk of fractures from falls would be decreased. Almost all of the studies failed exclude patients with neurological problems. During study periods, many subjects may have been started on drugs for diseases that usually occur with aging which could cause drowsiness and lead to falls. The sample sizes used in some of the trials were small and the duration of treatment and follow up might not have been long enough to see clinically relevant results.

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Pulmonary Thromboembolism after Post-menopause Hormonal Replacement Therapy (폐경기 호르몬 대체요법 후 발생한 폐 색전증)

  • Kim, Sun Young;Park, Jong Hyeok;Lee, Hyun Kyung;Lee, Hyuk Pyo;Lee, Hye Kyung;Choi, Soo Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.362-367
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    • 2007
  • Hormonal replacement therapy (HRT) has been proven for treatment of postmenopausal symptoms such as hot flushes, night sweats and urologic symptoms. HRT became very popular in the 1990's, when there were several reports showing that it also helped with other menopausal complications such as osteoporosis and cardiovascular disease. Recent studies report that the incidence of breast cancer, endometrial cancer, cerebral infarction, coronary artery diseases, deep vein thrombosis and pulmonary thrombembolism could rise after HRT. Among these side effects of HRT, the risk of pulmonary thromboembolism increases 2 to 4 fold after HRT, but can vary with the use of different doses and preparations. Here, we summarize the risk factors and clinical courses for 5 patients who developed pulmonary thromboembolism after postmenopausal HRT.

Bone Metabolism and Estrogenic Effect of Phytochemicals (골 대사 및 phytochemicals의 estrogen 효과)

  • Kim, Bokyung;Kim, Mihyang
    • Journal of Life Science
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    • v.28 no.7
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    • pp.874-883
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    • 2018
  • Osteoporosis is a disease that increases the risk of fracture by decreasing the mass and strength of bone. It is caused by imbalance of osteoclast bone formation and osteoclast bone resorption. Bone formation by osteoblast is activated via bone morphogenetic proteins and runt-related transcription factor 2. $Wnt/{\beta}-catenin$ signaling and bone resorption by osteoclast are initiated by the binding of receptor activator of nuclear $factor-{\kappa}B$ ligand and receptor activator of nuclear $factor-{\kappa}B$. Menopausal women are at risk for many diseases due to hormonal imbalances, and osteoporosis is the most common metabolic disorder in 30% of postmenopausal women. When estrogen is deficient, bone resorption of osteoclasts is promoted, and the risk of osteoporosis especially increases in postmenopausal women. Hormone replacement therapy has been widely used to relieve or treat the symptoms of menopausal syndrome. However, long-term administration of hormone therapy has been associated with a high risk of side effects, such as breast cancer, ovarian cancer, and uterine cancer. Recently, phytochemicals have been actively studied as a phytoestrogen, which has an estrogen-like activity to cope with symptoms of menopausal syndrome. Therefore, in this review, we investigated the differentiation mechanism of osteoblast and osteoclast and the role of estrogen and phytoestrogen in bone metabolism in relation to previous studies.

The Mediating Effect of Fall Risk Perception on the Relationship between Fracture Risk and Fall Prevention Behaviors in Women with Osteoporosis (골다공증 여성의 골절위험도와 낙상예방행위와의 관계에 미치는 낙상위험지각의 매개효과)

  • Lee, Eun Nam;Choi, Eun Jung;Jang, Moon Jung;Hwang, Hyun Ju
    • Journal of muscle and joint health
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    • v.22 no.2
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    • pp.130-137
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    • 2015
  • Purpose: This study aims to establish a theoretical framework for the fall prevention behavior improvement program by verifying the associations between fracture risk, fall risk perception, and fall prevention behaviors in women with osteoporosis. Methods: A survey was conducted in 122 women who were diagnosed as osteoporosis by having T-score of the femur bone density below -2.5 standard deviation from the bone density examination performed in 2 orthopedic clinics located in B metropolitan city between July 2014 and September 2014. The risk of fracture, level of fall risk perception, and fall prevention behaviors were measured. Results: Fall risk perception had a complete mediating effect on the relationship between the fracture risk and fall prevention behaviors in women with osteoporosis. Conclusion: The perception of fall risk is important to enhance fall prevention behaviors in women with osteoporosis, and the development of various education programs to improve awareness of fall risk is needed.

A review of epigenetic nutrients on chronic inflammation associated with sarcopenic obesity in the elderly (노인의 저근육형 비만에 따른 만성염증 억제를 위한 후생유전학적 영양에 관한 고찰)

  • No, Jae Kyung
    • Korean Journal of Human Ecology
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    • v.22 no.1
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    • pp.181-188
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    • 2013
  • 노인에게서 두드러지게 나타나고 있는 저근육형 비만은 근육감소를 동반한 체지방의 증가로 신체상의 뚜렷한 체성분의 변화를 야기 시킨다. 이때 골감소증을 동반하여 신체기능의 감소 및 골절장애 그리고 대사성 관련 질환의 위험도가 올라가는 것으로 보고되고 있다. 노화로 인한 체성분의 변화는 단순한 저근육형일 경우와 비만일 때 보다 급격히 증가된 복부내장 지방조직에서 분비되는 염증성 사이토카인, C-반응성 단백질(CRP), 인터루킨(IL)-6, IL-8 및 종양 괴사 인자(TNF-${\alpha}$)들이 단백질 대사를 저해하여 근육량의 감소를 더욱 촉진시키며, 염증관련 대사질환의 유병률에 중요한 요인이다. 본 연구에서는 DNA 메틸화가 당뇨병, 심혈관질환, 암과 같은 만성염증성 질환에 관계하고 있다는 최근 연구 결과를 기초로 하여 항염증 영양소와 생리활성을 갖는 식품인자들의 충분한 섭취가 염증조절에 중요하게 기여할 것으로 생각되며, 또한 염증성 질환의 주요 표식자인 DNA 메틸화와 히스톤 변형을 유발하는 효소의 활성 또는 비 암호화된 RNA의 발현을 조절함으로써 근육량 증가와 체지방 감소에 중요한 역할을 하는 것을 살펴보았다. 따라서 최근 새롭게 인식되는 후생유전학적 연구의 중심에 있는 항염증 영양소의 효과와 체성분 변화와의 긍정적 관계를 중심으로 저근육형 비만의 예방 및 인구고령화에 건강한 노화를 위한 효과적인 방법을 제시하였다.

The Epidemiology of Delirium (섬망의 역학)

  • Kim, Jeong-Lan
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.2
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    • pp.81-86
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    • 2008
  • Delirium is not developed naturally and is not an endogenous disease. However, delirium has occurred in some specific populations, such as the elderly or medically compromised patients. These become limitations on the systematic study of the epidemiology of delirium. Many epidemiologic studies of delirium have been focused on the elderly due to the fact there are relatively few in the general population. In addition, assessment tools with various sensitivity and specificity have been used. Advanced age, male, poorer cognitive and functional status, and alcohol abuse are well known risk factors of delirium. the epidemiological data will be reviewed in the elderly, patients with dementia, hip fractures, patients hospitalized in intensive care units, terminal cancer and patients with stroke.

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마우스 골재생모델의 제작방법 검토와 골질(bone quality) 및 골양(bone quantity) 파라미터의 해석

  • Lee, Ji-Uk;Kawahara, Keita;Nakano, Takayoshi;Kim, Seung-Eon;Yun, Hui-Suk
    • Proceedings of the Materials Research Society of Korea Conference
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    • 2009.05a
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    • pp.44.1-44.1
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    • 2009
  • 최근 경조직 재생 (hard tissue regeneration) 에 대한 연구가 활발히 진행되고 있다. 그러나 이와같은 연구는 결손도입의 어려움 및 이차적인 골절의 위험성 때문에 대형동물을 중심으로 진행되고 있으며, 그 결과 동물실험에 있어서 시간적 경제적으로 큰 리스크를 수반한다. 그러나 유전자 변형동물의 대부분은 마우스이며, 분자생물학적 관점에서 골재생의 과정을 이해하기 위해서는 마우스를 이용한 골재생 모델의 확립이 필요하다. 따라서 본 연구에서는 마우스를 통해 경조직 재생모델의 제작방법을 검토함과 동시에, 골재생부위에 대한 골질 (bone quality) 및 골양 (bone quantity) 평가의 방법을 수립하는 것을 목적으로 하였다. 골결손은 생후 8주의 마우스에 시술하였다. 치과용 드릴을 이용하여 경골 (tibia) 길이의 30 % 부근의 내측(medial) 면에서 골수강 (marrow cavity) 방향으로 $500\;{\mu}m\varphi$의 원주형 결손을 도입하였다. 시술 후의 골재생과정을 관찰하기 위해 ${\mu}CT$ (SMX-100CT: Simazu) 를 이용하여 주기적으로 촬영하였으며, 골양 (BV/TV) 의 회복과정은3D-bon (RATOC) 을 이용하여 정량적인 해석을 수행하였다. 그리고 재생부의 골질 (아파타이트 배행성; BAp orientation) 평가는 투과형micro-beam XRD (R-AXIS BQ: Rigaku)를 이용하여 수행하였다.

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Analysis of Bone Mineral Density According to Lumbar Spine Rotation and Inclination (허리뼈 회전과 기울기에 따른 골밀도 분석)

  • Je, Jaeyong
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.779-783
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    • 2019
  • Osteoporosis is a disease that increases the risk of fracture. In this study, dual energy X-ray absorptiometry (DXA) was used to compare bone density according to the lumbar spine rotation and inclination. The results of the showed that the bone density decreases with the rotation of the lumbar spine, but the result was not predicted in the inclination of the lumbar spine. This is due to the change of the inclusion of lumbar spine in the area of the bone and the bone density due to the overlap between the lumbar spine 1 and 4. In other words, the Radiogical technologists needs to make efforts to prevent the rotation of lumbar spine and the overlap according to the inclusion to obtain the accurate bone density results.