• The Korean Journal of Nuclear Medicine
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• v.35 no.3
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• pp.161-167
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• 2001

Purpose: Bone scintigraphy with $^{99m}Tc$-labeled phosphates is one of the most common procedures in evaluation of various skeletal disorders. Metabolic bone diseases show involvement of the whole skeleton and are associated with increased bone turnover and increased uptake of $^{99m}Tc$-labeled phosphates. In this study, we investigated apparently normal women who were examined with routine bone scintigraphy applied bone densitometry to correlate it with skeletal uptake in bone scan. Materials and Methods: This study includes 79 women who were performed both of bone mineral density(BMD) and bone scintigraphy. We investigated the relation of bone scan findings and BMD of lumbar, femur, radius. Results: Regional BMD were negatively correlated with increased age. Among the bone scintigraphy findings representing metabolic bone disease, uptakes by the long bones, skull and mandible increased with age in women, while that in the costochondral junction decreased. Increased skull and mandible uptakes is associated with decreased BMD, and it has statistically significance. Conclusion: Our results show that increased radionuclide uptake in bone scintigraphy, especially skull and mandible uptake was associated with decreased lumbar, femur BMD in women. So that, increased skull and mandible uptake in women would be a scintigraphic sign of osteopenia of osteoporosis.

• Journal of radiological science and technology
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• v.32 no.4
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• pp.411-418
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• 2009

To evaluate the bone mineral density (BMD) and biochemical markers. We evaluated the BMD of femoral neck and lumbar spines of 998(male 568, female 430) persons who took a regular health screening in Woosuk University Hospital from September 2007 to March 2008 by dual energy bone mineral densitometry. Results of BMD are different in terms of biochemical markers. Especially aged people showed osteoporotic change progressively. Degree of osteoporosis increases with age. A steep decrease of BMD can be found in postmenopausal women who have low level of female hormone. More persistent effort is needed to find out the factors that can reduce BMD values for prevention of problems by osteoporosis. In essence, research on factors related to other biochemical markers must be studied continuously.

• The Journal of the Acoustical Society of Korea
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• v.28 no.6
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• pp.542-547
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• 2009

In this in vivo study, correlations of lumbar and femoral bone mineral densities (BMDs) with calcaneal speed of sound (SOS) were investigated in 36 osteoporotic women. Areal BMDs of the L2-L4 lumbar spine and the right femoral neck were measured by using dual energy X-ray absorptiometry (DEXA). SOS of the right calcaneus was measured by using ultrasound bone densitometry. Pearson's correlation coefficient (r) and level of significance (p) were used to evaluate the correlations between measurements. Lumbar BMD was highly correlated with femoral BMD (r=0.81). Lumbar and femoral BMDs exhibited similar comparable negative correlations with age (r=-0.52 and r=-0.55). A moderate negative correlation was found between calcaneal SOS and age (r=-0.45). Calcaneal SOS was significantly correlated with lumbar and femoral BMDs, with a higher correlation with femoral BMD rather than with lumbar BMD (r=0.54 and r=0.62). However, calcaneal SOS may not be an optimum index for the estimation of BMD of the most important fracture sites, such as the lumbar and the femur, because it showed lower correlations with lumbar and femoral BMDs compared to that with calcaneal BMD. Therefore, the development of a quantitative ultrasound technology for the direct measurement of acoustic properties at the lumbar and the femur is required to estimate BMD of these sites more accurately.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.67-72
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• 2009

Purpose: ISCD (International Society for Clinical Densitometry) requests that users perform mandatory Precision test to raise their quality even though there is no recommendation about patient selection for the test. Thus, we investigated the effect on precision test by measuring reproducibility of 3 bone density groups (normal, osteopenia, osteoporosis). Materials and Methods: 4 users performed precision test with 420 patients (age: $57.8{\pm}9.02$) for BMD in Asan Medical Center (JAN-2008 ~ JUN-2008). In first group (A), 4 users selected 30 patient respectively regardless of bone density condition and measured 2 part (L-spine, femur) in twice. In second group (B), 4 users measured bone density of 10 patients respectively in the same manner of first group (A) users but dividing patient into 3 stages (normal, osteopenia, osteoporosis). In third group (C), 2 users measured 30 patients respectively in the same manner of first group (A) users considering bone density condition. We used GE Lunar Prodigy Advance (Encore. V11.4) and analyzed the result by comparing %CV to LSC using precision tool from ISCD. Check back was done using SPSS. Results: In group A, the %CV calculated by 4 users (a, b, c, d) were 1.16, 1.01, 1.19, 0.65 g/$cm^2$ in L-spine and 0.69, 0.58, 0.97, 0.47 g/$cm^2$ in femur. In group B, the %CV calculated by 4 users (a, b, c, d) were 1.01, 1.19, 0.83, 1.37 g/$cm^2$ in L-spine and 1.03, 0.54, 0.69, 0.58 g/$cm^2$ in femur. When comparing results (group A, B), we found no considerable differences. In group C, the user_1's %CV of normal, osteopenia and osteoporosis were 1.26, 0.94, 0.94 g/$cm^2$ in L-spine and 0.94, 0.79, 1.01 g/$cm^2$ in femur. And the user_2's %CV were 0.97, 0.83, 0.72 g/$cm^2$ L-spine and 0.65, 0.65, 1.05 g/$cm^2$ in femur. When analyzing the result, we figured out that the difference of reproducibility was almost not found but the differences of two users' several result values have effect on total reproducibility. Conclusions: Precision test is a important factor of bone density follow up. When Machine and user's reproducibility is getting better, it’s useful in clinics because of low range of deviation. Users have to check machine's reproducibility before the test and keep the same mind doing BMD test for patient. In precision test, the difference of measured value is usually found for ROI change caused by patient position. In case of osteoporosis patient, there is difficult to make initial ROI accurately more than normal and osteopenia patient due to lack of bone recognition even though ROI is made automatically by computer software. However, initial ROI is very important and users have to make coherent ROI because we use ROI Copy function in a follow up. In this study, we performed precision test considering bone density condition and found LSC value was stayed within 3%. There was no considerable difference. Thus, patient selection could be done regardless of bone density condition.

• Journal of radiological science and technology
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• v.22 no.2
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• pp.41-46
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• 1999

Osteoporosis, which causes mainly fracture of the spine, proximal femur and distal radius by minimal trauma, is a major public health problem and its prevalence is steadily increasing in Korea according to the development of public health care. There are reliable methods for diagnosis based on bone densitometry. Early detection and intervention are important for reducing the incidence of fractures. A consensus definition of osteoporosis, based on bone density measurement, has been developed by the World Health Organization(WHO). In this study, bone mineral density(RMD) was measured by dual energy x-ray absorptiometry(DEXA) at the proximal femur and lumbar spine in 132 post-menopausal women. The purpose of this study is to find influential factors on the BMD of the proximal femur and the lumbar spine and to analyze correlation between BMD and the problematic factors. We obtained the following results : 1. Mean BMD score, T-score and Z-score of the proximal femur were $0.81(g/cm^2)$, -2.45(S.D.) and -2.09(S.D.) respectively and in the lumbar spine were $0.83(g/cm^2)$, -2.02(S.D.), -2.43(S.D.) respectively. 2. In correlation analysis between BMD and many factors, correlation coefficients were -0.467, 0.212, -0.321 and 0.241 in age, height, duration after menopause respectively. BMI and the residuals were comparatively small. 3. Correlation coefficients to age matched BMD, in height and body weight were 0.222 and 0.241, in age and duration after menopause were -0.268, -0.282. 4. The fracture threshold of proximal femur BMD to the 90th percentile was $0.845(g/cm^2)$. 5. At the result of multiple regression analysis, age, body weight, $BMI(kg/m^2)$ and duration after menopause described as significant variables.

• Proceedings of the KOSOMBE Conference
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• v.1995 no.05
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• pp.19-22
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• 1995

A biomechanical study was made to demonstrate the superior mechanical performance of the newly designed Miniplate staple to the conventional Coventry staple in high tibial osteotomy(HTO). Using twenty fresh porcine tibiae, the fixational strengh of the two different types of staple in HTO was compared. To minimize the error due to the specimen-to-specimen individuality, the bone mineral density of the tibiae was measured with a bone densitometry (Dual photon absorptionometer, Luner, USA) and those with $0.8\;{\sim}\;1.2\;gm/cm^2$ at the proximal tibia was used in the biomechanical test. Testing was performed on a material testing system (Autogram ET-5, Shimatzu, Japan) with aid of a commercial data processor (IBM 80386/ ASYST). Using two differant loading modes, 'pull-out' and 'push-out', the maximum resistant force required to release the staple from the substrate bone was recorded. In the pull-out test, ten non-osteotomized specimens were used and the staple was pullout by subjecting an axial tension on the head of the staple inserted. While in the pull-out test where ten tibiae osteotomized in the usual way of HTO were used, the staple was not directly loaded. In this testing, as a mimic condition of the natural knee, the distal part of the specimen tibia was pushed horizontally in order for the staple to be pulled out while the proximal tibia was fixed. The pull-out strength of Coventry staple and miniplate staple were found to be $27.88\;{\pm}\;5.12\;kgf$ and $182.47\;{\pm}\;32.75\;kgf$, respectively. The push-out strength of Coventry staple and miniplate staple were $18.40\;{\pm}\;4.47\;kgf$ and $119.95\;{\pm}\;19.06\;kgf$, respectively. The result revealed that miniplate staple had the pull-out/ push-out strength at least fivetimes higher than Coventry staple. Based on the measured data, it was believed that the newly designed miniplate staple could provide much better postoperative fixation in HTO. The postoerative application of long leg casting may not be needed after HTO surgery.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.73-76
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• 2009

Purpose: Bone mineral densitometry test region advised by ISCD (International Society for Clinical Densitometry) is both site in case of femur, whereas our medical center measures left femur except for few extraordinary cases. It is said that right-handers had higher mean femur BMD in the left side than in the right side, but the factor influence the femur BMD is unknown. Thus, we investigate whether testing left femur only is a adequate clinical diagnosis. Materials and Methods: Subjects were 209 right-handers and 20 left-handers patient in Asan Medical Center from July to August, 30 to 70 years of age ($51{\pm}6.7$). Subjects fill out the questionnaire on hand preference and taking regular exercise. Total BMDs of bilateral femur were measured with GE Lunar Prodigy advance densitometer, and the statistical soft ware SPSS 12.0 for windows was used for statistical analysis. Results: In the total sample of the exercise group (n=127), the difference of both femur mean BMDs are $0.001{\pm}0.127\;g/cm^2$ and the non-exercise group's (n=102) both femur difference is $0.002{\pm}0.126\;g/cm^2$, there is no significant difference. And in exercise group, classified according to hand preference, each t-value is shown at right handers (n=114) are 0.65, left handers (n=13) are -0.39. Also, In non-exercise group, right handers (n=95) are -0.78, left handers (n=7) are -0.64. In the 95% confidence limit, there was no statistically significant difference (p>0.05). Conclusions: In recently researchs, there have been differences between both femurs according to hand preference. However, Our study have no significant difference both femurs BMDs. Therefore we suggest that BMD measurement of femur has no problem only one side, except for particular case like femur operation.

• Journal of radiological science and technology
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• v.46 no.1
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• pp.1-8
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• 2023

As the demand for bone mineral density testing increases in Korea, which is close to an aging society, it is necessary to evaluate the repeatability of equipment such as femur phantom other than l-spine for more accurate diagnosis. However, in clinical practice, it is often not possible to proceed such evaluation due to insufficient quality control conditions. Therefore, this study is to evaluate the usefulness of the femur phantom after fabricating the same using 3D printing technology. The femur phantom was output using GlowFill filament and FDM 3D printing type. Each phantom was repeatedly scaned 20 times to compare whether the existing l-spine phantom and the fabricated femur phantom were suitable as a phantom for quality control. Each time the seven researchers took three times, the location of the femur phantom was readjusted, and then scanned to confirm the error between the researchers. As a result of conducting repeatability evaluation using femur phantom, the coefficient of variation rate was 2%, which was within the minimum precision tolerance of 2.5%. The reproducibility between the researcher was also found to be suitable as the average coefficient of variation was 0.031 and the coefficient of variation rate was 3.1%, which was within the minimum precision error range of 5%. In conclusion, it is considered that the prospective attitude and usefulness of the femur phantom fabricated by 3D printing in clinical practice will be sufficient.

• Journal of radiological science and technology
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• v.29 no.3
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• pp.177-184
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• 2006

Purpose: To evaluate the correlation between BMD and life habit such as drinking. exercise smoking or physical condition such as age, sex, height, weight, body mass index(BMI). Materials and Methods: I evaluated the BMD of the femoral neck and L2-L4 spines of 321 persons who took a regular health screening in Woosuk university oriental medical hospital from February to April in 2006 by dual energy bone mineral densitometry. Results: The age of persons ranged from 20 years to 75 years(mean $45.10{\pm}11.54$) and there were 160 males and 161 females. In males, BMD of the femoral head was highest at 2nd decade, BMD of the spine was highest at 4th decade, and BMD of both femoral head and lumbar spine was lowest at 6th decade. In fenales, BMD of both femoral head and lumbar spine was highest at 4th decade and lowest at 6th decade. Among the various physical conditions, only height of persons showed significant correlation with BMD in both males and females. BMD was increased according to increasing height. In males, BMD of persons who had habit such as drinking, exercise or smoking did not show significant change statistically. But in females, drinking group showed high BMD relative to non-drinking group in both femoral head and lumbar spine. Conclusion: BMD was different according to age, sex, height and life habit. Especially aged people showed osteoporotic change progressively. More persistent effort is needed to find out the factors decreasing BMD for prevention of problems by osteoporosis.

• Journal of Korean Foot and Ankle Society
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• v.21 no.3
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• pp.93-97
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• 2017

Purpose: The aim of this study was to evaluate the radiological and clinical outcomes of scarf osteotomy for hallux valgus (HV) deformity in elderly patient with osteoporosis. Materials and Methods: A total of 58 elderly patients (mean age, 72.6 years) underwent scarf osteotomy for HV deformity between 2008 and 2015. The mean follow-up period was 24.4 months. Of the 58 patients, 42 were diagnosed with osteoporosis and 16 were diagnosed as normal. The radiological and clinical outcomes were assessed preoperatively, postoperatively, and at final follow-up, including HV angle, intermetatarsal (IM) angle, American Orthopaedic Foot and Ankle Society (AOFAS) score, patient satisfaction, visual analogue scale (VAS), and complication. Results: There was no significant difference in HV angle and IM angle between the osteoporosis group and normal bone mineral densitometry group at all time points, preoperative, postoperative, and final follow-up. Moreover, there was no statistically significant difference between the two groups with respect to the AOFAS score and VAS evaluations. In the osteoporosis group, the mean HV angle improved from $36.7^{\circ}$ preoperatively to $11.3^{\circ}$ at the time of final follow-up, and the mean IM angle improved from $13.2^{\circ}$ to $5.7^{\circ}$. The mean AOFAS score improved from 52.6 preoperatively to 89.1 at the time of final follow-up. With respect to satisfaction, 83.4% of patients were very satisfied or satisfied. There were no serious complications, and all cases showed complete union at the osteotomy site. Conclusion: We believed that scarf osteotomy is a safe, effective procedure for the correction of elderly patients with osteoporosis.