• Title/Summary/Keyword: Bone volume density

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Quantitative Vertebral Bone Density Seen on Chest CT in Chronic Obstructive Pulmonary Disease Patients: Association with Mortality in the Korean Obstructive Lung Disease Cohort

  • Hye Jeon Hwang;Sang Min Lee;Joon Beom Seo;Ji-Eun Kim;Hye Young Choi;Namkug Kim;Jae Seung Lee;Sei Won Lee;Yeon-Mok Oh
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.880-890
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    • 2020
  • Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (DThorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. DThorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between DThorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. DThorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. DThorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV1) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DLCO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower DThorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower DThorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV1, and lower DLCO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

Fabrication of Porous β-TCP Bone Graft Substitutes Using PMMA Powder and their Biocompatibility Study (PMMA를 이용한 다공질 β-TCP 골충진제 제조 및 생체적합성 평가)

  • Song, Ho-Yeon;Youn, Min-Ho;Kim, Young-Hee;Min, Young-Ki;Yang, Hun-Mo;Lee, Byong-Taek
    • Korean Journal of Materials Research
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    • v.17 no.6
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    • pp.318-322
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    • 2007
  • Porous ${\beta}-tricalcium$ phosphate $({\beta}-TCP)$ bioceramic was fabricated by pressureless sintering using commercial HAp and different volume percentages of PMMA powders (30-60 vol.%). The range of spherical pore size was about $200-250\;{\mu}m$ in diameter. By increasing the PMMA content, the number of pores and their morphology were dramatically changed as well as decreased the material properties. In case of using 60 vol.% PMMA content, network-type pores were found, due to the necking of the PMMA powders. The values of relative density, elastic modulus, bending strength and hardness of the 60 vol.% PMMA content sample, sintered at $1500^{\circ}C$, were about 46%, 22.2 GPa, 5MPa and 182 Hv respectively. Human osteoblast-like MG-63 cells and osteoclast-like Raw 264.7 cells were well grown and fully covered all of the porous ${\beta}-TCP$ bodies sintered at $1500^{\circ}C$.

Effect of Space Holder Content on Pore Size and Distribution in HA/β-TCP Composites Consolidated by SPS (SPS로 제조된 HA/β-TCP 복합재의 기공의 크기와 분포에 미치는 지지체 량의 영향)

  • Lee, Tack;Woo, Kee-Do;Kang, Dong-Soo;Lee, Hae-Cheol;Jang, Jun-Ho
    • Korean Journal of Materials Research
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    • v.25 no.4
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    • pp.165-170
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    • 2015
  • Ceramics biomaterials are useful as implant materials in orthopedic surgery. In this study, porous HA(hydroxyapatite)/${\beta}$-TCP(tricalcium phosphate) composite biomaterials were successfully fabricated using HA/${\beta}$-TCP powders with 10-30 wt% $NH_4HCO_3$ as a space holder(SH) and $TiH_2$ as a foaming agent, and MgO powder as a binder. The HA/${\beta}$-TCP powders were consolidated by spark plasma sintering(SPS) process at $1000^{\circ}C$ under 20 MPa conditions. The effect of SH content on the pore size and distribution of the HA/${\beta}$-TCP composite was observed by scanning electron microscopy(SEM) and a microfocus X-ray computer tomography system(SMX-225CT). These microstructure observations revealed that the volume fraction of the pores increased with increasing SH content. The pore size of the HA/${\beta}$-TCP composites is about $400-500{\mu}m$. The relative density of the porous HA/${\beta}$-TCP composite increased with decreasing SH content. The porous HA/${\beta}$-TCP composite fabricated with 30%SH exhibited an elastic modulus similar to that of cortical bone; however, the compression strength of this composite is higher than that of cortical bone.

Expression of Human Growth Hormone Gene using Retrovirus Vector System In Vitro (In Vitro에서 Retrovirus Vector System을 이용한 인간 성장 호르몬 유전자의 발현)

  • Kim, Min-Ki;Koo, Bon-Chul;Kwon, Mo-Sun;Kim, Te-Oan
    • Reproductive and Developmental Biology
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    • v.35 no.3
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    • pp.251-256
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    • 2011
  • Human growth hormone (hGH), one of the most important hormones in medicine, is secreted from anterior pituitary gland. Its broad physiological function includes body growth, cell regeneration, increasement of muscle volume, bone density, body fat reduction, and so on. Due to the wide range of therapeutic effects, the hGH produced from E. coli has been commercialized already. In this study, we asked whether it is possible to produce recombinant hGH efficiently from various cultured mammalia cells. To meet this purpose, we chose a retrovirus vector system for transfer and expression of the hGH gene in various mammalian cells. Analyses of RT-PCR, ELISA, and Western blot to determine expression of the hGH gene showed the highest production of the hGH was determined from chicken embronic fibroblast (CEF) cells with the concentration of 8.58 ${\mu}g$/ml. The biological activity of the hGH was similar to the commercially available counterpart. These results suggest that mass production of hGH is possible not only in the E. coli but also in the various mammalian cells.

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction

  • Doh, Re-Mee;Kim, Sungtae;Keum, Ki Chang;Kim, Jun Won;Shim, June-Sung;Jung, Han-Sung;Park, Kyeong-Mee;Chung, Moon-Kyu
    • The Journal of Advanced Prosthodontics
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    • v.8 no.5
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    • pp.363-371
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    • 2016
  • PURPOSE. On maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages. MATERIALS AND METHODS. Custom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation). RESULTS. The bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study. CONCLUSION. Within the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

The Analysis of Patterns and Risk Factors of Newly Developed Vertebral Compression Fractures after Percutaneous Vertebroplasty

  • Yoo, Chai Min;Park, Kyung Bum;Hwang, Soo Hyun;Kang, Dong Ho;Jung, Jin Myung;Park, In Sung
    • Journal of Korean Neurosurgical Society
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    • v.52 no.4
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    • pp.339-345
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    • 2012
  • Objective : The purpose of this study was to investigate the patterns and the risk factors of newly developed vertebral compression fractures (VCFs) after percutaneous vertebroplasty (PVP). Methods : We performed a retrospective review of the 244 patients treated with PVP from September 2006 to February 2011. Among these patients, we selected 49 patients with newly developed VCFs following PVP as the new VCFs group, and the remaining 195 patients as the no VCFs group. The new VCFs group was further divided into 2 groups : an adjacent fractures group and a nonadjacent fractures group. The following data were collected from the groups : age, gender, body weight/height, body mass index (BMI), bone mineral density (BMD) score of the spine and femur, level of initial fracture, restoration rate of anterior/middle vertebral height, and intradiscal cement leakage, volume of polymethylmethacrylate (PMMA). Results : Age, gender, mean body height/weight, mean BMI and volume of PMMA of each of the group are not statistically significantly associated with fractures. In comparison between the new VCFs group and the no VCFs group, lower BMD, intradiscal cement leakage and anterior vertebral height restoration were the significant predictive factors of the fracture. In addition, new VCFs occurrence at the adjacent spines was statistically significant, when the initial fracture levels were confined to the thoracolumbar junction, among the subgroups of new VCFs. Conclusion : Lower spinal BMD, the greater anterior vertebral height restoration rate and intradiscal cement leakage were confirmed as risk factors for newly formed VCFs after PVP.

Risk Factors of Proximal Junctional Kyphosis after Multilevel Fusion Surgery : More Than 2 Years Follow-Up Data

  • Kim, Do Keun;Kim, Ji Yong;Kim, Do Yeon;Rhim, Seung Chul;Yoon, Seung Hwan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.174-180
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    • 2017
  • Objective : Proximal junctional kyphosis (PJK) is radiologic finding, and is defined as kyphosis of >$10^{\circ}$ at the proximal end of a construct. The aim of this study is to identify factors associated with PJK after segmental spinal instrumented fusion in adults with spinal deformity with a minimum follow-up of 2 years. Methods : A total of 49 cases of adult spinal deformity treated by segmental spinal instrumented fusion at two university hospitals from 2004 to 2011 were enrolled in this study. All enrolled cases included at least 4 or more levels from L5 or the sacral level. The patients were divided into two groups based on the presence of PJK during follow-up, and these two groups were compared to identify factors related to PJK. Results : PJK was observed in 16 of the 49 cases. Age, sex and mean follow-up duration were not statistically different between two groups. However, mean bone marrow density (BMD) and mean back muscle volume at the T10 to L2 level was significantly lower in the PJK group. Preoperatively, the distance between the C7 plumb line and uppermost instrumented vertebra (UIV) were no different in the two groups, but at final follow-up a significant intergroup difference was observed. Interestingly, spinal instrumentation factors, such as, receipt of a revision operation, the use of a cross-link, and screw fracture were no different in the two groups at final follow-up. Conclusion : Preoperative BMD, sagittal imbalance at UIV, and thoracolumbar muscle volume were found to be strongly associated with the presence of PJK.

The role of internal architecture in producing high-strength 3D printed cobalt-chromium objects

  • Abdullah Jasim Mohammed;Ahmed Asim Al-Ali
    • The Journal of Advanced Prosthodontics
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    • v.16 no.2
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    • pp.91-104
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    • 2024
  • PURPOSE. The objectives of the current study were to estimate the influence of self-reinforced hollow structures with a graded density on the dimensional accuracy, weight, and mechanical properties of Co-Cr objects printed with the direct metal laser sintering (DMLS) technique. MATERIALS AND METHODS. Sixty-five dog-bone samples were manufactured to evaluate the dimensional accuracy of printing, weight, and tensile properties of DMLS printed Co-Cr. They were divided into Group 1 (control) (n = 5), Group 2, 3, and 4 with incorporated hollow structures based on (spherical, elliptical, and diamond) shapes; they were subdivided into subgroups (n = 5) according to the volumetric reduction (10%, 15%, 20% and 25%). Radiographic imaging and microscopic analysis of the fractographs were conducted to validate the created geometries; the dimensional accuracy, weight, yield tensile strength, and modulus of elasticity were calculated. The data were estimated by one-way ANOVA and Duncan's tests at P < .05. RESULTS. The accuracy test showed an insignificant difference in the x, y, z directions in all printed groups. The weight was significantly reduced proportionally to the reduced volume fraction. The yield strength and elastic modulus of the control group and Group 2 at 10% volume reduction were comparable and significantly higher than the other subgroups. CONCLUSION. The printing accuracy was not affected by the presence or type of the hollow geometry. The weight of Group 2 at 10% reduction was significantly lower than that of the control group. The yield strength and elastic modulus of the Group 2 at a 10% reduction showed means equivalent to the compact objects and were significantly higher than other subgroups.

Effect of Inhomogeneity correction for lung volume model in TPS (Lnug Volume을 모델로 한 방사선치료계획 시 불균질 조직 보정에 따른 효과)

  • Chung SeYoung;Lee SangRok;Kim YoungBum;Kwon YoungHo
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.57-65
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    • 2004
  • Introduction : The phantom that includes high density materials such as steel was custom-made to fix lung and bone in order to evaluation inhomogeneity correction at the time of conducting radiation therapy to treat lung cancer. Using this, values resulting from the inhomogeneous correction algorithm are compared on the 2 and 3 dimensional radiation therapy planning systems. Moreover, change in dose calculation was evaluated according to inhomogeneous by comparing with the actual measurement. Materials and Methods : As for the image acquisition, inhomogeneous correction phantom(Pig's vertebra, steel(8.21g/cm3), cork(0.23 g/cm3)) that was custom-made and the CT(Volume zoom, Siemens, Germany) were used. As for the radiation therapy planning system, Marks Plan(2D) and XiO(CMS, USA, 3D) were used. To compare with the measurement value, linear accelerator(CL/1800, Varian, USA) and ion chamber were used. Image, obtained from the CT was used to obtain point dose and dose distribution from the region of interest (ROI) while on the radiation therapy planning device. After measurement was conducted under the same conditions, value on the treatment planning device and measured value were subjected to comparison and analysis. And difference between the resulting for the evaluation on the use (or non-use) of inhomogeneity correction algorithm, and diverse inhomogeneity correction algorithm that is included in the radiation therapy planning device was compared as well. Results : As result of comparing the results of measurement value on the region of interest within the inhomogeneity correction phantom and the value that resulted from the homogeneous and inhomogeneous correction, gained from the therapy planning device, margin of error of the measurement value and inhomogeneous correction value at the location 1 of the lung showed $0.8\%$ on 2D and $0.5\%$ on 3D. Margin of error of the measurement value and inhomogeneous correction value at the location 1 of the steel showed $12\%$ on 2D and $5\%$ on 3D, however, it is possible to see that the value that is not correction and the margin of error of the measurement value stand at $16\%$ and $14\%$, respectively. Moreover, values of the 3D showed lower margin of error compared to 2D. Conclusion : Revision according to the density of tissue must be executed during radiation therapy planning. To ensure a more accurate planning, use of 3D planning system is recommended more so than the 2D Planning system to ensure a more accurate revision on the therapy plan. Moreover, 3D Planning system needs to select and use the most accurate and appropriate inhomogeneous correction algorithm through actual measurement. In addition, comparison and analysis through TLD or film dosimetry are needed.

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Is the Agricultural Work a Risk Factor for Koreans Elderly Spinal Sagittal Imbalance?

  • Hong, Jong-Hwan;Han, Moon-Soo;Lee, Seul-Kee;Lee, Jung-Kil;Moon, Bong Ju
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.623-630
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    • 2020
  • Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.