• Journal of Preventive Medicine and Public Health
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• v.54 no.6
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• pp.412-421
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• 2021

Objectives: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent metabolic disease. Muscle is known to influence NAFLD development. Therefore, this study aimed to determine the relationships among low muscle mass, NAFLD, and hepatic fibrosis using various definitions of low muscle mass and NAFLD diagnostic methods, including magnetic resonance imaging-based proton density fat fraction (MRI-PDFF). Methods: This cross-sectional study included 320 participants (107 males, 213 females) from the Korean Genome and Epidemiology Study on Atherosclerosis Risk of Rural Areas in the Korean General Population cohort. Muscle mass was assessed using whole-body dual-energy X-ray absorptiometry and adjusted for the height squared, body weight, and body mass index (BMI). NAFLD was diagnosed using ultrasonography (US), MRI-PDFF, and the comprehensive NAFLD score (CNS). Hepatic fibrosis was assessed using magnetic resonance elastography. Multivariable logistic and linear regression analyses were performed to determine the aforementioned associations. Results: According to US, 183 participants (57.2%) had NAFLD. Muscle mass adjusted for body weight was associated with NAFLD diagnosed using US (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.70 to 5.31), MRI-PDFF (OR, 2.00; 95% CI, 1.13 to 3.53), and CNS (OR, 3.39; 95% CI, 1.73 to 6.65) and hepatic fibrosis (males: β=-0.070, p<0.01; females: β=-0.037, p<0.04). Muscle mass adjusted for BMI was associated with NAFLD diagnosed by US (OR, 1.71; 95% CI, 1.02 to 2.86) and CNS (OR, 1.95; 95% CI, 1.04 to 3.65), whereas muscle mass adjusted for height was not associated with NAFLD. Conclusions: Low muscle mass was associated with NAFLD and liver fibrosis; therefore, maintaining sufficient muscle mass is important to prevent NAFLD. A prospective study and additional consideration of muscle quality are needed to strengthen the findings regarding this association.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.96-106
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• 2022

Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

• 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.

• 한국체육학회지인문사회과학편
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• v.54 no.1
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• pp.535-544
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• 2015

This study was performed to determine the effect of low-intensity resistance training with blood flow restriction (BFR) on muscle volume and strength in elderly women. Sixteen elderly women (70.9±4.6 years) were divided into low (30% 1RM) and high (75% 1RM) intense resistance training groups. Tourniquet cuff (Zimmer, Germany) for BFR was applied only to the right leg during the training period. All subjects performed unilateral leg press, leg extension and leg curl (3 sets×12 repetitions) for 10 weeks (2d/wk). Blood pressure was increased from 110 to 240 mmHg during the training period at the most proximal region of exercised leg. Muscle volume and cross-sectional area (CSA) were measured by MRI and body composition was monitored by dual-energy X-ray absorptiometry (DEXA) and isokinetic muscular strength were analyzed in both legs. The quadriceps CSA (15.2%, p<.001) and muscle volume (13.8%, p<.001) were increased in high-intense trained leg with BFR and the increased rate was highest among groups. The quadriceps CSA (9.8%, p<.001) and muscle volume (6.9%, p<.001) were increased in low-intensity training group with BFR and their increased rates were higher than control groups. The strength by exercise training was significantly improved in all groups and tended to be higher in BFR groups. These results demonstrate low-intensity resistance training with blood flow restriction could be an effective way to improve muscle volume and strength in elderly women.

• Journal of radiological science and technology
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• v.36 no.4
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• pp.263-271
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• 2013

The decrease of bone mineral density gives rise to the outbreak of osteopenia and makes the possibility of a bone fracture. It makes health problems in society. It's very important to prevent osteopenia in advance. Also it's critical to prevent and take care of it in adolescent because it's the most developing period comparing to middle ages because that bone mineral density decreases. There are genetic, physical and enviromental factors that affect bone mineral density. Recently, a lifestyle and eating habits are also changing as the society atmosphere is gradually doing. This study have shown that 134 women and 75 men was chosen and responded to the survey of measuring bone mineral density and investigating a lifestyle. The measure of bone mineral density is to use Dual energy X-ray absorptiometry(DEXA) and check femoral neck and lumbar spine. Also questionaries was required to pre-made survey about their lifestyles. Analysis of data was done with SPSS program. Multiple regression analysis was used for the relation of bone mineral density, the heigths and BMI. The sample of Groups are checked for drinking, smoking or excercising about differences by t-test. The results of the experiments were; first, there is statistically significant differences in the comparisons between BMD and BMD. But there isn't any special correlation between drinking, smoking and BMD. Secondly, bone mineral density becomes low related to an intake of caffeine. Particularly, this is statically significant on women. Also there is statically significant correlation between femoral neck and quantity of motion for both men and women. Third, there is significant relation between eating habits and bone mineral density on women's lumbar spine. However, there is no significant relation between men's lumbar spine and women's one. Therefore, to prevent osteopenia, it's good to abstain from intaking caffeine within an hour after a meal. In addition, it's helpful to walk or run regularly and have a balanced meal.

• Journal of the Korean Society of Radiology
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• v.11 no.1
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• pp.43-48
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• 2017

Measurement of bone marrow measurements may occur if bone marrow examination performed with bone marrow examination (bone marrow examination) and bone density (bone scan) are performed together recently. Thus, it was examined in clinical aspects that $^{99m}Tc-MDP$ compounds were affected by bone mineral density measurements. The average age of the participants in the experiment was $35.17{\pm}9.45$ and the patient fractures of the lumbar vertebrae that could affect the metabolic disease and bone density measurements affecting the metabolic disease of the 17 subjects. 6 patients with normal bone mineral density T-scores>-1.0 in 12 patients were analyzed before and after the administration of $^{99m}Tc-MDP$. In the lumbar spine, the average of $0.975{\pm}0.084g/cm^2$ and $0.966{\pm}0.078g/cm^2$ were increased by $0.009g/cm^2$. respectively In the right proximal femur, mean values were $0.909{\pm}0.078g/cm^2$ and $0.913{\pm}0.086g/cm^2$. In the right proximal thigh, mean values were $0.909{\pm}0.078g/cm^2$ and $0.913{\pm}0.08 g/cm^2$, respectively, which decreased by $0.004g/cm^2$. In the left side proximal femur, mean $0.887{\pm}0.099g/cm^2$ and $0.881{\pm}0.103g/cm^2$, respectively, increased by $0.007g/cm^2$. Therefore, the BMD changes in the lumbar region were larger than that in the proximal thigh. In addition, $^{99m}Tc-MDP$ did not affect the BMD. And a bone scan test using a technetium-labeled compound emitting a gamma-ray energy of 140 keV did not significantly affect bone density measurements. However, if the nuclear medical examination and the osteoporosis test are to be performed together, the examination should be carried out at intervals considering the exposures of the patient.

• The Korean Journal of Food And Nutrition
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• v.11 no.1
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• pp.87-98
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• 1998

This study was conducted to investigate Osteoporosis on the effect of dietary factors and past young age period's dairy products consumption on BMD in 170 postmenopausal Korean women without diagnosed disease. Bone mineral density(BMD) of lumbar spine was investigated by dual energy X-ray absorptiometry. Dietary assesment of the subjects were measured by Cognitive Food Frequency Recall method. The measurements of group average were 57.9kg of body weight, 36.73 of BMI(Body Mass Index), 2103.3㎉ of energy, 638.7mg of dietary calcium, 70.3g of protein, and 10.58mg of iron. Nutrient intake levels were similar to or more than the level of Korean Recommended Dietary Allowances. Bone Mineral Density(BMD) of Lumbar spine(L2-L4) of group average was 0.912g/$\textrm{cm}^2$, and under 50 yr's 1,02g/$\textrm{cm}^2$, 50~54 yr's 0.92g/$\textrm{cm}^2$, 55~59 yr's 0.85g/$\textrm{cm}^2$, over 60 yr's 0.85g/$\textrm{cm}^2$, had been getting low degree on aging. BMD of the Lumbar spine was positively correlated with calorie, body weight, dietary calcium, protein, phosphorus and serum albumin. Past dairy products consumption experiment was highly significant on BMD in teenage period(R square = 26, p-value 0.0031). Particularly in over 60 yr group, the correlations between BMD and past dairy products consumption in teenage period had shown highly significance(r=0.48, p<0.02). 55~59 yr age group had also positive correlation(R squae = 0.29, p<0.05). This results confirm that the most effective way of preventing osteoporosis and the fractures is to maximize peak bone mass in early life and to minimize bone loss through the balanced intake of Ca and other nutrients and regular physical activity.

• Journal of Nutrition and Health
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• v.35 no.4
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• pp.473-479
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• 2002

This study investigated associations between calcium intake, exercise behaviors, lumbar bona mineral density (BMD), and bone mineral content (BMC) among 79 premenopausal women (mean age = 41yr). The BMD and BMC of the lumbar spine (L$_2$-L$_4$) were measured by dual energy x-ray absorptiometry. Nutrient intake was estimated by the convenient method and a quantitative food frequency questionnaire was designed for this study that included the most commonly consumed floods sources of Ca. Participants were asked to identify all activities of exercise they had participated in including estimation of number of years of participation, number of weeks per year, number of times per week, and the number of hours per session. Participants were then categorized into the exercise group or nonexercise group (control). To meet the criteria for inclusion in the exercise group, the subjects participated more than 3 sessions per week and more than 30 minutes per session and the length of the exercise participation was at least more then 6 months. The participants were also grouped by calcium intake. The total calcium intake of all participants was estimated by dietary calcium intake and then the subjects were divided into quartiles to assess the lumbar BMD and BMC of the upper 25% (average calcium intake = 910 mg) and the lower 25% (average calcium intake = 414 mg). Results indicated that there were no significant differences in energy and calcium intake, and that there were no significant differences in lumbar BMD and BMC between participants in exercise group and the nonexercising control group. However, the exercise group had significantly lower ALP concentration than the nonexercise group. The upper 25% calcium intake group had significantly greater lumbar bone mineral density and bone mineral content than the lower 25% calcium intake group. Also the upper 25% calcium intake group had significantly lower ALP concentration than the lower 25% calcium intake group. Correlation analysis revealed that the spinal BMB was positively associated with body weight, while calcium intake was negatively associated with ALP concentration in nonexercising women. However, neither body weight nor dietary calcium intake were associated with both spinal BMD or ALP concentration in exercising women. These results suggest that calcium intake positively influence bone mineral density and bone mineral content in nonexercisulg premenopausal women. Exercise group did not affected by body weight and dietary calcium, but decreased ALP concentration than nonexercising group. Both exercise and calcium intake positively influence bone mineral density and bone mineral content in premenopausal women.

• Journal of Nutrition and Health
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• v.35 no.4
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• pp.464-472
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• 2002

This study was conducted to investigate dietary and other factors affecting bone mineral density in young Korean collage women. Thirty subjects were recruited; the mean age was 22.1 years and the mean age at menarche was 12.6 years. Bone mineral density (BMD) was measured in the spine (LS), femoral neck (FN), ward's triangle (WT), and femoral trochanter (FT) by Dual Energy X-ray Absorptiometry (DEXA), and physical activity was assessed by a questionnaire. Dietary intake data were obtained 8 times by using a 24 hour recall method to evaluate the subjects' usual diet. Bone mineral densities of lumbar spine, femoral neck, ward's triangle and femoral trochanter were 1.149 g/$\textrm{cm}^2$, 0.980 g/$\textrm{cm}^2$, 0.936 g/$\textrm{cm}^2$ and 0.759 g/$\textrm{cm}^2$ respectively. The met energy intake of subjects was 1,790 kcal, and calcium and iron intakes were found to be inadequate compared to the Korean RDA. The BMD of the lumbar spine was significantly and positively related to the BMI and intake of vitamin C, carbohydrate, potatoes, fruits and plant food. The BMD of the femur (FN, WT, FT) was positively related to the BMI, to carbohydrate and fruit intake, and to the percentage of plant food in total food intake. Multiple recession analysis showed that fruit intake was significantly related to the BMD of the LS. The subjects'ages and fruit intakes were significantly related to the BMD of the femur (FN, WT, FT). These results indicate that higher fruit intakes may have a beneficial effect on bone mineral density.

• Korean Journal of Community Nutrition
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• v.7 no.1
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• pp.121-129
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• 2002

Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.