• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.137-142
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• 2009

Purpose: World Health Organization (WHO) have suggested that an individual's 10-year absolute fracture risk is more reliable than Bone Mineral Density (BMD) measurement as the predictor of osteoporotic fracture. In 2008, Fracture Risk Assessment Tool ($FRAX^{TM}$) was developed by WHO to evaluate fracture risk of patients based on individual's clinical risk factors. The purpose of this study is to offer the comparative analysis of the existing GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Materials and Methods: 201 women ($55{\pm}3.5$ years) underwent femoral neck BMD measurement using GE Prodigy. The 10-year probability (%) of hip fracture (or a major osteoporosis-related fracture) was estimated using T-scores of GE prodigy and $FRAX^{TM}$. We made a comparative analysis of these data using SPSS (Ver.12). Results: There was a significant difference statistically between T-score ($-0.52{\pm}0.97$) of GE prodigy and T-score ($-1.45{\pm}0.81$) of $FRAX^{TM}$ (r=0.977, p=0.000). Also, there was a significant difference statistically between a major osteoporosis- related fracture ($9.15{\pm}3.71$) of GE prodigy and a major osteoporosis-related fracture ($4.87{\pm}1.51$) of $FRAX^{TM}$ (r=0.909, p=0.000). Moreover, a statistically significant difference was found in the 10-year probability of hip fracture of GE prodigy ($1.56{\pm}1.48$) and of hip fracture ($0.53{\pm}0.61$) of $FRAX^{TM}$ (r=0.905, p=0.000). Conclusions: There was a significant difference statistically between GE prodigy and $FRAX^{TM}$ Tool in Absolute Fracture Risk Assessment Tool. Especially, T-score, a major osteoporosis-related fracture and the 10-year probability of hip fracture that were estimated using GE prodigy tended to show the higher results than one evaluated by $FRAX^{TM}$ Tool. In conclusion, $FRAX^{TM}$ Tool may provide a better tool. The application of $FRAX^{TM}$ Tool as a fracture predictor remains to be clarified.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.346-349
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• 2015

Objective : To investigate the value of lumbar bone mineral density (BMD) in fracture risk assessment (FRAX) tool. Methods : One hundred and ten patients aged over 60 years were enrolled and divided into 2 groups as non-osteoporotic vertebral fracture (OVF) and OVF groups. The 10-year-risk of major osteoporotic vertebral fracture of each group was calculated by FRAX tool with femoral and lumbar spine BMDs to compare the usefulness of lumbar spine BMD in prediction of OVF. The blood level of osteocalcin and C-terminal telopeptide (CTX) as markers of activities of osteoblast and osteoclast, respectively were analyzed using the institutional database. Results : In the OVF group, the ratio of patients with previous fracture history or use of glucocorticoid was higher than those in non-OVF group (p=0.000 and 0.030, respectively). The levels of T-score of femur neck and lumbar spine in OVF group were significantly lower than those in non-OVF group (p=0.001 and 0.000, respectively). The risk of OVF in FRAX using femur BMD in non-OVF and OVF groups was $6.7{\pm}6.13$ and $11.4{\pm}10.06$, respectively (p=0.007). The risk of using lumbar BMD in the 2 groups was $6.9{\pm}8.91$ and $15.1{\pm}15.08$, respectively (p=0.002). The areas under the receiver operator characteristic curve in the FRAX risk with lumbar and femur neck BMD were 0.726 and 0.684, respectively. The comparison of osteocalcin and CTX was not significant (p=0.162 and 0.369, respectively). Conclusion : In our study, the 10-year risk of major osteoporotic fracture in the OVF group of our study was lower than the recommended threshold of intervention for osteoporosis. Hence, a lower threshold for the treatment of osteoporosis may be set for the Korean population to prevent OVF. In the prediction of symptomatic OVF, FRAX tool using lumbar spine BMD may be more useful than that using femur neck BMD.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.132-136
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• 2009

Purpose: WHO(world health organization) announced the FRAX Tool(fracture risk assessment) of new software in the beginning of 2008. FRAX Tool was considered various risk factor, being different from existing fracture risk. In this study, we wanted to know the fracture risk of following the changing of the risk factor of fracture. Materials and Methods: A total of 50 women aged 50~60 were studied. We measured BMD at the part of femur neck which was based on the age, weight, height of individual with GE, Lunar-prodigy. The control group is fracture risk without considering fracture risk factor. The experimental group is previous fracture, parent fracture, current smoking, glucocorticoid, rheumatoid arthritis, secondary osteoporosis, alcohol. if each items makes one 'existence', others are all 'nothing'. and the results produced major osteoporotic region and hip fracture risk in 10-years. Statistics used t-test of SPSS 12.0. Results: The average rate of increment of major osteoporotic region between control group and experimental group, previous fracture-74% increase, parent fracture-96% increase, current smoking-2% increase, glucocorticoid-61% increase, rheumatoid arthritis-29% increase, alcohol-20% increase, secondary osteoporosis-0.18% decrease. The average rate of increment of hip region between control group and experimental group, previous fracture-84% increase, parent fracture-5% increase, current smoking-72% increase, glucocorticoid-84% increase, rheumatoid arthritis-40% increase, alcohol-52% increase, secondary osteoporosis-1.69% decrease. Conclusions: Each fracture risk factor has different rate of increment between major osteoporotic and hip region while in occasion of the second osteoporosis it has little relation because of low P-value. We could know that a contribution of the risk factor is different between major osteoporotic and hip region.

• Asian Spine Journal
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• v.12 no.6
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• pp.992-997
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• 2018

Study Design: Feasibility study. Purpose: To evaluate the feasibility of using serum pentosidine level as a potential marker for osteoporotic vertebral compression fracture (OVCF). Overview of Literature: A review of previous studies suggests a negative correlation between serum pentosidine concentration and bone strength. However, it is unclear whether serum pentosidine level might be a potential marker of OVCF in Koreans. Methods: Forty patients who underwent bone mineral density examination were included in this study, and their serum pentosidine levels were prospectively analyzed. Serum pentosidine level was evaluated using enzyme-linked immunosorbent assay. Among all the patients, 11 with OVCF were assigned to the vertebral fracture group and 29 who did not have vertebral fracture were included in the non-fracture group. In addition, we used the Fracture Risk Assessment (FRAX) tool Korean version for assessing the 10-year probability of fracture. Results: There was a statistically significant difference in the mean serum pentosidine level (p=0.04) of the vertebral fracture group (110.8 ng/mL) and the non-fracture group (64.3 ng/mL). Logistic regression analyses showed that serum pentosidine was significantly associated with OVCF. The vertebral fracture group had significantly higher 10-year probability of major osteoporotic fracture as per FRAX than the non-fracture group. There was a positive correlation between pentosidine level and FRAX results (r=0.35, p=0.02). Conclusions: These results suggest that increased serum pentosidine level could be a potential marker for OVCF.

• Korean Journal of Clinical Pharmacy
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• v.30 no.3
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• pp.196-205
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• 2020

Background: The indication of denosumab for osteoporosis was expanded from second-line to first-line therapy in 2019. The aim of this study was to evaluate the efficacy of denosumab as both first- and second-line therapy in postmenopausal women with osteoporosis and osteopenia with risk factors by using the Fracture Risk Assessment Tool (FRAX). Methods: We conducted a medication use evaluation of denosumab in 98 patients who had been treated three or more times for osteoporosis or osteopenia at Chungnam National University Hospital from July 1^st, 2017 to January 31^st, 2020. Risk factors were identified using quantitative N-gram analyses of FRAX estimations. Patient information, including menopause status and results of bone mineral density tests (T-score), was obtained from electronic medical records. Results: Age, body mass index (BMI), prior medication use, and T-score were identified as risk factors and were included as variables in the evaluation of denosumab use. Since no significant differences were detected between groups, denosumab is likely effective regardless of age or BMI. In addition, no significant difference was detected in T-scores following denosumab treatment, between groups who took bisphosphonates and selective estrogen receptor modulators (SERMs) with denosumab as first-line therapy for postmenopausal osteoporosis. Denosumab may, therefore, be effective as second-line therapy. Conclusion: Efficacy of denosumab was evaluated in postmenopausal women with osteoporosis. Denosumab may be used as first- and second-line therapy regardless of age, BMI, and prior use of bisphosphonates and SERMs.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.195-211
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• 2018

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.

• Tunnel and Underground Space
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• v.33 no.1
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• pp.57-69
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• 2023

In this study, we simulated induced seismicity in the Groningen natural gas reservoir using 2D hydro-mechanical coupled discrete element modelling (DEM). The code used is PFC2D (Particle Flow Code 2D), a commercial software developed by Itasca, and in order to apply to this study we further developed 1)initialization of inhomogeneous reservoir pressure distribution, 2)a non-linear pressure-time history boundary condition, 3)local stress field monitoring logic. We generated a 2D reservoir model with a size of 40 × 50 km² and a complex fault system, and simulated years of pressure depletion with a time range between 1960 and 2020. We simulated fault system failure induced by pressure depletion and reproduced the spatiotemporal distribution of induced seismicity and assessed its failure mechanism. Also, we estimated the ground subsidence distribution and confirmed its similarity to the field measurements in the Groningen region. Through this study, we confirm the feasibility of the presented 2D hydro-mechanical coupled DEM in simulating the deformation of a complex fault system by hydro-mechanical coupled processes.

• The Journal of Korean Medicine
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• v.42 no.2
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• pp.90-97
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• 2021

Bone mineral density (BMD) is a major diagnostic marker for bone health. A 44-year-old male had BMD of 0.81 g/cm² (Z-score: -3.1) in lumbar spine scan and 0.54 g/cm² (Z-score: -2.7) for femoral neck from regular medical checkup in Apr 2020. He had no other specific medical conditions except hyperlipidemia and alcohol was a single risk factor for fracture according to Fracture Risk Assessment Tool. After he was diagnosed with liver-kidney deficiency and treated for 20 weeks with Jeopgol-tang originally patented for promoting fracture recovery, lumbar spine BMD increased by 13.6 % (0.92 g/cm², Z-score: -2.1) and femoral neck BMD by 22.2% (0.66 g/cm², Z-score: -1.8) compared with those of Mar 2020. Herbal medicine treatment for tonifying liver and kidney to improve BMD warrants further investigation.

• Korean Journal of Clinical Pharmacy
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• v.30 no.1
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• pp.51-58
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• 2020

Background: Prevention of osteoporosis and bone fracture is one of the important issues for liver transplant recipients because a long history of liver disease and lifelong use of immunosuppressants, including corticosteroids, may cause these diseases. In this study, we aimed to analyze liver recipient bone status, 10-year fracture risk, and medication history. Methods: The electronic medical records of adult patients aged >40 years who received liver transplantation at Seoul National University Bundang Hospital between January 2009 and June 2017 were reviewed retrospectively. On the basis of their bone mineral density and fracture history, their fracture risks were analyzed using the Korean fracture risk assessment tool. Results: A total of 57 liver transplant recipients were treated with corticosteroids during a mean of 8.8 months after transplantation. 30 patients (52.6%) showed bone metabolism dysfunction such as osteopenia or osteoporosis. The 10-year femoral fracture risk was 2.1%, and dual-energy X-ray absorptiometry monitoring was performed, including right before liver transplantation every 27.5±19.2 months. The mean femoral bone mineral density decreased by -7.2%±7.3%. Four patients (7.0%) had a fracture after liver transplantation. Osteoporotic fracture occurred in 3 patients with osteoporosis (25.0%). Among the osteopenia patients with moderate fracture risk who were not treated with bisphosphonate, 1 patient (12.5%) had a history of bone fracture after liver transplantation. Conclusions: Considering the deterioration of bone density and moderate fracture risk, medication for osteoporosis should be prescribed to liver transplant recipients with regular monitoring of bone density after transplantation.