• 제목/요약/키워드: Femoral Neck

검색결과 216건 처리시간 0.027초

만성페쇄성폐질환 환자에서 스테로이드 투여 방법에 따른 골다공증의 발생빈도 (Incidence of Osteoporosis in Patients with COPD According to Different Methods of Glucocorticoid Administration)

  • 이양덕;이강휴;이흥범;이용철;이양근
    • Tuberculosis and Respiratory Diseases
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    • 제54권1호
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    • pp.15-21
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    • 2003
  • 연구 배경 : 만성폐쇄성폐질환 환자의 경우 흡연, 저체중 질량지수, 활동량의 저하, 스테로이드 사용 등과 같은 골다공증의 위험요소를 동반하고 있는 실정이다. 그러나 아직까지 투여방법에 따른 골다공증의 발생률에 대한 연구가 부족한 실정이다. 이에 저자들은 만성폐쇄성폐질환에서 스테로이드 투여방법에 따른 골다공증의 발생빈도의 차이를 알아보고자 하였다. 대상 및 방법 : 스테로이드의 총 투여량이 1,000 mg이 넘는 환자를 대상으로 세군으로 분류하였다. 제 I군은 입원력이 없고 흡입성 스테로이드 제재를 지속적으로 사용하며 간헐적 경구투여를 시행한 환자 15명, 제 II군은 경구 스테로이드 제재를 주로 사용하고 보조적으로 흡입성 스테로이드 제재를 사용하였지만 급성악화로 인한 입원력이 없는 환자 15명, 제 III군은 경구 스테로이드 제재나 흡입성 스테로이드 제재를 단독 또는 병용하였지만 급성악화로 인한 입원력이 1년에 1회 이상인 환자로 입원중 스테로이드 정주요법이 2주 이상 시행된 환자 15명이었다. 대상 환자들에 대하여 요추와 대퇴경부의 골밀도 검사 및 폐기능 검사를 시행하였다. 결과 : 세군 간에 스테로이드의 총 투여량, 흡연량, 체중질량지수 등에서는 유의한 차이가 없었으나, 제 III군에서 유의한 $FEV_1$ 감소(p<0.05)와, 요추부 및 대퇴경부의 골다공증 발생률이 제 I군과 제 II군에 비해 유의한 증가가 있었다(p<0.01). 결론 : 이상의 결과로 보아 경구 스테로이드보다는 정주스테로이드 요법 후 골다공증의 발생이 증가하였으며, 이는 일정량의 스테로이드 투여시 투여 방법에 따라 골다공증의 발생이 영향을 받을 것으로 생각된다.

지방우세 딕슨기법을 이용한 슬관절 자기공명영상 지방신호분율과 골밀도 간의 상관관계 분석: 예비 연구 (Correlation Analysis between Fat Fraction and Bone Mineral Density Using the DIXON Method for Fat Dominant Tissue in Knee Joint MRI: A Preliminary Study)

  • 안성현;곽규성;박성훈;윤재성;박범희;김지수
    • 대한영상의학회지
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    • 제84권2호
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    • pp.427-440
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    • 2023
  • 목적 MRI Dixon method (이하 DIXON) 기법을 이용하여 슬관절 지방우세 골조직의 지방신호분율(fat signal fraction; 이하 FF)을 구하고 골밀도(bone mineral density; 이하 BMD)와 상관관계 분석을 시행하였다. 대상과 방법 본원 슬관절 DIXON 영상을 촬영한 환자들 중 일 년 이내의 dual energy X-ray absorptiometry가 있는 환자 93명을 후향적으로 분석하였다. DIXON 영상에서 원위부 대퇴골 골간단(femur metaphyseal; 이하 Fm)과 근위부 경골 골간단(tibia metaphyseal; 이하 Tm)의 FF를 계산하였다. FF와 BMD 간 상관관계를 분석하였다. 또, 요추(lumbar spine; 이하 L), 대퇴경부(femoral neck; 이하 FN), 총대퇴골(femur total; 이하 FT)의 BMD 별로 나누고 FF에 대하여 Kruskal-Wallis H test를 시행하였다. 결과 전체 환자군에서 TmFF와 FN-BMD 사이에 유의미한 음의 상관관계를 보였다(r = -0.26, p < 0.05). 여성 환자에서는 TmFF가 FN-BMD, FT-BMD 및 L-BMD와 음의 상관관계를 보였다(r = -0.38, -0.28과 -0.27, p < 0.05). 남성 환자에서는 FmFF가 FN-BMD 및 FT-BMD와 음의 상관관계를 보였다(r = -0.58과 r = -0.42, p < 0.05). 여성 환자들을 세 군으로 나누었을 때 TmFF에 유의한 차이를 보였다(p < 0.05). 남성 환자들을 두 군으로 나누었을 때, FmFF이 군간에 유의미한 차이를 보였다(p < 0.05). 결론 슬관절 주변의 FF와 BMD는 음의 상관관계를 보였으며, DIXON을 이용한 FF 측정이 BMD 스크리닝에 사용될 수 있는 가능성을 보였다.

대퇴 골두 충돌 증후군(Cam type)의 진단과 치료를 위한 자기공명 3D 영상 재구성 기법의 유용성 (Usefulness of MRI 3D Image Reconstruction Techniques for the Diagnosis and Treatment of Femoral Acetabular Impingement Syndrome(Cam type))

  • 곽영곤;김종일;조영기
    • 한국콘텐츠학회논문지
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    • 제15권11호
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    • pp.313-321
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    • 2015
  • Hip FAI 진단과 수술 계획 시 Hip FAI MRI 검사시 3D 영상을 추가로 활용하여 CT 영상으로 이루어지는 Hip Clock face 영상을 MRI 3D 영상으로 대체할 수 있는지 비교 평가 하였다. Hip 자기공명 영상검사(MRI)와 3D Hip 컴퓨터 단층 촬영(CT)을 동시 시행한 환자 31명 (남: 21명 평균연령: 35세 여: 10명 평균연령: 40.3세)을 대상으로 분석하였으며, 영상평가는 정형외과 전문의 1명과 영상의학과 전문의 1명이 MR과 CT modality에서 Hip joint articular transverse ligament의 6 o'clock을 중심으로 Superior을 12 o'clock, Labrum의 전면을 3 o'clock, 반대쪽을 9 o'clock로 기술하는 Clock face을 재구성 한 후 11 o'clock에서 A. retinacular vessel, B. head neck junction, 12 o'clock A. Epiphyseal line, B. Cam lesion, 1,2,3,4 o'clock의 Cam lesion, Posterior Cam lesion확인 여부를 리커트(Likert scale) 5점 척도로 평가하였다(Independent t-test p<0.05). 리커드 척도 결과 11 o'clock A. retinacular vessel MR 평균 값 $3.69{\pm}1.0$, CT 평균값 $2.8{\pm}0.78$이며 통계적으로 유의하였다(p<0.001). B. head neck junction은 두 평가자간 차이가 없었다(p<0.416). 12 o'clock A. Epiphyseal line MR 평균값 $3.54{\pm}1.00$, CT 평균값 $4.5{\pm}0.62$이었다(p<0.000). B. Cam lesion은 두 평가자간 차이가 없었다(p<0.532). 1,2,3,4 o'clock 의 Cam lesion과 Posterior Cam lesion은 통계적으로 유의하지 않았다(p<0.656, p<0.658). weighted Kappa 검증 결과 11 o'clock A.retinacular vessel CT K값이 0.663으로 가장 낮은 일치도였으며, 각각의 평가 항목의 일치도 평가 결과 매우 높은 결과로 두 평가자간 높은 신뢰도를 보여주었다.

CT조영제가 방사선치료계획(두경부, 전립선)에 미치는 영향 (Effect of CT Contrast Media on Radiation Therapy Planning (Head & Neck Cancer and Prostate Cancer))

  • 장재욱;한만석;김민정;강현수
    • 한국자기학회지
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    • 제26권5호
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    • pp.173-178
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    • 2016
  • 두경부와 전립선 암 환자에서 CT조영제가 방사선치료계획에 미치는 영향을 확인하고 선량계산 정확성 향상을 위하여 본 연구를 실시하였다. 30명의 환자에 대하여 Pinnacle 8.0 시스템을 이용하여 조영제에 의한 조직의 전자밀도 변화를 측정하였으며 각각의 방사선치료계획을 통한 선량계산을 실시하였다. Pinnacle과 Tomotherapy planning 시스템을 이용하여 각각의 전자밀도와 3D 입체조형방사선치료(3D CRT)와 세기변조방사선치료(IMRT)계획을 수립하였다. 조영제에 의한 전자밀도의 변화는 4%이하로 두경부: 표적용적 2.1%, 이하선 1.9%, 하악선 3.6%, 혀 0.9%, 척수 0.3%, 식도 2.6%, 하악골 0.1%, 전립선: 표적용적 0.7%, 림프절 1.1%, 방광 1.2%, 직장 1.5%, 소장 1.2%, 대장 0.6%, penile bulb 0.8%, 대퇴골두 -0.2%로 나타났다. 선량계산의 차이는 2.5% 이하의 선량 증가가 발생하였다(3D CRT: 두경부 0.69~2.51%, 전립선 0.04~1.14%, IMRT: 두경부 0.58~1.31%, 전립선 0.36~1.04%). 이러한 오차는 임상에서 허용 가능한 오차 이내이지만 영상융합(조영증강 영상과 조영증강 하지않은 영상)이나 ROI import 기능을 활용하여 조영 증강하지 않은 영상에서 선량계산을 실시한다면 1~3%의 방사선치료계획 선량 오차를 줄일 수 있을 것으로 기대된다.

젊은 성인과 폐경 여성간의 악골 골밀도에 관한 비교 연구 (COMPARISON OF JAW BONE DENSITY IN YOUNG ADULTS AND POSTMENOPAUSAL WOMEN)

  • 김태성;이동근;이병도;정선관
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권2호
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    • pp.107-114
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    • 2001
  • Objectives : To compare jaw bone density of young adults (control group) and post-menopausal women(experimental group) in periapical and panoramic film. Materials and Methods : The bone mineral density values of lumbar and femur were measured by dual-energy X-ray absorptiometry(DEXA) and T scores of lumbar were obtained. T scores were classified into 3 group (T<-2.5, $-2.5{\leqq}T<-1$, $-1{\leqq}T$). Radiographic densities of alveolar bones were measured from interdental bones of premolar, molar areas in the maxilla and mandible and expressed into copper step wedge thickness by Scion $Image^{(R)}$ program. We considered these values of step wedge thickness as bone density of alveolar bone. Panorama mandibular index(PMI) was calculated by the method that the height of the inferior cortex of the mandible was divided by the height from the lower border of the mandible to the superior edge of the mental foramen. Bone density of alveolar bone and PMI were analysed statistically. Results : There were significant differences in bone mineral density of lumbar and femoral neck between control and experimental groups. There were also significant differences in bone density of premolar and molar area of jaw between control and experimental groups by MANOVA test. When considered lumbar T variables, there was only difference in interdental bone density of maxillary molar area between control and experimental group, but there was interaction. Interdental bone density of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. There was significant difference in PMI between control and experimental groups, but there was also inter action, thus, PMI of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. Conclusion : There were significant differences of alveolar density and cortical bone thickness between young men and post-menopausal women in periapical and panoramic film. These differences were dependent on lumbar T.

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고관절 주위 골절환자에서 술 전 색 도플러 초음파를 이용하여 진단한 심부 정맥 혈전의 빈도 (Incidence of Deep Vein Thrombosis before Hip Fracture Surgery Diagnosed by Color Doppler Sonography Surveillance)

  • 정재훈;이경재;민병우;손은석;구태원
    • 대한정형외과 초음파학회지
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    • 제7권2호
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    • pp.98-104
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    • 2014
  • 목적: 고관절 주위 골절 환자에서 술 전 색 도플러 초음파 검사를 이용하여 심부 정맥 혈전증을 진단하고 그 발생 빈도를 알아 보고자 하였다. 대상 및 방법: 2013년 6월부터 2014년 5월까지 본원에 내원한 고관절 주위 골절 환자 중 이전에 심부 정맥 혈전의 과거력이 없으며 술 전 색 도플러 초음파 검사에 동의한 환자 27예를 대상으로 하였으며 남자가 8예, 여자가 19예이었다. 평균 연령은 74.3세(41-87)였다. 고관절 주위 골절의 진단명은 대퇴 경부 골절 15예, 대퇴 전자간 골절 11예, 비구 골절이 1예였다. 모든 수술은 본원 내원 후 48시간 이내에 시행하는 것을 원칙으로 하였으며 내원 24시간 이내에 색 도플러 초음파 검사를 시행하였다. 결과: 심부 정맥 혈전은 총 6예(22.2%)에서 발견되었다. 이중 2예(7.4%)는 근위 심부 정맥 혈전이었고 4예(14.8%)는 원위 심부 정맥 혈전이었다. 심부 정맥 혈전 발생 군이 평균 79세(75-87), 발생하지 않은 환자 군이 평균 72세(65-86)로 유의하게 많았다(p=0.038). 결론: 고관절 주위 골절 환자에게 수술 이전 실시한 색 도플러 초음파 검사상 22.2%로 비교적 높은 빈도로 심부 정맥 혈전이 발견되었다. 고관절 주위 골절 환자에서 술 전 심부 정맥 혈전증에 대한 보다 적극적인 검사가 필요할 것으로 사료된다.

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Ca과 Vitamin D 보충이 폐경 이후 여성의 뼈대사에 미치는 영향 (The Effect of Ca and Vitamin D Supplementation on Bone Metabolism in Postmenopausal Women)

  • 홍희옥
    • Journal of Nutrition and Health
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    • 제27권10호
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    • pp.1025-1036
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    • 1994
  • This study was designed to investigate the effects of Ca and/or vitamin D supplementation for 53 weeks on bone metabolism in postmenopausal women. The subjects were healthy 18 women aged from 59 to 69 years old. They were divided into three groups : placebo, Ca(1000mg/day) supplementation and Ca(1000mg/day) with vitamin D(12.5$\mu\textrm{g}$/day) supplementation. During the experimental periods except for metabolic studies, the subjects ate their usual diets and the use of drugs as well as excessive exercise was prohibited. Metabolic studies were conducted in the 1st week and in the 53rd week of the experimental periods. The subjects ate experimental diets which consisted of 1787.3kcal, 69.6g of protein, 561.5mg of Ca and 1078.6mg of P daily during both of the metabolic study periods. The results were summarized as follows; 1) Bone density of the second lumbar spine and trochanter measured after treatment decreased significantly in control group as compared with pre-experimental level(p<0.05). On the contrary, bone density of femoral neck and Ward's triangle in Ca group and the second lumbar spine in Ca.Vit D group increased significantly after treatment. 2) Serum PTH and calcitonin levels did not show any significant differences among groups before and after treatment. But serum PTH level increased significantly in all groups after treatment(P<0.05). 3) Serum Ca and P levels did not show any significant differences among groups before and after treatment. But serum Ca level increased significantly in all groups after treatment (P<0.05) and serum P level decreased significantly in Ca.Vit D group after treatment(P<0.05). 4) Mean 24-hours fecal Ca excretion of Ca group was the highest in the 1st week of treatment(P<0.01), and that of control group was the lowest in the 53rd week of treatment(P<0.01). Fecal Ca excretion increased significantly in control and Ca.Vit D group in the 53rd week of treatment(P<0.05). Urinary Ca excretion did not show any significant differences among groups in the 1st and 53rd week of treatment, but that of Ca.Vit D group was the highest the 1st week of treatment(P<0.01). In the 53rd week of treatment Ca and Ca.Vit D group showed positive Ca balance, but control group showed negative Ca balance. The above results showed that it will be difficult to prevent degenerative bone loss without Ca and/or vitamin D supplementation in postmenopausal women eating Korean usual diets.

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한국 여대생의 골밀도에 영향을 미치는 요인 분석 연구 (Some Factors Affecting Bone Density of Korean College Women)

  • 유춘희
    • Journal of Nutrition and Health
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    • 제31권1호
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    • pp.36-45
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    • 1998
  • Dietary and other factors affecting bone density of 32 Korean healthy college women aged 19-23 years were assessed. Data for food and nutrient intake was obtained by a semiquantitiative food frequency questionnaire. Serum samples were anlayzed for total Ca, P, Ca++, PTH, calcitonin and 25-hydroxycholecalciferol , (25-OH-Vit D3) and BMDs of lumbar spine(L2-L4), femoral neck(FN), ward's triangle (WT) and trochanter(TR) were measured by an XR-series X-ray bone densitometer. Relationships between the factors and BMDs were analyzed by stepwise multiple regression analysis and Pearson's correlation coefficient(r). The results are summarized as follows. Mean daily intake of energy(86.1%), Ca(74.3%), vitamin A (53.75), Fe(49.75) and vitamin B$_2$(86.6%) were lower while other notrients incuding P(126%) were higher than the Korean RDA. The BMDs of lumbar spines and femurs ranged from 0.73g/$\textrm{cm}^2$ to 1.23g/$\textrm{cm}^2$and 0.48g/$\textrm{cm}^2$ to 1.04g/$\textrm{cm}^2$, respectively. Both protein and P intakes were inversely associated with serum total Ca. Furthermore, Ca intake as well as Ca/P ratio (Ca/P) were inversely associated with serum ionized Ca(Ca++) concentration. The intakes of protein P and Ca , however, were not significantly associated with the BMDs measured in this study. There were little association between BMDs and alcoholic beverage or caffeine consumption. The only significant association detected was a positive relationship between caffeine consumption and BMD of WT. It seemed to be noticeable that BMDs of L2-L$_4$, FN and WT were significantly inversely associated with serum P concentration. However, there was no significant association between BMDs and the levels of total Ca to Ca++ in serum. Body weight was positively associated with BMD of lumbar spine and BMI was also positively associated with BMDs of FN and WT. The subjects who had an early menarche appeared to have higher BMDs than those who had had a late mearche. According to stepwise multiple regression analysis. Menarche and BMI were stronger determinants of BMDs in the young women than was diet. P intake appeared to be a more potent dietary determinant than Ca intake. The three factors, menarche, BMI , and P intake , additionally accounted for 24% and 378% of the variance in BMDs of FN and L$_2$-L$_4$, respectively. Further investigation is necessary to determine the factors needed to increase serum P level which negatively affects. BMD in young Korean college women.

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폐경 후 여성의 골밀도에 따른 영양소 섭취상태와 혈청 구리, 아연, 망간 함량에 관한 연구 (A Study on Nutrient Intakes and Serum Levels of Copper, Zinc and Manganese in Korean Postmenopausal Women with Different Bone Mineral Density)

  • 최윤희;승정자
    • Journal of Nutrition and Health
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    • 제39권5호
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    • pp.485-493
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    • 2006
  • The purpose of this study was to investigate the relationships among nutrient intakes, BMD, serum copper, zinc and manganese contents in Korean postmenopausal women residing in Seoul and Kyunggi-do. Nutrient intakes analyses and anthropometric measurements were performed for 64 postmenopausal women. Also, fasting blood samples were collected. The BMDs of the lumbar spine (L2-L4) and femoral neck were measured by dual energy X-ray absorptiometry (DEXA). Subjects were classified into three groups: osteoporosis (T-score ${\leq}$ -2.5, n = 20), osteopenia (-2.5 < T-score ${\leq}$ -1, n = 24), and normal (T-score) -1, n = 20). The results are summarized as follows; the mean age, height and weight were 62.1 yrs, 153.8 em, and 56.1 kg, respectively, with no significant difference among three groups. On the other hand, the mean BMI $(23.7\;g/m^2)$ of normal group was significantly higher than those of other two groups. The mean energy intake was 1,395.3 kcal (77.5% of Dietary referance intakes for koreans (KDRls)). The average daily intakes of vitamin $B_2$, calcium and zinc did not reach KDRIs. The mean intakes of iron, copper, zinc and manganese were 10.9 mg, 1.6 mg, 7.8 mg and 5.1 mg respectively, with no significant difference among three groups, The mean serum levels of copper, zinc and manganese were 96.4 mg/dl, 91.5 mg/dl and 39.5 ng/dl, respectively with no significant differences among three groups. The BMD of lumbar spine showed a significantly negative correlation intakes of animal protein, fat and iron intakes after adjusting for age, Bill. However, the BMD of lumbar spine was not significantly correlated with animal iron intakes after adjusting for animal protein, and fat intakes, indicating animal food intake is a possible confounding factor. Proper intakes of vitamin $B_2$, vitamin C are required to protect osteoporosis in postmenopausal women. These results suggest that excessive animal food intakes may have adverse effect on bone mineral density. Further studies arc necessary to elucidate the role of serum minerals in BMD.

폐경 후 정상여성과 폐경 후 류마티스 관절염환자의 골밀도 및 골다공증 위험요인 비교 (Comparison of Bone Mineral Density and Risk Factors of Osteoporosis between Normal and Rheumatoid Arthritis in Postmenopausal women)

  • 이은남
    • 근관절건강학회지
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    • 제7권1호
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    • pp.89-101
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    • 2000
  • This study was carried out to compare the bone mineral density and risk factors of osteoporosis between normal and rheumatoid arthritis in postmenopausal women. Sixty-eight postmenopausal patients with rheumatoid arthritis(RA) were compared with 124 postmenopausal normal women. Data were collected from october, 1998 to April, 1999 at Dong-a university hospital in Pusan. From all subjects, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption, exercise, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of osteoporosis by questionnaire. From RA patients, health assessment score, Ritchie articular index, erythrocyte sedimentation rate, C-reactive protein and steroid dosage were measured by rheumatologist on measuring bone mineral density. Bone mineral density was measured at the Lumbar spine, femoral neck, femur Ward's triangle, and femur trochanter using dual x-ray absorptiometry. The data was analyzed by using a frequency, t-test, Chi-square, ANCOVA with SPSS PC program. The results could be summarized as follows : 1) There was a significant difference in age and breast feeding period between RA patients and normal women. 2) RA patients took less calcium in the past and practiced less regular exercise in past and present than normal women. 3) There was no difference in lumbar bone mineral density between RA patients and normal women. 4) There was a significant difference in femur Ward's triangle and femur trochanter between RA patients and normal women after adjustment for age and breast feeding period. 5) The prevalence of osteoporosis of all subjects was the highest in femur Ward's triangle. In summary, our findings suggest that the bone mineral densities of femur Ward's triangle and trochanter in postmenopausal women with RA is significantly lower than normal women. Also the exercise participation rate of postmenopausal women with RA is lower than normal women. For the further study, we recommend to develop exercise program that improve the bone mineral density in femur Ward's triangle and trochanter and to test the effect of that exercise program.

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