• Korean Journal of Radiology
• /
• v.23 no.2
• /
• pp.264-270
• /
• 2022

Objective: This study aimed to investigate the usefulness of bone single-positron emission tomography/computed tomography (SPECT/CT) of the hip in predicting the later occurrence of avascular necrosis (AVN) after slipped capital femoral epiphysis (SCFE) or femoral neck fracture in pediatric patients. The quantitative parameters of SPECT/CT useful in predicting AVN were identified. Materials and Methods: Twenty-one (male:female, 10:11) consecutive patients aged < 18 years (mean age ± standard deviation [SD], 11.0 ± 2.7 years) who underwent surgery for SCFE or femoral neck fracture and postoperative bone SPECT/CT were included. The maximum standardized uptake value (SUV), mean SUV, and minimum SUV of the femoral head were measured. The ratios of the maximum SUV, mean SUV, and minimum SUV of the affected femoral head to the contralateral side were determined. Patients were followed up for > 1 year after the surgery. The SPECT/CT parameters were compared between patients who developed AVN and those who did not. The accuracy of SPECT/CT parameters for predicting AVN was assessed. Results: Six patients developed AVN. There was a significant difference in the ratio of the mean SUV among patients who developed AVN (mean ± SD, 0.8 ± 0.3) and those who did not (1.1 ± 0.2, p = 0.018). However, there were no significant differences in the ratios of the maximum and minimum SUV between the groups (all p = 0.205). For the maximum, mean, and minimum SUVs, no significant differences were observed between the groups (p = 0.519, 0.733, and 0.470, respectively). The cutoff mean SUV ratio of 0.87 yielded a 66.7% sensitivity and 93.2% specificity for predicting AVN. Conclusion: Quantitative bone SPECT/CT is useful for evaluating femoral head viability in pediatric patients with SCFE or femoral neck fractures. Clinicians should consider the high possibility of later AVN development in patients with a decreased mean SUV ratio.

• Korean Journal of Community Nutrition
• /
• v.13 no.3
• /
• pp.418-425
• /
• 2008

The purpose of this study was to investigate correlations between bone mineral density (BMD) and dietary and non-dietary factors in female college students. The BMD of the subjects (n = 38) was measured using DEXA (Dual Energy X-ray Absorptiometry) at lumbar spine and three femoral sites including femoral neck, ward's triangle, and femoral trochanter. Three-day 24-hour dietary recall data were collected from each subject to assess consumption levels of nutrients and food groups. The mean (${\pm}SD$) values of age, age of menarche, height, weight, body mass index (BMI), waist-to-hip ratio (WHR), fat mass, and % body fat of the subjects were 21.34 (${\pm}1.73$) years, 13.1 (${\pm}1.2$) years, 161.3 (${\pm}5.0$) cm, 53.7 (${\pm}7.2$) kg, 20.6 (${\pm}2.6$) $kg/m^2$, 0.80 (${\pm}0.04$), 15.4 (${\pm}4.4$) kg, and 28.2 (${\pm}4.7$), respectively. The BMD values of lumbar spine, femoral neck, ward's triangle, and femoral trochanter as T-value were $1.150{\pm}0.13\;g/cm^2$, $0.932{\pm}0.11\;g/cm^2$, $0.850{\pm}0.13\;g/cm^2$, and $0.721{\pm}0.10\;g/cm^2$, respectively. The daily mean energy intake of the subjects was 1660.6 kcal. The intake levels of carbohydrate, calcium, iron, vitamin C, and folic acid were lower than the KDRIs, while those of fat, phosphorus, sodium, vitamin A, and vitamin $B_6$ were higher than the KDRIs. Significantly negative correlation were detected between consumption of fat and oils and the BMD of all sites measured (p < 0.05). Potato and starch intake was negatively correlated to the BMD of femoral neck and word's triangle (p < 0.05). The intake of cereals was found to be negatively correlated to the BMD of ward's triangle (p v 0.05). There was also negative correlation of intake of soybeans and products with the BMD of lumbar spine (p < 0.05). Weight and muscle mass were positively correlated to the BMD of both lumbar spine and femurs (p < 0.01). Significantly positive correlations between BMI, and fat mass and the BMD of lumbar spine were observed (p < 0.001). Additionally fat mass was positively correlated to the BMD of femoral neck. WHR and % body fat were positively correlated to the BMD of lumbar spine (p < 0.05). Negative correlation was found between a serum calcium level and the BMD of femoral neck (p < 0.05). In summary non-dietary factors generally showed significant correlations with the BMD of lumbar spine, while several dietary factors showed significant correlations with the BMD of femurs.

• YAKHAK HOEJI
• /
• v.48 no.1
• /
• pp.75-81
• /
• 2004

Bone mineral density (BMD) is influenced by genetic and environmental factors. Among genetic study; calcitonin receptor (CTR) gene is a good candidate influencing the inter-individual difference in BMD because CTR is involved in calcium and bone metabolism. Thus, we investigated the distribution of C1377T polymorphism in the CTR gene among male Korean elite athletic and control groups, respectively and also an association with BMD in lumbar spine and femoral neck. Our results suggested that this polymorphism of CTR gene was not significantly associated with lumbar spine or femoral neck BMDs in the both groups, respectively. However, we found that there was the racial difference in genotype distribution of this polymorphism between Caucasian and Asian populations. Though we could not detect the significant association between C1377T polymorphism of CTR gene and lumbar spine or femoral neck BMDs, further studies using other ethnic groups are necessary to clarify the precise role in BMD of CTR gene.

• Hip & pelvis
• /
• v.34 no.2
• /
• pp.122-126
• /
• 2022

Tumoral calcinosis is a rare disease characterized by massive subcutaneous soft tissue deposits of calcium phosphate around large joints in patients with chronic kidney disease. Invasion of bone by tumoral calcinosis is rare. We experienced a case involving a femoral neck pathologic fracture due to bony invasion of tumoral calcinosis in a 46-year-old female with chronic kidney disease who had been on dialysis for 15 years. Successful outcomes were obtained by performance of total hip arthroplasty for treatment of the pathologic fracture of the femoral neck. Careful precaution is necessary to prevent pathologic fractures in patients with tumoral calcinosis around the hip joint.

• Hip & pelvis
• /
• v.35 no.3
• /
• pp.157-163
• /
• 2023

Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.

• Hip & pelvis
• /
• v.34 no.1
• /
• pp.35-44
• /
• 2022

Purpose: Osteosynthesis has been recommended for treatment of Pauwels type III femoral neck fractures in young patients. However, no implant of choice has been reported so far. This study was conducted in order to compare the fixation stability of two conventional fixation methods with three different novel fixed angle devices in this type of fracture. Materials and Methods: A total of 25 composite femurs (4th Generation Saw bone; Pacific Research Laboratories, USA) corresponding to human bone were used. Pauwels type III fracture type was uniformly reproduced. Specimens were fixed with a cannulated screw, cannulated screw with cable, and Intertan nail, dynamic hip screw, and IKEY nail. Measurement of failure loads and the rotational change of the femoral head fragment was performed for evaluation of fixation stability. Results: All implants were compared with cannulated screw and dynmaic hip screw. No meaningful improvement was observed for the cannulated screw with cable compared with the cannulated screw and dynamic hip screw. Meaningful improvement in load-to-failure and y-rotation and z-rotation was observed for both the Intertan nail and IKEY nail compared with the cannulated screw. However, compared with the dynamic hip screw, only the IKEY nail showed improvement in the same profile but the Intertan nail did not. Conclusion: Among novel fixed angle devices, meaningful improvement was observed for the IKEY nail compared with conventional implants. Strengths of this implant include biomechanical stability and simplicity of surgical technique, indicating that it may be another good option for osteosynthesis of Pauwels type III femoral neck fractures.

• Journal of Nutrition and Health
• /
• v.35 no.7
• /
• pp.779-790
• /
• 2002

Nutritional factors affecting bone mineral density (BMD) in the different age groups of Korean women were investigated to obtain baseline data for maintaining bone health. Information on diet and anthropometry were collected in 80 elementary school children (height 127.2 cm, weight 27.3 kg), 84 high school students (height 161.6 cm, weight 52.4 kg), 100 adults aged 25 to 35 years (height 159.4 cm, weight 52.7 kg) and 120 elderly people over 60 years of age (height 150.9 cm, weight 55.6 kg). Data for nutrient intake were obtained by 24-hour recall method. BMDs of lumbar spine (L$_2$-L$_4$) and femoral neck were measured by dual energy x-ray absorptiometry. The relationship between BMD of femoral neck and nutritional factors were analyzed. The average BMD of femoral neck for females was 0.61 g/$\textrm{cm}^2$ in children, 0.88 g/$\textrm{cm}^2$ in adolescents, 0.90 g/$\textrm{cm}^2$ in adults, 0.64 g/$\textrm{cm}^2$ in elderly people. Among the adult subjects, 11.0% was classified as osteopenia in the femoral neck. For the elderly, the prevalence of osteopenia and osteoporosis were 34.2% and 47.5% of the subjects. It was shown the intake of energy, protein, plant protein, animal protein, fat, carbohydrate, Ca, P, Fe, vitamin A, thiamin, riboflavin, niacin, vitamin C, carbohydrate energy percent and fat energy percent influenced bone health status in all age groups. In the MAR on bone health status, children, adult and elderly subjects were significantly different among groups classified by bone health status and the MAR of the groups with good in bone health was higher. The RDA percent of each nutrient was influence factor on BMD. Nutrient intake of energy, protein, P, Fe, thiamin, niacin were lower BMD on below 75% of Korean RDA. Stepwise multiple regression analysis revealed that several dietary factors were influence on BMD. MAR on femoral neck BMD of children and elderly subjects was the highest influence factor. Beyond this, the most influential dietary factors on BMD were the vitamin A, total Ca and vegetable Ca. The above results have confirmed that dietary factors influence BMD in various age groups. Energy, protein, Ca, P, Fe, thiamin, riboflavin, niacin, vitamin C as well as MAR were important dietary factors influencing BMD. The results of this study revealed that people who received sufficient nutrients intake showed healthy bone status. The MAR mainly influenced the bone health status.

• Journal of Nutrition and Health
• /
• v.42 no.1
• /
• pp.59-67
• /
• 2009

Lifestyle behaviors including dietary habits are well known to play key roles in bone metabolism. The purpose of this study was to investigate the relationship among the factors affecting bone mineral density (BMD) including age, anthropometric parameters, lifestyle behaviors, and dietary habits of men aged more than 50 years. Ninety-one men, who visited health promotion center at one of the university medical centers, were divided into two groups according to the BMD: normal and osteopenia. The BMD of femoral neck in the osteopenia group was significantly lower than that of the normal group ($0.77\;{\pm}\;0.28$ vs. $0.98\;{\pm}\;0.08\;g/cm^2$). The proportion of the regular exercisers was significantly lower in the osteopenia group than in the normal group (p = 0.027). In the osteopenia group, the femoral neck BMD was significantly decreased in smokers and coffee drinkers compared to no-smokers and no-coffee drinkers. The femoral neck BMD was increased among those who consume breakfast and beans and bean products more frequently and those with a greater meal regularity. In the normal group, the lumbar spine BMD was significantly increased among those with frequent consumption of beans and bean products. The lumbar spine BMD was significantly correlated with exercise (r = 0.263), and the femoral neck BMD with weight (r = 0.284), BMI (r = 0.324), relative body weight (r = 0.294), exercise (r = 0.269) and frequency of beans and bean products consumption (r = 0.216). These results indicate that lifestyle behaviors and dietary habits play important roles in maintaining optimum bone health in the middle-aged men.

• Journal of Nutrition and Health
• /
• v.36 no.5
• /
• pp.470-475
• /
• 2003

The purpose of this study was to investigate the effect of isoflavone supplementation using soymilk on bone mineral density in underweight college women aged 19-22 years with lower than average bone mass. The bone mineral density (BMD) of the lumbar spine and femoral neck of a number of underweight (BMI < 20) college women was measured. From this group, 33 subjects whose T-score value was below -1 were selected. Anthropometric measurements, dietary recall and BMD were measured before the study began and at the end of the 10th week. The 33 subjects were given 400 ml of soymilk containing 60 mg of isoflavones daily for 10 weeks. After 12 weeks at the end of 10 weeks treatment, the BMD of the subjects was reassessed. The average age of the subjects was 21.1 yrs. At the baseline, average height, weight, and BMI of the subjects were 161 cm, 49.1 kg, 18.8 kg/$m^2$, respectively. Mean daily intake of energy and protein was 1637.2 kcal and 61.2 g, respectively. Mean dietary isoflavone intake was 17.4 mg. Despite the 400 ml soymilk supplementation, there was no significant change in nutrient intake after the 10-week treatment. However, there were significant increases in lumbar spine and femoral neck BMD. After the study, the BMD of the subjects' spine and femoral neck was lower than that before the study. In conclusion, soymilk intake was associated with a significant increase in the BMD of the lumbar spine and femoral neck in underweight college women with lower than average bone mass. (Korean J Nutrition 36(5): 470~475, 2003)

• Imaging Science in Dentistry
• /
• v.44 no.4
• /
• pp.263-271
• /
• 2014

Purpose: This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. Materials and Methods: Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: $13cm{\times}15cm;$ voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. Results: RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. Conclusion: Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.