• Journal of Life Science
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• v.21 no.2
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• pp.300-308
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• 2011

Osteoporosis is a disease involving a decrease in bone mineral density and increased risk of fractures. Osteoblast and osteoclast activities are important for bone formation. The MC3T3-E1 osteoblastic cell line is a well-accepted model of osteogellsis in vitro. Hijikia fusiforme is a kind of edible brown seaweed that grows mainly in the Northwest Pacific region, including the countries of Korea, Japan and China, and it has been widely used as a medicinal and health food in Korea. In this study, by using osteoblasts, the effects of Hijikia fusiforme fractions on proliferation, alkaline phosphatase (ALP) activity, collagen synthesis and mineralization of cells were investigated. Hijikia fusiforme were subjected to fractionation by using hexane, methanol, butanol and aqueous. Proliferation of the MC3T3-E1 osteoblastic cells that were treated with Hijikia fusiforme fractions increased by approximately 120%. Regarding effects of Hijikia fusiforme fractions on ALP activity, 1 ${\mu}g$/ml butanol fraction showed the highest activity. The synthesis of collagen increased significantly in response to treatment with Hijikia fusiforme fractions, with the exception of the hexane fraction. Moreover, mineralization in the MC3T3-E1 cells that were treated with 100 ${\mu}g$/ml butanol fraction increased by 281%. Also, when 100 ${\mu}g$/ml aqueous fraction was added, mineralization increased by 240%. These results indicate that Hijikia fusiforme fractions have anabolic effect on bone through the promotion of osteoblastic differentiation, suggesting that it could be used for the treatment of common metabolic bone diseases.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.336-342
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• 2019

Purpose: To examine the relationship between the progression of a kyphotic deformity and the magnetic resonance imaging (MRI) findings in conservatively treated osteoporotic thoracolumbar compression fracture patients. Materials and Methods: This study categorized the patients who underwent conservative treatment among those patients who underwent treatment under the suspicion of a thoracolumbar compression fracture from January 2007 to March 2016. Among them, this retrospective study included eighty-nine patients with osteoporosis and osteopenia with a bone density of less than -2.0 and single vertebral body fracture. This study examined the MRI of anterior longitudinal ligament or posterior longitudinal ligament injury, superior or inferior endplate disruption, superior of inferior intravertebral disc injury, the presence of low signal intensity on T2-weighted images, and bone edema of intravertebral bodies in fractured intravertebral bodies. Results: In cases where the superior endplate was disrupted or the level of bone edema of the intravertebral bodies was high, the kyphotic angle, wedge angle, and anterior vertebral compression showed remarkably progression. In the case of damage to the anterior longitudinal ligament or the superior disc, only the kyphotic angle was markedly prominent. On the T2-weighted images, low signal intensity lesions showed a high wedge angle and high anterior vertebral compression. On the other hand, there were no significant correlations among the posterior longitudinal ligament injury, inferior endplate disruption, inferior disc injury, and the progression of kyphotic deformity and vertebral compression. The risk factors that increase the kyphotic angle by more than 5° include the presence of injuries to the anterior longitudinal ligament, superior endplate disruption, and superior disc injury, and the risk factors were 21.3, 5.1, and 8.5 times higher than those of the uninjured case, and the risk differed according to the level of bone edema. Conclusion: An osteoporotic thoracolumbar compression fracture in osteoporotic or osteopenic patients, anterior longitudinal ligament injury, superior endplate and intravertebral disc injury, and high level of edema in the MRI were critical factors that increases the risk of kyphotic deformity.

• 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 (D_Thorax) 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. D_Thorax 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 D_Thorax 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. D_Thorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. D_Thorax 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 (DL_CO) (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 D_Thorax (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 D_Thorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV₁, and lower DL_CO 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.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.156-163
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• 2009

Statement of problem: Recently, there have been increased esthetic needs for posterior dental restorations. The failure of posterior dental ceramic restoration are possible not only by the characters of the component materials but also by the type of food. Purpose: The research aim was to compare the in vitro fracture resistance of simulated first molar crowns fabricated using 4 dental ceramic systems, full-porcelain-occlusal-surfaced PFG, half-porcelain-occlusal-surfaced PFG, Empress 2, Ice Zirkon and selected Korean foods. Material and methods: Eighty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a Instron 4465, and the maximum load(N) was recorded. Afterwards, selected Korean foods specimens(boiled crab, boiled chicken with bone, boiled beef rib, dried squid, dried anchovy, round candy, walnut shell) were prepared. 15 specimens per each food were placed under the Instron and the maximum fracture loads for them were recorded. The 95% confidence intervals of the characteristic failure load were compared between dental ceramic systems and Korean foods. Afterwards, on the basis of previous results, 14Hz cyclic load was applied on the 4 systems of dental ceramic restorations in MTS. The reults were analyzed by analysis of variance and Post Hoc tests. Results: 95% confidence intervals for mean of fracture load 1. full porcelain occlusal surfaced PFG Crown: 2599.3 to 2809.1 N 2. half porcelain occlusal surfaced PFG Crown: 3689.4 to 3819.8 N 3. Ice Zirkon Crown: 1501.2 to 1867.9 N 4. Empress 2 Crown: 803.2 to 1188.5 N 5. boiled crab: 294.1 to 367.9 N 6. boiled chicken with bone: 357.1 to 408.6 N 7. boiled beef rib: 4077.7 to 4356.0 N 8. dried squid: 147.5 to 190.5 N 9. dried anchovy: 35.6 to 46.5 N 10. round candy: 1900.5 to 2615.8 N 11. walnut shell: 85.7 to 373.1 N under cyclic load(14Hz) in MTS, fracture load and masticatory cycles are: 1. full porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 4796.8-9321.2 cycles under 2224.8 N(round candy)load, no fracture under smaller loads. 2. half porcelain occlusal surfaced PFG Crown fractured at 95% confidence intervals of 881705.1-1143565.7 cycles under 2224.8 N(round candy). no fracture under smaller loads. 3. Ice Zirkon Crown fractured at 95% confidence intervlas of 979993.0-1145773.4 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. 4. Empress 2 Crown fractured at 95% confidence intervals of 564.1-954.7 cycles under 382.9 N(boiled chicken with bone). no fracture under smaller loads. Conclusion: There was a significant difference in fracture resistance between experimental groups. Under single load, Korean foods than can cause fracture to the dental ceramic restorations are boiled beef rib and round candy. Even if there is no fracture under single load, cyclic dynamic load can fracture dental posterior ceramic crowns. Experimental data with 14 Hz dynamic cyclic load are obtained as follows. 1. PFG crown(full porcelain occlusion) was failed after mean 0.03 years under fracture load for round candy(2224.8 N). 2. PFG crown(half porcelain occlusion) was failed after mean 4.1 years under fracture load for round candy(2224.8 N). 3. Ice Zirkon crown was failed after mean 4.3 years under fracture load for boiled chicken with bone(382.9 N). 4. Empress 2 crown was failed after mean 0.003 years under fracture load for boiled chicken with bone(382.9 N).

• Journal of Life Science
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• v.20 no.4
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• pp.607-613
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• 2010

Osteoporosis is a disease involving a decrease in bone mineral density and an increased risk of fractures. The MC3T3-E1 pre-osteoblastic cell line is a well-accepted model of osteogenesis in vitro. Pine needles have long been used as a traditional health-promoting medicinal food in Korea. In this study, MTT assay, the alkaline phosphatase (ALP) activity and collagen synthesis of osteoblast cells were investigated to determine the effects of pine needle extracts on cell proliferation and differentiation. Pine needle extracts were prepared using hexane, ethanol and water. The effects of the pine needle extracts were examined by comparing the results with those of commercial agents, such as proanthocyanidin. The MC3T3-E1 cells exposed to proanthocyanidin showed increased proliferation in a concentration-dependent manner. The cells exposed to the hexane extract showed a similar increase in proliferation to that observed with proanthocyanidin. The hexane extract showed the highest ALP activity. Moreover, a supplement of pine needle extracts induced collagen synthesis in MC3T3-E1 cells. The pine needle extract produced the highest level of collagen synthesis at concentrations of $10{\sim}50\;{\mu}g/ml$. These results indicate that pine needle extracts have an anabolic effect on bone by promoting osteoblastic differentiation, and may be used in the treatment of common metabolic bone diseases.

• Journal of Biomedical Engineering Research
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• v.25 no.3
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• pp.171-182
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• 2004

This study investigates the biomechanical efficacies of vertebroplasty which is used to treat vertebral body fracture with bone cement augmentation for osteoporotic patients using image and finite element analysis. Simulated models were divided into two groups: (a) a vertebral body, (b) a functional spinal unit(FSU). For a vertebral body model, the maximum axial displacement was investigated under axial compression to evaluate the effect of structural integrity. The stiffness of each FE model simulated was normalized by the stiffness of intact model. In the case of FSU model, 3 types of compression fractures were formulated to assess the influence on spinal curvature changes. The FSU models were loaded under compressive pressure to calculate the change of spinal curvature. The results according to the various factors suggest that vertebroplasty has the biomechanical efficacy of the increment of structural reinforcement in a patient who has relatively high level of BMD and a patient with the amount of 15％, PMMA injection of the cancellous bone volume. The spinal curvatures after compression fracture simulation vary from 9$^{\circ}$ to 17$^{\circ}$ of kyphosis compared to that the spinal curvature of normal model was -2.8$^{\circ}$ of lordosis. These spinal curvature changes cause the severe spinal deformity under the same loading. As the degree of compressive fracture increases the spinal deformity also increases. The results indicate that vertebroplasty has the increasing effect of the structural integrity regardless of the amount of PMMA or BMD and the restoration of decreased vertebral body height may be an important factor when the compressive fracture caused the significant height loss of vertebral body.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.121-143
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• 2010

To investigate the effect of implant types and bone resorption on the fracture characteristics. 4 types of Osstem$^{(R)}$Implant were chosen and classified into external parallel, internal parallel, external taper, internal taper groups. Finite elements analysis was conducted with ANSYS Multi Physics software. Fatigue fracture test was performed by connecting the mold to the dynamic load fatigue testing machine with maximum load of 600N and minimum load of 60N. The entire fatigue test was performed with frequency of 14Hz and fractured specimens were observed with Hitachi S-3000 H scanning electron microscope. The results were as follows: 1. In the fatigue test of 2 mm exposed implants group, Tapered type and external connected type had higher fatigue life. 2. In the fatigue test of 4 mm exposed implants group, Parallel type and external connected types had higher fatigue life. 3. The fracture patterns of all 4 mm exposed implant system appeared transversely near the dead space of the fixture. With a exposing level of 2 mm, all internally connected implant systems were fractured transversely at the platform of fixture facing the abutment. but externally connected ones were fractured at the fillet of abutment body and hexa of fixture or near the dead space of the fixture. 4. Many fatigue striations were observed near the crack initiation and propagation sites. The cleavage with facet or dimple fractures appeared at the final fracture sites. 5. Effective stress of buccal site with compressive stress is higher than that of lingual site with tensile stress, and effective stress acting on the fixture is higher than that of the abutment screw. Also, maximum effective stress acting on the parallel type fixtures is higher. It is careful to use the internal type implant system in posterior area.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.139-155
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• 2009

Objective : To assess the biological stability of immediate transmucosal placement of tapered implants into tooth extraction sockets. Material and methods : Following tooth extraction, tapered implants were immediately placed into the sockets. Teeth with evidence of acute periapical pathology were excluded. After implant placement, sutured allowing a non-submerged, transmucosal healing. Standardized radiographs were obtained every visiting from baseline to 32 weeks after implant placment. Changes in depth of the distance from the implant shoulder (IS) and from the alveolar crest (AC) to the bottom of the defect (BD) were assessed. Results : Thirteen patients (10 males and 3 females) were enrolled and followed. They contributed with 15 tapered implants. extraction iste displayed sufficient residual bone volume to allow primary stability of all implants. The mean surgery time was $41{\pm}10.0$ mins. All implants healed uneventfully yielding a survival rate of 100%. Mean ISQ values were relatively stable. Interproximal crestal bone decreased $1.69{\pm}1.2mm$ (mesial), $1.65{\pm}1.2mm$ (distal) from baseline to 32-week follow-up. No statistically significant changes with respect to FMPS, FMBS, PPD and width of KG were observed. Conclusions: Immediate transmucosal implant placement represented a predictable treatment option for the replacement of teeth lost due to reasons including fractures, endodontic failures and caries.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.436-442
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• 2007

Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.25-31
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• 2012

Purpose: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated. Materials and Methods: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle. Results: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head. Conclusion: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.