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

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.3
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• pp.158-167
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• 2024

Purpose: To evaluate the prevalence of vertebral fracture (VF) in children with chronic liver disease (CLD) with and without liver transplantation (LT) and to determine the associated factors. Methods: A cross-sectional study was conducted. Patients aged 3-21 years with CLD both before and after LT were enrolled in the study. Lateral thoracolumbar spine radiographs were obtained and assessed for VF using Mäkitie's method. Clinical and biochemical data were collected. Results: We enrolled 147 patients (80 females; median age 8.8 years [interquartile range 6.0-11.8]; 110 [74.8%] in the LT group and 37 [25.2%] in the non-LT group). VF was identified in 21 patients (14.3%): 17/110 (15.5%) in the LT group and 4/37 (10.8%) in the non-LT group (p=0.54). Back pain was noted in only three patients with VF. In the univariate analysis, a height z-score below -2.0 (p=0.010), pre-LT hepatopulmonary syndrome (p=0.014), elevated serum direct and total bilirubin levels (p=0.037 and p=0.049, respectively), and vitamin D deficiency at 1-year post-LT (p=0.048) were associated with VF in the LT group. In multivariate analysis, height z-score below -2.0 was the only significant associated factor (odds ratio, 5.94; 95% confidence interval, 1.49-23.76; p=0.012) for VF. All VFs in the non-LT group were reported in males. Conclusion: In children with CLD, VF is common before and after LT. Most patients with VF are asymptomatic. Screening for VF should be considered in patients with a height z-score below -2.0 after LT.

• Journal of the Korean Society of Radiology
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• v.18 no.3
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• pp.309-315
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• 2024

The Study In order to obtain a Clear Image of fractures in Atlas and Axis of Cervical Spin, this Study obtained Images examined using a Cervical Spin Pantom and a Radiation device, and then Commissioned five Radiologists and three Orthopedic Regent Doctors for Subjective Psychological ROC (Receiver, Operation, Characteristic) Evaluation. As aRresult, the X-ray Tube was Tilted 15° toward the leg to Receive a high score of 29 Points during the Eamination, and the Objective Evaluation Signal-to-noise Ratio (SNR) was 6.032 points, which was high. In Addition, by Tilting the X-ray tube 10° toward the head, it received a high score of 33 points during the Examination, and a high score of 7.840 Points in the objective evaluation. And as a result of Subjectively and Objectively Statistically Evaluating the Examined Images, the Cronbach Alpha value was Calculated as 0.791. Since the Cronbach Alpha value was 0.7 or higher, the Reliability could be Evaluated as 'very good', and the significance probability (p) was Statistically Significant at 0.042 points.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.357-365
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• 2023

Background: The purpose of this study was to evaluate the effect of concomitant open distal clavicle excision (DCE) on postoperative clinical outcomes and incidence of acromial and scapular stress fractures (ASFs) in patients with symptomatic acromioclavicular joint osteoarthritis (ACJ OA) undergoing reverse total shoulder arthroplasty (RTSA). Methods: A single-surgeon retrospective cohort study was conducted including patients who underwent primary elective RTSA with or without DCE from 2015 to 2019 with a minimum 6-month follow-up period. Shoulder active range of motion (AROM) and visual analog scale (VAS) pain were recorded preoperatively and postoperatively. ASFs and other adverse events were identified using postoperative notes and/or radiographs. Characteristics and outcomes were compared between the RTSA and RTSA-DCE groups. Results: Forty-six RTSA patients (mean age, 67.9±8.7 years; 60.9% male; mean follow-up, 24.9±16.6 months) and 70 RTSA-DCE patients (mean age, 70.2±8.9 years; 20.0% male; mean follow-up, 22.7±12.9 months) were included. There were no significant intergroup differences in rates of ASF (RTSA, 0.0% vs. RTSA-DCE, 1.4%; P=1.00), stress reactions (RTSA, 8.7% vs. RTSA-DCE, 11.4%; P=0.76), reoperation, revision, or infection (all P>0.05), or in pre-to-postoperative reduction in VAS pain (P=0.17) at latest follow-up. However, the RTSA-DCE group had greater pre-to-postoperative improvement in flexion AROM (RTSA, 43.7°±38.5° vs. RTSA-DCE, 59.5°±33.4°; P=0.03) and internal rotation (IR) AROM (P=0.02) at latest follow-up. Conclusions: Concomitant DCE in RTSA improves shoulder flexion and IR AROM, alleviates shoulder pain, and does not increase the risk of ASFs. Level of evidence: III.

• Hip & pelvis
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• v.34 no.1
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• pp.25-34
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• 2022

Purpose: Mortality rates following hip fracture surgery have been well-studied. This study was conducted to examine mortality rates in asymptomatic patients presenting for treatment of acute hip fractures with concurrent positive COVID-19(+) tests compared to those with negative COVID-19(-) tests. Materials and Methods: A total of 149 consecutive patients undergoing hip fracture surgery during the COVID-19 pandemic at two academic medical centers were reviewed retrospectively. Patients were divided into two groups for comparative analysis: one group included asymptomatic patients with COVID-19+ tests versus COVID-19- tests. The primary outcome was mortality at 30-days and 90-days. Results: COVID-19+ patients had a higher mortality rate than COVID-19- patients at 30-days (26.7% vs 6.0%, P=0.005) and 90-days (41.7% vs 17.2%, P=0.046) and trended towards an increased length of hospital stay (10.1±6.2 vs 6.8±3.8 days, P=0.06). COVID-19+ patients had more pre-existing respiratory disease (46.7% vs 11.2%, P=0.0002). Results of a Cox regression analysis showed an increased risk of mortality at 30-days and 90-days from COVID-19+ status alone without an increased risk of death in patients with pre-existing chronic respiratory disease. Conclusion: Factors including time to surgery, age, preexisting comorbidities, and postoperative ambulatory status have been proven to affect mortality and complications in hip fracture patients; however, a positive COVID-19 test result adds another variable to this process. Implementation of protocols that will promote prompt orthogeriatric assessments, expedite patient transfer, limit operating room traffic, and optimize anesthesia time can preserve the standard of care in this unique patient population.

• 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.

• Economic and Environmental Geology
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• v.47 no.4
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• pp.317-333
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• 2014

The Pocheon iron (-copper) deposit, located at the northwestern part of the Precambrian Gyeonggi massif in South Korea, genetically remains controversial. Previous researchers advocated a metamorphosed (-exhalative) sedimentary origin for iron enrichment. In this study, we present strong evidences for skarnification and Fe mineralization, spatially associated with the Myeongseongsan granite. The Pocheon deposit is composed of diverse carbonate rocks such as dolostone and limestone which are partially overprinted by various hydrothermal skarns such as sodic-calcic, calcic and magnesian skarn. Iron (-copper) mineralization occurs mainly in the sodic-calcic skarn zone, locally superimposed by copper mineralization during retrograde stage of skarn. Age data determined on phlogopites from retrograde skarn stage by Ar-Ar and K-Ar methods range from $110.3{\pm}1.0Ma$ to $108.3{\pm}2.8Ma$, showing that skarn iron mineralization in the Pocheon is closely related to the shallow-depth Myeongseongsan granite (ca. 112 Ma). Carbon-oxygen isotopic depletions of carbonates in marbles, diverse skarns, and veins can be explained by decarbonation and interaction with an infiltrating hydrothermal fluids in open system ($XCO_2=0.1$). The results of sulfur isotope analyses indicate that both of sulfide (chalcopyrite-pyrite composite) and anhydrites in skarn have very high sulfur isotope values, suggesting the $^{34}S$ enrichment of the Pocheon sulfide and sulfate sulfur was derived from sulfate in the carbonate protolith. Shear zones with fractures in the Pocheon area channeled the saline, high $fO_2$ hydrothermal fluids, resulting in locally developed intense skarn alteration at temperature range of about $500^{\circ}$ to $400^{\circ}C$.

• Economic and Environmental Geology
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• v.30 no.6
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• pp.505-517
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• 1997

Lead and zinc mineralization of the Kwangsin mine was formed in quartz and carbonate veins that filled fault-related fractures in the limestone-rich Samtaesan Formation of the Chosun Supergroup and the phyllite-rich Suchangni Formation of unknown age. A K-Ar date of alteration sericite indicates that the Pb-Zn mineralization took place during Late Cretaceous (83.5 Ma), genetically in relation to the cooling of the nearby Muamsa Granite (83~87 Ma). Mineral paragenesis can be divided into three stages (I, II, III): (I) the deposition of barren massive white quartz, (II) the main Pb-Zn mineralization with deposition of white crystalline quartz and/or carbonates (rhodochrosite and dolomite), and (III) the deposition of post-ore barren calcite. Mineralogic and fluid inclusion data indicate that lead-zinc minerals in middle stage II (IIb) were deposited at temperatures between $182^{\circ}$ and $276^{\circ}C$ from fluids with salinities of 2.7 to 5.4 wt. % equiv. NaCl and with log $fs_2$ values of -15.5 to -11.8 atm. The relationship between homogenization temperature and salinity data indicates that lead-zinc deposition was a result of fluid boiling and later meteoric water mixing. Ore mineralization occurred at depths of about 600 to 700 m. Sulfur isotope compositions of sulfide minerals (${\delta}^{34}S_{CDT}=9.0{\sim}14.5$ ‰) indicate a relatively high ${\delta}^{34}S_{{\Sigma}S}$ value of ore fluids (up to 14 ‰), likely indicating an igneous source of sulfur largely mixed with an isotopically heavier sulfur source (possibly sulfates in surrounding sedimentary rocks). There is a remarkable decrease of calculated ${\delta}^{18}O$ value of water in hydrothermal fluids with increasing paragenetic time: stage I, 14.6~10.1 ‰; stage IIa, 5.8~2.2 ‰; stage IIb, 0.8~2.0 ‰; stage IIc, -6.1~-6.8 ‰, This indicates a progressive increase of meteoric water influx in the hydrothermal system at Kwangsin. Measured and calculated hydrogen and oxygen isotope values indicate that the Kwangsin hydrothermal fluids was formed from a circulating (due to intrusion of the Muamsa Granite) meteoric waters which evolved through interaction mainly with the Samtaesan Formation (${\delta}^{18}O=20.1$ to 24.9 ‰) under low water/rock ratios.

• Economic and Environmental Geology
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• v.49 no.6
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• pp.491-504
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• 2016

Jinwon Au-Ag deposit is located in the Uijin gun which is southeast 300 km from Seoul. The deposit area consists of mainly Precambrian Hongjesa granite, which occurs as porphyroblastic texture, medium grain and composed of quartz, feldspar and mica. This deposit consists of four parallel hydrothermal quartz veins that fill NE oriented fractures in Precambrian Hongjesa granite. The grade of quartz veins contain from 3.0 to 21.4 g/t (average 6.4 g/t) gold and from 5.0 to 252.0 g/t (average 117.9 g/t) silver, respectively. They vary from 0.2 m to 0.6 m (average 0.3 m) in thickness and extend to about 200 m in strike length. Quartz veins occur as massive, network, cavity, breccia, crustiform, comb and zonal textures. Wallrock alteration has silicification, sericitization, pyritization and argillitization. The mineralogy of the quartz veins consists of quartz, arsenopyrite, cassiterite, pyrite, sphalerite, chalcopyrite, galena, electrum, tetrahedrite, canfieldite, argentite, Ag-Sb-S mineral, Mn-Fe-O mineral, Pb-O mineral and Pb-P-Cl-O mineral(chloro-pyromorphite). Chemical compositions of minerals from this deposit are as followed; Fe/Fe+Mg of sericite is from 0.32 to 0.71, As content of arsenopyrite ranges from 27.91 to 30.33 atomic %, FeS content of sphalerite range from 9.77 to 16.76 mole %, Ag content of electrum is from 29.42 to 37.41 atomic % and Ag content of tetrahedrite range from 32.17 to 36.53 wt.%, respectively. Baased on mineralogy and chemical compositions of minerals from Jinwon Au-Ag deposit, deposition of minerals was caused by a change in temperature, oxygen fugacity($fO_2$) and sulfur fugacity($fS_2$) from the near neutral hydrothermal fluid evolved by reaction with wallrock.

• 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.