• Journal of Nutrition and Health
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• v.39 no.5
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• pp.451-459
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• 2006

The purpose of our study was to evaluate an association between milk consumption and bone mineral density (BMD) of female college students in Korea. The dietary data of 1,410 Korean college students living in the vicinity of Seoul area were collected through the Food Frequency Questionnaire. The mean age, height, weight and 8MI of the subjects were 20.4 years, 162.1 cm, 52.7 kg, and $20.0\;kg/m^2$ respectively. The mean intakes of energy, protein, and phosphorus were 2,398.7 kcal, 95.2 g, and 1,302.9 mg respectively, which were above their EER or Recommended Intake (RI), but the mean intake of calcium was 657.8 mg which was below its RI, and 44.0% of the subjects did not meet Estimated Average Requirement (EAR) of calcium. The daily milk consumption was 131.1 g, and the total consumption of milk and dairy product was 228.7 g. Forty five percent of the subjects consumed $50{\sim}200\;g$ of milk or dairy products. After the analysis of their dietary intakes, the subjects were divided into quintiles of total consumption of milk and dairy product, which were considered as major source of dietary calcium. Ninety two subjects from the upper quintile (UQ) and 85 subjects from the lower quintile (LQ) were selected and their bone mineral densities (BMD) of lumbar spine (L1-L4) and the femur were examined by the dual energy X-ray absorptiometry. The BMD $(g/cm^2)$of L1, L2, L3, and average of femur were 1.065, 1.150, 1.187, and 0.988 for the UQ subjects, which were significantly higher than those of the LQ subjects, 1.010, 1.090, 1.146, and 0.942 respectively. Moreover, the T-scores of the UQ were significantly higher than those of the LQ. The prevalence rates of osteopenia classified according to WHO's criterion were 12.0% in the UQ. and 20.0% in the LQ group which showed non significant. Blood levels of calcium, and phosphorus of UQ and LQ group were both within the normal range, and were not significantly different. Our results showed that UQ group presented the better status of bone mineral density and bone health. Therfore our results suggest that continuous consumption of more than one and a half cups of milk per day, which corresponds to the least amount of UQ group's consumption, would affect positively on the bone health of Korean adults.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.2
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• pp.339-348
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• 2004

This study was peformed to assess the relationships among bone mineral density (BMD), Physiological characteristics and lifestyle factors in 61 premenopausal working women aged 30∼49 y in Busan. The BMDs of the lumbar spines (Ll∼L4), femoral necks (FN), ward's triangles (WT) and trochanters (TC) were measured by dual energy X-ray absorptiometry. Data for physiological characteristics and physical activity was assessed by questionnaire and usual intakes of coffee, green tea, alcohol, Coca cola by food frequency questionnaire. The BMDs of L14, FN, WT and TC were 1.02 g/$\textrm{cm}^2$, 0.76 g/$\textrm{cm}^2$,0.69 g/$\textrm{cm}^2$ and 0.66 g/$\textrm{cm}^2$respectively The BMD of FN was assessed as osteopenia by T-score. The BMD of WT was positively correlated with age of monarch (p<0.05) and the BMD of Ll4 was positively correlated with delivery number (p<0.05). The BMD of Ll4 was positively correlated with hours of outdoor activity per weekend and week (p<0.05, p<0.05). The BMDs of FN and WT (p<0.05, p<0.05) were positively correlated with intake of green tea per month and the BMD of FN (p<0.05) was positively correlated with intake of wine per month. But the BMD of Ll (p<0.05) was negatively correlated with intake of Coca cola per month. So nutritional education for increasing hours of outdoor activity and decreasing intake frequency of beverage contributing to diminishment of bone mineral density is needed for premenopausal working women to prevent osteoporosis.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.323-327
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• 2012

Objective : The purpose of this study was to verify the appropriateness of ovariectomized rats as the osteoporosis animal model. Methods : Twelve female Sprague-Dawley rats underwent a sham operation (the sham group) or bilateral ovariectomy [the ovariectomy (OVX) group]. Eight weeks after operations, serum biochemical markers of bone turnover were analyzed; osteocalcin and alkaline phosphatase, which are sensitive biochemical markers of bone formation, and C-terminal telopeptide fragment of type I collagen C-terminus (CTX), which is a sensitive biochemical marker of bone resorption. Bone histomorphometric parameters and microarchitectural properties of 4th lumbar vertebrae were determined by micro-computed tomographic (CT) scan. Results : The OVX group showed on average 75.4% higher osteocalcin and 72.5% higher CTX levels than the sham group, indicating increased bone turnover. Micro-CT analysis showed significantly lower bone mineral density (BMD) (p=0.005) and cortical BMD (p=0.021) in the OVX group. Furthermore, the OVX group was found to have a significantly lower trabecular bone volume fraction (p=0.002). Conclusion : Our results showed that bone turnover was significantly increased and bone mass was significantly decreased 8 weeks after ovariectomy in rats. Thus, we propose that the ovariectomized rat model be considered a reproducible and reliable model of osteoporosis.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.337-342
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• 2014

Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. Results : Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and $5.34^{\circ}$ compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by $8.32^{\circ}$ (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). Conclusion : In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.

• Journal of Nutrition and Health
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• v.35 no.8
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• pp.863-869
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• 2002

Soy isoflavones have been hypothesized to exert hormonal effects and to enhance bone mineral density in postmenopausal women. To test this hypothesis, we studied the effects of soy isoflavones supplements on bone mineral density and sex hormones (serum estradiol, sex hormone-binding globulin and testosterone) in 47 postmenopausal women. There were 24 participants in the treatment group and 23 in the control group. The treatment group consumed the isoftavones extract capsule daily (which contained 90 mg of soy isoflavones) for 12 weeks. The study compared pre- and post-isoflavones intake in the following areas: physical examination, diet survey, bone mineral density and serum sex hormone levels. The average age of the treatment group was 64.63 years and that of the control group was 66.48 years. There were no significant differences between the two groups in terms of height, weight, and body mass index. Both groups maintained regular diet patterns in terms of their average daily nutrient intake. There was no significant difference between the treatment group (18.49 mg) and the control group (21.27 mg) in terms of daily isoflavones intake based on diet. The 12-week analysis of bone mineral density change after taking isoflavones supplements demonstrated no significant differences in the following : lumbar spine BMD (0.82 g/$\textrm{cm}^2$ in pre versus 0.81 g/$\textrm{cm}^2$ in post), femoral neck BMD (0.58 g/$\textrm{cm}^2$ in pre versus 0.57 g/$\textrm{cm}^2$ in post) in the treatment group. There was no significant difference in serum estradiol in the isoflavones treatment group. The subjects indicated no significant difference in serum testosterone in the isoflavones treatment group. But the subjects indicated a significant difference in sex hormone-binding globulin (60.04 nmol/L in pre versus 52.39 nmol/L in post) in the isoflavones treatment group at the levels of p < 0.05. The significant decrease in sex hormone-binding globulin did indicate the need for long-term study on isoflavones supplementation as well as its positive effect on bone mineral density.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.327-335
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• 2019

Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm². The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

• Radiation Oncology Journal
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• v.27 no.1
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• pp.15-22
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• 2009

Purpose: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. Materials and Methods: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. Results: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). Conclusion: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.1
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• pp.95-104
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• 2020

PURPOSE: A prospective study was conducted to investigate the correlation between the inspiration ability, bone mineral density, lumbar muscle strength, and muscular endurance for the national softball athletes in the national training center. METHODS: The general characteristics of study subjects, inspiration ability, bone mineral density, muscle strength, and muscular endurance data were analyzed using descriptive statistics. In addition, the Pearson product moment correlation was performed to investigate the correlation between the inspiratory capacity, bone mineral density, muscle strength, and muscular endurance. RESULTS: The inspiration, flow rates, and volume were not correlated with the bone mass and bone mineral density. Inspiration and the flow rates and volume were not correlated with the bone mass and bone mineral density. On the other hand, inspiration was correlated with the Extensor muscles (r=.464, p=.006) at an angular velocity of 60°/s and the flexors (r=.463, p=.006) and extensor muscles (r=.615, p<.001) at an angular velocity of 180°/s. The flow rate was also correlated with the extensor muscles (r=.444, p=.009) at an angular velocity of 60°/s and with flexor muscles (r=.432, p=.011) and extensor muscles (r=.589, p<.001) at an angular velocity of 180°/s. Finally, the volume was correlated at the extensor muscles at an angular velocity of 180°/s (r=.534, p=.001). CONCLUSION: The correlation between the inspiratory capacity, bone mineral density, muscle strength, and muscular endurance of softball athletes did not correlate with the bone mass and bone density. On the other hand, the lumbar muscle strength increased with increasing inspiratory capacity.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.357-362
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• 2015

Objective : To investigate risk factors for S1 screw loosening after lumbosacral fusion, including spinopelvic parameters and paraspinal muscles. Methods : We studied with 156 patients with degenerative lumbar disease who underwent lumbosacral interbody fusion and pedicle screw fixation including the level of L5-S1 between 2005 and 2012. The patients were divided into loosening and non-loosening groups. Screw loosening was defined as a halo sign larger than 1 mm around a screw. We checked cross sectional area of paraspinal muscles, mean signal intensity of the muscles on T2 weight MRI as a degree of fatty degeneration, spinopelvic parameters, bone mineral density, number of fusion level, and the characteristic of S1 screw. Results : Twenty seven patients showed S1 screw loosening, which is 24.4% of total. The mean duration for S1 screw loosening was $7.3{\pm}4.1$ months after surgery. Statistically significant risk factors were increased age, poor BMD, 3 or more fusion levels (p<0.05). Among spinopelvic parameters, a high pelvic incidence (p<0.01), a greater difference between pelvic incidence and lumbar lordotic angle preoperatively (p<0.01) and postoperatively (p<0.05). Smaller cross-sectional area and high T2 signal intensity in both multifidus and erector spinae muscles were also significant muscular risk factors (p<0.05). Small converging angle (p<0.001) and short intraosseous length (p<0.05) of S1 screw were significant screw related risk factors (p<0.05). Conclusion : In addition to well known risk factors, spinopelvic parameters and the degeneration of paraspinal muscles also showed significant effects on the S1 screw loosening.

• Journal of Korean Neurosurgical Society
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• v.42 no.1
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• pp.6-10
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• 2007

Objective : The purpose of this study was to determine the effect of bone cement augmentation of pedicular screwing in severe osteoporotic spondylolisthetic patients. Methods : Twenty patients with spondylolisthesis (8 : spondylolytic spondylolisthesis 12 : degenerative spondylolisthesis) who had undergone pedicular screwing and interbody fusion for osteoporotic lumbar spine (T-score on bone mineral density<-3.0) from 2002 to 2005 were reviewed. Mean age was 62.3 years with 3 male and 17 female patients. Average follow-up period was 14 months. Average T-score on bone mineral density (BMD) was -3.62. After decompression of neural elements, about 6cc of polymethylmethacrylate (PMMA) was injected into the each vertebral body through transpedicular route. All patients underwent one level interbody fusion and pedicular screw fixation. Clinical outcome was assessed using Oswestry Disability Index (ODI) on the last clinical follow-up. In addition, a modified MacNab's grading criteria was used to objectively assess patient's outcome postoperatively. Radiographic analysis of sagittal contour was assessed preoperatively, immediately postoperatively, and at final follow-up including fusion rate. Results : Eighteen of 20 patients were graded as excellent or good according to the modified MacNab's criteria. An significant improvement of ODI was achieved in both groups. Mean sagittal angle at the preoperative state, postoperative state and at the last follow-up state was $11.0^{\circ},\;20.1^{\circ}$ and $18.3^{\circ}$, respectively, with mean sagittal angle correction gain $7.3^{\circ}$. Firm fusion was achieved in all patients. There were one compression fracture above the fused segment after 6 months follow-up and one case of seroma. But there were no postoperative complications related to bone cement leakage and pedicular screwings such as screw pullout or screw cut-up. Conclusion : Bone cement augmentation of pedicular screwing can be an effective procedure for osteoporotic lumbar spine in spondylolisthetic patients.