• Title/Summary/Keyword: Lumbar Spine

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A Study on Bone Mineral Density, dietary habits and Nutritional Status of Adult Women in the three age groups (연령에 따른 성인여성의 골밀도와 식습관 및 영양섭취상태 연구)

  • Choi, Mi-Kyeong;Kim, Mi-Hyun
    • Journal of the Korean Society of Food Culture
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    • v.22 no.6
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    • pp.833-840
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    • 2007
  • The purpose of this study was to obtain baseline data of nutritional management for women's bone health according to age. This study was conducted through questionnaire, bone mineral density(BMD) measurement by DEXA and dietary survey by 24hr recalls to 134 adult women. Subjects were divided into three groups: young women group who aged 20-29(n=48), middle aged women group who aged over 30 and were pre-menopause(n=36), postmenopausal women group(n=48). The body fat percent of postmenopausal women group was the highest among the three groups. BMD of lumbar spine(L1-L2) were $0.93\;g/cm^2$ for young women, $0.97\;g/cm^2$ for middle aged women, and $0.88\;g/cm^2$ for postmenopausal women, respectively(p<0.05). BMD of femoral neck(p<0.05), trochanter(p<0.05), and ward's (p<0.001) were significantly decreased as age increasement. Drinking alcohol and skipping meals were significantly higher in young women groups than in the other groups, however frequency of doing regular exercise was significantly lower in young women groups. Young women group consumed the significantly higher amount of cereals(p<0.05), sugar and sweeteners(p<0.001), meats(p<0.01), eggs(p<0.01), milks(p<0.05) and oils(p<0.001) than middle aged and postmenopausal women. Also, energy(p<0.001), animal protein, (p<0.01), plant oil(p<0.001), animal fat(p<0.001), retinol(p<0.001), vitamin E(p<0.01), and cholesterol(p<0.001) intakes of young women were highest among the three groups. However, young women group consumed the significantly lower amount of dietary fiber(p<0.05), vitamin C(p<0.01), folate(p<0.05) and fruits(p<0.01) than the other groups. To summarized the our results, young women who were in still undergoing bone formation activity to develope peak bone mass, had more dietary habit and lifestyle problems than middle aged and postmenopausal women. The results of this study revealed that nutritional management and education for bone health should be emphasized in young women not only aged women.

MR Imaging Characteristics of Primary T-Cell Lymphoma of the Cauda Equina: A Case Report and Literature Review (말총의 원발성 T세포 림프종에서 MR 영상 소견: 증례 보고와 문헌 고찰)

  • Younguk Kim;Guen Young Lee;Sujin Kim;Kwang-sup Song;Hee Sung Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1613-1618
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    • 2021
  • Primary central nervous system lymphoma is a rare form of extranodal non-Hodgkin lymphoma, and primary T-cell lymphoma of the cauda equina is extremely rare. We describe a case involving a 56-year-old female who presented with low back pain and radiating leg pain for 4 months. MRI of the lumbar spine revealed an elongated, multinodular intradural lesion of approximately 10 cm from the L4 body to the S2 body level with iso-signal intensity on T1-weighted imaging, heterogeneous iso- and high-signal intensity on T2-weighted imaging, and a heterogeneous intense enhancement on gadolinium contrast-enhanced T1-weighted imaging. A peripheral T-cell lymphoma of the cauda equina was diagnosed on the basis of immunohistochemical and T-cell receptor gamma gene rearrangement analysis after intradural biopsy of the mass.

Effects of Physiological Factors and Lifestyles on Bone Mineral Density in Postmenopausal Women (생리적 요인과 생활습관이 폐경 후 여성의 골밀도에 미치는 영향)

  • Sung, Chung-Ja;Choi, Yun-Hee
    • Journal of Nutrition and Health
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    • v.40 no.6
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    • pp.517-525
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    • 2007
  • This study was performed to assess the effects of physiological factors and lifestyles on bone mineral density (BMD) in 64 postmenopausal women. Sixty four subjects were selected out of 223 postmenopausal women in Seoul and Kyunggido. The BMD of the lumbar spine (L2 ${\rightarrow}$ L4) and femoral neck were measured dual energy X-ray absorptiometry (DEXA). Subjects were assigned to one of three groups such as normal (T-score > -1, n = 20), osteopenia (-2.5 < Tscore ${\leq}$ -1, n = 24), and osteoporosis (T-score ${\leq}$ -2.5, n = 20). Anthropometric measurements and questionares were administered to these women. The mean age, height, weight and BMI were 62.09 yrs, 153.78 cm, 56.09 kg and 23.70 $kg/m^2$ respectively. The BMDs of lumbar spines (L2 ${\rightarrow}$ L4), femoral neck were 0.84 $g/cm^2$, 0.71 $g/cm^2$ respectively. Years after menopause and age of last delivery of the osteoporosis and osteopenia group were significantly longer than the normal group (p < 0.05). The hours of exercise and outdoor activity of the normal group were longer than the osteoporosis and osteopenia group, but there were no significant differences among the three groups. The BMDs of these two sites were positively correlated with weight, BMI, hip and body fat and negatively correlated with LBM, TBW. These results show there are no consistent effects on bone mineral density, adjusting for age and BMI, of physiological factors and lifestyles in postmenopausal women. Therefore. this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight.

A Descriptive Statistical Analysis of the Hospitalized Patients with Low Back Pain in Departments of Korean Rehabilitation Medicine of Korean Medicine Hospitals (한국의 5개 한의과대학 부속한방병원 재활의학과의 요통 입원 환자에 대한 후향적 기술통계분석 - 입원 기간, 상병명, 치료 방법을 중심으로 -)

  • Maeng, Tae-Ho;Kim, Jongyeon;Yi, Woon-Sup;Chung, Won-Seok;Ko, Youn-Seok;Lee, Jung-Han;Shin, Byung-Cheul;Cha, Yun-Yeop;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Song, Yun-Kyung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.213-223
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    • 2013
  • Objectives Low back pain (LBP) is one of the most common reason for people in Korea to visit Korean medical institutions. To assess actual amounts of use in the treatment of LBP in Korean medicine and to provide objective base line data for policy decision making, research regarding the current state of LBP patients' treatment in Korean medical institutions are in need. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 304 patients who were hospitalized for the treatment of LBP in Korean rehabilitation medicine inpatient clinics of five different Korean medicine hospitals were analyzed. The percentage of patient characteristics such as sex, age, average duration of admission, insurance type, diagnosed LBP related disease code, and rates of interventions applied were assessed. Results 1. The female sex was significantly predominant among patients with LBP : 105 patients (34.5%) were male and 199 patients (65.5%) were female. Percentage of the patients' age appeared as followed : 76 people (25.0%) were in their 50s, 64 people (21.1%) were in their 40s, 51 people (16.8%) were in their 30s, 37 people (12.2%) were in their 60s, and 33 people (10.9%) were in their 70s. Approximately half of the total LBP patients investigated were older than 50. 2. The average duration of admission was 16.2 days. Approximately one third (30.3%) of the patients were hospitalized for 8 to 14 days. 3. Female patients tended to stay admitted in hospitals slightly longer than male patients. Elderly (age 60~79) patients stayed in hospitals longer (17.8 days) compared to younger (age 20~39) patients (13.5 days). 4. More than half of the patients (171 cases, 56.3%) had their hospital bills covered with automobile insurance. 40.1% (122 cases) of the patients had medical insurance to cover their hospital bills. The average duration of admission of patients who had automobile insurance was 14.2 days, while that of the patients who had medical insurance was 18.4 days. 5. "Sprain and strain of the lumbar spine and pelvis" was the most commonly used (195 cases, 64.1%) disease code in patients with LBP. Patients diagnosed as "lumbar and other intervertebral disc disorders with radiculopathy" required the longest admission duration (22.1 days). 6. Herbal medication was applied to all of the patients during admission. Acupuncture was applied to all of the patients except one case diagnosed as spinal stenosis. Physical therapy, cupping therapy, moxibustion therapy, chuna therapy, and pharmacopuncture therapy were applied to 94.7, 92.8, 85.2, 83.9, and 49.7% of the patients, respectively. 7. There were certain differences among Korean medicine hospitals in terms of the LBP patients' duration of admission, type of insurance, frequency of the disease code use, type of intervention applied. Conclusions It is thought that the current study can be used as reference data in assessing the current state of LBP treatment in Korean rehabilitation medicine and a basis for future research. Provided improvements of certain limitations of the current study in future researches, such data would act as better base line data in policy decision making.

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

  • Lee, Yang Deok;Lee, Kang Hyu;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.1
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    • pp.15-21
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    • 2003
  • Background : There are many risk factors for osteoporosis in patients with chronic obstructive pulmonary disease(COPD). These include smoking, a low body mass index, insufficient exercise, and the use of glucocortcoids. However, there is lack of data on the incidence of osteoporosis according to the different glucocorticoid administration methods in patients with COPD. This study compared the incidence of osteoporosis according to the different administration methods of glucocorticoid. Methods : A matched case-controlled study (gender, age, cumulative steroid dose and pack-years of smoking) was conducted. Forty-five patients with documented COPD for at least a 3 year duration and a cumulative glucocorticoid dose above 1,000 mg were enrolled in study. The patients were classified into the following three groups. First, fifteen patients received continuous inhaled glucocorticoid with intermittent oral steroids but had no admission history due to an acute exacerbation(Group I). Secondly, fifteen patients received a multiple course of oral steroids with additional inhaled glucocorticoid but had no admission history due to their acute exacerbation(Group II). Lastly, fifteen patients received intermittent oral or inhaled glucocorticoids and had an admission history due to the acute exacerbation with intravenous steroid treatment for at least 2 weeks per year(Group III). The enrolled patients had apulmonary function test and bone densitometry performed at the lumbar spine and femoral neck. Results : The patients from Group III had significantly high incidence of osteoporosis in the lumbar and femoral neck compared to Group I and Group II (p<0.01). Conclusion : The incidence of osteoporosis in patients with COPD appears to be strongly affected by the method of steroid administration. This result suggests that intravenous steroid administration is strongly associated with the risk of osteoporosis.

Efficacy of Unilateral Biportal Endoscopic Decompression in Lumbar Foraminal Stenosis (요추 추간공 협착증에서 일측성 양방향 내시경적 측부 추간공 감압술의 효과)

  • Lee, Ji-Min;Woo, Young-Ha;Yoo, Seong-Ho;Kim, Young-Jun;Seo, Jin-Hyuk;Bae, Hyuk
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.411-417
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    • 2020
  • Purpose: This paper reports the short-term clinical and radiological results of unilateral biportal endoscopic decompression (UBE) to prove its efficacy. Materials and Methods: Twenty patients who received unilateral biportal endoscopic far-lateral decompression (UBEFLD) were analyzed statistically using the visual analogue scale (VAS), modified Macnab criteria and Oswestry Disability Index (ODI) clinically. Radiologically, their intervertebral angle (IVA), percentage slip, disc height index (DHI) and foraminal height index (FHI) were analyzed pre- and postoperatively. Results: The VAS scores were 6.20 preoperatively, which improved to 2.05, 1.75 and 1.45 at postoperative one month, three months and one year, respectively (p<0.001). The modified macnab criteria in both the good or excellent category was 70.0%, 80.0% and 85.0% at postoperative one month, three months and one year, respectively (p=0.034). The ODI improved from 59.8% preoperatively to 35.8%, 33.2%, and 17.1% at postoperative one month, three months, and one year, respectively (p<0.001). The IVA was increased 0.40±0.88 after a surgery (p=0.057). Percentage slip was increased 0.19% after surgery (p=0.134). The DHI changed from 0.49 preoperatively to 0.62 postoperatively (p=0.359), and the FHI changed from 0.71 preoperatively to 0.79 postoperatively (p<0.001). Conclusion: UBEFLD displayed satisfactory results. Such a result highlights the potential of UBEFLD as an excellent alternative to spinal fusion or microscopic surgery.

Efficacy of Statins on BMB or Fracture Risk in Postmenopausal Women (스타틴이 폐경기 여성의 골밀도 혹은 골절위험에 미치는 효과 -보고된 임상연구결과 분석을 중심으로-)

  • Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.86-91
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    • 2006
  • There are 3 different hypotheses on how statins may affect bones, through promoting bone formation, inhibiting bone resorption or through anti-inflammatory effect. In the 3 cross-sectional studies above, one showed increase BMD at hip and spine, one showed increase BMD only at mid-forearm and one showed that the risk reduction in fractures is not explained by the changes in BMD however, all 3 studies showed a decrease in risk of fracture associated with statins. In the 2 prospective cohort studies, one showed the use of statins was not associated with BMD at any skeletal site or decreasing the risk of fracture, and the other showed statins except pravastatin decreased in risk of vertebrate fracture but not affecting lumbar spine BMD. All of case-control studies indicated reduction in fracture risk but did not provide any data regarding BMD. 2 of the randomized, controlled studies showed no significant reduction in fracture risk as well as statins' effects on BMD. Finally, one longitudinal study showed statin use reduced fracture risk and increased BMD. Among the conflicting results shown above, even when statin use was shown to increase BMD, it does not seem to account for the reduction in fracture risk. There may be different ways that statins affect bone other than those hypotheses proposed above. Many studies seem to agree that pravastatin does not have any effect on bone. Some studies suggested that the reason statins did not achieve clinically significant increases in BMD in some studies, is due to the low affinity of statins on bone; statins are designed to act in the liver therefore their effective concentration in extrahepatic tissue is low. The limitations to those studies discussed above. Many studies did not account for the change of lifestyle while subjects' were on statins. Increases in weight bearing exercise and changes in diet might affect BMD and thus reduce risk of fractures. Mental alertness and vision acuity might prevent falls from occurring; many statin-users in the studies were young so the risk of fractures from falls would be decreased. Almost all of the studies failed exclude patients with neurological problems. During study periods, many subjects may have been started on drugs for diseases that usually occur with aging which could cause drowsiness and lead to falls. The sample sizes used in some of the trials were small and the duration of treatment and follow up might not have been long enough to see clinically relevant results.

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The Comparative Analysis of Exposure Conditions between F/S and C/R System for an Ideal Image in Simple Abdomen (복부 단순촬영의 이상적 영상구현을 위한 F. S system과 C.R system의 촬영조건 비교분석)

  • Son, Sang-Hyuk;Song, Young-Geun;Kim, Je-Bong
    • Korean Journal of Digital Imaging in Medicine
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    • v.9 no.1
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    • pp.37-43
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    • 2007
  • 1. Purpose : This study is to present effective exposure conditions to acquire the best image of simple abdomen in Film Screen (F.S) system and Computed Radiography (C.R) system. 2. Method : In the F.S system, while an exposure condition was fixed as 70kVp, images of a patients simple abdomen were taken under the different mAs exposure conditions. Among these images, the best one was chosen by radiologists and radiological technologists. In the C.R system, the best image of the same patient was acquired with the same method from the F.S system. Both characteristic curves from F.S system and C.R system were analyzed. 3. Results : In the F.S system, the best exposure condition of simple abdomen was 70kVp and 20mAs. In the CR system, with the fixed condition at 70kVp, the image densities of human organs, such as liver, kidney, spleen, psoas muscle, lumbar spine body and iliac crest, were almost same despite different environments (3.2mAs, 8mAs, 12mAs, 16mAs and 20mAs). However, when the exposure conditions were over or under (below) 12mAs, the images between the abdominal wall and the directly exposed part became blurred because the gap of density was decreased. In the C.R system, while the volume of mAs was decreased, an artifact of quantum mottle was increased. 4. Conclusion : This study shows that the exposure condition in the C.R system can be reduced 40% than in the F.S system. This paper concluded that when the exposure conditions are set in CR environment, after the analysis of equipment character, such as image processing system(EDR : Exposure Data Recognition processing), PACS and so on, the high quality of image with maximum information can be acquired with a minimum exposure dose.

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Effects of inhaled corticosteroids on bone mineral density and bone metabolism in children with asthma (천식 환아에서 흡입용 스테로이드의 사용이 골밀도와 골대사에 미치는 영향)

  • Choi, Ic Sun;Byeon, Jung Hye;Lee, Seung Min;La, Kyong Suk;Oh, Yeon-Joung;Yoo, Young;Lee, Kee Hyoung;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.811-817
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    • 2009
  • Purpose : Inhaled corticosteroids (ICS) are used as first-line agents for the treatment of persistent asthma; however, their use is accompanied by apprehension of potential systemic adverse effects. This study aimed to assess the effects of ICS on bone mineral density (BMD) and bone metabolism in children with asthma. Methods : From February 2008 to September 2008, 26 asthmatic children treated with ICS (ICS group), 15 asthmatic children treated with leukotriene receptor antagonist (LTRA) (LTRA group), and 30 healthy children (Control group) were selected from the Korea University Anam Hospital. BMD and serum bone-specific alkaline phosphatase (BALP) levels were measured. The asthmatic children underwent spirometry and methacholine bronchial challenge test. Results : There were no significant differences in BMD in the lumbar spine (P=0.254) and proximal femur (P=0.297) among the 3 groups. The serum BALP levels were significantly higher in both the ICS (P=0.017) and LTRA (P=0.025) groups than in the Control group. None of the parameters pertaining to ICS use, such as the mean daily dose during the last 6 months, the total cumulative dose, duration of use, and age of commencement of use, showed significant correlations with BMD (P>0.05 for all parameters). Conclusions : We demonstrated that a low dose of ICS does not exert any significant adverse effect on bone metabolism in asthmatic children. These findings support the current recommendations with regard to the use of ICS for asthmatic children.

Assessment of Osteoporosis Based on Changes in SNR and ADC Values on MR Diffusion Weighted Images (확산강조영상에서 신호대 잡음비, 현성 확산 계수 변화에 따른 골다공증 평가)

  • Cho, Jae-Hwan;Kim, Yeong-Soo
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.70-77
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    • 2010
  • This study tested how S/N (Signal to Noise Ratio) ratios and ADC (apparent diffusion coefficient) values vary with different T-scores in a group of patients with osteoporosis. Based on DEXA (Dual Energy X-ray Absorptiometry) T-scores for L1.L4 for two groups of subjects consisting of 30 healthy people without osteoporosis and 30 patients who came for treatment of waist (lumbar or low back) pain and were suspected to have osteoporosis as judged from the simple X-ray findings, this study classified every spine into two groups of osteoporosis and osteopenia. Signal intensity measurements were made in the four regions of L1 to L4 on diffusion-weighted MR images obtained using 1.5T MR scanner, while ADC measurements were obtained from ADC map images. As an approach for quantitative analysis, the comparison of the variances in S/N ratios and ADC values for varying T-scores in the selected regions of interest was carried out based on averaged T-scores, S/N ratios, and ADC values. Also, the variances in S/N ratios and ADC values for each of the groups of osteoporosis and osteopenia, which were classified into by T-scores, were compared. For qualitative analysis, a careful naked eye examination of signal intensity differences in the area of L4 was made on T1-weighted sagittal images for each of the healthy (normal), osteopenia, and osteoporosis groups. In the qualitative analysis, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the S/N ratios on diffusion-weighted MR images also decreased, with the greatest decrease in the S/N ratio found in the osteoporosis group. Additionally, among the three groups, the lowest S/N ratio was found in the osteoporosis group. With respect to ADC map, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the ADC values on diffusion-weighted MR images also decreased, with the greatest decrease in the ADC values found in the osteoporosis group. Additionally, among the three groups, the lowest ADC value was found in the osteoporosis group. On the other hand, in the qualitative analysis, the osteoporosis group showed the highest signal intensity. Additionally, among the three groups, the lowest signal intensity was found in the healthy (normal) group. It was found that as osteoporosis progressed, S/N ratio and ADC decreased, whereas signal intensity increased on T1-weighted images. Also, in diagnosing osteoporosis, MRI tests turned out to be (more) effective.