• Title/Summary/Keyword: Medical X-ray

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Evaluation of Clinical Availability for Shoulder Forced Traction Method to Minimize the Beam Hardening Artifact in Cervical-spine Computed Tomography (CT) (경추부 전산화단층촬영에서 선속 경화 인공물을 최소화하기 위한 견부 강제 견인법에 대한 임상적 유용성 평가)

  • Kim, Moonjeung;Cho, Wonjin;Kang, Suyeon;Lee, Wonseok;Park, Jinwoo;Yu, Yunsik;Im, Inchul;Lee, Jaeseung;Kim, Hyeonjin;Kwak, Byungjoon
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.37-44
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    • 2013
  • In study suggested clinical availability to shoulder forced traction method in term of quality of image, the patient's convenience and stability, according to whether to use of shoulder forced traction bend using computed tomography(CT) that X-ray calibration and various mathematic calibration algorithm application can be applied by AEC. To achieve this, 79 patients is complaining of cervical pain oriented that shoulder forced traction bend use the before and after acquires lateral projection scout image and transverse image. transverse image of a fixed size in concern field of pixel and figure the average HU value compare that quantitative analysis. Artifact and pixel and resolution to qualitative clinical estimation image analysis. the patient feel inconvenience degree that self-diagnosis survey that estimate. As a result, lateral projection scout image if you used shoulder forced traction bend for the depicted has been an increase in the number of a cervical vertebrae. transverse image concern field shoulder forced traction bend use the before and after for pixel and the average HU-value changes was judged to be almost irrelevant. Artifact and resolution and contrast, in qualitative analysis of the results relating the observer to the unusual result. So, the patients of 82.27% complained discomfort that use of shoulder forced traction bend in self-diagnosis survey. No merit of medical image by using of bend from result was analyzed quality of image to quantitative and qualitative method judged. Nowadays, CT is supplied possible revision of quality of radiation by reduction of slice and automatic exposure controller, etc and application of preconditioning filter process due to various mathematic revision algorithm. So, image noise by beam hardening artifact should not be a problem. shoulder forced traction bend of use no longer judged clinically availability because have not influence of image quality and give discomfort, have extra dangerousness.

Usefulness of Interferon-$\gamma$ Measurement Following Stimulation of Tuberculosis-specific Antigens for Diagnosis of Latent Tuberculosis Infection in Children Exposed to Pulmonary Tuberculosis (폐결핵 접촉력을 가진 소아에서 잠복 결핵 감염의 진단을 위한 결핵 특이항원 자극 인터페론-감마 측정의 유용성)

  • Sung, Ji Yeon;Ki, Joo Hwa;Yang, Mi Ae;Kim, So Hee;Eun, Byung Wook;Kim, Nam Hee;Park, Kyoung Un;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.52-58
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    • 2008
  • Purpose : Whole blood interferon-$\gamma$ assay was developed and many studies showed its usefulness in diagnosing tuberculosis (TB) including latent tuberculosis infection (LTBI). However, assessment in children has been limited. This study was undertaken to evaluate the usefulness of QuantiFERON-TB Gold for the diagnosis of LTBI in children exposed to pulmonary TB. Methods : Children who visited Seoul National University Bundang Hospital with a history of TB exposure were enrolled from January 2006 to December 2007. They were evaluated with chest x-rays, tuberculin skin test (TST) and QuantiFERON-TB Gold test. TST was retested 3 months later for those with initial negative reactivity. Definition of LTBI was made on the basis of the TST reactivity. Results : Among the 103 children with a history of TB exposure, 49 children were tested with chest x-ray, TST, and QuantiFERON-TB Gold. Twenty-two were males. Median age was 7.5 years (range; 3 months to 14.7 years). According to TST reactivity, LTBI was in 8 (19%), no infection was in 21 (50%), possible LTBI was in 13 (31%). QuantiFERON-TB Gold test was positive in 5 of the 49 subjects (10%); 3 of the 13 subjects (23.1%) in unknown status, 1 of the 8 subjects (13%) in LTBI, and 1 of the 21 subjects (5%) without infection. The agreement between the QuantiFERON-TB Gold and the TST was poor (${\kappa}=0.101$). Conclusion : QuantiFERON-TB Gold showed poor sensitivity for the diagnosis of LTBI in children with exposure to TB. QuantiFERON-TB Gold alone does not seem to be useful in the diagnosis of LTBI in children.

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The Radioprotective Effect and Mechanism of Captopril on Radiation Induced Lung Damage in Rat (방사선조사에 의한 쥐 폐손상에 방사선보호제로서 Captopril의 역할에 관한 연구)

  • Song Mi Hee;Lee Kyung Ja;Koo Heasoo;Oh Won Young
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.190-198
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    • 2001
  • Purpose : It was reported that Captopril (angiotensin converting enzyme inhibitor) had an effect to reduce the pneumonitis and pulmonary fibrosis induced by radiation in rat. We peformed this study to investigate the radioprotective effect and mechanism of Captopril. Methods and Materials : The comparison was made between the radiation only group and the combined Captopril and radiation group by examining histopathologic findings and immunohistochemical stains $(TNF\alpha\;and\;TGF\beta1)$ at 2 and 8 weeks after irradiation. Each group has 8 to 10 rats (Sprague-Dawley). 12.5 Gy of X-ray was irradiated to the left hemithorax in a single fraction. Captopril (50 mg/kg/d) mixed with water was given per oral and continuously from 1 week prior to irradiation up to 8th week of the experiment. Result : In the combined Captopril and radiation group, the histopathologic changes which were hemorrhage into alveolar space, changes of alveolar epithelium, bronchial epithelium and blood vessels, and perivascular edema were less severe than in the radisation only group at 2 weeks. At 8 weeks, the alveolar epithelial changes and perivascular edema were less prominant in the combined Captopril and radiation group. At 2 weeks, the $TNF\alpha$ expression of the combined Captopril and radiation group was markedly decreased at the alveolar epithelium (p<0.01), lymphoid tissue (p=0.06) and the macrophage of alveolar space (p<0.01) compared with the radiation only group. Furthermore the $TGF\beta1$ expression was significantly prominant at the alveolar epithelium (p<0.02) and the macrophage in alveolar space (p<0.02). At 8 weeks, the expression of $TNF\alpha\;and\;TGF\beta1$ of most sites, except $TGF\beta1$ of the macrophage of alveolar space (p=0.09), showed no significant difference between 2 groups. Conclusion : This study revealed that early lung damage induced by irradiation was reduced with the addition of Captopril in the latent and early pneumonitis phase. The expression of $TNF\alpha\;and\;TGF\beta1$ at 2 weeks and $TGF\beta1$ at 8 weeks was further decreased in the combined Captopril and radiation group than the radiation only group. From these results, it may be concluded that the proinflammatoy cytokine $(TNF\alpha)$ and fibrogenic cytokine $(TGF\beta1)$ probably play the role of the radioprotective mechanism in Captopril.

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일부 농촌지역의 결핵 치료 환자에 대한 실태 조사에 관한 연구

  • 이재희
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.85-94
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    • 1970
  • This is a study of 21 tuberculosis patients receiving medical treatment at the Public Health Center in Kyongi Do, Pu Chun Gun and at the General Hospital. The results cover the findings of the period from May, 1969 to November 1970. The information obtained is based on personal interviews with the patients, and symptomatic diagnosis made from observations. The following statistics when not equalling 100% contain only the responses of the two extremes in each case. The findings of the research are as follows: 1. 52.3% of the patients in the study are males and 47.7% are females. 28.6% of the subjects are between 20 and 29 years of age and an equal percent are between 30 and 39 years. 2. 47.5% of the subjects had graduated from primary school, while only 4.8% had graduated from high school. 3. 57.1% of the patients said they had no religions beliefs, while 4.8% professed to being Buddhists or believing in superstition. 4. 47.3% of the people said they were unemployed, while 4.8% classified themselves as labourers. 5. In response to how tuberculosis was first detected in their respective cases, 52.6% became aware of their disease through X-ray results, while 4.8% were discovered to have tuberculosis when being treated for other diseases at the hospital. 6. When asked how many of the patients knew anything about their disease when treated, 57.1% knew nothing about tuberculosis when they received treatment, while 42.9% had some knowledge of the disease. 7. Of those who knew something about tuberculosis, 61.9% learned about from doctors and nurses, while 4.8% learned from other people. 8. 57.1% of the patients knew that tuberculosis is a communicable disease, while 42.9% did not know. 9. 52.4% of the patients did not know the cause of tuberculosis while 4.9% believed the disease was caused by a curse. 10. When asked about the extent of treatment, 52.4% responded that they had undergone continuous treatment, while 4.8% had not received treatment. 11.The reasons given for not continuing treatment were the following: economic factors 55.6%; side reactions to the treatment, lack of knowledge of how to get treatment, of the need for treatment, or of the positive effects of treatment 11.1%. 12. 61.9% of the subjects usually took the medical treatment at home, 9.5% took it in the mountains or at the beach. 13. 42.9% of the patients received drugs for treatment at the local public health center, while 4.8% received them at the hospital 14. 33.3% of the patients received P.A.S+I.N.H.+S.M. for treatment of tuberculosis, while 4.8% received P.A.S.+S.M.. and some secondary drug. 15. Of the patients who took some extra medicine for tuberculosis, 38.1% took a Chinese drug, while 9.5% took herb medicine. 16. 38.1% of the patients had continued treatment for three years, 4.8% had interrupted the treatment. 17. When asked about the development of the disease after treatment, the patients gave the following information: after one month, 90.5% thought the treatment helped, while 9.5% weren't sure; after one year, 55.6% thought it was good, while 5.5% thought it was not; after three years, 63.6% had a very bad condition. while 4.8% didn't know. 18. 61.9% of the patients were unconcerned about covering their mouths when they coughed, while 38.1% covered their mouths. 19. 57.2% were unconcerned they spit, while 23.8% spit into a waste basket. 20. 66.7% were unconcerned about sterilizing tableware, while 9.5% handled it separately. 21. 66.7% were unconcerned about ventilating their room, while 9.5% ventilated the room twice a week.

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Effective Dose Evaluation using Clinical PET/CT Acquisition Protocols (전신 PET/CT 영상 획득 프로토콜을 이용한 유효선량 평가)

  • Nam, So-Ra;Son, Hye-Kyung;Lee, Sang-Hoon;Lee, Chang-Lae;Cho, Hyo-Min;Kim, Hee-Joung
    • Progress in Medical Physics
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    • v.17 no.3
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    • pp.173-178
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    • 2006
  • The purpose of this study was to evaluate the radiation dose for clinical PET/CT protocols in clinical environments using Alderson phantom and TLDs. Radiation doses were evaluated for both Philips GEMINI 16 slice PET/CT system and GE DSTe 16 slice PET/CT system. Specific organ doses with $^{137}Cs$ transmission scan, high quality CT scan and topogram in philips GEMINI PET/CT system were measured. Specific organ doses with CT scan for attenuation map, CT scan for diagnosis and topogram in GE DSTe PET/CT system were also measured. The organs were selected based on ICRP60 recommendation. The TLDs used for measurements were selected for within an accuracy of ${\pm}5%$ and calibrated in 10 MV X-ray radiation field. The effective doses for $^{137}Cs$ transmission scan, high qualify scan, and topogram in Philips GEMINI PET/CT system were $0.14{\pm}0.950,\;29.49{\pm}1.508\;and\;0.72{\pm}0.032mSv$ respectively. The effective doses for CT scan to make attenuation map, CT scan to diagnose and topogram in GE DSTe PET/CT system were $20.06{\pm}1.003,\;24.83{\pm}0.805\;and\;0.27{\pm}0.008mSv$ respectively. We evaluated the total effective dose by adding effective dose for PET Image. The total PET/CT doses for Philips GEMINI PET/CT (Topogram+$^{137}Cs$ transmission scan+PET, Topogram+high qualify CT+PET) and GE DSTe PET/CT (Topogram +CT for attenuation map+ PET, Topogram+diagnostic CT+ PET) are $7.65{\pm}0.951,\;37.00{\pm}1.508,\;27.12{\pm}1.003\;and\;31.89{\pm}0.805mSv$ respectively. Further study may be needed to be peformed to find optimal PET/CT acquisition protocols for reducing the patient exposure with good image qualify.

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Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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Development of Phantom and Comparison Analysis for Performance Characteristics of MOSFET Dosimeter (MOSFET 선량계 특성분석을 위한 팬톰 개발 및 특성 비교)

  • Chung, Jin-Beom;Lee, Jeong-Woo;Kim, Yon-Lae;Lee, Doo-Hyun;Choi, Kyoung-Sik;Kim, Jae-Sung;Kim, In-Ah;Hong, Se-Mie;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.18 no.1
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    • pp.48-54
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    • 2007
  • This study is to develope a phantom for MOSFET (Metal Oxide Semiconductors Field Effect Transistors) dosimetry and compare the dosimetric properties of standard MOSFET and microMOSFET with the phantom. In this study, the developed phantom have two shape: one is the shape of semi-sphere with 10cm diameters and the other one is the flat slab of $30{\times}30cm$with 1 cm thickness. The slab phantom was used for calibration and characterization measurements of reproducibility, linearity and dose rate dependency. The semi-sphere phantom was used for angular and directional dependence on the types of MOSFETs. The measurements were conducted under $10{\times}10cm^2$ fields at 100cm SSD with 6MV photon of Clinac (21EX, Varian, USA). For calibration and reproducibility, five standard MOSFETS and microMOSFETs were repeatedly Irradiated by 200cGy five times. The average calibration factor was a range of $1.09{\pm}0.01{\sim}1.12{\pm}0.02mV/cGy$ for standard MOSFETS and $2.81{\pm}0.03{\sim}2.85{\pm}0.04 mV/cGy$ for microMOSFETs. The response of reproducibility in the two types of MOSFETS was found to be maximum 2% variation. Dose linearity was evaluated In the range of 5 to 600 cGy and showed good linear response with $R^2$ value of 0.997 and 0.999. The dose rate dependence of standard MOSFET and microMOSFET was within 1% for 200 cGy from 100 to 500MU/min. For linearity, reproducibility and calibration factor, two types of MOSFETS showed similar results. On the other hand, the standard MOSFET and microMOSFET were found to be remarkable difference in angular and directional dependence. The measured angular dependence of standard MOSFET and microMOSFET was also found to be the variation of 13%, 10% and standard deviation of ${\pm}4.4%,\;{\pm}2.1%$. The directional dependence was found to be the variation of 5%, 2% and standard deviation of ${\pm}2.1%,\;{\pm}1.5%$. Therefore, dose verification of radiation therapy used multidirectional X-ray beam treatments allows for better the use of microMOSFET which has a reduced angular and directional dependence than that of standard MOSFET.

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Development of Quality Assurance Program for the On-board Imager Isocenter Accuracy with Gantry Rotation (갠트리 회전에 의한 온-보드 영상장치 회전중심점의 정도관리 프로그램 개발)

  • Cheong, Kwang-Ho;Cho, Byung-Chul;Kang, Sei-Kwon;Kim, Kyoung-Joo;Bae, Hoon-Sik;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.17 no.4
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    • pp.212-223
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    • 2006
  • Positional accuracy of the on-board imager (OBI) isocenter with gantry rotation was presented in this paper. Three different type of automatic evaluation methods of discrepancies between therapeutic and OBI isocenter using digital image processing techniques as well as a procedure stated in the customer acceptance procedure (CAP) were applied to check OBI isocenter migration trends. Two kinds of kV x-ray image set obtained at OBI source angle of $0^{\circ},\;90^{\circ},\;180^{\circ},\;270^{\circ}$ and every $10^{\circ}$ and raw projection data for cone-beam CT reconstruction were used for each evaluation method. Efficiencies of the methods were also estimated. If a user needs to obtain an isocenter variation map with full gantry rotation, a method taking OBI image for every $10^{\circ}$ and fitting with 5th order polynomial was appropriate. However for a mere quality assurance (QA) purpose of OBI isocenter accuracy, it was adequate to use only four OBI Images taken at the OBI source angle of $0^{\circ},\;90^{\circ},\;180^{\circ}\;and\;270^{\circ}$. Maximal discrepancy was 0.44 mm which was observed between the OBI source angle of $90^{\circ}\;and\;180^{\circ}$ OBI isocenter accuracy was maintained below 0.5 mm for a year. Proposed QA program may be helpful to Implement a reasonable routine QA of the OBI isocenter accuracy without great efforts.

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THE REACTION OF BONE REGENERATE TO THE VARIOUS FORCE RATIO AND PERIODS ON DISTRACTION OSTEOGENESIS WITH COMBINED DISTRACTION FORCE AND COMPRESSION FORCE (수축력과 신장력을 병용한 골신장술에서의 다양한 힘의 비와 부여시기에 따른 신연골 반응)

  • Kim, Uk-Kyu;Shin, Sang-Hun;Chung, In-Kyo;Kim, Cheol-Hun;Huo, Jun;Yun, Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.5
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    • pp.403-414
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    • 2005
  • The purpose of this study was to identify the effectiveness of the modified distraction osteogenesis (DO) method with the concept of overdistraction and compression stimulation which have been previously suggested by the authors in 2002 and to explore the optimal distraction-compression ratio and appropriate latency period for the compression force application during consolidation. The experimental specimens were assessed with radiography, histologic findings, and dual energy x-ray absorptiometry (DEXA) after the conventional DO method and the modified DO technique had been applied on rat mandibles. Total 60 rats were used for the study. In experimental group of 54 adult rats, mandibular osteotomies between the first and second molar areas were performed and customized external distractors were applied. The surgeries on 6 rats of control group also were done with same osteotomy technique and DO device application. Final amount of distraction was set-up as 2 mm on both groups. But, in a experimental group of 54 rats, distraction osteogenesis with a compression force were performed with the different distraction-compression ratio and variant latency periods for compression. The three ratio-subgroups were made as distraction 4 mm group with compression 2 mm, distraction 3 mm group with compression 1 mm, and distraction 2.5 mm group with compression 0.5 mm. In addition, The three subgroups with 3, 7, 11 days latency period prior compression were allocated on each ratio-subgroups. Total 9 subgroups consisted of 6 rats on each subgroup. In control group of 6 rats, conventional distraction technique were routinely performed. The rats of control groups were sacrificed on postoperative 3, 6 weeks after 2 mm distraction. The rats in the experimental groups also were sacrificed on the same euthanasia days of control groups to compare the wound healing. Final available specimens were 55 rats except 5 due to osteomyelitis, device dislodgement. Distraction-compression combined group on 6 weeks generally had showed increased bone mineral density than the same period group of conventional distraction technique on the DEXA study. More matured lamellar bone state and extended trabecular pattern in the combined group than those of control group were also observed in the histologic findings on 6 weeks. In the distraction-compression combined groups, the bone density of 2.5 mm distraction subgroups with 0.5 mm compression showed the highest value on the DEXA study among various force ratio groups. In the distraction-compression combined groups, the bone density of 3 day latency period subgroups showed the highest value on the DEXA study among various latency period groups for the compression application. From this study, we could deduce that 1/5 force ratio for the compression versus distraction, 3 day latency period prior compression application would be the most effective condition if modified distraction osteogenesis technique might be applicable. The modified DO method with a compression force may improve the quality of bone regenerate and shorten total treatment period in comparison with conventional DO technique clinically.

Therapeutic Efficacy of Alendronate for Glucocorticoid Induced Metabolic Bone Disease in Children with Nephrotic Syndrome (신증후군 환아에서 스테로이드 유발 대사성 골질환에 대한 Alendronate의 치료 효과)

  • Lee Ji-Eun;Lee Hyun-Ok;Paik Kyung-Hoon;Lee Suk-Hyang;Jin Dong-Kyu
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.33-42
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    • 2004
  • Purpose : Children with nephrotic syndrome(NS) are under high risk for metabolic bone disease(MBD) as a complication of long-term glucocorticoid therapy. We prospectively evaluated the effect of oral bisphosphonate(alendronate) therapy in children with NS, which has proven efficacy in adult patients with glucocorticoid induced MBD. Methods : Among 58 children with NS, aged 5 to 8 years and haying a disease duration of more than 2 years, 30(51.7%) were enrolled to meet the selection criteria, less than -1.0 Z-scores of lumbar spine bone mineral density(BMD) by dual energy X-ray absorptiometry (DEXA). These 30 children were divided into three groups and each were assigned to receive alendronate, calcitriol, and no-medication, respectively for one year. Lumbar spine BMD was followed up every 6 months and the biochemical indexes were measured before and 1 year after the treatment. There were no significant difference among groups with respect to the average age, the initial BMD, and the cumulative steroid doses. Analysis of the treatment efficacy was done by the % change of BMD and by the changes in Z-scores of lumbar spine BMD. Results : Mean age and disease duration of patients at the initial lumbar spine BMD evaluation was $7.4{\pm}1.7$ years and $2.2{\pm}1.2$ years, respectively. Twenty-three of 30 children(76%) had osteopenia, and seven(23%) had osteoporosis. There was no difference in the biochemical values among the groups, before and 1 year after the treatment(P<0.05). Twenty two children(73.3%) with frequent relapsing or steroid dependant NS had more frequent MBD, compared to the 8 children(26.6%) with infrequent relapsing NS. The one year % changes of BMD were 8.56 in alendronate group, 5.79 in calcitriol group, and 1.9 in no-medication group. The changes in Z-score of lumbar spine BMD increased in the alendronate group and the calcitriol group, but not in the no-medication group. One year % changes of BMD were different among groups(P=0.0002). Significant differences were found between the alendronate and the no-medication group, and between the calcitriol and the no-medication group(P<0.05). There was no difference between the alendronate and the calcitriol group. No serious adverse effect was observed in the alendronate group. Conclusion : Children with NS receiving high dose steroids are under the high risk of BMD and should undergo regular BMD evaluation. Z-score of lumbar spine BMD was a useful parameter in diagnosing low bone mass in children. Alendronate weekly oral therapy was effective and relatively safe in increasing the lumbar spine BMD in children with NS having steroid induced MBD.

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