• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.173-181
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• 2021

Purpose To evaluate the ability of the Hounsfield unit (HU) measurement of the femoral neck during multidetector computed tomography (MDCT) for assessing osteoporosis compared with dual-energy X-ray absorptiometry (DXA). Materials and Methods Forty-two patients with femoral neck fractures who underwent MDCT and DXA from July to December 2016 were included in this study. HU measurements were made of the cancellous portions of the normal contralateral femoral neck on MDCT. Bone mineral density (BMD) and T-scores were obtained at the femur DXA. Correlations of HU values with BMD and T-scores were analyzed using Spearman's correlation test. Results The mean BMD and T-score of the femoral neck were 0.650 g/cm² and -2.4, respectively. The mean HU values for the normal, osteopenia, and osteoporosis groups were 131.9, 98.9, and 41.3, respectively. HU values at the femoral neck were positively correlated with BMD (r² = 0.670; p < 0.001) and T-scores (r² = 0.676; p < 0.001). Conclusion The HU values of the femoral neck on MDCT are significantly correlated with BMD and T-scores of femur DXA. The HU values may serve as a diagnostic tool for the screening of regional bone quality when MDCT is performed for other reasons.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.367-377
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• 2008

We studied the change of bone mineral density (BMD) by age, body mass index (BMI), coffee, carbonated drink, alcohol, smoking, and exercise in adults who checked in health center. The number of study subjects was total 268 persons (women of 136 persons and men of 132 persons). The BMD was determined in lumbar spine and femoral neck by dual energy x-ray absorptiometry. And we got some results as below : 1. In women, mean body height was $155.8{\pm}6.0cm$, mean body weight was $56.8{\pm}7.9kg$, and mean BMI was $23.4{\pm}3.1kg/m^2$. In men, mean body height was $169.1{\pm}6.0cm$, mean body weight was $69.0{\pm}9.5kg$, and mean BMI was $24.1{\pm}2.7kg/m^2$. 2. BMD decreased as age increased, and the age was the most determinant factor for BMD (p<0.01). Women's BMD decreased rapidly in the groups aged $\geq$50s, while men's BMD decreased gradually with age. In addition, for both sex, lower BMD was measured in lumbar spine than in femoral neck. 3. BMD increased in high BMI, and BMD with BMI increased distinctly in the group aged 50s. But their relationship was not significant. 4. In view of the distribution by three BMD categories, women's BMD was mostly normal in the groups aged $\geq$40s, but the rate of osteopenia and osteoporosis was similar in the group aged 50s, and the rate of osteoporosis was the highest in the groups aged 60s and 70s. Men's BMD was mostly normal through all groups except the group aged 70s. 5. Coffee and carbonated drink were not influenced in BMD. But alcohol-drinking group showed higher BMD than non-drinking group, and alcohol was statistically significant determinant for BMD (p<0.05). Smoking and exercise were not statistically significant determinant of BMD.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.953-959
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• 2005

Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in very low birth weight infants. Methods : A total of 56 very low birth weight infants below 1,500 g during the period from January 1998 to December 2003 were enrolled and their medical records reviewed. Study group(n=32) included the babies who had undergone PCVC and a control group(n=24) included babies who had not undergone PCVC. We compared the study group with the control group for factors such as subject characteristics and catheter-related complications. Results : There was no difference in subject characteristics, such as birth weight, gestational week, respiratory distress syndrome, duration of ventilator therapy, duration from tube to complete oral feeding, days at TPN and its total duration, body weight at discontinuation of TPN and the days taken to reach to 2,000 g. However, the morbidity rate due to patent ductus arterious, chronic lung disease, necrotizing enterocolitis, osteopenia, cholestasis, and sepsis showed no difference. The study group with infants below 1,000 g showed a higher incidence of sepsis compared to the control group of the same weight group. The study group with infants between 1,000 to 1,500 g showed significantly higher incidences of intraventricular hemorrhage and took longer reach the a body weight of 2,000 g. Conclusion : Considering the high incidence of sepsis in the PCVC group, every attempt should be made to minimize the length of TPN therapy and encourage early enteral feeding. We also recommend the use of PCVC carefully in patients requiring prolonged nutritional support.

• The Korean Journal of Pharmacology
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• v.7 no.1
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• pp.53-65
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• 1971

It is well known that diabetes mellitus is associated with metabolic derangements, such as hyper-glycemia, ketosis, glycosuria, and also widespread alterations in the blood vessels, kidneys, eyes, peripheral nerves and heart. It is also recognized that healing of skin wound is delayed in diabetics. In bone, according to Aegerter, osteopenia develops in diabetes mellitus and it is chiefly ascribed to overutilization of protein. Shim claims that total blood flow to the entire skeletal system is approximately 4 to 8 percent of resting cardiac output and blood supply to the skeletal system would be decreased on account of secondary arteriosclerotic changes in the diabetics. An adequate blood supply is an essential factor in the healing process of fracture, and disturbed blood flow, either local or systemic, will invariably delay union of the fragments or the fragments from being fused. As the author has encountered several cases of diabetics in whom healing of fracture was delayed or incomplete, this experimental study was undertaken to elucidate the effects of hyperglycemia and diabetes mellitus on the healing process of fracture. In this experiment adult albino rabbits, weighing about 2 kg. were used and divided into 6 groups. The femur of each animal was fractured surgically, and then the healing process of fracture was periodically checked by radiography at an interval of one week for a period of 6 weeks. Thereafter, all the rabbits were killed to obtain tissue preparation of the femur. The experimental groups were as follows; 1) Control group: Six rabbits sustained a surgical fracture to the femur, without being given any other treatment or drug. 2) Alloxan-treated group: For inducing diabetes, alloxan was given intravenously to 17 rabbits in various dose as follows; to 7 of them 40 mg/kg, to 6 rabbits 80 mg/kg and to 4 rabbits 120 mg/kg of body weight, respectively. 3) Insulin-treated group: Protamine-zinc insulin was injected subcutaneously to each of 6 rabbits in a daily dose of 1 unit per kilogram of body weight. 4) Group treated with insulin after alloxan: Four rabbits were given 80 mg of alloxan once and than 1 unit of insulin per kilogram of body weight daily. Another 5 rabbits were injected 1 unit of insulin per kg of body weight daily following administration of alloxan in a dose of 120 mg/kg. 5) Homotransplantation group: Following intravenous injection of alloxan in a dose of 120 mg/kg, 10 rabbits underwent homotransplantation of a short bone segment to the femur. Five of them were subsequently given 1 unit/kg of insulin daily. 6) Sugar-treated group: six rabbits were fed $15{\sim}20$ gm of sugar daily throughout the period of experiment. The results obtained are summarized as follows; 1. Blood sugar level and damage to the pancreatic islet increased proportionately when alloxan was given to the rabbits in various doses. No appreciable change could be observed in the islets when the blood sugar level was altered by either oral administration of sugar or subcutaneous injection of insulin. 2. Comparing with the control group, healing of fracture was delayed in the alloxan-treated group, while callus formation and periosteal reaction were shown to be more prominent in this group and subsequently, the ultimate osseous tissue formed at the fracture site was significantly smaller in amount and less compact. These findings were more marked as the amount of alloxan increased. 3. Administration of insulin prevented the delay in healing process of fracture in the rabbits with alloxan-induced hyperglycemia. In this case, the course and progression of fracture healing were almost similar to those of control group. 4. Union between the host bone and the fragment transplanted from other rabbit of the same species was more delayed in the group treated with alloxan alone than in the group to which insulin was administered after development of alloxan-induced diabetes. In both groups periosteal new bone developed from the ends of the host bone, above and below the transplanted fragment, and directly fused with failure of periosteal callus to bridge the adjacent ends of the host bone and the transplanted fragment. 5. The healing process of fracture was not inhibited by alteration in blood sugar level when the blood sugar was abnormally increased by excessive sugar intake or lowered by administration of insulin alone. The healing of fracture in these groups progressed similarly as in the control group. In brief summary, it appears that the healing process of fracture would be definitely disturbed in diabetic state brought about by damage to the pancreatic islet. As such an inhibition could be overcome with insulin, it seems that insulin plays an important role in healing of fracture, but alteration in blood sugar level alone does not modify healing process of fracture to significant degree.

• Journal of radiological science and technology
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• v.31 no.3
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• pp.259-266
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• 2008

Objective : The purpose of this study was to examine the relationship between bone mineral density (BMD) and the metabolic syndrome. Method : We conducted a cross-sectional study of 1204 adults(males: 364 females: 840) in a general hospital health promotion center. They were grouped into the normal and lower BMD group according to bone loss(osteopenia, osteoporosis), as determined by duel energy X-ray absorptiometery(DEXA). We analyzed the association between BMD and metabolic syndrome by multiple logistic regression analysis. After adjustment for age, weight, alcohol intake, smoking, regular exercise, regular intake of meals, and menopausal status, odds ratios for the prevalence of the metabolic syndrome by gender were calculated for lower BMD. Results : After adjustment for the effect of potential covariates, the prevalence of metabolic syndrome was associated with bone loss in men(p<0.001). If the odds ratio of normal group is 1.00, then that of the lower BMD group is 3.07(95% CI=1.83-5.16). The prevalence of metabolic alterations fitting the criteria of metabolic syndrome was significantly decreased in High BMI, Low HDL in men and in High BMI in women(p<0.05). Conclusions : This study shows that BMD was associated with metabolic syndrome. Further studies needed to obtain evidence concerning the association between BMD and metabolic syndrome.

• Journal of the Korean Society of Radiology
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• v.11 no.2
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• pp.145-155
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• 2017

The purpose of this study was to compare and analyze changes in body composition and bone mineral density (BMD) during combined exercise in premenopausal women who did not take regular diet or regular physical activity within 6 months, In addition to being able to recognize the importance of pre-menopausal women's health and exercise, it also provides basic data for the development of educational programs for early prevention of osteoporosis prevention education I want to. The average age of the subjects in their 30s was 35.44 years and their height was 158.89 cm in their 30s. The average age of the subjects in their 40s was 41.89 and their average height was 160.78 cm in their 40s. Body composition, BMI, and body fat percentage were higher in the 30s, and bone mineral content, lean body mass, skeletal muscle mass, body weight, body fat mass and waist circumference were higher in their forties. Lumbar spine BMD and femur density were higher in their 30s than their 40s. Body composition, skeletal muscle mass, and fat mass increased in the 30s body composition by age - related complex exercise in premenopausal women, body fat mass, body fat percentage, waist circumference decreased. Body mass, body fat, body fat percentage, and BMI decreased in the 40s. The lumbar spine, the lumbar spine, the lumbar spine, and the femur were increased in the lumbar spine, the lumbar spine, the femur, and the femur. In the post-analysis results, changes in body composition were statistically significant due to decrease in muscle mass, body weight, body fat mass and BMI after combined exercise. In the change of bone density, lumbar spine BMD was measured as lumbar spine 1, lumbar spine 2, lumbar spine 3, And the femur density was increase.

• 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.

• Journal of the Korean Society of Radiology
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• v.9 no.3
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• pp.147-168
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• 2015

In this research, we have analyzed the impact factors on the bone mineral density thru the examination of bone density difference in the entire femur, femoral neck and lumbar of adult women before the menopause in accordance with the general features, lifestyle, eating habits, health and body composition. The survey was conducted among adult women before the menopause and older than 30 years based on the data of the National Health and Nutrition Examination Survey carried out in the 4th term (2008-2009) and 5th term (2010-2011) and we would like to provide the research results for the establishment of recommendations or guidelines for the treatment of adult women before the menopause with regard to the impact factors on the bone mineral density and for the development of health education materials for the accurate measurement of bone mineral density of young women in order to prevent the postmenopausal osteoporosis. With respect to the general features of adult women before the menopause, the bone mineral density was higher in the entire femur at age 40-44, femoral neck at 35-39, in high-school education level, in the earlier menarche group, without smoking experiences, with regular walking time and exercise frequency and with the habits of eating no hamburger or pizza. With regard to the body composition, the bone mineral density was higher in obesity and lower in underweight cases, higher among people with abdominal obesity and weight control experiences. In terms of total body fat ratio, total amount of fat and muscle, the bone mineral density got gradually increased from the 1st quarter (Q1) to the 4th quarter(Q4). The obesity, disease, total amount of fat and muscle were shown to be significantly related with the bone mineral density in this research and it is required for young women to keep the adequate weight and the normal BMI in order to increase the bone mineral density. For the prevention of osteoporosis, it is advised to keep the right habits including regular exercise and no smoking discipline from the growing period and achieve the maximum bone mass thru the control of proper weight from a young age.

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

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

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.1
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• pp.5-28
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• 2001

Objectives: The objective of this study was to investigate analysis of bone mineral density according to Women with low back pain women. Methods: The data were collected from women who visited Physical Examination Center of a Catholic university hospital located in Daegu. Questionnaires were completed by 50 women during the period from July 20, 2000 to January 12, 2001. The sample was divided into three groups(the normal group of 16 cases and the osteopenia group of 12cases and the osteoporosis group of 22 cases). Bone mineral density(BMD) of lumbar spine was measured using energy absorptiometry. Results: The bone mineral density of the lumbar spine decreased with aging. The bone mineral density of the lumbar spine decreased with the serum Calcium and Phosphorus and Alkaline phosphatase increased. The mean bone mineral density of the lumbar spine of healthy women in age(50~59) was 0.87g/$cm^2$, the lumbar spine of women with low back pain in age(50~59) was 0.77g/$cm^2$. In the multiple regression of risk factors to bone mineral density(BMD) of lumbar spine were correlated with age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores(p<0.05). The experience for LBP increased as weight increased(Odds ratio=999.000). The experience for LBP increased as number of Exercise decreased(Odds ratio=999.000). The experience for LBP increased as menopause existence increased(Odds ratio=999.000). The experience for LBP increased as serum Calcium and Phosphorus increased (Odds ratio=999.000). however all four variables had significant no relationship. The correlation in variables in relation to low back pain and bone mineral density, age showed contra-correlation with low back pain existence, Alkaline phosphatase(p<0.01). Weight showed contra-correlation with body mass index(BMI)(p<0.01). Exercise time showed correlation with number of exercise(p<0.01). The loving food of taste showed contra-correlation with Alkaline phosphatase(p<0.05). Bone mineral density showed correlation with menopause existence(p<0.05). Conclusions: Results from this study indicated that a statistically significant association between bone mineral density of the lumbar spin and age, marriage existence, exercise time, the loving food of taste, calcium, bone mineral density standard T scores. In logistic regression test, there were no related variables. The combination of bone mineral density measurement and assessment of the bone turnover rate by measuring biochemical would be helpful for the treatment of patients with risks of osteoporosis. The more precise study for risk factors to osteoporosis is essential.