• 제목/요약/키워드: Osteoporosis

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정량적 전산화 단층촬영법을 이용한 척추 골밀도 측정 (A Study on Spinal Bone Mineral Density Measured with Quantitative Computed Tomography)

  • 여진동;고인호
    • 한국방사선학회논문지
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    • 제4권2호
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    • pp.5-11
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    • 2010
  • 골다공성 폐경 후 여성에서 단일 에너지를 이용한 정량적 전산화 단층촬영술로 골무기질 함량을 측정하여 건강한 여성과 비교분석하였다. 1군은 건강한 폐경전 여성, 2군은 폐경후 건강한 여성, 3군은 골다공증성 폐경후 여성으로 나눈 환자들에게 QCT를 이용하여 측정된 골밀도가 각 군간에 차이가 있는지 알아보고 각 군내 혹은 다른 군간에 척추 부위에 따른 영향이 있는지를 부위별로 비교분석하였고, 골무기질 함량의 측정은 타원형의 region of interest를 이용하여 T12-L4에서 척추의 해면질 부위에서 측정하였다. 연령이 증가함에 따라 골밀도는 감소하였고 건강한 군과 비교하여 골다공증 환자군에서 유의하게 낮은 골밀도를 관할 할 수 있었다. 건강한 폐경전 여성군을 제외한 모든군에서 T12에서 L4로 갈수록 골밀도가 감소하였다. 통계학적으로 모든 척추체에서 골밀도로 1, 2, 3군간 서로를 구분할 수 있으나 2군과 3군은 골밀도로는 서로간의 구분할 수 없는 것으로 분석되었다.

159명의 골다공증성 흉추 및 요추부 골다공증성 추체 압박골절 환자에 대한 경피적 척추성형술 후 치료결과 (Percutaneous Polymethylmethacrylate Vertebroplasty in the Treatment of Osteoporotic Thoracic and Lumbar Vertebral Body Compression Fractures : Outcome of 159 Patients)

  • 이제언;류경식;박춘근;최영근;박춘근;지철;조경석;강준기
    • Journal of Korean Neurosurgical Society
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    • 제30권2호
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    • pp.173-179
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    • 2001
  • Purpose : To assess therapeutic effects of percutaneous polymethylmethacrylate(PMMA) vertebroplasty on the pain caused by osteoporotic thoracic and lumbar vertebral body compression fractures in a large scale of a prospective clinical design, and to determine clinical factors influencing its therapeutic effects. Methods : A prospective clinical study was carried out in 349 vertebral levels of 159 patients between April 1998 and July 1999. The compression fractures were confirmed with bone scan and spine CT, and bone marrow density was measured. Visual analogue scale(VAS) score was used for pre- and post-operative assessments of the pain. All 159 patients were assessed immediately after surgery, and 140 patients of them were followed-up for about 6 months in average. Results : Partial and complete pain relief was sustained immediately after operation in 73%, through follow-up period in 88% of the patients. Pain relief was not proportional to the amount of PMMA or the rate of increase in the height of the compressed vertebral body. It appears that 3 to 6cc of PMMA was proper enough to sustain pain relief. Better clinical improvement was achieved in the patients treated within 6 months after occurrence of vertebral body fracture. The most frequent surgical complication was epidural leakage of PMMA, and the most serious complication was extravertebral leakage into the paravertebral muscles, which appeared to exert the worst influence on the outcome. However, surgery was not required in these patients. Conclusion : Therapeutic effects of PMMA percutaneous vertebroplasty on osteoporotic vertebral body compression fractures were confirmed in a relatively large scale of prospective clinical study. It appears that good outcome can be achieved in patients treated within 6 months after fracture, treated each level with 3 to 6cc of PMMA in amount. without serious complications.

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고학력 기혼여성의 취업여부별 영양소 섭취로 본 식사의 질 평가 (Evaluation of Diet Quality according to Nutrient Intake between Highly Educated, Married, Unemployed and Employed Women)

  • 최지현;정영진
    • Journal of Nutrition and Health
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    • 제39권2호
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    • pp.160-170
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    • 2006
  • This study was conducted to provide foundation data for making health care policy for married women by assessing the dietary intake between highly educated married, employed and unemployed women. It is a direct interview, cross-sectional study with 24-hour recall method for one day. In selecting the subjects for this study, married, unemployed women were selected from a certain area (Daedeok Science Town) in Daejeon where there are high rates of highly educated women, and the married, employed women were selected from the teaching profession in order to avoid confounding due to including a variety of jobs. According to the Korean Standard Classification of Occupations, teaching is the representational occupation of highly educated, married women. Then, to prevent confounding due to age, we selected the subjects out of each age group at the same rate through random sampling. Women who had not graduated college, worked only part-time, or had no current spouse were excluded. As a result, 486 highly-educated, married, unemployed (250) and employed (236) women were used for analyzing data. The unemployed women consumed a higher amount of fat, cholesterol, sodium, vitamin C and folic acid while the employed women consumed a higher amount of iron, vitamin $B_l$ and vitamin $B_2$. P/M/S ratio being 1/1.18/1.05 and 1/1.05/0.87, for the unemployed women and the employed women, respectively, unemployed respondents had a higher saturated fat intake than those of employed. It is in excess of the standard ratio (1/1/1) of the Korean RDA. At the same time, in unemployed respondents the percent of energy intake from fat (24.8%, 23.2%) and animal fat (12.4%, 11.4%) were higher than those of employed respondents. The mean daily nutrient intake of calcium, zinc, and iron for both groups of respondents were lower than the Korean RDA. Both groups had phosphorus as the highest nutrient and calcium as the lowest nutrient of INQ (Index of Nutritional Quality) while nutrients with the INQ being less than 1 were calcium and iron. To sum up, the following conclusions can be made: Nutrition education and guidance for reduction of the intake of fat, especially animal fat, are necessary for unemployed women. In addition, highly educated, married, unemployed and employed women should increase the consumption of foods rich in iron and calcium to prevent anemia and osteoporosis, while decreasing the intake of phosphorus to balance proportions of calcium and phosphorus.

단일 분절 퇴행성 경추질환에서 Titanium Cage를 이용한 전방 융합술의 조기 치험 : 골편 이식을 동반하지 않은 경우의 임상적 방사선학적 초기 결과 (Preliminary Experience with Cervical Implantable Titanium Cage(RABEA) in Patients with Monosegmental Degenerative Disease : Clinical and Radiological Outcomes without Cancellous Bone Filling into Cage)

  • 이영균;한영민;김종태;정동섭;박영섭;박춘근;강준기
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.300-308
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    • 2001
  • Objectives : Anterior cervical discectomy and interbody fusion has become a well-accepted surgical treatment of degenerative cervical diseases. Implatable cages have a stabilizing effect without plates and no need for autogenous bone graft. The authors evaluates the effect of implatable titanium cage(RABEA) on the clinical and radiological outcomes. Methods : 34 patients with symptomatic cervical degenerative diseases due to one level disc pathology were underwent anterior cervical discectomy and interbody fusion with titanium cages(RABEA) which were not filled with cancallous bone grafts from January 1999 to May 2001. Patients with osteoporosis and older than 65 years were not included. Among them, 15 patients could be followed-up for at least 1 year. The authors retrospectively reviewed the charts and radiographic data. Mean follow-up period was $1.3{\pm}0.2years$. Results : Clinical results according to the Odom's criteria was exellent and good in 14(93%) patients. One patient with fair result showed complete loss of the disc space height due to settlement of the cage. Preoperatively, the mean height of the disc space(${\pm}$standard deviation) was $3.42{\pm}1.10mm$(range 2.0-5.5mm), and at 1 day postoperatively it was $7.88{\pm}0.90mm$(range 6.50-9.0). The mean height of the disc space after 1 year was $6.50{\pm}1.38mm$(range 3.0-8.0). The restoration of the height was statistically significant(p<0.05). The mean height after 1 year was $82.7{\pm}15.9%$ of the height at 1 day postoperatively. Preoperatively the mean value of the cervical lodortic angle was $21.8{\pm}11.8^{\circ}$ and 1 year postopertively, it was $24.5{\pm}8.3^{\circ}$, which was statistically not significant. All patients showed no abnormal movements on flexion and extension lateral film after 6 months. Conclusion : Implantable titanium cages appear safe and effective in selected patients, and their use helps to avoid complications associated with bone graft harvest. Subsidence of the cage seems to be a potential risk factor for recurrence of the symptoms. For long-term results, a longer follow-up is required.

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대퇴 경부 골절의 임상적 고찰 (A Clinical Study of Femur Neck Fractures)

  • 구환모;안면환;인주철
    • Journal of Yeungnam Medical Science
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    • 제7권1호
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    • pp.69-80
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    • 1990
  • 본 영남의대 정형외과학 교실에서는 1984년 1월 부터 1988년 5월 까지 입원 치료한 대퇴 경부 골절 환자 중 최근까지 2년 이상 추적 조사가 가능 하였던 23명의 24례를 대상으로 하여 고찰한 결과를 요약하면 다음과 같다. 1. 총 23명중 여자가 19명, 65세 이상의 노년층의 환자가 11명으로 노년층의 여자에서 호발하였다. 2. 18례에서 경도의 외력에 의한 것이었고 65세 이상의 12례 중 전례에서 경도의 외력에 의해 골절되었고 8례에서 심각한 골조송증을 보였다. 3. 24례 중 14례에서 전위된 골두하 골절이었고 6례에서 전위된 횡경부 골절이었으며 4례에서 전위되지 않은 횡경부 골절이었다. 4. 치료는 14례에서 도수 정복후 내고정을 10례에서 일차적 관절 치환술을 시행하였고 내고정한 14례중 4례에서 대퇴 골두 괴사로 이차적 관절 치환술을 시행하였다. 5. 내고정을 시행한 14례 중 7례에서 합병증을 관찰할 수 있었고 무혈성 괴사가 6례, 불유합 2례, Pin 이동 3례, 내고정물 부전이 1례였다. 6. 관절 치환술을 시행한 14례에서 수술 직후의 대퇴경의 수술적 접합률이 대퇴경의 해리와 관계가 있었다.(r=-0.68. p<0.01) 대퇴 경부 골절의 치료시에 합병증의 발생은 대개 골절의 양상 및 치료시기, 정복의 정도에 의해 결정되며 치료의 지연, 정복의 불가능, 과내반 교정, 병적 골절일 경우에는 일차적 고관절 치환술이 환자의 조기 거동과 사망률의 감소를 위해 바람직할 것으로 사료된다.

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Proliferative Effects of Flavan-3-ols and Propelargonidins from Rhizomes of Drynaria fortunei on MCF-7 and Osteoblastic Cells

  • Chang, Eun-Ju;Lee, Won-Jung;Cho, Sung-Hee;Choi, Sang-Won
    • Archives of Pharmacal Research
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    • 제26권8호
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    • pp.620-630
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    • 2003
  • The proliferative effects of thirty Oriental medicinal herbs on MCF-7 (estrogen-sensitive breast cancer cell line) and ROS 17/2.8 osteoblast-like cells were determined using the MTT assay. Methanol extracts from several herbs was found to show proliferative activity on the above two cell lines in the range of 5 to 100 $\mu$g/mL. Among these active herbs, the methanol extract from the rhizomes of Drynaria fortunei showed the most potent proliferative activity, and the cell proliferations were significantly increase by 136 and 158% in the MCF-7 and ROS 17/2.8 cells, respectively, when treated with 100 $\mu$ g/mL. Through a bioassay-guided separation, eight flavonoids, including four new flavan-3-ols and two propelargonidins, together with the known (-)-epiafzelechin and naringin, were isolated. Their chemical structures were characterized as (-)-epiafzelechin (1), (-)-epiafzelechin-3-O-$\beta$-D-allopyranoside (2), (-)-epiafzelechin-3-O-(6"-O-acetyl)-$\beta$-D-allopyranoside (3), 4$\beta$-carboxymethyl-(-)-epiafzelechin methyl ester (4), 4$\beta$-car-boxymethyl-(-)-epiafzelechin sodium salt (5), naringin (6), (-)-epiafzelechin-(4$\beta$\rightarrow8)-4$\beta$-car-boxymethylepiafzelechin methyl ester (7) and (-)-epiafzelechin-($4\beta\rightarrow8, 2\beta\rightarrowΟ\rightarrow7)-epiafzelechin-(4\beta\righarrow8)-epiafzelechin (8) by extensive 1D and 2D NMR spectroscopy. Most of these flavonoids, in the range of $10^{-15}∼10^{-6}$ M, accelerated the proliferation of MCF-7 cell, with compounds 7 and 8, in the range of $10^{-15}∼10^{-12}$ M, showing especially potent proliferation effects. Meanwhile, seven flavonoids, with the exception of compound 4, stimulated the proliferation of ROS 17/2.8 cells in the range of $10^{-15}∼10^{-6}$ M, with compounds 5-8 especially accelerating the proliferation, in dose-dependent manners ($10^{-15}∼10^{-9}$ M), and their proliferative effect was much stronger than that of $E_2$ and genistein. These results suggest that propelargonidin dimers and trimers isolated from the rhizomes of Drynaria fortunei may be useful as potential phytoestrogens, which play important physiological roles in the prevention of postmenopausal osteoporosis.

전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고 (Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy)

  • 목서희;이지원;이태종;서정복;김경아;김조영;박병준;김동희
    • 동의생리병리학회지
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    • 제35권2호
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    • pp.71-80
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    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.

지역사회거주 성인의 뇌졸중 영향 요인 : 건강관련 삶의 질을 중심으로 (Factors Influencing Stroke in Community-dwelling Adults : Focusing on Health-related Quality of Life)

  • 문종훈
    • 대한지역사회작업치료학회지
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    • 제9권1호
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    • pp.35-45
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    • 2019
  • 목적 : 본 연구는 지역사회거주 성인에서 뇌졸중에 영향을 미치는 요인을 규명하고자 하였다. 연구방법 : 본 연구는 2016년 지역사회건강조사의 원시자료를 이용하였다. 이 조사에 참여한 대상자 228,452명 중 결측 값을 제거한 225,003명(98.5%)이 본 연구의 분석에 포함되었다. 사회인구학적 특성은 성별, 나이, 지역, 소득, 혼인상태로 설정하였고, 동반질환은 골다공증, 고혈압, 당뇨병, 이상고지혈증, 심근경색, 관절염이 선택되었다. 건강관련 삶의 질은 EuroQol-5 Dimension로 평가되었고 하위영역인 운동능력, 자기관리, 일상활동, 통증/불편, 불안/우울의 수준을 확인하였다. 종속변수는 뇌졸중 여부, 독립변수는 위에 서술한 16개 변수였다. 통계분석은 이분형 로지스틱 회귀분석을 이용하였다. 결과 : 인구사회학적 특성 변수에서는 남성일수록, 나이가 증가할수록, 소득수준이 낮을수록 뇌졸중을 높게 예측하였다. 동반질환 여부에서, 고혈압, 당뇨, 이상고지혈증, 심근경색이 있을수록 뇌졸중을 높게 예측하였다. 건강관련 삶의 질 하위영역에서 뇌졸중을 예측하는 영역은 자기관리, 일상활동, 운동능력, 불안/우울 순서로 나타났다. 결론 : 본 연구의 결과는 지역사회에 거주하는 뇌졸중 성인의 자조관리와 일상생활 능력 증진을 위한 맞춤형 건강증진 프로그램 개발이 필요함을 제안한다.

Salicylate가 성체줄기세포의 골분화에 미치는 영향 (Salicylate Can Enhance Osteogenic Differentiation of Human Periosteum-derived Mesenchymal Stem Cells)

  • 김보규;이아람;이보영;심성보;문동규;황선철;변준호;우동균
    • 생명과학회지
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    • 제28권12호
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    • pp.1455-1460
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    • 2018
  • 최근 들어 급속한 고령화 사회가 진행되고 있으며 이로 인해 골관절염과 골다공증 등의 퇴행성 골질환 환자수도 동반하여 증가하고 있다. 따라서 고령화에 따른 골관련 질환의 새로운 제어와 치료법 개발을 위해 성체줄기세포의 골세포 분화유도를 활용한 재생의학도 활발히 연구되고 있다. 또한 관련 연구에서 줄기세포의 분화과정에서 미토콘드리아의 산화적인산화가 중요하다고 알려지고 있다. 흥미롭게도 최근 연구에서 아스피린의 주성분인 salicylate가 동물세포의 미토콘드리아 생합성을 증진시키는 효과가 보고되었다. 그러나 성체줄기세포에서 salicylate가 골세포분화나 미토콘드리아 생합성을 유도할 수 있는지에 대한 연구결과는 미비한 실정이다. 본 연구에서는 인체 골막 유래의 성체줄기세포를 이용하여 골세포분화나 미토콘드리아 생합성에 대한 salicylate의 영향을 분석하였다. 골막 유래 성체줄기세포의 골세포 분화유도 과정에 동반한 salicylate 처리는 잘 알려진 골세포분화 표지자인 alkaline phosphatase의 활성을 증가시키는 결과를 본 연구에서 얻었다. 이러한 연구결과는 salicylate가 줄기세포로부터 골세포로의 분화를 조절할 수 있는 물질이 될 수 있음을 제시한다. 또한 이러한 골세포 분화과정에서 미토콘드리아 생합성도 salicylate 처리에 의해 증가됨이 관찰되었다. 따라서, 미토콘드리아 생합성이나 기능을 조절하는 물질이 성체줄기세포의 골세포 분화과정에도 영향을 줄 수 있으며, 이러한 물질이 골세포분화나 재생의학의 새로운 조절 물질로 응용될 수 있음을 제시한다.

Salivary Flow According to Elderly's Whole Health and Oral Health Status: According to Application of Oral exercise and Salivary Gland Massage

  • Oh, Ji-Young;Noh, Eun-Mi;Park, Hye-Young;Lee, Min-Kyung;Kim, Hye-Jin
    • 대한의생명과학회지
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    • 제25권3호
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    • pp.218-226
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    • 2019
  • In old age, measures to cope with the natural phenomenon of aging and various diseases of the elderly due to the deterioration of physical function are also a challenge for this society. While interest in systematic health is increasing, it is true that awareness and interest in oral-related diseases is relatively lacking. This study aims to present basic data necessary to improve the quality of life for senior citizens aged 65 or older by improving the oral dryness caused by systemic health. By research method, improve oral dryness caused by whole-body health with the elderly over 65 and promote their oral health, inducing the increase of the salivary flow rate through oral health care education, oral exercise, and salivary gland massage. First, on the DMSQ according to the general characteristics of the elderly, the recognition of the whole body and oral health status, independent sample t-test and One-way ANOVA were conducted. Second, on changes in the salivary flow rate and saliva pH according to the general characteristics of the elderly, recognition of oral and whole-body health status, and whole-body health, paired samples t-test was conducted. Studies have shown that salivary gland flow increased significantly after oral exercise and salivary gland massage, the salivary flow rate significantly increased. In all variables of the recognition of the oral health status, the salivary flow rate increased after oral exercise and salivary gland massage, and in the whole-body health, regardless of hypertension, diabetes, cardiovascular disorders, and osteoporosis, the salivary flow rate increased after oral exercise and salivary gland massage, and the salivary flow rate increased after oral exercise and salivary gland massage if the subjects responded that they did not have thyroid abnormality, anemia, abnormalities of breathing, hypotension, gastrointestinal disturbance, or kidney diseases. As a comprehensive analysis of this study, many felt oral dryness when they had a problem with the whole-body health, and many felt oral dryness when they had a problem with oral health cognition. After applying oral exercise and salivary gland massage as intervention methods in the oral health care for the elderly, the salivary flow rate significantly increased, and it is judged that the methods were very effective for controlling oral dryness. Furthermore, it is judged that the factors affecting oral health, whole-body health, and oral dryness would be identified, which would be helpful for the promotion of whole-body health and oral health. It is judged that continuous research would be needed so that measures for the application of the oral care program and system for the elderly would be prepared in the future.