• Title/Summary/Keyword: Osteoporosis.

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Health and nutrition intake status of the Korean elderly according to their food security level: data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018 (식품안정성 수준에 따른 한국노인의 건강상태와 영양섭취현황: 제7기 (2016-2018) 국민건강영양조사 자료 활용)

  • Maeng, Ahreum;Lee, Jeehyun;Yoon, Eunju
    • Journal of Nutrition and Health
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    • v.54 no.2
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    • pp.179-198
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    • 2021
  • Purpose: This study examined general characteristics, health status, accessibility to medical services, health-related quality of life, dietary behavior, and energy and nutrient intakes of the elderly at different levels of food security utilizing data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Methods: The elderly subjects (1,721 males and 2,271 females) were divided into 3 groups (secure, mildly insecure, moderately/severely insecure) according to their food security levels. Health and nutrient status was determined using energy intake, nutrient density, the prevalence of insufficient nutrient intake, dietary behavior, and health status. Results: The elderly with food insecurities had a lower self-evaluated health status and a higher prevalence of physician-diagnosed chronic diseases such as arthritis, osteoarthritis, rheumatoid arthritis, osteoporosis for males, and hypertension, stroke, arthritis, and osteoarthritis for females. The associated financial burden was the major reason for not accessing medical services in the food insecure group. Furthermore, the food insecure group had a higher risk of impaired health-related quality of life compared to the secure group. The proportion of subjects with an energy intake below the estimated energy requirement was higher in the food insecure group and a significantly higher prevalence of insufficient intake was observed for all the nutrients (proteins, vitamin A, vitamin B1, vitamin B2, niacin, vitamin C, calcium, and iron) assessed in this study compared to the food secure group. Conclusion: This study suggests that food insecurity poses a challenge to the health and nutritional status of the elderly population in Korea and needs proper management. It would be helpful to develop food and nutrition assistance programs to ensure the food stability of the elderly population and assure quality to address gaps in their nutrient intake.

Early Failure of Cortical-Bone Screw Fixation in the Lumbar Spinal Stenosis (요추부 협착에서의 피질골 궤도 나사못 고정의 초기 실패 사례에 대한 고찰)

  • Kwon, Ji-Won;Kim, Jin-Gyu;Ha, Joong-Won;Moon, Seong-Hwan;Lee, Hwan-Mo;Park, Yung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.405-410
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    • 2020
  • Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.

Correlation of the Deformation of the Kyphotic Angle with the Fat Infiltration Rate of Multifidus and Erector Spinae in Patients with Acute Osteoporotic Fractures of the Lumbar Spine (급성 골다공증성 요추 골절 환자에서 척추 기립근 및 다열근의 지방침투율과 후만각 변형의 연관 관계)

  • Jun, Deuk Soo;Baik, Jong-Min;Baek, Seung Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.208-214
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    • 2021
  • Purpose: Verifying a reliable predictor of the progression of vertebral deformity in patients with acute osteoporotic fractures of the lumbar spine may be useful. A qualitative analysis of the muscle near the spine was performed using magnetic resonance imaging (MRI), and its correlation with a spinal deformity was determined under the hypothesis that the causes of the kyphotic deformity are associated with muscle reduction in the multifidus and erector spinae. Materials and Methods: The study was performed in a retrospective manner using the electronic medical records of patients who presented to the author's institution between January 2007 and March 2018, and were diagnosed with an acute lumbar fracture. The fat infiltration rates of the multifidus and erector spinae were measured using MRI taken at the time of injury, and the mean value was defined as the total fat infiltration rate (TFI). Based on lateral radiographs of the lumbar spine at the one-year follow-up, the loss of height of the vertebral body, the kyphotic angle and the wedge angle were measured. The statistical significance was confirmed by calculating the Pearson correlation coefficient. Results: One hundred twenty-nine patients, of which 30 were male and 99 were female, were examined. The mean age was 71.28 years. The mean T-score was -3.53±0.79 g/cm2, and the mean fat infiltration was 15.20%±11.99%. TFI was positively correlated with age (R=0.373, p<0.001), compression rate (R=0.369, p<0.001), and Cobb's angle (R=0.386, p<0.001) after a one year follow-up, but negatively correlated with the BMD score (R=-0.252, p=0.004). As the fracture progressed to the lower lumbar level, the compression rate (R=-0191, p=0.030) and wedge angle (R=-0.428, p<0.001) at the time of injury tended to decrease. Conclusion: In patients with osteoporotic vertebral fractures, the fat infiltration rate may be an important predictor of conservative treatment. The prognosis of patients with a high-fat infiltration rate should be explained during patient education, and the patients must be monitored closely through short-term outpatient follow-up.

Atorvastatin and Fluvastatin Can Reduce IL-1β-induced Inflammatory Responses in Human Keratinocytes (Atorvastatin 그리고 fluvastatin 약물의 IL-1β-유도 염증반응 억제 효과)

  • Choe, Yeong-In;Moon, Kyoung Mi;Yoo, Jae Cheal;Byun, June-Ho;Hwang, Sun-Chul;Moon, Dong Kyu;Woo, Dong Kyun
    • Journal of Life Science
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    • v.31 no.4
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    • pp.418-424
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    • 2021
  • Skin inflammation (dermatitis) is caused by varying skin damage due to ultraviolet radiation and microbial infection. Currently prescribed drugs for dermatitis include anti-histamine and steroid drug classes that soothe inflammation. However, incorrect or prolonged use of steroids can cause weakening of skin barriers as well as osteoporosis. Therefore, treating dermatitis with a drug that has minimal side effects is important. Statins, also known as 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, are cholesterol-lowering drugs that have been widely treated for hyperlipidemia and cardiovascular diseases. Interestingly, recent studies have shown the anti-inflammatory effects of statins in both experimental and clinical models for of osteoarthritis. This study investigated the possible anti-inflammatory effects of atorvastatin and fluvastatin in human keratinocytes (HaCaT cells), which are crucial components of skin barriers. Stimulation of HaCaT cells with IL-1β increased the expression of the COX2 protein, a major player of inflammatory responses. However, this induction of the COX2 protein was downregulated by pretreatments with atorvastatin and fluvastatin. Treatment with IL-1ß-induced the upregulation of other inflammatory genes (such as iNOS and MMP-1) and these expressions were similarly lowered by these two statin drug treatments. Taken together, these results indicated that atorvastatin and fluvastatin can reduce IL-1β-induced inflammatory responses in HaCaT cells. In conclusion, the findings suggest that atorvastatin and fluvastatin can be potential modulators for ameliorating skin inflammation.

Effect on Physiological Metabolism of Calcium Ion at Cell Membrane Model of Parathyroid which Irradiated by High Energy X-ray (고에너지 엑스선을 조사한 부갑상선의 세포막모델에서 칼슘이온의 생리학적 대사에 미치는 영향)

  • Ko, In-Ho;Yeo, Jin-Dong
    • Journal of the Korean Society of Radiology
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    • v.16 no.2
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    • pp.141-150
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    • 2022
  • The initial co-transport and counter-transport permeate transport characteristics of calcium ion at epithelial cell membrane model in parathyroid which irradiated by high energy x-ray(linac 6 MV) was investigated. The epithelial cell membrane model used in this experiment was a polysulfonated copolymerized membrane of poly(PS-DVB: polystyrene-divinylbenzene). The difference of sorbed water in membrane, fixed carrier concentration(SO32-), initial pH value, OH- concentration were occurred at difference of Ca2+concentration and quantity of parathyroid hormone, respectively. The initial co-transport and counter-transport permeate flux of Cl-, OH-, Ca2+ on fixed carrier concentration(SO32-) and initial pH value of irradiated membrane was found to be decreased than non-irradiated membrane. The initial co-transport and counter-transport permeate flux of Ca2+ on fixed carrier concentration (SO32-), initial pH value, OH- concentration in irradiated membrane were found to be decreased about 2.68 ~ 6.87 times, about 1.42 ~ 1.63 times, about 2.07 ~ 1.672 times than non-irradiated membrane, respectively. As a result, the quantity of parathyroid hormone was decreased at irradiated membrane than non-irradiated membrane. The decrease of parathyroid hormone was occurred at hypoparathyroidism and osteoporosis, parathyroiditis, and so on. As the parathyroid hormone in epithelial cell membrane model were abnormal, cell damages were appeared at cell.

Development and evaluation of a nutrition education program for housewives to reduce sodium intake: application of the social cognitive theory and a transtheoretical model (주부대상 나트륨 섭취 줄이기 영양교육 프로그램 개발 및 효과 평가: 사회인지론과 행동변화단계모델 적용)

  • Ahn, Sohyun;Kwon, Jong-Sook;Kim, Kyungmin;Kim, Hye-Kyeong
    • Journal of Nutrition and Health
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    • v.55 no.1
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    • pp.174-187
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    • 2022
  • Purpose: This study was performed to evaluate an education program for housewives to reduce sodium intake based on the social cognitive theory. Methods: Housewives (n = 387) received 2 education sessions focused on food purchase and cooking, and completed a questionnaire on their perceptions of environmental, cognitive, and behavioral factors and the stages of behavioral change to reducing sodium intake both before and after the education program. Results: After the education program, the recognition of social efforts for sodium reduction and sodium labeling and experience with low-sodium products increased. Positive expectancies for the prevention of osteoporosis by the reduction of sodium were enhanced while the main barriers in practicing sodium reduction decreased, especially 'interrupting social relationships when dining with others', 'bad taste', 'preference for soup or stew', and 'limited knowledge and skills to practice'. In addition, cognition and nutrition knowledge related to reducing sodium intake were improved on all scores, but the effect on self-efficacy and dietary behavior was limited to only a few items. The percentage of participants in the pre-action stage (including pre-contemplation, contemplation, and preparation stages) for reducing sodium intake decreased from 43.2% before education to 21.5% after education, while that in the action stage increased from 19.6% before education to 43.5% after education (p < 0.001). The education program had the most significant impact on participants who were in the pre-action stage and showed improved scores in all sections. Conclusion: These results suggest that a customized education program for housewives could be an effective tool to reduce sodium intake by improving personal expectancies, cognition, and nutrition knowledge regarding sodium reduction and enabling a greater section of the population to move to the action stage of reducing sodium intake.

Surgical Treatment of Osteoporotic Vertebral Compression Fractures at Thoraco-Lumbar Levels: Only Pedicle Screw Constructs with Polymethylmethacrylate Augmentation (흉요추부 골다공증성 척추 압박 골절의 수술적 치료: 골시멘트 보강술을 이용한 척추경 나사 고정)

  • Jun, Deuk Soo;Baik, Jong-Min;Park, Ji Hyeon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.327-335
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    • 2019
  • Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm2. The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

Correlation Analysis between Fat Fraction and Bone Mineral Density Using the DIXON Method for Fat Dominant Tissue in Knee Joint MRI: A Preliminary Study (지방우세 딕슨기법을 이용한 슬관절 자기공명영상 지방신호분율과 골밀도 간의 상관관계 분석: 예비 연구)

  • Sung Hyun An;Kyu-Sung Kwack;Sunghoon Park;Jae Sung Yun;Bumhee Park;Ji Su Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.427-440
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    • 2023
  • Purpose This study aimed to investigate the correlation between the fat signal fraction (FF) of the fat-dominant bone tissue of the knee joint, measured using the MRI Dixon method (DIXON) technique, and bone mineral density (BMD). Materials and Methods Among the patients who underwent knee DIXON imaging at our institute, we retrospectively analyzed 93 patients who also underwent dual energy X-ray absorptiometry within 1 year. The FFs of the distal femur metaphyseal (Fm) and proximal tibia metaphyseal (Tm) were calculated from the DIXON images, and the correlation between FF and BMD was analyzed. Patients were grouped based on BMD of lumbar spine (L), femoral neck (FN), and common femur (FT) respectively, and the Kruskal-Wallis H test was performed for FF. Results We identified a significant negative correlation between TmFF and FN-BMD in the entire patient group (r = -0.26, p < 0.05). In female patients, TmFF showed a negative correlation with FN-BMD, FT-BMD, and L-BMD (r = -0.38, 0.28 and -0.27, p < 0.05). In male patients, FmFF was negatively correlated with only FN-BMD and FT-BMD (r = -0.58 and -0.42, p < 0.05). There was a significant difference in the TmFF between female patients grouped by BMD (p < 0.05). In male patients, there was a significant difference in FmFF (p < 0.05). Conclusion Overall, we found that FF and BMD around the knee joints showed a negative correlation. This suggests the potential of FF measurement using DIXON for BMD screening.

Evaluation of Sodium Intake and Relationship between Sodium Intake and the Bone Mineral Density of Female University Students (중부 지역 여대생에서 음식섭취빈도조사지를 이용한 나트륨 섭취량 평가 및 나트륨 섭취와 골밀도와의 관련성 조사)

  • Bae, Yun-Jung;Yeon, Jee-Young
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.5
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    • pp.625-636
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    • 2011
  • The purpose of this study was to evaluate the relationship between bone health and sodium intake in female university students using a dish frequency questionnaire (DFQ 125), anthropometric checkups, food records for 3 days, and ultrasound measurement of calcaneus bone mineral density. Subjects were divided into two groups: normal (n=196) and osteopenia (n=52). There were no significant differences in age or height between the two groups. The average weight, body mass index, and body fat in the normal group were significantly higher than in the osteopenia group. The sodium intake of DFQ was positively correlated with the sodium intake of 3 days of dietary records (p=0.0003). There were no significant differences in the sodium intake between the two groups from DFQ. The dishes were ranked by sodium intake: kimchies were 17.68%, noodles and mandu were 16.36%, stews were 13.69%, main dishes such as meat, egg, and beans were 11.47%, and fish and shellfish were 11.07%. The frequency of eating noodles and mandu (p=0.0116), stews (p=0.0008), kimchies (p=0.0482), fish and shellfish (p=0.0362), vegetables (p=0.0064) and seasoning (p=0.0347) were negatively associated with bone mineral density. Bone health was not significantly different with increasing quartiles of sodium intake. As excessive sodium intakes may indirectly affect bone mineral density, these results suggest that to prevent osteoporosis, university students needed to be more educated about diets containing less sodium through nutrition education programs.

SNR and ADC Changes at Increasing b Values among Patients with Lumbar Vertebral Compression Fracture on 1.5T MR Diffusion Weighted Images (1.5T MR 기기를 이용한 확산강조영상에서 b Value의 증가에 따른 요추압박골절 환자의 신호대 잡음비와 현성 확산 계수의 변화)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.52-59
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    • 2010
  • To examine among patients with vertebral compression fracture the extent to which signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values at the lumbar vertebral compression fracture site vary on diffusion-weighted MR images according to varying b values on the 1.5T MR device. Diffusion-weighted MR images of 30 patients with compression fracture due to chronic osteoporosis who underwent vertebral MRI from Jan. 2008 to Nov. 2009 were respectively obtained using a 1.5-T MR scanner with the b values increased from 400, 600, 800, 1,000 to $1,200\;s/mm^2$. For diffusion-weighted MR images with different b values, the signal-to-noise ratio (SNR) was assessed at three sites: the site of compression fracture of the lumbar vertebral body at L1 to L5, and both the upper and lower discs of the said fracture site, while for ADC map images with different b values, the SNR and ADC were respectively assessed at those three sites. As a quantitative analysis, diffusion-weighted MR images and ADC map images with b value of $400\;s/mm^2$ (the base b values) were respectively compared with the corresponding images with each different b value. As far as qualitative analysis is concerned, for both diffusion-weighted MR and ADC map images with b value of $400\;s/mm^2$, the extent to which signal intensity values obtained at the site of compression fracture of the lumbar vertebral body at L1 to L5 vary according to the increasing b values were examined. The quantitative analysis found that for both diffusion-weighted MR and ADC map images, as the b values increased, the SNR were relatively lowered at all the three sites, compared to the base b value. Also, it was found that as the b values increased, ADC valueswere relatively lowered at all the three sites on ADC map images. On the other hand, the qualitative analysis found that as the b values increased to more than $400\;s/mm^2$, the signal intensity gradually decreased at all the sites, while at the levels of more than $1,000\;s/mm^2$, severe image noises appeared at all of the three sites. In addition, higher signal intensity was found at the site of compression fracture of the lumbar vertebral body than at the discs. Findings showed that with the b value being increased, both the signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values gradually decreased at all the sites of the lumbar vertebral compression fracture and both the upper and lower discs of the fracture site, suggesting that there is a possibility of a wider range of applications to assessment of various vertebral pathologies by utilizing multi b values in the diffusion-weighted MRI examination.