• Journal of Biomedical Engineering Research
• /
• v.30 no.1
• /
• pp.49-55
• /
• 2009

Purpose : The aim of this study is to evaluate a possibility of clinical application for the effects of low intensity ultrasound stimulation (LIUS) in morphological characteristics (i.e., structure, bone mineral density) of bone on osteoporotic fracturesprevention. Materials and Methods : Eight virgin 14-week-old ICR mice (approximate weight 25g) were used and ovariectomized (OVX) to induce osteoporosis. Right tibia (US) for each mouse served as the LIUS (1.5MHz frequency, 1.0 kHz pulse repetition on frequency, $30mW/cm^2$ intensity, $200{\mu}s$ pulse length, and stimulation for 20 minutes a day and 5 days a week over a 6-week period). Left tibia (CON) for each mouse served as the non-stimulated controls. Structural parameters and bone mineral density ($g/cm^3$) on trabecular bone of tibiae were calculated and measured from images derived in-vivo micro computed tomography (micro-CT) at 0 week and after 6weeks. Results : The BV/TV and Tb.N in US group were significantly bigger than those in CON group. The Tb.Pf in US group, moreover, was significantly smaller than that in CON group (p<0.05).For the others structural parameters and BMD, however, there were no significant difference between US group and CON group (p>0.05). Conclusion : The LIUS might prevent bone loss and keep bone connectivity in osteoporotic bones. Therefore, the LIUS might prevent effectively the osteoporotic fractures in clinics.

• 대한예방의학회:학술대회논문집
• /
• 2005.10a
• /
• pp.504-504
• /
• 2005

• Hip & pelvis
• /
• v.30 no.4
• /
• pp.233-240
• /
• 2018

Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.

• Journal of Korean Neurosurgical Society
• /
• v.62 no.1
• /
• pp.71-82
• /
• 2019

Objective : To determine the prevalence of osteoporosis (OP) and osteoporotic vertebral fracture (OVF) in people with Parkinson's disease (PD) in Korea and its association with socioeconomic status. Methods : Using Health Insurance Review and Assessment Service-National Inpatient Sample (HIRA-NIS) data from 2009 to 2013, we estimated the annual prevalence of PD, OP, and OVF and investigated its association with socioeconomic status using data from National Health Insurance (NHI) beneficiaries and Medical Aid (MA) recipients. This study was supported by research funding from Korean Society for Bone and Mineral Research 2015. There were no study-specific biases related to conflicts of interest. Results : The number of PD patients in the HIRA-NIS increased each year from 2009 to 2013. Among patients with PD, the standardized prevalence rates of OP and OVF increased from 2009 to 2013; from 23.2 to 27.8 and from 2.8 to 4.2, respectively. Among patients with PD with OP, the prevalence of OVF were 12.2% and 15.1% in 2009 and 2013, respectively. The standardized prevalence rates of PD with OP and PD with OVF were significantly higher in MA recipients than in NHI beneficiaries. Conclusion : The prevalence of PD both with OP and with OVF increased and the prevalence was higher in MA recipients than in NHI beneficiaries. These findings may suggest that age over 65 years, female and low income may be a significant factor related to PD occurring with OP and OVF.

• Investigative Magnetic Resonance Imaging
• /
• v.21 no.3
• /
• pp.148-153
• /
• 2017

Purpose: To identify the differences between injected cement volumes during vertebroplasty procedures according to the enhancement pattern of pre-procedure magnetic resonance imaging (MRI) findings. Materials and Methods: Thirty-two patients who underwent 52 vertebroplasty procedures as well as pre-procedure contrast-enhanced spine MRI in the authors' institution were reviewed retrospectively. The 52 procedures were divided into two groups according to different enhancement patterns shown by pre-procedure MR imaging [E(+) and E(-)]. The volumes of the enhancing/non-enhancing portions of the fractured vertebral body shown by pre-procedural MR imaging were calculated and compared to the volumes of the injected cement during the vertebroplasty procedures. Results: The 52 injections included 28 (56%) in Group E(+) and 24 (44%) in Group E(-). The actual volume ratio of the injected cement to the volume of the non-enhanced or enhanced region calculated based on the contrast-enhanced MRI was $0.22{\pm}0.11(cc/cm^3)$ in the E(+) group and $0.93{\pm}0.62(cc/cm^3)$ in the E(-) group. The average amount of injected cement was significantly different between Group E(+) and Group E(-) (P < 0.001). In addition, the ratio of the injected cement amount to the volume of the enhanced or non-enhanced portion based on the contrast-enhanced MRI in Group E(-) was significantly higher than that of Group E(+) (P < 0.001). Conclusion: Different enhancement patterns shown by pre-procedure MRI can predictors of the injected cement volume during vertebroplasty procedures for osteoporotic fractures.

• Genomics & Informatics
• /
• v.14 no.4
• /
• pp.216-221
• /
• 2016

Osteoporotic fractures (OFs) are critical hard outcomes of osteoporosis and are characterized by decreased bone strength induced by low bone density and microarchitectural deterioration in bone tissue. Most OFs cause acute pain, hospitalization, immobilization, and slow recovery in patients and are associated with increased mortality. A variety of genetic studies have suggested associations of genetic variants with the risk of OF. Genome-wide association studies have reported various single-nucleotide polymorphisms and copy number variations (CNVs) in European and Asian populations. To identify CNV regions associated with OF risk, we conducted a genome-wide CNV study in a Korean population. We performed logistic regression analyses in 1,537 Korean subjects (299 OF cases and 1,238 healthy controls) and identified a total of 8 CNV regions significantly associated with OF (p < 0.05). Then, one CNV region located on chromosome 20q13.12 was selected for experimental validation. The selected CNV region was experimentally validated by quantitative polymerase chain reaction. The CNV region of chromosome 20q13.12 is positioned upstream of a family of long non-coding RNAs, LINC01260. Our findings could provide new information on the genetic factors associated with the risk of OF.

• Clinics in Shoulder and Elbow
• /
• v.20 no.4
• /
• pp.217-221
• /
• 2017

Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.

• The Korean Journal of Pain
• /
• v.18 no.2
• /
• pp.142-145
• /
• 2005

Background: Vertebroplasty that is performed in the upper and middle thoracic spine presents technical challenges that are different from those in the lower thoracic or lumbar region due to the small pedicle size and angular severity for thoracic kyphosis. We report the results of percutaneous vertebroplasty and review its effectiveness in treating intractable osteoporotic compression fractures in the upper and middle thoracic spine. Methods: Patients who underwent vertebroplasty due to painful osteoporotic compression fractures at T3 T8 were retrospectively analyzed. The compression rate, volume of injected cement, clinical outcome (VAS score) and complications were analyzed. Results: Forty-three vertebral bodies from 41 patients (32 females and 9 males, age from 64 to 78 years old) underwent vertebroplasty. The mean compression rate improved from 35% to 17%. Bipedicular injections of bone cement were performed at 3 levels of 2 patients, and unipedicular injections were performed in 40 levels of 39 patients. The mean VAS score prior to surgery was 7.7, which improved to 2.4 within 48 hours after surgery, and the mean VAS score after 6 months was 1.5, which was significantly lower. All patients recovered uneventfully, and the neurological examination revealed no deficits. Cement leakage to the adjacent disc (9 levels) and paravertebral soft tissues (10 levels) developed. However, there were no significant complications related to the procedure such as a pneumothorax or pulmonary embolism. Conclusions: Transpedicular vertebroplasty is a safe and effective treatment for the upper and middle thoracic regions, and has a low complication rate.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.26 no.5
• /
• pp.519-526
• /
• 2000

Osteoporosis has recently been recognized as a major health problem in the elderly population. The disorder is manifested as a loss of bone mass accompanied by structural alteration of bone and increased incidence of fracture. Mandible also may be affected. So, I evaluated panoramic views of 66 postmenopausal women for finding the possibility of useful diagnostic mandibular parmeters of osteoporosis. To know the correlationship between skeleton and mandible, the average of the bone mineral density of lumbar from 2nd to 4th by the dual energy X-ray absorptiometry(DEXA, LUNAR DPZ. USA), and age and mandibular parameters, that is, the number of residual teeth, alveolar ridge resorption ratio, panoramic mandibular index (PMI), mandibular cortical width (MCW), angular cortical thickness (ACT), ramus cortical thickness (RCT), morphology of mandibular inferior cortical (MIC) were compared. And I divided the all tested women to the osteoporotic group and non-osteoporotic group by the use of T-score -2.0, which was derived from skeletal bone mineral density (BMD). To find the correlationship of the each group with mandibular parameters, t-test and discriminant analysis were done. The results of the t-test were that all parameters were highly related with 2 groups (p<0.05). Especially ACT, MIC, age have had even higher correlationship than others (p<0.001). The results of the discriminant analysis by the use of these ACT, MIC and age were that the discriminant function was Z = -2.973+(-1.447)$\times$(ACT)+1.131$\times$(MIC score)+(0.052)$\times$(age), the cutting score was 0.257 and the classification accuracy was 84.8%. Therefore I suggest that the consideration of the angular cortical thickness (ACT), the age of patient and the morphology of mandibular inferior cortical(MIC) may help find the osteoporosis.

• Proceedings of the KOSOMBE Conference
• /
• v.1998 no.11
• /
• pp.169-170
• /
• 1998

In this study, regional variation in vertebral bone density due to osteoporosis were investigated using a method that employs images from QCT. QCT images(1mm thick slices) of the first lumbar vertebra from a normal person (23/M, BMD=139.8mg/ml) and from an osteoporotic patient (54/F, BMD=82.0mg/ml) were obtained. Uniform settings (140kVp, 204mA) were used and images of 300 Hounsfield Unit or greater were selectied to filler out soft tissue interference. To assess the regional variation of the area fraction the vertebral body was divided into 3 layers and each layer contained 9 regions. Area faction was calculated based on image analysis data. Our results showed that the area fraction at the middle of the vertebra was quite lower than the endplate and peripheral regions, but the area fraction values from the osteoporotic patient were uniform throughout the entire height of the vertebral body, which indicates the significant drop of BMD had occurred near both end-plates due to the osteoporosis, especially at the peripheral regions. Our results suggest the susceptability of the vertebrae to compression fracture types in osteoporotic spine.