• Journal of Biomedical Engineering Research
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• v.37 no.4
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• pp.147-151
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• 2016

Tibial defect, or fracture is very routine musculoskeletal case which brings fully uncomfortable and painful situations to patient. Moreover, it has long hospitalization period because of its risk of non-union. There are many studies using ultrasound, vibration, and laser for bone regeneration to figure out fast bone healing. Among them, Low Level Laser Therapy (LLLT) is already known that it is very easy to treat and may have positive effect for bone regeneration. However, LLLT has uncertain energy dose because of scattering and absorption of laser in tissue. In this study, we used interstitial LLLT to treat tibial defect in animal study. The Interstitial LLLT can overcome some limitations caused by laser scattering or absorption in tissue medium. The results were evaluated using u-CT which can calculate X-ray attenuation coefficient and bone volume of bone defect area. These results showed that interstitial LLLT may affect fast bone healing process in early phase.

• Archives of Reconstructive Microsurgery
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• v.25 no.2
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• pp.65-68
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• 2016

Acute bone shortening and delayed lengthening by Ilizarov surgery have been used to treat a wide range of soft tissue injuries including open fracture, osteomyelitis of the tibia and lower leg amputation. It has advantages such as bone lengthening as well as minimizing the loss of damaged tissues via tissue expansion. Here, we report a case of 52-year-old male with satisfactory results through acute bone shortening, replantation, and gradual bone lengthening after complete amputation of the ankle with related literature reviews.

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

• The Journal of the Korean bone and joint tumor society
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• v.16 no.2
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• pp.80-86
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• 2010

Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

• Journal of Broadcast Engineering
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• v.17 no.1
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• pp.73-80
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• 2012

Recently, medical equipments are developed and used for diagnosis or studies. In addition, demand of techniques which automatically deal with three dimensional medical images obtained from the medical equipments is growing. One of the techniques is automatic bone segmentation which is expected to enhance the diagnosis efficiency of osteoporosis, fracture, and other bone diseases. Although various researches have been proposed to solve it, they are unable to be used in practice since a size of the medical data is large and there are many low contrast boundaries with other tissues. In this paper, we present a fast and accurate automatic framework for bone segmentation based on multi-resolutions. On a low resolution step, a position of the bone is roughly detected using constrained branch and mincut which find the optimal template from the training set. Then, the segmentation and the registration are iteratively conducted on the multiple resolutions. To evaluate the performance of the proposed method, we make an experiment with femur and tibia from 50 test knee magnetic resonance images using 100 training set. The proposed method outperformed the constrained branch and mincut in aspect of segmentation accuracy and implementation time.

• The Journal of Korean Obstetrics and Gynecology
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• v.25 no.4
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• pp.1-11
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• 2012

Objectives: Osteoporosis, which occurs after menopause, is a kind of metabolic bone disorder. It develops when the bone mass begins to decrease radically, and its main symptoms are bone fracture and height-shortening. This thesis aims at what effects the Cuscutae Semen Extract(CSE) has on the prevention of osteoporosis in SD-rat that is caused by ovariectomy. Methods: The 24 female white rats, after removing their ovaries, were divided into the Normals, the Control group, and the CSE administrated group. For the next 8 weeks, distilled water to the normals and the control, and the CSE(45.9 mg/100 g) to the CSE administrated group were given in the mouths of them. After 8 weeks the rats were sacrificed. Weight, albumin, aspartate aminotransferase, alanine aminotransferase, total-cholesterol, triglyceride, phosphorus, calcium, tetraiodothyronine, estradiol, the weight of the femur, the amount of tibia ash, the area of trabecular bone, and the thickness of trabecular bone were measured. Results: The serum analysis shows that the calcium and phosphorous of the CSE administrated group significantly increased compared to that of the control group. Aspartate aminotransferase, alkalinephosphatase, total cholesterol, tetraiodothyronine of CSE group were decreased, but not so significant. Albumin, alanine aminotransferase, triglyceride and estradiol of the group showed the tendency to increase, but the significance wasn't admitted. Regarding the variation of bone, the femur weight and the ash content of tibia, CSE group was more increased than the control group but the significance wasn't admitted. The histological observation shows that the trabecular thickness was more increased than the control group, and trabecular area increased significantly compared to those of the control group. The number of osteoclast and osteoblast area of the CSE groups decreased significantly compared to those of the control group. Conclusions: From the result of the above study, CSE should be effective for the osteoporosis cure and precaution and deeper study through bedside and clinical demonstration is much needed from now on.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.447-463
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• 1994

Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

• Biomedical Science Letters
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• v.18 no.3
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• pp.244-253
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• 2012

Bone mineral density (BMD) is used in the clinical diagnosis of osteoporosis and the assessment of fracture risk. Osteoporosis, characterized mainly by decreased BMD, is a highly heritable complex disorder and a major public health concern to hundreds of millions of elderly persons worldwide. However, the specific genetic variants determining risk for low bone density are still largely unknown. Here, we performed association analysis to elucidate the possible relations of genetic polymorphisms in ESR1 gene with low bone density. By examining genotype data of a total of 1813 women in the Korean Association REsource (KARE) study, we discovered the ESR1 gene polymorphisms are associated with decreased BMD and osteoporosis. The results on the BD-RT (bone density estimated by T-score at distal radius), three SNPs (rs2248586, rs9371557, and rs1569788) within the ESR1 gene were significantly associated with bone density. The results on the BD-TT (bone density estimated by T-score at midshaft tibia), five SNPs (rs9371552, rs2248586, rs712221, rs7772475, and rs3798577) were significantly associated with bone density. The SNP rs2248586 within the ESR1 gene had commonly significance in both BD-RT (${\beta}$=-0.151, dominant P=0.049) and BD-TT (${\beta}$=-0.156, dominant P=0.039). In the SNP rs2248586, their ${\beta}$-values in BD-RT and/or BD-TT showed consistent trends with the odds ratios (ORs) of osteoporosis. In summary, we found statistically significant SNPs in ESR1 gene that are associated with both decreased BMD and osteoporosis traits. Therefore, our findings suggest ESR1 gene could be related to pathogenesis of osteoporosis.

• Journal of Periodontal and Implant Science
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• v.30 no.3
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• pp.553-569
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• 2000

Many natural medicines have been studied for their capacity and effects of antibacterial, anti-inflammatory and regenerative potential in periodontal tissues. Safflower seed has been traditionally used as a drug for treatment of bone fracture in oriental medicine. The purpose of the present study was to compare the effects of safflower seed extract and bone substitute on bone formation and regeneration in artificial defects in mongrel dogs. The bony defects were made with round bur at mandible and tibia. Extracts of safflower seed and bovine bone were placed directly at each defect for experimental group, and the defect of control group was sutured without any other treatment. Experimental animals were sacrificed at 8 weeks. And then histopathologic reading and histomorphometric study was done. There was not significant differences between control and experimental groups in osteoclastic activity and infiltration of inflammatory cells. However, new capillary proliferation, fibrosis and new bone formation were prominent in safflower seed extract group. The mandibular defects of safflower seed extract group were healed with dense connective and bony tissues, and endochondral bone formation was observed in tibial defect of safflower seed extract group only. New bone area of safflower seed extract group was more significantly increased than that of control and that of bone substitute group. These results indicate that direct local application of safflower seed extracts on bony defects seems to reduces the early inflammatory response and to promotes the bone regeneration.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.66-73
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• 2008

Purpose: To report the clinical results of tibio-talo-calcaneal arthrodesis fixed with multiple cannulated screws for the cases of painful ankle and hindfoot arthropathy regardless of any deformity or instability. Materials and Methods: A retrospective analysis was performed upon 10 patients that underwent tibio-talo-calcaneal arthrodesis from October 1999 to May 2006. There were 4 males and 6 females, with an average age of 63 years (43-70). The etioloty of arthrodesis included 5 osteoarthritis, 2 Charcot joints, 1 rheumatoid arthritis, 1 Tbc arthritis and 1 residual poliomyelitis. Chief complaints were pain in 9 cases and instability in 1 case. Three patients had combined severe varus deformity. Tibio-talo-calcaneal arthrodesis using multiple cannulated screws was performed by transfibular approach for all cases and short leg cast was applied for 12 weeks postoperatively. Results: The average follow-up period was 16.5 months (12-26 months). VAS pain score was average 8.2 (7-10) and modified AOFAS score was average 25 (8-40, total 86) preoperatively. At final follow-up, VAS score was average 1.0 (0-3) and AOFAS score improved to average 66 (58-75). There were 4 complications: 2 nonunion, 1 tibia stress fracture and 1 malunion. Seven of 8 patients were satisfied with the results at final follow-up. Conclusion: Fixation with multiple cannulated screws for tibio-talo-calcaneal arthrodesis through transfibular approach is a recommendable surgical option.