• The Journal of Internal Korean Medicine
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• v.44 no.6
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• pp.1318-1326
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• 2023

Introduction: Pressure ulcers, often found in patients with mobility issues, particularly elderly patients, are increasing in prevalence. Their treatment is complex, with recovery more challenging in advanced stages, and certain factors can delay healing. Case Presentation: An 87-year-old male developed a grade IV pressure ulcer on his left greater trochanter following lumbar fractures and subsequent percutaneous vertebroplasty in 2021. Despite potential surgical recommendations, his treatment consisted of daily wet dressings, acupuncture from July 2021 to February 2022, and Gami-sipjeondaebo-tang beginning August 2021. The ulcer, initially measuring 6 cm×6 cm and showing a red wound without necrosis, healed completely and showed no signs of recurrence as of August 2023. Conclusion: A grade IV pressure ulcer was effectively treated using wet dressing, acupuncture, and Gami-sipjeondaebo-tang, demonstrating no recurrence over a 1.5-year period.

• Journal of Nutrition and Health
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• v.40 no.8
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• pp.719-727
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• 2007

To elucidate the relationship among the levels of nutrients intake, bone mineral density(BMD) and the urinary biochemical markers of bone metabolism, this survey is conducted with 225 postmenopausal women over 50 years of age. The urinary biochemical markers including deoxypyridinoline(DPD) and Ca excretion were measured. Bone mineral densities of lumbar spine(L2-L4), femoral neck, ward's triangle and trochanter were measured with dual-energy X-ray absorptiometry and the nutrient intake data obtained by 24 hr recall method. Mean age of all subjects was 64.8 years old, and the BMDs of the subjects were $0.86g/cm^2$(lumbar spine), $0.60g/cm^2$(femoral neck), $0.49g/cm^2$(trochanter), and $0.41g/cm^2$(ward's triangle). The results were compared among 3 groups with different nutrient intake levels classified by the percentage of Dietary Reference Intakes(DRIs) for Koreans as follows: low < 75% DRIs, 75% DRI $\leq$ adequate < 125% DRIs, high $\geq$ 125% DRIs. Bone mineral density of adequate protein intake group was significantly higher than those of low and high protein intake groups(p<0.05). Urinary DPD excretion was lowest in protein and calcium adequate intake groups(p<0.05, p<0.05), respectively. In relation to urinary Ca excretion, it is revealed to be considerably lower in the groups taking protein and vitamin C adequate intake(p<0.05, p<0.05). The percent DRI of protein and calcium were positively correlated with the BMD of the femoral neck after adjusted age(p<0.05, p<0.05). These results showed that there are probably some relationships between nutrient intake levels and urinary biochemical markers. For postmenopausal women with adequate nutrition expecially protein, calcium and vitamin C, has an important role to postpone bone resorption and to prevent the decrease of bone density.

• Journal of Nutrition and Health
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• v.35 no.4
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• pp.464-472
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• 2002

This study was conducted to investigate dietary and other factors affecting bone mineral density in young Korean collage women. Thirty subjects were recruited; the mean age was 22.1 years and the mean age at menarche was 12.6 years. Bone mineral density (BMD) was measured in the spine (LS), femoral neck (FN), ward's triangle (WT), and femoral trochanter (FT) by Dual Energy X-ray Absorptiometry (DEXA), and physical activity was assessed by a questionnaire. Dietary intake data were obtained 8 times by using a 24 hour recall method to evaluate the subjects' usual diet. Bone mineral densities of lumbar spine, femoral neck, ward's triangle and femoral trochanter were 1.149 g/$\textrm{cm}^2$, 0.980 g/$\textrm{cm}^2$, 0.936 g/$\textrm{cm}^2$ and 0.759 g/$\textrm{cm}^2$ respectively. The met energy intake of subjects was 1,790 kcal, and calcium and iron intakes were found to be inadequate compared to the Korean RDA. The BMD of the lumbar spine was significantly and positively related to the BMI and intake of vitamin C, carbohydrate, potatoes, fruits and plant food. The BMD of the femur (FN, WT, FT) was positively related to the BMI, to carbohydrate and fruit intake, and to the percentage of plant food in total food intake. Multiple recession analysis showed that fruit intake was significantly related to the BMD of the LS. The subjects'ages and fruit intakes were significantly related to the BMD of the femur (FN, WT, FT). These results indicate that higher fruit intakes may have a beneficial effect on bone mineral density.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.75-84
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• 2006

Background : Osteoporosis and atrophic cell pattern in Pap smear are frequent findings In postmenopausal women due to loss of ovarian function, The present study attempted to find out possible correlation between morphologic characteristics of Pap smear and osteoporosis. Material & methods: The subjects were 825 women(age from 35 to 80) who had undergone Pap smear and bone mineral density(BMD) at The Korea Association of Health Promotion, Seoul Branch, from March 8 to May 10, 2005. Pap smears from 825 women were reviewed and classified either mature cell pattern or atrophic cell pattern by their cytologic patterns, BMD were measured using LUNAR DPX MdIQ(Minster, Ohio, USA). BMD value of lumbar spine(Ll, L2,L3 and L4) were measured from 825 women and BMD value of proximal region off emur(neck NK, Wards triangle WT, and trochanter TR) were measured from 818 women and their bone status were classified as normal( T-sore:>-1.0), osteopenia (T-score: -l~<-2,5) and osteoporosis(T-score: ≤ -2.5). And age distribution of Pap smear, average T-value andfrequency ofsteoporo-sis of each region of the bone, percentage of osteoporosis of each boneregion by age group and changing pattern of percentage of osteopenia and osteoporosis in certain postmenopausal period were compared between mature and atrophic cell pattern. Results: Pap smears revealed total mature cell pattern 53,9%(445/825) and total atrophic cell pattern 46.1%(380/825), Percentage of mature cell pattern decreased from 98.2%(168/171)under 44 age group to 13,3%(17/128) over 65 age group and mature cell pattern increased from 1.8%(3/171) under 44 age group to 86.7%(111/128) oyer 65 age group. Mean T-value of each region of lumbar spine and femur of mature cell pattern were lower than that of atrophic cell pattern about -1,5. And osteoporosis has noted in atrophic cell pattern showing odds ratio Ll 13.9, L2 15.3, L3 12.0, L4 10,4, UK 6.7, WT 10.9 and TR 4.1.Atrophic cell pattern started to increase after 45 years of age and osteoporosis of a trophic cell pattern started after 55 years of age. During 50 to 64 years of age period, L3, L4 and WT revealed parallel increased of osteopenia and osteoporosis and Ll, L2 revealed decreased of osteopenia and increased of osteoporosis. nia Conclusion: Above findings suggest that atrophic cell pattern of Pap smear precedes osteoporosis about 10 years and one of predictor of osteoporosis.

• Journal of Korean Academy of Nursing
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• v.4 no.3
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• pp.93-104
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• 1974

Regardless of a patient's diagnosis, the care of his skin has been a primary concern of nurses throughout the years. Nurses has washed, dried, and rubbed the skin and have changed his position so as to keep the patient's skin in good condition and to protect him from pressure sores. However, we still find many-patients suffering from the pressure sores which may take many mothers or years of treatment and cost a lot to be repaired. In view of expensive cost for treatment of the sores and low ratios of nursing staff per patient for intensive nursing care, prophylaxis of the bed sores with sufficient aids is extremely important both for patients and for nurses. Therefore, the unique purpose of this study was to determine whether sponge is good enough to treat and prevent the pressure sore as compared with gel pad and sheepskin. Sixty patients in the age range of 15 through 45 who were in unconscious status or have difficulty of mobility were chosen between January and March of 1974 at Seoul National University Hospital. They were randomly assigned to each treatment and observed on every 4th day with regard to level of consciousness, status of mobility, moisture or dryness of the bed, general skin condition, intake of nutrition, vital signs and intervals of position change in comparison with the changes of skin over the bony prominences. The study results were reviewed in a statistical method analysis of valiance-to obtain the following findings: 1. There was no significantly different changes of skin over the sanctum or the trochanter in each group using get pad, sheepskin or sponge. It means that we may substitute sponge for expensive gel pad or sheepskin. 2. There was no significant difference among mean changes of patient's skin in relation to sheepskin, gel pad and sponge. 3. There was no significant changes of patient's akin in relation to level of consciousness, status of mobility, intake of nutrition, general skin condition, temperature, blood pressure or interval of position change. 4. There were no meaningful interactions between each treatment and level of consciousness, moisture or dryness of the bed, intake of nutrition, general skin condition, temperature or blood pressure. 5. Sheepskin and gel pad had significantly better influence on patients with limited mobility than on patients with immobility, and sponge on patients with immobility on than patients with limited mobility, 6. Sheepskin and sponge had meaningfully totter influence on patients changing position at below 2-hour interval, gel pad at 2-4-hour interval, sheepskin at 4-6-hour interval, and three of them at above 6-hour interval.

• Investigative Magnetic Resonance Imaging
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• v.10 no.2
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• pp.63-69
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• 2006

Purpose : Marrow edema and fatty degeneration of the hip joint bones could be initial and late signs in hip joint and its bone diseases respectively, which might be differentiated from age-related marrow conversion pattern. So authors have investigated normal marrow conversion pattern of the femur and acetabulum around the hip joints. Materials and methods : Three coronal MR images of 288 hip joint bones in 144 subjects, aged 2 days to 76 years divided to 8 groups every 10 years, were retrospectively analysed for the location and appearance of the converted yellow marrow. The converted yellow marrow were divided to head, neck, and trochanter in the proximal femur and below and above 50% in acetabulum of the hip. Results : The most common type of marrow conversion is the converted yellow marrow in the entire proximal femur and below 50% of acetabulum of the hip. We observed the start of marrow conversion in just before and after 2 years old and stopped at just before and after 20 years old. Conclusion : The understanding of age-related marrow conversion pattern of the hip joint bones would provide some information for differentiation from pathologic condition of them such as edema, fatty degeneration, metastasis, or leukemia.

• Journal of Nutrition and Health
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• v.27 no.10
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• pp.1025-1036
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• 1994

This study was designed to investigate the effects of Ca and/or vitamin D supplementation for 53 weeks on bone metabolism in postmenopausal women. The subjects were healthy 18 women aged from 59 to 69 years old. They were divided into three groups : placebo, Ca(1000mg/day) supplementation and Ca(1000mg/day) with vitamin D(12.5$\mu\textrm{g}$/day) supplementation. During the experimental periods except for metabolic studies, the subjects ate their usual diets and the use of drugs as well as excessive exercise was prohibited. Metabolic studies were conducted in the 1st week and in the 53rd week of the experimental periods. The subjects ate experimental diets which consisted of 1787.3kcal, 69.6g of protein, 561.5mg of Ca and 1078.6mg of P daily during both of the metabolic study periods. The results were summarized as follows; 1) Bone density of the second lumbar spine and trochanter measured after treatment decreased significantly in control group as compared with pre-experimental level(p<0.05). On the contrary, bone density of femoral neck and Ward's triangle in Ca group and the second lumbar spine in Ca.Vit D group increased significantly after treatment. 2) Serum PTH and calcitonin levels did not show any significant differences among groups before and after treatment. But serum PTH level increased significantly in all groups after treatment(P<0.05). 3) Serum Ca and P levels did not show any significant differences among groups before and after treatment. But serum Ca level increased significantly in all groups after treatment (P<0.05) and serum P level decreased significantly in Ca.Vit D group after treatment(P<0.05). 4) Mean 24-hours fecal Ca excretion of Ca group was the highest in the 1st week of treatment(P<0.01), and that of control group was the lowest in the 53rd week of treatment(P<0.01). Fecal Ca excretion increased significantly in control and Ca.Vit D group in the 53rd week of treatment(P<0.05). Urinary Ca excretion did not show any significant differences among groups in the 1st and 53rd week of treatment, but that of Ca.Vit D group was the highest the 1st week of treatment(P<0.01). In the 53rd week of treatment Ca and Ca.Vit D group showed positive Ca balance, but control group showed negative Ca balance. The above results showed that it will be difficult to prevent degenerative bone loss without Ca and/or vitamin D supplementation in postmenopausal women eating Korean usual diets.

• Journal of Nutrition and Health
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• v.31 no.1
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• pp.36-45
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• 1998

Dietary and other factors affecting bone density of 32 Korean healthy college women aged 19-23 years were assessed. Data for food and nutrient intake was obtained by a semiquantitiative food frequency questionnaire. Serum samples were anlayzed for total Ca, P, Ca++, PTH, calcitonin and 25-hydroxycholecalciferol , (25-OH-Vit D3) and BMDs of lumbar spine(L2-L4), femoral neck(FN), ward's triangle (WT) and trochanter(TR) were measured by an XR-series X-ray bone densitometer. Relationships between the factors and BMDs were analyzed by stepwise multiple regression analysis and Pearson's correlation coefficient(r). The results are summarized as follows. Mean daily intake of energy(86.1%), Ca(74.3%), vitamin A (53.75), Fe(49.75) and vitamin B$_2$(86.6%) were lower while other notrients incuding P(126%) were higher than the Korean RDA. The BMDs of lumbar spines and femurs ranged from 0.73g/$\textrm{cm}^2$ to 1.23g/$\textrm{cm}^2$and 0.48g/$\textrm{cm}^2$ to 1.04g/$\textrm{cm}^2$, respectively. Both protein and P intakes were inversely associated with serum total Ca. Furthermore, Ca intake as well as Ca/P ratio (Ca/P) were inversely associated with serum ionized Ca(Ca++) concentration. The intakes of protein P and Ca , however, were not significantly associated with the BMDs measured in this study. There were little association between BMDs and alcoholic beverage or caffeine consumption. The only significant association detected was a positive relationship between caffeine consumption and BMD of WT. It seemed to be noticeable that BMDs of L2-L$_4$, FN and WT were significantly inversely associated with serum P concentration. However, there was no significant association between BMDs and the levels of total Ca to Ca++ in serum. Body weight was positively associated with BMD of lumbar spine and BMI was also positively associated with BMDs of FN and WT. The subjects who had an early menarche appeared to have higher BMDs than those who had had a late mearche. According to stepwise multiple regression analysis. Menarche and BMI were stronger determinants of BMDs in the young women than was diet. P intake appeared to be a more potent dietary determinant than Ca intake. The three factors, menarche, BMI , and P intake , additionally accounted for 24% and 378% of the variance in BMDs of FN and L$_2$-L$_4$, respectively. Further investigation is necessary to determine the factors needed to increase serum P level which negatively affects. BMD in young Korean college women.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.1
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• pp.43-60
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• 1997

This study was to identify the nursing intervention method in finding out the incidence, risk factor, prevention and treatment of bed sore cilents who received regional home care nursing services. The eleven home care nurse practitioners took the survey on 97 patients who received home care nursing service from Seoul City Nurses Association for one month from September 26 to October 26 1996. A modified version of Braden's bed sore assessment tool for bed sore risks and a tool for assessment of bed sore stage and measurement bed sore sizes by Bergstrom, Braden, Laguzza and Holman(1987) were as research tools for this study and a questionnare with 40 questions and 12 items on nursing activities was used to find out the prevention and treatment of bed sores. Also, two open ended questions were used on current approaches and efforts of the treatment being applied to clients. The finding of the study were summarized as following : 1. The rate of bed sore occurrence was 47.4% 2. The areas of bed sore occurrence were hip(28.9%), sacrum(18.6%), great trochanter(14.4%) and the average number of sore spots were 2.26 3. Two groups-one with bed sores and the other without-were studied to determine prediction factors for bed sore risks. Sensory function, humidity, level of activity, mobility, nutrition, skin friction and chapping and body temperature turned out to be statistically significant factors for bed sores. Also the age of clients turned out to be a individual characteristic variable significantly affecting the rate of bed sore occurrences. 4. The education for clients and family on systematic skin assessment and bed sores and practice of active/passive R.O.M. are mainly used as nursing activities for bed sore care. 5. The treatment method varied by stages of bed sores. Sometimes folk remedies like applying the powders of dried elm tree roots to sores were used. Good nutrition, frequent position change and skin care turned to be the most effective means to fast recovery of sores.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.12 no.1
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• pp.1-9
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• 2018

This study is intended to identify how horseback riding affect the bone density of the elderly. A total of 31 normal senior citizens participated in the research, who were randomly divided into two groups: 15 in horseback riding exercise group and 16 in horseback riding machine exercise group. A horseback riding exercise program was carried out for 25 minutes twice a week for 12 weeks. A pre-test was conducted before starting the program and two post-tests were conducted 6 weeks and 12 weeks after exercises in the same way as the pre-test. Measured items were bone density of lumbar vertebrae and femur. In order to identify the changes in measurement variables before exercises and 6 weeks and 12 weeks after exercises, two-way repeated analysis of variance were used. The comparison of changes in the bone density in both groups revealed that there were significant differences in lumbar vertebrae L3, L4, femur trochanter in both groups over time. This study suggests that three-dimensional movements of horses through horseback riding exercises induce normal movements of senior citizens, providing positive effects on their bone density. If appropriate horse riding exercise programs are used considering the health status, time and economic conditions, and preferences of senior citizens, it would improve their quality of life.