• 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.

• Journal of Preventive Medicine and Public Health
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• v.30 no.4 s.59
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• pp.669-685
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• 1997

Previous studies, reporting the inverse relationship between osteoarthritis and osteoporosis suggest the existence of possible pathophysiologic mechanisms between them. To examinine the hypothesis that 'bone mineral densities of women with osteoarthritis are significantly higher than that of women without osteoarthritis in Korea', subjects from the health and nutritional examination survey in Kuri city were sampled. Samples were selected through multi-stage sampling frame using established clusters in Kuri city. From August 18 to September 10,1997, the survey was conducted. Among the. total number of selected sample population (1,656 people), response .ate was 52.4 percent (348 men and 519 women). 420 women who took BMD measurement, radiologic exam, and anthropometric exam were selected for the analysis. The analytic results are as follows. 1. General characteristics: Mean BMD was $0.493g/cm^2$, mean age was 43.0, mean BMI was $23.9kg/m^2$. The number of women who experienced menopause was 106, hysterectomy was 19. There were 0 case of osteoarthritis of hip, 64 cases of osteoarthritis of knee, and 2 cases of osteoarthritis of hand. 2. Univariate analysis results: Mean BMD of women with the osteoarthritis of knee was significantly lower than that of women without the osteoarthritis of knee(0.4269 vs. $0.5057g/cm^2$). But, there were too few cases of osteoarthritis of hip and hand, so comparative studies of BMD in osteoarthritis of hip and hand could not be conducted. There were significant differences of BMD among pre-menopause group(0.5204), post-menopause group(0.4206), and hysterectomy group(0.4881). Additionally, there were significant differences of BMD among diabetes group(0.4297), impaired glucose tolerance group(0.4874), and normal group(0.5057). Furthermore, age, parity, BMI, bioimpedance were significantly related with BMD. 3. Multivariate analysis results: To examinine the relationship between osteoarthritis and BMD while controlling the other variables' effects which were significant in the univariate analyses, multiple linear regression analysis was done. But, it was found that osteoarthritis of knee was not a significant variable to BMD anymore. While age and menopause had significant negative relationship with BMD. Diabetes, parity, BMI, and bioimpedance did not have significant relationships with BMD. After stratification of subjects according to menopause, multiple linear regression analyses were done to each strata. Consequently, age in post-menopause group, age and osteoarthritis of knee in hysterectomy group showed significant negative relationship with BMD. The results did not support the many results of other previous studies done with white men and women. further studies of biological plausibility to Korean women are recommended. Also it is suggested that longitudinal study to verify the relationship between osteoarthritis and BMD will be valuable.

• Journal of Life Science
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• v.20 no.4
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• pp.607-613
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• 2010

Osteoporosis is a disease involving a decrease in bone mineral density and an increased risk of fractures. The MC3T3-E1 pre-osteoblastic cell line is a well-accepted model of osteogenesis in vitro. Pine needles have long been used as a traditional health-promoting medicinal food in Korea. In this study, MTT assay, the alkaline phosphatase (ALP) activity and collagen synthesis of osteoblast cells were investigated to determine the effects of pine needle extracts on cell proliferation and differentiation. Pine needle extracts were prepared using hexane, ethanol and water. The effects of the pine needle extracts were examined by comparing the results with those of commercial agents, such as proanthocyanidin. The MC3T3-E1 cells exposed to proanthocyanidin showed increased proliferation in a concentration-dependent manner. The cells exposed to the hexane extract showed a similar increase in proliferation to that observed with proanthocyanidin. The hexane extract showed the highest ALP activity. Moreover, a supplement of pine needle extracts induced collagen synthesis in MC3T3-E1 cells. The pine needle extract produced the highest level of collagen synthesis at concentrations of $10{\sim}50\;{\mu}g/ml$. These results indicate that pine needle extracts have an anabolic effect on bone by promoting osteoblastic differentiation, and may be used in the treatment of common metabolic bone diseases.

• Journal of Biomedical Engineering Research
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• v.25 no.3
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• pp.171-182
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• 2004

This study investigates the biomechanical efficacies of vertebroplasty which is used to treat vertebral body fracture with bone cement augmentation for osteoporotic patients using image and finite element analysis. Simulated models were divided into two groups: (a) a vertebral body, (b) a functional spinal unit(FSU). For a vertebral body model, the maximum axial displacement was investigated under axial compression to evaluate the effect of structural integrity. The stiffness of each FE model simulated was normalized by the stiffness of intact model. In the case of FSU model, 3 types of compression fractures were formulated to assess the influence on spinal curvature changes. The FSU models were loaded under compressive pressure to calculate the change of spinal curvature. The results according to the various factors suggest that vertebroplasty has the biomechanical efficacy of the increment of structural reinforcement in a patient who has relatively high level of BMD and a patient with the amount of 15％, PMMA injection of the cancellous bone volume. The spinal curvatures after compression fracture simulation vary from 9$^{\circ}$ to 17$^{\circ}$ of kyphosis compared to that the spinal curvature of normal model was -2.8$^{\circ}$ of lordosis. These spinal curvature changes cause the severe spinal deformity under the same loading. As the degree of compressive fracture increases the spinal deformity also increases. The results indicate that vertebroplasty has the increasing effect of the structural integrity regardless of the amount of PMMA or BMD and the restoration of decreased vertebral body height may be an important factor when the compressive fracture caused the significant height loss of vertebral body.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.168-175
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• 2003

Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.12 no.1
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• pp.14-22
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• 2012

Objectives: This study was performed to review clinical manifestations of hyperphenylalaninemia patients in Korean. Methods: 178 cases of hyperphenyalaninemia were diagnosed at department of pediatrics, Soonchunhyang University Hospital from January, 1983 to August. We reviewed DNA analysis, MR imaging, EEG, radiography of the left hand and wrist, bone densitometry (BMD), IQ test of hyperphenyalaninemia patients. Results: Out of 178 cases, 161 cases were diagnosed classic phenylketonuria and 17 cases were diagnosed BH4 deficiency. 122 cases performed DNA analysis. R243Q (10.3%), Y204C (9.9%), and IVS4-1G>A (8.1%) mutations were predominant. 22 cases underwent MR imaging. Varying degrees of symmetrical high signal intensity were noted on T2-weighted sequences in the periventricular deep white matter of 15 cases. 23 cases were performed EEG. 12 cases (52.3%) showed abnormal pattern. EEG abnormalities showed in 11 cases. On lumbar BMD four of 11 cases (36%) showed reduced bone density of more than 1 S.D. in four of 11 cases, bone age was less than chronological age by at least one year. 18 cases were performed IQ test. Mean IQ scores was $84{\pm}21.6$. Among older than 15 years (9 cases), Mean IQ scores was $72{\pm}21.2$. PTPS deficiency was 14 cases, DHPR deficiency was 2 cases, and GTPCH deficiency was 1 case. Conclusion: We confirmed there were varieties of DNA mutations. And MR imaging and EEG were nonspecific in PKU patients. Older children showed lower IQ score. Low phenylalanine diet prevents brain damage in PKU patient. Not only first few years of life but also lifetime, Keeping low phenylalanine diet is important.

• Korean Journal of Veterinary Service
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• v.23 no.3
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• pp.235-245
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• 2000

This study was peformed to elucidate the effects of antler, red ginseng, safflower seed, ipriflavone and estrogen on ovariectomized rats. The rats were fed with Ca and P deficient diet for five weeks to induce osteoporosis. After this period, these animals were fed with normal for and treated every other day with antler(600mg/kg, PO), red ginseng(200mg/kg, PO), safflower(200mg/kg, PO), ipriflavone(80mg/kg, PO) and estrogene(400$\mu\textrm{g}$/kg, IM) for S weeks. During the treatment, the rats were examined for body, organ, femur and femur ash weights. And electron-microscopical examinations were also performed on femora. The results are summarized as follows : 1. The body weights of the antler, red ginseng, safflower, ipriflavone and estrogen-treated groups after five weeks of treatment, were 303.0$\pm$3.0g, 273.3$\pm$4.4g, 288.3$\pm$5.1g, 300.5$\pm$5.2g, 320.5$\pm$4.2g, respectively. They, except the red ginseng-treated group, were significantly higher than 278.4$\pm$2.7g of normal control group(P<0.05). And the body weight of non-treatment group was 29it.2$\pm$5.5g which was higher than that of control group, too. 2. The weights of left femur after five weeks of treatment were showed 0.83$\pm$0.2g by antler, 0.89$\pm$0.2g by red ginseng, 0.87$\pm$0.2g by safflower 0.83$\pm$0.1g by ipriflavone and 0.78$\pm$0.1g by estrogen-treated group. They were a little lower than 0.97$\pm$0.1g of normal control group. Non-treatment group showed 0.83$\pm$0.1g which was lower than that of control group but not significant. 3. The weights of ashed left femora after five weeks of treatment were showed 0.36$\pm$0.01g by antler, 0.40$\pm$0.01g by red ginseng, 0.41$\pm$0.01g by safflower, 0.36$\pm$0.01g by ipriflavone and 0.35$\pm$0.01g by estrogen-treated group. Those results were significantly lower than 0.43$\pm$0.01g of normal control group. And non-treatment group showed 0.29$\pm$0.01g of femoral ash which was significantly lower than that showed by control group(p<0.05). 4. The femoral Ca contents of the antler, red ginseng, safflower, ipriflavone and estrogen-treated rats were 19.6$\pm$0.7%, 17.8$\pm$1.1%, 18.8$\pm$0.9%, 18.0$\pm$1.1%, 15.3$\pm$1.1%, respectively, after five weeks of treatment. The femoral Ca contents of antler and safflower-treated groups were higher than that of control group which showed 18.2$\pm$0.9% of Ca The non-treatment group, showing 15.3$\pm$0.7%, had significantly lower content of Ca than normal group(p<0.05). 5. The weights of liver, spleen, and kidney in the osteoporosis-induced rats during the treatment with antler, red ginseng, safflower, jpriflavone and estrogen showed not significant changes. 6. The connections among the trabeculae of control group were maintained well, showing no bone loss. However, the connections among the trabeculae of non-treatment group were thinner than those of control group and were almost disconnected and the lacunae were found to be broadened. Antler and safflower-treated group showed only slight changes. The recovery rates were prominent in antler, safflower, estrogen-treated groups but they were insignificant in red ginseng and ipriflavone-treated groups.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.15-28
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• 2019

Purpose Nuclear medicine was initially introduced in Korea in 1969 and widely applied to treat hyperthyroidism with $^{131}I$. Also, gamma camera was adopted in 1969 in the first place and its application has been growing continually in many ways. We analyzed long-term trend in nuclear medicine examinations for the last 2 decades. The purpose of this paper is to make predictions and to set both plans and directions on the development of nuclear medicine. Materials and Methods We analyzed the performance of nuclear medicine examinations and therapies performed in Asan Medical Center from 1998 to 2017. Results Results from the last 20 years regarding Bone scan, Renal scan, MUGA scan and $^{18}F$-FPCIT, Bone Mineral Density were on a increase. And Myocardium perfusion SPECT, Thyroid scan, Lung scan were on a decrease while $^{18}F-FDG$ PET maintained on a steady course. Until 2010 there was a positive performance with the therapy but after the excessive medical care in thyroid examination performance is at status quo. Key events such as a medical strike(2000), Middle-East Respiratory Syndrome (2015) influenced the overall performance of the therapy. Conclusion In order to promote a long-term growth in nuclear medicine examination and therapy, it is inevitable to respond to the changes in current medical environment. Furthermore, it is strongly suggested to put efforts to maintain and develop new examinations and clinical indicators.

• The Korean Journal of Nuclear Medicine
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• v.39 no.3
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• pp.182-190
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• 2005

Purpose: There are differences between Standard Uptake Value (SUV) of CT attenuation corrected PET and that of $^{137}Cs$. Since various causes lead to difference of SUV, it is important to know what is the cause of these difference. Since only the X-ray CT and $^{137}Cs$ transmission data are used for the attenuation correction, in Philips GEMINI PET/CT scanner, proper transformation of these data into usable attenuation coefficients for 511 keV photon has to be ascertained. The aim of this study was to evaluate the accuracy in the CT measurement and compare the CT and $^{137}Cs$-based attenuation correction in this scanner. Methods: For all the experiments, CT was set to 40 keV (120 kVp) and 50 mAs. To evaluate the accuracy of the CT measurement, CT performance phantom was scanned and Hounsfield units (HU) for those regions were compared to the true values. For the comparison of CT and $^{137}Cs$-based attenuation corrections, transmission scans of the elliptical lung-spine-body phantom and electron density CT phantom composed of various components, such as water, bone, brain and adipose, were performed using CT and $^{137}Cs$. Transformed attenuation coefficients from these data were compared to each other and true 511 keV attenuation coefficient acquired using $^{68}Ge$ and ECAT EXACT 47 scanner. In addition, CT and $^{137}Cs$-derived attenuation coefficients and SUV values for $^{18}F$-FDG measured from the regions with normal and pathological uptake in patients' data were also compared. Results: HU of all the regions in CT performance phantom measured using GEMINI PET/CT were equivalent to the known true values. CT based attenuation coefficients were lower than those of $^{68}Ge$ about 10% in bony region of NEMA ECT phantom. Attenuation coefficients derived from $^{137}Cs$ data was slightly higher than those from CT data also in the images of electron density CT phantom and patients' body with electron density. However, the SUV values in attenuation corrected images using $^{137}Cs$ were lower than images corrected using CT. Percent difference between SUV values was about 15%. Conclusion: Although the HU measured using this scanner was accurate, accuracy in the conversion from CT data into the 511 keV attenuation coefficients was limited in the bony region. Discrepancy in the transformed attenuation coefficients and SUV values between CT and $^{137}Cs$-based data shown in this study suggests that further optimization of various parameters in data acquisition and processing would be necessary for this scanner.

• Journal of radiological science and technology
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• v.30 no.1
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• pp.25-32
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• 2007

This study is to evaluate the factors that affect to the bone mineral density(BMD) of postpartum women by comparing BMD between postpartum and general women who are ages from 20 to 39, and to identify correlation between various factors weight, height, body mass index(BMI), hemoglobin(Hb) and BMD. Study subjects were postpartum(n=159) and general(n=180) women. We checked the BMD of femoral neck and lumbar spine by using dual energy X-ray bone densitometry. The mean age was $30.69{\pm}3.32$ in postpartum care group and $31.22{\pm}5.66$ in general women group. In postpartum care group, the mean BMD of femoral neck and lumbar spine were -0.187 and -0.076. In general women group, the mean BMD of femoral neck and lumbar spine were -0.029, and -0.169. According to BMI level, each group was divided into two subgroups. One was 23 or more BMI subgroup, and the other was under 23 BMI subgroup. There was a significant difference in BMD of femoral neck and lumbar spine between two subgroups in general women group, but only a significant difference in BMD of lumbar spine is noted between two subgroups of postpartum group. According to Hb level, each group was divided into two subgroups. One was 11g/dl or more subgroup, and the other was under 11g/dl subgroup. There was not a statistically significant difference of BMD in all subgroups. BMD of femoral neck and lumbar spine showed a significant correlation with weight, height, BMI in both groups. There was a significant correlation between BMD and Hb level in postpartum care group, but a significant correlation was not noted in general women group. The postpartum women showed a significant correlation between BMD and various factors such as weight, height, BMI just like in general women. There was a significant correlation between BMD and Hb in postpartum women, but not in general women.