• 핵의학기술
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• 제27권2호
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• pp.99-109
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• 2023

Purpose: CT scan makes up for the weak point of the nuclear medicine image having a low resolution and also were used for attenuation correction on image reconstruction. Recently, many studies try to make use of CT images additionally, one of them is to measure the bone mineral density(BMD) using Quantitative CT(QCT) software. BMD exams are performed to scan lumbar and femur with DXA(Dual-Energy X-Ray Absorptiometry) in order to diagnose bone disease such as osteopenia, osteoporosis. The purpose of this study is to identify the usefulness of QCT_BMD analyzed with low dose CT images on L-spine Bone SPECT/CT comparing with DXA_BMD. Materials and Methods: Fifty five women over 50 years old (mean 66.4 ± 9.1) who took the both examinations(L-spine Bone SPECT/CT with SIEMENS Intevo 16 and DXA scan with GE Lunar prodigy advance) within 90 days from April 2017 to July 2022, BMD, T-score and disease classification were analyzed. Three-dimensional BMD was analyzed with low dose CT images acquired on L-spine Bone SPECT/CT scan on Mindways QCT PRO^TM software and two-dimensional BMD was analyzed on DXA scan. Basically, Lumbar 1-4 were analyzed and the patients who has lesion or spine implants on L-spine were excluded for this study. Pearson's correlation analysis was performed in BMD and T-score, chi-square test was performed in disease classification between QCT and DXA. Results: On 55 patients, the minimum of QCT_BMD was 18.10, maximum was 166.50, average was 82.71 ± 31.5 mg/cm³. And the minimum of DXA-BMD was 0.540, maximum was 1.302, average was 0.902 ± 0.201 g/cm², respectively. The result shows a strong statistical correlation between QCT_BMD and DXA_BMD(p<0.001, r=0.76). The minimum of QCT_T-score was -5.7, maximum was -0.1, average was -3.2 ± 1.3 and the minimum of DXA_T-score was -5.0, maximum was 1.7, average was -2.0 ± 1.3, respectively. The result shows a statistical correlation between QCT T-score and DXA T-score (p<0.001, r=0.66). On the disease classification, normal was 5, osteopenia was 25, osteoporosis was 25 in QCT and normal was 10, osteopenia was 25, osteoporosis was 20 in DXA. There was under-estimation of bone decrease relatively on DXA than QCT, but there was no significant differences statistically by chi-square test between QCT and DXA. Conclusion: Through this study, we could identify that the QCT measurement with low dose CT images QCT from L-Spine Bone SPECT/CT was reliable because of a strong statistical correlation between QCT_BMD and DXA_BMD. Bone SPECT/CT scan can provide three-dimensional information also BMD measurement with CT images. In the future, rather than various exams such as CT, BMD, Bone scan are performed, it will be possible to provide multipurpose information via only SPECT/CT scan. In addition, it will be very helpful clinically in the sense that we can provide a diagnosis of potential osteoporosis, especially in middle-aged patients.

• 대한의용생체공학회:의공학회지
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• 제25권4호
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• pp.261-268
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• 2004

골다공증은 골 조직의 량이 감소하여 골절의 가능성이 증가하는 상태이다. 뼈의 전기적 특성은 골 밀도와 관련이 있으며, 특히 뼈의 절기 저항은 골 소실이 증가할수록 감소하는 것으로 알려져 있다. 만일 신뢰성 있는 측정이 가능하다면, 뼈의 전기적인 특성은 골다공증 진단을 위한 유용한 변수가 될 수 있음을 의미한다 본 연구에서는 EIT (electrical impedance tomography) 기술을 이용하여 뼈의 전기 전도도 평가를 시도하였다. 뼈와 주위의 연조직 간의 전기적인 특성의 차이가 크기 때문에 (100 정도), 일반적으로, 뼈의 EIT를 얻기는 쉽지 않다. 본 연구에서는 이상 경계 검출을 위해 개발된 adaptive mesh regeneration 기법을 이용하여, 주어진 경계면의 기하학적 조건하에서, 경계 내부의 전기전도도를 복원할 수 있도 록 하였다. 수치 해석은 균일한 타원형 (장경 17 mm, 단경 15 mm) 뼈와 주위의 연 조직으로 구성된 반경 40 mm인 원통형 팬텀으로 모의한 경골에 대해 수행하였다. 타원형 뼈는 팬텀의 원형 단면 중심에서 15 mm 위쪽에 위치하도록 하였다. 연 조직의 전기 전도도는 4 mS/cm로 고정하였고, 뼈에 대해서는 0.01 - 1 mS/cm에서 변하도록 하였다. 측정 오차에 의한 효과를 분석하기 위해 시뮬레이션은 측정 오차를 포함하도록 하였다. 시뮬레이션 결과, 만일 측정 오차가 5 % 미만으로 유지될 경우, 재구성된 뼈의 전기전도도는 10 % 이내의 오차를 갖는 것으로 나타났다. 예측할수 있듯이 복원의 정확도는 뼈의 전기 전도도가 증가함에 따라 증가하였다. 이것은 사용된 EIT가 골 소실이 진행된 뼈에 대한 좀더 정확한 정보를 제공할 수 있음을 시사한다. 본 연구는, 뼈의 해부학적인 정보를 알고 있을 때 뼈와 주위의 연조직에 대한 단순한 이상 영상에 한정된 결과를 제공하지만, EIT 기술이 골다공증 골절을 예측하는 새로운 방법으로 활용될 가능성을 시사한다.

• 대한족부족관절학회지
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• 제8권1호
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• pp.101-106
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• 2004

Purpose: To determine the efficacy of the SDBBA (Subtalar distraction bone block arthrodesis) procedure on patients with late complication of intra-articular calcaneal fractures including subtalar joint arthritis and anterior ankle impingement syndrome. Materials and Methods: Five cases in which the SDBBA procedure was implemented were followed for more than one year. All five patients were male with an average age of 56. Clinically, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the pain score were assessed. Radiographically, the talocalcaneal height and the talar inclination angle were determined. Results: All five patients achieved subtalar joint fusion. The average pre-operative AOFAS score was 22.8 scores (range, 8-32 scores). At last follow-up, these scores improved to an average of 72.4 scores (range, 64-82 scores). The average pre-operative pain score was 8.2 scores (range, 7-10 scores). At last follow-up, these scores improved to an average of 13.2 (range, 12-15 scores). The average pre-operative talocalcaneal height was 72.8 mm (range, 70-77 mm), average post-operative talocalcaneal height improved to 79.8 mm (range, 78-84 mm). At final follow-up, these measurement was slightly decreased to average 78.6 mm (range, 74-83 mm). The average pre-operative talar inclination angle was 13.2 degrees (range, 12-15 degrees), average post-operative talar inclination angle improvedto 19.2 degrees (range, 15-24 degrees). At final follow-up, these measurement was slightly decreased to average 18.6 degrees (range, 12-24 degrees). Four patients achieved successful outcomes. One patient developed a wound infection with subsequent sural neuropathy as well as collapse of the bone graft. Conclusion: This study shows that the SDBBA procedure successfully restores the talocalcaneal height and tibio-talar relationship. This procedure is useful in surgically managed patients with talo-calcaneal height loss and anterior ankle impingement syndrome due to the late complications of calcaneal intra-articular fractures.

• Journal of Nutrition and Health
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• 제29권9호
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• pp.991-1002
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• 1996

The objectives of this study were to obtain normative data for 45 mother-daughter pairs on spine, femur(neck, ward's triangle, trochanter) and total body BMD (bone mineral density) measured by dual energy X-ray absorptiometry, anthropometric measurement, body composition, biochemical markers, nutrient intakes and energy expenditure, to determin the interrelations of these factors within each group, to measure familial resemblance for each variable. We observed significantly positive correlations between height, weight, head, hip and calf circumferences, tricep, femur and calf skinfold thickness, total lean body mass(=weight-total fat body mass-bone mineral content), protein and fat intakes, Ca index, serum total protein and albumin of monter-daughter pairs(p<.05-p<.001). Among mothers, age, osteocalcin, higher, weight, Ca and energy intakes were predictors of BMDs. Among daughters, weight and energy intake were predictors of BMDs. The BMD in lumbar spine(r=.48, p<.01), femoral neck(r=.38, p<.05), ward's triangle(r=.36, p<.05) of the mothers were significantly correlated with those of the daughters, after adjustment for mother's age, hight, weight, osteocalcin, Ca and energy intakes and daughter's weight, energy intake. In regression analyses, mother's BMD also were positively associated with daughter's BMD in lumbar spine, femoral neck, ward's triangle. Our findings support that mothers with low BMD tended to have daughters with low BMD. In the age groups studied, as well genetic factors as environmental factors may have an important role in determining BMD. This study suggests that women may successfully enhance their genetically determined BMD through adequate nutrient intakes and weight bearing exercise.

• 대한치과보철학회지
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• 제43권4호
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• pp.487-497
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• 2005

Purpose: Resonance frequency analysis (RFA) , a non-invasive technique for the clinical measurement of implant stability, was investigated. Peri-implant bony defect may contribute to implant failure. This in vitro study evaluated the resonance frequencies according to various bony defects and determined whether the directional bone defect can affect the value of frequency analysis. Material and Method: Fifteen 3.75 mm in diameter and 10 mm in length, machined self-tapping implant future were used. Twelve types of bone defects that have different horizontal and vertical dimensions were simulated. Embedded implants were attached to the dental surveyor. Then, the transducer was connected with the implant fixture and the ISQ value was measured at four different directions. Two-way analysis of variance and post hoc $Sch\`{e}ffe'$ test were performed at the 95% significance level. Results: The control group showed the highest ISQ value and 5 thread-$360^{\circ}$ group had the lowest one. As the vertical exposure of implants in each angle was increased, the ISQ value was decreased. Although the horizontal exposure in each thread was increased, the ISQ value was not significantly decreased. Conclusion : Although the simulated defect type was different from each other, the ISQ value was similar among groups.

• 한국정보전자통신기술학회논문지
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• 제4권4호
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• pp.236-241
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• 2011

높은 기공성을 갖춘 망상골과 고체의 비율이 높은 피질골의 기계적 성질은 초음파 파동 전파 측정법으로 알 수 있다. 초음파의 속도(SOS)는 bulk wave 방정식과 bar wave 방정식을 통해 산출할 수 있다. Bulk wave는 Biot의 이론에서 빠른 파동과 매우 유사함을 이용해, 본 연구에서 뼈의 이방성을 담은 행렬에 의해 bulk wave 속도가 변하는 여부를 측정하였다. 음파의 속도는 뼈가 횡방적인(transversely isotropy) 특성을 갖을 때보다 등방적인 특성을 갖을 때 0.69% 빠르다. 또한 bar wave 방정식을 사용하여 피질골에 대한 속도를 측정하였다. 전의 논문에 의하면 bar wave 속도는 탄성 계수 텐서 혹은 영의 계수의 함수이고 이와 같은 방법으로 bar wave 속도에 의해 등방성과 이방성을 측정하였다.

• Journal of Periodontal and Implant Science
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• 제34권2호
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• pp.303-315
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• 2004

The success and failure of dental implants depends on various factors such as patient's systemic status, quantity and quality of surrounding bone, presence or absence of marginal infection and mechanical loading condition. The measurement of crestal bone changes around the implants is implemental to evaluate the success and long-term prognosis of the implant. This study was to evaluate the cumulative survival rate of the implants which had been placed in the Department of Periodontics, Chonnam National University Hospital between 1992 and 2003, and to observe the crestal bone loss around the implants which had at least 2 consecutive periapical radiographs after connecting the transmucosal abutment. The radiographs were scanned and digitalized, and the crestal bone levels on the mesial and distal surface of implants were measured using Image analyzer (Image Pro Plus, Media Cybernetics, USA), immediately after implant placement, at 2nd surgery, and 3 months, 6 months, 1 year, and every year thereafter. Any bone loss was not observed during the period between the 1stand 2nd surgery, and the bone loss was 0.86 ${\pm}$ 0.92 mm for the first year of loading after connecting the transmucosal abutment. After 1 year of loading, annual bone loss was 0.1 ${\pm}$ 0.27 mm, and total bone loss was 0.90 ${\pm}$ 0.80 mm (during the average follow-up periods of 22.5 ${\pm}$ 25.6 Mos), The implant, with smooth surface, in the mandible, and with the fixed bridge prosthesis showed greater bone loss, compared to those, with the rough surface, in the maxilla and with single crown. In systemically diseased patients (including DM or osteoporosis), the greater bone loss was observed. The cumulative survival rate among 432 implants was 94.10% for 7 years. Among 15 failed implants, 9 implants were removed due to mobility from disintegration of bone-implant interface. From this results, crestal bone loss around the implants were greatest during 1 year after transmucosal abutment connection, and various factors could affect peri-implant bone loss. To prevent and predict the bone loss around the implants and improve the prognosis, further comprehensive maintenance and follow-up schedules are required.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권3호
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• pp.285-292
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• 2008

Purpose: The present study was performed to evaluate the effect of surface treatment of the cervical area of implant on bone regeneration in fresh extraction socket following implant installation. Materials and methods: The four minipigs, 18 months old and 30 kg weighted, were used. Four premolars of the left side of both the mandible and maxilla were extracted. ${\phi}$3.3 mm and 11.5 mm long US II plus implants (Osstem Implant co., Korea) with resorbable blasting media (RBM) treated surface and US II implants (Osstem Implant co., Korea) with machined surface at the top and RBM surface at lower portion were installed in the socket. Stability of the implant was measured with $Osstell^{TM}$ (Model 6 Resonance Frequency Analyser: Integration Diagnostics Ltd., Sweden). After 2 months of healing, the procedures and measurement of implant stability were repeated in the right side by same method of left side. At four months after first experiment, the animals were sacrificed after measurement of stability of all implants, and biopsies were obtained. Results: Well healed soft tissue and no mobility of the implants were observed in both groups. Histologically satisfactory osseointegration of implants was observed with RBM surface, and no foreign body reaction as well as inflammatory infiltration around implant were found. Furthermore, substantial bone formation and high degree of osseointegration were exhibited at the marginal defects around the cervical area of US II plus implants. However, healing of US II implants was characterized by the incomplete bone substitution and the presence of the connective tissue zone between the implant and newly formed bone. The distance between the implant platform (P) and the most coronal level of bone-to-implant contact (B) after 2 months of healing was $2.66{\pm}0.11$ mm at US II implants group and $1.80{\pm}0.13$mm at US II plus implant group. The P-B distance after 4 months of healing was $2.29{\pm}0.13$mm at US II implants group and $1.25{\pm}0.10$mm at US II plus implants group. The difference between both groups regarding the length of P-B distance was statistically significant(p<0.05). Concerning the resonance frequency analysis (RFA) value, the stability of US II plus implants group showed relatively higher RFA value than US II implants group. Conclusion: The current results suggest that implants with rough surface at the cervical area have an advantage in process of bone regeneration on defect around implant placed in a fresh extraction socket.

• 대한의생명과학회지
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• 제8권4호
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• pp.217-221
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• 2002

Age-related osteopenia and osteoporosis are common in postmenopausal women due to decrease in bone mass and ovarian function. A therapy for osteoporosis would depend on only drugs to inhibit bone loss, hormonal replacement therapy, exercise and dietary supplementation and it is very hard to fad an ideal therapy for osteoporosis as yet. Chlorella which is rich in minerals such as calcium magnesium fatty acids, vitamins and sterol, could be applicable for prevention and co-treatment of osteoporosis, but it has yet to be studied. The purpose of this study was to assess the relationship between the effect of dietary chlorella on bone mineral density (BMD) and nutritional improvement. BMD was measured in the femural neck and lumber spine portion. Nutritional and bone turnover markers from blood samples were assessed serum lkaline phosphatase, hemoglobin, number of erythrocytes and total protein. Studies for the femur neck measurement showed that normal BMD increased 2.1% for the group fed chlorella supplemented diet for four month and increased 6.6% fur group treated for one year when compared to the control group, and for the lumber spine measurements the few month group showed an increase of 9.1% over the control group, the one year group showed an increase of 64.2% over the control group. Hemoglobin content, number of erythrocytes and total protein showed similar increased patterns with BMD measurement, meanwhile, serum alkaline phosphatase increased 3% for the four month group and decrease 16% for the one year group compare to the control group. In conclusion, the postmenopausal women fed chlorella supplemented diet results in an increase in BMD. This is a marked increment in lumber spine, enhancement of nutritional state and stable bone turnover. This data showed a positive relationship between BMD and nutritional change with chlorella treatment, and suggested that chlorella dietary may lead to improving and preventing rapid loss of BMD in postmenopausal women.

• Nutritional Sciences
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• 제9권4호
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• pp.233-239
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• 2006

Porous matrices of bioactive polymers such as polyglycolic acid (PGA) or polylactic acid (PLA) can be used as scaffolds in bone tissue growth during bone repair process. These polymers are highly porous and serve as a template for the growth and organization of new bone tissues. We evaluated the effect of PGA and PLA polymers on osteoblastic MC3T3-E1 cell extracellular mineralization. MC3T3-E1 cells were cultured in a time-dependent manner -1, 15, 25d as appropriate - for the period of bone formation stages in one of the five culture circumstances, such as normal osteogenic differentiation medium, PGA-plated, fetal bovine serum (FBS)-plated, PGA/FBS-coplated, and PLA-plated For the evaluation of bone formation, minerals (Ca, Mg, Mn) and alkaline phosphatase activity, a marker for osteoblast differentiation, were measured Alizarin Red staining was used for the measurement of extracellular matrix Ca deposit During the culture period, PGA-plated one was reabsorbed into the medium more easily and faster than the PLA-plated one. At day 15, at the middle stage of bone formation, cellular Ca and Mg levels showed higher tendency in PGA- or PLA-plated treatments compared to non-plated control and at day 25, at the early late stage of bone formation, all three cellular Ca, Mg or Mn levels showed higher tendency as in order of PGA-related treatments and PLA-plated treatments, compared to control even without significance. Medium Ca, Mg or Mn levels didn't show any consistent tendency. Cellular ALP activity was higher in the PGA- or PLA-plated treatments compare to normal osteogenic medium treatment PGA-plated and PGA/FBS-plated treatments showed better Ca deposits than other treatments by measurement of Alizarin Red staining, although PLA-plated treatment also showed reasonable Ca deposit. The results of the present study suggest that biodegradable material, PGA and also with less extent for PLA, can be used as a biomaterial for better extracellular matrix mineralization in osteoblastic MC3T3-E1 cells.