• The Journal of the Korean bone and joint tumor society
• /
• v.19 no.2
• /
• pp.56-63
• /
• 2013

Purpose: This study was performed to evaluate the efficiency of demineralized bone matrix (DBM, Genesis$^{(R)}$) used for bone defect after operative traetment of benign bone tumors by clinical and radiological methods. Materials and Methods: DBM was used to treat bone defect after operative treatment of benign tumor from February 2012 to May 2013. Total 25 benign bone tumor cases (15 males, and 10 females) with mean age of 30.3 were studied. The diagnoses were solitary bone cyst in 9 cases, non ossifying fibroma in 5, fibrous dysplasia in 5, aneurysmal bone cyst in 3 and enchondroma in 3. In categorization by location of tumor, there were 5 cases of distal femur, 4 of proximal tibia, 3 of proximal femur, 3 of proximal humerus, 3 of phalanx, 2 of distal radius, 2 of hip bone, 2 of calcaneus, and 1 of scapula. Autogenous bone was used with DBM in 6 cases, and only DBM used in 19 cases. Mean periods of follow up were 8.7 months (range: 6 to 14 months). Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Resorption level was measured by DBM level which could be observed from simple x-ray, and bone formation level by bone trabecular formation level at impaired site. Results: Twenty three cases of total 25 cases showed bone union. In the 23 cases, more than 98% DBM resorption was observed after mean 4.3 months, and more than 98% bone formation was observed after mean 6.9 months. Lesser bone defect sizes showed faster bone formation and it was statistically significant (p=0.036). But other comparative studies on other factors such as, sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complication in periods of follow-up. Conclusion: Demineralized Bone Matrix (Genesis$^{(R)}$) is thought to be useful treatment for bone defect after operative treatment of benign bone tumor, however longer follow-up periods appears to be needed.

• Journal of Sasang Constitutional Medicine
• /
• v.32 no.3
• /
• pp.33-45
• /
• 2020

Object Although Taeeum and Soyang constitutional types have bigger body shapes and higher body mass index values than those with the Soeum, the relationship between the Sasang constitutional type and bone mass density is controversial and the association of osteopenia and osteoporosis remains unknown. Therefore, we investigated the relationship between bone mineral density, osteopenia, and osteoporosis according to Sasang constitutional type. Methods A total of 2,508 participants were included in this study. Among the study participants, 1,396 had Taeeum type, 276 had Soeum type, and 836 had Soyang type, respectively. The relationships to bone mass density, osteopenia, and osteoporosis in those with Sasang constitutional type were estimated using logistic and linear regression models. Results Bone mass density was significantly higher in the order of Taeeum, Soyang, and Soeum group (p < 0.01). Soeum group in comparison with Taeeum or Soyang group was significantly associated with a high odds ratio for osteopenia and osteoporosis except in the hip and femoral neck in the comparison of Taeeum and Soeum group (p < 0.01). Moreover, the bone mass density of Soeum group decreased more rapidly as the age increased when compared with Taeeum and Soyang group. Conclusions Our findings may contribute to the early prevention and management of high-risk individuals with poor bone mass density, osteopenia, and osteoporosis using Sasang constitution medicine.

• Journal of Nutrition and Health
• /
• v.29 no.9
• /
• pp.991-1002
• /
• 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.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.30 no.1
• /
• pp.159-167
• /
• 2001

The objective of this study is to examine the factors affecting bone mineral density in pre- and postmenopausal women. The subject were 30 Korean premenopausal women with mean ages of 33.6 years, and 30 Korean post menopausal women with mean ages of 63.3 years without diagnosed diseases. Data for food and nutrient intake were obtained by the24-hour recall method. BMD of lumbar spine and femoral neck were measured by the dual-energy X-ray absorptiometry (DEXA). Anthropometric measurement were made, and a blood sample was taken for assay osteocalcin. The results are summarized as follows: 16.67% of the subjects in the premenopausal women and 87.33% of the subjects in the postmenopausal women was less than the korean RDA level exceping phosphorus and vitamin C. In the premenopausal women, BMD of lumbar spine is correlated significantly with anthropometric measurement such as weight, waist circumference, BMI, and body fat mass BMD of femoral neck for the premenopausal women is correlated significantly with weight, BMI, waist circumference, body fat mass, hip circumference, and BMDs of both site are negatively correlated with lean body mass, total body water, but they are not related with intake of nutrients in this study. In the postmenopausal women group, BMDs of both site are not significantly correlated with anthropometric measurement, but BMD of lumbar spine showed positive relation with intake of energy, protein, and carbohydrate. In conclusion, adequate nutrient intake, especially energy, protein have been suggested to prevent the loss of bone mineral density in the postmenopausal women. Also, adequate body weight and BMI have been suggested in the premenopausal women.

• The Korean Journal of Food And Nutrition
• /
• v.20 no.4
• /
• pp.450-459
• /
• 2007

This study was performed to assess the relationships between bone mineral density(BMD), anthropometric measurements, and maternal factors in postmenopausal women. The anthropometric measurements were taken by a trained practitioner, and the maternal factors of the 85 subjects in Chungnam were acquired by an interview questionaire. The BMDs of the lumbar $spines(L_2-L_4)$, femoral necks(FN), ward's triangles(WT), and trochanters(TR) were measured by dual energy X-ray absorptiometry(DEXA). The BMDs(T-score) for $L_2-L_4$, FN, and WT were 0.996 $g/cm^2$(-1.601), 0.697 $g/cm^2(-1.657)$, and 0.793 $g/cm^2(-1.512)$ respectively, which were assessed as osteopenia by the T-score ; TR was noma1 at 0.718 $g/cm^2(-0.675)$. The 85 subjects in Chungnam were divided into three groups according to their BMD measurements for $L_2-L_4$ and FN, assessed by the T-score. The percentages in the osteoporosis, osteopenia, and normal groups were 32.9%, 42.4, and 24.7%, respectively. The average age was significantly the highest in the osteoporosis group than in the other two osteopenia and normal group(p<0.001). The subjects' BMDs were positively correlated with weight, height, BMI, waist, WHR, OBR and hip circumference, and negatively correlated with the age, duration time after menopause, lactation, the age of last delivery, menarche age, and number of children. The average age at menopause was 48.8. The osteoporosis group's average age at menopause was lower than those of the other groups. However, the BMD of the lumbar spine positively correlated with duration time after menopause and the BMD of the femoral neck with lactation, last delivery, menarch age, number of children. Therefore, researches are needed to find out the effective way to minimize the effect of age and other physiological conditions on the decrease of bone mass density.

• Imaging Science in Dentistry
• /
• v.52 no.1
• /
• pp.53-60
• /
• 2022

Purpose: The aim of this study was to compare the fractal dimension (FD) measured at 2 bone sites (second cervical vertebra and mandible) on cone-beam computed tomography (CBCT). The research question was whether FD could serve as an accessory tool to refer postmenopausal women for densitometric analysis. Therefore, the reliability and accuracy of FD were evaluated. Materials and Methods: In total, 103 postmenopausal women were evaluated, of whom 52 had normal bone mineral density and 51 had osteoporosis, according to dual X-ray absorptiometry of the lumbar spine and hip. On the CBCT scans, 2 regions of interest were selected for FD analysis: 1 at the second cervical vertebra and 1 located at the mandible. The correlations between both measurements, intra- and inter-observer agreement, and the accuracy of the measurements were calculated. A P value less than 0.05 was considered to indicate statistical significance for all tests. Results: The mean FD values were significantly lower at the mandibular region of interest in osteoporotic patients than in individuals with normal bone mineral density. The areas under the curve were 0.644 (P=0.008) and 0.531 (P=0.720) for the mandibular and vertebral sites, respectively. Conclusion: FD at the vertebral site could not be used as an adjuvant tool to refer women for osteoporosis investigation. Although FD differed between women with normal BMD and osteoporosis at the mandibular site, it demonstrated low accuracy and reliability.

• The Korean Journal of Nuclear Medicine
• /
• v.33 no.4
• /
• pp.405-412
• /
• 1999

Purpose: It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. Materials and Methods: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. Results: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). Conclusion: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.

• Proceedings of the KOSOMBE Conference
• /
• v.1997 no.05
• /
• pp.374-378
• /
• 1997

Operative procedures such as core drilling with and without fibular bone grafting have been recognized as the treatment methods for osteonecrosis of femoral head(ONFH) by delaying or preventing the collapse of the femoral head. In addition, core drilling with cementation using polymethylmethacrylate (PMMA) has been proposed recently as another surgical method. However, no definite treatment modality has been found yet while operative procedures remain controversial to many clinicians In this study, a finite element method(FEM) was employed to analyze and compare various surgical procedures of ONFH to provide a biomechanical insight. This study was based upon biomechanical findings which suggest stress concentration within the femoral head may facilitate the progression of the necrosis and eventual collapse. For this purpose, five anatomically relevant hip models were constructed in three dimensions : they were (1) intact(Type I), (2) necrotic(Type II), (3) core drilled only(Type III), (4) core drilled with fibular bone graft(Type IV), and (5) core drilled with cementation(Type V). Physiologically relevant loading were simulated. Resulting stresses were calculated. Our results showed that the volumetric percentage subjected to high stress in the necrotic cancellous region was greatest in the core drilled only model(Type III), followed by the necrotic(Type II), the bone graft (Type IV), and the cemented(Type V) models. Von Mises stresses at the tip of the graft(Type IV) was found to be twice more than those of cemented core(Type V) indicating the likelihood of the implant failure. In addition, stresses within the cemented core(Type V) were more evenly distributed and relatively lower than within the fibular bone graft(Type IV). In conclusion, our biomechanical analyses have demonstrated that the bone graft method(Type IV) and the cementation method(Type V) are both superior to the core decompression method(Type III) by reducing the high stress regions within the necrotic cancellous bone. Also it was found that the core region filled with PMMA(Type V) provides far smoother transfer of physiological load without causing the concentration of malignant stresses which may lead to the failure than with the fibular bone graft(Type IV). Therefore, considering the above results along with the degree of difficulties and risk of infection involved with preparation of the fibular bone graft, the cementation method appears to be a promising surgical treatment for the early stage of osteonecrosis of the femoral head.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3337-3343
• /
• 2013

This systematic review was conducted to assess the efficacy and safety of bisphosphonates for prevention and treatment of osteopenia or osteoporosis in men with non-metastatic prostate cancer receiving androgendeprivation therapy. We searched for randomised controlled trials (RCTs) of bisphosphonates compared with placebo from Pubmed, Embase, the Cochrane Library, and ISI - Science Citation Index. Meta-analyses of prespecified outcomes (bone mineral density, fractures, and adverse events) were performed using Review Manager. Ten RCTs with a total patient population of 1,017 were identified. There was generally more improvement in bone mineral density of the lumbar spine for patients who received bisphosphonate treatment than placebo or other medical treatment at 12 months (WMD 6.02,95%CI 5.39 to 6.65). Similar effects were also observed for total hip, trochanter or femoral neck bone mineral density. However, there was no significant reduction in fractures. Fever and gastrointestinal symptoms were the most common adverse events (10.4% vs. 1.2%; 0.10% vs. 0.03%). Currently, our meta-analysis suggested that oral and intravenous bisphosphonates caused a rapid increase in spine and hip or femoral BMD in non-metastatic prostate cancer patients receiving androgen-deprivation therapy. Fever and gastrointestinal symptoms were common with the use of bisphosphonates. These short-term trials (maximum of 12 months) did not show fracture reduction. In future, more efficient performance of higher quality, more rigorous, large sample, long-term randomised controlled trials (>12 months) are needed where outcomes are detailed.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.6
• /
• pp.503-510
• /
• 2020

Purpose: Bipolar hemiarthroplasty is used as an alternative to open reduction and internal fixation for unstable intertrochanteric fractures in elderly patients. Recent advances in medical systems and technologies have resulted in increased survival rates after intertrochanteric fractures of the femur, requiring selection of the appropriate femoral stems considering the mid- to long-term duration of survival. Hemiarthroplasty was performed for unstable intertrochanteric fractures using a double tapered quadrilateral femoral stem (C2 stem), and the clinical and radiological results were evaluated as a five-year follow-up post-surgery. Materials and Methods: From January 2004 to December 2013, 43 patients (43 hips) who underwent hemiarthroplasty with a C2 stem were enrolled in this study. Their mean age was 78.6 years (range, 70-84 years), and the mean follow-up period was 85.4 months (range, 60-96 months). During the follow-up period, clinical parameters, such as the changes in pain, walking ability, and functional status, were examined. Radiologically, changes in the proximal femur, such as osteoporosis and bone resorption of cortical bone, were noted. Complications that occurred during the follow-up period, such as dislocation and prosthetic features, were also reviewed. Results: Initially, the pain was relieved postoperatively, but it increased four years after surgery. The walking ability was reduced by two steps in nine patients after 60 months, and the Harris hip score was reduced significantly postoperatively after two to three years. Radiologically, cortical osteoporosis occurred in 14 patients. Five patients developed cortical bone resorption. Four of them showed nonunion of the trochanteric fracture fragments, and three of them suffered reverse oblique fractures. Conclusion: Careful selection considering the general health condition and remaining lifespan of the patient would be necessary for primary hip hemiarthroplasty using a 3C type cementless femoral stem for unstable intertrochanteric fractures in elderly patients with osteoporosis.