• Korean Journal of Community Nutrition
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• v.22 no.2
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• pp.136-144
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• 2017

Objectives: The purpose of this study was to determine which factors influence the bone mineral density (BMD) of total femur (TF), femoral neck (FN) and lumbar spine (LS) of the adult men by analyzing nationally representative Korean survey data. Methods: This study was conducted based on the data of 1,770 men aged 19-64 years from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2011. The BMD was analyzed by various factors (general characteristics, anthropometric data, health habits, chronic diseases, nutrient intake status). SPSS statistics for complex samples was used to analyze the data. Results: We observed that the BMD decreased significantly with aging. The BMD in each of the second lowest quartile of waist circumference (in TF & FN) and body mass index (in TF & LS) was lower than the respective BMD in the highest quartile group. The BMD in FN was higher in the group who reported the weight training. The BMD in LS was lower in hypercholesterolemia group than in the normal group. The BMD in TF, FN and LS was lower in hypertriglyceridemia group and in diabetes group than in the normal group. The BMD in TF, FN and LS was higher in the group with < Estimated Average Requirement iron intake. But there was no evidence to suggest that the BMD was related with educational level, income level, smoking, alcohol intake, anemia and nutrient intake status (except for iron). Conclusions: This study suggested that aging, waist circumference, body mass index, weight training, hypercholesterolemia, hypertriglycemia, diabetes were site-specifically associated with the BMD in TF, FN and LS in the adult men. These bone site-specific factors need to be considered for the prevention of osteoporosis.

• Physical Therapy Korea
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• v.15 no.1
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• pp.61-68
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• 2008

The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.

• Journal of the Society of Disaster Information
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• v.5 no.1
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• pp.142-158
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• 2009

The increasing number of crimes in rapidly changing modern society is enhancing people's desire for safety. As of 2008, 2,900 private security businesses with 133,000 employees operated in the private security industry which emerged in response to growing demands from society and people. Of the employees, bodyguards (hereinafter referred to as "private security guard") accounted for about 10% or 13,000. Most private security guards were suffering from various occupational diseases. Especially as they needed to guard their clients many hours a day and worked in a standing position for a long time, private security guards often complained of low back pain. Under the pain, they were hardly expected to perform their tasks efficiently. There are several causes of low back pain. The most prevalent cause is muscle weakness and imbalance around low back. Especially because private security work often requires security guards to maintain a standing position for a long time, many of them are suffering from low back pain. This study pursued the following purposes. First, it tried to identify the pathogenesis of low back pain caused by muscle weakness and imbalance around low back. Second, it tried to provide private security guards, who can hardly have personal time at work, with an easy method to prevent and manage low back pain any time by researching an effective therapy for low back pain caused by muscle weakness and imbalance around low back.

• Journal of Korean Medical Science
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• v.33 no.52
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• pp.339.1-339.11
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• 2018

Background: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ${\leq}50years\;old$. Methods: We retrospectively analyzed a consecutive cohort of 150 patients (${\leq}50years\;old$) with chronic hip pain (${\geq}6weeks$), which was not diagnosed or misdiagnosed based on the information provided on the referral form. Results: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. Conclusion: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.81-89
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• 2022

Purpose : Kegel exercises reported that it is effective in managing stress-related or complex urinary incontinence through contraction and relaxation of the pelvic floor muscles. In many previous studies, it was confirmed that Kegel exercise is involved in respiration as well as urinary system diseases. However, there is a lack of research on the effect of pelvic setting when performing Kegel exercises. Therefore, this study was conducted to investigate the effect on maximum voluntary ventilation (MVV) and abdominal muscle thickness through Kegel exercise after lumbar-pelvic motor control using pressure biofeedback unit (PBU). Methods : The subjects of this study were 10 healthy female students in their 20s. Subjects measured MVV with a spirometer. In hooklying, external oblique, internal oblique, and transverse abdominis of the dominant hand were measured using ultrasound. The measured value was an average of three times. After one week of intervention, measurements were made in the same manner. Before Kegel exercise, pelvic setting training was performed using PBU. In hooklying, PBU was placed in the waist and set to 40 mmHg, and it was adjusted to 60 mmHg through pelvic muscle contraction. For Kegel exercise, the pelvis was first set using PBU, and then the pelvic floor muscles were contracted for 8 seconds and relaxed for 8 seconds, 10 times, 1 set, and 3 sets. Results : In MVV, a significant difference was confirmed after exercise than before exercise (p<.05). There was also a significant difference in abdominal muscle thickness before and after exercise (p<.05). Conclusion : Based on the results of this study, Kegel exercise using PBU had an effect on MVV and abdominal muscle thickness. However, since this study was conducted without a control group as a preliminary study, additional research should be conducted to supplement this.

• Korean Journal of Clinical Pharmacy
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• v.33 no.2
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• pp.128-134
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• 2023

Background: This systematic review and meta-analysis aimed to evaluate the efficacy and cardiovascular safety of romosozumab compared with placebo. Methods: Randomized controlled trials (RCTs) were searched from Medline, EMBASE, Cochrane Central, and Web of Science until July 2022. Primary outcomes included the change in bone mineral density (BMD) from baseline at month 6. The secondary outcomes were the change of bone turnover markers (N-terminal propeptide of type 1 procollagen (P1NP); C-terminal telopeptide of type 1 collagen (CTX)) from baseline at month 3, and the incidence of cardiovascular adverse events for the total follow-up period. Results: A total of 7 RCTs on 8,370patients were included. Romosozumab showed better effects in improving BMD in both lumbar spine and femoral neck at month 6 (standardized mean difference, SMD 2.20 [95% CI: 1.89-2.52], SMD 0.63 [95% CI: 0.41-0.86]). In contrast to placebo, romosozumab significantly increased PINP levels and reduced CTX levels at month 3 (SMD 0.93 [95% CI: 0.65-1.22], SMD -1.03 [95% CI: -1.23~ -0.82]. However, there was no significant difference in the composite incidence of cardiovascular adverse events and major adverse cardiovascular events (OR 1.16 [95% CI: 0.82-1.65], OR 1.08 [95% CI: 0.75-1.56]). Conclusion: This analysis showed that romosozumab significantly improved BMD compared to placebo and was beneficial for change in bone turnover markers. There is no significant difference in the incidence of cardiovascular adverse events compared to placebo.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.211-215
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• 2001

Purpose : This study was done to evaluate the efficacy of low-dose radiation in reduction of thoracic vertebral metastases in patients with breast cancer. Materials and Methods : 109 patients who were treated for bone metastasis from breast cancer from June, 1988 to June, 1998 in the Department of Therapeutic Radiology, Seoul National University were included. Of the 109 patients, 40 patients had been previously treated by postoperative radiotherapy and 69 had not. Postoperative radiotherapy had been given using Co-60 teletherapy device in 30 patients or 6 MV linear accelerator in 10. Thoracic spines from 1 to 10 were usually irradiated except in 1 patient and cervical vertebrae 6 and/or 7 were partially included in ,: patients. A total of 50.4 Gy was given with 1.8 Gy fraction. Metastatic bone diseases were scored in 11 regions, i. e., skull, conical spine, thoracic spine from 1 to 4, from 5 to 8, 9 and 10, 11 and 12, lumbar spine, pelvis, femur, ribs and others. Results : In no postoperative parasternal irradiation group, lumbar vertebrae were the most common metastatic sites $(55.1\%)$ followed by pelvis $(44.9\%)$, ribs $(40.6\%)$, thoracic vertebrae 11 and 12 $(37.7\%)$, thoracic vertebrae between 5 and 8 $(36.2\%)$, thoracic vertebrae 9 and 10 $(34.8\%)$, and thoracic vertebrae between 1 and 4 $(26.1\%)$. In postoperative parasternal irradiation group, lumbar vertebrae and pelvis were also the most common sites of metastases ($55.0\%$, respectively) followed by ribs $(37.5\%)$, and thoracic vertebrae 11 and 12 $(32.5\%)$. But significant less metastases were seen at thoracic vertebrae from 1 to 10. Conclusion : We can find that the were significantly less bony metastases at thoracic vertebrae which had been previously irradiated postoperatively.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.15-21
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• 2003

Background : There are many risk factors for osteoporosis in patients with chronic obstructive pulmonary disease(COPD). These include smoking, a low body mass index, insufficient exercise, and the use of glucocortcoids. However, there is lack of data on the incidence of osteoporosis according to the different glucocorticoid administration methods in patients with COPD. This study compared the incidence of osteoporosis according to the different administration methods of glucocorticoid. Methods : A matched case-controlled study (gender, age, cumulative steroid dose and pack-years of smoking) was conducted. Forty-five patients with documented COPD for at least a 3 year duration and a cumulative glucocorticoid dose above 1,000 mg were enrolled in study. The patients were classified into the following three groups. First, fifteen patients received continuous inhaled glucocorticoid with intermittent oral steroids but had no admission history due to an acute exacerbation(Group I). Secondly, fifteen patients received a multiple course of oral steroids with additional inhaled glucocorticoid but had no admission history due to their acute exacerbation(Group II). Lastly, fifteen patients received intermittent oral or inhaled glucocorticoids and had an admission history due to the acute exacerbation with intravenous steroid treatment for at least 2 weeks per year(Group III). The enrolled patients had apulmonary function test and bone densitometry performed at the lumbar spine and femoral neck. Results : The patients from Group III had significantly high incidence of osteoporosis in the lumbar and femoral neck compared to Group I and Group II (p<0.01). Conclusion : The incidence of osteoporosis in patients with COPD appears to be strongly affected by the method of steroid administration. This result suggests that intravenous steroid administration is strongly associated with the risk of osteoporosis.

• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.310-317
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• 2012

Background: Airway obstruction and the extent of emphysema are reported to be responsible for reduced bone mineral density (BMD). Corresponding to different phenotypes of a pulmonary disease, different severity in extra pulmonary features may exist. We compared BMDs of subjects with or without airway obstruction and/or emphysema and investigated the relationships among BMD, the severity of airway obstruction, and the extent of emphysema. Methods: Using a university hospital database, we reviewed patients over 40 years old who performed spirometry, computed tomography of chest, and measurement of BMD of the lumbar (L) spine. According to the presence or absence of airway obstruction and/or emphysema, four groups were classified. Results: Among a total of 59 subjects, 33 (56%) had osteoporosis. The prevalence of osteoporosis in subjects with no airway obstruction and no emphysema, those with only emphysema, those with only airway obstruction, and those with both airway obstruction and emphysema were 42%, 57%, 64%, and 73%, respectively (p=0.047 by linear-by-linear association). The mean T-scores of BMD of L1 (p=0.032) and L1-4 spines were different among the four groups (p=0.034). Although the T-score of L1 BMD negatively correlated with the extent of emphysema (r=-0.275, p=0.035) and positively with each of body mass index (BMI) (r=0.520, p<0.001), forced expiratory volume in one second ($FEV_1$) (r=0.330, p=0.011), $FEV_1$/forced vital capacity (r=0.409, p=0.001), and forced expiratory flow at 25~75% of FVC ($FEF_{25-75%}$) (r=0.438, p=0.0001), respectively, multiple linear regression analysis indicated that BMI (p<0.001) and $FEF_{25-75%}$ were predictive of BMD (p=0.012). Conclusion: Low BMI and airway obstruction were strongly associated with reduced bone density rather than the extent of emphysema.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.43-50
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• 2004

Background : Steroid-induced osteoporosis(SIO) is one of the serious complications of long-term steroid therapy, especially in growing children. Recently bisphosphonates have been used to treat or prevent SIO in adult, which is rare in children with glomerular diseases. We studied the effect of pamidronate on SIO using dual energy X-ray absorptiometry and biochemical markers of bone turnover. Methods : Forty four children receiving moderate-to-high doses of steroids were enrolled. They had no history of bone, liver, or endocrine disease. Patients were stratified by their baseline bone mineral density(BMD) findings. All patients received corticosteroids for 3 month and oral calcium supplementation(500 mg/day) daily. Among them, 28 patients were treated with placebo and 16 were treated with pamidronate(125 mg) for 3 months. Blood chemistry and bone mineral density(BMD) were measured at baseline, and 3months. In addition, parathyroid hormone(PTH), serum osteocalcin, and urinary dipyridinoline levels were evaluated. Results : In overall population, the mean lumbar spine BMD decreased from $0.754{\pm}0.211(g/cm^2)$ to $0.728{\pm}0.208(g/cm^2)$ in the placebo group(P<0.05) and increased from $0.652{\pm}0.194(g/cm^2)$ to $0.658{\pm}0.226(g/cm^2)$ in the pamidronate group(P>0.05). Conclusion : Pamidronate appears to be effective in preventing SIO in children with glomerular diseases requiring long-term steroids therapy. Further careful observation and follow-up might be needed for children receiving bisphosphonates such as pamidronate.