• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.10
• /
• pp.4711-4716
• /
• 2012

This study was conducted to investigate the association between soy protein intake and bone mineral density (BMD) in women using data from 2008 and 2009 Korea National Health and Nutrition Examination Survey (KNHANES). The study sample comprised 686 Korean women who were within the first 12 years of postmenopause and had no history of hysterectomy. Adjusting for age, weight, height and calcium intake, statistical analysis was performed among women under 4 years postmenopausal and at least 4 years postmenopausal, respectively. Among women under 4 years postmenopausal, there was no significant association between soy protein intake and BMD at lumbar spine or proximal femur. On the other hand, in the later postmenopausal women, there was a reverse correlation between soy protein intake and BMD, especially at the femoral neck and the total hip. However, the correlation disappeared with additional adjustment for total protein intake, Na intake and energy intake. In conclusion, there may be no correlation between soy protein intake and bone density in Korean menopausal women.

• The Journal of the Korea Contents Association
• /
• v.12 no.10
• /
• pp.385-394
• /
• 2012

The aim of this study was to determine the effectiveness of diagnostic range for BMD measurement tools(DEXA, QUS, and RA) to health examination in transitional ages. In standard T-score -2.5 of DEXA, cutoff value by RA is -1.675(sensitivity: 70.0%, specificity: 63.7%) and cutoff value by QUS is -1.733(sensitivity: 70.4, specificity: 59.5%), also T-score -3.0 of DEXA, cutoff value by RA is -2.325(sensitivity: 70.0%, specificity: 42.9%) and cutoff value by QUS is -2.323(sensitivity: 70.4, specificity: 56.8%). There was, however, no significant difference in standard DEXA(lumbar spine and femur) between RA and QUS by repeat measurement(precision), and correlation were without effect. ROC analysis showed that all methods are qualified for BMD measurement tools to health examination in transitional ages; however, the different sensitivities and specificities of the methods, as well as age and gender, calibration parameters for diagnostic tests have to be considered.

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

• Physical Therapy Korea
• /
• v.11 no.4
• /
• pp.19-29
• /
• 2004

Many muscles of the trunk and hip are capable of contributing to the stabilization and protection of the lumbar spine. To have optimal effectiveness, a training program should include dynamic back/stomach/hip exercises. This study was designed to assess the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscle activities during various low back stabilization exercises. Participants were 26 healthy adults (13 males, 13 Females), aged 21 to 28 years. The surface electromyography (EMG) was recorded from the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken during 3 low back stabilization exercises. One-way analysis of variance with repeated measures was used to examine the difference, and a post hoc test was performed with least significant difference. A level of significance was set at p<.05. The significance of difference between men and women, and between the electromyographic recording sites was evaluated by an independent t-test. The EMG activity for the externus oblique and gluteus maximus muscles had significant differences among 3 exercises (p<.05). In males, the EMG activity for the external abdominal oblique muscle had significantly increased differences during exercises 1 and exercise 2 (p<.05). The gluteus maximus muscle had significantly increased differences during exercise 2 and exercise 3 (p<.05). In females, the multifidus muscle had significantly increased difference during exercise 3 (p<.05), the external abdominal oblique muscle had significantly increased difference during exercise 1 (p<.05). and the gluteus maximus muscle had significantly decreased difference during exercise 3 (p<.05). The results were that the external abdominal oblique muscle was apparently activated during the curl-up exercise in females and males, and the multifidus muscle was apparently activated during the bridging exercise in females and during the sling exercise in males and females.1)In comparison of the %MVC between males and females, exercise 2 and exercise 3 apparently activated of the multifidus and gluteus maximus muscles in both males and females (p<.05). The EMG activity of the gluteus maximus muscle of the males significantly increased during exercise 2 and exercise 3 (p<.05). The EMG activity the multifidus muscle of the females was significantly increased during exercise 2 and exercise 3 (p<.05). More research is needed to understand the nature of motor control problems in the deep muscles in patients with low back pain.

• Physical Therapy Korea
• /
• v.4 no.2
• /
• pp.18-35
• /
• 1997

The purpose of this study were to determine causes of low back pain in bus drivers who usually work in prolonged sitting position and to find the relationship of back pain with general characteristics and work environmental characteristics, stress symptoms, to com맹re lordosis angle of habitual driving posture and resting posture in low back pain group and non-low back pain group, and to use this result as a basis for improvement of work environment and comprehensive rehabilitative management of low back pain. Ninety-eight bus drivers were selected from the membership of an urban transit union in Seoul. These informations were collected from May 1, 1997 to May 25, 1997 by means of structured questionnaires and X-ray findings. These data were analyzed by $x^2$ test, t-test, logistic regression using SAS. The major results were as follows: 1. Of the respondents, 66.3% of bus drivers were found to be experiencing back pain. 2. Of the respondents of low back pain groups, 78.5% reported that major cause of low back pain was due to prolonged sitting. 3. The group with experiences of frequent or continuous vibration had more low back pain (p<0.05). There were no significant differences among other work environmental factors. 4. Average stress score was significantly higher in the group with low back pain than in the group without low back pain (p<0.05). 5. The results of the logistic regression analyses were statistically significant vibration from seat and stress score among the risk factors (p<0.05). 6. Averaged lordosis angle of habitual driving posture was $7.6{\pm}14.9$ degrees in low back pain group, $16.5{\pm}8.7$ degrees in non-low back pain and averaged lordosis angle of resting sitting posture was $10.8{\pm}13.7$ degrees in low back pain, $18.9{\pm}9.6$ degrees in non-low back pain group but the difference in mean lordosis angles of two groups was not statistically significant. The results of this study indicate that professional drivers developed chronicity of low back pain due to unfit seat, poor habitual posture and stress from vibration or other risk factors. Therefore, there is need to improve work environment, i.e. enough resting, to set a seat to support lumbar spine properly and to provide comprehensive rehabilitation program including early diagnosis, proper treatment and education for self help management.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.18 no.6
• /
• pp.1918-1926
• /
• 2004

Osteoporosis is defined as a progressive systemic skeletal disorder characterized by low bone mineral density, microarchitectual deteriorations of bone and susceptibility to fracture. numerous methods have been used for quantitative assessment of the skeleton in osteoporosis. QCT has been shown to measure changes in trabecular mineral content in the spine with great sensitivity and precision. To provide the normal reference values and changes of lumbar spinal bone mineral density in korean adult spinal bone mineral density was evaluated in 451 women (229 premenopausal and 222 postmenopausal women) and 206 men, aged 20 to 74 years old in Wonkwang hospital from 2000 to 2004, which was carried out by using QCT. women with oophorectomy, vertebral compression fracture, any history of endocrine disease and use of drugs that alter bone metabolism were excluded. According to the WHO definition, a patient is osteoporotic based on a bone mineral density(BMD) measurement that is 2.5 standard deviations (SDs) below typical peak bone mass of young healthy white women. This measurement of standard deviation from peak mass is called the T score. BMD values of normal women in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 168.95㎎/㏄ K₂PHO₄, 155.41㎎/㏄ K₂PHO₄, 166.87㎎/㏄ K₂PHO₄, 160.67㎎/㏄ K₂PHO₄, 154.06㎎/㏄ K₂PHO₄, 132.04㎎/㏄ K₂PHO₄, 114.05㎎/㏄ K₂PHO₄, 91.78㎎/㏄ K₂PHO₄, 78.61 ㎎/㏄ K₂PHO₄, 61.35㎎/㏄ K₂PHO₄, 50.53㎎/㏄ K₂PHO₄ Mean bone density of normal women was 115.77K₂PHO₄ K₂PHO₄. BMD values of normal men in their 20-24 years, 25-29 years, 30-34 years, 35-39 years, 40-44 years, 45-49 years, 50-54 years, 55-59 years, 60-64 years, 65-69 years, over 70 years were 171.46㎎/㏄ K₂PHO₄, 162.19㎎/㏄ K₂PHO₄, 155.62㎎/㏄ K₂PHO₄, 147.28㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 137.56㎎/㏄ K₂PHO₄, 101.25㎎/㏄ K₂PHO₄, 109.00㎎/㏄ K₂PHO₄, 103.32㎎/㏄ K₂PHO₄, 91.53㎎/㏄ K₂PHO₄, 88.35㎎/㏄ K₂PHO₄ Mean density of normal men was 115.77㎎/㏄ K₂PHO₄. Peak bone density of women and men was in the age group of 20-24 years and 168.95㎎/㏄ K₂PHO₄, 171.46㎎/㏄ K₂PHO₄, respectively. Bone loss was increased with aging and was accelerated in postmenopausal women than that of premenopausal women. The total loss of BMD for women and men was 70.09% and 48.47%, respectively. Postmenopausal women(mean BMD : 85.83㎎/㏄ K₂PHO₄) had significantly lower BMD than premenopausal women(meand BMD : 144.80㎎/㏄ K₂PHO₄)(p<0.001). The annual loss of BMD of women and men was 2.702㎎/㏄ K₂PHO₄ and 1.795㎎/㏄ K₂PHO₄, respectively. This study provided the BMD reference data for normal korean adult. further studies on BMD in healthy adult and comparison with published data are needed.

• Journal of Acupuncture Research
• /
• v.23 no.3
• /
• pp.207-214
• /
• 2006

Objectives : This study is designed in order to evaluate the therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) on acute low back pain Methods : We investigated 30 patients suffering from acute low back pain were admitted to Dunsan O.M.hospital from March. 1st 2005 to December. 30th 2005. We divided into two groups: one group was treated with Scalp acupunture, another group was treated with common acupuncture. 30 patients, were diagnosed only straightened curvature on lateral view of lumbar spine X -ray. Scalp acupunture related with Governer Vessel(Dok) and Bladder Meridian(Chok-taeyang) and Do-ma acupuncture. To estimate the efficacy of treatment that applied for two groups, we compared the visual analog scale(VAS), Oswestry disabiliby index(ODI) and Straight Leg Raising Test(SLRT) score of two groups statistically. Results : Both Scalp acupuncture related with Governer Vessel(Dok) and Bladder Meridian (Chok-taeyang) and Do-ma acupuncture therapy showed good effect on acute low back pain. It was proved by the difference between VAS, ODI and SLRT score checked before treatment and what checked after treatment on each groups. Conclusion: The therapeutic effect of Scalp Acupuncture and Do-ma Acupuncture on acute low back pain can be recommended as a useful therapy to treat acute low back pain.

• Journal of Nutrition and Health
• /
• v.35 no.7
• /
• pp.779-790
• /
• 2002

Nutritional factors affecting bone mineral density (BMD) in the different age groups of Korean women were investigated to obtain baseline data for maintaining bone health. Information on diet and anthropometry were collected in 80 elementary school children (height 127.2 cm, weight 27.3 kg), 84 high school students (height 161.6 cm, weight 52.4 kg), 100 adults aged 25 to 35 years (height 159.4 cm, weight 52.7 kg) and 120 elderly people over 60 years of age (height 150.9 cm, weight 55.6 kg). Data for nutrient intake were obtained by 24-hour recall method. BMDs of lumbar spine (L$_2$-L$_4$) and femoral neck were measured by dual energy x-ray absorptiometry. The relationship between BMD of femoral neck and nutritional factors were analyzed. The average BMD of femoral neck for females was 0.61 g/$\textrm{cm}^2$ in children, 0.88 g/$\textrm{cm}^2$ in adolescents, 0.90 g/$\textrm{cm}^2$ in adults, 0.64 g/$\textrm{cm}^2$ in elderly people. Among the adult subjects, 11.0% was classified as osteopenia in the femoral neck. For the elderly, the prevalence of osteopenia and osteoporosis were 34.2% and 47.5% of the subjects. It was shown the intake of energy, protein, plant protein, animal protein, fat, carbohydrate, Ca, P, Fe, vitamin A, thiamin, riboflavin, niacin, vitamin C, carbohydrate energy percent and fat energy percent influenced bone health status in all age groups. In the MAR on bone health status, children, adult and elderly subjects were significantly different among groups classified by bone health status and the MAR of the groups with good in bone health was higher. The RDA percent of each nutrient was influence factor on BMD. Nutrient intake of energy, protein, P, Fe, thiamin, niacin were lower BMD on below 75% of Korean RDA. Stepwise multiple regression analysis revealed that several dietary factors were influence on BMD. MAR on femoral neck BMD of children and elderly subjects was the highest influence factor. Beyond this, the most influential dietary factors on BMD were the vitamin A, total Ca and vegetable Ca. The above results have confirmed that dietary factors influence BMD in various age groups. Energy, protein, Ca, P, Fe, thiamin, riboflavin, niacin, vitamin C as well as MAR were important dietary factors influencing BMD. The results of this study revealed that people who received sufficient nutrients intake showed healthy bone status. The MAR mainly influenced the bone health status.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.2
• /
• pp.240-248
• /
• 2000

Objective : Spontaneous intracranial hypotension is a rarely reported syndrome of spontaneous postural headache associated with low CSF pressure and has rarely been demonstrated radiographically or surgically. But recently, it is being recognized with increasing frequency. The purpose of this study was to characterize clinical and imaging features, etiologic factors, and outcome in the spontaneous intracranial hypotension. Patients and Methods : We reviewed our experience with documented cases of spontaneous intracranial hypotension in 5 consecutive patients with orthostatic headaches from April 1998 to April 1999. Results : The mean age was 41 years(from 35 to 49 years). All patients had postural headaches, which were completely alleviated by recumbency position. Nausea, neck pain, horizontal diplopia, photophobia, and blurred vision were noted in some of the patients. Brain MRI showed diffuse pachymeningeal gadolinium enhancement, subdural collections of fluid, and descent of the brain. The opening pressure from lumbar puncture was $4cmH_2O$ or less in three of five patients whereas the opening pressure was within normal range in two patients. All patients underwent radioisotope cisternography and computerized tomographic myelography. On radioisotope cisternography, CSF leakage was suspected at the level of cervical area(1 patient), upper thoracic area(2 patients), mid-thoracic area(1 patient). Computed tomography myelography revealed extraarachnoid accumulation of contrast media(compatible finding with CSF leakage) at the level of cervical or thoracic area. In all patients, the symptoms resolved in response to supportive measures or epidural blood patch(1 patient). Conclusion : Spontaneous spinal CSF leakage is increasingly recognized as a cause of spinal postural headache. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine and can be demonstrated by variable diagnostic method. The condition is usually self-limiting and its prognosis is typically good.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.7
• /
• pp.935-939
• /
• 2000

Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.