• Journal of Nutrition and Health
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• 제52권5호
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• pp.449-464
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• 2019

Purpose: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). Methods: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. Results: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. Conclusion: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.

• The Korean Journal of Food And Nutrition
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• 제11권1호
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• pp.87-98
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• 1998

This study was conducted to investigate Osteoporosis on the effect of dietary factors and past young age period's dairy products consumption on BMD in 170 postmenopausal Korean women without diagnosed disease. Bone mineral density(BMD) of lumbar spine was investigated by dual energy X-ray absorptiometry. Dietary assesment of the subjects were measured by Cognitive Food Frequency Recall method. The measurements of group average were 57.9kg of body weight, 36.73 of BMI(Body Mass Index), 2103.3㎉ of energy, 638.7mg of dietary calcium, 70.3g of protein, and 10.58mg of iron. Nutrient intake levels were similar to or more than the level of Korean Recommended Dietary Allowances. Bone Mineral Density(BMD) of Lumbar spine(L2-L4) of group average was 0.912g/$\textrm{cm}^2$, and under 50 yr's 1,02g/$\textrm{cm}^2$, 50~54 yr's 0.92g/$\textrm{cm}^2$, 55~59 yr's 0.85g/$\textrm{cm}^2$, over 60 yr's 0.85g/$\textrm{cm}^2$, had been getting low degree on aging. BMD of the Lumbar spine was positively correlated with calorie, body weight, dietary calcium, protein, phosphorus and serum albumin. Past dairy products consumption experiment was highly significant on BMD in teenage period(R square = 26, p-value 0.0031). Particularly in over 60 yr group, the correlations between BMD and past dairy products consumption in teenage period had shown highly significance(r=0.48, p<0.02). 55~59 yr age group had also positive correlation(R squae = 0.29, p<0.05). This results confirm that the most effective way of preventing osteoporosis and the fractures is to maximize peak bone mass in early life and to minimize bone loss through the balanced intake of Ca and other nutrients and regular physical activity.

• Journal of radiological science and technology
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• 제32권3호
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• pp.271-276
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• 2009

The aim of this study was to evaluate the effect of Bone Mineral Density(BMD) at mandible. So, we studied how to measure the BMD at mandible using DEXA(Dual energy X-ray absorptiometry, DEXA) by Horner er al (1996) and knew reproducibility of the measurements. Thirty-five patients (13 men, 22 women, mean age : 25.4 years) were examined using the GE Lunar Prodigy Advance(LUNAR Corporation, madison, USA). They were examined in Semiprone position of their body and true lateral position of their mandible selected the Lumbar lateral mode. We used the custom mode in analysis when ROI (area $30{\times}2.5\;mm^2$). Three ROIs ($30{\times}2.5\;mm^2$, $50{\times}2.5\;mm^2$, $20{\times}2.5\;mm^2$) were located each at the two different sites of the mandible (angle of mandible and mental symphysis) and BMD was measured. Differences in BMD measurement was statistically compared according to the size and location of ROI. BMD was $1.320{\pm}0.358g/cm^3$ in men and was $1.152{\pm}0.340g/cm^3$ in women. BMD at the angle of mandible was $1.201{\pm}0.361g/cm^3$ in men and was $1.025{\pm}0.377g/cm^3$ in women. BMD of men at the mental symphysis was $1.434{\pm}0.341g/cm^3$ and that of women was $1.19{\pm}0.358g/cm^3$. With the ROI of $20{\times}2.5\;mm^2$, BMD was $1.262{\pm}0.384g/cm^3$ in men and was $1.113{\pm}0.357g/cm^3$ in women. With the ROI of $50{\times}2.5\;mm^2$, BMD of men was $1.320{\pm}0.358g/cm^3$ and that of women was $1.129{\pm}0.340g/cm^3$. There was a statistically significant difference of BMD according to the size and location of ROI. When measuring mandible BMD, there are good for increasing ROI and locate between ramus and mental symphysis. Especially following exam, refer to same size and location with fore exam. According to study which measure mandible BMD, It's correct to measure better a portion of mandible then whole of BMD. Using DEXA protocol is studied good for the additional study to compare the BMD at mandible. Later date, It will be good for measurement value in implant and bone graft quantitatively. Using DEXA method gain BMD threshold value in korean.

• Journal of the Korean Society of Radiology
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• 제15권1호
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• pp.63-70
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• 2021

Radiographic contrast agents are used for diagnostic purposes and are one of the factors affecting measured values in bone density tests. They are absorbed into tissues and have an effect of increasing the measured values of bone density, so they are avoided as much as possible before performing a bone density test. MRI contrast agents, which have different physical properties and mechanisms of action than radiographic contrast agents, are based on gadolinium, a metal element. They have radiopacity characteristics, so MRI are generally performed prior to examination using radiation. The purpose of this study was to investigate the effects of MRI contrast agents on bone mineral density examination using dual energy X-ray absorption. Two types of gadolinium based MRI contrast agents were injected into an acrylic water tank for each volume, and the humanoid spine phantom was inserted and the BMD and T-score from (L1-L4) were analyzed by scanning a total of 30 times, 5 times for each injection type. The average value of the measured total (L1-L4) bone density for each of the two contrast agents was 0.952±0.052, 0.957±0.050, and 0.956±0.05g/㎠, respectively, for the Gadoterate Meglumine component 0mL, 7.5mL and 15mL, when the gadobutrol components were 0mL, 5mL, and 10mL, there was no statistically significant difference at all sites at 0.953±0.001, 0.954±0.001, and 0.945±0.001g/㎠, respectively(p>0.05). The average value of total T-score was -0.46±0.05, -0.4±0, -0.42±0.04 when the Gadoterate Meglumine component was 0mL, 7.5mL and 15mL, respectively. When the Gadobutrol ingredients were 0mL, 5mL and 10mL, there was no statistically significant difference in all areas, with -0.46±0.05, -0.46±0.05, and 0.5±0.00, respectively. In this experiment, the MRI contrast agent was found to have no effect on bone density tests, using the dual-energy X-ray absorption method. There is a limitation in that physical conditions such as kidney and health conditions etc. were not taken into consideration, so further clinical research is expected to be conducted in the future.

• Journal of the Korean Society of Radiology
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• 제14권1호
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• pp.31-37
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• 2020

This study was conducted to examine the kinds and the frequency of incorrect outcomes occurring depending examiners' skills, in testing osteoporosis by using Dual Energy X-ray Absorptiometry(DXA) and improve frequently occurring errors by educating them. The results of an analysis show that the outcomes from the test of hips in patients with wrong postures or some regions with pressure fracture and degenerative changes were often included, even though they should be excluded, and that surgical instruments were also included in the analysis, though they should be excluded from resulting values. Of them, the errors most often found were those about patients' postures (n=56, 6 cases for spines and 50 cases for hips), followed by those about analytical processes (n=37, 35 cases for spines and 2 cases for hips), and then those about regions of interest (n=33, 28 cases for spines and 5 cases for hips). There were, however, no errors caused by the defectiveness of quality control.

• Journal of the Korean Orthopaedic Association
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• 제54권6호
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• pp.528-536
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• 2019

Purpose: This study examined the effects of a weekly teriparatide on the change in vertebral compression ratio, back pain, and vertebral fracture healing in osteoporosis patients with vertebral compression fractured induced by low energy trauma. Materials and Methods: From January 2016 to December 2017, 57 patients with severe osteoporotic vertebral fractures with a T score of -3.5 or less were included in this study. The changes in the vertebral compression ratio, visual analogue scale (VAS), Oswestry disability index (ODI) for at least 6 months were examined. The morphology of bone marrow edema and the presence of intervertebral cleft, osteocalcin, and N-terminal telopeptide (NTx) were also investigated. Results: The mean compression ratio was 20% in the experimental group (teripratide group) at 3 months, and 38% in the control group. A significant difference in the compression ratio of the vertebral body over time was observed (p<0.05; t-test). A comparison of the compression ratio of the vertebral body with the follow-up duration in each group showed no significant increase in the, compression (p=0.063) in the experimental group and a significant increase in the control group (p<0.05). The mean time to reach the plateau of the compression rate was one month in the experimental group and three months in the control group. The VAS score in the experimental and control group was 0.39 and 1.07 points, respectively. The ODI score in the experimental and control group was 33.72 and 39.52, respectively. At the last follow-up radiographs, there were no cases with an intervertebral cleft (0%) in the experimental group and 1 case (2.2%) in the control group. A significant difference in the osteocalcin level was observed between the injury and 6 months after the injury (p=0.003). In addition, there was no significant difference in the NTx level between the injury and 6 months after injury (p=0.960). Conclusion: In vertebral compression fractures patients with severe osteoporosis, a weekly teriparatide can promote the union of fractures, prevent further collapse of the vertebral body, and reduce the back pain faster.

• Journal of radiological science and technology
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• 제34권4호
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• pp.271-276
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• 2011

Statistical analysis was performed on the patients who took bone densitometry using Lunar and Hologic equipments for 5 months from January $1^{st}$ 2010 to May $30^{st}$, 2010. Patients consisted of 50 in their 40s, 100 in 50s and 50 in 60s. In addition, the results from bone densitometry were carried out on the same subject with two equipments on the same day. In case of 200 subjects, who received the bone densitometry with two equipments, the average age was 54.5 and 54.4 years old, respectively. There was no difference. The T- score of Lunar equipment was $-1.377{\pm}1.221$ and that of Hologic equipment was $-1.806{\pm}1.123$. The T-score of Lunar equipment was measured higher than that of Hologic equipment. T-test was conducted to determine the equality of the mean of two groups with 200 patients. Since the pvalue was 0.000, the value of bone mineral density was significant in two equipments. Furthermore, the patients, who were diagnosed by Lunar, showed more 'normal' and who were diagnosed by Hologic, showed more osteoporosis, which cartegorized by WHO, such as normal, osteopenia, and osteoporosis. Thus, compared results of bone densitometry on lumbar spine L1 - L4 of four normal people with the same equipment showed that T- score of Lunar equipment was $-0.4{\pm}1.2$, and T- score of Hologic equipment was $-1.1{\pm}1.5$. It showed the higher T- score was measured in Lunar equipment as well. Therefore, the correction factor should be considered to use, since T- scores are different between two equipments.

• The Korean Journal of Health Service Management
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• 제3권2호
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• pp.87-94
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• 2009

The purpose of this study is to evaluate the relationship between osteoporotic postmenopausal women and its bone mineral density value by using the single energy quantitative CT. 1. Decreasing BMD with age is evident. There is a significant low BMD value in the osteoporotic women compared with the healthy subgroup. 2. BMD decrease from T12 to L4, except in healthy premenopausal women. 3. Relationship of spinal BMD expressed as average BMD of T12 through L4 Show strong correlation with mean BMD in all vertebral levels. 4. There are significantly different BMD value from T12 through L4 in subgroup 1, 2, 3 but there is no statistically significant difference between subgroup 2 and 3. Conclusion, There is a significant decreasing BMD with age but it is difficult to differentiate postmenopausal relatively healthy women from osteoporotic women by BMD.

• Journal of the Korean Orthopaedic Association
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• 제55권4호
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• pp.318-323
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• 2020

Purpose: To examine the relationship between total fat infiltration (TFI) rate, which quantifies the reduction of muscles around the spine and is an important factor for sarcopenia, and the factors affecting osteoporotic vertebral compression fracture. Materials and Methods: Patients treated for osteoporotic compression fractures of the lumber spine from January 2012 to December 2016 were analyzed retrospectively. Among them, this study included ninety-eight patients who were 1) diagnosed with osteoporosis with a bone mineral density (BMD) T score of less than 2.5 g/cm², 2) received vertebroplasty or kyphoplasty for lumbar fractures, 3) involved one segment of the lumbar spine, and 4) were followed-up for more than one year. The TFI rate confirmed by analyzing magnetic resonance imagings with the Image J program was studied. Based on this, the relationship between the TFI of the multifidus and erector spinae muscles and the factors of osteoporosis were analyzed. Results: The mean TFI of the multifidus and erector spinae was 14.66±10.16. The spine BMD showed a positive correlation with the hip BMD, but a negative correlation with the TFI. A positive correlation was observed between the hip BMD and body mass index. In addition, vitamin D was positively correlated with both the hip and spine BMD but negatively correlated with the TFI rate. Conclusion: Muscle growth helps treat osteoporosis, and can prevent fractures that occur frequently in osteoporosis patients. Increasing the vitamin intake can also slow the progression of muscle atrophy.

• Journal of the Korean Orthopaedic Association
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• 제54권4호
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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.