• Radiation Oncology Journal
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• v.27 no.1
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• pp.15-22
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• 2009

Purpose: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. Materials and Methods: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. Results: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). Conclusion: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.

• Journal of the Korean Society of Food Science and Nutrition
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• v.32 no.4
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• pp.608-613
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• 2003

Recently, interests in the influences of vegetarian diet on bone mineral density after menopause have been rapidly increased. The purpose of this study was to compare the protein nutritional status and bone mineral density of postmenopausal vegetarian women with that of the omnivores. Vegetarian (n＝38, seven day adventists) were chosen from the subjects in previous study, and the subjects were matched with omnivores counterparts with respect to age and BMI. Anthropometric measurements, dietary intakes, and bone mineral density (BMD) were taken. The bone metabolism related marker including urinary deoxypyridinoline and urinary pH, and serum protein and albumin concentrations were evaluated. The average age of vegetarians and omnivores were 60.7 yrs and 60.5 yrs, respectively md, there was no significant difference. The mean daily energy intake of vegetarians and omnivores were 1518.5 ㎉ (82.7% of RDA) and 1355.5 ㎉ (72.6% of RDA), respectively. The mean calcium intake of vegetarians (492.6 mg, 70.3% of RDA) was not significantly different from that of omnivores (436.6 mg, 62.3% of RDA). There was no significant difference in BMDs of spine and femoral neck between vegetarians and omnivores. Urinary deoxypyridinoline (DPD) level was not significantly different. In the vegetarians, the intakes of total protein (p＜0.05) and plant protein (p＜0.05) had significant negative correlations with urinary DPD. In the omnivores, serum albumin showed significant positive correlations with urinary DPD (p＜0.05). In conclusion, we can not find the beneficial roles of vegetarian diet on bone mineral metabolism. For the postmenopausal vegetarian woman, protein intake would be an important factor to promote skeletal health.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.90-96
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• 1999

Background : Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. Method: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar. USA). Results: Mean bone mineral density(BMD) of spine in COPD group was $0.683{\pm}0.154 g/cm^2$ and $0.971{\pm}0.212g/cm^2$ in controls(p<0.01). But there was no significant difference in femoral neck BMD. There were seventeen cases of osteoporosis and six cases of osteopenia in COPD group and three patients of osteoporosis and one case of osteopenia in controls. But, there was no significant correlation between disease duration of COPD and spinal T score(r=-0.395, p>0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were $-3.82{\pm}0.94(SD)$ and $-2.82{\pm}0.97(SD)$ in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T score(r=-0.457. p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls($0.71{\pm}0.13 g/cm^2$ and $0.97{\pm}0.21 g/cm^2$, p<0.01). Conclusion : Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

• Journal of Acupuncture Research
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• v.29 no.2
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• pp.59-71
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• 2012

Objectives : The purpose of this study was to examine the effects of the Astragali radix Pharmacopuncture on improvement of senile osteoporosis (Type 2) in SAM P6. Methods : At 10 weeks after birth, Astragali radix Pharmacopunctures were given 100mL, 200mL/kg/day, i.p. 3times a week for 4 weeks at $CV_{12}$ in SAM P6 mice. We measured complete blood cells (CBC) such as RBC, HGB, Hct, PLT, MPB and MCHC. And we analyzed the plasma concentrations of blood urea nitrogen, creatinine, inorganic phosphate and total iron. In addition, we tested bone mineral density (BMD) using the soft X-ray. Results : The results were as follows. 1. At $CV_{12}$ in SAM P6, treatments of Astragali radix Pharmacopuncture were showed a trend of increase in bone mineral density (BMD) of the vertebrae lumbales, femurand tibia in P6 mice. 2. At $CV_{12}$ in SAM P6, treatment of Astragali radix Pharmacopuncture increased in RBC, HB, HCT and PLT, in comparison with control group. It was also found that the inorganic phosphate levels increased in the treatment on groups of the Astragali radix Pharmacopuncture from that of the control group, but blood urea nitrogen was no significant. Conclusions : These results are suggested that at $CV_{12}$ the Astragali radix Pharmacopuncture help on improvement of osteoporosis in SAMs.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.229-236
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• 2006

Purpose: This study was conducted to search for the type of technical error in DEXA(dual-energy X-ray absorptiometry) and the effect of error to measurement of BMD. Materials and Methods: The changes of BMD($g/cm^2$, T-score) by patients information(Age, Weight, Height, Manopause age) input error and Confirming ROI error were investigated. Using spine phantom, we canned 10 times by age(5, 10), weight(10, 20 kg), height(5, 10 cm), manopause age(5, 10) increase & decrease respectively. Scanning region(L-spine, femur, Forearm) of 10 patients was calculated by changing ROI respectively. Analysis of difference for mean(precision 1%) were carried out. Results: The error of patient information(Age, Weight, Height, Manopause age) was not changed differently. In confirming ROI, the BMD and T-score of L-spine involving T-12 was decreased to $0.063\;g/cm^2$, 0.3 and involving L-5 increased to $0.077\;g/cm^2$, 0.5. In narrowing 1 cm of vertical line of ROI, the BMD and T-score decreased to $0.006\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.15, each. In hip ROI, Upper and left shift(0.5 cm) of line was not influenced BMD and T-score. In 0.5 cm lower shift(lesser trochanter below), the BMD and T-score increased $0.031\;g/cm^2$, 0.3 and in 1 cm $0.094\;g/cm^2$, 0.65, each. In forearm ROI, the BMD and T-score decreased $0.042\;g/cm^2$, 0.9 involving 1 cm lower wrist. And expanding 1 cm of vertical line, the BMD and T-score decreased $0.008\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.3, each. The L-spine, hip, forearm ROI error was changed differently. Conclusion: There are so many kinds of technical error in BMD processing. Errors according to age, weight, height, manopause age did not influent to $BMD(g/cm^2)$ and T-score. There are mean differences BMD and T-score in confirming ROI. For the precision exam, in L-spine processing, L1-4 have to confirmed without shift of ROI vertical line. In hip processing, the ROI have to included greater trochanter, femur head and lesser trochanter. In forearm processing, the ROI have to included wrist, radius and ulnar.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.67-72
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• 2009

Purpose: ISCD (International Society for Clinical Densitometry) requests that users perform mandatory Precision test to raise their quality even though there is no recommendation about patient selection for the test. Thus, we investigated the effect on precision test by measuring reproducibility of 3 bone density groups (normal, osteopenia, osteoporosis). Materials and Methods: 4 users performed precision test with 420 patients (age: $57.8{\pm}9.02$) for BMD in Asan Medical Center (JAN-2008 ~ JUN-2008). In first group (A), 4 users selected 30 patient respectively regardless of bone density condition and measured 2 part (L-spine, femur) in twice. In second group (B), 4 users measured bone density of 10 patients respectively in the same manner of first group (A) users but dividing patient into 3 stages (normal, osteopenia, osteoporosis). In third group (C), 2 users measured 30 patients respectively in the same manner of first group (A) users considering bone density condition. We used GE Lunar Prodigy Advance (Encore. V11.4) and analyzed the result by comparing %CV to LSC using precision tool from ISCD. Check back was done using SPSS. Results: In group A, the %CV calculated by 4 users (a, b, c, d) were 1.16, 1.01, 1.19, 0.65 g/$cm^2$ in L-spine and 0.69, 0.58, 0.97, 0.47 g/$cm^2$ in femur. In group B, the %CV calculated by 4 users (a, b, c, d) were 1.01, 1.19, 0.83, 1.37 g/$cm^2$ in L-spine and 1.03, 0.54, 0.69, 0.58 g/$cm^2$ in femur. When comparing results (group A, B), we found no considerable differences. In group C, the user_1's %CV of normal, osteopenia and osteoporosis were 1.26, 0.94, 0.94 g/$cm^2$ in L-spine and 0.94, 0.79, 1.01 g/$cm^2$ in femur. And the user_2's %CV were 0.97, 0.83, 0.72 g/$cm^2$ L-spine and 0.65, 0.65, 1.05 g/$cm^2$ in femur. When analyzing the result, we figured out that the difference of reproducibility was almost not found but the differences of two users' several result values have effect on total reproducibility. Conclusions: Precision test is a important factor of bone density follow up. When Machine and user's reproducibility is getting better, it’s useful in clinics because of low range of deviation. Users have to check machine's reproducibility before the test and keep the same mind doing BMD test for patient. In precision test, the difference of measured value is usually found for ROI change caused by patient position. In case of osteoporosis patient, there is difficult to make initial ROI accurately more than normal and osteopenia patient due to lack of bone recognition even though ROI is made automatically by computer software. However, initial ROI is very important and users have to make coherent ROI because we use ROI Copy function in a follow up. In this study, we performed precision test considering bone density condition and found LSC value was stayed within 3%. There was no considerable difference. Thus, patient selection could be done regardless of bone density condition.

• Women's Health Nursing
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• v.15 no.4
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• pp.344-352
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• 2009

Purpose: The study was to identify influencing factors on fear of falling in postmenopausal women. Methods: With a correlational survey design, 125 postmenopausal women were recruited at the D metropolitan city by a convenience sampling. Fracture risk status was assessed by bone mineral densities (BMD) at lumbar and femur with DEXA method. A structured study questionnaire was used to measure demographic variables, osteoporosis self-efficacy, and fear of falling. Results: Mean age of the subjects was 59 years old and duration since menopause was 9.55 years. Twenty six percent of the subjects belonged to osteoporotic group in fracture risk status. Mean score for fear of falling was 16.10 (SD=5.18) indicating low level, and osteoporosis self-efficacy for exercise and diet was 44.76 (SD=7.41), indicating mid-range level. Factors influencing the fear of falling was longer time since menopause ($\beta=.30$), lower score of osteoporosis self-efficacy for exercise ($\beta=-.26$), poor health perception status ($\beta=-.16$), and presence of chronic disease ($\beta=.16$), and the explained variance was 20%. Conclusion: Although the level of fear of falling was yet low in postmenopausal women, women who had lower self-efficacy of osteoporosis for exercise and poorer health perception felt greater fear of falling. Therefore, an educational program specific to improve osteoporosis self-efficacy and reduce the fear of falling is needed for improving postmenopausal women's psychosocial well-being.

• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.338-350
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• 2022

Purpose: Various studies have investigated 3-dimensional (3D)-printed implants using Ti6Al-4V powder; however, multi-root 3D-printed implants have not been fully investigated. The purpose of this study was to explore the stability of multirooted 3D-printed implants with lattice and solid structures. The secondary outcomes were comparisons between the 2 types of 3D-printed implants in micro-computed tomographic and histological analyses. Methods: Lattice- and solid-type 3D-printed implants for the left and right mandibular third premolars in beagle dogs were fabricated. Four implants in each group were placed immediately following tooth extraction. Implant stability measurement and periapical X-rays were performed every 2 weeks for 12 weeks. Peri-implant bone volume/tissue volume (BV/TV) and bone mineral density (BMD) were measured by micro-computed tomography. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were measured in histomorphometric analyses. Results: All 4 lattice-type 3D-printed implants survived. Three solid-type 3D-printed implants were removed before the planned sacrifice date due to implant mobility. A slight, gradual increase in implant stability values from implant surgery to 4 weeks after surgery was observed in the lattice-type 3D-printed implants. The marginal bone change of the surviving solid-type 3D-printed implant was approximately 5 mm, whereas the value was approximately 2 mm in the lattice-type 3D-printed implants. BV/TV and BMD in the lattice type 3D-printed implants were similar to those in the surviving solid-type implant. However, BIC and BAFO were lower in the surviving solid-type 3D-printed implant than in the lattice-type 3D-printed implants. Conclusions: Within the limits of this preclinical study, 3D-printed implants of double-rooted teeth showed high primary stability. However, 3D-printed implants with interlocking structures such as lattices might provide high secondary stability and successful osseointegration.

• Korean Journal of Community Nutrition
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• v.6 no.5
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• pp.765-772
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• 2001

To delineate the relationship between the nutrient intake from diet and the serum biochemical markers of bone metabolism, 56 postmenopausal women of 50 to 77 years of age were recruited. The biochemical markers including osteocalcin, calcium, phosphorus, estradiol and free testosterone were measured in fasting blood. Bone mineral density(BMD) was measured also by dual energy X-ray absorptiometry, and the nutrient intake of earth individual subject was estimated by 24-hour recall of 3 days. The age of the subjects was 64.8 $\pm$ 7.7 years, and the BMDs of the subject were 0.86 $\pm$ 0.26g/$cm^2$(Lumbar spine), 0.60 $\pm$ 0.10g/$cm^2$ (Femoral neck), 0.49 $\pm$ 0.10g/$cm^2$(Trochanter), and 0.41 $\pm$ 0.14g/$cm^2$(Ward's triangle). There were no significant differences among age and nutrient intake level groups due to the small sample size. The biochemical markers showed certain degree of relationship with nutrient intake levels. The results were compared among 3 groups with different nutrient intake level classified by the percentage of Recommended Daily Allowances(RDA) for Koreans as follows low < 75% RDA, 75% RDA $\leq$ adequate < 125% RDA, high $\geq$ 125% RDA. The low energy and low riboflavin groups showed significantly higher serum osteocalcin levels than those of the high intake groups(p < 0.05). On the other hand, there was a trend for serum Ca level to be higher with high nutrient intake. In this case, protein and thiamin were the only nutrients that reached a statistical significance(p < 0.05). And the groups with low intake for protein and Ca showed significantly lower serum free testosterone levels than that of other intake groups(p < 0.05). This study suggests an important role of nutrient intake levels on blood biochemical markers of bone metabolism.

• Journal of Nutrition and Health
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• v.48 no.5
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• pp.381-389
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• 2015

Purpose: The objective of this study was to investigate the effects of a high fructose and fat diet on bone growth and maturation in growing female rats. Methods: Three-week-old female SD rats were randomly assigned to four experimental groups; the control group (CON: fed control diet based on AIN-93G, n = 8); the high-fructose diet group (HFrc: fed control diet with 30% fructose, n = 8); the high-fat diet group (Hfat: fed control diet with 45 kcal% fat, n = 8); and the high-fat diet plus high fructose group (HFrc + HFat: fed diets 45 kcal% fat with 30% fructose, n = 8). Each group was assigned their respective diets for the remaining eight weeks. Bone-related parameters (bone mineral density (BMD) and structural parameters, osteocalcin (OC), deoxypyridinoline (DPD)) and morphologic changes of kidney were analyzed at the end of the experiment. Results: Final body weights and weight gain were higher in the HFat and HFrc + HFat groups and showed higher tendency in the HFrc group compared with those of the CON group (p < 0.05); however, no significant difference in caloric intake was observed among the four experimental groups. The serum OC levels of the HFrc and HFrc + HFat groups were lower than those of the CON and HFat groups (p < 0.05). Urinary levels of DPD did not differ among the experimental groups. BV/TV and Tb.N of trabecular bone were higher in the HFrc + HFat group and showed a higher tendency in the HFrc group than those of the CON and HFat groups (p < 0.05). Tb.Pf of trabecular bone were lower in the HFrc + HFat group than those in the CON and HFat groups (p < 0.05). However, no difference in trabecular BMD was observed among the experimental groups. Cortical bone volume was higher in the HFat and HFrc + HFat groups than in the CON and HFrc groups (p < 0.05). No morphology change in kidney was observed among the experimental groups. Conclusion: Our study suggests that 8 weeks of high-fructose and high fat intake could improve the bone quality (Structural parameters) of trabecular and cortical bone of tibia in growing female rats.