• Title/Summary/Keyword: Femur fracture

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Rutin Improves Bone Histomorphometric Values by Reduction of Osteoclastic Activity in Osteoporosis Mouse Model Induced by Bilateral Ovariectomy

  • Lee, Hye-Hwa;Jang, Jae-Won;Lee, Jung-Kil;Park, Choon-Keun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.433-443
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    • 2020
  • Objective : Osteoporosis is a disease of unbalanced bone metabolism that results in low bone mineral density with increased bone fragility and propensity for fractures. The increased rate of bone fracture due to osteoporosis places a significant burden on public health care expenditures. Therefore, numerous studies have been designed and performed to identify the drugs or health foods that can improve the bone quality or quantity. This study was designed to evaluate and analyze the therapeutic effects of rutin on histomorphometric values of the spine and femur in an osteoporotic mouse model induced by bilateral ovariectomy. Methods : Thirty female ICR mice (8 weeks old) underwent either a sham operation (only abdominal incision, sham group, n=10) or bilateral ovariectomy (n=20). The ovariectomized (OVX) animals were randomly divided into two groups : untreated OVX group (OVX-C, n=10), or rutin-administered group (OVX-R, n=10). The OVX-C group received weight-adjusted doses of saline vehicle and the OVX-R group received 50 mg/kg of rutin intraperitoneally, starting 1 day after surgery. At 4 and 8 weeks after surgery, serum estrogen, osteocalcin, alkaline phosphatase (ALP), and the telopeptide fragment of type I collagen C-terminus (CTX-1) were analyzed. Interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α were also analyzed. Bone histomorphometric parameters of the 4th lumbar vertebra and femur were determined by micro-computed tomography. Results : In OVX-C group, ALP, osteocalcin, CTX-1, IL-1β, IL-6, and TNF-α levels were significantly increased at 4 and 8 weeks compared to sham operation group. Rutin administration after OVX statistically significantly reduced ALP, CTX-1, IL-1β, IL-6, and TNF-α levels at 4 and 8 weeks. Rutin administration also improves bone histomorphometric parameters including trabecular bone volume fraction, trabecular thickness, and trabecular number. Trabecular separation was also decreased in OVX-R group compared to OVX-C group. Conclusion : The present study demonstrated that rutin has therapeutic effects on improving bone histomorphometric values in an OVX mouse model. The improvement in histomorphometric values may be associated with the reduction of osteoclastic activity via inhibition of IL-1β, IL-6, and TNF-α. In future studies, the mechanism for the effect of rutin on osteoporosis should be demonstrated more clearly to use rutin in human osteoporosis.

Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate (잠김 금속판을 이용한 하지의 전이성 병적 골절에 대한 치료)

  • Seo, Chang-Young;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.80-86
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    • 2010
  • Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

Genome-Wide Association Study of Bone Mineral Density in Korean Men

  • Bae, Ye Seul;Im, Sun-Wha;Kang, Mi So;Kim, Jin Hee;Lee, Soon Hang;Cho, Be Long;Park, Jin Ho;Nam, You-Seon;Son, Ho-Young;Yang, San Deok;Sung, Joohon;Oh, Kwang Ho;Yun, Jae Moon;Kim, Jong Il
    • Genomics & Informatics
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    • v.14 no.2
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    • pp.62-68
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    • 2016
  • Osteoporosis is a medical condition of global concern, with increasing incidence in both sexes. Bone mineral density (BMD), a highly heritable trait, has been proven a useful diagnostic factor in predicting fracture. Because medical information is lacking about male osteoporotic genetics, we conducted a genome-wide association study of BMD in Korean men. With 1,176 participants, we analyzed 4,414,664 single nucleotide polymorphisms (SNPs) after genomic imputation, and identified five SNPs and three loci correlated with bone density and strength. Multivariate linear regression models were applied to adjust for age and body mass index interference. Rs17124500 ($p=6.42{\times}10^{-7}$), rs34594869 ($p=6.53{\times}10^{-7}$) and rs17124504 ($p=6.53{\times}10^{-7}$) in 14q31.3 and rs140155614 ($p=8.64{\times}10^{-7}$) in 15q25.1 were significantly associated with lumbar spine BMD (LS-BMD), while rs111822233 ($p=6.35{\times}10^{-7}$) was linked with the femur total BMD (FT-BMD). Additionally, we analyzed the relationship between BMD and five genes previously identified in Korean men. Rs61382873 (p = 0.0009) in LRP5, rs9567003 (p = 0.0033) in TNFSF11 and rs9935828 (p = 0.0248) in FOXL1 were observed for LS-BMD. Furthermore, rs33997547 (p = 0.0057) in ZBTB and rs1664496 (p = 0.0012) in MEF2C were found to influence FT-BMD and rs61769193 (p = 0.0114) in ZBTB to influence femur neck BMD. We identified five SNPs and three genomic regions, associated with BMD. The significance of our results lies in the discovery of new loci, while also affirming a previously significant locus, as potential osteoporotic factors in the Korean male population.

Bone Segmentation Method based on Multi-Resolution using Iterative Segmentation and Registration in 3D Magnetic Resonance Image (3차원 무릎 자기공명영상 내에서 영역화와 정합 기법을 반복적으로 이용한 다중 해상도 기반의 뼈 영역화 기법)

  • Park, Sang-Hyun;Lee, Soo-Chan;Yun, Il-Dong;Lee, Sang-Uk
    • Journal of Broadcast Engineering
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    • v.17 no.1
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    • pp.73-80
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    • 2012
  • Recently, medical equipments are developed and used for diagnosis or studies. In addition, demand of techniques which automatically deal with three dimensional medical images obtained from the medical equipments is growing. One of the techniques is automatic bone segmentation which is expected to enhance the diagnosis efficiency of osteoporosis, fracture, and other bone diseases. Although various researches have been proposed to solve it, they are unable to be used in practice since a size of the medical data is large and there are many low contrast boundaries with other tissues. In this paper, we present a fast and accurate automatic framework for bone segmentation based on multi-resolutions. On a low resolution step, a position of the bone is roughly detected using constrained branch and mincut which find the optimal template from the training set. Then, the segmentation and the registration are iteratively conducted on the multiple resolutions. To evaluate the performance of the proposed method, we make an experiment with femur and tibia from 50 test knee magnetic resonance images using 100 training set. The proposed method outperformed the constrained branch and mincut in aspect of segmentation accuracy and implementation time.

Dependences of Ultrasonic Parameters for Osteoporosis Diagnosis on Bone Mineral Density (골다공증 진단을 위한 초음파 변수의 골밀도에 대한 의존성)

  • Hwang, Kyo Seung;Kim, Yoon Mi;Park, Jong Chan;Choi, Min Joo;Lee, Kang Il
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.502-508
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    • 2012
  • Quantitative ultrasound technologies for osteoporosis diagnosis measure ultrasonic parameters such as speed of sound(SOS) and normalized broadband ultrasound attenuation(nBUA) in the calcaneus (heel bone). In the present study, the dependences of SOS and nBUA on bone mineral density in the proximal femur with high risk of fracture were investigated by using 20 trabecular bone samples extracted from bovine femurs. SOS and nBUA in the femoral trabecular bone samples were measured by using a transverse transmission method with one matched pair of ultrasonic transducers with a center frequency of 1.0 MHz. SOS and nBUA measured in the 20 trabecular bone samples exhibited high Pearson's correlation coefficients (r) of r = 0.83 and 0.72 with apparent bone density, respectively. The multiple regression analysis with SOS and nBUA as independent variables and apparent bone density as a dependent variable showed that the correlation coefficient r = 0.85 of the multiple linear regression model was higher than those of the simple linear regression model with either parameter SOS or nBUA as an independent variable. These high linear correlations between the ultrasonic parameters and the bone density suggest that the ultrasonic parameters measured in the femur can be useful for predicting the femoral bone mineral density.

Effects of Cuscutae Semen Extract on Prevention of Osteoporosis in Ovariectomized Rats (토사자(兎絲子)가 난소적출(卵巢摘出)로 유도(誘導)된 흰쥐의 골다공증(骨多孔症)에 미치는 영향(影響))

  • Kim, Jong-Hyun;Kim, Ho-Seok;Jun, Jae-Yun;Jeong, Da-Won;Cho, Chang-Young;Sohn, Young-Joo;Jung, Hyuk-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.25 no.4
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    • pp.1-11
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    • 2012
  • Objectives: Osteoporosis, which occurs after menopause, is a kind of metabolic bone disorder. It develops when the bone mass begins to decrease radically, and its main symptoms are bone fracture and height-shortening. This thesis aims at what effects the Cuscutae Semen Extract(CSE) has on the prevention of osteoporosis in SD-rat that is caused by ovariectomy. Methods: The 24 female white rats, after removing their ovaries, were divided into the Normals, the Control group, and the CSE administrated group. For the next 8 weeks, distilled water to the normals and the control, and the CSE(45.9 mg/100 g) to the CSE administrated group were given in the mouths of them. After 8 weeks the rats were sacrificed. Weight, albumin, aspartate aminotransferase, alanine aminotransferase, total-cholesterol, triglyceride, phosphorus, calcium, tetraiodothyronine, estradiol, the weight of the femur, the amount of tibia ash, the area of trabecular bone, and the thickness of trabecular bone were measured. Results: The serum analysis shows that the calcium and phosphorous of the CSE administrated group significantly increased compared to that of the control group. Aspartate aminotransferase, alkalinephosphatase, total cholesterol, tetraiodothyronine of CSE group were decreased, but not so significant. Albumin, alanine aminotransferase, triglyceride and estradiol of the group showed the tendency to increase, but the significance wasn't admitted. Regarding the variation of bone, the femur weight and the ash content of tibia, CSE group was more increased than the control group but the significance wasn't admitted. The histological observation shows that the trabecular thickness was more increased than the control group, and trabecular area increased significantly compared to those of the control group. The number of osteoclast and osteoblast area of the CSE groups decreased significantly compared to those of the control group. Conclusions: From the result of the above study, CSE should be effective for the osteoporosis cure and precaution and deeper study through bedside and clinical demonstration is much needed from now on.

Multidetector Computed Tomography in Patients with Femoral Neck Fracture for Assessing Osteoporosis: Comparison with Dual Energy X-Ray Absorptiometry (대퇴골 경부 골절 환자에서 골다공증 평가를 위한 다중검출 CT의 이용: 이중에너지 X-선 흡수계측법과의 비교)

  • Hyo Jeong Lee;Ji Young Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.173-181
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    • 2021
  • Purpose To evaluate the ability of the Hounsfield unit (HU) measurement of the femoral neck during multidetector computed tomography (MDCT) for assessing osteoporosis compared with dual-energy X-ray absorptiometry (DXA). Materials and Methods Forty-two patients with femoral neck fractures who underwent MDCT and DXA from July to December 2016 were included in this study. HU measurements were made of the cancellous portions of the normal contralateral femoral neck on MDCT. Bone mineral density (BMD) and T-scores were obtained at the femur DXA. Correlations of HU values with BMD and T-scores were analyzed using Spearman's correlation test. Results The mean BMD and T-score of the femoral neck were 0.650 g/cm2 and -2.4, respectively. The mean HU values for the normal, osteopenia, and osteoporosis groups were 131.9, 98.9, and 41.3, respectively. HU values at the femoral neck were positively correlated with BMD (r2 = 0.670; p < 0.001) and T-scores (r2 = 0.676; p < 0.001). Conclusion The HU values of the femoral neck on MDCT are significantly correlated with BMD and T-scores of femur DXA. The HU values may serve as a diagnostic tool for the screening of regional bone quality when MDCT is performed for other reasons.

Treatment of Large Bone Defect with Vascularized Bone Graft (혈관 부착 생골 이식술을 이용한 대량 골결손의 치료)

  • Chung, Moon-Sang;Baek, Goo-Hyun;Kim, Tae-Gyun;Won, Choong-Hee;Koh, Young-Do
    • Archives of Reconstructive Microsurgery
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    • v.2 no.1
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    • pp.20-28
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    • 1993
  • From 1981 to 1991, twenty one vascularized bone grafts had been performed for the treatment of large bone defects of the extremities, with average follow-up of 65.4 months. Fibulae were used in 15 patients Including two cases of osteocutaneous flap, iliums in 5 including two of osteocutaneous flap, and osteocutneous rib in one. Ten of these patients were treated for segmental defects derived from trauma or infection sequelae of long bones, while eight for locally aggressive benign or malignant bone tumors ; and three for congenital pseudarthrosis of tibia. The location of the lesions were 8 cases in tibia; 7 in humerus ; 3 in forearm bone ; 2 in foot ; and 1 in femur. The length of bone defects were averaged as 10 cm, ranging from 3 to 17.5. In eighteen patients(85.7%), the operation was successful. The duration from operation to bony union was average 5.1 months on successful cases, and three of them needed additional procedures, such as bone graft and electrical stimulation to promote bony union. Local recurrence was found in one case of chondrosarcoma, resulting in AK amputation. Wound infections were noted each one case on donor or recipient site. In five cases, the fracture of grafted bone, which united with cast immobilization in four, occurred average 16.7 months after operation.

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A CASE REPORT OF PAPILLARY THYROID CARCINOMA METASTASIZED TO MANDIBULAR CONDYLE (하악골과두부에 전이된 유두상 갑상선암의 치험례)

  • Kim, J.K.;Lee, B.I.;Kim, H.J.;Suh, C.H.;Cha, I.H.;Lee, E.W.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.442-446
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    • 1995
  • Thyroid carcinomas are usually classified as papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma. Among the thyroid carcinomas, the incidence of medullary and anaplastic thyroid carcinoma is low, but the rate of lymph node & distant metastasis from them are more common compared to other types. Follicular thyroid carcinoma has a low rate of lymph node metastasis as 10% and has a high occurrence of hematogenous metastasis to lung, bone, brain and liver. Papillary thyroid carcinoma accounts for $60{\sim}70%$ of whole thyroid carcinomas and the cervical lymph node metastasis is $21{\sim}81%$ including micrometastasis, but the distant metastasis is rare. In the case of bone metastasis, follicular type reveals most frequent, and the rate is about 5%, and more likely to be found on vertebra, pelvis, ribs, femur, and skull. The clinical symptoms of bone metastasis are pain, swelling, pathological fracture and radiologically osteolytic lesions can be observed. But distant metastasis of papillary thyroid carcinoma is very rare and especially, bone metastasis has hardly been reported. The treatment modalities of metastatic thyroid carcinoma to mandible are known as follows : thyroidectomy to treat primary site, resection of the affected site of mandible, external beam radiotherapy and radioiodine therapy etc.

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An Epidemiological Study on Traffic Accidents (교통사고(交通事故)에 대(對)한 역학적(疫學的) 고찰(考察))

  • Park, Dong-Chul;Lew, Dong-Joon
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.75-83
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    • 1984
  • A retrospective study has been made of 170,026 cases of motor vehicle accidents which had been reported to the National Police Headquarters of Republic of Korea, 1983. Also a study has been made of 264 cases of road traffic casualties who were treated at the Eul-ji General Hospital from Jan. 1, 1983 to Dec. 31, 1983. This study was conducted to find out the nature and pattern of the traffic accidents from the clinical and epidemiological view points. In additions, the modes of injury from the road accidents were persued which might help to reduce the traffic accident rate. The results of the study were summarized as follows; 1. In this study, the highest incidence was in the age group between $21{\sim}30$ years (21.29%). And the age group of highest death rate was under 10 years (7.28%). 2. In the comparison of sexual differences, male was dominated in accidents number and death rate. (Casualty rate; 61.66%). 3. In the comparison of each hour differences, the accident was mostly occured during afternoon from 16:00 to 18:00(12.23%). 4. The most common day of week was Sunday (14.74%). 5. The most common season of year was Autumn (27.92%). 6. In the comparison of occupational differences, the high incidences were showed in labor men (31.06%) and business men (12.12%). 7. In the comparison of accidental vehicles, the most common vehicle were cars and the next were trucks and buses. 8. The most common mechanism of accidents was collision (57.41%). 9. In the comparison of clinical differences, orthopaedic and neurosurgical injuries were most common types of the hospitalized casualties. 10. In the comparison of anatomical fracture sites, the most common site was tibia (15.81%) and the next site was femur (12.56%).

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