• Journal of radiological science and technology
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• v.32 no.3
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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.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.3-9
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• 2011

Purpose: Generally dual energy X-ray absorptiometry has been used for the purpose of evaluation of osteoporosis and treatment. Recently the interest of obesity came to be high and body percent fat test is increasing. Existing measure of body fat have to scan the whole body can be evaluated, but only lumbar spine and hip measurements was assumed to be whole body fat as well as improving the software. It tries to check whether the part measured value not being whole body measurement has the validity or not compared with the value calculated with the method that it is different, it forgives through a correlation with a (BIA) and (BMI). Materials and Methods: In 2010, the body percent fat was measured among the examinee coming to the Asan Medical Center public health care center from March till August against 90 females more than 40 years old through (DXA) and BIA. BMI utilized the value which wrote an hight and weight measured through the body measuring instrument in the examinee information and is automatically calculated. In addition, it classified as the low weight ($13-18.5kg/m^2$), normal ($18.5-25kg/m^2$), and corpulence ($25-30kg/m^2$) based on BMI and so that it could check whether there was the difference according to the weight or not BMI and BIA and correlation between DXA were analyzed in each group. The statistical program for the analysis used SPSS 12.0. Results: The comparison of DXA at 3 which it divides into the low weight and normal and corpulence groups and BIA did not show the difference noted statistically in all groups and the between group comparison was exposed to do not have a meaning. The body percent fat measured by the correlation analysis result DXA at the state that it doesn't divide into the group showed the high correlation (r=0.908, p0.01) noted statistically compared with BMI and showed the high correlation noted statistically in a comparison with BIA (r=0.927, p0.01). Conclusion: It confirmed that the whole body percent fat presumed from the part bone density measurement showed the excel correlation compared with BIA and BMI and information is high. There is still no clear standard about the presumed whole body percent fat and it is difficult to evaluate the fat evaluation by the bone mineral density measurement. However, it is determined that the information offering which is more objective through the comparative study with the body percent fat which is very efficient and in that it can obtain till the information about a fat as well as diagnosis of the osteoporosis through the bone density checkup is measured by the afterward telegraph bone density checkup and is clinically useful is possible.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1314-1319
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• 2001

Objects : Because of the nonspecific nature of symptoms in tuberculous spondylitis, a delay in the diagnosis can result in progressive neurologic deficits. The authors evaluate the clinical and the radiological results of the 10 cases of surgically treated tuberculous spondylitis. Clinical materials & Methods : We retrospectively analyzed the medical records of 10 patients with tuberculous spondylitis who were treated between February 1996 and March 2000. Six patients were female, and four were male. Mean age was 43 years old, and mean follow-up period was 20.5 months. All patients were treated with 12 months of antituberculous medication postoperatively, and were followed by complete blood count, ESR, spine X-ray and MRI. Results : The lumbar spine was involved in 5 patients, the thoracic in 4, and the thoracolumbar in one. The infected vertebral bodies were 2.8 in average. The associated lesions were pulmonary tuberculosis in 3 cases, and renal tuberculosis in one. Five patients were treated by anterior debridement and fusion with bone graft using anterior instrumentation, 2 with anterior debridement and fusion with bone graft(Hong Kong procedure only), 1 with Hong Kong procedure with posterior spinal instrumentation, and 2 were managed with posterior debridement and posterior spinal instrumentation. All patients improved after operation, and the average kyphotic angle decreased postoperatively. Postoperatively, one patient had a fistula at the operative site. Conclusion : The debridement and minimal level fusion of motion segment with instrument fixation is one of surgical option for tuberculous spondyltis to preserve the spine motion segment as much as possible. Spine instability and kyphosis were prevented by anterior and posterior spinal instrumentation. But, large number of cases and longer period follow-up study in future will be needed to confirm the long term results.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.2
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• pp.37-42
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• 2008

Objectives : One of the most important cause of spondylolisthesis is it's epidemiological structure and L5's stability takes a significant role. The purpose of this study is to assess the difference of the Tuffier's line among of Spondylolythesis patients. Methods : We analyzed the Anterior view of lumbar spine checked at erect position on 60 patients who had been diagnosed as spondylolythesis. We investigated the Tuffier's Line on X-ray film. Results and Conclusions : Age distribution was 15 to 66 and the average was 47.81. Men were 19 cases(31.6%) and women were 41 cases(68.4%). Compared to men, women were more exposed to spondylolisthesis and for the age distribution, 50's showed the biggest portion. Group of normal people showed proportion of 14.3% at L4, 44% at L4/5 and 41.7% at L5 each. And group of patients showed proportion of 48.4% at L4, 35% at L4/5 and 51.6% at L5 each. Comparing these results, significance probability was 0.004(<0.05) which was significant. As the results of comparing the relation between L4/5 and L5/S1 patients, Normal group showed average of 3.33 which were close to L4/5. When there are spondylolisthesis at L4/5, averege was 3.33, placed at lower part of the vertebra body. When there are spondylolisthesis at L5/S1, averege was 3.566, placed between lower part of the veterbra body of L4 and L4/5. The p value of Normal group and L4/5 spondylolisthesis patient group was 0.022(p<0.05) which was significant. But the p value of Normal group and L5/S1 spondylolisthesis patient group was 0.0239 which was not significant. Also p value of L4/5 spcndylolisthesis patient group and L5/S1 spondylolisthesis patient group was 0.721 which was also not significant.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.311-316
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• 2017

Generally assessing bone mineral density (BMD) were performed on dual energy X-ray absorptiometry (DEXA) the same as dual energy CT (DECT) with a rapid-kVp switching. The purpose of this study is to compare the different of BMD value between DEXA and DECT method, and evaluate usefulness of DECT method. Using scanner for BMD measurements were GE, Healthcare Discovery 750 HD for DECT and Hologic QDR 4500W for DEXA. For compare BMD value in each method, scanned lumbar spine phantom and subjects visiting Korean National Cancer Center from April 2015 to December 2015, records of 50 patients. This study was approved by the Institutional Review Board. The mean BMD value measures for spine phantom and for subjects in each scanners presented strong correlation (r=0.948 with p<0.05 for phantom; r=0.635 with p<0.05 and Kendall's tau $({\tau})=0.46$ with p<0.05 for subjects) and linear relationship between DECT and conventional DEXA. DECT technique for BMD measurement will provide a very useful methodology without additional radiation dose.

• Journal of Acupuncture Research
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• v.23 no.3
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• pp.207-214
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• 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
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• v.35 no.7
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• pp.779-790
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• 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
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• v.63 no.5
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.58-65
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• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.763-771
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• 2000

Objectives : Thoracolumbar burst fractures(TBLF) result in not only compressive deformity of vertebral body but also spinal cord compression by bony fragments. Many thoracolumbar burst fractures demand both anterior decompression and intervertebral fusion. Most of spinal surgeons use anterior instrumentation for anteior intervertebral bony fusion. The use of Z-plate has been increased recently, however there has been only a few reports regarding its clinical long-term strength. We studied nineteen patients with TBLF to find out the long-term stability of Z-plate. Methods : We have operated 19 patients from March 1996 to August 1998. They were treated with anterior decompression through either a transthoracic, retroperitoneal extrapleural or retroperitoneal approach. Retropulsed bony fragments were removed completely by corpectomy. Iliac bone graft was used for interbody fusion in all of the cases. They were evaluated by plain X-ray films including flexion and extention lateral films. Cobbs angle was used to evaluate kyphotic and lateral wedging deformity. Results : Burst fractured sites were T11 in two, three T12, nine L1, and five L2. Mean follow-up duration was fifteen months. Preoperative average kyphotic angle was 23.7 degree. Immediate postoperative kyphotic angle was 10.2 degree. Follow-up resluts of average kyphotic angles revealed 14 degrees. Four patients(21%), including two spinal 3-column injury, showed increasement of kyphotic angle more than 5 degree or breakage of intrumentation. Two patients showed the difference of kyphotic angle more than 3 degree. Five patients(26%) revealed lateral wedging deformity more than 3 degrees. Postoperative complications were two meralgia parestheticas, one pulmonary atelectasis and two donor site infections. Four of the eight patients, who initially showed incomplete spinal cord deficits, were nerologically improved by Frankel's grade. Conclusion : Z-plate fixation and iliac bone graft after anterior decompression in thoracolumbar burst fractures is a safe and easy method. Immediate postoperative results revealed excellent correction of posttraumatic kyphosis, but long-term follow-up evalution showed insufficient strength. Therefore we believe that use of Z-plate should be carefully decided, especially in the case of large lumbar fracture or 3-column injury.