• 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.

• Journal of Nutrition and Health
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• v.39 no.5
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• pp.451-459
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• 2006

The purpose of our study was to evaluate an association between milk consumption and bone mineral density (BMD) of female college students in Korea. The dietary data of 1,410 Korean college students living in the vicinity of Seoul area were collected through the Food Frequency Questionnaire. The mean age, height, weight and 8MI of the subjects were 20.4 years, 162.1 cm, 52.7 kg, and $20.0\;kg/m^2$ respectively. The mean intakes of energy, protein, and phosphorus were 2,398.7 kcal, 95.2 g, and 1,302.9 mg respectively, which were above their EER or Recommended Intake (RI), but the mean intake of calcium was 657.8 mg which was below its RI, and 44.0% of the subjects did not meet Estimated Average Requirement (EAR) of calcium. The daily milk consumption was 131.1 g, and the total consumption of milk and dairy product was 228.7 g. Forty five percent of the subjects consumed $50{\sim}200\;g$ of milk or dairy products. After the analysis of their dietary intakes, the subjects were divided into quintiles of total consumption of milk and dairy product, which were considered as major source of dietary calcium. Ninety two subjects from the upper quintile (UQ) and 85 subjects from the lower quintile (LQ) were selected and their bone mineral densities (BMD) of lumbar spine (L1-L4) and the femur were examined by the dual energy X-ray absorptiometry. The BMD $(g/cm^2)$of L1, L2, L3, and average of femur were 1.065, 1.150, 1.187, and 0.988 for the UQ subjects, which were significantly higher than those of the LQ subjects, 1.010, 1.090, 1.146, and 0.942 respectively. Moreover, the T-scores of the UQ were significantly higher than those of the LQ. The prevalence rates of osteopenia classified according to WHO's criterion were 12.0% in the UQ. and 20.0% in the LQ group which showed non significant. Blood levels of calcium, and phosphorus of UQ and LQ group were both within the normal range, and were not significantly different. Our results showed that UQ group presented the better status of bone mineral density and bone health. Therfore our results suggest that continuous consumption of more than one and a half cups of milk per day, which corresponds to the least amount of UQ group's consumption, would affect positively on the bone health of Korean adults.

• Journal of radiological science and technology
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• v.39 no.3
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• pp.429-434
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• 2016

This study was performed in order to identify the relation between bone nineral density and life styles of some of Korean colleage students. A total of 121 college students were assessed through bone mineral density test on femoral neck and lumbar spine using dual energy X-ray absorptiometry(DEXA). The survey about their lifestyles with a self-rating questionnaire, was conducted from September 2014 to November 2014. SPSS 18.0 Program was used for those research data analyses such as the frequency analysis, the cross analysis. The percentage of the osteoporisis, osteopenia and normal groups were 0.0%, 24.8% and 75.2%. BMI, Regular menstrual cycle, Walking and Regular exercise in adolescence were positively related with T-score. But Using time of electronic devices was negative related with T-score. It can be concluded that desirable life style in time of college students and adolescence is important for their bone health. The necessity of preparing guideline for preventing bone disease in old age connected with the school curriculum should be recognized to the public and educational authorities.

• Journal of Community Nutrition
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• v.1 no.2
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• pp.98-107
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• 1999

The purpose of this study was to investigate Bone Mineral Density(BMD) and affecting factors on BMD of college women in Seoul. The subjects were 47 healthy college women aged 18-25 years. Antrophometric and body fat measurements were performed by Bioelectrical Impedance Fatness Analyzer(Tanita TVF 202). Blood pressure and pulse frequency were measured. Dietary intakes and general living habits were examined through questionnaires and nutrient intakes were analyzed by Computer Aided Nutritional Analysis(CAN) program for professional. Serum total cholesterol, TG(triglyceride), HDL-cholesterol, total protein, albumin, GOT, calcium were measured by Spotchem(SP-4410). Serum osteocalcin and alkaline phosphatase(ALP) were measured to monitor bone formation. BMD of lumbar spine(L2-L4), right hip(neck, ward's triangle, trochanter) and right forearm were measured by Dual Energy X-ray Absorptiometry(DEXA). Muscle strength was measured by examining leg flexion strength(right and left), leg extension power(right and left), handgrip power(right and left) and back strength. All data were statistically analyzed by the SAS PC package program. BMD of college women was normal(by WHO, 1994). Their muscle strength was bad(by national fitness guidebook, 1995). Only a mall number of them exercised (32.6% of subjects). There was no significant difference among BMD, muscle strength and % body fat(p<0.05). There were significant differences between BMD and total cholesterol as well as TG and VLDL-cholesterol(p<0.05). Total cholesterol was associated with decreasing BMD of the right forearm(p<0.05). TG and VLDL-cholesterol are associated with increasing BMD of right hip ward's triangle(p<0.05). There were significant differences among BMD, ALP and serum total protein. ALP was associated with decreasing BMD of the right forearm(p<0.05). There were significant differences between BMD and Ca as well as between Na and K intakes (p<0.05). Intakes of Na and K were associated with decreasing BMD of the right forearm (UD)(p<0.05). There were significant differences between in BMD and pulse frequently and serum albumin (p<0.05). Serum albumin is associated with increasing BMD of L3-L4(p<0.05), right hip neck(p<0.05). %Body fat, TG, VLDL-C, Ca intake, pulse frequency and serum albumin were associated with increasing BMD(p<0.05). Intakes of Na and K, ALP, total cholesterol, total cholesterol, total protein and height are associated with decreasing BMD(p<0.05). Overall results indicate that Ca intake but to be moderate in protein and Na intakes in order to increase BMD. Body exercise was recommended to increase BMD as well.

• Journal of the Korean Society of Radiology
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• v.14 no.7
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• pp.899-906
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• 2020

The WSS lateral examination is important for diagnosing spinal disorders. Recently, long-length detectors for large-area diagnose have been popularized to effectively reduce the exposure dose and examination time. It can be applied very efficiently to examinations of patients with high risk of falls, children, and adolescents. However, since the image is acquired through a single irradiation, the volume of cervical vertebra is relatively smaller than the lumbar due to the geometrical anatomy of the spine. Therefore, this study intends to fabricate an additional filter using 3D printing technology and copper filament to obtain uniform image quality in the WSS lateral examination and to analyze the results. 3D printing technology is able to easily print a desired shape, so it is widely used in the entire industrial field, and recently, a copper filament has been developed to confirm the possibility as an additional filter. In the WSS lateral examination, CNR and SNR were excellently measured when the additional filter was applied, confirming the possibility of using the additional filter.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.96-106
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• 2022

Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

• Journal of radiological science and technology
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• v.37 no.4
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• pp.279-286
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• 2014

The purpose of this study is to provide basic data of comparing BMD(bone mineral density) value of preoperative breast cancer patient and postoperative breast cancer patient due to bone loss with radiation/chemical therapy. The participants consisted of 254 breast cancer patients with BMD after having surgery and treatment from March 2007 to September 2013. Except for 84 patients with menopause or hysterectomy and we have analysed 171 patients. The BMD value(lumbar spine and femur) of before and after treatment from PACS by dure-energy X-ray absorptiometry was analyzed. First, we found variation of entire BMD and BMD according to treatment type, and analyzed detailed correlation by using marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types as variable. Data was analyzed by using SPSS for Windows Program(version 18.0). BMD was decreased 7.1% in lumbar spine, 3.1% in femur respectively(p<.01). Also there is relatively high decrement($0.067g/cm^2$) in group who had just chemotherapy in femur(p<.05). There is decrement depend on marital status, number of children, presence of feeding, age of menarche, breast cancer therapy types but there was no statistical significance. The results show that BMD was decreased after treatment in premenopausal breast cancer patient, patient who had relatively high decrement need to be included high-risk group. As a result, aggressive prevention policy would be necessary.

• Journal of Nutrition and Health
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• v.40 no.8
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• pp.719-727
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• 2007

To elucidate the relationship among the levels of nutrients intake, bone mineral density(BMD) and the urinary biochemical markers of bone metabolism, this survey is conducted with 225 postmenopausal women over 50 years of age. The urinary biochemical markers including deoxypyridinoline(DPD) and Ca excretion were measured. Bone mineral densities of lumbar spine(L2-L4), femoral neck, ward's triangle and trochanter were measured with dual-energy X-ray absorptiometry and the nutrient intake data obtained by 24 hr recall method. Mean age of all subjects was 64.8 years old, and the BMDs of the subjects were $0.86g/cm^2$(lumbar spine), $0.60g/cm^2$(femoral neck), $0.49g/cm^2$(trochanter), and $0.41g/cm^2$(ward's triangle). The results were compared among 3 groups with different nutrient intake levels classified by the percentage of Dietary Reference Intakes(DRIs) for Koreans as follows: low < 75% DRIs, 75% DRI $\leq$ adequate < 125% DRIs, high $\geq$ 125% DRIs. Bone mineral density of adequate protein intake group was significantly higher than those of low and high protein intake groups(p<0.05). Urinary DPD excretion was lowest in protein and calcium adequate intake groups(p<0.05, p<0.05), respectively. In relation to urinary Ca excretion, it is revealed to be considerably lower in the groups taking protein and vitamin C adequate intake(p<0.05, p<0.05). The percent DRI of protein and calcium were positively correlated with the BMD of the femoral neck after adjusted age(p<0.05, p<0.05). These results showed that there are probably some relationships between nutrient intake levels and urinary biochemical markers. For postmenopausal women with adequate nutrition expecially protein, calcium and vitamin C, has an important role to postpone bone resorption and to prevent the decrease of bone density.

• Journal of Nutrition and Health
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• v.40 no.6
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• pp.517-525
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• 2007

This study was performed to assess the effects of physiological factors and lifestyles on bone mineral density (BMD) in 64 postmenopausal women. Sixty four subjects were selected out of 223 postmenopausal women in Seoul and Kyunggido. The BMD of the lumbar spine (L2 ${\rightarrow}$ L4) and femoral neck were measured dual energy X-ray absorptiometry (DEXA). Subjects were assigned to one of three groups such as normal (T-score > -1, n = 20), osteopenia (-2.5 < Tscore ${\leq}$ -1, n = 24), and osteoporosis (T-score ${\leq}$ -2.5, n = 20). Anthropometric measurements and questionares were administered to these women. The mean age, height, weight and BMI were 62.09 yrs, 153.78 cm, 56.09 kg and 23.70 $kg/m^2$ respectively. The BMDs of lumbar spines (L2 ${\rightarrow}$ L4), femoral neck were 0.84 $g/cm^2$, 0.71 $g/cm^2$ respectively. Years after menopause and age of last delivery of the osteoporosis and osteopenia group were significantly longer than the normal group (p < 0.05). The hours of exercise and outdoor activity of the normal group were longer than the osteoporosis and osteopenia group, but there were no significant differences among the three groups. The BMDs of these two sites were positively correlated with weight, BMI, hip and body fat and negatively correlated with LBM, TBW. These results show there are no consistent effects on bone mineral density, adjusting for age and BMI, of physiological factors and lifestyles in postmenopausal women. Therefore. this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight.

• The Korean Journal of Nuclear Medicine Technology
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• v.27 no.2
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• pp.99-109
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• 2023

Purpose: CT scan makes up for the weak point of the nuclear medicine image having a low resolution and also were used for attenuation correction on image reconstruction. Recently, many studies try to make use of CT images additionally, one of them is to measure the bone mineral density(BMD) using Quantitative CT(QCT) software. BMD exams are performed to scan lumbar and femur with DXA(Dual-Energy X-Ray Absorptiometry) in order to diagnose bone disease such as osteopenia, osteoporosis. The purpose of this study is to identify the usefulness of QCT_BMD analyzed with low dose CT images on L-spine Bone SPECT/CT comparing with DXA_BMD. Materials and Methods: Fifty five women over 50 years old (mean 66.4 ± 9.1) who took the both examinations(L-spine Bone SPECT/CT with SIEMENS Intevo 16 and DXA scan with GE Lunar prodigy advance) within 90 days from April 2017 to July 2022, BMD, T-score and disease classification were analyzed. Three-dimensional BMD was analyzed with low dose CT images acquired on L-spine Bone SPECT/CT scan on Mindways QCT PRO^TM software and two-dimensional BMD was analyzed on DXA scan. Basically, Lumbar 1-4 were analyzed and the patients who has lesion or spine implants on L-spine were excluded for this study. Pearson's correlation analysis was performed in BMD and T-score, chi-square test was performed in disease classification between QCT and DXA. Results: On 55 patients, the minimum of QCT_BMD was 18.10, maximum was 166.50, average was 82.71 ± 31.5 mg/cm³. And the minimum of DXA-BMD was 0.540, maximum was 1.302, average was 0.902 ± 0.201 g/cm², respectively. The result shows a strong statistical correlation between QCT_BMD and DXA_BMD(p<0.001, r=0.76). The minimum of QCT_T-score was -5.7, maximum was -0.1, average was -3.2 ± 1.3 and the minimum of DXA_T-score was -5.0, maximum was 1.7, average was -2.0 ± 1.3, respectively. The result shows a statistical correlation between QCT T-score and DXA T-score (p<0.001, r=0.66). On the disease classification, normal was 5, osteopenia was 25, osteoporosis was 25 in QCT and normal was 10, osteopenia was 25, osteoporosis was 20 in DXA. There was under-estimation of bone decrease relatively on DXA than QCT, but there was no significant differences statistically by chi-square test between QCT and DXA. Conclusion: Through this study, we could identify that the QCT measurement with low dose CT images QCT from L-Spine Bone SPECT/CT was reliable because of a strong statistical correlation between QCT_BMD and DXA_BMD. Bone SPECT/CT scan can provide three-dimensional information also BMD measurement with CT images. In the future, rather than various exams such as CT, BMD, Bone scan are performed, it will be possible to provide multipurpose information via only SPECT/CT scan. In addition, it will be very helpful clinically in the sense that we can provide a diagnosis of potential osteoporosis, especially in middle-aged patients.