The purpose of this study was to determine the evaluation parameters' osteoporosis predictability in accordance with measuring regions by analyzing the correlations between bone mineral density and trabecular patterns derived from different measuring regions. Experimental subjects were a total of 40 female patients after menopause aged over 40 years, and were classified into 20 control and 20 osteoporotic groups according to the T-score. Bone mineral density was measured on femoral neck, trochanter and ward's triangle by DEXA(Dual Energy X-ray Absorptiometry). We designated ROI(Region of Interest) with $50{\times}50$ pixel size on each measuring regions, and extracted trabecular patterns by using existing image processing method. We also selected a total of eight evaluation parameters that are categorized into structural(mean gray level, area, perimeter, thickness and terminal distance), skeletonized parameters(number, length) and fractal dimension. As a result, it was observed that area, perimeter, thickness, terminal distance, number, length and fractal dimension reflected the bone mineral density with high statistical validity(p<0.003). We also confirmed that the evaluation parameters could predict the osteoporosis more efficiently.
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 Korea Academia-Industrial cooperation Society
/
v.14
no.3
/
pp.1180-1190
/
2013
This study is to analyze femoral necks and lumbar spine bone mineral density in Korean men aged 60 or older 2,736 people, as well as to research in its relation to anthropometry, life style, diet, fracture history, family history of osteoporosis and medical history using data from Korea National Health and Nutrition Examination Survey (KNHANES)(the 2nd(2008) and 3rd(2009) year at the 1st survey, and the 1st(2010) year at the 5th survey). To express the strength of the associations, percent differences were calculated from multiple linear regression models using the formula ${\beta}{\times}$(unit/mesnBMD). Unit for continuous variables were chosen to approximate 1 standard deviation(SD). Prevalence of osteoporosis for 60-69, 70-79 and >80 old men were 6.7%, 15.8% and 31.4% respectively. The proportion of osteoporosis calculated for each age group in the femoral neck group was: 60-69 years old, 2.6%, 70-79years old, 8.2%, >80years old, 24.8%. For the lumbar spine group, the values were: 60-69 years old, 5.5%, 70-79years old, 11.3%, >80years old, 15.4%. In men aged 60 or older, lean mass greatly influenced bone density in the femoral neck and lumbar spine. Thus, to increase the lean mass would be an effective way to prevent osteoporosis in elderly men.
Objective : Craniovertebral junctional anomalies constitute a technical challenge. Surgical opening of atlantoaxial joint region is a complex procedure especially in patients with nuchal deformity like basilar invagination. This region has actually very complicated anatomical and functional characteristics, including multiple joints providing extension, flexion, and wide rotation. In fact, it is also a bottleneck region where bones, neural structures, and blood vessels are located. Stabilization surgery regarding this region should consider the fact that the area exposes excessive and life-long stress due to complex movements and human posture. Therefore, all options should be considered for surgical stabilization, and they could be interchanged during the surgery, if required. Methods : A 53-year-old male patient applied to outpatients' clinic with complaints of head and neck pain persisting for a long time. Physical examination was normal except increased deep tendon reflexes. The patient was on long-term corticosteroid due to an allergic disease. Magnetic resonance imaging and computed tomography findings indicated basilar invagination and atlantoaxial dislocation.The patient underwent C0-C3-C4 (lateral mass) and additional C0-C2 (translaminar) stabilization surgery. Results : In routine practice, the sites where rods are bound to occipital plates were placed as paramedian. Instead, we inserted lateral mass screw to the sites where occipital screws were inserted on the occipital plate, thereby creating a site where extra rod could be bound.When C2 translaminar screw is inserted, screw caps remain on the median plane, which makes them difficult to bind to contralateral system. These bind directly to occipital plate without any connection from this region to the contralateral system.Advantages of this technique include easy insertion of C2 translaminar screws, presence of increased screw sizes, and exclusion of pullout forces onto the screw from neck movements. Another advantage of the technique is the median placement of the rod; i.e., thick part of the occipital bone is in alignment with axial loading. Conclusion : We believe that this technique, which could be easily performed as adjuvant to classical stabilization surgery with no need for special screw and rod, may improve distraction force in patients with low bone density.
A number of experimental studies have been carried out in order to clarify the question as to how temporomandibular joint adapt to the changes of mandibular movement and occlusal equilibration. Recently, the studies on the interrelations between anatomical structure of temporomandibular joint and the state of occlusion have been actively performed in dentistry particularly in prosthodontic field. Author performed extraction of unilateral mandibular molars in 30 mature male rats, and observed histological changes of temporomandibular joint through the light microscope. Following results were obtained. 1. The loss of unilateral teeth gave rise to the changes in the location of condylar head, that is, interior displacement of condylar head in the extraction side and upper displacement in the non-extraction side. 2. Articular disk was compressed by the interior surface of condylar head, resulting in its extension below the condylar neck in the extraction side, and the histological arrangement of the compressed area showed irregular feature. 3. The extension of articular disk below the condylar neck was accompanied with the contraction of muscle fibers which were originated from the articular disk. 4. The cartilage layer of articular fossa to the exterior of the extraction side showed hypertropy. 5. Early in the experiment, the inernal extremity of condylar head of extract ion side showed bone resorption, and cartilage layer of condylar head showed hypertropy. At 12 weeks after experiment, the condylar surface showed flattened, and the cartilage layer of condylar head was replaced by the compact bone. 6. The articular disk showed the formation of pannus in the extraction side as well as in the non-extraction side. 7. The occlusal disturbance due to unilateral missing teeth has brought about the non-inflammatory retrogressive change and osteoarthrotic change late in the experiment.
Lee, Hak Sung;Choi, Matthew Seung Suk;Ahn, Hee Chang;Lee, Jang Hyun
Archives of Craniofacial Surgery
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v.11
no.1
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pp.65-68
/
2010
Purpose: Dermoid cysts are benign neoplasms that are derived from both ectoderm and mesoderm. Approximately 7 percent of all dermoid cysts occur in the head and neck, as most common sites are the lateral ends of the eyebrows, the midline in the nasal root and neck. Rarely they can be found in the frontal sinus, temporal bone, maxilla and the floor of the mouth. Dermoid cysts in the temporal fossa are extremely rare. We experienced a characteristic dermoid cyst that occupied the temporal fossa. Methods: A 16-year-old man had a progressive enlarging mass on the left eyebrow. Computerized tomographic scan showed a bulging mass in the temporal fossa, and it had the density similar to that of fat. The size of the mass was $3{\times}3{\times}2cm$, and it was composed of high density of fat with clear margin. There was no bony invasion, but the mass was fixed on bone. Results: We performed the surgery through coronal incision under general anesthesia. Because the mass was closely connected with temporal fat pads, we removed this mass with some portion of temporal fat pads, avoiding damage to the facial nerve. The postoperative course was ordinary without complication. Conclusion: The reports about dermoid cyst on the temporal fossa is uncommon. However, if there is a mass in the temporal fossa which has the density similar to that of fat in CT scan, we should consider the possibility of dermoid cyst. We suggest that excision through coronal incision with bewaring temporal fat pad can induce good result.
In recent years there has been a growing interest in total body irradiation. For refractory leukemia or lymphoma patients, varions techniques and dose regimens were intridused, including high dose total body irradiation for destruction of leukemic or bone marrow cells and immunosupperression prior to bone marrow transplantation. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiatio. When performed in total body irradiation, the problem obtain uniform uniform dose distribution in brain, neck, lung, umbilicus, pelvis and leg. Authors compared to dose distribution with method 1 and method 1. The method 1 used compensationg filters for homogeneous dose distribution(Minesota University Method). The method 2 used fixing frame made in acryl developing authors. Results were following 1. Method 1 was showed dose distribution from 95.6% to 100%, method 2 showed dose distribution from 95.4% to 100% 2. Method 2 was showed different to 3.4% at skin region and midline in the brain. In the neck, showed different to 1.5%. In the umbilicus, showed different to 2.3%.
Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.
In recent years there has been a growing interest in total body, hemibody, total lymphoid irradiation. For refractory leukemia or lymphoma patients, various techniques and dose regimens were introduced, including high dose total body irradiation for destruction of leukemic or bone marrow cells and immunosuppression prior to bone marrow transplantation, and low dose total body irradiation for treatment of lymphocytic leukemia or lymphomas. Accurate provision for specified dose and the desired homogeneity are essential before clinical total body irradiation. Purposes of this paper are to discuss calibrating Cobalt Unit in 3m distance using Rando Phantom, to compare calculated dose, calibrated dose, and compensating filters for homogeneous dose distribution in the head and neck, the lung, and the pelvis. Results were following. 1. Measured dose on the lung was 6% higher than on the abdomen. Measured dose on the head (10%) and neck (18%) were higher than the abdomen because of thinness. Pelvic dose was measured 12% less than the abdomen. Those data suggest that compensating filter was essential. 2. Measured dose according to distance was 3% less than calculated dose which suggest that all doses in clinical use should be compared with calculated dose for minimizing error.
Few studies have shown the correlation between metabolic syndrome and bone mineral density (BMD). The main pathogenic mechanisms of metabolic syndrome rely on chronic low-level inflammatory status and oxidative stress. There are few studies that examine the gender-specific effects of inflammation and antioxidants on BMD. In this study, we evaluated the relative contribution of these factors in patients with metabolic syndrome. We conducted a cross-sectional study of 67 men and 46 postmenopausal women with metabolic syndrome; metabolic syndrome was defined as having three or more metabolic syndrome risk factors. BMD, body fat mass, and lean body mass were evaluated. We also examined the levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), adiponectin, vitamin E, and C in serum. Log-transformed hs-CRP levels were significantly higher in lumbar spine osteoporotic subjects than in normal subjects for women but not for men. There was no significant difference between the normal group and the osteoporotic group in other inflammatory markers. Stepwise regression analyses for BMD of the lumbar spine showed that lean body mass and vitamin E were significant determinants in men. Lean body mass and log-transformed hs-CRP were significant determinants in women Analysis for BMD of the femoral neck showed that lean body mass was a significant determinant for both men and women. There was no significant factor among the inflammatory markers or antioxidant vitamins affecting the femoral neck BMD for either gender. In conclusion, while hs-CRP is an independent predictor of the BMD of the lumbar spine in women, vitamin E showed profound effects on BMD in men but not women with metabolic syndrome.
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