• Title/Summary/Keyword: Neck Bone

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Safety and efficacy of transcutaneous bone conduction implant surgery for hearing improvement in microtia patients with bilateral hearing impairment

  • Cheon, Jeong Hyun;Lee, Hyung Chul;Im, Gi Jung;Park, Jung Youl;Park, Chul
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.525-534
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    • 2019
  • Background In microtia patients with bilateral hearing impairment, hearing improvement is crucial for language development and performance. External auditory canal reconstruction (EACR) has been performed to improve hearing, but often results in complications. We performed transcutaneous bone conduction implant (TBCI) surgery in these patients. This study aimed to evaluate the safety and efficacy of TBCI surgery. Methods A retrospective review was performed of five patients who underwent auricular reconstruction and TBCI surgery and 12 patients who underwent EACR between March 2007 and August 2018. Hearing improvement was measured based on the air-bone gap values using pure-tone audiometry over a 6-week postoperative period. We reviewed other studies on hearing improvement using EACR and compared the findings with our results. The surgical techniques for TBCI were reviewed through case analyses. Results Postoperative hearing outcomes showed a significant improvement, with a mean gain of 34.1 dB in the TBCI cohort and 14.1 dB in the EACR cohort. Both gains were statistically significant; however, the TBCI cohort showed much larger gains. Only three of the 12 patients who underwent EACR achieved hearing gains of more than 20 dB, which is consistent with previous studies. All patients who underwent TBCI surgery demonstrated hearing gains of more than 20 dB and experienced no device-related complications. Conclusions TBCI is a safe and effective method of promoting hearing gains in microtia patients with bilateral hearing impairment. TBCI surgery provided better hearing outcomes than EACR and could be performed along with various auricular reconstruction techniques using virgin mastoid skin.

A Study of Factors Affecting Bone Mineral Density in Korean Adolescents: Anthropometric Measurements, Life Style, and Other Environmental Factors (청소년의 골밀도에 영향을 주는 요인에 관한 연구: 신체계측치, 생활습관 및 기타 환경요인)

  • Ahn Hae-Sun;Kim Sun-Hee;Lee Sang-Sun
    • Journal of Nutrition and Health
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    • v.38 no.3
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    • pp.242-250
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    • 2005
  • This study was conducted to assess the bone mineral density (BMD) and the anthropometric measurements, life style, and other environmental factors affecting BMD in Korean adolescents. Subjects were 167 high school students (83 male students, 84 female students) in Seoul. BMD was measured in the lumbar spine (LS), femoral neck (FN), femoral trochanter (FT), and Ward's triangle (WT) by dual energy x-ray absorptiometry (DEXA). The questionnaire was used to assess the anthropometric measurements, life style, and other environmental factors. Bone mineral density of LS, FN, FT and WT were 0.967, 0.960, 0.795, $0.761 g/{\cal}cm^2$. The BMD of LS was not different by sex but the male students's BMD of FN, FT and WT were higher significantly than the female students (LS: 0.976 vs. 0.958, FN: 1.040 vs. 0.880, FT: 0.842 vs. 0.749, WT: 0.827 vs. $0.695 g/{\cal}cm^2$) Female students's BMD of LS, FN, WT, and FT was positively correlated with weight but male students's BMD of WT was not correlated with weight. The factors such as the life style, activity and exercise have significant influence on BMD. This study confirms that the major factor affecting BMD was body weight and the factors such as the life style, activity and exercise is related to accumulation of BMD. The classification of sexual characteristics is needed for further studies on BMD of adolescents.

Effect of irradiation on the periodontal tissues in streptozotocin-induced diabetic rats (방사선조사가 당뇨 백서의 치주조직에 미치는 영향)

  • Park Dong-Sin;Hwang Eui-Hwan;Lee Sang-Rae
    • Imaging Science in Dentistry
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    • v.35 no.3
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    • pp.133-139
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    • 2005
  • Purpose To observe the histopathological changes in the periodontal tissues of mandibular molars in streptozotocin-induced diabetic rats after irradiation. Materials and Methods : The male Sprague-Dawley rats weighing approximately 250 gm were divided into four groups: control, diabetes, irradiation, and diabetes- irradiation groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in the control and irradiation groups were injected with citrate buffer only After 5days, the head and neck region of the rats in irradiation and diabetes-irradiation groups were irradiated with a single absorbed dose of 10Gy. All the rats were sacrificed at 3, 7, 14, 21, and 28 days after irradiation. The specimen including the mandibular molars were sectioned and observed using a histopathological method. Results In the diabetes group, osteoclastic activity was observed in the alveolar bone and the root throughout the period of experiment. Also, osteoblastic and fibroblastic activities were markedly decreased. In the irradiation group, the osteoclasts were observed in the alveolar bone and the dilated capillaries were increased in the early experimental phases. However, vigorous osteoblastic activity was noted in the late experimental phases. In the diabetes-irradiation group, osteoblastic activity in the alveolar bone and the root was observed in the early experimental phases. However, there were no resorption and osteoblastic activity in the alveolar bone and the root in the late experimental phases, and obvious atrophic change of fibrous tissues was noted. Conclusion : This experiment suggests that osteoblastic activity was caused by irradiation in the late experimental phases, but atrophic change of the periodontal ligament tissues was induced after irradiation in diabetic state.

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Does matching relation exist between the length and the tilting angle of terminal implants in the all-on-four protocol? stress distributions by 3D finite element analysis

  • Li, Xiaomei;Cao, Zhizhong;Qiu, Xiaoqian;Tang, Zhen;Gong, Lulu;Wang, Dalin
    • The Journal of Advanced Prosthodontics
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    • v.7 no.3
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    • pp.240-248
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    • 2015
  • PURPOSE. To explore whether there is matching relation between the length and the tilting angle of terminal implants in the All-on-Four protocol by studying the effects of different implant configurations on stress distributions of implant, bone, and framework. MATERIALS AND METHODS. Four implants were employed to support a full-arch fixed prosthesis and five three-dimensional finite element models were established with CT images, based on the length (S and L) and distal tilt angle ($0^{\circ}$, $30^{\circ}$ and $45^{\circ}$) of terminal implants for an edentulous mandible, which named: Tilt0-S, Tilt30-S, Tilt30-L, Tilt45-S and Tilt45-L. An oblique 240 N was loaded at second molar. The von Mises Stresses were analyzed. The implants were consecutively named #1 to #4 from the loading point. RESULTS. 1) Tilt0-S had the greatest stress on the implants, with the other groups exhibiting variable reductions; the four implants of Tilt45-L demonstrated the greatest reduction in stress. 2) Tilt0-S had the greatest stress at bone around #1 implant neck, and Tilt45-L exhibited the least stress, which was a 36.3% reduction compared to Tilt0-S. 3) The greatest stress in the framework was found on the cantilevers distal to #1 implant. Tilt45-S exhibited the least stress. CONCLUSION. Matching different length and tilting angle of the terminal implants led to variable stress reductions on implants, bone and the superstructure. By optimizing implant configuration, the reduction of stress on implants and surrounding bone could be maximized. Under the present condition, Tilt45-L was the preferred configuration. Further clinical testings are required.

Bone Mineral Density, with Anthropometric Measurement, and Maternal Factors for Postmenopausal Women in Chungnam (폐경 후 여성들의 골밀도와 신체 측정치 및 모성 요인과의 관련성 연구 -충남 일부 지역을 중심으로-)

  • Park, Mie-Ja
    • The Korean Journal of Food And Nutrition
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    • v.20 no.4
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    • pp.450-459
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    • 2007
  • This study was performed to assess the relationships between bone mineral density(BMD), anthropometric measurements, and maternal factors in postmenopausal women. The anthropometric measurements were taken by a trained practitioner, and the maternal factors of the 85 subjects in Chungnam were acquired by an interview questionaire. The BMDs of the lumbar $spines(L_2-L_4)$, femoral necks(FN), ward's triangles(WT), and trochanters(TR) were measured by dual energy X-ray absorptiometry(DEXA). The BMDs(T-score) for $L_2-L_4$, FN, and WT were 0.996 $g/cm^2$(-1.601), 0.697 $g/cm^2(-1.657)$, and 0.793 $g/cm^2(-1.512)$ respectively, which were assessed as osteopenia by the T-score ; TR was noma1 at 0.718 $g/cm^2(-0.675)$. The 85 subjects in Chungnam were divided into three groups according to their BMD measurements for $L_2-L_4$ and FN, assessed by the T-score. The percentages in the osteoporosis, osteopenia, and normal groups were 32.9%, 42.4, and 24.7%, respectively. The average age was significantly the highest in the osteoporosis group than in the other two osteopenia and normal group(p<0.001). The subjects' BMDs were positively correlated with weight, height, BMI, waist, WHR, OBR and hip circumference, and negatively correlated with the age, duration time after menopause, lactation, the age of last delivery, menarche age, and number of children. The average age at menopause was 48.8. The osteoporosis group's average age at menopause was lower than those of the other groups. However, the BMD of the lumbar spine positively correlated with duration time after menopause and the BMD of the femoral neck with lactation, last delivery, menarch age, number of children. Therefore, researches are needed to find out the effective way to minimize the effect of age and other physiological conditions on the decrease of bone mass density.

Atypical Fibroxanthoma of Scalp Involving Occipital Bone (후두골을 침범한 두피의 비전형적 섬유황색종)

  • Jo, Yong Woo;Lim, So Young;Mun, Goo Hyun;Hyon, Won Sok;Bang, Sa Ik;Oh, Kap Sung
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.383-387
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    • 2006
  • Atypical fibroxanthoma is a pleomorphic spindle cell neoplasm characterized by a variable combination of cells with fibroblastic and histiocytic features. It occurs mostly on sun-exposed area of the head and neck of elderly person and is a clinically benign reactive lesion despite apparent malignant histologic features. However, because of its potential for metastasis, it is widely regarded as a low-grade sarcoma. We report a 30-year-old woman with atypical fibroxanthoma developed on the left occipital area. The lesion was $1.5{\times}2cm$ sized papule. There was no skin lesion such as ulcer or eschar. However, mass was involving occipital bone and composed of dense, pleomorphic spindle cells and several bizarre multinucleated giant cells. After wide excision of the scalp and occipital bone, the defect was covered with bone cement, bipedicled local flap and the donor site was covered with STSG. The wound healed completely without complication. It remained free of recurrence for a period of about 1 year follow up.

Effect of Dietary, Biochemical and Other Factors on Bone Mineral Density Change for 2 Years in Korean College Women (한국 여대생의 2년간의 골밀도 변화와 이에 영향을 미치는 요인 분석)

  • 송윤주;백희영
    • Journal of Nutrition and Health
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    • v.36 no.2
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    • pp.175-182
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    • 2003
  • This study was conducted to examine whether bone mineral density changes in 55 young Korean college women aged 19 to 26 years over 2 years and nutritional and biochemical factors are related. Bone mineral density (BMD) was measured in the spine (LS), femoral neck (FN), ward's triangle (WT), and femoral trochanter (FT) by dual energy X-ray absorptiometry three times at one-year intervals. Serum osteocalcin (OC), parathyroid hormone (PTH), and urinary cross-linked N-teleopeptides of type collagen (NTx) were measured. Dietary intake was assessed 8 times with 24-hour recall method. Physical activity (PA) was obtained by questionnaire and body fat content was measured by bioelectrical impedance analysis at baseline and after 2 years. Analyses were performed on 34 subjects with all three BMD measurements. The BMDs at the lumbar spine gradually increased over 2 years, while the BMDs of three sites at the femur were sustained or increased. The mean OC, PTH had a similar pattern with the change of BMD at the femur. The mean NTx decreased over 2 years but was still higher than those in other studies. BMI, body fat, vitamin A and zinc intake had a significant correlation with LS-BMD. Femur, PTH, body fat, vitamin A, vitamin B$_2$and calcium intake had a significant correlation with WT-BMD and was mostly influenced by diet. By multiple regression analysis, it was shown that the significant factors affecting the LS-BMD were BMI and vitamin A intake and those affecting FN and WT were age, BMI, PTH and calcium intake. These results indicate that some Korean women still experience increases in BMD and that this was associated with PTH and vitamin A and calcium intake. Therefore, proper diet and diet management is needed to increase changes in BMD among college women.

Relationship between Nutrient Intake and Biochemical Markers of Bone Metabolism in Korean Postmenopausal Women (폐경 후 여성의 영양소섭취수준에 따른 골대사 지표물질의 관련성 분석)

  • 이행신;이다홍;이다홍
    • 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.

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The Factors Influencing the Bone Mineral Density in Korean Adult Men : Based on Korea National Health and Nutrition Examination Survey 2010~2011 Data (우리나라 성인 남성의 골밀도에 연관성을 보이는 요인 : 국민건강영양조사자료, 2010~2011)

  • Lee, Hye-Sang
    • Korean Journal of Community Nutrition
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    • v.22 no.2
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    • pp.136-144
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    • 2017
  • Objectives: The purpose of this study was to determine which factors influence the bone mineral density (BMD) of total femur (TF), femoral neck (FN) and lumbar spine (LS) of the adult men by analyzing nationally representative Korean survey data. Methods: This study was conducted based on the data of 1,770 men aged 19-64 years from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2011. The BMD was analyzed by various factors (general characteristics, anthropometric data, health habits, chronic diseases, nutrient intake status). SPSS statistics for complex samples was used to analyze the data. Results: We observed that the BMD decreased significantly with aging. The BMD in each of the second lowest quartile of waist circumference (in TF & FN) and body mass index (in TF & LS) was lower than the respective BMD in the highest quartile group. The BMD in FN was higher in the group who reported the weight training. The BMD in LS was lower in hypercholesterolemia group than in the normal group. The BMD in TF, FN and LS was lower in hypertriglyceridemia group and in diabetes group than in the normal group. The BMD in TF, FN and LS was higher in the group with < Estimated Average Requirement iron intake. But there was no evidence to suggest that the BMD was related with educational level, income level, smoking, alcohol intake, anemia and nutrient intake status (except for iron). Conclusions: This study suggested that aging, waist circumference, body mass index, weight training, hypercholesterolemia, hypertriglycemia, diabetes were site-specifically associated with the BMD in TF, FN and LS in the adult men. These bone site-specific factors need to be considered for the prevention of osteoporosis.

Efficacy and Cardiovascular Safety of Romosozumab: A Meta-analysis and Systematic Review (Romosozumab의 효과 및 심혈관계 안전성: 체계적 문헌고찰 및 메타분석)

  • Seo-Yong Choi;Jeong-Min Kim;Sang-Hyeon Oh;Seunghyun Cheon;Jee-Eun Chung
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.2
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    • pp.128-134
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    • 2023
  • Background: This systematic review and meta-analysis aimed to evaluate the efficacy and cardiovascular safety of romosozumab compared with placebo. Methods: Randomized controlled trials (RCTs) were searched from Medline, EMBASE, Cochrane Central, and Web of Science until July 2022. Primary outcomes included the change in bone mineral density (BMD) from baseline at month 6. The secondary outcomes were the change of bone turnover markers (N-terminal propeptide of type 1 procollagen (P1NP); C-terminal telopeptide of type 1 collagen (CTX)) from baseline at month 3, and the incidence of cardiovascular adverse events for the total follow-up period. Results: A total of 7 RCTs on 8,370patients were included. Romosozumab showed better effects in improving BMD in both lumbar spine and femoral neck at month 6 (standardized mean difference, SMD 2.20 [95% CI: 1.89-2.52], SMD 0.63 [95% CI: 0.41-0.86]). In contrast to placebo, romosozumab significantly increased PINP levels and reduced CTX levels at month 3 (SMD 0.93 [95% CI: 0.65-1.22], SMD -1.03 [95% CI: -1.23~ -0.82]. However, there was no significant difference in the composite incidence of cardiovascular adverse events and major adverse cardiovascular events (OR 1.16 [95% CI: 0.82-1.65], OR 1.08 [95% CI: 0.75-1.56]). Conclusion: This analysis showed that romosozumab significantly improved BMD compared to placebo and was beneficial for change in bone turnover markers. There is no significant difference in the incidence of cardiovascular adverse events compared to placebo.