• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.293-296
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• 2009

Objective : Pain has long been regarded as a subjective symptom. Recently, however, some regard a type of intractable chronic pain as a disease. Furthermore, chronic persistent pain becomes a cause of permanent impairment (PI) In 6th edition, the American Medical Association (AMA) Guides has rated the pain as a PI. In Korea, pain has been already been rated as a PI. Here, we examined the present status and the prospect of disability evaluation for the pain in Korea. Methods : Pain can be rated as a PI by the Workmen's Compensation Insurance Act (WCIA) and Patriots and Veterans Welfare Corporation Act (PVWCA) in Korea. We examined the definition, diagnostic criteria and grades of the pain related disability (PRD) in these two acts. We also examined legal judgments, which were made in 2005 for patients with severe pain. We also compared the acts and the judgments to the criteria of the 6th AMA Guides. Results : The PRD can berated as one of the 4 grades according to the WCIA. The provisions of the law do not limit the pain only for the complex regional pain syndrome (CRPS). The PRD can berated as one of the 3 grades by the PVWCA. If there were objective signs such as osteoporosis, joint contracture and muscle atrophy corresponding to the CRPS, the grade is rated as 6. When the pain always interferes with one's job except easy work,the grade is rated as high as 5. In Korea, judicial precedents dealt the pain a sa permanent disability in 2005. Conclusion : Although there were no objective criteria for evaluation of the PRD, pain has been already rated as a PI by the laws or judicial precedents, in Korea. Thus, we should regulate the Korean criteria of PRD like the AMA 6th edition. We also should develop the objective tools for evaluation of the PRD near in future.

• Proceedings of the Korean Institute of Surface Engineering Conference
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• 2017.05a
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• pp.157-157
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• 2017

Titanium and its alloys that have a good biocompatibility, corrosion resistance, and mechanical properties such as hardness and wear resistance are widely used in dental and orthopedic implant applications. They can directly connect to bone. However, they do not form a chemical bond with bone tissue. Plasma electrolytic oxidation (PEO) that combines the high voltage spark and electrochemical oxidation is a novel method to form ceramic coatings on light metals such as titanium and its alloys. This is an excellent reproducibility and economical, because the size and shape control of the nano-structure is relatively easy. Silicon (Si), manganese (Mn), and magnesium (Mg) has a useful to bone. Particularly, Si has been found to be essential for normal bone, cartilage growth and development. Manganese influences regulation of bone remodeling because its low content in body is connected with the rise of the concentration of calcium, phosphates and phosphatase out of cells. Insufficience of Mn in human body is probably contributing cause of osteoporosis. Pre-studies have shown that Mg plays very important roles in essential for normal growth and metabolism of skeletal tissue in vertebrates and can be detected as minor constituents in teeth and bone. The objective of this work was to study nucleation and growth of bone-like apatite formation on Ti-6Al-4V in solution containing Mn, Mg, and Si ions after plasma electrolytic oxidation. Anodized alloys was prepared at 270V~300V voltages. And bone-like apatite formation was carried out in SBF solution for 1, 3, 5, and 7 days. The morphologies of PEO-treated Ti-6Al-4V alloy in containing Mn, Mg, and Si ions were examined by FE-SEM, EDS, and XRD.

• Journal of Nutrition and Health
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• v.41 no.3
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• pp.206-215
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• 2008

The purpose of this study was to investigate the effect of manganese (Mn) supplementation on bone status and calcium balance in ovariectomized rats according to the calcium intake levels. Total of 50 Sprague Dawley female rats (6 weeks) were divided into 5 groups and bred for 12 weeks: sham operated control group (SACa), OVX Ca deficiency group (OLCa) with Ca deficiency diet (0.1% Ca modified AIN-93N diet), OVX Ca deficiency & Mn supplement group (OLCaMn), OVX adequate Ca group (OACa; 0.5% Ca AIN-93N diet) and OVX adequate Ca & Mn supplement group (OACaMn). BMD (bone mineral density) of the femur was increased by Mn supplementation in OVX adequate Ca group. However, BMDs of spine, femur and tibia were lowered in OLCa compared to the OLCaMn group. Bone strength of tibia in OLCaMn group was significantly lower than OLCa group. Serum ALP (alkaline phosphatase) and CTx (C-telopeptide of collagen cross-links) levels were significantly higher in ovariectomized rats than those in the sham group, but they were not changed by Mn supplementation. Ca retention rate and Ca absorption rate did not differ among the experimental groups. Urinary Ca excretion was increased by Mn supplementation in Ca deficiency rats. In summary, Mn supplementation resulted in positive effects on bone mineral density ovariectomized rats with which intake adequate Ca. However, Mn supplementation on Ca deficiency ovariectomized rats resulted in decrement of BMO and bone strength by increasing Ca excretion. Therefore, it is encouraged to consider calcium intake levels in supplementation of manganese in order to prevent postmenopausal osteoporosis and to keep bone healthy. (KoreanJNutr2008; 41(3): 206~215)

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.155-156
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• 1998

Screw loosening and subsequent pullout can be attributed to the reduction in bone mineral density in the vertebrae manifested by osteoporosis in which the decrease in fixation strength between the cancellous bone and screw threads are accelerated by repeated loads exerted by patients own weight and activities following the surgery. In this study, the change in pullout strength of the pedicle screws was investigated before and after repeated loads were imparted. For this purpose. Diapason pedicle screws $(6.7\times40mm)$ were inserted onto fresh porcine spine specimens (T1-L5) after bone mineral density was measured using a DEXA. With an MTS, an axial load was applied at a loading rate of 0.33mm/sec until failure to measure the maximum pullout strength. Flexion moment of 7.5N-m was then imparted at 0.5Hz for 2000 cycles. It was found that the maximum pullout strength was exponentially related to BMD regardless of load types ($107.71\;\times\;\exp^{(1.43{\times}BMD)}r^2=0.93$, P<0.0001 without repeated load; ($107.71\;\times\;\exp^{(2.19{\times}BMD)}r^2=0.78$, P<0.0001 with repeated load). The results suggest that the reduction in pullout strength for pedicle screws is far more prominent in osteoporotic spine than in normal spine especially as number of repeated load was increased. More importantly, it was demonstrated that the level of bone mineral density and the activity level of the patient should be evaluated in more detail for successful implementation of pedicle screw systems in spinal surgery.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.198-204
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• 1998

Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

• Clinics in Shoulder and Elbow
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• v.18 no.2
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• pp.86-90
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• 2015

Background: Although there are several methods for evaluating bone quality, Hounsfield units (HU), a standardized computed tomography (CT) attenuation coefficient, provide a useful tool for estimating focal bone mineral density (BMD). The aim of this study is to investigate the HU for evaluating the degree of osteoporosis in greater tuberosity with regard to anchor positioning. Methods: Forty patients diagnosed as normal on shoulder CT were included and categorized according to age and gender. Axially sectioned CT images were processed to 3-dimensional models containing information about bone quality using Mimics (14.11 platform v14.1.1.1 Materialise). Three-dimensional anchors were simulated and positioned according to 6 regions of interest (ROI) in the greater tuberosity classified using Tingart's system. Mean HU of intra-anchor volumes in the 6 regions was measured. Results: A significant decrease in HU was observed with increasing age (p=0.0001) and menopause (p<0.001). A significant difference in HU was found between male and female groups with males showing the higher values (p=0.0001). HU of proximal areas of ROI was higher than those of distal areas (p<0.005). However, although mean HU of distal posterior ROI showed the lowest values, no statistically significant difference was found between anterior, middle, and posterior regions (p=0.087). Conclusions: Mean HU of ROIs provides a tool for preoperative assessment of focal BMD, which is a factor of suture anchor stability and can be used to aid decision-making regarding secure anchor positioning for rotator cuff repair. Our data support that the most secure point is the proximal regions of ROI.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.527-534
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• 2016

Dual-energy X-ray absorptiometry (DEXA) is the most widely used technical instrument for evaluating bone mineral content (BMC) and density (BMD) in patients of all ages. In 2016, DEXA devices operating is 5617 in Korea. In this study we investigated the quality of management practices survey for DEXA equipment and we analyzed it. We got a survey response rate of 12.6%. Accurate bone densitometry test is used data for estimation a patient's risk of fracture. However, improper bone densitometry will increase the possibility of causing a false positive. Therefore. it is essential to use the proper aids accurate bone densitomenty to be performed, and the quality control of the device to reduce the error factor of the tester through the training to reduce error for the device and the attitude.

• Journal of Society of Preventive Korean Medicine
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• v.8 no.2
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• pp.13-30
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• 2004

This study was performed to evaluate the effect of Kangwhal-Sokdan tang(KS) on osteoblast function and gene expression. The osteoblast separated from the murine calvariae and MG-63 cell were cultivated to evaluate the cell function and gene expression. The results were summarized as followes. 1) KS increased cell proliferation of murine calvarial cell. 2) KS increased protein synthesis, collagen synthesis and ALP activity of murine calvarial cell. 3) KS increased the survival rate of murine calvarial cell. 4) KS increased the expression of calcitonin receptor and PTH receptor. 5) KS increased the expression of PKA and PKC. 6) KS decreased the expression of $PLA_2$, COX, $PGE_2$ synthase, but increased prostacyclin synthase. 7) KS increased the expression of collagen(type IV) gene. It is concluded that KS might improve the osteoporosis resulted from augumentation of osteoblast proliferation and gene expression.

• Biomolecules & Therapeutics
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• v.19 no.1
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• pp.70-76
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• 2011

Bone remodeling is a dynamic process involving a constant balance between osteoclast-induced bone resorption and osteoblast-induced bone formation. Osteoclasts play a crucial homeostatic role in skeletal modeling and remodeling, and destroy bone in many pathological conditions. Previously, we reported that the hexane soluble fraction of Ficus carica inhibited osteoclast differentiation. Poly unsaturated fatty acids, such as ethyl docosahexaenoate (E-DHA), docosahexaenoic acid (DHA), cis-11,14-eicosadienoic acid (EDA) and eicosapentaenoic acid (EPA), were identified from the hexane soluble fraction of Ficus carica. Among them, E-DHA most potently inhibited osteoclastogenesis in RAW264.7 cells. E-DHA reduced the activities of JNK and NF-$\kappa}B$. E-DHA suppressed the expression of c-Fos and nuclear factor of activated T cells c1 (NFATc1). Interestingly, DHA increased the activity of alkaline phosphatase and expression of bone morphogenetic protein 2 (BMP2) more than E-DHA in MC3T3-E1 cells, suggesting that DHA may induce osteoblast differentiation. The data suggests that a combination of E-DHA and DHA has potential use in the treatment of diseases involving abnormal bone lysis, such as osteoporosis, rheumatoid arthritis and periodontal bone erosion.

• Biomolecules & Therapeutics
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• v.19 no.1
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• pp.126-133
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• 2011

The fruit of Actinidia arguta (AA) has been used mainly for the treatment of skin diseases, diuresis, diabetes mellitus and osteoporosis in Korean traditional medicine. It is known that AA (hardy kiwi) fruit extract has an effect on 2-chloro-1,3,5-trinitrobenzene-induced atopic dermatitis-like skin lesions in NC/Nga mice. Mode of action for it is associated with the modulation of biphasic Th1/Th2 cytokines. Furthermore, DA9102 containing AA is a herbal medicine currently under phase II clinical trial for atopic dermatitis in Korea. However, no active principles of AA on the decrease of Th2 cytokines including IL-4 and IL-10 have been identified. In this study, bioactivity-guided fractionation of an alcohol extract from the dried fruits of AA using ELISA assay for IL-4 production led to the isolation of $\alpha$-linolenic acid (I), linoleic acid (II), ethyl linolenate (III), ethyl linoleate (IV) and ethyl stearate (V) as the major active components. These compounds showed the down-regulatory effects of IL-4 production in A23187-stimulated RBL-2H3 cells without cytotoxicity.