• 한국임상약학회지
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• 제26권2호
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• pp.97-106
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• 2016

Background: Sevelamer is associated with reduced complications of chronic kidney disease-mineral bone disorder (CKD-MBD) resulted from hyperphosphatemia, which may contribute mortality, in CKD patients with dialysis. So far clinical outcomes of sevelamer on mortality and risk of cardiovascular mortality related to CKD-MBD are debating. Purpose of this study was to evaluate the effectiveness of sevelamer HCl on mortality of secondary hyperparathyroidism (SHPT), risk of cardiovascular mortality and, frequency of osteopathy in end stage renal disease (ESRD) patients with dialysis. Methods: We retrospectively reviewed the electronic medical records of 536 patients with ESRD, who were admitted for moderate to severe SHPT, for 36 months. 75 patients who met inclusion criteria were evaluated for the efficacy of sevelamer (mean serum iPTH = 487.5 pg/mL). Results: Sevelamer intervention was not associated with increased three-year survival time compared with non-sevelamers group [average survival month: 30.4 months in sevelamer group, 26.8 months in non-sevelamer group, p = 0.463]. Sevelamer intervention was not associated with significant mortality benefit and cardiovascular mortality benefit as compared to non-sevelamer group [sevelamer group: non-sevelamer group, all-cause mortality (iPTH > 600 pg/mL): 14.3% (1/34): 20% (1/41) p = 0.962, OR = 0.935, 95% CI, 0.058-14.98, heart disease mortality: 6.67% (2/30): 0% (0/32) p = 0.138]. Sevelamer was not associated with significantly lower cumulative incidence of osteopathy compared to non-sevelamer group (sevelamer group: non-sevelamer group, 5.9% (2/34):9.8% (4/41); p = 0.538; OR = 0.578; 95% CI, 0.099-3.367). Conclusion: Sevelamer was not associated with decreased all-cause mortality and risk of cardiovascular mortality compared to non-sevelamer group in ESRD patients with SHPT.

• 지역사회간호학회지
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• 제27권1호
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• pp.51-59
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• 2016

Purpose: The purpose of this study is to provide a disease management, nutrition education, and group exercise program for three months to the moderately frail elderly whose physical functions have deteriorated, and to investigate its effects in order to develop an intervention program. Methods: As a quasi-experiment, this study was conducted based on non-equivalence studies designed as a similar experiment. The milk intake group and calcium intake group participated in the disease education, individual nutrition education, and group exercise program for three months, and the control group was visited once in the three months by a nurse who provided disease education, nutrition education, and oral instruction of exercise, and asked them to exercise on their own every day. For the data analysis, ${\chi}^2$-test, ANOVA and $Scheff{\acute{e}}$ test were used. Results: After three months of intervention, there was a significant difference in the frailty level (p=.029) and bone density (p=.001) between the groups. Conclusion: The comprehensive intervention program had an effect on the bone density and the frailty level of the socially-vulnerable and moderately frail elderly, suggesting that the program can be used as a nursing intervention to prevent functional deterioration and damage of the moderately frail elderly.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권1호
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• pp.89-97
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• 2020

Purpose: Obese children may often present with advanced bone age. We aimed to evaluate the correlation between factors associated with childhood obesity and advanced bone age. Methods: We enrolled 232 overweight or obese children. Anthropometric and laboratory data, and the degree of nonalcoholic fatty liver disease (NAFLD) were measured. We analyzed factors associated with advanced bone age by measuring the differences between bone and chronological ages. Results: The normal and advanced bone age groups were comprised of 183 (78.9%) and 49 (21.1%) children, respectively. The prevalence of advanced bone age significantly increased as the percentiles of height, weight, waist circumference, and body mass index (BMI) increased. BMI z-score was higher in the advanced bone age group than in the normal bone age group (2.43±0.52 vs. 2.10±0.46; p<0.001). The levels of insulin (27.80±26.13 μU/mL vs. 18.65±12.33 μU/mL; p=0.034) and homeostatic model assessment-insulin resistance (6.56±6.18 vs. 4.43±2.93; p=0.037) were significantly higher, while high density lipoprotein-cholesterol levels were lower (43.88±9.98 mg/dL vs. 48.95±10.50 mg/dL; p=0.005) in the advanced bone age group compared to those in the normal bone age group, respectively. The prevalence of advanced bone age was higher in obese children with metabolic syndrome than in those without (28.2% vs. 14.7%; p=0.016). The prevalence of advanced bone age was higher in obese children with a more severe degree of NAFLD. Conclusion: Advanced bone age is associated with a severe degree of obesity and its complications.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.201-206
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• 2001

Objective : The purpose of this study was to assess the complications, duration of admission, cost effectiveness, radiologic stabilization of the anterior cervical bone fusion in the treatment of cervical disc disease with and without plating. Materials and Methods : Fifty-two surgically treated patients for cervical disc disease were reviewed. Group I consisted of consecutive treated patients with iliac auto-bone graft without instrumentation after anterior cervical discectomy. Group II consisted of consecutive treated patients with iliac autologous-bone graft with CASPER cervical plate fixations. Radiologic fusion was decided when loss of end plate boundary between graft bone and vertebral body and immobile, maintenance of the disc space were evident on simple dynamic plain films. The patients were discharged after the stabilization of cervical motion by films was of tained. These groups were analysed multiple variably with Mann-Whitney U-test. Results : Group I consisted of 18 patients, group II consisted of 34 patients. Mean age was $49.0{\pm}8.1years$, mean duration of admission was $17.27{\pm}10.51days$, mean costs for treatment was $1,970,000{\pm}475,000won$. In group I, mean age was 47.7(34-60) years, 16 patients had undergo on one-level operation, 2-patients had undergo on two-level operation, mean duration of admission was $28.7{\pm}10.4days$, mean costs for treatment was $2,194,473{\pm}561,639won$. The periods of stabilization was $6.6{\pm}3.36weeks$ on radiologic study. Mean periods of out patient follow up was 16.8(6-64) weeks after discharge. Mean period of radiologic follow up was 17.3(4-6) weeks after surgical operation. In group II, mean age was 49.7(37-62) years and 18 patients one-level operation, 14- patients had undergo on two-level operation and 2-patients three-level operation. Mean duration of admission was $11.24{\pm}3.29days$, mean costs for treatment was $1,850,823{\pm}389,372won$. The periods of stabilization was $5.88{\pm}7.07weeks$ on radiologic study. Mean period of out patients follow up was 16.7(4-60) weeks after discharge. Mean period of radiologic follow up was 12.4(3-52) weeks after surgical operation. The duration of admission showed statistical significance in Group II but other items showed no significant difference between two groups. Conclusions : The more economic, early life return and effective method of cervical disc disease in our series were evident in patients who had undergone, iliac bone graft and plate fixations after anterior discectomy.

• Journal of Periodontal and Implant Science
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• 제52권5호
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• pp.383-393
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• 2022

Purpose: Aloe-emodin (AE), a natural anthraquinone abundant in aloe plants and rhubarb (Rheum rhabarbarum), has long been used to treat chronic inflammatory diseases. However, AE's underlying mechanisms in periodontal inflammation have not been fully elucidated. Acidic mammalian chitinase (AMCase) is a potential biomarker involved in bone remodeling. This study aimed to evaluate AE's effect on periodontitis in rats and investigate AMCase expression. Methods: Eighteen Sprague-Dawley rats were separated into the following groups: healthy (group 1), disease (group 2), vehicle (group 3), AE high-dose (group 4), and AE low-dose (group 5). Porphyromonas gingivalis ligatures were placed in rats (groups 2-5) for 7 days. Groups 4 and 5 were then treated with AE for an additional 14 days. Saliva was collected from all groups, and probing pocket depth was measured in succession. Periodontal pocket tissues were subjected to histomorphometric analysis after the rats were sacrificed. Bone marrow-derived macrophages and murine macrophages were stimulated with receptor activator of nuclear factor-κB ligand (RANKL) and treated with different concentrations of AE. AMCase expression was detected from the analysis of saliva, periodontal pocket tissues, and differentiated osteoclasts. Results: Among rats with P. gingivalis-induced periodontitis, the alveolar bone resorption levels and periodontal pocket depth were significantly reduced after treatment with AE. AMCase protein expression was significantly higher in the disease group than in the healthy control (P<0.05). However, AE inhibited periodontal inflammation by downregulating AMCase expression in saliva and periodontal pocket tissue. AE significantly reduced RANKL-stimulated osteoclastogenesis by modulating AMCase (P<0.05). Conclusions: AE decreases alveolar bone loss and periodontal inflammation, suggesting that this natural anthraquinone has potential value as a novel therapeutic agent against periodontal disease.

• 대한방사선기술학회지:방사선기술과학
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• 제17권1호
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• pp.77-86
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• 1994

The bone scan reflects the metabolic reaction of bone to a disease process, whether neoplastic, traumatic or inflammatory. In normal bone tissue, the labeled diphosphate complexes accumulate in the perivascular fluid next to the marrow cavity at the interface between uncalcified and calcified bone matrix. HMDP has the most rapid plasma clearance among the commonly used diphosphonate followed by MDP and then HEDP. I have studied about bone scan time by use of $^{99m}Tc-MDP$, and got 336 images from 112 patients. The result obtained as follow; 1. Accumulation rate of $^{99m}Tc-MDP$ is higher than other age groups in below 30-year old group. 2. Accumulation rate, in 10year old group, is 75.85% on 120min. but other groups are most high on 180 min. 3. The density differants between bone and soft tissue increased with time. 4. Image contrast is good in younger group than old.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권1호
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• pp.33-41
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• 2007

Bone scan using radioactive isotope can be more effective than conventional X-ray radiograph for finding jaw lesion because it takes an image of the physiologic change of bone. This study is designed to show how available bone scan is able to diagnose jaw lesion better than simple X-ray and CT, as well as to determine a basis of diagnosis for jaw lesion using bone scan. The 77 patients, visiting the Oral & Maxillofacial Surgery, Department of Dankook University Hospital from January 2002. to August 2005. who were diagnosed histopathologically with postoperative malignant tumor, osteomyelitis, and bone infiltrative benign disease. Preoperative X-ray, CT, bone scan were taken and were compared with histopathologic finding. Also to compare specificty of each lesion in bone scan, bone density was measured to compare. The results were as follows. 1. Among the 25 cases of oral malignant tumor of bony invasion, a positive diagnosis associated with histopathologic evaluation, 22 cases(88%) in bone scan, 14 cases(56%) in CT image, and 10 cases40%) in simple X-ray. 2. Among the 31 cases of osteomyelitis, a positive diagnosis associated with histopathologic evaluation, 30 cases(97%) in bone scan, 23 cases(74%) in CT image, and 19 cases(61%) in simple X-ray. 3. Among the 11cases of bone infiltrative benign disease, a positive diagnosis associated with histopathologic evaluation, 11 cases(100%) in bone scan, 10 cases(91%) in CT image, and 6 cases(55%) in simple X-ray. 4. Measurement of bone density in each group showed no statistical significant difference between malignant tumor and osteomyelitis as well as benign bone disease. But, a statistical significance was seen between osteomyelitis and benign bone disease. From this results, bone scan are more sensitive than simple X-ray and CT image in jaw lesion diagnosis, but specificity shows no significant difference. Therefore, it should be suggested that evaluation of bone scan must be carrying out in reference to final histopathologic diagnosis.

• Journal of Acupuncture Research
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• 제26권2호
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• pp.91-101
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• 2009

Objectives: Osteoporosis is the most common metabolic disease of the bone, and is one of the most important major public health problems world wide. It is more occurred in female than male, but as the osteoporosis of men is increasing, therefore bone fractures of men are increasing. So we investigated the factors which are related to Bone Mineral Density(BMD) of male for prevention of osteoporosis. Methods: We measured the Bone Mineral Density(BMD) of lumbar spine($L_2$-$L_4$) and femoral neck in 5198 male, using dual energy X-ray absorptionmetry(DEXA; DPX-alpha). And then we analysed the 8 factors - age group, bone mass index(BMI), amount of smoking, drinking, exercise, and fast blood sugar, gastric disease, thyroid disease - which are related to BMD of male. Results: 1. In age group according to ${\ll}$Hwangjaenaekyong Somun, 黃帝內徑 素問${\gg}$, T-score was the highest at 17-24(三八歲) years group and decreased rapidly after 57-64(八八歲) years group in both lumbar spine($L_2$-$L_4$) and femoral neck. Therefore we concluded that T-score of male in lumbar spine($L_2$-$L_4$) and femoral neck change according to age group in ${\ll}$Hwangjaenaekyong Somun, 黃帝內徑 素問${\gg}$. 2. In BMI(body mass index), T-score of lumbar spine($L_2$-$L_4$) and femoral neck were the highest in obese group than non-obese group. In comparison of age group according to BMI, T-score of lumbar spine($L_2$-$L_4$) was significant difference in 17-72 years group and T-score of femoral neck was in 25-72 years group. 3. In exercise, T-score of lumbar spine($L_2$-$L_4$) and femoral neck was increasing as exercising more. In comparison of age group according to exercise, Both T -score of lumbar spine and femoral neck were significant difference in 25-72 years old. 4. T-score of lumbar spine($L_2$-$L_4$) was the highest in men who have taken exercise daily, and T-score of femoral neck was the highest in men who have taken exercise 1-3 times for a week. Conclusions : The age group in ${\ll}$Hwangjaenaekyong Somun, 黃帝內徑 素問${\gg}$ is related to BMD of men. And risk factors - BMI, exercise - are related to BMD of men. Therefore we expect that this study will help for prevention of osteoporosis of men.

• 한국식품영양과학회지
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• 제37권7호
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• pp.869-878
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• 2008

최대골질량에 근접할 수 있는 20대 여성들의 골격건강 상태는 중년기 이후 급증하는 골절이나 골다공증 발병과 밀접한 관련이 있다. 본 연구는 골격계질환 예방을 위하여 청년층의 식사지침 설정에 필요한 기초자료를 얻고자, 20대 여대생들의 골밀도를 측정하여 정상군과 골질환군으로 분류한 후, 신체계측과 식사섭취 상태 등을 조사 비교하고, 골밀도와 관련된 제 요인들을 분석하였다. 대상자들의 골밀도는 WHO에서 분류한 T-score값에 따라 정상군 59명($-0.42{\pm}0.45$), 골감소증군(골다공증 2명+골감소증 41명, $-1.52{\pm}0.41$) 43명이었으며, 골다공증과 골감소증을 나타낸 대상자는 전체 대상자의 약 42%로 나타났다. 평균 연령은 21.43세, 신장, 체중 및 체질량지수(BMI)는 각각 $161.25{\pm}4.77\;cm$, $56.05{\pm}9.20\;kg$과 21.5($kg/m^2$)이었으며 전체 대상자 중 60명(58.8%)만이 정상체중군에 속하였고 골감소증군에서 저체중자의 비율이 높게 나타났다. 정상군과 골감소증군의 신체계측치를 비교했을 때, 체중, 체단백질(protein mass), 무기질(mineral mass), 골격근량(skeletal muscle mass), 제지방량(fat free mass) 및 체수분(total body water) 함량 등이 골감소증군에서 유의적으로(p<0.05) 낮게 나타났다. 영양소 섭취 상태를 분석한 결과에서는 한국인영양섭취기준(KDRIs)의 75% 이하로 섭취하고 있는 영양소에는 비타민 C(73%), 엽산(49%), 칼슘(66%)과 칼륨(45%) 등이었고, 영양섭취기준에 비해 높게 섭취하고 있는 영양소에는 단백질(136%), 비타민B6(120%), 인(122%) 및 나트륨(충분섭취량의 256%) 등이었다. 체중 1 kg당 영양소섭취량을 분석 비교한 결과에서는 두 군간 유의적인 차이는 나타나지 않았으나, 정상군에 비해 골감소증군에서 에너지섭취량이 다소 높았고, 칼슘은 섭취량자체는 많았지만 동물성칼슘의 비율이 낮게 나타났고, 마그네슘(Mg)의 섭취량도 적게 나타났다. 식품군별 섭취량과 섭취빈도를 분석한 결과에서는, 정상군과 골질환군에서 섭취량에는 유의적인 차이가 없었으나 우유와 유제품의 섭취빈도가 골감소증군에서 다소 낮게 나타났다. Tscore와 관련성을 보인 신체계측지수는 체중(p<0.01), PIBW(p<0.05), 신장(p<0.01), 체단백질(p<0.001), 체지방량(plt;0.05), 무기질(p<0.001), 체수분(p<0.001), 근육량(p<0.001), 제지방량(p<0.001), BMI(p<0.05), 골격근량(p<0.001), 허리둘레(plt;0.05) 및 엉덩이둘레(plt;0.05) 등이었으며, 체중 1 kg당 영양소섭취량과의 관련성에서는 에너지, 단백질, 지질, 당질, 인, 나트륨 및 칼륨이 유의적으로($p<0.05{\sim}p<0.01$) 음(-)의 관련성을 나타내었고, 섭취빈도와의 관련성에서는 우유 및 유제품의 섭취빈도는 양(+)의, 버섯류의 섭취빈도는 음(-)의 유의적인(p<0.05) 관련성을 보였다. 이상의 결과에서 최대의 골질량에 근접해야하는 20대 여대생의 골격건강상태는 약 42%의 대상자가 골감소증군으로 나타나, 중년층의 골질환 발병율과 거의 같은 수준을 보였다. 따라서 이에 대한 예방대책이 조속히 이루어져야 할 것으로 생각된다. 골격건강 상태에 영향을 주는 요인으로는 적정 체중유지가 중요한데, 전체 대상자의 약 59%만이 적정체중 범위에 있었고, 골감소증군에서 저체중자의 비율이 높게 나타나 건강체중유지에 대한 교육도 강조되어져야 할 것이다. 식사관련요인에서는 각 영양소의 섭취량 자체도 중요하지만 특히 칼슘, 인, 나트륨, 칼륨 및 마그네슘등의 경우 각 영양소 상호간의 섭취 비율이 골격건강에 더 많은 영향을 주는 것으로 사료된다. 취약한 칼슘섭취상태를 보완하기 위한 주요 급원식품으로는, 우유와 유제품의 공급이 우선시되어야 함을 확인할 수 있었다.

• 대한족부족관절학회지
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• 제14권2호
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• pp.165-168
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• 2010

Purpose: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. Materials and Methods: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. Results: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p <0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p <0.05). Conclusion: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.