• 제목/요약/키워드: bone quality

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Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

  • Jo, Dae-Jean;Jun, Jae-Kyun;Kim, Ki-Tack;Kim, Sung-Min
    • Journal of Korean Neurosurgical Society
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    • 제48권5호
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    • pp.412-418
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    • 2010
  • Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

차동 전자 트랜스듀서를 이용한 이식형 인공중이 시스템의 실험적 검증 (Experimental Verification of Implantable Middle Ear System using the Differential Electromagnetic Type Transducer)

  • 송병섭;이기찬;원철호;박세광;이상흔;조진호
    • 대한의용생체공학회:의공학회지
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    • 제23권3호
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    • pp.217-225
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    • 2002
  • 이식형 인공중이는 일반적인 공기전도형 보청기가 가지는 난점인 고이득에서의 왜곡과 음향 피이드백에 의한 링잉 현상을 해결할 수 있는 동시에 음질과 주파수 특성 및 청음명료도가 우수하다 본 논문에서는 마이크로머시닝 기술을 이용하여 차동 전자 트랜스듀서를 제작한 후 이를 사용하여 이식형 인공중이 시스템을 구현하였다. 제작된 시스템을 이용하여 무부하 진동실험. 사체를 이용한 부하진동실험 및 살아있는 개를 이용하여 동물이식실험을 실시함으로써 이의 성능을 확인하였다. 무부하 진동실험을 통하여 제작된 트랜스듀서는 입력되는 소리신호와 같은 형태의 진동을 일으킴을 확인하였고, 사체의 이소골에 트랜스듀서를 이식하고 부하실험을 실시함으로써 트랜스듀서의 이소골 구동능력과 진동특성을 조사하였다. 그리고 개를 이용하여 동물이식실험을 실시한 후 뇌간 유발 반응검사를 실시함으로써 생체 내에서의 이식형 인공중이의 동작을 확인하였다. 이를 통하여 제작된 차동 전자 트랜스듀서를 이용한 이식형 인공중이 시스템의 성능을 검증하였고 난청자에게 적용할 경우에도 잘 동작할 수 있음을 증명함으로써 임상실험을 실시할 수 있는 근거를 마련하였다.

조리저장식(Ready-Prepared) 급식 시스템 이용을 위한 한식 탕반류의 저장 특성 평가 (Evaluation of the Storage Characteristics of Korean Soups for the Utilization of the Ready-Prepared Foodservice System)

  • 한경수;이은정;홍상필
    • 한국식품조리과학회지
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    • 제21권4호
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    • pp.406-415
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    • 2005
  • 우리나라의 대표적인 탕반류인 육개장, 사골우거지탕, 갈비탕 및 설렁탕을 Ready-prepared 급식 시스템 이용을 위해 저장 특성을 분석 평가하였다. 탕반류 4종의 pH는 저장온도와 기간에 상관없이 유의적인 변화를 보이지 않았으나 TBA가는 저장기간이 증가할수록, 저장온도가 높아질수록 유의적으로 증가하는 경향을 보였다. 색도분석에 있어서 육개장은 L값, a값 및 b값에서 모두 유의적으로 증가하고 나머지 탕반류는 유의적으로 감소하는 경향을 보였다. 총균수 측정 결과, 육개장, 사골우거지탕, 설렁탕은 $20^{\circ}C$, 3일경부터 $10^7CFU/ml$ 수준 검출되었다. 관능평가에서는 저장기간이 증가할수록 4종 탕반류 모두 외관, 색깔, 향미, 맛, 조직감 및 전반적 수응도 점수가 유의적으로 감소하는 경향을 보였다. $4^{\circ}C$의 각 품질요인간의 상호관련성을 분석한 결과, 전반적인 수응도는 육개장의 외관, 색, 향미, 조직감에 유의적인 양의 상관성을, 사골우거지탕의 a값(적색도)과 TBA가에 유의적인 음의 상관성을, 갈비탕의 L값(밝기)과 향미에 유의적인 양의 상관성을, 설렁탕의 외판, b값(황색도), 색, 향미, 조직감에 유의적인 양의 상관성을 나타내었다. TBA가는 육개장의 b값(황색도)과 pH에 유의적인 양의 상관성을, 사골우거지탕의 L값(밝기)에 유의적인 음의 상관성을, 갈비탕의 b값에 유의적인 음의 상관성을 나타내었다. 종합적으로 평가된 저장 가능 기간은 육개장, 사골우거지탕, 갈비탕은 $4^{\circ}C$, 5일 이하, $10^{\circ}C$, 3일 이하, 설렁탕은 $4^{\circ}C$, 7일 이하, $10^{\circ}C$, 3일 이하로 평가되었다. 따라서 상기 4종의 탕반류는 장시간 조리한 음식을 냉장 혹은 냉동 후 배식 시 재가열하여 급식할 수 있는 Ready-prepared 급식 시스템의 이용이 충분히 가능할 것으로 판단된다.

Physiological Activity of Coffee Beans and Roasted Black Beans (Rhynchosia nulubilis) Mixture Extracts for Coffee Alternative Beverage Development

  • Kim, Ae-Jung;Lee, Hankyu;Ko, Hyuk Wan;Ko, Seong Hee;Woo, Nariyah
    • 한국식품영양학회지
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    • 제29권2호
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    • pp.178-185
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    • 2016
  • This study was designed to develop and to qualify a coffee alternative beverage using a mixture of coffee beans and roasted black beans (Rhynchosia nulubilis). Therefore, the total isoflavone content (TIC), total phenol content (TPC), antioxidant activity, anti-inflammatory activity, NFATc1 (Nuclear factor of activated T-cells c1) expression in RANKL (receptor activator of nuclear factor kappa-B ligand)-stimulated RAW264.7 cells and sensory evaluation were measured for 5 different Cb (coffee bean)-RoS (roasted seomoktae) mixture extracts (Cb100RoS0, Cb75RoS25, Cb50RoS50, Cb25RoS75, and Cb0RoS100). Cb0RoS100 had the highest TIC ($516.83{\pm}36.61mg/100g$) and TPC ($18.11{\pm}1.77mg$ TAE/100 g) along with the highest antioxidant activity as measured by DPPH radical scavenging activity ($73.55{\pm}8.11%$) and ABTS radical scavenging activity ($63.27{\pm}7.27%$). Also, Cb0RoS100 showed the highest anti-inflammatory activity as measured by NO production ($13.57{\pm}2.21{\mu}M$) and PGE2 production ($3.25{\pm}0.21ng/mL$). The more the RoS ratio was increased in the mixtures of Cb-RoS, the more the NFATc1 protein expression was decreased in RANKL-stimulated RAW264.7 cells. In case of sensory evaluation, Cb50RoS50 had the highest scores for flavor, delicate flavor and overall quality, which were similar to those in Cb alone (Cb100RoS0). We suggest that the use of RoS replacement instead of Cb in/as a coffee alternative beverage may help to reduce the risk of caffeine-related bone loss and/or bone disease by effectively blocking NFATc1 expression in RANKL-stimulated RAW264.7 cells compared with Cb alone.

오디가 난소를 절제한 흰쥐 결함조직 중의 collagen 함량 변화에 미치는 영향 (Effects of Mulberry Fruits on Collagen Content of Connective Tissues in Ovariectomized Rats)

  • 최경하;박미화;김미향
    • 생명과학회지
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    • 제15권6호
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    • pp.1022-1027
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    • 2005
  • 폐경을 앞둔 여성에게는 폐경을 전후하여 지속되는 골 손실 가속화 등의 문제점을 가지고 있다. 그러므로 본 연구에서는 인위적 폐경을 유발시킬 수 있는 난소 절제 쥐에서의 골 손실의 유무를 결합조직 중의 collagen함량 변화를 통하여 그 효과를 검토하였다. 그 결과 생화학적 골 대사 지표인 혈 중 ALP활성은 난소 절제로(OVX-control)로 인하여 증가하는 반면, 난소 절제 후 오디 추출물 투여(OVX-EE, OVX-EA)로 혈 중 ALP활성은 감소하는 경향을 보여 골 흡수를 저하시킬 수 있는 가능성을 나타내었다. 한편 난소 절제 후 오디 추출물 투여에 의해 폐 조직과 골 $\cdot$ 연골 조직에서 collagen 함량이 증가하는 경향을 보였고, 그 중 연골 조직에서는 collagen 함량의 저하가 정상적으로 회복되었다. 한편 피부 조직에서도 난소 절제 후 오디 추출물 투여군 모두에서 collagen 합성량이 유의적으로 증가하였다. 오디 추출물이 estrogen감소로 인한 collagen 합성저하를 회복시킨 본 실험 결과로 미루어 보아 오디 중의 phytoestrogen이 estrogen유사효과를 나타냄을 알 수 있었고, 국내산 오디뿐만 아니라 중국산 오디에서도 갱년기 유도에 의한 collagen 함량 저하를 회복하는 결과가 나타났으므로 외인성 estrogen 투여로 인한 부작용을 줄여 줄 수 있을 것으로 기대된다. 이상과 같이 폐경기 여성에게 오디의 섭취는 폐경으로 인한 장애를 감소시키기 위하여 estrogen의 장기간 복용에 의한 부작용을 오디중의 phytoestrogen이 estrogen대체 작용을 함으로써 그 부작용을 감소시켜 줄 것으로 사료되며, 이들의 구조 및 기전에 대해서는 앞으로 연구가 더 필요한 것으로 생각된다.

유기성폐기물이 느티나무 재배지 토양의 화학성 및 생물에 미치는 영향 (Effect of Organic Waste Application on Soil Chemical Properties and Organisms under Zelkova serrata Cultivation)

  • 어진우;김명현;남형규;권순익;송영주
    • 환경생물
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    • 제36권4호
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    • pp.471-478
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    • 2018
  • 식품생산과정에서 발생하는 유기성폐기물인 골분, 유박, 굴 패화석을 토양에 투입한 결과 일부 처리구에서 토양생물과 화학성이 영향을 받았다. 골분은 토양의 질산태질소를 일시적으로 증가시켰고, 패화석은 pH를 증가시켰다. 골분은 느티나무 생장을 증진시키는 효과가 있었기 때문에 이차적으로 토양생태계에 영향을 미칠 수 있다. 미생물 PLFA는 패화석에 의해 증가하였으며 환경스트레스를 나타내는 지표도 낮은 경향이 있었다. 이것은 패화석이 양분 증가보다는 pH 증가를 통해 미생물의 서식환경을 개선하는 효과가 있다는 것을 보여준다. 토양미소동물 중에는 세균섭식성 선충만이 유박과 골분 처리구에서 증가하였다. 이들 밀도와 세균 PLFA 간에 상관관계는 없었다. 다만 식물생장과 식물섭식성선충의 유의적 상관관계는 유기물투입이 식물을 통해 이차적으로 토양생태계에 영향을 줄 수 있다는 것을 부분적으로 보여준다. 따라서 유기성폐기물 처리는 토양화학성 변화를 통해 일차적으로 미생물 군집에 영향을 주지만, 미생물을 섭식하는 생물군에게 상향식의 양적인 연쇄반응을 일으키지 않을 수 있다는 것을 시사한다.

척추경 나사못 삽입술 CT검사의 영상평가 분석 (Image Evaluation Analysis of CT Examination for Pedicle Screw Insertion)

  • 황형석;임인철
    • 한국방사선학회논문지
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    • 제16권2호
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    • pp.131-139
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    • 2022
  • 본 연구는 척추경 나사못(Pedicle screw)을 돼지 흉추에 삽입하여 일반적인 CT검사(Non MAR)와 인공물을 줄이기 위한 금속성 인공물 감소기법(Metallic Artifact Reduction for Orthopedic Implants, O-MAR)으로 얻어진 흉추 Axial영상을 4개의 알고리즘(Standard, Soft, Bone, Detail)에 재구성하였다. 이에 얻은 영상을 image J 프로그램을 이용하여 신호대잡음비(Signal Noise Ratio, SNR)와 대조도대잡음비(Contrast to Noise Ratio, CNR)를 주어진 식에 의거하여 측정값을 구하고 흉추 척추경 나사못 삽입술 CT검사에 맞는 관전압과 알고리즘을 알아보고자 하였다. 결과적으로 Non MAR 사용한 경우에는 80, 100, 120, 140 kVp에서 soft 알고리즘이 SNR, CNR이 가장 높게 나타났다. 반면에 MAR를 사용한 경우 80 kVp에서는 Standard 알고리즘이 가장 높게 나타났고 100 kVp에서는 Standard, Soft 알고리즘이 비슷한 값으로 높게 나타났다. 120 kVp에서는 Soft, Standard 알고리즘이 비슷한 값으로 나타났고 140 kVp에서는 Soft 알고리즘에서 SNR, CNR이 가장 높게 나타났다. 따라서 Non MAR와 MAR를 비교했을 경우 MAR를 사용한다고 하더라도 관전압 변화에 따라 모든 알고리즘에서 SNR과 CNR이 증가하는 것은 아니었다. 본 연구는 이후 척추경 나사못 CT검사 영상 평가에 도움이 되는 기초자료로써 선택적인 관전압과 알고리즘 사용으로 영상의 질을 더 높일 수 있는 계기가 될 것으로 사료된다.

The Effect of Hounsfield Unit Value with Conventional Computed Tomography and Intraoperative Distraction on Postoperative Intervertebral Height Reduction in Patients Following Stand-Alone Anterior Cervical Discectomy and Fusion

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung;Woo, Joon Bum;Kim, Young Ha
    • Journal of Korean Neurosurgical Society
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    • 제65권1호
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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.

골다공증 유발 동물모델에서 녹용 추출물의 경구 투여 효과: 체계적 문헌고찰 및 메타분석 (The Effects of Oral Administration of Deer Antler Extracts on an Osteoporosis-induced Animal Model: A Systematic Review and Meta-analysis)

  • 이정민;김남훈;이은정
    • 한방재활의학과학회지
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    • 제32권2호
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    • pp.65-81
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    • 2022
  • Objectives This study aimed to assess the effects of oral administration of deer antler extracts on an osteoporosis-induced animal model. We analyzed the results of using deer antler single extracts on animal models with osteoporosis through a systematic review and meta-analysis. Methods We included osteoporosis studies in animal experiments that administrated deer antler extracts orally. We searched the following 13 databases without a language restriction: PubMed, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), Wanfang, Korean Medical Database (KMbase), National Digital Science Library (NDSL), Korean Traditional Knowledge (Koreantk), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), Korea Institute of Science and Technology Information (KISTI), and Koreanstudies Information Service System (KISS). We used Systematic Review Centre for Laboratory Animal Experimentation's risk of bias tool for assessing the methodological quality of the included studies. Results A total of 299 potentially relevant studies were searched and 11 were included for a systematic review. Nine studies used a single deer antler extract. A study compared the effects of single extracts of deer antler and antler glue, while another study compared the effects of three single extracts of deer antler, old antler, and antler glue. For evaluating the intervention effect, bone mineral density (BMD) was measured as the primary outcome, while the histomorphometric indicators of the bone and serum alkaline phosphatase and osteocalcin levels were used as the secondary outcome variables. On conducting a meta-analysis of studies on single deer antler extract, BMD was observed to be significantly increased compared to that in control group (standardized mean difference [SMD]=2.11; 95% confidence interval [CI]=1.58~2.65; Z=7.75; p<0.00001; I2=56%). As a result of meta-analysis, according to the concentration of deer antler, the group with high concentration showed statistically significantly higher BMD than the group with low concentration (SMD=1.28; 95% CI=0.74~1.82; Z=4.63; p<0.00001; I2=9%). Conclusions The research shows that the deer antler extracts have significant anti-osteoporotic effects on the osteoporosis-induced animal model. However the studies included in this research had a high methodological risk of bias. This indicates the requirement of considerable attention in the interpretation of the study results.

Dosimetric Study Using Patient-Specific Three-Dimensional-Printed Head Phantom with Polymer Gel in Radiation Therapy

  • Choi, Yona;Chun, Kook Jin;Kim, Eun San;Jang, Young Jae;Park, Ji-Ae;Kim, Kum Bae;Kim, Geun Hee;Choi, Sang Hyoun
    • 한국의학물리학회지:의학물리
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    • 제32권4호
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    • pp.99-106
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    • 2021
  • Purpose: In this study, we aimed to manufacture a patient-specific gel phantom combining three-dimensional (3D) printing and polymer gel and evaluate the radiation dose and dose profile using gel dosimetry. Methods: The patient-specific head phantom was manufactured based on the patient's computed tomography (CT) scan data to create an anatomically replicated phantom; this was then produced using a ColorJet 3D printer. A 3D polymer gel dosimeter called RTgel-100 is contained inside the 3D printing head phantom, and irradiation was performed using a 6 MV LINAC (Varian Clinac) X-ray beam, a linear accelerator for treatment. The irradiated phantom was scanned using magnetic resonance imaging (Siemens) with a magnetic field of 3 Tesla (3T) of the Korea Institute of Nuclear Medicine, and then compared the irradiated head phantom with the dose calculated by the patient's treatment planning system (TPS). Results: The comparison between the Hounsfield unit (HU) values of the CT image of the patient and those of the phantom revealed that they were almost similar. The electron density value of the patient's bone and brain was 996±167 HU and 58±15 HU, respectively, and that of the head phantom bone and brain material was 986±25 HU and 45±17 HU, respectively. The comparison of the data of TPS and 3D gel revealed that the difference in gamma index was 2%/2 mm and the passing rate was within 95%. Conclusions: 3D printing allows us to manufacture variable density phantoms for patient-specific dosimetric quality assurance (DQA), develop a customized body phantom of the patient in the future, and perform a patient-specific dosimetry with film, ion chamber, gel, and so on.