BACKGROUND: Proximal femoral geometry may be a risk factor of osteoporotic hip fractures. However, there existed great differences among studies depending on race, sex and age of subjects. The purpose of the present study is to analyze proximal femoral geometry and bone mineral density (BMD) in the osteoporotic hip fracture patients. Furthermore, we investigated proximal femoral geometric parameters affecting fractures, and whether the geometric parameters could be an independent risk factor of fractures regardless of BMD. METHODS: This study was conducted on 197 women aged 65 years or more who were hospitalized with osteoporotic hip fracture (femur neck fractures ; 84, intertrochanteric fractures; 113). Control group included 551 women who visited to check osteoporosis. Femur BMD and proximal femoral geometry for all subjects were measured using dual energy X-ray absorptiometry (DXA), and compared between the control and fracture groups. Besides, proximal femoral geometric parameters associated with fractures were statistically analyzed. RESULTS: There were statistically significant differences in the age and weight, cross-sectional area (CSA)/length/width of the femoral neck and BMD of the proximal femur between fracture group and control group. BMD of the proximal femur in the control group was higher than in the fracture group. For the femoral neck fractures group, the odds ratio (OR) for fractures decrease in the CSA and neck length (NL) of the femur increased by 1.97 times and 1.73 times respectively, regardless of BMD. The OR for fractures increase in the femoral neck width increased by 1.53 times. In the intertrochanteric fracture group, the OR for fractures increase in the femoral neck width increased by 1.45 times regardless of BMD. CONCLUSIONS: We found that an increase of the femoral neck width could be a proximal femoral geometric parameter which plays important roles as a risk factor for fracture independently of BMD.
Absorptiometry, Photon ; Bone Density ; Continental Population Groups ; Female* ; Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Hip* ; Humans ; Neck ; Odds Ratio ; Osteoporosis ; Risk Factors*

No abstract available.
Animals ; Ethanol* ; Metabolism* ; Phenobarbital* ; Rats* ; Trichloroethylene*

The purpose of this study was to compare the occupational health concerns and opinions among 4 groups: workers, employers and managers, government officials, and health & safety managers. It could help establishing occupational health plans efficiently and providing the way to solve health problems in workplaces in the Inchon area. The delphi technique which is used for deciding group opinion was adopted for this study. Questionnaires regarding health problems and their priorities in the workplaces were sent to four groups three times. All items were measured by five degree ordinal scales. The four groups agreed with questionnaire items, improvement of working environment, occupational health concerns of the employers, the health concerns of workers, and measurement and analysis of working environment, as the upper five priorities for solving the occupational health problems. Besides with the first five priorities, health examinations, health education, and occupational diseases were suggested as important health problems in workplace.
Delphi Technique ; Health Education ; Health Priorities ; Humans ; Incheon* ; Occupational Diseases ; Occupational Groups ; Occupational Health* ; Surveys and Questionnaires ; Weights and Measures

BACKGROUND: There are few reports on bone mineral density (BMD) changes of axial bones after total knee replacement (TKR) due to severe osteoarthritis (OA) of the knee joint and its results are controversial. The purpose of our study was to measure the BMD changes of hip and spine in patients receiving TKR due to severe OA and to identify clinical factors relating BMD changes. METHODS: Among 66 female patients above 65 years old who underwent TKR due to severe OA and checked preoperative BMD, 52 patients who checked 1 year follow up BMD were enrolled. We investigated the association of the BMD changes with bilaterality of operation, obesity, preoperative knee functional scores, bisphosphonate medication, and diagnosis of osteoporosis. RESULTS: We found no correlation between BMD changes and bilaterality of operation, obesity, preoperative knee functional scores and diagnosis of osteoporosis. Spine BMD increased in non-treatment and bisphosphonate treatment group but total hip BMD significantly increased in bisphosphonate treatment group. CONCLUSIONS: Bisphosphonate treatment for 1 year prevents early reduction of hip BMD just after TKR regardless osteoporosis diagnosis. We considered that the bisphosphonate medication would be beneficial to prevention of later hip fracture in elderly patient receiving TKR due to severe OA of knee joints.
Arthroplasty, Replacement, Knee* ; Bone Density* ; Diagnosis ; Female ; Follow-Up Studies ; Hip ; Humans ; Knee ; Knee Joint ; Obesity ; Osteoarthritis ; Osteoporosis ; Spine

BACKGROUND: Recently, as an independent fracture factor from Bone mineral density (BMD), muscle weakness due to the fatty degeneration of thigh muscles have been attracting attentions as causes of hip fracture. The purpose of this study is to investigate the correlation between the body composition and BMD and fatty degeneration of thigh muscles of the female patients over 65 years old with osteoporotic hip fracture. METHODS: This study was conducted with 178 female osteoporotic hip fracture patients. Total hip BMD was measured using dual energy X-ray absorptiometry. Cross-sectional area (CSA), cross-sectional muscle area (CSmA), muscle attenuation coefficient (MAC), and intramuscular adipose tissue (IMAT) of gluteus maximus, hip abductors, quadriceps and hamstring muscle were measured with computed tomography. Normalized IMAT (nIMAT) was calculated by dividing the fat area in the muscle into the size of each muscle. The correlation between each measurement is examined then the differences between the intertrochanteric fracture group and the femoral neck fracture group were analyzed. RESULTS: CSmA and MAC of quadriceps were the largest and nIMAT was the lowest. CSA and CSmA of the four muscles showed a statistically significant positive correlation with weight, height, body mass index (BMI), and BMD. MAC of 2 gluteal muscles was positively correlated with weight, BMI and BMD. nIMAT of all four muscles was positively correlation with weight and BMI but nIMAT of 2 mid-thigh muscles was positively correlation with BMD. CONCLUSIONS: Muscle size and fatty degeneration in the thigh muscles were most positively correlated with the body weight. BMD was positively correlation with CSA and CSmA of all thigh muscles, and MAC of 2 gluteal muscles and fatty degeneration of 2 mid-thigh muscles. There was no statistically significant difference in the size of the femoral muscle and the degree of fatty degeneration between the two fracture groups.
Absorptiometry, Photon ; Adipose Tissue ; Attention ; Body Composition ; Body Height ; Body Weight ; Bone Density* ; Female ; Femoral Neck Fractures ; Hip Fractures ; Hip* ; Humans ; Muscle Weakness ; Muscles* ; Osteoporosis ; Thigh*

The authors have examined 980 children with strabismus who were 6 years of age or under at the Eye Clinic of Yeungnam University Hospital. This study was conducted during the 4-year period between January 1990 and December 1994. The main objective of this study was to determine the incidence and clinical characteristics of fundus abnormality in children with strabismus. The total number of subjects in this study are 980 cases. Sixty subjects(6.1%) are found to have optic disc, chorioretinal and vitreous anomalies. Among them, 26 cases(43%) are diagnosed as having optic nervehypoplasia, in 7 cases (12%) coloboma, in 4 cases(7%) morning glory syndrome, in another 4 cases persistent hyperplastic primary vitreous, and in 3 cases retinoblastoma. In our study, 6.1% of the patients with strabismus are found to have disorders in optic disc and vitreoretina. These finding suggests that infants and young children with strabismus should have been examined to detect other related disorders of the eye.
Child* ; Coloboma ; Humans ; Incidence ; Infant ; Persistent Hyperplastic Primary Vitreous ; Retinoblastoma ; Strabismus*

PURPOSE: The result of more than 5 year follow up after cementless total hip arthroplasty using circumferentially porous coated femoralstem was evaluated. MATERIALS AND METHODS: Eighty five patients (95 hips) were followed more than 5 years after a primary total hip arthroplasty using multilockfemoral stem, which was circumferentially porous coated at the proximal 1/3 of femoral stem. The average age at the time of operation was 48 years. The average duration of followup was 6.9 years. The Harris hip score was used for the evaluation of clinical results. The canal fit of the stem at the proximal canal and isthmus level was evaluated from the postoperative radiographs. The component stability, endosteal bone formation, radiolucent line, osteolysis and polyethylene wear were evaluated from serial followup radiographs. RESULTS: The mean Harris hip scores increased from 60.1 points preoperatively to 91.3 points at the time of the most recent followup. All hips had a press fit at both the proximal canal and isthmus level. On the lastest followup radiograph, endosteal bone formation was observed in all cases (100%). The radiolucent line around the femoral stem was observed in 92 cases (97%), mainly Gruen zones II, III, IV, V and VI. The radiolucent line was thinner than 1 mm and there was no progressive widening. The acetabular osteolysis developed in 31 cases(33%) and the femoral osteolysis in 31 cases (33%) mostly in Gruen zones I, II, and VII. There was no distal osteolysis in the femur. There was no loosening or migration of cup and stem. The mean linear wear was 1.29 (0-5.69) mm and the mean rate of linear wear was 0.18(0-0.81) mm/year. Seventeen hips (18%) were revised for the dissociation of polyethylene liner in 10 hips (11%), excessive wear in the polyethylene liner and progressive osteolysis in 6 hips (6%) and recurence of tuberculous arthritis in 1 hip (1%). CONCLUSION: Cementless total hip arthroplsty using circumferentially porous coated femoral stem showed good medium-term results clinicallyand radiologically, it is likely that circumferential porous coating in the femoral stem induces bone ingrowth and prevents distal osteolysis.
Acetabulum ; Arthritis ; Arthroplasty, Replacement, Hip* ; Femur ; Follow-Up Studies* ; Hip ; Humans ; Osteogenesis ; Osteolysis ; Polyethylene

BACKGROUND: The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients. METHODS: We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including “Fracture” [tiab] AND “Teriparatide [tiab] OR “PTH” [tiab]. RESULTS: This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis. Fracture location was 2 in pelvis, 3 in proximal femur, 1 in distal femur, 1 in shoulder, 2 in wrist and 2 in spine. The use of teriparatide yielded positive effects on radiographic bone healing in 6 studies, but was not associated with better radiographic outcome in 3. In terms of functional recovery, teriparatide injection was related with decrease in pain or shorter time to mobilization in 6 studies, but not related with pain numerical scale and mobility in 3. CONCLUSIONS: Our findings suggest that teriparatide provide selective advantages to fracture healing or functional recovery in the management of osteoporotic fractures. A better understanding of the role of teriparatide on osteoporotic fractures requires greater evidences from large volume prospective trials.
Femur ; Fracture Healing* ; Humans ; Osteoporosis ; Osteoporotic Fractures ; Parathyroid Hormone ; Pelvis ; Prospective Studies ; Retrospective Studies ; Shoulder ; Spine ; Teriparatide* ; Wrist

PURPOSE: We studied short-term effects of steroid and anti-inflammatory drugs on collagen synthesis in rat skin. MATERIALS AND METHODS: The 18 rats were divided equally into three groups: group I; piroxicam, group II; triamcinolone, group III; saline. All drugs were given by intraperitoneal injection. Drugs were administered to rats for 4 days after dorsal skin incision. One day after operation and at 24 hour interval there after, skin tissues containing subcutaneous fat were randomly harvested. Measurement procedures were composed of three steps: the first was Masson's trichrome stain for collagen tissue identification; the second involved transporting the image to a computer and the third the analyses of the collagen area using a morphometry program. RESULTS: Statistically significant differences were found in the mean values of the relative collagen contents of the triamcinolone and saline injection groups on the third day (p<0.05). Relative collagen content of the saline injection group was greater than those of the other groups. The triamcinolone group showed the least collagen content. Collagen content of groups increased in time. CONCLUSION: Steroid had an inhibitory effect on the synthesis of collagen. Anti-inflammatory drugs also reduced the amount of collagen synthesis, but without statistical difference.
Animals ; Collagen* ; Injections, Intraperitoneal ; Piroxicam ; Rats* ; Skin* ; Subcutaneous Fat ; Triamcinolone ; Wound Healing* ; Wounds and Injuries*

PURPOSE: Femoroacetabular impingement (FAI) is considered an important cause of early degenerative arthritis development. Although three-dimensional (3D) imaging such as computed tomography (CT) and magnetic resonance imaging are considered precise imaging modalities for 3D morphology of FAI, they are associated with several limitations when used in out-patient clinics. The paucity of FAI morphologic data in Koreans makes it difficult to select the most effective radiographical method when screening for general orthopedic problems. We postulate that there might be an individual variation in the distribution of cam deformity in the asymptomatic Korean population. MATERIALS AND METHODS: From January 2011 to December 2015, CT images of the hips of 100 subjects without any history of hip joint ailments were evaluated. A computer program which generates 3D models from CT scans was used to provide sectional images which cross the central axis of the femoral head and neck. Alpha angles were measured in each sectional images. Alpha angles above 55° were regarded as cam deformity. RESULTS: The mean alpha angle was 43.5°, range 34.7–56.1°(3 o'clock); 51.24°, range 39.5–58.8°(2 o'clock); 52.45°, range 43.3–65.5°(1 o'clock); 44.09°, range 36.8–49.8°(12 o'clock); 40.71, range 33.5–45.8°(11 o'clock); and 39.21°, range 34.1–44.6°(10 o'clock). Alpha angle in 1 and 2 o'clock was significantly larger than other locations (P < 0.01). The prevalence of cam deformity was 18.0% and 19.0% in 1 and 2 o'clock, respectively. CONCLUSION: Cam deformity of FAI was observed in 31% of asymptomatic hips. The most common region of cam deformity was antero-superior area of femoral head-neck junction (1 and 2 o'clock).
Adult ; Congenital Abnormalities ; Femoracetabular Impingement ; Femur ; Head ; Hip Joint ; Hip ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Methods ; Neck ; Orthopedics ; Osteoarthritis ; Outpatients ; Prevalence ; Tomography, X-Ray Computed