Objective: To describe the regional and population-related differences in calcaneus bone mineral density (BMD) across ten regions of China. Methods: Based on the results: from the second Re-survey of China Kadoorie Biobank project, in which 5% of the surviving participants were interviewed during 2013-2014 and 24 677 participants aged 38-87 years were included in the study. We excluded those people with missing data for BMD and important variables. Calcaneus BMD was measured using the quantitative ultrasound bone densitometer. We analyzed four indexes, including broadband ultrasound attenuation (BUA), speed of sound (SOS), stiffness index (SI), and T score. Results The average calcaneus BMDs of the present population were: BUA (109.7±12.6) dB/MHz, SOS (1 554.7±45.6) m/s, SI (88.3±18.8), T score (-0.74±1.28). Urban residents showed higher calcaneus BMD, so as in men. The calcaneus BMD decreased by age, with a larger decline seen in women. Current smokers and postmenopausal women presented lower calcaneus BMD, while in those who frequently drank milk or yogurt or being physically more active, had higher calcaneus BMD. Conclusion: Calcaneus BMD varied greatly among people from the ten regions of CKB study and among participants having different demographic characteristics, lifestyle behaviors or health conditions.
Absorptiometry, Photon/methods* ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bone Density/physiology* ; Calcaneus/diagnostic imaging* ; China ; Female ; Humans ; Male ; Middle Aged ; Residence Characteristics ; Rural Population ; Sex Factors ; Ultrasonography ; Urban Population

The purpose of this study was to investigate the association between coffee consumption and bone status (bone mineral density and bone metabolism-related markers) according to calcium intake level in Korean young adult males. Healthy and nonsmoking males (19-26 years, n = 330) participated in this study. Anthropometric measurements, dietary habits, and nutrient intakes were surveyed. Bone status of the calcaneus was measured by using quantitative ultrasound (QUS). Bone metabolism-related markers including serum total alkaline phosphatase activity (TALP), N-mid osteocalcin (OC), and type 1 collagen C-terminal telopeptide (1CTP) were analyzed. The subjects were divided into two groups based on daily calcium intake level: a calcium-sufficient group (calcium intake ≥ 75% RI, n = 171) and a calcium-deficient group (calcium intake < 75% RI, n = 159). Each group was then further divided into three subgroups based on daily average coffee consumption: no-coffee, less than one serving of coffee per day, and one or more servings of coffee per day. There were no significant differences in height, body weight, body mass index, energy intake, or calcium intake among the three coffee consumption subgroups. QUS parameters and serum 1CTP, TALP, and OC were not significantly different among either the two calcium-intake groups or the three coffee consumption subgroups. Our results may show that current coffee consumption level in Korean young men is not significantly associated with their bone status and metabolism according to the calcium intake level.
Alkaline Phosphatase ; Body Height ; Body Weight ; Calcaneus ; Calcium* ; Coffee* ; Collagen Type I ; Energy Intake ; Food Habits ; Humans ; Male* ; Metabolism ; Miners ; Multiple Endocrine Neoplasia Type 1 ; Osteocalcin ; Ultrasonography ; Young Adult*

Mycetoma is a chronic, debilitating, granulomatous disease affecting the subcutaneous tissue, fascia, muscle, bone and adjacent organs characterized by triad of tumefaction, draining sinus, and grains. The ten-year incidence in our institution from 2000 to 2010 is 3 out of 81,015 cases. We present a 33-year-old man with a nine-year history of painless nodules and draining sinuses on the left foot which were unresponsive to oral antibiotics and topical antifungals. Biopsy of a nodule was consistent with mycetoma. Fungal culture revealed Madurella mycetomatis growth confirming eumycetoma. X-ray of the left foot showed poorly marginated lucencies on the calcaneus and navicular bones. Ultrasound revealed mixed hyperreflective echoes and multiple small cavities. We diagnosed the patient with Stage III eumycetoma based on the radiographic classification of bone involvement and prescribed oral ketoconazole 400 mg daily for nine months achieving 50-60% decrease in lesion size. Surgical debulking was done and ketoconazole was continued at the same dose for another nine months. There was good granulation tissue formation and no appearance of new lesions after surgery.

Human ; Adult ; Anti-bacterial Agents ; Calcaneus ; Cytoreduction Surgical Procedures ; Fascia ; Foot ; Granulation Tissue ; Ketoconazole ; Madurella ; Mycetoma ; Subcutaneous Tissue ; Ultrasonography

A 56-year-old man complained of continuous pain in the right foot that began 6 months after undergoing surgery on the right calcaneus bone. The patient was diagnosed with complex regional pain syndrome (CRPS) type I and was treated with medication, lumbar sympathetic ganglion blocks, epidural nerve blocks, and spinal cord stimulation. However, all treatments were halted because they were ineffective or complications developed. Peripheral nerve stimulation (PNS) was planned after confirming the analgesic effects of a sciatic nerve block, and the patient received PNS via minimally invasive ultrasound-guided electrode placement. PNS reduced the pain intensity and the incidence of paroxysmal pain. Other than discomfort at the battery insertion site (resolved with re-implantation), the patient developed no complications. These results suggest that ultrasound-guided minimally invasive PNS is a safe and effective treatment for patients with CRPS in the lower extremities.
Calcaneus ; Complex Regional Pain Syndromes ; Electrodes ; Foot ; Ganglia, Sympathetic ; Humans ; Implantable Neurostimulators ; Incidence ; Lower Extremity ; Middle Aged ; Nerve Block ; Neuralgia ; Pain Management ; Peripheral Nerves* ; Sciatic Nerve ; Spinal Cord Stimulation ; Ultrasonography

PURPOSE: Differing lifestyle, nutritional, and genetic factors may lead to a differing stiffness index (SI) determined by quantitative ultrasound in elderly men and women. The purpose of this study was to determine SI and the gender-specific factors associated with low SI in a Korean elderly cohort. METHODS: This was a cross-sectional descriptive study identifying the gender-specific factors related to SI in 252 men and women aged 65 years and greater from local senior centers in Seoul, Korea between January and February 2009. RESULTS: The mean SI of elderly men was significantly higher than that of the women's. A multiple regression analysis reveals that age, nutritional status, and physical activity were predictive factors of lower SI in men, whereas age, alcohol consumption, educational level, and genetic polymorphism were predictive factors for elderly women. CONCLUSIONS: Low SI was common in both elderly men and women. We found gender differences in factors linked to low SI. In multiple regression analysis, nutritional status and physical activity were more important factors in men, whereas alcohol consumption, educational level, and genetic polymorphism were significant factors predicting low SI in women. Gender-specific modifiable risk factors associated with low SI should be considered when developing osteoporosis prevention programs for the elderly.
Age Factors ; Aged ; Aged, 80 and over ; Alcohol Drinking/epidemiology ; Calcaneus/*ultrasonography ; Cross-Sectional Studies ; Educational Status ; Female ; Humans ; Life Style ; Male ; Motor Activity/physiology ; Nutritional Status ; Polymorphism, Genetic ; Regression Analysis ; Risk Factors ; Seoul/epidemiology ; Sex Factors

OBJECTIVES: The aim of this study was to investigate prevalence of osteoporosis and its related factors in women farm workers. METHODS: The present study is a cross-sectional study. The study population consisted of 94 women farm workers aged 38 years and older with BMD measurements using quantitative ultrasound at calcaneus. Prevalence of osteoporosis and its related risk factors were analyzed. RESULTS: Prevalence of osteoporosis in women farm workers (range of age, 38~83 year-old; average age, 61.3 year-old) was 40.4% at calcaneus. Risk of osteoporosis was significantly increased with age; 60~69 year-old (OR, 18.50; 95% CI, 3.55~96.34) and > or =70 year-old (OR, 57.81; 95% CI, 11.32~295.20). After adjusting for age, risk of osteoporosis was significantly associated with annual household income below 20,000,000 Won (OR, 9.86; 95% CI, 1.03~94.34) and overweight (BMI, 23.0~24.9 kg/m2) (OR, 0.18; 95% CI, 0.05~0.72). CONCLUSIONS: Prevalence of osteoporosis in women farm workers was high and risk of osteoporosis was significantly associated with age, household income and BMI.
Calcaneus ; Cross-Sectional Studies ; Family Characteristics ; Female ; Humans ; Osteoporosis ; Overweight ; Prevalence ; Risk Factors ; Ultrasonography

The objective of this study is to determine the effectiveness of 16-month milk consumption as a part of the health promotion community program for women in Asan. Subjects included 313 women belonging to the milk group (mean age = 69.1, range 47~89 y) and 66 women to the control (mean age = 43.6, range 20~69 y) group. For those in the milk group, one cup (200ml) of partially lactose-digested low-fat milk was provided everyday for 16 months. Each subject was interviewed to assess calcium intake by a 24-h recall after fasting blood was obtained for analyzing bone turnover markers, and calcaneus broadband ultrasound attenuation (BUA) was measured by quantitative ultrasound (QUS) on the left heel before and after the milk supplementation. After 16 months, the calcium intake levels changed from 55% of recommended dietary allowance (RDA) to 85% RDA in the milk group and from 73% RDA to 84% RDA in the control group. BUA were reduced from 67.9+/-8.1 to 64.7+/-17.5 dB/MHz for milk and from 90.4+/-13.0 to 87.2+/-15.2 dB/MHz for control groups. Paired ttest showed the changes of BUA for both groups (-3.24 and -3.15 dB/MHz for milk and control groups, respectively) were significant, but the two groups did not show any differences in absolute changes. When post-BUA was analyzed after age, initial BUA and menopausal status were controlled as covariates in ANCOVA model, the milk group showed significantly (p < 0.05) smaller changes than the control group (-3.50 vs -6.71 dB/MHz, respectively). According to a multiple regression analysis, milk consumption and initial BUA showed significant interaction meaning that those with lower initial BUA showed higher milk effects. We conclude that one-cup a day milk consumption for 16 month can prevent further bone loss and significantly improve calcium intake.
Calcaneus ; Calcium ; Chungcheongnam-do* ; Fasting ; Female ; Health Promotion ; Heel ; Humans ; Milk* ; Osteocalcin ; Recommended Dietary Allowances ; Ultrasonography*

The purpose of this study was to investigate the relation between bone mineral density and nutrient intake among normal and obese elementary students. Each subject was assigned to one of such as normal (n = 69) and obese groups (n = 94) according to their obesity indices. And they were asked for general characteristics, dietary habits and nutrient intakes using questionnaires and 24-hr recall method. They measured the sound of speed (SOS) of calcaneus using quantitative ultrasound. The averages age of the subjects were 10.6 years in normal and 10.7 years in obese group. The averages weight (p < 0.001) and obesity index (p < 0.001) of the normal group were significantly lower than those of the obese group. In dietary habits, the obese group in boys was the higher skipped breakfast than normal group (p < 0.01). The plant calcium intake of obesity in girls was lower than those of normal group (p < 0.05). The SOS in the calcaneus was 1697.6 m/s in the obese group and 1763.7 m/s in the normal group (p < 0.01). The SOS in the calcaneus was negatively correlated to weight (p < 0.01), obesity index (p < 0.001) and percent of body fat (p < 0.01). Also the SOS in the calcaneus was positively correlated plant calcium intake (p < 0.05). In conclusion, the excessive increase of weight and percent of body fat in elementary students appeared to have negative impact to bone health. And based on these results, further studies on the effects on bone mineral density of obese and nutrient intakes in needed for proper bone health.
Adipose Tissue ; Bone Density* ; Breakfast ; Calcaneus ; Calcium ; Female ; Food Habits* ; Humans ; Obesity ; Plants ; Ultrasonography ; Surveys and Questionnaires

OBJECTIVETo study the relationship between ultrasonic bone mineral density (BMD) of calcaneus and age, height, and body weight, and to establish the normal reference value for stiffness index (SI) of healthy subjects in Guangxi autonomous region and provide scientific foundation for the diagnosis and prevention of osteoporosis.

METHODSSI of calcaneus in 1 816 healthy adults aged 11-90 years (775 men, 1 041 women) were measured with quantitative ultrasound. According to their ages, all the men and women were divided into 13 groups by 5-year age group.

RESULTSSI reached peak values in 21-25 year group in men (range: 111.45 +/- 21.19) and in 16-20 year group in women (range: 101.26 +/- 17.51). Then the SI value began to decline with aging. The SI featured by a typical dual-peak curve in women and the decrease rate of SI was faster in women than in men over 61 years. Multivariate linear regression analysis showed significantly negative correlation between SI and age (P < 0.001), positive correlation between SI and body weight (P < 0.05 for men; P < 0.01 for women), and positive correlation between SI and height in women (P < 0.01).

CONCLUSIONSI correlates with age, height, and weight. The acquired SI value may provide a reference for the diagnosis of osteoporosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Density ; Calcaneus ; diagnostic imaging ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Osteoporosis ; diagnosis ; epidemiology ; Ultrasonography

OBJECTIVE: To evaluate the effects of age, height, weight, body mass index (BMI), diabetes mellitus, osteoporosis, smoking and alcohol on postural sway (PS) and limb load asymmetry (LLA) in the rural inhabitants in Korea METHOD: Nine hundred and sixty inhabitants were included in this study. PS and LLA were recorded while the subjects were standing on two adjacent force platforms (Mediance(R); Human-Tech Inc, Korea) in a comfortable stance for 30 seconds. Bone mineral density was measured in the right calcaneus by ultrasonography (Sahara(R); Hologic Inc, USA). History of diabetes and smoking were taken through interview. RESULTS: PS and LLA were correlated with age (p<0.01). There were significant decreases in PS and LLA in the young age-group (p<0.01). There was no significant difference in PS and LLA in terms of sex, osteoporosis, height, weight, BMI and smoking. There was a significant difference in LLA (p<0.05) but no difference in PS between diabetic and normal groups. CONCLUSION: PS and LLA may be related with ageing. Diabetic group may have higher LLA than normal group. However, sex, osteoporosis, height, weight, BMI, and smoking may not affect on PS and LLA.
Body Weight ; Bone Density ; Calcaneus ; Diabetes Mellitus ; Extremities* ; Korea* ; Osteoporosis ; Smoke ; Smoking ; Ultrasonography