Primary hyperparathyroidism is a disease that causes hypercalcemia and abnormal bone metabolism due to an increase in parathyroid hormones, and the occurrence rate of bone fracturing is higher in patients with primary hyperparathyroidism. Parathyroid hormones have recently frequently been used as an osteogenesis catalyst treatment for osteoporosis in the elderly. This research study examined the case study that was experienced on the diagnosis and treatment of primary hyperparathyroidism caused by adenoma and extreme hypercalcemia that was discovered in menopausal women with bone fractures and extreme osteoporosis.
Adenoma ; Aged ; Diagnosis ; Female ; Fractures, Bone ; Humans ; Hypercalcemia ; Hyperparathyroidism, Primary ; Metabolism ; Osteogenesis ; Osteoporosis ; Teriparatide

The purpose of this study were to constructed multi-level cervical spine finite element (FE) model and to investigate changes in load distribution and range of motion (ROM) at index level and adjacent levels at immediately after anterior cervical discectomy and fusion (ACDF) and after full bony union using constrained and semi-constrained cervical plate systems(dynamic plate, variable screw). A FE model of intact cervical spine (C3-6) was created from computer tomography (CT) images of the healthy adult (male, 26 years, no pathologies). The post-op FE models (C5-6 with ACDF, cage with bone graft) were constructed by modifying a intact cervical FE model. Four different configurations of the model were considered: Type 1-Rigid plate+Fixed screw, Type II-Rigid plate + Variable screw, Type III-Dynamic plate + Fixed screw, Type IV-Dynamic plate + Variable screw. The bone-cage and bone screw interface behavior were accomplished via 'tie' contact condition and friction coefficient of 0.2 to assume fusion and non-fusion, respectively. The inferior endplate of C6 vertebral body was constrained in all directions. Loading condition used hybrid protocol with follower load of 73.6N at superior endplate of C3 vertebral body. In non-fusion cases, load at the bone graft increased from Type I to IV (2.3
Adult ; Biomechanical Phenomena ; Bone Screws ; Diskectomy ; Freedom ; Friction ; Humans ; Range of Motion, Articular ; Spine ; Transplants

OBJECTIVES: The present study was performed to evaluate the association between serum ferritin concentrations and bone mineral density (BMD) in a representative Korean general population. METHODS: This was a cross-sectional study based on data obtained in the Korean National Health and Nutrition Examination Survey (2008~2010). The present cross-sectional analysis was restricted to participants > or =20 years of age who completed the health examination survey and BMD measurement (n=15,538).
Bone Density ; Cross-Sectional Studies ; Female ; Ferritins ; Humans ; Iron ; Linear Models ; Male ; Nutrition Surveys ; Prevalence ; Public Health

PURPOSE: To analyze serum markers in proximal femur fracture patients, which are known to be accompanied with osteophorosis or metabolic diseases, and consider it as predictive factor and to study how it affects on the fracture form. MATERIALS AND METHODS: Vit. D3 known as serum marker of Vit. D, 25(OH)D, and 1,25(OH)2D of 152 patients from April, 2013 to March, 2014 who visited our hospital and diagnosed as proximal femur fracture(Femur neck fracture 73, Intertrochanteric fracture 79) were analyzed. Also, serum calcium level corrected by serum protein, phosphate, creatinine, alkaline phosphatase, estradiol, IGF-1, and PTH were compared and analyzed. RESULTS: Femur neck fracture group showed significantly low value of D3, 25(OH)D, and 1,25(OH)2D (P-value<0.05) as the values were 37.72+/-7.21 pg/mL, 27.05+/-8.43 ng/mL, 25.05+/-6.78 pg/mL in femur neck fracture group, and 40.36+/-6.97 pg/mL, 29.54+/-9.12 ng/mL, 28.87+/-7.43 pg/mL in intertrochanteric fracture group respectively. The number of patients who were diagnosed as hypovitaminosis D. due to serum 25(OH)D value lower than 30ng/ml were significantly high in femur neck fracture group as the numbers were 56 in femur neck fracture, and 44 in intertrochanteric fracture. Serum calcium level corrected by serum protein, phosphate, creatinine, alkaline phosphatase, estradiol, IGF-1 and PTH level showed no significant difference between two groups. CONCLUSION: Serum 25(OH)D level was decreased in proximal femur fracture patiens, and was lower as the patient was older and BMD was lower. Therefore it is thought that proximal femur fracture is affected by vitamin D metabolism.
Alkaline Phosphatase ; Biomarkers ; Calcium ; Creatinine ; Estradiol ; Femoral Neck Fractures ; Femur ; Humans ; Insulin-Like Growth Factor I ; Metabolic Diseases ; Metabolism ; Neck ; Vitamin D

INTRODUCTION: Percutaneous vertebroplasty is effective surgical method for treating osteoporotic compression fracture. But there is a few data for long term follow-up clinical and radiologic result, especially injected cement features. We assessed the radiographic features of patients who underwent percutaneous vertebroplasty (PVP) in osteoporotic compression fractures with a minimum of 7 years follow-up retrospectively. METHODS: Between January 2000 and August 2007, 253 patients were treated with PVP for osteoporotic compression fracture at our department; 81 patients died during follow-up and 101 patients (177 vertebras) were available for follow-up for over 7 years. We analyzed the radiologic outcome focused on injected cement feature. RESULTS: The mean follow-up period was 7.9 years. A new adjacent vertebral fracture was documented by 55 vertebral bodies in 35 patients. During the follow-up period, 81 patients (44.5%) in 182 patients died. Anterior body height in the last follow-up was improved about 0.3 mm compared with the preprocedural value , but was not statistically significant. Also, the focal kyphotic angle was reduced from 12.3degrees at the preprocedural state to 11.7degrees at the postprocedural state but was not statistically significant (P>0.05). Out of the 101 cases, the 89 cases for whom the cement was injected into the vertebral body were kept in a stable condition. Seven cases of radiolucent line with decreased bone density in the adjacent area of cement and 5 cases of cement cracks accompanied with vertebral collapse were observed. CONCLUSION: PVP for osteoporotic compression fracture is an efficient procedure for pain relief by long term follow-up. The cement injected vertebrae showed stable radiologic progression without significant changes in vertebral height or kyphotic angle.
Body Height ; Bone Density ; Follow-Up Studies ; Fractures, Compression ; Humans ; Retrospective Studies ; Spine ; Vertebroplasty

OBJECTIVES: To examine and compare the effects of vertebroplasty or kyphoplasty on change in the vertebral height and kyphotic angle and presence of new vertebral fracture of adjacent level. MATERIALS AND METHODS: A total of 60 patients with vertebral compression fractures or stable burst fractures underwent vertebroplasty or kyphoplasty from Jan, 2007 to April, 2014 were included in the study. Preoperative, postoperative and last follow-up radiographs were analyzed to quantify presence of new vertebral fractures and preoperative and postoperative vertebral height and kyphotic angle at fracture levels were also measured. Changes in the vertebral body height and kyphotic angle at fracture levels were compared for vertebroplasty and kyphoplasty to determine if there was a significant differences. RESULTS: Measurements revealed that vertebroplasty increased vertebral body height at fracture level by an average 5.5mm or or by 33% of preoperative height and reduced local kyphotic angle by an average 3.5 degrees and kyphoplasty increased vertebral body height at fracture level by an average 5.8mm or by 36% of preoperative height and reduced local kyphotic angel by an average 3.6 degrees. New vertebral fractures occurred in 8 patients (24%) after vertebroplasty and 4 patients (14%) after kyphoplasty. CONCLUSION: There was no significant statistically greater improvement of changes in the vertebral body height at fracture level and kyphotic angle found with vertebroplasty and kyphoplasty. But the vertebroplasty has statistically greater risk of new fracture than kyphoplasty.
Body Height ; Follow-Up Studies ; Fractures, Compression ; Humans ; Kyphoplasty ; Vertebroplasty

Selective estrogen receptor modulators (SERMs) are a diverse group of synthetic non-steroidal compounds that have various levels of estrogen receptor (ER) agonist or antagonist activity depending on the target tissue. This feature of SERMs could be explained by the differential expression of two ER isoforms (ERalpha or ERbeta), the differential ER conformational change and the differential coregulatory proteins (coactivator or corepressor) in a selected tissue. Based on their efficacy and safety, SERMs have been used for the prevention and treatment of breast cancer (tamoxifene and toremifene), prevention and treatment of osteoporosis (relaoxifene and bazedoxifene), treatment for dyspareunia related to vulvovaginal atrophy (ospemifene) and treatment for vasomotor symptoms associated with menopause (tissue selective estrogen complex; TSEC). Many of the available SERMs are well-known for their anti-estrogenic effects in breast and for their estrogenic effects in bone. The effect on the endometrium have played a key role in differentiate SERMs in clinical practice. The effect of SERMs in the vagina also shows clear distinction among different SERMs. This review summarizes their action mechanism and describes their clinical findings in different target tissues. In the osteoporosis treatment, SERMs such as raloxifene and bazedoxifene is a safe and effective option for women who cannot tolerate or are unwilling to take bisphosphonates and may be appropriate for younger woman with the age of < or =70 years old who expect to remain on therapy for many years and are concerned about the long-term safety of bisphosphonates.
Atrophy ; Breast ; Breast Neoplasms ; Diphosphonates ; Dyspareunia ; Endometrium ; Estrogens ; Female ; Humans ; Menopause ; Osteoporosis ; Protein Isoforms ; Raloxifene Hydrochloride ; Selective Estrogen Receptor Modulators ; Vagina

Calcific tendinitis of the longus colli is an inflammatory disease caused by calcium hydroxyapatite crystal deposition in the longus colli tendon of the prevertebral space. It is also known as retropharyngeal calcific tendinitis or prevertebral tendinitis. The typical imaging characteristics of this entity are calcifications on the superior insertion of the longus colli tendons at the C1-2 level and fluid collection in the retropharyngeal space. However, we introduce 2 case of acute longus colli tendinitis without definite calcification deposition on simple X-ray.
Durapatite ; Tendinopathy ; Tendons

Adefovir dipivoxil is used antiviral agent in the treatment of chronic hepatitis B virus infection. This drug is recommended for patients infected with lamivudine-refractory hepatitis B. Many studies of low-dose adefovir have shown little evidence of renal tubular dysfunction. However, hypophosphatemic osteomalacia has recently been reported in patients treated with adefovir. We report three cases of low dose adefovir-induced hypophosphatemic osteomalacia with fractures. All three patients had been receiving adefovir due to lamivudine-refractory hepatitis B, presented multiple bone pain. The laboratory tests revealed hypophosphatemia and phosphaturia. Bone scintigraphy showed increased uptake in multiple lesions. They were diagnosed as adefovir induced hypophophatemic osteomalacia. Changing the antiviral agent and administration of calcitriol and phosphates improved hypophosphatemia and clinical symptoms. Patients with hepatitis B virus treated with adefovir should be monitored with the serum phosphate levels and presenting symptoms of diffuse bone pain, clinicians need to suspect this infrequent complication.
Calcitriol ; Hepatitis B ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hypophosphatemia ; Hypophosphatemia, Familial ; Osteomalacia ; Phosphates ; Radionuclide Imaging

INTRODUCTION: Percutaneous vertebroplasty(PVP) is effective surgical method for treating osteoporotic compression fracture. But there is a few data for long term follow-up radiologic result, especially injected bone cement features. We assessed the radiographic features of patients who underwent percutaneous vertebroplasty in osteoporotic compression fractures with a minimum of 7 years follow-up retrospectively. MATERIALS AND METHODS: Between January 2000 and August 2007, 253 patients were treated with PVP for osteoporotic compression fracture at our department; 81 patients died during follow-up and 101 patients (177 vertebrae) were available for follow-up for over 7 years. We analyzed the radiologic outcome focused on injected bone cement feature. RESULTS: The mean follow-up period was 7.9 years. A new adjacent vertebral fracture was documented by 55 vertebral bodies in 35 patients. Anterior body height in the last follow-up was improved about 0.3 mm compared with the preprocedural value, but was not statistically significant. Also, the focal kyphotic angle was reduced from 12.3° at the preprocedural state to 11.7° at the postprocedural state but was not statistically significant (P>0.05). Out of the 101 cases, the 89 cases for whom the cement was injected into the vertebral body were kept in a stable condition. Seven cases of radiolucent line with decreased bone density in the adjacent area of cement and 5 cases of cement cracks accompanied with vertebral collapse were observed. CONCLUSIONS: The bone cement injected vertebrae showed stable radiologic progression without significant changes in vertebral height or kyphotic angle.
Body Height ; Bone Density ; Follow-Up Studies ; Fractures, Compression ; Humans ; Retrospective Studies ; Spine ; Vertebroplasty