Prevalence of premenopausal osteoporosis in hypothyroid patients

Background: Hypothyroidism alone is not a risk factor for osteoporosis but the patient on treatment with levothyroxine in chronic terms have the greater chances of osteoporosis. This study is to evaluate the role of chronic levo-thyroxine treatment on bone mineral density and the development of osteoporosis.Methods: A cross sectional descriptive study in which patients with recently diagnosed as hypothyroidism were taken as the first group and the second group as those who were having hypothyroidism for more than 2 years plus on chronic treatment with levothyroxine. Healthy premenopausal women were the control group. TSH was measured in all and the T score were used to measure osteoporosis severity. T score of lumbar vertebra and neck of femur were used for comparison. The description of qualitative data was done in absolute frequencies and percentages. The description of quantitative data were done as the, mean standard deviation, median, minimum and maximum. In the comparison of qualitative data between groups, the Chi-square test and contingency tables was used by rearranging the percentages of several variables (TSH, t-score). The statistical significance was set p<0.05.Results: TSH levels in the first group were slightly different from rest of the groups. T score were significantly lesser in patients in the second group who are diagnosed with hypothyroidism and on treatment with levothyroxine.Conclusions: The treatment for hypothyroidism with levo thyroxine reduces both TSH and bone mineral density in the study groups. Proper control of risk factors and avoidance of high dose thyroxine supplements are an effective way in prevention of osteoporosis.

Prospective evaluation of heparin-induced thrombocytopenia expert probability and 4T scores in Chinese patients with suspected heparin-induced thrombocytopenia / 中华医学杂志(英文版)

Background@#Diagnosis of heparin-induced thrombocytopenia (HIT) is challenging. This study aimed to compare the diagnostic performance of HIT expert probability (HEP) and 4T scores, and to evaluate the inter-observer reliability for the 4T score in a clinical setting.@*Methods@#This prospective study included HIT-suspected patients between 2016 and 2018. Three hematologists assessed the HEP and 4T scores. Correlations between scores and anti-platelet factor 4 (anti-PF4)/heparin antibodies were evaluated. Receiver operating characteristic curves and area under the curve (AUC) were used to assess the predictive accuracy of these two scoring models. The intraclass correlation coefficient (ICC) was used to assess the inter-observer agreement of 4T scores between residents and hematologists.@*Results@#Of the 89 subjects included, 22 (24.7%) were positive for anti-PF4/heparin antibody. The correlations between antibody titer and either HEP or 4T scores were similar (r = 0.392, P < 0.01 for the HEP score; r = 0.444, P < 0.01 for the 4T score). No significant difference in the diagnostic performance was displayed between these two scores (AUC for the HEP score: 0.778 vs. AUC for the 4T score: 0.741, P = 0.357). Only 72 4T scores were collected from the residents, with a surprisingly low percentage of observers (43.1%) presenting the four individual item scores which made up their 4T score. The AUC of 4T score assessed by residents and hematologists was 0.657 (95% confidence interval [CI]: 536–0.765) and 0.780 (95% CI: 0.667–0.869, P < 0.05), respectively. The ICC of 4T score between residents and hematologists was 0.49 (95% CI: 0.29–0.65, P < 0.01), demonstrating a fair inter-observer agreement.@*Conclusions@#The HEP score does not display a better performance for predicting HIT than the 4T score. With the unsatisfactory completion rate, the inter-observer agreement of 4T score in a tertiary hospital is fair, underscoring the necessity for continuing education for physicians.

Geographical variations of osteoporosis rate in Mongolian adults / Монголын Анагаах Ухаан

IntroductionOsteoporosis is becoming an increasingly important economic and public health problem as ourpopulation ages. Different results are reported about osteoporosis rate among various geographicalzones and ethnic groups even in same country. These differences cannot be attributed to hormonalstate or to the dietary intake of calcium, but do accord in general with the living standards of the differentcountries and the degree of physical activity undertaken by the different populations and sexes.GoalTo determine the osteoporosis rate among Mongolian adults and evaluate the geographical distributionsof osteoporosis rateMaterials and MethodsOur study group was 1990 adults who are over 18 years and participated from Uvs, Arkhangai, Dundgovi,Sukhbaatar province and Ulaanbaatar. We have evaluated serum PTH, 25-hydroxyvitamin D level andbone mineral density via bone sonometer (Sunlight Mini-Omni, Beammed, USA). Lifestyle risk factorswere evaluated through a specific questionnaire.ResultsThe osteoporosis rate is 25.5% (n=507) among Mongolian adults and 2 times higher in women thanmen in all age group. SOS was inversely correlated with age in both sexes (men: r=-0.286, p<0.01,women: r=-0.513, p<0.01). Osteoporosis rate was lowest in Ulaanbaatar but highest in Arkhangai(male osteoporosis) and Dundgovi province (female osteoporosis). Of 25-hydroxyvitamin D values 29%were below 20ng/ml (deficient), 39.8% ranged from 20-29.9ng/ml (insufficient) and 31.2% were above30ng/ml (sufficient). In addition, 25-hydroxivitamin D concentrations were not related to bone density.Serum 25-hydroxivitamin D level was highest in Dundgovi province in both sexes. Mean PTH level was26.0±17.7pg/ml and inversely correlated with T-score (r=-0.248, p<0.01) in men.ConclusionOsteoporosis rate among Mongolian adult is lowest in Ulaanbaatar comparing to other rural areas. Andserum 25-hydroxivitamin D deficiency is 68.8% in Mongolian adults.

Bone mineral density and nutritional state according to milk consumption in Korean postmenopausal women who drink coffee: Using the 2008~2009 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study investigated bone mineral density and nutritional state according to consumption of milk in Korean postmenopausal women who drink coffee. METHODS: Using the 2008~2009 Korean National Health & Nutrition Examination Survey data, a total of 1,373 postmenopausal females aged 50 yrs and over were analyzed after excluding those with diseases related to bone health. According to coffee and/or milk consumption, subjects were divided into four groups: coffee only, both coffee & milk, milk only, and none of the above. All data were processed after application of weighted values and adjustment of age, body mass index, physical activity, drinking, and smoking using a general linear model. For analysis of nutrient intake and bone density, data were additionally adjusted by total energy and calcium intake. RESULTS: The coffee & milk group had more subjects younger than 65 yrs and higher education, urban residents, and higher income than any other group. The coffee only group showed somewhat similar characteristics as the none of the above group, which showed the highest percentage of subjects older than 65 and in a lower education and socio-economic state. Body weight, height, body mass index, and lean mass were the highest in coffee & milk group and lowest in the none of the above group. On the other hand, the milk only group showed the lowest values for body mass index and waist circumference, whereas percent body fat did not show any difference among the groups. The coffee and milk group showed the highest bone mineral density in the total femur and lumbar spine as well as the highest nutritional state and most food group intakes, followed by the milk only group, coffee only group, and none of the above group. In the assessment of osteoporosis based on T-score of bone mineral density, although not significant, the coffee and milk group and milk only group, which showed a better nutritional state, included more subjects with a normal bone density, whereas the none of the above group included more subjects with osteoporosis than any other group. CONCLUSION: Bone mineral density in postmenopausal women might not be affected by coffee drinking if their diets are accompanied by balanced food and nutrient intake including milk.

Appropriate Cement Volume in Vertebroplasty: A Multivariate Analysis with Short-Term Follow-Up / 대한신경손상학회지

OBJECTIVE: The optimal threshold of the infusion volume of cement has been a continuous subject in percutaneous vertebroplasty (PVP). This study verifies a causal relationship between the cement volume and the clinical outcome, and suggests the parameters of the appropriate volume of cement in PVP. METHODS: This is a retrospective study. One hundred nine patients, who underwent PVP between 2012 and 2015, were included in the study. Various factors such as patients' fracture levels, fracture types, fracture body volumes, fracture rates, bone mineral densities, and infused cement volumes were analyzed. Cement infusion ratios were calculated, using total amount of infused cement and fractured body volume. Follow up was done after one-week, one-month and three-months, postoperatively. Changes in the middle body height and the cement leakage levels were monitored and clinical outcomes were evaluated using a visual analogue scale. RESULTS: Among the variables, the infusion ratio (r=-0.320, p=0.003, Pearson's correlation) was the only index that showed a significant cause and effect relationship with favorable clinical outcome, except the group with a T-score of higher than -2.5, and the group with a upper thoracic vertebral level. The patients with a cement infusion ratio of 27.8% or more of the fractured body volume had favorable results. CONCLUSION: This study showed that high cement infusion ratio revealed favorable outcome in the vertebroplasty of the osteoporotic compression fractures. Infusion ratio of more than 27.8% to osteoporotic compressed vertebrae is optimal for rapid recovery after PVP.

BONE MINERAL DENSITY IN PATIENTS WITH HYPERTHYROIDISM / Шинэ санаа Шинэ нээлт

Hyperthyroidism is associated with accelerated bone remodeling, reduced bone density, osteoporosis and an increase in fracture rate. In the statistical report of Center for Health Development, in 2015, there were 4960 female patients with thyrotoxicosis (E05) registered which more than 589 female patients with hypothyroidism (E00-E02). Therefore, we studied bone mineral density changes due to thyroid dysfunction in female patients. In the study 48 reproductive age female patients were participated. 24 of them were evaluated as relatively healthy patients and 24 of them were diagnosed by laboratory test with hyperthyroidism. The risk factors of osteoporosis were evaluated by questionnaires and bone mineral density was evaluated by bone sonometer. We determined serum level of TSH, fT3 and fT4 (TSH, fT3, fT4 TOSOH Corporation, Tokyo, Japan) and calcitonin (Calcitonin ELISA Kit, Eucardio laboratory, CA, USA). Results were calculated by SPSS-17 program. Total 48 patients ranging 18-45 years old (average age was 33.3±4.2 in control group and 32.2±6.7 in hyperthyroid group) were participated. As evaluating the osteoporosis diagnostic criteria of WHO, result for the control group was 92% (n=22) patients were healthy, 8% (n=2) patients had osteopenia and; 54% (n=13) was healthy, 25% (n=6) had osteopenia and 21%-д (n=5) had osteoporosis in hyperthyroid group. In the control group, T score mean was 1.3±1.3 (-1.9-(+2.5)) healthy to osteopenia and; -0.9±2.1 (-5.3-(+2.0)) healthy to osteoporosis in hyperthyroid group. Comparison of T score between control and hyperthyroid group, there were statistically relevant (p0.05. Depending on serum level of TSH, fT3 and fT4, bone mineral density was decreased more in patients with hyperthyroidism.

A study of factors leading to osteo-penia in the community: BMD camp based approach.

Background: Osteoporosis is an important public health problem in times of increasing life expectancy. A large number of cases are undiagnosed resulting in bone fragility & fractures. Bone mineral density reduces physiological in both sexes, but it is more rampant in women in hypoandrogenic states, i.e. post menopause. Methods: A community based bone mineral density estimation camp was organized in a private health facility catering to the urban community in Jabalpur district of M.P during February 2015. In the camp bone mass density of attendees was assessed using DEXA technique & WHO criteria based on T score were used in the study to assess the bone mineral density. Information about social-demographic condition along with brief medical & surgical history was elicited. The results were presented in terms of percentage & proportions. The tests of significance were used for establishing associations between variables. Results: In total 298 persons attended the camp. There is a statistically significant association between prevalence of decreased BMD with age (p<0.001). In total, 55.74 % female attendees had T-score < -1.0. Hysterectomiesed women had statistically significant lower mineral densities. There is a significant association between regular alcohol intake & decreased BMD as all the Osteoporotic men in the study had BMD < -2.5. Conclusion: A camp based approach helps in identifying subclinical cases of Osteopenia in the community.

Effect of zoledronic acid on bone mineral density in patients of celiac disease: A prospective, randomized, pilot study.

Background & objectives: The symptoms of celiac disease (CD) are varied and metabolic bone disease (MBD) is less recognized amongst all manifestations in CD patients. Bone disease in CD is attributed to secondary hyperparathyroidism, which in turn is associated with increased bone remodelling. Improvement in bone mineral density (BMD) with gluten free diet (GFD) is known, but the data on efficacy of bisphosphonates in CD patients are limited. Bisphosphonates being a potent inhibitor of bone resorption may be useful in patients with CD having low BMD. The aim of the present investigation was to study the effect of zoledronic acid on BMD in CD patients. Methods: A total of 28 CD patients were randomized to receive GFD, calcium and cholecalciferol (group A), and zoledronic acid (group B). Baseline biochemical tests and T-score by dual energy x-ray absorptiometer were done and repeated after 12 months. Results: The T-score showed improvement in the control arm (group A) from -3.31 ± 1.46 to -2.12 ± 1.44, a gain of 35.9 per cent (P<0.05) and in drug arm (group B) -2.82 ± 1.27 to -1.06 ± 1.84, registering a gain of 62.4 per cent (P<0.001). However, there was no difference in improvement of T-score in zoledronic acid group as compared to the control group. Interpretation & conclusions: Administration of zoledronic acid was not found to be better than GFD alone in increasing BMD in CD patients with low BMD in this pilot study.

Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis

PURPOSE: To determine the influence of osteoporosis on the results of percutaneous K-wire fixation for distal radius fractures. MATERIALS AND METHODS: Between March 2007 and February 2011, Fifty seven patients who underwent fixative surgery with K-wires after closed reduction and those available for follow-up for at least 6 months were reviewed. They were divided into the two groups of T score -3 or more (group 1) and T score less than -3 (group 2). These groups were compared by the range of motion of the wrist and Disabilities of the Arm, Shoulder and Hand (DASH) score. Radiologic evaluations consisting of radial length, radial inclination and volar tilt were compared. In group 1 with 34 cases, the average age was 65.4 years (50 to 78 years) and T score was -1.97 (-0.1 to -2.93). In group 2 with 23 cases, the average age was 74 years (54 to 89 years) and T score was -4.11 (-3.1 to -6.97). RESULTS: There was no statistical difference between group 1 and group 2 in terms of range of motion, DASH score and radiologic evaluations. CONCLUSION: In the case of no volar side cortical comminution, percutaneous K-wire fixation can be applied for the treatment of distal radius fracture with osteoporosis.

Correlation between Bone Mineral Density Measured by Dual-Energy X-Ray Absorptiometry and Hounsfield Units Measured by Diagnostic CT in Lumbar Spine

OBJECTIVE: Use of quantitative computed tomography (CT) to evaluate bone mineral density was suggested in the 1970s. Despite its reliability and accuracy, technical shortcomings restricted its usage, and dual-energy X-ray absorptiometry (DXA) became the gold standard evaluation method. Advances in CT technology have reduced its previous limitations, and CT evaluation of bone quality may now be applicable in clinical practice. The aim of this study was to determine if the Hounsfield unit (HU) values obtained from CT correlate with patient age and bone mineral density. METHODS: A total of 128 female patients who underwent lumbar CT for back pain were enrolled in the study. Their mean age was 66.4 years. Among them, 70 patients also underwent DXA. The patients were stratified by decade of life, forming five age groups. Lumbar vertebrae L1-4 were analyzed. The HU value of each vertebra was determined by averaging three measurements of the vertebra's trabecular portion, as shown in consecutive axial CT images. The HU values were compared between age groups, and correlations of HU value with bone mineral density and T-scores were determined. RESULTS: The HU values consistently decreased with increasing age with significant differences between age groups (p<0.001). There were significant positive correlations (p<0.001) of HU value with bone mineral density and T-score. CONCLUSION: The trabecular area HU value consistently decreases with age. Based on the strong positive correlation between HU value and bone mineral density, CT-based HU values might be useful in detecting bone mineral diseases, such as osteoporosis.

"Analysis on Bone Mineral Density and Its Relation to ""Kidney-deficiency, Qi-deficiency and Blood Stasis"" among 392 Cases" / 世界科学技术-中医药现代化

This study was aimed to discuss traditional Chinese medicine (TCM) factors of bone mineral density (BMD) in order to figure out the relation of BMD T-Score to the TCM syndrome of kidney-deficiency, qi-deficiency , and blood-stasis . It may provide the scientific basis for TCM treatment of osteoporosis . Patients were collected from August 2010 to April 2011 at the Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine . The assay of BMD was performed with the U . S . HOLOGIC dual-energy radia-tion . The BMD was measured and recorded in the form . All data were collected into the computer using Epi-Data3 . 02 software . Then , the data was analyzed by the SPSS15 . 0 statistical software . The results showed that through the Mann-Whitney U test , the BMD of patients with kidney-deficiency syndrome was worse compared to patients without kidney-deficiency syndrome ( P < 0 . 01 ); the BMD of patients with q i-deficiency syndrome was worse compared to patients without q i-deficiency syndrome ( P < 0 . 01 ); the BMD of patients with blood-stasis syndrome was worse compared to patients without blood-stasis syndrome ( P < 0 . 01 ) . It showed that the BMD of patients with kidney-deficiency , q i-deficiency and blood-stasis was worse compared to patients with-out syndrome of kidney-deficiency , q i-deficiency and blood-stasis . Under a variety of evidence-based BMD distribution , the chi-square test showed that there was significant difference ( P < 0 . 01 ) . It showed that differ-ent BMD had different TCM syndrome distributions . Among normal BMD cases , distributions of syndrome with-out kidney-deficiency, qi-deficiency and blood-stasis occupied the largest proportion. Among osteoporosis cas-es , the distribution of syndrome of kidney-deficiency , q i-deficiency and blood-stasis occupied the largest pro-portion . It was concluded that the syndrome of kidney-deficiency , q i-deficiency and blood-stasis maybe impor-tant factors to influence BMD . It may also be the risk factor of osteoporosis complication . The BMD are relat-ed to the syndrome of kidney-deficiency , q i-deficiency and blood-stasis and their combinations . Among bone mass reduction and osteoporosis cases , the proportion of combination of two or three types of syndromes was more than single one syndrome . It suggested that the combination of kidney-deficiency , q i-deficiency and blood-stasis had more influence on BMD .

Assessment of Osteoporosis Based on Changes in SNR and ADC Values on MR Diffusion Weighted Images / 의학물리

This study tested how S/N (Signal to Noise Ratio) ratios and ADC (apparent diffusion coefficient) values vary with different T-scores in a group of patients with osteoporosis. Based on DEXA (Dual Energy X-ray Absorptiometry) T-scores for L1?L4 for two groups of subjects consisting of 30 healthy people without osteoporosis and 30 patients who came for treatment of waist (lumbar or low back) pain and were suspected to have osteoporosis as judged from the simple X-ray findings, this study classified every spine into two groups of osteoporosis and osteopenia. Signal intensity measurements were made in the four regions of L1 to L4 on diffusion-weighted MR images obtained using 1.5T MR scanner, while ADC measurements were obtained from ADC map images. As an approach for quantitative analysis, the comparison of the variances in S/N ratios and ADC values for varying T-scores in the selected regions of interest was carried out based on averaged T-scores, S/N ratios, and ADC values. Also, the variances in S/N ratios and ADC values for each of the groups of osteoporosis and osteopenia, which were classified into by T-scores, were compared. For qualitative analysis, a careful naked eye examination of signal intensity differences in the area of L4 was made on T1-weighted sagittal images for each of the healthy (normal), osteopenia, and osteoporosis groups. In the qualitative analysis, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the S/N ratios on diffusion-weighted MR images also decreased, with the greatest decrease in the S/N ratio found in the osteoporosis group. Additionally, among the three groups, the lowest S/N ratio was found in the osteoporosis group. With respect to ADC map, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the ADC values on diffusion-weighted MR images also decreased, with the greatest decrease in the ADC values found in the osteoporosis group. Additionally, among the three groups, the lowest ADC value was found in the osteoporosis group. On the other hand, in the qualitative analysis, the osteoporosis group showed the highest signal intensity. Additionally, among the three groups, the lowest signal intensity was found in the healthy (normal) group. It was found that as osteoporosis progressed, S/N ratio and ADC decreased, whereas signal intensity increased on T1-weighted images. Also, in diagnosing osteoporosis, MRI tests turned out to be (more) effective.

Analysis of Bone Mineral Density and Related Factors after Pelvic Radiotherapy in Patients with Cervical Cancer / 대한방사선종양학회지

PURPOSE: This study was designed to evaluate the effects on bone mineral density (BMD) and related factors according to the distance from the radiation field at different sites. This study was conducted on patients with uterine cervical cancer who received pelvic radiotherapy. MATERIALS AND METHODS: We selected 96 patients with cervical cancer who underwent determination of BMD from November 2002 to December 2006 after pelvic radiotherapy at Kosin University Gospel Hospital. The T-score and Z-score for the first lumbar spine (L1), fourth lumbar spine (L4) and femur neck (F) were analyzed to determine the difference in BMD among the sites by the use of ANOVA and the post-hoc test. The study subjects were evaluated for age, body weight, body mass index (BMI), post-radiotherapy follow-up duration, intracavitary radiotherapy (ICR) and hormonal replacement therapy (HRT). Association between the characteristics of the study subjects and T-score for each site was evaluated by the use of Pearson's correlation and multiple regression analysis. RESULTS: The average T-score for all ages was -1.94 for the L1, -0.42 for the L4 and -0.53 for the F. The average Z-score for all ages was -1.11 for the L1, -0.40 for the L4 and -0.48 for the F. The T-score and Z-score for the L4 and F were significantly different from the scores for the L1 (p<0.05). There was no significant difference between the L4 and F. Results for patients younger than 60 years were the same as for all ages. Age and ICR were negatively correlated and body weight and HRT were positively correlated with the T-score for all sites (p<0.05). BMI was positively correlated with the T-score for the L4 and F (p<0.05). Based on the use of multiple regression analysis, age was negatively associated with the T-score for the L1 and F and was positively correlated for the L4 (p<0.05). Body weight was positively associated with the T-score for all sites (p<0.05). ICR was negatively associated with the T-score for the L1 (p<0.05). HRT was positively associated with the T-score for the L4 and F (p<0.05). CONCLUSION: The T-score and Z-score for the L4 and F were significantly higher than the scores for the L1, a finding in contrast to some previous studies on normal women. It was thought that radiation could partly influence BMD because of a higher T-score and Z-score for sites around the radiotherapy field. We suggest that a further long-term study is necessary to determine the clinical significance of these findings, which will influence the diagnosis of osteoporosis based on BMD in patients with cervical cancer who have received radiotherapy.

Usefulness of Clinical T-Score of Continuous Performance Test for Differential Diagnosis: among Attention-Deficit Hyperactivity Disorder, Depressive Disorder, Anxiety Disorder, and Tic Disorder

OBJECTIVES: This study was conducted to examine whether there are qualitative differences in attention problem among children with various psychiatric disorders, including attention-deficit hyperactivity disorder (ADHD), depressive disorder, anxiety disorder, and tic disorder using clinical ADHD diagnostic system (ADS) T-scores. METHODS: The subjects were 794 outpatient children aged from 5 to 15 years, including 540 children with ADHD, 95 children with depressive disorder, 86 children with anxiety disorder, and 73 children with tic disorder. Clinical T-scores on the ADS were calculated using the mean and standard deviations of four ADS variables for the ADHD group. RESULTS: All four groups had T-scores on the ADS in the abnormal range. However, when comparing the clinical Tscores, the children with depressive and anxiety disorders performed better than the children with ADHD. We also found that although the four groups seemed to be similar in terms of clinical T-scores for omission and commission erros, there were significant differences in clinical T-scores for reaction time and the standard deviation of response time (RT) between the ADHD and other groups. CONCLUSIONS: We concluded that inattention and impulsivity might not be specific only to ADHD and that the clinical T-scores of RT and standard deviation of RT on the ADS could be used to discriminate between ADHD and other clinical groups.

Normative Study of the K-ARS(Korean ADHD Rating Scale) for Parents

OBJECTIVES: The K-ARS(Korean ADHD Rating Scale) is one of the most important assessment tool of attentiondeficit hyperactivity disorder(ADHD) in Korea. In this study, we presented detailed normative data on the K-ARS for school-aged children in Seoul metropolitan area to put it to practical use. METHODS: The subjects were 2,397 students(1,223 boys and 1,174 girls, aged 6-12) from 4 elementary schools in Seoul, and one caretaker of each child completed the K-ARS for parents. Children who showed high scores of the KARS for parents were screened, and 2 child psychiatrists interviewed them to make a clinical diagnosis. We compared the mean scores of the K-ARS for parents between ADHD and normal group, and examined the percentage of correct classification. RESULTS: There were some differences in score of the K-ARS for parents according to sex and age, so we presented continuous normative data with T score and subdivided cut-off points for ADHD screening. Interviews with child psychiatrists using DSM-IV criteria were performed to test diagnostic validity, and the difference in every the K-ARS for parents index between ADHD and normal group was significant(p<.001). Using 3 different cut-off points(80th, 90th, 93rd percentage), the accuracies of ADHD correct classification were 67.9, 72.2, 71.1% and all 3 canonical discriminants were significant(p<.05) between ADHD and normal group. CONCLUSION: The normative data and cut-off points on the K-ARS for parents are useful in screening ADHD children in Seoul metropolitan area.

Factors which are related with BMD in Premenopausal women

BACKGROUND: As the mean life span is prolonged, the concern about health care in postmenopuasal women is now promoted. Expecially, osteoporosis is the serious health problem in postmenopausal women. Bone mineral density in postmenopause is controlled by that in premenopause. Therefore, we searched for the factors which contribute to bone mineral density in premenopause. METHODS: The study subjects who visited the Health Screening and Diagnosis Center in Yeungnam University Hospital from March 1998 to July 1999 was measured BMD at the lumbar spine using Dual Energy X ray Absorptiometry. Subjects were checked past medical history, life style(smoking, drinking, physical activity, exercise etc.), birth history, breast feeding, oral pill intake. The subjects who had disorders known to interfere with bone metabolism and premature menopausal and surgical menopausal women were excluded from the study. And we reviewed the results of the laboratory and radiologic findings which had done in Health Screening and Diagnosis Center. RESULTS: 352 women were included in this study. The number of normal BMD was 228 and the number of osteopenia was 124. Weight, height, BMI, exercise was significant positively correlated with bone mineral density(p<0.05). Previous operation history was significant negatively correlation with bone mineral density(p<0.05). Multiple logistic regression result showed that weight was the most significant factor affecting to BMD and the history of operation and exercise were significant factor affecting BMD(p<0.05). CONCLUSION: In postmenopausal women, who has low weight, past operation history and lack of exercise were need to evaluation of BMD and education for prevention of osteoporosis is needed.

The Clinical Change of Bone Mineral Density after Surgery and Hormone Replacement Therapy on Menopausal Woman / 대한산부인과학회잡지

The objective of this study is to compare bone mineral densities(BMD) between the symptomatic menopausal women and the asymptomatic menopausal women, between the spontaneous menopausal group and the surgical menopausal group, and especially between the HRT group and no-HRT group. From January, 1995 to December 1995, this study was prospectively analysed in 96 menopausal women(47 spontaneous menopausal women, 23 surgical nopausal women) who were admitted to Department of Obstetrics and Gynecology, Chosun University Hospital for HRT. The all women was measured T-score of bone mineral densities at L1, L2, L3 and L4 of lumbar spine and neck, trochanter, ward`s area of femur from dual-energy X-ray absorptiometry(DEXA). Student t-test and chi-squre test were used for statistical comparison. The results obtained were as follows: 1. The mean age of the osteoporotic group(54.96 +/- 6.6) is higher than the non-osteoporotic group(50.55 +/- 81). 2. No difference is detected in the BMD between the surgical menopausal group and the spontaneous menopausal group, because duration of the follow-up is too short and the study group is too small perhaps. 3. Descent of T-score in the symtomatic menopausal women is not severe than the asymptomatic group, but especially in L4 area, T-score of the symptomatic group(-1.76 +/- 1.3 < -1.04 +/- 1.4) is more decreased(p<0.04). 4. T-score between the long term HRT group and the no-HRT group is different markedly. HRT during only 1 year is not attributed to BMD loss. So the continuous HRT over 1 year and Follow-up is need to improvement of BMD in the menopausal women with risk factors.

Lotus 1-2-3 in t-score grading.

Eight bits microcomputer which was used in T-score grading for years becomes faced with problem due to increasing of student number and lack of CPU memory. The 16 bits microcomputer then was replaced for the job with easy to use program LOTUS 1-2-3. Student grading now is very easy and can be done separately in dependent of the main frame computer.