Correlation between Osteoporosis and Skin Thickness on CT Scan

PURPOSE: The purpose of this study was to evaluate the relationship between osteoporosis and skin thicknessas shown by CT scanning. MATERIALS AND METHODS: Eighty- six women with osteoporosis (mean age, 52) and 51 normalcontrols (mean age, 50) participated in the study. For a quantitative CT examinations, a CT scanner(Somatom Plus,Siemens) was used. Osteoporosis was defined as present when spinal bone mineral density was more than 2.5 standarddeviations below young normal density, as determined by quantitative CT. Patients with endocrinologic, malignantor collagen disease and undergoing antimetabolite or steroid therapy were excluded. The thickness of back skin wasretrospectively measured at the third lumbar vertebra level, as seen on CT films, using a conventional magnifier.For statistical analysis, Students' t test and Spearman's rank correlation were used. RESULTS: On the basis of CTscans, the mean thickness of back skin in the osteoporotic group(0.50+/-0.20 mm) was significantly less than innormal control subjects(0.80+/-0.23 mm) (p<0.001). Significant correlation was observed between skin thickness andbone mineral density(r=0.523, p<0.0001). Sensitivity, specificity, accuracy, and positive and negative predictivevalues were measured as 76, 78, 76, 88, 62% with a cut-off value of 0.6 and 84, 61, 77, 81, 66% with a cut-offvalue of 0.7, respectively. CONCLUSION: The present study demonstrated that the thickness of back skin, asmeasured by CT scanning, is predictive of osteoporosis.

The Modified Pulse-Spray Method Using Urokinase in Subacute and Chronic Thrombotic Arterial Occlusion

PURPOSE: To evaluate the effectiveness and safety of the modified pulse-spray method using Urokinase (UK) in subacute and chronic thrombotic arterial occlusion. MATERIALS AND METHODS: Modified pulse-spray methods using UKwere performed in seven patients with subacute (1week-1month) to chronic (1 month-5years) occlusive sysmptoms suchas limb pain, claudication and impotence. Angiographic examination revealed thrombotic occlusion of the aorta, common iliac arteries, brachial arterio-venous hemodialysis graft and femoro-popliteal bypass graft. The patients underwent thrombolysis using modified pulse-spray and additional constant infusion of UK. In the presence of underlying stenosis or organized clots, balloon angioplasty or stent placement was performed. RESULTS: Completelysis was obtained in five of seven patients. For initial lysis, the mean dose of UK was 420,000 units, and the mean modified pulse-spray time was 50 minutes. Mean total dose of UK and mean total time for complete lysis were 800,000 units and 161 minutes, respectively. Thrombolysis of the femoro-popliteal bypass graft failed due to severe occlusion of the distal anastomosis. Partial lysis was achieved in one patient with aorto-iliac occlusion, but further thrombolysis was stopped due to bleeding at the puncture site. CONCLUSION: The modified pulse-spraymethod using UK is effective in treating subacute and chronic arterial thrombotic occlusion. It augments the speed, safety and efficacy of thrombolysis. When underlying stenosis or organized clots remain after thrombolysis, balloon angioplasty or stent placement would be helpful.