Study for Reliability of Interpretation of the Three Phase Bone Scintigraphy in Patients with Post-traumatic Complex Regional Pain Syndrome / 핵의학분자영상

PURPOSE: We performed this study to evaluate reliability on interpretation of three phase bone scintigraphy (TPBS) in patients with post-traumatic complex regional pain syndrome (PT-CRPS). METHODS: Based on International Association for the Study of Pain guideline in 1994, 34 patients with PT-CRPS were selected for this study. Two nuclear medicine physicians evaluated identical TPBS according to the uptake pattern, extent and intensity of the lesion, and their agreements (kappa values) were analysed. The final diagnosis based on arbitrary criteria of each physician were compared with those obtained by the criteria for PT-CRPS established in this study, which are hyperactivity on all phases (criteria 1), hyperactivity of whole joints on delayed phase (criteria 2), and hyperactivity of either whole or focal joints on delayed phase (criteria 3). RESULTS: Intra-observer agreements were good for uptake pattern, intensity, and extent on TPBS. Inter-observer agreements were also good, except extent on blood pool phase (0.55). The inter-observer agreements on final diagnosis improved when criteria 1-3 were applied (0.77-0.88), compared to when physician's own criteria were used (0.63). Those also improved from 0.29 to 0.47-0.82 for acute stage, and from 0.37 to 1.0 for chronic stage. The sensitivities of chronic stage were relatively lower to those of acute stage. CONCLUSIONS: Inter-observer's variations in diagnosis of the patients with PT-CRPS using TPBS were observed. These results were attributed to different criteria set by observers. In order to improve agreement on interpretation of TPBS, common positive criteria should be established, especially considering uptake pattern and clinical stages.

Biochemical Bone Markers in Postmenopausal Women with Hormone Replacement Therapy / 대한산부인과학회잡지

OBJECTIVES: To investigate the patterns of biochemical bone markers, such as urinary deoxypyridinoline (DPD), N-telopeptide of type I collagen (NTX), and serum osteocalcin (OC), bone-specific alkaline pbosphatase (BSAP) in postmenopansal women with hormone replacement therapy (HRT). Materials and METHOD: From July 1997 to January 1998, total 239 postmenopausal women were emolled in the present study, and 198 healthy premenopausal women with regular menstruation were served as control. The postmenopausal women were pouped into the HRT group and the non-HRT group. The women in the HRT poup have received estrogen with continuous or cyclic progestin therapy far more tban 6 months. The biochemical bone markers of all women were assayed. Results were analysed with Students t-test. RESULTS: The urinary DPD of the non-HRT group was sigaificantly higher than both the HRT poup and the premenopausal group(5.51 +/- 2.47 vs. 3.36 +/- 1.02 and 4.01 +/- 3.86 nM/mM, p < 0.05, repectively). The urinary NTX of the non-HRT group was also higher in comparison to the HRT group and the premenopausal group(48.71 +/- 11.54 vs. 33.70 +/- 17.43 and 33.70 +/- 17.43 nM BCE/mmol, p < 0.05, repectively). However, there were no significant differences in the concentrations of serum BSAP and OC among the three poups. CONCLUSION: The urinary DPD and NTX were more sensitive indicators of bone metabolism tban serum BSAP and OC in postmenopausal women undergoing HRT.

Comparison of Nutrient Intakes, Bone Metabolism and Risk Factors of Chronic Diseases between Postmenopausal Lacto-Ovo-Vegetarian and Omnivores in Kyunggi-Do / 대한지역사회영양학회지

The amount and type of dietary protein that effects affect bone mineral loss after menopause and different dietary patterns may influence anthropometric measurements, biochemical values, and bone metabolism. Objective : Our objective was to investigate bone metabolism and chronic disease factors in two different dietary patterns. Design: The sample consisted of 40 lacto-ove-vegetarians(LOV) and 49 omnivores aged from 47 to 85 years in good condition without any medical problems. Results : The average energy intake of LOV was 1414.0 kcal and omnivores, 1403.2 kcal. The difference between means was not statistically significant. The differences of means of body weight and BMI between the two groups were not significant but the systolic blood pressure of LOV group was significantly lower than omniovores(p0.05) and plant iron(p0.05) and animal iron(p>0.05) had negative correlations with the urinary pH. The level of urinary biochemical marker of bone resorption, deoxpyidinoline(DPD) of LOV was significantly lower than the other group(p>0.05). The T-scores of bone mineral density for the two sites in the two groups were not significantly different. Conclusions : The DPD level and urinary pH value of LOV were more desirable for the bone metabolism that the omnivores. The diet of LOV had lower risk factors of chronic diseases than the other group.

The Effects of Hormone Replacement Therapy on Urinary Deoxypyridinoline of Postmenopausal Women / 대한산부인과학회잡지

OBJECTIVE: Our purpose was to determine whether the bone resorption rate is evaluated by Deoxypyridinoline(Dpd) i urine, and to evaluate the clinical utility of Dpd to monitor the hormone replacement therapy effect in postmenopausal women. STUDY DESIGN: We divided the patients into three groups, the control group was the women who were postmenopausal health state, and the experimental groups were the postmenopausal hormone replacement therapy group and the podtmenopausal nontherapy group. Urinary Dpd and serum FSH, Osteocalcin was measured in the both groups. RESULTS: The urinary Dpd and serum osteocalcin were significantly increase in postmenopausal group(6.63+/-3.09 pmol/nmol creatinine; 10.54+/-3.77 ng/ml) compared to premenopausal group(4.15+/-1.32 pmol/nmol creatinine; 7.85+/-2.17 ng/ml). The urinary Dpd and Serum osteocalcin were significantly decreased in the postmenopausal HRT group(3.31+/-1.79 pmol/nmol creatinine; 8.31+/-3.13 ng/ml) compared to the postmenopausal nontherapy group (6.63+/-3.09 pmol/nmol creatinine; 10.54+/-3.77 ng/ml). In postmenopausal nontherapy group, there was no correlation between urinary Dpd and serum osteocalcin. But these makers were good correlated in postmenopausal HRT group. CONCLUSIONS: It is concluded that the assay of urinary Dpd is useful for the resorption marker of postmenopausal osteoporosis and it should be useful for the monitoring of hormone replacement therapy effect in postmenopausal women. Furthermore, urinary Dpd may be an important indicator to determine when to resume the therapy during cessation of HRT.

Effect of Prednisone on Bone Metabolism in Children with Chronic Thrombocytopenic Purpura and the Interventional Effect of Vitamin D / 中国药房

0.05).The serum PICP in the non-intervention group was significantly lower after 4 weeks' treatment as compared with before treatment or control group,and the urine excretory rate of DPD significantly increased after treatment as compared with before treatment or control group(all P