This study aimed to investigate the difference that convolutional neural network(CNN) shows in the determining osteoporosis on panoramic radiograph by performing a paired test by inputting the original image and the limited image including the cortical bone of the posterior border of the mandible used by radiologists. On panoramic radiographs of a total of 661 subjects (mean age 66.3 years ± 11.42), the area including the cortical bone of the posterior part of the mandible was divided into the left and right sides, and the ROI was set, and the remaining area was masked in black to form the limited image. For training of VGG-16, panoramic radiographs of 243 osteoporosis subjects (mean age 72.67 years ± 7.97) and 222 normal subjects (mean age 53.21 years ± 2.46) were used, and testing 1 and testing 2 were performed on the original and limited images, respectively, using panoramic radiographs of 51 osteoporosis subjects (mean age 72.78 years ± 8.3) and 47 normal subjects (mean age 53.32 years ± 2.81). The accuracy of VGG-16 for determining osteoporosis was 97%, in the testing 1 and 100% in the testing 2. When determining osteoporosis on the original image, CNN showed sensitivity in a wide range of areas including not only the inferior cortical bone of the mandible but also the maxillary and mandibular cancellous bone, cervical spine, and zygomatic bone. When the same ROI including the lower inferior cortical border of the mandible of the osteoporosis group was applied and the sensitive region was compared between the original image and the limited image, the original image showed wider sensitive region in cancellous bone and cortical bone than on the limited image (p<.05). Since osteoporosis is a disease that affects throughout the skeletal system, this finding seems very valid.

This study aimed to investigate which areas AI is sensitive when inputting panoramic radiographs with dental area masked and when inputting unmasked ones. Therefore, the null hypothesis of this study was that masking dental area would not make a difference in the sensitive areas of osteoporosis determination of AI. For this study 1165 female(average age 48.4 ± 23.9 years) from whom panoramic radiographs were taken were selected. Either osteoporosis or normal should be clearly defined by oral and maxillofacial radiologists. The panoramic radiographs from the female were classified as either osteoporosis or normal according to the mandibular inferior cortex shape. VGG-16 model was used to get training, validating, and testing to determine between osteoporosis or normal. Two experiments were performed; one using unmasked images of panoramic radiographs, and the other using panoramic radiographs with dental region masked. In two experiments, accuracy of VGG-16 was 97.9% with unmasked images and 98.6% with dental-region-masked images. In the osteoporosis group, the sensitive areas identified with unmasked images included cervical vertebrae, maxillary and mandibular cancellous bone, dental area, zygomatic bone, mandibular inferior cortex, and cranial base. The osteoporosis group shows sensitivity on mandibular cancellous bone, cervical vertebrae, and mandibular inferior cortex with masked images. In the normal group, when unmasked images were input, only dental region was sensitive, while with masked images, only mandibular cancellous bone was sensitive. It is suggestive that when dental influence of panoramic radiographs was excluded, AI determined osteoporosis on the mandibular cancellous bone more sensitively.

본 연구는 저소득층 중년 여성의 골다공증 지식, 골다공증 예방행위의 상관관계 및 골다공증 예방행위에 영향을 미치는 요인을 확인하기 위한 서술적 조사연구이다. 연구대상자는 P시에 소재한 3개 종 합병원에 내원한 저소득층 중년 여성 317명이며, 구조화된 설문지를 이용하여 2021년 2월 1일부터 2022 년 12월 30일까지 자료를 수집하였다. 수집된 자료는 SPSS/WIN 27.0 프로그램을 이용하여 기술 통계, t-test, ANOVA, Pearson’s correlation, Stepwise multiple linear regression으로 분석하였다. 연구 결과, 연구대상자의 골다공증 지식은 11.97±6.89점으로 낮게 나타났고, 골다공증 예방 교육 및 골절 경험에서 차이를 보였다. 골다공증 예방행위는 41.03±7.63점으로 낮았고, 종교, 동반질환, 골다공증 예방 교육 및 골절 경험, 주관적 건강상태에 따라 차이를 보였다. 골다공증 지식과 골다공증 예방행위는 통계적으로 유 의한 양의 상관관계를 보였고(r=.527, p<.001), 골다공증 예방행위에 영향을 미치는 요인은 골절 경험(β =.415, p<.001), 골다공증 예방 교육(β=.359, p<.001), 주관적 건강상태(β=.186, p<.001) 순으로 나타났 다. 따라서 본 연구 결과를 토대로 저소득층 중년 여성의 골다공증 예방행위를 증진시킬 수 있는 프로그램 을 개발하고, 참여를 권장할 수 있는 방안을 마련하는 등의 지속적인 관리가 이루어져야 할 것이다.

The purpose of this study was to verify the sensitive areas when the AI determines osteoporosis for the entire area of the panoramic radiograph. Panoramic radiographs of a total of 1,156 female patients(average age of 49.0±24.0 years) were used for this study. The panoramic radiographs were diagnosed as osteoporosis and the normal by Oral and Maxillofacial Radiology specialists. The VGG16 deep learning convolutional neural network(CNN) model was used to determine osteoporosis and the normal from testing 72 osteoporosis(average age of 73.7±8.0 years) and 93 normal(average age of 26.4±5.1 years). VGG16 conducted a gradient-weighted class activation mapping(Grad-CAM) visualization to indicate sensitive areas when determining osteoporosis. The accuracy of CNN in determining osteoporosis was 100%. Heatmap image from 72 panoamic radiographs of osteoporosis revealed that CNN was sensitive to the cervical vertebral in 70.8%(51/72), the cortical bone of the lower mandible in 72.2%(52/72), the cranial base area in 30.6%(22/72), the cancellous bone of the mandible in 33.3%(24/72), the cancellous bone of the maxilla in 20.8%(15/72), the zygoma in 8.3%(6/72), and the dental area in 5.6%(4/72). Consideration: it was found that the cervical vertebral area and the cortical bone of the lower mandible were sensitive areas when CNN determines osteoporosis in the entire area of panoramic radiographs.

This study was performed as a part of serial experiments of applying convolutional neural network(CNN) in determining osteoporosis on panoramic radiograph. The purpose of this study was to investigate how sensitively CNN determine osteoporosis on cropped panoramic radiograph. Panoramic radiographs from 1268 female patients(mean age 45.2 ± 21.1 yrs) were selected for this study. For the osteoporosis group, 633(mean age 72.2 ± 8.5 yrs) were selected, while for the normal group 635(mean age 28.3 ± 7.0 yrs). AlexNet was utilized as CNN in this study. A multiple-column CNN was designed with two rectangular regions of interest on the mandible inferior area. An occluding method was used to analyze the sensitive area in determining osteoporosis on AlexNet. Testing of AlexNet showed accuracy of 99% in determining osteoporosis on panoramic radiographs. AlexNet was sensitive at the area of cortical and cancellous bone of the mandible inferior area including adjacent soft tissue.

Artificial intelligence, has been applied in interpreting osteoporosis on dental panoramic radiograph with high accuracy. The purpose of this study was to investigate the sensitive area of convolutional neural network(CNN), one of artificial intelligence, in interpreting osteoporosis on dental panoramic radiograph. Dental panoramic radiographs taken from 1,170 female (49.19 ±21.91 average age, 21 minimum age, and 84 maximum age) were selected for this study. Two oral maxillofacial radiologists agreed upon interpreting osteoporosis by interpreting mandibular inferior cortical changes. The region of interest included upper and lower jaws for training and testing CNN in interpreting osteoporosis. A filter which was set to look for image characteristics moved through the entire panoramic radiography to identify sensitive areas that distinguish normal groups and osteoporosis patients. In interpreting osteoporosis on panoramic radiograph, CNN responded sensitively at the cancellous bone of the upper and lower jaws while oral maxillofacial radiologists interpreted mandibular inferior cortical change.

This study was conducted as part of a series of studies to introduce the Convolutional Neural Network(CNN) into the diagnostic field of osteoporosis. The purpose of this study was to compare the results when testing Digital Radiography(DR) and Computed Radiography(CR) panoramic radiographs by CNN that were trained by DR panoramic radiographs. The digital panoramic radiographs of females who visited for the purpose of diagnosis and treatment at Chonnam National University Dental Hospital were taken. Two Oral and Maxillofacial Radiologists were selected for the study to compare the panoramic radiographs with normal and osteoporosis images. Among them, 1068 panoramic radiographs of females{Mean [± standard deviation] age: 49.19 ± 21.91 years} obtained by DR method were used for training of CNN. 200 panoramic radiographs of females{Mean [± standard deviation] age: 63.95 ± 6.45 years} obtained by DR method and 202 panoramic radiographs of females{Mean [± standard deviation] age: 62.00 ± 6.86 years} obtained by CR method were used for testing of CNN. When the DR panoramic radiographs were tested, the Accuracy was 92.5%. When the CR panoramic radiographs were tested, the Accuracy was 76.2%. It can be seen that the CNN trained by DR panoramic radiographs is suitable to be tested with the same DR panoramic radiographs.

This study aimed to test a convolutional neural network (CNN) in two different settings of training and testing data. Panoramic radiographs were selected from 1170 female dental patients (mean age 49.19 ± 21.91 yr). The cortical bone of the mandible inferior border was evaluated for osteoporosis or normal condition on the panoramic radiographs. Among them, 586 patients (mean age 27.46 ± 6.73 yr) had normal condition, and osteoporosis was interpreted on 584 patients (mean age 71.00 ± 7.64 yr). Among them, one data set of 569 normal patients (mean age 26.61 ± 4.60 yr) and 502 osteoporosis patients (mean age 72.37 ± 7.10 yr) was used for training CNN, and the other data set of 17 normal patients (mean age 55.94 ± 4.0 yr) and 82 osteoporosis patients (mean age 62.60 ± 5.00 yr) for testing CNN in the first experiment, while the latter was used for training CNN and the former for testing CNN in the second experiment. The error rate was 15.15% in the first experiment and 5.14% in the second experiment. This study suggests that age-matched training data make more accurate testing results.

Selenium (Se) is an essential trace element for humans and animals, and several findings suggest that dietary Se intake may be necessary for bone health. Accumulating evidence indicates that Se compounds possess anticancer properties. Se is specifically incorporated into proteins in the form of selenocysteine and non-specifically incorporated as selenomethionine in place of methionine. This study evaluated protection by Se in the bone repair process in ovariectomized rats after irradiation. For such purpose, 80 ovariectomized female Sprague-Dawley rats were randomly divided into 4 experimental groups: ovariectomized (Ov), Ov/Se, Ov/irradiated (Irr) and Ov/ Se/Irr. A bone defect was created on the tibia of all animals 40 days after ovariectomy. Two days after surgery, only the Ov/Se and Ov/Se/Irr rats received 0.8 mg Se/kg. Three days after surgery, only the Ov/Irr and Ov/Se/Irr rats received 10 Gy of X-rays on the lower limb region. The animals were euthanized at 7, 15, 22 and 29 days after surgery to assess the repair process, which was evaluated by analysis of trabecular bone number (Masson Trichrome) and birefringence analysis (Picrosirius). It was possible to observe a delay in the bone repair process in the ovariectomized/irradiated group and similarity between the ovariectomized, Ov/ Se and Ov/Se/Irr groups. Our findings suggest that sodium selenite may influence a radioprotective effect in the bone repair of tibia of ovariectomized rats without toxicity.

To determine the relationships between soybean food intake, dietary isoflavone intake, and osteoporosis incidence, questionnaire surveys, bone mineral density measurements, and dietary surveys by food record were performed with 19 postmenopausal women (57.6±7.3 yrs of age) in Daejeon city. The subjects were divided into two groups: an ‘osteoporosis group’ (OG, n=10) and a ‘normal group’ (NG, n=9). Mean age, height, and body weight were similar between the two groups but BMI was higher in OG than in NG. Mean age at menarche was not different between the two groups. However, mean number of childbirths was greater in OG than in NG and mean total period of lactation was shorter in OG. Mean exercise time per week was similar between the two groups, and mean time of sunlight exposure tended to be shorter in OG. Mean daily intake of calcium was lower in OG whereas sodium intake was higher in OG. Mean daily intakes of total soybean food (OG: 203.8±84.6 g/d, NG: 285.0±146.3 g/d) and total dietary isoflavone (OG: 29.1±14.3 mg/d, NG: 38.3±23.1 mg/ d) were not different between the two groups. However, greater intakes of soybean food and dietary isoflavone were associated with higher bone mineral density, respectively. The above results indicate that osteoporosis incidence tends to be influenced by BMI, maternal factors, dietary nutrient intakes, soybean food intakes, and dietary isoflavone intakes in postmenopausal women; although no significant differences in soybean food and dietary isoflavone intake were found between the two groups. This tendency implies that greater intakes of soybean food and dietary isoflavone lead to lower incidence of osteoporosis in postmenopausal women.

Osteoporosis is the most prevalent metabolic bone disease and is characterized by diminished bone strength predisposing to an increased risk of fracture. Thus, this study was performed (1) to examine the effect of aquatic exercise on osteoporosis caused by an ovariectomy in the rats, and (2) to elucidate involvement of histopathologic findings in mediating these actions. The results of this study were as follows: 1. Body weight of the subjects increased after the experiment. There was a statistically significant difference (p<.05) between Group I (sham operated) and Group II (control group). 2. In respect to the length, circumference and weight of the femur, there was no statistically significant difference between the control group and the other groups (p>.05). 3. With the osteocalcin level used as one of the bone formation indexes the bone mineral density increased in every group in comparison with the control group, and in particular, there was a statistically significant difference between Group III and Group IV. The above results suggest that aquatic exercise treatment is effective in the prevention and treatment of osteoporosis.

This study was carried out to investigate the effects of the Cirsium japonicum var. ussuriense (C. japonicum)extract on serum level of hormones from induced osteoporosis by ovariectomized rats. Two month-old rats were ovariecto-mized (OVX), remained untreated for 8 weeks, and were subsequently administered C. japonicum (200㎎/㎏) every day for8 weeks. We examined the effects of treated C. japonicum on ovariectomy-related changes in Insulin-like Growth Factors(IGF), Insulin-like Growth Factor binding protein-3 (IGBF-3), Estrogen, Calcium, and Phosporus. After 8 weeks, the serumlevels of IGF-I, -II, and IGFBP-3 were higher presented as compared to the other two groups (P<0.05), in the C. japonicumextract treatment on OVX rats. There were differences between OVX and C. japonicum extract treated OVX rats in serumlevels of Ca2+, but Ca2+ levels for the normal group was higher than for the other two groups. The C. japonicum extractincreased both serum IGFs and IGFBP-3 levels on induced osteoporotic rat by ovariectomized. Thus, these results revealedthat the C. japonicum extract is a possible role for improvement of osteoporosis induced-ovariectomized rats and has a greatpotential as an alternative tool for the treatment of osteoporosis.

골다공증의 유발제인 카드뮴(cadmium, Cd)에 대한 세포 독성과 이에 대한 우슬(Achyranthis radix, AR) 추출물의 영향을 배양 골모세포(HFOB-1)를 재료로 항산화 측면에서 조사하여 다음과 같은 결과를 얻었다. 본 연구에서 Cd의 일종인 CdCl2는 처리 농도에 비례하여 배양 HFOB-1세포의 생존율(cell viability)을 유의하게 감소시킴으로서 세포 독성을 나타냈다. 한편, 항산화제인 superoxide dismutase(SOD)와 butylated hydroxytoluene(BHT)는 CdCl2에 의해 감소된 세포 생존율을 유의하게 증가시킴으로서 CdCl2에 의한 세포독성을 방어하였다. 한편, CdCl2의 세포 독성에 대한 AR 추출물의 영향에 있어서, AR 추출물은 CdCl2에 의하여 감소된 세포 생존율을 유의하게 증가시킴으로서 CdCl2에 의한 세포 독성을 방어하였으며, 또한 전자공여능(electron donating activity, EDA)과 지질과산화(lipid peroxidation, LP) 억제능을 보였다. 이상의 결과에서 CdCl2의 세포 독성에 산화적 손상이 관여하고 있으며 CR 추출물은 CdCl2에 의하여 감소된 세포생존율의 증가는 물론, EDA 및 LP 억제능과 같은 항산화 효과(antioxidative effect)에 의하여 세포 독성을 방어한 것으로 나타났다. 따라서 AR 추출물과 같은 천연성분은 뇌졸중(stroke)이나 허혈(ischemia)과 같이 산화적 손상으로 매개되는 난치성 질환의 치료적 접근을 위한 소재로서의 적용가치가 클 것으로 생각된다.

일반적으로 중년여성의 골다공증은 저체중에서 발생률이 높은 것으로 보고되었으나 비만인 경우에도 발생할 수 있 다. 따라서 본 연구의 목적은 골밀도 검사에서 골다공증으로 진단받은 중년여성 120명을 대상으로 골다공증과 체질량 지수의 상관관계를 비교하고자 하였다. 체질량지수가 18.5 미만을 저체중, 18.5 ~ 22.9를 정상, 23.0 ~ 24.9를 과체 중, 25.0 ~ 29.9를 비만, 30.0 이상인 경우를 고도비만으로 하였다. 연구 결과 대상자의 체질량지수 분포는 저체중이 2명(1.7%), 정상이 18명(15.0%), 과체중이 19명(15.8%), 비만이 75명(62.5%), 고도비만이 6명(5.0%) 이었다. 또한 체질량지수와 골다공증의 상관관계는 체질량지수가 정상인 경우 18명 중 13명(72.2%)이 골다공증 이었으며 과체중 의 경우 19명 중 14명(73.7%), 비만의 경우 75명 중 63명(84%), 고도비만의 경우 6명 중 5명(83.3%)로 나타나 체 질량지수가 비만인 경우에서 골다공증 발생률이 높았다. 결론적으로 중년여성의 골다공증은 체질량지수가 비만일수록 골다공증 환자가 많다는 것을 알 수 있었으며 대부분 골감소증보다는 골다공증이 높게 나타남을 알 수 있었다.