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Minimally Invasive Lateral Lumbar Interbody Fusion: Indications, Outcomes and Complications (최소 침습적 외측 요추간 유합술: 적응증, 결과, 합병증)

  • Soh, Jaewan;Lee, Jae Chul
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.203-210
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    • 2019
  • The aim of this review was to evaluate minimally invasive lateral lumbar interbody fusion on the latest update. Lumbar interbody fusion was introduced recently. This study performed, a literature review of the indications, clinical outcomes, fusion rate, and complications regarding recently highlighted minimally invasive lateral lumbar interbody fusion. The indications of lateral lumbar interbody fusion are similar to the conventional anterior and posterior interbody fusion in degenerative lumbar diseases. In particular, lateral lumbar interbody fusion is an effective minimally invasive surgery in spinal stenosis, degenerative spondylolisthesis, degenerative adult deformity, degenerative disc disease and adjacent segment disease. In addition, the clinical outcomes and fusion rates of lateral lumbar interbody fusion are similar compared to conventional lumbar fusion. On the other hand, non-specific complications including hip flexor weakness, nerve injury, vascular injury, visceral injury, cage subsidence and pseudohernia have been reported. Lateral lumbar interbody fusion is a very useful minimally invasive surgery because it has advantages over conventional anterior and posterior interbody fusion without many of the disadvantages. Nevertheless, nonspecific complications during lateral lumbar interbody fusion procedure remain a challenge to be improved.

Spinal Tuberculosis in Children: Predictable Kyphotic Deformity after Cure of the Tuberculosis (소아 척추 결핵: 투약 후의 병의 정지와 치유점, 그리고 후만 변형)

  • Moon, Myung-Sang;Kim, Dong-Hyeon;Kim, Sang-Jae;Moon, Hanlim;Kim, Sung-Soo;Kim, Sung-Sim
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.73-82
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    • 2017
  • Purpose: To assess the chronological changes of disease-related kyphosis after chemotherapy alone. Materials and Methods: A total of 101 children aged 2 to 15 years with spinal tuberculosis, accompanied by various stages of disease processes were enrolled for analysis. By utilizing the images in them, the growth plate condition and chronological changes of kyphosis after chemotherapy were analyzed at two points in time; the first assessment was at post-chemotherapy one-year and second at the final discharge. Results: Complete disc destruction in the cervical, dorsal and lumbosacral spines was observed in 2 out of 40 children (5.0%), 8 out of 30 children (26.7%), and 6 out of 31 children (19.4%), respectively. In those cases, the residual kyphosis inevitably developed. In the remaining children, the discs were intact or partially damaged. Among the 101 children kyphotic deformity was maintained without change in 20 children (19.8%). Kyphosis decreased in 14 children (13.9%), while it increased in 67 children (66.3%) with non-recoverably damaged growth plate. Conclusion: Although it is tentatively possible to predict the deformity progress or non-progress and spontaneous correction at the time of the initial treatment, its predictive accuracy is low. Therefore, assessment of the chronological changes should be performed at the end of chemotherapy. In children with progressive curve change, assessment of deformity should be continued until maturity.

Separation of Antioxidants and Glucose from Grape Skin Extract Using Polyethylene Glycol and Sodium Citrate (폴리에틸렌글리콜과 구연산 나트륨을 이용하여 포도껍질 추출물에서 항산화물질과 포도당 분리)

  • Eun Min Shin;Yeong Eun Joo;Su Min Jung;Jaechan Suh;Chang-Joon Kim
    • Clean Technology
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    • v.29 no.2
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    • pp.109-117
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    • 2023
  • The purpose of this study is to develop a method for separating antioxidants and sugars from grape skin extract. The extract was first mixed with a variety of organic solvents to investigate whether the separation was feasible. When employing acetone, ethanol, dimethylsulfoxide, or dimethylformamide, the organic solvent-extract combination formed a single phase. However, when benzene, ethyl acetate, or n-hexane was added to the extract, the mixture separated into an organic and an aqueous phase and the pigments remained in the aqueous phase. On the other hand, when polyethylene glycol-2,000 (PEG-2000) and sodium citrate were added to the extract, the mixture was separated into three layers, with the majority of the flavonoids migrating to the top layer and 53% of the extract's glucose migrating to the bottom layer. The top layer had significant antioxidant activity, whereas the bottom layer showed no antioxidant activity. The glucose recovery in the bottom layer increased as the molecular weight of PEG increased and the highest recovery (67%) was observed when PEG-8,000 was added. The highest flavonoid separation was observed with PEG-2,000, followed by PEG-8,000 and PEG-400. The flavonoid separation when PEG-2,000 was added resulted in a flavonoid recovery of 48% and 0.2% from the top and bottom layers, respectively. Examining the effect of the separated solution using the agar disc diffusion method on yeast cell growth confirmed that the addition of the extract, the top, and the bottom layer did not inhibit cell growth.

H2O2 Generating Ability and Multi-Drug Resistance of Lactic Acid Bacteria Required for Long-Term Inpatient Treatment with Antibiotic Resistance

  • Yuk, Young Sam
    • International journal of advanced smart convergence
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    • v.11 no.4
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    • pp.227-239
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    • 2022
  • Purpose: In our study, in order to find lactic acid bacteria (LAB) with multi-drug resistance to antibiotics, we isolated 140 strains from 15 types of kimchi commercially available in Korea and 20 types of Kimchi made at home from January to December in 2016, and investigated their H2O2 generating ability and multi-drug resistance to antibiotics. Methods: In order to observe the H2O2 generation ability of LAB, we performed the experiment with methods such as Rabe, Hillier, and Kang. To test the antibacterial susceptibility of LAB, we used the disc agar diffusion method using MRS agar (Difco, USA) according to the CLSI and WHO test methods. There are 18 types of antibiotic discs used. Results: Out of the total numbers of 140 strains, 6 strains of Ent. Faecium, 25 strains of L. plantarum, 1 strain of L. rhamnosus, 3 strains of L. sakei, 1 strain of L. acidophilus, 1 strains St. thermophilus, and 7 of unidentified strains generated H2O2. The antibiotic susceptibility of Ent. Faecium indicated SXT, OX, NA, and E; and the antibiotic susceptibility of L. plantarum indicated NA; and the antibiotic susceptibility of St. thermophilus indicated NA, CC, RA, CTT, CM, and P ; and the antibiotic susceptibility of L. rhamnosus indicated SXT, VA, NA and CTT; and the antibiotic susceptibility of 6 strains of L. sakei indicated SXT, OX, NOR, NA, CTT and CIP, all indicating antibiotic resistance. In the case of multi-drug resistance to antibiotics for 53 strains of L. antarum, 8-drug resistance was the most common with 25 strains, followed by 7-drug-resistant strains with 18 strains, 9-drug-resistant strains with 4 strains, 6-drug-resistant strains with 3 strains, 5-drug-resistant strains with 2 strains, and 17-drug-resistant strains with 1 strain. In the case of multi-drug resistance to antibiotics for Ent. Faecium 27 strains, 9-drug resistance was most commonly identified as 9 strains, 8-drug resistance was identified as 6 strains, 7- and 11 drug resistances were identified as 4 strains each, and 4- and 6-drug resistances were identified as 1 strain each. Conclusion: Ent. Faecium, L. plantarum, L. rhamnosus, L. sakei, and St. thermophilus, shown to have anantibacterial activity in previous studies on LAB and shown to have and H2O2 generating ability, antibiotic resistance and multi-drug resistance in this study, are expected to be able to play an excellent role for long-term inpatients to use as an alternative to antibiotics and to cope with emerging antibiotic resistance.

Diabetes Self-management According to the DISC Personality Type and Diabetes-related Distress in Older Adults with Type 2 Diabetes (제2형 당뇨병 노인의 성격유형과 당뇨병 관련 스트레스에 따른 당뇨병 자기관리 행위)

  • Lee, Soo Jin;Song, Misoon
    • 한국노년학
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    • v.34 no.2
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    • pp.229-246
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    • 2014
  • The purpose of this study was to identify differences in the personality type, diabetes-related distress, and diabetes self-management among older adults with type 2 diabetes. The data of 180 older adults was collected at S Senior Center from between August 14 and October 14, 2012. There were significant differences in self-management between individual personality types(p<.001). The self-management level was lower in the dominance personality type than in the steadiness and conscientiousness types. In particular, foot care subunit self-management was significantly lower in the dominance personality than in the other personality types(p<.001). Moreover, dominance personality was the most important factors influencing diabetes self-management negatively. Using hypoglycemic agent and drinking also influence on diabetes self-management negatively(modified R2=16%). Therefore, when we provide intervention to the older adults with type 2 diabetes, we should consider their personality type and check whether using hypoglycemic agent and drinking alcohol or not. Furthermore, we need to develop intervention program focus on the older adults with dominance personality type, using hypoglycemic agent and having drinking behavior.

Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

  • Junsang Park;Sang Mook Kang;Yu Deok Won;Myung-Hoon Han;Jin Hwan Cheong;Byeong-Jin Ha;Je Il Ryu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.716-725
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    • 2023
  • Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

A Study on the Antifungal Properties of Ranunculaceae Herbal Medicines (미나리아재비과 한약재의 항진균성 검증 및 비교 연구)

  • Jae-yeoup Lim;Sang Ki Choi
    • Journal of Life Science
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    • v.34 no.6
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    • pp.393-398
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    • 2024
  • The purpose of this study was to verify the antifungal properties of various herbal medicines belonging to the Ranunculaceae family and to find an extraction method effective in inhibiting fungal growth. When antifungal activity was measured in a liquid medium with extracts obtained by either hot water extraction or organic solvent extraction of the herbal medicines Clematis apiifolia, Coptis chinensis, and Pusatilla chinensis, effective results were obtained from the chloroform extract. In addition, fungal growth inhibition experiments were performed on unicellular fungi, Candida albicans, Candida tropicalis, and Candida lusitaniae, and on filamentous fungi, such as Pythium ultimum, Aspergillus fumigatus, and Fusarium oxysporum, using disk diffusion experiments on solid media. It was confirmed that P. chinensis extract has excellent antifungal properties against Candida spp. and C. apiifolia extract against filamentous mold. Finally, GC-MS analysis was performed to explore the useful antifungal substances present in the extract. As a result of the study, thurbergenone from C. apiifolia and 16-hydroxycleroda-3, 13(14)-dien-15, 16-olide (16-HCDO) from C. chinensis were confirmed as antifungal candidates. In conclusion, it was confirmed that C. apiifolia, C. chinensis, and P. chinensis have antifungal activity against various fungi, and in GC-MS analysis, all herbal medicines were confirmed to have different antifungal candidates. These results indicate that the Ranunculaceae family has evolved in several directions for fungal resistance traits.

Detection of microbial organisms on Apis mellifera L. beehives in palm garden, Eastern Thailand

  • Sirikwan Dokuta;Sumed Yadoung;Peerapong Jeeno;Sayamon Hongjaisee;Phadungkiat Khamnoi;Khanchai Danmek;Jakkrawut Maitip;Bajaree Chuttong;Surat Hongsibsong
    • Journal of Ecology and Environment
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    • v.48 no.1
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    • pp.17-23
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    • 2024
  • Background: Honey bees play a crucial role in pollination and ecological balance. Apis mellifera L. colonies, especially those located in specific geographic regions, such as the palm garden in Eastern Thailand, are susceptible to potential threats from microbial contaminants. Understanding and detecting microbial organisms in these beehives is essential for the preservation of bee health, honey production, and the broader ecosystem. However, the problem of microbial infection and antibiotic-resistant bacteria is more severe and continuously increasing, resulting in a health, economic, and social crisis. The purpose of this study is to determine the prevalence of microorganisms in A. mellifera beehives in palm gardens in Rayong province, Eastern Thailand. Results: Ten swabs in transport media were swabbed and obtained from different parts of each beehive (1 swab per beehive), for a total of 10 hives. Traditional microbial culture-based methods, biochemical tests, and antimicrobial susceptibility (disc-diffusion) tests were used to detect microbial organisms and antibiotic resistance in bacteria. The swab tests from nine beehives resulted in the detection of Gram-positive bacteria (63.64%), Gram-negative bacteria (27.27%), and fungi/yeast (9.09%). These microorganisms are classified as a group of coagulase-negative Staphylococcus spp. and made up 40.91% of the bacteria discovered. Other bacteria found were Coryneform bacteria (13.64%), Pantoea spp. (13.64%), Bacillus spp. (9.09%), yeast (9.09%), glucose non-fermentative Gram-negative bacilli (9.09%), and Pseudomonas spp. (4.55%). However, due to the traditional culture-based and 0biochemical tests usually used to identify the microbial organisms in clinical specimens and the limitation of identifying some environmental microbial species, the results of the antimicrobial susceptibility test cannot reveal if the organism is resistant or susceptible to the drug. Nevertheless, drug-sensitive inhibition zones were formed with each antibiotic agent. Conclusions: Overall, the study supports prevention, healthcare, and public health systems. The contamination of microorganisms in the beehives may affect the quality of honey and other bee products or even the health of the beekeeper. To avoid this kind of contamination, it is therefore necessary to wear personal protective equipment while harvesting honey and other bee products.

FEM Analysis of the Effects of Mouth guard material properties on the Head and Brain under Mandibular Impact (구강보호장치의 재료적인 특성이 하악골 충격 시악골 및 두부에 미치는 영향에 관한 유한요소분석)

  • Kang, Nam-Hyun;Kim, Hyung-Sub;Woo, Yi-Hyung;Choi, Dae-Gyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.4
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    • pp.325-334
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    • 2008
  • Statement of problem & Purpose: The purpose of this study was to investigate the effect of a mouth guard material properties on the skull and brain when they were under impact loads on mandible. Material and methods: Two customized mouth protectors having different material propeerst ieach other were made for a female Korean who had no history of brain trauma, no cerebral diseases, nomal occlusion and natural dentition. The 3D finite element model of human skull and brain scanned by means of computed tomography was constructed. The FEM model of head was composed of 407,825 elements and 82,138 nodes, including skull, brain, maxilla, mandible, articular disc, teeth and mouth guard. The stress concentrations on maxillary teeth, maxilla and skull with two mouth guards were evaluated under oblique impact load of 800N onto mandibular 3 loading points for 0.1sec. And the brain relative displacement was compared in two different mouth guard materials under same condition. Result and Conclusion: The results were as follows; 1. In comparison of von Mises stress on maxillary teeth, a soft mouth guard material had significantly lower stress values on measuring point than a hard mouth protector materials (P < .05). 2. In comparison of von Mises stress on maxilla and skull, A soft mouth protector material had significantly lower stress values on measuring point than a hard mouth protector materials (P < .05). 3. For impact loads on mandible, there were more stress concentrated area on maxilla and skull with hard mouth guard than soft with mouth protector. 4. For impact loads on mandible, brain relative displacement had little relation with mouth guard material properties. In results of this study, soft mouth guard materials were superior to hard mouth guard materials for mandible impact loads for prevention of sports injuries. Although the results of this study were not enough to figure out the roles of needed mouth guard material properties for a human head, we got some knowledge of the pattern about stress concentration and distribution on maxilla and skull for impact loads with soft or hard mouth protector. More studies are needed to substantiate the relationship between the mouth guard materials and sports injuries.

Bionomics of Tetranychus urticae Koch on Eggplants under Various Silicate Regimes in Controlled Environment (시설 재배 가지에서 규소 시비 수준에 따른 점박이응애의 생물적 특성)

  • Kim, Ju;Lee, Sang-Koo;Kim, Jeong-Man;Kim, Tae-Heung;Kim, Ji-Soo;Park, Eun-Suk;Jeong, Jong-Sung
    • Korean journal of applied entomology
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    • v.47 no.3
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    • pp.227-235
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    • 2008
  • Development of T. urticae was studied on the leaves of eggplant grown in hydroponics with silica contents of 0 mM, 1.7 mM, and 5.1 mM. As the levels of sllica increased, those of N, P, K, Ca, and Mg decreased and those of Si increased. While contents of calory, crude protein, carbohydrates, and vitamin C decreased, those of ash, fiber, and sugar increased. Biomass and content of cholorophyll decreased as the level of silica increased while leaves became thicker. Laboratory leaf disc tests provided with various silica levels revealed that feeding preference of T. urticae was the highest at 0 mM and the lowest at 1.7 mM. The oviposition preference decreased as the levels of silica increased, on the lower leaf appeared to hinder the feeding and the oviposition of T. urticae. The development slowed down both in female and male. Adult life span of female shortend as the silica level increased and that of male was the longest as 5.7 days at 0mM and the shortest at 1.7 mM. Oviposition period also shortened as the silica content increased. The number of eggs laid was the most as 86.3 at 1.7 mM while average oviposition per day was the least as 77 at 0 mM. No differences in hatchability was detected whereas the ratio of sex was the highest as 0.71 in favor of female at 0mM. $R_o$ and T decreased as the levels of silica increased. Rm and $\lambda$ was the lowest at 5.1 mM while Dt was the longest as 1.8271 at 5.1 mM and the shortest as 1.6991 days at 1.7 mM. Silica content in eggplant turned to affect the development of T. urticae, however, it deterred T. urticae from feeding and oviposition and the rate of increase tended to decrease due to lesser nutrients in the eggplant leaf.