• Title/Summary/Keyword: Fusion Index

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Demineralized Bone Matrix (DBM) as a Bone Void Filler in Lumbar Interbody Fusion : A Prospective Pilot Study of Simultaneous DBM and Autologous Bone Grafts

  • Kim, Bum-Joon;Kim, Se-Hoon;Lee, Haebin;Lee, Seung-Hwan;Kim, Won-Hyung;Jin, Sung-Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.225-231
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    • 2017
  • Objective : Solid bone fusion is an essential process in spinal stabilization surgery. Recently, as several minimally invasive spinal surgeries have developed, a need of artificial bone substitutes such as demineralized bone matrix (DBM), has arisen. We investigated the in vivo bone growth rate of DBM as a bone void filler compared to a local autologous bone grafts. Methods : From April 2014 to August 2015, 20 patients with a one or two-level spinal stenosis were included. A posterior lumbar interbody fusion using two cages and pedicle screw fixation was performed for every patient, and each cage was packed with autologous local bone and DBM. Clinical outcomes were assessed using the Numeric Rating Scale (NRS) of leg pain and back pain and the Korean Oswestry Disability Index (K-ODI). Clinical outcome parameters and range of motion (ROM) of the operated level were collected preoperatively and at 3 months, 6 months, and 1 year postoperatively. Computed tomography was performed 1 year after fusion surgery and bone growth of the autologous bone grafts and DBM were analyzed by ImageJ software. Results : Eighteen patients completed 1 year of follow-up, including 10 men and 8 women, and the mean age was 56.4 (32-71). The operated level ranged from L3/4 to L5/S1. Eleven patients had single level and 7 patients had two-level repairs. The mean back pain NRS improved from 4.61 to 2.78 (p=0.003) and the leg pain NRS improved from 6.89 to 2.39 (p<0.001). The mean K-ODI score also improved from 27.33 to 13.83 (p<0.001). The ROM decreased below 2.0 degrees at the 3-month assessment, and remained less than 2 degrees through the 1 year postoperative assessment. Every local autologous bone graft and DBM packed cage showed bone bridge formation. On the quantitative analysis of bone growth, the autologous bone grafts showed significantly higher bone growth compared to DBM on both coronal and sagittal images (p<0.001 and p=0.028, respectively). Osteoporotic patients showed less bone growth on sagittal images. Conclusion : Though DBM alone can induce favorable bone bridging in lumbar interbody fusion, it is still inferior to autologous bone grafts. Therefore, DBM is recommended as a bone graft extender rather than bone void filler, particularly in patients with osteoporosis.

A Prospective, Multi-Center, Double-Blind, Randomized Study to Evaluate the Efficacy and Safety of the Synthetic Bone Graft Material DBM Gel with rhBMP-2 versus DBM Gel Used during the TLIF Procedure in Patients with Lumbar Disc Disease

  • Hyun, Seung-Jae;Yoon, Seung Hwan;Kim, Joo Han;Oh, Jae Keun;Lee, Chang-Hyun;Shin, Jun Jae;Kang, Jiin;Ha, Yoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.562-574
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    • 2021
  • Objective : This study is to evaluate the efficacy and safety of demineralized bone matrix (DBM) gel versus DBM gel with recombinant human bone morphogenetic protein-2 (rhBMP-2) used in transforaminal lumbar interbody fusion (TLIF). Methods : This study was designed as a prospective, multi-center, double-blind method, randomized study. All randomized subjects underwent TLIF with DBM gel with rhBMP-2 group (40 patients) as an experimental group or DBM gel group (36 patients) as a control group. Post-operative observations were performed at 12, 24, and 48 weeks. The spinal fusion rate on computed tomography scans and X-rays films, Visual analog scale pain scores, Oswestry disability index and SF-36 quality of life (QOL) scores were used for the efficacy evaluation. The incidence rate of adverse device effects (ADEs) and serious adverse device effects (SADEs) were used for safety evaluation. Results : The spinal fusion rate at 12 weeks for the DBM gel with rhBMP-2 group was higher with 73.68% compared to 58.82% for the DBM gel group. The 24 and 48 weeks were 72.22% and 82.86% for the DBM gel with rhBMP-2 group and 78.79% and 78.13%, respectively, for the DBM gel group. However, there were no significant differences between two groups in the spinal fusion rate at 12, 24, and 48 weeks post-treatment (p=0.1817, p=0.5272, p=0.6247). There was no significant difference between the two groups in the incidence rate of ADEs (p=0.3836). For ADEs in the experimental group, 'Pyrexia' (5.00%) was the most common ADE, followed by 'Hypesthesia', 'Paresthesia', 'Transient peripheral paralysis', 'Spondylitis' and 'Insomnia' (2.50%, respectively). ADEs reported in control group included 'Pyrexia', 'Chest discomfort', 'Pain', 'Osteoarthritis', 'Nephropathy toxic', 'Neurogenic bladder', 'Liver function analyses' and 'Urticaria' (2.86%, respectively). There was no significant difference between the two groups in the incidence rate of SADEs (p=0.6594). For SADE in the experimental group, ''Pyrexia' and 'Spondylitis' were 2.50%. SADE reported in the control group included 'Chest discomfort', 'Osteoarthritis' and 'Neurogenic bladder'. All SADEs described above were resolved after medical treatment. Conclusion : This study demonstrated that the spinal fusion rates of DBM gel group and DBM gel with rhBMP-2 group were not significantly different. But, this study provides knowledge regarding the earlier postoperative effect of rhBMP-2 containing DBM gel and also supports the idea that the longer term follow-up results are essential to confirm the safety and effectiveness.

Cardiac Autonomic Control and Neural Arousal as Indexes of Fatigue in Professional Bus Drivers

  • Lecca, Luigi I.;Fadda, Paolo;Fancello, Gianfranco;Medda, Andrea;Meloni, Michele
    • Safety and Health at Work
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    • v.13 no.2
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    • pp.148-154
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    • 2022
  • Background: Bus driving is a mentally demanding activity that requires prolonged attention to ensure safety. The aim of the study was to assess mental fatigue caused by driving a public bus and to find a profile of workers at higher risk. Methods: We evaluated changes of critical flicker fusion (CFF) (index of central arousal) and heart rate variability (HRV) (index of autonomic balance) in a 6-hour driving shift on a real route, in 31 professional bus drivers, and we tested the influence of personal factors such as sleep quality, BMI, and age. Paired t-test was used to test differences of CFF and HRV between both initial and final phase of driving, while multiple linear regression tested the influence of personal variables on the indexes of mental fatigue. Results: Results showed that CFF significantly decreased after 6 hours of bus driving (41.91 Hz, sd 3.31 vs. 41.15 Hz, sd 3.15; p = 0.041), and heart rate significantly decreased in the final phase of driving, with respect to the initial phase (85 vs. 78 bpm, p = 0.027). Increasing age (beta = -0.729, p = 0.022), risk of obstructive sleep apnea syndrome (beta = -0.530, p = 0.04), and diurnal sleepiness (beta = -0.406, p = 0.017) showed a significant effect on influencing mental fatigue. Conclusion: Elderly drivers at higher risk of sleep disorders are more prone to mental fatigue, when exposed to driving activity. Monitoring indexes of central arousal and autonomic balance, coupled with the use of structured questionnaires can represent a useful strategy to detect profile of workers at higher risk of mental fatigue in such duty.

Evaluating LIMU System Quality with Interval Evidence and Input Uncertainty

  • Xiangyi Zhou;Zhijie Zhou;Xiaoxia Han;Zhichao Ming;Yanshan Bian
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.17 no.11
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    • pp.2945-2965
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    • 2023
  • The laser inertial measurement unit is a precision device widely used in rocket navigation system and other equipment, and its quality is directly related to navigation accuracy. In the quality evaluation of laser inertial measurement unit, there is inevitably uncertainty in the index input information. First, the input numerical information is in interval form. Second, the index input grade and the quality evaluation result grade are given according to different national standards. So, it is a key step to transform the interval information input by the index into the data form consistent with the evaluation result grade. In the case of uncertain input, this paper puts forward a method based on probability distribution to solve the problem of asymmetry between the reference grade given by the index and the evaluation result grade when evaluating the quality of laser inertial measurement unit. By mapping the numerical relationship between the designated reference level and the evaluation reference level of the index information under different distributions, the index evidence symmetrical with the evaluation reference level is given. After the uncertain input information is transformed into evidence of interval degree distribution by this method, the information fusion of interval degree distribution evidence is carried out by interval evidential reasoning algorithm, and the evaluation result is obtained by projection covariance matrix adaptive evolution strategy optimization. Taking a five-meter redundant laser inertial measurement unit as an example, the applicability and effectiveness of this method are verified.

Improvement of Vegetation Index Image Simulations by Applying Accumulated Temperature

  • Park, Jin Sue;Park, Wan Yong;Eo, Yang Dam
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.38 no.2
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    • pp.97-107
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    • 2020
  • To analyze temporal and spatial changes in vegetation, it is necessary to determine the associated continuous distribution and conduct growth observations using time series data. For this purpose, the normalized difference vegetation index, which is calculated from optical images, is employed. However, acquiring images under cloud cover and rainfall conditions is challenging; therefore, time series data may often be unavailable. To address this issue, La et al. (2015) developed a multilinear simulation method to generate missing images on the target date using the obtained images. This method was applied to a small simulation area, and it employed a simple analysis of variables with lower constraints on the simulation conditions (where the environmental characteristics at the moment of image capture are considered as the variables). In contrast, the present study employs variables that reflect the growth characteristics of vegetation in a greater simulation area, and the results are compared with those of the existing simulation method. By applying the accumulated temperature, the average coefficient of determination (R2) and RMSE (Root Mean-Squared Error) increased and decreased by 0.0850 and 0.0249, respectively. Moreover, when data were unavailable for the same season, R2 and RMSE increased and decreased by 0.2421 and 0.1289, respectively.

Optimal Operation Scheme and Reliability Index Improvement of Micro Grid Using Energy Storage Systems (에너지 저장장치를 이용한 마이크로 그리드의 최적운영 및 신뢰도 지수 개선)

  • Kim, Kyu-Ho
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.63 no.2
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    • pp.205-210
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    • 2014
  • The micro grid considered in this paper consists of a diesel generator, a photovoltaic array, a wind turbine, a fuel cell, and a energy storage system. This paper explains and simulates the micro grid components in terms of accuracy and efficiency of having a system model based on the costs of fuel as well as operation and maintenance. For operational efficiency, the objective function in a diesel generator consists of the fuel cost function similar to the cost functions used for the conventional fossil-fuel generating plants. The wind turbine generator is modeled by the characteristics of variable output. The optimization is aimed at minimizing the cost function of the system while constraining it to meet the customer demand and safety of micro grid. The operating cost in fuel-cell system includes the fuel costs and the efficiency for fuel to generate electric power. To develop the overall system model gives a possibility to minimize of the total cost of micro grid. The application of optimal operation can save the interruption costs as well as the operating costs, and improve reliability index in micro grid.

Development of human tumor necrosis factor-α muteins with improved therapeutic potential

  • Jang, Seung-Hwan;Kim, Hyo-Jin;Cho, Kwang-Hwi;Shin, Hang-Cheol
    • BMB Reports
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    • v.42 no.5
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    • pp.260-264
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    • 2009
  • Tumor necrosis factor-$\alpha$ (TNF-$\alpha$) exhibits cytotoxicity towards various tumor cells in vitro and induces apoptotic necrosis in transplanted tumors in vivo. It also shows severe toxicity when used systemically for the treatment of cancer patients, hampering the development of TNF-$\alpha$ as a potential anticancer drug. In order to understand the structure-function relation of TNF-$\alpha$ with respect to receptor binding, we selected four regions on the bottom of the TNF-$\alpha$ trimer that are in close contact with the receptor and carried out mutagenesis studies and computational modeling. From the study, various TNF-$\alpha$ muteins with a high therapeutic index were identified. These results will provide a structural basis for the design of highly potent TNF-$\alpha$ for therapeutic purposes. By conjugating TNF-$\alpha$ muteins with a high therapeutic index to a fusion partner, which targets a marker of angiogenesis, it could be possible to develop TNF-$\alpha$ based anticancer drugs.

Protective Effect of Enzymatically Modified Stevia on C2C12 Cell-based Model of Dexamethasone-induced Muscle Atrophy (덱사메타손으로 유도된 근위축 C2C12 모델에서 효소처리스테비아의 보호 효과)

  • Geon Oh;Sun-Il Choi;Xionggao Han;Xiao Men;Se-Jeong Lee;Ji-Hyun Im;Ho-Seong Lee;Hyeong-Dong Jung;Moon Jin La;Min Hee Kwon;Ok-Hwan Lee
    • Journal of Food Hygiene and Safety
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    • v.38 no.2
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    • pp.69-78
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    • 2023
  • This study aimed to investigate the protective effect of enzymatically modified stevia (EMS) on C2C12 cell-based model of dexamethasone (DEX)-induced muscle atrophy to provide baseline data for utilizing EMS in functional health products. C2C12 cells with DEX-induced muscle atrophy were treated with EMS (10, 50, and 100 ㎍/mL) for 24 h. C2C12 cells were treated with EMS and DEX to test their effects on cell viability and myotube formation (myotube diameter and fusion index), and analyze the expression of muscle strengthening or degrading protein markers. Schisandra chinensis Extract, a common functional ingredient, was used as a positive control. EMS did not show any cytotoxic effect at all treatment concentrations. Moreover, it exerted protective effects on C2C12 cell-based model of DEX-induced muscle atrophy at all concentrations. In addition, the positive effect of EMS on myotube formation was confirmed based on the measurement and comparison of the fusion index and myotube diameter when compared with myotubes treated with DEX alone. EMS treatment reduced the expression of muscle cell degradation-related proteins Fbx32 and MuRF1, and increased the expression of muscle strengthening and synthesis related proteins SIRT1 and pAkt/Akt. Thus, EMS is a potential ingredient for developing functional health foods and should be further evaluated in preclinical models.

A study of usefulness for the plan based on only MRI using ViewRay MRIdian system (ViewRay MRIdian System을 이용한 MRI only based plan의 유용성 고찰)

  • Jeon, Chang Woo;Lee, Ho Jin;An, Beom Seok;Kim, Chan young;Lee, Je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.131-143
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    • 2015
  • Purpose : By comparing a CT fusion plan based on MRI with a plan based on only MRI without CT, we intended to study usefulness of a plan based on only MRI. And furthermore, we intended to realize a realtime MR-IGRT by MRI image without CT scan during the course of simulation, treatment planning, and radiation treatment. Materials and Methods : BBB CT (Brilliance Big Bore CT, 16slice, Philips), Viewray MRIdian system (Viewray, USA) were used for CT & MR simulation and Treatment plan of 11 patients (1 Head and Neck, 5 Breast, 1 Lung, 3 Liver, 1 Prostate). When scanning for treatment, Free Breathing was enacted for Head&Neck, Breast, Prostate and Inhalation Breathing Holding for Lung and Liver. Considering the difference of size between CT and Viewray, the patient's position and devices were in the same condition. Using Viewray MRIdian system, two treatment plans were established. The one was CT fusion treatment plan based on MR image. Another was MR treatment plan including electron density that [ICRU 46] recommend for Lung, Air and Bone. For Head&Neck, Breast and Prostate, IMRT was established and for Lung and Liver, Gating treatment plan was established. PTV's Homogeneity Index(HI) and Conformity Index(CI) were use to estimate the treatment plan. And DVH and dose difference of each PTV and OAR were compared to estimate the treatment plan. Results : Between the two treatment plan, each difference of PTV's HI value is 0.089% (Head&Neck), 0.26% (Breast), 0.67% (Lung), 0.2% (Liver), 0.4% (Prostate) and in case of CI, 0.043% (Head&Neck), 0.84% (Breast), 0.68% (Lung), 0.46% (Liver), 0.3% (Prostate). As showed above, it is on Head&Neck that HI and CI's difference value is smallest. Each difference of average dose on PTV is 0.07 Gy (Head&Neck), 0.29 Gy (Breast), 0.18 Gy (Lung), 0.3 Gy (Liver), 0.18 Gy (Prostate). And by percentage, it is 0.06% (Head&Neck), 0.7% (Breast), 0.29% (Lung), 0.69% (Liver), 0.44% (Prostate). Likewise, All is under 1%. In Head&Neck, average dose difference of each OAR is 0.01~0.12 Gy, 0.04~0.06 Gy in Breast, 0.01~0.21 Gy in Lung, 0.06~0.27 Gy in Liver and 0.02~0.23 Gy in Prostate. Conclusion : PTV's HI, CI dose difference on the Treatment plan using MR image is under 1% and OAR's dose difference is maximum 0.89 Gy as heterogeneous tissue increases when comparing with that fused CT image. Besides, It characterizes excellent contrast in soft tissue. So, radiation therapy using only MR image without CT scan is useful in the part like Head&Neck, partial breast and prostate cancer which has a little difference of heterogeneity.

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The Functional Role of Maturation Promoting Factor in the Two-cell Embryos (생쥐 2-세포기 배아에서 성숙유도물질의 기능적 역할)

  • 강해묵;이대기
    • The Korean Journal of Zoology
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    • v.36 no.2
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    • pp.277-284
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    • 1993
  • A possible involvement of maturation promoting factor (nfPF) in the two-cell block phenomenon was studied by fusion experiments. Germinal vesicle (GlF) ooeyte was fused with a blastomore from late or blocked 2-cell mouse embryos. and germinal vesicle breakdoum (GVBD) of fused GV oocvtes in the presence of dbcAMP (100$\mu$g/ml) was scored as an index of MPF aniviD. GnD was induced approximately 30% by fusion of a blastomere derived from late 2-cell embryos, but not from blocked 2-cell embryos. The rate of GVBD was changed when GV oocyte was fused with a blastomere from late 2-cell embryos which were treated with u-amanitin, puromvcin or colcemid before and after hsion: Treatment of late 2-cell embryos with puromycin (50 Is/mll but not with u-amanitin (100 Is/ml) clearly inhibited GVBD, indicating that do novo protein synthesis maw be required for the appearance of MPF activity in late 2-cell embryos. Treatment of late 2-cell embryos w기h colcemid (0.1 Is/mll doubled GVBD, presumably due to the maintenance of metaphase or mitotic phase. SDS-PAGE and twoiimensional electrophoresis revealed that there was no difference in protein synthetic pattern in late and blocked 2-cell embryos, but three phosphoproteins with 27, 35 and 46 M)a, presumsblv M-phase components were phosphorylated in late 2-cell embryos but not in blocked 2-cell embryos. It seems then that MPF activity is closely related to phosphorylstion of M-phase components in late 2-cell embryos.

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