• Journal of Korean Neurosurgical Society
• /
• 제65권1호
• /
• pp.96-106
• /
• 2022

Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

• Journal of Chest Surgery
• /
• 제15권4호
• /
• pp.460-466
• /
• 1982

A analysis of CPK & LDH Isoenzyme was done on the consecutive patients undergoing thoracic operations from July 1982 to October 1982 in the Department of Thoracic and Cardiovascular Surgery, Capital Armed Forces General Hospital. Eighteen patients were analysed by three groups, such as open heart surgery [group A], major thoracic operation [group B] , minor thoracic operation group [group C]. In all patients serial determination of total level and Isoenzyme of CPK, LDH wad done on preoperative operative and up to 8th post-operative day, The results obtained are as follows. 1. The average value of serum CPK before the operation was 61 IU/L. The value of serum CPK was increased following the operation mainly MM portion and reached to the maximal level of 536107 IU/L in A group 1200191 IU/L in B group, 306150 IU/L in C group on the first postoperative day. The enzyme activity was gradually decreased thereafter and returned to the normal range on the 3rd or 4th day after the operation. 2. The average value of serum LDH before the operation was found to be 83 IU/L. The value was increased during the operation and reached to the maximal level of 481108 IU/L in group A, 14827 I U/L in group B, 10035 IU/L in group C on the second day after the operation. The enzyme activity was gradually decreased thereafter and returned to the normal range on the seventh day after the operation. The enzyme activity was dependent to the duration of operation, severity of muscle damage, type of thoracotomy, effect of extracorporeal circulation, state of disease.

• Journal of Korean Neurosurgical Society
• /
• 제59권3호
• /
• pp.306-309
• /
• 2016

Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.

• 대한물리치료과학회지
• /
• 제2권3호
• /
• pp.609-622
• /
• 1995

The purpose of this study was l)to compare a pelvic tilt angle between sound side and affected side in hemiplegic patients, 2)to determine the difference of weight bearing and weight shifting between sound and affected lower extremity according to the pelvic tilt angle. The subject for the study were 40 hemiplegic patients(mean age of 55.6 years)without orthopedic disability on pelvic bone. The data were analyzed by t-test, one way ANOVA, Multiple comparison and Range. The results of this study were as follows : 1. There was a significant difference in the pelvic tilt angle between sound side and affected side in hemiplegic patients(p<0.05). 2. There was a significant difference in the weight bearing value between sound and affected side in hemiplegic patients according to the posterior pelvic tilt angle(F = 12.43, df = 3/36, p<0.001). Therefore, the lesser the posterior pelvic tilt angle, the higher the weight bearing value on the affected side. 3. The lesser the posterior pelvic tilt angle, the higher the weight shifting value on the affected side. 4. There was a significant difference in weight bearing value between sound and affected side according to the grade spasticity(F = 3.61, df = 4/35, p<0.05). Therefore, the higher the grade spasticity, the lower the weight bearing value on affected side.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제19권3호
• /
• pp.199-206
• /
• 2016

Purpose: To analyze the associations among the degrees of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and metabolic syndrome, degrees of obesity in children, and degrees of parental obesity. Methods: A total of 198 children with obesity who visited a pediatric obesity clinic were prospectively enrolled in this study. The severity of NAFLD based on ultrasonography was classified into no, mild, moderate, or severe NAFLD group. The degree of obesity based on the percentage over standard weight for height per sex was classified into mild, moderate, or severe. Results: Of 132 patients evaluated for the degree of NAFLD and metabolic syndrome, the p-value of correlation between the two factors was 0.009. Therefore, metabolic syndrome might significantly affect the degree of NAFLD. Of 158 patients evaluated for the degree of NAFLD and the degree of obesity, the p-value of correlation between the two factors was 0.122. Of 154 patients evaluated for the degree of obesity and father's obesity, the p-value was 0.076. Of 159 patients evaluated for the degree of obesity and mother's obesity, the p-value was 0.000, indicating that mother's obesity could significantly affect the degree of obesity in children. Of 142 patients evaluated for the degree of obesity and metabolic syndrome, the p-value was 0.288. Conclusion: Metabolic syndrome might significantly affect the degree of nonalcoholic fatty liver in children. In addition, mother's obesity might be a significant factor that affects the degree of obesity in children.

• Annals of Clinical Neurophysiology
• /
• 제2권1호
• /
• pp.13-20
• /
• 2000

Background and Objective : Visual evoked potentials(VEPs) is considered to be a reliable diagnostic procedure for examining patients with anterior visual pathways. Some abnormalities in the recordings on monocular stimulation have been said to indicate retrochiasmal lesion, but less consistent results have been reported. This study is to evaluate the positive predictability of VEP for the detection of retrochiasmal lesion. Methods : We reviewed VEPs that could be interpreted as indicative of a retrochiasmal lesions, based on amplitude or latency asymmetry recorded on the left(O1) and right(O2) occipital regions. Bilateral absent VEPs on both recording(O1 and O2) without evidence of prechiasmal lesion were included. During 5 years, we identified 31 patients who met the above criteria and who had undergone magnetic resonance imaging(MRI) of brain(one patient underwent computerized tomography). Twenty three patients underwent pattern reversal VEPs and others underwent flash goggle VEPs. Results : Brain imagings were abnormal in 29 and were normal in 2. Of the 29 abnormal scans, lesions in posterior visual pathway were detected in 21 scans(predictive value=68%). The predictive value was not significantly different between flash goggle VEP(75%) and pattern reversal VEP(68%). The predictive value was higher in patient with visual field defect(100%) than those without visual field defect(25%). The pathologic nature of lesion also showed close relations to the predictive value. VEPs is usually paradoxically lateralized(78%), but not in all patients. Conclusion : VEPs abnormalities suggesting retrochiasmal lesion were usually corresponded with brain MRI findings. Diagnostic reliability could be increased when considering the visual field defect and nature of lesion. Therefore, the authors suggest that VEPs studies could be useful in evaluating the patients with the retrochismal lesion.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권16호
• /
• pp.6923-6928
• /
• 2015

Background: Early detection of various kinds of cancers nowadays is needed including colorectal cancer due to the highly significant effects in improving cancer treatment. The aim of this study was to evaluate the potential value of adiponectin, visfatin and resistin as early biomarkers for colorectal cancer patients. Materials and Methods: Serum levels of adiponectin, visfatin and resistin were measured by a sandwich-enzyme-linked (ELISA) assay technique in 114 serum samples comprising 34 patients with colorectal cancer (CRC), 27 with colonic polyps (CP), 24 with inflammatory bowel disease (IBD) and 29 healthy controls. The diagnostic accuracy of each serum marker was evaluated using receiver-operating characteristic (ROC) curve analysis. Results: The mean concentration of adiponectin was significantly higher in CRC and CP groups than IBD and control groups (P-value <0.05). Also the mean concentration of serum resistin was significantly elevated in the IBD and control groups compared to CRC and CP groups (P-value = 0.014). However, no significant difference was noted in patients of the CRC and CP groups. On the other hand, the mean concentration of visfatin was significantly elevated in CRC and control groups compared to CP and IBD groups (P-value = 0.03). ROC analysis curves for the studied markers revealed that between CRC and IBD groups serum level of adiponectin had a sensitivity of 76.7% and a specificity of 76% at a cut off value of 3940, +LR being 3.2 and -LR 0.31 with AUC 0.852, while serum level of adiponectin between CP and IBD had a sensitivity of 77.8% and a specificity of 75% at a cut off value of 3300, with +LR=3.11 and -LR = 0.3 with AUC 0.852. On the other hand the serum level of visfatin between CRC and CP groups had a sensitivity of 65.5% and a specificity of 66.7 at a cut off value of 2.4, +LR being 1.67 and -LR 0.52 with AUC 0.698. Also the serum level of resistin had a sensitivity of 62.5% and a specificity of 70.3% at a cut off value of 24500, with +LR=2.1 and -LR = 0.53 with AUC 0.685 between control and other groups. On the other hand by comparing control vs CP groups resistin had a sensitivity of 81.8% and a specificity of 70.8% at a cut off value of 17700, with +LR=2.8 and -LR = 0.26 with AUC 0.763 while visfatin had a sensitivity of 68.2% and a specificity of 70.8% at a cut off value of 2.7, with +LR=2.34 and -LR = 0.0.45 with AUC 0.812. Conclusions: These findings support potential roles of adiponectin, visfatin and resistin in early detection of CRC and discrimination of different groups of CRC, CP or IBD patients from normal healthy individuals.

• Korean Circulation Journal
• /
• 제52권5호
• /
• pp.368-378
• /
• 2022

Background and Objectives: Recurrence rates after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients are not low especially in non-paroxysmal AF. The diameter of left atrium (LA) has been widely used to predict the recurrence after RFCA for decades. However, LA diameter represents structural remodeling of LA and does not reflect electrical remodeling. We aimed to determine the predictive value of electrical remodeling of LA which is represented by the amount of low voltage zone (LVZ). Methods: We performed a retrospective cohort analysis of AF patients who underwent de novo RFCA in a single-center. Results: A total of 3,120 AF patients with de novo RFCA were analyzed. Among these patients, 537 patients underwent an electroanatomic mapping with bipolar voltage measurement of LA. The diameter of LA and flow velocity of LA appendage (LAA) differed significantly according to quartile group of LVZ area and percentage: patients with high LVZ had large LA diameter and low LAA flow velocity (p<0.001). Freedom from late recurrence (LR) was significantly lower in patients with high LVZ area and percentage (p<0.001). The diameter and surface area of LA had area under curve (AUC) of 0.592 and 0.593, respectively (p=0.002 for both). The predictive value of LVZ area (AUC, 0.676) and percentage (AUC, 0.671) were both superior compared with LA diameter (p=0.011 and 0.027 for each comparison). Conclusions: In conclusion, LVZ can predict freedom from LR after RFCA in AF patients. Predictive value was higher in parameters reflecting electrical rather than structural remodeling of LA.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권2호
• /
• pp.657-660
• /
• 2015

Background: A diagnosis of H. pylori infection can be made by invasive or non-invasive methods. Several noninvasive diagnostic tests based on the detection of H. pylori stool antigen (HpSA) have been developed. The Genx H. pylori stool antigen card test is a new rapid, non-invasive test that is based on monoclonal immunochromatographic assay. The aim of this study was to determine its sensitivity, specificity, and diagnostic accuracy for diagnosing H. pylori infection in adult patients. Materials and Methods: A total of 162 patients were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results: Using the reference test, 50.6% of the samples were positive for H. pylori infection. The Genx H. pylori antigen test was positive in 19.7% of patients. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the Genx H. pylori antigen test were 51.6%, 96.0%, 88.8%, 76.1%, and 79.0%, respectively. Conclusions: The Genx H. pylori stool antigen card test is a new non-invasive method that is fast and simple to perform but provides less reliable results.

• The Journal of Asian Finance, Economics and Business
• /
• 제8권1호
• /
• pp.419-430
• /
• 2021

The study aims to analyze the factors that shape patient loyalty, namely, by involving the service quality factor (SERVQUAL), hospital image, patient value, and patient satisfaction in private hospitals. This study was conducted in Makassar City, Indonesia, with a sample of 296 eligible samples from private hospitals. The sample criteria were patients with outpatient and hospitalization status. Then, this study developed 23 hypotheses to test the statistical relationship between direct, intervening and multiple-effect models. Problem-solving and research focus are carried out using a quantitative method approach with a PLS-SEM-based testing tool. The bootstrapping method is being used with the constant bootstrapping step to demonstrate the results of hypothesis testing; we find that the overall hypothesis has a positive and significant effect. The combination of testing models involving several variables shows that a patient's loyalty can be formed if a patient's satisfaction has been realized. Satisfaction can be realized if the value-customer has been felt by the patients. Therefore, the hospital image must be directly proportional to service quality. Service quality is the essence of service that directly affects customers; service quality is also the reason that shapes consumer perceptions in increasing rationalization and solid customer (patient's) decision-making.