• Title/Summary/Keyword: Success Rates

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A Computed Tomography Analysis of the Success of Spinal Fusion Using Ultra-Low Dose (0.7 mg per Facet) of Recombinant Human Bone Morphogenetic Protein 2 in Multilevel Adult Degenerative Spinal Deformity Surgery

  • Liu, Gabriel;Tan, Jun Hao;Yang, Changwei;Ruiz, John;Wong, Hee-Kit
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1010-1016
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    • 2018
  • Study Design: Retrospective cohort study. Purpose: To report on spinal fusion assessment using computed tomography (CT) after adult spinal deformity (ASD) surgery using ultra-low dose recombinant human bone morphogenetic protein 2 (RhBMP-2). Overview of Literature: The reported dose of RhBMP-2 needed for successful spinal posterolateral fusion in ASD ranges from 10 to 20 mg per spinal level. This study reports the use of ultra-low dose of RhBMP-2 (0.07 mg per facet) to achieve spinal fusion in multilevel ASD surgery. Methods: Consecutive patients who underwent ASD surgery using ultra-low dose RhBMP-2 were recruited. Routine postoperative CT analysis for spinal fusion was performed by two spine surgeons. Inter-observer agreement was calculated for facet fusion (FF) and interbody fusion (IBF) at 6 and 12 months after the procedure. Results: Six consecutive ASD patients with a mean age of 62 years (28-72 years) were examined. Each patient received a total dose of 12 mg with an average dose of $0.69{\pm}0.2mg$ (0.42-1 mg) per single FF and $1.38{\pm}0.44mg$ (0.85-2 mg) for IBF. Total 131 FF and 15 IBF were examined in the study, with 88 FFs and nine IBFs being analyzed specifically at 6 months after the surgery. FF and IBF reported by surgeons A and B at 6 months were 97.7% vs. 91.9% FF, respectively (${\kappa}=0.95$) and 100% vs. 100% IBF, respectively (${\kappa}=1$). Two patients underwent longitudinal follow-up CT at 12 months, and the FF rates reported by surgeons A and B were 100% vs. 95.8%, respectively (${\kappa}=0.96$). Five out of nine facet (56%) non-unions were identified at the cross-links. The remaining four facet pseudarthrosis were noted at 1-2 spinal levels caudal to the cross-links. At the final clinical follow-up, there was no rod breakage, deformity progression, neurological deficit, or symptom recurrence. The Oswestry Disability Index improved by an average of $32.8{\pm}6.3$, while the mental component summary of the 36-item Short-Form Health Survey improved by an average of $4.7{\pm}2.1$, and physical component summary improved by an average of $10.5{\pm}2.1$. Conclusions: To our knowledge, this is the first study to report a CT that defined 92%-98% FF and 100% IBF using the lowest reported dose of RhBMP-2 in multilevel ASD surgery. The use of ultra-low dose RhBMP-2 reduces the RhBMP-2 related complications and healthcare costs.

An Empirical Analysis on the Effects of Kyoto Protocol on the Greenhouse Gas Emissions (교토의정서의 온실가스 감축 변화로 본 레짐효과 분석)

  • Kim, Yeong Sin;Chon, Chun Hwang;Baek, Hee Jeong
    • Journal of Climate Change Research
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    • v.1 no.1
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    • pp.1-11
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    • 2010
  • This study is analyzed based on the statistical data for the effect of Kyoto Protocol which is adopted on 1997. The first greenhouse gas obligation reduction countries such as OECD (Organization for Economic Cooperation and Development), and the first non-obligated developing countries such as China and India, the increasing rate of carbon dioxide emission displayed -10.2% and 88.1% in 2005 with respect to 1990, respectively. This increasing rate is not only shows statistically significant differences but also shows significant meanings when we consider the global increasing rate of carbon dioxide is 29.1%. Changes in the carbon dioxide emissions are also analyzed based on the time of the adaptation of Kyoto Protocol, time of the publication of the second and third reports of IPCC, and withdrawal of the Kyoto Protocol of the United States. Withdrawal of the Kyoto Protocol of the United States is the most significantly affected to the differences in the carbon dioxide emission rates rather than the adaptation of Kyoto Protocol, international agreement on the greenhouse gas reduction, and belief on the scientific evidence for the reasons for increasing carbon dioxide concentrations. Therefore, acceptance of the post-Kyoto Protocol in the United States is very important in order to success as a climate regime.

Establishment of efficient Alstromeria callus induction system using node culture and various hormones (마디배양과 다양한 호르몬을 이용한 효율적인 알스트로메리아 캘러스 유도 시스템 체계 확립)

  • Yang, Hwan Rae;Lee, Sang Hee;Kim, Jong Bo
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.1
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    • pp.413-416
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    • 2019
  • Alstroemeria (Alstroemeriaceae) is one of the most important cut flowers in international market. Especially, characteristics like long vase-life, various colors, tolerance to low temperature and a low energy requirement during cultivation have stimulated this success. Because of its characteristics such as low multiplication rates, time-consuming process and high risk of carrying viral disease, in vitro propagation techniques based on rhizome meristems culture have been developing nowadays. The callus induction has various cultivation sites compared with the direct plant generation method, and if the callus is maintained well, the plant differentiation can be performed simultaneously while maintaining the callus, so that it can be used for mass proliferation. In this study, we tested various hormones and cultivars for efficient callus induction. As a result of culturing between the nodes and the internodes, the callus began to be formed after 8 weeks, and the calli incidence in the nodes was higher than that between the internodes. Also, in the comparison of 2,4-D and picloram, the callus incidence rate was up to 2 times higher in the medium treated with 2,4-D. Using these results, it is thought that it will help establish the system of mass propagation system of Alstroemeria and cultivate new varieties.

Effect of oocyte chromatin status in porcine follicles on the embryo development in vitro

  • Lee, Joo Bin;Lee, Min Gu;Lin, Tao;Shin, Hyeon Yeong;Lee, Jae Eun;Kang, Jung Won;Jin, Dong-Il
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.7
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    • pp.956-965
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    • 2019
  • Objective: The main goal of this study was to provide a morphological indicator that could be used to select high-quality oocytes of appropriate meiotic and developmental capabilities in pig. The higher quality of immature oocytes, the higher success rates of in vitro maturation (IVM) and in vitro fertilization (IVF). Thus, prior to the IVM culture, it is important to characterize oocytes morphologically and biochemically in order to assess their quality. Two of the largest indicators of oocyte quality are the presence of cumulus cells and status of chromatin. To investigate the effects of porcine oocyte chromatin configurations on the developmental capacity of blastocysts, we assessed oocyte chromatin status according to follicle size and measured the developmental potency of blastocysts. Methods: To sort by follicle size, we divided the oocytes into three groups (less than 1 mm, 1 to 3 mm, and more than 3 mm in diameter). To assess chromatin configuration, the oocytes were assessed for their stages (surrounded nucleolus [SN] germinal vesicle [GV], non-surrounded nucleolus [NSN] GV, GV breakdown, metaphase I [MI], pro-metaphase II [proMII], and metaphase II [MII]) at different maturation times (22, 44, and 66 h). To assess the development rate, oocytes of each follicle size were subjected to parthenogenetic activation for further development. Finally, GV oocytes were grouped by their chromatin configuration (SN, SN/NSN, and NSN) and their global transcriptional levels were measured. Results: SN GV oocytes were more suitable for IVF than NSN GV oocytes. Moreover, oocytes collected from the larger follicles had a greater distribution of SN GV oocytes and a higher developmental capacity during IVM, reaching MII more quickly and developing more often to blastocysts. Conclusion: Porcine oocytes with high-level meiotic and developmental capacity were identified by analyzing the relationship between follicle size and chromatin configuration. The porcine oocytes from large follicles had a significantly higher SN status in which the transcription level was low and could be better in the degree of meiotic progression and developmental capacity.

A Study on the Design Diagnostic Guideline in Crowdfunding for Makers (메이커스(Makers)를 위한 크라우드 펀딩 디자인 진단 가이드라인에 관한 연구)

  • Oh, In Kyun;Lee, Jang Woo
    • Korea Science and Art Forum
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    • v.35
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    • pp.281-292
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    • 2018
  • Crowd funding is also called social funding because of SNS that it helps early start-up founder and makers to raise money for idea product production. Recently, the funding platform has recorded high growth rates. As a result, the government in Korea has introduced various support policies for the crowd funding. The purpose of this study is to develop a diagnostic design guideline for product design oriented makers based on the historical situation. The paper writer applied literature survey and expert interview as research methods. The literature survey focused on internet news and previous research studies. The expert interview was conducted for 10 specialist people and divided for the second time. As a result of the text survey, the current guideline was lacking in design and in detail. Researchers have been informed through previous paper that information transfer text and images are important factors for funding success. In the first interview with seven special participants, we made a draft design guideline for social funding with a two-step process and nine themes. We, research and three professional people having a evaluation experience, conducted verification and supplementation for establishing the design guider with a three-step process and eight themes in the next interview. The design guideline for crowd funding, it can be used by money funding manager apart from design makers. Through the results of this paper, researchers are expected to prevent problems and contribute to healthy crowd funding ecosystem development.

Ultrasound-Guided Percutaneous Thrombin Injection of Femoral Artery Pseudoaneurysms Caused by Vascular Access (대퇴동맥을 통한 시술 후 발생한 가성동맥류의 초음파 유도하 경피적 트롬빈 주입 치료)

  • Seung Yoon Chae;Chan Park;Jae Kyu Kim;Hyoung Ook Kim;Byung Chan Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.589-599
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    • 2021
  • Purpose To analyze the success and complication rates and factors associated with technical failure of the ultrasound (US)-guided percutaneous thrombin injection of femoral artery pseudoaneurysms caused by vascular access. Materials and Methods Records of 30 patients with post-catheterization femoral artery pseudoaneurysms who had been treated with US-guided percutaneous thrombin injections in the department of radiology between March 2009 and June 2019 were retrospectively analyzed. The lesion was diagnosed based on US or contrast-enhanced CT. The characteristics of the patients and their lesions were analyzed. Results The mean patient age was 67.8 years. The mean diameter of the pseudoaneurysmal sac was 20.88 mm (5-40 mm). Twenty patients (66.6%) obtained complete thrombosis after the primary injection, while 10 patients (33.3%) obtained partial thrombosis. The number of patients with a low platelet count (< 130 k/µL) was significantly higher in the partial thrombosis group than in the complete thrombosis group (p = 0.02). No substantial procedure-related complications were found in any patient. Conclusion The US-guided percutaneous thrombin injection is considered an initial treatment option for pseudoaneurysms caused by vascular access because of its safety and efficacy.

Percutaneous Transgastric Stent Placement for Malignant Gastroduodenal Obstruction (악성 위십이지장 협착 환자에서의 경피적 위 경유 스텐트 설치)

  • Bumsang Cho;Gyoo-Sik Jung;Jong Hyouk Yun
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1175-1183
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    • 2020
  • Purpose To evaluate the technical feasibility and clinical efficacy of percutaneous transgastric stent placement after the failure of treatment attempt with the transoral approach in malignant gastroduodenal obstruction patients. Materials and Methods From October 2008 to April 2016, nine patients (M:F = 4:5; mean age = 66 years) with malignant gastroduodenal obstruction underwent stent placement via a gastrostomy tract, which was attributed to the failure of the transoral approach. The primary etiologies of the obstruction were pancreatic (n = 5), gastric (n = 2), and metastatic (n = 2) cancers. Through percutaneous gastrostomy, dual stents (inner bare metal and outer polytetrafluoroethylene-covered) were deployed at the obstruction site. The technical and clinical success rates, as well as complications were evaluated during the follow-up period. Results Stents were successfully inserted in eight patients (88%). We failed to insert stent in one patient due to the presence of a tight obstruction. After stent placement, symptoms improved in seven patients. Gastrostomy tube was removed 9 to 20 days (mean = 12 days) after the stent insertion. During the mean follow-up of 136 days (range, 3-387 days), one patient developed a recurrent symptom due to tumor overgrowth. However, there were no other major complications associated with the procedure. Conclusion Percutaneous transgastric stent placement appeared to be technically feasible and clinically effective in patients who underwent a failed transoral approach.

Percutaneous Transhepatic Treatment of Benign Bile Duct Strictures Using Retrievable Covered Stents: Long-Term Outcomes in 148 Patients

  • Byung Soo Im;Dong Il Gwon;Hee Ho Chu;Jin Hyoung Kim;Gi-Young Ko;Hyun-Ki Yoon
    • Korean Journal of Radiology
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    • v.23 no.9
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    • pp.889-900
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    • 2022
  • Objective: To investigate the long-term outcomes of percutaneous treatment of benign biliary strictures using temporary placement of a retrievable expanded polytetrafluoroethylene (PTFE) covered stent. Materials and Methods: We retrospectively analyzed the outcomes of 148 patients (84 male and 64 female; age range, 11-92 years) who underwent percutaneous transhepatic placement and removal of a retrievable PTFE-covered stent for the treatment of benign biliary strictures between March 2007 and August 2019 through long-term follow-up. Ninety-two patients had treatment-naïve strictures and 56 had recurrent/refractory strictures. Results: Stent placement was technically successful in all 148 patients. The mean indwelling period of the stent was 2.4 months (median period, 2.3 months; range, 0.2-7.7 months). Stent migration, either early or late, occurred in 28 (18.9%) patients. Clinical success, defined as resolution of stricture after completing stent placement and removal, was achieved in 94.2% (131 of 139 patients). The overall complication rate was 15.5% (23 of 148 patients). During the mean follow-up of 60.2 months (median period, 52.7 months; range, 1.6-146.1 months), 37 patients had a recurrence of clinically significant strictures at 0.5-124.5 months after removal of biliary stent and catheter (median, 16.1 months). The primary patency rates at 1, 3, 5, 7, and 10 years after removal of biliary stent and catheter were 88.2%, 70.0%, 66.2%, 60.5%, and 54.5%, respectively. In the multivariable Cox proportional hazard regression analysis, sex, age, underlying disease, relation to surgery, stricture type, biliary stones, history of previous treatment, and stricture site were not significantly associated with the primary patency. Conclusion: Long-term outcomes suggest that percutaneous treatment of benign biliary strictures using temporary placement of retrievable PTFE-covered stents may be a clinically effective method.

The Use of an Iliac Branch Device: Single-Center Study of Endovascular Preservation of Internal Iliac Artery Flow (장골 분지 장치 사용: 내장골동맥 흐름의 혈관내 보존에 대한 단일 기관의 경험)

  • Hyeseung Lee;Jeong-min Lee;Soongu Cho;JungUi Hong
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1339-1349
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    • 2023
  • Purpose To determine the efficacy and safety of iliac branch device (IBD) implantation and to evaluate its limitations based on 7 years of experience in a single center. Materials and Methods This single-center study included patients with bilateral common iliac artery aneurysms (CIAAs). We investigated follow-up CT and reviewed the internal iliac artery (IIA) patency and complications related to IBD. A retrospective analysis was performed and the overall survival rate and freedom from reintervention rate were reported according to the Kaplan-Meier method. Results Of the 38 patients with CIAAs, only 10 (12 CIAAs) were suitable for IBD treatment. Five patients underwent unilateral IBD insertion with contralateral IIA embolization, and three (60%) showed claudication; however, symptoms resolved within 6 months. The 7-year freedom from IBD-related reintervention rate was 77.8%. No procedure-related deaths occurred. Conclusion IBD has good technical success and long-term patency rates; however, anatomical factors frequently limit its application, particularly in Asians. Additionally, unilateral IIA embolization showed relatively mild complications and a good prognosis; therefore, it can be performed safely for anatomically complex aortoiliac aneurysms.

The Effect of the Serum Progesterone and Estradiol Levels of hCG Administration Day on the Pregnancy and Fertilization Rate in IVF-ET Patients (체외수정 과배란 유도에서 hCG 주사 당일의 혈청 Progesterone과 Estradiol 농도가 수정율 및 임신율에 미치는 영향에 관한 연구)

  • Lee, Eun-Sook;Lee, Sang-Hoon;Bae, Do-Hwan
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.1
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    • pp.51-59
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    • 1996
  • Controlled Ovarian hyperstimulation(COH) is generally used to obtain synchronous high quality oocytes in in vitro fertilization-embryo transfer(IVF-ET). Many investigators have studied the relationship between serum hormone levels and outcomes of IVF-ET because there is no accurate estimation method of oocyte quality. Early premature luteinization of follicles before oocyte retrieval is the most troublesome problem in COH for IVF-ET. Gonadotropin-releasing hormone agonists(GnRH-a) are used as adjuncts with gonadotropins for COH in patients undergoing in IVF. The possible benefits of GnRH-a pretreatment include improving oocyte quality, allowing a more synchronous cohort of follicles to be recruited, and preventing premature lueinization hormone surges. In COH of IVF cycles, we investigated whether an elevated progesterone(P4) level on the day of human chorionic gonadotropin(hCG) administration indicates premature luteinization and is associated with a lower fertilization rate. Many investigators have studied that the lower fertilization rates seen in patients with elevated P4 levels might result from an adverse effect of P4 on the oocytes. We hypothesizes that serum P4 levels around the day of hCG may be helpful prediction of out come in IVF-ET cycles. Success rates after COH of IVF-ET cycles are dependent upon many variable factors. Follicular factors including the number of follicles, follicular diameters and especially serum estradiol(E2) levels as an indirect measurement of follicular function and guality have been thought to influence the outcomes of IVF-ET. To assess whether serum P4 and E2 levels affect the fertilization and pregnancy rate, we reviewed the stimulation cycles of 113 patients (119 cycles) undergoing IVF-ET with short protocol with GnRH-a, from March 1993 to August 1994 retrospectively. The serum P4 and E2 levels were compared on the day of hCG in the pregnant group, 45 patients(47 cycles) and in the non-pregnant group, 68 patients (72 cycles) respectively. The serum E2 level in non-pregnant group was $1367{\pm}875.8$ pg/ml which was significantly lower than that of pregnant group, $1643{\pm}987.9$ pg/ml( p< 0.01 ). And the serum P4 level in non-pregnant group was $2.1{\pm}1.4$ ng/ml which was significantly higher than that of pregnant group, $1.0{\pm}0.7$ ng/ml( p< 0.001 ). The fertilization rate was $61.3{\pm}21.3%$ in pregnant group which was higher than that of non-pregnant group, $41.1{\pm}20.2%$ (p< 0.01). We suggest that the serum levels of P4 and E2 on the day of hCG administration are additional parameters that predict the outcomes of IVF-ET cycles.

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