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A Single-Center Experience of Robotic-Assisted Spine Surgery in Korea : Analysis of Screw Accuracy, Potential Risk Factor of Screw Malposition and Learning Curve

  • Bu Kwang Oh;Dong Wuk Son;Jun Seok Lee;Su Hun Lee;Young Ha Kim;Soon Ki Sung;Sang Weon Lee;Geun Sung Song;Seong Yi
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.60-72
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    • 2024
  • Objective : Recently, robotic-assisted spine surgery (RASS) has been considered a minimally invasive and relatively accurate method. In total, 495 robotic-assisted pedicle screw fixation (RAPSF) procedures were attempted on 100 patients during a 14-month period. The current study aimed to analyze the accuracy, potential risk factors, and learning curve of RAPSF. Methods : This retrospective study evaluated the position of RAPSF using the Gertzbein and Robbins scale (GRS). The accuracy was analyzed using the ratio of the clinically acceptable group (GRS grades A and B), the dissatisfying group (GRS grades C, D, and E), and the Surgical Evaluation Assistant program. The RAPSF was divided into the no-breached group (GRS grade A) and breached group (GRS grades B, C, D, and E), and the potential risk factors of RAPSF were evaluated. The learning curve was analyzed by changes in robot-used time per screw and the occurrence tendency of breached and failed screws according to case accumulation. Results : The clinically acceptable group in RAPSF was 98.12%. In the analysis using the Surgical Evaluation Assistant program, the tip offset was 2.37±1.89 mm, the tail offset was 3.09±1.90 mm, and the angular offset was 3.72°±2.72°. In the analysis of potential risk factors, the difference in screw fixation level (p=0.009) and segmental distance between the tracker and the instrumented level (p=0.001) between the no-breached and breached group were statistically significant, but not for the other factors. The mean difference between the no-breach and breach groups was statistically significant in terms of pedicle width (p<0.001) and tail offset (p=0.042). In the learning curve analysis, the occurrence of breached and failed screws and the robot-used time per screw screws showed a significant decreasing trend. Conclusion : In the current study, RAPSF was highly accurate and the specific potential risk factors were not identified. However, pedicle width was presumed to be related to breached screw. Meanwhile, the robot-used time per screw and the incidence of breached and failed screws decreased with the learning curve.

Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction (악성 담관 폐쇄 환자에서 경피경간 담도 배액술의 유증상 이탈 발생의 예측 인자)

  • Hee Jeong Yu;Jung Gu Park;Gyoo Sik Jung;Kwang Il Seo;Hyun Joon Park;Jong Hyouk Yun
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1350-1360
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    • 2023
  • Purpose To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction. Materials and Methods This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated. Results During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1-233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131-2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080-2.274, p = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005-1.026, p = 0.005), and incomplete closed-loop pigtail formation (OR: 1.672, 95% CI: 1.098-2.545, p = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter. Conclusion Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.

Biological Control of Sclerotinia Rot Caused by Sclerotinia sclerotiorum in Lettuce Using Bacillus amyloliquefaciens HY (Bacillus amyloliquefaciens HY를 이용한 상추 균핵병의 생물학적 방제)

  • Mi-Ra Son;Jin-Won Kim
    • Research in Plant Disease
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    • v.30 no.3
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    • pp.247-255
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    • 2024
  • To test the antagonistic ability of Bacillus amyloliquefaciens HY against lettuce sclerotinia rot caused by Sclerotinia sclerotiorum, an in vitro test, greenhouse test and growth chamber test were conducted. As a result of in vitro dual culture test for sclerotia of B. amyloliquefaciens HY, the mycelial growth inhibition rate was 70.7%. Mycelial tip was swollen, black, and had an irregular and deformed shape. In I-plate test, the antagonistic volatile compounds produced by B. amyloliquefaciens HY, the mycelial growth inhibition rate was 57.7% and the sclerotia germination inhibition rate was 46.7%. In addition, B. amyloliquefaciens HY had sideropore production capacity, phosphate solubillibty, and protease production capability, but B. amyloliquefaciens HY did not produce chitinase. In growth chamber test, the lettuce survival rate was 0% in the control group treated with only the pathogen, and 80% in the treatment group treated with of S. sclerotiorum and B. amyloliquefaciens HY by diluting 10 times of the lettuce survival rate. In addition, the lettuce survival rate of 80% was shown in the treatment group treated with the culture medium of B. amyloliquefaciens HY 50 times 1 week later after inoculation with S. sclerotiorum.

Chronological observation of intestinal lesions of rots experimentally infected with Echinostoma hortense (흰쥐의 실험적 호르틴스극구흡충 감염에 있어서 장 병변에 대한 경시적 관찰)

  • 이순형;노태영
    • Parasites, Hosts and Diseases
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    • v.28 no.1
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    • pp.45-52
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    • 1990
  • Intestinal histopathological changes due to infection with Echinostcma hortense (Trematoda) were studied in rats after experimental infection with the metacercariae. The metacercariae were obtained from the tadpoles of Rana nigrcmaculata, a second intermediate host infected in the laboratory. Total 18 albino rats(Sprague-Dawley) were given 200 matacercariae each and sacrificed on the day 1, 3, 7, 11, 22 or 44 post-infection(PI) Segments of- the small intestine at 1, 3, 5, 8 and 30 cm posterior to the pylorus(PTP) were rejected and studied histopathologically. 1. The flukes were seen to have intruded into the intervillous space in the upper small intestine at early stages(1∼3 days PI), however, they were located mainly in the intestinal lumen at later stages(7∼44 days PI) . The flukes were sucking and destroying the epithelial layers of villi with their oral and ventral suckers. 2. Histopathological changes of the intestine were recognizable in as early as 1∼3 days after infection, and the changes became severer as the infection progressed. 3. The intestinal mucosa was histopathologically characterized by villous atrophy and crypt hyperplasia throughout the infection period. Major villous changes were blunting, fusion, severe destruction and loss of epithelial layers of villi. Villous/crypt(V/C) height ratio was remarkably reduced from 3 : 1 in controls to 1 : 1 in severely infected animals. In the stroma of villi, inaamma- tory cell infiltrations, vascular congestion, edema, and/or fibrosis were recognized. The goblet cells were increased in number after 11 days PI. It was revealed in the present study that the pathological changes in the intestine of rats infected with E. hortense were chieay confined to the mucosal layer of the upper small intestine, however, the changes were very severe accompanying remarkable destruction of villi and loss of mucosal integrity, and persistent until 44 days PI.

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GPU Based Feature Profile Simulation for Deep Contact Hole Etching in Fluorocarbon Plasma

  • Im, Yeon-Ho;Chang, Won-Seok;Choi, Kwang-Sung;Yu, Dong-Hun;Cho, Deog-Gyun;Yook, Yeong-Geun;Chun, Poo-Reum;Lee, Se-A;Kim, Jin-Tae;Kwon, Deuk-Chul;Yoon, Jung-Sik;Kim3, Dae-Woong;You, Shin-Jae
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.08a
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    • pp.80-81
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    • 2012
  • Recently, one of the critical issues in the etching processes of the nanoscale devices is to achieve ultra-high aspect ratio contact (UHARC) profile without anomalous behaviors such as sidewall bowing, and twisting profile. To achieve this goal, the fluorocarbon plasmas with major advantage of the sidewall passivation have been used commonly with numerous additives to obtain the ideal etch profiles. However, they still suffer from formidable challenges such as tight limits of sidewall bowing and controlling the randomly distorted features in nanoscale etching profile. Furthermore, the absence of the available plasma simulation tools has made it difficult to develop revolutionary technologies to overcome these process limitations, including novel plasma chemistries, and plasma sources. As an effort to address these issues, we performed a fluorocarbon surface kinetic modeling based on the experimental plasma diagnostic data for silicon dioxide etching process under inductively coupled C4F6/Ar/O2 plasmas. For this work, the SiO2 etch rates were investigated with bulk plasma diagnostics tools such as Langmuir probe, cutoff probe and Quadruple Mass Spectrometer (QMS). The surface chemistries of the etched samples were measured by X-ray Photoelectron Spectrometer. To measure plasma parameters, the self-cleaned RF Langmuir probe was used for polymer deposition environment on the probe tip and double-checked by the cutoff probe which was known to be a precise plasma diagnostic tool for the electron density measurement. In addition, neutral and ion fluxes from bulk plasma were monitored with appearance methods using QMS signal. Based on these experimental data, we proposed a phenomenological, and realistic two-layer surface reaction model of SiO2 etch process under the overlying polymer passivation layer, considering material balance of deposition and etching through steady-state fluorocarbon layer. The predicted surface reaction modeling results showed good agreement with the experimental data. With the above studies of plasma surface reaction, we have developed a 3D topography simulator using the multi-layer level set algorithm and new memory saving technique, which is suitable in 3D UHARC etch simulation. Ballistic transports of neutral and ion species inside feature profile was considered by deterministic and Monte Carlo methods, respectively. In case of ultra-high aspect ratio contact hole etching, it is already well-known that the huge computational burden is required for realistic consideration of these ballistic transports. To address this issue, the related computational codes were efficiently parallelized for GPU (Graphic Processing Unit) computing, so that the total computation time could be improved more than few hundred times compared to the serial version. Finally, the 3D topography simulator was integrated with ballistic transport module and etch reaction model. Realistic etch-profile simulations with consideration of the sidewall polymer passivation layer were demonstrated.

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The effects of mandibular setback osteotomy on the oropharyngeal airway space in mandibular prognathic patients (하악전돌 환자에서 하악골 후퇴수술이 기도공간에 미치는 영향)

  • Kim, Hyo-Young;Choi, Hyun-Gue;Kim, Eun-Kyung;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.27 no.5 s.64
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    • pp.733-741
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    • 1997
  • As a result of surgical orthodontic treatment of mandibular prognathism, changes take place in the skeletal and soft orofacial components. Although some investigators had stated that permanent reduction of airway space was observed after mandibular setback surgery, it was not clear that this permanent reduction was sustained during long-term follow-up. The purpose of this study was to assess the changes in oropharyngeal airway space and soft tissue orofacial component following the mandibular setback surgery and during the follow-up period. The correlation between the changes of the oropharyngeal airway space and the changes of other soft tissue orofacial component was also assessed. The findings of this study were as follows ; 1. The oropharyngeal airway space area decreased following mandibular setback surgery for mandibular prognathism and continued to decrease during the follow-up period(p<0.05). 2. The pharyngeal depth at Xi point level and the 2nd cervical vertebra point level decreased after the surgery and remained during the follow-up period(p<0.05). The decrease of these pharyngeal depth was correlated with the decrease of oropharyngeal airway space area(p<0.01). 3. The decrease of pharyngeal depth at the 3rd and 4th cervical vertebra point level was not significant after the surgery and during the follow up period. 4. The hyoid bone moved downward after the surgery(p<0.05), but returned to its original position during the follow-up period. 5. The length & height of tongue and the Position of epiglottis base did not change significantly(p>0.05). 6. The soft palate was displaced posteriorly after the surgery and remained to its changed position during the follow-up period(p<0.05) due to posterior displacement of tongue. The changes of soft palate were significantly correlated with the decrease of oropharyngeal airway space area(p<0.01). 7. The narrowing of oropharyngeal airway space was due to the posterior displacement of tongue above the level of epiglottis tip. The posterior displacement of tongue following mandibular setback osteotomy remained during the follow-up period.

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Finite Element Method Modeling for Individual Malocclusions: Development and Application of the Basic Algorithm (유한요소법을 이용한 환자별 교정시스템 구축의 기초 알고리즘 개발과 적용)

  • Shin, Jung-Woog;Nahm, Dong-Seok;Kim, Tae-Woo;Lee, Sung Jae
    • The korean journal of orthodontics
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    • v.27 no.5 s.64
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    • pp.815-824
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    • 1997
  • The purpose of this study is to develop the basic algorithm for the finite element method modeling of individual malocclusions. Usually, a great deal of time is spent in preprocessing. To reduce the time required, we developed a standardized procedure for measuring the position of each tooth and a program to automatically preprocess. The following procedures were carried to complete this study. 1. Twenty-eight teeth morphologies were constructed three-dimensionally for the finite element analysis and saved as separate files. 2. Standard brackets were attached so that the FA points coincide with the center of the brackets. 3. The study model of a patient was made. 4. Using the study model, the crown inclination, angulation, and the vertical distance from the tip of a tooth was measured by using specially designed tools. 5. The arch form was determined from a picture of the model with an image processing technique. 6. The measured data were input as a rotational matrix. 7. The program provides an output file containing the necessary information about the three-dimensional position of teeth, which is applicable to several finite element programs commonly used. The program for a basic algorithm was made with Turbo-C and the subsequent outfile was applied to ANSYS. This standardized model measuring procedure and the program reduce the time required, especially for preprocessing and can be applied to other malocclusions easily.

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A study of the arch length discrepancy and the diagnostic analysis (치열궁내 공간 부조화와 진단적 평가에 관한 연구)

  • Ryu, Young-Kyu;Ahn, Kwang-Seok
    • The korean journal of orthodontics
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    • v.34 no.1 s.102
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    • pp.1-11
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    • 2004
  • Predicting the arch length discrepancy by simply comparing the available arch perimeter with tooth materials is merely a 2-dimensional analysis of the teeth movement. However, the real teeth movement takes place 3-dimensionally and is affected by various factors such as, the arch fen the curve of Spee and the axis of the incisors. The purpose of this study is to clarify the relationship between the decrease in the arch perimeter and the horizontal positional change of the incisors after extraction of the 1st bicuspids, for more analytic evaluation of the arch length discrepancy at pre-treatment model analysis stage. In addition to that to evaluate the effect of the curve of Spee, teeth axis to the basal plane, and the incisional crowding to the treatment outcome. All patients were treated at the department of orthodontics, dental hospital, Yonsei university. Inclusion criteria for patients selection were as follows. $\cdot$ Angle classification I malocclusion with bialveolar protrusion $\cdot$ Extraction of 4 1st bicuspids $\cdot$ No tooth anomaly or prosthesis $\cdot$ No abnormal attrition $\cdot$ No ectopically erupted teeth $\cdot$ Angle classification I canine and molar relationship $\cdot$ Less than 3mm of crowding Model analysis of the above patients was performed and the following conclusions were obtained. 1. When the intercanine distance was maintained, the available space for the distal movement of the mandibular incisors after the extraction of the 4 1st bicuspids was larger than the space provided by the extraction of the 4 1st bicuspids. However the difference was less than 1mm. The more tapered the anterior arch form, the larger the difference. 2. Compared to the situation in which the intercanine distance was maintained, when the intercanine distance was expanded to meet the width of the Posterior teeth, the incisors could move about 3mm more distally. 3. The positional difference of the incisal tip was insignificant whether the central incisors were moved by tipping or bodily movement. 4. When the anterior crowding was solved without changing the intercanine distance, the larger the anterior arch length was, the more the anterior movement of the incisors. 5. When the curve of Spee was levelled, the increase in the arch perimeter was less than half of the deepest curve of Spee.

Early Life History of the Sea Bass, Lateolabrax japonicus(Cuvier) (농어(Lateolabrax japonicus)의 초기 생활사)

  • Han, Kyeong-Ho;Lee, Won-Kyo;Yang, Seok-Woo;O, Sung-Hyun;Shin, Sang-Boo
    • Korean Journal of Ichthyology
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    • v.11 no.1
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    • pp.94-101
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    • 1999
  • This study was conducted to observe the early life history of sea bass, Lateolabrax japonicus. The fertilized eggs were spherical in shape and turned out to be separative and floated. Their membrane and yolk having 1~5 oil globule were transparent. Fertilized eggs were measured to be 1.33~1.46 mm in diameter. Hatching of eggs were started at 74 hrs 15 mins, 54 hrs 55 mins, 50 hrs 45 mins, after fertilization in water temperature $16.0^{\circ}C$, $18.0^{\circ}C$, $20.0^{\circ}C$ respectively. The newly hatching larvae were 3.79~3.97 mm in total length with 35~37 myomeres, and mouth and anus were closed. Melanophores were distributed on the up side of head, upper jaw and margins of the body. The 5 days after hatching larvae measured 4.78~5.24 mm in total length, yolk were completely absorbed, and transformed to postlarval stage. In this time, mouth of larvae was opened, and also melanophores were presented on the lower jaw. Head of larvae grew remarkably. The 21~22 days after hatching, total length of the larvae was 7.15~8.12 mm, the caudal fin rays began to differentiation. In 31 days after hatching, the larva were 8.46~9.16 mm in total length, and tip of the caudal notochord flexed $45^{\circ}$. The larvae reached to the juvenile stage with all the fins were developed at 61 days after hatching and attained 16.28~17.31 mm in total length.

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The Growth Phase and Yield Difference of Kenaf (Hibiscus cannabinus L.) on Soil Salinity in Reclaimed Land (간척지에서 토양 염농도별 케나프의 생육반응 및 수량성)

  • Kang, Chan-Ho;Choi, Weon-Young;Yoo, Young-Jin;Choi, Kyu-Hwan;Kim, Hyo-Jin;Song, Young-Ju;Kim, Chung-Kon
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.59 no.4
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    • pp.511-520
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    • 2014
  • Kenaf (Hibiscus cannabinus L.) was recognized as a potential source of forage. To reduce the production cost, we should insure large cultivation area. The one of the best candidate places to expand the useful kenaf production was 'Saemangeum' reclaimed land. To confirm the possibility of kenaf growth in reclaimed land, we seeding and cultivated the kenaf in 'Saemangeum'. The germination percentage of kenaf on 5.0 dS/m soil salinity was 18%. It is less 66% than that of 4.0 dS/m soil salinity and at 6.0 dS/m, the germination percentage of kenaf was under 10%. The growth and development of kenaf in reclaimed land grew worse with increasing soil salinity. The stem diameter which the most important factor that decide the value and yield of product was upper 2.6 cm when soil salinity maintained under 4.0 dS/m, but if soil salinity marked over 4.0 dS/m, the stem diameter of kenaf was drop under 2.0 cm and it deteriorate the number of leaves per plant by 20~46%. The necrosis on older tip and marginal leaves were noted approximately first month after seeding which was correlated directly with the salinity levels of reclaimed soil. Reduction of total yield was coincide with increasing levels of EC. If soil salinity over 5.0 dS/m, the amount of decreased by soil salinity was 51% than that of non-reclaimed region. The allowable soil salinity level of which could be maintained within 20% reduction rate was 4.2 dS/m. Consequently kenaf can be grown successfully with moderately saline soil condition. However, salt levels in excess of 4.2 dS/m severely have restricted plant growth and development and will result in significant yield reduction.