Han, Sanghyun;Park, Bumsoo;Lim, Jeong-Wook;Youm, Jin-Young;Choi, Seoung-Won;Kim, Dae Hwan;Ahn, Dong Ki
Journal of Korean Neurosurgical Society
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v.63
no.6
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pp.673-680
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2020
The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90-1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91-1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.
Kim, Young-Hoon;Han, Jung Ho;Kim, Chae-Yong;Oh, Chang Wan
Journal of Korean Neurosurgical Society
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v.54
no.2
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pp.112-117
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2013
Objective : We performed this study to investigate whether the use of closed-suction drainage following microvascular decompression (MVD) causes cerebrospinal fluid (CSF) leakage. Methods : Between 2004 and 2011, a total of 157 patients with neurovascular compression were treated with MVD. MVD was performed for hemifacial spasm in 150 (95.5%) cases and for trigeminal neuralgia in 7 (4.5%) cases. The mean age of the patients was $49.8{\pm}9.6$ years (range, 20-69). Dural substitutes were used in 44 (28.0%) patients. Ninety-two patients (58.6%) were underwent a 4-5 cm craniotomy using drainage (drainage group), and 65 (41.4%) did a small 2-2.5 cm retromastoid craniectomy without closed-suction drainage (no-drainage group). Results : Eleven (7.0%) patients experienced CSF leakage following MVD based on the criteria of this study; all of these patients were in the drainage group. In the unadjusted analyses, the incidence of CSF leakage was significantly related with the use of closed-suction drainage following MVD (12.0% in the drainage group vs. 0% in the no-drainage group, respectively; p=0.003; Fisher's exact test). Those who received dural substitutes and the elderly (cut-off value=60 years) exhibited a tendency to develop CSF leakage (p=0.075 and p=0.090, respectively; Fisher's exact test). In the multivariate analysis, only the use of closed-suction drainage was significantly and independently associated with the development of CSF leakage following MVD (odds ratio=9.900; 95% confidence interval, 1.418 to infinity; p=0.017). Conclusion : The use of closed-suction drainage following MVD appears to be related to the development of CSF leakage.
The purpose of the paper is to propose a method to give a more accurate prediction of prestress changes in prestressed concrete(PSC) bridges. The statistical approach of the method is using the measurement data of the structural system to develop a nonlinear regression analysis. Long-term prediction of prestress is achieved using nonlinear regression analysis. The proposed method is applied to the prediction of prestress of an actual prestressed concrete box girder bridge. The present study represents that confidence interval of long-term prediction becomes progressively narrower with the increase of in-situ measurement data. Therefore, the numerical results prove that a more realistic long-term prediction of prestress changes in PSC structures can be achieved by employing the proposed method. The prediction results can be efficiently used to evaluate prestress during the service life of structure so that the remaining prestress exceeds the control criteria.
Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI) are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS). Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.
Han, Seung-A;Yang, Eu Jeen;Song, Mi-Kyoung;Kim, Sun Jun
Clinical and Experimental Pediatrics
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v.60
no.6
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pp.189-195
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2017
Purpose: The purpose of this study was to investigate the effects of lamotrigine for the treatment of attention-deficit hyperactivity disorder (ADHD) symptoms in children with epilepsy. Methods: Pediatric patients newly diagnosed with epilepsy (n=90 [61 boys and 29 girls]; mean age, $9.1{\pm}3.4years$) were enrolled. All patients were evaluated with the Korean ADHD rating scale (K-ARS)-IV before treatment with lamotrigine and after doses had been administered. The mean interval of ADHD testing was approximately 12.3 months. The initial dosage of lamotrigine was 1 mg/kg/day (maximum 25 mg/day for the first 2 weeks), and increased by 1 mg/kg every 2 weeks until titrated up to 7 mg/kg/day (or maximum 200 mg/day). Results: The mean ADHD test score of the 90 subjects was $17.0{\pm}1.8$ at baseline. It was slightly reduced to $15.6{\pm}1.7$ after lamotrigine monotherapy (P>0.01). Prior to treatment, a total of 31 patients (34.4%) met the diagnostic criteria for ADHD according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, Of these 31 patients, 27 (87.1%) had significantly improved ADHD scores with lamotrigine monotherapy ($28.0{\pm}1.6$ reduced to $18.1{\pm}2.6$, P<0.001). Among these 27 patients, 25 (92.6%) showed normalized electroencephalogram (EEG) and 26 (96.3%) achieved total freedom from seizures within 12 months of the initiation of lamotrigine monotherapy. Conclusion: The results from our study show that lamotrigine had a positive effect in pediatric epilepsy patients by reducing ADHD symptoms, preventing seizures, and normalizing EEG. However, further research is required to determine whether lamotrigine is efficacious against ADHD symptoms independent of its effects on epileptic seizures.
The high salt concentration of reclaimed tidelands in the beginning of reclamation interferes with the growth of most crops. Although the crops are cultivated in the unripened tidal reclaimed paddy fields after desalinization to be arable, they we apt to be injured from salt by the resalinization through accumulated salts in the root zone during the growing period. In oder to make the reasonable irrigation plan in the unripened tidal reclaimed paddy fields, the preventive water requirements of resalinization as well as leaching requirements have to be included in irrigation water requirements. The critical salinity for the normal growth of crops should be determined to estimate the preventive water requirements of resalinization, and the changes of salinity in soil and water should be analyzed during the growing period, In this study, the growth tests of crops were conducted by soil textures and water management methods in the experimental field with lysimeters, using the samples of good drainage soils and poor drainage soils. And the changes of salinity in soil and water during the growing period, were analyzed to obtain the basic data for determining the critical salinity and making the estimation criteria of the preventive water requirements of resalinization. As the results obtained from analyzing the changes of salinity during the growing period in the unripened tidal reclaimed paddy fields, the exchanging interval of water for the prevention of resalinization was estimated to be within two weeks in good drainage soils and a week in poor drainage soils. And the total exchanging requirements of water for the prevention of resalinization during the growing period was estimated to be over 280mm in good drainage soils and 540mm in poor drainage soils.
Yoon, Han Gyul;Noh, Jae Myoung;Ahn, Yong Chan;Oh, Dongryul;Pyo, Hongryull;Kim, Haeyoung
Radiation Oncology Journal
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v.37
no.3
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pp.185-192
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2019
Purpose: The effectiveness of thoracic radiation therapy (TRT) in extensive-stage small cell lung cancer (ES-SCLC) patients is increasingly reported, but there is no definite consensus on its application. The aim of this study was to identify factors associated with better outcomes of TRT among patients with ES-SCLC, focusing on whether a higher TRT dose could improve treatment outcome. Materials and Methods: The medical records of 85 patients with ES-SCLC who received TRT between January 2008 and June 2017 were retrospectively reviewed. Eligibility criteria were a biological effective dose with α/β = 10 (BED) higher than 30 Gy10 and completion of planned radiotherapy. Results: During a median follow-up of 5.3 months, 68 patients (80.0%) experienced disease progression. In univariate analysis, a BED >50 Gy10 was a significant prognostic factor for overall survival (OS; 40.8% vs. 12.5%, p = 0.006), progression-free survival (PFS; 15.9% vs. 9.6%, p = 0.004), and intrathoracic PFS (IT-PFS; 39.3% vs. 20.5%, p = 0.004) at 1 year. In multivariate analysis, a BED >50 Gy10 remained a significant prognostic factor for OS (hazard ratio [HR] = 0.502; 95% confidence interval [CI], 0.287-0.876; p = 0.015), PFS (HR = 0.453; 95% CI, 0.265-0.773; p = 0.004), and IT-PFS (HR = 0.331; 95% CI, 0.171-0.641; p = 0.001). Response to the last chemotherapy was also associated with better OS in both univariate and multivariate analysis. Conclusion: A TRT dose of BED >50 Gy10 may be beneficial for patients with ES-SCLC. Further studies are needed to select patients who will most benefit from high-dose TRT.
Objectives: This study was performed to investigate the associations between the metabolic syndrome (MetS) and inflammatory markers. Methods: This cross-sectional analysis was performed using data from 1578 Koreans aged 40-69 years residing in a rural area. We investigated associations between MetS and circulating high sensitivity C-reactive protein (hs-CRP), white blood cells (WBC) and adiponectin. MetS was defined using the criteria proposed by the National Cholesterol Education Program Adult Treatment Panel III (ATP-III). Results: Increased WBC counts and hs-CRP levels and decreased adiponectin levels were observed in subjects with MetS. WBC, hs-CRP and adiponectin levels linearly deteriorated with an increase in the number of MetS components (all ptrend <0.005). Finally, adjusted odds ratios (ORs) for the risk of MetS by increase/decrease in 3 inflammatory markers were calculated by multivariate logistic regression analyses. In terms of changes in inflammation markers, in men, the adjusted ORs (95% confidence interval) were 1.15 (1.01-1.31) for WBC, 1.64 (1.02-2.64) for hs-CRP, and 0.19(0.08-0.45) for adiponectin, whereas corresponding adjusted ORs (95% Cls) in women were 1.27 (1.15-1.40), 0.98 (0.67-1.42), 0.09 (0.04-0.18), respectively. Conclusions: Serum adiponectin levels and WBC counts were found to be strongly associated with MetS in both sexes. However, hs-CRP lost its significance after adjusting for BMI and other inflammatory markers in women. This study shows that inflammatory response is associated with MetS in the Korean population. Further prospective studies are necessary to confirm the contribution made by inflammatory markers to the development of MetS.
The purpose of this study is to evaluate a new flight suit in bilateral ways; subjectively and objectively in the improvements of comfort and mobility. Seven healthy males at the age of twenties volunteered in this wearing test. They were over 177 cm in height and 92-95 cm in chest circumference, which satisfies the M95 Special' size described in the Korean Military Specifications and Standards. The subjective satisfaction was evaluated according to the criteria of ease of donning and doffing, fitness of wear, mobility, space between cloth and body, convenience in using restroom. Subjective satisfaction evaluation says that the best improvement of movement are neck circumference, chest breadth, armscye circumference, waist back length, crotch length, crotch height and body rise. According to the evaluation, improvements of mobility were conspicuous especially in parts of body like neck, breast, waist, back, and arms. When evaluating objective satisfaction, we measured a angle difference in a prescribed standard-grid on a photograph that picked up while the subject performed each motion in front of 10 cm-interval grid. As a result, the motion that had angle difference above 5 degrees were arm stretching and standing on single leg holding at forward or at his side. Bending necks and waist, crouching also had angle difference of over 5 degrees. The improvements are discussed from the viewpoint that the increased ease in parts of armscye circumference and crotch in new flight suit pattern.
Quantitative trait loci (QTLs) controlling ability of somatic embryogenesis were identified in soybean. A frame map with 204-point markers was developed using an RI population consisting of 117 $F_{11}$ lines derived from a cross between cultivar 'Keburi' and a weedy soybean 'Masshokutou Kou 502'. The parents differed greatly in their abilities of somatic embryogenesis using immature cotyledons as explants. The ability of somatic embryogenesis was evaluated in five different experiments: the $F_{11}$ (evaluated in 1998) and $F_{15}$ (2002) generations cultured on basal media supplemented with $40\;mg\;l^{-1}$ 2,4-D (2,4-D1998 and 2,4-D2002), $F_{14}$ (2001) generation on medium with $40\;mg\;l^{-1}$ 2,4-D and high sucrose concentration [2,4-D2001 ($30\;g\;l^{-1}$ sucrose)], and the $F_{11}$ (1998) and $F_{12}$ (1999) generations on medium with $10\;mg\;l^{-1}$ NAA (NAA1998 and NAA1999). The RILs showed wide and continuous variations in each of the five experiments. In the composite interval mapping analysis, 2 QTLs were found in group 8 (D1b + W, LOD = 5.42, $r^2$ = 37.5) in the experiment of 2,4-D1998 and in group 6 (C2, LOD = 6.03, $r^2$ = 26.0) in the experiment of 2,4-D2001 (high concentration sucrose). In both QTLs, alleles of 'Masshokutou Kou 502' with high ability of somatic embryogenesis contributed to the QTLs. For the other three experiments, no QTL was detected in the criteria of LOD >3.0, suggesting the presence of minor genes.
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