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Outcome Analysis of the Patients with and without Anterior Plating in Multi-Level Degenerative Cervical Diseases (다분절 퇴행성 경추질환에서의 전방 금속판 사용 유무에 따른 환자의 예후분석)

  • Kim, Sang Woo;Kim, Sung Min;Shin, Dong Ik;Cho, Yong Jun;Shim, Young Bo;Choi, Sun Kil
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1369-1374
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    • 2001
  • Objectives : The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. Methods : Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. Results : The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. Conclusion : Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.

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Bone Flap Resorption Following Cranioplasty with Autologous Bone : Quantitative Measurement of Bone Flap Resorption and Predictive Factors

  • Park, Sang Pil;Kim, Jae Hoon;Kang, Hee In;Kim, Deok Ryeong;Moon, Byung Gwan;Kim, Joo Seung
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.749-754
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    • 2017
  • Objective : To quantitatively measure the degree of bone flap resorption (BFR) following autologous bone cranioplasty and to investigate factors associated with BFR. Methods : We retrospectively reviewed 29 patients who underwent decompressive craniectomy and subsequent autologous bone cranioplasty between April 2005 and October 2014. BFR was defined as : 1) decrement ratio ([the ratio of initial BF size/craniectomy size]-[the ratio of last BF/craniectomy size]) >0.1; and 2) bone flap thinning or geometrical irregularity of bone flap shape on computed tomographic scan or skull plain X-ray. The minimal interval between craniectomy and cranioplasty was one month and the minimal follow-up period was one year. Clinical factors were compared between the BFR and no-BFR groups. Results : The time interval between craniectomy and cranioplasty was $175.7{\pm}258.2$ days and the mean period of follow up was $1364{\pm}886.8$ days. Among the 29 patients (mean age 48.1 years, male : female ratio 20 : 9), BFR occurred in 8 patients (27.6%). In one patient, removal of the bone flap was carried out due to severe BFR. The overall rate of BFR was $0.10{\pm}0.11$ over 3.7 years. Following univariate analysis, younger age ($30.5{\pm}23.2$ vs. $54.9{\pm}13.4$) and longer follow-up period ($2204.5{\pm}897.3$ vs. $1044.1{\pm}655.1$) were significantly associated with BFR (p=0.008 and 0.003, respectively). Conclusion : The degree of BFR following autologous bone cranioplasty was 2.7%/year and was associated with younger age and longer follow-up period.

Noradrenergic Modulation of Spontaneous Inhibitory Postsynaptic Currents in the Hypothalamic Paraventricular Nucleus

  • Lee, Long-Hwa;Chong, Won-Ee;Lee, Ki-Ho;Park, Jin-Bong;Ryu, Pan-Dong
    • The Korean Journal of Physiology and Pharmacology
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    • v.6 no.2
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    • pp.71-80
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    • 2002
  • Previous studies have suggested that brain stem noradrenergic inputs differentially modulate neurons in the paraventricular nucleus (PVN). Here, we compared the effects of norepinephrine (NE) on spontaneous GABAergic inhibitory postsynaptic currents (sIPSCs) in identified PVN neurons using slice patch technique. In 17 of 18 type I neurons, NE $(30{\sim}100{\mu}M)$ reversibly decreased sIPSC frequency to $41{\pm}7%$ of the baseline value $(4.4{\pm}0.8\;Hz,\;p<0.001).$ This effect was blocked by yohimbine $(2{\sim}20{\mu}M),$ an ${\alpha}_2-adrenoceptor$ antagonist and mimicked by clonidine $(50{\mu}M),$ an ${\alpha}_2-adrenoceptor$ agonist. In contrast, NE increased sIPSC frequency to $248{\pm}32%$ of the control $(3.06{\pm}0.37\;Hz,\;p<0.001)$ in 31 of 54 type II neurons, but decreased the frequency to $41{\pm}7$ of the control $(5.5{\pm}1.3\;Hz)$ in the rest of type II neurons (p<0.001). In both types of PVN neurons, NE did not affect the mean amplitude and decay time constant of sIPSCs. In addition, membrane input resistance and amplitude of sIPSC of type I neurons were larger than those of type II neurons tested (1209 vs. 736 $M{\Omega},$ p<0.001; 110 vs. 81 pS, p<0.001). The results suggest that noradrenergic modulation of inhibitory synaptic transmission in the PVN decreases the neuronal excitability in most type I neurons via ${\alpha}_2-adrenoceptor,$ however, either increases in about 60% or decreases in 40% of type II neurons.

The Effects of Ischemic Postconditioning on Myocardial Function and Nitric Oxide Metabolites Following Ischemia-Reperfusion in Hyperthyroid Rats

  • Zaman, Jalal;Jeddi, Sajjad;Ghasemi, Asghar
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.6
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    • pp.481-487
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    • 2014
  • Ischemic postconditioning (IPost) could decrease ischemia-reperfusion (IR) injury. It has not yet reported whether IPost is useful when ischemic heart disease is accompanied with co-morbidities like hyperthyroidism. The aim of this study was to examine the effect of IPost on myocardial IR injury in hyperthyroid male rats. Hyperthyroidism was induced with administration of thyroxine in drinking water (12 mg/L) over a period of 21 days. After thoracotomy, the hearts of control and hyperthyroid rats were perfused in the Langendorff apparatus and subjected to 30 minutes global ischemia, followed by 120 minutes reperfusion; IPost, intermittent early reperfusion, was induced instantly following ischemia. In control rats, IPost significantly improved the left ventricular developed pressure (LVDP) and ${\pm}dp/dt$ during reperfusion (p<0.05); however it had no effect in hyperthyroid rats. In addition, hyperthyroidism significantly increased basal $NO_x$ (nitrate+nitrite) content in serum ($125.5{\pm}5.4{\mu}mol/L$ vs. $102.8{\pm}3.7{\mu}mol/L$; p<0.05) and heart ($34.9{\pm}4.1{\mu}mol/L$ vs. $19.9{\pm}1.94{\mu}mol/L$; p<0.05). In hyperthyroid groups, heart $NO_x$ concentration significantly increased after IR and IPost, whereas in the control groups, heart $NO_x$ were significantly higher after IR and lower after IPost (p<0.05). IPost reduced infarct size (p<0.05) only in control groups. In hyperthyroid group subjected to IPost, aminoguanidine, an inducible nitric oxide (NO) inhibitor, significantly reduced both the infarct size and heart $NO_x$ concentrations. In conclusion, unlike normal rats, IPost cycles following reperfusion does not provide cardioprotection against IR injury in hyperthyroid rats; an effect that may be due to NO overproduction because it is restored by iNOS inhibition.

Image Retrieval Using Combination of Color and Multiresolution Texture Features (칼라 및 다해상도 질감 특징 결합에 의한 영상검색)

  • Chun Young-deok;Sung Joong-ki;Kim Nam-chul
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.30 no.9C
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    • pp.930-938
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    • 2005
  • We propose a content-based image retrieval(CBIR) method based on an efncient combination of a color feature and multiresolution texture features. As a color feature, a HSV autocorrelograrn is chosen which is blown to measure spatial correlation of colors well. As texture features, BDIP and BVLC moments are chosen which is hewn to measure local intensity variations well and measure local texture smoothness well, respectively. The texture features are obtained in a wavelet pyramid of the luminance component of a color image. The extracted features are combined for efficient similarity computation by the normalization depending on their dimensions and standard deviation vectors. Experimental results show that the proposed method yielded average $8\%\;and\;11\%$ better performance in precision vs. recall than the method using BDIPBVLC moments and the method using color autocorrelograrn, respectively and yielded at least $10\%$ better performance than the methods using wavelet moments, CSD, color histogram. Specially, the proposed method shows an excellent performance over the other methods in image DBs contained images of various resolutions.

Outcomes of the Multimodal Treatment of Malignant Pleural Mesiothelioma: The Role of Surgery

  • Na, Bub-Se;Kim, Ji Seong;Hyun, Kwanyong;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.35-40
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    • 2018
  • Background: The treatment of malignant pleural mesothelioma (MPM) is challenging, and multimodal treatment including surgery is recommended; however, the role of surgery is debated. The treatment outcomes of MPM in Korea have not been reported. We analyzed the outcomes of MPM in the context of multimodal treatment, including surgery. Methods: The records of 29 patients with pathologically proven MPM from April 1998 to July 2015 were retrospectively reviewed. The treatment outcomes of the surgery and non-surgery groups were compared. Results: The overall median survival time was 10.6 months, and the overall 3-year survival rate was 25%. No postoperative 30-day or in-hospital mortality occurred in the surgery group. Postoperative complications included tachyarrhythmia (n=4), pulmonary thromboembolism (n=1), pneumonia (n=1), chylothorax (n=1), and wound complications (n=3). The treatment outcomes between the surgery and non-surgery groups were not significantly different (3-year survival rate: 31.3% vs. 16.7%, respectively; p=0.47). In a subgroup analysis, there was no significant difference in the treatment outcomes between the extrapleural pneumonectomy group and the non-surgery group (3-year survival rate: 45.5% vs. 16.7%, respectively; p=0.23). Conclusion: Multimodal treatment incorporating surgery did not show better outcomes than non-surgical treatment. A nationwide multicenter data registry and prospective randomized controlled studies are necessary to optimize the treatment of MPM.

Advantages of Laparoscopic Abdominoperineal Resection for Anastomotic Recurrence of Rectal Cancer

  • Zhang, Xing-Mao;Wang, Zheng;Ma, Sheng-Hui;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4295-4299
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    • 2014
  • Background: Surgery offers the only potential for cure and long-term survival of recurrence of rectal cancer. Few studies about laparoscopic recurrent lesion resection have been reported. This study was designed to evaluate the safety and feasibility of laparoscopic abdomino-perineal resection for anastomotic recurrence of rectal cancer. Materials and Methods: Data for 42 patients with recurrence of rectal cancer were collected retrospectively. Of the 42 patients, 22 underwent laparoscopic surgery (LR group) and 20 received open surgery (OR group). Outcomes between the two groups were compared. Results: Operation time in LR group was shorter compared with the OR group ($164.6{\pm}27.7min$ vs $203.0{\pm}45.3min$); intra-operative blood loss was $119.7{\pm}44.4ml$ and $185.0{\cdot}94.0ml$ in LR group and OR group, respectively (p<0.001); time to first flatus in LR group was shorter than in OR group, and the difference was statistically significant ($2.6{\pm}0.8$ days vs $3.1{\pm}0.8$ days, p=0.013); hospital stay in the LR and OR groups was $8.6{\pm}1.3$ days and $9.8{\pm}2.2$ days; 3-year survival rates in the LR and OR groups were 44.4% and 42.8% (p=0.915) and the 3-year disease-free survival rates were 36.4% and 30.0%, respectively (p=0.737). Conclusions: Laparoscopic abdomino-perineal resection is safe and feasible for anastomotic recurrence of rectal cancer.

A Multicenter Matched Case Control Study of Breast Cancer Risk Factors among Women in Karachi, Pakistan

  • Shamsi, Uzma;Khan, Shaista;Usman, Sheheryar;Soomro, Saleem;Azam, Iqbal
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.183-188
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    • 2013
  • Background: Breast cancer (BC), the most common female cancer in Pakistan, is associated with a very high mortality. However, the roles of individual risk factors for BC among Pakistani women are still controversial. To assess potential risk factors for BC, a matched case-control study was conducted in two tertiary care hospitals of Karachi, Pakistan. Materials and Methods: The study population included 297 pathologically confirmed incident cases of BC patients diagnosed between January 2009 and December 2010. 586 controls without any history of BC were matched on hospital and ${\pm}5$ years of ages. Results: Positive family history of BC (MOR=1.72; 95%CI: 1.10, 2.80 for first degree vs. none), single marital status (MOR=1.55; 95%CI: 1.10, 2.39 for single/divorced/widowed women vs. married women), older age at menopause (MOR=3.92; 95%CI: 2.52, 6.18 for menopausal women aged below 45 years, MOR=6.42; 95%CI: 3.47, 11.98 for menopausal women above 45 years of age compared with premenopausal women) conferred an increased risk of BC for women. Increasing parity decreased the risk of BC (MOR=0.90; 95%CI: 0.85, 0.97 for each live birth). Intake of Vitamin D supplements (MOR=0.30; 95%CI: 0.12, 0.81 for ${\leq}3$ years and MOR=0.27; 95%CI: 0.13, 0.56 for >3 years) was protective compared to non-users of Vitamin D. Conclusions: This study confirmed only few of the recognized risk factors in Pakistani women. The protective effect of Vitamin D is important from public health perspective and needs to be further explored through a randomized controlled trial.

Sperm chromatin structure assay results in Nigerian men with unexplained infertility

  • Faduola, Paul;Kolade, Charles Oluwabukunmi
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.3
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    • pp.101-105
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    • 2015
  • Objective: Several publications have established a relationship between sperm DNA damage and male factor infertility, based on data from America, Europe, and Asia. This study aimed to compare the extent of sperm DNA damage in sperm samples from Nigerian men with unexplained infertility and in sperm samples from a fertile group composed of sperm donors who had successfully impregnated a female partner naturally or through assisted conception. Methods: A total of 404 men underwent male fertility evaluation at Androcare Laboratories and Cryobank participated in this study. Semen analysis and a sperm chromatin structure assay (SCSA) were performed on all subjects. Results: The men in the unexplained infertility group were slightly older than the men in the fertile sperm group ($36{\pm}10$ years vs. $32{\pm}6$ years, p=0.051). No significant difference was observed between the two groups in semen analysis parameters ($p{\geq}0.05$). Men in the unexplained infertility group with normal semen parameters had a significantly higher DNA fragmentation index (DFI) than men in the fertile sperm group ($27.5%{\pm}7.0%$ vs. $14.1%{\pm}5.3%$, p<0.05). In the unexplained infertility group, 63% of the men had a DFI greater than 20%, compared to 4% in the fertile sperm group. In the unexplained infertility group, 15.2% of the subjects had a DFI greater than 30%, compared to 1% in the fertile sperm group. Conclusion: Our study showed that the SCSA may be a more reliable predictor of fertility potential than traditional semen analysis in cases of unexplained infertility.

Oocyte maturity in repeated ovarian stimulation

  • Lee, Jae-Eun;Kim, Sang-Don;Jee, Byung-Chul;Suh, Chang-Suk;Kim, Seok-Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.4
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    • pp.234-237
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    • 2011
  • Objective: During stimulated IVF cycles, up to 15% of oocytes are recovered as immature. The purpose of this study was to investigate the trend of oocyte maturity in repeated ovarian stimulation for IVF. Methods: One hundred forty-eight patients were selected who underwent two consecutive IVF cycles using same stimulation protocol during 2008 to 2010. Ovarian stimulation was performed with FSH and human menopausal gonadotropin and flexible GnRH antagonist protocol in both cycles. Oocyte maturity was assessed according to presence of germinal vesicle (GV) and the first polar body. Immature oocyte was defined as GV stage or metaphase I oocyte (GV breakdown with no visible polar body) and cultured up to 48 hours. If matured, they were fertilized with ICSI. Results: Percentages of immature oocytes were 30.8% and 32.9% ($p$=0.466) and IVM rates of immature oocytes were 36.2% and 25.7% ($p$=0.077), respectively. A significant correlation was noted between percentage of immature oocytes in the two cycles (R=0.178, $p$=0.03). Women with >40% immaturity in both cycles (n=21) showed lower fertilization rate of $in$ $vivo$ matured oocytes (56.4% vs. 72.0%, $p$=0.005) and lower pregnancy rate (19.0% vs. 27.1%, $p$=0.454) after the second cycle when compared with women with <40% immaturity (n=70). In both groups, female age, number of total retrieved oocyte and embryos transferred were similar. Conclusion: In repeated ovarian stimulation cycles for IVF, the immature oocyte tended to be retrieved repetitively in consecutive IVF cycles.