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Risk Factors for Prevertebral Soft Tissue Swelling Following Single-level Anterior Cervical Spine Surgery

  • Junsang Park;Sang Mook Kang;Yu Deok Won;Myung-Hoon Han;Jin Hwan Cheong;Byeong-Jin Ha;Je Il Ryu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.716-725
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    • 2023
  • Objective : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

Outcomes of Completion Lobectomy for Locoregional Recurrence after Sublobar Resection in Patients with Non-small Cell Lung Cancer

  • Cho Eun Lee;Jeonghee Yun;Yeong Jeong Jeon;Junghee Lee;Seong Yong Park;Jong Ho Cho;Hong Kwan Kim;Yong Soo Choi;Jhingook Kim;Young Mog Shim
    • Journal of Chest Surgery
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    • v.57 no.2
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    • pp.128-135
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    • 2024
  • Background: This retrospective study aimed to determine the treatment patterns and the surgical and oncologic outcomes after completion lobectomy (CL) in patients with locoregionally recurrent stage I non-small cell lung cancer (NSCLC) who previously underwent sublobar resection. Methods: Data from 36 patients who initially underwent sublobar resection for clinical, pathological stage IA NSCLC and experienced locoregional recurrence between 2008 and 2016 were analyzed. Results: Thirty-six (3.6%) of 1,003 patients who underwent sublobar resection for NSCLC experienced locoregional recurrence. The patients' median age was 66.5 (range, 44-77) years at the initial operation, and 28 (77.8%) patients were men. Six (16.7%) patients underwent segmentectomy and 30 (83.3%) underwent wedge resection as the initial operation. The median follow-up from the initial operation was 56 (range, 9-150) months. Ten (27.8%) patients underwent CL, 22 (61.1%) underwent non-surgical treatments (chemotherapy, radiation, concurrent chemoradiation therapy), and 4 (11.1%) did not receive treatment or were lost to follow-up after recurrence. Patients who underwent CL experienced no significant complications or deaths. The median follow-up time after CL was 64.5 (range, 19-93) months. The 5-year overall survival (OS) and post-recurrence survival (PRS) were higher in the surgical group than in the non-surgical (p<0.001) and no-treatment groups (p<0.001). Conclusion: CL is a technically demanding but safe procedure for locoregionally recurrent stage I NSCLC after sublobar resection. Patients who underwent CL had better OS and PRS than patients who underwent non-surgical treatments or no treatments; however, a larger cohort study and long-term surveillance are necessary.

Efficacy and Safety of the Safe Triangular Working Zone Approach in Percutaneous Vertebroplasty for Spinal Metastasis

  • Bi Cong Yan;Yan Feng Fan;Qing Hua Tian;Tao Wang;Zhi Long Huang;Hong Mei Song;Ying Li;Lei Jiao;Chun Gen Wu
    • Korean Journal of Radiology
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    • v.23 no.9
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    • pp.901-910
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    • 2022
  • Objective: This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. Materials and Methods: We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31-76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29-81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan-Meier curves. Results: The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (p < 0.001). Cement leakage was not significantly different between groups A and B (p = 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan-Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). Conclusion: The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.

Effect of Stent Placement on Survival in Patients with Malignant Portal Vein Stenosis: A Propensity Score-Matched Study

  • Dong Jae Shim;Jong Woo Kim;Doyoung Kim;Gi-Young Ko;Dong Il Gwon;Ji Hoon Shin;Yun-Jung Yang
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.68-76
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    • 2022
  • Objective: Percutaneous portal vein (PV) stent placement can be an effective treatment for symptoms associated with portal hypertension. This study aimed to evaluate the effect of PV stenting on the overall survival (OS) in patients with malignant PV stenosis. Materials and Methods: Two groups of patients with malignant PV stenosis were compared in this retrospective study involving two institutions. A total of 197 patients who underwent PV stenting between November 2016 and August 2019 were established as the stent group, whereas 29 patients with PV stenosis who were treated conservatively between July 2013 and October 2016 constituted the no-stent group. OS was compared between the two groups before and after propensity score matching (PSM). Risk factors associated with OS were evaluated using the Cox proportional hazards model. Procedure-associated adverse events were also evaluated. Results: The stent group finally included 100 patients (median age, 65 [interquartile range, 58-71] years; 64 male). The no-stent group included 22 patients (69 [61-75] years, 13 male). Stent placement was successful in 95% of attempted cases, and the 1- and 2-year stent occlusion-free survival rate was 56% (95% confidence interval, 45%-69%) and 44% (32%-60%), respectively. The median stent occlusion-free survival time was 176 (interquartile range, 70-440) days. OS was significantly longer in the stent group than in the no-stent group (median 294 vs. 87 days, p < 0.001 before PSM, p = 0.011 after PSM). The 1- and 3-year OS rates before PSM were 40% and 11%, respectively, in the stent group. The 1-year OS rate after PSM was 32% and 5% in the stent and no-stent groups, respectively. Anemia requiring transfusion (n = 2) and acute thrombosis necessitating re-stenting (n = 1) occurred in three patients in the stent group within 1 week. Conclusion: Percutaneous placement of a PV stent may be effective in improving OS in patients with malignant PV stenosis.

Implant assisted removable partial denture using bilateral single implant-supported surveyed crown: a case report (양측성 단일 임플란트 지지 서베이드 크라운을 이용한 하악 임플 란트 보조 국소의치 수복 증례)

  • Seojune Choi;Hong Seok Moon;Jaeyoung Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.146-156
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    • 2024
  • Implant assisted removable partial denture (IARPD) has been practiced in various forms for a long time, and among them, implant surveyed crown RPD is gaining predictability as well as being considered as a treatment option for patients with anatomical and financial disadvantages. The position of implant could be divided as posterior placement or anterior placement according to the purpose of the treatment and should be planned in consider to the alveolar ridge of patient, anticipated prognosis of remaining teeth, and opposing dentition. This case report describes a treatment for mandibular Kennedy class I partial edentulous patient with two implant-supported surveyed crown and implant assisted removable partial denture. Given the difficulty of posterior placement in this patient and the prognosis of the residual teeth, the plan was to place two implants in close proximity to the residual teeth, which were placed in the planned position, angle, and depth using guided surgery. The process of fabricating the fixed prosthesis was carried out in parallel with the maxillary edentulous tooth arrangement process to increase predictability, and when fabricating the localized tooth, the implant was designed in a form that allows the patient to perform functional movements by preventing excessive loading as the last supporting tooth, and was fabricated through a secondary impression process. Each treatment procedure was proceeded as planned, with aesthetically and functionally satisfactory results for both patient and operator.

Development of Spent Nuclear Fuel Transportation Worker Exposure Scenario by Dry Storage Methods (건식 저장방식별 사용후핵연료 운반 작업자 피폭시나리오 개발)

  • Geon Woo Son;Hyeok Jae Kim;Shin Dong Lee;Min Woo Kwak;Kwang Pyo Kim
    • Journal of Radiation Industry
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    • v.18 no.1
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    • pp.43-52
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    • 2024
  • Currently, there are no interim storage facilities and permanent disposal facilities in Korea, so all spent nuclear fuels are temporarily stored. However, the temporary storage facility is approaching saturation, and as a measure to this, the 2nd Basic Plan for the Management of High-Level Radioactive Waste presented an operation plan for dry interim storage facilities and dry temporary storage facilities on the NPP on-site. The dry storage can be operated in various ways, and to select the optimal dry storage method, the reduction of exposure for workers must be considered. Accordingly, it is necessary to develop a worker exposure scenario according to the dry storage method and evaluate and compare the radiological impact for each method. The purpose of this study is to develop an exposure scenario for workers transporting spent nuclear fuel by dry storage method. To this end, first, the operation procedure of the foreign commercial spent nuclear fuel dry storage system was analyzed based on the Final Safety Analysis Report (FSAR). 1) the concrete overpack-based system, 2) the metal overpack-based system, and 3) the vertical storage module-based system were selected for analysis. Factors were assumed that could affect the type of work (working distance, working hours, number of workers, etc.) during transportation work. Finally, the work type of the processes involved in transporting spent nuclear fuel by dry storage method was set, and an exposure scenario was developed accordingly. The concrete overpack method, the metal overpack method, and the vertical storage module method were classified into a total of 31, 9, and 23 processes, respectively. The work distance, work time, and number of workers for each process were set. The product of working hours and number of workers (Man-hour) was set high in the order of concrete overpack method, vertical storage module method, and metal overpack method, and short-range work (10 cm) was most often applied to the concrete overpack method. The results of this study are expected to be used as basic data for performing radiological comparisons of transport workers by dry storage method of spent nuclear fuel.

Endoscopic radiofrequency Stretta therapy reduces proton pump inhibitor dependency and the need for anti-reflux surgery for refractory gastroesophageal reflux disease

  • Abraham Joel;Alakh Konjengbam;Yirupaiahgari Viswanath;Georgios Kourounis;Emily Hammond;Helen Frank;Shivani Kuttuva;Simon Mbarushimana;Hena Hidayat;Srivishnu Thulasiraman
    • Clinical Endoscopy
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    • v.57 no.1
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    • pp.58-64
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    • 2024
  • Background/Aims: Radiofrequency treatment of the gastroesophageal junction using the Stretta procedure for treating gastroesophageal reflux disease (GERD) is observed to improve the symptoms and proton pump inhibitor (PPI) dependence and reduce the need for anti-reflux operations. As one of the largest studies in Europe, we evaluated the clinical outcomes of Stretta in patients with medically refractory GERD. Methods: A tertiary UK center evaluated all patients with refractory GERD who underwent Stretta between 2014 and 2022. Patients and primary care professionals were contacted to obtain information regarding the initiation of PPI and reintervention after Stretta. Results: Of the 195 patients (median age, 55 years; 116 women [59.5%]) who underwent Stretta, PPI-free period (PFP) data were available for 144 (73.8%) patients. Overall, 66 patients (45.8%) did not receive PPI after a median follow-up of 55 months. Six patients (3.1%) underwent further interventions. The median PFP after Stretta was 41 months. There was a significant negative correlation between PFP and age (p=0.007), with no differences between sexes (p=0.96). Patients younger than 55 years of age had a longer PFP than their older counterparts (p=0.005). Younger males had a significantly longer PFP than older males (p=0.021). However, this was not observed in the female cohort (p=0.09) or between the younger men and women (p=0.66). Conclusions: Our findings suggest that Stretta is a safe and feasible option for treating refractory GERD, especially in younger patients. It prevents further anti-reflux interventions in most patients and increases the lead-time to surgery in patients with refractory GERD.

Comparison of Tyurin Method and Dry Combustion Method for Carbon Analysis in Soils of Low Iorganic Carbon content (무기탄소 함량이 낮은 토양의 탄소함량 분석을 위한 Tyurin법과 건식연소법의 비교)

  • Seo, Myung-Chul;So, Kyu-Ho;Ko, Byong-Gu;Son, Yeon-Kyu
    • Korean Journal of Soil Science and Fertilizer
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    • v.37 no.5
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    • pp.315-321
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    • 2004
  • To compare soil carbon contents by Tyurin method and dry combustion method, we carried out analysis for 212 samples of agricultural land in Korea. The average values of soil carbon contents analyzed by Tyurin method and dry combustion method were $17.47{\pm}10.80$ and $19.91{\pm}10.63g\;kg^{-1}$, respectively. Both methods were evaluated as acceptable methods for soil carbon contents as the results showed. The results showed that soil texture had little effect on analysis method of carbon contents. Highly significant linear regression equation, Y = 0.846X ($R^2=0.991$), was obtained between carbon contents analyzed by Tyurin method (Y) and dry combustion method (X). As a result of comparison with data of carbon contents of the two methods, about 69% of results at dry combustion method have exceeded to results at Tyurin method. Especially, differences between results at two methods became higher as carbon contents were increasing. Tyurin method has been advantages such as shorter analysis time for one sample, more recognition for carbon analysis, and no need for expensive analyzer, while dry combustion method has simpler procedure, no heavy metal wastes, and more samples for analysis at one time.

A Case Study on Scientific Inquiry and Argumentative Communication in Earth Science MBL Classes (지구과학 MBL 수업의 과학 탐구와 논의적 의사소통에 관한 사례 연구)

  • Oh, Jin-Ah;Lee, Sun-Kyung;Kim, Chan-Jong
    • Journal of the Korean earth science society
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    • v.29 no.2
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    • pp.189-203
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    • 2008
  • Microcomputer Based Laboratory (MBL), by offering accurate and effective data collection and real-time graphs, enables students to reduce experiment time and, thereby, have deeper discussions concerning experimental results. This helps to emphasis the essential aspect of scientific inquiry; the process communication. Therefore, this study examined secondary school earth science MBL lessons with regards to the five basic aspects of scientific inquiry: "Asking", "Evidencing", "Explaining", "Evaluating" and "Communicating". It then investigated the level of argumentative communication between the students and teachers and also among the students themselves. For this study, three classroom activities were observed and videotaped, and teaching materials, textbooks and students' notes were collected. The transcribed data were analyzed from the perspective of scientific inquiry level and argument frames. The results showed that the scientific inquiry levels of the three classes were similar, except for the "Communicating" aspect, which appeared in only one episode. "Asking" was carried out by the teacher and then students were directed to collect certain data in the "Evidencing" stage. Furthermore, students were given possible ways to use evidence to formulate explanations and connections through the "Explaining" and "Evaluating" stages. In the argumentation analysis, most argumentative communication was identified as being associated with a given procedure, rather than with any scientific phenomena. In only one episode, did "Communicating" relate directly to any scientific phenomena. It can be concluded, that although MEL places emphasis on communication for authentic scientific inquiry, the environment required for such inquiry and argumentative communication can not be easily created in the classroom. Therefore, in order for authentic inquiry to take place in the MBL classroom, teachers should provide students with the opportunity to develop meaningful argumentation and scaffolding abilities.

Effect of SeaR gene on virginiamycins production in Streptomyces virginiae (희소방선균 SeaR 유전자가 Streptomyces virginiae의 virginiamycins 생산에 미치는 영향)

  • Ryu, Jae-Ki;Kim, Hyun-Kyung;Kim, Byung-Won;Kim, Dong-Chan;Lee, Hyeong-Seon
    • Korean Journal of Microbiology
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    • v.51 no.3
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    • pp.256-262
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    • 2015
  • In order to study the effect of the receptor protein (SeaR), which is isolated from Saccharopolyspora erythraea, we introduced the SeaR gene to Streptomyces virginiae as host strains. An effective transformation procedure for S. virginiae was established based on transconjugation by Escherichia coli ET12567/pUZ8002 with a ${\varphi}C31$-derived integration vector, pSET152, which contained int, oriT, attP, and $ermEp^{\ast}$ (erythromycin promotor). Therefore, the pEV615 was introduced into S. virginiae by conjugation and integrated at the attB locus in the chromosome of the recipients by the ${\varphi}C31$ integrase (int) function. Transformants of S. virginiae containing the SeaR gene were confirmed by PCR and transcriptional expression of the SeaR gene in the transformants was analyzed by RT-PCR, respectively. And, we examined the production time of virginiamycins in the culture media of both the transformants and the wild type. The production time of virginiamycins in the wild type and transformants was the same. When 100 ng/ml of synthetic $VB-C_6$ was added to the state of 6 or 8 hour cultivation of wild type and transformants, respectively, the virginiamycins production was induced, meaning that the virginiamycins production in the wild type was detected 2 h early than transformants. From these results, SeaR expression was also affected to virginiamycins production in transformants derived from S. virginiae. In this study, we showed that the SeaR protein worked as a repressor in transformants.