• 제목/요약/키워드: Segmental analysis

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Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

  • Kim, Kyoung-Tae;Cho, Dae-Chul;Sung, Joo-Kyung;Kim, Young-Baeg;Kim, Du Hwan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.30-39
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    • 2017
  • Objective : To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods : Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2-7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results : The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were $8.6{\pm}2.3$ and $8.4{\pm}2.0$, and lower level motion values were $8.4{\pm}2.2$ and $8.3{\pm}1.9$. Preoperative and postoperative FSU heights were $37.0{\pm}2.1$ and $37.1{\pm}1.8$. In the group B, upper level adjacent segment motion values were $8.1{\pm}2.6$ and $8.2{\pm}2.8$, and lower level motion values were $6.5{\pm}3.3$ and $6.3{\pm}3.1$. FSU heights were $37.1{\pm}2.0$ and $36.2{\pm}1.8$. The postoperative FSU motion and height changes were significant (p<0.05). The patient's satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion : TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient's biomechanical characteristics and economic status should be understood and treated using the optimal procedure.

Effectiveness and Safety of Tranexamic Acid in Spinal Deformity Surgery

  • Choi, Ho Yong;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.60 no.1
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    • pp.75-81
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    • 2017
  • Objective : Spinal deformity surgery has the potential risk of massive blood loss. To reduce surgical bleeding, the use of tranexamic acid (TXA) became popular in spinal surgery, recently. The purpose of this study was to determine the effectiveness of intra-operative TXA use to reduce surgical bleeding and transfusion requirements in spinal deformity surgery. Methods : A total of 132 consecutive patients undergoing multi-level posterior spinal segmental instrumented fusion (${\geq}5$ levels) were analyzed retrospectively. Primary outcome measures included intraoperative estimated blood loss (EBL), transfusion amount and rate of transfusion. Secondary outcome measures included postoperative transfusion amount, rate of transfusion, and complications associated with TXA or allogeneic blood transfusions. Results : The number of patients was 89 in TXA group and 43 in non-TXA group. There were no significant differences in demographic or surgical traits between the groups except hypertension. The EBL was significantly lower in TXA group than non-TXA group (841 vs. 1336 mL, p=0.002). TXA group also showed less intra-operative and postoperative transfusion requirements (544 vs. 812 mL, p=0.012; 193 vs. 359 mL, p=0.034). Based on multiple regression analysis, TXA use could reduce surgical bleeding by 371 mL (37 % of mean EBL). Complication rate was not different between the groups. Conclusion : TXA use can effectively reduce the amount of intra-operative bleeding and transfusion requirements in spinal deformity surgery. Future randomized controlled study could confirm the routine use of TXA in major spinal surgery.

Genetic analysis using whole-exome sequencing in pediatric chronic kidney disease: a single center's experience

  • Lee, Hyeonju;Min, Jeesu;Ahn, Yo Han;Kang, Hee Gyung
    • Childhood Kidney Diseases
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    • v.26 no.1
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    • pp.40-45
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    • 2022
  • Purpose: Chronic kidney disease (CKD) has various underlying causes in children. Identification of the underlying causes of CKD is important. Genetic causes comprise a significant proportion of pediatric CKD cases. Methods: In this study, we performed whole-exome sequencing (WES) to identify genetic causes of pediatric CKD. From January to June 2021, WES was performed using samples from pediatric patients with CKD of unclear etiology. Results: Genetic causes were investigated using WES in 37 patients (17 males) with pediatric CKD stages 1 (n=5), 2 (n=7), 3 (n=2), 4 (n=2), and 5 (n=21). The underlying diseases were focal segmental glomerulosclerosis (n=9), congenital anomalies of the kidney and urinary tract including reflux nephropathy (n=8), other glomerulopathies (n=7), unknown etiology (n=6), and others (n=7). WES identified genetic causes of CKD in 12 of the 37 patients (32.4%). Genetic defects were discovered in the COL4A4 (n=2), WT1 (n=2), ACTN4, CEP290, COL4A3, CUBN, GATA3, LAMA5, NUP107, and PAX2 genes. WT1 defects were found in patients whose pathologic diagnosis was membranoproliferative glomerulonephritis, and identification of CUBN defects led to discontinuation of immunosuppressive agents. Genetic diagnosis confirmed the clinical diagnosis of hypoparathyroidism, sensorineural deafness, and renal disease; Alport syndrome; and Joubert syndrome in three of the patients with CKD of unknown etiology (COL4A4 [n=2], CUBN [n=1]). Extrarenal symptoms were considered phenotypic presentations of WT1, PAX2, and CEP290 defects. Conclusions: WES provided a genetic diagnosis that confirmed the clinical diagnosis in a significant proportion (32.4%) of patients with pediatric CKD.

Teaching English Prosody through English Poems with Cloned Native Intonation (프랏을 이용한 영시 운율 교육)

  • Yoon, Kyuchul;Oh, Ji-Yeon;Ahn, Sang-Cheol
    • Journal of English Language & Literature
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    • v.56 no.4
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    • pp.753-772
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    • 2010
  • The purpose of this work is to examine the viability of employing the prosody cloning technique in teaching English prosody. Ten native speakers of Korean high school students with similar level of English proficiency participated in the poem self-study experiment. Five of them were grouped into the experimental group and the remaining five into the control group. One popular English poem from a high school textbook was selected and its recording by a professional native speaker of English was used in the experiment. The members of the two groups made a recording of the poem both before and after the experiment. For the study material, the experimental group used their own recorded utterances with their prosody cloned from the professional English speaker, while the control group used the utterances of the professional speaker alone. The acoustic analysis of the recordings by the prosodic foot both before and after the experiment showed that the experimental group performed slightly better than the control group in the realization of the intensity contour of the poem. There were no significant differences in the realization of the intonation contour and segmental durations between the two groups. The recording after the experiment was also subjectively evaluated by a native speaker of English and the scores for the experimental group were slightly higher than the control group. These findings suggest that the use of English poems with the help of the prosody cloning technique is a potentially viable approach to teaching English intonation to high school students. A long-term study with more students is necessary.

Clinical Characteristics, Risk Factors, and Outcomes of Acute Pulmonary Embolism in Thailand: 6-Year Retrospective Study

  • Pattarin Pirompanich;Ornnicha Sathitakorn;Teeraphan Suppakomonnun;Tunlanut Sapankaew
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.349-356
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    • 2024
  • Background: Acute pulmonary embolism (APE) is a fatal disease with varying clinical characteristics and imaging. The aim of this study was to define the clinical characteristics, risk factors, and outcomes in patients with APE at a university hospital in Thailand. Methods: Patients diagnosed with APE and admitted to our institute between January 1, 2017 and December 31, 2022 were retrospectively enrolled. The clinical characteristics, investigations, and outcomes were recorded. Results: Over the 6-year study period, 369 patients were diagnosed with APE. The mean age was 65 years; 64.2% were female. The most common risk factor for APE was malignancy (46.1%). In-hospital mortality rate was 23.6%. The computed tomography pulmonary artery revealed the most proximal clots largely in segmental pulmonary artery (39.0%), followed by main pulmonary artery (36.3%). This distribution was consistent between survivors and non-survivors. Multivariate logistic regression analysis revealed that APE mortality was associated with active malignancy, higher serum creatinine, lower body mass index (BMI), and tachycardia with adjusted odds ratio (95% confidence interval [CI]) of 3.70 (1.59 to 8.58), 3.54 (1.35 to 9.25), 2.91 (1.26 to 6.75), and 2.54 (1.14 to 5.64), respectively. The prediction model was constructed with area under the curve of 0.77 (95% CI, 0.70 to 0.84). Conclusion: The overall mortality rate among APE patients was 23.6%, with APE-related death accounting for 5.1%. APE mortality was associated with active malignancy, higher serum creatinine, lower BMI, and tachycardia.

Analysis of Isolated Proteinuria on School Urinary Mass Screening (학교 신체 검사에서 발견된 단독 단백뇨에 대한 연구)

  • Kim Cheol- Min;Hahn HyeWon;Lee Byung-Sun;Park Young Seo
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.61-67
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    • 2002
  • Purpose: The urinary mass screening program in school aged population has been performed since 1981, but the consensus on the follow-up schedule and the management of isolated proteinuria has not been reached yet. The aim of this study was to investigate the cause of isolated proteinuria and to propose a guideline for the treatment and follow-up afterwards Methods: The medical records of 114 cases of isolated proteinuria detected through the analysis of urinary mass screening and evaluated at the pediatric outpatient clinic of Asan Medical Center from January 1990 to July 2001 have been reviewed. Results: The classification of isolated proteinuria was as follows. Transient proteinuria $32\%$, orthostatic proteinuria $65\%$, persistent proteinuria $3\%$, In orthostatic proteinuria group, daytime and nighttime proteinuria were $319.2{\pm}189.1\;mg/dL$ and $56.5{\pm}56.1\;mg/dL$. In persistent proteinuria group, daytime and nighttime proteinuria were $1140{\pm}540.5\;mg/dL$ and $289{\pm}58\;mg/dL$. After 30 month follow-up, 2 cases of persistent proteinuria were needed renal biopsy and 1 case revealed focal segmental glomerular sclerosis. In all cases, serum creatinine, albumin and complements levels were normal. In the orthostatic proteinuria group, no significant renal diseases were detected. Conclusion: Since most of the isolated proteinuria detected through the school urinary mass screening were orthostatic proteinuria or transient proteinuria, initially aggressive diagnostic method such as renal biopsy is not needed and regular follow- up with quantitation of proteinuria is warranted.(J Korean Soc Pediatr Nephrol 2002 ; 6 61-7)

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A Feature-based Approach to American English Vowel Production by Korean Learners (한국 학습자들의 미국 영어 모음 발화에 대한 자질적 접근)

  • Jeong, Soon-Yong
    • The Journal of the Korea Contents Association
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    • v.22 no.2
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    • pp.326-336
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    • 2022
  • This study aims to examine Korean learners' production of American English vowel focused on feature analysis. Specifically, the present study adopts feature analysis so that vowel production is analyzed in terms of vowel features as well as overall segmental accuracy. To this end, 22 Korean college students participated in a production test which contained 11 English vowels /i, ɪ, eɪ, ɛ, æ, ɑ, oʊ, ɔ, ʊ, u, ʌ/. The results revealed that the degree of difficulty varied depending on features; the Korean participants showed higher accuracy for front/back features than for tongue height features and tense/lax features. In particular, the participants had more difficulty producing back vowels and non-high vowels than front vowels and high vowels with respect to tongue height features and lip rounding features. Among the individual vowels, /eɪ/ showed the highest accuracy in feature analysis. On the other hand, /ɑ, ɔ, ʌ/ showed low accuracy with respect to height features and lip rounding features, and high vowels /i, ʊ, u/ showed low accuracy with respect to tense/lax features. As for the correlation between the vowel features, tongue height features and lip rounding features are significantly correlated. Also, tongue height features and tense/lax features showed a strong correlation. Finally, pedagogical implications for teaching English vowels were further discussed based on the findings of the current study.

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.

A Study on Site Repeat Visit and Purchase Decision-Making of On-line Consumer using Two-Stage Mixture Regression Analysis - Focus on Internet Shopping Mall - (2단계 Mixture Model을 이용한 온라인 소비 자의 방문행동특성이 사이트 재방문과 구매에 미치는 영향에 관한 연구 - 온라인 쇼핑몰을 중심으로 -)

  • Lee, Young-Seung
    • Journal of Global Scholars of Marketing Science
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    • v.13
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    • pp.135-158
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    • 2004
  • On-line consumers have some visit behavior characteristics when they visit internet-shopping mall between visit-stage and purchase-stage. Therefore, information of on-line consumers have influenced on internet-shopping mall's profitabilities at site manager's perspectives. For examples, Are any on-line consumers continuous visiting under any situations? Or are any on-line consumers purchased on any specific internet-shopping mall? Expecially in this paper, researcher tried to understand visit behavioral characteristics of on-line consumers using two-stage mixture regression analysis. Throughout this process, it could be proposed method, which could be reinforced competitiveness of internet-shopping mall by segmental decision-making method. Additionally, it is expected that visit behavioral characteristics' information could be supplied strategic implications between visit-stage and purchase-stage Throughout empirical test it could be proved two-stage decision-making process, which decision-making process of on-line consumers would be processed visit-stage and purchase-stage. In this study, researcher proposed suitable response strategy after understanding visiting behavioral characteristics of on-line consumers. This paper has some academical contributions, which visit behavioral characteristics of on-line consumers could be grasped the meaning by site stickiness and navigation pattern.

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Analysis on Bond Characteristics of Reinforcements for UHPC Hybrid Cable-Stayed Bridge Deck Joints (초고성능 콘크리트 하이브리드 사장교 바닥판 접합부 철근의 부착 성능에 대한 해석)

  • Seonwoo, Yoon Ho;Park, Sung Kyun;Kwahk, Im Jong;Yoon, Young Soo
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.31 no.3A
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    • pp.207-214
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    • 2011
  • Ultra High Performance Concrete (UHPC), which is characterized by its high strength and advanced ductile behavior that is much superior to those of convention concrete, is a useful material to make thinner and longer bridges. The precast segmental construction method utilizing UHPC has been mainly studied because cast-in-place UHPC is very difficult and complicate to be achieved. As a part of those research, the structural performance evaluation of different types of joint connection method for hybrid cable-stayed bridge utilizing UHPC by using nonlinear analyses is performed in this study. The bond stress at joint is obtained by section force analyses for a 600 m cable-stayed bridge deck, and compared with the required bond stress at joint. Analysis results show that the U Type connection and straight type connection resist the highest ultimate load and bond strength, respectively. In addition, all considered joint connection systems satisfy the bond performances at joint required in the final stage of cable-stayed bridge utilizing UHPC.