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Kang KC, Lee JH, Lee KY, Jang TS. Surgical Outcomes of Extensive Dome-Like Laminoplasty Using En Bloc Resection of C2 Inner Lamina for Patients With Severe Cord Compression Behind C2 Body. Clin Spine Surg 2024; 37:115-123. [PMID: 38637931 DOI: 10.1097/bsd.0000000000001610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/28/2024] [Indexed: 04/20/2024]
Abstract
STUDY DESIGN A retrospective, single-center study. OBJECTIVE The aim of this study is to evaluate the efficacy and safety of a newly developed extensive dome-like laminoplasty using en bloc resection of the C2 inner lamina in patients with severe cord compression behind the C2 body. SUMMARY OF BACKGROUND DATA A surgery for severe cord compression behind C2 body is challenging for spinal surgeons. To date, there has been no established solution for severe cord compression behind the C2 body. MATERIALS AND METHODS Patients with severe cord compression behind the C2 body who underwent posterior surgery consecutively were enrolled. Extensive dome-like laminoplasty that was newly developed was performed to remove en bloc removal of the C2 inner lamina were performed. Preoperative and postoperative canal diameters behind the C2 and mean removed area of the C2 inner lamina were measured using MRI and CT scan. Clinical and radiographic parameters were assessed preoperative and postoperative periods. In addition, perioperative complications were analyzed. RESULTS A total of 36 patients underwent extensive dome-like laminoplasty and their diagnoses were ossification of the posterior longitudinal ligament (OPLL, 66.7%) and congenital stenosis with spondylosis (33.3%). The mean canal diameter behind the C2 increased from 9.85 (2.28) mm preoperatively to 19.91 (3.93) mm at the last follow-up ( P <0.001). Clinically, neck and arm visual analog scale, Japanese Orthopaedic Association score, and neck disability index significantly improved at postoperative 1 month ( P <0.05), and the scores were maintained until the last follow-up. No meaningful radiographic changes occurred after the surgeries. During the procedures, there were no particular complications, but one patient showed deteriorated myelopathic symptoms and underwent additional C1-C2 decompressive surgery. CONCLUSIONS After extensive dome-like laminoplasty, surgical outcomes are satisfactory, and complications are rare. This technique may be a viable option for patients with severe cord compression behind the C2 body. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Kyung-Chung Kang
- Department of Orthopaedic Surgery, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Lee KY, Lee JH, Kang KC, Cho SJ, Jang WJ. Ideal length of accessory rod for the prevention of rod fracture after pedicle subtraction osteotomy in adult spinal deformity: short or long? J Neurosurg Spine 2024; 40:585-592. [PMID: 38306637 DOI: 10.3171/2023.12.spine23937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/04/2023] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Pedicle subtraction osteotomy (PSO) is an effective surgical procedure for adult spinal deformity (ASD). However, the complexity of the procedure and its associated complications including rod fracture (RF) remain challenging issues. Among several RF reduction methods, the accessory rod (AR) is an important surgical technique. To date, knowledge about the ideal length and configuration of the AR is limited. This study aimed to assess the influence of the connection levels and configuration of the AR on RF occurrence in patients with ASD who underwent long level constructs and PSO. METHODS The authors retrospectively selected 57 consecutive patients (mean age 70.6 years) who underwent deformity correction including PSO and the AR technique with a minimum 2-year follow-up. The patients were classified into a non-RF group (n = 49) and an RF group (n = 8). Along with analysis of patient and radiological factors in the 2 groups, comparative studies were performed including configuration of the AR (D shaped vs linear shaped) and the connection levels of AR (long AR [the lower end below S1-2] vs short AR [above L5-S1]). RESULTS The overall rate of RF incidence was 14% (8/57 cases) at an average of 42.5 months (2 patients with unilateral RF and 6 with bilateral RF). RF occurred most commonly at the L4-5 level, below the lower end of the AR: 6 below the lower end of the AR and 2 at the PSO site. There were no significant differences in patient and radiological factors between the groups. Comparisons between the 2 groups indicated that more RFs occurred when the configuration of the AR was a linear shape (p = 0.016) and when the distal end of the AR was above L5-S1 (p = 0.025). CONCLUSIONS In this study the authors found that the D-shaped configuration of the AR and lower end of the AR below S1-2 (i.e., long AR) could be preventive methods for reducing RF after deformity correction performed using PSO and the AR technique for ASD. Here, the authors have provided the first comprehensive outline for the AR technique. These findings could establish effective guidelines for spine surgeons.
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3
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Lee KY, Lee JH, Kang KC, Jung CH. Effects of Minimally Invasive Lateral Lumbar Interbody Fusion with Accessory Rod Technique on Rod Fracture in Adult Spinal Deformity Surgery: Analysis of 239 Patients. Spine (Phila Pa 1976) 2024:00007632-990000000-00551. [PMID: 38212931 DOI: 10.1097/brs.0000000000004920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/11/2022] [Indexed: 01/13/2024]
Abstract
STUDY DESIGN A retrospective study. OBJECTIVES To analyze factors associated with rod fracture (RF) in adult spinal deformity (ASD), and to assess whether the accessory rod (AR) technique can reduce RF occurrence in deformity correction in the setting of minimally invasive lateral lumbar interbody fusion (LLIF). SUMMARY OF BACKGROUND DATA Instrumentation failure is the most common reason for revision surgery in ASD. Several RF reduction methods have been introduced. However, there are insufficient studies on postoperative RF after deformity correction using minimally invasive LLIF. METHODS This study included 239 patients (average age 71.4 y and a minimum 2-year follow up) with ASD who underwent long-segment fusion from T10 to sacrum with sacropelvic fixation. Patients were classified into the non-RF group and the RF group. After logistic regression analysis of the risk factors for RF, subgroup analyses were performed; pedicle subtraction osteotomy (PSO) with 2-rod (P2 group) versus PSO with 2-rod and AR (P4 group), and LLIF with 2-rod (L2 group) versus LLIF with 2-rod and AR (L4 group). RESULTS RF occurred in 50 patients (21%) at an average of 25 months. RF occurred more frequently in patients who underwent PSO than in those who underwent LLIF (P=0.002), and the use of the AR technique was significantly higher in the non-RF group (P<0.05).Following logistic regression analysis, preoperative PI-LL mismatch, PSO, and the AR technique were associated with RF. In subgroup analyses, RF incidence was 65% (24/37 cases) of P2 group, 8% (4/51 cases) of P4 group, and 21% (22/105 cases) of L2 group. In the L4 group, there was no RF. CONCLUSION Minimally invasive multilevel LLIF with the AR technique is capable of as much LL correction as conventional PSO and appears to be an effective method for reducing RF.
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Affiliation(s)
- Ki Young Lee
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
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4
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Albanese R, Alexandrov A, Alicante F, Anokhina A, Asada T, Battilana C, Bay A, Betancourt C, Biswas R, Blanco Castro A, Bogomilov M, Bonacorsi D, Bonivento WM, Bordalo P, Boyarsky A, Buontempo S, Campanelli M, Camporesi T, Canale V, Castro A, Centanni D, Cerutti F, Chernyavskiy M, Choi KY, Cholak S, Cindolo F, Climescu M, Conaboy AP, Dallavalle GM, Davino D, de Bryas PT, De Lellis G, De Magistris M, De Roeck A, De Rújula A, De Serio M, De Simone D, Di Crescenzo A, Donà R, Durhan O, Fabbri F, Fedotovs F, Ferrillo M, Ferro-Luzzi M, Fini RA, Fiorillo A, Fresa R, Funk W, Garay Walls FM, Golovatiuk A, Golutvin A, Graverini E, Guler AM, Guliaeva V, Haefeli GJ, Helo Herrera JC, van Herwijnen E, Iengo P, Ilieva S, Infantino A, Iuliano A, Jacobsson R, Kamiscioglu C, Kauniskangas AM, Khalikov E, Kim SH, Kim YG, Klioutchnikov G, Komatsu M, Konovalova N, Kovalenko S, Kuleshov S, Lacker HM, Lantwin O, Lasagni Manghi F, Lauria A, Lee KY, Lee KS, Lo Meo S, Loschiavo VP, Marcellini S, Margiotta A, Mascellani A, Miano A, Mikulenko A, Montesi MC, Navarria FL, Ogawa S, Okateva N, Ovchynnikov M, Paggi G, Park BD, Pastore A, Perrotta A, Podgrudkov D, Polukhina N, Prota A, Quercia A, Ramos S, Reghunath A, Roganova T, Ronchetti F, Rovelli T, Ruchayskiy O, Ruf T, Sabate Gilarte M, Samoilov M, Scalera V, Schneider O, Sekhniaidze G, Serra N, Shaposhnikov M, Shevchenko V, Shchedrina T, Shchutska L, Shibuya H, Simone S, Siroli GP, Sirri G, Soares G, Soto Sandoval OJ, Spurio M, Starkov N, Timiryasov I, Tioukov V, Tramontano F, Trippl C, Ursov E, Ustyuzhanin A, Vankova-Kirilova G, Verguilov V, Viegas Guerreiro Leonardo N, Vilela C, Visone C, Wanke R, Yaman E, Yazici C, Yoon CS, Zaffaroni E, Zamora Saa J. Observation of Collider Muon Neutrinos with the SND@LHC Experiment. Phys Rev Lett 2023; 131:031802. [PMID: 37540851 DOI: 10.1103/physrevlett.131.031802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 08/06/2023]
Abstract
We report the direct observation of muon neutrino interactions with the SND@LHC detector at the Large Hadron Collider. A dataset of proton-proton collisions at sqrt[s]=13.6 TeV collected by SND@LHC in 2022 is used, corresponding to an integrated luminosity of 36.8 fb^{-1}. The search is based on information from the active electronic components of the SND@LHC detector, which covers the pseudorapidity region of 7.2<η<8.4, inaccessible to the other experiments at the collider. Muon neutrino candidates are identified through their charged-current interaction topology, with a track propagating through the entire length of the muon detector. After selection cuts, 8 ν_{μ} interaction candidate events remain with an estimated background of 0.086 events, yielding a significance of about 7 standard deviations for the observed ν_{μ} signal.
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Affiliation(s)
- R Albanese
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | | | - F Alicante
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Anokhina
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - T Asada
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - C Battilana
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - A Bay
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - C Betancourt
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - R Biswas
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - A Blanco Castro
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - M Bogomilov
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria
| | - D Bonacorsi
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - W M Bonivento
- Università degli Studi di Cagliari, 09124 Cagliari, Italy
| | - P Bordalo
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - A Boyarsky
- University of Leiden, 2300 RA Leiden, The Netherlands
- Taras Shevchenko National University of Kyiv, 01033 Kyiv, Ukraine
| | | | - M Campanelli
- University College London, WC1E 6BT London, United Kingdom
| | - T Camporesi
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - V Canale
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Castro
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - D Centanni
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli Parthenope, 80143 Napoli, Italy
| | - F Cerutti
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Chernyavskiy
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - K-Y Choi
- Sungkyunkwan University, 16419 Suwon-si, Gyeong Gi-do, Korea
| | - S Cholak
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - F Cindolo
- Sezione INFN di Bologna, Bologna, Italy
| | - M Climescu
- Institut für Physik and PRISMA Cluster of Excellence, Johannes Gutenberg Universität Mainz, 55099 Mainz, Germany
| | - A P Conaboy
- Humboldt-Universität zu Berlin, 12489 Berlin, Germany
| | | | - D Davino
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università del Sannio, 82100 Benevento, Italy
| | - P T de Bryas
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - G De Lellis
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - M De Magistris
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli Parthenope, 80143 Napoli, Italy
| | - A De Roeck
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - A De Rújula
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M De Serio
- Sezione INFN di Bari, 70126 Bari, Italy
- Università di Bari, 70126 Bari, Italy
| | - D De Simone
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - A Di Crescenzo
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Donà
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - O Durhan
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - F Fabbri
- Sezione INFN di Bologna, Bologna, Italy
| | - F Fedotovs
- University College London, WC1E 6BT London, United Kingdom
| | - M Ferrillo
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - M Ferro-Luzzi
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - R A Fini
- Sezione INFN di Bari, 70126 Bari, Italy
| | - A Fiorillo
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Fresa
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università della Basilicata, 85100 Potenza, Italy
| | - W Funk
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - F M Garay Walls
- Departamento de Física, Pontificia Universidad Católica de Chile, 4860 Santiago, Chile
| | - A Golovatiuk
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Golutvin
- Imperial College London, SW7 2AZ London, United Kingdom
| | - E Graverini
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - A M Guler
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - V Guliaeva
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - G J Haefeli
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - J C Helo Herrera
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Departamento de Física, Facultad de Ciencias, Universidad de La Serena, Avenida Cisternas 1200, La Serena, Chile
| | | | - P Iengo
- Sezione INFN di Napoli, 80126 Napoli, Italy
| | - S Ilieva
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria
| | - A Infantino
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - A Iuliano
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Jacobsson
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - C Kamiscioglu
- Middle East Technical University (METU), 06800 Ankara, Turkey
- Ankara University, 06100 Ankara, Turkey
| | - A M Kauniskangas
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - E Khalikov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - S H Kim
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - Y G Kim
- Gwangju National University of Education, 61204 Gwangju, Korea
| | - G Klioutchnikov
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Komatsu
- Nagoya University, 464-8602 Nagoya, Japan
| | - N Konovalova
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - S Kovalenko
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Center for Theoretical and Experimental Particle Physics, Facultad de Ciencias Exactas, Universidad Andrés Bello, Fernandez Concha 700, Santiago, Chile
| | - S Kuleshov
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Center for Theoretical and Experimental Particle Physics, Facultad de Ciencias Exactas, Universidad Andrés Bello, Fernandez Concha 700, Santiago, Chile
| | - H M Lacker
- Humboldt-Universität zu Berlin, 12489 Berlin, Germany
| | - O Lantwin
- Affiliated with an institute covered by a cooperation agreement with CERN
| | | | - A Lauria
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - K Y Lee
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - K S Lee
- Korea University, 02841 Seoul, Korea
| | - S Lo Meo
- Sezione INFN di Bologna, Bologna, Italy
| | - V P Loschiavo
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università del Sannio, 82100 Benevento, Italy
| | | | - A Margiotta
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - A Mascellani
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - A Miano
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Mikulenko
- University of Leiden, 2300 RA Leiden, The Netherlands
| | - M C Montesi
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - F L Navarria
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - S Ogawa
- Toho University, 274-8510 Funabashi, Chiba, Japan
| | - N Okateva
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - M Ovchynnikov
- University of Leiden, 2300 RA Leiden, The Netherlands
| | - G Paggi
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - B D Park
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - A Pastore
- Sezione INFN di Bari, 70126 Bari, Italy
| | | | - D Podgrudkov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - N Polukhina
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - A Prota
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Quercia
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - S Ramos
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - A Reghunath
- Humboldt-Universität zu Berlin, 12489 Berlin, Germany
| | - T Roganova
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - F Ronchetti
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - T Rovelli
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - O Ruchayskiy
- Niels Bohr Institute, University of Copenhagen, 2100 Copenhagen, Denmark
| | - T Ruf
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Sabate Gilarte
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Samoilov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - V Scalera
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli Parthenope, 80143 Napoli, Italy
| | - O Schneider
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | | | - N Serra
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - M Shaposhnikov
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - V Shevchenko
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - T Shchedrina
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - L Shchutska
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - H Shibuya
- Toho University, 274-8510 Funabashi, Chiba, Japan
- Constructor University, Campus Ring 1, Bremen 28759, Germany
| | - S Simone
- Sezione INFN di Bari, 70126 Bari, Italy
- Università di Bari, 70126 Bari, Italy
| | - G P Siroli
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - G Sirri
- Sezione INFN di Bologna, Bologna, Italy
| | - G Soares
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - O J Soto Sandoval
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Departamento de Física, Facultad de Ciencias, Universidad de La Serena, Avenida Cisternas 1200, La Serena, Chile
| | - M Spurio
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - N Starkov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - I Timiryasov
- Niels Bohr Institute, University of Copenhagen, 2100 Copenhagen, Denmark
| | - V Tioukov
- Sezione INFN di Napoli, 80126 Napoli, Italy
| | | | - C Trippl
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - E Ursov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - A Ustyuzhanin
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Constructor University, Campus Ring 1, Bremen 28759, Germany
| | | | - V Verguilov
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria
| | | | - C Vilela
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - C Visone
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Wanke
- Institut für Physik and PRISMA Cluster of Excellence, Johannes Gutenberg Universität Mainz, 55099 Mainz, Germany
| | - E Yaman
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - C Yazici
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - C S Yoon
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - E Zaffaroni
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - J Zamora Saa
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Center for Theoretical and Experimental Particle Physics, Facultad de Ciencias Exactas, Universidad Andrés Bello, Fernandez Concha 700, Santiago, Chile
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Haam JH, Kim BT, Kim EM, Kwon H, Kang JH, Park JH, Kim KK, Rhee SY, Kim YH, Lee KY. Diagnosis of Obesity: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity. J Obes Metab Syndr 2023; 32:121-129. [PMID: 37386771 DOI: 10.7570/jomes23031] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 07/01/2023] Open
Abstract
The prevalence of obesity has consistently increased worldwide, and many obesity-related diseases are emerging as major health problems. Body mass index (BMI) is used to define obesity and is highly correlated with body fat mass. Moreover, obesity-related morbidities increase linearly with the increase in BMI. The Korean Society for the Study of Obesity defined overweight as a BMI ≥23 kg/m2 and obesity as a BMI ≥25 kg/m2, based on a significant increase in obesity-related diseases. A waist circumference of ≥90 cm in men and ≥85 cm in women are defined as abdominal obesity, which is also correlated with obesity-related diseases. These diagnostic criteria are the same as in the previous version; however, the updated guidelines put greater emphasis on the use of morbidity as the basis for obesity and abdominal obesity diagnoses. These new guidelines will help to identify and manage high-risk groups for obesity-related comorbidities among Korean adults.
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Affiliation(s)
- Ji-Hee Haam
- Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bom Taeck Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ki Young Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
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Jeon E, Lee KY, Kim KK. Exploring Approved Medications and the Promise of Phase 3 Clinical Trials: Anti-Obesity Drugs in the Sky and on the Horizon. J Obes Metab Syndr 2023:jomes23032. [PMID: 37349257 DOI: 10.7570/jomes23032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/06/2023] [Accepted: 06/20/2023] [Indexed: 06/24/2023] Open
Abstract
Obesity is a prevalent global health issue affecting approximately half of the world's population. Extensive scientific research highlights the urgent need for effective obesity management to mitigate health risks and prevent complications. While bariatric surgery has proven to be highly effective, providing substantial short-term and long-term weight loss and resolution of obesity-related comorbidities, it is important to recognize its limitations and associated risks. Given the global obesity epidemic and the limitations of surgical interventions, there is high demand for effective and safe anti-obesity medications (AOMs). In Korea, the Korean Society for the Study of Obesity strongly advocates for the use of pharmacotherapy in Korean adults with a body mass index of 25 kg/m2 or higher who have not achieved weight reduction through non-pharmacological treatments. Currently, five AOMs have been approved for long-term weight management: orlistat, naltrexone/bupropion, phentermine/topiramate, liraglutide, and semaglutide. Tirzepatide is awaiting approval, and compounds such as CagriSema (Novo Nordisk) and oral semaglutide are currently undergoing rigorous evaluation in phase 3 clinical trials. Furthermore, other promising drugs, including orforglipron, BI 456906, and retartrutide, are progressing to phase 3 studies, expanding the therapeutic options for obesity management. In personalized patient care, physicians play a crucial role in accurately identifying individuals who genuinely require pharmacotherapy and selecting appropriate AOMs based on individual patient characteristics. By integrating evidence-based interventions and considering the unique needs of patients, healthcare professionals significantly contribute to the success of obesity management strategies.
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Affiliation(s)
- Eonju Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Ki Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea
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Haam JH, Kim BT, Kim EM, Kwon H, Kang JH, Park JH, Kim KK, Rhee SY, Kim YH, Lee KY. Diagnosis of Obesity: 2022 Update of Clinical Practice Guidelines for Obesity by the Korean Society for the Study of Obesity. J Obes Metab Syndr 2023:jome23031. [PMID: 37340518 DOI: 10.7570/jome23031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/22/2023] Open
Abstract
The prevalence of obesity has consistently increased worldwide, and many obesity-related diseases are emerging as major health problems. Body mass index (BMI) is used to define obesity and is highly correlated with body fat mass. Moreover, obesity-related morbidities increase linearly with the increase in BMI. The Korean Society for the Study of Obesity defined overweight as a BMI ≥23 kg/m2 and obesity as a BMI ≥25 kg/m2, based on a significant increase in obesity-related diseases. A waist circumference of ≥90 cm in men and ≥85 cm in women are defined as abdominal obesity, which is also correlated with obesity-related diseases. These diagnostic criteria are the same as in the previous version; however, the updated guidelines put greater emphasis on the use of morbidity as the basis for obesity and abdominal obesity diagnoses. These new guidelines will help to identify and manage high-risk groups for obesity-related comorbidities among Korean adults.
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Affiliation(s)
- Ji-Hee Haam
- Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bom Taeck Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Hyuktae Kwon
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University College of Medicine, Daejeon, Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Kyoung-Kon Kim
- Department of Family Medicine, Gachon University College of Medicine, Incheon, Korea
| | - Sang Youl Rhee
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ki Young Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
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Kim KS, Han KA, Kim TN, Park CY, Park JH, Kim SY, Kim YH, Song KH, Kang ES, Kim CS, Koh G, Kang JG, Kim MK, Han JM, Kim NH, Mok JO, Lee JH, Lim S, Kim SS, Kim TH, Won KC, Lee KY, Cho JH, Han JY, Kim SH, Nah JJ, Song HR, Lee SE, Kim S. Efficacy and safety of enavogliflozin versus dapagliflozin added to metformin plus gemigliptin treatment in patients with type 2 diabetes: A double-blind, randomized, comparator-active study: ENHANCE-D study. Diabetes Metab 2023; 49:101440. [PMID: 36906135 DOI: 10.1016/j.diabet.2023.101440] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 03/13/2023]
Abstract
AIMS This study evaluated the efficacy and safety of enavogliflozin, a novel sodium-glucose cotransporter 2 inhibitor, versus dapagliflozin in Korean patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin and gemigliptin. METHODS In this multicenter, double-blind, randomized study, patients with inadequate response to metformin (≥ 1000 mg/day) plus gemigliptin (50 mg/day) were randomized to receive enavogliflozin 0.3 mg/day (n = 134) or dapagliflozin 10 mg/day (n = 136) in addition to the metformin plus gemigliptin therapy. The primary endpoint was change in HbA1c from baseline to week 24. RESULTS Both treatments significantly reduced HbA1c at week 24 (-0.92% in enavogliflozin group, -0.86% in dapagliflozin group). The enavogliflozin and dapagliflozin groups did not differ in terms of changes in HbA1c (between-group difference: -0.06%, 95% confidence interval [CI]: -0.19, 0.06) and fasting plasma glucose (between-group difference: -3.49 mg/dl [-8.08;1.10]). An increase in urine glucose-creatinine ratio was significantly greater in the enavogliflozin group than in the dapagliflozin group (60.2 g/g versus 43.5 g/g, P < 0.0001). The incidence of treatment-emergent adverse events was similar between the groups (21.64% versus 23.53%). CONCLUSIONS Enavogliflozin, added to metformin plus gemigliptin, was well tolerated and as effective as dapagliflozin in the treatment of patients with T2DM.
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Affiliation(s)
- Kyung-Soo Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Kyung Ah Han
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Tae Nyun Kim
- Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Cheol-Young Park
- Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Sang Yong Kim
- Department of Internal Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Republic of Korea
| | - Yong Hyun Kim
- Department of Internal Medicine, BunDang JeSaeng general Hospital, Seongnam, Republic of Korea
| | - Kee Ho Song
- Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chul Sik Kim
- Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Gwanpyo Koh
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea
| | - Jun Goo Kang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Mi Kyung Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Dongsan hospital, Daegu, Republic of Korea
| | - Ji Min Han
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Nan Hee Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Oh Mok
- Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Bucheon, Republic of Korea
| | - Jae Hyuk Lee
- Department of Internal Medicine, Myongji Hospital, Goyang, Republic of Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sang Soo Kim
- Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Tae Ho Kim
- Department of Internal Medicine, Seoul Medical Center, Seoul, Republic of Korea
| | - Kyu Chang Won
- Department of Internal Medicine, Yeungnam University College of Medicine, Deagu, Republic of Korea
| | - Ki Young Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jae Hyoung Cho
- Department of Internal Medicine, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Ju Young Han
- Department of Internal Medicine, Central Hospital, Siheung, Republic of Korea
| | - So Hun Kim
- Department of Internal Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jae Jin Nah
- Clinical Development Center, Daewoong Pharmaceutical Co., Ltd., Seoul, Republic of Korea
| | - Hwa Rang Song
- Clinical Development Center, Daewoong Pharmaceutical Co., Ltd., Seoul, Republic of Korea
| | - Si Eun Lee
- Clinical Development Center, Daewoong Pharmaceutical Co., Ltd., Seoul, Republic of Korea
| | - Sungrae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
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- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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9
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Kang KC, Im SK, Lee JH, Lee KY, Seo DU, Hwang IU. Impact of lamina-open side on unilateral open door laminoplasty in patients with degenerative cervical myelopathy. Sci Rep 2023; 13:2062. [PMID: 36739303 PMCID: PMC9899267 DOI: 10.1038/s41598-023-28490-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 01/19/2023] [Indexed: 02/06/2023] Open
Abstract
Surgeons should select one side for cervical unilateral open door laminoplasty (UODL). However, few reports suggest proper guidelines for deciding which side to open. The aim of this study is to evaluate the impact of opening side in UODL on dominant cord compressive or symptomatic side. 193 degenerative cervical myeloradiculopathy patients with followed-up more than 2 years were enrolled. In all cases, UODL was performed uniformly on the right side. Patients were sub-grouped based on preoperative dominant 3 characteristics: cord compression, myelopathy symptom and radiculopathy symptom (right, symmetric, left). Pre- and postoperative radiographic and clinical parameters and incidence of postoperative C5 palsy were analyzed and compared among the groups. According to dominant compressive side, there were no significant differences in postoperative radiographic and clinical parameters among three groups. According to dominant myelopathy or radiculopathy symptom side, there were no significant differences of all radiographic and clinical parameters postoperatively, except slightly lower neck VAS in groups of preoperative right dominant myelopathy or radiculopathy symptom side at postoperative 1 month. C5 palsies occurred in twelve patients (6.2%), but the incidences were not different among the groups. Therefore, when performing UODL, the choice of lamina opening side can be left to surgeon's preference.
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Affiliation(s)
- Kyung-Chung Kang
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Kyung HeeUniversity, Seoul, Republic of Korea
| | - Sang-Kyu Im
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Kyung HeeUniversity, Seoul, Republic of Korea.
| | - Jung-Hee Lee
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Kyung HeeUniversity, Seoul, Republic of Korea
| | - Ki Young Lee
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Kyung HeeUniversity, Seoul, Republic of Korea
| | - Dong-Uk Seo
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Kyung HeeUniversity, Seoul, Republic of Korea
| | - In-Uk Hwang
- Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Kyung HeeUniversity, Seoul, Republic of Korea
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Abstract
Nanophotonic light emitters are key components in numerous application areas because of their compactness and versatility. Here, we propose a topological beam emitter structure that takes advantage of submicrometer footprint size, small divergence angle, high efficiency, and adaptable beam shaping capability. The proposed structure consists of a topological junction of two guided-mode resonance gratings inducing a leaky Jackiw-Rebbi state resonance. The leaky Jackiw-Rebbi state leads to in-plane optical confinement with funnel-like energy flow and enhanced emission probability, resulting in highly efficient optical beam emission. In addition, the structure allows adaptable beam shaping for any desired positive definite profiles by means of Dirac mass distribution control, which can be directly encoded in lattice geometry parameters. Therefore, the proposed approach provides highly desirable properties for efficient micro-light emitters and detectors in various applications including display, solid-state light detection and ranging, laser machining, label-free sensors, optical interconnects, and telecommunications.
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Affiliation(s)
- Ki Young Lee
- Department of Physics, Hanyang University, Seoul, 133-791, Republic of Korea
| | - Seungjin Yoon
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK
| | - Seok Ho Song
- Department of Physics, Hanyang University, Seoul, 133-791, Republic of Korea
| | - Jae Woong Yoon
- Department of Physics, Hanyang University, Seoul, 133-791, Republic of Korea
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11
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Im SK, Lee KY, Lee JH. The Impact of Upper Instrumented Vertebra Orientation on Proximal Junctional Kyphosis: A Novel and Fixed Parameter, Fused Spinopelvic Angle. Spine (Phila Pa 1976) 2022; 47:1651-1658. [PMID: 36129995 PMCID: PMC9632945 DOI: 10.1097/brs.0000000000004442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/16/2022] [Accepted: 07/05/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective study. OBJECTIVES To evaluate the impact of upper instrumented vertebra (UIV) orientation including the fused spinopelvic angle (FSPA) on proximal junctional kyphosis (PJK). SUMMARY OF BACKGROUND DATA PJK is a challenging complication after adult spinal deformity (ASD) surgery. Some studies proposed UIV orientation act as a risk factor of PJK, but there remain debates because UIV orientation is changed by position. Therefore, we investigated the relationship between the FSPA, a novel parameter for the relationship between UIV and pelvis which did not change by position, and PJK. MATERIALS AND METHODS ASD patients who underwent long-segment fusion to the pelvis and followed up for more than two years were included. Comparative analysis was performed on spinopelvic parameters including UIV orientation parameters (UIV slope angle and FSPA) between PJK and non-PJK group. Binary regression analysis was conducted to find out the risk factors for PJK. And correlation analysis was conducted to find out the parameters that affect the FSPA. RESULTS A total of 190 patients were included. PJK incidence was 13.2% (25/190). PJK group showed a significantly greater postoperative UIV slope (21.3° vs. 18.8°, P =0.041) and significantly lesser postoperative FSPA (-0.9° vs. 4.5°, P <0.001). In binary regression analysis, only FSPA acted as a risk factor of PJK (odds ratio=0.920, P =0.004). The FSPA has strong positive correlation with pelvic incidence (PI)-lumbar lordosis (LL) ( r =0.666, P <0.001) and negative correlation with lordosis distribution index (LDI) ( r =-0.228, P =0.004). CONCLUSION The FSPA is a fixed parameter which is not dependent on position. A reduction of the FSPA increases the risk for PJK. The FSPA can be adjusted through PI-LL and LDI. Thus, surgeons should increase the FSPA by adjusting the PI-LL and LDI during ASD surgery to prevent PJK.
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12
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Kong MG, Suh J, Moon IK, Lee KY, Jang HJ, Kim JS, Choi IJ. Heart failure with improved ejection fraction (HFimpEF) in patients treated with sacubitril/valsartan (SV). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Several studies demonstrated that patients with improvement of left ventricular ejection fraction (LVEF) and symptoms had good prognosis in heart failure with reduced ejection fraction (HFrEF). Based on these results, new classification of HF according to LVEF was currently proposed. Sacubitril/valsartan (SV) is recommended as one of the first-line therapy of HFrEF patients. SV reduced hospitalization for HF and cardiovascular mortality compared to enalapril in PARADIGM-HF trial. However, it is unclear that patients with improvement of LVEF also have better prognosis compared to patients without LVEF improvement among patients treated with SV.
Purpose
We aimed to evaluate the clinical characteristics and outcomes of heart failure with improved ejection fraction (HFimpEF) in heart failure with reduced ejection fraction (HFrEF) patients treated with SV.
Methods
We analyzed 230 patients with HFrEF taking SV in a multicenter retrospective cohort (RECORD-SV registry) from 2017 to 2019. Enrolled 230 patients were performed baseline and 1-year follow-up echocardiography. Based on 2 echocardiographic results, we defined “HFimpEF” as HF with a baseline LVEF ≤40%, ≥10% increase from baseline LVEF and a follow-up measurement of LVEF >40%. Others were defined as “Persistent HFrEF”. We analyzed and compared clinical characteristics and outcomes between two groups. Primary endpoint was a composite outcome of all-cause death and hospitalization for HF (HHF).
Results
From 230 patients, 65 patients with HFimpEF and 165 patients with Persistent HFrEF were analyzed. The median follow-up duration was 557 days (interquartile range 364 to 727 days). Patients with HFimpEF had a higher prevalence of female gender (50.8% vs. 30.3%) and de novo HF (44.6% vs. 21.2%). There were no significant differences for age, etiology (ischemic vs. non-ischemic), diabetes, atrial fibrillation, hypertension, and HF medications including SV dose between two groups. Patients with HFimpEF showed lower rate of all-cause death or HHF as a primary endpoint compared to patients with persistent HFrEF (6.2% vs. 22.4%; IPTW adjusted HR 0.24; 95% CI 0.13–0.46; p<0.001) (Table 1). It was also shown that HFimpEF patients had a reduced risk of primary endpoint in the Kaplan-Meier curves compared with persistent HFrEF (Log-rank p=0.045) (Figure 1). We demonstrated that Non-prior MI (adjusted OR 7.29; 95% CI 1.50–35.36; p=0.014) and de novo HF (adjusted OR 4.33; 95% CI 1.70–11.04; p=0.002) were independent prognostic factors of HFimpEF in HFrEF patients treated with SV.
Conclusions
HFimpEF patients had better clinical outcomes compared to those with persistent HFrEF in HFrEF patients treated with SV. Non-prior MI and de novo HF were independent predictors of HFimpEF in patients treated with SV.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kong
- Soonchunhyang University Hospital , Bucheon , Korea (Republic of)
| | - J Suh
- Soonchunhyang University Hospital , Bucheon , Korea (Republic of)
| | - I K Moon
- Soonchunhyang University Hospital , Bucheon , Korea (Republic of)
| | - K Y Lee
- The Catholic University of Korea Seoul St. Mary's Hospital, Cardiovascular center and cardiology , Seoul , Korea (Republic of)
| | - H J Jang
- Sejong general hospital, Cardiology , Seoul , Korea (Republic of)
| | - J S Kim
- Dongguk University hospital, Cardiology , Ilsan , Korea (Republic of)
| | - I J Choi
- St.Marys Hospital, Cardiology , Incheon , Korea (Republic of)
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13
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Im SK, Lee JH, Lee KY, Yoo SJ. Effectiveness and Feasibility of Injectable Escherichia coli-Derived Recombinant Human Bone Morphogenetic Protein-2 for Anterior Lumbar Interbody Fusion at the Lumbosacral Junction in Adult Spinal Deformity Surgery: A Clinical Pilot Study. Orthop Surg 2022; 14:1350-1358. [PMID: 35633034 PMCID: PMC9251273 DOI: 10.1111/os.13303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To explore the effectiveness and feasibility of injectable Escherichia coli‐derived recombinant human bone morphogenetic protein‐2 (injectable E‐rhBMP‐2, a combination of E. coli‐derived recombinant human bone morphogenic protein‐2 and a hydrogel type beta‐tricalcium phosphate carrier) as a bone substitute for anterior lumbar interbody fusion (ALIF) of the lumbosacral junction in adult spinal deformity (ASD) patients. Methods A prospective single‐institution therapeutic exploratory trial was conducted. Twenty patients (average age: 69.1 years; 19 female and one male; average fusion level: 7.95) diagnosed with ASD with sagittal imbalance who underwent surgical treatment including ALIF at the lumbosacral junction from December 2017 to January 2019 were evaluated. Injectable E‐rhBMP‐2 was prepared by dissolving 3 mg of E. coli‐derived recombinant human bone morphogenetic protein‐2 in 1.5 ml H2O and mixing in situ with 9 g hydrogel type beta‐tricalcium phosphate. This bone graft substitute was loaded onto a metal ALIF cage and L5–S1 ALIF was performed in routine manner. Then posterior column osteotomy with multilevel oblique lumbar interbody fusion or pedicle subtraction osteotomy with accessory rod technique was performed to restore sagittal balance. Patients were followed up for 12 months. CT‐based fusion rates were examined at 6 and 12 months after surgery. Also, clinical outcomes (Oswestry Disability Index [ODI], Visual Analog Scale [VAS] score of the back and leg) were evaluated at 6 and 12 months after surgery. All postoperative adverse events were evaluated for the association with injectable E.BMP‐2. Results Of the 20 patients, loss to follow‐up occurred with one patient at 6 months after surgery and one patient at 12 months after surgery, resulting in a total of 18 patients who were available for follow‐up. Six months after surgery, 68.4% patients achieved solid fusion. Twelve months after surgery, 100% fusion rate was achieved. Compared to baseline values, ODI scores improved to 45.8% and 63.7%, VAS (back) improved to 69.2% and 72.8%, and VAS (leg) improved to 49.2% and 64.8%, respectively, at 6 and 12 months after surgery (p < 0.001 for all). Ten cases of adverse events occurred. But no adverse events were associated with injectable E‐rhBMP‐2. Conclusion Injectable E‐rhBMP‐2 will be an effective bone graft substitute when achieving solid interbody fusion in the lumbosacral junction.
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Affiliation(s)
- Sang-Kyu Im
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Jung-Hee Lee
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Ki Young Lee
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seung-Jin Yoo
- Department of Radiology, College of Medicine, Hanyang University, Seoul, South Korea
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14
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Lee KY, Yoo KW, Cheon S, Joo WJ, Yoon JW, Song SH. Synthetic Topological Nodal Phase in Bilayer Resonant Gratings. Phys Rev Lett 2022; 128:053002. [PMID: 35179923 DOI: 10.1103/physrevlett.128.053002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
The notion of synthetic dimensions in artificial photonic systems has received considerable attention as it provides novel methods for exploring hypothetical topological phenomena as well as potential device applications. Here, we present nanophotonic manifestation of a two-dimensional topological nodal phase in bilayer resonant grating structures. Using the mathematical analogy between a topological semimetal and vertically asymmetric photonic lattices, we show that the interlayer shift simulates an extra momentum dimension for creating a two-dimensional topological nodal phase. We present a theoretical model and rigorous numerical analyses showing the two nodal points that produce a complex gapless band structure and localized edge states in the topologically nontrivial region. Therefore, our results provide a practical scheme for producing high-dimensional topological effects in simple low-dimensional photonic structures.
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Affiliation(s)
- Ki Young Lee
- Department of Physics, Hanyang University, Seoul 133-791, Korea
| | - Kwang Wook Yoo
- Department of Physics, Hanyang University, Seoul 133-791, Korea
| | - Sangmo Cheon
- Department of Physics, Hanyang University, Seoul 133-791, Korea
| | - Won-Jae Joo
- Samsung Advanced Institute of Technology, Samsung Electronics, Suwon 16678, Korea
| | - Jae Woong Yoon
- Department of Physics, Hanyang University, Seoul 133-791, Korea
| | - Seok Ho Song
- Department of Physics, Hanyang University, Seoul 133-791, Korea
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Lee KY, Lee JH, Im SK, Lee WY. Analysis of measurement changes in pelvic incidence according to pelvic rotation using a three-dimensional model. BMC Musculoskelet Disord 2022; 23:110. [PMID: 35109846 PMCID: PMC8808983 DOI: 10.1186/s12891-022-05063-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/18/2022] [Indexed: 11/11/2022] Open
Abstract
Background Pelvic incidence (PI) is used as a key parameter in surgical correction of adult spinal deformity (ASD). However, reflecting the exact center or inclination of the three-dimensional anatomical structures on the two-dimensional (2D) sagittal radiographs is limited, resulting in measurement errors. Therefore, we evaluated whether there is a change in PI measurement according to the actual rotation of the pelvis, and conducted a study on a more accurate method for PI measurement using 2D sagittal radiographs. Methods From 2014 to 2015, the data of 30 patients who visited our outpatient clinic were analyzed retrospectively. CT scans including those of the lower lumbar spine, pelvis, and both femurs in the DICOM format were imported to Mimics Research 17.0 (Materialise NV, Belgium), SolidWorks (Dassault systems, France), and AutoCAD 2014 (AUTODESK, US). The changes in PI according to vertical and horizontal pelvic rotations were evaluated. Results The average PIs according to the horizontal pelvic rotations measured on AutoCAD with 0°, 5°, 10°, 15°, 20°, 25°, 30°, 35°, and 40° were 48.8°, 48.7°, 48.3°, 47.8°, 46.9°, 45.6°, 44.0°, 42.2°, and 39.9°, respectively. The PI with an acceptable error of 6° on radiographs was 35° in the horizontal pelvic rotation. The average PIs according to the vertical pelvic rotations measured on AutoCAD with 0°, 5°, 10°, 15°, 20°, 25°, 30°, 35°, and 40° were 48.8°, 49.0°, 49.5°, 50.2°, 51.3°, 52.7°, 54.4°, 56.6°, and 59.4°, respectively. The PI with an acceptable error of 6° on radiographs was 30° in the vertical pelvic rotation. Conclusions This study revealed that the PI value could differ from the actual anatomical value due to the horizontal and vertical rotation of the pelvis while acquiring the radiograph. Regarding whole-spine lateral radiographs, errors in PI measurement may occur due to pelvic rotation or nonvertical projection of X-rays. In the standing pelvic lateral radiographs, ensuring superposition of the femoral heads at the center and obtaining the straight sacral endplate by referring to CT or magnetic resonance imaging would be a more accurate measurement method to define PI.
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Affiliation(s)
- Ki Young Lee
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
| | - Jung-Hee Lee
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea.
| | - Sang-Kyu Im
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
| | - Won Young Lee
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyungheedae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
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Lee KY, Lee JH, Im SK. Optimal Lumbar Lordosis Correction for Adult Spinal Deformity with Severe Sagittal Imbalance in Patients Over Age 60: Role of Pelvic Tilt and Pelvic Tilt Ratio. Spine (Phila Pa 1976) 2021; 46:E1246-E1253. [PMID: 33907085 PMCID: PMC8565504 DOI: 10.1097/brs.0000000000004068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/26/2021] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective study. OBJECTIVES The purpose of this study was to evaluate optimal and ideal target values of the spine balance correction in elderly patients with adult spinal deformity who were over the age of 60 years. SUMMARY OF BACKGROUND DATA The target values of the Scoliosis Research Society -Schwab classification to obtain satisfactory alignment and favorable outcomes are used in many spinal reconstruction surgeries. However, uniformly applying the Scoliosis Research Society-Schwab classification to all elderly patients aged 60 years or older showing sagittal malalignment may lead to several inconsistencies. METHODS This study included 121 patients (average age 70.5 yr and a minimum 2-yr follow-up) with adult spinal deformity who underwent long-segment fusion from T10 to sacrum. We used Pearson's correlation coefficient to analyze the relationship between clinical and radiographic parameters, and multilinear regression analysis and multivariate logistic regression model (backward elimination method) were conducted using the correlation factors of postoperative (Post) and last follow-up (Last) sagittal vertical axis to find the risk factors of Post sagittal imbalance. RESULTS Logistic regression analysis with the correlation factors of Post and Last sagittal vertical axis led to risk factors of Post sagittal imbalance, and after confirming the significance of each path, it was confirmed that the effects of pelvic incidence (PI)- lumbar lordosis (LL) and Post pelvic tilt ratio (PTr) were valid (P < 0.05). After using ROC curve, target value of PI-LL was 1.33, and that of PTr was 25.95%. CONCLUSION Through our study, the risk factors of Post sagittal imbalance were the Post value of PI-LL and that of PTr, and target value of PI-LL was <1.33 and that of PTr was <25.95%. These target values can be effective guidelines for spine surgeons who perform spine reconstruction surgeries for elderly patients with a pure sagittal imbalance based on Schwab's formula.Level of Evidence: 4.
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Affiliation(s)
- Ki Young Lee
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
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Yoo M, Chung SH, Park YS, Oh IH, Chae WY, Kim SH, Lee KY, Song CW, Son BK, Kim SH, Jo YK, Jung KH, Lee HY, Chae JD. Clinical Characteristics of Campylobacter Enterocolitis in Korean Adults: A Retrospective Study at a Single Center. Korean J Gastroenterol 2021; 75:188-197. [PMID: 32326685 DOI: 10.4166/kjg.2020.75.4.188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 11/03/2022]
Abstract
Background/Aims Although the diarrheal disease caused by Campylobacter bacteria has been continuously increasing in Korea, there has been limited study on the clinical aspects of Campylobacter enteritis in adults in Korea. The purpose of this study was to analyze the clinical features and characteristics of adult patients with Campylobacter enteritis. Methods This retrospective study included patients diagnosed with Campylobacter enterocolitis at Nowon Eulji University Hopsital between January 2016 and December 2017. Campylobacter enterocolitis was diagnosed through polymerase chain reaction of stools from patients with acute diarrhea. Results Among 630 hospitalized patients with acute diarrhea, Campylobacter enterocolitis was diagnosed in 88 patients (14.0%). The mean age was 37.9±19.1 years. Campylobacter enterocolitis was most prevalent in the summer (52 patients, 59.1%). Patients exhibited more than 10 times of diarrhea in 36 (40.9%), high fever above 39°C in 19 (21.59%), and abdominal pain above 5 points on the numeric rating scale in 23 (26.14%) cases. In abdominal CT scan, pancolitis was found in 58 patients (65.9%). Small intestine was involved in 37 patients (42.4%). Mean CRP was 10.14 mg/dL (range 0.72-32.27 mg/dL). The duration of diarrhea after antibiotics treatment was 2.34±1.51 days in the ciprofloxacin treatment group and 2.26±1.71 days in the 3rd cephalosporin treatment group. Conclusions Campylobacter enterocolitis was common during summer. Commonly healthy young adults were hospitalized due to severe symptoms of Campylobacter enterocolitis. Whole colon and small bowel were frequently involved. Most patients were treated with antibiotics, and the efficacy of 3rd cephalosporin treatment was not inferior to that of ciprofloxacin treatment.
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Affiliation(s)
- Minseok Yoo
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Sook Hee Chung
- Department of Internal Medicine, Anyang SAM Hospital, Anyang, Korea
| | - Young Sook Park
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Il Hwan Oh
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Won Young Chae
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Soo Hyung Kim
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Ki Young Lee
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Chi Woo Song
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Byoung Kwan Son
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Seong Hwan Kim
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Young Kwan Jo
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Kwang Hyun Jung
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Hyo Young Lee
- Department of Internal Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
| | - Jeong Don Chae
- Department of Laboratory Medicine, Nowon Eulji University Hopsital, Eulji Universitiy, School of Medicine, Seoul, Korea
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Kim MH, Yoo YC, Bai SJ, Lee KY, Kim N, Lee KY. Physiologic and hemodynamic changes in patients undergoing open abdominal cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. J Int Med Res 2021; 49:300060520983263. [PMID: 33445991 PMCID: PMC7812408 DOI: 10.1177/0300060520983263] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective We aimed to determine the physiological and hemodynamic changes in patients who were undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) cytoreductive surgeries. Methods This prospective, observational study enrolled 21 patients who were undergoing elective cytoreductive surgery with HIPEC at our hospital over 2 years. We collected vital signs, hemodynamic parameters including global end-diastolic volume index (GEVI) and extravascular lung water index (ELWI) using the VolumeView™ system, and arterial blood gas analysis from all patients. Data were recorded before skin incision (T1); 30 minutes before HIPEC initiation (T2); 30 (T3), 60 (T4), and 90 (T5) minutes after HIPEC initiation; 30 minutes after HIPEC completion (T6); and 10 minutes before surgery completion (T7). Results Patients showed an increase in body temperature and cardiac index and a decrease in the systemic vascular resistance index. GEDI was 715.4 (T1) to 809.7 (T6), and ELWI was 6.9 (T1) to 7.3 (T5). Conclusions HIPEC increased patients’ body temperature and cardiac output and decreased systemic vascular resistance. Although parameters that were extracted from the VolumeView™ system were within their normal ranges, transpulmonary thermodilution approach is helpful in intraoperative hemodynamic management during open abdominal cytoreductive surgery with HIPEC. Trial registry name: ClinicalTrials.gov Trial registration number: NCT02325648 URL: https://clinicaltrials.gov/ct2/results?cond=NCT02325648&term
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Affiliation(s)
- Myoung Hwa Kim
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Young Chul Yoo
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Joon Bai
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kang-Young Lee
- Division of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nayeon Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Ki Young Lee
- Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Im SK, Lee KY, Lim HS, Suh DU, Lee JH. Optimized Surgical Strategy for Adult Spinal Deformity: Quantitative Lordosis Correction versus Lordosis Morphology. J Clin Med 2021; 10:jcm10091867. [PMID: 33925824 PMCID: PMC8123441 DOI: 10.3390/jcm10091867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In surgical correction of adult spinal deformity (ASD), pelvic incidence (PI)-lumbar lordosis (LL) plays a key role to restore normal sagittal alignment. Recently, it has been found that postoperative lordosis morphology act as an important factor in preventing mechanical complications. However, there have been no studies on the effect of postoperative lordosis morphology on the restoration of sagittal alignment. The primary objective of this study was to evaluate the effect of postoperative lordosis morphology on achievement of optimal sagittal alignment. The secondary objective was to find out which radiographic or morphologic parameter affects sagittal alignment in surgical correction of ASD. METHODS 228 consecutive patients with lumbar degenerative kyphosis who underwent deformity correction and long-segment fixation from T10 to S1 with sacropelvic fixation and follow-up over 2 years were enrolled. Patients were divided according to whether optimal alignment was achieved (balanced group) or not (non-balanced group) at last follow-up. We analyzed the differences of postoperative radiographic parameters and morphologic parameters between two groups. Correlation analysis and stepwise multiple linear regression analysis was performed to predict the effect of PI-LL and morphologic parameters on the sagittal vertical axis (SVA). RESULTS Of 228 patients, 195 (85.5%) achieved optimal alignment at last follow-up. Two groups significantly differed in postoperative and last follow-up LL (p < 0.001 and p = 0.028, respectively) and postoperative and last follow-up PI-LL (p < 0.001 and p = 0.001, respectively). Morphologic parameters did not significantly differ between the two groups except lower lordosis arc angle (=postoperative sacral slope). In correlation analysis and stepwise multiple linear regression analysis, postoperative PI-LL was the only parameter which had significant association with last follow-up SVA (R2 = 0.134, p < 0.001). Morphologic parameters did not have any association with last follow-up SVA. CONCLUSIONS When planning spine reconstruction surgery, although considering postoperative lordosis morphology is necessary, it is still very important considering proportional lordosis correction based on individual spinopelvic alignment (PI-LL) to achieve optimal sagittal alignment.
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Morikane K, Russo PL, Lee KY, Chakravarthy M, Ling ML, Saguil E, Spencer M, Danker W, Seno A, Charles EE. Expert commentary on the challenges and opportunities for surgical site infection prevention through implementation of evidence-based guidelines in the Asia-Pacific Region. Antimicrob Resist Infect Control 2021; 10:65. [PMID: 33795007 PMCID: PMC8017777 DOI: 10.1186/s13756-021-00916-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/26/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Surgical site infections (SSIs) are a significant source of morbidity and mortality in the Asia-Pacific region (APAC), adversely impacting patient quality of life, fiscal productivity and placing a major economic burden on the country's healthcare system. This commentary reports the findings of a two-day meeting that was held in Singapore on July 30-31, 2019, where a series of consensus recommendations were developed by an expert panel composed of infection control, surgical and quality experts from APAC nations in an effort to develop an evidence-based pathway to improving surgical patient outcomes in APAC. METHODS The expert panel conducted a literature review targeting four sentinel areas within the APAC region: national and societal guidelines, implementation strategies, postoperative surveillance and clinical outcomes. The panel formulated a series of key questions regarding APAC-specific challenges and opportunities for SSI prevention. RESULTS The expert panel identified several challenges for mitigating SSIs in APAC; (a) constraints on human resources, (b) lack of adequate policies and procedures, (c) lack of a strong safety culture, (d) limitation in funding resources, (e) environmental and geographic challenges, (f) cultural diversity, (g) poor patient awareness and (h) limitation in self-responsibility. Corrective strategies for guideline implementation in APAC were proposed that included: (a) institutional ownership of infection prevention strategies, (b) perform baseline assessments, (c) review evidence-based practices within the local context, (d) develop a plan for guideline implementation, (e) assess outcome and stakeholder feedback, and (f) ensure long-term sustainability. CONCLUSIONS Reducing the risk of SSIs in APAC region will require: (a) ongoing consultation and collaboration among stakeholders with a high level of clinical staff engagement and (b) a strong institutional and national commitment to alleviate the burden of SSIs by embracing a safety culture and accountability.
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Affiliation(s)
- K Morikane
- Division of Clinical Laboratory and Infection Control, Yamagata University Hospital, Yamagata, Japan
| | - P L Russo
- School of Nursing and Midwifery, Monash University, Frankston, VC, Australia
| | - K Y Lee
- Department of Surgery, KyungHee University Medical Center, Seoul, South Korea
| | | | - M L Ling
- Infection Prevention and Epidemiology, Singapore General Hospital, Singapore, Singapore
| | - E Saguil
- Philippine General Hospital, Manila, Philippines
| | - M Spencer
- Infection Prevention Consultant, Boston, MA, USA
| | - W Danker
- Ethicon, Johnson and Johnson Medical Device Companies, Somerville, NJ, USA
| | - A Seno
- Johnson and Johnson Medical Asia Pacific, Singapore, Singapore
| | - E Edmiston Charles
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
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Lee KY, Lee JH, Kang KC, Im SK, Lim HS, Choi SW. Strategies for prevention of rod fracture in adult spinal deformity: cobalt chrome rod, accessory rod technique, and lateral lumbar interbody fusion. J Neurosurg Spine 2021:1-10. [PMID: 33607617 DOI: 10.3171/2020.8.spine201037] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/18/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Restoring the proper sagittal alignment in adult spinal deformity (ASD) can improve radiological and clinical outcomes, but pseudarthrosis including rod fracture (RF) is a common problematic complication. The purpose of this study was to analyze the methods for reducing the incidence of RF in deformity correction of ASD. METHODS The authors retrospectively selected 178 consecutive patients (mean age 70.8 years) with lumbar degenerative kyphosis (LDK) who underwent deformity correction with a minimum 2-year follow-up. Patients were classified into the non-RF group (n = 131) and the RF group (n = 47). For predicting the crucial factors of RF, patient factors, radiographic parameters, and surgical factors were analyzed. RESULTS The overall incidence of RF was 26% (47/178 cases), occurring in 42% (42/100 cases) of pedicle subtraction osteotomy (PSO), 7% (5/67 cases) of lateral lumbar interbody fusion (LLIF) with posterior column osteotomy, 18% (23/129 cases) of cobalt chrome rods, 49% (24/49 cases) of titanium alloy rods, 6% (2/36 cases) placed with the accessory rod technique, and 32% (45/142 cases) placed with the 2-rod technique. There were no significant differences in the incidence of RF regarding patient factors between two groups. While both groups showed severe sagittal imbalance before operation, lumbar lordosis (LL) was more kyphotic and pelvic incidence (PI) minus LL (PI-LL) mismatch was greater in the RF group (p < 0.05). Postoperatively, while LL and PI-LL did not show significant differences between the two groups, LL and sagittal vertical axis correction were greater in the RF group (p < 0.05). Nonetheless, at the last follow-up, the two groups did not show significant differences in radiographic parameters except thoracolumbar junctional angles. As for surgical factors, use of the cobalt chrome rod and the accessory rod technique was significantly greater in the non-RF group (p < 0.05). As for the correction method, PSO was associated with more RFs than the other correction methods, including LLIF (p < 0.05). By logistic regression analysis, PSO, preoperative PI-LL mismatch, and the accessory rod technique were crucial factors for RF. CONCLUSIONS Greater preoperative sagittal spinopelvic malalignment including preoperative PI-LL mismatch was the crucial risk factor for RF in LDK patients 65 years or older. For restoring and maintaining sagittal alignment, use of the cobalt chrome rod, accessory rod technique, or LLIF was shown to be effective for reducing RF in ASD surgery.
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Lee KY, Lee JH, Kang KC, Im SK, Chang DG, Choi SH. Spino-Pelvic Thresholds for Prevention of Proximal Junctional Kyphosis Following Combined Anterior Column Realignment and Short Posterior Spinal Fusion in Degenerative Lumbar Kyphosis. Orthop Surg 2020; 12:1674-1684. [PMID: 32936527 PMCID: PMC7767665 DOI: 10.1111/os.12645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/10/2020] [Accepted: 02/05/2020] [Indexed: 12/31/2022] Open
Abstract
Objective To analyze ideal indication for combined anterior column realignment (ACR) with short posterior spinal fusion (PSF) and posterior column osteotomy (PCO) for preventing proximal junctional kyphosis (PJK) in adult spinal deformity (ASD) patients with lower lumbar kyphosis and compensatory thoracolumbar lordosis. Methods A retrospective study was conducted. This study included 27 ASD patients (average age of 66.6 years; one male and 26 females) with lower lumbar kyphosis and compensated thoracolumbar lordosis who underwent short PSF with PCO following ACR from 2006 to 2010. The minimum follow‐up period was 5 years. The patients were divided into two groups based on the sagittal vertical axis (SVA) of the last follow‐up radiographs, and a comparative analysis was performed evaluating spino‐pelvic parameters and clinical outcomes including the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), and complications. Results The mean follow‐up time of included patients was 109.7 months, and the mean number of fused segments was 3.7. The uppermost instrumented vertebra was L2 in 18 patients or L3 in nine patients, and lowermost instrumented vertebra was sacrum in all patients. The mean lumbar lordosis (LL) values in the optimal SVA and suboptimal SVA groups were 4.4° and 4.2° preoperatively (P = 0.639), −48.1° and −35° postoperatively (P = 0.007), and −45.2° and −20.7° at the last follow‐up (P < 0.05). Overcorrection was seen in seven patients in the optimal SVA group, whereas all of the patients of the suboptimal SVA group were in the category of undercorrection (P = 0.021). Pelvic incidence (PI) of optimal SVA group (<50 mm, n = 16) and suboptimal SVA group (≥50 mm, n = 11) was 44.1° and 53.8° (P = 0.009). The prevalence of PJK was significantly higher in the suboptimal SVA group (P = 0.008), and last follow‐up VAS for back pain (P < 0.05), and postoperative and last follow‐up ODI (P = 0.002 and P < 0.05) were statistically larger for the suboptimal group than the optimal group. Conclusions Combined ACR with short PSF and PCO could effectively prevent sagittal decompensation of PJK and help achieve sagittal balance in the treatment of ASD patients with lower lumbar kyphosis, compensatory thoracolumbar lordosis, and especially low PI (<50°).
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Affiliation(s)
- Ki Young Lee
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jung-Hee Lee
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Kyung-Chung Kang
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Sang-Kyu Im
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Dong-Gune Chang
- Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University, Seoul, Korea
| | - Sun Hwan Choi
- Department of Orthopaedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
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Im SK, Lee JH, Kang KC, Shin SJ, Lee KY, Park JJ, Kim MH. Proximal Junctional Kyphosis in Degenerative Sagittal Deformity After Under- and Overcorrection of Lumbar Lordosis: Does Overcorrection of Lumbar Lordosis Instigate PJK? Spine (Phila Pa 1976) 2020; 45:E933-E942. [PMID: 32675608 DOI: 10.1097/brs.0000000000003468] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective study. OBJECTIVE To analyze proximal junctional kyphosis (PJK) occurrence and surgical outcomes according to degree of lumbar lordosis (LL) correction relative to pelvic incidence (PI). In addition, risk factors of PJK including LL and sagittal vertical axis (SVA) correction were investigated. SUMMARY OF BACKGROUND DATA PJK is a common complication after adult spinal deformity surgery, and many factors are known to be associated with PJK. However, the effect of degree of LL correction on PJK occurrence is not fully understood. METHODS Eighty-three degenerative sagittal imbalance patients treated with deformity correction and long instrumented fusion to the sacrum with a minimum follow-up of 2 years were studied. Patients were divided into three groups according to their postoperative LL angle relative to PI using the SRS-Schwab classification: Group A (undercorrection, PI-LL> 10°), Group B (ideal correction, -10° RESULTS Overall PJK prevalence was 36.1% (30/83), and ratio of optimal SVA at postoperative and last follow-up were significantly higher in Group C (P < 0.001, P < 0.001). Nevertheless, there was no significant difference in PJK prevalence among three groups (40% vs. 37.5% vs. 34.1%; P = 0.907). Group C had better clinical outcomes (last follow-up ODI, VAS of LBP) than Group A (10.0 vs. 18.4; P < 0.001 and 1.5 vs. 4.0; P < 0.001). The increases in LL or SVA correction degree were not associated with PJK occurrence (P = 0.304, P = 0.201). CONCLUSION Overcorrection showed good surgical outcomes without increasing PJK prevalence. Degrees of LL and SVA correction do not act as risk factors for PJK. Therefore, in adult spinal deformity patients, LL correction greater than PI may be a good choice that can result in better clinical outcomes without increasing risk of PJK. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Sang-Kyu Im
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, Seoul, Korea
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Lee KY, Lee JH, Kang KC, Shin SJ, Shin WJ, Im SK, Park MS. Minimally invasive multilevel lateral lumbar interbody fusion with posterior column osteotomy compared with pedicle subtraction osteotomy for adult spinal deformity. Spine J 2020; 20:925-933. [PMID: 31837467 DOI: 10.1016/j.spinee.2019.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Pedicle subtraction osteotomy (PSO) is highly effective as a sagittal correction approach in patients with adult spinal deformity, but relevant issues such as surgical complexity and long-term complications limit its applicability. Recently, minimally invasive techniques have been reported to be useful for surgical treatment of adult spinal deformity; however, few reports have directly compared these techniques with PSO. PURPOSE The purpose of this study was to evaluate the radiological and clinical efficacies of oblique lateral interbody fusion (OLIF) with posterior column osteotomy (PCO) using stiff rods (6.35-mm cobalt chrome [CoCr]). STUDY DESIGN Retrospective comparative study. PATIENT SAMPLE One-hundred six patients (average age 71.3 years) diagnosed with adult spinal deformity presenting with sagittal imbalance for whom follow-up of over 2 years after sagittal correction (between 2013 and 2017) was available. OUTCOME MEASURES Description and analysis of X-ray, computed tomography scans, operative time, estimated blood loss, and clinical outcomes (Oswestry Disability Index [ODI] and Visual Analog Scale [VAS]). METHODS A comparative analysis was performed evaluating spinopelvic parameters and clinical outcomes including the ODI, VAS, and complications in patients who underwent PSO (PSO group; n=65) or multilevel prepsoas OLIF combined with PCO and open posterior spinal fusion using 6.35-mm CoCr rods (OLIF group; n=41). The authors have no conflicts of interest to disclose. RESULTS There were no differences in preoperative spinopelvic parameters between the PSO and OLIF groups. Although no differences were observed between the two groups in terms of postoperative SVA (-12.66 mm vs. -16.44 mm), postoperative lumbar lordosis (-71.46° vs. -72.55°), lumbar lordosis correction (77.96° vs. 73.54°), or postoperative pelvic tilt (9.35° vs. 7.17°), the estimated blood loss was significantly lower in the OLIF group (2824 mL vs. 1736 mL, p<.05). No differences were observed in clinical outcomes (ODI, VAS, and clinical complications), proximal junctional kyphosis, and spinopelvic parameters between the two groups 2 years after surgery. However, pseudarthrosis during the follow-up period, including rod fracture, occurred less frequently in the OLIF group compared with that in the PSO group (p<.05). OLIF was performed from the T12-L1 to L5-S1 regions (124 segments), with an average of three segments per patient. The computed tomography scans immediately after surgery showed an average segmental correction of -18° and 12.9% (16 segments) of 124 segments showed a correction angle of >30°. CONCLUSIONS Multilevel OLIF with PCO using a stiff rod to treat severe sagittal imbalance resulted in similar levels of sagittal balance and lordosis correction as obtained by PSO. Multilevel OLIF with PCO using a stiff rod can be an effective alternative to PSO for patients with severe sagittal imbalance.
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Affiliation(s)
- Ki Young Lee
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
| | - Jung-Hee Lee
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea.
| | - Kyung-Chung Kang
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
| | - Sung Joon Shin
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
| | - Won Ju Shin
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
| | - Sang Kyu Im
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
| | - Moon Su Park
- Department of Orthopedic Surgery, Graduate School, College of Medicine, Kyung Hee University, 23, Kyunghee dae-ro, Dongdaemun-gu, Seoul, 130-872, South Korea
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Lee KY, Lee JH, Kang KC, Shin SJ, Shin WJ, Im SK, Park JH. Strategy for obtaining solid fusion at L5-S1 in adult spinal deformity: risk factor analysis for nonunion at L5-S1. J Neurosurg Spine 2020; 33:1-9. [PMID: 32302980 DOI: 10.3171/2020.2.spine191181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/10/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Maintaining lumbosacral (LS) arthrodesis and global sagittal balance after long fusion to the sacrum remains an important issue in the surgical treatment for adult spinal deformity (ASD). The importance and usefulness of LS fixation have been documented, but the optimal surgical long fusion to the sacrum remains a matter for debate. Therefore, the authors performed a retrospective study to evaluate fusion on CT scans and the risk factors for LS pseudarthrosis (nonunion) after long fusion to the sacrum in ASD. METHODS The authors performed a retrospective study of 59 patients with lumbar degenerative kyphosis (mean age 69.6 years) who underwent surgical correction, including an interbody fusion of the L5-S1, with a minimum 2-year follow-up. Achievement of LS fusion was evaluated by analyzing 3D-CT scans at 3 months, 6 months, 9 months, 1 year, and 2 years after surgery. Patients were classified into a union group (n = 36) and nonunion group (n = 23). Risk factors for nonunion were analyzed, including patient and surgical factors. RESULTS The overall fusion rate was 61% (36/59). Regarding radiological factors, optimal sagittal balance at the final follow-up significantly differed between two groups. There were no significant differences in terms of patient factors, and no significant differences with respect to the use of pedicle subtraction osteotomy, the number of fused segments, the proportion of anterior versus posterior interbody fusion, S2 alar iliac fixation versus conventional iliac fixation, or loosening of sacral or iliac screws. However, the proportion of metal cages to polyetheretherketone cages and the proportion of sacropelvic fixation were significantly higher in the union group (p = 0.022 and p < 0.05, respectively). CONCLUSIONS LS junction fusion is crucial for global sagittal balance, and the use of iliac screws in addition to LS interbody fusion using a metal cage improves the outcomes of long fusion surgery for ASD patients.
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Ho C, Lee PH, So TC, Chiang MCS, Wong MH, Fong YH, Tsang CF, Cheng YW, Luk NH, Chui SF, Chan KC, Wong CY, Fu CL, Lee KY, Chan KT. 224 Malignancy associated pericardial effusion- do we need to drain them all? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
On Behalf
Cardiac Team, Department of Medicine, Queen Elizabeth Hospital
Background
Management of significant pericardial effusion in cancer patients is controversial. These patients have poor prognosis, and avoiding unnecessary intervention is important. Close monitoring of symptoms and echocardiogram is often a reasonable option, but inherits risk of cardiac tamponade. Whether pericardial drainage by means of percutaneous pericardiocentesis or surgical pericardiotomy could prevent future deterioration or affect survival is unknown.
Purpose
To evaluate the benefit of elective pericardial drainage in malignancy associated pericardial effusion without echocardiographic or clinical evidence of tamponade effect.
Methods
From 1st Jul 2014 to 31st Dec 2017, all patients with new onset malignancy-associated pericardial effusion with size more than 1cm were retrospectively analyzed. Patients with clinical or echocardiographic evidence of cardiac tamponade were excluded. We compared pericardial drainage versus monitoring for short-term (30-day), mid-term (90-day) and long term (1 year) survival without need for drainage.
Results
101 patients were retrospectively analyzed. 40 (39.6%) patients underwent drainage. Overall median survival free from drainage was 4 months. There were no significant difference in short-term (30-day), mid-term (90-day) and long term (1-year) survival free from drainage or mortality between treatment and monitoring group. Size of pericardial effusion did not predict mortality or future need of drainage. Chemotherapy was associated with improved 30-day mortality (RR 0.53 CI 0.32-0.87 p = 0.025) but not survival free from drainage or longer term mortality.
Conclusion
Close monitoring could be a feasible strategy in cancer patients with significant pericardial effusion without tamponade effect.
Baseline characteristics Factor Drainage (n = 40) monitoring (n = 61) p-value method of drainage pericardiocentesis alone 17 NA pericardiotomy alone 13 both 10 Male 19 (47.5%) 27 (44.3%) 0.749 mean size (cm) 1.93 2.77 <0.001 mean age 60.9 63.1 0.357 on chemotherapy 27 (67.5%) 38 (62.3%) 0.593
Abstract 224 Figure. Survival free from drainage
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Affiliation(s)
- C Ho
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - P H Lee
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - T C So
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | | | - M H Wong
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - Y H Fong
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - C F Tsang
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - Y W Cheng
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - N H Luk
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - S F Chui
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - K C Chan
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - C Y Wong
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - C L Fu
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - K Y Lee
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - K T Chan
- Queen Elizabeth Hospital, Hong Kong, Hong Kong
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Cheng M, Lee KY. Type A aortic dissection involving the superior mesenteric artery with peripheral malperfusion managed with a hybrid approach: a case report. Hong Kong Med J 2019; 25:403-405. [PMID: 31761751 DOI: 10.12809/hkmj177127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M Cheng
- Department of Surgery, Queen Elizabeth Hospital, Jordan, Hong Kong
| | - K Y Lee
- Department of Surgery, Queen Elizabeth Hospital, Jordan, Hong Kong
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Lee KY, Lee JH, Kang KC, Shin WJ, Im SK, Cho SJ. Preliminary report on the flexible rod technique for prevention of proximal junctional kyphosis following long-segment fusion to the sacrum in adult spinal deformity. J Neurosurg Spine 2019; 31:1-8. [PMID: 31299643 DOI: 10.3171/2019.4.spine1915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/25/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The incidence of proximal junctional kyphosis (PJK) after long-segment fixation in patients with adult spinal deformity (ASD) has been reported to range from 17% to 61.7%. Recent studies have reported using "hybrid" techniques in which semirigid fixation is introduced between the fused and flexible segments at the proximal level to allow a more gradual transition. The authors used these hybrid techniques in a clinical setting and analyzed PJK to evaluate the usefulness of the flexible rod (FR) technique. METHODS The authors retrospectively selected 77 patients with lumbar degenerative kyphosis (LDK) who underwent sagittal correction and long-segment fixation and had follow-up for > 1 year. An FR was used in 30 of the 77 patients. PJK development and spinal sagittal changes were analyzed in the FR and non-FR groups, and the predictive factors of PJK between a PJK group and a non-PJK group were compared. RESULTS The patient population comprised 77 patients (75 females and 2 males) with a mean (± SD) follow-up of 32.0 ± 12.7 months (36.7 ± 9.8 months in the non-FR group and 16.8 ± 4.7 months in the FR group) and mean (± SD) age of 71.7 ± 5.1 years. Sagittal balance was well maintained at final follow-up (10.5 and 1.5 mm) in the non-FR and FR groups, respectively. Thoracic kyphosis (TK) and lumbar lordosis (LL) were improved in both groups, without significant differences between the two (p > 0.05). PJK occurred in 28 cases (36.4%) in total, 3 (10%) in the FR and 25 (53.2%) in the non-FR group (p < 0.001). Postoperatively, PJK was observed at an average of 8.9 months in the non-FR group and 1 month in the FR group. No significant differences in the incidence of PJK regarding patient factors or radiological parameters were found between the PJK group and non-PJK group (p > 0.05). However, FR (vs non-FR) and interbody fusion except L5-S1 using oblique lumbar interbody fusion (vs non-oblique lumbar interbody fusion), demonstrated a significantly lower PJK prevalence (p < 0.001 and p = 0.044) among the surgical factors. CONCLUSIONS PJK was reduced after surgical treatment with the FR in the patients with LDK. Solid long-segment fixation and the use of the FR may become another surgical option for spine surgeons who plan and make decisions regarding spine reconstruction surgery for patients with ASD.
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Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, Kim BY, Kim YH, Kim WJ, Kim EM, Kim HS, Shin YA, Shin HJ, Lee KR, Lee KY, Lee SY, Lee SK, Lee JH, Lee CB, Chung S, Cho YH, Choi KM, Han JS, Yoo SJ. Corrigendum: 2018 Korean Society for the Study of Obesity Guideline for the Management of Obesity in Korea. J Obes Metab Syndr 2019; 28:143. [PMID: 31294348 PMCID: PMC6604844 DOI: 10.7570/jomes.2019.28.2.143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Mi Hae Seo
- Division of Endocrinology, Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi, Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Soo Kim
- Department of Family Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Kyoung Kon Kim
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Bo-Yeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Won-Jun Kim
- Department of Endocrinology and Metabolism, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul, Korea
| | - Hyun Soo Kim
- Department of Sport Science, Seoul National University of Science and Technology, Seoul, Korea
| | - Yun-A Shin
- Department of Exercise Prescription and Rehabilitation, Dankook University, Cheonan, Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Kyu Rae Lee
- Department of Family Medicine, Dongincheon Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea
| | - Ki Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Sang Yeoup Lee
- Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Seong-Kyu Lee
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
| | - Joo Ho Lee
- Department of Surgery, Ewha Medical Center, Seoul, Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Young Hye Cho
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jung Soon Han
- Research Institute of Human Ecology, Korea University, Seoul, Korea
| | - Soon Jib Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
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Sanjay DS, Lee KY, Syafiq H, Salleh MS. A 4-Year Audit of Open Method Chemoport Insertions through Cephalic Vein Performed In Hospital Tengku Ampuan Afzan. imjm 2019. [DOI: 10.31436/imjm.v18i1.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Introduction: Many cancer patients in general require long term venous access such as chemoport for chemotherapy, as well as infusion of fluids and blood taking. However, chemoport insertions carry complications such as infection, blockage, pneumothorax and malposition. We received feedbacks regarding complications endured by patients after chemoport insertion from the respective teams managing the patients in our hospital. In view of that, we conducted a retrospective audit on the chemoport insertions which we have done. Materials and Methods: We conducted a retrospective audit on the chemoport insertions which was planned for open method insertion through cephalic vein performed over the last 4 years from 2014 to 2017. Results: A total of 102 chemoports were inserted. Majority of patient’s ages are 50-59 years old. 88 (86%) of the cases were done via open method whereas another 14 cases were converted to percutaneous route. Majority of patients (55%) of the patients have breast carcinoma followed by colorectal (28%), haematological (12%) and gynaecological malignancies (5%). Complications occurred in 10 patients (rate at 9.8%). Most common complications were catheter related infection (5 cases) followed by wound infection (3 cases) and malposition (2 cases). Malposition was detected on post-operative chest radiograph and revision was done. All catheter related infection occurred in patients with haematological malignancies. Our complication rate of 9.8% is lower than the accepted complication rate of 15-25% worldwide. Conclusion: Chemoport provides a robust vascular access especially for the purpose of chemotherapy infusion. We showed with adequate training and privileging, it can be performed with very limited complications.
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Kim MJ, Jeong SY, Park JW, Ryoo SB, Cho SS, Lee KY, Park KJ. Oncologic Outcomes in Patients Who Undergo Neoadjuvant Chemoradiotherapy and Total Mesorectal Excision for Locally Advanced Rectal Cancer: A 14-Year Experience in a Single Institution. Ann Coloproctol 2019; 35:83-93. [PMID: 31113173 PMCID: PMC6529756 DOI: 10.3393/ac.2019.04.22.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 04/22/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE This study evaluated the oncologic outcomes of locally advanced rectal cancer patients who underwent preoperative neoadjuvant chemoradiotherapy (CRT) followed by surgery and determined the prognostic significance of pathologic complete response (pCR). METHODS Between January 2002 and December 2015, 580 patients with rectal cancer who underwent surgery after neoadjuvant CRT were identified. Survival according to tumor response to CRT and pathologic stage was analyzed using the Kaplan-Meier method, and the Cox proportional hazard model was used to identify factors associated with survival outcomes. RESULTS A total of 111 patients (23.7%) achieved pCR while the other 469 patients showed residual disease. Patients with pCR had a lower pretreatment carcinoembryonic antigen level and earlier cT classification than those with residual disease. With a median follow-up of 78 months, disease-free survival (DFS) and overall survival (OS) were significantly better in the pCR group than in the residual disease group. The 5-year DFS and 5-year OS for patients with ypStage 0, I, II, or III were 92.5%, 85.1%, 72.2%, 54.3% (P < 0.001) and 94.5%, 91.0%, 83.1%, 69.3%, respectively (P < 0.001). Pathologic AJCC stage after CRT was the most statistically significant independent predictor of OS (HR, 6.97 [95% confidence interval, 3.16-15.39] for stage III vs. stage 0) and DFS (HR, 7.30 [95% confidence interval, 3.63-14.67] for stage III vs. stage 0). CONCLUSION Rectal cancer patients who achieved pCR showed improved survival compared to those with residual disease after preoperative CRT. Moreover, pCR was an independent indicator of OS and DFS, and pathologic AJCC stage was correlated with survival after preoperative CRT.
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Affiliation(s)
- Min Jung Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Yong Jeong
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Won Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung-Bum Ryoo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Sik Cho
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Young Lee
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Joo Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
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Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, Kim BY, Kim YH, Kim WJ, Kim EM, Kim HS, Shin YA, Shin HJ, Lee KR, Lee KY, Lee SY, Lee SK, Lee JH, Lee CB, Chung S, Cho YH, Choi KM, Han JS, Yoo SJ. 2018 Korean Society for the Study of Obesity Guideline for the Management of Obesity in Korea. J Obes Metab Syndr 2019; 28:40-45. [PMID: 31089578 PMCID: PMC6484940 DOI: 10.7570/jomes.2019.28.1.40] [Citation(s) in RCA: 348] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/12/2018] [Accepted: 12/11/2018] [Indexed: 02/06/2023] Open
Abstract
Obesity increases the risks of diabetes, hypertension, and cardiovascular diseases, ultimately contributing to mortality. Korean Society for the Study of Obesity (KSSO) was established to improve the management of obesity through research and education; to that end, the Committee of Clinical Practice Guidelines of KSSO reviews systemic evidence using expert panels to develop clinical guidelines. The clinical practice guidelines for obesity were revised in 2018 using National Health Insurance Service Health checkup data from 2006 to 2015. Following these guidelines, we added a category, class III obesity, which includes individuals with body mass index (BMI) ≥35 kg/m2. Agreeing with the International Federation for the Surgery of Obesity and Metabolic Disorders, Asian Pacific Chapter consensus, we determined that bariatric surgery is indicated for Korean patients with BMI ≥35 kg/m2 and for Korean patients with BMI ≥30 kg/m2 who have comorbidities. The new guidelines focus on guiding clinicians and patients to manage obesity more effectively. Our recommendations and treatment algorithms can serve as a guide for the evaluation, prevention, and management of overweight and obesity.
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Affiliation(s)
- Mi Hae Seo
- Division of Endocrinology, Department of Internal Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University School of Medicine, Gumi,
Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Sung Soo Kim
- Department of Family Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon,
Korea
| | - Kyoung Kon Kim
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - Bo-Yeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon,
Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul,
Korea
| | - Won-Jun Kim
- Department of Endocrinology and Metabolism, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung,
Korea
| | - Eun Mi Kim
- Department of Dietetics, Kangbuk Samsung Hospital, Seoul,
Korea
| | - Hyun Soo Kim
- Department of Sport Science, Seoul National University of Science and Technology, Seoul,
Korea
| | - Yun-A Shin
- Department of Exercise Prescription and Rehabilitation, Dankook University, Cheonan,
Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul,
Korea
| | - Kyu Rae Lee
- Department of Family Medicine, Dongincheon Gil Hospital, Gachon University of Medicine and Science, Incheon,
Korea
| | - Ki Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon,
Korea
| | - Sang Yeoup Lee
- Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan,
Korea
| | - Seong-Kyu Lee
- Department of Internal Medicine, Eulji University Hospital, Eulji University School of Medicine, Daejeon,
Korea
| | - Joo Ho Lee
- Department of Surgery, Ewha Medical Center, Seoul,
Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri,
Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul,
Korea
| | - Young Hye Cho
- Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan,
Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul,
Korea
| | - Jung Soon Han
- Research Institute of Human Ecology, Korea University, Seoul,
Korea
| | - Soon Jib Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon,
Korea
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Lee JY, Kim Y, Han S, Kim J, Yoon JW, Lee KY, Song SH, Yang K, Lee CS. CMOS-compatible Si metasurface at visible wavelengths prepared by low-temperature green laser annealing. Nanotechnology 2019; 30:045301. [PMID: 30457976 DOI: 10.1088/1361-6528/aaecbd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A low-temperature laser crystallization is newly devised for producing polycrystalline silicon (poly-Si) thin films of low-loss, low surface roughness enough for nanoscale patterning, applicable to practical Si metasurface elements on complementary metal-oxide semiconductor (CMOS) electronic architectures in visible lights. The method is based on dielectric encapsulation of an amorphous Si film and subsequent laser-induced local crystallization. Such poly-Si thin film yields order-of-magnitude smaller surface roughness and grain size than those obtained with the conventional laser annealing processes. The mechanism of the formation of small and uniform crystalline grains during solidification is studied to ensure the smooth surfaces enough for nanoscale patterning. By obtaining root mean square of surface roughness <2.49 nm and extinction coefficient <4.8 × 10-2 at 550 nm, visible metasurface color-filter elements are experimentally demonstrated with the resonant transmission-peak efficiency approaching ∼85%. This low-loss poly-Si metasurface is favorably compatible with embedded CMOS electronic architectures in contrast to the conventional thermal annealing processes that often cause failure of electrical device functionalities due to delamination and material-property degradation problems. The proposed fabrication in this study provides a practical method for further development of various Si metasurfaces in the visible domain and their integration with CMOS electronic devices as well.
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Affiliation(s)
- Jeong Yub Lee
- Samsung Advanced Institute of Technology, Samsung Electronics Co. Ltd, Yeongtong-gu, Suwon-si, Gyeonggi-do 16678, Republic of Korea
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Nguyen DH, Lee KY, Mohammadigheisar M, Kim IH. Evaluation of the blend of organic acids and medium-chain fatty acids in matrix coating as antibiotic growth promoter alternative on growth performance, nutrient digestibility, blood profiles, excreta microflora, and carcass quality in broilers. Poult Sci 2019; 97:4351-4358. [PMID: 30165535 DOI: 10.3382/ps/pey339] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 07/12/2018] [Indexed: 01/18/2023] Open
Abstract
This study was conducted to evaluate the effects of the blend of organic acids (OAs) and medium-chain fatty acids (MCFAs) in broiler chickens. A total of 816 1-d-old male Ross 308 broiler chickens (35 ± 0.44 g) were randomly allocated into 1 of the following 6 dietary treatments (17 broilers per pen with 8 pens per treatment): dietary treatments consisted of corn-soybean meal-based basal diet and the basal diet supplemented with 0.02, 0.03, 0.04, 0.05, and 0.06% blend of OAs and MCFAs. The study lasted 5 wk during which growth performance was determined. In the current study, the inclusion of 0.02, 0.03, 0.04, 0.05, and 0.06% blend of OAs and MCFAs in the basal diet linearly increased (P < 0.05) body weight gain and improved feed conversion ratio (P < 0.0001) on day 7 to 14, day 14 to 35, as well as overall. Increasing inclusion of the blend of OAs and MCFAs levels in the diets also linearly increased (P = 0.001) the digestibility of dry matter on day 35. Broilers fed with different levels of the blend of OAs and MCFAs showed a linear increment (P = 0.042) in Lactobacillus concentration and decrease (P = 0.002) in Escherichia coli concentration. With regard to relative organ weight, a trend of linear reduction (P = 0.052) in bursa of Fabricius weight of broilers fed the blend of OAs and MCFAs was observed. There was a significant linear improvement (P = 0.011) in the IgG concentration associated with the inclusion of the blend of OAs and MCFAs levels in the diets. In conclusion, the blend of OAs and MCFAs supplementation positively influenced growth performance, nutrient digestibility, and excreta microflora in broiler chickens.
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Affiliation(s)
- D H Nguyen
- Department of Animal Resource and Science, Dankook University, Cheonan-si, Chungnam 31116, South Korea
| | - K Y Lee
- Morningbio Co., Ltd, Cheonan, Chungnam 31116, South Korea
| | - M Mohammadigheisar
- Department of animal biosciences, university of Guelph, Guelph, ON, Canada
| | - I H Kim
- Department of Animal Resource and Science, Dankook University, Cheonan-si, Chungnam 31116, South Korea
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Choi Y, Hwang BH, Hwang BH, Lee WJ, Lee KY, Park HW, Kim BH, Lee KY, Byeon JH, Kim JJ, Park HW, Kim JJ, Kim CJ, Chang KY, Kim CJ, Chang KY. P2264A clinical risk score to predict the presence of obstructive coronary artery disease in asymptomatic patients with type 2 diabetes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Choi
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - B H Hwang
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - B H Hwang
- St.Paul's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - W J Lee
- St.Paul's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - K Y Lee
- St.Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Incheon, Korea Republic of
| | - H W Park
- Daejeon St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Daejeon, Korea Republic of
| | - B H Kim
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - K Y Lee
- St.Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Incheon, Korea Republic of
| | - J H Byeon
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - J J Kim
- Yeouido St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - H W Park
- Daejeon St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Daejeon, Korea Republic of
| | - J J Kim
- Yeouido St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - C J Kim
- Uijeongbu St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Uijeongbu, Korea Republic of
| | - K Y Chang
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
| | - C J Kim
- Uijeongbu St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Uijeongbu, Korea Republic of
| | - K Y Chang
- Seoul St. Mary's Hospital, Division of Cardiology, Department of Internal Medicine, Seoul, Korea Republic of
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Lei XJ, Lee KY, Kim IH. Performance, egg quality, nutrient digestibility, and excreta microbiota shedding in laying hens fed corn-soybean-meal-wheat-based diets supplemented with xylanase. Poult Sci 2018; 97:2071-2077. [PMID: 29509938 DOI: 10.3382/ps/pey041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/16/2018] [Indexed: 12/17/2023] Open
Abstract
The aim of this study was to evaluate the effects of dietary levels of xylanase on production performance, egg quality, nutrient digestibility, and excreta microbiota shedding of laying hens in a 12-week trial. Two-hundred-forty Hy-Line brown laying hens (44 wk old) were distributed according to a randomized block experimental design into one of 4 dietary treatments with 10 replicates of 6 birds each. The 4 dietary treatments were corn-soybean-meal-wheat-based diets supplemented with 0, 225, 450, or 900 U/kg xylanase. Daily feed intake, egg production, egg weight, egg mass, feed conversion ratio, and damaged egg rate showed no significant response to increasing xylanase supplementation during any phase (P > 0.05). No significant responses were observed for apparent total tract digestibility of dry matter, nitrogen, or gross energy (P > 0.05). A significant linear increase to increasing xylanase supplementation was seen for lactic acid bacteria numbers, although coliforms and Salmonella counts were not affected. Increasing the dietary xylanase resulted in a significant linear increase in eggshell thickness in wk 3, 6, 9, and 12 (P < 0.05). In addition, a significant linear increase occurred for Haugh unit and albumen height in wk 12 (P < 0.05). In summary, the inclusion of xylanase in corn-soybean-meal-wheat-based diets increased eggshell thickness, Haugh unit, albumen height, and excreta lactic acid bacteria count but had no effect on production performance or nutrient digestibility.
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Affiliation(s)
- X J Lei
- Department of Animal Resource and Science, Dankook University, Cheonan, Chungnam 330-714, South Korea
| | - K Y Lee
- Department of Animal Resource and Science, Dankook University, Cheonan, Chungnam 330-714, South Korea
| | - I H Kim
- Department of Animal Resource and Science, Dankook University, Cheonan, Chungnam 330-714, South Korea
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Kim J, Cheon SY, Kook MS, Lee CM, Lee KY. Thermo-Responsive Hydrogels Containing Xenogenic Graft Materials for Bone Regeneration. pk 2018. [DOI: 10.7317/pk.2018.42.2.280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lee KY, Shin JK, Park YA, Yun SH, Huh JW, Cho YB, Kim HC, Lee WY. Transanal Endoscopic and Transabdominal Robotic Total Mesorectal Excision for Mid-to-Low Rectal Cancer: Comparison of Short-term Postoperative and Oncologic Outcomes by Using a Case-Matched Analysis. Ann Coloproctol 2018. [PMID: 29535985 PMCID: PMC5847400 DOI: 10.3393/ac.2018.34.1.29] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose This study aimed to compare short-term postoperative and oncologic outcomes of a transanal endoscopic total mesorectal excision (TME) to those of a transabdominal robotic TME. Methods A total of 62 patients with rectal cancer underwent transanal (n = 26) or robotic (n = 36) TME between June 2013 and December 2014. After case-matching by tumor location and TNM stage, 45 patients were included for analysis. The median follow-up period was 21.3 months. Operative, histopathologic and postoperative outcomes and recurrences were analyzed. Results Patients younger than 60 years of age were more frequently observed in the robotic TME group (75.0% vs. 47.6%, P = 0.059), but tumor location, cT and cN category, and preoperative chemoradiotherapy were not different between the 2 groups. Estimated blood loss was greater in the transanal group (283 mL vs. 155 mL, P = 0.061); however, the operation time and the rate of a diverting ileostomy and subsequent ileostomy repair were not different between the groups. The proximal resection margin was longer in the transanal TME group (20.8 cm ± 16.0 cm, P = 0.030), but the distal resection margins, involvements of the circumferential resection margin, TME quality, numbers of retrieved lymph nodes, postoperative complications, including anastomotic leak and voiding difficulty, and recurrence rates for the 2 groups were not statistically different. Conclusion Transanal endoscopic and transabdominal robotic TME showed similar histopathologic and postoperative outcomes with the exception of the estimated blood loss and the proximal resection margin for a select group of patients.
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Affiliation(s)
- Ki Young Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Kyoung Shin
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Ah Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seong Hyeon Yun
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Wook Huh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Beom Cho
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Cheol Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee KY, Lee KI, Kim JH, Lho T. High resolution Thomson scattering system for steady-state linear plasma sources. Rev Sci Instrum 2018; 89:013508. [PMID: 29390720 DOI: 10.1063/1.5003723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The high resolution Thomson scattering system with 63 points along a 25 mm line measures the radial electron temperature (Te) and its density (ne) in an argon plasma. By using a DC arc source with lanthanum hexaboride (LaB6) electrode, plasmas with electron temperature of over 5 eV and densities of 1.5 × 1019 m-3 have been measured. The system uses a frequency doubled (532 nm) Nd:YAG laser with 0.25 J/pulse at 20 Hz. The scattered light is collected and sent to a triple-grating spectrometer via optical-fibers, where images are recorded by an intensified charge coupled device (ICCD) camera. Although excellent in stray-light reduction, a disadvantage comes with its relatively low optical transmission and in sampling a tiny scattering volume. Thus requires accumulating multitude of images. In order to improve photon statistics, pixel binning in the ICCD camera as well as enlarging the intermediate slit-width inside the triple-grating spectrometer has been exploited. In addition, the ICCD camera capture images at 40 Hz while the laser is at 20 Hz. This operation mode allows us to alternate between background and scattering shot images. By image subtraction, influences from the plasma background are effectively taken out. Maximum likelihood estimation that uses a parameter sweep finds best fitting parameters Te and ne with the incoherent scattering spectrum.
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Affiliation(s)
- K Y Lee
- Plasma Technology Research Center, National Fusion Research Institute, 814-2 Osikdo-dong, Gunsan, Jeollabuk-do 573-540, South Korea
| | - K I Lee
- Plasma Technology Research Center, National Fusion Research Institute, 814-2 Osikdo-dong, Gunsan, Jeollabuk-do 573-540, South Korea
| | - J H Kim
- Plasma Technology Research Center, National Fusion Research Institute, 814-2 Osikdo-dong, Gunsan, Jeollabuk-do 573-540, South Korea
| | - T Lho
- Plasma Technology Research Center, National Fusion Research Institute, 814-2 Osikdo-dong, Gunsan, Jeollabuk-do 573-540, South Korea
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Hong CK, Hwang SY, Lee KY, Kim YS, Ha YR, Park SO. Metronome vs. Popular Song: A Comparison of Long-Term Retention of Chest Compression Skills after Layperson Training for Cardiopulmonary Resuscitation. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Long-term retention of cardiopulmonary resuscitation (CPR) skill is challenging for layperson trainees. This study compared the long-term retention of chest compression skills after either metronome-guided (MG) or popular song-guided (PG) CPR training. Methods This was a prospective randomised simulation trial. Untrained laypersons were randomly allocated to MG (n=61) or PG (n=68) groups at CPR training sessions. After CPR training, each participant performed 5-cycle CPR using a manikin with a Skill-Reporter™ immediately and six months afterwards. Results Immediately after training, the mean compression rate (MCR) was slightly higher in the PG than the MG group (107.4 vs. 102.2/min; p<0.0001), but there was no significant difference in the proportions of participants with an appropriate chest compression rate (100-120/min) (PSACCR) between the MG and PG (53/61 (86.9%) vs. 65/68 (95.6%); p=0.114). Six months later, MCR was faster in the MG than the PG (124.8 vs. 110.0/min; p<0.0001), and PSACCR in the PG was higher than that in the MG (62/68 (91.2%) vs. 25/61 (41.0%); p<0.0001). In both tests, there were no significant differences in other chest compression parameters of between the two groups, except for a minimal difference in incomplete chest release. Conclusion CPR training using a popular song is more effective than metronome-guided training in helping laypersons to maintain recommended compression rates after 6 months. (Hong Kong j.emerg.med. 2016;23:145-152)
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Affiliation(s)
- CK Hong
- Bundang Jesaeng General Hospital, Department of Emergency Medicine, 20 Seohyeon-ro, 180 Beon-gil, Bundang-gu, Seongnam-si, Republic of Korea
| | - SY Hwang
- Sungkyunkwan University School of Medicine, Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158 Palyoungro, MasanHoiwon-si, Changwon-si, Gyeongsangnam-do, Republic of Korea
| | - KY Lee
- Kyungnam University, Department of Physical Education, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do, Republic of Korea
| | - YS Kim
- Bundang Jesaeng General Hospital, Department of Emergency Medicine, 20 Seohyeon-ro, 180 Beon-gil, Bundang-gu, Seongnam-si, Republic of Korea
| | - YR Ha
- Bundang Jesaeng General Hospital, Department of Emergency Medicine, 20 Seohyeon-ro, 180 Beon-gil, Bundang-gu, Seongnam-si, Republic of Korea
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Yu SH, Kim YS, Lee KY. Resolution of Metabolic Disorders and Overweight in a Patient with ACTH-independent Cushing's Syndrome after Unilateral Adrenalectomy. J Obes Metab Syndr 2017; 26:227-230. [PMID: 31089521 PMCID: PMC6484914 DOI: 10.7570/jomes.2017.26.3.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 11/24/2022] Open
Abstract
Excessive production of cortisol by abnormal adrenocortical tissue causes clinical manifestations of Cushing’s syndrome and is associated with metabolic abnormalities including abdominal obesity, hyperglycemia, dyslipidemia, and hypertension, which increase the risk for type 2 diabetes mellitus as well as vascular morbidity and mortality. Removing the cause of hypercortisolism is initially required to resolve metabolic disorders in patients with adrenal Cushing’s syndrome. A 38-year-old woman with diabetes mellitus and hypertension, which were not well controlled by medications, complained of abdominal obesity, rounded face, thin limbs, and bruising. Based on clinical manifestations and laboratory findings, she was diagnosed with Cushing’s syndrome due to unilateral cortisol-producing adrenal adenoma. After left adrenalectomy, the patient’s blood glucose improved to a satisfactory level, and she rapidly discontinued insulin and oral glucose-lowering agent therapy. Her body mass index decreased to the normal range, and her other metabolic symptoms, dyslipidemia and hypertension, also improved significantly. She has maintained resolution of metabolic disorders and overweight for eight years since surgery without recurrence of Cushing’s syndrome.
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Affiliation(s)
- Seung Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yeun Sun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Ki Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
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Kim MH, Kim DW, Kim JH, Lee KY, Park S, Yoo YC. Does the type of anesthesia really affect the recurrence-free survival after breast cancer surgery? Oncotarget 2017; 8:90477-90487. [PMID: 29163846 PMCID: PMC5685767 DOI: 10.18632/oncotarget.21014] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/28/2017] [Indexed: 12/28/2022] Open
Abstract
Background Although previous studies have suggested that propofol inhibits cancer recurrence and metastasis, the association between anesthetic agents and the recurrence of breast cancer has not been clearly investigated. We compared total intravenous anesthesia and balanced anesthesia with volatile agents to investigate the differences in their effects on recurrence-free survival and overall survival after breast cancer surgery. Materials and Methods The electronic medical records of 2,729 patients who underwent breast cancer surgery between November 2005 and December 2010 were retrospectively reviewed to analyze the factors associated with recurrence-free survival after surgery. Cox proportional hazards models were used to identify the risk factors for cancer recurrence and overall mortality after breast cancer surgery. Results Data from 2,645 patients were finally analyzed. The recurrence-free survival rate in this study was 91.2%. Tumor-node-metastasis staging exhibited the strongest association with breast cancer recurrence. However, we were unable to identify significant differences between the preventive effects of total intravenous anesthesia and those of volatile agents on postoperative breast cancer recurrence using Cox regression analyses and propensity score matching. Furthermore, the survival probability with regard to postoperative recurrence and mortality showed no significant differences among anesthetic agents. Conclusions Our findings suggest that the effects of total intravenous anesthesia are comparable with those of volatile agents with regard to postoperative recurrence-free survival and overall survival in patients with breast cancer.
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Affiliation(s)
- Myoung Hwa Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Dong Wook Kim
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Goyang, Republic of Korea
| | - Joo Heung Kim
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Ki Young Lee
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Seho Park
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
| | - Young Chul Yoo
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea.,Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
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Kang SM, Rosales JL, Meier-Stephenson V, Kim S, Lee KY, Narendran A. Genome-wide loss-of-function genetic screening identifies opioid receptor μ1 as a key regulator of L-asparaginase resistance in pediatric acute lymphoblastic leukemia. Oncogene 2017. [PMID: 28650467 PMCID: PMC5658664 DOI: 10.1038/onc.2017.211] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
L-asparaginase is a critical chemotherapeutic agent for acute lymphoblastic leukemia (ALL). It hydrolyzes plasma asparagine into aspartate and NH3, causing asparagine deficit and inhibition of protein synthesis and eventually, leukemic cell death. However, patient relapse often occurs due to development of resistance. The molecular mechanism by which ALL cells acquire resistance to L-asparaginase is unknown. Therefore, we sought to identify genes that are involved in L-asparaginase resistance in primary leukemic cells. By unbiased genome-wide RNAi screening, we found that among 10 resistant ALL clones, six hits were for opioid receptor mu 1 (oprm1), two hits were for carbonic anhydrase 1 (ca1) and another two hits were for ubiquitin-conjugating enzyme E2C (ube2c). We also found that OPRM1 is expressed in all leukemic cells tested. Specific knockdown of OPRM1 confers L-asparaginase resistance, validating our genome-wide retroviral shRNA library screening data. Methadone, an agonist of OPRM1, enhances the sensitivity of parental leukemic cells, but not OPRM1-depleted cells, to L-asparaginase treatment, indicating that OPRM1 is required for the synergistic action of L-asparaginase and methadone, and that OPRM1 loss promotes leukemic cell survival likely through downregulation of the OPRM1-mediated apoptotic pathway. Consistent with this premise, patient leukemic cells with relatively high levels of OPRM1 are more sensitive to L-asparaginase treatment compared to OPRM1-depleted leukemic cells, further indicating that OPRM1 loss has a crucial role in L-asparaginase resistance in leukemic patients. Thus, our study demonstrates for the first time, a novel OPRM1-mediated mechanism for L-asparaginase resistance in ALL, and identifies OPRM1 as a functional biomarker for defining high-risk subpopulations and for the detection of evolving resistant clones. Oprm1 may also be utilized for effective treatment of L-asparaginase-resistant ALL.
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Affiliation(s)
- S M Kang
- Department of Cell Biology and Anatomy, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada.,Division of Pediatric Oncology, Alberta Children's Hospital and POETIC Laboratory for Preclinical and Drug Discovery Studies, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada
| | - J L Rosales
- Department of Biochemistry and Molecular Biology, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
| | - V Meier-Stephenson
- Division of Pediatric Oncology, Alberta Children's Hospital and POETIC Laboratory for Preclinical and Drug Discovery Studies, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada
| | - S Kim
- Department of Biochemistry and Molecular Biology, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada
| | - K Y Lee
- Department of Cell Biology and Anatomy, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada
| | - A Narendran
- Division of Pediatric Oncology, Alberta Children's Hospital and POETIC Laboratory for Preclinical and Drug Discovery Studies, Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada
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Sun IO, Yoon HJ, Cho AY, Kim Y, Lee JH, Lee HS, Lee KY. A Case of Peritoneal Dialysis-Associated Peritonitis Caused by Agromyces mediolanus. Perit Dial Int 2017; 37:346-347. [PMID: 28512166 DOI: 10.3747/pdi.2016.00274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- I O Sun
- Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - H J Yoon
- Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - A Y Cho
- Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - Y Kim
- Department of Laboratory Medicine, Presbyterian Medical Center, Jeonju, Korea
| | - J H Lee
- Department of Laboratory medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - H S Lee
- Department of Laboratory medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea.,Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - K Y Lee
- Division of Nephrology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea
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Sim T, Yoo H, Choi A, Lee KY, Choi MT, Lee S, Mun JH. Analysis of Pelvis-Thorax Coordination Patterns of Professional and Amateur Golfers during Golf Swing. J Mot Behav 2017; 49:668-674. [PMID: 28287933 DOI: 10.1080/00222895.2016.1271297] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim of this research was to quantify the coordination pattern between thorax and pelvis during a golf swing. The coordination patterns were calculated using vector coding technique, which had been applied to quantify the coordination changes in coupling angle (γ) between two different segments. For this, fifteen professional and fifteen amateur golfers who had no significant history of musculoskeletal injuries. There was no significant difference in coordination patterns between the two groups for rotation motion during backswing (p = 0.333). On the other hand, during the downswing phase, there were significant differences between professional and amateur groups in all motions (flexion/extension: professional [γ] = 187.8°, amateur [γ] = 167.4°; side bending: professional [γ] = 288.4°, amateur [γ] = 245.7°; rotation: professional [γ] = 232.0°, amateur [γ] = 229.5°). These results are expected to be a discriminating measure to assess complex coordination of golfers' trunk movements and preliminary study for interesting comparison by golf skilled levels.
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Affiliation(s)
- Taeyong Sim
- a Department of Bio-Mechatronic Engineering , College of Biotechnology & Bioengineering, Sungkyunkwan University , Suwon , South Korea
| | - Hakje Yoo
- a Department of Bio-Mechatronic Engineering , College of Biotechnology & Bioengineering, Sungkyunkwan University , Suwon , South Korea
| | - Ahnryul Choi
- a Department of Bio-Mechatronic Engineering , College of Biotechnology & Bioengineering, Sungkyunkwan University , Suwon , South Korea
| | - Ki Young Lee
- b Department of Biomedical Engineering , Catholic Kwandong University , Gangneung , South Korea
| | - Mun-Taek Choi
- c College of Information & Communication Engineering, Sungkyunkwan University , Suwon , South Korea
| | - Soeun Lee
- d Department of Sports Medicine , College of Physical Education, Kyung Hee University , Youngin , South Korea
| | - Joung Hwan Mun
- a Department of Bio-Mechatronic Engineering , College of Biotechnology & Bioengineering, Sungkyunkwan University , Suwon , South Korea
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Park KJ, Ryoo SB, Kim JS, Kim TI, Baik SH, Kim HJ, Lee KY, Kim M, Kim WH. Allogeneic adipose-derived stem cells for the treatment of perianal fistula in Crohn's disease: a pilot clinical trial. Colorectal Dis 2016; 18:468-76. [PMID: 26603576 DOI: 10.1111/codi.13223] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/10/2015] [Indexed: 12/13/2022]
Abstract
AIM Many perianal fistulae in Crohn's disease do not respond to conventional surgical and medical management and recurrence rates are high. The study evaluated the safety and feasibility of allogeneic adipose-derived stem cells for the treatment of perianal fistula in Crohn's disease. METHOD A multicentre, open-label, dose escalation pilot study was performed. The first three patients (group 1) were administered 1 × 10(7) cells/ml based on the size of the fistula tract. Four weeks later, after which time this dose had been confirmed to be safe, the next three patients (group 2) were administered 3 × 10(7) cells/ml. The end-point was complete closure at 8 weeks after the injection. Patients who attended for the 8 week assessment were followed for an additional 6 months. RESULTS There were no adverse events of Grade 3 or 4 severity and no adverse events related to the treatment with allogeneic adipose-derived stem cells. Two patients in group 1 achieved complete closure of the fistula at month 4 and month 6, and one patient in group 2 achieved complete closure at 8 weeks. The closure was sustained up to month 8 in all three of those patients. CONCLUSION These data suggest that allogeneic adipose-derived stem cells may be a feasible treatment option for perianal fistula in Crohn's disease.
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Affiliation(s)
- K J Park
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - S-B Ryoo
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - J S Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - T I Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - S H Baik
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - H J Kim
- Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - K Y Lee
- Department of Surgery, Kyung Hee University College of Medicine, Seoul, Korea
| | - M Kim
- Anterogen Co. Ltd, Seoul, Korea
| | - W H Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Kim MH, Lee KY, Lee KY, Min BS, Yoo YC. Maintaining Optimal Surgical Conditions With Low Insufflation Pressures is Possible With Deep Neuromuscular Blockade During Laparoscopic Colorectal Surgery: A Prospective, Randomized, Double-Blind, Parallel-Group Clinical Trial. Medicine (Baltimore) 2016; 95:e2920. [PMID: 26945393 PMCID: PMC4782877 DOI: 10.1097/md.0000000000002920] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Carbon dioxide (CO2) absorption and increased intra-abdominal pressure can adversely affect perioperative physiology and postoperative recovery. Deep muscle relaxation is known to improve the surgical conditions during laparoscopic surgery. We aimed to compare the effects of deep and moderate neuromuscular block in laparoscopic colorectal surgery, including intra-abdominal pressure. In this prospective, double-blind, parallel-group trial, 72 adult patients undergoing laparoscopic colorectal surgery were randomized using an online randomization generator to achieve either moderate (1-2 train-of-four response, n = 36) or deep (1-2 post-tetanic count, n = 36) neuromuscular block by receiving a continuous infusion of rocuronium. Adjusted intra-abdominal pressure, which was titrated by a surgeon with maintaining the operative field during pneumoperitoneum, was recorded at 5-minute intervals. Perioperative hemodynamic parameters and postoperative outcomes were assessed. Six patients from the deep and 5 from the moderate neuromuscular block group were excluded, leaving 61 for analysis. The average adjusted IAP was lower in the deep compared to the moderate neuromuscular block group (9.3 vs 12 mm Hg, P < 0.001). The postoperative pain scores (P < 0.001) and incidence of postoperative shoulder tip pain were lower, whereas gas passing time (P = 0.002) and sips of water time (P = 0.005) were shorter in the deep neuromuscular block than in the moderate neuromuscular block group. Deep neuromuscular blocking showed several benefits compared to conventional moderate neuromuscular block, including a greater intra-abdominal pressure lowering effect, whereas surgical conditions are maintained, less severe postoperative pain and faster bowel function recovery.
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Affiliation(s)
- Myoung Hwa Kim
- From the Department of Anesthesiology and Pain Medicine (MHK, KYL, YCY); Anesthesia and Pain Research Institute (MHK, KYL,YCY); and Division of Colon and Rectal Surgery, Department of Surgery (KYL, BSM), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Republic of Korea
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Park JS, Kim NK, Kim SH, Lee KY, Lee KY, Shin JY, Kim CN, Choi GS. Multicentre study of robotic intersphincteric resection for low rectal cancer. Br J Surg 2015; 102:1567-73. [PMID: 26312601 DOI: 10.1002/bjs.9914] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/22/2015] [Accepted: 07/08/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is a lack of information regarding the oncological safety of robotic intersphincteric resection (ISR) with coloanal anastomosis. The objective of this study was to compare the long-term feasibility of robotic compared with laparoscopic ISR. METHODS Between January 2008 and May 2011, consecutive patients who underwent robotic or laparoscopic ISR with coloanal anastomosis from seven institutions were included. Propensity score analyses were performed to compare outcomes for groups in a 1 : 1 case-matched cohort. The primary endpoint was 3-year disease-free survival. RESULTS A total of 334 patients underwent ISR with coloanal anastomosis, of whom 212 matched patients (106 in each group) formed the cohort for analysis. The overall rate of conversion to open surgery was 0.9 per cent in the robotic ISR group and 1.9 per cent in the laparoscopic ISR group. Nine patients (8.5 per cent) in the laparoscopic group and three (2.8 per cent) in the robotic ISR group still had a stoma at last follow-up (P = 0.075). Total mean hospital costs were significantly higher for robotic ISR (€ 12,757 versus € 9223 for laparoscopic ISR; P = 0.037). Overall 3-year local recurrence rates were similar in the two groups (6.7 per cent for robotic and 5.7 per cent for laparoscopic resection; P = 0.935). The combined 3-year disease-free survival rates were 89.6 (95 per cent c.i. 84.1 to 95.9) and 90.5 (85.4 to 96.6) per cent respectively (P = 0.298). CONCLUSION Robotic ISR with coloanal anastomosis for rectal cancer has reasonable oncological outcomes, but is currently too expensive with no short-term advantages.
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Affiliation(s)
- J S Park
- Departments of Surgery, Kyungpook National University Medical Centre, Kyungpook National University School of Medicine, Daegu, Korea
| | - N K Kim
- Yonsei University College of Medicine, Seoul, Korea
| | - S H Kim
- Korea University Anam Hospital, Seoul, Korea
| | - K Y Lee
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - K Y Lee
- Kyung Hee University, Seoul, Korea
| | - J Y Shin
- Inje University Paik-Hospital, Pusan, Korea
| | - C N Kim
- Eulji University Hospital, Daejeon, Korea
| | - G-S Choi
- Departments of Surgery, Kyungpook National University Medical Centre, Kyungpook National University School of Medicine, Daegu, Korea
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Chin SO, Chung CH, Chung YS, Kim BJ, Kim HY, Kim IJ, Kim JG, Kim MS, Kim SY, Lee EJ, Lee KY, Kim SW. Change in quality of life in patients with acromegaly after treatment with octreotide LAR: first application of AcroQoL in Korea. BMJ Open 2015; 5:e006898. [PMID: 26063564 PMCID: PMC4466761 DOI: 10.1136/bmjopen-2014-006898] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES This study was designed to investigate changes in health-related quality of life (HRQoL) of patients with acromegaly in Korea after medical treatment with octreotide LAR using the validated Korean version of the acromegaly quality of life questionnaire (AcroQoL). DESIGN A prospective, open-label, single-arm study. SETTING 11 tertiary centres in Korea. PARTICIPANTS 58 Korean patients (aged 21-72 years) who were newly diagnosed with acromegaly between 2009 and 2012 were prescribed octreotide LAR 20 mg at the time of enrolment. During 24 weeks of observation, AcroQoL survey questionnaires and measurement of growth hormone insulin-like growth factor 1(GH/IGF-I) were performed at baseline, week 12 and week 24. MAIN OUTCOME MEASURES We assessed the HRQoL of Korean patients with acromegaly after medical treatment with octreotide LAR using the validated Korean version of the AcroQoL questionnaire. RESULTS Patients had a mean age of 47.2 years (29 males), and GH and IGF-I significantly decreased during the first 12 weeks (GH: 4.8 vs 1.9 μg/L, p<0.001; IGF-I: 497 vs 265 μg/L, p<0.001), but showed insignificant change at week 24 (GH: 2.3 μg/L; IGF-I: 294 μg/L). Only AcroQoL scores for the psychological appearance subdomain showed a significant increase during the entire 24 weeks (p<0.05). The change in the psychological appearance subdomain of AcroQoL scores demonstrated a significant but weak negative correlation with change in IGF-I levels (r=-0.282, p=0.039). When patients were divided into two groups according to their disease activity at week 24 (controlled vs uncontrolled), there was no difference in AcroQoL scores, but the psychological appearance subdomain of the two groups appeared to change differently over the entire 24-week period (p=0.047). CONCLUSIONS Medical treatment with octreotide LAR in patients with acromegaly has a limited contribution to HRQoL as assessed by the AcroQoL.
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Affiliation(s)
- Sang Ouk Chin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Choon Hee Chung
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Byung-Joon Kim
- Department of Endocrinology and Metabolism, Gachon University Gil Medical Center, Incheon, Korea
| | - Hee Young Kim
- Division of Endocrinology and Metabolism, Department of Endocrinology, Korea University College of Medicine, Seoul, Korea
| | - In-Ju Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jung Guk Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook University School of Medicine, Daegu, Korea
| | - Min-Seon Kim
- Department of Internal Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Seong-Yeon Kim
- Department of Internal Medicine, Seoul National University School of Medicine, Seoul, Korea
| | - Eun Jig Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Young Lee
- Department of Endocrinology and Metabolism, Gachon University Gil Medical Center, Incheon, Korea
| | - Sung-Woon Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea
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Lee YH, Kim YS, Lee HC, Lee SW, Kang YN, Kang JH, Hong SH, Kim YK, Kim SJ, Ahn MI, Han DH, Yoo IR, Park JG, Sung SW, Lee KY. Tumour volume changes assessed with high-quality KVCT in lung cancer patients undergoing concurrent chemoradiotherapy. Br J Radiol 2015; 88:20150156. [PMID: 26055505 DOI: 10.1259/bjr.20150156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We evaluated tumour volume changes in patients with lung cancer undergoing concurrent chemoradiotherapy using image-guided radiotherapy (RT). METHODS The kilovoltage image was obtained using CT on rail at every five fractions. The gross tumour volumes (GTVs), including the primary tumour and lymph nodes (LNs), were contoured to analyse the time and degree of tumour regression. RESULTS 46 patients [32, non-small-cell lung cancer (NSCLC), and 14, small-cell lung cancer (SCLC)] were included in this study. In total, 281 CT scans and 82 sites of GTVs were evaluated. Significant volume changes occurred in both the NSCLC and SCLC groups (p < 0.001 and 0.002), and the average GTV change compared with baseline was 49.85 ± 3.65 [standard error (SE)]% and 65.95 ± 4.60 (SE)% for the NSCLC and SCLC groups, respectively. A significant difference in the degree of volume reduction between the primary tumour and LNs was observed in only the NSCLC group (p < 0.0001) but not in the SCLC group (p = 0.735). The greatest volume regression compared with the volume before the five fractions occurred between the 15 and 20 fractions in the NSCLC group and between the 5 and 10 fractions in the SCLC group. CONCLUSION Both primary tumour and LNs were well defined using CT on rail. Significant volume changes occurred during RT, and there was a difference in volume reduction between the NSCLC and SCLC groups, regarding the degree and timing of the tumour reduction in the primary tumour and LNs. ADVANCES IN KNOWLEDGE NSCLC and SCLC groups showed differences in the degree and timing of volume reduction. The primary tumour and LNs in NSCLC regressed differently.
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Affiliation(s)
- Y H Lee
- 1 Department of Radiation Oncology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y S Kim
- 1 Department of Radiation Oncology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - H C Lee
- 1 Department of Radiation Oncology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S W Lee
- 1 Department of Radiation Oncology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y N Kang
- 1 Department of Radiation Oncology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J H Kang
- 2 Department of Medical Oncology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S H Hong
- 2 Department of Medical Oncology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y K Kim
- 3 Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S J Kim
- 3 Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - M I Ahn
- 4 Department of Radiology, Seoul St Mary's Hospital, Seoul, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - D H Han
- 4 Department of Radiology, Seoul St Mary's Hospital, Seoul, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - I R Yoo
- 5 Department of Nuclear Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - J G Park
- 6 Department of Thoracic Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S W Sung
- 6 Department of Thoracic Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K Y Lee
- 7 Department of Pathology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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