Impact of Iliac Crest Bone Grafting on Postoperative Outcomes and Complication Rates Following Minimally Invasive Transforaminal Lumbar Interbody Fusion

Brittany E. Haws,Benjamin Khechen,Dil V. Patel,Joon S. Yoo,Jordan A. Guntin,Kaitlyn L. Cardinal,Junyoung Ahn,Kern Singh 대한척추신경외과학회 2019 Neurospine Vol.16 No.4

Objective: The relationship between bone graft technique and postoperative outcomes for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) has not been well-defined. This study aims to determine the effect of iliac crest bone grafting (ICBG) on patient-reported outcomes (PROs) and complication rates following MIS TLIF. Methods: Primary, single-level MIS TLIF patients were consecutively analyzed. Patients that prospectively received a percutaneous technique of ICBG were compared to patients that retrospectively received bone morphogenetic protein-2 (BMP-2). Complication rates were assessed perioperatively and up to 1 year postoperatively. Changes in Oswestry Disability Index (ODI), visual analogue scale (VAS) back, and VAS leg pain were compared. Rates of minimum clinically important difference (MCID) achievement at final follow-up for ODI, VAS back, and VAS leg scores were compared. Results: One hundred forty-nine patients were included: 101 in the BMP-2 cohort and 48 in the ICBG cohort. The ICBG cohort demonstrated increases in intraoperative blood loss and shorter lengths of stay. ICBG patients also experienced longer operative times, though this did not reach statistical significance. No significant differences in complication or reoperation rates were identified. The ICBG cohort demonstrated greater improvements in VAS leg pain at 6-week and 12-week follow-up. No other significant differences in PROs or MCID achievement rates were identified. Conclusion: Patients undergoing MIS TLIF with ICBG experienced clinically insignificant increases in intraoperative blood loss and did not experience increases in postoperative pain or disability. Complication and reoperation rates were similar between groups. These results suggest that ICBG is a safe option for MIS TLIF.

Swallowing Function Following Anterior Cervical Discectomy and Fusion With and Without Anterior Plating: A SWAL-QOL (Swallowing-Quality of Life) and Radiographic Assessment

Brittany E. Haws,Benjamin Khechen,Dil V. Patel,Joon S. Yoo,Jordan A. Guntin,Kaitlyn L. Cardinal,Kern Singh 대한척추신경외과학회 2019 Neurospine Vol.16 No.3

Objective: Anterior cervical plating in anterior cervical discectomy and fusion (ACDF) procedures are associated with improved outcomes compared to stand-alone cages. However, concerns exist regarding increased rates of postoperative dysphagia following an ACDF. This study aims to quantify the effect of anterior plating on swallowing-quality of life (SWAL-QOL) scores and radiographic swelling assessments following a primary, single-level ACDF. Methods: Patients retrospectively reviewed. Patients grouped into those receiving a cage or anterior plate. SWAL-QOL scores were recorded preoperatively and 6 weeks and 12 weeks postoperatively. Lateral radiographs were used to create a swelling index with a ratio of the prevertebral swelling distance to the anterior-posterior diameter of each involved vertebral body. An air index was created using the same methodology. Statistical analysis was performed using chi-square analysis and independent t-tests for categorical and continuous variables. Results: Sixty-eight primary, single-level ACDF patients were included. Forty-one (60.3%) received a stand-alone cage and 27 (39.7%) received a cage with anterior plating. No differences in demographics, comorbidities, operative time, estimated blood loss, or length of hospital stay were identified between Cage and Plate cohorts. Finally, no differences were observed in postoperative SWAL-QOL scores or swelling and air indices between groups. Conclusion: The results demonstrate that patients undergoing a primary, single-level ACDF with or without anterior plating experience similar operative times and lengths of stay. Patients that receive a cage with anterior plating did not experience significant increases in dysphagia as measured by the SWAL-QOL questionnaire compared to patients that received a stand-alone cage. Furthermore, radiographic assessments of swelling are comparable.

Design of Transverse Fillet Welds in the Lapped Joints of Thin Steel Plates

Shahabeddin Torabian,Feng Xiao,Richard B. Haws,Benjamin W. Schafer 한국강구조학회 2018 International Journal of Steel Structures Vol.18 No.1

Transverse fillet welds in the lapped joints have been tested and the results compared against the predictions of the North American Specification for the Design of Cold-Formed Steel Structural Members, AISI S100, to address the strength discontinuity in the transverse fillet weld design method at the thickness of 2.54 mm (0.1 inches). The tests performed by the authors and those available in the literature, have not shown any significant discontinuity in the weld strength when the connected plates get thicker than 2.54 mm (0.1 inches). It has also shown that the current design method could be nonconservative for thin plates. Accordingly, potentials to improve strength predictions have been discussed and a modified design method is proposed. The proposed design method is in a good agreement with the experimental results and resolves the inconsistencies in the current design methods. Finally, a reliability analysis based on the available test results has been performed and resistance factors for the proposed design method are provided.

Decreased Glutamate/Glutamine Levels May Mediate Cytidine’s Efficacy in Treating Bipolar Depression: A Longitudinal Proton Magnetic Resonance Spectroscopy Study

Yoon, Sujung J,Lyoo, In Kyoon,Haws, Charlotte,Kim, Tae-Suk,Cohen, Bruce M,Renshaw, Perry F American College of Neuropsychopharmacology 2009 Neuropsychopharmacology Vol.34 No.7

Targeting the glutamatergic system has been suggested as a promising new option for developing treatment strategies for bipolar depression. Cytidine, a pyrimidine, may exert therapeutic effects through a pathway that leads to altered neuronal-glial glutamate cycling. Pyrimidines are also known to exert beneficial effects on cerebral phospholipid metabolism, catecholamine synthesis, and mitochondrial function, which have each been linked to the pathophysiology of bipolar depression. This study was aimed at determining cytidine’s efficacy in bipolar depression and at assessing the longitudinal effects of cytidine on cerebral glutamate/glutamine levels. Thirty-five patients with bipolar depression were randomly assigned to receive the mood-stabilizing drug valproate plus either cytidine or placebo for 12 weeks. Midfrontal cerebral glutamate/glutamine levels were measured using proton magnetic resonance spectroscopy before and after 2, 4, and 12 weeks of oral cytidine administration. Cytidine supplementation was associated with an earlier improvement in depressive symptoms (weeks 1–4; p=0.02, 0.001, 0.002, and 0.004, respectively) and also produced a greater reduction in cerebral glutamate/glutamine levels in patients with bipolar depression (weeks 2, 4, and 12; p=0.004, 0.004, and 0.02, respectively). Cytidine-related glutamate/glutamine decrements correlated with a reduction in depressive symptoms (p=0.001). In contrast, these relationships were not observed in the placebo add-on group. The study results suggest that cytidine supplementation of valproate is associated with an earlier treatment response in bipolar depression. Furthermore, cytidine’s efficacy in bipolar depression may be mediated by decreased levels of cerebral glutamate and/or glutamine, consistent with alterations in excitatory neurotransmission.Neuropsychopharmacology (2009) 34, 1810–1818; doi:10.1038/npp.2009.2; published online 4 February 2009

Postoperative Fever Evaluation Following Lumbar Fusion Procedures

Benjamin C. Mayo,Brittany E. Haws,Daniel D. Bohl,Philip K. Louie,Fady Y. Hijji,Ankur S. Narain,Dustin H. Massel,Benjamin Khechen,Kern Singh 대한척추신경외과학회 2018 Neurospine Vol.15 No.2

Objective: This study aimed to determine the incidence of postoperative fever, the workup conducted for postoperative fever, the rate of subsequent fever-related diagnoses or complications, and the risk factors associated with fever following lumbar fusion. Methods: A retrospective review of patients undergoing lumbar fusion was performed. For patients in whom fever (≥38.6°C) was documented, charts were reviewed for any fever workup or diagnosis. Multivariate regression was used to identify independent risk factors for the development of postoperative fever. Results: A total of 868 patients met the inclusion criteria, of whom 105 exhibited at least 1 episode of fever during hospitalization. The first documentation of fever occurred during the first 24 hours in 43.8% of cases, during postoperative hours 24–48 in 53.3%, and later than 48 hours postoperatively in 2.9%. At least 1 component of a fever workup was conducted in 47 of the 105 patients who had fever, resulting in fever-associated diagnoses in 4 patients prior to discharge. Three patients who had fever during the inpatient stay developed complications after discharge. On multivariate analysis, operations longer than 150 minutes (relative risk [RR], 1.66; p=0.015) and narcotic consumption greater than 85 oral morphine equivalents on postoperative day 0 (RR, 1.53; p=0.038) were independently associated with an increased risk of developing postoperative fever. Conclusion: The results of this study suggest that inpatient fever occurred in roughly 1 in 8 patients following lumbar fusion surgery. In most cases where a fever workup was performed, no cause of fever was detected. Longer operative time and increased early postoperative narcotic use may increase the risk of developing postoperative fever.

Heartbreak House의 喜悲劇性 硏究

윤화영 釜山大學校 1983 人文論叢 Vol.23 No.1

<Abstract> In Heartbreak House one can find characteristics that distinguish it from both tragedy and comedy. Although the initial tendency of the play is toward comedy, comedy here does not yield a happy resolution or new moral order. Rather, comedy is employed in the Play to show the futility and triviality of the lives of the characters, thus revealing the tragic defects in "the cultured and leisured Europe. " Like Ibsen's peer Gynt, Heartbreak House is a play about evasion of responsibility. Negligence of responsibility when there is a really worthy goal is both humorous and grave, and this mixed feeling is what we get from the play. One might say that Shaw evokes in Heartbreak House both types of contradiction as observed by Søoren Kierkegaard. Although there is a way out? navigation, the characters avoid it. Captain Shotover implies that the contradiction might still be corrected, but it is not crrected in the course of the play. Hence the tragicomic nature of Heartbreak House. Cyrus Hoy's observation concerning the truth about oneself and the world holds for the characters of Heartbreak House. Although they gain self-knowledge, their self-knowledge has come too late or inconsequential. In this tragicomedy of Shaw, it is not the lack of self-knowledge but the lack of resolution to turn it into meaningful action that leads to destruction. since the audience, by not changing the states quo is made the villain, the essentially disturbing effect on the audience seems to be present in Heartbreak House. As to catharsis, it may be safe to say that, in Heartbreak House tragic irony replaces the purgation of tragedy. Likewise, no catharsis through comedy is attempted in the play since comedy is continuously undermined through anticlimaxes. As regards the mixing of the comic and the tragic events, Heartbreak House in part fellows the tradition of the native "mongrel tragicomedy" as Sir Philip Sidney calls it. Otherwise? structurally? the mixture of comedy and tragedy is an Ibsenite "chemical combination" as the element of tragedy, the failure of England and Western Civilization? is continually dramatized by comedy.

中國 資本原始蓄積에 관한 小考 : A Study on the Primitive Accumulation of Capital in China

주호림 연세대학교 대학원 1986 원우론집 Vol.14 No.1

ABSTRACT The Chinese feudal society had existed far about three thousand years, and was attacked by foreign capitalism. When (it was) proceeding to the primitive accumulation of capital, it was not, however, completely destroyed, but transformed into a semi-colonial and semi-feudal society. This paper is intended to analyze the process of the primitive accumulation of capital in China which was done under the invasion of foreign capitalism, which could be dichotomized into the first stage (1840-1894) and the second (1895-1922). Above analyses lead to the following conclusions. First, Before the Opium war, the Chinese feudal society had included the germination of capitalism in it through the development of commodity economy. But this does not mean that it accomplished the primitive accumulation of capital. Second, When the primitive accumulation of capital and the capitalistic mode of production began, most manufacture could not be transformed into the capitalistic factory system because of the attack of imported foreign commodity and the oppression of feudal powers. In other words, Chinese manufacture could not play the role of the primitive accumulation of capital in China. Third, Since foreign imperialism invaded China, without destroying feudalism, it severely exploitated Chinese peasants and simple commodity producers with the help of landlords, merchants, and usurymen, therefore produced a large number of proletarians who lost means of production. Fourth, Imperialist enterprises in China, which had been formed through the exploitation of Chinese pesants and simple commodity producers, had powerful positions in the semi-colonial and semi-feudal China. Their capital was accumulated through the exploitation and consequently simulated the primitive accumulation of capital. Fifth, The national capitalism of China appeared and developed under the oppression of imperialism and feudal powers. Therefore national capitalism was subjected to the oppression and restriction of these two, and inseparately related of them. Sixth, Bourgeoisie and proletariat were formed in the process of the primitive accumulation of capital. The predecessor of bourgeoisis was bureaucrats, landlords, and merchants, but on the contrary that of proletariat was pesants and simple commodity producers. Like any other Capitalism, the Chinese primitive accumulation of capital was accomplished by making use of violent exploitation. Especially since the invasion of foreign capitalism, the use of violence was even more cruel because Chinese capitalism came into existence under the more cruel because Chinese capitalism came into existence under the double oppression of internal feudalism and external imperialism.

갈근 추출물의 항산화효과

손화영,이가순,오만진 충남대학교 농업과학연구소 1990 농업과학연구 Vol.17 No.2

In order to investigate possible utilization as a naturall antioxidant. antioxidative fraction from pueraria root powder was obtained by solvent extraction. PO,CO and TBA values were measured at 60℃, 100℃, 145℃, respectively, after adding the pueraria root extract to the final concentration of 0.1% to the lard, beef tallow, pallor and soybean oil. The results of antioxidative effect of pueraria root extract to edible oils and fats were as follows : 1. Antioxidative fractions in pueraria root were extracted by sequential solvent systems using ethanol, methanol : isopropyl alcohol (1:4) and chloroform : methanol(95:5). 2. Antioxidative activity of the extracts to edible oils and fats was more effective than that of adding 100 ppm α-tocopherol at 60℃. 3. At 60℃ and 100℃, antioxidative effect was beef tallow> palm oil>lard>soybean oil in its orders. 4. At 145℃, the pueraria root extract showed antioxidative activity in beef tallow, lard and palm oil, but not in soybean oil. 5. The content of saturated fatty acids by the heat treatment was remained small] change, but that of unsaturated fatty acids was noticeable decreased.

논문 : 경로분석을 이용한 뮤지컬 만족도에 관한 가치사슬 구조 분석

김윤태 ( Haw Rye Kim ),김화례 ( Youn Tae Kim ),권병웅 ( Byung Woong Kwon ) 한국연극교육학회 2012 연극교육연구 Vol.20 No.-

Analysis on the Value Chain Structure of Musical Satisfaction Using Path Analysis Kim, Haw-rye/Kwon, Byung-woong/Kim, Youn-tae Path analysis is a form of statistical analysis used to examine therelationships betweenvariablesand its advantage is to enable direct effect, indirect effect and spuriouseffect which are hard to identify by regression analysis. Using path analysis, this study examined the value chain structure of musical elements such as distribution, planning, production and consumption which are expected to affect musical satisfaction. The selected population was Seoul Citizens who watched musicals at least one time and, through random sampling, 250 were selected as sample at eight musical theaterslocated in Daehakro, Chungmuro, etc. in Seoul. Among the questionnaires collected from the 250 samples, 212 were used for this study except 38 unfit for analysis. Survey is composed with total of 24 questions which include 6 demographic questions, 17 audience tendency questions and 18 satisfaction questions. We made value chain structure analysis by dividing each level of satisfaction in planning, manufacturing, distribution and consumption and executing subsequent factor analysis in those satisfaction questions. Study results after reliability analysis of 18 satisfaction level questions showed high level of 0.893 reliability coefficient and therefore, we can tell there exists high level of internal consistency in each factor.

제주도 중 ·고등학생의 용돈관리에 관한 연구

성화선,김정숙 한국 가정과 교육 학회 2000 한국가정과교육학회지 Vol.12 No.1

The objective of this study is to analyze variables that have significant effects pocket money management of adolescents, and to provide useful information for parents and educators who educate adolescents. Data obtained from questionnaires returned by 1,200 adolescents who were randomly selected from middle and high Schools in Chejudo. The data were analyzed by using SPSS Win Program. 40.3% of the adolescents were satisfied with their pocket money. Monthly average pocket money of them was 305,00￦, middle school students were 19.780￦, high school students were 41,230, male students were 32,880￦, and female students were 28,130￦. Pocket money expenditure of adolescents differed significantly according to gender, school, region, and pocket money, 43.3% of adolescents had experiences in doing part time for making pocket money. Gender, school, and pocket money management of adolescnts is their consumer socialization. Pocket money management of them mostly was influenced by family, friends, school, and mass media.