The Effect of Rod Pattern, Outrigger, and Multiple Screw-Rod Constructs for Surgical Stabilization of the 3-Column Destabilized Cervical Spine - A Biomechanical Analysis and Introduction of a Novel Technique

Sebastian Hartmann,Claudius Thomé,Anto Abramovic,Sara Lener,Werner Schmoelz,Juliane Koller,Heiko Koller 대한척추신경외과학회 2020 Neurospine Vol.17 No.3

Objective: Anterior-only reconstructions for cervical multilevel corpectomies are prone to fail under continuous mechanical loading. This study sought to define the mechanical characteristics of different constructs in reducing a range of motion (ROM) of the 3-column destabilized cervical spine, including posterior cobalt-chromium (CoCr)-rods, outrigger-rods (OGR), and a novel triple rod construct using lamina screws (6S3R). The clinical implications of biomechanical findings are discussed in depth from the perspective of the challenges surgeons face cervical deformity correction. Methods: Three-column deficient cervical spinal models were produced based on reconstructed computed tomography scans. The corpectomy defect between C3 and C7 end-level vertebrae was restored with anterior titanium (Ti) mesh-cage. The ROM was evaluated in a customized 6-degree of freedom spine tester. Tests were performed with different rod materials (Ti vs. CoCr), varying diameter rods (3.5 mm vs. 4.0 mm), with and without anterior plating, and using different construct patterns: bilateral rod fixation (standard-group), OGRgroup, and 6S3R-Group. Construct stability was expressed in changes and differences of ROM (°). Results: The largest reduction of ROM was noticed in the 6S3R-group compared to the standard- and the OGR-group. All differences observed were emphasized with an increasing number of corpectomy levels and if anterior plating was not added. For all simulated 1-, 2-, and 3-level corpectomy constructs, the OGR-group revealed decreased ROM for all motion directions compared to the standard-group. An increase of construct stiffness was also recorded for increased rod diameter (4.0 mm) and stiffer rod material (CoCr), though these effects lacked behind the more advanced construct pattern. Conclusion: A novel reconstructive technique, the 6S3R-construct, was shown to outperform all other constructs and might resemble a new standard of reference for advanced posterior fixation.

Primary Limited Lumbar Discectomy with an annulus Closure Device: One-Year Clinical and Radiographic Results from a Prospective, Multi-Center Study

Michiel B. Lequin,Martin Barth,Claudius Thomė,Gerrit J. Bouma 대한척추신경외과학회 2012 Neurospine Vol.9 No.4

Objective: Discectomy as a treatment for herniated lumbar discs results in outcomes after surgery that are not uniformly positive. Surgeons face the dilemma between limited nucleus removal which is associated with a higher risk of recurrence, or more aggressive nucleus removal which may lead to disc height loss and persistent back-pain. annulus closure devices may allow for the benefits of limited nucleus removal without the increased risk of recurrence. This is an interim report of an ongoing 24-month post-marketing study of the Barricaid® annulus closure device, consisting of a flexible polymer mesh that blocks the defect, held in place by a titanium bone anchor. Methods: We prospectively enrolled 45 patients at four hospitals, and implanted the Barricaid® after a limited discectomy. annulus defect size and volume of removed nucleus were recorded. Reherniations were reported, pain and function were monitored and imaging was performed at regular intervals during 24 months of follow-up. Results: At 12 months postsurgery, pain and function were significantly improved, comparing favorably to reported results from limited discectomy. Disc height has been well maintained. One reherniation has occurred (2.4%), which was associated with a misplaced device. No device fracture, subsidence or migration has been observed. Conclusion: The use of an annulus closure device may provide a reduction in reherniation rate for lumbar discectomy patients with large annulus defects who are at the greatest risk of recurrence. Using such a device should provide the surgeon increa- sed confidence in minimizing nucleus removal, which, in turn, may preserve disc height and biomechanics, reducing dege- neration and associated poor clinical outcomes in the long-term. A randomized multicenter study evaluating limited discectomy with and without the Barricaid® is currently underway, and will provide a higher level of evidence. Objective: Discectomy as a treatment for herniated lumbar discs results in outcomes after surgery that are not uniformly positive. Surgeons face the dilemma between limited nucleus removal which is associated with a higher risk of recurrence, or more aggressive nucleus removal which may lead to disc height loss and persistent back-pain. annulus closure devices may allow for the benefits of limited nucleus removal without the increased risk of recurrence. This is an interim report of an ongoing 24-month post-marketing study of the Barricaid® annulus closure device, consisting of a flexible polymer mesh that blocks the defect, held in place by a titanium bone anchor. Methods: We prospectively enrolled 45 patients at four hospitals, and implanted the Barricaid® after a limited discectomy. annulus defect size and volume of removed nucleus were recorded. Reherniations were reported, pain and function were monitored and imaging was performed at regular intervals during 24 months of follow-up. Results: At 12 months postsurgery, pain and function were significantly improved, comparing favorably to reported results from limited discectomy. Disc height has been well maintained. One reherniation has occurred (2.4%), which was associated with a misplaced device. No device fracture, subsidence or migration has been observed. Conclusion: The use of an annulus closure device may provide a reduction in reherniation rate for lumbar discectomy patients with large annulus defects who are at the greatest risk of recurrence. Using such a device should provide the surgeon increa- sed confidence in minimizing nucleus removal, which, in turn, may preserve disc height and biomechanics, reducing dege- neration and associated poor clinical outcomes in the long-term. A randomized multicenter study evaluating limited discectomy with and without the Barricaid® is currently underway, and will provide a higher level of evidence.

Occupational Safety and Health Among Young Workers in the Nordic Countries: A Systematic Literature Review

Therese N. Hanvold,Pete Kines,Mikko Nykänen,Sara Thomée,Kari A. Holte,Jukka Vuori,Morten Wærsted,Kaj B. Veiersted 한국산업안전보건공단 산업안전보건연구원 2019 Safety and health at work Vol.10 No.1

This review aimed to identify risk factors for occupational accidents and illnesses among young workers in the Nordic countries and to attain knowledge on specific vulnerable groups within the young working force that may need special attention. We conducted a systematic review from 1994 to 2014 using five online databases. Of the 12,528 retrieved articles, 54 met the review criteria and were quality assessed, in which data were extracted focusing on identifying occupational safety, health risk factors, and vulnerable groups among the young workers. The review shows that mechanical factors such as heavy lifting, psychosocial factors such as low control over work pace, and organizational factors such as safety climate are all associated with increased injury risk for young Nordic workers. Results show that exposures to chemical substances were associated with skin reactions, e.g., hand eczema. Heavy lifting and awkward postures were risk factors for low back pain, and high job demands were risk factors for mental health outcomes. The review identified young unskilled workers including school drop-out workers as particularly vulnerable groups when it comes to occupational accidents. In addition, apprentices and young skilled workers were found to be vulnerable to work-related illnesses. It is essential to avoid stereotyping young Nordic workers into one group using only age as a factor, as young workers are a heterogeneous group and their vulnerabilities to occupational safety and health risks are contextual. Politicians, researchers, and practitioners should account for this complexity in the education, training and organization of work, and workplace health and safety culture.

(BOOK REVIEW) Corruption in public administration: an ethnographic approach

Thom Reilly 한국행정학회 2017 International Review of Public Administration Vol.22 No.1

서울예술공연센터 - 2등

Thom Mayne(톰메인) 현대건축사 2009 월간 CONCEPT Vol.- No.120

mediaJazz, the art of the 21st century

Thom Gillespie 이화여자대학교 음악연구소 2002 하계 국제학술회의 자료집 Vol.2002 No.-

Docosahexaenoic acid reduces adenosine triphosphate-induced calcium influx via inhibition of store-operated calcium channels and enhances baseline endothelial nitric oxide synthase phosphorylation in human endothelial cells

Thom Thi Vu,Peter Dieterich,Thu Thi Vu,Andreas Deussen 대한약리학회 2019 The Korean Journal of Physiology & Pharmacology Vol.23 No.5

Docosahexaenoic acid (DHA), an omega-3-fatty acid, modulates multiple cellular functions. In this study, we addressed the effects of DHA on human umbilical vein endothelial cell calcium transient and endothelial nitric oxide synthase (eNOS) phosphorylation under control and adenosine triphosphate (ATP, 100 M) stimulated conditions. Cells were treated for 48 h with DHA concentrations from 3 to 50 M. Calcium transient was measured using the fluorescent dye Fura-2-AM and eNOS phosphorylation was addressed by western blot. DHA dose-dependently reduced the ATP stimulated Ca2+-transient. This effect was preserved in the presence of BAPTA (10 and 20 M) which chelated the intracellular calcium, but eliminated after withdrawal of extracellular calcium, application of 2-aminoethoxy-diphenylborane (75 M) to inhibit store-operated calcium channel or thapsigargin (2 M) to delete calcium store. In addition, DHA (12 M) increased ser1177/thr495 phosphorylation of eNOS under baseline conditions but had no significant effect on this ratio under conditions of ATP stimulation. In conclusion, DHA dose-dependently inhibited the ATP-induced calcium transient, probably via store-operated calcium channels. Furthermore, DHA changed eNOS phosphorylation suggesting activation of the enzyme. Hence, DHA may shift the regulation of eNOS away from a Ca2+ activated mode to a preferentially controlled phosphorylation mode.

Informality and survival in Ukraine's nuclear landscape: Living with the risks of Chernobyl

Thom Davies,Abel Polese 한양대학교 아태지역연구센터 2015 Journal of Eurasian Studies Vol.6 No.1

Recent debates on informal economic activities have partially switched away from a pure monetary logic towards a more complex one, embedded in long term relations and reckoning with non materialistic paradigms. The role of informality in certain aspects of people's lives has however, remained largely unexplored. This article uncovers what happens when the state retires from (providing benefits and social services to) a geographic area and what kind of mechanisms, practices and institutions are created to make up for this. We suggest that, in the face of de facto abandonment by state welfare, and the absence of a private sector alternative, a myriad of transactions and actors can make up for this by replacing these forms of welfare informally. Our case study focuses on the nuclear landscapes around the Chernobyl Exclusion Zone in north–central Ukraine as we reveal the ways the excluded and abandoned, which we frame as post-nuclear “bare life” (Agamben, 1998), have created a mechanism of social security that is independent from the state and yet complements it. Informal, local and unofficial understandings of nuclear spaces are central to survival in this marginalised and risky environment.

Single Molecule Spectroscopy of a Ladder-type Conjugated Polymer: On the Origin of the Green Emission

Stefan Thoms,Klaus Mullen,Thomas Basche 한국고분자학회 2019 한국고분자학회 학술대회 연구논문 초록집 Vol.44 No.2

Docosahexaenoic acid reduces adenosine triphosphate-induced calcium influx via inhibition of store-operated calcium channels and enhances baseline endothelial nitric oxide synthase phosphorylation in human endothelial cells

Vu, Thom Thi,Dieterich, Peter,Vu, Thu Thi,Deussen, Andreas The Korean Society of Pharmacology 2019 The Korean Journal of Physiology & Pharmacology Vol.23 No.5

Docosahexaenoic acid (DHA), an omega-3-fatty acid, modulates multiple cellular functions. In this study, we addressed the effects of DHA on human umbilical vein endothelial cell calcium transient and endothelial nitric oxide synthase (eNOS) phosphorylation under control and adenosine triphosphate (ATP, $100{\mu}M$) stimulated conditions. Cells were treated for 48 h with DHA concentrations from 3 to $50{\mu}M$. Calcium transient was measured using the fluorescent dye Fura-2-AM and eNOS phosphorylation was addressed by western blot. DHA dose-dependently reduced the ATP stimulated $Ca^{2+}$-transient. This effect was preserved in the presence of BAPTA (10 and $20{\mu}M$) which chelated the intracellular calcium, but eliminated after withdrawal of extracellular calcium, application of 2-aminoethoxy-diphenylborane ($75{\mu}M$) to inhibit store-operated calcium channel or thapsigargin ($2{\mu}M$) to delete calcium store. In addition, DHA ($12{\mu}M$) increased ser1177/thr495 phosphorylation of eNOS under baseline conditions but had no significant effect on this ratio under conditions of ATP stimulation. In conclusion, DHA dose-dependently inhibited the ATP-induced calcium transient, probably via store-operated calcium channels. Furthermore, DHA changed eNOS phosphorylation suggesting activation of the enzyme. Hence, DHA may shift the regulation of eNOS away from a $Ca^{2+}$ activated mode to a preferentially controlled phosphorylation mode.