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      • KCI등재후보

        Blood lead levels for Eurasian black vultures (Aegypius monachus) migrating between Mongolia and the Republic of Korea

        David Kenny,김영준,이한수,Richard Reading 국립중앙과학관 2015 Journal of Asia-Pacific Biodiversity Vol.8 No.3

        Since 2009, we have been determining blood lead levels (BLLs) for Eurasian black vulture (EbVs, Aegypius monachus) in Mongolia. Since EbVs migrated from Mongolia to the Republic (R.) of Korea in 2012, we started comparing BLLs from Mongolia to Korean birds [Mongolia; mean = 2.72 ± 0.09 ㎍/dL standard error (SE), n = 181, R. of Korea; mean = 6.68 ± 0.58 ㎍/dL SE, n = 124]. In Korea we also analyzed birds by comparing BLLs for free-ranging birds (mean = 7.54 ± 0.50 ㎍/dL SE, n= 44) to rehabilitation center birds (mean = 6.21 +(-) 0.86 ㎍/dL SE, n= 80), and for birds fed rescued water deer (Hydropotes inermis) (mean = 11.26 ± 1.66 ㎍/dL SE, n = 7) to birds fed livestock (mean = 1.97 ± 0.27 ㎍/dL, n = 4). Finally, we analyzed BLLs from Mongolia and the R. of Korea according to the following categories: background= <10.0 ㎍/dL (Mongolia 100%, n = 181; R. of Korea 83.1%), exposure= ≥10.0 ㎍/dL to <45.0 mg/dL (Mongolia 0%; R. of Korea 16.1%, n = 20), and diagnostic= ≥45.0 ㎍/dL (Mongolia 0%; R. of Korea 0.8%, n = 1). Our research indicates that EbVs are acquiring lead while migrating to the R. of Korea.

      • Programmed serial stereochemical relay and its application in the synthesis of morphinans

        Ho (Kenny) Park, Kun,Chen, Rui,Chen, David Y.-K. Royal Society of Chemistry 2017 Chemical science Vol.8 No.10

        <▼1><P>A rationally designed, serial point-to-axial and axial-to-point stereoinduction and its integration into a multi-step and target-oriented organic synthesis was demonstrated in a novel chemical method to access morphinans and it is potentially applicable to other structurally related alkaloids.</P></▼1><▼2><P>Herein we report a rationally designed, serial point-to-axial and axial-to-point stereoinduction and its integration into multi-step and target-oriented organic synthesis. In this proof-of-concept study, the configurational stability of several carefully designed atropisomeric intermediates and the fidelity of their unconventional stereoinductions were systematically investigated. The highly functionalized prepared synthetic intermediate was further applied in a novel chemical method to access the morphinans and it is potentially applicable to other structurally related alkaloids.</P></▼2>

      • A desymmetrization-based approach to morphinans: application in the total synthesis of oxycodone

        Park, Kun Ho (Kenny),Chen, David Y.-K. The Royal Society of Chemistry 2018 Chemical communications Vol.54 No.92

        <P>Here we report a total synthesis of the pharmacologically significant morphinan alkaloid, oxycodone. The centerpiece of the developed strategy features the first application of the Rovis desymmetrization of peroxyquinol in target-oriented total synthesis to access an optically active phenanthrene framework shared by the morphinans. A Stork-Ueno radical cyclization under photoredox conditions installed the all-carbon quaternary stereocenter, and a late-stage reductive detosylation with concomitant piperidine formation secured the core structure of the target molecule.</P>

      • KCI등재

        Treatment Strategy and Outcomes in Patients with Hematogenous Culture-Negative Pyogenic Vertebral Osteomyelitis

        Gouse Mohamad,Rohit Amritanand,Kenny Samuel David,Venkatesh Krishnan,Justin Arockiaraj 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.1

        Study Design: Retrospective case series. Purpose: The aim of this study was to analyze functional and radiological outcomes in patients with culture-negative pyogenic vertebral osteomyelitis (PVO). Overview of Literature: There were only few literature available for these group of patients. Methods: Patients with biopsy-positive but culture-negative PVO were included. We analyzed records for data on demography, comorbidities, coexisting infections, neurological status, prior antibiotic therapy, pre- and postoperative erythrocyte sedimentation rate, C-reactive protein levels, and Oswestry Disability Index, and Japanese Orthopedics Association scores. Results: Sixty-one patients were included, of which data of 45 patients were available for follow-up. The patients were predominantly males (71%), with a mean age of 53.2 years. Seventy-seven percent patients had comorbidities. Echocardiography, blood culture, and urine culture were performed on 8%, 24%, and 18% of patients, respectively. Thirty-one percent patients had neurological deficits. Computed tomography-guided biopsy was performed on 67% patients. Fifty-two percent patients were treated surgically, and 48% were treated non-surgically. Nineteen percent patients were treated according to the results of cultures from other foci, and the rest were treated empirically. For the initial 2 weeks, all patients were treated with intravenous antibiotics empirically or based on culture from other foci. This treatment was followed by 10 weeks of oral cloxacillin/cephalexin for gram-positive organisms or ciprofloxacin for gram-negative organisms. The mean follow-up time was 18 months (range, 12–120 months). All patients had improvement in Japanese Orthopedics Association, Oswestry Disability Index, and Visual Analog Scale scores (p <0.001). Conclusions: Treatment with empirical antibiotics for 12 weeks with watchful clinical and radiological follow-up yields good resolution of the disease. Further multicenter clinical research needs to be performed for obtaining an algorithmic treatment plan for these patients.

      • Does the Surgical Reduction of High Grade Spondylolisthesis Restore Spino-Pelvic Alignment? An Analysis of 35 Patients

        Amritanand Rohit,Arockiaraj Justin,David Kenny S.,Krishnan Venkatesh 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.5

        Study Design: Retrospective case series. Purpose: This study aimed to analyze how the sagittal spinopelvic alignment is influenced by an attempted surgical reduction of the L5–S1 segment in patients with high-grade spondylolisthesis (HGS). Overview of Literature: Conventional treatment strategies stress the importance of achieving fusion across the lumbosacral junction in patients with HGS. The role of reduction in this subset of patients is controversial. Methods: This is a retrospective case series of 35 patients with Meyerding grades III, IV, or V spondylolisthesis who underwent surgical treatment in our institution. Before and after surgery, we took standing lateral radiographs from L1 vertebra to pelvis, including the femoral heads, and measured the slip grade, pelvic incidence, sacral slope, pelvic tilt, lumbosacral angle, and lumbar lordosis. Patients were subdivided into “balanced” and “unbalanced” pelvis groups. To determine the effect and correlation of reduction on these spinopelvic parameters, we statistically compared the pre- and postoperative measurements. Results: The average follow-up was 9 months (range, 3–169 months). Slip grade improved from an average 74.0%±13.2% to 30.0%±14.0% (p<0.001), and lumbosacral angle reduced from an average 32.0°±11.6° to 6.0°±0.6° (p<0.001). Although the pelvic tilt was reduced, this was not significant. There was a modest negative correlation between the reduction in slip grade and the increase in sacral slope (r=−0.3, p=0.06). At follow-up, five patients improved, from an unbalanced pelvis to a balanced pelvis. Fusion occurred in 33 patients (95%). Conclusions: Surgical reduction of HGS restores the lumbosacral alignment. However, a similar trend is not noted with the pelvic parameters.

      • KCI등재

        Symptomatic Solitary Osteochondroma of the Subaxial Cervical Spine in a 52-Year-Old Patient

        Vijay Sekharappa,Rohit Amritanand,Venkatesh Krishnan,Kenny Samuel David 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.1

        Osteochondromas are the most common benign tumors of the bone. They mostly arise from the appendicular skeleton and present clinically in the second or third decade of life. Ostechondromas arising from the subaxial cervical spine and presenting after the 5th decade of life are extremely rare. We report a 52-year-old male patient who presented with numbness and subjective weakness of left upper and lower limbs and neck pain, and had lobulated bony hard fixed swelling in the right lower cervical paraspinal region. Radiological images revealed a bony swelling arising from C4 and C5 lamina with a cartilaginous cap and intraspinal extension. Excision biopsy with stabilisation of the spine was performed. Histopathalogical examination of the specimen confirmed the diagnosis of osteochondroma. We conclude surgical excision of such rare tumors, including the cartilaginous cap as well as the intraspinal component can reliably produce a good clinical outcome.

      • KCI등재

        Orthopaedics, PostGraduate Institute of Medical Education and Research, Chandigarh, India

        Vijay Sekharappa,Rohit Amritanand,Venkatesh Krishnan,Kenny Samuel David 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.1

        Study Design: Retrospective analysis of radiological images. Purpose: To determine the prevalence of lumbosacral transition vertebra (LSTV) and to study its significance with respect to clinically significant spinal symptoms, disc degeneration and herniation. Overview of Literature: LSTV is the most common congenital anomaly of the lumbosacral spine. The prevalence has been debated to vary between 7% and 30%, and its relationship to back pain, disc degeneration and herniation has also not been established. Methods: The study involved examining the radiological images of 3 groups of patients. Group A consisted of kidney urinary bladder (KUB) X-rays of patients attending urology outpatient clinic. Group B consisted of X-rays with or without magnetic resonance images (MRIs) of patients at-tending a spine outpatient clinic, and group C consisted of X-rays and MRI of patients who had undergone surgery for lumbar disc herniation. One thousand patients meeting the inclusion criteria were selected to be in each group. LSTV was classified by Castellvi’s classification and disc degeneration was assessed by Pfirrmann’s grading on MRI scans. Results: The prevalence of LSTV among urology outpatients, spine outpatients and discectomy patients was 8.1%, 14%, and 16.9% respectively. LSTV patients showed a higher Pfirrmann’s grade of degeneration of the last mobile disc. Results were found to be significant statistically. Conclusions: The prevalence of LSTV in spinal outpatients and discectomy patients was significantly higher as compared to those attending the urology outpatient clinic. There was a definite causal relationship between the transitional vertebra and the degeneration of the disc immediately cephalad to it.

      • Role of Biochemical Nutritional Parameters as Predictors of Postoperative Morbidity in Major Spine Surgeries

        Sugumar Deepak,Arockiaraj Justin,Amritanand Rohit,David Kenny S.,Krishnan Venkatesh 대한척추외과학회 2021 Asian Spine Journal Vol.15 No.4

        Study Design: Prospective cohort study.Purpose: To evaluate the association between nutritional parameters related to postoperative surgical site infections and duration of hospital stay and intensive care unit (ICU) stay in patients undergoing major spine surgery.Overview of Literature: Malnutrition is highly prevalent in surgical patients. Malnourished patients are considered to be at higher risk for postoperative morbidity and mortality due to impaired wound healing, delayed inflammation, impaired fibroblast proliferation, and collagen synthesis. Decreased lymphocyte count also impairs the ability of the immune system to eradicate or prevent infection, which predisposes these patients to infections. However, this association between malnutrition and postoperative morbidity is not consistent across studies, thus necessitating further investigation.Methods: The values of serum albumin, prealbumin, total lymphocyte counts, and transferrin were documented preoperatively and postoperatively on day 5 for all patients undergoing major spine surgery (surgery involving instrumentation of at least three motion segments). In addition, patients’ surgical wound healing status, duration of hospital stay, and duration of ICU stay in the postoperative period were documented. Finally, the statistical correlation between the nutritional markers and these complications was determined.Results: Low postoperative prealbumin levels was significantly associated with increased complication rates. ICU stay demonstrated a statistically significant association with low postoperative albumin, prealbumin, and transferrin levels. Similarly, we observed that low postoperative albumin and prealbumin levels could significantly predict the need for prolonged hospital stay in patients undergoing major spine surgery.Conclusions: The magnitude of the decrease in nutritional status due to surgery with respect to albumin and prealbumin levels is a significant (p<0.05) predictor of wound-related complications, rather than a single nutritional parameter evaluated at a point of time.

      • KCI등재

        Differential movement of adult and juvenile Cinereous Vultures (Aegypius monachus) (Accipitriformes: Accipitridae) in Northeast Asia

        Richard P. Reading,John Azua,Travis Garrett,David Kenny,이한수,백운기,Nanette Reece,Purevsuren Tsolmonjav,Mary Jo Willis,Ganchimeg Wingard 국립중앙과학관 2020 Journal of Asia-Pacific Biodiversity Vol.13 No.2

        We report on differential movement of adult and juvenile cinereous vultures (Aegypius monachus) in thenortheast Asia. Adult vultures remain in Mongolia throughout the year, whereas many juvenile vulturesmigrate from their breeding grounds in Mongolia to wintering grounds in the Republic of Korea (SouthKorea).We trapped adult and juvenile Cinereous Vultures in Mongolia and Korea to attach wing tags (n ¼270 fledglings and 10 adults) and, for some, global positioning system telemetry units (n ¼ 31 fledglings,18 juveniles, and 10 adults). While adult birds never left Mongolia, fledglings and juveniles wanderedmore widely into Russia (rarely), China, and the Korean Peninsula. Most telemetered fledglings andjuveniles for which we obtained data migrated seasonally between Mongolia and South Korea. Juvenilevultures used larger summer home ranges than adults. Juveniles used much smaller winter than summerhome ranges. Over the course of the year, adult and juvenile vultures moved similar amounts thatdiffered seasonally. How juvenile vultures learn the migration route between Mongolia and Republic ofKorea remains unknown. Our results have important conservation implications, as factors influencing thesurvivorship of migratory birds can strongly impact populations.

      • KCI등재

        Recurrent Lumbar Disc Herniation: Results of Revision Surgery and Assessment of Factors that May Affect the Outcome. A Non-Concurrent Prospective Study

        Mohammed Ibrahim,Justin Arockiaraj,Rohit Amritanand,Krishnan Venkatesh,Kenny Samuel David 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.5

        Study Design: Non-concurrent prospective study. Purpose: To determine the functional outcome after open ‘fragment’ discectomy for recurrent lumbar disc herniation, and to analyze the factors that may affect the outcome. Overview of Literature: Literature search revealed only four studies where the factors affecting the outcome of a revision surgery for recurrent disc herniation have been evaluated. None of these studies analyzed for diabetes, disc degeneration and facet arthropathy. We have analyzed these features, in addition to the demographic and clinical factors. Methods: Thirty-four patients who underwent the procedure were followed up for an average period of 27.1 months. The Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI) were used to assess the functional outcome. Age, gender, smoking, diabetic status, duration of recurrent symptoms, the side of leg pain, level and type of disc herniation, degree of disc degeneration on magnetic resonance imaging, and facet joint arthritis before first and second surgeries, were analyzed as factors affecting the outcome. Results: The average Hirabayashi improvement in JOA was 56.4%. The mean preoperative ODI was 74.5% and the mean ODI at final follow-up was 32.2%, the difference being statistically significant (p <0.01). Patients with diabetes, all of whom had poor long term glycemic control, were found to have a poor outcome in terms of ODI improvement (p =0.03). Conclusions: Open fragment discectomy is a safe and effective surgical technique for the treatment of recurrent disc herniation. However, patients with uncontrolled diabetes may have a less favorable outcome.

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