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RISS 인기검색어
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- 저자 : Andre M. Samuel (검색결과 2 건)
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Andre M. Samuel,Harold G. Moore,Avani S. Vaishnav,Steven McAnany,Todd Albert,Sravisht Iyer,Yoshihiro Katsuura,Catherine Himo Gang,Sheeraz A. Qureshi 대한척추신경외과학회 2019 Neurospine Vol.16 No.3
Objective: Cervical disc replacement (CDR) is an effective long-term treatment for both cervical radiculopathy and myelopathy. However, there may be unique differences in the early postoperative clinical improvement for patients with and without myelopathy. In addition, previous studies using CDR to treat cervical myelopathy were underpowered to determine risk factors for relatively postoperative medical complications. Methods: Two different cohorts were studied. A local cohort of patients undergoing CDR by a single surgeon was utilized to study the early postoperative course of clinical improvement. In addition, a national cohort of patients undergoing CDR in the 2015 and 2016 National Surgical Quality Improvement Program database was utilized to study differences in postoperative medical complications after CDR. Patients with a preoperative diagnosis of cervical myelopathy were identified in both cohorts, and perioperative outcomes and complications were compared to patients without myelopathy. Results: A total of 43 patients undergoing CDR were included in the institutional cohort, of those 16 patients (37% of cohort) had a preoperative diagnosis of cervical myelopathy. A total of 3,023 patients undergoing CDR were included in the national cohort, of those 411 (13% of cohort) had a preoperative diagnosis of cervical myelopathy. In the institutional cohort, the nonmyelopathy group had a lower initial Neck Disability Index (NDI) and saw a faster improvement in NDI by 2 weeks postoperative. However, at 24 weeks there was no significant difference between groups in terms of NDI. Interestingly, only the nonmyelopathy cohort had a significant improvement in modified Japanese Orthopaedic Association score by 6 weeks (p<0.05). In the national cohort, myelopathy was associated with longer operative time and length of stay (p<0.05). However, there was no significant difference in perioperative complications (p>0.05) between myelopathy and nonmyelopathy patients. Conclusion: Significant improvements in NDI, visual analogue scale (VAS)-arm pain, and VAS-neck pain are seen in both myelopathy and nonmyelopathy populations undergoing CDR by 6 weeks postoperatively. However, nonmyelopathy populations improve faster by 2 weeks postoperatively. In the national cohort analysis, medical complications were similarly low in both myelopathy and nonmyelopathy groups.
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Samuel J. van Bohemen,Jeffrey M. Rogers,Philip C. Boughton,Jillian L. Clarke,Joaquin T. Valderrama,Andre Z. Kyme 대한의용생체공학회 2023 Biomedical Engineering Letters (BMEL) Vol.13 No.2
This paper describes a potential method to detect changes in cerebral blood flow (CBF) using electrocardiography (ECG)signals, measured across scalp electrodes with reference to the same signal across the chest—a metric we term the ElectrocardiographyBrain Perfusion index (EBPi). We investigated the feasibility of EBPi to monitor CBF changes in response tospecific tasks. Twenty healthy volunteers wore a head-mounted device to monitor EBPi and electroencephalography (EEG)during tasks known to alter CBF. Transcranial Doppler (TCD) ultrasound measurements provided ground-truth estimatesof CBF. Statistical analyses were applied to EBPi, TCD right middle cerebral artery blood flow velocity (rMCAv) and EEGrelative Alpha (rAlpha) data to detect significant task-induced changes and correlations. Breath-holding and aerobic exerciseinduced highly significant increases in EBPi and TCD rMCAv (p < 0.01). Verbal fluency also increased both measures,however the increase was only significant for EBPi (p < 0.05). Hyperventilation induced a highly significant decrease in TCDrMCAv (p < 0.01) but EBPi was unchanged. Combining all tasks, EBPi exhibited a highly significant, weak positive correlationwith TCD rMCAv (r = 0.27, p < 0.01) and the Pearson coefficient between EBPi and rAlpha was r = − 0.09 (p = 0.05). EBPi appears to be responsive to dynamic changes in CBF and, can enable practical, continuous monitoring. CBF is a keyparameter of brain health and function but is not easily measured in a practical, continuous, non-invasive fashion. EBPi mayhave important clinical implications in this context for stroke monitoring and management. Additional studies are requiredto support this claim.
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