Spinal instrumentation is popular nowadays. After applying the Harrington distraction rod, there might be a severe, tragic complication, paraplegia. Recently SSEP is widely used to detect the early change of the spinal cord dysfunction. The force to correct the spinal deformity is usually distraction. The distraction force will stretch the spinal dura. But the relation of neural deficit between distraction force and duration is not clearly determined yet. Also the anatomical level of neural deficit is not known. The purpose of this study is to find that the distraction force of 200gm on the spinal dura will change the SSEP by the stimulation of the posterior tibial nerve and if there is change of SSEP, what portion of nerve stimulation pathway is responsible for. Results are as followings. 1) The distraction force of 200gm makes change of SSEP wave. 2) P2 wave is most susceptible, N1 wave is less susceptible and P1 is relatively contant for one hour dural traction. 3) After release of traction, the wave is partially reversible but not completely for next one hour recovery period. 4) While the wave of SSEP is changed by the dural distraction force, the nerve conduction between the nerve root just outside of the spinal dura and calf shows constant latency. That means the anatomical level responsible for the change of SSEP wave is proximal to the spinal dura, not the peripheral nerve distal to the spinal dura.
Animals ; Congenital Abnormalities ; Dogs ; Evoked Potentials ; Evoked Potentials, Somatosensory ; Neural Conduction ; Paraplegia ; Peripheral Nerves ; Spinal Cord ; Tibial Nerve ; Traction

No abstract available.
Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Axis, Cervical Vertebra* ; Spondylolysis*

PURPOSE: To examine the effect of back massage on immune response, symptom distress, and mood state of patients undergoing allogeneic hematopoietic stem cell transplantation (allogeneic HSCT). METHODS: Subjects were thirty-seven patients undergoing sibling allogeneic HSCT (including 16 in the experimental group and 21 in the control group). Experimental subjects participated in an intervention group of back massage for 10 minutes, once a day and 5 times a week, from one week prior to the HSCT to the third week after the HSCT or a control group. A non-equivalent pretest-posttest design was used. t-test and Repeated measures ANOVA were used to examine group differences by using SAS. RESULTS: No significant group differences were found in Immune response (CD4+, CD8+,CD19+, CD56+) and symptom distress. The experimental group had significantly less mood state (anxiety, confusion) than the control group. CONCLUSION: The back massage for the patients undergoing allogeneic HSCT may be effective in altering the anxiety and confusion during hematopoietic stem cell transplantation. However, this study did not provide evidence in improving immune response and symptom distress.
Anxiety ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Massage ; Phenothiazines ; Siblings

No abstract available.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri* ; Diagnosis* ; Female

OBJECTIVES: In this paper, we proposed an algorithm for recognizing a rotator cuff supraspinatus tendon tear using a texture analysis based on a histogram, gray level co-occurrence matrix (GLCM), and gray level run length matrix (GLRLM). METHODS: First, we applied a total of 57 features (5 first order descriptors, 40 GLCM features, and 12 GLRLM features) to each rotator cuff region of interest. Our results show that first order statistics (mean, skewness, entropy, energy, smoothness), GLCM (correlation, contrast, energy, entropy, difference entropy, homogeneity, maximum probability, sum average, sum entropy), and GLRLM features are helpful to distinguish a normal supraspinatus tendon and an abnormal supraspinatus tendon. The statistical significance of these features is verified using a t-test. The support vector machine classification showed accuracy using feature combinations. Support Vector Machine offers good performance with a small amount of training data. Sensitivity, specificity, and accuracy are used to evaluate performance of a classification test. RESULTS: From the results, first order statics features and GLCM and GLRLM features afford 95%, 85%, and 100% accuracy, respectively. First order statistics and GLCM and GLRLM features in combination provided 100% accuracy. Combinations that include GLRLM features had high accuracy. GLRLM features were confirmed as highly accurate features for classified normal and abnormal. CONCLUSIONS: This algorithm will be helpful to diagnose supraspinatus tendon tear on ultrasound images.
Classification ; Data Interpretation, Statistical ; Entropy ; Image Processing, Computer-Assisted ; Rotator Cuff ; Sensitivity and Specificity ; Subject Headings ; Support Vector Machine ; Tears ; Tendons ; Ultrasonography*

No abstract available.
Education* ; Humans ; Internship and Residency* ; Korea*

Diabetes is one of the important risk factors in cardiovascular disease associated with atherosclerosis, and cardiovascular disease is the leading cause of death in patients with diabetes mellitus. Recent randomized placebo-controlled cardiovascular outcome trials of all new antidiabetic drugs have linked SGLT-2 inhibitors and GLP1-agonists to not only increased cardiovascular stability but significant reduction of cardiovascular disease. These results have led to preferential selection of the most effective and beneficial antidiabetic drugs with the evidence of cardiovascular safety and efficacy. Herein, we address cardiovascular stability and the effectiveness of antidiabetic drugs, focusing on recently developed ones.

Diabetes is one of the important risk factors in cardiovascular disease associated with atherosclerosis, and cardiovascular disease is the leading cause of death in patients with diabetes mellitus. Recent randomized placebo-controlled cardiovascular outcome trials of all new antidiabetic drugs have linked SGLT-2 inhibitors and GLP1-agonists to not only increased cardiovascular stability but significant reduction of cardiovascular disease. These results have led to preferential selection of the most effective and beneficial antidiabetic drugs with the evidence of cardiovascular safety and efficacy. Herein, we address cardiovascular stability and the effectiveness of antidiabetic drugs, focusing on recently developed ones.

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.