Background: To identify the optimal surgical technique for single-level anterior cervical discectomy and fusion (ACDF), this study compared surgical outcomes and incidence of adjacent segment degeneration (ASD) in patients undergoing single-level ACDF using cage alone single-level fusion and plate fixation techniques. Methods: This single-center retrospective study (2003–2018) included patients who underwent single-level ACDF with either plate fixation (PLATE) or cage (CAGE) alone. The radiologic and clinical outcomes between the 2 surgical groups were compared over a 4-year follow-up period. Outcomes of interest included parameters related to range of motion, sagittal alignment, as well as fusion, subsidence, and ASD rates. Clinical outcomes were evaluated using the Neck Disability Index (NDI) and visual analog scale (VAS) for pain. Dysphagia and hoarseness rates were estimated based on medical records. Results: Forty-seven patients were included (n=17 in CAGE group). In the CAGE group, 94.1% of the patients had Bridwell grade 1 or 2, compared to 83.3% in the PLATE group (p = 0.396). Subsidence occurred in 12.5% and 3.6% of the CAGE and PLATE cases, respectively (p = 0.543). Segmental kyphosis progressed in the CAGE group compared to the PLATE group at 12, 24, and 48 months (p < 0.001). Radiographic ASD was observed in 41.2% and 30.0% of patients in the CAGE and PLATE groups, respectively, with a higher incidence in the upper segments for both groups. Preoperative NDI scores were similar between the groups; however, postoperatively, the CAGE group had significantly lower NDI scores (3.50 ± 2.74 vs. 8.00 ± 5.81) at 4 years (p = 0.020). Neck pain VAS scores also showed significant improvement in the CAGE group (2.33 ± 2.94) compared with that in the PLATE group (3.07 ± 2.31) at 4 years (p = 0.045). Both groups showed comparable arm pain VAS scores at 2 and 4 years postoperatively. Postoperative dysphagia occurred in 1 patient in the PLATE group, resolving almost completely by 1 year. Conclusions Single-level ACDF using a cage alone technique demonstrated favorable radiologic and clinical outcomes overall compared to plate-augmented ACDF. However, plate augmentation is recommended for patients with severe cervical kyphosis or those at high risk of subsidence.

Background: To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM). Methods: This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy. Results: GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, −6.98 ± 2.49, P < 0.001) and the least impact on the sex life (−0.25 ± 0.80, P = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, P < 0.001), independent of glycemic control during pregnancy. Conclusion Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control.Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.

Background: To identify the optimal surgical technique for single-level anterior cervical discectomy and fusion (ACDF), this study compared surgical outcomes and incidence of adjacent segment degeneration (ASD) in patients undergoing single-level ACDF using cage alone single-level fusion and plate fixation techniques. Methods: This single-center retrospective study (2003–2018) included patients who underwent single-level ACDF with either plate fixation (PLATE) or cage (CAGE) alone. The radiologic and clinical outcomes between the 2 surgical groups were compared over a 4-year follow-up period. Outcomes of interest included parameters related to range of motion, sagittal alignment, as well as fusion, subsidence, and ASD rates. Clinical outcomes were evaluated using the Neck Disability Index (NDI) and visual analog scale (VAS) for pain. Dysphagia and hoarseness rates were estimated based on medical records. Results: Forty-seven patients were included (n=17 in CAGE group). In the CAGE group, 94.1% of the patients had Bridwell grade 1 or 2, compared to 83.3% in the PLATE group (p = 0.396). Subsidence occurred in 12.5% and 3.6% of the CAGE and PLATE cases, respectively (p = 0.543). Segmental kyphosis progressed in the CAGE group compared to the PLATE group at 12, 24, and 48 months (p < 0.001). Radiographic ASD was observed in 41.2% and 30.0% of patients in the CAGE and PLATE groups, respectively, with a higher incidence in the upper segments for both groups. Preoperative NDI scores were similar between the groups; however, postoperatively, the CAGE group had significantly lower NDI scores (3.50 ± 2.74 vs. 8.00 ± 5.81) at 4 years (p = 0.020). Neck pain VAS scores also showed significant improvement in the CAGE group (2.33 ± 2.94) compared with that in the PLATE group (3.07 ± 2.31) at 4 years (p = 0.045). Both groups showed comparable arm pain VAS scores at 2 and 4 years postoperatively. Postoperative dysphagia occurred in 1 patient in the PLATE group, resolving almost completely by 1 year. Conclusions Single-level ACDF using a cage alone technique demonstrated favorable radiologic and clinical outcomes overall compared to plate-augmented ACDF. However, plate augmentation is recommended for patients with severe cervical kyphosis or those at high risk of subsidence.

Background: To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM). Methods: This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy. Results: GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, −6.98 ± 2.49, P < 0.001) and the least impact on the sex life (−0.25 ± 0.80, P = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, P < 0.001), independent of glycemic control during pregnancy. Conclusion Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control.Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.

Background: To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM). Methods: This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy. Results: GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, −6.98 ± 2.49, P < 0.001) and the least impact on the sex life (−0.25 ± 0.80, P = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, P < 0.001), independent of glycemic control during pregnancy. Conclusion Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control.Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.

Background: To identify the optimal surgical technique for single-level anterior cervical discectomy and fusion (ACDF), this study compared surgical outcomes and incidence of adjacent segment degeneration (ASD) in patients undergoing single-level ACDF using cage alone single-level fusion and plate fixation techniques. Methods: This single-center retrospective study (2003–2018) included patients who underwent single-level ACDF with either plate fixation (PLATE) or cage (CAGE) alone. The radiologic and clinical outcomes between the 2 surgical groups were compared over a 4-year follow-up period. Outcomes of interest included parameters related to range of motion, sagittal alignment, as well as fusion, subsidence, and ASD rates. Clinical outcomes were evaluated using the Neck Disability Index (NDI) and visual analog scale (VAS) for pain. Dysphagia and hoarseness rates were estimated based on medical records. Results: Forty-seven patients were included (n=17 in CAGE group). In the CAGE group, 94.1% of the patients had Bridwell grade 1 or 2, compared to 83.3% in the PLATE group (p = 0.396). Subsidence occurred in 12.5% and 3.6% of the CAGE and PLATE cases, respectively (p = 0.543). Segmental kyphosis progressed in the CAGE group compared to the PLATE group at 12, 24, and 48 months (p < 0.001). Radiographic ASD was observed in 41.2% and 30.0% of patients in the CAGE and PLATE groups, respectively, with a higher incidence in the upper segments for both groups. Preoperative NDI scores were similar between the groups; however, postoperatively, the CAGE group had significantly lower NDI scores (3.50 ± 2.74 vs. 8.00 ± 5.81) at 4 years (p = 0.020). Neck pain VAS scores also showed significant improvement in the CAGE group (2.33 ± 2.94) compared with that in the PLATE group (3.07 ± 2.31) at 4 years (p = 0.045). Both groups showed comparable arm pain VAS scores at 2 and 4 years postoperatively. Postoperative dysphagia occurred in 1 patient in the PLATE group, resolving almost completely by 1 year. Conclusions Single-level ACDF using a cage alone technique demonstrated favorable radiologic and clinical outcomes overall compared to plate-augmented ACDF. However, plate augmentation is recommended for patients with severe cervical kyphosis or those at high risk of subsidence.

Background: To identify the optimal surgical technique for single-level anterior cervical discectomy and fusion (ACDF), this study compared surgical outcomes and incidence of adjacent segment degeneration (ASD) in patients undergoing single-level ACDF using cage alone single-level fusion and plate fixation techniques. Methods: This single-center retrospective study (2003–2018) included patients who underwent single-level ACDF with either plate fixation (PLATE) or cage (CAGE) alone. The radiologic and clinical outcomes between the 2 surgical groups were compared over a 4-year follow-up period. Outcomes of interest included parameters related to range of motion, sagittal alignment, as well as fusion, subsidence, and ASD rates. Clinical outcomes were evaluated using the Neck Disability Index (NDI) and visual analog scale (VAS) for pain. Dysphagia and hoarseness rates were estimated based on medical records. Results: Forty-seven patients were included (n=17 in CAGE group). In the CAGE group, 94.1% of the patients had Bridwell grade 1 or 2, compared to 83.3% in the PLATE group (p = 0.396). Subsidence occurred in 12.5% and 3.6% of the CAGE and PLATE cases, respectively (p = 0.543). Segmental kyphosis progressed in the CAGE group compared to the PLATE group at 12, 24, and 48 months (p < 0.001). Radiographic ASD was observed in 41.2% and 30.0% of patients in the CAGE and PLATE groups, respectively, with a higher incidence in the upper segments for both groups. Preoperative NDI scores were similar between the groups; however, postoperatively, the CAGE group had significantly lower NDI scores (3.50 ± 2.74 vs. 8.00 ± 5.81) at 4 years (p = 0.020). Neck pain VAS scores also showed significant improvement in the CAGE group (2.33 ± 2.94) compared with that in the PLATE group (3.07 ± 2.31) at 4 years (p = 0.045). Both groups showed comparable arm pain VAS scores at 2 and 4 years postoperatively. Postoperative dysphagia occurred in 1 patient in the PLATE group, resolving almost completely by 1 year. Conclusions Single-level ACDF using a cage alone technique demonstrated favorable radiologic and clinical outcomes overall compared to plate-augmented ACDF. However, plate augmentation is recommended for patients with severe cervical kyphosis or those at high risk of subsidence.

Background: To assess the quality of life (QoL) and treatment satisfaction with intermittently-scanned continuous glucose monitoring (isCGM) in women with gestational diabetes mellitus (GDM). Methods: This prospective observational study included 189 women with GDM who completed the Korean version of the Audit of Diabetes-Dependent Quality of Life Questionnaire (K-ADDQoL). Among them, 25 women who utilized isCGM between gestational weeks 30 and 34 completed the Korean version of the Diabetes Treatment Satisfaction Questionnaire change version (K-DTSQc) to evaluate their satisfaction with isCGM during pregnancy. Results: GDM had a negative impact on the perceived QoL in 89.4% of the women. All 19 domains of the K-ADDQoL were adversely influenced by GDM, with the most significant impact on the freedom to eat (weighted impact score, −6.98 ± 2.49, P < 0.001) and the least impact on the sex life (−0.25 ± 0.80, P = 0.008). Younger women and those treated with insulin perceived themselves as being more affected in their QoL due to GDM. Women perceived to have less effect on their QoL attributed to GDM exhibited higher ΔHbA1c one year after delivery (ΔHbA1c, 0.3 ± 0.4% vs. 0.0 ± 0.4% in less affected vs. more affected women). The utilization of isCGM improved treatment satisfaction (overall satisfaction score, 10.36 ± 9.21, P < 0.001), independent of glycemic control during pregnancy. Conclusion Although GDM negatively affects the perceived QoL during pregnancy, attentiveness to GDM management may have a positive impact on long-term glycemic control.Moreover, employing isCGM can enhance treatment satisfaction in women with GDM.

Purpose: It is important to understand changes in energy requirements in critically ill patients with sepsis. This study investigates alterations in energy requirements based on the clinical course of sepsis in patients admitted to the surgical intensive care unit (SICU) using indirect calorimetry. Methods: In this prospective study, 36 patients admitted to the surgical intensive care unit with sepsis were analyzed. Using indirect calorimetry, the resting energy expenditure (REE) and respiratory quotient (RQ) were assessed on the 1st, 3rd, and 7th day of Intensive Care Unit admission. Measured REE through indirect calorimetry was compared with the predictive equations (Weight-based, Harris-Benedict, IretonJones, and Penn state 2003) using intraclass correlation coefficient (ICC) and Bland-Altman analysis. Results: Measured REE was highest on Day 1 and remained unchanged on Day 3 and 7 (Day 1 vs. Day 3 vs. Day 7: 24.29 ± 3.72 kcal/kg vs. 22.42 ± 3.72 kcal/kg vs. 23.26 ± 5.78 kcal/kg). RQ decreased on Day 3 but increased on Day 7 after caloric intake (Day 1 vs. Day 3 vs. Day 7: 0.69 ± 0.06 vs. 0.67 ± 0.05 vs. 0.71 ± 0.06). Comparing the correlation between the 4 predictive equations and the measured REE, the Penn state 2003 equation demonstrated the highest correlation at each time point, although it showed a decreasing trend over time (Penn state equation ICC: Day 1-0.71, Day 3-0.65, Day 7-0.53). Conclusion In sepsis patients, it is necessary to understand metabolic changes according to the clinical course and provide appropriate calories as determined by using indirect calorimetry when the patients enter the stable phase.

Purpose: It is important to understand changes in energy requirements in critically ill patients with sepsis. This study investigates alterations in energy requirements based on the clinical course of sepsis in patients admitted to the surgical intensive care unit (SICU) using indirect calorimetry. Methods: In this prospective study, 36 patients admitted to the surgical intensive care unit with sepsis were analyzed. Using indirect calorimetry, the resting energy expenditure (REE) and respiratory quotient (RQ) were assessed on the 1st, 3rd, and 7th day of Intensive Care Unit admission. Measured REE through indirect calorimetry was compared with the predictive equations (Weight-based, Harris-Benedict, IretonJones, and Penn state 2003) using intraclass correlation coefficient (ICC) and Bland-Altman analysis. Results: Measured REE was highest on Day 1 and remained unchanged on Day 3 and 7 (Day 1 vs. Day 3 vs. Day 7: 24.29 ± 3.72 kcal/kg vs. 22.42 ± 3.72 kcal/kg vs. 23.26 ± 5.78 kcal/kg). RQ decreased on Day 3 but increased on Day 7 after caloric intake (Day 1 vs. Day 3 vs. Day 7: 0.69 ± 0.06 vs. 0.67 ± 0.05 vs. 0.71 ± 0.06). Comparing the correlation between the 4 predictive equations and the measured REE, the Penn state 2003 equation demonstrated the highest correlation at each time point, although it showed a decreasing trend over time (Penn state equation ICC: Day 1-0.71, Day 3-0.65, Day 7-0.53). Conclusion In sepsis patients, it is necessary to understand metabolic changes according to the clinical course and provide appropriate calories as determined by using indirect calorimetry when the patients enter the stable phase.