1.Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial
Myoung Hwa KIM ; Jinyoung PARK ; Yoon Ghil PARK ; Yong Eun CHO ; Dawoon KIM ; Dong Jun LEE ; Kyu Wan KWAK ; Jongyun LEE ; Dong Woo HAN
Korean Journal of Anesthesiology 2025;78(1):16-29
Background:
Although total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used to optimize intraoperative neurophysiological monitoring (IONM), the exact effect of remimazolam on IONM remains unknown. Here, we compared the effects of propofol and remimazolam along with remifentanil on IONM during TIVA.
Methods:
In this prospective, double-blind, randomized controlled trial, 64 patients requiring IONM during cervical spine surgery were administered either propofol (Group P) or remimazolam (Group R). The preoperative latencies of the somatosensory-evoked potentials (SEP; N20 for the median nerve and P37 for the tibial nerve) were measured. SEP latencies and amplitudes and motor-evoked potential (MEP) amplitudes were measured 30 min after anesthetic induction (T1), 30 min after surgical incision (T2), after laminectomy or discectomy (T3), immediately after plate insertion or pedicle screw fixation (T4), and before surgical wound closure (T5). The primary outcome was the between-group difference in the N20 latency changes measured at T1 and preoperatively.
Results:
The change in SEP latencies including N20 and P37 at T1 compared with preoperative time was not significantly different between Groups P and R. Except for the amplitude of the right abductor brevis, there was no significant group-by-time interaction effect for intraoperative MEP amplitudes or SEP latencies and amplitudes.
Conclusions
TIVA with remimazolam and remifentanil for cervical spine surgery yielded stable IONM, comparable to those observed with conventional TIVA with propofol and remifentanil. Further clinical trials are needed in other surgical contexts and with more diverse patient populations to determine the effects of remimazolam on IONM.
2.Effect of Nationwide Postoperative Rehabilitation at Home Program after Lower Extremity Surgeries in Older and Younger People
Kyunghoon MIN ; Sangchul LEE ; Jae Min KIM ; Jung Hyun PARK ; Jun Hwan CHOI ; Bo Ryun KIM ; Kyu Wan KWAK ; Seong Jun KIM ; Jae-Young LIM
Annals of Geriatric Medicine and Research 2025;29(1):119-130
Background:
A nationwide Rehabilitation at Home Care Pilot Program for patients undergoing lower extremity orthopedic surgeries has been ongoing since 2020. The program was designed to improve clinical outcomes through early mobilization and rehabilitation after discharge. This study aimed to analyze the interim data to assess its effectiveness and suggest improvements, particularly for older patients who are more vulnerable compared to younger patients.
Methods:
We analyzed the data of 872 patients from seven hospitals. Patients were divided into an older-age group (OG; ≥60 years) and younger-age group (YG; <60 years). The Berg Balance Scale (BBS) and Numeric Rating Scale (NRS) scores for pain were the main outcomes.
Results:
Participants were categorized into OG (n=801) and YG (n=71). The most common surgeries were knee joint replacement (63.7%) in OG and hip joint replacement in YG (77.5%). It took more days to enroll in the pilot program in OG (4.4 days) than YG (3.2 days). OG showed less improvement in BBS than YG for all surgeries (23.3 vs. 31.9) and hip joint surgery (19.8 vs. 33.5). In patients with hip joint replacement in OG, those with a higher number of comorbidities (≥3) showed less BBS improvement than those with fewer comorbidities (<3). In the pain domain, NRS scores decreased in both groups.
Conclusion
The postoperative rehabilitation education program appeared to be effective in improving physical function and reducing pain severity, though the improvement was less obvious in older patients who may require a more comprehensive approach compared to younger patients.
3.Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial
Myoung Hwa KIM ; Jinyoung PARK ; Yoon Ghil PARK ; Yong Eun CHO ; Dawoon KIM ; Dong Jun LEE ; Kyu Wan KWAK ; Jongyun LEE ; Dong Woo HAN
Korean Journal of Anesthesiology 2025;78(1):16-29
Background:
Although total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used to optimize intraoperative neurophysiological monitoring (IONM), the exact effect of remimazolam on IONM remains unknown. Here, we compared the effects of propofol and remimazolam along with remifentanil on IONM during TIVA.
Methods:
In this prospective, double-blind, randomized controlled trial, 64 patients requiring IONM during cervical spine surgery were administered either propofol (Group P) or remimazolam (Group R). The preoperative latencies of the somatosensory-evoked potentials (SEP; N20 for the median nerve and P37 for the tibial nerve) were measured. SEP latencies and amplitudes and motor-evoked potential (MEP) amplitudes were measured 30 min after anesthetic induction (T1), 30 min after surgical incision (T2), after laminectomy or discectomy (T3), immediately after plate insertion or pedicle screw fixation (T4), and before surgical wound closure (T5). The primary outcome was the between-group difference in the N20 latency changes measured at T1 and preoperatively.
Results:
The change in SEP latencies including N20 and P37 at T1 compared with preoperative time was not significantly different between Groups P and R. Except for the amplitude of the right abductor brevis, there was no significant group-by-time interaction effect for intraoperative MEP amplitudes or SEP latencies and amplitudes.
Conclusions
TIVA with remimazolam and remifentanil for cervical spine surgery yielded stable IONM, comparable to those observed with conventional TIVA with propofol and remifentanil. Further clinical trials are needed in other surgical contexts and with more diverse patient populations to determine the effects of remimazolam on IONM.
4.Effect of Nationwide Postoperative Rehabilitation at Home Program after Lower Extremity Surgeries in Older and Younger People
Kyunghoon MIN ; Sangchul LEE ; Jae Min KIM ; Jung Hyun PARK ; Jun Hwan CHOI ; Bo Ryun KIM ; Kyu Wan KWAK ; Seong Jun KIM ; Jae-Young LIM
Annals of Geriatric Medicine and Research 2025;29(1):119-130
Background:
A nationwide Rehabilitation at Home Care Pilot Program for patients undergoing lower extremity orthopedic surgeries has been ongoing since 2020. The program was designed to improve clinical outcomes through early mobilization and rehabilitation after discharge. This study aimed to analyze the interim data to assess its effectiveness and suggest improvements, particularly for older patients who are more vulnerable compared to younger patients.
Methods:
We analyzed the data of 872 patients from seven hospitals. Patients were divided into an older-age group (OG; ≥60 years) and younger-age group (YG; <60 years). The Berg Balance Scale (BBS) and Numeric Rating Scale (NRS) scores for pain were the main outcomes.
Results:
Participants were categorized into OG (n=801) and YG (n=71). The most common surgeries were knee joint replacement (63.7%) in OG and hip joint replacement in YG (77.5%). It took more days to enroll in the pilot program in OG (4.4 days) than YG (3.2 days). OG showed less improvement in BBS than YG for all surgeries (23.3 vs. 31.9) and hip joint surgery (19.8 vs. 33.5). In patients with hip joint replacement in OG, those with a higher number of comorbidities (≥3) showed less BBS improvement than those with fewer comorbidities (<3). In the pain domain, NRS scores decreased in both groups.
Conclusion
The postoperative rehabilitation education program appeared to be effective in improving physical function and reducing pain severity, though the improvement was less obvious in older patients who may require a more comprehensive approach compared to younger patients.
5.Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial
Myoung Hwa KIM ; Jinyoung PARK ; Yoon Ghil PARK ; Yong Eun CHO ; Dawoon KIM ; Dong Jun LEE ; Kyu Wan KWAK ; Jongyun LEE ; Dong Woo HAN
Korean Journal of Anesthesiology 2025;78(1):16-29
Background:
Although total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used to optimize intraoperative neurophysiological monitoring (IONM), the exact effect of remimazolam on IONM remains unknown. Here, we compared the effects of propofol and remimazolam along with remifentanil on IONM during TIVA.
Methods:
In this prospective, double-blind, randomized controlled trial, 64 patients requiring IONM during cervical spine surgery were administered either propofol (Group P) or remimazolam (Group R). The preoperative latencies of the somatosensory-evoked potentials (SEP; N20 for the median nerve and P37 for the tibial nerve) were measured. SEP latencies and amplitudes and motor-evoked potential (MEP) amplitudes were measured 30 min after anesthetic induction (T1), 30 min after surgical incision (T2), after laminectomy or discectomy (T3), immediately after plate insertion or pedicle screw fixation (T4), and before surgical wound closure (T5). The primary outcome was the between-group difference in the N20 latency changes measured at T1 and preoperatively.
Results:
The change in SEP latencies including N20 and P37 at T1 compared with preoperative time was not significantly different between Groups P and R. Except for the amplitude of the right abductor brevis, there was no significant group-by-time interaction effect for intraoperative MEP amplitudes or SEP latencies and amplitudes.
Conclusions
TIVA with remimazolam and remifentanil for cervical spine surgery yielded stable IONM, comparable to those observed with conventional TIVA with propofol and remifentanil. Further clinical trials are needed in other surgical contexts and with more diverse patient populations to determine the effects of remimazolam on IONM.
6.Effect of Nationwide Postoperative Rehabilitation at Home Program after Lower Extremity Surgeries in Older and Younger People
Kyunghoon MIN ; Sangchul LEE ; Jae Min KIM ; Jung Hyun PARK ; Jun Hwan CHOI ; Bo Ryun KIM ; Kyu Wan KWAK ; Seong Jun KIM ; Jae-Young LIM
Annals of Geriatric Medicine and Research 2025;29(1):119-130
Background:
A nationwide Rehabilitation at Home Care Pilot Program for patients undergoing lower extremity orthopedic surgeries has been ongoing since 2020. The program was designed to improve clinical outcomes through early mobilization and rehabilitation after discharge. This study aimed to analyze the interim data to assess its effectiveness and suggest improvements, particularly for older patients who are more vulnerable compared to younger patients.
Methods:
We analyzed the data of 872 patients from seven hospitals. Patients were divided into an older-age group (OG; ≥60 years) and younger-age group (YG; <60 years). The Berg Balance Scale (BBS) and Numeric Rating Scale (NRS) scores for pain were the main outcomes.
Results:
Participants were categorized into OG (n=801) and YG (n=71). The most common surgeries were knee joint replacement (63.7%) in OG and hip joint replacement in YG (77.5%). It took more days to enroll in the pilot program in OG (4.4 days) than YG (3.2 days). OG showed less improvement in BBS than YG for all surgeries (23.3 vs. 31.9) and hip joint surgery (19.8 vs. 33.5). In patients with hip joint replacement in OG, those with a higher number of comorbidities (≥3) showed less BBS improvement than those with fewer comorbidities (<3). In the pain domain, NRS scores decreased in both groups.
Conclusion
The postoperative rehabilitation education program appeared to be effective in improving physical function and reducing pain severity, though the improvement was less obvious in older patients who may require a more comprehensive approach compared to younger patients.
7.Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial
Myoung Hwa KIM ; Jinyoung PARK ; Yoon Ghil PARK ; Yong Eun CHO ; Dawoon KIM ; Dong Jun LEE ; Kyu Wan KWAK ; Jongyun LEE ; Dong Woo HAN
Korean Journal of Anesthesiology 2025;78(1):16-29
Background:
Although total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used to optimize intraoperative neurophysiological monitoring (IONM), the exact effect of remimazolam on IONM remains unknown. Here, we compared the effects of propofol and remimazolam along with remifentanil on IONM during TIVA.
Methods:
In this prospective, double-blind, randomized controlled trial, 64 patients requiring IONM during cervical spine surgery were administered either propofol (Group P) or remimazolam (Group R). The preoperative latencies of the somatosensory-evoked potentials (SEP; N20 for the median nerve and P37 for the tibial nerve) were measured. SEP latencies and amplitudes and motor-evoked potential (MEP) amplitudes were measured 30 min after anesthetic induction (T1), 30 min after surgical incision (T2), after laminectomy or discectomy (T3), immediately after plate insertion or pedicle screw fixation (T4), and before surgical wound closure (T5). The primary outcome was the between-group difference in the N20 latency changes measured at T1 and preoperatively.
Results:
The change in SEP latencies including N20 and P37 at T1 compared with preoperative time was not significantly different between Groups P and R. Except for the amplitude of the right abductor brevis, there was no significant group-by-time interaction effect for intraoperative MEP amplitudes or SEP latencies and amplitudes.
Conclusions
TIVA with remimazolam and remifentanil for cervical spine surgery yielded stable IONM, comparable to those observed with conventional TIVA with propofol and remifentanil. Further clinical trials are needed in other surgical contexts and with more diverse patient populations to determine the effects of remimazolam on IONM.
8.Quarantine procedures for management of infectious diseases in non-human primate
Gyu-Seo BAE ; Bon-Sang KOO ; Eun-Su JEON ; Wan-Kyu LEE
Journal of Biomedical and Translational Research 2024;25(4):169-183
Non-human primates, due to their high genetic similarity to humans, are used as laboratory animals in biotechnology researches. The growing demand has recently led to a shortage of primate resources, which has become a significant issue both domestically and internation-ally. This shortage has been further exacerbated by the COVID-19 pandemic. Consequently, the importance of resource conservation through effective primate management is increas-ing. This requires the establishment of proper quarantine procedures and infectious disease control. Quarantine is an important process that protects not only animal health but also pub-lic health significance. Non-human primate quarantine procedures were organized in order.We compared the differences in quarantine procedures not only in Korea but also in variouscountries such as the US, EU, and Australia. In addition, the etiology, clinical symptoms, diagnosis, and treatment methods of representative infectious diseases of quarantine concern(tuberculosis, monkeypox, monkey immunodeficiency virus, salmonellosis, and shigellosis) were summarized. A literature review of nonhuman primate quarantine procedures in other countries revealed minimal differences in the basic structure. The quarantine periods were similar around 30 days, but we found some differences in details such as legal requirements, documentation forms, and quarantine authorities. These findings are expected to contributeto the development of strategies for improving methods to prevent the spread of infectious diseases and enhancing quarantine management methods.
9.Quarantine procedures for management of infectious diseases in non-human primate
Gyu-Seo BAE ; Bon-Sang KOO ; Eun-Su JEON ; Wan-Kyu LEE
Journal of Biomedical and Translational Research 2024;25(4):169-183
Non-human primates, due to their high genetic similarity to humans, are used as laboratory animals in biotechnology researches. The growing demand has recently led to a shortage of primate resources, which has become a significant issue both domestically and internation-ally. This shortage has been further exacerbated by the COVID-19 pandemic. Consequently, the importance of resource conservation through effective primate management is increas-ing. This requires the establishment of proper quarantine procedures and infectious disease control. Quarantine is an important process that protects not only animal health but also pub-lic health significance. Non-human primate quarantine procedures were organized in order.We compared the differences in quarantine procedures not only in Korea but also in variouscountries such as the US, EU, and Australia. In addition, the etiology, clinical symptoms, diagnosis, and treatment methods of representative infectious diseases of quarantine concern(tuberculosis, monkeypox, monkey immunodeficiency virus, salmonellosis, and shigellosis) were summarized. A literature review of nonhuman primate quarantine procedures in other countries revealed minimal differences in the basic structure. The quarantine periods were similar around 30 days, but we found some differences in details such as legal requirements, documentation forms, and quarantine authorities. These findings are expected to contributeto the development of strategies for improving methods to prevent the spread of infectious diseases and enhancing quarantine management methods.
10.Alteration of goat kids’ gut microbiota by Cryptosporidium parvum infection
Subin LEE ; Badriah ALKATHIRI ; Ah-Young KIM ; Kyung-Hyo DO ; Kwangwon SEO ; Soochong KIM ; Wan-Kyu LEE ; Dongmi KWAK ; Seung-Hun LEE
Journal of Biomedical and Translational Research 2024;25(2):41-52
Caprine cryptosporidiosis mainly occurs in young goats, with morbidity rates of 80%–100% and mortality over 50% in goat kids. However, limited research has been conducted on the impact of Cryptosporidium parvum, a diarrhea-causing pathogen, on the intestinal microbiota of goat kids. In this study, 16S rRNA-based metataxonomic analysis was performed to compare the microbial diversity and abundance of the gut microbiota between C. parvum-infected and uninfected goat kids. In total, 12 goat fecal samples were collected, including seven naturally C. parvum-infected and five uninfected goats from Chungcheongbuk-do, Korea. After amplification of the V3–V4 hypervariable region of the bacterial 16S rRNA, high-throughput sequencing was performed. The results showed differences in the microbial composition between C. parvum-infected and uninfected groups based on beta diversity. Firmicutes and Bacteroidetes were the most dominant phyla in both groups. However, no significant differ-ence was observed in the Bacteroidetes/Firmicutes ratio between the two groups. Compared with the uninfected group, the C. parvum-infected group showed significantly higher abun-dances of Tyzzerella nexillis, Lactobacillus johnsonii, Butyricicoccus pullicaecorum, Entero-coccus raffinosus, Enterococcus faecalis, and Negativicoccus massiliensis, and significantly reduced abundances of Aerococcus vaginalis, Faecalicoccus pleomorphus, Oribacterium parvum, and Coprococcus comes. These findings indicate that C. parvum infection, which is associated with diarrhea in neonatal goats, induces alterations in the caprine gut microbiota.

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