1.A Propensity Score-Matched Cohort Study Comparing 3 Different Spine Pedicle Screw Fixation Methods: Freehand, Fluoroscopy-Guided, and Robot-Assisted Techniques
Yoon Ha HWANG ; Byeong-Jin HA ; Hyung Cheol KIM ; Byung Ho LEE ; Jeong-Yoon PARK ; Dong-Kyu CHIN ; Seong YI
Neurospine 2024;21(1):83-94
Objective:
This study aimed to compare the accuracy of robotic spine surgery and conventional pedicle screw fixation in lumbar degenerative disease. We evaluated clinical and radiological outcomes to demonstrate the noninferiority of robotic surgery.
Methods:
This study employed propensity score matching and included 3 groups: robot-assisted mini-open posterior lumbar interbody fusion (PLIF) (robotic surgery, RS), c-arm guided minimally invasive surgery transforaminal lumbar interbody fusion (C-arm guidance, CG), and freehand open PLIF (free of guidance, FG) (54 patients each). The mean follow-up period was 2.2 years. The preoperative spine condition was considered. Accuracy was evaluated using the Gertzbein-Robbins scale (GRS score) and Babu classification (Babu score). Radiological outcomes included adjacent segmental disease (ASD) and mechanical failure. Clinical outcomes were assessed based on the visual analogue scale, Oswestry Disability Index, 36-item Short Form health survey, and clinical ASD rate.
Results:
Accuracy was higher in the RS group (p < 0.01) than in other groups. The GRS score was lower in the CG group, whereas the Babu score was lower in the FG group compared with the RS group. No significant differences were observed in radiological and clinical outcomes among the 3 groups. Regression analysis identified preoperative facet degeneration, GRS and Babu scores as significant variables for radiological and clinical ASD. Mechanical failure was influenced by the GRS score and patients’ age.
Conclusion
This study showed the superior accuracy of robotic spine surgery compared with conventional techniques. When combined with minimally invasive surgery, robotic surgery is advantageous with reduced ligament and muscle damage associated with traditional open procedures.
2.Pharmacological properties of Technekitty injection (Tc-99m) in diagnosing feline hyperthyroidism
Jae Cheong LIM ; So-Young LEE ; Eun Ha CHO ; Yu Mi JUNG ; Ki Hwan PARK ; Young Uk PARK ; Sung Soo NAM ; Tae Hoon LEE ; Jae Won LEE ; Jisu SUN ; Hye Kyung CHUNG ; Yong Jin LEE ; Yeon CHAE ; Byeong-Teck KANG
Journal of Biomedical and Translational Research 2024;25(4):185-199
Thyroid scanning using technetium-99m ( 99mTc) is the gold standard for diagnosing feline hyperthyroidism. In cats with an overactive thyroid, a thyroid scan is the most appropriate imaging technique to detect and localize any hyperfunctional adenomatous thyroid tissue. In this study, the pharmacological properties of the Technekitty injection (Tc-99m), developed as a diagnostic agent for feline hyperthyroidism using 99mTc as an active ingredient, were tested in FRTL-5 thyroid follicular cell line and ICR mice. The percentage of cell uptake of the Tc-99m in FRTL-5 thyroid cells was 0.182 ± 0.018%, which was about 6 times higher compared to Clone 9 hepatocytes. This uptake decreased by 38.2% due to competitive inhibition by iodine (sodium iodide). In tissue distribution tests by using ICR mice, the highest distribution was observed in the liver, kidneys, spleen, lungs, and femur at 0.083 hours after administration, and this distribution decreased as the compound was excreted through the kidneys, the pri-mary excretory organ. Maximum distribution was confirmed at 1 hour in the small intestine, 6hours in the large intestine, and 2 hours in the thyroid gland. Additionally, the total amount excreted through urine and feces over 48 hours (2 days) was 78.80% of the injected dose, with 37.70% (47.84% of the total excretion) excreted through urine and 41.10% (52.16% of the total excretion) through feces. In conclusion, the Tc-99m has the same mechanism of action, potency, absorption, distribution, metabolism, and excretion characteristics as 99mTc used for feline hyperthyroidism in the United States, Europe, and other countries, because the Technekitty injection (Tc-99m) contains 99mTc as its sole active ingredient. Based on these results, the Technekitty injection (Tc-99m) is expected to be safely used in the clinical diagnosis of feline hyperthyroidism.
3.Lecanemab: Appropriate Use Recommendations by Korean Dementia Association
Kee Hyung PARK ; Geon Ha KIM ; Chi-Hun KIM ; Seong-Ho KOH ; So Young MOON ; Young Ho PARK ; Sang Won SEO ; Bora YOON ; Jae-Sung LIM ; Byeong C. KIM ; Hee-Jin KIM ; Hae Ri NA ; YongSoo SHIM ; YoungSoon YANG ; Chan-Nyoung LEE ; Hak Young RHEE ; San JUNG ; Jee Hyang JEONG ; Hojin CHOI ; Dong Won YANG ; Seong Hye CHOI
Dementia and Neurocognitive Disorders 2024;23(4):165-187
Lecanemab (product name Leqembi ® ) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations,administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.
4.A Propensity Score-Matched Cohort Study Comparing 3 Different Spine Pedicle Screw Fixation Methods: Freehand, Fluoroscopy-Guided, and Robot-Assisted Techniques
Yoon Ha HWANG ; Byeong-Jin HA ; Hyung Cheol KIM ; Byung Ho LEE ; Jeong-Yoon PARK ; Dong-Kyu CHIN ; Seong YI
Neurospine 2024;21(1):83-94
Objective:
This study aimed to compare the accuracy of robotic spine surgery and conventional pedicle screw fixation in lumbar degenerative disease. We evaluated clinical and radiological outcomes to demonstrate the noninferiority of robotic surgery.
Methods:
This study employed propensity score matching and included 3 groups: robot-assisted mini-open posterior lumbar interbody fusion (PLIF) (robotic surgery, RS), c-arm guided minimally invasive surgery transforaminal lumbar interbody fusion (C-arm guidance, CG), and freehand open PLIF (free of guidance, FG) (54 patients each). The mean follow-up period was 2.2 years. The preoperative spine condition was considered. Accuracy was evaluated using the Gertzbein-Robbins scale (GRS score) and Babu classification (Babu score). Radiological outcomes included adjacent segmental disease (ASD) and mechanical failure. Clinical outcomes were assessed based on the visual analogue scale, Oswestry Disability Index, 36-item Short Form health survey, and clinical ASD rate.
Results:
Accuracy was higher in the RS group (p < 0.01) than in other groups. The GRS score was lower in the CG group, whereas the Babu score was lower in the FG group compared with the RS group. No significant differences were observed in radiological and clinical outcomes among the 3 groups. Regression analysis identified preoperative facet degeneration, GRS and Babu scores as significant variables for radiological and clinical ASD. Mechanical failure was influenced by the GRS score and patients’ age.
Conclusion
This study showed the superior accuracy of robotic spine surgery compared with conventional techniques. When combined with minimally invasive surgery, robotic surgery is advantageous with reduced ligament and muscle damage associated with traditional open procedures.
5.A Propensity Score-Matched Cohort Study Comparing 3 Different Spine Pedicle Screw Fixation Methods: Freehand, Fluoroscopy-Guided, and Robot-Assisted Techniques
Yoon Ha HWANG ; Byeong-Jin HA ; Hyung Cheol KIM ; Byung Ho LEE ; Jeong-Yoon PARK ; Dong-Kyu CHIN ; Seong YI
Neurospine 2024;21(1):83-94
Objective:
This study aimed to compare the accuracy of robotic spine surgery and conventional pedicle screw fixation in lumbar degenerative disease. We evaluated clinical and radiological outcomes to demonstrate the noninferiority of robotic surgery.
Methods:
This study employed propensity score matching and included 3 groups: robot-assisted mini-open posterior lumbar interbody fusion (PLIF) (robotic surgery, RS), c-arm guided minimally invasive surgery transforaminal lumbar interbody fusion (C-arm guidance, CG), and freehand open PLIF (free of guidance, FG) (54 patients each). The mean follow-up period was 2.2 years. The preoperative spine condition was considered. Accuracy was evaluated using the Gertzbein-Robbins scale (GRS score) and Babu classification (Babu score). Radiological outcomes included adjacent segmental disease (ASD) and mechanical failure. Clinical outcomes were assessed based on the visual analogue scale, Oswestry Disability Index, 36-item Short Form health survey, and clinical ASD rate.
Results:
Accuracy was higher in the RS group (p < 0.01) than in other groups. The GRS score was lower in the CG group, whereas the Babu score was lower in the FG group compared with the RS group. No significant differences were observed in radiological and clinical outcomes among the 3 groups. Regression analysis identified preoperative facet degeneration, GRS and Babu scores as significant variables for radiological and clinical ASD. Mechanical failure was influenced by the GRS score and patients’ age.
Conclusion
This study showed the superior accuracy of robotic spine surgery compared with conventional techniques. When combined with minimally invasive surgery, robotic surgery is advantageous with reduced ligament and muscle damage associated with traditional open procedures.
6.Clinical Application of Artificial Intelligence-Based Computed Tomography Analysis of Myosteatosis in Localized Renal Cell Carcinoma
Byeong Jin KANG ; Kyung Hwan KIM ; Seung Baek HONG ; Nam Kyung LEE ; Suk KIM ; Sihwan KIM ; Hong Koo HA
Journal of Urologic Oncology 2024;22(3):237-245
Purpose:
Myosteatosis, defined as fat infiltration in muscle tissue, has been linked to poor outcomes in various cancers. However, the prognostic impact of myosteatosis on renal cell carcinoma (RCC) remains poorly understood. This study evaluated the predictive value of myosteatosis based on an artificial intelligence (AI)-driven computed tomography (CT) analysis in patients with localized RCC who underwent partial nephrectomy.
Materials and Methods:
This retrospective study included 170 patients with localized RCC who underwent partial nephrectomy at a single institution between 2011 and 2017. Myosteatosis was assessed on CT scans using an AI-based tool. The patients were categorized into 2 groups according to the presence or absence of myosteatosis. The clinical outcomes, including disease-free survival (DFS), were compared to determine the prognostic significance of myosteatosis.
Results:
Of 170 patients, 36 (21.2%) were diagnosed with myosteatosis. These patients were older and had a higher body mass index. The myosteatosis group had a higher proportion of females than the no myosteatosis group. Lymphovascular invasion and tumor necrosis were prevalent pathological features in patients with myosteatosis. Kaplan-Meier analysis demonstrated that myosteatosis was associated with significantly shorter DFS (p<0.05). Multivariate analysis confirmed that myosteatosis independently predicted adverse outcomes in patients with localized RCC.
Conclusion
AI-based CT analysis of myosteatosis is a reliable method for improving the risk stratification of patients with localized RCC. Patients with myosteatosis demonstrate poor pathological features and shorter DFS. These findings highlight the potential of AI-driven body composition analysis to refine prognostic models and personalized treatment strategies.
7.Lecanemab: Appropriate Use Recommendations by Korean Dementia Association
Kee Hyung PARK ; Geon Ha KIM ; Chi-Hun KIM ; Seong-Ho KOH ; So Young MOON ; Young Ho PARK ; Sang Won SEO ; Bora YOON ; Jae-Sung LIM ; Byeong C. KIM ; Hee-Jin KIM ; Hae Ri NA ; YongSoo SHIM ; YoungSoon YANG ; Chan-Nyoung LEE ; Hak Young RHEE ; San JUNG ; Jee Hyang JEONG ; Hojin CHOI ; Dong Won YANG ; Seong Hye CHOI
Dementia and Neurocognitive Disorders 2024;23(4):165-187
Lecanemab (product name Leqembi ® ) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations,administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.
8.Lecanemab: Appropriate Use Recommendations by Korean Dementia Association
Kee Hyung PARK ; Geon Ha KIM ; Chi-Hun KIM ; Seong-Ho KOH ; So Young MOON ; Young Ho PARK ; Sang Won SEO ; Bora YOON ; Jae-Sung LIM ; Byeong C. KIM ; Hee-Jin KIM ; Hae Ri NA ; YongSoo SHIM ; YoungSoon YANG ; Chan-Nyoung LEE ; Hak Young RHEE ; San JUNG ; Jee Hyang JEONG ; Hojin CHOI ; Dong Won YANG ; Seong Hye CHOI
Dementia and Neurocognitive Disorders 2024;23(4):165-187
Lecanemab (product name Leqembi ® ) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations,administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.
9.Pharmacological properties of Technekitty injection (Tc-99m) in diagnosing feline hyperthyroidism
Jae Cheong LIM ; So-Young LEE ; Eun Ha CHO ; Yu Mi JUNG ; Ki Hwan PARK ; Young Uk PARK ; Sung Soo NAM ; Tae Hoon LEE ; Jae Won LEE ; Jisu SUN ; Hye Kyung CHUNG ; Yong Jin LEE ; Yeon CHAE ; Byeong-Teck KANG
Journal of Biomedical and Translational Research 2024;25(4):185-199
Thyroid scanning using technetium-99m ( 99mTc) is the gold standard for diagnosing feline hyperthyroidism. In cats with an overactive thyroid, a thyroid scan is the most appropriate imaging technique to detect and localize any hyperfunctional adenomatous thyroid tissue. In this study, the pharmacological properties of the Technekitty injection (Tc-99m), developed as a diagnostic agent for feline hyperthyroidism using 99mTc as an active ingredient, were tested in FRTL-5 thyroid follicular cell line and ICR mice. The percentage of cell uptake of the Tc-99m in FRTL-5 thyroid cells was 0.182 ± 0.018%, which was about 6 times higher compared to Clone 9 hepatocytes. This uptake decreased by 38.2% due to competitive inhibition by iodine (sodium iodide). In tissue distribution tests by using ICR mice, the highest distribution was observed in the liver, kidneys, spleen, lungs, and femur at 0.083 hours after administration, and this distribution decreased as the compound was excreted through the kidneys, the pri-mary excretory organ. Maximum distribution was confirmed at 1 hour in the small intestine, 6hours in the large intestine, and 2 hours in the thyroid gland. Additionally, the total amount excreted through urine and feces over 48 hours (2 days) was 78.80% of the injected dose, with 37.70% (47.84% of the total excretion) excreted through urine and 41.10% (52.16% of the total excretion) through feces. In conclusion, the Tc-99m has the same mechanism of action, potency, absorption, distribution, metabolism, and excretion characteristics as 99mTc used for feline hyperthyroidism in the United States, Europe, and other countries, because the Technekitty injection (Tc-99m) contains 99mTc as its sole active ingredient. Based on these results, the Technekitty injection (Tc-99m) is expected to be safely used in the clinical diagnosis of feline hyperthyroidism.
10.Clinical Application of Artificial Intelligence-Based Computed Tomography Analysis of Myosteatosis in Localized Renal Cell Carcinoma
Byeong Jin KANG ; Kyung Hwan KIM ; Seung Baek HONG ; Nam Kyung LEE ; Suk KIM ; Sihwan KIM ; Hong Koo HA
Journal of Urologic Oncology 2024;22(3):237-245
Purpose:
Myosteatosis, defined as fat infiltration in muscle tissue, has been linked to poor outcomes in various cancers. However, the prognostic impact of myosteatosis on renal cell carcinoma (RCC) remains poorly understood. This study evaluated the predictive value of myosteatosis based on an artificial intelligence (AI)-driven computed tomography (CT) analysis in patients with localized RCC who underwent partial nephrectomy.
Materials and Methods:
This retrospective study included 170 patients with localized RCC who underwent partial nephrectomy at a single institution between 2011 and 2017. Myosteatosis was assessed on CT scans using an AI-based tool. The patients were categorized into 2 groups according to the presence or absence of myosteatosis. The clinical outcomes, including disease-free survival (DFS), were compared to determine the prognostic significance of myosteatosis.
Results:
Of 170 patients, 36 (21.2%) were diagnosed with myosteatosis. These patients were older and had a higher body mass index. The myosteatosis group had a higher proportion of females than the no myosteatosis group. Lymphovascular invasion and tumor necrosis were prevalent pathological features in patients with myosteatosis. Kaplan-Meier analysis demonstrated that myosteatosis was associated with significantly shorter DFS (p<0.05). Multivariate analysis confirmed that myosteatosis independently predicted adverse outcomes in patients with localized RCC.
Conclusion
AI-based CT analysis of myosteatosis is a reliable method for improving the risk stratification of patients with localized RCC. Patients with myosteatosis demonstrate poor pathological features and shorter DFS. These findings highlight the potential of AI-driven body composition analysis to refine prognostic models and personalized treatment strategies.

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