1.Application of Transverse Process Hooks at Distal Thoracic Vertebrae in Uppermost Vertebral Instrumentation for Adult Spinal Deformity Surgery: Special Focus on Delayed-Onset Neurologic Deficits
Sun-Joon YOO ; Hyun-Jun JANG ; Bong Ju MOON ; Jeong-Yoon PARK ; Sung Uk KUH ; Dong-Kyu CHIN ; Keun-Su KIM ; Jun Jae SHIN ; Yoon HA ; Kyung-Hyun KIM
Neurospine 2024;21(4):1219-1229
		                        		
		                        			 Objective:
		                        			We aimed to investigate the incidence of delayed-onset neurological deficits (DONDs), DOND-related reoperation rates following adult spinal deformity (ASD) surgery, and efficacy of transverse process hooks (TPHs) at the uppermost instrumented vertebra (UIV) compared to pedicle screws (PSs). 
		                        		
		                        			Methods:
		                        			We included 90 consecutive patients who underwent instrumented fusion from the sacrum to the distal thoracic spine for ASD, with a minimum follow-up of 24 months. Clinical and radiological outcomes were compared between 33 patients in the TPH group and 57 patients in the PS group, using the Scoliosis Research Society-22 Outcomes questionnaire (SRS-22), Medical Outcomes Study Questionnaire Short-Form 36 (SF-36), and various spinal sagittal parameters. 
		                        		
		                        			Results:
		                        			While absent in the TPH group, myelopathy occurred in 15.8% of the PS group, wherein 15 patients underwent reoperation. The change in the proximal junctional angle, from the pre- to postoperative assessment, was lower in the TPH group than in the PS group (0.2 vs. 6.6, p=0.002). Postoperative facet degeneration in the PS group progressed more significantly than in the TPH group (0.5 vs. 0.1, p=0.002). Surgical outcomes were comparable for both groups, except for the back visual analogue scale (3.5 vs. 4.1, p=0.010) and SRS-22 domains, including pain and satisfaction (3.3 vs. 2.9, p=0.033; 3.7 vs. 3.3, p=0.041). No intergroup difference was observed in SF-36. 
		                        		
		                        			Conclusion
		                        			Using TPHs at the UIV level can prevent DOND, and thereby prevent postoperative myelopathy that necessitates reoperation; thus, TPHs is preferable over PSs in ASD surgery. 
		                        		
		                        		
		                        		
		                        	
2.Application of Transverse Process Hooks at Distal Thoracic Vertebrae in Uppermost Vertebral Instrumentation for Adult Spinal Deformity Surgery: Special Focus on Delayed-Onset Neurologic Deficits
Sun-Joon YOO ; Hyun-Jun JANG ; Bong Ju MOON ; Jeong-Yoon PARK ; Sung Uk KUH ; Dong-Kyu CHIN ; Keun-Su KIM ; Jun Jae SHIN ; Yoon HA ; Kyung-Hyun KIM
Neurospine 2024;21(4):1219-1229
		                        		
		                        			 Objective:
		                        			We aimed to investigate the incidence of delayed-onset neurological deficits (DONDs), DOND-related reoperation rates following adult spinal deformity (ASD) surgery, and efficacy of transverse process hooks (TPHs) at the uppermost instrumented vertebra (UIV) compared to pedicle screws (PSs). 
		                        		
		                        			Methods:
		                        			We included 90 consecutive patients who underwent instrumented fusion from the sacrum to the distal thoracic spine for ASD, with a minimum follow-up of 24 months. Clinical and radiological outcomes were compared between 33 patients in the TPH group and 57 patients in the PS group, using the Scoliosis Research Society-22 Outcomes questionnaire (SRS-22), Medical Outcomes Study Questionnaire Short-Form 36 (SF-36), and various spinal sagittal parameters. 
		                        		
		                        			Results:
		                        			While absent in the TPH group, myelopathy occurred in 15.8% of the PS group, wherein 15 patients underwent reoperation. The change in the proximal junctional angle, from the pre- to postoperative assessment, was lower in the TPH group than in the PS group (0.2 vs. 6.6, p=0.002). Postoperative facet degeneration in the PS group progressed more significantly than in the TPH group (0.5 vs. 0.1, p=0.002). Surgical outcomes were comparable for both groups, except for the back visual analogue scale (3.5 vs. 4.1, p=0.010) and SRS-22 domains, including pain and satisfaction (3.3 vs. 2.9, p=0.033; 3.7 vs. 3.3, p=0.041). No intergroup difference was observed in SF-36. 
		                        		
		                        			Conclusion
		                        			Using TPHs at the UIV level can prevent DOND, and thereby prevent postoperative myelopathy that necessitates reoperation; thus, TPHs is preferable over PSs in ASD surgery. 
		                        		
		                        		
		                        		
		                        	
3.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
		                        		
		                        			 Objectives:
		                        			This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).  
		                        		
		                        			Methods:
		                        			This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.  
		                        		
		                        			Results:
		                        			The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.  
		                        		
		                        			Conclusions
		                        			This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia. 
		                        		
		                        		
		                        		
		                        	
4.Application of Transverse Process Hooks at Distal Thoracic Vertebrae in Uppermost Vertebral Instrumentation for Adult Spinal Deformity Surgery: Special Focus on Delayed-Onset Neurologic Deficits
Sun-Joon YOO ; Hyun-Jun JANG ; Bong Ju MOON ; Jeong-Yoon PARK ; Sung Uk KUH ; Dong-Kyu CHIN ; Keun-Su KIM ; Jun Jae SHIN ; Yoon HA ; Kyung-Hyun KIM
Neurospine 2024;21(4):1219-1229
		                        		
		                        			 Objective:
		                        			We aimed to investigate the incidence of delayed-onset neurological deficits (DONDs), DOND-related reoperation rates following adult spinal deformity (ASD) surgery, and efficacy of transverse process hooks (TPHs) at the uppermost instrumented vertebra (UIV) compared to pedicle screws (PSs). 
		                        		
		                        			Methods:
		                        			We included 90 consecutive patients who underwent instrumented fusion from the sacrum to the distal thoracic spine for ASD, with a minimum follow-up of 24 months. Clinical and radiological outcomes were compared between 33 patients in the TPH group and 57 patients in the PS group, using the Scoliosis Research Society-22 Outcomes questionnaire (SRS-22), Medical Outcomes Study Questionnaire Short-Form 36 (SF-36), and various spinal sagittal parameters. 
		                        		
		                        			Results:
		                        			While absent in the TPH group, myelopathy occurred in 15.8% of the PS group, wherein 15 patients underwent reoperation. The change in the proximal junctional angle, from the pre- to postoperative assessment, was lower in the TPH group than in the PS group (0.2 vs. 6.6, p=0.002). Postoperative facet degeneration in the PS group progressed more significantly than in the TPH group (0.5 vs. 0.1, p=0.002). Surgical outcomes were comparable for both groups, except for the back visual analogue scale (3.5 vs. 4.1, p=0.010) and SRS-22 domains, including pain and satisfaction (3.3 vs. 2.9, p=0.033; 3.7 vs. 3.3, p=0.041). No intergroup difference was observed in SF-36. 
		                        		
		                        			Conclusion
		                        			Using TPHs at the UIV level can prevent DOND, and thereby prevent postoperative myelopathy that necessitates reoperation; thus, TPHs is preferable over PSs in ASD surgery. 
		                        		
		                        		
		                        		
		                        	
5.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
		                        		
		                        			 Objectives:
		                        			This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).  
		                        		
		                        			Methods:
		                        			This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.  
		                        		
		                        			Results:
		                        			The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.  
		                        		
		                        			Conclusions
		                        			This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia. 
		                        		
		                        		
		                        		
		                        	
6.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
		                        		
		                        			 Objectives:
		                        			This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).  
		                        		
		                        			Methods:
		                        			This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.  
		                        		
		                        			Results:
		                        			The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.  
		                        		
		                        			Conclusions
		                        			This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia. 
		                        		
		                        		
		                        		
		                        	
7.Application of Transverse Process Hooks at Distal Thoracic Vertebrae in Uppermost Vertebral Instrumentation for Adult Spinal Deformity Surgery: Special Focus on Delayed-Onset Neurologic Deficits
Sun-Joon YOO ; Hyun-Jun JANG ; Bong Ju MOON ; Jeong-Yoon PARK ; Sung Uk KUH ; Dong-Kyu CHIN ; Keun-Su KIM ; Jun Jae SHIN ; Yoon HA ; Kyung-Hyun KIM
Neurospine 2024;21(4):1219-1229
		                        		
		                        			 Objective:
		                        			We aimed to investigate the incidence of delayed-onset neurological deficits (DONDs), DOND-related reoperation rates following adult spinal deformity (ASD) surgery, and efficacy of transverse process hooks (TPHs) at the uppermost instrumented vertebra (UIV) compared to pedicle screws (PSs). 
		                        		
		                        			Methods:
		                        			We included 90 consecutive patients who underwent instrumented fusion from the sacrum to the distal thoracic spine for ASD, with a minimum follow-up of 24 months. Clinical and radiological outcomes were compared between 33 patients in the TPH group and 57 patients in the PS group, using the Scoliosis Research Society-22 Outcomes questionnaire (SRS-22), Medical Outcomes Study Questionnaire Short-Form 36 (SF-36), and various spinal sagittal parameters. 
		                        		
		                        			Results:
		                        			While absent in the TPH group, myelopathy occurred in 15.8% of the PS group, wherein 15 patients underwent reoperation. The change in the proximal junctional angle, from the pre- to postoperative assessment, was lower in the TPH group than in the PS group (0.2 vs. 6.6, p=0.002). Postoperative facet degeneration in the PS group progressed more significantly than in the TPH group (0.5 vs. 0.1, p=0.002). Surgical outcomes were comparable for both groups, except for the back visual analogue scale (3.5 vs. 4.1, p=0.010) and SRS-22 domains, including pain and satisfaction (3.3 vs. 2.9, p=0.033; 3.7 vs. 3.3, p=0.041). No intergroup difference was observed in SF-36. 
		                        		
		                        			Conclusion
		                        			Using TPHs at the UIV level can prevent DOND, and thereby prevent postoperative myelopathy that necessitates reoperation; thus, TPHs is preferable over PSs in ASD surgery. 
		                        		
		                        		
		                        		
		                        	
8.Clinical Burden of Aripiprazole Once-Monthly in Patients With Schizophrenia Receiving Antipsychotic Polypharmacy
Jiwan MOON ; Hyeryun YANG ; Sra JUNG ; Soo Bong JUNG ; Jhin-Goo CHANG ; Won-Hyoung KIM ; Sang Min LEE ; Jangrae KIM ; Minji BANG ; Min-Kyoung KIM ; Eun Soo KIM ; Dong-Won SHIN ; Kang Seob OH ; Sang Won JEON ; Junhyung KIM ; Young Chul SHIN ; Sung Joon CHO
Journal of the Korean Society of Biological Psychiatry 2024;31(2):34-39
		                        		
		                        			 Objectives:
		                        			This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM).  
		                        		
		                        			Methods:
		                        			This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score.  
		                        		
		                        			Results:
		                        			The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6.  
		                        		
		                        			Conclusions
		                        			This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia. 
		                        		
		                        		
		                        		
		                        	
9.Application of Transverse Process Hooks at Distal Thoracic Vertebrae in Uppermost Vertebral Instrumentation for Adult Spinal Deformity Surgery: Special Focus on Delayed-Onset Neurologic Deficits
Sun-Joon YOO ; Hyun-Jun JANG ; Bong Ju MOON ; Jeong-Yoon PARK ; Sung Uk KUH ; Dong-Kyu CHIN ; Keun-Su KIM ; Jun Jae SHIN ; Yoon HA ; Kyung-Hyun KIM
Neurospine 2024;21(4):1219-1229
		                        		
		                        			 Objective:
		                        			We aimed to investigate the incidence of delayed-onset neurological deficits (DONDs), DOND-related reoperation rates following adult spinal deformity (ASD) surgery, and efficacy of transverse process hooks (TPHs) at the uppermost instrumented vertebra (UIV) compared to pedicle screws (PSs). 
		                        		
		                        			Methods:
		                        			We included 90 consecutive patients who underwent instrumented fusion from the sacrum to the distal thoracic spine for ASD, with a minimum follow-up of 24 months. Clinical and radiological outcomes were compared between 33 patients in the TPH group and 57 patients in the PS group, using the Scoliosis Research Society-22 Outcomes questionnaire (SRS-22), Medical Outcomes Study Questionnaire Short-Form 36 (SF-36), and various spinal sagittal parameters. 
		                        		
		                        			Results:
		                        			While absent in the TPH group, myelopathy occurred in 15.8% of the PS group, wherein 15 patients underwent reoperation. The change in the proximal junctional angle, from the pre- to postoperative assessment, was lower in the TPH group than in the PS group (0.2 vs. 6.6, p=0.002). Postoperative facet degeneration in the PS group progressed more significantly than in the TPH group (0.5 vs. 0.1, p=0.002). Surgical outcomes were comparable for both groups, except for the back visual analogue scale (3.5 vs. 4.1, p=0.010) and SRS-22 domains, including pain and satisfaction (3.3 vs. 2.9, p=0.033; 3.7 vs. 3.3, p=0.041). No intergroup difference was observed in SF-36. 
		                        		
		                        			Conclusion
		                        			Using TPHs at the UIV level can prevent DOND, and thereby prevent postoperative myelopathy that necessitates reoperation; thus, TPHs is preferable over PSs in ASD surgery. 
		                        		
		                        		
		                        		
		                        	
10.Harnessing Metabolic Indices as a Predictive Tool for Cardiovascular Disease in a Korean Population without Known Major Cardiovascular Event
Hyun-Jin KIM ; Byung Sik KIM ; Yonggu LEE ; Sang Bong AHN ; Dong Wook KIM ; Jeong-Hun SHIN
Diabetes & Metabolism Journal 2024;48(3):449-462
		                        		
		                        			 Background:
		                        			This study evaluated the usefulness of indices for metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), and insulin resistance (IR), as predictive tools for cardiovascular disease in middle-aged Korean adults. 
		                        		
		                        			Methods:
		                        			The prospective data obtained from the Ansan-Ansung cohort database, excluding patients with major adverse cardiac and cerebrovascular events (MACCE). The primary outcome was the incidence of MACCE during the follow-up period. 
		                        		
		                        			Results:
		                        			A total of 9,337 patients were included in the analysis, of whom 1,130 (12.1%) experienced MACCE during a median follow-up period of 15.5 years. The metabolic syndrome severity Z-score, metabolic syndrome severity score, hepatic steatosis index, and NAFLD liver fat score were found to significantly predict MACCE at values above the cut-off point and in the second and third tertiles. Among these indices, the hazard ratios of the metabolic syndrome severity score and metabolic syndrome severity Z-score were the highest after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) of the 10-year atherosclerotic cardiovascular disease (ASCVD) score for predicting MACCE was 0.716, and the metabolic syndrome severity Z-score had an AUC of 0.619. 
		                        		
		                        			Conclusion
		                        			The metabolic syndrome severity score is a highly reliable indicator and was closely associated with the 10-year ASCVD risk score in predicting MACCE in the general population. Given the specific characteristics and limitations of metabolic syndrome severity scores as well as the indices of NAFLD and IR, a more practical scoring system that considers these factors is essential to achieve greater accuracy in forecasting cardiovascular outcomes. 
		                        		
		                        		
		                        		
		                        	
            
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