Application of a Cumulative Summation test (CUSUM)in the Lumbar Spine

Study design: Retrospective analysisObjectives: The aim of this study was to monitor the quality control of pedicle screw fixation using a cumulativesummation test (CUSUM).Overview of Literature: CUSUM test has already been used in several different surgical settings including theassessment of outcomes in transplant, laparoscopic, and total hip replacement surgeries. However, there has been nodata regarding CUSUM analysis for spine surgery.Methods: Patients with lumbar spinal stenosis who underwent lumbar fusion surgery were included in this study.The primary outcome was the CUSUM analysis for monitoring the quality control of the accuracy of pedicle screwinsertion.Results: Seven screws of the 100 pedicle screw insertions were considered to have failed in the lumbar fusion surgery,respectively. Throughout the monitoring period, there was no indication by the CUSUM test that the quality ofperformance of the pedicle screw fixation procedure was inadequate.Conclusions: Thisstudy demonstrates the CUSUM test can be a useful tool for monitoring of the quality of proceduresrelated with spine surgery.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000004226/7SEQ:7PERF_CD:SNU2014-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:NEMP_ID:A079510DEPT_CD:801CITE_RATE:0DEPT_NM:의학과SCOPUS_YN:NCONFIRM:

Increasing uptake of colorectal cancer screening in Korea: a population-based study

<p>Abstract</p> <p>Background</p> <p>Colorectal cancer (CRC) screening rates are low in most Asian countries and remain largely unknown. This study examined trends in CRC screening rates after the introduction of the Korean National Cancer Screening Programme (NCSP) and determined the factors associated with uptake of CRC screening by test modality over time.</p> <p>Methods</p> <p>An annual population-based survey conducted through nationally representative random sampling from 2005-2008. In total, 3,699 participants from the 2005-2008 surveys were selected as study subjects. Face-to-face interviews were performed to assess the utilization rate of CRC screening by each screening modality.</p> <p>Results</p> <p>Overall, CRC screening within the recommended time interval increased significantly from 22.9% in 2005 to 36.6% in 2008 (<it>p </it>< 0.001). The proportion of subjects receiving a fecal occult blood test (FOBT) test within the previous year increased significantly from 7.2% in 2005 to 21.3% in 2008 (<it>p </it>< 0.001). Increases in FOBT testing were highest among those who had a lower income status (relative difference = 511.9%) and women (relative difference = 266.1%). Endoscopy use also increased from 18.0% in 2005 to 20.5% in 2008, albeit not significant. Overall, those who were male, non-smokers, 60-69 years old, and had a higher income status were more likely to have undergone up-to-date endoscopy and CRC screening.</p> <p>Conclusions</p> <p>This study revealed a substantial increase in up-to-date CRC screening in the general population from 2005 to 2008. However, more than half of adults in Korea are still not up-to-date with their CRC tests. It will be important to continue to investigate factors associated with up-to-date CRC screening by each modality.</p

Efficient CO2-Reducing Activity of NAD-Dependent Formate Dehydrogenase from Thiobacillus sp KNK65MA for Formate Production from CO2 Gas

NAD-dependent formate dehydrogenase (FDH) from Candida boidinii (CbFDH) has been widely used in various CO2 reduction systems but its practical applications are often impeded due to low CO2-reducing activity. In this study, we demonstrated superior CO2-reducing properties of FDH from Thiobacillus sp. KNK65MA (TsFDH) for production of formate from CO2 gas. To discover more efficient CO2-reducing FDHs than a reference enzyme e. CbFDH, five FDHs were selected with biochemical properties and then, their CO2-reducing activities were evaluated. All FDHs including CbFDH showed better CO2-reducing activities at acidic pHs than at neutral pHs and four FDHs were more active than CbFDH in the CO2 reduction reaction. In particular, the FDH from Thiobacillus sp. KNK65IVIA (TsFDH) exhibited the highest CO2-reducing activity and had a dramatic preference for the reduction reaction, i.e., a 84.2-fold higher ratio of CO2 reduction to formate oxidation in catalytic efficiency (k(cat)/K-B) compared to CbFDH. Formate was produced from CO2 gas using TsFDH and CbFDH, and TsFDH showed a 5.8-fold higher formate production rate than CbFDH. A sequence and structural comparison showed that FDHs with relatively high CO2-reducing activities had elongated N- and C-terminal loops. The experimental results demonstrate that TsFDH can be an alternative to CbFDH as a biocatalyst in CO2 reduction systemsope

Airway sizes and proportions in children quantified by a video-bronchoscopic technique

Background: A quantitative understanding of airway sizes and proportions and a reference point for comparisons are important to a bronchoscopist. The aims of this study were to measure large airway areas, and define proportions and predictors of airway size in children. Methods: A validated videobronchoscope technique was used to measure in-vivo airway cross-sectional areas (cricoid, right (RMS) and left (LMS) main stem and major lobar bronchi) of 125 children. Airway proportions were calculated as ratios of airways to cricoid areas and to endotracheal tube (ETT) areas. Mann Whitney U, T-tests, and one-way ANOVA were used for comparisons and standard univariate and backwards, stepwise multivariate regression analyses were used to define airway size predictors. Results: Airways size increased progressively with increasing age but proportions remained constant. The LMS was 21% smaller than the RMS. Gender differences in airways' size were not significant in any age group or airway site. Cricoid area related best to body length (BL): cricoid area (mm2) = 26.782 + 0.254*BL (cm) while the RMS and LMS area related best to weight: RMS area (mm2) = 23.938 + 0.394*Wt (kg) and LMS area (mm2) = 20.055 + 0.263*Wt (kg) respectively. Airways to cricoid ratios were larger than airway to ETT ratios (p=0.0001). Conclusions: The cricoid and large airways progressively increase in size but maintain constant proportional relationships to the cricoid across childhood. The cricoid area correlates with body length while the RMS and LMS are best predicted by weight. These data provide for quantitative comparisons of airway lesions

Recognising contributions to work in research collaboratives: Guidelines for standardising reporting of authorship in collaborative research

Background Trainee research collaboratives (TRCs) have been revolutionary changes to the delivery of high-quality, multicentre research. The aim of this study was to define common roles in the conduct of collaborative research, and map these to academic competencies as set out by General Medical Council (GMC) in the United Kingdom. This will support trainers and assessors when judging academic achievements of those involved in TRC projects, and supports trainees by providing guidance on how to fulfil their role in these studies. Methods A modified Delphi process was followed. Electronic discussion with key stakeholders was undertaken to identify and describe common roles. These were refined and mapped to GMC educational domains and International Committee of Medical Journal Editors authorship (ICJME) guidelines. The resulting roles and descriptions were presented to a face-to-face consensus meeting for voting. The agreed roles were then presented back to the electronic discussion group for approval. Results Electronic discussion generated six common roles. All of these were agreed in face-to-face meetings, where two further roles identified and described. All eight roles required skills that map to part of the academic requirements for surgical training in the UK. Discussion This paper presents a standardised framework for reporting authorship in collaborative group authored research publications. Linkage of collaborator roles to the ICMJE guidelines and GMC academic competency guidelines will facilitate incorporation into relevant training curricular and journal publication policies

Monitoring the Quality of Robot-Assisted Pedicle Screw Fixation in the Lumbar Spine by Using a Cumulative Summation Test

Study Design. Prospective randomized controlled trial.Objective. The aim of this study was to monitor the quality control of robot-assisted pedicle screw fixation accuracy by using a cumulative summation (CUSUM) test at the initial stage of its application.Summary of Background Data. Although robot-assisted pedicle screw fixation reduces screw misplacement rates and provides critical support for minimally invasive surgical procedures, there have been no reports relating to the monitoring of quality control of the accuracy of this robot-assisted pedicle screw fixation procedure.Methods. Patients with lumbar spinal stenosis scheduled to undergo surgery were randomly and equally assigned through 1:1 allocation to a robot-assisted minimally invasive posterior lumbar interbody fusion (Rom-PLIF) group or a conventional open posterior PLIF using freehand technique group. The accuracy of pedicle screw placement was evaluated using postoperative computed tomography. The primary outcome was the CUSUM analysis for monitoring the quality control of the accuracy of pedicle screw insertion between the Rom-PLIF and conventional open posterior PLIF using freehand technique groups.Results. Of the 80 pedicle screws inserted in each group, 4 screws in the Rom-PLIF group, and 7 in the conventional open PLIF group, breached the pedicle. Of these 11 offending screws, 4 cases were categorized as grade B in the Rom-PLIF group, whereas 6 were grade B and 1 case was grade C in the Com-PLIF group, using the Gertzbein and Robbins classification. Throughout the monitoring period, there was no CUSUM test-derived indication that the quality of performance of the pedicle screw fixation procedure was inadequate in either group.Conclusion. First, this study demonstrates the adequacy of quality control of robot-assisted pedicle screw fixation even early in the application period based on the CUSUM analysis. Second, the CUSUM test can be a useful tool for monitoring of the quality of procedures related with spine surgery.OAIID:oai:osos.snu.ac.kr:snu2015-01/102/0000004226/2SEQ:2PERF_CD:SNU2015-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:YEMP_ID:A079510DEPT_CD:801CITE_RATE:2.447FILENAME:spine-2015_kim_monitoring the quality of robot assisted pedicle screw fixation in the lumbar spine.pdfDEPT_NM:의학과SCOPUS_YN:YCONFIRM:

Comparative study of LHX8 expression between odontoma and dental tissue-derived stem cells

Background: LHX8 (LIM-homeobox gene 8) is known as an important regulating factor in tooth morphogenesis. Odontoma is a mixed odontogenic tumor where epithelium and mesenchyme differentiated together, resulting in anomalous tooth structures. In this study, gene and protein expressions of LHX8 were analyzed in human odontoma-derived mesenchymal cells (HODC) compared to adult dental mesenchymal stem cells (aDSC), as well as morphological and histological characteristics of odontoma were analyzed. Methods: aDSCs were isolated from normal teeth, and HODCs were isolated from surgically removed odontoma mass. Morphological and histological evaluations were performed to compare between compound odontomas and normal premolars. RT-PCR and real-time PCR were performed to identify LHX8 mRNA expression in the HODCs and aDSCs. LHX8 protein expression levels were observed by immunoblotting and immunofluorescent staining. Results: The compound odontoma was composed of multiple tooth-like structures, which contained disorganized but recognizable enamel matrix, dentin, pulp, and cementum. LHX8 mRNA and LHX8 protein expressions were all higher in HODCs compared to those in aDSCs examined by RT-PCR, immunoblot, and immunofluorescent staining. Especially, real-time PCR showed 2.77-fold higher LHX8 expression in HODCs than in normal periodontal ligament stem cells (PDLSCs), while alveolar bone marrow stem cells (ABMSCs) expressed 0.12-fold LHX8 than PDLSCs. Conclusions: Based on these observations, LHX8 might play an important role in odontoma formation. This is the first report regarding the comparison of LHX8 expression between HODC and normal aDSCs and its overexpression in human samples. The specific mechanism of LHX8 in odontoma morphogenesis awaits further study.