Neuropathic Pain after Spinal Surgery

Neuropathic pain after spinal surgery, the so-called failed back surgery syndrome (FBSS), is a frequently observed troublesome disease entity. Although medications may be effective to some degree, many patients continue experiencing intolerable pain and functional disability. Only gabapentin has been proven effective in patients with FBSS. No relevant studies regarding manipulation or physiotherapy for FBSS have been published. Spinal cord stimulation (SCS) has been widely investigated as a treatment option for chronic neuropathic pain, including FBSS. SCS was generally accepted to improve chronic back and leg pain, physical function, and sleep quality. Although the cost effectiveness of SCS has been proved in many studies, its routine application is limited considering that it is invasive and is associated with safety issues. Percutaneous epidural adhesiolysis has also shown good clinical outcomes; however, its effects persisted for only a short period. Because none of the current methods provide absolute superiority in terms of clinical outcomes, a multidisciplinary approach is required to manage this complex disease. Further studies concerning the etiology, diagnosis, treatment, and cost effectiveness of FBSS are warranted to deepen our understanding of this condition

An Updated Overview of Low Back Pain Management in Primary Care

Currently, guidelines for lower back pain (LBP) treatment are needed. We reviewed the current guidelines and high-quality articles to confirm the LBP guidelines for the Korean Society of Spine Surgery. We searched available databases for high-quality articles in English on LBP published from 2000 to the present year. Literature searches using these guidelines included studies from MEDLINE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Embase. We analyzed a total of 132 randomized clinical trials, 116 systematic reviews, 9 meta-analyses, and 4 clinical guideline reviews. We adopted the SIGN checklist for the assessment of article quality. Data were subsequently abstracted by a reviewer and verified. Many treatment options exist for LBP, with a variety of recommendation grades. We assessed the recommendation grade for general behavior, pharmacological therapy, psychological therapy, and specific exercises. This information should be helpful to physicians in the treatment of LBP patients

(E)-2,2′-[3-(2-Nitro­phen­yl)prop-2-ene-1,1-di­yl]bis­(3-hy­droxy­cyclo­hex-2-en-1-one)

In the title compound, C21H21NO6, each of the cyclo­hexenone rings adopts a half-chair conformation. Each of the pairs of hy­droxy and carbonyl O atoms are oriented to allow for the formation of intra­molecular O—H⋯O hydrogen bonds, which are typical of xanthene derivatives

Dosimetric Effects of Rotational Setup Error in Volumetric Modulated Arc Radiotherapy on Brain Tumor Patients

Introduction: This study examined the dosimetric effects based on the rotational setup error to correct patient setup errors occur during volumetric modulated arc radiotherapy (VMAT) for brain tumor patients. Material and Methods: This study included 1129 cases of cone beam computed tomography (CBCT) images obtained from 46 brain tumor patients, who experienced VMAT and used the 6DoF (degree of freedom) treatment couch. The dosimetric effects regarding the application of the rotational setup error were examined by comparing the treatment plans. Results: The mean patient setup errors at the lateral (X-axis), longitudinal (Y-axis), and vertical (Z-axis) directions were 0.1±1.4, 0.0±1.1, and -0.4±1.2 mm, respectively. The pitch, roll, and yaw were -0.29±0.61°,-0.42±0.98°, and -0.53±0.69°, respectively. When an absolute value was taken for the setup error, the mean error was 1.06±0.14 mm at the three translation directions, and the error of rotation was 0.82±0.14°, showing a larger error than that of translation. In terms of the mean dose difference by each region of interest (ROI) before and after correcting for the rotational setup error on the treatment plan, Brain_max was 2.17 Gy, and Brain_mean was 0.28 Gy, whereas the maximum and mean of Brain_stem were -3.58 and -4.43 Gy, respectively. These findings suggested a dose difference according to the correction of the rotational setup error. Conclusion: This study indicated that the dose effect is influenced by the rotational setup error in VMAT of brain tumor patients. Moreover, the 6DoF positional correction could reduce the positional uncertainties and deliver a more accurate dose

A simple iterative independent component analysis algorithm for vibration source signal identification of complex structures

ABSTRACT:Independent Component Analysis (ICA), one of the blind source separation methods, can be applied for extracting unknown source signals only from received signals. This is accomplished by finding statistical independence of signal mixtures and has been successfully applied to myriad fields such as medical science, image processing, and numerous others. Nevertheless, there are inherent problems that have been reported when using this technique: insta- bility and invalid ordering of separated signals, particularly when using a conventional ICA technique in vibratory source signal identification of complex structures. In this study, a simple iterative algorithm of the conventional ICA has been proposed to mitigate these problems. The proposed method to extract more stable source signals having valid order includes an iterative and reordering process of extracted mixing matrix to reconstruct finally converged source signals, referring to the magnitudes of correlation coefficients between the intermediately separated signals and the signals measured on or nearby sources. In order to review the problems of the conventional ICA technique and to vali- date the proposed method, numerical analyses have been carried out for a virtual response model and a 30m class submarine model. Moreover, in order to investigate applicability of the proposed method to real problem of complex structure, an experiment has been carried out for a scaled submarine mockup. The results show that the proposed method could resolve the inherent problems of a conventional ICA technique

Risk Factors for Musculoskeletal Symptoms Among Korean Broadcast Actors

Background: Musculoskeletal diseases (MSDs) are functional disabilities in the musculoskeletal area that occur when continuous damage to the muscles or tissues is caused by performing a repetitive task. These diseases are usually found in the waist, shoulder, neck, arm, and wrist. MSD is also referred to as cumulative trauma disorder, repetitive strain injury, occupational overuse syndrome, and visual display terminal, depending on the country. The condition is now commonly referred to as work-related musculoskeletal disorder. Objectives: The aim of this study was to develop a prevention plan against musculoskeletal disease and to provide better health care to broadcast actors by understanding the association between musculoskeletal symptoms and working conditions. The results of the study can be utilized to maintain effective systematic resources to treat such diseases. Methods: A survey was conducted in Seoul between January 1 and May 10, 2014 with broadcast actors working in the South Korean entertainment industry. Findings: Tests with respect to musculoskeletal symptoms indicated that the study participants were likely to experience having musculoskeletal symptoms in the shoulders, waist, neck, leg/foot, hand/wrist/finger, and arm/elbow. Most of the participants reported pain on both sides of their shoulders and in their legs/feet or on the right side of the arm/elbow and in hand/wrist/finger. Pain lasted between 1 and 7 days, with an incidence of 33.8% in the neck, 36% in the shoulders, 33.3% in the arm/elbow, 47.4% in the hand/wrist/finger, 34.7% in the waist, and 39.3% in the leg/foot. Conclusions: This study should prove useful in determining systematic and effective resources to prevent broadcast actors from developing MSD in the future

(E)-2,2′-[3-(2-Nitro­phen­yl)prop-2-ene-1,1-di­yl]bis­(3-hy­droxy-5,5-dimethyl­cyclo­hex-2-en-1-one)

In the title compound, C25H29NO6, each of the cyclo­hexenone rings adopts a half-chair conformation. Each of the pairs of hy­droxy and carbonyl O atoms are oriented to allow for the formation of intra­molecular O—H⋯O hydrogen bonds, which are typical of xanthene derivatives. The nitro group is rotationally disordered over two orientations in a 0.544 (6):0.456 (6) ratio. In the crystal, weak inter­molecualr C—H⋯O hydrogen bonds link mol­ecules into layers parallel to the ab plane

Enhanced black state induced by spatial silver nanoparticles in an electrochromic device

The use of three-dimensional (3D) hierarchical indium tin oxide (ITO) branches of electrochromic devices (ECDs) is an effective approach for increasing the optical properties via localized surface plasmon resonance compared with two- dimensional nanostructured electrodes. ECDs with 3D branches were designed to operate in transparent, mirror and black states. Finite- difference time- domain simulation was used to find the electrical field distributions in three types of ECD: glass/ITO with Ag film, glass/ITO branches and glass/ITO branches with Ag nanoparticles. The ECDs had an optical transmittance of 73.76% in the transparent state, a reflectance of 79.77% in the mirror state and a reflectance of 8.78% in the black state. We achieved an ECD with high stability that can show similar to 10 000 switching cycles among the three states.113Ysciescopu