Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace : a prospective randomized controlled non-inferiority trial

BACKGROUND:The efficacy of brace application for the treatment of osteoporotic compression fractures remains unclear. The purpose of this study was to compare the treatment outcomes in patients with osteoporotic compression fractures with regard to whether the patients had no braces, rigid braces, or soft braces.METHODS:We randomly assigned sixty patients with acute one-level osteoporotic compression fractures within three days of injury to the no-brace, soft-brace, and rigid-brace groups through 1:1:1 allocation. The primary outcome was the baseline adjusted Oswestry Disability Index score at twelve weeks after compression fracture. The non-inferior margin of the Oswestry Disability Index was set at an average of 10 points.RESULTS:The baseline adjusted Oswestry Disability Index score at twelve weeks after compression fracture in the no-brace group was not inferior to that in the soft-brace or rigid-brace groups. The mean adjusted Oswestry Disability Index score was 35.95 points (95% confidence interval, 25.42 to 46.47 points) in the no-brace group and 37.83 points (95% confidence interval, 26.77 to 48.90 points) in the soft-brace group, with a difference of -1.88 points (95% confidence interval, -7.02 to 9.38 points) between the groups. Similarly, the mean adjusted Oswestry Disability Index score was 35.95 points (95% confidence interval, 25.42 to 46.47 points) in the no-brace group and 33.54 points (95% confidence interval, 23.79 to 43.29 points) in the rigid-brace group, with a difference of 2.41 points (95% confidence interval, -7.86 to 9.27 points) between the groups. During the follow-up assessment period, there was no significant difference among the groups for the overall Oswestry Disability Index scores (p = 0.260), visual analog scale for pain scores for back pain (p = 0.292), and anterior body compression ratios (p = 0.237). However, the Oswestry Disability Index scores and the visual analog scale scores for back pain significantly improved with time after the fractures (p < 0.001), and the body compression ratios significantly decreased with time in all three groups (p < 0.001).CONCLUSIONS:The Oswestry Disability Index scores for the treatment of compression fractures without a brace were not inferior to those with soft or rigid braces. Moreover, the improvement in back pain and progression of anterior body compression were similar among the three groups.OAIID:oai:osos.snu.ac.kr:snu2014-01/102/0000004226/15SEQ:15PERF_CD:SNU2014-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:NEMP_ID:A079510DEPT_CD:801CITE_RATE:4.309DEPT_NM:의학과SCOPUS_YN:NCONFIRM:

Ecological connectivity analysis based on the fish community in Jeongan Stream

This study focused on the longitudinal connectivity analysis, based on fish communities in the aspect of spatial variations of 34 sites from upstream to downstream. The Fish Assessment Index (FAI), based on ecological guilds and species composition, was applied to compare the ecological health among the sampling sites. The total number of 35 fish species, were sampled during the study period with dominant species of Zacco platypus (35.4%) and Zacco koreanus (11.8%). Cluster analysis showed that all sites were categorized as 4 distinct group communities (A, B, C, D). Non-metric multidimensional scaling analysis showed distinct difference between upstream (A, B) and downstream groups (C, D). Indicator Value Analysis (IndVal method), conducted to identify indicator species within each group, indicated that the species favoring upstream environments Rhynchocypris oxycephalus for the Group A and Iksookimia koreensis for the Group B. In contrast, the analysis indicated that the species with a preference for downstream habitats Pseudogobio esocinus for the Group C and Carassius auratus for the Group D. Ecological health, based on the FAI scores, showed a declining pattern toward the downstream, along with an increasing proportion of tolerant species and omnivores within the fish community. Overall these findings suggest the compositions of fish communities, as four groups, were modified by the weir structures and organic matter, nutrient pollutions

Monte Carlo Methods in Finance

Monte Carlo method has received significant consideration from the context of quantitative finance mainly due to its ease of implementation for complex problems in the field. Among topics of its application to finance, we address two topics: (1) optimal importance sampling for the Laplace transform of exponential Brownian functionals and (2) analysis on the convergence of quasi-regression method for pricing American option. In the first part of this dissertation, we present an asymptotically optimal importance sampling method for Monte Carlo simulation of the Laplace transform of exponential Brownian functionals via Large deviations principle and calculus of variations the closed form solutions of which induces an optimal measure for sampling. Some numerical tests are conducted through the Dothan bond pricing model, which shows the method achieves a significant variance reduction. Secondly, we study the convergence of a quasi-regression Monte Carlo method proposed by Glasserman and Yu (2004) that is a variant of least-squares method proposed by Longstaff and Schwartz (2001) for pricing American option. Glasserman and Yu (2004) showed that the method converges to an approximation to the true price of American option with critical relations between the number of paths simulated and the number of basis functions for two examples: Brownian motion and geometric Brownian motion. We show that the method surely converges to the true price of American option even under multiple underlying assets and prove a more promising critical relation between the number of basis functions and the number of simulations in the previous study holds. Finally, we propose a rate of convergence of the method

Prostate-Specific Antigen fluctuation: what does it mean in diagnosis of prostate cancer?

Objective To investigate whether prostate-specific antigen (PSA) fluctuation correlates with a prostate cancer and to assess whether PSA fluctuation could be used for diagnosis of prostate cancer. Materials and Methods Our study included 229 patients who were performed a prostate biopsy (non-cancer group, 177; prostate cancer group, 52). Enrolled patients were provided twice PSA tests within 6 months. PSA fluctuation (%/month) was defined as a change rate of PSA per a month. Independent t test was used to compare between two groups. Receiver operator characteristic curve was used to assess the availability as a differential diagnostic tool and the correlation. Simple linear regression was performed to analyze a correlation between PSA fluctuation and other factors such as age, PSA, PSA density, and prostate volume. Results There were significant differences in PSA, PSA density, percentage of free PSA, and PSA fluctuation between two groups. PSA fluctuation was significantly greater in non-cancer group than prostate cancer group (19.95&#177;23.34%/month vs 9.63&#177;8.57%/month, P=0.004). The most optimal cut-off value of PSA fluctuation was defined as 8.48%/month (sensitivity, 61.6%; specificity, 59.6%; AUC, 0.633; P=0.004). In a simple linear regression model, only PSA level was significantly correlated with PSA fluctuation. Conclusion Patients with wide PSA fluctuations, although baseline PSA levels are high, might have a low risk of diagnosis with prostate cancer. Thus, serial PSA measurements could be an option in patients with an elevated PSA level

Current Status of Pyroprocessing Development at KAERI

Pyroprocessing technology has been actively developed at Korea Atomic Energy Research Institute (KAERI) to meet the necessity of addressing spent fuel management issue. This technology has advantages over aqueous process such as less proliferation risk, treatment of spent fuel with relatively high heat and radioactivity, and compact equipments. This paper describes the pyroprocessing technology development at KAERI from head-end process to waste treatment. The unit process with various scales has been tested to produce the design data associated with scale-up. Pyroprocess integrated inactive demonstration facility (PRIDE) was constructed at KAERI and it began test operation in 2012. The purpose of PRIDE is to test the process regarding unit process performance, remote operation of equipments, integration of unit processes, scale-up of process, process monitoring, argon environment system operation, and safeguards-related activities. The test of PRIDE will be promising for further pyroprocessing technology development

The Outcome of Multiple Slit on Plaque with Plication Technique for the Treatment of Peyronie’s Disease

Purpose: To evaluate the postoperative outcome of the multiple slit on plaque plication technique for the treatment of Peyronie’s disease. Materials and Methods: We retrospectively evaluated 22 patients who underwent plaque incision with penile plication for the surgical treatment of Peyronie’s disease, who had failed medical treatment between 2009 and 2014. Patients were grouped by preoperative degree of penile curvature into Group I: mild (n=5, 22.7%), Group II: moderate (n=11, 50.0%), and Group III: severe (n=6, 27.3%). After a thorough review of the medical records, we evaluated (a) the correction of the curvature; (b) sexual function; and (c) any penile shortening or other complications. Results: The mean postoperative follow-up period was 39 months. Complete correction of the curvature was attained in 21 patients (95.5%). As an inevitable complication, minimal penile shortening (＜1.5 cm) was reported by 14 patients (82.4%) but did not adversely affect sexual intercourse (0%), and all patients found the extent of penile shortening to be acceptable. Nineteen patients had good erectile function (International Index of Erectile Function ＞21). The most frequent complication was subcutaneous penile edema in three patients (13.6%), which was resolved within about 3 months following surgery. Conclusions: As a modified technique, multiple slit on plaque with plication is a simple, minimally-invasive and effective technique for correcting penile curvature regardless of curvature severity. The degree of penile curvature does not significantly predict the amount of penile length loss

The Efficacy of Medical Treatment of Peyronie’s Disease: Potassium Para-Aminobenzoate Monotherapy vs. Combination Therapy with Tamoxifen, L-Carnitine, and Phosphodiesterase Type 5 Inhibitor

Purpose: This study was designed to evaluate the efficacy of medical treatment of Peyronie’s disease. Materials and Methods: A total of 109 patients with Peyronie’s disease who had been treated from January 2011 to December 2014 were retrospectively reviewed in this study. Forty-four patients (Group 1) were treated with 12 mg of potassium para-aminobenzoate daily. Sixty-five patients (Group 2) were treated with combination therapy: tamoxifen (20 mg) and acetyl-L-carnitine (300 mg) twice daily in addition to a phosphodiesterase type 5 inhibitor. Ability to perform sexual intercourse, pain during erection, size of plaque, and penile curvature angle were assessed. Results: In Group 1, 30 of 44 patients (68.2%) discontinued treatment within 12 weeks, while 5 patients (7.7%) in Group 2 discontinued treatment. Pain during erection and plaque size were improved in both groups but showed no statistical difference due to the high dropout rate in Group 1. In both groups, penile curvature was improved, but demonstrated no statistical difference between the treatment groups. However, combination therapy demonstrated a better response rate in patients whose penile curvature angle was less than 30o (44.4% vs. 79.1%, p=0.048). The rate of successful sexual intercourse was significantly higher in Group 2 (42.8% vs. 78.3%, p=0.034). The number of patients who underwent surgical correction despite medical treatment was significantly higher in Group 1 (35.7% vs. 13.3%, p=0.048). Conclusions: Early medical combination therapy in Peyronie’s disease may present better results in patients whose curvature angle is less than 30o