The impact of sagittal balance on clinical results after posterior interbody fusion for patients with degenerative spondylolisthesis: A Pilot study

<p>Abstract</p> <p>Background</p> <p>Comparatively little is known about the relation between the sagittal vertical axis and clinical outcome in cases of degenerative lumbar spondylolisthesis. The objective of this study was to determine whether lumbar sagittal balance affects clinical outcomes after posterior interbody fusion. This series suggests that consideration of sagittal balance during posterior interbody fusion for degenerative spondylolisthesis can yield high levels of patient satisfaction and restore spinal balance</p> <p>Methods</p> <p>A retrospective study of clinical outcomes and a radiological review was performed on 18 patients with one or two level degenerative spondylolisthesis. Patients were divided into two groups: the patients without improvement in pelvic tilt, postoperatively (Group A; n = 10) and the patients with improvement in pelvic tilt postoperatively (Group B; n = 8). Pre- and postoperative clinical outcome surveys were administered to determine Visual Analogue Pain Scores (VAS) and Oswestry disability index (ODI). In addition, we evaluated full spine radiographic films for pelvic tilt (PT), sacral slope (SS), pelvic incidence (PI), thoracic kyphosis (TK), lumbar lordosis (LL), sacrofemoral distance (SFD), and sacro C7 plumb line distance (SC7D)</p> <p>Results</p> <p>All 18 patients underwent surgery principally for the relief of radicular leg pain and back pain. In groups A and B, mean preoperative VAS were 6.85 and 6.81, respectively, and these improved to 3.20 and 1.63 at last follow-up. Mean preoperative ODI were 43.2 and 50.4, respectively, and these improved to 23.6 and 18.9 at last follow-up. In spinopelvic parameters, no significant difference was found between preoperative and follow up variables except PT in Group A. However, significant difference was found between the preoperative and follows up values of PT, SS, TK, LL, and SFD/SC7D in Group B. Between parameters of group A and B, there is borderline significance on preoperative PT, preoperative LL and last follow up SS.</p> <p>Correlation analysis revealed the VAS improvements in Group A were significantly related to postoperative lumbar lordosis (Pearson's coefficient = -0.829; p = 0.003). Similarly, ODI improvements were also associated with postoperative lumbar lordosis (Pearson's coefficient = -0.700; p = 0.024). However, in Group B, VAS and ODI improvements were not found to be related to postoperative lumbar lordosis and to spinopelvic parameters.</p> <p>Conclusion</p> <p>In the current series, patients improving PT after fusion were found to achieve good clinical outcomes in degenerative spondylolisthesis. Overall, our findings show that it is important to quantify sagittal spinopelvic parameters and promote sagittal balance when performing lumbar fusion for degenerative spondylolisthesis.</p

OsABCG9 Is an Important ABC Transporter of Cuticular Wax Deposition in Rice

The importance of the cuticular layer in regulating a plant’s water status and providing protection from environmental challenges has been recognized for a long time. The cuticular layer in plants restricts non-stomatal water loss and protects plants against damage from pathogen infection and UV radiation. Much genetic and biochemical research has been done about cutin and wax transportation in Arabidopsis thaliana, but little is known about it in rice. Here, we report that a rice ATP-binding cassette (ABC) transporter, OsABCG9, is essential for normal development during vegetative growth and could play a critical role in the transportation of epicuticular wax in rice. Rice phenotypes with mutated OsABCG9 exhibited growth retardation and sensitivity to low humidity. The total amount of cuticular wax on the leaves of the osabcg9-1 mutant diminished by 53% compared with the wild type, and wax crystals disappeared completely in osabcg9-2 mutant leaves. However, OsABCG9 does not seem to be involved in cutin transportation, even though its ortholog in Arabidopsis, AtABCG11, transports both wax and cutin. Furthermore, the osabcg9-1 mutant had increased leaf chlorophyll leaching and more severe drought susceptibility. This study provides new insights about differences between rice and A. thaliana in wax and cutin transportation associated with the ABCG family during evolution

The Korean Baekdudaegan Mountains: A Glacial Refugium and a Biodiversity Hotspot That Needs to Be Conserved

The Baekdudaegan (BDDG; Figure 1) is a mountain range relatively unknown outside Korea. From recent times, however, the BDDG is known outside Korea because it shelters the small county of Pyeongchang, the venue of the 2018 Winter Olympic Games.This research was supported by Korea Research Foundation grants; KRF-2013R1A1A2063524 to MYC and NRF-2011-0017236, NRF-2013R1A1A3010892, and NRF-2017R1A2B4012215 to MGC and was carried out as part of the Infrastructure for the Conservation and Restoration of Rare and Endemic Plants in Korea National Arboretum that supported to MGC from 2015 to 2018.Peer reviewe

Differences in Trauma-Related Guilt in Females with History of Sexual Violence Based on Insomnia Severity

Background and Objective Females with history of sexual violence report a high percentage of insomnia. Guilt is a common symptom among this group. This study investigated differences in trauma-related guilt cognition between females of sexual violence with high or low symptoms of insomnia. Methods Participants were 43 females who reported having a history of sexual violence (mean age 26.56±7.81). All participants completed questionnaires about insomnia symptoms (Insomnia Severity Index, ISI), Posttraumatic stress disorder (PTSD) symptoms (PTSD Symptom Scale Self-Report), trauma-related guilt (Trauma-related Guilt Inventory, TRGI), depression (Beck Depression Inventory) and trauma-related information. The TRGI is consisted by global guilt, distress and guilt cognitions. Guilt cognitions can further be divided into Hindsight-Bias/Responsibility, Wrongdoing, and Lack of Justification subscales. Analyses were conducted using Pearson’s correlation coefficient and analysis of covariance. Results Results indicated ISI scores were significantly positively associated with PSS scores (r = 0.620, p < 0.01) and the distress subscale of the TGRI (r = 0.488, p < 0.01), and negatively associated with guilt cognitions (r = −0.423, p < 0.01). 53.5% (n = 23) of the sample met criteria for clinical insomnia using ISI cut-off scores of 15. Participants in the insomnia group scored significantly lower in overall guilt cognitions (p < 0.001) and significantly higher in distress (p = 0.001) than the non-insomnia group after controlling for depression. Among the subscales of guilt cognitions, hindsight-bias/responsibility was significantly lower in the insomnia group (p < 0.001). Conclusions Guilt can sometimes be adaptive in trauma patients as it may work as a catalyst in cognitively processing their trauma. Our results indicate that individuals with insomnia report lower guilt cognition. This may subsequently interfere with their ability to process the traumatic experience and effectively cope with their situation

Endocardial Fibroelastosis in a 57-Year-Old Transplant Recipient

Endocardial fibroelastosis (EFE) is characterized by deposition of collagen and elastin leading to ventricular hypertrophy and diffuse endocardial thickening. Here we report (for the first time in Korea) the case of a EFE presenting with heart failure. The patient was a 57-year-old woman who had complained of dyspnea on exertion {New York Heart Association (NYHA) functional class 3} and abdominal distension at the time of hospital admission. Echocardiography showed severe diastolic dysfunction with normal systolic function. On MRI, the contrast-enhanced delayed myocardial image demonstrated hyperenhancement in the endocardium. Owing to progressive heart failure, the patient was transplanted. Histological examination of the explanted heart showed irregularly thickened endocardium with fibrosis and elastosis in the both ventricles, compatible with the diagnosis of EFE

Korean Type 2 Diabetes Patients have Multiple Adenomatous Polyps Compared to Non-diabetic Controls

We tested the correlation between diabetes and aggressiveness of colorectal polyps in diabetic patients and matched non-diabetic controls. We retrospectively studied 3,505 type 2 diabetes (T2DM) patients without gastrointestinal symptoms who underwent colonoscopy for colorectal cancer at Samsung Medical Center, Seoul, Korea from August 1995 to August 2009. We matched 495 non-diabetic subjects with colon polyps to the diabetic patients in whom polyps were detected by year of colonoscopy, age, sex and body mass index (BMI). Among the 3,505 T2DM patients screened, 509 were found to have 1,136 colon polyps. Those with diabetes had a greater proportion of adenomatous polyps (62.8% vs 53.6%) compared to the control. Multivariate logistic regression analysis identified DM, male gender, age and BMI as independent risk factors for multiple polyps (more than three polyps). Polyp multiplicity in diabetic patients was significantly associated with male gender (OR 2.360, P = 0.005), age (OR 1.033, P = 0.005) and BMI (OR 1.077, P = 0.028). Neither aspirin nor metformin use affected either size or number of polyps in diabetic patients. Male patients older than 65 yr with T2DM and BMI greater than 25 have increased risk for multiple adenomatous polyps and should be screened with colonoscopy to prevent colorectal cancer