Minimally Invasive Spine Surgery in Korea - A Neurosurgeon’s View -

In Korea, neurosurgery has taken the lead in minimally invasive spine surgery (MISS) since early 1980s, unlike most of other countries, in which orthopedic surgery usually leads MISS. Between 1990s and 2000s, surgical techniques and relevant equipments and tools of endoscopic discectomy have been rapidly developed and extended its surgical indications. In this development, KOMIISS and its members, especially practicing physicians made a great contribution, especially in the field of endoscopic discectomy in Korea and in the world. High technology and science have given a birth to new MISS devices currently, and some of these devices such as epiduroscopic laser discectomy and annuloplasty technologies have been launched and used in Korea market. Other advanced technologies and engineerings area also expected to contribute to the future of MISS. Korean spine surgeons should stand the pace of such scientific developments to maintain their reputation in MISS

Are Controversial Issues in Cervical Total Disc Replacement Resolved or Unresolved?: A Review of Literature and Recent Updates

Since the launch of cervical total disc replacement (CTDR) in the early 2000s, many clinical studies have reported better outcomes of CTDR compared to those of anterior cervical discectomy and fusion. However, CTDR is still a new and innovative procedure with limited indications for clinical application in spinal surgery, particularly, for young patients presenting with soft disc herniation with radiculopathy and/or myelopathy. In addition, some controversial issues related to the assessment of clinical outcomes of CTDR remain unresolved. These issues, including surgical outcomes, adjacent segment degeneration (ASD), heterotopic ossification (HO), wear debris and tissue reaction, and multilevel total disc replacement (TDR) and hybrid surgeries are a common concern of spine surgeons and need to be resolved. Among them, the effect of CTDR on patient outcomes and ASD is theoretically and clinically important; however, this issue remains disputable. Additionally, HO, wear debris, multilevel TDR, and hybrid surgery tend to favor CTDR in terms of their effects on outcomes, but the potential of these factors for jeopardizing patients' safety postoperatively and/or to exert harmful effects on surgical outcomes in longer-term follow-up cannot be ignored. Consequently, it is too early to determine the therapeutic efficacy and cost-effectiveness of CTDR and will require considerable time and studies to provide appropriate answers regarding the same. For these reasons, CTDR requires longer-term follow-up data

Comparison of MRI features and surgical outcome among the subtypes of focal cortical dysplasia

AbstractPurposeFocal cortical dysplasia (FCD) is the most common pathological diagnosis in patients who have undergone surgical treatment for intractable neocortical epilepsy. However, presurgical identification of MRI abnormalities in FCD patients remains difficult, and there are no highly sensitive imaging parameters available that can reliably differentiate among FCD subtypes. The purpose of our study was to investigate the surgical outcome in FCD patients with identifiable MRI abnormalities and to evaluate the prognostic role of the various MRI features and the characteristics of FCD pathology.MethodsWe retrospectively recruited epilepsy patients who had undergone surgical treatment for refractory epilepsy with focal MRI abnormalities and the pathological diagnosis of FCD. We evaluated the surgical outcome according to the pathological subtypes, and studied the prognostic roles of various MRI features. We used recently proposed three-tiered FCD classification system which included FCD type III when FCD occurs in association with other potentially epileptogenic pathologies.ResultsA total of 69 patients were included, and 68.1% of patients became seizure free. Patients with FCD type III had a lower chance for achieving seizure freedom (7/15) than in patients with isolated FCD (FCD types I and II) (40/54, p=0.044). Cortical thickness and blurring of gray–white matter junction were more common in isolated FCD than in FCD type III, but most MRI features failed to differentiate between FCD types I and II, and only the transmantle sign was specific for FCD type II. We failed to find a prognostic value of specific MRI abnormalities of prognostic value in terms of post-epilepsy surgery outcome in FCD patients.ConclusionsOur study showed that patients with FCD III have poor surgical outcome. Typical MRI features of isolated FCD such as cortical thickness and blurring of gray–white matter junction were less common in FCD type III and only transmantle sign was helpful in differentiating between FCD types I and II

Agent based mobile negotiation for personalized pricing of last minute theatre tickets

This is the post-print version of the final paper published in Expert Systems with Applications. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2012 Elsevier B.V.This paper proposes an agent based mobile negotiation framework for personalized pricing of last minutes theatre tickets whose values are dependent on the time remaining to the performance and the locations of potential customers. In particular, case based reasoning and fuzzy cognitive map techniques are adopted in the negotiation framework to identify the best initial offer zone and adopt multi criteria decision in the scoring function to evaluate offers. The proposed framework is tested via a computer simulation in which personalized pricing policy shows higher market performance than other policies therefore the validity of the proposed negotiation framework.The Ministry of Education, Science and Technology (Korea

PCR-based detection and genetic characterization of porcine parvoviruses in South Korea in 2018

with the advantage of sequencing technology, many novel porcine parvoviruses (PPV) rather than PPV1 has been reported. This study ultilized specific PCR- based method and gene- based analysis to study the presence and genetic diversity of porcine parvoviruses in South Korea in 2018. The present study was conducted in 2018 and found PPV1 and PPV7 in nine out of 151 field samples (organs and semen) by the PCR method. Among these, the complete genome sequences of five strains (N2, N91, N108, N133, and N141) were recovered. Phylogenic analysis revealed that the strains N2, N91, and N108 belong to the PPV1 genotype, while N133 and N141 belong to PPV7 genotype. The PPV7 strains collected in this study had deletion mutations in the VP2 gene but differed from that of PPV7 strains collected in 2017. Among the PPV1 strains, the amino acid variations in the B cell epitopes of the VP2 protein were observed between three Korean PPV1 field strains (N2, N91, and N108) and the reference PPV1 strains. Those substitutions resulted in six out of 12 predicted epitopes having significant differences in antigenic index compared to the other PPV1 strains. This study confirmed the presence of different genotypes of porcine parvoviruses in South Korea. The PPVs circulating in South Korea were phylogenetically classified as PPV1 and PPV7 genotypes. Three Korean PPV1 strains collected in 2018 were predicted to have antigenic alteration in VP2 compared to several reference strains of PPV1.This study was supported by Boehringer Ingelheim Vetmedica Korea Ltd. (Grant no. 20180002). The funder had no role in this study design, data collection and analysis, decision to publish, or preparation of the manuscript

Frontal lobe epilepsy: Clinical characteristics, surgical outcomes and diagnostic modalities

SummaryObjectiveTo identify surgical prognostic factors and to characterize clinical features according to the location of the intracranial ictal onset zone of frontal lobe epilepsy (FLE) in order to assess the role of various diagnostic modalities, including concordances with presurgical evaluations.MethodsWe studied 71 FLE patients who underwent epilepsy surgery and whose outcomes were followed for more than 2 years. Diagnoses were established by standard presurgical evaluation.ResultsClinical manifestations could be categorized into six types: initial focal motor (9 patients), initial versive seizure (15), frontal lobe complex partial seizure (14), complex partial seizure mimicking temporal lobe epilepsy (18), initial tonic elevation of arms (11), and sudden secondary generalized tonic–clonic seizure (4). Thirty-seven patients became seizure-free after surgery. Five patients were deleted in the analysis because of incomplete resection of ictal onset zones. The positive predictive value of interictal EEG, ictal EEG, MRI, PET, and ictal SPECT, respectively were 62.5%, 56.4%, 73.9%, 63.2%, and 63.6%, and the negative predictive value were 46.0%, 44.4%, 53.5%, 44.7%, and 51.7%. No significant relationship was found between the diagnostic accuracy of these modalities and surgical outcome, with the exception of MRI (p=0.029). Significant concordance of two or more modalities was observed in patients who became seizure-free (p=0.011). We could not find any clinical characteristic related to surgical outcome besides seizure frequency. No definite relationship was found between the location of intracranial ictal onset zone and clinical semiology.ConclusionAlthough various diagnostic methods can be useful in the diagnosis of FLE, only MRI can predict surgical outcome. Concordance between presurgical evaluations indicates a better surgical outcome