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1.  Long-term subjective outcomes of computer-assisted total knee arthroplasty 
International Orthopaedics  2013;37(10):1911-1915.
This study aimed to clarify the results of computer-assisted total knee arthroplasty (TKA) after ten years using patient-derived scores.
Thirty posterior-stabilised total knee prostheses implanted using a computed tomography-free navigation system were compared with 30 matched total knee prostheses of the same type implanted using a conventional, manual technique. At an average of ten years after surgery, we investigated patient-reported outcomes using the Knee Society’s new scoring system. The results of 27 patients (14 patients in the navigation group and 13 patients in the manual group) were assessed in this study.
There was no significant difference between the navigation and manual groups for any section of the questionnaire, which consisted of symptoms, patient satisfaction, patient expectation, walking/standing, standard activities, advanced activities, and discretionary activities.
After long-term follow-up, we found no subjective advantages of using a navigation system for patients who undergo TKA though the absolute number of patients was very small. Additional extensive studies are required to validate our result.
PMCID: PMC3779564  PMID: 23807729
2.  Neural decoding of single vowels during covert articulation using electrocorticography 
The human brain has important abilities for manipulating phonemes, the basic building blocks of speech; these abilities represent phonological processing. Previous studies have shown change in the activation levels of broad cortical areas such as the premotor cortex, the inferior frontal gyrus, and the superior temporal gyrus during phonological processing. However, whether these areas actually convey signals to representations related to individual phonemes remains unclear. This study focused on single vowels and investigated cortical areas important for representing single vowels using electrocorticography (ECoG) during covert articulation. To identify such cortical areas, we used a neural decoding approach in which machine learning models identify vowels. A decoding model was trained on the ECoG signals from individual electrodes placed on the subjects' cortices. We then statistically evaluated whether each decoding model showed accurate identification of vowels, and we found cortical areas such as the premotor cortex and the superior temporal gyrus. These cortical areas were consistent with previous findings. On the other hand, no electrodes over Broca's area showed significant decoding accuracies. This was inconsistent with findings from a previous study showing that vowels within the phonemic sequence of words can be decoded using ECoG signals from Broca's area. Our results therefore suggest that Broca's area is involved in the processing of vowels within phonemic sequences, but not in the processing of single vowels.
PMCID: PMC3945950  PMID: 24639642
covert articulation; single vowel; neural decoding; electrocorticography (ECoG); functional mapping
3.  Computed Three-Dimensional Atlas of Subthalamic Nucleus and Its Adjacent Structures for Deep Brain Stimulation in Parkinson's Disease 
ISRN Neurology  2012;2012:592678.
Background. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is one of the standard surgical treatments for advanced Parkinson's disease. However, it has been difficult to accurately localize the stimulated contact area of the electrode in the subthalamic nucleus and its adjacent structures using a two-dimensional atlas. The goal of this study is to verify the real and detailed localization of stimulated contact of the DBS electrode therapeutically inserted into the STN and its adjacent structures using a novel computed three-dimensional atlas built by a personal computer. Method. A three-dimensional atlas of the STN and its adjacent structures (3D-Subthalamus atlas) was elaborated on the basis of sagittal slices from the Schaltenbrand and Wahren stereotactic atlas on a personal computer utilizing a commercial software. The electrode inserted into the STN and its adjacent structures was superimposed on our 3D-Subthalamus atlas based on intraoperative third ventriculography in 11 cases. Findings. Accurate localization of the DBS electrode was identified using the 3D-Subthalamus atlas, and its clinical efficacy of the electrode stimulation was investigated in all 11 cases. Conclusion. This study demonstrates that the 3D-Subthalamus atlas is a useful tool for understanding the morphology of deep brain structures and for the precise anatomical position findings of the stimulated contact of a DBS electrode. The clinical analysis using the 3D atlas supports the contention that the stimulation of structures adjacent to the STN, particularly the zona incerta or the field of Forel H, is as effective as the stimulation of the STN itself for the treatment of advanced Parkinson's disease.
PMCID: PMC3265216  PMID: 22389840
4.  Hemiparesis Caused by Cervical Spontaneous Spinal Epidural Hematoma: A Report of 3 Cases 
Advances in Orthopedics  2011;2011:516382.
We report three cases of spontaneous spinal epidural hematoma (SSEH) with hemiparesis. The first patient was a 73-year-old woman who presented with left hemiparesis, neck pain, and left shoulder pain. A cervical MRI scan revealed a left posterolateral epidural hematoma at the C3–C6 level. The condition of the patient improved after laminectomy and evacuation of the epidural hematoma. The second patient was a 62-year-old man who presented with right hemiparesis and neck pain. A cervical MRI scan revealed a right posterolateral dominant epidural hematoma at the C6-T1 level. The condition of the patient improved after laminectomy and evacuation of the epidural hematoma. The third patient was a 60-year-old woman who presented with left hemiparesis and neck pain. A cervical MRI scan revealed a left posterolateral epidural hematoma at the C2–C4 level. The condition of the patient improved with conservative treatment. The classical clinical presentation of SSEH is acute onset of severe irradiating back pain followed by progression to paralysis, whereas SSEH with hemiparesis is less common. Our cases suggest that acute cervical spinal epidural hematoma should be considered as a differential diagnosis in patients presenting with clinical symptoms of sudden neck pain and radicular pain with progression to hemiparesis.
PMCID: PMC3170783  PMID: 21991415

Results 1-4 (4)