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  • SAGE Publications  (7)
  • English  (7)
  • 1
    Online Resource
    Online Resource
    Distal Junctional Kyphosis after Posterior Spinal Fusion in Lenke 1 and 2 Adolescent Idiopathic Scoliosis-Exploring Detailed Features of the Sagittal Stable Vertebra Concept
    SAGE Publications ; 2023
    In:  Global Spine Journal Vol. 13, No. 4 ( 2023-05), p. 1112-1119
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 13, No. 4 ( 2023-05), p. 1112-1119
    Abstract: A retrospective cohort study. Objective: To investigate the factors contributing to the development of postoperative distal junctional kyphosis (DJK) in adolescent idiopathic scoliosis (AIS) patients who underwent posterior spinal fusion (PSF) with lowest instrumented vertebrae (LIV) at or above L1. Methods: Patients with Lenke type 1 or 2 curves who underwent PSF with LIV at or above L1 with a minimum follow-up of 2 years were evaluated. The primary outcome measure was the occurrence of postoperative DJK. Radiographic parameters of sagittal alignment and inclusion/exclusion of sagittal stable vertebra (SSV) in PSF were analyzed to determine their associations with the occurrence of postoperative DJK. Results: Overall, 122 patients (mean age: 15.1 ± 3.2 years) were included. The overall incidence of postoperative DJK was 6.6%. DJK was observed in 19.0% (8/42) of patients whose SSV was not included in PSF and not in patients with SSV included in PSF (n = 80). In the SSV-excluded group, univariate analysis found two significant risk factors for DJK: postoperative thoracic kyphosis (TK, T5-12) and postoperative thoracolumbar kyphosis (TLK, T11-L2). The ROC curve revealed that postoperative TK ≥ 25° and TLK ≥ 10° best predicted the occurrence of postoperative DJK in the SSV-excluded group. The incidence was significantly higher in cases with postoperative TK ≥ 25° or TLK ≥ 10° (7/13 = 53.8%) than in those with postoperative TK 〈 25° and TLK 〈 10° (1/29 = 3.4%). Conclusions: The current study revealed that postoperative TK ≥ 25° or postoperative TLK ≥ 10° with SSV excluded from PSF were related to DJK after PSF for Lenke type 1 and type 2 AIS. When the SSV is intended to be spared from PSF to save more motion segments, TK and TLK should be carefully evaluated and attained in a lesser magnitude (TK 〈 25°, TLK 〈 10°) after surgery.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/21925682211019692
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2648287-3
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  • 2
    Online Resource
    Online Resource
    Controlled Release of Strontium through Neutralization Reaction within a Methoxy(Polyethylene Glycol)-Polyesterc hydrogel
    SAGE Publications ; 2017
    In:  Journal of Applied Biomaterials & Functional Materials Vol. 15, No. 2 ( 2017-04), p. 162-169
    Details
    In: Journal of Applied Biomaterials & Functional Materials, SAGE Publications, Vol. 15, No. 2 ( 2017-04), p. 162-169
    Abstract: The aim of this study was to develop a minimally invasive hydrogel system that can release strontium ions, an element that has been shown to increase osteoblast proliferation and prohibit bone resorption, in a controlled manner. Methods SrCO 3 was selected as the salt of choice due to potential acid neutralization reaction between SrCO 3 and degradation by-products of methoxy(polyethylene glycol)- co-poly(lactic- co-glycolic acid) (mPEG-PLGA): namely, lactic acid and glycolic acid. SrCO 3 was incorporated into mPEG-PLGA hydrogel, and the system was assessed for gelation properties, drug release and biocompatibility. Results SrCO 3 incorporation at hydrogel to SrCO 3 ratios of 5:1, 3:1 and 1:1 (wt%) did not compromise the thermosensitivity of mPEG-PLGA hydrogels. Furthermore, incorporation of SrCO 3 at 1:1 ratio prevented copolymer self-catalysis and decreased hydrogel weight loss from 85% to 61% in vitro after 30 days. During the 30-day time frame, zero-order strontium release was observed and was correlated to hydrogel degradation and acidity. The addition of SrCO 3 also improved in vivo hydrogel biocompatibility, due to moderation of acidic microenvironment and amelioration of inflammatory response. Conclusions These results showed that the described system is suitable for the extended release of strontium and exhibits potential for localized treatment for osteoporosis or as a bone void filler.
    Type of Medium: Online Resource
    ISSN: 2280-8000 , 2280-8000
    URL: Article
    DOI: 10.5301/jabfm.5000313
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2673624-X
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  • 3
    Online Resource
    Online Resource
    Biomechanical Comparison of Different Numbers and Configurations of Cross-Links in Long-Segment Spinal Fixation—An Experimental Study in a Porcine Model
    SAGE Publications ; 2023
    In:  Global Spine Journal Vol. 13, No. 1 ( 2023-01), p. 25-32
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 13, No. 1 ( 2023-01), p. 25-32
    Abstract: Biomechanical study. Objective: Cross-links are a type of common clinical spinal instrumentation. However, the effects of the position and number of cross-links have never been investigated in long-segment spinal fixation, and the variables have not been optimized. We conducted an in vitro biomechanical study by using a porcine long-segment spinal model with 5 different crosslink configurations to determine the optimal construct for clinical practice. Methods: Five modalities with paired segmental screws from T15-L5 were tested in 20 porcine spines. The spines without cross-links composed the control group, Group A; those with a single cross-link from L2-3 composed Group B; those with 2 cross-links from L1-2 and L3-4 composed Group C; those with 2 cross-links from T15-L1 and L4-5 composed Group D; and those with 3 cross-links from T15-L1, L2-3 and L4-5 composed Group E. Spinal stiffnesses in flexion, extension, lateral bending, and axial rotation were compared among 5 different cross-link configurations in 5-level porcine spinal units. Results: Flexional, extensional and lateral bending stiffnesses did not significantly change with an increasing number of cross-links or positions in the construct. Axial stiffness was significantly increased with 2 cross-links compared to one ( P 〈 0.05) and with placement more distant from the center of the long spinal fixation construct ( P 〈 0.05). Conclusions: Two cross-links individually placed proximal and distal from the center of a construct is an optimal and efficient configuration to achieve biomechanical stability in non-rigid lumbar spines undergoing long-level fixation.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568221990646
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2648287-3
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  • 4
    Online Resource
    Online Resource
    The Correlation of Anchor Density and the Curve Correction of Adolescent Idiopathic Scoliosis Surgery
    SAGE Publications ; 2016
    In:  Global Spine Journal Vol. 6, No. 1_suppl ( 2016-04), p. s-0036-1582775-s-0036-1582775
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 6, No. 1_suppl ( 2016-04), p. s-0036-1582775-s-0036-1582775
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0036-1582775
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2648287-3
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  • 5
    Online Resource
    Online Resource
    Should the Spinous Process be Harvested as Bone Graft in Idiopathic Scoliosis Surgery?
    SAGE Publications ; 2016
    In:  Global Spine Journal Vol. 6, No. 1_suppl ( 2016-04), p. s-0036-1582681-s-0036-1582681
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 6, No. 1_suppl ( 2016-04), p. s-0036-1582681-s-0036-1582681
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1055/s-0036-1582681
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2648287-3
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  • 6
    Online Resource
    Online Resource
    The relative importance of predictive factors for single first-generation EGFR-TKI use for more than 5 years in patients with advanced non-small cell lung cancer: Taiwan multicenter TIPS-5 study
    SAGE Publications ; 2021
    In:  Therapeutic Advances in Medical Oncology Vol. 13 ( 2021-01), p. 175883592110180-
    Details
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 13 ( 2021-01), p. 175883592110180-
    Abstract: The relative importance of predictive factors for advanced non-small cell lung cancer (NSCLC) patients on epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment remains unclear. Materials and methods: We retrospectively enrolled advanced NSCLC patients with single first-generation EGFR-TKI treatment for ⩾5 years (Y) in Taiwan. Clinical data was collected and compared with those of another cohort with single first-line EGFR-TKI treatment for 〈 5 Y. Plasma cell-free DNA (cfDNA) samples were collected from patient subsets, pre- and post-TKI, in the 〉 5 Y group. Results: Overall, 128 and 278 patients were enrolled in the ⩾5 Y and 〈 5 Y groups, respectively. Significant factors in the multivariate analysis of patients’ characteristics including Eastern Cooperative Oncology Group performance status 0–1, postoperative recurrence, without brain metastasis, oligometastasis (each score of 2), female sex, erlotinib use, and without bone metastasis (each score of 1), were incorporated into a risk scoring system. The area under the receiver operating characteristic curve was 0.82 [95% confidence interval (CI): 0.78–0.86]. Of the plasma cfDNA samples from 33 patients in the ⩾5 Y group, only 1 had a T790M in 25 patients without progressive disease. In 27 patients with single agent use for ⩾96 months, 22 (81.5%) received local treatment (surgery or radiotherapy) for the primary lung tumor before and during TKI treatment. Conclusion: For NSCLC patients with single first-generation EGFR-TKI use for ⩾5 Y, factors with different relative importance exist and the risk-scoring model is feasible with modest accuracy. The role of local treatment for primary tumors in patients with long-term TKI use requires further investigation.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    URL: Article
    DOI: 10.1177/17588359211018022
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2503443-1
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  • 7
    Online Resource
    Online Resource
    Preventing and treating brain metastases with three first-line EGFR-tyrosine kinase inhibitors in patients with EGFR mutation-positive advanced non-small cell lung cancer
    SAGE Publications ; 2018
    In:  Therapeutic Advances in Medical Oncology Vol. 10 ( 2018-01), p. 175883591879758-
    Details
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 10 ( 2018-01), p. 175883591879758-
    Abstract: Brain metastases (BM) are common in advanced non-small cell lung cancer (NSCLC), and the prognosis is poor with few therapeutic options. This study evaluated the efficacy of three epidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) in preventing and treating BM in patients with EGFR mutation-positive advanced NSCLC. Methods: Patients with EGFR mutation-positive advanced NSCLC who visited a tertiary referral center from 1 December 2013 to 30 November 2017 were analyzed retrospectively. They received gefitinib, erlotinib, or afatinib until disease progression, death, or intolerable adverse events. The cumulative incidence of subsequent BM of initial non-BM patients, progression-free survival (PFS), and overall survival (OS) of the BM and non-BM patients were estimated and compared using the Kaplan–Meier and log-rank tests. Results: 306 NSCLC patients were enrolled, with 116, 75, and 115 receiving first-line gefitinib, erlotinib, and afatinib, respectively. The afatinib group had a better PFS [12.7 versus 9.8 months; hazard ratio (HR) 0.59, p  = 0.001] and OS (39.1 versus 22.0 months; HR 0.64, p  = 0.035) than the gefitinib group. Afatinib tended to provide better BM prevention than gefitinib (BM cumulative incidence, HR 0.49; 95% confidence interval 0.34–0.71, p  〈  0.001) according to a Cox model adjusted for possible confounders. Patients with initial BM had a shorter PFS ( p  〈  0.001) and OS ( p  = 0.015) than those without initial BM. Among the former, there were no differences in median PFS ( p  = 0.34) and median OS ( p  = 0.46) in the three EGFR-TKI groups. Conclusions: Our data suggested that, compared with gefitinib, afatinib provided better benefits significantly in terms of PFS and OS. Both had the same effectiveness in preventing subsequent BM.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    URL: Article
    DOI: 10.1177/1758835918797589
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2503443-1
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