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  • SAGE Publications  (28)
  • 1
    Online Resource
    Online Resource
    Optimal use of antithrombotic agents in ischemic stroke with atrial fibrillation and large artery atherosclerosis
    SAGE Publications ; 2023
    In:  International Journal of Stroke Vol. 18, No. 7 ( 2023-08), p. 812-820
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 18, No. 7 ( 2023-08), p. 812-820
    Abstract: Optimal antithrombotic regimens to prevent recurrent stroke in patients with ischemic stroke due to atrial fibrillation (AF) and atherosclerotic large-vessel stenosis remain unknown. Aims: This study aimed to evaluate the effect of multiple antithrombotic therapies on outcomes at 1 year after ischemic stroke due to two or more causes. Methods: We identified 862 patients with ischemic stroke due to AF and large artery atherosclerosis from the linked data. These patients were categorized into three groups according to antithrombotic therapies at discharge: (1) antiplatelets, (2) oral anticoagulants (OAC), and (3) antiplatelets plus OAC. The study outcomes were recurrent ischemic stroke, composite outcomes for cardiovascular events, and major bleeding after 1 year. Inverse probability of treatment weighting (IPTW) was used to balance the three groups using propensity scores. Results: Among 862 patients, 169 (19.6%) were treated with antiplatelets, 405 (47.0%) were treated with OAC, and 288 (33.4%) were treated with antiplatelets and OAC. After applying IPTW, only OAC had a significant beneficial effect on the 1-year composite outcome (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.23–0.60, p  〈  0.001) and death (HR: 0.35, 95% CI: (0.19–0.63), p  〈  0.001). The combination of antiplatelet agents and OAC group had an increased risk of major bleeding complications (HR: 5.27, 95% CI: (1.31–21.16), p = 0.019). However, there was no significant difference in 1-year recurrent stroke events among the three groups. Conclusion: This study demonstrated that OAC monotherapy was associated with lower risks of composite outcome and death in patients at 1 year after ischemic stroke due to AF and atherosclerotic stenosis. In addition, the combination of an antiplatelet and OAC had a high risk of major bleeding.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930231158211
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2211666-7
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  • 2
    Online Resource
    Online Resource
    Results of Anterior Facial Nerve Rerouting Procedures for Removing Skull Base Tumors
    SAGE Publications ; 2014
    In:  Annals of Otology, Rhinology & Laryngology Vol. 123, No. 2 ( 2014-02), p. 141-147
    Details
    In: Annals of Otology, Rhinology & Laryngology, SAGE Publications, Vol. 123, No. 2 ( 2014-02), p. 141-147
    Abstract: The purpose of this study was to estimate the rates of functional recovery of the facial nerve and of total tumor resection in patients who undergo short anterior rerouting and long anterior rerouting of the facial nerve in removal of skull base tumors. Methods: We retrospectively collected data on 37 patients with skull base tumors who underwent facial nerve rerouting during the procedure for tumor removal. Information on the rerouting technique, the completeness of tumor resection, and changes in facial nerve function were obtained from the medical records. Rerouting techniques were classified as short anterior rerouting or long anterior rerouting. Results: Ten of 16 patients (62.5%) in the group with short anterior rerouting showed postoperative facial palsy, and all completely recovered within 1 year. In the group with long anterior rerouting, 18 of 21 patients (85.7%) showed postoperative facial palsy, and recovery to a preoperative level of facial function was found in 10 patients at 1 year of follow-up. Total tumor resection was possible in 94% and 81% of patients with short rerouting and long rerouting, respectively. The mean operation time was not significantly related to the postoperative recovery of facial function. Conclusions: Short rerouting techniques, when appropriately chosen on the basis of tumor and patient characteristics, offer excellent preservation of facial function and tumor resection, comparable to those of long rerouting techniques.
    Type of Medium: Online Resource
    ISSN: 0003-4894 , 1943-572X
    URL: Article
    DOI: 10.1177/0003489414523711
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2033055-8
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  • 3
    Online Resource
    Online Resource
    Patterns and Distribution of Deep Vein Thrombosis and Its Effects on Clinical Outcomes After Opening-Wedge High Tibial Osteotomy
    SAGE Publications ; 2021
    In:  Orthopaedic Journal of Sports Medicine Vol. 9, No. 10 ( 2021-10-01), p. 232596712110308-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 9, No. 10 ( 2021-10-01), p. 232596712110308-
    Abstract: Although a few studies have reported the incidence of deep vein thrombosis (DVT) after opening-wedge high tibial osteotomy (OWHTO), previous studies focused only on symptomatic DVT. Information is lacking regarding the overall incidence of DVT after OWHTO, thrombus location, and the relationship between DVT and clinical outcome. Purpose: To determine the overall incidence of DVT and classify the location of DVT after OWHTO. We also determined whether significant differences in clinical improvement exist in patients with and without DVT at 6 months and at 2 years after OWHTO. Study Design: Case-control study; Level of evidence, 3. Methods: This study included 46 patients (47 knees) who underwent OWHTO. All patients were instructed to perform knee range of motion exercises and partial weightbearing after drain removal. None of the patients received a chemoprophylaxis for DVT except intermittent pneumatic compression. DVT was diagnosed using 128-row multidetector computed tomography performed before discharge on the fourth postoperative day. The location was classified into 6 segments in the distal portion (muscular and axial veins) and proximal portion (popliteal, femoral, and common femoral veins and veins located above the iliac vein). International Knee Documentation Committee (IKDC) score was assessed preoperatively and postoperatively at 6 months, 1 year, and 2 years using a linear mixed model. Results: Although the incidence of symptomatic DVT was 8.5% (n = 4), the overall incidence of early DVT was 44.7% (n = 21). All DVTs were located in the distal portion of the lower extremity vein, and 76.2% of the DVTs were located in an axial vein. The IKDC scores were 33.6 ± 7.2 and 35.3 ± 9.1 ( P = .910) preoperatively, 38.1 ± 5.6 and 40.6 ± 8.4 ( P = .531) at 6 months after surgery, and 44.8 ± 6.9 and 45.9 ± 11.4 ( P = .786) at 2 years after surgery in patients without and those with DVT, respectively. Conclusion: The overall incidence of early DVT after OWHTO was 44.7%. DVT after OWHTO was found particularly around the osteotomy site (76.2%). Patients with DVT did not have inferior short-term clinical outcomes after surgery.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/23259671211030883
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2706251-X
    SSG: 31
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  • 4
    Online Resource
    Online Resource
    Outcome in Patients Treated with Intra-arterial thrombectomy: The optiMAL Blood Pressure control (OPTIMAL-BP) Trial
    SAGE Publications ; 2022
    In:  International Journal of Stroke Vol. 17, No. 8 ( 2022-10), p. 931-937
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 17, No. 8 ( 2022-10), p. 931-937
    Abstract: Very early stage blood pressure (BP) levels may affect outcome in stroke patients who have successfully undergone recanalization following intra-arterial treatment, but the optimal target of BP management remains uncertain. Aim We hypothesized that the clinical outcome after intensive BP-lowering is superior to conventional BP control after successful recanalization by intra-arterial treatment. Sample-size estimates We aim to randomize 668 patients (334 per arm), 1:1. Methods and design We initiated a multicenter, prospective, randomized, open-label trial with a blinded end-point assessment (PROBE) design. After successful recanalization (thrombolysis in cerebral infarction score ≥ 2 b), patients with elevated systolic BP level, defined as the mean of two readings ≥ 140 mmHg, will be randomly assigned to the intensive BP-lowering (systolic BP  〈  140 mm Hg) group or the conventional BP-lowering (systolic BP, 140−180 mm Hg) group. Study outcomes The primary efficacy outcomes are from dichotomized analysis of modified Rankin Scale (mRS) scores at three months (mRS scores: 0–2 vs. 3–6). The primary safety outcomes are symptomatic intracerebral hemorrhage and death within three months. Discussion The OPTIMAL-BP trial will provide evidence for the effectiveness of active BP control to achieve systolic BP  〈  140 mmHg during 24 h in patients with successful recanalization after intra-arterial treatment. Clinical trial registration ClinicalTrials.gov Identifier: NCT04205305.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930211041213
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2211666-7
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  • 5
    Online Resource
    Online Resource
    Rapid Breast Density Analysis of Partial Volumes of Automated Breast Ultrasound Images
    SAGE Publications ; 2013
    In:  Ultrasonic Imaging Vol. 35, No. 4 ( 2013-10), p. 333-343
    Details
    In: Ultrasonic Imaging, SAGE Publications, Vol. 35, No. 4 ( 2013-10), p. 333-343
    Abstract: Rapid volume density analysis (RVDA) for automated breast ultrasound (ABUS) has been proposed as a more efficient method for estimating breast density. In the current experiment, ABUS images were obtained for 67 breasts from 40 patients. For each case, three rectangular volumes of interest (VOIs) were extracted, including the VOIs located at the 6 and 12 o’clock positions relative to the nipple in the anterior to posterior pass and the lateral position relative to the nipple in the lateral pass. The centers of these VOIs were defined to align with the center of nipple, and the depths reached the retromammary fat boundary. The fuzzy c-means classifier was applied to differentiate the fibroglandular and fat tissues to estimate the density. The classification results of the three VOIs were averaged to obtain the breast density. The density correlations between the RVDA and the ABUS methods were 0.98 and 0.96 using Pearson’s correlation and linear regression coefficients, respectively. The average computation times for RVDA and ABUS were 4.2 and 17.8 seconds, respectively, using an Intel® Core™2 2.66 GHz computer with 3.25 GB memory. In conclusion, the RVDA method offers a quantitative and efficient breast density estimation for ABUS.
    Type of Medium: Online Resource
    ISSN: 0161-7346 , 1096-0910
    URL: Article
    DOI: 10.1177/0161734613505998
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 2012028-X
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  • 6
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    Online Resource
    Association of preoperative breast MRI features with locoregional recurrence after breast conservation therapy
    SAGE Publications ; 2018
    In:  Acta Radiologica Vol. 59, No. 4 ( 2018-04), p. 409-417
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 59, No. 4 ( 2018-04), p. 409-417
    Abstract: Locoregional recurrence (LRR) following breast conservation therapy (BCT) is associated with an increased risk of distant metastasis and death in patients with breast cancer. Purpose To investigate whether preoperative breast magnetic resonance imaging (MRI) features are associated with the risk of LRR in patients undergoing BCT. Material and Methods A total of 3781 women with primary invasive breast cancer underwent preoperative MRI and BCT between 2003 and 2013. Forty-eight patients who developed LRR comprised the LRR cohort and one-to-one matching (age, tumor stage, grade, and axillary nodal status) of each patient to a control participant was performed in patients who did not develop recurrence. Three readers independently reviewed MR images of the index cancer and the presence of multifocal disease was assessed. Χ 2 analysis was used to compare imaging and clinical features between LRR and control cohorts, with multivariate logistic regression analysis used to identify independent features. Results Significant differences were found in the proportion of multifocal disease ( P = 0.001), background parenchymal enhancement level ( P = 0.007), and breast cancer molecular subtype ( P = 0.01) between LRR and control cohorts. Multivariate analysis showed that multifocal disease (odds ratio [OR] = 11.9; 95% confidence interval [CI]  = 1.4–102.5; P = 0.02) and human epidermal growth factor receptor 2-positive subtype (OR = 12.7; 95% CI = 1.3–127.6; P = 0.03) were both independently associated with LRR. Conclusion Multifocal disease on preoperative breast MRI may indicate an increased risk of LRR in patients treated with BCT.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185117723041
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2024579-8
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  • 7
    Online Resource
    Online Resource
    Modeling of Composite Laminates with Multiple Delaminations under Compressive Loading
    SAGE Publications ; 1998
    In:  Journal of Composite Materials Vol. 32, No. 10 ( 1998-05), p. 951-968
    Details
    In: Journal of Composite Materials, SAGE Publications, Vol. 32, No. 10 ( 1998-05), p. 951-968
    Type of Medium: Online Resource
    ISSN: 0021-9983 , 1530-793X
    URL: Article
    DOI: 10.1177/002199839803201003
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1998
    detail.hit.zdb_id: 160490-9
    detail.hit.zdb_id: 2081924-9
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  • 8
    Online Resource
    Online Resource
    Comparison of peritumoral stromal tissue stiffness obtained by shear wave elastography between benign and malignant breast lesions
    SAGE Publications ; 2018
    In:  Acta Radiologica Vol. 59, No. 10 ( 2018-10), p. 1168-1175
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 59, No. 10 ( 2018-10), p. 1168-1175
    Abstract: Aggressive breast cancers produce abnormal peritumoral stiff areas, which can differ between benign and malignant lesions and between different subtypes of breast cancer. Purpose To compare the tissue stiffness of the inner tumor, tumor border, and peritumoral stroma (PS) between benign and malignant breast masses by shear wave elastography (SWE). Material and Methods We enrolled 133 consecutive patients who underwent preoperative SWE. Using OsiriX commercial software, we generated multiple 2-mm regions of interest (ROIs) in a linear arrangement on the inner tumor, tumor border, and PS. We obtained the mean elasticity value (E mean ) of each ROI, and compared the E mean between benign and malignant tumors. Odds ratios (ORs) for prediction of malignancy were calculated. Subgroup analyses were performed among tumor subtypes. Results There were 85 malignant and 48 benign masses. The E mean of the tumor border and PS were significantly different between benign and malignant masses ( P  〈  0.05 for all). ORs for malignancy were 1.06, 1.08, 1.05, and 1.04 for stiffness of the tumor border, proximal PS, middle PS, and distal PS, respectively ( P  〈  0.05 for all). Malignant masses with a stiff rim were significantly larger than malignant masses without a stiff rim, and were more commonly associated with the luminal B and triple negative subtypes. Conclusion Stiffness of the tumor border and PS obtained by SWE were significantly different between benign and malignant masses. Malignant masses with a stiff rim were larger in size and associated with more aggressive pathologic subtypes.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185117753728
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2024579-8
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  • 9
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    Impact of prior mammograms on combined reading of digital mammography and digital breast tomosynthesis
    SAGE Publications ; 2017
    In:  Acta Radiologica Vol. 58, No. 2 ( 2017-02), p. 148-155
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 58, No. 2 ( 2017-02), p. 148-155
    Abstract: Although digital breast tomosynthesis (DBT) is an emerging technique yielding higher sensitivity and specificity compared to digital mammography (DM) alone, relative contribution of prior mammograms on the interpretation of DBT combined with DM has not been investigated. Purpose To retrospectively compare the diagnostic performances of DM, DM + DBT, and DM + DBT with prior mammograms. Material and Methods Three breast radiologists independently reviewed images of 116 patients with 24 cancers in the sequential order of DM, DM + DBT, and DM + DBT with prior mammograms using Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Results The average areas under the receiver operating characteristic curve (AUC) of DM, DM + DBT, and DM + DBT with prior mammograms were 0.712, 0.777, and 0.816, respectively. Adding prior mammograms did not significantly affect the AUC of DM + DBT ( P = 0.108), whereas adding DBT significantly increased the AUC of DM ( P = 0.009). Sensitivity for DM, DM + DBT, and DM + DBT with prior mammograms was 58.3%, 69.4%, and 69.4%, and specificities were 84.1%, 85.9%, and 93.8%, respectively. Addition of DBT significantly increased the sensitivity ( P = 0.0090) of DM. Prior mammograms significantly improved the specificity of DM + DBT ( P = 0.0004), whereas adding prior mammogram did not affect sensitivity of DM + DBT ( P = 1.000). Conclusion DBT significantly increases the overall sensitivity and diagnostic performance of DM. Prior mammograms significantly increase the specificity of DM + DBT but have no significant effect on sensitivity and overall diagnostic performance.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185116647211
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 10
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    Mammography and ultrasonography evaluation of unexpected focal 18F-FDG uptakes in breast on PET/CT
    SAGE Publications ; 2012
    In:  Acta Radiologica Vol. 53, No. 3 ( 2012-04), p. 249-254
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 53, No. 3 ( 2012-04), p. 249-254
    Abstract: Unexpected focal 18F-FDG breast uptakes are occasionally identified on PET/CT due to its increased use for cancer staging and follow-up. The need for their characterization has been suggested. Purpose To retrospectively evaluate the diagnostic value of ultrasonography (US) in distinguishing benign from malignant lesions for unexpected focal 18F-FDG uptakes in breast on PET/CT scans. Material and Methods Between April 2004 and January 2010, 27 focal 18F-FDG breast uptakes in 27 patients (age range 33–62 years; mean age 46 years) among 5214 patients who had undergone PET/CT scans were retrospectively analyzed. The American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) final assessment categories of the US and the maximum standardized uptake values (SUVs) of the lesions were compared between the benign and malignant lesions. Results Of the 27 lesions, 15 (56%) lesions were malignant. The rate of malignancy, according to the final assessment category on the US, was 0% (0 of 6) for category 3, 60% for category 4 (9 of 15), and 100% (6 of 6) for category 5 ( P = 0.001). The US evaluation revealed a sensitivity of 100% (15 of 15) and a specificity of 50% (6 of 12). The average maximum SUV of the malignant lesions was greater than that of the benign lesions (4.12 ± 1.94 vs. 1.94 ± 0.82; P = 0.001). Conclusion US evaluation of unexpected focal 18F-FDG uptakes on PET/CT scans can accurately distinguish benign lesions from malignant lesions.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1258/ar.2011.110495
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
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