1.Full Endoscopic Paramedian Partial Lumbar Corpectomy for a Lumbar Burst Fracture With Spinal Canal and Foraminal Stenosis: A Case Report With a Technical Note
Chun-Hao LIN ; Jeffrey WU ; Ting-Shuo HSU ; Yueh-Ying HSIEH ; Chang-Jung CHIANG ; Chia-Hsien CHEN
Journal of Minimally Invasive Spine Surgery and Technique 2024;9(Suppl 1):S34-S40
Burst fractures are common in thoracolumbar spinal injuries, often resulting in vertebral collapse with or without neurological deficits. While traditional open surgery is the standard approach for surgical decompression, it has some drawbacks and complications. Conversely, full endoscopic spine surgery remains underexplored for these patients. This case report presents a 77-year-old patient with an L3 burst fracture and severe neurological deficits caused by retropulsion bone fragments, leading to spinal canal compromise and right L3–4 foraminal stenosis. The patient underwent a full endoscopic paramedian approach for partial lumbar corpectomy and foraminal fragment removal. Vertebroplasty and short-segment pedicle screw fixation were also performed to restore sagittal alignment and spinal stability. After surgery, the patient experienced significant improvements in pain, numbness, and muscle strength. Radiographic assessments confirmed successful correction of the deformity and decompression of the spinal canal. The study emphasizes the benefits of endoscopic techniques in enhancing patient recovery for burst fractures. However, certain limitations are acknowledged, including the need for further research and expertise in utilizing this approach. In conclusion, paramedian endoscopy shows promise as a valuable alternative to traditional open surgery, offering potential advantages in terms of complications and recovery for burst fracture management.
2.Comparison of the Infant and Adult Adipose-Derived Mesenchymal Stem Cells in Proliferation, Senescence, Antioxidative Ability and Differentiation Potential
Szu-Hsien WU ; Jin-Huei YU ; Yu-Ting LIAO ; Kuo-Hao LIU ; En-Rung CHIANG ; Ming-Chau CHANG ; Jung-pan WANG
Tissue Engineering and Regenerative Medicine 2022;19(3):589-601
BACKGROUND:
Infant adipose-derived mesenchymal stem cells (ADSCs) collected from excised polydactyly fat tissue, which was surgical waste, could be cultured and expanded in vitro in this study. In addition, the collecting process would not cause pain in the host. In this study, the proliferation, reduction of senescence, anti-oxidative ability, and differentiation potential in the infant ADSCs were compared with those in the adult ADSCs harvested from thigh liposuction to determine the availability of infant ADSCs.
METHODS:
Proliferation was determined by detecting the fold changes in cell numbers and doubling time periods.Senescence was analyzed by investigating the age-related gene expression levels and the replicative stress. The superoxide dismutase (SOD) gene expression, adipogenic, neurogenic, osteogenic, and tenogenic differentiation were compared by RTqPCR. The chondrogenic differentiation efficiency was also determined using RT-qPCR and immunohistochemical staining.
RESULTS:
The proliferation, SOD (SOD1, SOD2 and SOD3) gene expression, the stemness-related gene (c-MYC) and telomerase reverse transcriptase of the infant ADSCs at early passages were enhanced compared with those of the adults’Cellular senescence related genes, including p16, p21 and p53, and replicative stress were reduced in the infant ADSCs. The adipogenic genes (PPARγ and LPL) and neurogenic genes (MAP2 and NEFH) of the infant ADSC differentiated cells were significantly higher than those of the adults’ while the expression of the osteogenic genes (OCN and RUNX) and tenogenic genes (TNC and COL3A1) of both demonstrated opposite results. The chondrogenic markers (SOX9, COL2 and COL10) were enhanced in the infant ADSC differentiated chondrogenic pellets, and the expression levels of SODs were decreased during the differentiation process.
CONCLUSION
Cultured infant ADSCs demonstrate less cellular senescence and replicative stress, higher proliferation rates, better antioxidant defense activity, and higher potential of chondrogenic, adipogenic and neurogenic differentiation.
3.A longitudinal analysis with CA-125 to predict overall survival in patients with ovarian cancer.
An Jen CHIANG ; Jiabin CHEN ; Yu Che CHUNG ; Huan Jung HUANG ; Wen Shiung LIOU ; Chung CHANG
Journal of Gynecologic Oncology 2014;25(1):51-57
OBJECTIVE: The objective of this study was to explore the association of longitudinal CA-125 measurements with overall survival (OS) time by developing a flexible model for patient-specific CA-125 profiles, and to provide a simple and reliable prediction of OS. METHODS: A retrospective study was performed on 275 patients with ovarian cancer who underwent at least one cycle of primary chemotherapy in our institute. Serial measurements of patients' CA-125 levels were performed at different frequencies according to their clinical plans. A statistical model coupling the Cox proportional hazards and the mixed-effects models was applied to determine the association of OS with patient-specific longitudinal CA-125 values. Stage and residual tumor size were additional variables included in the analysis. RESULTS: A total of 1,601 values of CA-125 were included. Longitudinal CA-125 levels, stage, and the residual tumor size were all significantly associated with OS. A patient-specific survival probability could be calculated. Validation showed that, in average, 85.4% patients were correctly predicted to have a high or low risk of death at a given time point. Comparison with a traditional model using CA-125 half-life and time to reach CA-125 nadir showed that the longitudinal CA-125 model had an improved predicative value. CONCLUSION: Longitudinal CA-125 values, measured from the diagnosis of ovarian cancer to the completion of primary chemotherapy, could be used to reliably predict OS after adjusting for the stage and residual tumor disease. This model could be potentially useful in clinical counseling of patients with ovarian cancer.
Counseling
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Diagnosis
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Drug Therapy
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Half-Life
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Humans
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Models, Statistical
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Neoplasm, Residual
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Ovarian Neoplasms*
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Retrospective Studies
4.Complex Coil Assisted Single Coil Embolization for Small Intracranial Aneurysm.
Ming Shiang YANG ; Tzu Hsien YANG ; Chang Hsien OU ; Si Wa CHAN ; Tai I CHEN ; Chia Jung YANG ; Chia Ming CHIANG ; Wen Chien HUANG
Neurointervention 2013;8(2):105-109
The purpose of the technical note is to introduce the complex coil assisted coil embolization method in the treatment of intracranial small aneurysm, in order to enhance the safety of the procedure. The first microcatheter was navigated into the aneurysm sac and the ultrasoft coil was used as the embolization coil. If the embolizations coil could not stay within the aneurysm sac smoothly, such as coil herniation into parent artery during the delivery process. The second microcatheter would be navigated to the aneurysm level in the parent artery. Another complex coil was delivered within the parent artery via the second microcatheter to provide the neck bridge effect in order to enhance the stability of embolization coil. Besides, the protection coil will not disturb the parent artery flow. While the embolization coil was put into the aneurysm sac smoothly under the help of complex protective coil, the protective coil was then withdrawn gently. We use the most magnified view, dual-plane approach simultaneously to observe the stability of embolization coil. The embolization coil would be detached without any evidence of coil motion or vibration. The new method could provide the physiological protective method, without leaving any protective device such as stent within the parent artery.
Aneurysm
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Arteries
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Humans
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Intracranial Aneurysm
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Neck
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Parents
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Protective Devices
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Stents
;
Vibration

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