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Tanvir Johanning Bari,Martin Heegaard,Rachid Bech-Azeddine,Benny Dahl,Martin Gehrchen 대한척추신경외과학회 2021 Neurospine Vol.18 No.3
Objective: The demand for spinal fusion is increasing, with concurrent reports of iatrogenic adult spinal deformity (flatback deformity) possibly due to inappropriate lordosis distribution. This distribution is assessed using the lordosis distribution index (LDI) which describes the upper and lower arc lordosis ratio. Maldistributed LDI has been associated to adjacent segment disease following interbody fusion, although correlation to later-stage deformity is yet to be assessed. We therefore aimed to investigate if hypolordotic lordosis maldistribution was associated to radiographic deformity-surrogates or revision surgery following instrumented lumbar fusion. Methods: All patients undergoing fusion surgery (≤4 vertebra) for degenerative lumbar diseases were retrospectively included at a single center. Patients were categorized according to their postoperative LDI as: “normal” (LDI 50–80), “hypolordotic” (LDI<50), or “hyperlordotic” (LDI>80). Results: We included 149 patients who were followed for 21±14 months. Most attained a normally distributed lordosis (62%). The hypolordotic group had increased postoperative pelvic tilt (PT) (p<0.001), pelvic incidence minus lumbar lordosis (PI–LL) mismatch (p<0.001) and decreased global lordosis (p=0.007) compared to the normal group. Survival analyses revealed a significant difference in revision surgery (p=0.03), and subsequent multivariable logistic regression showed increased odds of 1-year revision in the hypolordotic group (p=0.04). There was also a negative, linear correlation between preoperative pelvic incidence (PI) and postoperative LDI (p<0.001). Conclusion: In patients undergoing instrumented lumbar fusion surgery, hypolordotic lordosis maldistribution (LDI<50) was associated to increased risk of revision surgery, increased postoperative PT and PI–LL mismatch. Lordosis distribution should be considered prior to spinal fusion, especially in high PI patients.
Stian Solumsmoen,Tanvir Johanning Bari,Sarah Woldu,Oliver Bremerskov Zielinski,Martin Gehrchen,Benny Dahl,Rachid Bech-Azeddine 대한척추신경외과학회 2021 Neurospine Vol.18 No.3
Objective: The reported incidence of complications and/or adverse events (AEs) following spine surgery varies greatly. A validated, systematic, reproducible reporting system to quantify AEs was used in 2 prospective cohorts, from 2 spine surgery centers, conducting either complex or purely degenerative spine surgery; in a comparative fashion. The aim was to highlight the differences between 2 distinctly different prospective cohorts with patients from the same background population. Methods: AEs were registered according to the predefined AE variables in the SAVES (Spine AdVerse Events Severity) system which was used to record all intra- and perioperative AEs. Additional outcomes, including mortality, length of stay, wound infection requiring revision, readmission, and unplanned revision surgery during the index admission, were also registered. Results: A total of 593 complex and 1,687 degenerative procedures were consecutively included with 100% data completion. There was a significant difference in morbidity when comparing the total number of AEs between the 2 groups (p<0.001): with a mean number of 1.42 AEs per patient (n=845) in the complex cohort, and 0.97 AEs per patient (n=1,630) in the degenerative cohort. Conclusion: In this prospective study comparing 2 cohorts, we report the rates of AEs related to spine surgery using a validated reproducible grading system for registration. The rates of morbidity and mortality were significantly higher following complex spine surgery compared to surgery for degenerative spine disease.
Molecular-Orientation-Driven Transient Behavior of Semicrystalline Polymeric Mixed Conductors
김지환,Roman Halaksa,김건우,조일영,Peter Anthony Finn,이인호,이종원,김영석,안형주,박성준,Christian Bech Nielsen,윤명한 한국고분자학회 2021 한국고분자학회 학술대회 연구논문 초록집 Vol.46 No.2
Despite the importance of transient behavior in organic mixed ionicelectronic conductors, there are very few studies on material characteristics affecting ion drift and transient responses of corresponding organic electrochemical transistors (OECTs). In this work, we investigated the effect of molecular orientation of a polymeric mixed conductor system with glycol side chains on the transient behavior of OECTs by varying the co-monomer unit (2,2’-bithiophene or phenylene) used in conjunction with a novel 1,4-dithienylphenylene monomer. Two polymers with similar mixed conductivity and electrochemical characteristics except molecular orientation were successfully synthesized. The comprehensive analysis of the OECT characteristics showed that the molecular orientation affects the length of the ion-drift pathway correlated with ion mobility, resulting in different transient behavior in OECT devices.
Yang, W.,Chen, L.,Ji, Q.,Liu, X.,Ma, J.,Tandon, N.,Bhattacharyya, A.,Kumar, A.,Kim, K.‐,W.,Yoon, K.‐,H.,Bech, O. M.,Zychma, M. Blackwell Publishing Ltd 2011 DIABETES OBESITY AND METABOLISM Vol.13 No.1
<P> <B>Aim:</B> To assess and compare the efficacy and safety of liraglutide with those of glimepiride, both in combination with metformin for the treatment of type 2 diabetes in Asian population from China, South Korea and India.</P><P> <B>Methods:</B> A 16‐week, randomized, double‐blind, double‐dummy, four‐arm, active control trial was carried out. In total, 929 subjects with type 2 diabetes with a mean (±s.d.) age of 53.3 ± 9.5 years, HbA<SUB>1c</SUB> of 8.6 ± 1.0% and body weight of 68.1 ± 11.7 kg were randomized (liraglutide 0.6, 1.2 or 1.8 mg once daily or glimepiride 4 mg once daily all in combination with metformin: 1 : 1 : 1 : 1). One subject withdrew immediately after randomization and before exposure.</P><P> <B>Results:</B> HbA<SUB>1c</SUB> was significantly reduced in all groups compared with baseline. Treatment with liraglutide 1.2 and 1.8 mg was non‐inferior to glimepiride (mean HbA<SUB>1c</SUB> reduction: 1.36% points, 1.45% points and 1.39% points, respectively). No significant difference was shown in the percentage of subjects reaching American Diabetes Association HbA<SUB>1c</SUB> target <7% or American Association of Clinical Endocrinologists target ≤6.5% between liraglutide 1.2 and 1.8 mg and glimepiride. Liraglutide was associated with a 1.8–2.4 kg mean weight reduction, compared with a 0.1 kg mean weight gain with glimepiride. Liraglutide led to a significantly greater reduction in systolic blood pressure (SBP) compared with glimepiride. Two subjects in the glimepiride group reported major hypoglycaemia while none in the liraglutide groups. Liraglutide was associated with about 10‐fold lower incidence of minor hypoglycaemia than glimepiride. Gastrointestinal disorders were the most common adverse events (AEs) for liraglutide, but were transient and resulted in few withdrawals.</P><P> <B>Conclusions:</B> In Asian subjects with type 2 diabetes, once‐daily liraglutide led to improvement in glycaemic control similar to that with glimepiride but with less frequent major and minor hypoglycaemia. Liraglutide also induced a significant weight loss and reduced SBP and was generally well tolerated. The most frequently reported AE was transient nausea. The effect of liraglutide in this Asian population is comparable to the effects seen in Caucasian, African American and Hispanic populations in global liraglutide phase 3 trials.</P>