The management of early stage hepatocellular carcinoma(HCC)presents significant challenges.While radiofrequency ablation(RFA)has shown safety and effectiveness in treating HCC,with lower mortality rates and shorter ho...The management of early stage hepatocellular carcinoma(HCC)presents significant challenges.While radiofrequency ablation(RFA)has shown safety and effectiveness in treating HCC,with lower mortality rates and shorter hospital stays,its high recurrence rate remains a significant impediment.Consequently,achieving improved survival solely through RFA is challenging,particularly in retrospective studies with inherent biases.Ultrasound is commonly used for guiding percutaneous RFA,but its low contrast can lead to missed tumors and the risk of HCC recurrence.To enhance the efficiency of ultrasound-guided percutaneous RFA,various techniques such as artificial ascites and contrast-enhanced ultrasound have been developed to facilitate complete tumor ablation.Minimally invasive surgery(MIS)offers advantages over open surgery and has gained traction in various surgical fields.Recent studies suggest that laparoscopic intraoperative RFA(IORFA)may be more effective than percutaneous RFA in terms of survival for HCC patients unsuitable for surgery,highlighting its significance.Therefore,combining MIS-IORFA with these enhanced percutaneous RFA techniques may hold greater significance for HCC treatment using the MIS-IORFA approach.This article reviews liver resection and RFA in HCC treatment,comparing their merits and proposing a trajectory involving their combination in future therapy.展开更多
Purpose： The aim of this study was to determine whether PET （positron emission tomography） imaging parameters from simultaneous ^11C-choline PET/MRI （magnetic resonance imaging） could be used to characterize prim...Purpose： The aim of this study was to determine whether PET （positron emission tomography） imaging parameters from simultaneous ^11C-choline PET/MRI （magnetic resonance imaging） could be used to characterize primary prostate cancer. Methods： Forty-six patients with biopsy-proven high-risk prostate cancer （clinical T stage ≥ cT2c, a Gleason score 〉 8, or PSA （prostate-specific antigen） level 〉 20 ng/mL） were prospectively enrolled. A SUV （standardized uptake value） histogram analysis including maximum SUV, mean SUV, SUV variance, SUV entropy, MTV （metabolic tumor volume）, and UVP （uptake volume product） was applied for the calculation of PET imaging parameters. Correlations between the PSA level and Gleason score were then evaluated. Results： Maximum SUV, mean SUV, MTV, UVP, and SUV variance were significantly correlated with PSA level, whereas SUV variance was the only parameter negatively correlated with the Gleason score. Multivariate logistic regression analysis demonstrated that MTV and PSA level at diagnosis were independent predictors of positive distant metastasis status. Conclusions： PET imaging parameters from simultaneous ^11C-choline PET/MRI were correlated with PSA level. However, ^11C-choline metabolic tumor heterogeneity was not associated with biospecimen-derived Gleason scores in prostate cancer. To apply PET texture quantification analysis to prostate cancer, a more specific PET radiotracer is required.展开更多
Peripheral nerve injuries are common in clinical practice because of traumas such as crushing and sectioning. Lesions of the nerve structure result in lost or diminished sensitivity and/or motor activity in the innerv...Peripheral nerve injuries are common in clinical practice because of traumas such as crushing and sectioning. Lesions of the nerve structure result in lost or diminished sensitivity and/or motor activity in the innervated territory. The degree of lesion depends on the specific nerve involved, the magnitude and type of pres- sure exerted, and the duration of the compression. The results of such injuries commonly include axonal degeneration and retro- grade degeneration of the corresponding neurons in the spinal medulla, followed by very slow regeneration （Rochkind et al., 2001）. The adverse effects on the daily activities of patients with a peripheral nerve injury are a determining factor in establishing the goals of early recovery （Rodriguez et al., 2004）.展开更多
Recent studies have shown the potential of artificially synthesized conduits in the repair of peripheral nerve injury. Natural biopolymers have received much attention because of their biocompatibility. To investigate...Recent studies have shown the potential of artificially synthesized conduits in the repair of peripheral nerve injury. Natural biopolymers have received much attention because of their biocompatibility. To investigate the effects of novel electrospun absorbable poly(ε-caprolactone)/type Ⅰ collagen nanofiber conduits(biopolymer nanofiber conduits) on the repair of peripheral nerve injury, we bridged 10-mm-long sciatic nerve defects with electrospun absorbable biopolymer nanofiber conduits, poly(ε-caprolactone) or silicone conduits in Sprague-Dawley rats. Rat neurologica1 function was weekly evaluated using sciatic function index within8 weeks after repair. Eight weeks after repair, sciatic nerve myelin sheaths and axon morphology were observed by osmium tetroxide staining, hematoxylin-eosin staining, and transmission electron microscopy.S-100(Schwann cell marker) and CD4(inflammatory marker) immunoreactivities in sciatic nerve were detected by immunohistochemistry. In rats subjected to repair with electrospun absorbable biopolymer nanofiber conduits, no serious inflammatory reactions were observed in rat hind limbs, the morphology of myelin sheaths in the injured sciatic nerve was close to normal. CD4 immunoreactivity was obviously weaker in rats subjected to repair with electrospun absorbable biopolymer nanofiber conduits than in those subjected to repair with poly(ε-caprolactone) or silicone. Rats subjected to repair with electrospun absorbable biopolymer nanofiber conduits tended to have greater sciatic nerve function recovery than those receiving poly(ε-caprolactone) or silicone repair. These results suggest that electrospun absorbable poly(ε-caprolactone)/type Ⅰ collagen nanofiber conduits have the potential of repairing sciatic nerve defects and exhibit good biocompatibility. All experimental procedures were approved by Institutional Animal Care and Use Committee of Taichung Veteran General Hospital, Taiwan, China(La-1031218) on October 2, 2014.展开更多
BACKGROUND Gallstone disease(GD)can have prolonged,subacute inflammatory period before biliary events.The intricate relationship between GD and inflammatory processes can possible lead to prothrombotic tendency that c...BACKGROUND Gallstone disease(GD)can have prolonged,subacute inflammatory period before biliary events.The intricate relationship between GD and inflammatory processes can possible lead to prothrombotic tendency that can result in confusing clinical course before diagnosis.CASE SUMMARY A 51-year-old man,presented with a 1-year history of self-relief occasional postprandial upper abdominal pain,had sudden onset severe left upper quadrant pain and visited our emergency room.Contrast enhanced computed tomography(CECT)showed filling defect in celiac trunk,common hepatic,part of splenic arteries and wedge-shaped hypo-enhancing region of spleen,consistent with splenic infarction secondary to splenic arterial occlusion.No convincing predisposing factors were found during first hospitalization.Abdominal pain mildly subsided after low molecular weight heparin and bridge to oral anticoagulant use.However,in the following six months,the patient was admitted twice due to acute cholangitis and finally cholecystitis.Second CECT revealed biliary impacted stone was adjacent to poor dissoluble thrombus.The abdominal pain did not achieve a clinical full remission until endoscopic retrograde cholangiopancreato-graphy stone removal and series laparoscopic cholecystectomy was performed.CONCLUSION This is the first case to present serious thrombotic complication due to inflammation status in chronic GD.It could be a rare,confusing and difficult recognizing cause of a celiac trunk thromboembolic event.展开更多
This study assessed elemental concentrations in the serum of 154 preschool children in central Taiwan via instrumental neutron activation analysis （INAA）. A total of eight elements, Br, C1, Fe, Na, Rb, Sc, Se and Zn...This study assessed elemental concentrations in the serum of 154 preschool children in central Taiwan via instrumental neutron activation analysis （INAA）. A total of eight elements, Br, C1, Fe, Na, Rb, Sc, Se and Zn of sera for Taiwan Residents preschool children living at four residential areas： Taichung city, Taichung urban townships and in a remote area inhabited by two groups of aborigines, Atayal and Bunun were determined. Standard reference materials （tomato leaves, NIST-SRM 1570a, and lichen, IAEA-336） were used as quality control standards to crosscheck the accuracy. Residential area, socioeconomic status and gender were shown to significantly influence serum levels of the eight trace elements. Statistical analysis revealed several different gender patterns via the two-tailed student＇s test. A quantified index of agreement （AT） was used to classify these elements. Small AT indicated a close consistency, while large AT indicated a larger fluctuation, or less agreement, such that the correlation between the elements could be interpreted using a series of quantified indices at the serum levels of preschool children.展开更多
The goal of this paper is to investigate different reconstruction methods for solving the limited angle problem in reconstructing the projection data from a stationary multi-pinhole system based on a three-head clinic...The goal of this paper is to investigate different reconstruction methods for solving the limited angle problem in reconstructing the projection data from a stationary multi-pinhole system based on a three-head clinical single photon emission computed tomography （SPECT） camera. Three iterative recon- struction approaches were studied including maximum likelihood expectation maximization （MLEM）, maximum a posteriori expectation maximization （MAPEM） with a smoothing prior, and an alternating optimization schemes from MLEM and total variation （TV） optimization. A three-headed multipinhole SPECT was simulated with apertures of nine 1-mm pinholes each, and covered scanning volume of 6-mm diameter. The reconstructions were optimized for various iterations based on visual inspections, and finally 20 iterations were applied for each method. For both MLEM-TV and MAPEM-TV, various initial reconstructions before TV optimization were studied. The smoothing parameter for MAPEM and the gradient descent constant for TV were also investigated through visual comparison. The preliminary results showed the 3 reconstruction methods generated compatible images, and can restore the images from projection data suffering limited angular sampling. However, MLEM was noisy for low-count and highly limited angle data, and thus suitable smoothing in MAPEM alleviated this problem, initial reconstructions were necessary for better edge enhancement in TV. The conclusion is that TV might be potential in producing more edge-enhanced images if all parameters were optimized.展开更多
文摘The management of early stage hepatocellular carcinoma(HCC)presents significant challenges.While radiofrequency ablation(RFA)has shown safety and effectiveness in treating HCC,with lower mortality rates and shorter hospital stays,its high recurrence rate remains a significant impediment.Consequently,achieving improved survival solely through RFA is challenging,particularly in retrospective studies with inherent biases.Ultrasound is commonly used for guiding percutaneous RFA,but its low contrast can lead to missed tumors and the risk of HCC recurrence.To enhance the efficiency of ultrasound-guided percutaneous RFA,various techniques such as artificial ascites and contrast-enhanced ultrasound have been developed to facilitate complete tumor ablation.Minimally invasive surgery(MIS)offers advantages over open surgery and has gained traction in various surgical fields.Recent studies suggest that laparoscopic intraoperative RFA(IORFA)may be more effective than percutaneous RFA in terms of survival for HCC patients unsuitable for surgery,highlighting its significance.Therefore,combining MIS-IORFA with these enhanced percutaneous RFA techniques may hold greater significance for HCC treatment using the MIS-IORFA approach.This article reviews liver resection and RFA in HCC treatment,comparing their merits and proposing a trajectory involving their combination in future therapy.
文摘Purpose： The aim of this study was to determine whether PET （positron emission tomography） imaging parameters from simultaneous ^11C-choline PET/MRI （magnetic resonance imaging） could be used to characterize primary prostate cancer. Methods： Forty-six patients with biopsy-proven high-risk prostate cancer （clinical T stage ≥ cT2c, a Gleason score 〉 8, or PSA （prostate-specific antigen） level 〉 20 ng/mL） were prospectively enrolled. A SUV （standardized uptake value） histogram analysis including maximum SUV, mean SUV, SUV variance, SUV entropy, MTV （metabolic tumor volume）, and UVP （uptake volume product） was applied for the calculation of PET imaging parameters. Correlations between the PSA level and Gleason score were then evaluated. Results： Maximum SUV, mean SUV, MTV, UVP, and SUV variance were significantly correlated with PSA level, whereas SUV variance was the only parameter negatively correlated with the Gleason score. Multivariate logistic regression analysis demonstrated that MTV and PSA level at diagnosis were independent predictors of positive distant metastasis status. Conclusions： PET imaging parameters from simultaneous ^11C-choline PET/MRI were correlated with PSA level. However, ^11C-choline metabolic tumor heterogeneity was not associated with biospecimen-derived Gleason scores in prostate cancer. To apply PET texture quantification analysis to prostate cancer, a more specific PET radiotracer is required.
文摘Peripheral nerve injuries are common in clinical practice because of traumas such as crushing and sectioning. Lesions of the nerve structure result in lost or diminished sensitivity and/or motor activity in the innervated territory. The degree of lesion depends on the specific nerve involved, the magnitude and type of pres- sure exerted, and the duration of the compression. The results of such injuries commonly include axonal degeneration and retro- grade degeneration of the corresponding neurons in the spinal medulla, followed by very slow regeneration （Rochkind et al., 2001）. The adverse effects on the daily activities of patients with a peripheral nerve injury are a determining factor in establishing the goals of early recovery （Rodriguez et al., 2004）.
基金supported by grants from the Taichung Veterans General Hospital and Central Taiwan University of Science and Technology,No.TCVGH-CTUST1047701(to CCS and BSL)Taichung Veterans General Hospital,No.TCVGH-1034907C(to CCS),Taiwan,China
文摘Recent studies have shown the potential of artificially synthesized conduits in the repair of peripheral nerve injury. Natural biopolymers have received much attention because of their biocompatibility. To investigate the effects of novel electrospun absorbable poly(ε-caprolactone)/type Ⅰ collagen nanofiber conduits(biopolymer nanofiber conduits) on the repair of peripheral nerve injury, we bridged 10-mm-long sciatic nerve defects with electrospun absorbable biopolymer nanofiber conduits, poly(ε-caprolactone) or silicone conduits in Sprague-Dawley rats. Rat neurologica1 function was weekly evaluated using sciatic function index within8 weeks after repair. Eight weeks after repair, sciatic nerve myelin sheaths and axon morphology were observed by osmium tetroxide staining, hematoxylin-eosin staining, and transmission electron microscopy.S-100(Schwann cell marker) and CD4(inflammatory marker) immunoreactivities in sciatic nerve were detected by immunohistochemistry. In rats subjected to repair with electrospun absorbable biopolymer nanofiber conduits, no serious inflammatory reactions were observed in rat hind limbs, the morphology of myelin sheaths in the injured sciatic nerve was close to normal. CD4 immunoreactivity was obviously weaker in rats subjected to repair with electrospun absorbable biopolymer nanofiber conduits than in those subjected to repair with poly(ε-caprolactone) or silicone. Rats subjected to repair with electrospun absorbable biopolymer nanofiber conduits tended to have greater sciatic nerve function recovery than those receiving poly(ε-caprolactone) or silicone repair. These results suggest that electrospun absorbable poly(ε-caprolactone)/type Ⅰ collagen nanofiber conduits have the potential of repairing sciatic nerve defects and exhibit good biocompatibility. All experimental procedures were approved by Institutional Animal Care and Use Committee of Taichung Veteran General Hospital, Taiwan, China(La-1031218) on October 2, 2014.
文摘BACKGROUND Gallstone disease(GD)can have prolonged,subacute inflammatory period before biliary events.The intricate relationship between GD and inflammatory processes can possible lead to prothrombotic tendency that can result in confusing clinical course before diagnosis.CASE SUMMARY A 51-year-old man,presented with a 1-year history of self-relief occasional postprandial upper abdominal pain,had sudden onset severe left upper quadrant pain and visited our emergency room.Contrast enhanced computed tomography(CECT)showed filling defect in celiac trunk,common hepatic,part of splenic arteries and wedge-shaped hypo-enhancing region of spleen,consistent with splenic infarction secondary to splenic arterial occlusion.No convincing predisposing factors were found during first hospitalization.Abdominal pain mildly subsided after low molecular weight heparin and bridge to oral anticoagulant use.However,in the following six months,the patient was admitted twice due to acute cholangitis and finally cholecystitis.Second CECT revealed biliary impacted stone was adjacent to poor dissoluble thrombus.The abdominal pain did not achieve a clinical full remission until endoscopic retrograde cholangiopancreato-graphy stone removal and series laparoscopic cholecystectomy was performed.CONCLUSION This is the first case to present serious thrombotic complication due to inflammation status in chronic GD.It could be a rare,confusing and difficult recognizing cause of a celiac trunk thromboembolic event.
文摘This study assessed elemental concentrations in the serum of 154 preschool children in central Taiwan via instrumental neutron activation analysis （INAA）. A total of eight elements, Br, C1, Fe, Na, Rb, Sc, Se and Zn of sera for Taiwan Residents preschool children living at four residential areas： Taichung city, Taichung urban townships and in a remote area inhabited by two groups of aborigines, Atayal and Bunun were determined. Standard reference materials （tomato leaves, NIST-SRM 1570a, and lichen, IAEA-336） were used as quality control standards to crosscheck the accuracy. Residential area, socioeconomic status and gender were shown to significantly influence serum levels of the eight trace elements. Statistical analysis revealed several different gender patterns via the two-tailed student＇s test. A quantified index of agreement （AT） was used to classify these elements. Small AT indicated a close consistency, while large AT indicated a larger fluctuation, or less agreement, such that the correlation between the elements could be interpreted using a series of quantified indices at the serum levels of preschool children.
基金Supported by the NSC (No.97-2314-B-182-029-MY3)the Research Fund of Chang Gung Memorial Hospital (No.CMRPD34005)
文摘The goal of this paper is to investigate different reconstruction methods for solving the limited angle problem in reconstructing the projection data from a stationary multi-pinhole system based on a three-head clinical single photon emission computed tomography （SPECT） camera. Three iterative recon- struction approaches were studied including maximum likelihood expectation maximization （MLEM）, maximum a posteriori expectation maximization （MAPEM） with a smoothing prior, and an alternating optimization schemes from MLEM and total variation （TV） optimization. A three-headed multipinhole SPECT was simulated with apertures of nine 1-mm pinholes each, and covered scanning volume of 6-mm diameter. The reconstructions were optimized for various iterations based on visual inspections, and finally 20 iterations were applied for each method. For both MLEM-TV and MAPEM-TV, various initial reconstructions before TV optimization were studied. The smoothing parameter for MAPEM and the gradient descent constant for TV were also investigated through visual comparison. The preliminary results showed the 3 reconstruction methods generated compatible images, and can restore the images from projection data suffering limited angular sampling. However, MLEM was noisy for low-count and highly limited angle data, and thus suitable smoothing in MAPEM alleviated this problem, initial reconstructions were necessary for better edge enhancement in TV. The conclusion is that TV might be potential in producing more edge-enhanced images if all parameters were optimized.
