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Zheng XL, Li WL, Lin YP, Huang TL. Computerized tomography-guided therapeutic percutaneous puncture catheter drainage-combined with somatostatin for severe acute pancreatitis: An analysis of efficacy and safety. World J Gastrointest Surg 2024; 16:59-66. [PMID: 38328327 PMCID: PMC10845273 DOI: 10.4240/wjgs.v16.i1.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/06/2023] [Accepted: 12/18/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Severe acute pancreatitis (SAP), a condition with rapid onset, critical condition and unsatisfactory prognosis, poses a certain threat to human health, warranting optimization of relevant treatment plans to improve treatment efficacy. AIM To evaluate the efficacy and safety of computerized tomography-guided therapeutic percutaneous puncture catheter drainage (CT-TPPCD) combined with somatostatin (SS) in the treatment of SAP. METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected. On the basis of routine treatment, 20 patients received SS therapy (control group) and 22 patients were given CT-TPPCD plus SS intervention (research group). The efficacy, safety (pancreatic fistula, intra-abdominal hemorrhage, sepsis, and organ dysfunction syndrome), abdominal bloating and pain relief time, bowel recovery time, hospital stay, inflammatory indicators (C-reactive protein, interleukin-6, and procalcitonin), and Acute Physiology and Chronic Health Evaluation (APACHE) II score of both groups were evaluated for comparison. RESULTS Compared with the control group, the research group had a markedly higher total effective rate, faster abdominal bloating and pain relief and bowel recovery, shorter hospital length of stay, fewer complications, and lower posttreatment inflammatory indices and APACHE-II scores. CONCLUSION CT-TPPCD in combination with SS is effective for SAP patients, which can reduce complications, accelerate symptom resolution, inhibit inflammation, and improve patient condition, with promising prospects for clinical promotion.
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Affiliation(s)
- Xue-Lan Zheng
- Department of Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Wan-Ling Li
- CT Room, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Yan-Ping Lin
- Department of Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Ting-Long Huang
- Department of Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
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Shi TF, Jia JJ, Huang TL, Ma JW, Si JQ, Ma KT, Li L. [Tanshinone ⅡA activates PI3K/AKT signaling pathway to inhibit the apoptosis of mice cochlear pericytes induced by high glucose]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:681-689. [PMID: 37455113 DOI: 10.3760/cma.j.cn115330-20230115-00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Objective: To investigate whether tanshinone ⅡA can protect the apoptosis of mice cochlear pericytes induced by high glucose and its specific protective mechanism, so as to provide experimental evidence for the prevention and treatment of diabetic hearing loss. Methods: C57BL/6J male mice were used to prepare type 2 diabetes model, which were divided into normal (NG) group, diabetic (DM) group, diabetic+tanshinone ⅡA (HG+tanshinone ⅡA) group and tanshinone ⅡA group. Each group had 10 animals. Primary cochlear pericytes were divided into NG group, HG group (high glucose 35 mmol/L), HG+tanshinone ⅡA (1, 3, 5 μmol/L) group, HG+Tanshinone ⅡA+LY294002 (PI3K/AKT pathway inhibitor) group, LY294002 group, tanshinone ⅡA group and DMSO group. Auditory brainstem response (ABR) was used to measure hearing threshold. Evans blue was used to detect the permeability of blood labyrinth barrier in each group. TBA methods were used to detect oxidative stress levels in various organs of mice. Morphological changes of stria vascularis were observed by hematoxylin-eosin staining (HE). Evans blue was used to detect the vascular labyrinth barrier permeability in cochlea. The expression of apoptosis protein in stria vascularis pericytes was observed by immunofluorescence. Pericytes apoptosis rate was observed by flow cytometry. DCFH-DA was combined with flow cytometry to detect intracellular ROS content, and Western blot was used to detect the expression of apoptotic proteins (Cleaved-caspase3, Bax), anti-apoptotic proteins (BCL-2) and pathway proteins (PI3K, p-PI3K, AKT, p-AKT). SPSS software was used for statistical analysis. Independent sample t test was performed, and P<0.05 was considered statistically significant. Results: Animal experiments: Tanshinone ⅡA decreased the hearing threshold of DM group [(35.0±3.5) dB SPL vs. (55.3±8.1) dB SPL] (t=4.899, P<0.01), decreased the oxidative stress level in cochlea (t=4.384, P<0.05), improved the structure disorder, atrophy of cochlea vascular lines, vacuole increased phenomenon. Tanshinone ⅡA alleviated the increased permeability of the blood labyrinth barrier [Evans blue leakage (6.84±0.27) AU vs. (8.59±0.85) AU] in the cochlea of DM mice (t=2.770, P<0.05), reversed the apoptotic protein: Caspase3 (t=4.956, P<0.01) and Bax (t=4.388, P<0.05) in cochlear vascularis. Cell experiments: Tanshinone ⅡA decreased intracellular ROS content in a concentration-dependent way (t=3.569, P<0.05; t=4.772, P<0.01; t=7.494, P<0.01); Tanshinone ⅡA decreased apoptosis rate and apoptotic protein, and increased the expression of anti-apoptotic protein, p-PI3K/PI3K and p-AKT/AKT in concentration-dependent manner (all P values<0.05); LY294002 reversed the protective effect of tanshinone ⅡA on pericytes apoptosis (all P values<0.05). Conclusion: Tanshinone ⅡA can inhibit the apoptosis of cochlear pericytes induced by high glucose by reducing oxidative stress level and activating PI3K/AKT signaling pathway under high glucose environment, thus playing a protective role in diabetic hearing loss.
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Affiliation(s)
- T F Shi
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - J J Jia
- College of Basic Medicine, Jiaxing University College of Medicine, Jiaxing 314000, China
| | - T L Huang
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - J W Ma
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - J Q Si
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - K T Ma
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - L Li
- College of Basic Medicine, Jiaxing University College of Medicine, Jiaxing 314000, China
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Deng S, Dong B, Xu SR, Huang TL, Ma JW, Si JQ, Ma KT, Li L. [Effect of microvascular pericytes of cochlear stria vascularis on endothelial cell permeability in C57BL/6J mice]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 56:1185-1193. [PMID: 34749458 DOI: 10.3760/cma.j.cn115330-20201202-00905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the changes in the permeability of the blood labyrinth barrier of the aging cochlea in mice, and to establish a non-contact co-culture model of endothelial cells (EC) and pericytes (PC) to furtherly investigate the cochlear stria vascularis microvascular pericytes impact on the permeability of endothelial cells. Methods: C57BL/6J mice were divided into two groups, three months old as young group, 12 months old as senile group. Cell experiment was divided into four groups, EC group, EC+PC co-culture group, D-gal+EC group and D-gal+EC+PC co-culture group. Auditory brainstem response (auditory brain response, ABR) was used to detect the auditory function of the two groups of mice. Evans blue staining was applied to detect the permeability of the cochlear blood labyrinth barrier of the two groups of mice. Transmission electron microscopy was used to observe the ultrastructure of blood labyrinth barrier endothelial cells, pericytes and tight junctions in the two groups of mice. Immunohistochemistry was used to detect the expression levels of tight junction proteins in the stria vascularis of the cochlea of the two groups of mice. Transwell chamber was used to detect the permeability of endothelial cells. Western blot and immunofluorescence technology were used to detect the expression level of tight junction protein on endothelial cells. SPSS 20.0 software was used to analyze the data. Results: Compared with the young group, the ABR threshold of the aging group was significantly increased, the latency of wave I was prolonged (t=10.25, P<0.01;t=5.61, P<0.05), the permeability of the cochlear blood labyrinth barrier was increased and the expression of tight junction protein on the vascular stria was decreased (P<0.05). The cochlear ultrastructure showed that the cochlear vascular stria microvascular lumen was deformed, the basement membrane thickened and the tight junction gap between endothelium enlarged. The positive rate of ECs and PCs in primary culture was more than 95%. The cells induced by 15 g/L D-gal were determined to be senescent cells. Compared with EC group, the expression of tight junction protein in endothelial cells of D-gal+EC group decreased(t=7.42,P<0.01;t=13.19,P<0.05)and the permeability increased (t=11.17, P<0.01). In the co-culture group, the expression of tight junction protein between endothelial cells in EC+PC co-culture group and D-gal+EC+PC co-culture group increased and the permeability decreased. Conclusions: In aging mice, the permeability of cochlear blood labyrinth barrier will increase and the level of tight junction protein will decrease; in aging state, cochlear vascular stria microvascular pericytes may affect endothelial cell permeability by regulating the expression of tight junction protein.
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Affiliation(s)
- S Deng
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - B Dong
- College of Basic Medicine, Jiaxing University College of Medicine, Jiaxing 314000, China
| | - S R Xu
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - T L Huang
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - J W Ma
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - J Q Si
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - K T Ma
- Department of Physiology, Shihezi University College Xinjiang, Shihezi 832002, China
| | - L Li
- College of Basic Medicine, Jiaxing University College of Medicine, Jiaxing 314000, China
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Tong YS, Huang TL, Chen TY, Tsang LLC, Ou HY, Yu CY, Hsu HW, Xiong LW, Liao CC, Eng HL, Chen CL, Cheng YF. Imaging Validation of Drug-Eluting Beads Transarterial Chemoembolization of Hepatocellular Carcinomas in Living Donor Liver Transplantation. Transplant Proc 2018; 50:2622-2625. [PMID: 30401362 DOI: 10.1016/j.transproceed.2018.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/05/2018] [Accepted: 05/21/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study is to determine whether post-transarterial chemoembolization imaging (computed tomography or magnetic resonance imaging) could accurately predict the tumors' necrosis on pathologic specimens. BACKGROUND Transarterial chemoembolization with drug-eluting beads has been proven to be an effective way to bridge patients with hepatocellular carcinomas to liver transplantation. MATERIALS AND METHODS From September 2012 to June 2017, 59 patients with a total of 78 hepatocellular carcinomas, who received transarterial chemoembolization with drug-eluting beads before liver transplantation in Kaohsiung Chang Gung Memorial Hospital, were included in the study. All patients and hepatocellular carcinomas have pre-transarterial chemoembolization and post-transarterial chemoembolization images (computed tomography or magnetic resonance imaging) and pathological findings for correlation. Tumor response was evaluated according to modified Response Evaluation Criteria in Solid Tumors. The ranges of necrotic percentage are 100%, 91-99%, 51-90%, and <50%. RESULTS The accuracy rate between the imaging and pathology correlation was 40% for computed tomography and 42% for magnetic resonance imaging. The recurrent rate of the complete respond group is 11.5%, the partial respond group is 16.0%, and the stationary group is 28.6%. CONCLUSION Computed tomography and magnetic resonance imaging sensitivity is not satisfactory for microscopic evaluation of residual tumors after transarterial chemoembolization with drug-eluting beads. However, survival is good after liver transplantation no matter what the microscopic findings were.
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Affiliation(s)
- Y S Tong
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - T L Huang
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - T Y Chen
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - L L C Tsang
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - H Y Ou
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C Y Yu
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - H W Hsu
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - L W Xiong
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C C Liao
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - H L Eng
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C L Chen
- Departments of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y F Cheng
- Liver Transplantation Program and Departments of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Chang MT, Huang TL, Liang HC, Su KW, Chen YF. Broad expansion of optical frequency combs by self-Raman scattering in coupled-cavity self-mode-locked monolithic lasers. Opt Express 2017; 25:7627-7636. [PMID: 28380882 DOI: 10.1364/oe.25.007627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Broad expansion of optical frequency comb (OFC) by the self-Raman scattering is numerically analyzed and experimentally accomplished in a coupled-cavity self-mode-locked (SML) monolithic Yb:KGW laser. The gain medium is coated to achieve the monolithic SML operation and a partially reflective mirror is further exploited to form the coupled cavity and to multiply the repetition rate up to 128.9 GHz. With a coupled reflectivity of 95%, it is experimentally found that not only the first-order but also second-order stimulated Raman scattering (SRS) can be efficiently generated. The mode-locked OFC can be consequently expanded to reach approximately 8.4 THz, leading the pulse width to be as narrow as 53 fs. At the pump power of 8.7 W, the total output power for the fundamental and the first- and second-Stokes waves can be maintained at 1.6 W. The present exploration provides a promising way to generate the ultrahigh-repetition-rate broadband OFC via the simultaneous SML and SRS processes.
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Cheng HP, Huang TL, Lee CY, Sung CL, Cho CY, Chen YF. Monolithic dual-polarization self-mode-locked Nd:YAG 946-nm lasers: controlling beat frequency and observation of temporal chaos. Opt Express 2016; 24:23829-23837. [PMID: 27828218 DOI: 10.1364/oe.24.023829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The self-mode-locked (SML) operation at 946 nm can be achieved with a monolithic Nd:YAG crystal when the pump power is above the threshold of the multiple-longitudinal-mode generation. The SML output is further found to include two orthogonal polarization components with a beat frequency coming from the birefringence effect in the laser crystal. The beat frequency can be widely adjusted in the range of 5-220 MHz by controlling the cooling temperature. The present experiment also confirms the theoretical prediction that the two-mode operation generally exhibits the chaotic dynamics when the frequency difference is sufficiently close to the relaxation frequency.
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Huang TL, Sung CL, Cheng HP, Cho CY, Liang HC, Su KW, Huang KF, Chen YF. Synchronized self-mode-locked 1061-nm and 1064-nm monolithic Nd:YAG laser at cryogenic temperatures with two orthogonally polarized emissions: generation of 670 GHz beating. Opt Express 2016; 24:22189-22197. [PMID: 27661953 DOI: 10.1364/oe.24.022189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A dual-wavelength self-mode-locked monolithic Nd:YAG laser at 1061 and 1064 nm is realized at cryogenic temperatures. At an incident pump power of 5.5 W, the total output power can reach 2.5 W and the mode-locked pulse width is 29 ps at a pulse repetition rate of 7.75 GHz. The synchronization of the dual-wavelength emissions leads to a beat frequency of 670 GHz in the individual mode-locked pulse. It is further discovered that the laser output consists of two orthogonally polarized components with a central frequency difference of 127 MHz. The central frequency difference between two orthogonal polarizations mainly arises from the external mechanical stress introduced by the copper holder for the laser crystal.
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Liou CW, Chuang JH, Chen JB, Tiao MM, Wang PW, Huang ST, Huang TL, Lee WC, Weng SW, Huang PH, Chen SD, Chen RS, Lu CS, Lin TK. Mitochondrial DNA variants as genetic risk factors for Parkinson disease. Eur J Neurol 2016; 23:1289-300. [PMID: 27160373 DOI: 10.1111/ene.13020] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 03/22/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Investigation of the relationship between mitochondrial DNA (mtDNA) variants and Parkinson disease (PD) remains an issue awaiting more supportive evidence. Moreover, an affirming cellular model study is also lacking. METHODS The index mtDNA variants and their defining mitochondrial haplogroup were determined in 725 PD patients and 744 non-PD controls. Full-length mtDNA sequences were also conducted in 110 cases harboring various haplogroups. Cybrid cellular models, composed by fusion of mitochondria-depleted rho-zero cells and donor mitochondria, were used for a rotenone-induced PD simulation study. RESULTS Multivariate logistic regression analysis revealed that subjects harboring the mitochondrial haplogroup B5 have resistance against PD (odds ratio 0.50, 95% confidence interval 0.32-0.78; P = 0.002). Furthermore, a composite mtDNA variant group consisting of A10398G and G8584A at the coding region was found to have resistance against PD (odds ratio 0.50, 95% confidence interval 0.33-0.78; P = 0.001). In cellular studies, B4 and B5 cybrids were selected according to their higher resistance to rotenone, in comparison with cybrids harboring other haplogroups. The B5 cybrid, containing G8584A/A10398G variants, showed more resistance to rotenone than the B4 cybrid not harboring these variants. This is supported by findings of low reactive oxygen species generation and a low apoptosis rate in the B5 cybrid, whereas a higher expression of autophagy was observed in the B4 cybrid particularly under medium dosage and longer treatment time with rotenone. CONCLUSIONS Our studies, offering positive results from clinical investigations and cybrid experiments, provide data supporting the role of variant mtDNA in the risk of PD.
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Affiliation(s)
- C W Liou
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. .,Mitochondrial Research Unit, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - J H Chuang
- Department of Pediatrics Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - J B Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - M M Tiao
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - P W Wang
- Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S T Huang
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - T L Huang
- Department of Psychiatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - W C Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S W Weng
- Division of Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - P H Huang
- Mitochondrial Research Unit, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S D Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - R S Chen
- Section of Movement Disorder, Department of Neurology, Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou Medical Center, Taoyuan, Taiwan
| | - C S Lu
- Section of Movement Disorder, Department of Neurology, Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou Medical Center, Taoyuan, Taiwan
| | - T K Lin
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Mitochondrial Research Unit, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Cho CY, Huang TL, Cheng HP, Huang KF, Chen YF. Analysis of the optimal temperature for the cryogenic monolithic Nd:YAG laser at 946-nm. Opt Express 2016; 24:1-8. [PMID: 26832232 DOI: 10.1364/oe.24.000001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The optimal temperature for the cryogenic monolithic Nd:YAG laser at 946-nm is theoretically and experimentally analyzed. It is clear that decreasing temperature can considerably eliminate the thermal population at the lower laser level to enhance the quantum efficiency. However, the narrowing of the absorption bandwidth for the gain medium leads to a reduction of the effective absorption efficiency as the temperature is decreased. Consequently, an optimal temperature for the maximum output power is found to be in the range of approximately 120 K to 140 K. It is experimentally verified that employing a pump source with a narrower emission spectrum linewidth contributes a more efficient output for the cryogenic laser.
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Li XR, Wakeel A, Huang TL, Wu GL, Huang X. Recrystallization textures and microstructures of Al-0.3%Cu alloy after deformation to high strains. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/1757-899x/89/1/012032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Cho CY, Huang TL, Wen SM, Huang YJ, Huang KF, Chen YF. Nd:YLF laser at cryogenic temperature with orthogonally polarized simultaneous emission at 1047 nm and 1053 nm. Opt Express 2014; 22:25318-25323. [PMID: 25401565 DOI: 10.1364/oe.22.025318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A Nd:YLF laser at cryogenic temperature is demonstrated for the first time with orthogonally polarized simultaneous emission at 1047 nm and 1053 nm. By exploring the temperature dependence of the fluorescence and the absorption spectra from the Nd:YLF crystal, the feasibility of simultaneous emission at low temperature is achieved. Due to the local heating from the pump absorption, the optimal temperature with respect to the pump power for balancing output powers of simultaneous emission is thoroughly explored. At the optimal temperature of 138 K, the total output power of the simultaneous emission can reach 3.1 W at an incident pump power of 7.9 W, corresponding to the optical to optical slope efficiency up to 43%.
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Liao CC, Chen TY, Tsang LC, Ou SY, Yu CY, Hsu HW, Cheng YF, Chiu KW, Eng HL, Chen CL, Huang TL. The acoustic radiation force impulse elastography evaluation of liver fibrosis in posttransplantation dysfunction of living donor liver transplantation. Transplant Proc 2014; 46:876-9. [PMID: 24767370 DOI: 10.1016/j.transproceed.2013.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/25/2013] [Accepted: 12/10/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND The acoustic radiation force impulse elastography (ARFI) is a new technology of elastography integrated into B-mode ultrasonography. It has been a reliable method to evaluate liver fibrosis of chronic liver disease in recent years, but less applied in the posttransplantation liver. The aim of the study was to evaluate liver fibrosis by the ARFI with correlation of pathological stages in living donor liver transplantation (LDLT). MATERIALS AND METHODS From August 2010 to August 2012, there were 57 LDLT patients with liver biopsy (LB) due to posttransplantation dysfunction; all patients also received posttransplantation ARFI liver stiffness measurement (LSM) after transplantation for liver fibrosis staging. The ARFI elastography was performed using a Siemens Acuson S2000 ultrasound system with 4V1 transducers (Acusion, Siemens Medical Systems Co. Ltd. Erlangen, Germany). The ARFI LSM value was presented by shear wave velocity (SWV, m/s). The fibrosis staging as F0 to F4 was in accordance with the Metavir scoring system. RESULTS A total of 57 patients had both posttransplantation LB and effective ARFI fibrosis staging for correlation. The ARFI LSM value increased with severity of liver fibrosis and had significant linear correlation with the results of histological fibrosis staging. The ARFI LSM sensitivities (Se), specificities (Sp), and cutoff values based on receiver-operator characteristic curve were F0: 0.75 m/s (Se: 93.8%, Sp: 4%), F1: 1.06 m/s (Se: 95.5%, Sp: 25.7%), F2: 1.81 m/s (Se: 50%, Sp: 83.6%) and F3: 2.33 m/s (Se: 100%, Sp: 92.9%). Predictive value of ARFI LSM reported a significant difference between early fibrosis stage (F0-F1) and advanced fibrosis stage (F ≧ 2) (P < .05). CONCLUSION In this study, ARFI demonstrated a strong linear correlation and severity of liver fibrosis with LB pathologic staging. ARFI can be an alternative and compensatory method for frequent LB in the posttransplantation liver.
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Affiliation(s)
- C C Liao
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - T Y Chen
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - L C Tsang
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S Y Ou
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C Y Yu
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - H W Hsu
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Y F Cheng
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - K W Chiu
- Liver Transplantation Program, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - H L Eng
- Liver Transplantation Program, Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - C L Chen
- Liver Transplantation Program, Department of General Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - T L Huang
- Liver Transplantation Program, Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Abstract
Brain-derived neurotropic factor (BDNF) is involved in the development of the brain, and likely influences the neuroplasticity in schizophrenia. BDNF is also believed to interact with other neurotransmitter systems implicated in schizophrenia, such as dopamine, glutamate, serotonin and GABA. Therefore, BDNF is a candidate gene for schizophrenia. In past decades, the blood (serum or plasma) BDNF protein levels and BDNF gene alleles and genotypes to the clinical features of schizophrenia, such as age of onset, clinical subtypes, symptom severity, and drug response, have been evaluated among different populations. However, the results are still inconsistent. Further, different drugs have been reported to have different effects on BDNF protein levels. A cross-sectional survey revealed that serum BDNF levels in chronic schizophrenic patients treated with clozapine exceeded those of patients treated with risperidone or with typical antipsychotics. In recent times, BDNF epigenetic studies have also been conducted in clinical studies of schizophrenia to address the question of why patients with the same gene genotype and alleles have different clinical presentations. In addition, the effects of different antipsychotic drugs on gene methylation and protein acetylation have also been reported. In conclusion, more data are needed regarding BDNF in the brain and in peripheral blood, including protein levels, single nucleotide polymorphisms, epigenetic regulation, and clinical data in order to understand the role of BDNF in schizophrenia.
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Affiliation(s)
- T L Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, 123, Ta-Pei Rd, Niao-Sung, Kaohsiung 833, Taiwan, ROC.
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14
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Zhou ZH, He SL, Huang TL, Liu LH, Liu QQ, Zhao YM, Ou BL, Zeng WN, Yang ZM, Cao DF. Degradation behaviour and biological properties of gelatin/hyaluronic acid composite scaffolds. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/1433075x13y.0000000084] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Z H Zhou
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
- Key Laboratory of Theoretical Chemistry and Molecular Simulation of Ministry of Education, Hunan University of Science and Technology, Xiangtan, China
| | - S L He
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - T L Huang
- Department of OrthopedicsThe Second Xiangya Hospital, Central South University, Changsha, China
| | - L H Liu
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - Q Q Liu
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - Y M Zhao
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - B L Ou
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - W N Zeng
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - Z M Yang
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
| | - D F Cao
- School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, China
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15
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Huang TL, Chen TY, Tsang LL, Ou HY, Yu CY, Wang CC, Wang SH, Lin CC, Liu YW, Yong CC, Chiu KW, Eng HL, Jawan B, Cheng YF, Chen CL. Hemodynamics of portal venous stenosis before and after treatment in pediatric liver transplantation: evaluation with Doppler ultrasound. Transplant Proc 2012; 44:481-3. [PMID: 22410051 DOI: 10.1016/j.transproceed.2012.01.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The aim of this study was to evaluate portal vein stenosis (PVS) in pediatric liver transplantation (PLT) using Doppler ultrasound (DUS) before and after interventional management for hemodynamic changes. MATERIALS AND METHODS From 2000 to 2010, we encountered 11 PVS cases among 180 PLT that were evaluated using DUS and computed tomography (CT) angiography (CTA); all underwent portal stenting. DUS was used to monitor portal hemodynamics. For the diagnosis of PVS, we investigated multiple parameters including stenotic size (SS), stenotic ratio (SR) (SR [%]=PRE-SS/PRE [PRE=stenotic size]), portal flow velocity ratio (VR) (VR=VS/PRE [PRE=velocity at prestenotic site; VS=peak velocity at stenotic site]), spleen size, and platelet count. RESULTS The incidence of PVS was 5.6% (11/180). The PV was 2.5 mm using DUS and 2.7 mm using CTA. The average SR was 65% fitting the criterion. Low prestenotic portal flow<12 cm/sec and high peak velocity in the stenotic segment (up to 147 cm/sec) were observed in 6 cases. The VR value was high at 7.5:1 and there was splenomegaly with thrombocytopenia. After portal vein stenting, hyperperfusion occurred might after reopening the stenosis: the flow increased to an average of 34 cm/sec and then flow decreased slowly to a stable level 2 weeks later. The size of the spleen decreased from 17 to 12 cm and the thrombocytopenia also improved with platelet counts increasing from 67×10(3) to 178×10(3)/μl at 2 months follow-up. The changes in portal flow, portal vein size, spleen size, and platelet count were significant (P<.05). CONCLUSION PVS is diagnosed using DUS by increased intrahepatic PV dilatation, peak flow at the stenotic site, discrepant VR. Early portal stenting showed a better prognosis. DUS is essential and effective for hemodynamic monitoring and management of PVS.
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Affiliation(s)
- T L Huang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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16
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Huang TL, Yu WW. Weight loss occurs over a decade prior to dementia diagnosis: comment on meta-analysis of obesity as a risk factor for dementia and its subtypes. Obes Rev 2008; 9:631-2; author reply 633-4. [PMID: 18801008 DOI: 10.1111/j.1467-789x.2008.00519.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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17
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Cheng YF, Huang TL, Chen TY, Concejero A, Tsang LLC, Wang CC, Wang SH, Sun CK, Lin CC, Liu YW, Yang CH, Yong CC, Ou SY, Yu CY, Chiu KW, Jawan B, Eng HL, Chen CL. Liver graft-to-recipient spleen size ratio as a novel predictor of portal hyperperfusion syndrome in living donor liver transplantation. Am J Transplant 2006; 6:2994-9. [PMID: 17061990 DOI: 10.1111/j.1600-6143.2006.01562.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Portal hyperperfusion in a small-size liver graft is one cause of posttransplant graft dysfunction. We retrospectively analyzed the potential risk factors predicting the development of portal hyperperfusion in 43 adult living donor liver transplantation recipients. The following were evaluated: age, body weight, native liver disease, spleen size, graft size, graft-to-recipient weight ratio (GRWR), total portal flow, recipient portal venous flow per 100 g graft weight (RPVF), graft-to-recipient spleen size ratio (GRSSR) and portosystemic shunting. Spleen size was directly proportional to the total portal flow (p = 0.001) and RPVF (p = 0.014). Graft hyperperfusion (RPVF flow > 250 mL/min/100 g graft) was seen in eight recipients. If the GRSSR was < 0.6, 5 of 11 cases were found to have graft hyperperfusion (p = 0.017). The presence of portosystemic shunting was significant in decreasing excessive RPVF (p = 0.059). A decrease in portal flow in the hyperperfused grafts was achieved by intraoperative splenic artery ligation or splenectomy. Spleen size is a major factor contributing to portal flow after transplant. The GRSSR is associated with posttransplant graft hyperperfusion at a ratio of < 0.6.
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Affiliation(s)
- Y F Cheng
- Liver Transplantation Program and Department of Diagnostic Radiology, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan
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Huang TL, Zandi PP, Tucker KL, Fitzpatrick AL, Kuller LH, Fried LP, Burke GL, Carlson MC. Benefits of fatty fish on dementia risk are stronger for those withoutAPOEε4. Neurology 2005; 65:1409-14. [PMID: 16275829 DOI: 10.1212/01.wnl.0000183148.34197.2e] [Citation(s) in RCA: 242] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare associations of lean fish vs fatty fish (tuna or other fish) intake with dementia, Alzheimer disease (AD), and vascular dementia (VaD) and in relation to APOE epsilon4 status in the Cardiovascular Health Cognition Study (CHCS). METHODS Fish intake was assessed by food frequency questionnaires. Incident dementia, AD, and VaD were determined through a series of cognitive tests, physician's assessment, and committee consensus. We used Cox proportional hazards regression to calculate hazard ratios of dementia, AD, and VaD with lean fried fish, fatty fish, or total fish intake, which were then stratified by the presence of APOE epsilon4. RESULTS Although consumption of lean fried fish had no protective effect, consumption of fatty fish more than twice per week was associated with a reduction in risk of dementia by 28% (95% CI: 0.51 to 1.02), and AD by 41% (95% CI: 0.36 to 0.95) in comparison to those who ate fish less than once per month. Stratification by APOE epsilon4 showed this effect to be selective to those without the epsilon4 allele. Adjustment by education and income attenuated the effect. CONCLUSION In the Cardiovascular Health Cognition Study, consumption of fatty fish was associated with a reduced risk of dementia and Alzheimer disease for those without the APOE epsilon4 allele.
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Affiliation(s)
- T L Huang
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
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19
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Huang TL, Carlson MC, Zandi PP, Fried LP, Kuller LH, Fitzpatrick AL, Burke GL, Tucker KL. 305-S: Benefits of Fatty Fish on Dementia Risk are Stronger for Those without Apoe ε 4. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Huang TL, Chen TY, Tsang LL, Weng HH, Cheng YF, Chen YS, Wang CC, Wang SH, Lin TS, Cheung HK, Jawan B, Chen CL. The Significance of Hepatic Vein Outflow Volume in Hepatic Outflow Insufficiency of Living Right Liver Graft Evaluated by Doppler Ultrasound. Transplant Proc 2005; 37:1115-6. [PMID: 15848639 DOI: 10.1016/j.transproceed.2005.01.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The color Doppler ultrasound has been used to evaluate hepatic vein (HV) outflow insufficiency based on flow velocity and waveforms. In our experience, some cases with flat waveforms are clinically asymptomatic. The parameters of HV flow velocity and waveforms are not always correlated with clinical problems. So, we proposed that total HV flow volume (HVFV) may be a more reliable index. From August 2001 to July 2003, 31 cases among 48 adult-to-adult living related transplants of a right liver graft had one HV anastomosis. HV velocity, waveforms, and HVFV were compared both before and after transplantation. We set the minimal HVFV ratio at 80% based on the original HVFV before graft retrieval. There was no significant difference in HVFV before liver graft retrieval between the 2 groups, but there was a significant change after transplantation. There were no cases of HV insufficiency among group A patients (>80%), whose HVFV ranged from 397 to 1181 mL/min with ratios from 75% to 180% (mean 115%). In group B, there were 4 complicated cases with prolonged severe ascites (<80%) with HVFV ratios from 56% to 76% (mean 66%). Fisher exact test showed a great significance (P < .001). Thus the preliminary criteria of 80% minimal HVFV ratio allows detection of HV insufficiency for further interventional management.
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Affiliation(s)
- T L Huang
- Department of Diagnostic Radiology, General Surgery and Liver Transplant Program, Chang Gung University and Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
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Huang TL, Chen TY, Tsang LL, Sun PL, Chen YS, Wang CC, Wang SH, Lin TS, Chiang YC, Chiu KW, Eng HL, Jawan B, Cheng YF, Chen CL. Hepatic venous stenosis in partial liver graft transplantation detected by color Doppler ultrasound before and after radiological interventional management. Transplant Proc 2004; 36:2342-3. [PMID: 15561243 DOI: 10.1016/j.transproceed.2004.07.067] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Hepatic outflow insufficiency remains one of the major complications causing postoperative graft failure especially among partial liver graft transplantations (PLT) including living donor liver transplantation (LDLT), reduced size liver transplantation (RLT), and split liver transplantation (SLT). These procedures are different from the whole liver graft transplantations (OLT), which include multiple vascular anastomoses. Color Doppler ultrasound (CDUS) was used to evaluate the hepatic venous outflow from grafts before and after radiological interventional management and to document treatment effects. From June 1994 to March 2003, our 136 cases of PLTs included 131 LDLTs, two RLTs, and three SLTs. Seven cases (six children and one adult) showed postoperative hepatic vein outflow obstruction and persistent massive ascites, as detected by color Doppler ultrasound (CDUS) and confirmed by interventional angiography. The CDUS showed a monophasic flat waveform with a relatively low hepatic vein average peak velocity (Va) in all cases (mean 11 cm/s). Successful interventional procedures included balloon dilatation in three cases and metallic stent replacement in four cases. CDUS was used with guidance during the procedure to confirm restoration of normal hepatic vein flow with a multiphasic waveform and an objective increase of average flow velocity (high to average 66 cm/s). Ascites disappeared dramatically after the procedure. In conclusion CDUS is the prime modality to diagnose and document a treatment response.
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Affiliation(s)
- T L Huang
- Department of Diagnostic Radiology, Chang Gung University, Memorial Hospital, Kaohsiung Medical Center, Taiwan
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Sun PL, Chen CL, Hsu SL, Huang TL, Chen TY, Chen YS, Tsang LC, Cheng YF. The significance of transarterial embolization for advanced hepatocellular carcinoma in liver transplantation. Transplant Proc 2004; 36:2295-6. [PMID: 15561225 DOI: 10.1016/j.transproceed.2004.07.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Transarterial embolization (TAE) is the treatment of choice for advanced HCC to control or even induce tumor shrinkage. The aim of this study was to evaluate the effect of pretransplantation TAE for treatment of advanced HCC. MATERIAL AND METHODS From 1996 to 2002, we studied 12 cirrhotic patients with HCC, including six who met and six who exceeded the Milan criteria. All patients had sufficient hepatic function to undergo TAE. Liver transplantations were performed subsequently and they were followed prospectively for a median of 22 months (range = 12 to 53 months). RESULTS The explanted livers from the 12 patients who had undergone TAE were noted to have extensive tumor necrosis. The pathological specimens at LT showed downstaging of the HCC, which allowed those six patients to meet the Milan criteria. The overall 1- and 2-year survival rates were 92% and 73%, respectively. The overall 1- and 2-year disease-free survival rates were 92% and 73%, respectively. One death unrelated to liver disease at 2 years after LT was noted in the downgraded group. One patient of the initially eligible group developed lung metastasis at 6 months and died at 12 months after LT. CONCLUSION TAE is effective to downstage advanced HCC and reduce the dropout rate on the LT waiting list. Pre-LT TAE may be considered as a better therapeutic strategy for patients with advanced HCC.
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Affiliation(s)
- P L Sun
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan
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Tung SC, Wang PW, Huang TL, Lee WC, Chen WJ. Bilateral adrenocortical adenomas causing ACTH-independent Cushing's syndrome at different periods: a case report and discussion of corticosteroid replacement therapy following bilateral adrenalectomy. J Endocrinol Invest 2004; 27:375-9. [PMID: 15233560 DOI: 10.1007/bf03351066] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We report a rare case of bilateral adrenocortical adenomas causing ACTH-independent Cushing's syndrome at different periods 9 yr apart. The subject, a 24-yr-old woman, in June 1989 had a typical Cushingoid appearance. Her baseline plasma cortisol levels did not show a diurnal rhythm and she had a very low baseline plasma ACTH level. Plasma cortisol levels could not be suppressed by overnight low-dose or two-day high-dose dexamethasone suppression test. Marked uptake of 131I-6beta-iodomethyl-19-norcholesterol (NP-59) was observed in the right adrenal gland. Abdominal computed tomography (CT) showed a right adrenal tumor. The right adrenal gland with adenoma was removed. The non-tumorous part of the adrenal cortex was atrophic. By April 1998, she had experienced a weight gain of more than 20 kg over a two-yr period. The baseline plasma cortisol levels were at the lower limit of the normal range with loss of diurnal rhythmicity. The baseline plasma ACTH levels were very low. Neither a two-day low-dose nor a two-day high-dose dexamethasone suppression test could suppress serum cortisol or urinary free cortisol levels. NP-59 adrenal scan revealed increased uptake of the left adrenal gland at 72 h after intravenous injection of the tracer. Abdominal CT and magnetic resonance imaging (MRI) all demonstrated a left adrenal mass. Left adrenalectomy was performed in June 1998; histological features showed a cortical adenoma and atrophic change in the non-tumorous part of the adrenal cortex. Elevated plasma ACTH levels after bilateral adrenalectomy could be suppressed with conventional corticosteroid replacement therapy and overnight low-dose dexamethasone suppression test.
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Affiliation(s)
- S C Tung
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
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Huang TL, Chen TY, Cheng YF, Weng HH, Yu PC, Lee TY, Chen YS, Wang CC, Wang SH, Chiu KW, Chiang YC, Eng HL, Jawan B, de Villa VH, Chen CL. The significance of hepatic vein outflow volume in adult-to-adult living donor liver transplantation evaluated by Doppler ultrasound. Transplant Proc 2003; 35:68-9. [PMID: 12591311 DOI: 10.1016/s0041-1345(02)03810-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- T L Huang
- Department of Diagnostic Radiology, Chang Gung University and Memmorial Hospital, Kaohsiung, Taiwan
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Affiliation(s)
- T Y Chen
- Department of Diagnostic Radiology and Liver Transplant Program, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
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Chen TY, Chen CL, Huang TL, Chen YS, Wang CC, de Villa VH, Chiang YC, Jawan B, Cheng YF. Noninvasive multislice CT angiography in pediatric liver transplantation: a novel application. Transplant Proc 2003; 35:62-3. [PMID: 12591308 DOI: 10.1016/s0041-1345(02)03817-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- T Y Chen
- Department of Diagnostic Radiology and Liver Transplant Program, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan
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Cheng YF, Chen CL, Huang TL, Chen TY, Lee TY, Chen YS, Wang CC, de Villa V, Goto S, Chiang YC, Eng HL, Jawan B, Cheung HK. Single imaging modality evaluation of living donors in liver transplantation: magnetic resonance imaging. Transplantation 2001; 72:1527-33. [PMID: 11707741 DOI: 10.1097/00007890-200111150-00010] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Liver graft size, anatomy of the bile duct and the vascular inflow and outflow are essential for living related liver transplantation (LRLT). Preoperative delineation of those variations that would change the operative procedure to achieve a successful result especially in an emergency condition. PURPOSE Our aim was to develop a rapid and noninvasive imaging diagnostic method for the detection of anatomical variants that is mandatory for a safe operation when selecting potential liver transplant living donors. We used a different magnetic resonance (MR) imaging technique, which enabled to us to exploit the anatomical landmark of the liver, signal enhancement of blood flow in the abdomen, and the intrahepatic biliary routes inside the liver. Then, with the help of Advantage Window workstation reconstruction, the reconstructed single vascular or biliary systems were displaced in a three-dimensional fashion and the whole examination finished within 30 min. METHODS Modification of the standard MR technique was performed on a superconductive 1.5T whole body image scanner, MR arteriogaphy, venography, and cholangiography with three-dimensional reconstruction in evaluating the anatomy of the hepatic arteries, hepatic veins, portal venous system, bile ducts, and liver size in potential liver transplant living donors. These anatomical structures were compared with traditional imaging methods. RESULTS In all 38 cases, as well as delineation of the portal vein detail to the segmental level was satisfactorily obtained in this MR study. The images were well displayed in a three-dimensional fashion, which had good correlation with images from traditional imaging modalities and operative findings. In 86.8% cases, the MR arteriography was well matched with the celiac angiography. Of those 17 operative cases, estimation of liver volume was well correlated with the liver graft within 3.9-12.5% variation. In the major hepatic vein, we obtained 100% accuracy and 88.2% in the minor branches. Of 12 donors received intraoperative cholangiography during liver donation, good correlation of biliary anatomy was achieved. One donor was excluded from graft donation due to the complicated arterial supply to the left liver. According to the anatomical variation, surgical procedures in graft harvesting and anastomosis were readjusted and no major complications were found in those donors and all recipients survived after liver transplantation. CONCLUSION MR volumetry, venography, angiography, and cholangiography with three-dimensional reconstruction is sufficient for all major imaging evaluation. It may replace the traditional conventional catheter angiography, computed tomography, sonography and endoscopic retrograde cholangiography as a single investigation in the evaluation of the potential liver transplant donors. Angiography is only valuable in suboptimal cases and intraoperative cholangiography is only performed in biliary ductile variants.
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Affiliation(s)
- Y F Cheng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao-Sung, Kaohsiung 83305, Taiwan
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28
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Affiliation(s)
- T Y Chen
- Department of Diagnostic Radiology, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
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Takatsuki M, Chen CL, de Villa VH, Chen YS, Wang CC, Wang SH, Cheng YF, Huang TL, Jawan B, Eng HL. Neoral-based immunosuppression in living donor liver transplantation. Transplant Proc 2001; 33:3450. [PMID: 11750477 DOI: 10.1016/s0041-1345(01)02487-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Takatsuki
- Department of Liver Transplant Program, Chang Gung University and Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
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Huang TL, Chen TY, Chen CL, Chen YS, Wang CC, Wang SH, Chiu KW, Chiang YC, Eng HL, Jawan B, de Villa VH, Weng HH, Lee TY, Cheng YF. Hepatic outflow insults in living-related liver transplantation: by Doppler sonography. Transplant Proc 2001; 33:3464-5. [PMID: 11750482 DOI: 10.1016/s0041-1345(01)02492-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- T L Huang
- Department of Diagnostic Radiology, Chang Gung University and Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
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Abstract
The synthesis, anti-Pneumocystis carinii activity and DNA binding properties of eight new N,N'-bis[4-(N-alkylamidino)phenyl]homopiperazines are reported. Compounds 2 and 8 were the most potent and caused about 70% inhibition of Pneumocystis carinii growth in a cell culture model at 1 microM concentrations.
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Affiliation(s)
- T L Huang
- Xavier University of Louisiana, College of Pharmacy, New Orleans, LA 70125, USA.
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Huang TL. Serum cholesterol levels in mood disorders associated with physical violence or suicide attempts in Taiwanese. Chang Gung Med J 2001; 24:563-8. [PMID: 11725626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Many previous studies have discussed the relationships between serum cholesterol levels and depression, violence and suicide in Western countries. In this paper, the relationships between serum cholesterol levels and mood disorders, physical violence and suicide attempts in Taiwanese psychiatric inpatients were reported. METHODS A review of medical charts over a 1-year period was carried out in a population of 213 Taiwanese psychiatric inpatients that included 61 patients with affective disorders. The collected data included age, body weight, height, and serum cholesterol levels. RESULTS There were no significant differences in the serum cholesterol levels between patients with mania and major depression, between patients with and without physical violence, or between patients who had and had not made a suicide attempt using analysis of covariance after age or body mass index adjustment. CONCLUSION Due to the limitations of case numbers and study methods, the results need to be further clarified with larger numbers of patients and in controlled studies.
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Affiliation(s)
- T L Huang
- Department of Psychiatry, Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan, R.O.C.
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Huang TL. Neuroleptic malignant syndrome associated with long-term clozapine treatment: report of a case and results of a clozapine rechallenge. Chang Gung Med J 2001; 24:522-5. [PMID: 11601195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Clozapine has recently been found to be associated with neuroleptic malignant syndrome (NMS) after long-term treatment. Here, I report on a 34-year-old Taiwanese woman who had been diagnosed with schizophrenic disorder 17 years previously. She had received clozapine 250 mg/day monotherapy for 7 years. She had sudden onset of NMS signs with high fever, profuse diaphoresis, severe muscular rigidity, elevated creatine phosphokinase level and consciousness disturbance. Brain computed tomography, blood culture and cerebral spinal fluid studies were negative. She had no muscle rigidity and fever after treatment with normal saline 1500 ml/day and diazepam 30 mg/day for 8 days. On day 15, a rechallenge with clozapine was done with caution because the patient was experiencing auditory hallucinations and delusions of persecution. The dose was slowly increased to 250 mg/day over 18 days. She had no active psychotic symptoms or NMS again in the following year. I reported this case to remind readers of the possibility of induced NMS with long-term use of clozapine and successful clozapine rechallenge.
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Affiliation(s)
- T L Huang
- Department of Psychiatry, Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niaosung, Kaohsiung, Taiwan, R.O.C.
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Cheng YF, Chen YS, Huang TL, de Villa V, Chen TY, Lee TY, Wang CC, Chiang YC, Eng HL, Cheung HK, Jawan B, Wang SH, Goto S, Chen CL. Interventional radiologic procedures in liver transplantation. Transpl Int 2001; 14:223-9. [PMID: 11512054 DOI: 10.1007/s001470100324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Postoperative biliary and vascular complications contribute significantly to morbidity and mortality in liver transplantation. Interventional radiologists are an integral part of the multidisciplinary team necessary for optimizing the management of these complications. During a 15-year period, 39 cadaveric and 25 living related liver transplantations were performed at the Chang Gung Memorial hospital, Taiwan. Of 64 liver transplant recipients, 9 (3 adult and 6 pediatric) underwent 13 interventional radiological procedures for the treatment of biliary sludge-casts (n = 2), bile duct occlusion or stenosis (n = 2), hepatic veins thrombosis (n = 1), hepatic veins stenosis (n = 1), portal vein stenosis with splenorenal shunting (n = 1), biloma (n = 1), and infected fluid collection or ascites (n = 4). Antegrade or retrograde interventional approach was used to successfully treat all biliary complications, and all percutaneous drainage procedures were effective in the control of intra-abdominal fluid collections. Portal vein stenosis was treated by balloon dilatation, and the associated splenorenal shunt was closed by metallic coil embolization via transhepatic catheterization of the portal vein. Hepatic vein stenosis was effectively treated by balloon dilatation and expandable metallic stent deployment via transfemoral and jugular venous approaches, respectively. Hepatic vein thrombosis was only partially lysed by transvenous streptokinase administration, and surgical thrombectomy was needed to achieve complete recanalization. The total success rate of the interventional procedures was 92 % with no procedure-related complications. The overall survival rate in this series is 89 %, and all patients who underwent living related liver transplantation maintain to date a 100 % survival rate. We can conclude that interventional radiological procedures are very useful for managing biliary and vascular complications after liver transplantation. These techniques provide a cure in most situations, thus obviating the need for further surgical intervention or re-transplantation.
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Affiliation(s)
- Y F Cheng
- Department of Diagnostic Radiology, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 123, Ta Pei Road, Niao Sung, Kaohsiung 83305, Taiwan
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Abstract
The ammonia-containing waste produced in industries is usually characterized by high concentration and high temperature, and is not treatable by biological methods directly. In this study, a hydrophobic Pt/SDB catalyst was first used in a trickle-bed reactor to remove ammonia from wastewater. In the reactor, both stripping and catalytic oxidation occur simultaneously. It was found that higher temperature and higher oxygen partial pressure enhanced the ammonia removal. A reaction pathway, which involves oxidizing ammonia to nitric oxide, which then further reacts with ammonia to produce nitrogen and water, was confirmed. Small amounts of by-products, nitrites and nitrates were also detected in the resultant reaction solution. These compounds came from the absorption of nitrogen oxides. Both the minimum NO2- selectivity and maximum ammonia removal were achieved when the resultant pH of treated water was near 7.5 for a feed of unbuffered ammonia solution.
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Affiliation(s)
- T L Huang
- Department of Environment and Biotechnology, Refining & Manufacturing Research Center, Chinese Petroleum Corporation, Chia-Yi, Taiwan.
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Cheng YF, Chen CL, Lai CY, Chen TY, Huang TL, Lee TY, Lin CL, Lord R, Chen YS, Eng HL, Pan TL, Lee TH, Wang YH, Iwashita Y, Kitano S, Goto S. Assessment of donor fatty livers for liver transplantation. Transplantation 2001; 71:1221-5. [PMID: 11397953 DOI: 10.1097/00007890-200105150-00007] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The effect of fatty liver on graft survival, especially with reference to macrovesicular and microvesicular steatosis, is still uncertain. This preliminarily study was designed to create a noninvasive method for the quantification of the hepatic fat content in vivo and to establish provisional criteria for the assessment of fatty donor livers before liver transplantation among transplant surgeons, radiologists, and pathologists. METHODS AND MATERIALS Different degrees of rat fatty liver model were established by feeding rats a diet deficient in choline and methionine for different periods of time. Computed tomography (CT) with test tubes containing variable percentages of fat equivalent substance were used to assess the severity of fatty change of the rat liver. This was then correlated with the histological classification, level of hepatic enzymes, and graft survival. RESULTS Linear correlation between the fat volume fraction added to the test tubes and CT density were found. The process of producing a fatty liver via diet alteration peaked at week 3. At this time hepatic enzymes, radiological fat content, and posttransplantation survival were worse (P=0.013), compared with other time points. Radiological assessment of fatty liver correlated well with survival and serum glutamic oxaloacetic transaminase and glutamic pyruvate transaminase levels. CONCLUSION Severe microvesicular steatosis does not influence recipient survival, however, macrovesicular steatosis affects graft survival. Caliber CT is a practical and simple method that allows an accurate noninvasive quantitative assessment of hepatic fatty infiltration. It has potential to be a useful parameter for the assessment of donor livers for clinical liver transplantation.
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Affiliation(s)
- Y F Cheng
- Department of Diagnostic Radiology, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Cheng YF, Chen YS, Huang TL, Chen TY, de Villa V, Lee TY, Wang CC, Wang SH, Chiang YC, Cheung HK, Jawan B, Chen CL. Biliary complications in living related liver transplantation. Chang Gung Med J 2001; 24:174-80. [PMID: 11355085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Biliary tract reconstruction has long been considered the Achilles' heel of liver transplantation as biliary complications can increase morbidity and mortality especially in partial liver graft transplantation. METHODS Thirty-four living related liver transplants were performed at Chang Gung Memorial Hospital in Kaohsiung for 33 children and 1 adolescent during a 5.5-year period. All potential donors underwent a detailed preoperative imaging study of the vascular and biliary anatomy, including three-dimensional helical computed tomographic cholangiography (n = 20), magnetic resonance cholangiography (n = 14), and intra-operative cholangiography (n = 31) before graft retrieval. All hepatic artery anastomoses were performed in the standard microsurgery fashion and their patency was confirmed intra-operatively using Doppler ultrasound. RESULTS The biliary complication rate was 8.8% (3/34), including multiple intrahepatic biliary stenosis of unknown origin (n = 1), bile leakage from the Roux-en-Y loop (n = 1), and a missed biliary radicle (n = 1) which were treated via interventional radiological and surgical procedures. The overall graft and patient survival rates were 100%. CONCLUSION The biliary complication rate in this series was low compared to those of other experienced centers. Complete study of the variations of intrahepatic duct ramification pre-and-intra-operatively provided adequate information on the appropriate transection plane. Furthermore, intra-operative Doppler ultrasound verification of vessel patency helps prevent vascular complications, which has been identified as a cause of biliary complications.
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Affiliation(s)
- Y F Cheng
- Department of Radiology, Liver Transplant Program, Department of Surgery, Chang Gung Memorial Hospital, 123, Tao-Pei Road, Niaosung, Kaohsiung, Taiwan, R.O.C
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38
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Huang TL, Chen CL, Chen TY, Weng HH, Lee TY, Chen YS, Chiang YC, Eng HL, Wang CC, Lin CL, Wang SH, Cheung HK, Jawan B, de Villa VH, Cheng YF. Doppler ultrasound in prediction of the early mortality risk factors on the waiting list for pediatric liver transplantation recipients. Transplant Proc 2001; 33:899-900. [PMID: 11267121 DOI: 10.1016/s0041-1345(00)02368-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- T L Huang
- Department of Diagnostic Radiology, General Surgery and Liver Transplant Program, Chang Gung University, Kaohsiung, People's Republic of China
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de Villa VH, Chen CL, Chen YS, Wang CC, Wang SH, Chiang YC, Cheng YF, Huang TL, Jawan B, Cheung HK. Outflow tract reconstruction in living donor liver transplantation. Transplantation 2000; 70:1604-8. [PMID: 11152222 DOI: 10.1097/00007890-200012150-00011] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hepatic venous reconstruction is critical in living donor liver transplantation because outflow obstruction may lead to graft dysfunction or loss. We describe our experience and analyze outcomes with a technique of creating a single outflow tract using venoplasties of the graft and recipient hepatic veins. PATIENTS AND METHODS A retrospective study was done on 38 consecutive living donor liver transplants performed from June 1994 to March 2000. The grafts included 36 left-side grafts and 2 right-side grafts. Nine grafts had multiple hepatic veins and required a venoplasty of two or three hepatic veins to create a single outflow orifice. Triple recipient hepatic venoplasty was performed in 32 patients, double venoplasty in 5 and none in 1. RESULTS There were four cases of outflow obstruction, three occurring in patients with a double recipient venoplasty. Two of the problems were remedied intraoperatively by adjusting the position of the graft although two were structural in nature and required the insertion of expandable metallic vascular stents. All donors and recipients with their original grafts are alive at a mean follow-up period of 27 months. CONCLUSION A triple recipient venoplasty with a matching venoplasty of multiple graft hepatic veins to create a single wide outflow orifice is recommended in living donor liver transplantation using left side grafts.
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Affiliation(s)
- V H de Villa
- Liver Transplant Program, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan
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40
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Cheng YF, Chen CL, Chen YS, Huang TL, Chen TY, Lee TY, Wang CC, Chiang YC, Eng HL, Lin CL, Cheung HK, Jawan B, Goto S. Interventional radiology in the treatment of post-liver transplant complications. Transplant Proc 2000; 32:2196-7. [PMID: 11120130 DOI: 10.1016/s0041-1345(00)01632-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Y F Cheng
- Department of Diagnostic Radiology and Liver Transplant Program, Chang-Gung University and Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan, People's Republic of China
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41
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Eng HL, Chen YS, Jawan B, Cheng YF, Chiang YC, Chen WJ, Huang TL, Cheung HK, Wang CC, Lin CL, Huang CB, Huang CC, Chen CL. Soluble thrombomodulin antigen as a marker for endothelial damage during liver transplantation. Transplant Proc 2000; 32:2273-5. [PMID: 11120163 DOI: 10.1016/s0041-1345(00)01662-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H L Eng
- Department of Pathology, Chang Gung University and Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
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Chen CL, Chen YS, Wang CC, Wang SH, Goto S, Chiang YC, Cheng YF, Huang TL, Jawan B, Cheung HK, Eng HL. Initial experience with right lobe living donor liver transplantation. Transplant Proc 2000; 32:2158-9. [PMID: 11120112 DOI: 10.1016/s0041-1345(00)01614-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Wang SH, Chen CL, Chen YS, Wang CC, Goto S, Chiang YC, Cheng YF, Huang TL, Cheung HK, Jawan B, Eng HL. Living donor liver transplantation: the Kaohsiung experience. Transplant Proc 2000; 32:2137-8. [PMID: 11120103 DOI: 10.1016/s0041-1345(00)01604-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S H Wang
- Department of Surgery and Liver Transplant Program, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
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Affiliation(s)
- T Y Chen
- Departments of Diagnostic Radiology and Liver Transplant Program, Chang Gung University, and Memorial Hospital, Kaohsiung Medical Center, Taiwan, Japan
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Huang TL, Cheng YF, Chen CL, Lee TY, Chen TY, Chen YS, Chiang YC, Eng HL, Wang CC, Wang SH, Lin CL, Cheung HK, Jawan B. Intraoperative Doppler ultrasound in living-related liver transplantation. Transplant Proc 2000; 32:2097-8. [PMID: 11120084 DOI: 10.1016/s0041-1345(00)01585-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- T L Huang
- Department of Diagnostic Radiology, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung Hsien, Taiwan, People's Republic of China
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Abstract
Fly ash from coal-fired thermal power plants can be used for the removal of 2-chlorophenol (2-CP) and 2,4-dichlorophenol (2,4-DCP) with enthalpy changes of about -3 kcal/mol. The amounts of 2-CP and 2,4-DCP removed are affected by the pH value of the solution. The efficiency of removal improves when the pH value is less than the pK(a) values of 2-CP and 2,4-DCP, respectively. The adsorbed amount of chlorophenol by fly ash is also affected by particle diameter, carbon content, and the specific surface area of the ash used in this study. As expected, more adsorption takes place with fly ash of higher carbon content and larger specific surface area. Moreover, the adsorbed amount of chlorophenol is not influenced by the matrix in the wastewater, as shown by studying the removal of 2-CP and 2, 4-DCP in wastewater from a synthetic fiber plant. Chlorophenols in the wastewater were also removed efficiently through a fly ash column, with breakthrough times being inversely proportional to flow rates.
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Affiliation(s)
- P C Kao
- Department of Environmental Engineering, National Chung-Hsing University, Taichung 402, Taichung, Taiwan
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47
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Chen CL, Chen YS, de Villa VH, Wang CC, Lin CL, Goto S, Wang SH, Cheng YF, Huang TL, Jawan B, Cheung HK. Minimal blood loss living donor hepatectomy. Transplantation 2000; 69:2580-6. [PMID: 10910280 DOI: 10.1097/00007890-200006270-00018] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Donor hepatectomy with maximal safety while preserving graft viability is of principal concern in living donor liver transplantation. There are compelling reasons for avoiding blood transfusion, even with autologous blood, to avoid the potential risks it imposes on healthy donors. This study aims to describe the surgical technique and clinical outcomes of living donor hepatectomy with minimal blood loss requiring no blood transfusion. METHODS Donor hepatectomy was performed in 30 living donors according to a detailed preoperative imaging study of the vascular and biliary anatomy. Liver parenchymal transection was carried out with strict adherence to a meticulous surgical technique without vascular inflow occlusion to either side of the liver. Pre-, intra-, and postoperative data were gathered, and factors related to blood loss were analyzed retrospectively. RESULTS The intraoperative blood loss ranged from 20 to 300 ml with a mean of 72.0+/-58.9 ml (median, 55 ml), and neither homologous nor autologous blood transfusion was required in any of the donors intra- and postoperatively. All 30 donors were discharged with minimal complications, and remain well at a mean follow-up of 24 months after donation. Excellent graft viability was verified by the fact that all 30 recipients are alive and well with a few manageable complications. The actual graft and patient survival are both 100% at the time of writing. CONCLUSIONS Regardless of the extent of donor hepatectomy, blood loss can and should be kept to a minimum, and living donor hepatectomy without blood transfusion is a realistic objective.
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Affiliation(s)
- C L Chen
- Department of Surgery, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan.
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Cheng YF, Lee TY, Sheen-Chen SM, Huang TL, Chen TY. Treatment of complicated hepatolithiasis with intrahepatic biliary stricture by ductal dilatation and stenting: long-term results. World J Surg 2000; 24:712-6. [PMID: 10773124 DOI: 10.1007/s002689910114] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A group of 190 cases of hepatolithiasis with postoperative residual stones located proximal to the stricture sites were managed with the aim of complete clearance of stones and relief of bile stasis to decrease the potential risk of recurrence. All procedures were performed through a T-tube track with gradual dilatation and stent placement through the stricture sites, creating a channel that allows cholangioscopy and electrohydraulic lithotripsy. Complete clearance of intrahepatic duct (IHD) stones was achieved in 88.4% of cases. Multiple sharply angulated IHD strictures in right-sided hepatolithiasis constituted a major cause of failure. Recurrent stone formation and repeated cholangitis, subsequent drainage, and liver resection are associated with high mortality rates particularly if there is late development of a cholangiocarcinoma. We concluded that postoperative ductal dilatation and stenting through the T-tube track combined with endoscopic electrohydraulic lithotripsy is effective and safe for managing complicated hepatolithiasis. Persistent irreversible aneurysmal dilatation of IHD and atrophic change of the affected hepatic lobe at follow-up were ominous signs of recurrence and cholangiocarcinoma development. Early drainage with stone extraction combined with surgical intervention can prevent subsequent morbidity and mortality.
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Affiliation(s)
- Y F Cheng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University, 123 Ta Pei Road, Kaohsiung Hsien, Taiwan.
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Jawan B, Cheung HK, Chen CC, Chen YS, Chiang YC, Wang CC, Cheng YF, Huang TL, Eng HL, Goto S, Pan TL, De Villa V, Liu PP, Wang SH, Lin CL, Lee JH. Repeated hypotensive episodes due to hepatic outflow obstruction during liver transplantation in adult patients. J Clin Anesth 2000; 12:231-3. [PMID: 10869925 DOI: 10.1016/s0952-8180(00)00146-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report two cases of unusual repeated hypotension, decreased cardiac output, decreased mixed venous oxygen saturation, decreased central venous pressure, pulmonary artery pressure, and pulmonary wedge pressure after the completion of all vascular anastamoses of liver transplantation. These unstable hemodynamics appear to reflect a clinically relevant picture of hypovolemia. However, the real cause was partial hepatic outflow obstruction. The obstruction was suspected because hypotension was alleviated by elevating the full-sized liver graft ventrally and to the left. Doppler ultrasound examination confirmed that the flow velocity of the hepatic vein outflow was insufficient when the liver fell to its resting position in the right hepatic fossa. An additional side-to-side cavo-caval anastomosis resolved the problem in one patient, whereas the other required not only the additional anastomosis, but also application of a tissue expander filled with 770 mL normal saline beneath the liver to eliminate the obstruction. We emphasize that obstruction of the hepatic outflow causes only temporal hypovolemia because of a decrease of venous return and that treatment of this complication should be surgical intervention to relieve the obstruction. Blind resuscitation with fluids will not solve the problem and, in fact, may result in fluid overload with subsequent complications.
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Affiliation(s)
- B Jawan
- Department of Anesthesiology and Liver Transplantation Program, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
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50
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Huang TL, Yang MJ, Wen JK, Yeh EK. Treatment refusal: analysis of 15 cases. Chang Gung Med J 2000; 23:218-23. [PMID: 10902227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
BACKGROUND In this paper, we investigate the reasons for treatment refusal at Linkou and Kaohsiung Chang Gung Memorial Hospitals, and offer ways to improve the doctor-patient relationship. METHODS Cases were collected during a 2-year period according to the criterion of notification of "refused treatment" on consultation sheets, with a total of 1631 consultation sheets. All cases were discussed once a week in detail by psychiatrists and the consulting medical staff, and were followed up from 1 to 4 weeks. All cases were treated by the processes of informed consent and crisis intervention. The final results for the reasons of treatment refusal and psychiatric diagnoses were made by psychiatrists and the consulting medical staff. RESULTS The number of cases compatible with the criterion was 15 (10 men and 5 women). The reasons for treatment refusal included poor communication, inadequate information, lack of competency, denial and shock reaction, reappearance of the suffered experience, and autonomy of patients. The distribution of psychiatric diagnoses included 8 with major depressive disorders, 2 with delirium, 1 with schizophrenic disorder, 1 with adjustment disorder, 1 with acute stress disorder (post-traffic accident), 1 with alcohol dependence, and 1 was deferred. After adequate processes of informed consent and crisis intervention, 12 persons accepted medical treatment. CONCLUSION We should give patients adequate informed consent and crisis intervention to establish a good doctor-patient relationship and to respect the patients' autonomy for their choice of treatment.
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Affiliation(s)
- T L Huang
- Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C
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