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Li JJ, Mao JX, Zhong HX, Zhao YY, Teng F, Lu XY, Zhu LY, Gao Y, Fu H, Guo WY. Multifaceted roles of lymphatic and blood endothelial cells in the tumor microenvironment of hepatocellular carcinoma: A comprehensive review. World J Hepatol 2024; 16:537-549. [PMID: 38689749 PMCID: PMC11056903 DOI: 10.4254/wjh.v16.i4.537] [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: 12/10/2023] [Revised: 01/11/2024] [Accepted: 03/18/2024] [Indexed: 04/24/2024] Open
Abstract
The tumor microenvironment is a complex network of cells, extracellular matrix, and signaling molecules that plays a critical role in tumor progression and metastasis. Lymphatic and blood vessels are major routes for solid tumor metastasis and essential parts of tumor drainage conduits. However, recent studies have shown that lymphatic endothelial cells (LECs) and blood endothelial cells (BECs) also play multifaceted roles in the tumor microenvironment beyond their structural functions, particularly in hepatocellular carcinoma (HCC). This comprehensive review summarizes the diverse roles played by LECs and BECs in HCC, including their involvement in angiogenesis, immune modulation, lymphangiogenesis, and metastasis. By providing a detailed account of the complex interplay between LECs, BECs, and tumor cells, this review aims to shed light on future research directions regarding the immune regulatory function of LECs and potential therapeutic targets for HCC.
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Affiliation(s)
- Jing-Jing Li
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Han-Xiang Zhong
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Yuan-Yu Zhao
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Xin-Yi Lu
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Li-Ye Zhu
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Yang Gao
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Hong Fu
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China.
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Mao JX, Li JJ, Zhao YY, Zhong HX, Lu XY, Zhu LY, Fu H, Ding GS, Guo WY, Teng F. Propensity score matching is recommended for retrospective comparative analysis of sarcopenia's clinical prognostic impact on hepatocellular carcinoma resection patients in Eastern and Western cohorts. Int J Surg 2024:01279778-990000000-01121. [PMID: 38445438 DOI: 10.1097/js9.0000000000001221] [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] [Received: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Jing-Jing Li
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Yuan-Yu Zhao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Han-Xiang Zhong
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Xin-Yi Lu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Li-Ye Zhu
- Department of Immunology and Medical Immunology State Key Laboratory, Naval Medical University, Shanghai, People's Republic of China
| | - Hong Fu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital
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3
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Liu HJ, Guo WY, He HY. [Clinicopathological and molecular features of two cases of plomorphic giant cell adenocarcinomas of prostate]. Zhonghua Bing Li Xue Za Zhi 2023; 52:1266-1268. [PMID: 38058045 DOI: 10.3760/cma.j.cn112151-20230903-00124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Affiliation(s)
- H J Liu
- Department of Pathology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China Department of Pathology, Peking University Third Hospital, Beijing 100191, China
| | - W Y Guo
- Department of Pathology, Peking University Third Hospital, Beijing 100191, China
| | - H Y He
- Department of Pathology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China Department of Pathology, Peking University Third Hospital, Beijing 100191, China
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Lu Y, Ding W, Guo WY, Zhu FM, Zhang J. [Analysis of the reentry status of blood donors with reactive bloodborne pathogen screening markers in Hangzhou City]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1565-1570. [PMID: 37859372 DOI: 10.3760/cma.j.cn112150-20221208-01187] [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: 10/21/2023]
Abstract
Objective: To explore the reentry rate of reactive blood donors in the bloodborne pathogen infection screening in Hangzhou City, and analyze the donation behavior of those who successfully returned. Methods: A retrospective analysis of the return data of blood donors with reactive bloodborne pathogen screening markers was conducted at Zhejiang Provincial Blood Center from June 2017 to May 2022. The reentry process for blood donors with reactive bloodborne pathogen screening markers in Hangzhou City is as follows: after the initial screening period of 6 months, donors can voluntarily apply for return to the blood center. Samples are collected and subjected to routine enzyme-linked immunosorbent assay (ELISA) screening for HBsAg, anti-HCV, HIV Ab/Ag, and anti-TP, as well as a single nucleic acid (HIV/HCV/HBV) test. For samples that show non-reactivity in both ELISA and nucleic acid tests, serum biomarker testing for the reasons of exclusion is performed using chemiluminescence immunoassay (CLIA), and those with non-reactivity are allowed to return. Results: A total of 4 583 reactive blood donors who met the criteria for re-entry applied for reentry, out of which 475 applications were received from donors in the Hangzhou area. Among these, 279 donors were successfully readmitted, resulting in a success rate of 58.74% (279/475). By the end of December 2021, out of the 174 donors who successfully returned, 114 donors chose to donate again. They collectively donated 39 530 ml of whole blood and 1 147.2 therapeutic doses of platelets. Among these, 21 donors once again showed reactivity for pathogen infection biomarkers, accounting for 18.42% (21/114). Conclusion: The reentry strategy has somewhat mitigated the attrition of blood donors. Nevertheless, there are instances where donors who were successfully readmitted show reactivity once more in the screening for pathogen infection biomarkers.
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Affiliation(s)
- Y Lu
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medical, Hangzhou 310016,China Quality Management Departments, Blood Center of Zhejiang Province, Hangzhou 310052,China
| | - W Ding
- Quality Management Departments, Blood Center of Zhejiang Province, Hangzhou 310052,China
| | - W Y Guo
- Quality Management Departments, Blood Center of Zhejiang Province, Hangzhou 310052,China
| | - F M Zhu
- Quality Management Departments, Blood Center of Zhejiang Province, Hangzhou 310052,China
| | - J Zhang
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medical, Hangzhou 310016,China
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5
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Wu Y, Huang LL, Gu MY, Guo WY. [Medium-term efficacy and safety analysis of Ex-PRESS shunt implantation for the treatment of secondary glaucoma in Sturge-Weber syndrome]. Zhonghua Yan Ke Za Zhi 2023; 59:716-722. [PMID: 37670654 DOI: 10.3760/cma.j.cn112142-20230323-00113] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Objective: To evaluate the medium-term efficacy and safety of Ex-PRESS shunt implantation in the treatment of secondary glaucoma associated with Sturge-Weber Syndrome (SWS). Methods: This was a retrospective case series study. Medical records of patients diagnosed with secondary glaucoma due to SWS who underwent Ex-PRESS shunt implantation at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, between January 2013 and February 2020 were collected. Only the right eye were included in the analysis when both eyes were affected. Follow-up visits were scheduled at postoperative week 1, 3 months, 6 months, 1 year, 2 years, and 3 years. Clinical data including intraocular pressure (IOP), vertical cup-to-disc (C/D) ratio, corneal horizontal diameter, visual field, anterior chamber condition, anti-glaucoma medication usage, and additional surgeries were evaluated and analyzed before and after the procedure. Surgical success rates and procedure-related complications at each follow-up time point were assessed. Statistical analyses were performed using t-test, Mann-Whitney U test, and χ2 test. Results: A total of 21 patients (21 eyes) were included in the study, comprising 10 females and 11 males. Among them, 15 eyes were on the right side, and 6 eyes were on the left side. The patients' ages ranged from 3 to 51 years, with a median age of 8.1 (6.3, 11.9) years. The follow-up period ranged from 3 to 53 months, with a median of 11 (6, 24) months. Preoperatively, the IOP in the 21 operated eyes was (32.9±9.1) mmHg (1 mmHg=0.133 kPa), significantly higher than the IOP in the 19 healthy eyes, which was (17.1±4.3) mmHg (t=5.80, P<0.001). The C/D ratio in the operated eyes was (0.75±0.13), also significantly higher than that in the healthy eyes, which was (0.32±0.10) (t=11.22, P<0.001). At the 1-year, 2-year, and 3-year follow-up, 8 eyes out of 16 operated eyes, 6 eyes out of 9 operated eyes, and 7 eyes out of 10 operated eyes achieved overall surgical success (complete success+conditional success), respectively. The number of eyes with complete success at the three follow-up time points was 3, 2, and 4, respectively. The IOP in the operated eyes was significantly reduced at all follow-up time points compared to preoperative values (all P<0.05), while there was no statistically significant difference in C/D ratio before and after surgery (all P>0.05). Two operated eyes experienced retinal detachment or choroidal leakage postoperatively, both of which recovered after conservative treatment. One eye developed postoperative degree Ⅰ shallow anterior chamber, and it resolved spontaneously on the third day after surgery. No serious surgical complications, such as bleb-related complications, malignant glaucoma, expulsive choroidal hemorrhage, or endophthalmitis, were observed postoperatively. Conclusions: Ex-PRESS shunt implantation for the treatment of secondary glaucoma in SWS demonstrated a relatively high level of safety. The medium-term IOP in the operated eyes significantly decreased compared to preoperative values. However, the majority of operated eyes did not achieve complete surgical success.
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Affiliation(s)
- Y Wu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - L L Huang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - M Y Gu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
| | - W Y Guo
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
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Xu JJ, Chen J, Liu YX, Song Y, Jiang L, Yan SD, Guo WY, Yao Y, Jia SD, Yuan DS, Wang PZ, Li JX, Zhao XY, Liu ZY, Yuan JQ. [The impact of LDL-C/HDL-C ratio on severity of coronary artery disease and 2-year outcome in patients with premature coronary heart disease: results of a prospective, multicenter, observational cohort study]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:702-708. [PMID: 37460423 DOI: 10.3760/cma.j.cn112148-20230128-00043] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Objective: To explore the relationship between low density lipoprotein cholesterol (LDL-C)/high density lipoprotein cholesterol (HDL-C) ratio with the severity of coronary artery disease and 2-yeat outcome in patients with premature coronary heart disease. Methods: This prospective, multicenter, observational cohort study is originated from the PROMISE study. Eighteen thousand seven hundred and one patients with coronary heart disease (CHD) were screened from January 2015 to May 2019. Three thousand eight hundred and sixty-one patients with premature CHD were enrolled in the current study. According to the median LDL-C/HDL-C ratio (2.4), the patients were divided into two groups: low LDL-C/HDL-C group (LDL-C/HDL-C≤2.4, n=1 867) and high LDL-C/HDL-C group (LDL-C/HDL-C>2.4, n=1 994). Baseline data and 2-year major adverse cardiovascular and cerebrovascular events (MACCE) were collected and analyzed in order to find the differences between premature CHD patients at different LDL-C/HDL-C levels, and explore the correlation between LDL-C/HDL-C ratio with the severity of coronary artery disease and MACCE. Results: The average age of the low LDL-C/HDL-C ratio group was (48.5±6.5) years, 1 154 patients were males (61.8%); the average age of high LDL-C/HDL-C ratio group was (46.5±6.8) years, 1 523 were males (76.4%). The number of target lesions, the number of coronary artery lesions, the preoperative SNYTAX score and the proportion of three-vessel coronary artery disease in the high LDL-C/HDL-C group were significantly higher than those in the low LDL-C/HDL-C group (1.04±0.74 vs. 0.97±0.80, P=0.002; 2.04±0.84 vs. 1.85±0.84, P<0.001; 13.81±8.87 vs. 11.70±8.05, P<0.001; 36.2% vs. 27.4%, respectively, P<0.001). Correlation analysis showed that there was a significant positive correlation between LDL-C/HDL-C ratio and preoperative SYNTAX score, the number of coronary artery lesions, the number of target lesions and whether it was a three-vessel coronary artery disease (all P<0.05). The 2-year follow-up results showed that the incidence of MACCE was significantly higher in the high LDL-C/HDL-C group than that in the low LDL-C/HDL-C group (6.9% vs. 9.1%, P=0.011). There was no significant difference in the incidence of all-cause death, cardiac death, myocardial infarction, stroke, revascularization and bleeding between the two groups. Cox multivariate regression analysis showed that the LDL-C/HDL-C ratio has no correlation with 2-year MACCE, death, myocardial infarction, revascularization, stroke and bleeding events above BARC2 in patients with premature CHD. Conclusion: High LDL-C/HDL-C ratio is positively correlated with the severity of coronary artery disease in patients with premature CHD. The incidence of MACCE of patients with high LDL-C/HDL-C ratio is significantly higher during 2 years follow-up; LDL-C/HDL-C ratio may be an indicator for evaluating the severity of coronary artery disease and long-term prognosis in patients with premature CHD.
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Affiliation(s)
- J J Xu
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J Chen
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518057, China
| | - Y X Liu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
| | - Y Song
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - L Jiang
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - S D Yan
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518057, China
| | - W Y Guo
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518057, China
| | - Y Yao
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - S D Jia
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - D S Yuan
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - P Z Wang
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - J X Li
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - X Y Zhao
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Z Y Liu
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
| | - J Q Yuan
- Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Fan JY, Dama G, Liu YL, Guo WY, Lin JT. [Combinational Overexpression of Foxa3 and Hnf4α Enhance the Proliferation and Prolong the Functional Maintenance of Primary Hepatocytes]. Mol Biol (Mosk) 2023; 57:668-670. [PMID: 37528786 DOI: 10.31857/s0026898423040031, edn: qkqquw] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/06/2022] [Indexed: 08/03/2023]
Abstract
In an in vitro culture system, primary hepatocytes usually display a low proliferation capacity, accompanied with a decrease of viability and a loss of hepatocyte-specific functions. Previous studies have demonstrated that the combination introductions of certain hepatocyte-specific transcription factors are able to convert fibroblasts into functional hepatocyte-like cells. However, such combinational usage of transcription factors in primary hepatocytes culture has not yet sufficiently studied. The forkhead box protein A3 (FoxA3) and hepatocyte nuclear factor 4α (Hnf4α) are liver-enriched transcription factors that play vital roles in the differentiation, and maintenance of hepatocytes. Thus, we simultaneously overexpressed the two genes, Foxa3 and Hnf4α, in rat hepatocytes and observed that the combinational augmentation of these two transcription factors have enhanced the proliferation and stabilized the hepatocyte-specific functions of primary hepatocytes over a long-term culture period.
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Affiliation(s)
- J Y Fan
- Stem Cell and Biotherapy Engineering Research Center of Henan, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, 453003 China
- College of Life Science and Technology, Xinxiang Medical University, Henan, Xinxiang, 453003 China
- Shandong Tianchuan Precision Medical Technology Co. Ltd., Dezhou, 253084 China
| | - G Dama
- Stem Cell and Biotherapy Engineering Research Center of Henan, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, 453003 China
- Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, 13200 Malaysia
| | - Y L Liu
- Stem Cell and Biotherapy Engineering Research Center of Henan, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, 453003 China
- College of Life Science and Technology, Xinxiang Medical University, Henan, Xinxiang, 453003 China
| | - W Y Guo
- College of Life Science and Technology, Xinxiang Medical University, Henan, Xinxiang, 453003 China
| | - J T Lin
- Stem Cell and Biotherapy Engineering Research Center of Henan, Henan Joint International Research Laboratory of Stem Cell Medicine, Xinxiang Medical University, Xinxiang, 453003 China
- College of Life Science and Technology, Xinxiang Medical University, Henan, Xinxiang, 453003 China
- College of Biomedical Engineering, Xinxiang Medical University, Henan, Xinxiang, 453003 China
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Dong JF, Xue Q, Chen T, Zhao YY, Fu H, Guo WY, Ji JS. Machine learning approach to predict acute kidney injury after liver surgery. World J Clin Cases 2021; 9:11255-11264. [PMID: 35071556 PMCID: PMC8717516 DOI: 10.12998/wjcc.v9.i36.11255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/10/2021] [Revised: 09/15/2021] [Accepted: 11/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute kidney injury (AKI) after surgery appears to increase the risk of death in patients with liver cancer. In recent years, machine learning algorithms have been shown to offer higher discriminative efficiency than classical statistical analysis.
AIM To develop prediction models for AKI after liver cancer resection using machine learning techniques.
METHODS We screened a total of 2450 patients who had undergone primary hepatocellular carcinoma resection at Changzheng Hospital, Shanghai City, China, from January 1, 2015 to August 31, 2020. The AKI definition used was consistent with the Kidney Disease: Improving Global Outcomes. We included in our analysis preoperative data such as demographic characteristics, laboratory findings, comorbidities, and medication, as well as perioperative data such as duration of surgery. Computerized algorithms used for model development included logistic regression (LR), support vector machine (SVM), random forest (RF), extreme gradient boosting (XGboost), and decision tree (DT). Feature importance was also ranked according to its contribution to model development.
RESULTS AKI events occurred in 296 patients (12.1%) within 7 d after surgery. Among the original models based on machine learning techniques, the RF algorithm had optimal discrimination with an area under the curve value of 0.92, compared to 0.87 for XGBoost, 0.90 for DT, 0.90 for SVM, and 0.85 for LR. The RF algorithm also had the highest concordance-index (0.86) and the lowest Brier score (0.076). The variable that contributed the most in the RF algorithm was age, followed by cholesterol, and surgery time.
CONCLUSION Machine learning algorithms are highly effective in discriminating patients at high risk of developing AKI. The successful application of machine learning models may help guide clinical decisions and help improve the long-term prognosis of patients.
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Affiliation(s)
- Jun-Feng Dong
- Department of Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Qiang Xue
- Department of Neurosurgery, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai 200082, China
| | - Ting Chen
- Department of Intensive Rehabilitation, Zhabei Central Hospital, Shanghai 200070, China
| | - Yuan-Yu Zhao
- Department of Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Hong Fu
- Department of Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Wen-Yuan Guo
- Department of Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Jun-Song Ji
- Department of Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
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Mao JX, Zhao YY, Dong JY, Liu C, Xue Q, Ding GS, Teng F, Guo WY. UBE2T And CYP3A4: hub genes regulating the transformation of cirrhosis into hepatocellular carcinoma. All Life 2021. [DOI: 10.1080/26895293.2021.1933208] [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: 10/21/2022] Open
Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, People’s Republic of China
| | - Yuan-Yu Zhao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, People’s Republic of China
| | - Jia-Yong Dong
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, People’s Republic of China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, People’s Republic of China
| | - Qiang Xue
- Department of Neurosurgery, Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai, People’s Republic of China
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, People’s Republic of China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, People’s Republic of China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, People’s Republic of China
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Mao JX, Liu C, Zhao YY, Ding GS, Ma JQ, Teng F, Guo WY. Merged hepatopulmonary features in hepatoid adenocarcinoma of the lung: a systematic review. Am J Transl Res 2021; 13:898-922. [PMID: 33841629 PMCID: PMC8014347] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
This study aimed to provide diagnostic clues for patients with elevated serum alpha-fetoprotein (AFP) in the absence of liver tumors and rectify some previously confused concepts about hepatoid carcinoma of the lung through a systematic review on hepatoid adenocarcinoma of the lung (HAL). A thorough search for original articles on HAL published prior to November 2020 was performed using the PubMed, EBSCOhost, Embase, WanFang Data, and China National Knowledge Infrastructure (CNKI) databases. Ninety-four patients from 88 studies met the eligibility criteria. HAL was rare and mainly occurred among male Asian smokers in their 60 s, presenting with cough, hemoptysis, chest pain, dyspnea and/or weight loss, as well as elevated serum AFP with a mass usually in the right upper lung lobe but no liver masses. Hepatoid differentiation regions, acinar or papillary structures in tumor tissues, and positive immunohistochemical expression of AFP, HepPar-1, and CK8/18 were crucial indicators for the diagnosis of HAL. Surgery-based strategies were recommended for stage I-III patients, while stage IV patients were mainly treated with chemotherapy-based strategy. The 1-, 3-, and 5-year overall survival rates were 40%, 35%, and 19%, respectively. The 1-year relapse-free survival rate was 58%. The postoperative monitoring of AFP contributed to the early detection of tumor recurrence, with a positive rate of 71.43%. In conclusion, patients with elevated serum AFP levels without any detectable hepatic lesions should be evaluated for the possibility of HAL.
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Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical UniversityShanghai 200003, China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical UniversityShanghai 200003, China
| | - Yuan-Yu Zhao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical UniversityShanghai 200003, China
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical UniversityShanghai 200003, China
| | - Ji-Qing Ma
- Department of General Surgery, Changhai Hospital, Naval Medical UniversityShanghai 200433, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical UniversityShanghai 200003, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical UniversityShanghai 200003, China
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Mao JX, Yuan H, Sun KY, Liu C, Fu H, Ding GS, Guo WY, Teng F. Pooled analysis of hepatic inflammatory angiomyolipoma. Clin Res Hepatol Gastroenterol 2020; 44:e145-e151. [PMID: 32482543 DOI: 10.1016/j.clinre.2020.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/03/2020] [Accepted: 04/11/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
| | - Hang Yuan
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
| | - Ke-Yan Sun
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
| | - Hong Fu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, 200003, China.
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Li GH, Li P, Lu L, Li Z, Mo MS, Chen X, Peng GY, Guo WY, Lin YW, Qiu JW, Yang XL, Liu XT, Xu PY. The outcome and burden of Chinese patients with neurodegenerative diseases: A 10-year clinical feature study. Int J Clin Pract 2020; 74:e13534. [PMID: 32418282 DOI: 10.1111/ijcp.13534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Received: 03/03/2020] [Accepted: 05/11/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND As the Chinese population continues to age, the incidence of neurodegenerative diseases (NDDs) has increased dramatically, which results in heavy medical and economic burden for families and society. OBJECTIVE The objective of this study was to evaluate NDDs in a southern Chinese hospital over a 10-year period and examine trends in demographics, outcome, length of stay (LOS) and cost. METHODS Retrospective medical records of patients from January 2010 to December 2019 were collected, including 7231 patients with NDDs (as case group) and 9663 patients without any NDDs (as control group). The information of social demographic data, admission source, reasons for admission, outcomes, LOS, and cost were extracted and analysed. RESULT The average hospitalisation age of the patients with NDDs is over 65 years (peak age 70-89 years). Compared with the control group, the case group had a longer LOS and a higher cost and the numbers of patients with NDDs increased yearly from 2010 to 2019. The LOS shortened while the cost increased. Clinical features affected LOS and cost. Patients suffering from infection, abnormal blood pressure and the imbalance of water-electrolyte homoeostasis as main reasons for admission were decreased; however, heart disease, cerebrovascular accident and mental diseases were significantly increased, the overall change trend of fracture/trauma remained stable. The rate of discharge to home care and mortality declined; discharge to other medical or community facilities increased over 10 years. CONCLUSION The majority of NDDs patients tended to be older. During the last 10 years from 2010 to 2019, the numbers of NDDs patients increased yearly, the trend of LOS became shortening and the cost gradually increasing. The main reasons of admission and outcomes of hospital showed different trends.
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Affiliation(s)
- Gui-Hua Li
- Department of Neurology, Guangdong Second People's hospital, Guangzhou, Guangdong, China
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Peng Li
- Department of Anesthesiology, The Chinese Medicine Hospital of Changji, Changji, Xinjiang, China
| | - Lin Lu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhe Li
- Department of Encephalopathy, The Second Affiliated Hospital of Guangzhou Medical University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ming-Shu Mo
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiang Chen
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Guo-You Peng
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wen-Yuan Guo
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yu-Wan Lin
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jie-Wen Qiu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xin-Ling Yang
- Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xin-Tong Liu
- Department of Neurology, Guangdong Second People's hospital, Guangzhou, Guangdong, China
| | - Ping-Yi Xu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Mao JX, Teng F, Sun KY, Liu C, Ding GS, Guo WY. Two-in-one: A pooled analysis of primary hepatic neuroendocrine carcinoma combined/collided with hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int 2020; 19:399-403. [PMID: 32359724 DOI: 10.1016/j.hbpd.2020.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/23/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Ke-Yan Sun
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai 200003, China.
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Mao JX, Guo WY, Guo M, Liu C, Teng F, Ding GS. Acute rejection after liver transplantation is less common, but predicts better prognosis in HBV-related hepatocellular carcinoma patients. Hepatol Int 2020; 14:347-361. [PMID: 32140981 DOI: 10.1007/s12072-020-10022-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/04/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND With a novel finding of significantly lower incidence of acute rejection (AR) in patients with hepatocellular carcinoma (HCC) after liver transplantation, compared with those with benign end-stage liver disease (BESLD), in a large national cohort, we analyzed the correlations among the perioperative immuno-inflammation status, postoperative AR, and prognosis in HCC and BESLD patients with same etiology of hepatitis B virus (HBV), who underwent liver transplantation. METHODS Patients who underwent liver transplantation due to HBV-related HCC or BESLD and experienced AR between September 2008 and April 2017 were analyzed retrospectively and followed up until April 2018. HCC patients with AR were matched with those without AR according to tumor stage and immunosuppressant concentration, at a 1:3 ratio. Preoperative immuno-inflammation status and prognosis of patients in both groups were compared. RESULTS The overall incidences of AR in patients with HCC and BESLD were 8.60% and 10.61%, respectively. The postoperative 28-day incidence of AR was significantly lower in HCC compared with BESLD patients (3.23% vs 7.08%, p = 0.031). Compared with BESLD patients, the rejection activity index and perioperative CD4/CD8 ratio were significantly lower (p = 0.047 and p < 0.001, respectively), while platelet/lymphocyte ratio was significantly higher in HCC patients (p = 0.041). Later tumor stage in HCC patients was associated with higher systemic immuno-inflammation index, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, platelet/lymphocyte ratio, aspartate aminotransferase/lymphocyte ratio, C-reactive protein/albumin ratio and fibrinogen level, and lower CD4/CD8 ratio before transplantation. In HCC patients with AR, the percentage of regulatory T cells (CD4+/CD25+) and the level of IL-10 significantly decreased (p = 0.0023, < 0.0001, respectively), while Th1/Th2 ratio, levels of IFN-γ and IL-2 markedly increased before transplantation (p = 0.0018, 0.0059, 0.0416, respectively). Preoperative monocyte/lymphocyte ratio was an independent risk factor for overall and recurrence-free survival after liver transplantation in HCC patients (p = 0.025, < 0.001, respectively). The 1-, 3-, and 5-year survival rates were 76%, 71% and 53% in the AR group, and 67%, 37% and 25% in the non-AR group (p = 0.042). CONCLUSION Preoperative tumor-related immunosuppression may persist after liver transplantation in HCC patients, and reduce the incidence of AR. AR after liver transplantation may indicate a better prognosis in HCC patients.
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Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Meng Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China.,National Key Laboratory of Medical Immunology & Institute of Immunology, Navy Medical University, Shanghai, China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China.
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Navy Medical University, Shanghai, China.
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Xu X, Chen J, Wei Q, Liu ZK, Yang Z, Zhang M, Wang GY, Gao J, Yang ZX, Guo WY, Xing TH, Shao Z, Xie QF, Zheng SS. Clinical practice guidelines on liver transplantation for hepatocellular carcinoma in China (2018 edition). Hepatobiliary Pancreat Dis Int 2019; 18:307-312. [PMID: 31279679 DOI: 10.1016/j.hbpd.2019.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/11/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Xiao Xu
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
| | - Jun Chen
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Qiang Wei
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Zhi-Kun Liu
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Zhe Yang
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Ming Zhang
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Guo-Ying Wang
- Department of Hepatic Surgery, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
| | - Jie Gao
- Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China
| | - Zhao-Xu Yang
- Department of Hepatobiliary Surgery, Xijing Hospital, Air Force Medical University, Xi'an 710032, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Tong-Hai Xing
- General Surgery Center, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200080, China
| | - Zhou Shao
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Qin-Fen Xie
- Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou 310004, China
| | - Shu-Sen Zheng
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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Mao JX, Teng F, Liu C, Yuan H, Dong JY, Fu H, Ding GS, Guo WY. Immunometabolic inflammation and hepatocellular carcinoma. Hepatobiliary Pancreat Dis Int 2019; 18:298-300. [PMID: 31027911 DOI: 10.1016/j.hbpd.2019.03.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/11/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Hang Yuan
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Jia-Yong Dong
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Hong Fu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China.
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17
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Mao JX, Teng F, Liu C, Yuan H, Sun KY, Zou Y, Dong JY, Ji JS, Dong JF, Fu H, Ding GS, Guo WY. Two case reports and literature review for hepatic epithelioid angiomyolipoma: Pitfall of misdiagnosis. World J Clin Cases 2019; 7:972-983. [PMID: 31119142 PMCID: PMC6509262 DOI: 10.12998/wjcc.v7.i8.972] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/17/2018] [Revised: 02/10/2019] [Accepted: 02/26/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatic epithelioid angiomyolipoma (HEAML) is a rare liver disease and is easily misdiagnosed. Enhanced recognition of HEAML is beneficial to the differential diagnosis of rare liver diseases.
CASE SUMMARY We presented two cases of HEAML in Changzheng Hospital, Naval Medical University, and then collected and analyzed all reports about HEAML recorded in PubMed, MEDLINE, China Science Periodical Database, and VIP database from January 2000 to March 2018. A total of 409 cases of HEAML in 97 reports were collected, with a ratio of men to women of 1:4.84 and an age range from 12 years to 80 years (median 44 years). Among the patients with clinical symptoms mentioned, 61.93% (205/331) were asymptomatic, 34.74% (115/331) showed upper or right upper quadrant abdomen discomfort, while a few of them showed abdominal mass, gastrointestinal symptoms, low fever, or weight loss. The misdiagnosis rate of HEAML was as high as 40.34% (165/409) due to its nonspecific imaging findings. Most of the tumors were solitary and round in morphology, with clear boundaries. Ultrasound scan indicated low echo with internal nonuniformity and rich blood supply in most cases. Computer tomography/magnetic resonance imaging enhanced scan showed varied characteristics. The ratio of fast wash-in and fast wash-out, fast wash-in and slow wash-out, and delayed enhancement was roughly 4:5:1. A definite diagnosis of HEAML depended on the pathological findings of the epithelioid cells in lesions and the expression of human melanoma black 45, smooth muscle actin, melanoma antigen, and actin by immunohistochemical staining. HEAML had a relatively low malignant rate of 3.91%. However, surgical resection was the main treatment for HEAML, due to the difficulty diagnosing before operation.
CONCLUSION HEAML is a rare and easily misdiagnosed disease, and it should be diagnosed carefully, taking into account clinical course, imaging, pathological ,and immunohistochemical findings.
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Affiliation(s)
- Jia-Xi Mao
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Cong Liu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Hang Yuan
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Ke-Yan Sun
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - You Zou
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Jia-Yong Dong
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Jun-Song Ji
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Jun-Feng Dong
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Hong Fu
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai 200003, China
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Mo MS, Li GH, Sun CC, Huang SX, Wei L, Zhang LM, Zhou MM, Wu ZH, Guo WY, Yang XL, Chen CJ, Qu SG, He JX, Xu PY. Dopaminergic neurons show increased low-molecular-mass protein 7 activity induced by 6-hydroxydopamine in vitro and in vivo. Transl Neurodegener 2018; 7:19. [PMID: 30128145 PMCID: PMC6097308 DOI: 10.1186/s40035-018-0125-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/30/2018] [Indexed: 02/08/2023] Open
Abstract
Background Abnormal expression of major histocompatibility complex class I (MHC-I) is increased in dopaminergic (DA) neurons in the substantia nigra (SN) in Parkinson’s disease (PD). Low-molecular-mass protein 7 (β5i) is a proteolytic subunit of the immunoproteasome that regulates protein degradation and the MHC pathway in immune cells. Methods In this study, we investigated the role of β5i in DA neurons using a 6-hydroxydopamine (6-OHDA) model in vitro and vivo. Results We showed that 6-OHDA upregulated β5i expression in DA neurons in a concentration- and time-dependent manner. Inhibition and downregulation of β5i induced the expression of glucose-regulated protein (Bip) and exacerbated 6-OHDA neurotoxicity in DA neurons. The inhibition of β5i further promoted the activation of Caspase 3-related pathways induced by 6-OHDA. β5i also activated transporter associated with antigen processing 1 (TAP1) and promoted MHC-I expression on DA neurons. Conclusion Taken together, our data suggest that β5i is activated in DA neurons under 6-OHDA treatment and may play a neuroprotective role in PD. Electronic supplementary material The online version of this article (10.1186/s40035-018-0125-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ming-Shu Mo
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Gui-Hua Li
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Cong-Cong Sun
- 2Department of Neurology, Qilu Hospital of Shandong University, Jinan, 250012 Shandong China
| | - Shu-Xuan Huang
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Lei Wei
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Li-Min Zhang
- 3Department of Neurology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080 Guangdong China
| | - Miao-Miao Zhou
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Zhuo-Hua Wu
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Wen-Yuan Guo
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Xin-Ling Yang
- 4Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumchi, 830011 Xinjiang China
| | - Chao-Jun Chen
- Clinic Brain Center, Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou, 510800 Guangdong China
| | - Shao-Gang Qu
- 6Department of Blood Transfusion, Fifth Affiliated Hospital Southern Medical University, Guangzhou, 510900 Guangdong China
| | - Jian-Xing He
- 7Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China
| | - Ping-Yi Xu
- 1Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 Guangdong China.,4Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumchi, 830011 Xinjiang China
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19
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Wu Y, Guo WY. [Research progress of Sturge-Weber syndrome induced glaucoma]. Zhonghua Yan Ke Za Zhi 2018. [PMID: 29518883 DOI: 10.3760/cma.j.issn.0412-4081.2018.03.017] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Sturge-Weber Syndrome is a sporadic rare disease. Its characteristic feature of Port-wine Stain in patient's face has been an important indicator for screening secondary glaucoma, which further provides patients with possibility of early diagnosis and treatment of Sturge-Weber Syndrome induced glaucoma. This paper focuses on the pathogenesis, risk factors and treatment of Sturge-Weber Syndrome secondary glaucoma. (Chin J Ophthalmol, 2018, 54: 229-233).
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Affiliation(s)
- Y Wu
- Department of Ophthalmology, Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai 200011, China
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20
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Wu Y, Yu RJ, Lin XX, Guo WY. [Sturge-Weber syndrome in port-wine stain patients: a retrospective study on the clinical features and screening strategy]. Zhonghua Yan Ke Za Zhi 2017; 53:753-757. [PMID: 29050188 DOI: 10.3760/cma.j.issn.0412-4081.2017.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical characteristics of Sturge-Weber syndrome (SWS) in the patients with Port-wine stain (PWS). Methods: A total of 279 PWS patients, 164 males, 115 females with a median age of first visit 17.00 (4.75, 56.00) months. Most of the PWS patients were referred to the Ophthalmology Department for screening eye problems when the cutaneous angiomas involved the ophthalmic division of the trigeminal nerve distribution. The intraocular pressure (IOP), cup to disk ratio (C/D), corneal condition and other essential measurements were examined to screen glaucoma or choroidal hemangioma. The differences of age, gender and vascular ectasia in the ipsilateral eyes were compared among PWS and SWS patients with chi-square test. The differences about the first visit time, IOP, C/D and corneal diameters were evaluated with independent-sample T test or nonparametric test followed by Mann-Whitney U test. Results: A total number of 66 out of 279 PWS patients (23.7%) were confirmed as SWS with glaucoma. The IOP of the ipsilateral eye with vascular ectasia in PWS and SWS was 13.00 mmHg (1 mmHg=0.133 kPa) (IQR: 9.75, 17.00) and 23.00 mmHg (20.00, 32.00), respectively (Z=-8.212, P<0.001); the IOP differences between the ipsilateral and contralateral eye in PWS and SWS was 1mmHg (0, 2) and 7 mmHg (3, 11) respectively; the C/D in the ipsilateral eye and the contralateral eye was 0.30 (0.30, 0.35) and 0.7 (0.6, 0.8) respectively in SWS cases with secondary glaucoma. Conclusions: There is a high proportion of SWS with glaucoma in ophthalmic division affected PWS patients. Fundus examinations were necessary for this type of patients. (Chin J Ophthalmol, 2017, 53:753-757).
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Affiliation(s)
- Y Wu
- Department of Ophthalmology, Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
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Liu B, Liu K, Teng F, Fu H, Guo WY, Shi XM, Ni ZJ, Gao XG, Ma J, Fu ZR, Ding GS. Favorable effect of thrombocytopenia on outcomes of liver transplantation for hepatocellular carcinoma. Scand J Gastroenterol 2016; 51:509-10. [PMID: 26784975 DOI: 10.3109/00365521.2015.1095940] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Bing Liu
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Kan Liu
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Fei Teng
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Hong Fu
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Wen-Yuan Guo
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Xiao-Min Shi
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Zhi-Jia Ni
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Xiao-Gang Gao
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Jun Ma
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Zhi-Ren Fu
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
| | - Guo-Shan Ding
- a Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University , 415 Fengyang Road , Shanghai 200003 , P.R. China
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Chen YQ, Li T, Guo WY, Su FJ, Zhang YX. Identification of altered pathways in Down syndrome-associated congenital heart defects using an individualized pathway aberrance score. Genet Mol Res 2016; 15:gmr7601. [PMID: 27173257 DOI: 10.4238/gmr.15027601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim of this study was to identify disrupted pathways related to Down syndrome (DS), and DS-associated congenital heart defects (DS-CHD). The gene expression profile and pathway data of 10 human DS patients and 5 control samples in E-GEOD-1789 were recruited and analyzed by the individualized pathway aberrance score (iPAS) method, consisting of the data processing, gene-level statistics, pathway-level statistics, and significant measurement steps. The pre-processing step identified 12,493 genes and 1022 pathways (4269 genes). The pathway significant analysis identified eight pathways (adjusted P value <0.1) that differed between the disease and control samples. The cross-presentation of particulate exogenous antigen (phagosomes) and methionine salvage pathways showed the most significant differences among these. The gene expression levels of key pathway genes, such as CYBB and ADI1, were higher in disease samples than in normal controls. Based on our results, we predicted that the cross-presentation of particulate exogenous antigens (phagosomes) and the methionine salvage pathway could be good indicators of DS-CHD.
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Affiliation(s)
- Y Q Chen
- Department of Cardiology, Lanzhou General Hospital of Lanzhou Military Area Command, Lanzhou, Gansu Province, China
| | - T Li
- Department of Cardiology, Lanzhou General Hospital of Lanzhou Military Area Command, Lanzhou, Gansu Province, China
| | - W Y Guo
- Department of Cardiology, Lanzhou General Hospital of Lanzhou Military Area Command, Lanzhou, Gansu Province, China
| | - F J Su
- Department of Cardiology, Lanzhou General Hospital of Lanzhou Military Area Command, Lanzhou, Gansu Province, China
| | - Y X Zhang
- Department of Cardiology, Lanzhou General Hospital of Lanzhou Military Area Command, Lanzhou, Gansu Province, China
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Tian SF, Liu AL, Liu JH, Li Y, Liu XD, Huang K, Song QW, Xu MZ, Guo WY. [Value of R2(*) in evaluating the biological behavior of primary hepatocellular carcinoma]. Zhonghua Yi Xue Za Zhi 2016; 96:1164-1167. [PMID: 27117360 DOI: 10.3760/cma.j.issn.0376-2491.2016.15.004] [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: 06/05/2023]
Abstract
OBJECTIVE To investigate the correlation between R2(*) value of enhanced T2 star-weighted angiography (ESWAN) sequence and primary hepatocellular carcinoma infiltration and tumor thrombus, and investigate the biological behavior of HCC. METHODS A total of 221 cases of patients' imaging data with MRI examination(including ESWAN sequence) diagnosed as primary HCC were retrospectively analyzed.All the patients were collected from January 2014 to September 2015 in the First Affiliated Hospital of Dalian Medical University.The differences of R2(*) values in different MR types of HCC were analyzed.All patients were divided into infiltration group and non-infiltration group, tumor thrombus group and non-tumor thrombus group, the R2(*) values of the paired groups were compared.The diagnostic efficiency of R2(*) in HCC infiltration and tumor thrombus were evaluated by ROC curve, and to find out the threshold values. RESULTS The MR types of 221 patients included 90 cases of nodular type, 62 cases of massive type, 69 cases of diffuse type.70 patients had tumor thrombus.The R2(*) values of different MR types were (21.82±8.52), (24.17±8.84)and (34.45±11.73) Hz, respectively.There was no statistically significant difference between the nodular and the massive types (P=0.144), while the difference between the nodular and diffuse type, the massive and diffuse types were statistically significant(P=0.000). The R2(*) values of infiltration group and non-infiltration group were (34.45±11.73) and (22.78±8.70) Hz , the R2(*) values of tumor thrombus group and non-tumor thrombus group were (31.20±12.17) and (24.21±9.90) Hz, the difference also had statistically significant(t=7.397 and 4.534, P=0.000 and 0.000). The AUC of R2(*) values for infiltration and tumor thrombus were 0.804, 0.681. R2(*) ≥24.68 Hz was the threshold value to diagnose the infiltration and tumor thrombus. CONCLUSION R2(*) value can be used as a MR non-enhancement quantitative index to evaluate the biological behavior of HCC.
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Affiliation(s)
- S F Tian
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
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Abstract
Post-stroke depression (PSD) is a mental illness characterized by subjective feelings of depression, cognitive dysfunction, and decreased interest. The serotoninergic system is involved in the pathogenesis of depressive disorders and is regulated by the serotonin transporter gene. The serotonin transporter-linked polymorphic region (5-HTTLPR) has been examined as a factor associated with depression and other mental disorders. This study was performed to explore the relationship between 5-HTTLPR and PSD in a Han Chinese population. In total, 199 patients with PSD and 202 unrelated non-PSD patients were recruited from psychiatric hospitals. Depression was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. Blood samples were collected from all patients for 5-HTTLPR genotyping. Genotype and allele frequencies were compared between the two groups. SS genotype frequency was significantly higher in the PSD group than in the non-PSD group. LL genotype frequency was significantly higher in the non-PSD group than in the PSD group (P < 0.01). This study describes a positive association between 5-HTTLPR and PSD in a Han Chinese population and provides genetic evidence to support the genetic susceptibility of PSD.
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Affiliation(s)
- W Y Guo
- Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, Henan, China
| | - Z H Zhang
- Department of Psychosomatic Medicine, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - J L Mu
- Department of Neurology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - D Liu
- Department of Neurology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - L Zhao
- Department of Psychosomatic Medicine, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Z Y Yao
- Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang, Henan, China.,School of Basic Medicine, Xinxiang Medical University, Xinxiang, Henan, China
| | - J G Song
- Department of Neurology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
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Niu YL, Guo WY, Bai LR, Zhao JC. Genetic diversity and the conservation priority of Glycine soja populations from Northern China. Genet Mol Res 2015; 14:16608-15. [PMID: 26681007 DOI: 10.4238/2015.december.11.8] [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] [Indexed: 11/03/2022]
Abstract
Knowledge of the spatial patterns of genetic variation in wild populations has significant implications for in situ conservation and the determination of conservation order. To study the levels of genetic diversity, spatial genetic structures, and genetic distances in Glycine soja, 11 natural populations in northern China were analyzed by estimating genetic coefficients using inter-simple sequence repeat (ISSR) fingerprints via mixed sampling strategies. Sixteen ISSR primers generated 98 reproducible polymorphic amplification banding patterns of 172 scored, accounting for 56.98% of the polymorphisms among the populations. The dendrogram based on Nei's genetic distance showed that distinct genetic differentiation occurred in G. soja. The Unweighted Pair-Group Method with Arithmetic Mean cluster analysis indicated two broad groups, and one contained all of the populations except three from Chengde, which formed the smaller second group. The spatial genetic structure evident in the wild soybean populations may be attributed to restricted seed dispersal and the dominant breeding system of this species. The detection of genetic structures in wild soybean populations could be a significant index for the effective conservation of many wild populations, and it could be exploited by soybean breeding programs to increase production.
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Affiliation(s)
- Y L Niu
- College of Life Science, Hebei Normal University, Shijiazhuang, China.,College of Life Science, Hengshui University, Hengshui, Hebei, China
| | - W Y Guo
- College of Life Science and Technology, Xinxiang Medical University, Xinxiang Henan, China
| | - L R Bai
- College of Life Science, Hengshui University, Hengshui, Hebei, China
| | - J C Zhao
- College of Life Science, Hebei Normal University, Shijiazhuang, China
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Liu B, Teng F, Fu H, Guo WY, Shi XM, Ni ZJ, Gao XG, Ma J, Fu ZR, Ding GS. Excessive intraoperative blood loss independently predicts recurrence of hepatocellular carcinoma after liver transplantation. BMC Gastroenterol 2015; 15:138. [PMID: 26472203 PMCID: PMC4608055 DOI: 10.1186/s12876-015-0364-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 10/01/2015] [Indexed: 12/13/2022] Open
Abstract
Background Several studies have investigated the effect of intraoperative blood loss (IBL) on recurrence of tumors. However, the independent effect of IBL on oncological outcome after liver transplantation (LT) for hepatocellular carcinoma (HCC) is unclear. Methods A total of 479 patients who underwent LT for HCC from January 2001 to December 2012 at our institution were enrolled in this retrospective study. Kaplan–Meier and Cox regression methods were used to assess the recurrence rate, as well as its risk factors. Stratified analysis was performed to further examine the effect of IBL on HCC recurrence according to different characteristics of tumors. We also investigated the independent risk factors for excessive IBL using logistic regression analysis. Results The median follow-up was 28 months (range, 1–131 months). Kaplan–Meier analysis with the log-rank test according to IBL at per liter intervals showed that IBL > 4 L was significantly associated with a higher recurrence rate (P < 0.001). Multivariate analysis identified that IBL > 4 L (P < 0.001; hazard ratio [HR] = 2.32, 95 % confidence interval [CI] = 1.60–3.36) was an independent risk factor for post-LT HCC recurrence, as well as age < 60 years, exceeding Milan criteria, α-fetoprotein levels > 400 ng/mL, and micro- and macrovascular invasion. IBL > 4 L (P < 0.001; HR = 2.45, 95 % CI = 1.64–3.66) was also independently associated with early (within 1 year) recurrence after LT. Furthermore, a significant correlation between IBL > 4 L and vascular invasion (P = 0.019) was found. IBL > 4 L was independently associated with HCC recurrence for patients with vascular invasion, but not for patients without vascular invasion. Finally, we found that the presence of ascites, model for end-stage liver disease score, and operation time were independent risk factors for IBL > 4 L. Conclusions Excessive IBL is an independent predictor of HCC recurrence after LT, especially in patients with vascular invasion.
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Affiliation(s)
- Bing Liu
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Fei Teng
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Hong Fu
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Wen-Yuan Guo
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Xiao-Min Shi
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Zhi-Jia Ni
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Xiao-Gang Gao
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Jun Ma
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Zhi-Ren Fu
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Guo-Shan Ding
- Department of Liver Surgery and Organ Transplantation Institute of Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
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Hao LZ, Gao W, Liu YJ, Han ZD, Xue QZ, Guo WY, Zhu J, Li YR. High-performance n-MoS2/i-SiO2/p-Si heterojunction solar cells. Nanoscale 2015; 7:8304-8308. [PMID: 25884108 DOI: 10.1039/c5nr01275a] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A solar cell based on the n-MoS2/i-SiO2/p-Si heterojunction is fabricated. The device exhibits a high power-conversion efficiency of 4.5% due to the incorporation of a nano-scale SiO2 buffer into the MoS2/Si interface. The present device architectures are envisaged as potentially valuable candidates for high-performance photovoltaic devices.
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Affiliation(s)
- L Z Hao
- College of Science, China University of Petroleum, Qingdao, Shandong 266580, People's Republic of China.
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28
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Wang GM, Spector A, Luo CQ, Tang LQ, Xu LH, Guo WY, Huang YQ. Prevalence of age-related cataract in Ganzi and in Qinpu. The Epidemiological Study Group. Dev Ophthalmol 2015; 21:33-40. [PMID: 1868946 DOI: 10.1159/000419931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G M Wang
- Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical University, People's Republic of China
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Teng F, Wang GH, Tao YF, Guo WY, Wang ZX, Ding GS, Shi XM, Fu ZR. Criteria-specific long-term survival prediction model for hepatocellular carcinoma patients after liver transplantation. World J Gastroenterol 2014; 20:10900-10907. [PMID: 25152592 PMCID: PMC4138469 DOI: 10.3748/wjg.v20.i31.10900] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 03/06/2014] [Accepted: 05/14/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To establish a model to predict long-term survival of hepatocellular carcinoma (HCC) patients after liver transplantation (MHCAT).
METHODS: Two hundred and twenty-three patients with HCC were followed for at least six years to identify independent risk factors for long-term survival after liver transplantation (LT). The criteria for HCC liver transplantation included the Milan, University of California San Francisco, Hangzhou and Shanghai Fudan criteria. The Cox regression model was used to build MHCAT specifying these criteria. A survival analysis was carried out for patients with high or low risk.
RESULTS: The one-, three- and five-year cumulative survival of HCC patients after LT was 78.9%, 53.2% and 46.4%, respectively. Of the HCC patients, the proportion meeting the Hangzhou and Fudan criteria was significantly higher than the proportion meeting the Milan criteria (64.6% vs 39.5%, 52.0% vs 39.5%, P < 0.05). Moreover, the proportion meeting the Hangzhou criteria was also significantly higher than the proportion meeting other criteria (P < 0.01). Pre-operative alfa-fetoprotein level, intraoperative blood loss and retransplantation were common significant predictors of long-term survival in HCC patients with reference to the Milan, University of California San Francisco and Fudan criteria, whereas in MHCAT based on the Hangzhou criteria, total bilirubin, intraoperative blood loss and retransplantation were independent predictors. The c-statistic for MHCAT was 0.773-0.824, with no statistical difference among these four criteria. According to the MHCAT scoring system, patients with low risk showed a higher five-year survival than those with high risk (P < 0.001).
CONCLUSION: MHCAT can effectively predict long-term survival for HCC patients, but needs to be verified by multi-center retrospective or randomized controlled trials.
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30
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Chu WF, Lin CJ, Chen WS, Hung SC, Chiu CF, Wu TH, Guo WY. Radiation doses of cerebral blood volume measurements using C-arm CT: A phantom study. AJNR Am J Neuroradiol 2014; 35:1073-7. [PMID: 24371024 PMCID: PMC7965136 DOI: 10.3174/ajnr.a3822] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 10/12/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND PURPOSE Parenchymal blood volume measurement by C-arm CT facilitates in-room peritherapeutic perfusion evaluation. However, the radiation dose remains a major concern. This study aimed to compare the radiation dose of parenchymal blood volume measurement using C-arm CT with that of conventional CTP using multidetector CT. MATERIALS AND METHODS A biplane DSA equipped with C-arm CT and a Rando-Alderson phantom were used. Slab parenchymal blood volume (8-cm scanning range in a craniocaudal direction) and whole-brain parenchymal blood volume with identical scanning parameters, except for scanning ranges, were undertaken on DSA. Eighty thermoluminescent dosimeters were embedded into 22 organ sites of the phantom. We followed the guidelines of the International Commission on Radiation Protection number 103 to calculate the effective doses. For comparison, 8-cm CTP with the same phantom and thermoluminescent dosimeter distribution was performed on a multidetector CT. Two repeat dose experiments with the same scanning parameters and phantom and thermoluminescent dosimeter settings were conducted. RESULTS Brain-equivalent dose in slab parenchymal blood volume, whole-brain parenchymal blood volume, and CTP were 52.29 ± 35.31, 107.51 ± 31.20, and 163.55 ± 89.45 mSv, respectively. Variations in the measurement of an equivalent dose for the lens were highest in slab parenchymal blood volume (64.5%), followed by CTP (54.6%) and whole-brain parenchymal blood volume (29.0%). The effective doses of slab parenchymal blood volume, whole-brain parenchymal blood volume, and CTP were 0.87 ± 0.55, 3.91 ± 0.78, and 2.77 ± 1.59 mSv, respectively. CONCLUSIONS The dose measurement conducted in the current study was reliable and reproducible. The effective dose of slab parenchymal blood volume is about one-third that of CTP. With the advantages of on-site and immediate imaging availability and saving procedural time and patient transportation, slab parenchymal blood volume measurement using C-arm CT can be recommended for clinical application.
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Affiliation(s)
- W F Chu
- From the Department of Radiology (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.), Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.)
| | - C J Lin
- From the Department of Radiology (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.), Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.)
| | - W S Chen
- Department of Biomedical Imaging and Radiological Sciences (W.S.C., T.H.W.), National Yang-Ming University, Taipei, Taiwan
| | - S C Hung
- From the Department of Radiology (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.), Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.)
| | - C F Chiu
- From the Department of Radiology (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.), Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.)
| | - T H Wu
- Department of Biomedical Imaging and Radiological Sciences (W.S.C., T.H.W.), National Yang-Ming University, Taipei, Taiwan.
| | - W Y Guo
- From the Department of Radiology (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.), Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine (W.F.C., C.J.L., S.C.H., C.F.C., W.Y.G.)
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Sun J, Jin G, Qin MX, Wan ZB, Wang JB, Wang C, Guo WY, Xu L, Ning X, Xu J, Pu XJ, Chen MS, Zhao HM. Detection of acute cerebral hemorrhage in rabbits by magnetic induction. Braz J Med Biol Res 2014; 47:144-50. [PMID: 24519130 PMCID: PMC4051184 DOI: 10.1590/1414-431x20132978] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 10/10/2013] [Indexed: 11/22/2022] Open
Abstract
Acute cerebral hemorrhage (ACH) is an important clinical problem that is often
monitored and studied with expensive devices such as computed tomography,
magnetic resonance imaging, and positron emission tomography. These devices are
not readily available in economically underdeveloped regions of the world,
emergency departments, and emergency zones. We have developed a less expensive
tool for non-contact monitoring of ACH. The system measures the magnetic
induction phase shift (MIPS) between the electromagnetic signals on two coils.
ACH was induced in 6 experimental rabbits and edema was induced in 4 control
rabbits by stereotactic methods, and their intracranial pressure and heart rate
were monitored for 1 h. Signals were continuously monitored for up to 1 h at an
exciting frequency of 10.7 MHz. Autologous blood was administered to the
experimental group, and saline to the control group (1 to 3 mL) by injection of
1-mL every 5 min. The results showed a significant increase in MIPS as a
function of the injection volume, but the heart rate was stable. In the
experimental (ACH) group, there was a statistically significant positive
correlation of the intracranial pressure and MIPS. The change of MIPS was
greater in the ACH group than in the control group. This high-sensitivity system
could detect a 1-mL change in blood volume. The MIPS was significantly related
to the intracranial pressure. This observation suggests that the method could be
valuable for detecting early warning signs in emergency medicine and critical
care units.
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Affiliation(s)
- J Sun
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - G Jin
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - M X Qin
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - Z B Wan
- Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing, China
| | - J B Wang
- College of Electronic Engineering, Xidian University, Xi'an, China, College of Electronic Engineering, Xidian University, Xi'an, China
| | - C Wang
- College of Electronic Engineering, Xidian University, Xi'an, China, College of Electronic Engineering, Xidian University, Xi'an, China
| | - W Y Guo
- College of Electronic Engineering, Xidian University, Xi'an, China, College of Electronic Engineering, Xidian University, Xi'an, China
| | - L Xu
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - X Ning
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - J Xu
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - X J Pu
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - M S Chen
- College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China, College of Biomedical Engineering and Medical Imaging, Third Military Medical University, Chongqing, China
| | - H M Zhao
- Experimental Animal Center, Third Military Medical University, Chongqing, China, Experimental Animal Center, Third Military Medical University, Chongqing, China
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Yin H, Wang XH, Zhu XD, Han H, Guo WY, Fu ZR. A Tissue Engineered Renovascular Graft Composed of Proteins, Polymers, Smooth Muscle and Endothelial Cells for Renal Artery Stenosis. J Biomed Nanotechnol 2013; 9:1345-53. [DOI: 10.1166/jbn.2013.1628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lin CJ, Wu TH, Lin CH, Hung SC, Chiu CF, Liu MJ, Teng MMH, Chang FC, Guo WY, Chang CY. Can iterative reconstruction improve imaging quality for lower radiation CT perfusion? Initial experience. AJNR Am J Neuroradiol 2013; 34:1516-21. [PMID: 23578678 DOI: 10.3174/ajnr.a3436] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Initial results using IR for CT of the head showed satisfactory subjective and objective imaging quality with a 20-40% radiation dose reduction. The aim of our study was to compare the influence of IR and FBP algorithms on perfusion parameters at standard and lowered doses of CTP. MATERIALS AND METHODS Forty patients with unilateral carotid stenosis post-carotid stent placement referred for follow-up CTP were divided into 2 groups (tube currents were 100 mAs in group A and 80 mAs in group B). Datasets were reconstructed with IR and FBP algorithms; and SNRs of gray matter, white matter, and arterial and venous ROIs were compared. CBF, CBV, and MTT means and SNRs were evaluated by using linear regression, and qualitative imaging scores were compared across the 2 algorithms. RESULTS The mean effective radiation dose of group B (2.06 mSv) was approximately 20% lower than that of group A (2.56 mSv). SNRs for ROIs in the dynamic contrast-enhanced images were significantly higher than those for the FBP images. Correlations of the SNRs for CBF, CBV, and MTT across the 2 algorithms were moderate (R² = 0.46, 0.23, and 0.44, respectively). ROIs in gray matter rather than the IR algorithm predicted increasing SNRs in all CBF, CBV, and MTT maps. Two cases of significant restenosis were confirmed in both algorithms. CBV, CBF, and MTT imaging scores did not differ significantly across algorithms or groups. CONCLUSIONS Lower dose CTP (20% below normal dose) without IR can effectively identify oligemic tissue in poststenting follow-up. IR does not alter the absolute values or increase the SNRs of perfusion parameters. Other methods should be attempted to improve SNRs in settings with low tube currents.
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Affiliation(s)
- C J Lin
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
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Lin CJ, Hung SC, Guo WY, Chang FC, Luo CB, Beilner J, Kowarschik M, Chu WF, Chang CY. Monitoring peri-therapeutic cerebral circulation time: a feasibility study using color-coded quantitative DSA in patients with steno-occlusive arterial disease. AJNR Am J Neuroradiol 2012; 33:1685-90. [PMID: 22499839 DOI: 10.3174/ajnr.a3049] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial hemodynamics are important for management of SOAD. This study aimed to monitor peri-stent placement intracranial CirT of patients with SOAD. MATERIALS AND METHODS Twenty-five patients received stent placement for extracranial ICA stenosis, and 34 patients with normal CirT were recruited as controls. Their color-coded DSAs were used to define the Tmax of selected intravascular ROI. A total of 20 ROIs of the ICA, OphA, ACA, MCA, FV, PV, OV, SSS, SS, IJV, and MCV were selected. rTmax was defined as the Tmax at the selected region of interest minus Tmax at the cervical segment of the ICA (I1 on AP view and IA on lateral view). rTmax of the PV was defined as intracranial CirT. Intergroup and intragroup longitudinal comparisons of rTmax were performed. RESULTS rTmax values of the normal cohorts were as follows: ICA-AP, 0.12; ICA-LAT, 0.10; A1, 0.28; A2, 0.53; A3, 0.81; M1, 0.40; M2, 0.80; M3, 0.95; OphA, 0.35; FV, 4.83; PV, 5.11; OV, 5.17; SSS, 6.16; SS, 6.51; IJV, 6.81; and MCV, 3.86 seconds. Before stent placement, the rTmax values of arterial ROIs, except A3 and M3, were prolonged compared with values from control subjects (P < .05). None of the rTmax of any venous ROIs in the stenotic group was prolonged with significance. After stent placement, the rTmax of all arterial ROIs shortened significantly, except A1and M3. Poststenting rTmax was not different from the control group. CONCLUSIONS Without extra contrast medium and radiation dosages, color-coded quantitative DSA enables real-time monitoring of peri-therapeutic intracranial CirT in patients with SOAD .
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Affiliation(s)
- C J Lin
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
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Xiao L, Fu ZR, Ding GS, Fu H, Ni ZJ, Wang ZX, Shi XM, Guo WY, Ma J. Prediction of survival after liver transplantation for chronic severe hepatitis B based on preoperative prognostic scores: a single center's experience in China. World J Surg 2010; 33:2420-6. [PMID: 19693632 PMCID: PMC7102514 DOI: 10.1007/s00268-009-0183-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The aim of this study was to estimate the utility of a preoperative model of end-stage liver disease (MELD) score and Child-Turcotte-Pugh (CTP) score in predicting the prognosis after othotopic liver transplantation (OLT) for chronic severe hepatitis B (CSHB) and explore the prognostic factors. Methods The outcome of 137 patients who underwent OLT using donors after cardiac death (DCDs) for CSHB in our center was reviewed retrospectively. Survival analysis was performed using the Kaplan-Meier method; the log-rank test was used for univariate analysis; and the Cox proportional hazards regression model was used for prognostic factors screening. Results The overall mortality rate was 33.6% (46/137); and 1-month, 6-month, 1-year, and 5-year patient survival rates were 75.8, 72.0, 71.0, and 60.1%, respectively. Most patients (33/46) died during the first month after OLT. The area under the curve values generated by the receiver operating characteristics curves were 0.82 [95% confidence interval (CI) 0.72–0.92] and 0.68 (95% CI 0.58–0.79), respectively (P < 0.01), for the MELD and CTP models in predicting 1-month mortality after OLT. Patients with a preoperative MELD score <33.8 or a CTP score <12.5 had significantly better prognosis than those with higher scores (P < 0.05). Other mortality predictors include hepatic encephalopathy, preoperative infection, serum creatinine ≥1.5 mg/dl. Conclusions The MELD score was more efficient than the CTP score for evaluating the short-term prognosis in patients with CSHB undergoing OLT using DCDs, which should be taken into consideration during graft allocation.
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Affiliation(s)
- Liang Xiao
- Department of Liver Transplantation, Shanghai Changzheng Hospital, 415 Fengyang Road, Shanghai 200003, People's Republic of China
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Wang ZX, Song SH, Teng F, Wang GH, Guo WY, Shi XM, Ma J, Wu YM, Ding GS, Fu ZR. A single-center retrospective analysis of liver transplantation on 255 patients with hepatocellular carcinoma. Clin Transplant 2010; 24:752-7. [DOI: 10.1111/j.1399-0012.2009.01172.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Tao YF, Teng F, Wang ZX, Guo WY, Shi XM, Wang GH, Ding GS, Fu ZR. Liver transplant recipients with portal vein thrombosis: a single center retrospective study. Hepatobiliary Pancreat Dis Int 2009; 8:34-9. [PMID: 19208512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Portal vein thrombosis (PVT) used to be a contraindication for liver transplantation (LT). This obstacle has been delt with following the improvement of LT-related techniques and therapeutic approaches to thrombosis. But the effect of PVT on LT outcomes is still controversial. We reviewed retrospectively the outcome of LT patients with PVT as well as risk factors and surgical management according to PVT grades. METHODS A total of 465 adult LTs were performed from December 2002 through December 2006. Operative findings and the result of preoperative ultrasonography and imaging were reviewed for PVT grading (Yerdel grading). Comparison of risk factors, variables associated with perioperative period and prognosis between recipients with and without PVT is based on the grades. RESULTS In the 465 LTs, 42 were operatively confirmed to have PVT (9.0%) (19 recipients with grade 1, 14 with grade 2, 7 with grade 3, and 2 with grade 4). Increased age and treatment of portal hypertension were associated with PVT. Grade 1 or 2 PVT was treated by direct anastomosis or single thrombectomy. In grade 3 PVT patients, the donor PV was directly anastomosed to the dilated branch of the recipient portal venous system or to the distal open superior mesenteric vein through an interposition vein graft if needed. Grade 4 PVT was managed by our modified cavoportal hemitransposition technique. The comparison between PVT patients and controls showed no significant difference in operative duration and blood transfusion (P>0.05). The flow rate of the PV was lower in the PVT patients (48.881+/-12.788 cm/s) than in the controls (57.172+/-21.715 cm/s, P<0.05). The PVT patients had such postoperative complications as renal failure and PV rethrombosis (P<0.05). The 1-year survival rates in PVT and non-PVT patients were 78.6% and 76.4% respectively (P>0.05); the 3-year survival rates were 58.8% and 56.4% respectively (P>0.05). CONCLUSIONS PVT is not contraindicated for LT if it is graded. PVT recipients may have post-transplantation complications like renal failure and PV rethrombosis, and operative difficulty and patient survival are similar to those in recipients without PVT. Development of therapeutic approaches and accumulation of experience in dealing with PVT further improve the outcomes of LT in PVT recipients.
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Affiliation(s)
- Yi-Feng Tao
- Organ Transplantation Center, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
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Luo CB, Teng MMH, Chang FC, Sheu MH, Guo WY, Chang CY. Bilateral traumatic carotid-cavernous fistulae: Strategies for endovascular treatment. Acta Neurochir (Wien) 2007; 149:675-80; discussion 680. [PMID: 17558454 DOI: 10.1007/s00701-007-1229-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2006] [Accepted: 04/24/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Most traumatic carotid-cavernous fistula/e (TCCF) are unilateral, and simultaneous bilateral TCCF are uncommon. The purpose of this study was to evaluate the angiographic architecture of bilateral TCCF and report our experience with their endovascular management. METHOD Over 15 years, 252 consecutive patients with TCCF were referred to our institute for endovascular treatment. Bilateral TCCF occurred in 5 men and 2 women with a mean age of 31 years. The angiographic architectures of bilateral TCCF were evaluated with cerebral angiography. All patients underwent a single session of transarterial embolisation by using various permanent embolic materials and were followed up clinically or with angiography for a mean of 22 months (range 9-36 months). FINDINGS All patients presented with neuro-ophthalmic symptoms and signs. No new instances of cerebrovascular ischemia or intracranial haematoma resulted from bilateral TCCF. All fistulae were associated with partial arterial steal and were successfully occluded by using a detachable balloon and/or a detachable coil with or without a liquid adhesive. Of 14 TCCF, 9 were completely obliterated with preserved flow of the internal carotid artery (ICA). In the other 5 fistulae, the ICA had to be sacrificed to achieve occlusion because the anatomy of the fistula was complex. All fistula related symptoms resolved immediately or gradually during clinical follow up. No clinically significant procedure related neurological complications or recurrent fistulae were observed. CONCLUSIONS All bilateral TCCF were associated with a partial arterial steal phenomenon. Single session endovascular treatment using various embolic materials was effective in managing these high-flow fistulae. In all patients, it was possible to preserve one or both ICAs.
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Affiliation(s)
- C B Luo
- Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China.
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Söderman M, Guo WY, Karlsson B, Pelz DM, Ulfarsson E, Andersson T. Neurovascular radiosurgery. Interv Neuroradiol 2006; 12:189-202. [PMID: 20569572 DOI: 10.1177/159101990601200301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2006] [Accepted: 08/15/2006] [Indexed: 11/16/2022] Open
Abstract
SUMMARY This article focuses on the treatment of neurovascular diseases, in particular brain arteriovenous malformations (BAVMs), with radiosurgery. The target group for this review is physicians who manage patients with neurovascular diseases, but are not actively engaged in radiosurgery. Radiosurgery for BAVMs is an established treatment with clearly defined risks and benefits. The efficacy of radiosurgery for dural arteriovenous shunts (DAVSs) is probably similar but the treatment has not yet gained the same acceptance. Radiosurgical treatment of cavernomas (cavernous hemangiomas) remains controversial. Well founded predictive models for BAVM radiosurgery show: * The probability of obliteration depends on the dose of radiation given to the periphery of the BAVM. * The risk of adverse radiation effects depends on the total dose of radiation, i.e. the amount of energy imparted into the tissue. The risk is greater in centrally located lesions. The risk of damage to brainstem nucleii and cranial nerves must be added to the risk predicted from current outcome models. * The risk of hemorrhage during the time span before obliteration depends on the BAVM volume, the dose of radiation to the periphery of the lesion and the age of the patient. Central location is a probably also a risk factor.
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Affiliation(s)
- M Söderman
- Dept of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden -
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Guo WY, Lee SM, Chang YC, Pan HC. The Impact of Arteriovenous Malformation Radiosurgery on the Brain: From Morphology and Perfusion to Neurocognition. Stereotact Funct Neurosurg 2006; 84:162-9. [PMID: 16905882 DOI: 10.1159/000094955] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2006] [Indexed: 11/19/2022]
Abstract
The therapeutic aims of brain arteriovenous malformation (AVM) radiosurgery are multiple. Protecting patients from rebleeding is the prime goal. Among the others, hemodynamics, perfusion and neurocognition recovery are interesting and important. Anatomically AVM contains an abnormal cluster of vascular networks (nidus) between arteries and veins. Hemodynamically the nidus contains a low resistance and causes high-flow transnidal shunts between both sides of the nidus. The shunts cause hypotension in the neighboring arteries and diversion of blood from the adjacent brain tissues. The diversion disturbs brain hemodynamics. Radiosurgery, by eliminating the nidus, reconstitutes normal brain hemodynamics. From the early stage after radiosurgery, the abnormal transnidal flows gradually decrease, and the adjacent hemodynamics recovers toward normal. For nonhemorrhagic AVM, improvement of seizure control and stable or improved neurological status are observed clinically. The radiosurgical effects are also reflected in the recovery of metabolism in the adjacent brain and neurocognitive function paralleling the hemodynamic normalization. Morphological cure of AVM and the associated recovery of brain hemodynamics, metabolism and neurocognitive function form the therapeutic rationale of AVM radiosurgery.
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Affiliation(s)
- W Y Guo
- Department of Radiology, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
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Chang FC, Lirng JF, Luo CB, Teng MMH, Guo WY, Chang CY. Carotid blowout treated by direct percutaneous puncture of internal carotid artery with temporary balloon occlusion. Interv Neuroradiol 2006; 11:349-54. [PMID: 20584447 DOI: 10.1177/159101990501100407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 11/20/2005] [Indexed: 11/16/2022] Open
Abstract
SUMMARY Direct percutaneous puncture of a cervical carotid pseudoaneurysm for coil placement or acrylic embolization is described for the endovascular management of acute carotid blowout. However, direct puncture of the internal carotid artery (ICA) for the endovascular management of carotid blowout has not been described. We report a difficult case of acute carotid blowout syndrome in a patient who had radiation- induced occlusion of the right common carotid artery with vasculopathy and pseudoaneurysm in the right cervical ICA. Collaterals from the branches of the controlateral external carotid artery (ECA) anastomosed with branches of right ECA supplied the vasculopathy. We performed direct percutaneous puncture of the bulb of the right ICA using a spinal needle and placed fiber coils to occlude antegrade flow of the artery. During the injection of a mixture of N-butyl cyanoacrylate and lipiodol oil for embolization of the remaining carotid bulb, we transiently inflated an occlusion balloon in the controlateral common carotid artery to further arrest antegrade flow in the ICA. The vasculopathy and pseudoaneurysm of the right cervical ICA were successfully embolized, with preservation of the distal branches of the right ICA.
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Affiliation(s)
- F C Chang
- Department of Radiology,Taipei Veterans General Hospital, National Yang Ming University, School of Medicine; Taipei, Taiwan -
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Cheng YC, Lirng JF, Chang FC, Guo WY, Teng MMH, Chang CY, Wong TT, Ho DMT. Neuroradiological findings in atypical teratoid/rhabdoid tumor of the central nervous system. Acta Radiol 2005; 46:89-96. [PMID: 15841745 DOI: 10.1080/02841850510020987] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [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: 10/25/2022]
Abstract
PURPOSE To evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) findings of atypical teratoid tumor/rhabdoid tumor (AT/RT) of the central nervous system (CNS). MATERIAL AND METHODS Twenty cases of CNS AT/RT have been found over the past 23 years in our hospital; these involving 11 boys and 9 girls whose mean age at diagnosis was 5.5 years. Their clinical data, the CT, and MRI findings were reviewed retrospectively. RESULTS AT/RT was located in the cerebellum in 15 cases. Four cases arose from the supratentorial region, while only one occurred primarily in the lumbar spinal cord. Almost all cases revealed heterogeneous intensity and heterogeneous enhancement. Peripheral cystic components were common. Survival time ranged from 2 months to 3 years, with a mean survival of 11.6 months. CONCLUSION Most cases of AT/RT are located in the cerebellum. The radiologic manifestations are non-specific. The diagnosis mainly depends on the pathologic findings. However, AT/RT should still remain in the differential diagnosis of brain tumors in young children, especially those located in the cerebellar hemisphere and with eccentric cysts.
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Affiliation(s)
- Y C Cheng
- Department of Radiology, I-Lan Hospital, Department of Health, The Executive Yuan, I-Lan, Taiwan, ROC
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Wang ZX, Ding GS, Fu H, Zhang JJ, Chen XS, Guo WY, Shi XM, Fu ZR. Prevention of hepatitis B virus reinfection after orthotopic liver transplantation. Hepatobiliary Pancreat Dis Int 2004; 3:345-8. [PMID: 15313666] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatitis B virus reinfection is an important problem after liver transplantation. The aim of this study was to discuss the prevention of hepatitis B virus reinfection following orthotopic liver transplantation. METHODS Sixty-eight cases of chronic fulminant hepatitis B, end-stage liver cirrhosis, and liver carcinoma complicated with HBV cirrhosis were given anti-viral drugs before and after transplantation to prevent hepatitis B virus reinfection. Lamivudine was administered in 2 patients, lamivudine+hepatitis B immunoglobulin (HBIG) in 63, and adefovir+HBIG in 3. The measurement of serum HBV, HBV DNA, liver biopsy immunohistochemistry and clinical study were performed. RESULTS In 1 of the 2 patients who developed reinfection after lamivudine administration, serum HBsAg, HBeAb, HBcAb, HBV DNA were positive and liver biopsy immunohistochemistry showed HBsAg phenotype. In 2 of 63 patients who developed reinfection after use of lamivudine+HBIG, serum HBsAg, HBeAb, HBcAb were positive and liver biopsy immunohistochemistry showed HBsAg phenotype. Serum HBV DNA was positive in one of them. Three patients developed no reinfection with HBV after use of adefovir. CONCLUSIONS Orthotopic liver transplantation is effective in the treatment of HBV-infected diseases. Lamivudine+HBIG or adefovir+HBIG could effectively prevent hepatitis B virus reinfection.
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Affiliation(s)
- Zheng-Xin Wang
- Liver Transplantation Group of Transplantation Center, Changzheng Hospital, Second Military University, Shanghai 200003, China
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Wu TH, Lee JS, Wu HM, Chu WF, Guo WY. Evaluating geometric accuracy of multi-platform stereotactic neuroimaging in radiosurgery. Stereotact Funct Neurosurg 2002; 78:39-48. [PMID: 12381884 DOI: 10.1159/000063833] [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: 11/19/2022]
Abstract
We used a spherical phantom to evaluate geometric accuracy in multi-platform stereotactic neuroimaging for radiosurgery. The phantom consisted of two plastic 16-cm-diameter hemispheres in which an exchangeable 8-cm plastic functional cube was incorporated. The functional cube contained cylinder and point targets. The targets were filled with a mixed aqueous solution of 2-mM copper sulfate and 300-mg/ml iodinated contrast medium and were visible on both MR and X-ray images. Two MR scanners and a biplane X-ray angio-suite were used to scan the phantom stereotactically in two sessions of the experiment. The angio-suite was equipped with digital subtraction and distortion-correction software. The resulting stereotactic images were transferred to a dose-planning computer for length measurement and coordinate determination of the targets. The mean errors of the measured cylinder length on distortion non-corrected X-ray stereotactic images were 0.24 +/- 0.14 and 0.73 +/- 0.10 mm, respectively, in the experiments; on distortion-corrected images 0.22 +/- 0.10 and 0.35 +/- 0.39 mm. They were 0.50 +/- 0.24, 0.25 +/- 0.19 and 0.49 +/- 0.34, 0.23 +/- 0.25 mm, respectively, of the two MR scanners. The mean errors of coordinate determination of point targets between the stereotactic MR and the distortion-corrected X-ray images were 0.70 +/- 0.18, 0.52 +/- 0.22 and 0.76 +/- 0.25, 0.40 +/- 0.10 mm, respectively, in the experiments. We found that the overall geometric errors of target delineation between stereotactic MR and X-ray images were in the submillimeter range. The current study validates the multi-platform and multi-facility stereotactic neuroimaging practice and ensures imaging accuracy in radiosurgery.
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Affiliation(s)
- T H Wu
- Institute of Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC
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Tseng YJ, Chu WC, Chung WY, Guo WY, Kao YH, Wang J, Huang SC. The role of dose distribution gradient in the observed ferric ion diffusion time scale in MRI-Fricke-infused gel dosimetry. Magn Reson Imaging 2002; 20:495-502. [PMID: 12361797 DOI: 10.1016/s0730-725x(02)00522-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ferric ion diffusion is a detrimental factor in MRI-Fricke-infused gel dosimetry. In this study, a novel approach involving MR image subtraction and a fast image-based dosimetry technique to study ferric ion diffusion effects is presented. The fast image-based approach allows studying dose profile degradation within minutes post-irradiation. The relationship between the rate of dose profile deterioration and dose distribution gradients can be elucidated with the improved imaging temporal resolution also. Our results showed that for a dose distribution with gradient 4 Gy/mm or higher, ferric ion diffusion causes apparent dose profile degradation in 0.5-1 h post-irradiation. For a gradual dose gradient change of 2.1 Gy/mm or smaller, dose profile degradation appears insignificant for a two-hour elapsed diffusion time. These observations agree well with the theoretical analysis of a square dependence between dose profile degradation and dose distribution gradient. Because all stereotactic radiosurgery procedures produce steep dose distributions and because the ideal "snapshot" of MR scanning cannot be achieved, knowledge of the ferric ion diffusion time scale is important in experimental designs in order to avoid potential measurement errors in MRI-Fricke-agarose gel dosimetry.
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Affiliation(s)
- Y J Tseng
- Institute of Biomedical Engineering, National Yang Ming University, Pei-Tou, Taipei, Taiwan, ROC
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Abstract
OBJECT We used MR after sonography to help us in prenatal counseling in 58 complicated pregnancies from 1998 to 2000. METHODS All fetal MR examinations were undertaken with a 1.5-T magnet using a body-phased-array coil and an ultrafast imaging technique, half-Fourier single-shot turbo spin-echo (HASTE). Twelve fetuses were found to have major anomalies, and in each of these cases either delivery was induced or the pregnancy was terminated. In 6 of the fetuses, with anomalies of the central nervous system, postmortem examinations were then performed after they failed to survive, and these constitute the patient sample investigated in the current study. The fetal gestational ages in these 6 cases ranged from 24 to 32 weeks. MR imaging demonstrated morphological details of the anomalies. They were: alobar holoprosencephaly in 2, middle interhemispheric fusion in 1, alobar holoprosencephaly with Dandy-Walker malformations in 1, a Dandy-Walker variant in 1 and twin-twin transfusion syndrome with hypoxic-ischemic injury to the brain in 1. CONCLUSIONS Postmortem examinations confirmed the MR diagnoses, and these observations support us in improving our understanding of the pathogenesis of fetal CNS anomalies.
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Affiliation(s)
- W Y Guo
- Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan, Republic of China.
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Abstract
OBJECTIVE To investigate neurourologic involvement in injuries to the thoracolumbar vertebra junction with magnetic resonance imaging (MRI) and electrophysiologic and urodynamic measurements and to characterize the neurogenic mechanisms of voiding dysfunctions. DESIGN Baseline comparisons among 3 anatomic groups before neural repair. SETTING Tertiary care center. PATIENTS Thirty-five T11 to L2 spinal cord injury patients consecutively admitted to a rehabilitation unit. Eight patients (Group 1) had above-conus lesions without denervation and polyphasic waves revealed in the anal sphincter electromyography; 13 patients (Group 2) had conal and/or above-conus lesions and anal sphincter electromyographic abnormalities; and 14 patients (Group 3) had below-conus lesions and anal sphincter electromyographic abnormalities. MAIN OUTCOME MEASURES Comparison of features identified on pudendal nerve terminal motor latency, urethral pressure profiles, and multichannel voiding pressure-flow study. RESULTS The pudendal nerve terminal motor latency in Group 3, showing a significantly higher abnormal ratio (100%; p =.011, Fisher's exact test), indicated that cauda equina lesions might be the cause. Urodynamic data from Group 3 showed a significant decrease in maximal urethral closure pressure (48 +/- 17cm H2O, p =.0022, analysis of variance [ANOVA], repeated measure) and an increase in bladder capacity (429 +/- 194mL, p =.037, ANOVA, repeated measure). There were no significant changes in the other groups. CONCLUSION Neurourologic abnormalities are less predictable with injuries to thoracolumbar junction, except in patients with cauda equina lesions.
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Affiliation(s)
- T Y Chuang
- Neuro-urodynamic Laboratory, Department of PM&R, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
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Yuan WH, Teng MM, Hsu HC, Chen SS, Lirng JF, Chang FC, Luo CB, Guo WY, Chiang JH, Chang CY. Image evaluation of suprazygomatic masticator space lesions. Kaohsiung J Med Sci 2001; 17:139-49. [PMID: 11486646] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
In order to understand lesions involving the suprazygomatic masticator space (SZMS) demonstrated on computered tomography (CT) or magnetic resonance (MR) images, we collected 45 cases of lesions in SZMS. There were hematomas in 26 cases, tumors in 16 cases, and abscesses in 3 cases. The location of these lesions in compartments of the SZMS and adjacent structures was analyzed. Most commonly hematoma was found in the deep loose connective tissue (80.8%), followed by the superficial dense connective tissue (61.5%). Only 2 SZMS hematoma involved the superficial fat pad. Five patients had air accumulation in the SZMS, and all were in the deep fat pad and with maxillary sinus fracture. Of the sixteen cases which were tumors, 12 were extended from adjacent structures, and four were primary tumor. In cases of tumor, compartments of SZMS involved most frequently were temporal muscles (15 of 16 cases), followed by deep fat pad (8 of 16 cases). The connective tissue layer of SZMS is a communication pathway for superficial spread of infection, hematoma, or tumor invasion to or from the scalp and face. Compartments of deep fat pad and temporal muscle are also pathways for the spread of disease to or from the face, intracranium and orbit. The primary tumors in infratemporal fossa and SZMS are rare. Malignant tumors in SZMS usually come from surrounding spaces.
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Affiliation(s)
- W H Yuan
- Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Peitou, Taipei, Taiwan
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Kwan SY, Wong TT, Chang KP, Yang TF, Lee YC, Guo WY, Su MS. Seizure outcomes after anterior callosotomy in patients with posterior-dominant and with anterior-dominant epileptiform discharges. Childs Nerv Syst 2001; 17:71-5. [PMID: 11219628 DOI: 10.1007/pl00013725] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTS We wished to find whether there was any difference in the postoperative seizure outcome between patients with bisynchronous anterior-dominant and those with posterior-dominant EDs after anterior callosotomy. METHODS Seizure outcomes after anterior callosotomy in 7 patients with bisynchronous posterior-dominant epileptiform discharges and in 54 patients with anterior-dominant seizures were compared. All 61 cases had been followed up for more than 2 years after operation. One patient (14.3%) had become seizure free. Two patients (28.6%) had more than 50% reduction in seizure frequency, but 4 patients (57.2%) showed no improvement at all. The percentage of cases with significant improvement (more than 50% reduction of seizure frequency) was 43% (3 in 7), which is lower than in the patients with bisynchronous anterior-dominant EDs (64.8%). CONCLUSIONS Our preliminary results suggest that anterior partial callosotomy could still be helpful in cases with bisynchronous posterior-dominant epileptiform discharges but the prognosis may be less optimistic than for those with anteriorly located discharges.
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Affiliation(s)
- S Y Kwan
- Section of Epilepsy, Neurological Institute, Taipei Veterans General Hospital, Taiwan, ROC.
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Chang CY, Luo CB, Teng MM, Guo WY, Chen SS, Lirng JF, Chang FC. Computed tomography and magnetic resonance imaging characteristics of giant pituitary adenomas. J Formos Med Assoc 2000; 99:833-8. [PMID: 11155772] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
PURPOSE The purpose of this study was to characterize the computed tomography (CT) and magnetic resonance (MR) imaging features of giant pituitary adenoma (GPA) and to demonstrate the pathways of the spread of GPA. METHODS CT and/or MR imaging scans of 356 patients evaluated preoperatively for single pituitary tumor were reviewed. Fourteen tumors (4%) fulfilled the radiologic criteria for GPA. There were 10 male and four female patients, ranging in age from 22 to 71 years (mean, 52 yr). We retrospectively reviewed the CT and MR imaging scans of these patients to characterize tumor appearances and identify the pathways of tumor extension. RESULTS Thirteen tumors (93%) extended upward to the suprasellar cistern, and/or hypothalamus and third ventricle. Infrasellar extension through the sellar floor and sphenoid sinus to the skull base, or to the ethmoid sinus or the nasopharynx, was identified in seven patients (50%). Eight patients (57%) had lateral invasion to the cavernous sinus. Temporal and frontal extension was apparent in seven patients (50%) and six patients (43%), respectively. Five patients (36%) had posterior subtentorial extension to the posterior fossa. Histologically, only two GPAs showed invasive features. There was no correlation among histologic features, pituitary hormone concentrations, and evidence of tumor aggressiveness on CT and MRI scans. CONCLUSIONS GPA has the potential for widespread, multi-directional extension. Our results indicate that any type of pituitary adenoma, regardless of its endocrinologic activity, may invade surrounding structures. Suprasellar invasion is the most common pathway of tumor spread, followed by infrasellar, lateral, anterior, and posterior routes.
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Affiliation(s)
- C Y Chang
- Department of Radiology, Veterans General Hospital-Taipei, 201, Section 2, Shih-Pai Road, Taipei, Taiwan
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