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Chen YC, Li YT, Lee CL, Kuo YT, Ho CL, Lin WC, Hsu MC, Long X, Chen JS, Li WP, Su CH, Okamoto A, Yeh CS. Electroactive membrane fusion-liposome for increased electron transfer to enhance radiodynamic therapy. Nat Nanotechnol 2023; 18:1492-1501. [PMID: 37537274 DOI: 10.1038/s41565-023-01476-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023]
Abstract
Dynamic therapies have potential in cancer treatments but have limitations in efficiency and penetration depth. Here a membrane-integrated liposome (MIL) is created to coat titanium dioxide (TiO2) nanoparticles to enhance electron transfer and increase radical production under low-dose X-ray irradiation. The exoelectrogenic Shewanella oneidensis MR-1 microorganism presents an innate capability for extracellular electron transfer (EET). An EET-mimicking photocatalytic system is created by coating the TiO2 nanoparticles with the MIL, which significantly enhances superoxide anions generation under low-dose (1 Gy) X-ray activation. The c-type cytochromes-constructed electron channel in the membrane mimics electron transfer to surrounding oxygen. Moreover, the hole transport in the valence band is also observed for water oxidation to produce hydroxyl radicals. The TiO2@MIL system is demonstrated against orthotopic liver tumours in vivo.
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Affiliation(s)
- Ying-Chi Chen
- Department of Chemistry, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ting Li
- Department of Chemistry, National Cheng Kung University, Tainan, Taiwan
| | - Chin-Lai Lee
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yen-Ting Kuo
- Department of Chemistry, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Lun Ho
- Graduate School of Life and Environmental Science, University of Tsukuba, Ibaraki, Japan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Chien Hsu
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Xizi Long
- International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science, Tsukuba, Japan
| | - Jia-Sin Chen
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Peng Li
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Center of Applied Nanomedicine, National Cheng Kung University, Tainan, Taiwan.
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chia-Hao Su
- Center for General Education, Chang Gung University, Taoyuan, Taiwan.
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
| | - Akihiro Okamoto
- International Center for Materials Nanoarchitectonics (WPI-MANA), National Institute for Materials Science, Tsukuba, Japan.
- Graduate School of Chemical Sciences and Engineering, Hokkaido University, Sapporo, Japan.
| | - Chen-Sheng Yeh
- Department of Chemistry, National Cheng Kung University, Tainan, Taiwan.
- Center of Applied Nanomedicine, National Cheng Kung University, Tainan, Taiwan.
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Kuo YT, Hsiao CT, Wu PH, Wu KH, Chang CP. Comparison of National Early Warning Score with shock index in patients with necrotizing fasciitis. Medicine (Baltimore) 2023; 102:e34651. [PMID: 37682200 PMCID: PMC10489463 DOI: 10.1097/md.0000000000034651] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/18/2023] [Indexed: 09/09/2023] Open
Abstract
Shock index (SI) and national early warning score (NEWS) are more frequently used as assessment tools in acute illnesses, patient disposition and early identification of critical condition. Both they are consisted of common vital signs and parameters including heart rate, systolic blood pressure, respiratory rate, oxygen saturation and level of conscious, which made it easy to evaluate in medical facilities. Its ability to predict mortality in patients with necrotizing fasciitis (NF) in the emergency department remains unclear. This study was conducted to compare the predictive capability of the risk scores among NF patients. A retrospective cohort study of hospitalized patients with NF was conducted in 2 tertiary teaching hospitals in Taiwan between January 2013 and March 2015. We investigated the association of NEWS and SI with mortality in NF patients. Of the 395 NF patients, 32 (8.1%) died in the hospital. For mortality, the area under the receiver curve value of NEWS (0.81, 95% confidence interval 0.76-0.86) was significantly higher than SI (0.76, 95% confidence interval 0.73-0.79, P = .016). The sensitivities of NEWS of 3, 4, and 5 for mortality were 98.1%, 95.6%, and 92.3%. On the contrast, the sensitivities of SI of 0.5, 0.6, and 0.7 for mortality were 87.8%, 84.7%, and 81.5%. NEWS had advantage in better discriminative performance of mortality in NF patients. The NEWS may be used to identify relative low risk patients among NF patients.
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Affiliation(s)
- Yen-Ting Kuo
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cheng-Ting Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Po-Han Wu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Kai-Hsiang Wu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chia-Peng Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
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3
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Wu PH, Chang CP, Chang CY, Kuo YT, Lin LC, Wu KH. A Woman with Unilateral Leg Swelling. Ann Emerg Med 2022; 79:e15-e16. [DOI: 10.1016/j.annemergmed.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Indexed: 11/01/2022]
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Wu KH, Wu PH, Chang CY, Kuo YT, Hsiao KY, Hsiao CT, Hung SK, Chang CP. Differentiating necrotizing soft tissue infections from cellulitis by soft tissue infectious fluid analysis: a pilot study. World J Emerg Surg 2022; 17:1. [PMID: 34998403 PMCID: PMC8742947 DOI: 10.1186/s13017-022-00404-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/19/2021] [Accepted: 01/03/2022] [Indexed: 01/12/2023] Open
Abstract
Background We conducted this study to evaluate the characteristics of the infectious fluid in soft tissue infection and investigate the utility of the biochemical tests and Gram stain smear of the infectious fluid in distinguishing necrotizing soft tissue infection (NSTI) from cellulitis. Methods This retrospective cohort study was conducted in a tertiary care hospital in Taiwan. From April 2019 to October 2020, patients who were clinically suspected of NSTI with infectious fluid accumulation along the deep fascia and received successful ultrasound-guided aspiration were enrolled. Based on the final discharge diagnosis, the patients were divided into NSTI group, which was supported by the surgical pathology report, or cellulitis group. The t test method and Fisher’s exact test were used to compare the difference between two groups. The receiver–operator characteristic (ROC) curves and area under the ROC curve (AUC) were used to evaluate the discriminating ability. Results Total twenty-five patients were enrolled, with 13 patients in NSTI group and 12 patients in cellulitis group. The statistical analysis showed lactate in fluid (AUC = 0.937) and LDH in fluid (AUC = 0.929) had outstanding discrimination. The optimal cut-off value of fluid in lactate was 69.6 mg/dL with corresponding sensitivity of 100% and specificity of 76.9%. The optimal cut-off value of fluid in LDH was 566 U/L with corresponding sensitivity of 83.3% and a specificity of 92.3%. In addition, albumin in fluid (AUC = 0.821), TP in fluid (AUC = 0.878) and pH in fluid (AUC = 0.858) also had excellent diagnostic accuracy for NSTI. The Gram stain smear revealed 50% bacteria present in NSTI group and all the following infectious fluid culture showed bacteria growth. Conclusions The analysis of infectious fluid along the deep fascia might provide high diagnostic accuracy to differentiate NSTI from cellulitis. Supplementary Information The online version contains supplementary material available at 10.1186/s13017-022-00404-4.
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Affiliation(s)
- Kai-Hsiang Wu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, 613, Chiayi County, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, No.2, Sec. W., Jiapu Rd., Puzi City, 613, Chiayi County, Taiwan
| | - Po-Han Wu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, 613, Chiayi County, Taiwan
| | - Chih-Yao Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, 613, Chiayi County, Taiwan
| | - Yen-Ting Kuo
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, 613, Chiayi County, Taiwan
| | - Kuang-Yu Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, 613, Chiayi County, Taiwan
| | - Cheng-Ting Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, 613, Chiayi County, Taiwan
| | - Shang-Kai Hung
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No.5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan
| | - Chia-Peng Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 6, W. Sec., Jiapu Rd., Puzih City, 613, Chiayi County, Taiwan. .,Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, No.2, Sec. W., Jiapu Rd., Puzi City, 613, Chiayi County, Taiwan.
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Baez M, Kuo YT, Dias Y, Souza T, Boudichevskaia A, Fuchs J, Schubert V, Vanzela ALL, Pedrosa-Harand A, Houben A. Analysis of the small chromosomal Prionium serratum (Cyperid) demonstrates the importance of reliable methods to differentiate between mono- and holocentricity. Chromosoma 2020; 129:285-297. [PMID: 33165742 PMCID: PMC7665975 DOI: 10.1007/s00412-020-00745-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/13/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/21/2022]
Abstract
For a long time, the Cyperid clade (Thurniceae-Juncaceae-Cyperaceae) was considered a group of species possessing holocentromeres exclusively. The basal phylogenetic position of Prionium serratum (Thunb.) Drège (Thurniceae) within Cyperids makes this species an important specimen to understand the centromere evolution within this clade. In contrast to the expectation, the chromosomal distribution of the centromere-specific histone H3 (CENH3), alpha-tubulin and different centromere-associated post-translational histone modifications (H3S10ph, H3S28ph and H2AT120ph) demonstrate a monocentromeric organisation of P. serratum chromosomes. Analysis of the high-copy repeat composition resulted in the identification of two centromere-localised satellite repeats. Hence, monocentricity was the ancestral condition for the Juncaceae-Cyperaceae-Thurniaceae Cyperid clade, and holocentricity in this clade has independently arisen at least twice after differentiation of the three families, once in Juncaceae and the other one in Cyperaceae. In this context, methods suitable for the identification of holocentromeres are discussed.
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Affiliation(s)
- M Baez
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany.,Laboratory of Plant Cytogenetics and Evolution, Department of Botany, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Y T Kuo
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany
| | - Y Dias
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany.,Laboratory of Plant Cytogenetics and Evolution, Department of Botany, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - T Souza
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany.,Laboratory of Cytogenetics and Plant Diversity, Department of General Biology, Center for Biological Sciences, State University of Londrina, Londrina, Paraná, 86057-970, Brazil
| | - A Boudichevskaia
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany.,KWS SAAT SE & Co. KGaA, 37574, Einbeck, Germany
| | - J Fuchs
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany
| | - V Schubert
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany
| | - A L L Vanzela
- Laboratory of Cytogenetics and Plant Diversity, Department of General Biology, Center for Biological Sciences, State University of Londrina, Londrina, Paraná, 86057-970, Brazil
| | - A Pedrosa-Harand
- Laboratory of Plant Cytogenetics and Evolution, Department of Botany, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - A Houben
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, 06466, Stadt Seeland, Germany.
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Tsai CC, Wang CJ, Lee YC, Kuo YT, Lin HH, Li CC, Wu WJ, Liu CC. Low-Intensity Extracorporeal Shockwave Therapy Can Improve Erectile Function in Patients Who Failed to Respond to Phosphodiesterase Type 5 Inhibitors. Am J Mens Health 2017; 11:1781-1790. [PMID: 28884638 PMCID: PMC5675264 DOI: 10.1177/1557988317721643] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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] [Indexed: 11/30/2022] Open
Abstract
Managing patients with erectile dysfunction (ED) who failed to respond to phosphodiesterase type 5 inhibitors (PDE5is) is a challenging task. Recently, low-intensity extracorporeal shockwave therapy (LI-ESWT) was reported to improve ED by enhancing perfusion of the penis. The current study was performed to evaluate whether combined treatment with LI-ESWT and PDE5is can restore erectile function in patients who failed to respond to PDE5is alone. This was an open-label single-arm prospective study. ED patients with an erection hardness score (EHS) ≦2 under a maximal dosage of PDE5is were enrolled. Sociodemographic information and detailed medical history were recorded. LI-ESWT treatment consisted of 3,000 shockwaves once weekly for 12 weeks. All patients continued their regular PDE5is use. The EHS and the 5-item version of the International Index of Erectile Function (IIEF-5) were used to evaluate the change in erectile function 1 and 3 months after LI-ESWT. A total of 52 patients were enrolled. After LI-ESWT treatment, 35 of the 52 patients (67.3%) could achieve an erection hard enough for intercourse (EHS ≧ 3) under PDE5is use at the 1-month follow-up. Initial severity of ED was the only significant predictor of a successful response (EHS1: 35.7% vs. EHS2: 78.9%, p = .005). Thirty-three of the 35 (94.3%) subjects who responded to LI-ESWT could still maintain their erectile function at the 3-month follow-up. LI-ESWT can serve as a salvage therapy for ED patients who failed to respond to PDE5is. Initial severity of ED was an important predictor of a successful response.
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Affiliation(s)
- Chia-Chun Tsai
- 1 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chii-Jye Wang
- 2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,3 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Chin Lee
- 2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,3 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Ting Kuo
- 4 Management Offices, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Hsiao-Hua Lin
- 5 Department of Laboratory Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
| | - Ching-Chia Li
- 1 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,3 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Jeng Wu
- 1 Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,3 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Chu Liu
- 2 Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,3 Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,6 Department of Urology, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
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Chen CK, Lin DT, Juang YD, Hu YC, Kuo YT, Chen CY. The Innovated Flexible Surface Acoustic Wave Devices on Fully InkJet Printing Technology. Smart Science 2016. [DOI: 10.1080/23080477.2013.11665581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Liu J, Kuo YT, Klabunde KJ, Rochford C, Wu J, Li J. Novel dye-sensitized solar cell architecture using TiO2-coated vertically aligned carbon nanofiber arrays. ACS Appl Mater Interfaces 2009; 1:1645-1649. [PMID: 20355778 DOI: 10.1021/am900316f] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A novel dye-sensitized solar cell (DSSC) architecture based on vertically aligned carbon nanofibers coated with a thin nanoneedle-textured anatase TiO2 film is demonstrated. An encouraging overall conversion efficiency of approximately 1.09% and a rather high open-circuit voltage of approximately 0.64 V have been achieved. The efficient charge separation at the TiO2-CNF junction and the large outer TiO2 surface of this core-shell architecture provide new methods to tune the materials and interfaces in solar cells.
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Affiliation(s)
- Jianwei Liu
- Department of Chemistry, Kansas State University, Manhattan, Kansas 66506, and Department of Physics, University of Kansas, Lawrence, Kansas 66044, USA
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Abstract
The imaging diagnosis of hepatocellular carcinoma is challenging as benign hypervascular lesions and arterioportal shunts (pseudolesions) often mimic it. There is also overlap in the imaging appearance from dysplastic and regenerating nodules. This article addresses the above imaging problems, examines proposed non-invasive imaging criteria for the diagnosis of hepatoma and discusses the optimal imaging modality.
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Affiliation(s)
- C H Thng
- Department of Oncologic Imaging, National Cancer Centre, Singapore, 11 Hospital Drive, Singapore 169610, Singapore
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Chiang IC, Liu GC, Sheu RS, Kuo YT. High resolution CT of Wegener's granulomatosis--case reports. Kaohsiung J Med Sci 2001; 17:221-5. [PMID: 11482135] [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
Computed Tomography (CT) of the chest was performed in three patients with Wegener's granulomatosis to define the anatomical basis of pulmonary involvement. Nodules, masses with cavitation, and areas of parenchymal opacities were typical manifestations on CT images. An extremely wide variety of radiologic findings were demonstrated in addition to the commonly described cavitary nodules.
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Affiliation(s)
- I C Chiang
- Department of Radiology, Kaohsiung Medical University, Kaohsiung, No. 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan
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12
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Wang CK, Kuo YT, Liu GC, Tsai KB, Huang YS. Dynamic contrast-enhanced subtraction and delayed MRI of gastric tumors: radiologic-pathologic correlation. J Comput Assist Tomogr 2000; 24:872-7. [PMID: 11105703 DOI: 10.1097/00004728-200011000-00009] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 11/27/2022]
Abstract
PURPOSE Our goal was to determine whether dynamic MR subtraction images could be used to detect and stage gastric tumors. METHOD Dynamic MR subtraction images were prospectively performed in 20 patients without gastric lesions and in 39 patients with gastric tumors. The flat- or depressed-type early gastric cancers were excluded. The MR findings were assessed for layered pattern of the normal gastric wall, detectability of tumors, enhanced pattern of tumor, and depth of the tumor invasion. Surgical specimens were obtained from 30 of the patients with tumors, and histopathologic sections were made in the dynamic MR scanning direction. RESULTS The three-layered structure of the normal gastric wall was apparent in more of the dynamic MR subtraction images (60%) than of the nonsubtraction images (30%) in the control group. All 39 gastric tumors were detected by MRI. The intact inner layers overlying stromal tumors and outer layers interrupted by advanced gastric cancers were clear on the subtracted images. MRI accurately T-staged 88% of the gastric cancers. CONCLUSION Dynamic MR subtraction images can be used to identify gastric tumors and to stage gastric cancers.
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Affiliation(s)
- C K Wang
- Department of Radiology, Kaohsiung Medical University, Taiwan, ROC
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Abstract
PURPOSE To evaluate the usefulness of magnetic resonance (MR) cholangiography in excluding biliary atresia as the cause of neonatal cholestasis. MATERIALS AND METHODS MR cholangiography was performed on 10 control and 16 jaundiced neonates and infants aged 3 days to 5 months. Diagnosis of biliary atresia (n = 6) was confirmed with surgery and liver biopsy, with or without surgical cholangiography. Diagnosis of neonatal hepatitis (n = 9) was confirmed with clinical follow-up until jaundice resolved. In one infant, paucity of intrahepatic ducts was diagnosed at liver biopsy. MR cholangiography was performed with respiratory-triggered, heavily T2-weighted turbo spin-echo and optional inversion-recovery turbo spin-echo sequences. Diagnosis of biliary atresia was based on nonvisualization of either the common bile duct or common hepatic duct. Cholescintigraphy with technetium 99m disofenin was performed in all 16 jaundiced patients. RESULTS In the 10 controls, the nine patients with neonatal hepatitis, and the one infant with paucity of intrahepatic ducts, MR cholangiography clearly depicted the gallbladder and common hepatic and common bile ducts. MR cholangiography was 100% accurate in excluding biliary atresia as the cause of neonatal cholestasis, while 99mTc disofenin cholescintigraphic findings were false-positive in four of 10 patients with nonobstructive cholestasis. CONCLUSION MR cholangiography can be used to depict the major biliary structures of neonates and small infants and to exclude biliary atresia as the cause of neonatal cholestasis by allowing visualization of the biliary tract.
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Affiliation(s)
- T S Jaw
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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Kuo YT, Chen MT, Liu GC, Huang CN, Huang CL, Huang CH. Emphysematous pyelonephritis: imaging diagnosis and follow-up. Kaohsiung J Med Sci 1999; 15:159-70. [PMID: 10224840] [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: 02/12/2023] Open
Abstract
We conducted the study to evaluate the efficacy and roles of different imaging modalities in the diagnosis and follow-up of emphysematous pyelonephritis (EPN) and to correlate imaging findings with clinical outcome. Retrospective analysis of the imaging studies and clinical outcome were performed in 28 consecutive patients with EPN. They were all initially treated with CT-guided percutaneous drainage (PCD). The imaging studies performed included plain abdominal radiography (KUB) (n = 28), sonography (US)(n = 24), intravenous urography (IVU)(n = 5), retrograde pyelography (RP)(n = 20) and computed tomography (CT)(n = 28). Follow-up imaging studies included CT(n = 23) and renal scintigraphy (n = 15). The sensitivities of detecting abnormal gas in EPN on KUB and US were 66% and 88%. The mortality rate was 11%, not associated with different types, stages or renal involvement. On the follow-up CT performed within one month of PCD, type I EPN evolved into type II in 86% of the cases. On the long-term follow-up CT, renal atrophy and focal scarring were revealed in the diffuse and focal renal involvement of EPN. The mean split renal function shown on the follow-up scintigraphy was 30%. We concluded KUB and US were valuable for screening EPN, although CT was the most specific and sensitive. Follow-up CT studies not only demonstrate the response of treatment but also depict the different courses and the results of different types and renal involvement of EPN, although not associated with mortality rate.
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Affiliation(s)
- Y T Kuo
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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Kuo YT, Jaw TS, Wang CK, Lee LW, Shen PC, Liu GC. Diagnostic efficacy of non-breath-hold magnetic resonance cholangiopancreatography. J Formos Med Assoc 1999; 98:97-103. [PMID: 10083764] [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: 02/11/2023] Open
Abstract
Magnetic resonance cholangiopancreatography (MRCP) is an emerging imaging technique for direct visualization of biliary and pancreatic ducts without the need for an invasive procedure, ionizing radiation, or iodine contrast media administration. The purpose of this study was to evaluate the efficacy of non-breath-hold MRCP in depicting normal and diseased biliary and pancreatic ducts. A retrospective analysis of 162 patients who underwent MRCP was performed, and a comparison between MRCP and direct cholangiography was made. The overall accuracy of MRCP in diagnosing malignant and benign pancreaticobiliary diseases was also calculated. MRCP depicted more than three hepatic segments in 99% of patients with dilated intrahepatic ducts and in 63% of patients with nondilated intrahepatic ducts. MRCP demonstrated the main hepatic duct, gallbladder, and cystic duct in 100%, 89%, and 72% of patients, respectively. The dilated extrahepatic duct, nondilated extrahepatic duct, dilated pancreatic duct, and nondilated pancreatic duct were visualized in 100%, 98%, 95%, and 77% of patients, respectively. The accuracy of MRCP in diagnosing hepatolithiasis, cholecystolithiasis, and choledocholithiasis was 96%, 97%, and 96%, respectively. The obstruction levels and characteristics determined by MRCP were in agreement with those determined from direct cholangiography in 98% of malignant obstructions and 89% of benign obstructions. The overall accuracy of a combination of MRCP and conventional magnetic resonance imaging in diagnosing pancreaticobiliary diseases was 81% for malignant diseases, 86% for benign diseases, and 82% for stone diseases. We conclude that non-breath-hold MRCP can reliably depict normal and diseased pancreaticobiliary ducts except for cystic ducts and nondilated pancreatic ducts.
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Affiliation(s)
- Y T Kuo
- Department of Radiology, Kaohsiung Medical College, Taiwan
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16
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Kuo YT, Wang CK, Wu DK, Liu GC, Huang CL, Chai CY, Huang CH. Imaging features of simultaneous occurrence of renal and pancreatic foreign body granuloma due to chronically retained gauze: a case report. Kaohsiung J Med Sci 1999; 15:104-9. [PMID: 10089720] [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: 02/11/2023] Open
Abstract
Herein we are reporting a case of simultaneous occurrence of renal and pancreatic foreign body granuloma due to retained gauze. The different imaging features of the two lesions make correct preoperative diagnosis difficult. Foreign body granulomas due to retained surgical gauze or sponges should be considered in patients who have previous histories of operations and who also have a mass in the surgical bed. Simultaneous occurrence of foreign body granuloma away from primary surgical field is also possible.
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Affiliation(s)
- Y T Kuo
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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17
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Sheu RS, Jaw TS, Wang YM, Liu GC, Kuo YT, Chue PY. Gd(DTPA-BBA) as a contrast agent in magnetic resonance imaging in rats. J Formos Med Assoc 1999; 98:49-55. [PMID: 10063274] [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: 02/11/2023] Open
Abstract
Gadolinium (III)-di(benzyl carbamoylmethyl) diethylenetrinitrilotriacetic acid [Gd(DTPA-BBA)] is a newly developed paramagnetic complex designed for use as a hepatobiliary-specific contrast agent. The purpose of this study was to examine the relaxivity, biodistribution, and magnetic resonance (MR) imaging characteristics of Gd(DTPA-BBA) in rats. Our results showed that the T1 relaxivity of Gd(DTPA-BBA) (3.89 dm3/mmol/s in aqueous solution) was similar to that of Gd(III) diethylenetriamine-pentaacetate [Gd(DTPA)]2- (4.08 dm3/mmol/s) and Gd(III) benzyloxypropionicte-traacetate [Gd(BOPTA)]2- (4.40 dm3/mmol/s). Biodistribution studies indicated that Gd(DTPA-BBA) exhibited hepatobiliary and urinary elimination. In MR imaging studies, Gd(DTPA-BBA) provided biphasic enhancement of normal liver parenchyma, which was characterized by an initial steep increase in enhancement followed by a plateau. The initial relative enhancement (RE%) of the liver, at 1 minute after administration of 0.2 mmol/kg Gd(DTPA-BBA) was 113 +/- 19. The plateau RE% of the liver (48 +/- 13) occurred within 10 minutes and persisted for at least 60 minutes after injection of the contrast agent. In addition, Gd(DTPA-BBA) provided better RE% of the liver than [Gd(DTPA)]2-. The contrast RE% of liver abscess capsules reached a plateau within 5 minutes after injection of 0.1 mmol/kg Gd(DTPA-BBA). Although the hepatic enhancement of Gd(DTPA-BBA) was inferior to that of [Gd(BOPTA)]2-, the results suggest that Gd(DTPA-BBA) has potential as an MR contrast agent for nonspecific and hepatobiliary uses.
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Affiliation(s)
- R S Sheu
- Department of Radiology, Kaohsiung Medical College, Kaohsiung, Taiwan
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18
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Abstract
Alice in Wonderland syndrome (AIWS) is characterized by visual hallucinations and bizarre perceptual distortions. Technetium-99m hexamethylpropyleneamine tomography (SPECT) brain scans were performed in four patients during the acute stage of AIWS. Two patients were demonstrated to have Epstein-Barr virus infections. One had abnormal (EEG) findings. The visual-evoked potential, cranial CT, and MRI findings were negative. The decreased cerebral perfusion areas in all patients were near the visual tract and visual cortex. All involved some regions of the temporal lobe. In most patients with AIWS, the EEG, CT, and MRI are unable to determine the precise pathologic areas. However, a SPECT brain scan may demonstrate abnormal perfusion areas and explain the clinical presentations.
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Affiliation(s)
- Y T Kuo
- Department of Pediatrics, Taipei Municipal Wan-Fang Hospital, Taiwan
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19
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Abstract
The purpose of this study is to review the computed tomography (CT) appearance of infectious and inflammatory diseases, and neoplasms of colon. Forty-five patients with 25 cases of colonic neoplasms and 20 cases of inflammatory and infectious diseases of colon were evaluated based on CT findings of colonic wall thickening (> 5 mm, soft tissue density versus pure wall edema or both), length of the involved segment (short (< or = 5 cm) versus long segment), pericolic infiltration, mesenteric infiltration, lateroconal fascial thickening, mechanical ileus, ascites, contiguous terminal ileum involvement, distribution of the diseased colon, and abscess formation. The results were compared using chi-square test or Fisher's exact test. Our results showed that colonic wall thickening of soft tissue density with or without edema and pure bowel wall edema were the two statistically significant findings in differential diagnosis of colon (p < 0.05). We concluded that CT is a good imaging tool to make differential diagnosis between infectious/ inflammatory diseases and neoplasms.
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Affiliation(s)
- K W Yeung
- Department of Radiology, Kaohsiung Medical College, Taiwan
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20
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Sheu RS, Liu GC, Wang YM, Jaw TS, Chen HM, Kuo YT. Preclinical evaluation of Fe-(5-C2H5-EHPG)- as a contrast agent in MR imaging of hepatobiliary system. Kaohsiung J Med Sci 1997; 13:75-85. [PMID: 9099045] [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: 02/04/2023] Open
Abstract
Iron(III)-N, N'-ethylenebis[2-(2-hydroxy-5-phenyl)glycine] [Fe-(5-C2H5-EHPG)-] is a paramagnetic complex designed for use as a hepatobiliary agent. Test procedures included synthesis, characterization, toxicity evaluation, biodistribution and experiments for animal MR images. The dose of LD50 in acute toxicity test of Fe-(5-C2H5-EHPG)- in mice was 3.49 mmol/kg. 111In-(5-C2H5-EHPG)- biodistribution studies revealed that the activities were (4.78 +/- 0.97, 5.34 +/- 0.91, 4.53 +/- 0.35)%ID and (0.88 +/- 0.18, 0.99 +/- 0.17, 0.84 +/- 0.06)%ID/gm in the liver at time intervals of 10, 30 and 60 minutes after injection; (5.76 +/- 0.15, 5.75 +/- 0.15, 4.00 +/- 0.04)%ID and (0.49 +/- 0.03, 0.49 +/- 0.05, 0.34 +/- 0.01)%ID/gm in the blood; (1.27 +/- 0.91, 1.46 +/- 1.00, 1.52 +/- 0.46) %ID and (0.89 +/- 0.17, 1.02 +/- 0.18, 1.06 +/- 0.08)%ID/gm in the kidneys, respectively. The results of image enhancement correlated well to the biodistribution. Analysis of the MR images showed degrees of maximal parenchymal % increase of signal to noise ratio (S/N) was 42.09 +/- 3.59% for normal liver at 30 minutes postinjection, which exceeded the value of pathologic liver with bile duct obstruction 16 hours 17.26 +/- 6.6 %, 1 week 19.80 +/- 6.46% and 4 weeks 32.20 +/- 9.01%, respectively, and acute hepatitis 16.50% +/- 4.02%. Persistent enhancement plateau was documented up to 60 minutes after injection and normalized to precontrast value within 22 hours. The common duct was opacified at 10-15 minutes after injection of contrast agent. These results indicated that the Fe-(5-C2H5-EHPG)- could be rapidly extracted from the blood stream by the hepatocytes and excreted into the bile duct. The initial evaluation of Fe-(5-C2H5-EHPG)- demonstrated that Fe-(5-C2H5-EHPG)- was well suited for enhancement of normal liver parenchyma and was compromised with deterioration of liver function. However, the increase of the liver intensities in the animal model of the total biliary obstruction group normalized to precontrast value within 22 hours, which indicated that renal clearance as an effective alternative pathway for biliary excretion. In conclusion, these results indicate that Fe-(5-C2H5-EHPG)- has the potential of becoming a safe and reliable magnetopharmaceutical for the hepatobiliary system.
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Affiliation(s)
- R S Sheu
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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21
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Yeung KW, Liu GC, Sheu RS, Kuo YT, Yang CW. Calcification in retroperitoneal non-Hodgkin lymphoma prior to treatment: a case report. Gaoxiong Yi Xue Ke Xue Za Zhi 1995; 11:290-4. [PMID: 7602667] [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: 01/26/2023]
Abstract
Calcification in malignant lymphoma before treatment is rare. Here we report a case of low grade non-Hodgkin lymphoma of sclerosing type presenting as a retroperitoneal calcified mass. The calcification was demonstrated with various imaging modalities, including conventional radiographs, sonography, computed tomography (CT) and magnetic resonance (MR) imaging. This case and other isolated reports show that radiographical examinations may, rarely, reveal calcification in lymphoma prior to treatment.
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Affiliation(s)
- K W Yeung
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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22
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Kuo YT, Lin MB, Sheu RS, Liu GC, Chai CY, Chou SH. Imaging diagnosis of cavernous hemangioma of the rib--one case report and review of the literature. Gaoxiong Yi Xue Ke Xue Za Zhi 1994; 10:469-73. [PMID: 7799468] [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: 01/27/2023]
Abstract
Osseous hemangioma is a benign neoplasm, rarely located in the ribs. A 56-year-old female patient without specific complaint had a large extrapleural lesion on chest posteroanterior radiograph. Expansile destruction of left seventh rib and relatively fine trabeculation were noticed in the mass from plain roentgenogram and computed tomography (CT). Contrast enhancement in noncalcified component of the lesion was revealed. Pleural effusion, lung parenchymal or mediastinal abnormality were not identified. Resection of the lesion with part of the originating rib was carried out. The pathologic diagnosis was cavernous hemangioma. We present a case with a large rib hemangioma which often leads to difficulty in radiologically differential diagnosis with other common malignant rib tumors. We also review the literature about hemangioma and malignant neoplasms of the ribs.
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Affiliation(s)
- Y T Kuo
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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23
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Yang CW, Liu GC, Chen HY, Wang ML, Lin MB, Kuo YT. MR imaging of sports-related muscle injuries. Gaoxiong Yi Xue Ke Xue Za Zhi 1994; 10:203-9. [PMID: 8007050] [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: 01/28/2023]
Abstract
Magnetic resonance (MR) imaging of the thighs of 26 baseball athletes and one softball athlete were studied to evaluate muscle injuries. We documented the abnormalities present in MR imaging after a muscle injury and evaluated the role of MR imaging in muscle injuries. Fifteen of the athletes showed muscle abnormalities in MR images. These include muscle strains without tear, muscle tear, scar and chronic tendon injury. Having the advantages of high tissue contrast and multiplanar display capability, MR allowed direct visualization of the injured muscles and characterization of traumatic lesions. We conclude that MR could be a good imaging modality for evaluating muscle injuries.
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Affiliation(s)
- C W Yang
- Department of Radiology, Kaohsiung Medical College, Taiwan, Republic of China
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Lin KT, Huang SH, Kao CL, Huang KM, Yu JC, Hung TP, Chou MY, Liu WT, Fang CT, Kuo YT. An autopsy-proved case of AIDS in Taiwan. Asian Pac J Allergy Immunol 1987; 5:25-31. [PMID: 3304320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The first case of AIDS positively identified in a non-foreigner in Taiwan was a 25-year-old unmarried male who had practiced homosexuality for ten years. The patient began to have abdominal pain accompanied with loose stools and weight loss in June 1985, followed by fever, cough, headache, dizziness, and loss of memory. Facial hyperpigmentation and extensive oroesophageal candidiasis were noted. Laboratory studies showed severe lymphopenia with a reversed T-helper to T-suppressor ratio, cutaneous anergy and polyclonal gammopathy. Human immunodeficiency virus (HIV) antibodies were positive by ELISA and Western blot, and the virus was isolated from the blood. At autopsy, disseminated cytomegalovirus infection, extensive CNS toxoplasmosis and early lesions of Kaposi's sarcoma were demonstrated. The detection of HIV in the adrenal medulla supports the consensus that the virus is neurotropic.
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Chen DS, Hsu NH, Sung JL, Hsu TC, Hsu ST, Kuo YT, Lo KJ, Shih YT. A mass vaccination program in Taiwan against hepatitis B virus infection in infants of hepatitis B surface antigen-carrier mothers. JAMA 1987. [PMID: 3573257 DOI: 10.1001/jama.1987.03390190075023] [Citation(s) in RCA: 196] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
To combat hepatitis B virus (HBV) infection in Taiwan, a mass immunoprophylaxis program was launched on July 1, 1984, aiming first at prevention of chronic HBV carriage from perinatal mother-to-infant infection. In the first 15-month period, 352,721 (78%) of 450,585 pregnant women were screened for hepatitis B surface antigen (HBsAg); HBsAg was present in 62,359 (18%), with 50% of them categorized as highly infectious. Infants born to HBsAg-positive women were given 5 micrograms of a plasma-derived hepatitis B vaccine at ages 1, 5, and 9 weeks, with a booster at age 12 months. Infants of highly infectious carrier mothers received an additional 0.5 mL of hepatitis B immune globulin within 24 hours after birth. The coverage rate of the hepatitis B immune globulin was 77% in 27,375 infants born to highly infectious mothers, and that of the first, second, third, and the fourth doses of vaccine was 88%, 86%, 84%, and 71%, respectively, in infants of 55,620 carrier mothers. The reported untoward reactions to immunization were negligible. We conclude that a mass hepatitis B vaccination program is feasible in hyperendemic areas such as Taiwan; this should be a significant step toward the effective control of HBV infection in these areas.
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