Navigation-Assisted Full-Endoscopic Radiofrequency Rhizotomy Versus Fluoroscopy-Guided Cooled Radiofrequency Ablation for Sacroiliac Joint Pain Treatment: Comparative Study

Chien-Min Chen,Jae Hwan Lee,Meng-Yin Yang,Shang-Wun Jhang,Kai-Sheng Chang,Su-Wei Ou,Li-Wei Sun,Kuo-Tai Chen 대한척추신경외과학회 2023 Neurospine Vol.20 No.1

Objective: Sacroiliac joint (SIJ) pain is a common cause of chronic low back pain. Full-endoscopic rhizotomy of lateral branches of dorsal rami innervating SIJ is a potential option for patients’ refractory to medical treatment. The full-endoscopic rhizotomy is sometimes challenging under fluoroscopic guidance. This study is to evaluate the effectiveness of the navigation-assisted full-endoscopic rhizotomy for SIJ pain. Methods: The study was a retrospective match-paired study that enrolled consecutive patients undergoing navigation-assisted full-endoscopic rhizotomy for SIJ pain. The patient demographics, clinical outcomes, and operative parameters of endoscopic rhizotomy were compared with conventional cooled radiofrequency ablation (RFA) treatment. Results: The study enrolled 72 patients, including 36 patients in the endoscopic group. Thirty-six patients in the cooled RFA group were matched by age as the control. The follow-up time was at least 1 year. Patient characteristics were similar between the groups. The navigation-assisted endoscopic rhizotomy operation time was significantly longer than the cooled RFA. The visual analogue scale (VAS) for pain and Oswestry Disability Index (ODI) significantly decreased after each treatment. However, the between-group comparison revealed that the VAS and ODI of the patients after endoscopic rhizotomy were significantly lower than those after the cooled RFA group. There were no postoperative complications in the study. Conclusion: Navigation-assisted full-endoscopic rhizotomy is an alternative to SIJ pain treatment. Integrating intraoperative navigation can ensure accurate full-endoscopic rhizotomy to provide better durability of pain relief than the cooled RFA.

Breast density analysis for whole breast ultrasound images : Whole breast ultrasound density analysis

Chen, Jeon-Hor,Huang, Chiun-Sheng,Chien, Kuang-Che Chang,Takada, Etsuo,Moon, Woo Kyung,Wu, Jeffery H. K.,Cho, Nariya,Wang, Yi-Fa,Chang, Ruey-Feng Wiley (John WileySons) 2009 Medical physics Vol.36 No.11

<P>Breast density has been established as an independent risk factor associated with the development of breast cancer. The terms mammographic density and breast density are often used interchangeably, since most breast density studies are performed with projection mammography. It is known that increase in mammographic density is associated with an increased cancer risk. A sensitive method that allows for the measurement of small changes in breast density may provide useful information for risk management. Despite the efforts to develop quantitative breast density measurements from projection mammograms, the measurements show large variability as a result of projection imaging, differing body position, differing levels of compression, and variation of the x-ray beam characteristics. This study used two separate computer-aided methods, threshold-based and proportion-based evaluations, to analyze breast density on whole breast ultrasound (US) imaging and to compare with the grading results of three radiologists using projection mammography. Thirty-two female subjects with 252 images per case were included in this study. Whole breast US images were obtained from an Aloka SSD-5500 ultrasound machine with an ASU-1004 transducer (Aloka, Japan). Before analyzing breast density, an adaptive speckle reduction filter was used for removing speckle noise, and a robust thresholding algorithm was used to divide breast tissue into fatty or fibroglandular classifications. Then, the proposed approaches were applied for analysis. In the threshold-based method, a statistical model was employed to determine whether each pixel in the breast region belonged to fibroglandular or fatty tissue. The proportion-based method was based on three-dimensional information to calculate the volumetric proportion of fibroglandular tissue to the total breast tissue. The experimental cases were graded by the proposed analysis methods and compared with the ground standard density classification assigned by a majority voting of three experienced breast radiologists. For the threshold-based method, 28 of 32 US test cases and for the proportion-based density classifier, 27 of 32 US test cases were found to be in agreement with the radiologist 'ground standard' mammographic interpretations, resulting in overall accuracies of 87.5% and 84.4%, respectively. Moreover, the concordance values of the proposed methods were between 0.0938 and 0.1563, which were less than the average interobserver concordance of 0.3958. The experiment result showed that the proposed methods could be a reference opinion and offer concordant and reliable quantification of breast density for the radiologist.</P>

Doxorubicin Promotes Migration and Invasion of Breast Cancer Cells through the Upregulation of the RhoA/MLC Pathway

Chien-Liang Liu,Ming-Jen Chen,Jiunn-Chang Lin,Chi-Hsin Lin,Wen-Chien Huang,Shih-Ping Cheng,Shan-Na Chen,Yuan-Ching Chang 한국유방암학회 2019 Journal of breast cancer Vol.22 No.2

Purpose: Cancer cells develop acquired resistance induced by chemotherapeutic drugs. In this study, we investigated the effects of brief treatment with cytotoxic drugs on the phenotype of breast cancer cells. Methods: Breast cancer cells MCF7 and BT-474 were briefly treated with paclitaxel or doxorubicin. Clonogenic, migration, and invasion assays were performed on the treated cells. Western blot analysis and RhoA activity assay were also performed. Results: Breast cancer cells when briefly treated with paclitaxel or doxorubicin showed reduced clonogenic ability. Doxorubicin, but not paclitaxel, augmented cell migration and invasion. The invasion-promoting effects of doxorubicin were lost when the two drugs were sequentially used in combination. Myosin light chain (MLC) 2 phosphorylation and RhoA activity were upregulated by doxorubicin and downregulated by paclitaxel. Pretreatment with RhoA inhibitors abolished the migration- and invasion-promoting effects of doxorubicin. Conclusion: Doxorubicin activates the RhoA/MLC pathway and enhances breast cancer cell migration and invasion. Therefore, this pathway might be explored as a therapeutic target to suppress anthracycline-enhanced tumor progression.

Effects of Wedge Visual Support on User Metacognitive Strategy and Wayfinding Behavior within a Virtual Environment

( Chien Hsiung Chen ),( Shih Chieh Chen ),( Yu Chang Huang ) 한국감성과학회 2014 춘계학술대회 Vol.2014 No.-

The purpose of this study is to investigate 2D wedge visual support design used in a 3D virtual environment pertinent to user wayfinding behavior. The independent variables adopted for the experiment are interaction mode (i.e., touch sensitive vs. body movement), viewing perspective (the first-person vs. the third-person), and gender (male vs. female). A total of 56 participants (28 males and 28 females) were recruited to take part in the wayfinding task experiment by convenient sampling method. The results generated from the experiment revealed that: (1) The participant who conducted touch sensitive interaction mode performed better than those who used body movement interaction mode due to better interaction flow. (2) The participant who adopted the third-person perspective performed better than those who adopted the first-person perspective. (3) The gender effect indicated that males performed better than females under the perceptual information followed by abstract information (P-A) type of task. It is concluded that within a 3D virtual environment, users who adopt touch sensitive mode with the third-person perspective can perform better wayfinding behavior.

REVIEW : Intestinal Stricture in Crohn`s Disease

( Chen Wang Chang ),( Jau Min Wong ),( Chien Chih Tung ),( I Lun Shih ),( Horng Yuan Wang ),( Shu Chen Wei ) 대한장연구학회 2015 Intestinal Research Vol.13 No.1

Crohn`s disease (CD) is a disease with chronic inflammation of unknown etiology involving any part of the gastrointestinal tract. The incidence and prevalence of CD are increasing recently in Asia. Half of the CD patients will have intestinal complica-tions, such as strictures or fistulas, within 20 years after diagnosis. Twenty-five percentage of CD patients have had at least one small bowel stricture and 10% have had at least one colonic stricture and lead to significant complications. Most of these pa-tients will require at least one surgery during their lifetime. Early diagnosis and evaluation with adequate managements for the patients can prevent disability and mortality of these patient. Here, we reviewed the current incidence of CD with stricture, the etiology of stricture, and how to diagnose and manage the stricture. (Intest Res 2015;13:19-26)

Cav3.2 T-Type Ca2+ Channel-Dependent Activation of ERK in Paraventricular Thalamus Modulates Acid-Induced Chronic Muscle Pain.

Chen, Wen-Kwei,Liu, Ingrid Y,Chang, Ya-Ting,Chen, Yong-Cyuan,Chen, Chih-Cheng,Yen, Chen-Tung,Shin, Hee-Sup,Chen, Chien-Chang The Society 2010 The Journal of neuroscience Vol.30 No.31

<P>Treatments for chronic musculoskeletal pain, such as lower back pain, fibromyalgia, and myofascial pain syndrome, remain inadequate because of our poor understanding of the mechanisms that underlie these conditions. Although T-type Ca(2+) channels (T-channels) have been implicated in peripheral and central pain sensory pathways, their role in chronic musculoskeletal pain is still unclear. Here, we show that acid-induced chronic mechanical hyperalgesia develops in Ca(v)3.1-deficient and wild-type but not in Ca(v)3.2-deficient male and female mice. We also show that T-channels are required for the initiation, but not maintenance, of acid-induced chronic muscle pain. Blocking T-channels using ethosuximide prevented chronic mechanical hyperalgesia in wild-type mice when administered intraperitoneally or intracerebroventricularly, but not intramuscularly or intrathecally. Furthermore, we found an acid-induced, Ca(v)3.2 T-channel-dependent activation of ERK (extracellular signal-regulated kinase) in the anterior nucleus of paraventricular thalamus (PVA), and prevention of the ERK activation abolished the chronic mechanical hyperalgesia. Our findings suggest that Ca(v)3.2 T-channel-dependent activation of ERK in PVA is required for the development of acid-induced chronic mechanical hyperalgesia.</P>

Moscatilin Induces Apoptosis and Mitotic Catastrophe in Human Esophageal Cancer Cells

Chien-An Chen,Chien-Chih Chen,Chien-Chang Shen,Hen-Hong Chang,Yu-Jen Chen 한국식품영양과학회 2013 Journal of medicinal food Vol.16 No.10

Moscatilin, a bibenzyl derivative from the orchid Dendrobium loddigesii, has been shown to possess anticancer activity. We examined the effect of moscatilin on human esophageal cancer cells, including squamous cell carcinoma (SCC) and adenocarcinoma (ADC) cells and its possible mechanisms. Moscatilin suppressed the growth of both the histological cell lines in a dose- and time-dependent manner. Morphological changes indicative of apoptosis and mitotic catastrophe were observed following moscatilin treatment. The population of cells in the sub-G1 phase and polyploidy phase significantly increased after treatment. Immunofluorescence revealed multipolar mitosis and subsequent multinucleation in moscatilin-treated cells, indicating the development of mitotic catastrophe. Western blot showed a marked increase in expressions of polo-like kinase 1 and cyclin B1 after exposure to moscatilin. In conclusion, moscatilin inhibits growth and induces apoptosis and mitotic catastrophe in human esophageal SCC- and ADC-derived cell lines, indicating that moscatilin has broad potential against esophageal cancer

Effects of Wedge Visual Support on User Wayfinding Behavior within a Virtual Environment

Chien-Hsiung Chen,Shih-Chieh Chen,Yu-Chang Huang 대한인간공학회 2014 대한인간공학회 학술대회논문집 Vol.2014 No.5

The purpose of this study is to investigate 2D wedge visual support design used in a 3D virtual environment pertinent to user wayfinding behavior. The independent variables adopted for the experiment are interaction mode (i.e., touch sensitive vs. body movement), viewing perspective (the first-person vs. the third-person), and gender (male vs. female). A total of 56 participants (28 males and 28 females) were recruited to take part in the wayfinding task experiment by convenient sampling method. The results generated from the experiment revealed that: (1) The participant who conducted touch sensitive interaction mode performed better than those who used body movement interaction mode due to better interaction flow. (2) The participant who adopted the third-person perspective performed better than those who adopted the first-person perspective. (3) The gender effect indicated that males performed better than females under the perceptual information followed by abstract information (P-A) type of task. It is concluded that within a 3D virtual environment, users who adopt touch sensitive mode with the third-person perspective can perform better wayfinding behavior.

UNDERSTANDING TOURIST SERVICE QUALITY PERCEPTIONS AND LOYALTY INTENTIONS IN THE INTERNATIONAL HOTEL SECTOR: APPLICATION OF DATA MINING METHODS AND KANO’S MODEL

Kuo-Chien Chang,Mu-Chen Chen,Nien-Te Kuo,Chia-Lin Hsu,Yi-Sung Cheng 글로벌지식마케팅경영학회 2014 Global Marketing Conference Vol.2014 No.1

This study used the methods of decision tree analysis, association rule analysis, and Kano’s model to explore the behavior patterns of mainland China tourists staying at the international tourist hotels in Taiwan. To this end, the data of their demographics, travel variables, overall satisfaction with the lodging experience, different service quality perceptions, and loyalty intentions were included. The decision tree analysis showed that a tourist’s overall satisfaction with the lodging experience, satisfaction with the quality of core intangible services, and certain demographic characteristics are three important determinants of tourist loyalty towards the hotels. In terms of the effect of demographics, the customers’ monthly income and length of stay at the hotel are two main determinants in this study. In addition, if the customer perceptions of different parts of hotel service quality are taken into account, among the five hotel service quality domains, core intangible services from the receptionist, housekeeping personnel, and food & beverage personnel are found to be important influences on hotel customer loyalty intention. In other words, high quality intangible services are important for luxury hotels to demonstrate their unique ability to help customers experience the service quality that creates loyalty intentions. With regard to the association rule analysis, the results showed that core intangible service aspects from the receptionist, housekeeping personnel, and food & beverage personnel are strongly associated with customer loyalty intentions, as are the tangible aspects of the reception and hotel room facilities. The former indicated that reception in the hotel lobby could be considered one of the most important servicescapes because of its impact in forming many of the first impressions of hotel guests, while the latter is treated as core offerings in hotels that would be encountered by most hotel customers. If the tourists are mainly from package tours, the intangible services and tangible facilities of these areas are the important areas to create customer satisfaction. However, if the tourists are mainly independent tourists because they have more time and free choice to stay at the hotel longer than the package tour tourists, the intangible services and tangible facilities of the entertainment or business centers would be even more important to these tourists than to the package tour tourists. With regard to Kano’s model analysis, the results showed that, based on mainland China tourists’ perceptions, most of the service elements fit into the category of one-dimensional quality attributes. This means that these service elements are positively and linearly related to customer satisfaction, and the greater fulfillment of the attribute results in a greater degree of satisfaction. This also means that hotels should make more effort to innovate their intangible services and tangible facilities to create business advantages in the market.

UNDERSTANDING TOURIST SERVICE QUALITY PERCEPTIONS AND LOYALTY INTENTIONS IN THE INTERNATIONAL HOTEL SECTOR: APPLICATION OF DATA MINING METHODS AND KANO’S MODEL

Kuo-Chien Chang,Mu-Chen Chen,Nien-Te Kuo,Chia-Lin Hsu,Yi-Sung Cheng 글로벌지식마케팅경영학회 2014 Global Marketing Conference Vol.2014 No.7

This study used the methods of decision tree analysis, association rule analysis, and Kano’s model to explore the behavior patterns of mainland China tourists staying at the international tourist hotels in Taiwan. To this end, the data of their demographics, travel variables, overall satisfaction with the lodging experience, different service quality perceptions, and loyalty intentions were included. The decision tree analysis showed that a tourist’s overall satisfaction with the lodging experience, satisfaction with the quality of core intangible services, and certain demographic characteristics are three important determinants of tourist loyalty towards the hotels. In terms of the effect of demographics, the customers’ monthly income and length of stay at the hotel are two main determinants in this study. In addition, if the customer perceptions of different parts of hotel service quality are taken into account, among the five hotel service quality domains, core intangible services from the receptionist, housekeeping personnel, and food & beverage personnel are found to be important influences on hotel customer loyalty intention. In other words, high quality intangible services are important for luxury hotels to demonstrate their unique ability to help customers experience the service quality that creates loyalty intentions. With regard to the association rule analysis, the results showed that core intangible service aspects from the receptionist, housekeeping personnel, and food & beverage personnel are strongly associated with customer loyalty intentions, as are the tangible aspects of the reception and hotel room facilities. The former indicated that reception in the hotel lobby could be considered one of the most important servicescapes because of its impact in forming many of the first impressions of hotel guests, while the latter is treated as core offerings in hotels that would be encountered by most hotel customers. If the tourists are mainly from package tours, the intangible services and tangible facilities of these areas are the important areas to create customer satisfaction. However, if the tourists are mainly independent tourists because they have more time and free choice to stay at the hotel longer than the package tour tourists, the intangible services and tangible facilities of the entertainment or business centers would be even more important to these tourists than to the package tour tourists. With regard to Kano’s model analysis, the results showed that, based on mainland China tourists’ perceptions, most of the service elements fit into the category of one-dimensional quality attributes. This means that these service elements are positively and linearly related to customer satisfaction, and the greater fulfillment of the attribute results in a greater degree of satisfaction. This also means that hotels should make more effort to innovate their intangible services and tangible facilities to create business advantages in the market.