Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Taiwan perspective

Tung-Hung Su,Chih-Horng Wu,Tsung-Hao Liu,Cheng-Maw Ho,Chun-Jen Liu 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.2

Hepatocellular carcinoma (HCC) is the fourth most common cancer and the second leading cause of cancer-related death in Taiwan. The Taiwan Liver Cancer Association and the Gastroenterological Society of Taiwan developed and updated the guidelines for HCC management in 2020. In clinical practice, we follow these guidelines and the reimbursement policy of the government. In Taiwan, abdominal ultrasonography, alpha-fetoprotein, and protein induced by vitamin K absence or antagonist-II (PIVKA-II) tests are performed for HCC surveillance every 6 months or every 3 months for high-risk patients. Dynamic computed tomography, magnetic resonance imaging, and contrast-enhanced ultrasound have been recommended for HCC surveillance in extremely high-risk patients or those with poor ultrasonographic visualization results. HCC is usually diagnosed through dynamic imaging, and pathological diagnosis is recommended. Staging of HCC is based on a modified version of the Barcelona Clinic Liver Cancer (BCLC) system, and the HCC management guidelines in Taiwan actively promote curative treatments including surgery and locoregional therapy for BCLC stage B or C patients. Transarterial chemoembolization (TACE), drug-eluting bead TACE, transarterial radioembolization, and hepatic artery infusion chemotherapy may be administered for patients with BCLC stage B or C HCC. Sorafenib and lenvatinib are reimbursed as systemic therapies, and regorafenib and ramucirumab may be reimbursed in cases of sorafenib failure. First-line atezolizumab with bevacizumab is not yet reimbursed but may be administered in clinical practice. Systemic therapy and external beam radiation therapy may be used in specific patients. Early switching to systemic therapy in TACE-refractory patients is a recent paradigm shift in HCC management.

2H-Silicon Carbide Epitaxial Growth on c-Plane Sapphire Substrate Using an AlN Buffer Layer and Effects of Surface Pre-Treatments

Tien-Tung Luong,Binh Tinh Tran,Yen-Teng Ho,Ting-Wei Wei,Yue-Han Wu,Tzu-Chun Yen,Lin-Lung Wei,Jer-Shen Maa,Edward Yi Chang 대한금속·재료학회 2015 ELECTRONIC MATERIALS LETTERS Vol.11 No.3

The effects of surface pre-treatments and the role of an AlN buffer layer for 2H-SiC growth on c-plane sapphire substrates by thermal CVD are investigated. While the crystallinity of SiC directly grown on sapphire substrate always degrades with a hydrogen pre-treatment but improves by optimizing carbonization, the crystallinity of SiC grown on sapphire substrate using an AlN buffer grown by MOCVD improves with sufficient time of exposure to the H pre-treatment but always deteriorates with carbonization. Detailed microstructural analysis by phi-scan x-ray diffraction reveals that SiC film grown on sapphire substrate consists of crystalline domains with two different crystallographic orientations which are rotated relative to each other along the [111] axis by 60°. A highly oriented hexagonal 2H-SiC film is obtained on low-cost c-plane sapphire substrate by using an AlN buffer. 2H-SiC is unambiguously determined not only by phi-scan x-ray diffraction but also by high-resolution transmission electron microscopy. The growth relationship between 2HSiC and 2H-AlN are coherent due to the favorable bonding of C and Al between SiC and AlN.

Quality Evaluation of Moutan Cortex Radicis Using Multiple Component Analysisby High Performance Liquid Chromatography

Ding, Yan,Wu, Enqi,Chen, Jianbo,Nguyen, Huu-Tung,Do, Thi-Ha,Park, Kyung-Lae,Bae, Ki-Hwan,Kim, Young-Ho,Kang, Jong-Seong Korean Chemical Society 2009 Bulletin of the Korean Chemical Society Vol.30 No.10

A simple high performance liquid chromatographic method was developed to evaluate the quality of Moutan Cortex Radicis based on chromatographic fingerprints that characterize eight pharmacological compounds, namely, gallic acid, paeoniflorin, galloyl paeoniflorin, benzoic acid, quercetin, benzoylpaeoniflorin, paeoniflorigenone, and paeonol. These compounds were identified by their characteristic UV profiles and the mass spectroscopy data, and their contents were determined by HPLC. The chromatographic separation was performed on a $C_{18}$ column by gradient elution with 0.05% formic acid in water and acetonitrile. The methodological validation gave acceptable linearities (r = 0.9996) and recoveries (ranging from 99.4∼103.1%). The limits of detection (LOD) of these compounds ranged from 10 to 30 $\mu$g/mL. The representative chromatographic fingerprints of Moutan Cortex Radicis were obtained by analyzing 20 batches of samples collected from markets in Korea and China. For the efficient evaluation of quality for the commercial Moutan Cortex Radicis it is recommended that the total content of the six characteristic compounds should contain more than a minimum of 2% and that the content of total paeoniflorin and paeonol should exceed a minimum of 1.5% of dry weight of Moutan Cortex Radicis.

Inhibiting the Growth of Cu3Sn and Kirkendall Voids in the Cu/Sn-Ag-Cu System by Minor Pd Alloying

Cheng En Ho,,Tsai Tung Kuo,Chun Chien Wang,Wei Hsiang Wu 대한금속·재료학회 2012 ELECTRONIC MATERIALS LETTERS Vol.8 No.5

In this study, the metallurgical reaction between Cu substrates (electrolytic type) and a Sn3Ag0.5Cu-xPd alloy at 180°C was examined using a scanning electron microscope (SEM), electron probe microanalyzer (EPMA),focused ion beam (FIB) microscope, and transmission electron microscope (TEM). The results showed that the growth of Cu3Sn in the Cu/Sn-Ag-Cu solder joints was substantially suppressed by doping with a minor quantity of Pd (0.1-0.7 wt. %) in the solder alloy. The sluggish growth of Cu3Sn reduced the formation of Kirkendall voids at the Cu/Cu3Sn interface and significantly improved the mechanical reliability of the joint interface. It was argued that a minor addition of Pd into the solder stabilized the Cu6Sn5 phase and enlarged the interdiffusion coefficient of Cu6Sn5 but diminished that of the neighboring phase (Cu3Sn), thereby decreasing the Kirkendall effect in the Cu/Sn-Ag-Cu reactive system.

Quality Evaluation of Moutan Cortex Radicis Using Multiple Component Analysis by High Performance Liquid Chromatography

Yan Ding,Enqi Wu,Jianbo Chen,Huu Tung Nguyen,Thi Ha Do,Kyung Lae Park,KiHwan Ba,Young Ho Kim,강종성 대한화학회 2009 Bulletin of the Korean Chemical Society Vol.30 No.10

A simple high performance liquid chromatographic method was developed to evaluate the quality of Moutan Cortex Radicis based on chromatographic fingerprints that characterize eight pharmacological compounds, namely, gallic acid, paeoniflorin, galloyl paeoniflorin, benzoic acid, quercetin, benzoylpaeoniflorin, paeoniflorigenone, and paeonol. These compounds were identified by their characteristic UV profiles and the mass spectroscopy data, and their contents were determined by HPLC. The chromatographic separation was performed on a C18 column by gradient elution with 0.05% formic acid in water and acetonitrile. The methodological validation gave acceptable linearities (r = 0.9996) and recoveries (ranging from 99.4∼103.1%). The limits of detection (LOD) of these compounds ranged from 10 to 30 μg/mL. The representative chromatographic fingerprints of Moutan Cortex Radicis were obtained by analyzing 20 batches of samples collected from markets in Korea and China. For the efficient evaluation of quality for the commercial Moutan Cortex Radicis it is recommended that the total content of the six characteristic compounds should contain more than a minimum of 2% and that the content of total paeoniflorin and paeonol should exceed a minimum of 1.5% of dry weight of Moutan Cortex Radicis.

Microreactor-Controlled Product Selectivity in Photosensitized Oxidation of Alkenes. Electron Transfer Versus Energy Transfer Pathways

Fu, Xiao-Gang,Zhang, Li-Ping,Wu, Li-Zhu,Tung, Chen-Ho Korean Society of Photoscience 2003 Journal of Photosciences Vol.10 No.1

Zeolite, Nafion membranes and vesicles were used as microreactors to control the pathway of photosensitized oxidation of alkenes and remarkable selectivity was achieved.

Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation

Huei-Lung Liang,Huay-Ben Pan,Yih-Huie Lin,Chiung-Yu Chen,Hsiao-Min Chung,Tung-Ho Wu,Kang-Ju Chou,Pin-Hong Lai,Chien-Fang Yang 대한영상의학회 2006 Korean Journal of Radiology Vol.7 No.2

Objective: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. Materials and Methods: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patients (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8 10mm in diameter and 40 80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. Results: No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates ( standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69% 9 and 88% 6, 41% 10 and 88% 6, 30% 10 and 77% 10, and 12% 8 and 61% 13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51% 16 and 86% 13 vs 45% 15 and 73% 13 at 6 months, and 25% 15 and 71% 17 vs 23% 17 and 73% 13 at 12 months (p = .346 and .224), respectively. Conclusion: Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.

압박성 신경병증에 의한 족하수(足下垂) 환자(患者) 1례(例)에 대한 임상적(臨床的) 고찰(考察)

신정철,이동현,위통순,김선종,최원확,류충열,윤여충,조명래,채우석,나건호,Shin, Jeong-Cheol,Lee, Dong-Hyun,Wei, Tung-Shuen,Kim, Seon-Jong,Choe, Won-Hwak,Ryu, Chung-Ryul,Yun, Yeo-Choong,Cho, Myung-Rae,Che, Wu-Suk,Na, Gun-Ho 대한침구의학회 2005 대한침구의학회지 Vol.22 No.4

Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.

견인요법(牽引療法)을 병용한 요통(腰痛) 및 요각통(腰脚痛) 환자 40례(例)의 임상적 고찰

이동현,박은주,신정철,나건호,위통순,이삼로,류충열,조명래,채우석,윤여충,Lee, Dong-hyun,Park, Eun-ju,Shin, Jung-chul,Na, Gun-ho,Wei, Tung-shuen,Lee, Sam-ro,Lyu, Chung-yeol,Cho, Myung-rae,Chae, Wu-suk,Yoon, Yeo-choong 대한침구의학회 2004 대한침구의학회지 Vol.21 No.5

Objectives : The purpose of this report is to use more Traction treatment clinically by comparing th Improvement of Low Back Pain and Sciatica between Common treatment Group and Common treatment with Traction treatment. Methods : This study was carried out on 40 patients with Low Back Pain and Sciatica who were hospitalized in Dongshin Univ. Oriental Hospital from January, 2003 to May, 2004. Group A of 20 patients were taken both common treatment and Traction treatment. And Group B of 20 patients were only taken common treatment. And at discharge day, we checked and compared VAS(Visual Analogue Scale) and ODI(Oswestry disability index) out of these two groups. SPSS(Statistical Program for Social Science) for Window was used for a statistical analysis and the independent T-test was performed to gauge the improvement of VAS(Visual Analogue Scale) and ODI(Oswestry disability index) out of these two groups, in which case, value of P below 0.05 is considered as useful. Results : The result of the VAS(Visual Analogue Scale) and ODI(Oswestry disability index) of comparison analysis between two groups at discharge day, shows that the improvement of Low Back Pain and Sciatica in cmmon treatment with Traction treatment Group is more effective than that in Common treatment.