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        Use of Magnetic Resonance Imaging for Evaluating Residual Breast Tissue After Robotic-Assisted Nipple-Sparing Mastectomy in Women With Early Breast Cancer

        Wu Wen-Pei,Lai Hung-Wen,Liao Chiung-Ying,Lin Joseph,Huang Hsin-I,Chen Shou-Tung,Chou Chen-Te,Chen Dar-Ren 대한영상의학회 2023 Korean Journal of Radiology Vol.24 No.7

        Objective: Prospective studies on postoperative residual breast tissue (RBT) after robotic-assisted nipple-sparing mastectomy (R-NSM) for breast cancer are limited. RBT presents an unknown risk of local recurrence or the development of new cancer after curative or risk-reducing mastectomies. This study investigated the technical feasibility of using magnetic resonance imaging (MRI) to evaluate RBT after R-NSM in women with breast cancer. Materials and Methods: In this prospective pilot study, 105 patients, who underwent R-NSM for breast cancer at Changhua Christian Hospital between March 2017 and May 2022, were subjected to postoperative breast MRI to evaluate the presence and location of RBT. The postoperative MRI scans of 43 patients (age, 47.8 ± 8.5 years), with existing preoperative MRI scans, were evaluated for the presence and location of RBT. In total, 54 R-NSM procedures were performed. In parallel, we reviewed the literature on RBT after nipple-sparing mastectomy, considering its prevalence. Results: RBT was detected in 7 (13.0%) of the 54 mastectomies (6 of the 48 therapeutic mastectomies and 1 of the 6 prophylactic mastectomies). The most common location for RBT was behind the nipple-areolar complex (5 of 7 [71.4%]). Another RBT was found in the upper inner quadrant (2 of 7 [28.6%]). Among the six patients who underwent RBT after therapeutic mastectomies, one patient developed a local recurrence of the skin flap. The other five patients with RBT after therapeutic mastectomies remained disease-free. Conclusion: R-NSM, a surgical innovation, does not seem to increase the prevalence of RBT, and breast MRI showed feasibility as a noninvasive imaging tool for evaluating the presence and location of RBT.

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        Damage detection for beam structures based on local flexibility method and macro-strain measurement

        Ting Yu Hsu,Wen I Liao,Shen Yau Hsiao 국제구조공학회 2017 Smart Structures and Systems, An International Jou Vol.19 No.4

        Many vibration-based global damage detection methods attempt to extract modal parameters from vibration signals as the main structural features to detect damage. The local flexibility method is one promising method that requires only the first few fundamental modes to detect not only the location but also the extent of damage. Generally, the mode shapes in the lateral degree of freedom are extracted from lateral vibration signals and then used to detect damage for a beam structure. In this study, a new approach which employs the mode shapes in the rotary degree of freedom obtained from the macro-strain vibration signals to detect damage of a beam structure is proposed. In order to facilitate the application of mode shapes in the rotary degree of freedom for beam structures, the local flexibility method is modified and utilized. The proposed rotary approach is verified by numerical and experimental studies of simply supported beams. The results illustrate potential feasibility of the proposed new idea. Compared to the method that uses lateral measurements, the proposed rotary approach seems more robust to noise in the numerical cases considered. The sensor configuration could also be more flexible and customized for a beam structure. Primarily, the proposed approach seems more sensitive to damage when the damage is close to the supports of simply supported beams.

      • SCOPUSSCIEKCI등재

        Post-Traumatic Cerebral Infarction Following Low-Energy Penetrating Craniocerebral Injury Caused by a Nail

        Chen, Po-Chuan,Tsai, Shih-Hung,Chen, Yu-Long,Liao, Wen-I The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.55 No.5

        Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompressive craniectomy, but permanent neurological damage occurred. This is the first case of profound PTCI following a low-energy penetrating craniocerebral nail injury and reminds clinicians of possibility this rare dreadful complication for care of head-injured patients.

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        Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients

        Chih-Weim Hsiang,Wei-Chou Chang,Chang-Hsien Liu,Hsiu-Lung Fan,Kai-Hsiung Ko,Chih-Yung Yu,Hong-Hau Wang,Wen-I Liao,Hsian-He Hsu 연세대학교의과대학 2015 Yonsei medical journal Vol.56 No.2

        Purpose: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. Materials and Methods: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and dividedinto two age groups: elderly (age ≥65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. Results: Elderly patients with non-KPLA were associatedwith a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were relatedto the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. Conclusion:In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.

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