Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma: A propensity case-matched analysis of the long-term survival

Kit-Man Ho,Kai-Chi Cheng,Fiona Ka-Man Chan,Yuk-Pang Yeung 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.1

Backgrounds/Aims: Despite the widespread popularity of laparoscopic surgery, laparoscopic liver resection (LLR) remains in evolution. This study aimed to compare the long-term outcomes for patients undergoing laparoscopic versus open hepatectomy for hepatocellular carcinoma (HCC) ≤7 cm. Methods: Patients diagnosed with HCC treated by hepatectomy from October 2000 to May 2019 were included. Excluding tumors larger than 7 cm, 1:2 propensity score matching was performed between laparoscopic and open hepatectomies. The perioperative outcomes, 5-year overall survival (OS) and disease-free survival (DFS) of the two groups were compared. Results: Forty-five patients who underwent LLR were matched to 90 open hepatectomy (OH) during the same period. LLR group had shorter median hospital stay (5 days vs. 9 days, p=0.00) but required longer operative time (326.0 minutes vs. 272.5 minutes, p=0.018) than the OH group. The 5-year overall survival was better in the LLR group (84.9% vs. 61.1%; p=0.036), though there was no significant difference in the 5-year disease free survival (20.0% vs. 22.2%, p=0.613). The rate of R0 resection was comparable between the 2 groups with a slightly better margin distance in the LLR (5 mm vs. 3 mm, p=0.043). Conclusions: Laparoscopic liver resection is safe and feasible for cirrhotic patients with HCC size up to 7 cm. It has better short-term outcomes and comparable perioperative blood loss and complication rates. The resection margin is not jeopardized and the 5-year overall and disease-free survivals are comparable with the open group.

Oral Lovastatin Attenuates Airway Inflammation and Mucus Secretion in Ovalbumin-Induced Murine Model of Asthma

Chian-Jiun Liou,,Pei-Yun Cheng,Wen-Chung Huang,Cheng-Chi Chan,Meng-Chun Chen,Ming-Ling Kuo,Jiann-Jong Shen 대한천식알레르기학회 2014 Allergy, Asthma & Immunology Research Vol.6 No.6

Purpose: Lovastatin is an effective inhibitor of cholesterol synthesis. A previous study demonstrated that lovastatin can also suppress airway hyperresponsiveness (AHR) in murine model of asthma. We aimed to investigate the effect of lovastatin on mucus secretion and inflammation-associated gene expression in the lungs of murine model of asthma. Methods: Female BALB/c mice were sensitized and challenged with ovalbumin (OVA) by intraperitoneal injection, and orally administered lovastatin from days 14 to 27 post-injection. Gene expression in lung tissues was analyzed using real-time polymerase chain reaction. AHR and goblet cell hyperplasia were also examined. BEAS-2B human bronchial epithelial cells were used to evaluate the effect of lovastatin on the expression of cell adhesion molecules, chemokines, and proinflammatory cytokines in vitro. Results: We showed that lovastatin inhibits the expression of Th2-associated genes, including eotaxins and adhesion molecules, in the lungs of murine model of asthma. Mucin 5AC expression, eosinophil infiltration and goblet cell hyperplasia were significantly decreased in the lung tissue of murine model of asthma treated with lovastatin. Furthermore, lovastatin inhibited AHR and expression of Th2-associated cytokines in bronchoalveolar lavage fluid. However, a high dose (40 mg/kg) of lovastatin was required to decrease specific IgE to OVA levels in serum, and suppress the expression of Th2-associated cytokines in splenocytes. Activated BEAS-2B cells treated with lovastatin exhibited reduced IL-6, eotaxins (CCL11 and CCL24), and intercellular adhesion molecule-1 protein expression. Consistent with this, lovastatin also suppressed the ability of HL-60 cells to adhere to inflammatory BEAS-2B cells. Conclusions: These data suggest that lovastatin suppresses mucus secretion and airway inflammation by inhibiting the production of eotaxins and Th2 cytokines in murine model of asthma.

2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

Wei-Che Lin,Wen-Chieh Chen,Pei-Wen Wang,Yi-Chia Chan,Yen-Hsiang Chang,Harn-Shen Chen,Szu-Tah Chen,Wei-Chih Chen,Kai-Lun Cheng,Shun-Yu Chi,Pi-Ling Chiang,Chen-Kai Chou,Feng-Fu Chou,Shun-Chen Huang,Feng 대한초음파의학회 2023 ULTRASONOGRAPHY Vol.42 No.3

Radiofrequency ablation (RFA) is a minimally invasive management strategy that has been widely applied for benign and recurrent malignant thyroid lesions as an alternative to surgery in Taiwan. Members of academic societies for specialists in interventional radiology, endocrinology, and endocrine surgery collaborated to develop the first consensus regarding thyroid RFA in Taiwan. The modified Delphi method was used to reach a consensus. Based on a comprehensive review of recent and valuable literature and expert opinions, the recommendations included indications, pre-procedural evaluations, procedural techniques, post-procedural monitoring, efficacy, and safety, providing a comprehensive review of the application of RFA. The consensus effectively consolidates advice regarding thyroid RFA in clinical practice for local experts.

Trends in contemporary advanced heart failure management: an in-depth review over 30 years of heart transplant service in Hong Kong

Yue Yan Katherine Fan,Ka Lam Wong,Ka Lai Cally Ho,Tai Leung Daniel Chan,Oswald Joseph Lee,Chi Yui Yung,Kin Shing Lun,Mo Chee Elaine Chau,Shui Wah Clement Chiu,Lik Cheung Cheng,Wing Kuk Timmy Au 대한이식학회 2022 Korean Journal of Transplantation Vol.36 No.4

Background: The year 2022 marks the 30th anniversary of heart transplant service in Hong Kong (HK). In this study, we describe prevailing trends and outcomes of advanced heart failure (AHF), including heart transplantations (HTx), in HK over the past 30 years. Methods: Trends in heart failure prevalence in HK from 1993 to 2021 were analyzed based on data from the Hospital Authority Clinical Data and Reporting System. All AHF patients referred for HTx consideration between 1992 and 2021 were reviewed. The bridge-to-transplant (BTT) utilization of short-term mechanical circulatory support (ST-MCS) devices, including venoarterial extracorporeal membrane oxygenation (VA-ECMO) and durable left ventricular assist devices (LVADs), from 2010 to 2021 was reviewed. Results: Overall, 237 heart transplants were performed in HK, with 10-year posttransplant and median survival of 68.1% and 18.7 years, respectively. An increase in AHF clinic referrals was correlated with increasing heart failure prevalence (R2=0.635, P<0.001). In total, 146 referrals were made for ST-MCS, and an observed increase in ST-MCS referrals was correlated with increasing VA-ECMO utilization (R2=0.849, P<0.001). Among 62 patients accepted for AHF therapy, those with durable LVAD implementation had better 1-year survival (71.5%) than those receiving an extracorporeal CentriMag (Levitronix) device as BTT (40%, P=0.008). In total, 143 LVADs were implanted, with 130 as BTT or bridge-to-candidacy (BTC) methods. The survival rate among the 130 BTT/BTC LVAD patients resembled that of HTx recipients (73.8% vs. 69.8% at 9 years, P=0.296). Conclusions: The burden of AHF management has increased and gained complexity over the past 30 years in Hong Kong.

한국(韓國)에서의 정관수술(精管手術)과 심혈관질환(心血管疾患)으로 인한 사망(死亡)과의 관련성(關聯性) 연구(硏究)

공세권 ( Sae Kwon Kong ),조애저 ( Ae Jeo Cho ),맹광호 ( Kwang Ho Meng ),박찬무 ( Chan Moo Park ),( L-cheng Chi ),( Lynne R. Wilkens ),( James E. Higgins ),( Albert J. Siemens ),( Malcolm Potts ) 한국보건사회연구원 1986 保健社會硏究 Vol.6 No.2

This community-based case-control study was carried out in four cities in South Korea to examine whether vasectomy is associated with a long-term increased risk of cardiovascular death in Korean men. Korea was chosen for study because of its long established vasectomy program (>20 years), the relatively high vasectomy prevalence (12% among adult males) and its location in the Orient. Cases are 413 men who died at age 35~65 between October 1982 and September 1983, with an underlying cause of death, as reported in the death certificate, of ischemic heart disease ( N=29, ICD 410~414), non-traumatic cerebrovascular disease (N=295, ICD 430~438)or hypertensive disease (N=89, ICD 401~405). Each case was matched on age and parity to a living male from the same neighborhood. Wives of cases and controls were interviewed at home as surrogates. Univariate analysis of the association of vasectomy and cardiovascular death revealed an odds ratio of 1.4 (95% CLs=0.8~2.4). Multivariate logistic regression analysis, controlling for potentially confounding variables, revealed a lower adjusted odds ratio of 1.0 (95% CLs=0.4~2.4). Thus we did not detect an association between vasectomy and cardiovascular death in Korean men, nor did we detect a statistically significant increased risk for those subjects who had a vasectomy 15 years or longer (odds ratio= 1.3, 95% CLs=0.4~4.4). The results coincide with those from Western epidemiologic studies and do not support the vasectomy-atherosclerosis hypothesis originating from animal research.

Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2-[18F]FDG PET/CT

Chuang Pei-Ju,Wang Hsiu-Po,Tien Yu-Wen,Chin Wei-Shan,Hsieh Min-Shu,Chen Chieh-Chang,Hong Tzu-Chan,Ko Chi-Lun,Wu Yen-Wen,Cheng Mei-Fang 대한영상의학회 2024 Korean Journal of Radiology Vol.25 No.3

Objective: We aimed to investigate whether 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[18F]FDG PET/CT for endoscopy-detected ampullary tumors 5–87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13–36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80–13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41–19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00–14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16–21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874–0.956] vs. 0.815 [0.732–0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816–0.967) in candidates for endoscopic papillectomy. Conclusion: Adding 2-[18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.