Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

Huang Tsung-Chun,Lee Jian-Jr,Yang Kuo-Hui,Chou Chia-Huei,Chang Yu-Chen 대한성형외과학회 2023 Archives of Plastic Surgery Vol.50 No.6

Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique “transaxillary capsulorrhaphy” to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

The Applications of Smart Wearable Devices for Detecting Balance Function in Individuals at High Risk of Falls

Tsung-Hsun Hsieh,Chih-Wei Peng,Kai-Yun Chen,Ying-Zu Huang,Yi-Huang Lin,Wei-Zong Zhong,Chun-Yu Cheng,Ya-Ju Chang,Chih-Hsiu Cheng,Yu-Fen Chuang 한국재활복지공학회 2017 한국재활복지공학회 학술대회논문집 Vol.2017 No.11

The Clinical Outcomes of Different First-Line EGFR-TKIs Plus Bevacizumab in Advanced EGFR-Mutant Lung Adenocarcinoma

Yen-Hsiang Huang,Kuo-Hsuan Hsu,Chun-Shih Chin,Jeng-Sen Tseng,Tsung-Ying Yang,Kun-Chieh Chen,Kang-Yi Su,Sung-Liang Yu,Jeremy J.W. Chen,Gee-Chen Chang 대한암학회 2022 Cancer Research and Treatment Vol.54 No.2

Purpose The aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced EGFR-mutant lung adenocarcinoma patients. Materials and Methods From August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis. Results A total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481). Conclusion Our research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced EGFR-mutant lung adenocarcinoma patients. PurposeThe aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced <i>EGFR</i>-mutant lung adenocarcinoma patients.Materials and MethodsFrom August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis.ResultsA total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481).ConclusionOur research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced <i>EGFR</i>-mutant lung adenocarcinoma patients.

Establishment and Evaluation of GC/MS Methods for Urinalysis of Multiple Phenethylamines

Po-Han Shih,Tsung-Hsien Lin,Shih-Ting Zeng,Shu-Yu Fan,Chi-Zong Zang,Ya-Chun Ko,Ya-Hui Hsu,Shou-Chieh Huang,Mei-Chih Lin,Su-Hsiang Tseng 사단법인 한국질량분석학회 2024 Mass spectrometry letters Vol.15 No.2

Over the past few decades, new psychoactive substances (NPS) have become prevailing. With the widespread emer- gence of NPS, phenethylamines (PEAs) have become one of the groups abused most which PEAs, along with other stimulants, make up the majority of stimulants. When determining the NPS, the methods for screening and confirmation are crucial which assesses the reliability of testimony. In this study, a set of GC/MS methods employing two derivatizing agents for determining 76 target PEAs in urine was established and further applied for authentic sample analysis. Five PEAs (N,N-DMA, PMMA, 4-CA, amphetamine, and methamphetamine) with contents over their LLOQs were detected in thirteen of the twenty tested samples. In order to compare the result from the GC/MS methods with the previously established LC-MS/MS method, Cohen's kappa coef- ficient and McNemar's test were applied for statistical analysis. Perfect agreement between GC/MS and LC-MS/MS techniques for determining target PEAs is demonstrated by the Kappa coefficient for each of the five detected targets.

The Quantitative Evaluation of Automatic Segmentation in Lumbar Magnetic Resonance Images

Yao-Wen Liang,Yu-Ting Fang,Ting-Chun Lin,Cheng-Ru Yang,Chih-Chang Chang,Hsuan-Kan Chang,Chin-Chu Ko,Tsung-Hsi Tu,Li-Yu Fay,Jau-Ching Wu,Wen-Cheng Huang,Hsiang-Wei Hu,You-Yin Chen,Chao-Hung Kuo 대한척추신경외과학회 2024 Neurospine Vol.21 No.2

Objective: This study aims to overcome challenges in lumbar spine imaging, particularly lumbar spinal stenosis, by developing an automated segmentation model using advanced techniques. Traditional manual measurement and lesion detection methods are limited by subjectivity and inefficiency. The objective is to create an accurate and automated segmentation model that identifies anatomical structures in lumbar spine magnetic resonance imaging scans. Methods: Leveraging a dataset of 539 lumbar spinal stenosis patients, the study utilizes the residual U-Net for semantic segmentation in sagittal and axial lumbar spine magnetic resonance images. The model, trained to recognize specific tissue categories, employs a geometry algorithm for anatomical structure quantification. Validation metrics, like Intersection over Union (IOU) and Dice coefficients, validate the residual U-Net’s segmentation accuracy. A novel rotation matrix approach is introduced for detecting bulging discs, assessing dural sac compression, and measuring yellow ligament thickness. Results: The residual U-Net achieves high precision in segmenting lumbar spine structures, with mean IOU values ranging from 0.82 to 0.93 across various tissue categories and views. The automated quantification system provides measurements for intervertebral disc dimensions, dural sac diameter, yellow ligament thickness, and disc hydration. Consistency between training and testing datasets assures the robustness of automated measurements. Conclusion: Automated lumbar spine segmentation with residual U-Net and deep learning exhibits high precision in identifying anatomical structures, facilitating efficient quantification in lumbar spinal stenosis cases. The introduction of a rotation matrix enhances lesion detection, promising improved diagnostic accuracy, and supporting treatment decisions for lumbar spinal stenosis patients.

Unveiling the enigma of acute kidney disease: predicting prognosis, exploring interventions, and embracing a multidisciplinary approach

( Szu-yu Pan ),( Thomas Tao-min Huang ),( Zheng-hong Jiang ),( Li-chun Lin ),( I-jung Tsai ),( Tsung-lin Wu ),( Chih-yi Hsu ),( Ting Wang ),( Hui-chuen Chen ),( Yu-feng Lin ),( Vin-cent Wu ) 대한신장학회 2024 Kidney Research and Clinical Practice Vol.43 No.4

Acute kidney disease (AKD) is a critical transitional period between acute kidney injury and chronic kidney disease. The incidence of AKD following acute kidney injury is approximately 33.6%, and it can occur without identifiable preceding acute kidney injury. The development of AKD is associated with increased risks of chronic kidney disease, dialysis, and mortality. Biomarkers and subphenotypes are promising tools to predict prognosis in AKD. The complex clinical situations in patients with AKD necessitate a comprehensive and structured approach, termed “KAMPS” (kidney function check, advocacy, medications, pressure, sick day protocols). We introduce “MAND-MASS,” an acronym devised to summarize the reconciliation of medications during episodes of acute illness, as a critical component of the sick day protocols at AKD. A multidisciplinary team care, consisting of nephrologists, pharmacists, dietitians, health educators, and nurses, is an optimal model to achieve the care bundle in KAMPS. Although the evidence for patients with AKD is still lacking, several potential pharmacological agents may improve outcomes, including but not limited to angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, sodium-glucose cotransporter 2 inhibitors, and glucagon-like peptide 1 receptor agonists. In conclusion, accurate prognosis prediction and effective treatment for AKD are critical yet unmet clinical needs. Future studies are urgently needed to improve patient care in this complex and rapidly evolving field.

Development and characterization of a potential diagnostic monoclonal antibody against capsid protein VP1 of the chicken anemia virus

Yi-Yang Lien,Chi-Hung Huang,Fang-Chun Sun,Shyang-Chwen Sheu,Tsung-Chi Lu,Meng-Shiunn Lee,Shu-Chin Hsueh,Hsi-Jien Chen,Meng-Shiou Lee 대한수의학회 2012 Journal of Veterinary Science Vol.13 No.1

Chicken anemia virus (CAV) is an important viral pathogen that causes anemia and severe immunodeficiency syndrome in chickens worldwide. In this study, a potential diagnostic monoclonal antibody against the CAV VP1 protein was developed which can precisely recognize the CAV antigen for diagnostic and virus recovery purposes. The VP1 gene of CAV encoding the N-terminus-deleted VP1 protein, VP1Nd129, was cloned into an Escherichia (E.) coli expression vector. After isopropyl-b-D-thiogalactopyronoside induction, VP1Nd129 protein was shown to be successfully expressed in the E. coli. By performing an enzyme-linked immunoabsorbent assay using two coating antigens, purified VP1Nd129 and CAV-infected liver tissue lysate, E3 monoclonal antibody (mAb) was found to have higher reactivity against VP1 protein than the other positive clones according to the result of limiting dilution method from 64 clones. Using immunohistochemistry, the presence of the VP1-specific mAb, E3, was confirmed using CAV- infected liver and thymus tissues as positive-infected samples. Additionally, CAV particle purification was also performed using an immunoaffinity column containing E3 mAb. The monoclonal E3 mAb developed in this study will not only be very useful for detecting CAV infection and performing histopathology studies of infected chickens, but may also be used to purify CAV particles in the future.

Where Are Landscape Designers' Spatial Abilities in the Brain? An fMRI Study

Shih-Han Hung,Chia-Yi Huang,Tsung-Ren Huang,Shih-An Tang,Yu-Ping Tsai,Chun-YenChang 인간식물환경학회 2023 인간식물환경학회지 Vol.26 No.5

Background and objective: To effectively understand and communicate their work, landscape designers should possessexcellent spatial abilities. Neurological methods have confirmed that activation of the occipital lobe, parietal cortex, andprefrontal cortex affect the judgment of space; however, few studies have measured spatial abilities in landscape design. This study aimed to identify the potential role of various brain regions during spatial interpretation processes by landscapedesigners, particularly the effect of stimulating the frontal lobe on enhancing design capabilities. Methods: This study tested the spatial abilities of landscape designers when transforming a planar drawing into a sectionaldrawing and the brain regions activated in this process. The subjects were asked to identify the correct option whenmatching given section lines in a planar drawing. The correct answer rate and response time were used to score brainactivation during spatial task processes. A total of 16 valid subjects were divided into high- and low-accuracy groupsaccording to the correct answer rate. Results: The results for the high-accuracy group showed that the left inferior frontal gyrus was activated during spatialdesign tasks. In contrast, the findings for the low-accuracy group revealed that the left middle occipital gyrus was activatedfor processing visual information. Conclusion: The findings suggest that the frontal lobe plays a role in allowing landscape designers to make planar tocross-sectional inferences via mental rotations and categorical spatial relations. The findings offer implications forlandscape designers in stimulating the frontal lobe and enhancing their design capabilities.

Using Adaptive Bandwidth Allocation Approach to Defend DDoS Attacks

Wei-Shen Lai,Chu-Hsing Lin,Jung-Chun Liu,Hsun-Chi Huang,Tsung-Che Yang 보안공학연구지원센터 2008 International Journal of Software Engineering and Vol.2 No.4

Denial of service attacks occur when the attacks are from a single host, whereas distributed denial of service attacks occur when multiple affected systems flood the bandwidth or resources of a targeted system. Although it is not possible to exempt entirely from denial of service or distributed denial of service attacks, we can limit the malicious user by controlling the traffic flow. In the paper, we propose to monitor the traffic pattern in order to alleviate distributed denial of service attacks. A bandwidth allocation policy will be adopted to assign normal users to a high priority queue and suspected attackers to a low priority queue. Simulations conducted in network simulator of our proposed priority queue-based scheme shows its effectiveness in blocking attacking traffic while maintaining constant flows for legitimate traffic.

The most ideal interval between blastocyst biopsy and vitrification applied in preimplantation genetic screening (PGS)

( Hui-ying Low ),( Hsiu-hui Chen ),( Chun-chia Huang ),( Tsung-hsien Lee ),( Chung-i Chen ),( Lii-sheng Huang ),( Maw-sheng Lee ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

Study Question: To evaluate the most ideal interval between blastocyst biopsy and vitrification in preimplantation genetic screening (PGS). Study Design, Size, Duration: This is a retrospective study and total 224 patients underwent the PGS from 2012 Dec. to 2015 Mar. All of patients underwent blastocyst vitrification after biopsy and 1~2 euploid blastocyst for transfer after warming. The primary outcome measures were the implantation and pregnancy rates per PGS-frozen embryo transfer cycle. Materials, Setting, Methods: The blastocyst grading including grade 4, 5 and 6 (according to Gardner grading system) on day 5 or day 6 were selected for trophectoderm biopsy. All blastocyst underwent vitrification immediately (interval: 0.5 hour) or 1 to 7 hours after biopsy. At the time of vitrification the grade of blastocyst expansion was also recorded. All patients were divided into two groups according to the grade of expanded (Group1: ≤1/2 expansion (n=41), Group2: ≥3/4 expansion (n=183)). Furthermore, combined two factors including the interval and morphology of blastocyst after biopsy, all patients were further divided into interval 1 (<3 hours and ≤1/2 expansion) and interval 2 (≥3 hours and ≥3/4 expansion). The morphologically best euploid blastocyst(s) (1~2 embryos) was/were selected first for transfer on the next cycle. Main Results: Assessment morphology of blastocyst after biopsy in different interval, at 0.5 hour after biopsy, 100% blastocyst was non-expansion; at 1 hour after biopsy, only 17% blastocyst was 3/4 expansion or all-expansion; at 3 hours after biopsy, 86% blastocyst was 3/4 expansion or all-expansion and after 5.5 hours, 100% blastocyst was all-expansion or hatching. All blastocysts were survival (100%, 359/359) after warming. The mean of embryo transfer number between all groups were no significantly difference. The implantation rate in Group2 (63.4%) was significantly higher than that in Group1 (46.9%, p=0.014). The pregnancy rates in Group4 (73.8%) was sig-nificantly higher than that in Group1 (51.2%, p=0.004). The implantation and pregnancy rates in the group of embryo ≥3/4 expansion combined with ≥3 hours after biopsy (63.6%, 178/280; 73.8%, 127/172) were significantly higher than that in the group of ≤1/2 expansion with <3 hour (45.6, 26/57; 50.0%, 18/36; p=0.0113 and p=0.0056, respectively). Conclusion: The most ideal interval between biopsy and vitrification was least 3 hours and ≥3/4 expansion of blastocyst after biopsy could improve the implantation and pregnancy rates for PGS.