Transforaminal Endoscopic Lumbar Discectomy for L5–S1 Disc Herniation With High Iliac Crest: Technical Note and Preliminary Series

Kuo-Tai Chen,Sung-Tai Wei,Chun Tseng,Su-Wei Ou,Li-Wei Sun,Chien-Min Chen 대한척추신경외과학회 2020 Neurospine Vol.17 No.sup.

With the trend of minimally invasive spine surgery, full-endoscopic lumbar discectomy (FELD) has evolved with the advancement of the optics and instruments. Regarding the techniques, the transforaminal and interlaminar approach remain the major accesses in FELD. Transforaminal endoscopic lumbar discectomy (TELD) is an effective and safe treatment for herniation of the lumbar disc. More and more evidence supports the TELD in enhancing recovery and decreasing surgical complications. However, the learning curve of TELD remains steep, especially at the L5–S1 level. The iliac crest height is an essential factor in the operability of TELD at the L5–S1 level. In the situation of the high iliac crest, TELD is technically challenging even for an experienced surgeon. Therefore, the authors report their techniques of TELD with foraminoplasty step-by-step and the preliminary results in this report.

A Quantitative Vigilance Measuring Model by Fuzzy Sets Theory in Unlimited Monitoring Task

Liu, Cheng-Li,Uang, Shiaw-Tsyr,Su, Kuo-Wei Korean Institute of Industrial Engineers 2005 Industrial Engineeering & Management Systems Vol.4 No.2

The theory of signal detection has been applied to a wide range of practical situation for a long time, including sonar detection, air traffic control and so on. In general, in this theory, sensitivity parametric index d' and bias parametric index $\beta$ are used to evaluated the performance of vigilance. These indices use observer's response "hit" and "false alarm" to explain and evaluate vigilance, but not considering reaction time. However, the reaction time of detecting should be considered in measuring vigilance in some supervisory tasks such as unlimited monitoring tasks (e.g., supervisors in nuclear plant). There are some researchers have used the segments of reaction time to generate a pair of probabilities of hit and false alarm probabilities and plot the receiver operating characteristic curve. The purpose of this study was to develop a quantitative vigilance-measuring model by fuzzy sets, which combined the concepts of hit, false alarm and reaction time. The model extends two-values logic to multi-values logic by membership functions of fuzzy sets. A simulated experiment of monitoring task in nuclear plant was carried out. Results indicated that the new vigilance-measuring model is more efficient than traditional indices; the characteristics of vigilance would be realized more clearly in unlimited monitoring task.

A Quantitative Vigilance Measuring Model by Fuzzy Sets Theory in Unlimited Monitoring Task

Cheng-Li Liu,Shiaw-Tsyr Uang,Kuo-Wei Su 대한산업공학회 2005 Industrial Engineeering & Management Systems Vol.4 No.2

Laser Patterning Technology Based on Nanosecond Pulsed Laser for Manufacturing Bifacial Perovskite Solar Modules

Bo-Qian Lin,Chao-Peng Huang,Kuo-Yo Tian,Pei-Huan Lee,Wei-Fang Su,Li Xu 한국정밀공학회 2023 International Journal of Precision Engineering and Vol.10 No.1

Bifacial semi-transparent perovskite (PVSK) solar cell is a promising candidate to achieve high photo-electrical conversion efficiency (PCE) in a tandem structure with Si solar cells. The gap between lab-scale cells and large area modules needs to be closed using innovative patterning technology. In this paper we demonstrate that a single nanosecond pulsed laser (wavelength 532 nm, pulse duration 7 ns) can be used to perform all scribing processes, i.e. P1, P2 and P3, to manufacture PVSK solar modules. Compared to picosecond or femtosecond lasers reported in the literature, our approach has the advantages of high stability and low cost, and is thus applicable to large scale manufacturing of PVSK solar modules. Detailed laser processing parameters such as laser power and overlap ratio etc. have been studied to achieve optimal results for each scribing process. A mini module with two cells was fabricated on a 2 × 2 cm2 substrate, showing an active area efficiency of 12.5%, FF of 72.4%, and high GFF of 94%.

Sofosbuvir/velpatasvir plus ribavirin for Child-Pugh B and Child-Pugh C hepatitis C virus-related cirrhosis

( Chen-hua Liu ),( Chi-yi Chen ),( Wei-wen Su ),( Chun-jen Liu ),( Ching-chu Lo ),( Ke-jhang Huang ),( Jyh-jou Chen ),( Kuo-chih Tseng ),( Chi-yang Chang ),( Cheng-yuan Peng ),( Yu-lueng Shih ),( Chia 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.4

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR₁₂) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. The safety profiles were reported. Results: The SVR₁₂ rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5-94.2%), 94.1% (95% CI, 87.8-97.3%), and 100% (95% CI, 96.2-100%). Number of patients who failed to achieve SVR₁₂ were attributed to virologic failures. The SVR₁₂ rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR₁₂, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16-14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 ㎡/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 ㎡/month; P<0.001). Conclusions: SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis. (Clin Mol Hepatol 2021;27:575-588)

Clinical Significance of Smudge Cells in Peripheral Blood Smears in Hematological Malignancies and Other Diseases

Chang, Chih-Chun,Sun, Jen-Tang,Liou, Tse-Hsuan,Kuo, Chin-Fu,Bei, Chia-Hao,Lin, Sheng-Jun,Tsai, Wei-Ting,Tan, N-Chi,Liou, Ching-Biau,Su, Ming-Jang,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.

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.