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Radiological prognosticators of hepatocellular carcinoma treated by hepatectomy

Hepatobiliary & Pancreatic Diseases International 2012年第6期11卷 612-617页

作者： Kevin KW Chu See Ching Chan Sheung Tat Fan Kenneth SH Chok Tan To Cheung William W Sharr Albert cy Chan Chung Mau Lo Department of Surgery The University of Hong Kong102 Pokfulam Road Hong Kong China State Key Laboratory for Liver Research The University of Hong Kong 102 Pokfulam Road Hong Kong China

BACKGROUND: Hepatectomy is the main curative treatment for hepatocellular carcinoma (HCC), but postoperative long- term survival is poor. Preoperative radiological features of HCC displayed by computed tomography or magnetic resonance imaging could serve as additional prognostic factors. This study aimed to identify preoperative radiological features of HCC that may be of prognostic significance in hepatectomy. METHODS: Ninety-two patients who underwent hepatectomy for HCC were included in this study. Preoperative radiological features including tumor number, size, location (peripheral, middle, central), portal vein invasion, hepatic vein invasion, and presence of pseudo-capsule were analyzed in relation to survival. RESULTS: With a median follow-up period of 41.7 months, the 1-, 3- and 5-year overall survival rates were 85%, 65% and 58%, respectively. Univariate analysis showed that portal vein invasion and absence of pseudo-capsule were significant prognostic factors for overall survival, while all the examined radiological features were prognostic factors for disease-free survival. Multivariate analysis for overall survival found no significant factor. On multivariate analysis for disease-free survival, patients who had tumors with portal vein invasion had poorer survival with a hazard ratio of 2.26 (95% CI, 1.05-4.91; P=0.038) and patients with single nodular HCC or pseudo-capsulated HCC had better survival with a hazard ratio of 0.50 (95% CI, 0.27-0.94; P=0.032) and 0.38 (95% CI, 0.14-0.99; P=0.048), respectively. CONCLUSIONS: Demonstrable pseudo-capsule of HCC and solitary HCC on imaging and absence of portal vein invasionare features associated with better disease-free survival after hepatectomy. These features may guide treatment planning for HCC.

关键词： hepatocellular carcinoma hepatectomy diagnostic imaging prognosis survival analysis

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Programme cell death maintains tissue homeostasis during normal tendon healing

Programme cell death maintains tissue homeostasis during nor...

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第29届FIMS世界运动医学大会

作者： PPY Lui cy Cheuk LK Hung Department of Orthopaedics and Traumatology The Chinese University of Hong KongHong Kong SARChina

Purpose: During normal tendon healing, growth factors and cytokines stimulate the hyperproliferation of fibroblasts to deposit extracellular matrix for tissue repair. The restoration of normal tissue homeostasis at the late stage requires the reduction in cell numbers to restore a normal cell-to-matrix ratio. Despite the importance of this process, the deviation of which may

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Loss of the vitamin D receptor in human breast and prostate cancers strongly induces cell apoptosis through downregulation of Wnt/β-catenin signaling

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Bone Research 2017年第3期5卷 195-206页

作者： Yu Zheng Trupti Trivedi Ruby cy Lin Colette Fong-Yee Rick Nolte Jeline Manibo Yunzhao Chen Musharraf Hossain Konstantin Horas Colin Dunstan Hong Zhou Markus J Seibel Bone Research Program ANZAC Research Institute Asbestos Diseases Research Institute Cardiothoracic Genomics School of Medical Sciences University of New South Wales Department of Pathology Shihezi University School of Medicine Biomedical Engineering AMME University of Sydney Concord Clinical School The University of Sydney

Vitamin D co-regulates cell proliferation, differentiation and apoptosis in numerous tissues, including cancers. The known anti-proliferative and pro-apoptotic actions of the active metabolite of vitamin D, 1,25-dihydroxy-vitamin D [1,25（OH）2D] are mediated through binding to the vitamin D receptor （VDR）. Here, we report on the unexpected finding that stable knockdown of VDR expression in the human breast and prostate cancer cell lines, MDA-MB-231 and PC3, strongly induces cell apoptosis and inhibits cell proliferation in vitro. Implantation of these VDR knockdown cells into the mammary fat pad （MDA-MB-231）, subcutaneously （PC3） or intra-tibially （both cell lines） in immune-incompetent nude mice resulted in reduced tumor growth associated with increased apoptosis and reduced cell proliferation compared with controls. These growth-retarding effects of VDR knockdown occur in the presence and absence of vitamin D and are independent of whether cells were grown in bone or soft tissues. Transcriptome analysis of VDR knockdown and non-target control cell lines demonstrated that loss of the VDR was associated with significant attenuation in the Wnt/0-catenin signaling pathway. In particular, cytoplasmic and nuclear β-catenin protein levels were reduced with a corresponding downregulation of downstream genes such as Axin2, cyclin D1, interleukin-6 （IL-6）, and IL-8. Stabilization of 0-catenin using the GSK-3β inhibitor BIO partly reversed the growth-retarding effects of VDR knockdown. Our results indicate that the unliganded VDR possesses hitherto unknown functions to promote breast and prostate cancer growth, which appear to be operational not only within but also outside the bone environment. These novel functions contrast with the known anti-proliferative nuclear actions of the liganded VDR and may represent targets for new diagnostic and therapeutic approaches in breast and prostate cancer.

关键词： MDA Loss of the vitamin D receptor in human breast and prostate cancers strongly induces cell apoptosis through downregulation of Wnt catenin signaling VDR Wnt

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The impact of family history of hepatocellular carcinoma on its patients' survival

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Hepatobiliary & Pancreatic Diseases International 2012年第2期11卷 160-164页

作者： Wing Chiu Dai Sheung Tat Fan Tan To Cheung Kenneth SH Chok Albert cy Chan Simon HY Tsang Ronnie TP Poon Chung Mau Lo Department of Surgery The University of Hong Kong 102 Pokfulam Road Hong Kong China State Key Laboratory for Liver Research The University of Hong Kong 102 Pokfulam Road Hong Kong China

BACKGROUND:Family history of hepatocellular carcinoma(HCC) has been identified as a risk factor for the development of the *** aim of this study is to evaluate the impact of such a history on HCC patients’ ***:Data of all HCC patients(n=4532) managed at our center from 1989 to 2008 were prospectively *** patients were quizzed on their various characteristics including family HCC ***:Totally 475(10.48%) patients had a family history of *** presented the disease at a significantly earlier age(median 53 vs 59 years,P<0.0001) and at an earlier stage(the United Network for Organ Sharing staging system).They had significantly better liver function in terms of ChildPugh classification and serum albumin and bilirubin *** more of them presented the disease without symptoms(44.0% vs 29.4%,P<0.0001).They also had significantly better overall survival under these specifications:patients in the whole study cohort,patients who had minor hepatectomy,patients with stage I disease,patients with stage II disease,and patients with stage III ***:Contrary to what is generally believed,we found in this study cohort that patients with a family history of HCC had better overall survival than those without such a *** believe this was in part due to earlier diagnosis of the disease and better liver function in this group of ***,the effects of genetic factors on the risk of HCC cannot be overlooked and are yet to be identified.

关键词： hepatocellular carcinoma family history resection survival risk factor

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Rapid measurement of indocyanine green retention by pulse spectrophotometry: a validation study in 70 patients with Child-Pugh A cirrhosis before hepatectomy for hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2012年第3期11卷 267-271页

作者： Tan To Cheung See Ching Chan Kenneth SH Chok Albert cy Chan Wan Ching Yu Ronnie TP Poon Chung Mau Lo Sheung Tat Fan Department of Surgery the University of Hong Kong Department of Surgery and State Key Laboratory for Liver Research the University of Hong Kong

BACKGROUND: The indocyanine green (ICG) retention test is the most popular liver function test for selecting patients for major hepatectomy. Traditionally, it is done using spectrophotometry with serial blood sampling. The newly- developed pulse spectrophotometry is a faster alternative, but its accuracy on Child-Pugh A cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma has not been well documented. This study aimed to assess the accuracy of the LiMON , one of the pulse spectrophotometry systems, in measuring preoperative ICG retention in these patients and to devise an easy formula for conversion of the results so that they can be compared with classical literature records where ICG retention was measured by the traditional method. METHODS: We measured the liver function of 70 Child-Pugh A cirrhotic patients before hepatectomy for hepatocellular carcinoma from September 2008 to January 2009. ICG retention at 15 minutes measured by traditional spectrophotometry (ICGR15) was compared with ICG retention at 15 minutes measured by the LiMON (ICGR15(L)). RESULTS: The median ICGR15 was 14.7% (5.6%-32%) and the median ICGR15(L) was 10.4% (1.2%-28%). The mean difference between them was -4.3606. There was a strong correlation between ICGR15 and ICGR15(L) (correlation coefficient, 0.844; 95% confidence interval, 0.762-0.899). The following formula was devised: ICGR15=1.16×ICGR15(L)+***: The LiMON provides a fast and repeatable way to measure ICG retention at 15 minutes, but with constant underestimation of the real value. Therefore, when comparing results obtained by traditional spectrophotometry and the LiMON, adjustment of results from the latter is necessary, and this can be done with a simple mathematical calculation using the above formula.

关键词： Child-Pugh A liver cirrhosis hepatocellular carcinoma indocyanine green clearance LiMON pulse spectrophotometry

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Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2013年第5期12卷 552-555页

作者： See Ching Chan William W Sharr Tan To Cheung Albert cy Chan Simon HY Tsang Kenneth SH Chok Kin Chung Leung Chung Mau Lo Department of Surgery The University of Hong Kong State Key Laboratory for Liver Research The University of Hong Kong Department of Pathology The University of Hong Kong

The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena *** is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total *** we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular *** order to ensure clear resection margins,the anterior portion of the inferior vena cava was *** right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena *** this technique,we observed the no-touch technique in tumor removal,hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation.

关键词： hepatocellular carcinoma liver transplantation

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Comparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study

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World Journal of Gastroenterology 2006年第31期12卷 5010-5016页

作者： Wayne HC Hu SK Lam Cindy LK Lam WM Wong KF Lam KC Lai YH Wong Benjamin cy Wong Annie OO Chan CK Chan Gabriel M Leung WM Hui Department of Medicine University of Hong Kong Hong Kong China Department of Statistics and Actuarial Science University of Hong Kong Hong Kong China Department of Community Medicine University of Hong Kong Hong Kong China

AIM： To investigate the optimal strategy to treat dyspeptic patients in primary care. METHODS： Dyspeptic patients presenting to primary care outpatient clinics were randomly assigned to- （1） empirical endoscopy, （2） H pylori test-and-treat, and （3） empirical prokinetic treatment with cisapride. Early endoscopy was arranged if patients remained symptomatic after 2 wk. Symptom severity, quality-of-life （SF-36） as well as patient preference and satisfaction were assessed. All patients underwent endoscopy by wk 6. Patients were followed up for one year. RESULTS： Two hundred and thirty four patients were recruited （163 female, mean age 49）. 46% were H pylori positive. 26% of H pylori tested and 25% of empirical prokinetic patients showed no improvement at wk 2 follow-up and needed early endoscopy. 15% of patients receiving empirical cisapride responded well to treatment but peptic ulcer was the final diagnosis. Symptom resolution and quality-of-life were similar among the groups. Costs for the three strategies were HK$4343, $1771 and $1750 per patient. 66% of the patients preferred to have early endoscopy. CONCLUSION： The three strategies are equally effective. Empirical prokinetic treatment was the least expensive but peptic ulcers may be missed with this treatment. The H pylori test-and-treat was the most cost-effective option .

关键词： Empirical endoscopy Dyspeptic patients Hpylori test-and treat

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Pancreaticoduodenectomy with vascular reconstruction for adenocarcinoma of the pancreas with borderline resectability

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World Journal of Gastroenterology 2014年第46期20卷 17448-17455页

作者： Tan To Cheung Ronnie TP Poon Kenneth SH Chok Albert cy Chan Simon HY Tsang Wing Chiu Dai See Ching Chan Sheung Tat Fan Chung Mau Lo Department of Surgery Queen Mary HospitalUniversity of Hong Kong

AIM: To analyze whether pancreaticoduodenectomy with simultaneous resection of tumor-involved vessels is a safe approach with acceptable patient survival.

关键词： Adjuvant therapy Head of pancreas Liver transplant Morbidity Mortality Portal vein resection Survival analysis Whipple operation

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Differing coping mechanisms, stress level and anorectal physiology in patients with functional constipation

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World Journal of Gastroenterology 2005年第34期11卷 5362-5366页

作者： Annie OO Chan Cecilia Cheng Wai Mo Hui Wayne HC Hu Nina YH Wong KF Lam Wai Man Wong Kam Chuen Lai Shiu Kum Lam Benjamin cy Wong Department of Medicine the University of Hong Kong Hong Kong China Division of Social Science the Hong Kong University of Science and Technology Hong Kong China Department of Medicine the University of Hong Kong Hong Kong China Department of Statistics the University of Hong Kong Hong Kong China

AIM: To investigate coping mechanisms, constipation symptoms and anorectal physiology in 80 constipated subjects and 18 ***: Constipation was diagnosed by Rome Ⅱ *** ability and anxiety/depression were assessed by validated questionnaires. Transit time and balloon distension test were ***: 34.5% patients were classified as slow transit type of constipation. The total colonic transit time (56 h vs 10 h, P＜0.0001) and rectal sensation including urge sensation (79 mL vs 63 mL, P = 0.019) and maximum tolerable volume (110 mL vs95 mL, P = 0.03) differed in patients and controls. Constipated subjects had significantly higher anxiety and depression scores and lower SF-36 scores in all categories. They also demonstrated higher scores of'monitoring' coping strategy (14+6 vs9+3, P = 0.001),which correlated with the rectal distension sensation (P = 0.005), urge sensation (P=0.002), and maximum tolerable volume (P = 0.035). The less use of blunting strategy predicted slow transit constipation in both univariate (P = 0.01) and multivariate analysis (P = 0.03).CONCLUSION: Defective or ineffective use of coping strategies may be an important etiology in functional constipation and subsequently reflected in abnormal anorectal physiology.

关键词： Constipation Anorectal physiology Coping mechanism

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A Modified Current-Doubler Rectifier for DC-DC Converters to Achieve Balanced Average Currents

A Modified Current-Doubler Rectifier for DC-DC Converters to...

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第4届国际电力电子及运动控制国际会议

作者： Osama Abdel-Rahman Timothy cy Wang Issa Batarseh University of Central Florida Department of Electrical and Computer Engineering Orlando Florida 32816USA Global Research Center General Electric Shanghai P.R.China University of Central Florida Department of Electrical and Computer Engineering Orlando Florida 32816USA

＜正＞ Half-bridge DC-DC converter with a current doubler rectifier is suited for low-voltage high-current on-board DC-DC converters. Due to the fact that peak current-mode cannot be directly applied to the conventional half-bridge DC-DC converter, the voltage mode control is most likely utilized. However, in this case, the DC current sharing between two inductors of the current-doubler rectifier cannot be achieved due to unbalanced DC resistive parameters. In this paper, a modified half-bridge DC-DC converter is proposed and verified by an established steady-state mathematical model. Simulation and experimental results shows that the current sharing and zero DC transformer magnetizing current arc achieved.

关键词： Half-bridge DC-DC converter current doubler rectifier current sharing

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