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Effects of Yttrium-90 selective internal radiation therapy on non-conventional liver tumors

World Journal of Gastroenterology 2015年第27期21卷 8271-8283页

作者： Andrew Kuei Sammy Saab Sung-Ki Cho Stephen T Kee edward wolfgang lee Division of Interventional Radiology Department of Radiology UCLA Medical Center David Geffen School of Medicine at UCLA Los Angeles Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Los Angeles Division of Interventional Radiology Department of Radiology Samsung Medical Center Sungkyunkwan University School of Medicine

The liver is a common site of metastasis, with essentially all metastatic malignancies having been known to spread to the liver. Nearly half of all patients with extrahepatic primary cancer have hepatic metastases. The severe prognostic implications of hepatic metastases have made surgical resection an important first line treatment in management. However, limitations such as the presence of extrahepatic spread or poor functional hepatic reserve exclude the majority of patients as surgical candidates, leaving chemotherapy and locoregional therapies as next best options. Selective internal radiation therapy(SIRT) is a form of catheter-based locoregional cancer treatment modality for unresectable tumors, involving trans-arterial injection of microspheres embedded with a radioisotope Yttrium-90. The therapeutic radiation dose is selectively delivered as the microspheres permanently embed themselves within the tumor vascular bed. Use of SIRT has been conventionally aimed at treating primary hepatic tumors(hepatocellular carcinoma) or colorectal and neuroendocrine metastases. Numerous reviews are available for these tumor types. However, little is known or reviewed on non-colorectal or nonneuroendocrine primaries. Therefore, the aim of this paper is to systematically review the current literature to evaluate the effects of Yttrium-90 radioembolization on non-conventional liver tumors including those secondary to breast cancer, cholangiocarcinoma, ocular and percutaneous melanoma, pancreatic cancer, renal cell carcinoma, and lung cancer.

关键词： Liver metastases Breast cancer Melanoma Cholangiocarcinoma Radioembolization Selective internal radiation therapy Transarterial radioembolization Yttrium-90

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Coil-assisted retrograde transvenous obliteration for gastric varices in a Chinese case

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Journal of Interventional Medicine 2021年第2期4卷 94-96页

作者： Pengxu Ding Chao Liu Xinwei Han edward wolfgang lee Department of Intervention The First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Division of Interventional Radiology Department of RadiologyUCLA Medical CenterDavid Geffen School of Medicine at UCLALos AngelesCAUSA

Gastric varices are a major complication of portal hypertension in patients with liver cirrhosis and are associated with more massive bleeding events and higher mortality *** intrahepatic portosystemic shunt(TIPS)and balloon-occluded retrograde transvenous obliteration(BRTO)have been well documented as effective therapies for portal hypertensive gastric variceal *** China,TIPS are well accepted but BRTO is not well recieved due to the increase risk of complications associated with traditional ***,modified-BRTO,known as coil-assisted and plug-assisted retrograde transvenous obliteration(CARTO and PARTO,respectively),is receiving increased attention due to devoid of BRTO’s *** CARTO case from China has been reported in literature thus ***,we present a Chinese case of CARTO to treat gastric varices bleeding.

关键词： Gastric varices Gastric variceal bleeding Coil assisted retrograde transvenous obliteration

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Fracture of inferior vena cava stent after endovascular treatment for Budd-Chiari syndrome:A case series and literature review

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Journal of Interventional Medicine 2023年第2期6卷 99-102页

作者： Pengxu Ding Wen Zhou Jiayin Ding Shaofeng Shui Luo Xu edward wolfgang lee Department of Intervention The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Department of Oncology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Division of Interventional Radiology Department of RadiologyUCLA Medical CenterDavid Geffen School of Medicine at UCLALos AngelesCAUSA Division of Liver and Pancreas Transplant Surgery Department of SurgeryUCLA Medical CenterDavid Geffen School of Medicine at UCLALos AngelesCAUSA

Budd-Chiari syndrome(BCS)is a rare condition characterized by hepatic venous outflow *** angioplasty,with or without stenting,is the recommended first-line treatment modality in Asian *** a supplement to balloon angioplasty,expandable metallic Z-stent deployment can effectively improve long-term inferior vena cava(IVC)*** stent placement is a standard and frequently performed treatment,very few IVC stent-related complications,such as stent fractures,have been *** we present a case series and a comprehensive review of IVC stent fractures in patients with *** most common characteristic of IVC stent fractures is a protrusion of the proximal segment of the IVC stent into the right atrium and its systolic and diastolic movements along with heart *** stent deployment,large-diameter balloon dilation,patient breath-holding training,preferential selection of a triple stent,and the use of an internal jugular vein approach to stent deployment may ensure precise stent localization and avoid postoperative complications.

关键词： Budd-Chiari syndrome Inferior vena cava Angioplasty Stenting Fracture

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Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy

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World Journal of Gastroenterology 2017年第10期23卷 1735-1746页

作者： Murad Feroz Bandali Anirudh Mirakhur edward wolfgang lee Mollie Clarke Ferris David James Sadler Robin Ritchie Gray Jason Kam Wong Department of Radiology Foothills Medical Centre University of Calgary Division of Interventional Radiology Department of Radiology UCLA Medical Center

Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.

关键词： Portal hypertension Diagnostic imaging Portosystemic collaterals Image-guided therapy

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Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt

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World Journal of Gastroenterology 2016年第25期22卷 5780-5789页

作者： edward wolfgang lee Andrew Kuei Sammy Saab Ronald W Busuttil Francisco Durazo Steven-Huy Han Mohamed M El-Kabany Justin P Mc Williams Stephen T Kee Department of Radiology Division of Interventional Radiology Ronald Reagan Medical Center at UCLA David Geffen School of Medicine at UCLA Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Dumont-UCLA Transplant Center Pfleger Liver Institute Division of Liver and Pancreas Transplantation Department of Surgery David Geffen School of Medicine at University of California Los Angeles

AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt (TIPS) in 15 ***: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and ***: Overall, 12.3% of patients died during hospitalization with downward trend in-hospital mortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients (OR = 1.809 vs Caucasian patients, P leeding (OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites (OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders (OR = 2.823), coagulopathy (OR = 2.016), and lymphoma (OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is stea

关键词： Transjugular intrahepatic portosystemic shunt Mortality Inpatient United States National Inpatient Sample database Health Cost and Utilization Project

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Management of hepatocellular carcinoma with portal vein thrombosis

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World Journal of Gastroenterology 2015年第12期21卷 3462-3471页

作者： Matthew Quirk Yun Hwan Kim Sammy Saab edward wolfgang lee Division of Inter-ventional Radiology Department of Radiology UCLA Medical Center David Geffen School of Medicine at UCLA Los Angeles Department of Radiology Korea University College of Medicine Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Los Angeles

Management of hepatocellular carcinoma(HCC) with portal vein thrombosis(PVT) is complex andrequires an understanding of multiple therapeutic options. PVT is present in 10%-40% of HCC at the time of diagnosis, and is an adverse prognostic factor. Management options are limited, as transplantation is generally contraindicated, and surgical resection is only rarely performed in select centers. Systemic medical therapy with sorafenib has been shown to modestly prolong survival. Transarterial chemoembolization has been performed in select cases but has shown a high incidence of complications. Emerging data on treatment of PVT with Y-90 radioembolization suggest that this modality is well-tolerated and associated with favorable overall survival. Current society guidelines do not yet specifically recommend radioembolization for patients with PVT, but this may change with the development of newer staging systems and treatment algorithms. In this comprehensive literature review, we present current and available management options with the relative advantages, disadvantages and contraindications of these treatment options with summarized data on overall survival.

关键词： Hepatocellular carcinoma Portal vein thrombosis Yt

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Areal Roughness of the Dorsal Nail Plate

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International Journal of Dermatology and Venereology 2024年第1期7卷 27-34页

作者： Brian lee Beatty edward Li Adaeze Anaekwe Anatomy Department NYIT College of Osteopathic MedicineOld WestburyNY 11568USA United States National Museum Smithsonian InstitutionWashingtonDC 20560USA Division of Paleobiology Friends AcademyLocust ValleyNY 11560USA

Objective:Beau lines,onychorrhexis,and psoriatic lesions of the dorsal nail plate may be missed by photographic methods,indicating a need for surface texture measurement methods that are more quantitative,sensitive,and repeatable than visual inspection or *** conducted this study to evaluate the utility of surface texture measurements of cadaveric nails that can be associated with histopathological studies in the ***:The nail plates of 4 cadaveric right pollices and halluces were cleaned and molded,cast in clear epoxy,and scanned with a Sensofar S Neox optical profilometer.A one-way analysis of variance was performed to determine statistical significance of ***:Almost no differences were observed between the pollex and hallux scans and between the distal and proximal *** greatest differences were found between *** lower magnification(5×)is less sensitive than higher magnification(20×),the lower magnification represented and characterized more of the dorsal nail ***:The dorsal nail plate areal roughness has a measurable range of values that may serve as a starting point for evaluating pathological findings,particularly Beau lines and psoriatic *** sensitivity of these techniques may be especially valuable in the recognition of less severe states of these diseases that may enable the diagnosis of earlier stages of growth disruptions(Beau lines)or *** applications could be especially useful in investigations of the health of wildlife populations or vulnerable human populations with incomplete treatment records.

关键词： nail plate surface metrology areal roughness

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Accelerated intermetallic phase amorphization in a Mg-based high-entropy alloy powder

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Journal of Magnesium and Alloys 2024年第5期12卷 1792-1798页

作者： Prince Sharma Purvam Mehulkumar Gandhi Kerri-lee Chintersingh Mirko Schoenitz edward L.Dreizin Sz-Chian Liou Ganesh Balasubramanian Institute for Functional Materials&Devices Lehigh UniversityBethlehemPA 18015USA Center of Materials for Advanced Energetics New Jersey Institute of TechnologyNewarkNJ 07102USA

We describe a novel mechanism for the synthesis of a stable high-entropy alloy powder from an otherwise immiscible Mg-Ti rich metallic mixture by employing high-energy mechanical *** presented methodology expedites the synthesis of amorphous alloy powder by strategically injecting entropic disorder through the inclusion of multi-principal elements in the alloy *** from first principles and materials theory corroborate the results from microscopic characterizations that reveal a transition of the amorphous phase from a precursor intermetallic *** transformation,characterized by the emergence of antisite disorder,lattice expansion,and the presence of nanograin boundaries,signifies a departure from the precursor intermetallic ***,this phase transformation is accelerated by the presence of multiple principal elements that induce severe lattice distortion and a higher configurational *** atomic size mismatch of the dissimilar elements present in the alloy produces a stable amorphous phase that resists reverting to an ordered lattice even on annealing.

关键词： High-entropy alloy High-energy milling Antisite disorder Amorphous Intermetallic

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Blast waveform tailoring using controlled venting in blast simulators and shock tubes

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Defence Technology（防务技术） 2024年第7期37卷 14-26页

作者： edward Chern Jinn Gan Alex Remennikov David Ritzel Faculty of Engineering and Information Sciences University of WollongongWollongongNSW2522Australia Dyn-FX Consulting Ltd 19 Laird Ave NorthAmherstburgONN9V 2T5Canada

A critical challenge of any blast simulation facility is in producing the widest possible pressure-impulse range for matching against equivalent high-explosive *** tubes and blast simulators are often constrained with the lack of effective ways to control blast wave profiles and as a result have a limited performance *** wave shaping techniques employed in some facilities are reviewed but often necessitate extensive geometric modifications,inadvertently cause flow anomalies,and/or are only applicable under very specific *** paper investigates controlled venting as an expedient way for waveforms to be tuned without requiring extensive modifications to the driver or existing geometry and could be widely applied by existing and future blast simulation and shock tube *** use of controlled venting is demonstrated experimentally using the Advanced Blast Simulator(shock tube)at the Australian National Facility of Physical Blast Simulation and via numerical flow simulations with Computational Fluid *** venting is determined as an effective method for mitigating the impact of re-reflected waves within the blast *** control method also allows for the adjustment of parameters such as tuning the peak overpressure,the positive phase duration,and modifying the magnitude of the negative phase and the secondary shock of the blast *** paper is concluded with an illustration of the potential expanded performance range of the Australian blast simulation facility when controlled venting for blast waveform tailoring as presented in this paper is applied.

关键词： Advanced blast simulator Shock wave propagation Far-field explosion Blast loads Blast waves Computational fluid dynamics

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Reflections on Studying Huang Di Nei Jing in the West

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Chinese Medicine and Culture 2024年第1期7卷 72-76页

作者： edward Neal Apricot Grove Educational Services Portland 97213the United States of America Xinglin Institute for Early East Asian Medicine Portland 97213the United States of America

Huang Di Nei Jing(《黄帝内经》The Yellow Emperor’s Inner Classic) has been the source text of Chinese medicine knowledge and innovation for over two thousand years. Despite this key relevance, many of its ideas and practices have proven difficult to understand and implement fully into clinical practice. Cultural and language differences can be compounded with these challenges but may also present new opportunities for advancement and insight when studied by researchers outside of the originating culture. This article introduces the method of Classical-Text Archaeology and delves into the author’s two-decade journey of researching this text, with a discussion on cultural differences and issues of medical scholarship.

关键词： Huang Di Nei Jing Chinese medicine Nei Jing nature-based medicine Classical text research Global health Medical anthropology Classical-Text Archaeology

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