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Radiological prognosticators of hepatocellular carcinoma treated by hepatectomy

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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

In-situ Observation of Initiation and Propagation of Cleavage Microcrack in TiAl

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Journal of Materials Science & Technology 1995年第1期11卷 11-14页

作者： GAO, kw CHEN, QH chu, WY HSIAO, CM

Nucleating and propagating of nanocrack formed in dislocation free zone (DFZ) for the brittle TiAl alloy has been studied through in-situ tensile test in TEM and analyzed using microfracture mechanics. The results show that a lot of dislocations can be emitted from a crack tip when the applied stress intensity K-la is larger than the stress intensity for dislocation emission K-le = 1.4 MPa . m(1/2) and a dislocation free zone, which sometimes is a close zone, can form after reaching equilibrium. The DFZ is a elastic zone with large strain and then the stress in the DFZ might equal to the cohesive strength sigma(th) because the crack tip is still sharp. When K-la is larger than the stress intensity for nanocrack nucleation K-li = 2.4 MPa . m(1/2), the stress within a certain range in the DFZ would equal to sigma(th) and then a nanocrack initiates in the DFZ or sometimes at the notch tip. The nanocrack formed in the DFZ is stable and can propagate a small distance in cleavage mode through multiplication and movement of dislocation in the plastic zone, during keeping constant displacement. Increasing K-la, can make the crack stably propagate continuously or discontinuously and it means that the stress intensify for crack propagation, K-lp, is larger than K-li. Therefore, K-le [K-li [K-lp [K-lC.

关键词： TiAl Figure DFZ

Is the treatment outcome of hepatocellular carcinoma inferior in elderly patients?

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World Journal of Gastroenterology 2019年第27期25卷 3563-3571页

作者： kevin Ka Wan chu Kenneth Siu Ho Chok Department of Surgery Queen Mary HospitalHong KongChina Department of Surgery and State Key Laboratory for Liver Research The University of Hong KongHong KongChina

In view of the increasing life expectancy in different parts of the world, a larger proportion of elderly patients with hepatocellular carcinoma(HCC) requiring oncological treatment is expected. The clinicopathological characteristics of HCC in elderly patients and in younger patients are different. Elderly patients, in general, also have more comorbidities. Evaluation of the efficacy of different HCC treatment options in elderly patients is necessary to optimize treatment outcomes for them. Treatment modalities for HCC include hepatectomy, liver transplantation, radiofrequency ablation, transarterial chemoembolization, and molecular-targeted therapy with sorafenib. In this review, current evidence on the risks and outcomes of the different HCC treatments for elderly patients are discussed. According to data in the literature, elderly patients and younger patients benefited similarly from HCC treatments. More clinical data are needed for the determination of selecting criteria on elderly HCC patients to maximize their chance of getting the most appropriate and effective treatments. As such,further studies evaluating the outcomes of different HCC treatment modalities in elderly patients are warranted.

关键词： Hepatocellular carcinoma Aged Clinical outcome Surgery Hepatectomy

Update in management of hepatocellular carcinoma in Eastern population

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World Journal of Hepatology 2015年第11期7卷 1562-1571页

作者： kevin Ka Wan chu Tan To Cheung Department of Surgery the University of Hong Kong

Hepatocellular carcinoma(HCC) is one of the commonest malignant tumours in the East. Although the management of HCC in the West is mainly based on the Barcelona Clinic for Liver Cancer staging, it is considered too conservative by Asian countries where the number of HCC patients is huge. Scientific and clinical advances were made in aspects of diagnosis, staging, and treatment of HCC. HCC is well known to be associated with cirrhosis and the treatment of HCC must take into account the presence and stage of chronic liver disease. The major treatment modalities of HCC include:(1) surgical resection;(2) liver transplantation;(3) local ablation therapy;(4) transarterial locoregional treatment; and(5) systemic treatment. Among these, resection, liver transplantation and ablation therapy for small HCC are considered as curative treatment. Portal vein embolisation and the associating liver partition with portal vein ligation for staged hepatectomy may reduce dropout in patients with marginally resectable disease but the midterm and long-term results are still to be confirmed. Patient selection for the best treatment modality is the key to success of treatment of HCC. The purpose of current review is to provide a description of the current advances in diagnosis, staging, preoperative liver function assessment and treatment options for patients with HCC in the east.

关键词： Hepatocellular carcinoma Liver cirrhosis Treatment Management Evidence Survival Update

Regulatory pressure and income smoothing by banks in response to anticipated changes to the Basel Ⅱ Accordq

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China Journal of Accounting Research 2017年第1期10卷 9-32页

作者： chu Yeong Lim kevin Ow Yong Singapore Institute of Technology Singapore School of Accountancy Singapore Management UniversitySingapore

We examine the effects of the revised Basel II rules on bank managers' discretionary behavior, specifically income smoothing and loan loss provisioning. As the revised rules exert greater regulatory pressure on corporate than retail banking, we predict corporate bank managers to reduce risk-taking activities or increase income smoothing. Analysis of segmental reports reveals greater(less) income smoothing in the corporate banking segments of low-capital(high-capital) banks during the Basel II period, with their managers recognizing loan loss provisions in a less timely fashion. We find no such effects for retail banking. Although we document an initially negative market reaction to the regulatory announcements, that reaction weakens over time. Overall,the study highlights the unintended consequences of the banking rule changes.

关键词： Basel Accord Income smoothing Loan loss provisions Corporate banking Retail banking

Temperature and composition dependent screw dislocation mobility in austenitic stainless steels from large-scale molecular dynamics

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npj Computational Materials 2020年第1期6卷 176-185页

作者： kevin chu Michael E.Foster Ryan B.Sills Xiaowang Zhou Ting Zhu David L.McDowell School of Materials Science and Engineering Georgia Institute of Technology AtlantaAtlantaGA 30332USA Sandia National Laboratories LivermoreCA 94550USA Department of Materials Science and Engineering Rutgers UniversityPiscatawayNJ 08854USA Woodruff School of Mechanical Engineering Georgia Institute of TechnologyAtlantaGA 30332USA

Extensive molecular dynamics simulations are performed to determine screw dislocation mobility in austenitic Fe_(0.7)NixCr_(0.3-x) stainless steels as a function of temperature ranging from 100 to 1300 K,resolved shear stress from 30 to 140 MPa,and Ni composition from 0.0 to 30.0 at%.These mobility data are fitted to a linear mobility law with a nonzero stress offset,referred to as the threshold *** find that both the linear drag coefficient and the threshold stress increase with Ni *** drag coefficient increases with temperature,whereas the threshold stress decreases with *** on these calculations,we determine fitting functions for the linear solute drag coefficient as a function of temperature and *** mobility laws determined in this study may serve to inform dislocation dynamics simulations pertinent to dislocation network evolution at elevated temperatures for a wide composition range of austenitic stainless steels.

关键词： austenitic dislocation dynamics

Net primary production in three bioenergy crop systems following land conversion

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Journal of Plant Ecology 2014年第5期7卷 451-460页

作者： Michael W.Deal Jianye Xu Ranjeet John Terenzio Zenone Jiquan Chen Housen chu Poonam Jasrotia kevin Kahmark Jonathan Bossenbroek Christine Mayer Department of Environmental Sciences University of Toledo2801 West Bancroft StreetMail Stop 604ToledoOH 43606USA Great Lakes Bioenergy Research Center Michigan State University164 Food Safety and Toxicology BuildingEast LansingMI 48824USA W.K.Kellogg Biological Station Michigan State University3700 East Gull Lake DriveHickory CornersMI 49060USA

Aims Identifying the amount of production and the partitioning to above-and belowground biomass is generally the first step toward select-ing bioenergy *** are very few existing studies on the dynamics of production following land *** objectives of this study were to(i)determine the differences in aboveground net primary production(ANPP),belowground net primary produc-tion(BNPP),shoot-to-root ratio(S:R)and leaf area index in three bioenergy crop systems and(ii)evaluate the production of these three systems in two different land use *** This investigation included biometric analysis of NPP on three agri-cultural sites converted from conservation reserve program(CRP)management to bioenergy crop production(corn,switchgrass and prairie mix)and three sites converted from traditional agriculture production to bioenergy crop *** findings The site converted from conventional agriculture produced smaller ANPP in corn(19.03±1.90 standard error[SE]Mg ha^(−1) year^(−1))than the site converted from CRP to corn(24.54±1.43 SE Mg ha^(−1) year^(−1)).The two land conversions were similar in terms of ANPP for switchgrass(4.88±0.43 SE for CRP and 2.04±0.23 SE Mg ha^(−1) year^(−1) for agriculture)and ANPP for prairie mix(4.70±0.50 SE for CRP and 3.38±0.33 SE Mg ha^(−1) year^(−1) for agriculture).The BNPP at the end of the growing season in all the bioenergy crop systems was not significantly different(P=0.75,N=8).

关键词： bioenergy crops land use change net primary production aboveground net primary production belowground net primary production

Current pre-hospital traumatic brain injury management in China

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World Journal of Emergency Medicine 2014年第4期5卷 245-254页

作者： Kou Kou iang-yu Hou Jian-dong Sun kevin chu School of Public Health and Social Work & Institute Health and Biomedical Innovation Queensland University of Technology Royal Brisbane and Women's Hospital Metro North Hospital and Health Service

BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, prehospital service can signifi cantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in *** SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure(CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identifi ed ***: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different ***: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.

关键词： Traumatic brain injury Pre-hospital China Emergency medicine

Language affects length of stay in emergency departments in Queensland public hospitals

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World Journal of Emergency Medicine 2013年第1期4卷 5-9页

作者： Ibrahim Mahmoud Xiang-yu Hou kevin chu Michele Clark School of Public Health Queensland University of TechnologyBrisbaneAustralia Department of Emergency Medicine Royal Brisbane and Women's HospitalBrisbaneAustralia

BACKGROUND:A long length of stay(LOS) in the emergency department(ED) associated with overcrowding has been found to adversely affect the quality of ED *** objective of this study is to determine whether patients who speak a language other than English at home have a longer LOS in EDs compared to those whose speak only English at ***:A secondary data analysis of a Queensland state-wide hospital EDs dataset(Emergency Department Information System) was conducted for the period,1 January 2008 to 31 December ***:The interpreter requirement was the highest among Vietnamese speakers(23.1%)followed by Chinese(19.8%) and Arabic speakers(18.7%).There were significant differences in the distributions of the departure statuses among the language groups(Chi-squared=3236.88,P<0.001).Compared with English speakers,the Beta coefficient for the LOS in the EDs measured in minutes was among Vietnamese,26.3(95%Cl:22.1-30.5);Arabic,10.3(95%Cl:7.3-13.2);Spanish,9.4(95%CI:7.1-11.7);Chinese,8.6(95%Cl:2.6-14.6);Hindi,4.0(95%Cl:2.2-5.7);Italian,3.5(95%Cl:1.6-5.4);and German,2.7(95%Cl:1.0-4.4).The final regression model explained 17%of the variability in ***:There is a close relationship between the language spoken at home and the LOS at EDs,indicating that language could be an important predictor of prolonged LOS in EDs and improving language services might reduce LOS and ease overcrowding in EDs in Queensland's public hospitals.

关键词： Emergency department Language Length of stay