Right-Sided Colonic Diverticulitis: Clinical Features,Sonographic Appearances,and Management

Purpose

This study aims to evaluate patients with right-sided colonic diverticulitis detected at ultrasonography (US).

Differential prognostic impact of renal insufficiency on patients with hepatocellular carcinoma: a propensity score analysis and staging strategy

Background and Aim: Renal insufficiency (RI) can coexist in patients with hepatocellular carcinoma (HCC). This study analyzed the prognostic impact of RI on patients with HCC and determined the optimal staging strategy for these patients. Methods: RI was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m². A total of 502 and 1701 HCC patients with and without RI, respectively, were enrolled. One‐to‐one matched patient cohorts according to treatments were built by using the propensity model. The prognostic ability of the Cancer of the Liver Italian Program, Barcelona Clinic Liver Cancer, Japan Integrated Scoring, and Taipei Integrated Scoring (TIS) systems in HCC patients with RI was compared by using the Akaike information criterion (AIC). Results: For patients undergoing percutaneous ablation and transarterial chemoembolization (TACE), RI was significantly associated with decreased long‐term survival (P = 0.001 and 0.004, respectively). In patients receiving resection and other treatments, there were no significant survival differences between patients with and without RI. With similar demographics generated in the propensity model, significantly decreased survival was found in patients with RI in the TACE group (P = 0.018), but not in the resection, percutaneous ablation, and other treatment groups. Among HCC patients with RI, the TIS system had the lowest AIC value. Conclusions: RI is often present in patients with HCC and predicts a poor outcome in patients undergoing TACE. The survival of HCC patients receiving resection, percutaneous ablation, and other treatments is not affected by RI. The TIS staging system is a more feasible prognostic model for HCC patients with RI.     

Percutaneous placement of metallic stents in the management of malignant biliary obstruction.

BACKGROUND AND PURPOSE: The placement of metallic stents is now a well-established method in the management of malignant biliary obstruction. This study evaluated the long-term clinical efficacy of percutaneous transhepatic insertion of metallic stents in the management of malignant biliary obstruction. METHODS: From January 1999 to December 2002, 102 consecutive patients with malignant biliary obstruction were treated with percutaneous transhepatic placement of metallic stents at a medical center in Taipei. The level of obstruction was at the hepatic hilum in 44 patients, and common bile duct (CBD) in 58 patients. Memotherm stents were used in 78 patients and Wallstents in 38. Among the 44 patients with hilar obstruction, 30 received a single stent and 14 received bilateral stents. Among the 58 patients with CBD obstruction, the stents were placed across the ampulla of Vater in 27. Patient survival rates and stent patency rates were compared using the Kaplan-Meier method. RESULTS: Placement of stents was successful in all patients. The mean (range) serum bilirubin level before, 1 week after, and 1 month after stent insertion was 15.1 mg/dL (4.2-32.4 mg/dL), 7.8 mg/dL (0.5-19.4 mg/dL), and 1.8 mg/dL (0.2-8.2 mg/dL), respectively. The mean survival in all patients was 66.0 weeks (1-130 weeks) and the mean stent patency period (MSPP) in all patients was 59.9 weeks (1-130 weeks). The MSPP was 71.4 versus 49.9 weeks in hilar type versus CBD type patients (p = 0.047). The MSPP was 53.9 versus 73.0 weeks in patients who received Memotherm stents versus Wallstents (p = 0.115). In the hilar obstruction group, the MSPP was 82.1 versus 58.0 weeks in patients receiving bilateral versus a single stent (p = 0.039). In the CBD obstruction group, the MSPP was 46.3 versus 45.5 weeks in stents placed across versus not placed across the ampulla of Vater (p = 0.338). CONCLUSIONS: The efficacy and patency period of percutaneous transhepatic insertion of metallic stents in the management of malignant biliary obstruction is satisfactory in the relief of obstructive jaundice. Both types of metallic stents performed well in relieving malignant biliary obstruction. Bilateral stenting was more effective than single stenting in treating patients with hilar obstruction. In patients with CBD obstruction, no significant difference in the stent patency period was found between stents placed across or not across the ampulla of Vater.     

Comparison of Plantar Pressure Distribution between Different Speed and Incline During Treadmill Jogging

The aim of this study was to examine the effect of changes in speed and incline slope on plantar pressure distribution of the foot during treadmill jogging. Plantar pressure parameters were measured with the Pedar-X system in twenty healthy girls (mean age of 20.7 years, mean height of 1.60m, and a mean weight of 53.35kg). Because variations in walking speed or slope can significantly change the magnitude of plantar pressure, comparisons of plantar pressure distribution between the two independent protocols during treadmill jogging were considered in this study. First, the subjects ran at the same speed of 2 m·s^-1 with different incline slopes of 0%, 5%, 10%, and 15%. Second, they ran on the same slope of 0% with different speeds of 1.5 m·s^-1, 2.0 m·s^-1, and 2.5 m·s^-1. The peak pressure of the eight plantar surface areas, apart from the medial forefoot and the hallux, significantly increased (p < 0.05) with an increase of 33% of peak pressure from 1.5 m·s^-1 to 2.5 m·s^-1 (speed) at heel region. In contrast, the peak pressures at the heel, medial fore-foot, toe and hallux decreased significantly (p < 0. 05) with increasing incline slope. At the heel, peak pressure reduced by 27% from 0% to 15% incline, however, pressure at the lateral midfoot region increased as following. Different speeds and incline slopes during jogging were associated with changes in plantar pressures. By systematic investigation of foot kinematics and plantar pressure during jogging with varying incline slope and speed, the results of this study provided further insight into foot biomechanics during jogging.

Key points

• The study aimed to compare the plantar pressure distribution of the foot between different incline and speed during treadmill jogging by using plantar insole measurement system.
• With the increase of speed, apart from the hallux and medical forefoot, the peak pressure of all regions was raised significantly.
• As the slope increased, there was reduced peak pressure of the heel, medial forefoot, and hallux and toes.

Key words: Jogging, plantar pressure, incline, speed     

Asymmetric dimethylarginine：A novel biomarker of gastric mucosal injury？

Nitric oxide(NO),a multifunctional endogenous gas molecule,is metabolized from L-arginine by enzymatic reaction in the presence of nitric oxide synthase.NO,an important gas signaling molecule,is a gastric mucosa protective factor that contributes significantly to maintain normal gastric mucosa integrity.NO increases gastric mucosa blood flow,regulates the secretion of mucus and bicarbonate,and inhibits the secretion of gastric juice.Asymmetric dimethylarginine(ADMA) has been identified as the major endogeno...     

Injectable biodegradable polymeric implants for the prevention of postoperative infection

Microbial infection is a potentially serious medical complication associated with implantation and surgical operation. Postoperative infection that occurs after antibacterial therapy for prophylaxis or infection has a greater probability of producing resistant organisms. Several antibacterials have been discovered and developed to combat this type of infection. However, their inability to target infected tissue and short half-lives contribute to low therapeutic efficiency. A better antibacterial administration method that can optimize antibacterial regimens and reduce the development of antibacterial resistance is needed. Thus, delivery methods of antibacterials of local and sustained release have become a high priority in conducting research. The material adopted for drug release is the main method to achieve such requirements. Injectable biodegradable polymer carriers for antibacterials possess numerous advantages, such as ease of application, localized delivery, sustained delivery periods, decreased drug dosage, and improved patient compliance. Nanoparticles, microspheres and sol-gel systems have all been studied as drug delivery vehicles that may give antibacterials a second lease on life.     

Rare benign and malignant appendiceal lesions: spectrum of computed tomography findings with pathologic correlation

Although acute appendicitis is the most common disease of the appendix, the appendix can be involved by a wide range of diseases. Diseases other than acute appendicitis may produce signs and symptoms indistinguishable from those of acute appendicitis. Computed tomography (CT) can provide important information for diagnosis and evaluation of appendiceal diseases. The various CT and histologic features of appendiceal benign and neoplastic diseases are discussed, illustrated, and correlated in this article. Radiologists need to understand the full spectrum of appendiceal abnormalities, their underlying pathologic changes, and associated CT imaging findings.     

Robust (Q,S, R)-γ-dissipative control of Takagi–Sugeno fuzzy systems with interval time-varying delay and sampling

The robust (Q, S, R)-γ-dissipative control of Takagi–Sugeno fuzzy time-delay model is considered by the developed robust control with sampling in this article. The proposed Lyapunov–Krasovskii functional and inequality are investigated to improve the main results in this article. Full matrix formulation approach is present to show our proposed results by some linear matrix inequalities. Interval delay and sampling period are contemplated instead of constant delay and fixed sampling in some circulated literatures. The less conservatism of our proposed results is demonstrated by our proposed numerical examples. Finally, we illustrate a mass-spring-damper nonlinear system to show our developed results.