Ching-Yu Chou

Three-dimensional analysis for radio-frequency ablation of liver tumor with blood perfusion effect

Increase of temperature above 50 ∼ 60°C for few minutes by the emitted radio-frequency (RF) energy has been shown to be able to denaturate the intracellular proteins and destruct membranes of tumor cells. To improve the efficacy of this thermal therapy, it is important to investigate factors that may affect the RF heating characteristics for the hepatocellular carcinoma and metastatic liver tumors. In order to make sure the applied RF energy is adequate to ablate the target tumor, a 3D thermoelectric analysis for the system consisting of liver, liver arteries and 4 mm diameter tumor is conducted. The effect of blood perfusion is addressed in this study.

Pregnancy Outcomes of Taiwanese Women with Gestational Diabetes Mellitus: A Comparison of Carpenter-Coustan and National Diabetes Data Group Criteria

AIMS To evaluate the pregnancy outcome of pregnant women in whom the 100-g oral glucose tolerance test (OGTT) met the criteria of Carpenter and Coustan (C&C) but not those of the National Diabetes Data Group (NDDG) for diagnosis of gestational diabetes mellitus (GDM). METHODS The medical records of 10,990 singleton pregnancies, delivered at Cathay General Hospital, Taiwan, between 2001 and 2008, were reviewed retrospectively. All pregnant women followed the two-step diagnostic algorithm for GDM; that is, women with a positive (>or=140 mg/dL) 50-g glucose challenge test (GCT) underwent a 100-g OGTT at 24-28 weeks of gestation. The pregnancies were classified as follows: group 1, women without GDM; group 2, women with GDM meeting the C&C criteria but not the NDDG criteria; and group 3, women with GDM diagnosed by NDDG criteria. RESULTS Of the pregnancies, 10,116 (92%), 489 (4.4%), and 385 (3.5%) were classified into groups 1, 2, and 3, respectively. Women with GDM by the C&C criteria but not by the NDDG criteria had an increase in macrosomia compared with women without GDM, 22 (4.5%) infants vs. 236 (2.3%) infants, respectively (p < 0.05); however, there were no associated adverse complications. If the C&C criteria were used, the incidence of GDM increased to 874 (7.9%) pregnancies. GDM as defined by either NDDG or C&C criteria identified pregnancies complicated by macrosomia, cesarean section, and gestational hypertension compared with the healthy population (p < 0.05). CONCLUSIONS In a Taiwanese population, using C&C criteria has no added advantages over using NDDG criteria.

First-trimester Down syndrome screening in women younger than 35 years old and cost-effectiveness analysis in Taiwan population

OBJECTIVES Outcome of the first-trimester Down syndrome screening in younger population was less reported before. We present the outcome of this screening in Taiwanese women younger than 35 years old. We also test whether or not the first-trimester Down syndrome screening of women <35 years of age and women >35 years old routinely receiving amniocentesis is cost-effective compared with all pregnant women screened with this test in the setting of increased maternal age. METHODS From 1999 to 2007, the first-trimester Down syndrome screening including nuchal thickness, pregnancy-associated plasma protein A and free beta-hCG are provided to 10 811 singleton women <35 years of age with the cut-off of 1/270. A cost-effectiveness analysis of young women receiving this screening and older women undergo amniocentesis versus all women undergo this screening was performed in Taiwan population from 1987 to 2006, in which advanced age pregnancies increased from 2.8% to 11.6% of total pregnancies. RESULTS Detection rates of trisomy 21, trisomy 18, Turner syndrome and other chromosome anormalies in women <35 years of age are 87.5% (14/16), 50% (2/4), 80% (8/10) and 63% (12/19), respectively, with a false-positive rate of 5.5% (590/10 811). As advanced age pregnancies reached 11.6%, the average cost per one case averted for all women screened ranged from

Cervical abscess with vaginal fistula after extraperitoneal cesarean section

77 204 to

EXPRESSION OF A HOECHST 33342 EFFLUX PHENOMENON AND COMMON CHARACTERISTICS OF PLURIPOTENT STEM CELLS IN A SIDE POPULATION OF AMNIOTIC FLUID CELLS

98 421, while the cost ranged from

The Mid-trimester Genetic Ultrasound: Past, Present and Future

99 647 to

Pregnancy in patients on chronic dialysis: A single center experience and combined analysis of reported results

116 433 for only women <35 years of age receiving this screening. CONCLUSIONS In an aging population, the first-trimester Down syndrome screening should be implemented for all pregnant women when it is available.

Haemoperitoneum in a pregnant woman with peritoneal dialysis

Extraperitoneal cesarean section was once used for the prevention of infection and postoperative adhesion. However, we report an unusual complication after this procedure. A 29-year-old woman had pus discharge from the anterior vaginal wall after extraperitoneal cesarean section. Broad-spectrum antibiotics failed to relieve her symptoms and vaginal culture yielded Morganella morganii . Magnetic resonance imaging, sagittal view, showed a cervical abscess measuring 5 x 5 cm with a tract extending to the anterior vagina. After performing dilation and abscess drainage via the cervical ostium, the symptoms gradually subsided with adequate antibiotic treatment. Cervical abscess may develop after extraperitoneal cesarean section and present initially as vaginal fistula. Detailed imaging study provides comprehensive anatomic information for effective management.

First trimester combined test for Down syndrome screening in unselected pregnancies - a report of a 13-year experience.

OBJECTIVE The aim of this study was to verify the existence of a side population (SP) of cells in second-trimester amniotic fluid. MATERIALS AND METHODS Amniotic fluid samples (n = 35) were obtained, and the number and size of viable amniotic fluid cells (AFCs) were analyzed. Small AFCs (SAFCs) and large AFCs (LAFCs) were isolated using a sterile 10-microm pore size strainer. Hoechst 33342 dye exclusion assay, flow cytometry analysis, reverse transcriptase polymerase chain reaction and immunocytochemistry were used to analyze the characteristics of SAFCs and LAFCs. RESULTS The mean concentration of viable AFCs from 16 to 21 weeks of gestation was 0.3 x 10(5), 0.8 x 10(5), 1.1 x 10(5), 1.3 x 10(5), 1.0 x 10(5) and 1.0 x 10(5) cells/mL respectively. The mean percentage of SAFCs from 16 to 21 weeks of gestation was 27.3%, 40.5%, 49.7%, 60.2%, 41.0% and 58.2%, respectively. The Hoechst 33342 efflux phenomenon was obvious among SAFCs but was rare in the LAFC population. Flow cytometry analyses showed that cell surface antigen expression on LAFCs and SAFCs were positive for CD29, CD44, CD73, CD90, CD166 and HLA-I, but negative for CD31, CD34, CD45, CD117 and HLA-II. Importantly, Nanog, Oct-4, ABCG2 and SOX2 expression in cells was easily detectable among the SAFC population. Expression of Nanog and ABCG2 was not observed among LAFCs. CONCLUSION Amniotic fluid contains a SP that was found mostly among the SAFCs. Enriched SP cells isolated by the efflux of Hoechst 33342 could be a novel and promising source of pluripotent-like amniotic derived stem cells for cellular therapy in the near future.

Prenatal diagnosis of congenital immature teratoma arising from retroperitoneum

Down syndrome is the most frequent disease of mental retardation thus many tests have been developed for its prenatal screening. Among these tests, the mid-trimester genetic ultrasound examination which assesses enormous soft markers has proceeded for more than 15 years. Although there is still a debate on the efficiency of the mid-trimester genetic ultrasound, many sonographers still pay much attention to these soft makers. One of the reasons is that as maternal age increase, there are more and more pregnant women over 35 years old and they are suggested to receive an invasive mid-trimester amniocentesis. However, some of them decline to have an invasive procedure and look for a noninvasive screening. With advances in the wide acceptance of first-trimester and second trimester Down syndrome screening, pregnant women with intermediate risk hesitate in deciding whether they should take the risk of abortion and receive further amniocentesis. Many expect other non-invasive methods in evaluating their risk of Down syndrome. In this article, we review the research of all the mid-trimester soft markers including nuchal thickness, the choroid plexus, hypoplasia of the nasal bone, echogenic cardiac focus, echogenic bowel, pyelectesis and shorter femurs or humerus. We also review the history of genetic ultrasound and its efficiency. As more and more non-invasive tests for Down syndrome are established, we compare the use of the genetic ultrasound and other maternal serum marker tests, alone and in combination. The future and perspectives of mid-trimester genetic ultrasound examination are discussed. Sonography examination is still one of the most important non-invasive methods for screening Down syndrome. With more understanding of mid-trimester genetic ultrasound, we can improve the detection rate of Down syndrome and decrease unnecessary invasive procedures such as chorionic villi samplings and amniocentesises. It may also give more assurance and decrease the anxiety of high risk women older than 35 years old or those told they have an intermediate risk after receiving first trimester and second trimester Down syndrome screenings.