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  • 1
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    Online Resource
    Super-Selective Intra-Arterial Indocyanine Green Administration for Near-Infrared Fluorescence-Based Positive Staining of Hepatic Segmentation: A Feasibility Study
    SAGE Publications ; 2021
    In:  Surgical Innovation Vol. 28, No. 6 ( 2021-12), p. 669-678
    Details
    In: Surgical Innovation, SAGE Publications, Vol. 28, No. 6 ( 2021-12), p. 669-678
    Abstract: Background. Despite the increasing number of laparoscopic hepatic procedures for the resection of hepatocellular carcinoma (HCC), intraoperative tumor localization and demarcation remains challenging in comparison to open surgery. In this study, we evaluated the feasibility of positive liver segment staining through the super-selective intra-arterial indocyanine green (ICG) administration. Methods. Eight patients presenting with a single HCC underwent an interventional vascular procedure followed by laparoscopic surgery. A microcatheter was advanced into the hepatic artery branches perfusing the HCC followed by digital subtraction angiography and angiography computed tomography (angio-CT). Patients were then transferred to the operating room, and a laparoscopic hepatectomy was performed under ultrasound guidance. A 5 mL bolus of ICG with a concentration of .125 mg/mL was injected through the microcatheter, and a near-infrared laparoscope was used to detect the fluorescence signal to assess the correspondence between the fluorescence-based demarcation and the intraoperative ultrasound–based demarcation. Results. The duration for the angiography procedure was 32.7 +/− 5.3 min, and it took 242 +/− 118 min from the end of angiography procedure until the start of the surgical procedure. In all cases, the fluorescent liver segment was corresponding to the angio-CT findings. In 6/8 cases, fluorescence imaging was considered helpful in the identification of the resection line. In 3 patients, the resection line was changed according to the positively stained liver segment. Conclusion. We successfully demonstrated the feasibility of the super-selective intra-arterial ICG administration for fluorescence-based positive staining of hepatic segmentation during laparoscopic surgery for HCC (NCT04266548).
    Type of Medium: Online Resource
    ISSN: 1553-3506 , 1553-3514
    URL: Article
    DOI: 10.1177/1553350621996972
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2233576-6
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  • 2
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    The SIH-EBP Score: A grading scale to predict the response to the first epidural blood patch in spontaneous intracranial hypotension
    SAGE Publications ; 2023
    In:  Cephalalgia Vol. 43, No. 3 ( 2023-03), p. 033310242211474-
    Details
    In: Cephalalgia, SAGE Publications, Vol. 43, No. 3 ( 2023-03), p. 033310242211474-
    Abstract: To develop and validate an easy-to-use scoring system to predict the response to the first epidural blood patching in patients with spontaneous intracranial hypotension. Methods This study recruited consecutive patients with spontaneous intracranial hypotension receiving epidural blood patching in a tertiary medical center, which were chronologically divided into a derivation cohort and a validation cohort. In the derivation cohort, factors associated with the first epidural blood patching response were identified by using multivariable logistic regression modeling. A scoring system was developed, and the cutoff score was determined by using the receiver operating characteristic curve. The findings were verified in an independent validation cohort. Results The study involved 280 patients in the derivation cohort and 78 patients in the validation cohort. The spontaneous intracranial hypotension-epidural blood patching score (range 0–5) included two clinical variables (sex and age) and two radiological variables (midbrain-pons angle and anterior epidural cerebrospinal fluid collections). A score of ≥3 was predictive of the first epidural blood patching response, which was consistent in the validation cohort. Overall, patients who scored ≥3 were more likely to respond to the first epidural blood patching (odds ratio = 10.3). Conclusion For patients with spontaneous intracranial hypotension-epidural blood patching score ≥3, it is prudent to attempt at least one targeted epidural blood patching before considering more invasive interventions.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/03331024221147488
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2019999-5
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  • 3
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    Urine metabolomics signatures in reversible cerebral vasoconstriction syndrome
    SAGE Publications ; 2020
    In:  Cephalalgia Vol. 40, No. 7 ( 2020-06), p. 735-747
    Details
    In: Cephalalgia, SAGE Publications, Vol. 40, No. 7 ( 2020-06), p. 735-747
    Abstract: The pathophysiology of reversible cerebral vasoconstriction syndrome is unclear. An unbiased systems-based approach might help to illustrate the metabolite profiling and underlying pathophysiology. Methods Urine samples were collected from reversible cerebral vasoconstriction syndrome patients and matched controls recruited in Taipei Veterans General Hospital. 1 H-Nuclear magnetic resonance was used to initially explore the metabolic profile, and liquid chromatography tandem mass spectrometry was then used to identify metabolic alterations in reversible cerebral vasoconstriction syndrome. Untargeted metabolite screening was randomly performed on 10 reversible cerebral vasoconstriction syndrome patients and 10 control subjects in the discovery phase. The selected untargeted metabolites were further validated on 47 reversible cerebral vasoconstriction syndrome patients during their ictal stage (with 40 of them having remission samples) and 47 controls in the replication phase. Results and conclusion Six metabolites-hippurate, citrate, 1,3,7-trimethyluric acid, ascorbic acid, D-glucurono-6,3-lactone, and D- threo-isocitric acid-with t-test derived p-value 〈 0.05 and VIP score 〉 1, were identified as potential urine signatures that can well distinguish reversible cerebral vasoconstriction syndrome subjects at ictal stage from controls. Among them, citrate, hippurate, ascorbic acid, and D-glucurono-6,3-lactone were significantly lower, and 1,3,7-trimethyluric acid and D- threo-isocitric acid were higher in reversible cerebral vasoconstriction syndrome patients. Of these, four selected metabolites, citrate, D-glucurono-6,3-lactone, ascorbic acid, and 1,3,7-trimethyluric acid, returned to normal levels in remission. These metabolites are related to pathways associated with free radical scavenging, with the hub molecules being associated with endothelial dysfunction or sympathetic overactivity. Whether these metabolites and their implicated networks play a role in the pathogenesis of reversible cerebral vasoconstriction syndrome remains to be confirmed.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102419897621
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2019999-5
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  • 4
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    Brain volume changes in spontaneous intracranial hypotension: Revisiting the Monro-Kellie doctrine
    SAGE Publications ; 2021
    In:  Cephalalgia Vol. 41, No. 1 ( 2021-01), p. 58-68
    Details
    In: Cephalalgia, SAGE Publications, Vol. 41, No. 1 ( 2021-01), p. 58-68
    Abstract: In the application of the Monro-Kellie doctrine in spontaneous intracranial hypotension, the brain tissue volume is generally considered as a fixed constant. Traditionally, cerebral venous dilation is thought to compensate for decreased cerebrospinal fluid. However, whether brain tissue volume is invariable has not yet been explored. The objective of this study is to evaluate whether brain tissue volume is fixed or variable in spontaneous intracranial hypotension patients using automatic quantitative methods. Methods This retrospective and longitudinal study analyzed spontaneous intracranial hypotension patients between 1 January 2007 and 31 July 2015. Voxel-based morphometry was used to examine brain volume changes during and after the resolution of spontaneous intracranial hypotension. Brain structure volume was analyzed using Statistical Parametric Mapping version 12 and FMRIB Software Library v6.0. Post-treatment neuroimages were used as surrogate baseline measures. Results Forty-four patients with spontaneous intracranial hypotension were analyzed (mean [standard deviation] age, 37.8 [8.5] years; 32 female and 12 male). The whole brain tissue volume was decreased during spontaneous intracranial hypotension compared to follow-up (1180.3 [103.5] mL vs. 1190.4 [93.1]  mL, difference: −10.1 mL [95% confidence interval: −18.4 to −1.8 mL], p = 0.019). In addition, ventricular cerebrospinal fluid volume was decreased during spontaneous intracranial hypotension compared to follow-up (15.8 [6.1]  mL vs. 18.9 [6.9] mL, difference: −3.2 mL [95% confidence interval: −4.5 to −1.8 mL] , p  〈  0.001). Longer anterior epidural cerebrospinal fluid collections, as measured by number of vertebral segments, were associated with greater reduction of ventricular cerebrospinal fluid volume (Pearson’s r = −0.32, p = 0.036). Conclusion The current study found the brain tissue volume and ventricular cerebrospinal fluid are decreased in spontaneous intracranial hypotension patients. The change in ventricular cerebrospinal fluid volume, but not brain tissue volume change, was associated with the severity of spinal cerebrospinal fluid leakage. These results challenge the assumption that brain tissue volume is a fixed constant.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102420950385
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 5
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    Who Gets Protection? A National Study of Multiple Victimization and Child Protection Among Taiwanese Children
    SAGE Publications ; 2019
    In:  Journal of Interpersonal Violence Vol. 34, No. 17 ( 2019-09), p. 3737-3761
    Details
    In: Journal of Interpersonal Violence, SAGE Publications, Vol. 34, No. 17 ( 2019-09), p. 3737-3761
    Abstract: This study aims to examine the prevalence of multiple types of child victimization and the effects of multiple types of victimization on children’s mental health and behavior in Taiwan. The study also examines the child-protection rate and its correlates among children experiencing various types of victimization. This study collected data with a self-report questionnaire from a national proportionately stratified sample of 6,233 fourth-grade students covering every city and county in Taiwan in 2014. After calculating the 1-year prevalence of child victimization, the study found that bullying was the most prevalent (71%), followed by physical neglect (66%), psychological violence (43%), inter-parental violence (28%), community violence (22%), physical abuse (21%), and sexual violence (9%). As the number of victimization types increased, children were more likely to report greater posttraumatic symptoms, psychiatric symptoms, suicide ideation, self-harm thoughts, and violent behaviors. Gender, neonatal status, parental marital status, and other family risks were significantly associated with elevated incidences of the victimization types. Only 20.6% of the children who had experienced all seven types of victimization had received child protective services. A child was more likely to receive child protective services if he or she had experienced sexual violence, community violence, inter-parental violence exposure, higher family risks, higher suicidal ideation, or living in a single-parent or separated family. In conclusion, this study demonstrates the cumulative effects and the harmful effects that children’s experience of multiple types of victimization can have on the children’s mental health and behavior. The present findings also raise alarms regarding the severity of under-serving in child-victimization cases. These results underscore the importance of assessing, identifying, and helping children with multiple victimization experiences.
    Type of Medium: Online Resource
    ISSN: 0886-2605 , 1552-6518
    URL: Article
    DOI: 10.1177/0886260516670885
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2028900-5
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  • 6
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    The time sequence of brain MRI findings in spontaneous intracranial hypotension
    SAGE Publications ; 2022
    In:  Cephalalgia Vol. 42, No. 1 ( 2022-01), p. 12-19
    Details
    In: Cephalalgia, SAGE Publications, Vol. 42, No. 1 ( 2022-01), p. 12-19
    Abstract: To investigate the time sequence of brain magnetic resonance imaging findings of spontaneous intracranial hypotension. Methods We retrospectively reviewed the medical records and brain magnetic resonance imaging findings of consecutive patients with spontaneous intracranial hypotension hospitalized between January 2007 and December 2017. Patients were divided into quartiles based on intervals between initial spontaneous intracranial hypotension symptom onset and brain magnetic resonance imaging scan. Six categorical and five continuous brain magnetic resonance imaging findings were assessed, including venous distension sign, enlarged pituitary gland, diffuse pachymeningeal enhancement, mid-brain pons deformity, subdural fluid collection, flattening of pons, midbrain-pons angle, descent of cerebral aqueduct, mamillopontine distance, distance of suprasellar cistern, and distance of prepontine cistern. In addition, we also calculated the neuroimaging scores with a score ≥5 classified as ‘high probability of spontaneous intracranial hypotension' and a score ≥3 as ‘intermediate-to-high probability.' Then, we analyzed the linkage between the onset-neuroimaging interval and brain magnetic resonance imaging findings, as well as different neuroimaging scores. Results A total of 173 patients (57 males and 116 females) were included in the analysis, and the range of onset-neuroimaging interval was 1 to 89 days (median [interquartile range]  =  17 [7 to 30 days] ). We divided the patients into quartiles based on their onset-neuroimaging interval (the first quartile: 0–6 days; the second quartile: 7–16 days; the third quartile: 17–29 days; the fourth quartile: ≥30 days). Among brain magnetic resonance imaging findings, the incidence of venous distension sign was high ( 〉 75%), with no difference among quartiles (p = 0.876). The incidence of diffuse pachymeningeal enhancement (p = 0.001), severe midbrain-pons deformity (p = 0.001), and subdural fluid collection ( 〈 0.001) followed a significant stepwise increase from the first quartile to fourth quartile. Patients with shorter onset-neuroimaging intervals were less likely to have neuroimaging scores ≥5 ( 〈 17 vs. ≥17 days: 72.9% vs. 86.4%; odds ratio = 2.3 [95% CI 1.1–5.1], p = 0.028), but not neuroimaging scores ≥3 ( 〈 17 vs. ≥17 days: 92.9% vs. 92.0%, p = 0.824). Conclusions The emergence of brain magnetic resonance imaging findings of spontaneous intracranial hypotension depended on disease duration and appeared sequentially. When using brain magnetic resonance imaging findings or neuroimaging scores for diagnostic purposes, the onset–neuroimaging interval should be considered.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/03331024211044424
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 7
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    Correlations among brain and spinal MRI findings in spontaneous intracranial hypotension
    SAGE Publications ; 2018
    In:  Cephalalgia Vol. 38, No. 14 ( 2018-12), p. 1998-2005
    Details
    In: Cephalalgia, SAGE Publications, Vol. 38, No. 14 ( 2018-12), p. 1998-2005
    Abstract: Several brain and spinal magnetic resonance imaging signs have been described in spontaneous intracranial hypotension. Their correlations are not fully studied. This study aimed to explore potential mechanisms underlying cerebral neuroimaging findings and to examine associations among spinal and brain magnetic resonance imaging signs. Methods We conducted a retrospective review of magnetic resonance myelography and brain magnetic resonance imaging records of patients with spontaneous intracranial hypotension. Categorical principal component analysis was employed to cluster brain neuroimaging findings. Spearman correlation was employed to analyze associations among different brain neuroimaging findings and between brain and spinal neuroimaging findings. Results In patients with spontaneous intracranial hypotension (n = 148), categorical principal component analysis of brain neuroimaging signs revealed two clusters: Cerebral venous dilation and brain descent. Among all brain magnetic resonance imaging signs examined, only midbrain-pons angle associated with anterior epidural cerebrospinal fluid collection length (surrogate spinal cerebrospinal fluid leak severity) (n = 148, Spearman’s ρ = −0.38, p  〈  .001). Subgroup analyses showed that the association between midbrain-pons angle (within brain descent cluster) and spinal cerebrospinal fluid leak severity was presented in patients with convex margins of the transverse sinuses (n = 122, Spearman’s ρ = −0.43, p  〈  .001), but not in patients without convex margins (n = 26, Spearman’s ρ = −0.19, p = .348). The association between severity of transverse sinus distension and spinal cerebrospinal fluid leak severity was only presented in patients without convex margins (n = 26, Spearman’s ρ = 0.52, p = .006). Conclusion This study indicates that there are two factors behind the brain neuroimaging findings in spontaneous intracranial hypotension: Cerebral venous dilation and brain descent. Certain brain neuroimaging signs correlate with spinal cerebrospinal fluid leakage severity, depending on different circumstances.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/0333102418804161
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 8
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    Mutation screening and association analysis of NOTCH3 p.R544C in patients with migraine with or without aura
    SAGE Publications ; 2022
    In:  Cephalalgia Vol. 42, No. 9 ( 2022-08), p. 888-898
    Details
    In: Cephalalgia, SAGE Publications, Vol. 42, No. 9 ( 2022-08), p. 888-898
    Abstract: The role of the NOTCH3 p.R544C variant, the predominant variant of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in multiple East Asian regions, in migraine is unknown. Methods Migraine patients (n = 2,884) (2,279F/605M, mean age 38.8 ± 11.7 years), including 324 (11.2%) with migraine with aura, were prospectively enrolled by headache specialists according to the International Classification of Headache Disorders criteria. These patients and 3,502 population controls free of stroke, dementia, and headache were genotyped for NOTCH3 p.R544C by TaqMan genotyping assay or Axiom Genome-Wide TWB 2.0 Array. Clinical manifestations and brain magnetic resonance images were examined and compared between migraine patients with and without NOTCH3 p.R544C. Results Thirty-two migraine patients (1.1%) and 36 controls (1.0%) harbored the p.R544C variant, and the percentages were comparable among migraine patients without and with aura, and controls (1.2%, vs. 0.6% vs. 1.0%, p = 0.625). Overall, migraine patients with and without the p.R544C variant had similar percentages of migraine with aura, headache characteristics, frequencies and disabilities. However, those with p.R544C were less likely to have pulsatile headaches (50.0% vs. 68.2%, p = 0.028), and more likely to have moderate to severe white matter hyperintensities in the external capsule (18.8% vs. 1.2%, p = 0.006) and anterior temporal lobe (12.5% vs. 0%, p = 0.008). Conclusions Our findings suggest that NOTCH3 p.R544C does not increase the risk of migraine with aura, or migraine as a whole, and generally does not alter clinical manifestations of migraine. The role of NOTCH3 variants, as well as potential influences from ethnicity or modifier genes, in migraine needs to be further clarified.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/03331024221080891
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 9
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    Eye-wearable head-mounted tracking and gaze estimation interactive machine system for human–machine interface
    SAGE Publications ; 2021
    In:  Journal of Low Frequency Noise, Vibration and Active Control Vol. 40, No. 1 ( 2021-03), p. 18-38
    Details
    In: Journal of Low Frequency Noise, Vibration and Active Control, SAGE Publications, Vol. 40, No. 1 ( 2021-03), p. 18-38
    Abstract: In this study, a head-mounted camera was used to track eye behaviors and estimate the gaze point on the user’s visual plane. The integration of the elastic mechanism design makes the headset adaptable for various users. The wearable cases were prototyped with low-cost cameras to produce an efficient eye tracking solution. This proposed system can effectively extract and estimate pupil ellipse from a few camera images of an eye and compute the corresponding three-dimensional eye model. The system can match later images of the same pupil ellipse from a head-mounted camera to give the possible visual angles. To estimate the gaze point, the system uses multiple-point calibration to solve the related polynomial formula for future angle-to-gaze mapping. The proposed eye-tracking algorithms can provide a low-complexity solution with high accuracy, precision, and speed. This tracking system is a low-cost and promising system that can be used in headsets for virtual reality, auxiliary equipment, interactive machine, and human–machine interface applications. The proposed eye-tracking algorithm can achieve satisfactory performance without using a high-end high-speed camera and can be detected under different lighting sources, and the average errors of the detection results are stably within 9 pixels and at a distance of 50 cm from the screen; while the average error of the fixation mapping results is within 3°.
    Type of Medium: Online Resource
    ISSN: 1461-3484 , 2048-4046
    URL: Article
    DOI: 10.1177/1461348419875047
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2025887-2
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  • 10
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    Follow-up on Percutaneous Vertebroplasty Using PMMA in Osteoporotic Patients
    SAGE Publications ; 2006
    In:  The Neuroradiology Journal Vol. 19, No. 4 ( 2006-08), p. 551-555
    Details
    In: The Neuroradiology Journal, SAGE Publications, Vol. 19, No. 4 ( 2006-08), p. 551-555
    Abstract: We reviewed the follow-up findings of patients who received percutaneous vertebroplasty, in order to understand the effects of vertebroplasty on following issues: pain relief, height restoration, wedge deformity correction, kyphosis correction, and other radiological findings found in follow up studies, such as new fractures. Generally, the pain relieving effect after vertebroplasty is long lasting except when new fracture occurred, or presence of other problems that caused the back pain. Height restoration and wedge deformity correction last for more than one year. The effect of kyphosis angle correction may vanish one year after procedure due to occurrence of new fracture in adjacent vertebral bodies.
    Type of Medium: Online Resource
    ISSN: 1971-4009 , 2385-1996
    URL: Article
    DOI: 10.1177/197140090601900412
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2006
    detail.hit.zdb_id: 2622347-8
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