BACKGROUNDS/AIMS: This study aims to evaluate the comparative effectiveness of two surgical approaches on the treatment outcomes of radiofrequency ablation (RFA) for malignant liver tumors. METHODS: Fifty-seven patients with malignant liver tumors, hepatocellular carcinoma, cholangiocarcinoma and liver metastases, who were candidates for RFA, underwent laparoscopic or open surgical treatments. RESULTS: The patients' characteristics were comparable in the two groups that received open (n=33, 57.9%) and laparoscopic (n=24, 42.1%) surgical treatments. There were no statistically significant differences between the two groups in terms of recurrence rate (p=0.337) and overall survival (p=0.423). However, patients in the laparoscopic RFA group had significantly shorter hospital stay (14.1 vs. 5.9 days, p<0.05) and experienced fewer complications (Grade I: 62.5% vs. 26.3%, p=0.102). CONCLUSIONS: Laparoscopic RFA can be performed for malignant liver tumors with lower morbidity rates, less invasiveness and lower expense compared to open surgical approach.
Carcinoma, Hepatocellular ; Catheter Ablation* ; Cholangiocarcinoma ; Humans ; Length of Stay ; Liver* ; Neoplasm Metastasis ; Recurrence

BACKGROUNDS/AIMS: We present our experience of laparoscopic liver resection for various liver diseases. METHODS: From April 2008 to August 2012 in Chungnam National University, 68 of 253 liver resections were performed laparoscopically. During the first year, laparoscopy-assisted liver resection was mainly performed and subsequently totally laparoscopic liver resection was the main operative type. Surgery type for treatment purposes was decided preoperatively. Clinical data were collected retrospectively and analyzed. RESULTS: Preoperatively, 43 patients (63.2%) were diagnosed with benign disease, 19 patients (27.9%) were malignant liver tumors and 6 patients (8.8%) were indeterminate liver tumor but favorable towards malignancy. Anatomical major liver resection was performed in 58 cases (85.3%) and 10 cases (14.7%) were non-anatomical resection. Left hemihepatectomy was performed in 38 cases (55.8%) followed by left lateral sectionectomy in 18 cases (26.5%), and segment IV and IVa segmentectomy, were each in 1 case. Mean operation time was 235.0 minutes (range, 60-470) and 14 patients (18.6%) had intraoperative transfusion. Mean postoperative hospital stay was 10.2 days (range, 4-32). Mean operation time of laparoscopy-assisted left lobectomy was 317 minutes and totally laparoscopic left lobectomy was 281 minutes, but there was no significant statistical difference between these two operation types. There were 11 episodes of postoperative complications in 8 patients. There was no mortality after laparoscopic liver resection. CONCLUSIONS: We concluded that laparoscopic liver resection is a feasible operation, but needs to be carefully conducted in malignant tumors.
Chungcheongnam-do ; Humans ; Laparoscopy ; Length of Stay ; Liver Diseases* ; Liver* ; Mastectomy, Segmental ; Mortality ; Postoperative Complications ; Retrospective Studies

Purpose: This study aims to enhance the performance of deep learning models for segmenting thin anatomical structures in medical images by introducing a label-preserving data-augmentation strategy. Materials and Methods: We developed a data-augmentation technique that applies geometric transformations and their inverses sequentially to input images while preserving the corresponding labels. This method was evaluated on inner ear magnetic resonance images for the automatic segmentation of semicircular canals characterized by thin and circular structures. The dataset included both internal and external samples. For the internal dataset, 70 subjects were used for model training and eight subjects for internal validation. Images were acquired using a 3 tesla magnetic resonance imaging scanner with a three-dimensional high-resolution T2 sequence, and ground-truth segmentations were manually annotated by an experienced radiologist. For external validation, four subjects from a public dataset (Vestibular-Schwannoma-SEG dataset, part of The Cancer Imaging Archive) with high-resolution T2 images for inner ear analysis were used. We performed quantitative evaluations using metrics such as Dice, intersection over union (IoU), 95% Hausdorff distance (HD), and average surface distance (ASD). A qualitative visual assessment was also performed. Results: The proposed model exhibited improved performance in semicircular canal segmentation in both quantitative and qualitative evaluations. Metrics such as Dice, IoU, 95% HD, and ASD indicated better performance than conventional methods. Conclusion The proposed label-preserving data augmentation method improves the segmentation of thin anatomical structures in medical images and offers a robust and efficient solution for enhancing deep learning models in medical imaging.

Purpose: This study aims to enhance the performance of deep learning models for segmenting thin anatomical structures in medical images by introducing a label-preserving data-augmentation strategy. Materials and Methods: We developed a data-augmentation technique that applies geometric transformations and their inverses sequentially to input images while preserving the corresponding labels. This method was evaluated on inner ear magnetic resonance images for the automatic segmentation of semicircular canals characterized by thin and circular structures. The dataset included both internal and external samples. For the internal dataset, 70 subjects were used for model training and eight subjects for internal validation. Images were acquired using a 3 tesla magnetic resonance imaging scanner with a three-dimensional high-resolution T2 sequence, and ground-truth segmentations were manually annotated by an experienced radiologist. For external validation, four subjects from a public dataset (Vestibular-Schwannoma-SEG dataset, part of The Cancer Imaging Archive) with high-resolution T2 images for inner ear analysis were used. We performed quantitative evaluations using metrics such as Dice, intersection over union (IoU), 95% Hausdorff distance (HD), and average surface distance (ASD). A qualitative visual assessment was also performed. Results: The proposed model exhibited improved performance in semicircular canal segmentation in both quantitative and qualitative evaluations. Metrics such as Dice, IoU, 95% HD, and ASD indicated better performance than conventional methods. Conclusion The proposed label-preserving data augmentation method improves the segmentation of thin anatomical structures in medical images and offers a robust and efficient solution for enhancing deep learning models in medical imaging.

Purpose: This study aims to enhance the performance of deep learning models for segmenting thin anatomical structures in medical images by introducing a label-preserving data-augmentation strategy. Materials and Methods: We developed a data-augmentation technique that applies geometric transformations and their inverses sequentially to input images while preserving the corresponding labels. This method was evaluated on inner ear magnetic resonance images for the automatic segmentation of semicircular canals characterized by thin and circular structures. The dataset included both internal and external samples. For the internal dataset, 70 subjects were used for model training and eight subjects for internal validation. Images were acquired using a 3 tesla magnetic resonance imaging scanner with a three-dimensional high-resolution T2 sequence, and ground-truth segmentations were manually annotated by an experienced radiologist. For external validation, four subjects from a public dataset (Vestibular-Schwannoma-SEG dataset, part of The Cancer Imaging Archive) with high-resolution T2 images for inner ear analysis were used. We performed quantitative evaluations using metrics such as Dice, intersection over union (IoU), 95% Hausdorff distance (HD), and average surface distance (ASD). A qualitative visual assessment was also performed. Results: The proposed model exhibited improved performance in semicircular canal segmentation in both quantitative and qualitative evaluations. Metrics such as Dice, IoU, 95% HD, and ASD indicated better performance than conventional methods. Conclusion The proposed label-preserving data augmentation method improves the segmentation of thin anatomical structures in medical images and offers a robust and efficient solution for enhancing deep learning models in medical imaging.

Purpose: This study aims to enhance the performance of deep learning models for segmenting thin anatomical structures in medical images by introducing a label-preserving data-augmentation strategy. Materials and Methods: We developed a data-augmentation technique that applies geometric transformations and their inverses sequentially to input images while preserving the corresponding labels. This method was evaluated on inner ear magnetic resonance images for the automatic segmentation of semicircular canals characterized by thin and circular structures. The dataset included both internal and external samples. For the internal dataset, 70 subjects were used for model training and eight subjects for internal validation. Images were acquired using a 3 tesla magnetic resonance imaging scanner with a three-dimensional high-resolution T2 sequence, and ground-truth segmentations were manually annotated by an experienced radiologist. For external validation, four subjects from a public dataset (Vestibular-Schwannoma-SEG dataset, part of The Cancer Imaging Archive) with high-resolution T2 images for inner ear analysis were used. We performed quantitative evaluations using metrics such as Dice, intersection over union (IoU), 95% Hausdorff distance (HD), and average surface distance (ASD). A qualitative visual assessment was also performed. Results: The proposed model exhibited improved performance in semicircular canal segmentation in both quantitative and qualitative evaluations. Metrics such as Dice, IoU, 95% HD, and ASD indicated better performance than conventional methods. Conclusion The proposed label-preserving data augmentation method improves the segmentation of thin anatomical structures in medical images and offers a robust and efficient solution for enhancing deep learning models in medical imaging.

BACKGROUND: The trigeminocardiac reflex (TCR), which occurs after stimulation of the territory of the trigeminal nerve, is very rarely reported to be caused by stimulation of the mandibular branch. We report a case of TCR in open reduction for temporomandibular joint (TMJ) dislocation. CASE: A 74-year-old female presented for TMJ dislocation. During open reduction of TMJ under general anesthesia, severe bradycardia (15 beats/min) occurred. Immediately 0.5 mg atropine was administered intravenously, and the surgical manipulation was stopped. After 30 seconds, heart rate normalized. During surgery, severe bradycardia occurred one more time. It disappeared spontaneously as soon as surgical manipulation was stopped. The surgery was completed uneventfully. CONCLUSIONS: Because of the possibility of profound bradycardia, asystole, or even death when evoked, it is important to be aware of the trigeminocardiac reflex during manipulation of the mandibular divisions, especially during surgical stimulation of the TMJ.
Aged ; Anesthesia, General ; Atropine ; Bradycardia ; Dislocations ; Female ; Heart Arrest ; Heart Rate ; Humans ; Reflex, Trigeminocardiac ; Temporomandibular Joint ; Trigeminal Nerve

Neural progenitor cells (NPs) have shown several promising benefits for the treatment of neurological disorders. To evaluate the therapeutic potential of human neural progenitor cells (hNPs) in amyotrophic lateral sclerosis (ALS), we transplanted hNPs or growth factor (GF)-expressing hNPs into the central nervous system (CNS) of mutant Cu/Zn superoxide dismutase (SOD(1G93A)) transgenic mice. The hNPs were engineered to express brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), VEGF, neurotrophin-3 (NT-3), or glial cell-derived neurotrophic factor (GDNF), respectively, by adenoviral vector and GDNF by lentiviral vector before transplantation. Donor-derived cells engrafted and migrated into the spinal cord or brain of ALS mice and differentiated into neurons, oligodendrocytes, or glutamate transporter-1 (GLT1)-expressing astrocytes while some cells retained immature markers. Transplantation of GDNF- or IGF-1-expressing hNPs attenuated the loss of motor neurons and induced trophic changes in motor neurons of the spinal cord. However, improvement in motor performance and extension of lifespan were not observed in all hNP transplantation groups compared to vehicle-injected controls. Moreover, the lifespan of GDNF-expressing hNP recipient mice by lentiviral vector was shortened compared to controls, which was largely due to the decreased survival times of female animals. These results imply that although implanted hNPs differentiate into GLT1-expressing astrocytes and secrete GFs, which maintain dying motor neurons, inadequate trophic support could be harmful and there is sexual dimorphism in response to GDNF delivery in ALS mice. Therefore, additional therapeutic approaches may be required for full functional recovery.
Adenoviridae/genetics ; Amyotrophic Lateral Sclerosis/metabolism/mortality/*therapy ; Animals ; Astrocytes/metabolism ; Brain/*embryology ; Cell Differentiation ; Disease Models, Animal ; Excitatory Amino Acid Transporter 2/metabolism ; Female ; Fetal Stem Cells/*metabolism ; Genetic Vectors ; Humans ; Immunoenzyme Techniques ; Male ; Mice ; Mice, Transgenic ; Motor Neurons/*physiology ; Nerve Growth Factors/*metabolism ; *Stem Cell Transplantation ; Superoxide Dismutase/genetics ; Transfection ; Vascular Endothelial Growth Factor A/genetics/metabolism

Purpose: The purpose of this study was to evaluate the efficacy and safety of red ginseng oil (RXGIN) in men with lower urinary tract symptoms. Materials and Methods: Men aged between 40 and 75 years with a total International Prostate Symptom Score (IPSS) of 8 to 19 points were recruited from April 2020 to December 2020. Subjects were randomly assigned to either the RXGIN group or the control group in a 1:1 ratio and received either RXGIN or placebo daily for 12 weeks. For the primary outcome, changes in IPSS scores at 6 and 12 weeks from baseline were analyzed. The secondary outcomes were changes in International Index of Erectile Function (IIEF), maximum urinary flow rate, and post-void residual volume at weeks 6 and 12 compared to baseline. Urine analysis and blood tests were additionally performed for safety assessment. Results: A total of 88 subjects (RXGIN group, 46; control group, 42) completed the study. The total IPSS and IPSS subscores (residual urine sensation, frequency, intermittency, urgency, weak stream, straining, nocturia, and quality of life) were significantly improved in the RXGIN group compared to the control group at weeks 6 and 12. Total IIEF and sexual desire were significantly improved in the RXGIN group at week 6 and week 12, respectively, but there were no significant changes in the level of serum testosterone or dihydrotestosterone. The serum prostate-specific antigen showed significant decrease at weeks 12. No serious adverse events leading to discontinuation of the study drug were observed in the RXGIN group. Conclusions Red ginseng oil (RXGIN) appears to be safe and effective in improving lower urinary tract symptoms in men and may also improve some aspects of sexual function.

Neural stem cells (NSCs) are characterized by a capacity for self-renewal, differentiation into multiple neural cell lineages, and migration toward damaged sites in the central nervous system (CNS). NSCs expanded in culture could be implanted into the brain where they integrate into host neural circuitry and stably express foreign genes. It hence appears that transplantation of NSCs has been proposed as a promising therapeutic strategy in neurological disorders. During hypoxic-ischemic (HI) brain injury, factors are transiently elaborated to which NSCs respond by migrating to degenerating regions and differentiating towards replacement of dying neural cells. In addition, NSCs serve as vehicles for gene delivery and appear capable of simultaneous neural cell replacement and gene therapy (e.g. with factors that might enhance neuronal differentiation, neurites outgrowth, proper connectivity, neuroprotection, and/or immunomodulatory substances). When combined with certain synthetic biomaterials, NSCs may be even more effective in 'engineering' the damaged CNS towards reconstitution. Human NSCs were isolated from the forebrain of an aborted fetus at 13 weeks of gestation and were grown as neurospheres in cultures. After the characterization of human NSCs in preclinical testing and the approval of the IRB, a clinical trial of the transplantation of human NSCs into patients with severe perinatal HI brain injury has been performed. The existing data from these clinical trials have shown to be safe, well tolerated, and of neurologically-some benefits. Therefore, long-term and large scale multicenter clinical study is required to determine its precise therapeutic effect and safety.
Aborted Fetus ; Biocompatible Materials ; Brain ; Brain Injuries ; Cell Lineage ; Central Nervous System ; Ethics Committees, Research ; Genetic Therapy ; Humans ; Nervous System Diseases ; Neural Stem Cells ; Neurites ; Neurons ; Pregnancy ; Prosencephalon ; Tissue Therapy ; Transplants