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Knee osteoarthritis (OA) is a common degenerate joint disorder that affects a large population of elderly people worldwide. Accurate radiographic assessment of knee OA severity plays a critical role in chronic patient management. Current clinically-adopted knee OA grading systems are observer subjective and suffer from inter-rater disagreements. In this work, we propose a computer-aided diagnosis approach to provide more accurate and consistent assessments of both composite and fine-grained OA grades simultaneously. A novel semi-supervised learning method is presented to exploit the underlying coherence in the composite and fine-grained OA grades by learning from unlabeled data. By representing the grade coherence using the log-probability of a pre-trained Gaussian Mixture Model, we formulate an incoherence loss to incorporate unlabeled data in training. The proposed method also describes a keypoint-based pooling network, where deep image features are pooled from the disease-targeted keypoints (extracted along the knee joint) to provide more aligned and pathologically informative feature representations, for accurate OA grade assessments. The proposed method is comprehensively evaluated on the public Osteoarthritis Initiative (OAI) data, a multi-center ten-year observational study on 4,796 subjects. Experimental results demonstrate that our method leads to significant improvements over previous strong whole image-based deep classification network baselines (like ResNet-50)., Comment: extension of RSNA 2020 report "Consistent and Coherent Computer-Aided Knee Osteoarthritis Assessment from Plain Radiographs"

This thesis is aimed at numerically investigating the aerodynamics and the starting of a vertical-axis wind turbine at low Reynolds number using the immersed boundary method. The influence of the Coriolis effect on dynamic stall is isolated by comparing the rotating airfoil to one undergoing an equivalent planar motion that is composed of surging and pitching motions that produce an equivalent speed and angle of attack variation over a cycle. At lower tip-speed ratios, the Coriolis force leads to the capture of a vortex pair which results in a significant decrease in lift when the angle of attack of a rotating airfoil begins to decrease in the upwind half cycle. In the absence of the wake-capturing, the equivalent planar motion is a good approximation to a rotating blade in a vertical-axis wind turbine. Analysis on the starting torque shows that when the turbine solidity is lower than about 0.5, the starting torque distribution can be well-modeled by considering a single blade at different orientations, and starting torque distributions for multi-bladed turbines can be constructed by linearly combining the torques at the respective positions of the blades. Using this model, optimal configurations to start a multi-bladed low-solidity vertical-axis wind turbine is proposed. A preliminary study is made to determine an optimal blade pitch for a single-bladed motor-driven turbine using optimal control theory. When the input power is minimized directly, the solution seems to converge to only a local minimum due to a lower input power reduction than that obtained by maximizing the mean tangential force. After a transient, both controls converge to time-invariant pitch angles of about the same magnitude but with opposite signs. The wake-capturing phenomenon observed in the uncontrolled case necessitates large input power. Under active control, the disappearance of wake-capturing and attendant changes in the flow field collectively result in a reduction of r

This thesis is aimed at numerically investigating the aerodynamics and the starting of a vertical-axis wind turbine at low Reynolds number using the immersed boundary method. The influence of the Coriolis effect on dynamic stall is isolated by comparing the rotating airfoil to one undergoing an equivalent planar motion that is composed of surging and pitching motions that produce an equivalent speed and angle of attack variation over a cycle. At lower tip-speed ratios, the Coriolis force leads to the capture of a vortex pair which results in a significant decrease in lift when the angle of attack of a rotating airfoil begins to decrease in the upwind half cycle. In the absence of the wake-capturing, the equivalent planar motion is a good approximation to a rotating blade in a vertical-axis wind turbine. Analysis on the starting torque shows that when the turbine solidity is lower than about 0.5, the starting torque distribution can be well-modeled by considering a single blade at different orientations, and starting torque distributions for multi-bladed turbines can be constructed by linearly combining the torques at the respective positions of the blades. Using this model, optimal configurations to start a multi-bladed low-solidity vertical-axis wind turbine is proposed. A preliminary study is made to determine an optimal blade pitch for a single-bladed motor-driven turbine using optimal control theory. When the input power is minimized directly, the solution seems to converge to only a local minimum due to a lower input power reduction than that obtained by maximizing the mean tangential force. After a transient, both controls converge to time-invariant pitch angles of about the same magnitude but with opposite signs. The wake-capturing phenomenon observed in the uncontrolled case necessitates large input power. Under active control, the disappearance of wake-capturing and attendant changes in the flow field collectively result in a reduction of r

This thesis is aimed at numerically investigating the aerodynamics and the starting of a vertical-axis wind turbine at low Reynolds number using the immersed boundary method. The influence of the Coriolis effect on dynamic stall is isolated by comparing the rotating airfoil to one undergoing an equivalent planar motion that is composed of surging and pitching motions that produce an equivalent speed and angle of attack variation over a cycle. At lower tip-speed ratios, the Coriolis force leads to the capture of a vortex pair which results in a significant decrease in lift when the angle of attack of a rotating airfoil begins to decrease in the upwind half cycle. In the absence of the wake-capturing, the equivalent planar motion is a good approximation to a rotating blade in a vertical-axis wind turbine. Analysis on the starting torque shows that when the turbine solidity is lower than about 0.5, the starting torque distribution can be well-modeled by considering a single blade at different orientations, and starting torque distributions for multi-bladed turbines can be constructed by linearly combining the torques at the respective positions of the blades. Using this model, optimal configurations to start a multi-bladed low-solidity vertical-axis wind turbine is proposed. A preliminary study is made to determine an optimal blade pitch for a single-bladed motor-driven turbine using optimal control theory. When the input power is minimized directly, the solution seems to converge to only a local minimum due to a lower input power reduction than that obtained by maximizing the mean tangential force. After a transient, both controls converge to time-invariant pitch angles of about the same magnitude but with opposite signs. The wake-capturing phenomenon observed in the uncontrolled case necessitates large input power. Under active control, the disappearance of wake-capturing and attendant changes in the flow field collectively result in a reduction of r

Generally, for some solar simulator manufactures, the measurement of irradiation non-uniformity is made by placing a PV cell artificially and point by point on each measuring point on the solar module. It records each corresponding output voltage of PV cell. It is time-consuming and easy to produce measurement error. If either an XY table or a multi-axis robot is applied in this case, it is ot only expensive but also difficult to carry and setup. Hence, an innovative and automated measurement system, which consists of both a self-developed smart robot and a monitoring and control system, is proposed in this paper to solve aforementioned problems. The monitoring and control system, i.e., constructed by a PC and a self-developed LabVIEW-based application program, plays the role of remotely commanding the operation mode of a robot, receiving the irradiance data being transmitted from the robot and calculating the irradiation non-uniformity. Once the irradiation non-uniformity is calculated, some operations are made to adjust the irradiation parameters of the solar simulator such that the irradiation non-uniformity can meet the specification, i.e., 2%, 5%, 10% for class A, B or C of solar module, respectively.

Generally, for some solar simulator manufactures, the measurement of irradiation non-uniformity is made by placing a PV cell artificially and point by point on each measuring point on the solar module. It records each corresponding output voltage of PV cell. It is time-consuming and easy to produce measurement error. If either an XY table or a multi-axis robot is applied in this case, it is ot only expensive but also difficult to carry and setup. Hence, an innovative and automated measurement system, which consists of both a self-developed smart robot and a monitoring and control system, is proposed in this paper to solve aforementioned problems. The monitoring and control system, i.e., constructed by a PC and a self-developed LabVIEW-based application program, plays the role of remotely commanding the operation mode of a robot, receiving the irradiance data being transmitted from the robot and calculating the irradiation non-uniformity. Once the irradiation non-uniformity is calculated, some operations are made to adjust the irradiation parameters of the solar simulator such that the irradiation non-uniformity can meet the specification, i.e., 2%, 5%, 10% for class A, B or C of solar module, respectively.

Vertical axis wind turbine blades undergo dynamic stall due to the large angle of attack variation they experience during a turbine rotation. Particle image velocimetry on a pitching and surging airfoil was used to perform time resolved measurements at blade Reynolds numbers near turbine operating conditions of 10^5. These experiments were compared to simulations performed in the rotating turbine frame as well as the linear, experimental, frame at a Reynolds number of 10^3 to investigate rotational and Reynolds number effects. The flow was shown to develop similarly prior to separation, but the kinematics of vortices shed post separation were reference frame dependent.

The self-starting capability of a NACA 0018 multi-bladed vertical-axis wind turbine is numerically investigated. The immersed boundary method is used to simulate the flow around a two-dimensional cross section of the wind turbine and the predictor-corrector method is used to couple the equation of motion of the turbine. A simple load model, which is linearly proportional to turbine angular velocity, is used for the load of the turbine. The angular velocity is characterized as a function of Reynolds number, density ratio, and viscous coefficient of the proposed load model. The power outputs and moment coefficients of motor-driven and flow-driven vertical-axis wind turbine are compared. For a particular Reynolds number, as the load on the flow-driven turbine is increased, the tip speed is reduced until the turbine fails to coherently rotate. The flow-driven and motor-driven moment coefficients in the computation have good agreement between each other and are qualitatively similar to the torque measured in experiments. These computations suggest that the load of a flow-driven turbine can be well-represented by the proposed load model and a motor-driven turbine can reproduce the physics of a flow-driven turbine within the range of tip-speed ratio examined. A simple model is proposed in order to analyze the starting torque. By assuming that the inertia of the blade is much larger than the fluid, the turbine can be considered stationary in the flow. The starting torque distribution of a multi-bladed turbine indicates the important orientations corresponding to maximum torque generation, at which a self-starting turbine always starts, and a stable equilibrium, where a non-self-starting turbine oscillates. These features agree with observations from the full simulations of the starting process. We further model the starting torque distribution by considering a single blade at different orientations, and construct starting torque distributions for multi-bladed turbines by li

Yueh-Feng Lu,1 Yu-Chin Lin,2 Kuo-Hsin Chen,3,4 Pei-Wei Shueng,1 Hsin-Pei Yeh,1 Chen-Hsi Hsieh1,5,6 1Division of Radiation Oncology, Department of Radiology, 2Division of Oncology and Hematology, Department of Medicine, 3Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, 4Department of Electrical Engineering, Yuan-Ze University, Taoyuan, 5Department of Medicine, 6Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Abstract: Treatment for bilateral breast cancer with chest wall and abdominal skin invasion normally involves conventional radiotherapy (RT); however, conventional RT provides inadequate target volume coverage and excessive treatment of large volumes of normal tissue. Helical tomotherapy (HT) has the ability to deliver continuous craniocaudal irradiation that suppresses junction problems and provides good conformity of dose distribution. A 47-year-old female with stage IV bilateral breast cancer with chest wall and pectoralis major muscle invasion, lymphadenopathy, bilateral pleural effusion, and multiple bone metastases received chemotherapy and target therapy beginning in January 2014; 4 months after the initiation of chemotherapy, computed tomography revealed progression of chest and abdominal wall invasion. A total dose of 70.2 Gy was delivered to both breasts, the chest wall, the abdominal wall, and the bilateral supraclavicular nodal areas in 39 fractions via HT. The total planning target volume was 4,533.29 cm3. The percent of lung volume receiving at least 20 Gy (V20) was 28%, 22%, and 25% for the right lung, left lung, and whole lung, respectively. The mean dose to the heart was 8.6 Gy. Follow-up computed tomography revealed complete response after the RT course. Grade 1 dysphagia, weight loss, grade 2 neutropenia, and grade 3 dermatitis were noted during the RT course. Pain score decreased from 6 to 1. No cardiac, pulmonary, liver, or intestinal toxicity developed during treatmen

Lung-Shuo Wang,1–4 Chih-Yu Wang,2 Chih-Hui Yang,5 Chen-Ling Hsieh,3,5 Szu-Yu Chen,3,5 Chi-Yen Shen,1 Jia-Jung Wang,2 Keng-Shiang Huang3 1Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan; 2Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan; 3The School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan; 4Department of Chinese Medicine, E-Da Hospital, Kaohsiung, Taiwan; 5Department of Biological Science and Technology, I-Shou University, Kaohsiung, Taiwan Abstract: Silver nanoparticles have been used in various fields, and several synthesis processes have been developed. The stability and dispersion of the synthesized nanoparticles is vital. The present article describes a novel approach for one-step synthesis of silver nanoparticles–embedded chitosan particles. The proposed approach was applied to simultaneously obtain and stabilize silver nanoparticles in a chitosan polymer matrix in-situ. The diameter of the synthesized chitosan composite particles ranged from 1.7 mm to 2.5 mm, and the embedded silver nanoparticles were measured to be 15±3.3 nm. Further, the analyses of ultraviolet-visible spectroscopy, energy dispersive spectroscopy, and X-ray diffraction were employed to characterize the prepared composites. The results show that the silver nanoparticles were distributed over the surface and interior of the chitosan spheres. The fabricated spheres had macroporous property, and could be used for many applications such as fungicidal agents in the future. Keywords: silver, nanoparticles, chitosan, anti-fungal

Lung-Shuo Wang,1–4 Chih-Yu Wang,2 Chih-Hui Yang,5 Chen-Ling Hsieh,3,5 Szu-Yu Chen,3,5 Chi-Yen Shen,1 Jia-Jung Wang,2 Keng-Shiang Huang3 1Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan; 2Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan; 3The School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan; 4Department of Chinese Medicine, E-Da Hospital, Kaohsiung, Taiwan; 5Department of Biological Science and Technology, I-Shou University, Kaohsiung, Taiwan Abstract: Silver nanoparticles have been used in various fields, and several synthesis processes have been developed. The stability and dispersion of the synthesized nanoparticles is vital. The present article describes a novel approach for one-step synthesis of silver nanoparticles–embedded chitosan particles. The proposed approach was applied to simultaneously obtain and stabilize silver nanoparticles in a chitosan polymer matrix in-situ. The diameter of the synthesized chitosan composite particles ranged from 1.7 mm to 2.5 mm, and the embedded silver nanoparticles were measured to be 15±3.3 nm. Further, the analyses of ultraviolet-visible spectroscopy, energy dispersive spectroscopy, and X-ray diffraction were employed to characterize the prepared composites. The results show that the silver nanoparticles were distributed over the surface and interior of the chitosan spheres. The fabricated spheres had macroporous property, and could be used for many applications such as fungicidal agents in the future. Keywords: silver, nanoparticles, chitosan, anti-fungal

Androgen deprivation therapy (ADT) is an important therapeutic strategy which has a fundamental impact on prostate cancer biology. However, the mechanism by which ADT influences this negative androgenic regulation in CRPC development is unclear. Here, I identified an androgen-inducible tumor suppressor, Promyelocytic leukemia zinc finger protein (PLZF) which plays different roles in growth control, senescence, self-renewal, and tumor suppression in various cancer types. Interestingly, PLZF was reported as an androgen-responsive gene with anti-proliferative activity in prostate cancer cells. Moreover, decreased PLZF gene expression was observed in CRPC as compared to primary tumors, suggesting that loss of PLZF expression may have a role on CRPC development., The original document contains color images.

The immersed boundary method is used to simulate the flow around a two-dimensional rotating NACA 0018 airfoil at sub-scale Reynolds number in order to investigate the separated flow occurring on a vertical-axis wind turbine. The influence of dynamic stall on the forces is characterized as a function of tip-speed ratio. The influence of the Coriolis effect is also investigated by comparing the rotating airfoil to one undergoing a equivalent planar motion, which is composed of surging and pitching motions that produce an equivalent speed and angle-of-attack variation over the cycle. When the angle of attack of a rotating airfoil starts to decrease in the upwind half cycle, the Coriolis force leads to a wake-capturing phenomenon of a vortex pair at low tip-speed ratio. This effects occurs at a slightly different phase in each cycle and leads to a significant decrease in the average lift during the downstroke phase. Moreover, the wake-capturing is only observed when the combination of surging, pitching, and Coriolis force are present. Finally, an actuator model is placed at an appropriate location on the suction side of the airfoil surface to control the wake-capturing phenomenon. Based on preliminary simulations, a momentum coefficient above 0.02 was able to increase the average lift by more than 70% over the upwind-half cycle.

Chen-Hsi Hsieh,1–3 Pei-Wei Shueng,1,4 Li-Ying Wang,5 Li-Jen Liao,6 Yu-Chin Lin,7 Ying-Shiung Kuo,8 Wu-Chia Lo,6 Chien-Fu Tseng,8 Hui-Ju Tien,1 Hsiu-Ling Chou,9,10 Yen-Ping Hsieh,11 Le-Jung Wu,1 Yu-Jen Chen3,12–14 1Department of Radiation Oncology, Far Eastern Memorial Hospital, 2Department of Medicine, 3Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, 4Department of Radiation Oncology, National Defense Medical Center, 5School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, 6Department of Otolaryngology, 7Division of Medical Oncology and Hematology, Department of Internal Medicine, 8Department of Dentistry and Oral Surgery, 9Department of Nursing, Far Eastern Memorial Hospital, 10Department of Nursing, Oriental Institute of Technology, Taipei, 11Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, 12Department of Radiation Oncology, 13Department of Medical Research, Mackay Memorial Hospital, 14Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan Background: The outcome of postoperative high- and intermediate-risk oral cavity cancer (OCC) patients receiving helical tomotherapy (HT) remains limited. Materials and methods: Between November 2006 and November 2012, 53 postoperative high- and intermediate-risk OCC patients treated with HT were enrolled. Results: The 4-year locoregional, local, and regional control rates were 66%, 76.4%, and 94.3%, respectively. The 4-year locoregional control rates of oral tongue and buccal mucosa cancer were 88.3% and 37.1%, respectively (P=0.012). Eleven (20.8%) patients experienced locoregional failure. In-field failure occurred in six of 53 (11.3%) in the primary area and three of 53 (5.7%) in the regional lymph-node area. No marginal failure was noted. Two of 53 (3.8%) experienced out-of-field failure. The rates of grade 3 dermatitis, muc

Chen-Hsi Hsieh,1,3,4 Shih-Chiang Lin,2 Pei-Wei Shueng,1,5,6 Deng-Yu Kuo11Division of Radiation Oncology, Department of Radiology, 2Division of Medical Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; 3Department of Medicine, 4Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, 5Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan; 6Oriental Institute of Technology, New Taipei City, TaiwanAbstract: We report on a 63-year-old man with a history of hepatitis B virus–related hepatocellular carcinoma with a thrombus extending into the inferior vena cava, who received image-guided stereotactic body radiation therapy (SBRT) with helical tomotherapy, followed by sorafenib. A total tumor dose of 48 Gy was delivered by 6 fractions within 2 weeks. The tumor responded dramatically, and the patient tolerated the courses well. Ten days after SBRT, sorafenib (200 mg), at 1.5 tablets twice a day, was prescribed. One week later, grade 2 recall radiation dermatitis subsequently developed in the previous SBRT off-target area. SBRT followed by sorafenib for the treatment of a portal vein thrombosis provided effective results, but the potential risk of enhanced adverse effects between radiation and sorafenib should be considered with caution, especially under a SBRT scheme.Keywords: hepatocellular carcinoma, recall radiation dermatitis

Li-Ying Wang,1,2 Huey-Dong Wu,3 Kuan-Yu Chen,4 Chen-Hsi Hsieh,5–7 Chung-Chun Lai21School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taiwan; 2Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan; 3Department of Integrated Diagnostic & Therapeutics, National Taiwan University Hospital, Taipei, Taiwan; 4Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; 5Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan; 6Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 7Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROCBackground: The functional exercise capacity and its correlates in advanced cancer patients in stratified age groups were examined.Materials and methods: A total of 105 patients with advanced lung cancer were recruited prospectively and stratified into young (≤50 years), middle (51–65 years), and old (>65 years) age groups. Respiratory performances, which included maximal inspiratory and expiratory pressure, forced expiratory volume in 1 second, and forced vital capacity were measured. The distance ambulated in a 6-minute walk test was used as an indicator for functional capacity.Results: The young age group had lowest baseline pulmonary function and performed worse on the 6-minute walk test among the three age groups. The risk factors for poor functional capacity were female, lower percent predicted maximal expiratory pressure, worse dyspnea, and lower hemoglobin in the young age group; lower percent predicated forced expiratory volume in 1 second and forced vital capacity, and greater weight loss in the middle age group; and only worse dyspnea in the old age group. The above identified risk factors accounted for 73.6%, 58.5%, and 42.1% variance in 6-minute walk distance for the young, middle, an

Chen-Hsi Hsieh,1–3 Hui-Ju Tien,1 Sheng-Mou Hsiao,4 Ming-Chow Wei,4 Wen-Yih Wu,4 Hsu-Dong Sun,4 Li-Ying Wang,5 Yen-Ping Hsieh,6 Yu-Jen Chen,3,7–9 Pei-Wei Shueng1,101Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan; 2Department of Medicine, 3Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 4Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Taipei, Taiwan; 5School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; 6Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan; 7Department of Radiation Oncology, 8Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; 9Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan; 10Department of Radiation Oncology, National Defense Medical Center, Taipei, TaiwanAim: To review the experience and to evaluate the results of stereotactic body radiation therapy (SBRT) via helical tomotherapy (HT), for the treatment of brachytherapy-unsuitable cervical cancer.Methods: Between September 1, 2008 to January 31, 2012, nine cervical cancer patients unsuitable for brachytherapy were enrolled. All of the patients received definitive whole pelvic radiotherapy with or without chemotherapy, followed by SBRT via HT.Results: The actuarial locoregional control rate at 3 years was 78%. The mean biological equivalent dose in 2-Gy fractions of the tumor, rectum, bladder, and intestines was 76.0 ± 7.3, 73.8 ± 13.2, 70.5 ± 10.0, and 43.1 ± 7.1, respectively. Only two had residual tumors after treatment, and the others were tumor-free. Two patients experienced grade 3 acute toxicity: one had diarrhea; and another experienced thrombocytopenia. There were no grade 3 or 4 subacute toxicities. Three patients suffered fro

Bing-Jie Shen,1 Shih-Chiang Lin,2 Pei-Wei Shueng,1,3 Yueh-Hung Chou,4 Li-Ming Tseng,5 Chen-Hsi Hsieh1,6,71Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, Taipei, Taiwan; 2Division of Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan; 3Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan; 4Department of Anatomical Pathology, Far Eastern Memorial Hospital, Taipei, Taiwan; 5Division of Colorectal Surgery, Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; 6Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 7Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, TaiwanAbstract: Development of nonantibiotic-associated pseudomembranous colitis has been reported in patients receiving chemotherapy. Herein, we report a case of a 70-year-old man with diabetes mellitus and hypertension who received concurrent chemoradiation therapy after surgery for stage III pT3N1M0 rectal cancer. After completion of the therapy, the patient presented with a 2-week history of intermittent watery diarrhea (seven to nine times per day). However, the patient was afebrile and laboratory examination revealed no evidence of leukocytosis. Computed tomography disclosed inflammation of the sigmoid colon, infiltrative changes around the anastomotic site, and edematous changes straddling the serosal surface. Colonoscopic examination revealed multiple whitish patches within the radiation field, a finding suggestive of pseudomembranous colitis. No concomitant antibiotics were used during the period of concurrent chemoradiation therapy. Empirical oral metronidazole (500 mg every 8 hours) was administrated for 2 weeks. At the end of this treatment, stool culture was negative for Clostridium difficile. Physicians should be aware of the potential for the development of pseudomembranous coliti

Chen-Hsi Hsieh,1,4–6 Pei-Wei Shueng,1,3 Sheng-Mou Hsiao,2 Ming-Chow Wei,2 Wen-Yih Wu,2 Hsu-Dong Sun,2 Hui-Ju Tien,1 Li-Ying Wang,7 Yen-Ping Hsieh81Division of Radiation Oncology, Department of Radiology, 2Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, 3Department of Radiation Oncology, National Defense Medical Center, 4Department of Medicine, 5Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, 6Oriental Institute of Technology, New Taipei City, 7School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, 8Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan, ChinaBackground: The purpose of this study was to compare the efficacy of intensity-modulated radiotherapy (IMRT) and helical tomotherapy for endometrial cancer.Methods: Between November 1, 2006 and November 31, 2010, 31 patients with histologically confirmed endometrial cancer were enrolled. All enrolled patients received total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant whole pelvic IMRT or helical tomotherapy.Results: The actuarial 3-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates for the IMRT and helical tomotherapy groups were 87.5% versus 100%, 91.7% versus 51.7%, 91.7% versus 83.3%, and 91.7% versus 51.7%, respectively. The conformal index and uniformity index for IMRT versus helical tomotherapy was 1.25 versus 1.17 (P = 0.04) and 1.08 versus 1.05 (P < 0.01), respectively. Two of 31 patients with cervical stump failure were noted, one in the IMRT group and the other in the helical tomotherapy group. No acute or late grade 3 or 4 toxicities were noted, including proctitis, or genitourinary or gastrointestinal disturbances.Conclusion: Helical tomotherapy is as effective as IMRT and has better uniformity and conformal i