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Rotating mandible backward downward is one of the treatment options in non-surgical skeletal class III malocclusion. The purpose of this study was to compare the true vertical changes after camouflage orthodontic treatment of adult patients with skeletal class III malocclusion categorized by vertical facial type.This retrospective study included 27 adult patients (age18 years) with skeletal class III malocclusion (ANB1°) who underwent nonsurgical orthodontic treatment at Taipei Veterans General Hospital. The patients were divided into the low-angle (SN-MP28°), high-angle (SN-MP36°), and normal-angle (28°≤ SN-MP ≤ 36°) groups according to the original vertical facial pattern. Pretreatment (T1) and post-treatment (T2) lateral cephalograms were superimposed and treatment changes were evaluated.In all cases, proper overjet and occlusion were achieved after treatment, and the lower anterior facial height increased with the backward rotation of the mandibular plane. Increase in vertical dimension was the most obvious in the high-angle group, while it was the least obvious in the low-angle group. Extrusion of both the maxillary and mandibular incisors was observed in the high-angle group; however, intrusion of the maxillary and mandibular incisors and decreased overbite were observed in the low-angle group.Camouflage orthodontic treatment of skeletal class III malocclusion improves the facial profile by increasing the vertical dimension and clockwise rotation of the mandible. According to our results, patients with a high mandibular plane angle showed better response to vertical dimension increment treatment mechanics than those with low and normal mandibular plane angles.

Whether oral lichen planus (OLP) was potentially malignant remains controversial. Here, we examined associations of ZNF582 methylation (ZNF582This is a case-control study. ZNF582OLP lesions showed significantly lower ZNF582OLP is unlikely to be potentially malignant based on ZNF582

Background To compare the outcomes of blunt splenic injuries (BSI) managed with proximal (P) versus distal (D) versus combined (C) splenic artery embolization (SAE). Methods This retrospective study included patients with BSI who demonstrated vascular injuries on angiograms and were managed with SAE between 2001 and 2015. The success rate and major complications (Clavien–Dindo classification ≥ III) were compared between the P, D, and C embolizations. Results In total, 202 patients were enrolled (P, n = 64, 31.7%; D, n = 84, 41.6%; C, n = 54, 26.7%). The median injury severity score was 25. The median times from injury to SAE were 8.3, 7.0, and 6.6 h for the P, D, and C embolization, respectively. The overall haemostasis success rates were 92.6%, 93.8%, 88.1%, and 98.1% in the P, D, and C embolizations, respectively, with no significant difference (p = 0.079). Additionally, the outcomes were not significantly different between the different types of vascular injuries on angiograms or the materials used in the location of embolization. Splenic abscess occurred in six patients (P, n = 0; D, n = 5; C, n = 1), although it occurred more commonly in those who underwent D embolization with no significant difference (p = 0.092). Conclusions The success rate and major complications of SAE were not significantly different regardless of the location of embolization. The different types of vascular injuries on angiograms and agents used in different embolization locations also did not affect the outcomes. Graphical abstract

Oral cancers are the seventh most common cancer globally. While progresses in oral cancer treatment has been made, not all patients respond to these therapies in the same way. To overcome this difficulty, numerous studies have been devoted to identifying biomarkers, which enable early identification of patients who may benefit from a particular treatment modality or at risk for poor prognosis. Biomarkers are protein molecules, gene expression, DNA variants, or metabolites that are derived from tumors, adjacent normal tissue or bodily fluids, which can be acquired prior to treatment and during follow-up, thus extending their use to the evaluation of cancer progression and prediction of treatment outcome. In this review, we employed a basic significance level (< 0.05) as the minimal requirement for candidate biomarkers. Effect sizes of the biomarkers in terms of odds ratio, hazard ratio and area under the receiver operating characteristic curves were subsequently used to evaluate the potential of their clinical use. We identified the CCND1 from the tumor, human papillomavirus, HSP70, and IL-17 from the peripheral blood, and high density of CD45RO+ tumor-infiltrating lymphocytes as the clinically relevant biomarkers for oral cancers.

BACKGROUND This study assessed the perception of facial taperness in Taiwanese females among people with dental knowledge and laypersons. Additionally, this study also specified the criteria by which "square face" was defined regarding Taiwanese females' facial taperness. METHODS A series of digitally modified photos with different levels of facial taperness (Gonion to Gonion/Zygoma point to Zygoma point-Go-Go/Zy-Zy ratio ranges from 65% to 90%) were randomly arranged and presented to the raters. Visual analog scale (VAS) lines were used for scoring the photos on a scale of 0-100. The true or false question about "defining square face" was incorporated in the same questionnaire. The reliability of the true/false square face question and the esthetic evaluation by VAS were assayed. The receiver operating characteristic curve was used to define the cutoff point on "square face." The effects on the raters' genders, orthodontic treatment experience, and their professional background on the perception of a square face were assayed. RESULTS The overall reliability of the raters was within the acceptable range. The VAS score evaluation revealed that the average expectation for best facial taperness was 75%, whereas the facial taperness of over 83% was considered as the square face. The facial taperness reaching to 90% was regarded as the most unattractive. Gender, therapy, and professional experience have no impact on the standard of square facial form evaluation. CONCLUSION A face with a taperness greater than 83% was evaluated as a square face, and a face with a taperness around 75% was considered as the most attractive.

This study investigates an improvement in memory characteristics through depositing an In2O3 layer as an oxygen ion reservoir in the switching layer (SL) of resistive random access memory (RRAM). The deposition of In2O3, denoted as Pt/HfO2/In2O3/TiN device, provides better memory characteristics including lower forming voltage ( ${V}_{F}$ ), set/reset voltage ( ${V}_{\mathrm {SET}}/{V}_{\mathrm {RESET}}$ ), larger memory window, and higher resistances with higher uniformity at low resistance state (LRS) and high resistance state (HRS), compared to the devices without the In2O3 deposition, denoted as Pt/HfO2/TiN device. The conduction mechanisms, verified through fitting current–voltage ( ${I} - {V}$ ) curves, are consistent with the results of a varied temperature ${I} - {V}$ experiment. Finally, a physical model is proposed to explain our observations.

Roll-to-roll technology is used to form optoelectronic products because it allows fast, continuous production and a short cycle time. It has become the mass production technology with the most potential for development for the production of plastic products with a microstructure. This study designs and manufactures a composite light guide plate (LGP) to replace a traditional LGP with two pieces of prism sheet. The bottom surface of the composite LGP features dot microstructures and the upper surface features prism microstructures. The optical design is optimized separately for the dot microstructure and the prism microstructure. T he optimum designs are used to produce a composite LGP. One side uses the optimized dot distribution, and the other side uses pyramid microstructures. A PMMA substrate with a thickness of 2 mm is manufactured using roll-to-plate UV-cured embossing. In order to manufacture LGPs with microstructures on both sides, a rolling machine with an adjustment and positioning function is manufactured. Taguchi analysis is used to determine the single-sided optimized parameters. The dot structure is replicated 97% and the pyramid structure is replicated 96%. The proposed design for a composite light guide plate with a double-sided structure significantly increases the central average brightness and the uniformity of luminance.

Background This study aimed to evaluate the management of blunt splenic injury (BSI) and highlight the role of splenic artery embolization (SAE). Methods We conducted a retrospective review of all patients with BSI over 15 years. Splenic injuries were graded by the 2018 revision of the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS). Our hospital provide 24/7 in-house surgeries and 24/7 in-house interventional radiology facility. Patients with BSI who arrived hypotensive and were refractory to resuscitation required surgery and patients with vascular injury on abdominal computed tomography were considered for SAE. Results In total, 680 patients with BSI, the number of patients who underwent nonoperative management with observation (NOM-obs), SAE, and surgery was 294, 234, and 152, respectively. The number of SAEs increased from 4 (8.3%) in 2001 to 23 (60.5%) in 2015 (p p = 0.001). The spleen-related mortality rate of NOM-obs, SAEs, and surgery was 0%, 0.4%, and 7.2%, respectively. In the SAE subgroup, according to the 2018 AAST-OIS, 234 patients were classified as grade II, n = 3; III, n = 21; IV, n = 111; and V, n = 99, respectively.; and compared with 1994 AST-OIS, 150 patients received a higher grade and the total number of grade IV and V injuries ranged from 96 (41.0%) to 210 (89.7%) (p Conclusions Our data confirm the superiority of the 2018 AAST-OIS and support the role of SAE in changing the trend of management of BSI. Graphical abstract

In this paper, the instability mechanism of resistive random access memory (RRAM) was investigated, and a technique was developed to stabilize the distribution of high resistance states (HRS) and better concentrate the set voltage. Due to the accumulation of oxygen, an interface-type switching characteristic was observed on the I-V curves beneath the filament-type switching behavior. In this work, the interface-type switching characteristic is used to fit the natural distribution of HRS as an analysis of the instability mechanism. According to the results, the HRS distribution is attributed to the accumulation of excess oxygen ions left from the lower oxygen content and oxygen vacancy recombination during the reset process. The proposed solution with simple plasma treatment, can create an excess oxygen reservoir by changing the surface topography of the electrode to store the surplus oxygen ions from the reset process, eliminating the oxygen accumulation effect and further improving the device stability.

Facile, room-temperature, and surfactant-free seed-mediated chemical bath deposition was developed to directly grow CuBi2O4 nanostructures on an electrode substrate for applications in electrochemical reforming of glucose and photoelectrochemical (PEC) hydrogen generation. The metal precursor concentration and Cu2+/Bi3+ molar ratio were found to be decisive factors in determining the structure of CuBi2O4, and single crystal CuBi2O4 submicron-square columns (microCuBi2O4), nano-square columns (nanoCuBi2O4), and c-axis oriented nano-square columns (c-nanoCuBi2O4) were selected for detailed electrochemical and PEC characterization. The results of Tauc plots and ultraviolet photoelectron spectroscopy (UPS) resolved the band structure of these CuBi2O4 compounds. Mott–Schottky and UPS analyses showed that these CuBi2O4 compounds had flat-band potentials of >1.10 V vs. RHE, which makes them promising photocathodes for PEC hydrogen generation. The synthesized CuBi2O4 compounds exhibited different levels of electrocatalytic activity towards electroreforming of glucose, in the order of nanoCuBi2O4 > c-nanoCuBi2O4 > microCuBi2O4, which is attributed to the structure-dependent kinetics of the chemical reaction between glucose and electrochemically activated Cu species in CuBi2O4 at elevated anodic potentials. Additionally, all synthesized CuBi2O4 samples showed high selectivity (faradaic efficiency > 93%) for formate generation from electro-oxidative conversion of glucose. This study opens up a new avenue for the synthesis of nanostructured CuBi2O4 with promising bi-functionality towards PEC biomass reforming.

Oral squamous cell carcinoma (OSCC) is a type of malignancy characterized by high relapse and recurrence rates in the late stage despite optimal surgical intervention and postoperative chemoradiotherapy. Because the management of relapse following definitive treatment is challenging, accurate risk stratification is of clinical significance to improve treatment outcomes. Circular RNAs (circRNAs) are noncoding RNAs featured with cell-type specificity and high stability, owing to their circular structure, making these molecules excellent biomarkers for a variety of diseases.The levels of hsa_circ_0000190 and 0001649 in plasma samples from 30 healthy controls and 66 OSCC patients were determined by droplet digital polymerase chain reaction. The same primer sets were used with PCR to examine the expression of these two circRNAs in cancerous and adjacent normal tissues. A receiver operating characteristics curve was generated to evaluate the diagnostic value. The Kaplan-Meier method with a log-rank test was used for survival analysis.We identified two circRNAs as potential biomarkers for OSCC, showing that the plasma level of hsa_circ_0000190 was significantly decreased in the late stage and marginally correlated with the development of second primary OSCC. We also found that the decreased plasma hsa_circ_0001649 was correlated with the recurrence and poor prognosis of patients. Additionally, we found that high plasma hsa_circ_0000190, but not hsa_circ_0001649, possibly predicted a better response of patients to induction chemotherapy.Our study demonstrated the potential of biomarkers in plasma to inform not just the tumor but the entire oral cavity, thereby offering a prediction for early recurrence and second primary OSCC. The plasma circRNAs remain valuable for OSCC, albeit the easy accessibility to the oral cavity.

Background: Portal vein thrombosis (PVT) was infrequently complicated by acute cholecystitis. The clinical signs of PVT are usually non-specific and subclinical. The treatment aim was to re-canalize the portal vein and to avoid serious complications. An early anticoagulation treatment would result in favorable outcome. Case Report: We present a case of acute cholecystitis with sole left portal vein thrombosis causing left liver atrophy in a 59-year-old woman.Conclusions: While the surgeon is familiar with this uncommon condition, the PVT could be detected on the pre-operative images through a tailored CT or MRI. The condition of PVT is often subclinical and might complicate liver atrophy, an early anticoagulation treatment would result in a favorable outcome.

Background: Failure of the primary management at controlling the post-partum hemorrhage (PPH) is occasionally encountered. A catastrophic cause of PPH as vagina arterial aneurysms with AVF is rare and not reported in English literature.Case presentations: We present a 34-year-old woman of arterial aneurysms with arteriovenous fistulas (AVF) at bilateral lower vagina causing intractable PPH with aggressive bleeding. By trans-arterial embolization (TAE) the bleeding is successfully controlled, and patient then could recover smoothly.Conclusion: These vascular anomalies being fierce culprit of the PPH would result in primary management failure. Knowledge of the possible etiology of post-partum hemorrhage is crucial for treatment management. This case report aims to point out a pivotal role of TAE at detecting and treating this unusual cause of PPH.

Purpose This study developed a novel multi-axial alveolar distractor and evaluated its safety and effectiveness by performing various mechanical tests and finite element (FE) analysis. Materials and methods A ball-and-socket joint with a high degree of freedom was proposed as the design concept to make the distractor produce a cone trajectory motion range of up to 60° with respect to the transport screw (central axis). This device was manufactured with Ti6Al4V alloy. Mechanical functional tests included four-point bending resistance testing of the base bone plate, pull-out testing of the multi-axial alveolar distractor, welding strength testing between the base bone plate and ball-and-socket joint mechanism, and torque strength testing of the ball-and-socket joint. These tests were performed to ensure the effectiveness and safety of the multi-axial alveolar distractor. The base bone plate FE analysis of four-point bending resistance and pull-out testing of the multi-axial alveolar distractor were performed to confirm the results obtained from the experimental testing. Results The bending strength for the four-point bending test and the maximum force for pull-out testing were 530.88 N mm and 716.33 N, respectively. Substantial equivalence FE simulations also found that large deformations for four-point bending and pull-out testing were smaller than those for the commercial alveolar distractor, indicating that our new distractor is as safe and effective as the commercially available device. The maximum debonding torque resistance for ball-and-socket joint mechanism welding strength was 3481.1 N mm, meaning it is unable to fall off during a surgical operation. No damage was found at the welding edge. The maximum average resistance force in the ball-and-socket joint was 30.26 N without rotation, allowing it to resist distraction forces during bone regeneration — an important safety consideration. Conclusion The alveolar distractor designed using a ball-and-socket joint concept can achieve multi-axial distraction with various angle adjustments in 3D space. Thorough mechanical/functional tests confirm the effectiveness and safety of our new multi-axial alveolar distractor.

This letter investigates Au30Ag70 (alloy electrode)/SiO2/TiN conductive-bridge random access memory (CBRAM) to verify the influence of ambient conditions on forming voltage ( $\text{V}_{\textsf {F}}$ ) and the location of galvanic reaction. Previous literature demonstrates that the galvanic reaction in CBRAM with an alloy electrode results in a lower $\text{V}_{\textsf {F}}$ . In this work, a higher environmental H2O concentration results in a decrease in $\text{V}_{\textsf {F}}$ . From this change in $\text{V}_{\textsf {F}}$ , we infer that environmental H2O concentration influences the amount of galvanic reaction. Moreover, we verify the location of the galvanic reaction by varying electrode thickness. Finally, we propose a physical model to explain our observations.

We report the synthesis of lanthanide-doped core/shell upconverting nanoparticles (UCNPs) LiYF4:Yb3+/Er3+/Ho3+/Tm3+@LiYF4:Yb3+. The photoluminescence (PL) spectra of the tetragonal-phase nanoparticles could be tuned by varying the doping ratio of lanthanide ions (Er3+, Ho3+, Tm3+) and their intensities were much enhanced through the active core/active shell strategy. The as-synthesized UCNPs were characterized and confirmed by X-ray diffraction (XRD), transmission electron microscope (TEM), and PL spectroscopy. By varying the composition and concentration of the dopant ions, the upconversion emissions upon near-infrared (NIR) excitation at 980 nm can be precisely modulated. After overcoating UCNP cores with LiYF4:Yb3+ shell, the upconversion emissions for all core/shell nanoparticles were about 3 times of those corresponding core nanoparticles. After ligand exchange, the hydrophobic LiYF4:Yb3+/Er3+/Ho3+/Tm3+@LiYF4:Yb3+ core/shell nanoparticles could be transferred into hydrophilic UCNPs. The colloid nanoparticles could be employed as a chemosensor for detection of Hg2+ at near-infrared excitation wavelengths.

Hot embossing is a novel technique for the cost-effective production of micro-parts. Misalignment between the top and bottom surfaces of a product that has double-sided microstructures reduces its functions. Most solutions involve repairing or reproducing the embossing mold, which increases the cost for the molding process. This study proposes a hybrid alignment platform that allows accurate positioning and angular alignment for the embossing processes. The hybrid alignment platform includes two units. The upper unit allows angular adjustment using a precision rotary table. The lower unit allows positional adjustment using two orthogonal micrometers. Calibration tests are conducted for a series of adjustment steps along the X, Y and C axis. Only one alignment step is necessary for each axis. The alignment platform allows rapid positioning and increases replicability. The hybrid mold adjustment platform is used to resolve a problem with gear misalignment and the problem of eccentricity in the production of micro-gears is effectively resolved.

In this study, CoOx nanoparticles decorated CuBi2O4 submicron-sized square columns (microCuBi2O4|CoOx) modified electrodes were fabricated and their electrocatalytic properties were investigated. microCuBi2O4, for the first time, was directly grown onto the electrode substrate using chemical bath deposition (CBD) at room temperature, whereas microCuBi2O4|CoOx was prepared by subjecting microCuBi2O4 to additional CBD process and subsequent electrochemical treatment. It was found that the crystalinity of microCuBi2O4 and the amount of CoOx play a decisive role in the overall electrocatalytic activity of microCuBi2O4|CoOx. In addition, the redox couples of the active species, responsible for the electrocatalytic glucose oxidation, in microCuBi2O4 and CoOx overlaps, and these active species exert a synergetic electrocatalytic effect in enhancing the overall electrocatalytic activity, in terms of overpotential and catalytic current, of microCuBi2O4|CoOx towards glucose oxidation. Under optimal conditions, the developed microCuBi2O4|CoOx exhibits a promising sensing characteristics for glucose detection, including a high sensitivity of 383.0 ± 32.3 µA/cm2/mM, a low limit of detection of 0.8 µM, a wide linear range upto 8.0 mM, a fast response time (t95) of

Dry eye disease (DED), also called the keratoconjunctivitis sicca, is one of the most common diseases in the ophthalmology clinics. While DED is not a life-threatening disease, life quality may be substantially affected by the discomfort and the complications of poor vision. As such, a large number of studies have made contributions to the investigation of the DED pathogenesis and novel treatments. DED is a multifactorial disease featured with various phenotypic consequences; therefore, animal models are valuable tools suitable for the related studies. Accordingly, selection of the animal model to recapitulate the clinical presentation of interest is important for appropriately addressing the research objective. To this end, we systemically reviewed different murine and rabbit models of DED, which are categorized into the quantitative (aqueous-deficient) type and the qualitative (evaporative) type, based on the schemes to establish. The clinical manifestations of dry eye on animal models can be induced by mechanical or surgical approaches, iatrogenic immune response, topical eye drops, blockage of neural pathway, or others. Although these models have shown promising results, each has its own limitation and cannot fully reproduce the pathophysiological mechanisms that occur in patients. Nonetheless, the animal models remain the best approximation of human DED and represent the valuable tool for the DED studies.

This study evaluates the biomechanical performance of a new multi-axial alveolar distractor using an animal study. The multi-axial alveolar distractor is designed with a ball and socket joint mechanism that can rotate up to 60° toward the buccal/lingual and mesial/distal sides intra-operatively to achieve vector control. The transport segment can be moved through activating the transport screw with 0.25 pitch, allowing 13 mm in distraction height. This distractor was fixed at the right angulus mandibular of experimental rabbits and adjusted 15° toward the mesial side and 25° toward the buccal side as Group TMB (toward mesial-buccal) (n = 3), and 15° toward the mesial side as Group TM (toward mesial) (n = 3). Group TC (control) was the control group. The distractors were activated 1 mm/day for 13 days. Living bone growth was observed at various periods. The total bone growth length at the angulus region and buccal side distraction thickness after distraction were calculated. The variations in bone growth geometric shape at the mandible angulus were also recorded. Fracture testing was performed to understand the variations in the mechanical strength between the distracted and intact bone specimens. The digital radiography results showed that the osteotomy areas at the mandible angulus were healed and the bone growth completed after surgery. The average bone growth length of Group TMB was 17.68 mm. This was greater than that of Group TM at 14.79 mm. The corresponding buccal side distractor thicknesses for Group TMB and TM after distraction were 5.12 ± 0.52 mm and 3.32 ± 0.37 mm, respectively. The tensile strengths of the bone specimens after distraction of Groups TMB, TM and TC were 172.13 N, 119.27 N and 304.24 N, respectively, and the percentage of distraction bone tensile strength to normal bone was 57% and 39% for Groups TMB and TM, respectively. This study concluded that this new multi-axial alveolar bone distractor can drive bones to grow in accordance with the direction/angle of the distraction plan. The bone growth healed gradually and presented insufficient mechanical strength.

This work investigates the influence of a supercritical fluid (SCF) treatment on the characteristics of resistive random access memory. A comparison between the experimental results for the device at initial, after the overset process, and after the SCF treatment, shows that the treatment dopes oxygen ions and generates defects in the switching region (SR). Moreover, the changes in the ratio of the components of the SR after the SCF treatment improve memory characteristics, including a lower set/reset voltage (V SET/V RESET), and higher resistances at low resistance state and high resistance state.

Endoplasmic reticulum (ER) stress response is an adaptive program to cope with cellular stress that disturbs the function and homeostasis of ER, which commonly occurs during cancer progression to late stage. Late-stage cancers, mostly requiring chemotherapy, often develop treatment resistance. Chemoresistance has been linked to ER stress response, however, most of the evidence has come from studies that correlate the expression of stress markers with poor prognosis or demonstrate proapoptosis by the knockdown of stress-responsive genes. Since ER stress in cancers usually persists and is essentially not induced by genetic manipulations, we used low doses of ER stress inducers at levels that allowed cell adaptation to occur in order to investigate the effect of stress response on chemoresistance. We found that prolonged tolerable ER stress promotes mesenchymal&ndash, epithelial transition, slows cell-cycle progression, and delays the S-phase exit. Consequently, cisplatin-induced apoptosis was significantly decreased in stress-adapted cells, implying their acquisition of cisplatin resistance. Molecularly, we found that proliferating cell nuclear antigen (PCNA) ubiquitination and the expression of polymerase &eta, the main polymerase responsible for translesion synthesis across cisplatin-DNA damage, were up-regulated in ER stress-adaptive cells, and their enhanced cisplatin resistance was abrogated by the knockout of polymerase &eta, We also found that a fraction of p53 in stress-adapted cells was translocated to the nucleus, and that these cells exhibited a significant decline in the level of cisplatin-DNA damage. Consistently, we showed that the nuclear p53 coincided with strong positivity of glucose-related protein 78 (GRP78) on immunostaining of clinical biopsies, and the cisplatin-based chemotherapy was less effective for patients with high levels of ER stress. Taken together, this study uncovers that adaptation to ER stress enhances DNA repair and damage tolerance, with which stressed cells gain resistance to chemotherapeutics.

Massive hepatic necrosis after therapeutic embolization has been reported. We employed a 320-detector CT scanner to compare liver perfusion differences between blunt liver trauma patients treated with embolization and observation. This prospective study with informed consent was approved by institution review board. From January 2013 to December 2016, we enrolled 16 major liver trauma patients (6 women, 10 men; mean age 34.9 ± 12.8 years) who fulfilled inclusion criteria. Liver CT perfusion parameters were calculated by a two-input maximum slope model. Of 16 patients, 9 received embolization and 7 received observation. Among 9 patients of embolization group, their arterial perfusion (78.1 ± 69.3 versus 163.1 ± 134.3 mL/min/100 mL, p = 0.011) and portal venous perfusion (74.4 ± 53.0 versus 160.9 ± 140.8 mL/min/100 mL, p = 0.008) were significantly lower at traumatic parenchyma than at non-traumatic parenchyma. Among 7 patients of observation group, only portal venous perfusion was significantly lower at traumatic parenchyma than non-traumatic parenchyma (132.1 ± 127.1 vs. 231.1 ± 174.4 mL/min/100 mL, p = 0.018). The perfusion index between groups did not differ. None had massive hepatic necrosis. They were not different in age, injury severity score and injury grades. Therefore, reduction of both arterial and portal venous perfusion can occur when therapeutic embolization was performed in preexisting major liver trauma, but hepatic perfusion index may not be compromised.

BackgroundAngiopoietin-Tie2 and nitric oxide pathway is crucial in tumor angiogenesis and closely correlates with tumor development, growth, and metastasis. This study aimed to investigate the angiopoietin-Tie2 and nitric oxide signaling of the erythrocyte membrane in response to surgical trauma in head and neck cancer.MethodsWe prospectively enrolled the patients with histology-proven head and neck squamous cell carcinoma undergoing surgical resection of primary tumors at the medical center between August and November 2019. We measured the preoperative and postoperative levels of angiopoietin-1, angiopoietin-2 in plasma using enzyme-linked immunosorbent assays, nitric oxide in plasma using nitrate/nitrite colorimetric assays, and Tie2 phosphorylation in erythrocyte membrane using Western blotting.ResultsThe plasma angiopoietin-1 was downregulated from the median 971.3 pg/mL (interquartile range [IQR] 532.1–1569.3) to 417.9 (IQR 270.5–597.3) after tumor resection (p= 0.0020). Conversely, the plasma angiopoietin-2 was enhanced from 1173.6 pg/mL (IQR 977.7–1450.2) to 2353.7 (IQR 1352.4–2954.3) after surgery (p= 0.0021), with a concomitant increase in plasma nitric oxide level from 7.73 μM (IQR 5.39–10.06) to 10.50 (IQR 7.65–14.18) after surgical resection (p= 0.0093). Subgroup analyses further showed the angiopoietin-Tie2 and nitric oxide signaling was significant only in stage III and IV cancer.ConclusionsThe dynamic change of angiopoietin-Tie2 signaling in the erythrocyte membrane along with the enhanced nitric oxide in plasma after tumor resection suggests erythrocytes play a significant role in modulating surgery-induced angiogenesis, which may provide a novel marker for cancer surveillance and control.

As of April 15, 2020, the US Food and Drug Administration has granted emergency use authorization to a first saliva test for diagnosis of severe acute respiratory syndrome coronavirus 2 infection, the device developed by RUCDR Infinite Biologics laboratory, Rutgers University. A key feature that distinguishes the saliva-based test from nasopharyngeal or oropharyngeal (throat) swabs is that this kit allows self-collection and can spare healthcare professionals to be at risk during collecting nasopharyngeal or oropharyngeal samples, thereby preserving personal protective equipment for use in patient care rather than sampling and testing. Consequently, broader testing than the current methods of nasal or throat swabs will significantly increase the number of people screening, leading to more effective control of the spread of COVID-19. Nonetheless, a comparison of saliva-based assay with current swab test is needed to understand what and how we can benefit from this newly developed assay. Therefore, in this mini-review article, we aimed to summarize the current and emerging tools, focusing on diagnostic power of different clinical sampling and specimens.

Background The aim of this study was to evaluate the outcome of intra-arterial urokinase thrombolysis for acute superior mesenteric artery (SMA) occlusion. Methods Ten patients with acute SMA occlusion who underwent intra-arterial urokinase therapy between 2008 and 2019 were retrospectively evaluated. Results Among the 10 patients, 7 were men and 3 were women (median age, 75.5 years). The median time from onset of abdominal pain to emergency department admission was 11 hours (interquartile range [IQR], 4.9 hours). None of the patients presented with shock in the triage screening or acute peritonitis on physical examination, and 4 (40%) had bloody stools. On angiography, 6 patients presented with complete SMA occlusion and the other 4 patients had incomplete occlusion. The median time from abdominal pain to attempting urokinase thrombolysis was 15.5 hours (IQR, 8.0 hours). During the course of the urokinase therapy, all the patients showed various degrees of recanalization (near-total, n = 2; partial, n = 8) on follow-up angiography. The median urokinase therapy duration was 39.0 hours (IQR, 48.0 hours). After urokinase therapy, bowel perfusion was restored with bowel preservation in 4 patients; however, in the other 6 patients, bowel perfusion was not restored. Comparison between the 4 patients with restored bowel perfusion and 6 patients with unrestored bowel perfusion revealed that the degree of SMA occlusion was statistically significant (complete vs. incomplete, p = 0.012). Of the 6 patients with complete SMA occlusion, 5 underwent bowel resection, of whom 2 died, and the remaining patient died of shock due to delayed surgery. Of the 4 patients with incomplete SMA occlusions, no bowel resection was performed except a partial omentectomy. Of the 3 deaths, one was attributed to delayed surgery, and the other two developed short bowel syndrome with sepsis and multiple-organ failure, with a 30% in-hospital mortality rate. The median hospital stay was 20.0 days (IQR, 32.0 days). Conclusion In our experience, thrombolysis with intra-arterial urokinase may serve as an adjunctive treatment modality to preserve the bowel and obviate surgery for incomplete SMA occlusion. However, it was not suitable for complete SMA occlusion, which requires surgery.

BACKGROUND Oral squamous cell carcinoma (OSCC) leads to thousands of deaths every year in Taiwan. Nearly 40% of OSCC patients are diagnosed with stage IV disease, which has a poor prognosis. Multimodality treatments including surgery and adjuvant therapy have been utilized, but their treatment outcomes are generally poor. In this study, we sought to identify possible clinical impact factors that may contribute to the survival of stage IV OSCC. METHODS Data for patients with malignant neoplasms of the oral cavity registered in the Cancer Registry Database of Taipei Veterans General Hospital between 2002 and 2011 were retrieved. The study patients consisted of OSCC patients with clinical stage IV disease who had undergone a surgery and adjuvant therapy. The primary endpoints were the 5-year disease-free survival (DFS) and overall survival (OS) rates. The clinicopathological characteristics of the patients were also stratified and compared. RESULTS A total of 191 OSCC patients were included for retrospective analysis. The different subgroups of stage IV disease presented different treatment outcomes. The 5-year OS versus DFS rates of each subgroup were as follows: T4N0: 70.9% versus 52.6%; T1-3N23: 66.1% versus 49.8%; T4N1: 49.6% versus 31.6%; and T4N23: 40.9% versus 31.0% (p < 0.01). Patients with diabetes, moderate or poor cell differentiation, perineural invasion, and extracapsular spread presented lower 5-year OS rates (hazard ratio [HR] = 1.87, 1.65, 2.42, and 2.14, respectively), and patients with perineural invasion, positive cut margin, and extracapsular spread presented lower 5-year DFS rates (HR = 1.57, 1.62, and 1.71, respectively). CONCLUSION In this study, we elucidated the different survival rates of different subgroups of stage IV OSCC following the same treatment scheme. The results of the study provide clinical physicians with references by which to evaluate prognosis and determine post-operative disease monitoring timetables based upon different characteristics.