Publications by authors named "Kevin Chang"

Arteriovenous fistula (AVF) is the preferred access for hemodialysis in patients with end-stage renal disease, and arteriovenous grafts are used when AVF creation is not feasible. Post renal transplantation, hemodialysis may be needed due to delayed graft function or transplantation failure. This review aimed to summarize current evidence on the impact of maintaining versus ligating AV access on renal function and cardiovascular outcomes post transplantation.

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Postoperative infections after ureteroscopy are common and potentially devastating complications. National and international guidelines recommend treatment of symptomatic positive urine cultures prior to operation, but how to manage patients with asymptomatic colonization remains unclear. In clinical practice, there is wide variation in the choice and duration of antibiotics for these patients.

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A groin mass can arise from multiple conditions, with common causes including hernias, enlarged lymph nodes, fluid collections, or tumors. An ultrasound, together with a clinical examination, plays a key role in diagnosing groin masses and identifying hidden hernias. A 44-year-old male presented with a painless right inguinal mass that had been continuously present for one month.

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Total joint arthroplasty (TJA) is one of the most common surgeries performed in the United States and is a durable and effective option in managing osteoarthritis of the hip and knee. Recent research regarding the procedure has focused on preoperative optimization and weight loss in particular. Obesity has been shown in prior studies to increase risks associated with TJA, and, as a result, debate has focused on whether a body mass index (BMI) cutoff is a prudent tool for preoperative optimization.

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Aim: To propose a standardized, high-resolution ultrasound (US) protocol to assess the patellar tendon-Hoffa fat pad interface (PTHFPI) in patients with (proximal) patellar tendinopathy (PPT).

Methods: Using a high-frequency transducer and a high-level machine, we matched the cadaveric and histological microarchitecture of the PTHFPI with multiple sonographic patterns of patients with PPT. Likewise, high-sensitive color/power Doppler assessments were also performed to evaluate the microcirculation of the soft tissues beneath the patellar tendon.

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Article Synopsis
  • * A meta-analysis examined 12 randomized controlled trials involving 2,050 participants to evaluate the effectiveness and side effects of ICI treatments in CRC.
  • * Results showed that PD-L1 inhibitors improved overall survival by 2.28 months, while PD-1 inhibitors enhanced progression-free survival by 4.79 months, but both types had similar rates for response and side effects compared to other treatments.
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Background: Low back pain is a globally prevalent musculoskeletal issue. Repetitive peripheral magnetic stimulation (rPMS) is emerging as a promising modality for managing musculoskeletal pain, while ultrasound-guided lumbar facet/multifidus injections are a potential therapeutic option for low back pain. This study explores the feasibility of combining these two treatments for managing low back pain.

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Objective: This umbrella review synthesizes systematic reviews and meta-analyses to reach a conclusion concerning the overall effectiveness of ultrasound-guided vs landmark-guided injections for treating musculoskeletal pain.

Design: Umbrella review.

Methods: PubMed, EMBASE, MEDLINE, and Web of Science were searched for relevant systematic reviews and meta-analyses from inception to March 2024.

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Background: The pathophysiology of sarcopenia is complex and multifactorial and has not been fully elucidated. The impact of resistance training and nutritional support (RTNS) on metabolomics and lipodomics in older adults with sarcopenia remains uncertain. This study aimed to explore potential biomarkers of sarcopenia and clinical indicators of RTNS in older sarcopenic adults.

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Insertional Achilles tendinopathy is an umbrella medical term referring to pain and swelling on the posterior aspect of the calcaneus. High-resolution ultrasound imaging is commonly used in daily practice to assess the pathological changes of the Achilles tendon, cortical bone of the calcaneus, and soft tissues located inside the retrocalcaneal space to optimize the management of relevant patients. To the best of our knowledge, a standardized ultrasound protocol to evaluate the retrocalcaneal bursal complex is lacking in the pertinent literature.

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Article Synopsis
  • Patellofemoral pain syndrome (PFPS) is a common cause of knee pain, and lumbopelvic manipulation (LPM) may help reduce this pain.
  • A meta-analysis of ten randomized controlled trials involving 346 participants found significant pain reduction in those receiving LPM compared to a control group.
  • LPM, especially when combined with other therapies, is considered a safe and effective treatment option, and clinicians are encouraged to incorporate it into PFPS management plans.
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Background: Reduced longitudinal median nerve gliding is a new promising diagnostic feature in carpal tunnel syndrome (CTS). However, the complexity of existing ultrasound analysis protocols undermines the application in routine clinical practice.

Aim: To provide a simple method for assessing longitudinal gliding with ultrasound, without the need for post-hoc image analysis.

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Article Synopsis
  • * Shear-wave sonoelastography helps evaluate muscle elasticity, while ultrasound-guided techniques, like interfascial hydrodissection and rhomboid blocks, effectively reduce pain in MPS patients.
  • * Combining shockwave therapy with ultrasound-guided injections has been particularly successful for trapezius MPS, showcasing the importance of ultrasonography in safe and accurate pain management.
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HER2, encoded by the ERBB2 gene, is an important druggable driver of human cancer gaining increasing importance as a therapeutic target in urothelial carcinoma (UC). The genomic underpinnings of HER2 overexpression in ERBB2 nonamplified UC are poorly defined. To address this knowledge gap, we investigated 172 UC tumors from patients treated at the University of California San Francisco, using immunohistochemistry and next-generation sequencing.

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