Significant overexpression of DVL1 in Taiwanese colorectal cancer patients with liver metastasis.

Undetected micrometastasis plays a key role in the metastasis of cancer in colorectal cancer (CRC) patients. The aim of this study is to identify a biomarker of CRC patients with liver metastasis through the detection of circulating tumor cells (CTCs). Microarray and bioinformatics analysis of 10 CRC cancer tissue specimens compared with normal adjacent tissues revealed that 31 genes were up-regulated (gene expression ratio of cancer tissue to paired normal tissue > 2) in the cancer patients.

Nonsurgical management of delayed splenic rupture after blunt trauma.

Background: Delayed splenic rupture (DSR) is a rare manifestation of blunt splenic trauma, and splenectomy remains the primary treatment for patients with DSR. The purpose of this study was to review our experience with nonsurgical management of DSR with the use of splenic artery embolization (SAE) as an adjunct treatment.

Methods: This retrospective study included patients with DSR treated at our institution from January 2001 to December 2008.

Gallbladder carcinoma manifesting as acute cholecystitis: clinical and computed tomographic features.

Background: Gallbladder carcinoma is uncommon and may manifest as acute cholecystitis. An accurate diagnosis is helpful for operative planning and this study attempted to explore the distinctive clinical and computed tomographic (CT) features for differentiating acute cholecystitis alone from that with contemporaneous gallbladder carcinoma.

Methods: This 20-year, retrospective study evaluated the CT features of 26 patients with surgically proven gallbladder carcinoma with clinical presentations of acute cholecystitis (carcinoma group).

Risk factors for the outcome of cirrhotic patients with soft tissue infections.

Goal: The aims of this study were to identify risk factors that influence outcomes of cirrhotic patients with soft tissue infections and to describe specific management for such patients.

Background: Soft tissue infections account for 11% of infections overall in cirrhotic patients and the severe form of necrotizing infection carries a high mortality rate. It is essential that clinicians make an early diagnosis and start appropriate treatment to improve outcomes of cirrhotic patients with soft tissue infections.

Left brachiocephalic vein perforation: computed tomographic features and treatment considerations.

Objective: To report the clinical and computed tomographic findings of 5 cases of left brachiocephalic vein perforation (LBCVP).

Methods: The clinical and imaging features of 5 patients with LBCVP (1 woman, 4 men; mean age, 57.6 years) encountered over the last 2 decades were reviewed.

Hemorrhagic bullae represent an ominous sign for cirrhotic patients.

Hemorrhagic bullae are a clinical manifestation of many underlying diseases, especially soft-tissue infection. The aim of this study was to evaluate the characteristics and prognosis of cirrhotic patients with hemorrhagic bullae. Fifteen patients with liver cirrhosis and hemorrhagic bullae had been admitted to Chang Gung Memorial Hospital, Kaohsiung, from January to December 2003.

Use of a refined operative strategy in combination with the multidisciplinary approach to manage blunt juxtahepatic venous injuries.

Background: Despite continuous advances in traumatology, juxtahepatic venous injuries are still the most difficult and deadly form of liver trauma. Most deaths result from exsanguination, and reported mortality ranges from 50% to 80%. This is an evaluation on our experience with the management of this high mortality injury following a refined operative strategy.

Effect of autologous blood donation on the central venous pressure, blood loss and blood transfusion during living donor left hepatectomy.

Aim: Autologous blood donation (ABD) is mainly used to reduce the use of banked blood. In fact, ABD can be regarded as acute blood loss. Would ABD 2-3 d before operation affect the CVP level and subsequently result in less blood loss during liver resection was to be determined.

Deceased-donor liver transplantation: 10 years' experience at Change Gung Memorial Hospital-Kaohsiung Medical Center.

Background: The purpose of this study was to summarize the outcomes we achieved using deceased-donor liver transplantation (DDLT) in the past 10 years at Chang Gung Memorial Hospital-Kaohsiung Medical Center (CGMH-KMC).

Methods: Between March 1993 and March 2003, 53 DDLTs were performed at CGMH-KMC. Patients were divided into 2 stages: stage 1 (n = 22) from March 1993 to February 1998, and stage 2 (n = 31) from March 1998 to March 2003.

Use of splenic artery embolization as an adjunct to nonsurgical management of blunt splenic injury.

Background: Splenic artery embolization (SAE) has been used as an adjunct to the nonsurgical treatment of blunt splenic injuries since 1981. It is imperative to define the role of SAE in the management of splenic trauma and to establish a guideline for its use.

Methods: In this study, 39 consecutive patients with blunt splenic ruptures were evaluated.

Perioperative normovolemic anemia is safe in pediatric living-donor liver transplantation.

Background: Perioperative normovolemic anemia was applied in pediatric living-donor liver transplant (LDLT) recipients with the aim of reducing the use of blood products and decreasing transfusion-related risk.

Methods: The anemic state was allowed to occur by replacing intraoperative blood and transudate loss with colloid solutions and a discriminate use of packed red blood cells. When blood transfusion was required, the amount of blood replacement was calculated to target a hemoglobin level not higher than 8 to 9 g/dL.

Testicular dislocation: an uncommon and easily overlooked complication of blunt abdominal trauma.

Study Objective: We report testicular dislocation as an unusual complication of blunt abdominal trauma.

Methods: The computer data bank of Chang Gung Memorial Hospital was searched for the period from 1987 to 2002, and 1,967 male patients with blunt abdominal trauma were admitted to the emergency department. Among these patients, records of 9 patients associated with testicular dislocation were collected.

The effect of liver graft-body weight ratio on the core temperature of pediatric patients during liver transplantation.

The left lateral segment of the liver from an adult living donor sometimes is relatively too large for a small pediatric recipient. It currently is unknown whether a high graft-recipient body weight ratio (GRWR) has a significant effect on core temperature during the anhepatic and reperfusion phases of living donor liver transplantation (LDLT). Seventy-two pediatric patients undergoing LDLT were divided into two groups according to body weight.

Ionized calcium changes during living-donor liver transplantation in patients with and without administration of blood-bank products.

Exogenous citrate load from blood transfusion during orthotopic liver transplantation is thought to be the main cause of ionized hypocalcemia, which may result in hemodynamic instability. This implies that if no blood is transfused, chelation of free ionized calcium (Ca(++)) by citrate is avoided and supplemental calcium need not be given. For this study, we divided 39 pediatric living-donor liver transplant patients into two groups according to the blood component replacement given: group I received packed red blood cells and fresh frozen plasma with and without 5% albumin, and group II received 5% albumin alone.