Novel Use of the Falciform Ligament for MHV Reconstruction During Laparoscopic Hepatectomy of Colorectal Liver Metastasis.

BACKGROUND: Laparoscopic hepatectomy (LH) with oncological R0 resection combined with systemic therapy offers the best chance of cure for colorectal liver metastasis. However, tumors in vicinity of major hepatic veins require complex technique. Parenchyma-sparing resection with involved vein resection and peritoneal patch reconstruction could be an efficacious alternative to preserve liver volume for adjuvant chemotherapy and avoid venous congestion of the remnant liver.1,2 METHODS: A 64-year-old female, with history of colon cancer, had new diagnosis of liver metastatic tumor of S8 (2.8 cm), which was considering encroached on middle hepatic vein (MHV) with distal part patent. Thus margin-negative, parenchyma-sparing liver resection with involved vein resection and proximal MHV reconstruction was indicated for oncological radicality. RESULTS: With the patient in modified French position, we dissected falciform ligament and right coronary ligament to expose the crypt between right hepatic vein (RHV) and MHV. Intraoperative ultrasound localized the tumor and resection margin. Parenchymal dissection was performed caudally to cranially, left to right, to ligate dorsal branch of G8 (G8d) and V8 and expose main trunk of MHV. The involved side-wall of MHV was incised after the proximal and distal parts clamped. Peritoneal patch was harvested from falciform ligament to repair MHV side-wall before clamps released. The patient had an uneventful recovery and remained disease-free at 1 year postoperatively with patency of distal MHV by image. CONCLUSIONS: LH with MHV reconstruction by falciform ligament for metastatic lesion is technically demanding but feasible with oncological radicality and volume preservation for adjuvant chemotherapy.

Novel method for laparoscopic rectus sheath tunneling with Lin's tube in peritoneal dialysis catheter implantation.

Laparoscopic implantation of a catheter through rectus sheath tunnel minimizes the risks of catheter failure and reduces some complications like catheter migration, hernias, and leaks. We described a novel method for laparoscopic catheter rectus sheath tunneling using an aspiration tube and a silk tie (Lin's tube). This material is easily available and yields a small fascial defect with an equivalent cannula size to minimize tissue disruption. The technique is feasible, reproducible and it may reduce the risks of postoperative leakage and hemorrhage.

CRC Therapy Identifies Indian Hedgehog Signaling in Mouse Endometrial Epithelial Cells and Inhibition of Ihh-KLF9 as a Novel Strategy for Treating IUA.

Intrauterine adhesion (IUA) causes menstrual disturbance and infertility. There is no effective treatment available for moderate to severe IUA cases. Stem cell-based therapy has been investigated for treating IUA but is limited in clinical applications due to issues including the precise induction of differentiation, tumorigenesis, and unclear molecular mechanisms. In our recent study, we isolated and expanded the long-term cultures of conditional reprogrammed (CR) mouse endometrial epithelial cells. Treating IUA mice with these CR cells (CRCs) restored the morphology and structure of the endometrium and significantly improved the pregnancy rate. In this study, our data with high-throughput sequencing, CRISPR knockout Ihh-/-CRCs, and transplantation identified for the first time that the Indian hedgehog (Ihh) gene plays a critical role in the regulation of endometrial epithelial cell proliferation. We also found that aberrant activated Ihh-krüppel-like factor 9 (KLF9) signaling contributes to the inhibition of normal progesterone receptor (PR) function in IUA mice. Thus, we hypothesized that inhibition of the Ihh-KLF9 pathway may be a novel strategy to treat IUA. Our data demonstrated that treatment with the hedgehog signaling inhibitor Vismodegib restored the morphology, structure, and microenvironment of the endometrium, and greatly improved the pregnancy rate in IUA mice. This study suggests a promising application of hedgehog inhibitors as a targeted drug in the IUA clinic.

Performance and limitation estimation of a three-tap gated imaging sensor in wide field time-gated fluorescence lifetime imaging systems.

In this paper, a computational performance analysis is presented of a wide-field time-gated fluorescence lifetime imaging microscope (FLIM) using practically realizable properties of the laser, sample, and a three-tap time-gated CMOS image sensor. The impact of these component-level properties on the accuracy and the precision of the measurement results are estimated and discussed based on Monte Carlo simulations. The correlation between the detector speed and the accuracy of the extracted fluorescence lifetime is studied, and the minimum required incident photoelectron number of each pixel is estimated for different detector speeds and different fluorescence lifetime measurements. In addition, the detection limits due to the dark current and the parasitic light sensitivity of the detector are also investigated. This work gives an overview of the required fluorescence emission condition as well as the required detector properties for a three-tap time-gated image sensor to achieve good FLIM data in biological applications.

Carbon nanotubes for highly sensitive colorimetric immunoassay biosensor.

A colorimetric immunoassay biosensor is developed employing CNTs as a label material, which allowed direct observation of the sensing result by the naked eye. Implemented for HSA, the detection limit is 3 × 10-5 mg ml-1 when characterized using UV-Vis.

Flexible direct-growth CNT biosensors.

A biosensor was fabricated by growing carbon nanotubes (CNTs) directly on a polyimide flexible substrate at low temperatures (≤400 °C). A biocompatible polymer (poly(para-xylylene), parylene) was subsequently coated on the surface without CNTs as an insulator for future applications of flexible biosensors in in vivo sensing. The feasibility of the CNT flexible biosensor was demonstrated by quantitatively detecting human serum albumin (HSA). The CNT surface was modified with functional groups using UV-ozone, 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC), and treated with N-hydroxysuccinimide (NHS) to improve the biocompatibility for the conjugation of protein. In addition, anti-HSA (AHSA) was used to capture HSA specifically, and bovine serum albumin (BSA) was applied to block the non-specific sites. The electrical properties of the biosensors applied with various HSA concentrations were measured and quantified using an electrochemical impedance spectroscopy system under AC conditions. The detection limit of the biosensor for HSA detection was approximately 3×10(-11) mg/ml. The proposed sensor has considerable potential for future application in wearable biosensors and implant detection.

A quantum dot-based optical immunosensor for human serum albumin detection.

In this study, a CdSe/ZnS quantum dot (QD)-based immunosensor using a simple optical system for human serum albumin (HSA) detection is developed. Monoclonal anti-HSA (AHSA) immobilized on 3-aminopropyltriethoxysilane (APTES)-modified glass was used to capture HSA specifically. Bovine serum albumin (BSA) was used to block non-specific sites. The solution, containing AHSA-QD complex prepared by mixing biotinylated polyclonal anti-HSA and streptavidin coated QD, was used to conjugate with the HSA molecules captured on AHSA/BSA/APTES-modified glass for the modification of HSA with QD. A simple optical system, comprising a diode laser (405 nm), an optical lens, a 515-nm-long pass filter, and an Si-photodiode, was used to detect fluorescence and convert it to photocurrent. The current intensity was determined by the amount of QD specifically conjugated with HSA, and was therefore HSA-concentration-dependent and could be used to quantify HSA concentration. The detection limit of the pure QD solution was ~3.5×10(-12) M, and the detection limit for the CdSe/ZnS QD-based immunosensor developed in this study was approximately 3.2×10(-5) mg/ml. This small optical biosensing system shows considerable potential for future applications of on-chip liver-function detection.

Electrical impedimetric biosensors for liver function detection.

In this study, electrical impedimetric biosensors composed of Au-electrodes were fabricated for the quantitative detection of human serum albumin (HSA), an essential biomarker of liver function. The Au-electrodes were fabricated via a single-step photolithography process, and can be easily integrated in biochips for assessing liver function in the future. The glass sensing surface between two adjacent Au-electrodes was modified with 3-aminopropyltriethoxysilane (APTES) to improve the biocompatibility for its subsequent binding to anti-human serum albumin (AHSA). The sensing surface without AHSA binding was blocked using skim milk powders, preventing possible non-specific bonding HSA conjugation. Biosensors were used to measure HSA concentration for liver function detection. The impedance between two adjacent Au-electrodes of the biosensors applied with various HSA concentrations was directly measured, and quantified using an electrochemical impedance spectroscopy system under AC conditions. The results of plotting both values in log scales indicated the impedance increased linearly with HSA conjugation increase. The limit of HSA detection was about 2'10(-4)mg/ml using the electrochemical impedimetric biosensor proposed in this work. This study demonstrates the feasibility of using electrochemical impedimetry as a bio-sensing mechanism to quantify human serum albumin concentration. The sensor proposed in this work also displays great potential for assessing liver function because of its simple detection mechanism, ease of biochip integration, and low cost.

A multi-functional plasmonic biosensor.

We present a coupler-free, multi-mode refractive index sensor based on nanostructured split ring resonators (SRRs). The fabricated SRR structures exhibit multiple reflectance peaks, whose spectral positions are sensitive to local dielectric environment and can be quantitatively described by our standing-wave plasmonic resonance model, providing a design rule for this multi-mode refractive-index (MMRI) sensor. We further manifest that the lower-order modes possess greater sensitivity associated with stronger localized electromagnetic field leading to shorter detection lengths within five hundreds nanometers, while the higher-order modes present mediate sensitivity with micron-scale detection lengths to allow intracellular bio-events detection. These unique merits enable the SRR-based sensor a multi-functional biosensor and a potential label-free imaging device.