Noninvasive assessment of liver function reserve with fluorescent dosimetry of indocyanine green.

Using in vivo multiphoton fluorescent dosimetry, we demonstrate that the clearance dynamics of Indocyanine Green (ICG) in the blood can quickly reveal liver function reserve. In normal rats, the ICG retention rate was below 10% at the 15-minute post-administration; While in the rat with severe hepatocellular carcinoma (HCC), the 15-minute retention rate is over 40% due to poor liver metabolism. With a 785 nm CW laser, the fluorescence dosimeter can evaluate the liver function reserve at a 1/10 clinical dosage of ICG without any blood sampling. In the future, this low-dosage ICG 15-minute retention dosimetry can be applied for the preoperative assessment of hepatectomy or timely perioperative examination.

Is robotic hepatectomy cost-effective? In view of patient-reported outcomes.

BACKGROUND: Robotic hepatectomy has been accepted as an alternative for patients needing surgery. However, few reports addressed the patient-reported outcomes and long-term quality of life (QoL) of patients having undergone robotic liver surgery. METHODS: This study presented the QoL and cost-effectiveness associated with robotic and open hepatectomy by performing a comparative survey using two standardized questionnaires (Short Form-36 and Gastrointestinal Quality of Life Index). RESULTS: One hundred patients completed the study. The robotic group tended to experienced longer operation time but shorter length of hospital stay compared to open group. Moreover, the robotic group had faster return to daily activities, less need of patient-controlled anesthesia, and less wound-related complaints in long-term follow-up. The robotic group incurred higher peri-operative expenses; however, the cost of inpatient care was lower. CONCLUSIONS: Our study suggested that robotic hepatectomy provided good post-operative QoL and recovery of daily activity. However, efforts for lowering the financial burden of medical care by reducing the cost of robotic surgery is necessary for further application.

Systematic review and meta-analysis of robotic versus open hepatectomy.

BACKGROUND: To date, there are few studies comparing the outcomes of robotic hepatectomy (RH) versus open hepatectomy (OH). We report the first systematic review and meta-analysis comparing the outcomes of RH versus OH. METHODS: A systemic review was performed of all comparative studies of RH versus OH that reported the perioperative outcome(s) of interest. RESULTS: Seven retrospective cohort studies were included. There was no significant difference in patients' baseline characteristics. RH was associated with a longer operation time (mean difference (MD) 61.47 min; 95% confidence interval (CI) (7.03, 115.91); P = 0.03), shorter hospital stay (MD -2.57 days; 95% CI (-3.31, -1.82); P < 0.001), lower costs, less overall (risk ratio (RR) 0.63; 95% CI (0.46, 0.86); P = 0.004), minor (RR 0.64; 95% CI (0.43, 0.95); P = 0.03) and major (RR 0.45; 95% CI (0.22, 0.94); P = 0.03) post-operative complications compared to OH. CONCLUSION: RH had superior perioperative outcomes and was not cost prohibitive compared to OH, but had longer operation times.

Low-cost and facile one-pot synthesis of pure single-crystalline ε-Cu(0.95)V2O5 nanoribbons: high capacity cathode material for rechargeable Li-ion batteries.

Pure single-crystalline ε-Cu(0.95)V(2)O(5) nanoribbons have been successfully synthesized via a facile one-pot solvothermal route using low-cost raw materials. The obtained materials can react electrochemically with 2.64 Li in a reversible fashion and thus greatly expands the range of cathode choices.

Longitudinal assessment of prognostic factors for patients with hepatorenal syndrome in a tertiary center.

INTRODUCTION: Hepatorenal syndrome (HRS) is one of the serious complications in patients with advanced cirrhosis and ascites. In tertiary centers, most patients were classified as having type 1 HRS for their rapid progressive diseases. However, no significant predictors have been assessed previously for patients with type 1 HRS. In addition to the initial model of end-stage liver disease (MELD) scores and biochemistry parameters, we want to further investigate the prognostic importance of changes in MELD scores and biochemistry parameters over time for patients with type 1 HRS. MATERIALS AND METHODS: Data from type 1 HRS patients were incorporated, including their demographic, clinical progression, all recording biochemical parameters, therapeutic methods, and outcomes. RESULTS: A total of 103 patients were included in our study. According to the definition of the International Ascites Club, 67 patients (or 65%) had type 1 HRS whereas 36 (or 35%) had type 2 HRS. According to the multivariate COX proportional hazards regression model, either initial biochemistry parameters or MELD scores were not significantly associated with prognosis. By time-dependent proportional hazards model, each point elevated in creatinine (CRE) and total bilirubin (TBI) levels during the admission increased mortality risk by 29 and 4%, respectively. Increasing albumin level during the admission showed its protective value. Changes in MELD score simple during the admission, which were calculated by CRE and TBI [3.8 × log (bilirubin (mg/dl)] + 9.6 × log [Creatinine (mg/dl) + 6.43], were significant predictor for patients with type 1 HRS. CONCLUSION: In patients with type 1 HRS, changes in TBI, CRE, and albumin level during the admission were associated with prognosis. Changes in MELD score simple is superior to initial and changes in MELD scores to predict prognosis in patients with type 1 HRS.

Quantitative assessment of hepatic fat of intact liver tissues with coherent anti-stokes Raman scattering microscopy.

A fatty liver might progress from being a benign fatty liver, to steatohepatitis, cirrhosis, or even hepatocellular carcinoma. The great prevalence and severe outcome have warranted much investigation of the pathology and the development of effective therapies, which involve animal studies requiring critical evaluation of the hepatic fatty change. Histological examination and wet chemical analysis of liver biopsy specimens are generally employed for this purpose despite numerous procedures being involved. Using coherent anti-Stokes Raman scattering (CARS) microscopy, we have demonstrated the specific imaging of fat droplets in intact liver tissues and extracted the hepatic fat content through image analysis while eliminating laborious procedures required by traditional histopathological examination. The content of hepatic fat measured with CARS imaging was correlated strongly with that determined by biochemical analysis (R(2) = 0.89) over a pathologically significant range of the hepatic fat (from 2% to 20% of the total mass of tissue). Our work validates the quantitative assessment of fat in intact tissue through the use of CARS microscopy. When combined with the increasingly diverse animal models of diseases related to metabolic disorders of lipids, our approach is extensible to enable acquiring important insight into the genetic, environmental, and dietary factors affecting the uptake and accumulation of fat within tissues.