Contrasting Some Differences in Managing Advanced Unresectable Hepatocellular Carcinoma Between the East and the West.

Hepatocellular carcinoma (HCC) is a common malignancy worldwide, although its aetiologies vary significantly between the East and the West. About a half of HCC cases present with advanced unresectable HCC at the time of diagnosis, leading to a worse prognosis. Over the past 20 years, the treatment paradigm for advanced unresectable HCC has shifted from an entirely palliative approach to a multidisciplinary treatment, with continuous reassessment and possible repeat treatment attributed to the advent of novel and improved local, regional and systemic therapeutic options, contributed by both the East and the West. An individualised treatment plan should be determined for each patient, as there can be substantial differences in the decision-making and treatment response to the same treatment for different patients and different patient populations. This review provides a summary of the recent advances in management and compares Eastern and Western strategies for HCC.

Communicating facial plane information to the dental laboratory: introducing the Facial Plane Relator device.

The ability of the restorative dentist to communicate the location and orientation of the patient's pertinent facial landmarks to the dental laboratory technician has great bearing on the esthetic success of final anterior dental restorations. This article describes a new device designed to facilitate this process.

Near-infrared photo-excited emission from tissues treated at different temperature levels.

BACKGROUND AND OBJECTIVE: There is a lack of methods to evaluate the extent of thermal treatment of biological tissue. The intensity of the near-infrared (NIR) emission photo-excitation was investigated from tissue undergoing different levels of heat treatment. STUDY DESIGN/MATERIALS AND METHODS: Chicken muscle was heated in an oven at different temperature levels ranging from 40 degrees C until burn-off. The spectral emission intensity from these heat-treated tissues was measured with a CCD camera and the intensity was calculated. RESULTS: The emission intensity increased proportionally with respect to the extent of treatment temperature until burning. Linear relationships between treatment temperature and the emission intensity from tissue samples were found in three temperature ranges: from 40 to 160 degrees C, from 165 to 220 degrees C, and from 225 to 250 degrees C. CONCLUSIONS: The change in tissue damage after heat treatment could be detected by measuring the NIR emission intensity from the thermally damaged tissues.

Laser irradiative tissue probed in situ by collagen 380-nm fluorescence imaging.

BACKGROUND AND OBJECTIVE: There is no ideal method to detect molecular changes in situ of laser-irradiated tissue without removing a section of tissue for histologic examination. A new method is reported to evaluate laser-induced thermal tissue damage in situ by using 380-nm native fluorescence imaging under 340-nm excitation. STUDY DESIGN/MATERIALS AND METHODS: Native fluorescence imaging was performed on laser irradiated bovine tendon tissue and compared with light illuminated photography and histology with picrosirius red F3BA stain. RESULTS AND CONCLUSION: The results indicate that a decrease in collagen fluorescence at 380 nm was observed in laser-induced thermally damaged tissues. The injured region of tissue defined by its fluorescence image coincided with an area defined by photography and histology.

Nondestructive evaluation of incipient corrosion in a metal beneath paint by second-harmonic tomography.

A second-harmonic optical scanning imaging method for nondestructive evaluation of corrosion of painted metals is demonstrated. Two-dimensional images of the sectional structure from a sample of painted metal with corrosion were obtained by detection of second-harmonic generation (SHG). The second-harmonic signals generated from paint, corrosion, and metal can be spatially imaged in ~10-mum sliced subsurface layers. Corroded metal layers covered with paint are found to have more intensity variation than normal polished metal. The spatial mapping of the second-harmonic signals shows depth differentiation of paint, corrosion, and metal surfaces. The depth of corrosion beneath the paint can be measured from the SHG images.

Detection of corrosion beneath a paint layer by use of spectral polarization optical imaging.

The spectral and polarization properties of scattered light were used to image corrosion beneath the surface of a painted aluminum plate. The quality of imaging of the corrosion on the metal surface was significantly enhanced by the spectral polarization optical imaging technique. Depolarization scattered light was used to detect and image corrosion beneath the paint layer.

A comparison of Cunyite and Fosterite NIR tunable laser tissue welding using native collagen fluorescence imaging.

OBJECTIVE: To evaluate the technique of native collagen fluorescence imaging for assessing the extent of welded areas for tissues exposed to different near-infrared (NIR) laser wavelengths. BACKGROUND: Native fluorescence imaging may be used to identify the distribution of collagen and elastin in tissues. Our past work demonstrated that different welding strengths were obtained under the same laser power conditions using different NIR wavelengths. The role of collagen in tissue welding experiments is not well understood. METHODS: Two new NIR tunable lasers were used to weld canine skin. The welded areas on the surface and in cross sections were analyzed by measuring the spatial distribution of native collagen fluorescence at 380 nm excited by 340 nm radiation. RESULTS: The results show that native collagen fluorescence imaging is a useful technique for analyzing the extent of tissue welds produced under a range of laser exposures. Fluorescence imaging reveals the depth of laser interaction with the tissue as well as evaluating collateral damage to the tissue surface. The welded volume obtained in skin using Cunyite laser exposure at 1,430 nm is deeper than that produced with Forsterite laser exposure at 1,250 nm. The post welded tensile strength for the same power density is greater for the Cunyite lasers. Ablated tissue on the surface is more prevalent with Forsterite laser welding at 1,250 nm than with Cunyite at 1,430 nm. CONCLUSION: Native collagen fluorescence can distinguish between tissue welds that have been produced by different NIR wavelengths. Tissue welding using 1,430 nm radiation is more effective than that using 1,250 nm.

Fluorescence spectroscopic imaging to detect changes in collagen and elastin following laser tissue welding.

OBJECTIVE: A study was performed to evaluate the use of native fluorescence imaging to detect in situ molecular changes. SUMMARY BACKGROUND DATA: There is no ideal noninvasive method to monitor molecular changes in a local region at a laser weld joint without removing a section of tissue for histological examination. METHODS: Two sections of animal skin were welded together border to border using a Ti:sapphire laser beam (800 nm). Fluorescence imaging was performed on the cross section of the welded site at specific emission wavelengths (lambda c) for collagen at 380 nm and for elastin at 450 nm using excitation wavelengths (lambda e) of 340 nm, and 380 nm, respectively. RESULTS: A reduction of the collagen and elastin emission was observed in the fluorescence images of the welded region. These results were confirmed with histology using picrosirius red F3BA under polarized light and orcein stains. CONCLUSION: Optical spectroscopic imaging offers a new noninvasive detecting method for microscopic evaluation of laser tissue welding.

Comparison of frequencies of left ventricular systolic and diastolic heart failure in Chinese living in Hong Kong.

There is a wide variation (13% to 74%) in the reported prevalence of heart failure associated with normal left ventricular (LV) systolic function (diastolic heart failure). There is no published information on this condition in China. To ascertain the prevalence of diastolic heart failure in this community, 200 consecutive patients with the typical features of congestive heart failure were studied with standard 2-dimensional Doppler echocardiography. A LV ejection fraction (LVEF) >45% was considered normal. The results showed that 12.5% had significant valvular heart disease. Of the remaining 175 patients, 132 had a LVEF >45% (75%). Therefore, 66% of patients with a clinical diagnosis of heart failure had a normal LVEF. Heart failure with normal LV systolic function was more common than systolic heart failure in those >70 years old (65% vs 47%; p = 0.015). Most (57%) had an abnormal relaxation pattern in diastole and 14% had a restrictive filling pattern. In the systolic heart failure group, a restrictive filling pattern was more common (46%). There were no significant differences in the sex distribution, etiology, or prevalence of LV hypertrophy between these 2 heart failure groups. In conclusion, heart failure with a normal LVEF or diastolic heart failure is more common than systolic heart failure in Chinese patients with the symptoms of heart failure. This may be related to older age at presentation and the high prevalence of hypertension in this community.

Subsurface tumor progression investigated by noninvasive optical second harmonic tomography.

Nonlinear optical imaging with femtosecond (10(-15)-second) laser technology was used to evaluate the subsurface tumor progression in control, dysplasia, and cancerous 7, 12-dimethylbenz[a]anthracene-treated hamster cheek pouch mucosa tissues. Two-dimensional images of hamster cheek pouch mucosa tissues were obtained by scanning the second harmonic signal at various sagittal and axial positions. The spatial mapping of the second harmonic signals showed depth differentiation between normal, dysplasia, and a more advanced cancerous state. This nonlinear optical method offers a noninvasive in situ imaging tool to the medical community.

Time-resolved and nonlinear optical imaging for medical applications.

In this article, we have presented an overview of emerging novel techniques for early-light transillumination imaging as well as nonlinear optical tomography of body organs. The use of light for probing and imaging biomedical media offers the promise for development of safe, noninvasive, and inexpensive clinical imaging modalities with diagnostic ability. The strong scattering of light by biological tissues buries the shadowgram formed by forward-propatating image-bearing photons in the background noise of multiple-scattered light. Several methods for extraction of image-bearing light that capitalize on spatial, temporal and polarization characteristics of transmitted light are reviewed. More recently emerging nonlinear-optical histopathology methods for imaging subsurface structures of tissues in terms of its local spatial symmetry and molecular content are introduced. The progress made so far indicates that some of these techniques are apt to make a transition from laboratory to useful clinical modalities.

Time-resolved polarization shadowgrams in turbid media.

The use of the polarization of light as a parameter to discriminate against multiple-scattered light for transillumination imaging through random scattering media is examined. Time-resolved two-dimensional images of submillimeter test bars immersed in 5-cm-thick Intralipid solutions with different micelle dilutions were measured for two orthogonal polarizations (parallel and perpendicular) of light emerging from the turbid medium by using a picosecond Kerr-Fourier (KF) imaging system. The measured contrast and intensity of parallel-polarized KF shadowgrams decreased as the concentration of the scattering medium was increased, whereas the behavior of the perpendicular-polarized KF shadowgrams varied in an opposite matter to the micelle concentration.

Ultrafast optical pulse digitization with unary spectrally encoded cross-phase modulation.

A method to digitize the intensity of ultrashort laser pulses for high-speed optical signal processing is described. This digitization was based on the spectral broadening of a weak probe (carrier) pulse by a more intense pump (signal) pulse through the nonlinear optical process of cross-phase modulation (XPM). The signal pulse intensity was varied to generate different spectral widths that can be encoded into digital form. Using a 50-ps time-divided multiplexing pulse train with a waveguide splitter, combiner, and an array of fibers with variable lengths, a unary XPM encoding approach is demonstrated. The spectral encoding scheme can be used to achieve a 5-GHz sampling rate at a 16-level accuracy.

Two-photon excitation of fluorescence from chicken tissue.

We have measured UV fluorescence excited through two-photon absorption from native chicken tissue, using 600-nm, 500-fs pulses from a R6G dye laser. The observed emission signal was found to depend quadratically on the excitation intensity. The two-photon excitation-induced fluorescence spectrum is attributed to tryptophan residues in proteins.

Image-quality enhancement of objects in turbid media by use of a combined computational-photonics approach.

Ultrafast time-gated optical imaging and computational image-enhancement techniques were combined to produce a robust system for viewing objects in turbid media. Image enhancement was implemented by use of images from the early light with a histogram contrast-enhancement algorithm. Image quality was assessed by use of the contrast radius of gyration and the contrast-to-noise ratio. The technique was applied to viewing the dispersion of water droplets emanating from a jet spray and to pictures of an object embedded in turbid media. In all instances there were substantial improvements in image quality at a given time delay.

Second-harmonic tomography of tissues.

A novel noninvasive second-harmonic-generation tomographic method of mapping the structure of animal tissues by use of 100-fs laser pulses at 625nm is described. Subsurface structures were measured with this approach, which is potentially a symmetry-sensitive tool for optical histological reconstruction.

Optical harmonic generation from animal tissues by the use of picosecond and femtosecond laser pulses.

Second- and third-harmonic generations of femtosecond and picosecond laser pulses have been measured from chicken skin, muscle, and fat tissues. The magnitude of the harmonic signals showed a strong structural dependence with the signal from skin interface being the strongest. The polarization dependence of the signal was also measured and found to be consistent with the fact that the tissue samples were highly scattering random media. The second-harmonic- and third-harmonic-generation conversion efficiencies were found to be in the range of ~10(-7) to ~10(-10).

Localization of the human homolog of the yeast cell division control 27 gene (CDC27) proximal to ITGB3 on human chromosome 17q21.3.

The human homolog of the Saccharomyces cerevisiae cell division control 27 gene (CDC27) was mapped to human chromosome 17q12-q21 using a panel of human/rodent somatic cell hybrids and localized distal to the breast cancer susceptibility gene, BRCA1, using a panel of radiation hybrids. The radiation hybrid panel indicates that the most likely position of human CDC27 on human chromosomes 17 is between the marker D17S409 and the beta 3 subunit of integrin (ITGB3). Further confirmation of this localization comes from the sequence tagged site (STS) mapping of human CDC27 to the same yeast artificial chromosomes (YACs) positive for ITGB3. The estimated distance between ITGB3 and human CDC27 is less than 600 kb.

Construction of a transcription map surrounding the BRCA1 locus of human chromosome 17.

We have used a combination of methods (exon amplification, direct selection, direct screening, evolutionary conservation, island rescue-PCR, and direct sequence analysis) to survey approximately 600 kb of genomic DNA surrounding the BRCA1 gene for transcribed sequences. We have cloned a set of fragments representing at least 26 genes. The DNA sequence of these clones reveals that 5 are previously cloned genes; the precise chromosomal location of 2 was previously unknown, and 3 have been cloned and mapped by others to this interval. Three other genes, including BRCA1 itself, have recently been mapped independently to this region. Sequences from 11 genes are similar but not identical matches to known genes; 5 of these appear to be the human homologues of genes cloned from other species. Another 7 genes have no similarity with known genes. In addition, 39 putative exons and 14 expressed sequence tags have been identified and mapped to individual cosmids. This transcript map provides a detailed description of gene organization for this region of the genome.