Case Experience of Radiofrequency Ablation for Benign Thyroid Nodules: From an Ex Vivo Animal Study to an Initial Ablation in Taiwan

AbstractRadiofrequency ablation (RFA) is a minimally invasive technique, used with ultrasound or computed tomography guidance, which can produce tissue coagulation necrosis in various kinds of tumors in the human body. In the past 10 years, numerous studies about RFA in benign thyroid nodules have been published. Reviewing these studies, we noticed that the effectiveness of ablation was higher when it was performed with the “moving-shot technique” via an internally cooled electrode. A consensus statement published from the Korean Society of Radiology also suggested the moving-shot technique as a standard ablation procedure for benign thyroid nodule ablation in Korea. In Taiwan, most symptomatic benign nodules are currently treated with surgical removal. RFA for mass lesions is primarily performed for the treatment of metastatic hepatic tumors. In our case, we have attempted to introduce RFA for benign thyroid nodules in Taiwan. Because endocrinologists in Taiwan were not familiar with this technique, we adopted a stepwise approach in learning how to perform RFA. We conducted ex vivo animal ablation exercises to gain experience in setting the radiofrequency generator for the right ablation mode and appropriate power output. The thyroid nodule volume reduction rate after 1 year of follow up was approximately 50% in this case. The most important thing we learned from this trial is that we confirmed the safety of thyroid nodule ablation. To the best of our knowledge, this is the first reported study of RFA of a thyroid nodule in Taiwan

Innovation Resilience in Cities

Achieving innovation has been a challenging task, as maintaining its momentum is akin to landing on the moon. What are the key ingredients that innovative cities need to possess to sustain their momentum, especially after experiencing economic setbacks?https://dc.suffolk.edu/ciclseries/1001/thumbnail.jp

Scientific and Regulatory Perspective on Monoclonal Antibody Biosimilars

Similar biotherapeutic products (SBPs), also called biosimilars, exhibit similar biological and clinical properties to authorized reference products. Biosimilars, including small molecules like erythropoietin and complex macromolecules like monoclonal antibodies (mAbs), have been used extensively in disease treatment. Monoclonal antibody biosimilars have gradually become a dominant development in the global pharmaceutical industry since their patents or data protection have been expired or nearing expiration. Since the mAb biosimilars are complex biological macromolecules with various post-translation modifications, it is important to evaluate whether these tiny differences significantly affect the quality. From a regulatory perspective, the comparability study needs to be performed to demonstrate that the quality, safety, and efficacy are similar to the biological reference. Based on these comprehensive comparative results, the indicated extrapolation might be acceptable. Post-market surveillance is also required because of unexpected biological variation caused by slightly different manufacturing processes. This chapter presents the scientific and regulatory considerations for monoclonal antibody biosimilar products for manufactures and for the regulatory authorities to administrate wisely and comprehensively

Molecular Mechanism of Isocupressic Acid Supresses MA-10 Cell Steroidogenesis

Consumption of ponderosa pine needles causes late-term abortions in cattle and is a serious poisonous plant problem in foothill and mountain rangelands. Isocupressic acid (IA) is the component of pine needles responsible for the abortifacient effect, its abortifacient effect may be due to inhibition of steroidogenesis. To investigate the more detail molecular mechanism, we used MA-10 cell, which is wild used to investigate molecular mechanism of steroidogenesis, to characterize the molecular mechanisms underlying the actions of IA in more detail. In this report, we focus on the function of IA on important steroidogenic genes, including steroidogenic acute regulatory protein (StAR), cytochrome P450 cholesterol side-chain cleavage (P450scc), and 3β-hydroxysteroid dehydrogenase (3β-HSD). We found that IA does not affect enzyme activities of these genes but inhibits transcription of P450scc and translation of StAR and P450scc through attenuating cAMP-PKA signaling. Thus, steroid productions of cells were suppressed

COMPARISON OF STATIC BALANCE MEASURES WITH HEIGHT AND WEIGHT ADJUSTMENTS BETWEEN TAEKWONDO AND HANDBALL PLAYERS

This study aimed to compare the static balance of taekwondo athletes and handball players. Considering the body size might affect the sway during static balance testing as the inverted pendulum model demonstrated. The static balance of the subjects was evaluated by the Bidex Balance System. The results showed that the APSI, MLSI and OSI of taekwondo athletes were significantly lower than those of the handball players. Moreover, the three stability indices of the two groups of athletes were significantly correlated with height and weight, but not age. The data showed that body size were positively related to the sway in the static balance testing. The taekwondo athletes were lighter than the handball players in average, nevertheless, lower height-and-weight adjusted stability indices of the taekwondo athletes were found

Solving finite production rate model with scrap and multiple shipments using algebraic approach

This paper solves a finite production rate (FPR) model with scrap and multiple shipments using an algebraic method. Classic FPR model assumes a continuous inventory issuing policy to satisfy demand and perfect quality production for all items produced. However, in real life vendor-buyer integrated production-inventory system, multiple shipment policy is practically used in lieu of a continuous issuing policy and generation of defective items during production run is inevitable. In this study, it is assumed that all defective items are scrap and the perfect quality items can only be delivered to customers if the whole lot is quality assured at the end of the production run. A conventional approach for solving the FPR model is the use of differential calculus on the long-run average cost function with the need to prove optimality first. This paper demonstrates that optimal lot size and its overall costs for the aforementioned FPR model can be derived without derivatives. As a result, it enables students or practitioners who have little knowledge of calculus to understand and to handle with ease the real-life FPR model