Yu-Cing Jhuo

Background: Homocysteine (Hcy) is a sulfur-containing amino acid crucial for various physiological processes, with elevated levels linked to cardiovascular and neurological adverse conditions. Various factors contribute to high Hcy, and past studies of impact factors relied on traditional statistical methods. Recently, machine learning (ML) techniques have greatly improved and are now widely applied in medical research. This study used four ML methods to identify key factors influencing Hcy in healthy elderly Taiwanese men, comparing their accuracy using multiple linear regression (MLR). The study seeks to improve Hcy prediction accuracy and provide insights into relevant impact factors. Methods: A total of 468 healthy elderly men were studied in terms of 33 parameters using four ML methods: random forest (RF), stochastic gradient boosting (SGB), eXtreme gradient boosting (XGBoost), and elastic net (EN). MLR served as a benchmark. Model performance was assessed using SMAPE, RAE, RRSE, and RMSE. Results: All ML methods demonstrated lower prediction errors than MLR, indicating higher accuracy. By averaging the importance scores from the four ML models, C-reactive protein (CRP) emerged as the leading impact factor for Hcy, followed by GPT, WBC, LDH, eGFR, and sport volume (SV). Conclusions: Machine learning methods outperformed MLR in predicting Hcy levels in healthy elderly Taiwanese men. CRP was identified as the most crucial factor, followed by GPT/ALT, WBC, LDH, and eGFR.

Background and Objectives: Post-transplant anastomotic pseudoaneurysms are a rare but serious complication of renal transplantation, typically requiring graft sacrifice. This case report demonstrates a novel hybrid approach for managing a mycotic pseudoaneurysm while preserving graft function. Case report: A 56-year-old male developed a pseudoaneurysm at the anastomotic site after cadaveric kidney transplantation, presenting with recurrent infections and declining renal function. Imaging confirmed the pseudoaneurysm. A hybrid strategy combining femoral–femoral bypass with a polytetrafluoroethylene graft, percutaneous transluminal angioplasty with stenting, and coil embolization was performed. Results: The intervention successfully isolated the pseudoaneurysm and preserved graft function. Post-procedure, serum creatinine levels improved, stabilizing at 2.3 mg/dL during follow-up. Imaging confirmed no residual flow in the aneurysm, and vascular complications were absent. Conclusions: This report highlights a successful combined surgical and endovascular approach for treating mycotic pseudoaneurysms, preserving graft function and restoring limb blood flow. This strategy offers a promising alternative for managing complex post-transplant complications, though long-term outcomes require further evaluation.

Bladder cancer is a common genitourinary malignancy with variable metastatic potential. Cutaneous metastasis is uncommon and often presents with a poor prognosis. We presented a 47-year-old man with a history of muscle-invasive urothelial carcinoma of the bladder and suffered from headache and right arm swelling that had persisted for months. The excisional biopsy of the skin lesions and scalp tumor showed high-grade metastatic carcinoma of urothelial origin. Even though is rare, cutaneous metastasis is still the possibility of urothelial carcinoma metastasis and mimics several types of skin lesions. There is no guideline for cutaneous metastases of urothelial carcinoma because of the small number of patients and poor prognoses. Chemotherapy remains the treatment of choice, and further studies are needed to assess the efficacy of immunotherapy for skin metastases of urothelial carcinoma.

This study aimed to explore the existence of circulating tumor cells (CTCs) in patients with muscle-invasive bladder cancer (MIBC) and their predictive potential for response to neoadjuvant chemotherapy (NAC). From 33 blood samples of MIBC patients, CTCs were isolated by cell surface markers and enriched by the IsoFlux™ device, followed by morphological and immunofluorescent identification. CTCs were detected at baseline in all samples. Immunofluorescence confirmed the tumor origin. MIBC patients were stratified by NAC response into the disease control (DC) and progressive disease (PD) groups. In the DC group, the number of CTCs decreased significantly after four courses of NAC (p < 0.0001). CTC counts in 7.5 mL after four NAC cycles were highly correlated with postoperative pathological T stage (p < 0.0001). Our study demonstrated that CTCs might represent a valuable predictive marker for NAC response in MIBC. CTC detection in MIBC patients could allow early arrangement of radical cystectomy for NAC non-responders to prevent disease progression while receiving the NAC courses.

By continuously enhancing the blood flow, far-infrared (FIR) textile is anticipated to be a potential non-pharmacological therapy in patients with peripheral vascular disorders, for instance, patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) and experiencing vasculogenic erectile dysfunction (VED). Hence, we manufactured a novel polymer composite, namely, germanium-titanium-π (Ge-Ti-π) textile and aimed to evaluate its characteristics and quality. We also investigated the immediate and long-term effects of the textile on patients with ESRD undergoing HD and experiencing VED. The Ge-Ti-π textile was found to have 0.93 FIR emissivity, 3.05 g/d strength, and 18.98% elongation. The results also showed a 51.6% bacteria reduction and negative fungal growth. On application in patients receiving HD, the Ge-Ti-π textile significantly reduced the limb numbness/pain (p < 0.001) and pain score on the visual analog scale (p < 0.001). Moreover, the Doppler ultrasound assessment data indicated a significant enhancement of blood flow in the right hand after 1 week of Ge-Ti-π textile treatment (p < 0.041). In VED patients, the Ge-Ti-π underpants treatment significantly improved the quality of sexual function and increased the average penile blood flow velocity after 3 months of the treatment. Our study suggests that the Ge-Ti-π textile could be beneficial for patients with blood circulation disorders.