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World journal of Gastroenterology 2010年第15期16卷 1885-1889页

作者： Hoi-Poh Tee arthur j.kaffes A W Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital

AIM:To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their ***: A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from june 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during ***: There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 ± 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular ***: A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required.

关键词： Bleeding Obscure gastrointestinal bleeding Endoscopy Double-balloon enteroscopy

Placement of removable metal biliary stent in post-orthotopic liver transplantation anastomotic stricture

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World journal of Gastroenterology 2010年第28期16卷 3597-3600页

作者： Hoi-Poh Tee Martin W james arthur j.kaffes Gastroenterology Unit Medical Department Hospital Tengku Ampuan AfzanJalan Tanah Putih25100 KuantanPahangMalaysia Wolfson Digestive Disease Biomedical Re search Unit Nottingham NG7 2UHUnited Kingdom AW Morrow Gastroenterology and Live Centre Royal Prince Alfred HospitalMissenden RoadCamp erdownNSW 2050Australia

Postoperative biliary strictures are the most common cause of benign biliary stricture in Western countries, secondary to either operative injury or bile duct anastomotic stricture following orthotopic liver transplantation(OLT).Surgery or endoscopic interventions are the mainstay of treatment for benign biliary *** aim to report the outcome of 2 patients with refractory anastomotic biliary stricture post-OLT,who had successful temporary placement of a prototype removable covered self-expandable metal stent(RCSEMS).These 2 patients(both men,aged 44 and 53 years)were given temporary placement of a prototype RCSEMS (8.5 Fr gauge delivery system,8 mm×40 mm stent dimensions)in the common bile duct across the biliary *** was no morbidity associated with stent placement and removal in these 2 *** parameters improved after the RCSEMS *** biliary patency was achieved in both the patients. No further biliary intervention was required within 14 and 18 mo follow-up after stent removal.

关键词： Anastomosis Biliary stent Biliary stricture Orthotopic liver transplantation Niti-S stent

Bilateral nephrolithiasis and upper tract transitional cell carcinoma in horseshoe kidney

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Current Urology 2024年第3期18卷 247-249页

作者： jacob M.Gaines Eric j.Macdonald Arun Rai David Hoenig arthur Smith Zeph Okeke Tareq Aro The Smith Institute for Urology Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellLake SuccessNYUSA

Nephroureterectomy is currently the criterion-standard treatment for high-grade upper tract urothelial carcinoma(UTUC).Current guidelines and expert opinions propose some exceptions to this approach based on patient characteristics,disease status,and function of the contralateral *** present a rare case of a patient with horseshoe kidney,bilateral large nephrolithiasis,high-grade UTUC in one moiety,and relative parenchymal thinning of the contralateral *** patient was treated with a percutaneous,minimally invasive,nephron sparing *** patient also had intracollecting system instillations of gemcitabine and *** invasive percutaneous resection of high-grade UTUC is a safe procedure in select *** guidelines may not apply to all patients;unique scenarios with UTUC may require personalized decision-making and treatment at specialized centers.

关键词： Upper tract urothelial cancer Percutaneous resection Horseshoe kidney Nephrolithiasis

Double-balloon enteroscopy-assisted dilatation avoids surgery for small bowel strictures: A systematic review

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World journal of Gastroenterology 2017年第45期23卷 8073-8081页

作者： judith E Baars Ruben Theyventhiran Patrick Aepli Payal Saxena arthur j.kaffes AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital

AIM To evaluate the therapeutic role of double-balloon enteroscopy(DBE) in small bowel strictures and to propose a standard approach to small bowel *** Systematic review of studies involving DBE in patients with small bowel strictures. Only studies limited to small bowel strictures were included and those with ileo-colonic strictures were excluded. RESULTS In total 13 studies were included,in which 310 patients were dilated. The average follow-up time was 31.8 mo per patient. The complication rate was 4.8% per patient and 2.6% per dilatation. Surgery was avoided in 80% of patients. After the first dilatation,46% were treated with re-dilatation and only 17% required *** DBE-assisted dilatation avoids surgery in 80% of patients with small bowel strictures and is safe and effective. We propose a standardized approach to small bowel strictures.

关键词： Double-ballloon enteroscopy Dilatation Small bowel stricture Enteroscopy Crohn's disease Systematic review

Prospective randomized controlled trial evaluating cap-assisted colonoscopy vs standard colonoscopy

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World journal of Gastroenterology 2010年第31期16卷 3905-3910页

作者： Hoi-Poh Tee Crispin Corte Hamdan Al-Ghamdi Emilia Prakoso john Darke Raman Chettiar Wassim Rahman Scott Davison Sean P Griffin Warwick S Selby arthur j.kaffes Gastroenterology Unit Medical DepartmentHospital Tengku Ampuan AfzanJalan Tanah Putih25100 KuantanPahang Malaysia AW Morrow Gastroenter-ology and Liver Centre Royal Prince Alfred HospitalMissen-den RoadCamperdownNSW 2050Australia Gastroenterology Unit Medical DepartmentQueen Elizabeth HospitalKarung Berkunci No.202988586 Kota KinabaluMalaysia

AIM: To study the significance of cap-fitted colonoscopy in improving cecal intubation time and polyp detection rate. METHODS: This study was a prospective randomized controlled trial conducted from March 2008 to February 2009 in a tertiary referral hospital at Sydney. The primary end point was cecal intubation time and the secondary endpoint was polyp detection rate. Consecutive cases of total colonoscopy over a 1-year period were recruited. Randomization into either standard colonoscopy (SC) or cap-assisted colonoscopy (CAC) was performed after consent was obtained. For cases randomized to CAC, one of the three sizes of cap was used: D-201-15004 (with a diameter of 15.3 mm), D-201-14304 (14.6 mm) and D-201-12704 (13.0 mm). All of these caps were produced by Olympus Medical Systems, japan. Independent predictors for faster cecal time and better polyp detection rate were also determined from this study. RESULTS: There were 200 cases in each group. There was no signif icant difference in terms of demographic characteristics between the two groups. CAC, when compared to the SC group, had no signif icant difference in terms of cecal intubation rate (96.0% vs 97.0%, P = 0.40) and time (9.94 ± 7.05 min vs 10.34 ± 6.82 min, P = 0.21), or polyp detection rate (32.8% vs 31.3%, P = 0.75). On the subgroup analysis, there was no significant difference in terms of cecal intubation time by trainees (88.1% vs 84.8%, P = 0.40), ileal intubation rate (82.5% vs 79.0%, P = 0.38) or total colonoscopy time (23.24 ± 13.95 min vs 22.56 ± 9.94 min, P = 0.88). On multivariate analysis, the independent determinants of faster cecal time were consultant-performed procedures (P < 0.001), male patients (P < 0.001), non-usage of hyoscine (P < 0.001) and better bowel preparation (P = 0.01). The determinants of better polyp detection rate were older age (P < 0.001), no history of previous abdominal surgery (P = 0.04), patients not having esophagogastroduodenoscopy in the same setting (P = 0.003),

关键词： Cap Hood Cecum Colonoscopy Cecal intubation Colonic polyps

Prevalence and outcomes of pancreatic cystic neoplasms in liver transplant recipients

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World journal of Gastroenterology 2017年第48期23卷 8526-8532页

作者： Ken Liu Vikram joshi Louise van Camp Qi-Wei Yang judith E Baars Simone I Strasser Geoffrey W McCaughan Avik Majumdar Payal Saxena arthur j.kaffes Sydney Medical School The University of Sydney AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital Department of Radiology Royal Prince Alfred Hospital

AIM To determine the prevalence,characteristics and clinical course of pancreatic cystic neoplasms(PCNs) in liver transplantation(LT) *** We retrospectively studied consecutive patients who underwent LT between january 1998 to April 2016. Clinical and laboratory data were obtained from patient medical records. Imaging findings on computed tomography and magnetic resonance cholangiopancreatography were reviewed by two *** During the study period,872 patients underwent cadaveric LT. Pancreatic cysts were identified in 53/872(6.1%) and 31/53(58.5%) were PCNs [28 intraductal papillary mucinous neoplasm(IPMN),2 mucinous cystic neoplasm(MCN),1 serous cystadenoma]. Patients with PCNs exhibited less male predominance(55% vs 73%,P = 0.03) compared to patients without pancreatic cysts. Thirteen patients(42%) were diagnosed with PCN pre-LT while 18 patients(58%) developed PCN post-LT. The median size of PCNs was 13 mm [interquartile range(IQR) 10-20 mm]. All IPMNs were side-branch type. Most PCNs were found in the head and body of pancreas(37% each),followed by the tail(25%). Five patients underwent further evaluation with endoscopic ultrasound. Progress imaging was performed on 81% of patients. PCNs remained stable in size and number in all but 2 patients. During a median follow up of 39 mo(IQR 26-58 mo),the 2(6%) patients with MCN underwent pancreatectomy. No PCN patient developed pancreatic adenocarcinoma,while 5 died from illnesses unrelated to the PCN. Among patients without PCN,1/841(0.1%) developed pancreatic *** The prevalence of PCNs in LT recipients was similar to the general population(3.6%,31/872). Side-branch IPMNs do not appear to have accelerated malignant potential in post-LT patients,indicating the current surveillance guidelines are applicable to this group.

关键词： Pancreatic cystic neoplasm Intraductal papillary mucinous neoplasm Mucinous cystic neoplasm Liver transplantation Pancreatic adenocarcinoma Immunosuppression

Learning curve for double-balloon enteroscopy: Findings from an analysis of 282 procedures

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World journal of Gastrointestinal Endoscopy 2012年第8期4卷 368-372页

作者： Hoi-Poh Tee Soon-Hin How arthur j.kaffes A W Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital Camperdown Sydney NSW 2050 Australia Department of Medicine Gastroenterology Unit Hospital Tengku Ampuan Afzan Jalan Tanah Putih 25100 Kuan-tan Pahang Malaysia Kulliyyah of Medicine International Islamic University of Malaysia Jalan Hospital 25100 Kuantan Pahang Malaysia

AIM: To determine the learning curves for antegrade double-balloon enteroscopy (aDBE) and retrograde DBE (rDBE) by analyzing the technical success rates. METHODS: A retrospective analysis in a tertiary referral center. This study reviewed all cases from june 2006 to April 2011 with a target lesion in the small-bowel identified by either capsule endoscopy or computed tomography scan posted for DBE examinations. Main outcome measurements were: (1) Technical success of aDBE def ined by f inding or excluding a target lesion after achieving suff icient length of small bowel intubation; and (2) Technical success for rDBE was def ined by either f inding the target lesion or achieving stable overtube placement in the ileum. RESULTS: Two hundred and eighty two procedures fulf illed the inclusion criteria and were analyzed. These procedures were analyzed by blocks of 30 cases. Therewas no distinct learning curve for aDBE. Technical success rates for rDBE continued to rise over time, although on logistic regression analysis testing for trend, there was no signif icance (P = 0.09). The odds of success increased by a factor of 1.73 (95% CI: 0.93-3.22) for rDBE. For these data, it was estimated that at least 30-35 cases of rDBE under supervision were needed to achieve a good technical success of more than 75%. CONCLUSION: There was no learning curve for aDBE. Technical success continued to increase over time for rDBE, although a learning curve could not be proven statistically. Approximately 30-35 cases of rDBE will be required for stable overtube intubation in ileum.

关键词： Double-balloon enteroscopy Learning curve Credential Training Success rate

Expediting the transition from replacement medicine to tissue engineering

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Regenerative Biomaterials 2016年第2期3卷 111-113页

作者： arthur j.Coury Department of Chemical Engineering Northeastern UniversityBostonMAUSA

In this article,an expansive interpretation of“Tissue Engineering”is proposed which is in congruence with classical and recent published definitions.I further simplify the definition of tissue engineering as:“Exerting systematic control of the body’s cells,matrices and fluids.”As a consequence,many medical therapies not commonly considered tissue engineering are placed in this category because of their effect on the body’s *** the progress of tissue engineering strategies is inexorable and generally positive,it has been subject to setbacks as have many important medical *** practice is currently undergoing a transition on several fronts(academics,start-up companies,going concerns)from the era of“replacement medicine”where body parts and functions are replaced by mechanical,electrical or chemical therapies to the era of tissue engineering where health is restored by regeneration generation or limitation of the body’s tissues and functions by exploiting our expanding knowledge of the body’s biological processes to produce natural,healthy outcomes.

关键词： tissue engineering medical devices combination products regenerative medicine

Rigid polyurethane foam reinforced with cellulosewhiskers: Synthesis and characterization

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Nano-Micro Letters 2010年第2期2卷 89-94页

作者： Yang Li Hongfeng Ren arthur j.Ragauskas School of Chemistry and Biochemistry Georgia Institute of Technology School of Polymer Textile and Fiber Engineering Georgia Institute of Technology

A novel nanocomposite of rigid polyurethane foam was prepared by the polymerization of a sucrose-based polyol, a glycerol-based polyol and polymeric methylene diphenyl diisocyanate in the presence of cellulose whiskers. The cell morphology of the resulting foams was examined by scanning electron microscopy which showed both the pure foam and the nanocomposite foam had homogeneous cell dispersion and uniform cell size of approximately 200 μm. Analysis of the foams by Fourier transform infrared(FT-IR) spectroscopy indicated that both samples exhibited signals attributed to the polyurethane including the NH stretching and bending vibrations at 3320 cm^(-1) and 1530 cm^(-1), the OC=O vibration at 1730 cm^(-1) and the CO-NH vibration at 1600 cm^(-1). FT-IR analysis of the nanocomposite indicated that cellulose whiskers were crosslinked with the polyurethane matrix as the signal intensity of the OH stretch at 3500 cm^(-1) was significantly reduced in comparison to the spectral data acquired for a control sample prepared from the pure polyurethane foam mixed with cellulose whiskers. According to ASTM standard testing procedures, the tensile modulus, tensile strength and yield strength of the nanocomposite foam were found to be improved by 36.8%, 13.8% and 15.2%, and the compressive modulus and strength were enhanced by 179.9% and 143.4%, respectively. Dynamic mechanical analysis results testified the improvements of mechanical properties and showed a better thermal stability of the nanocomposite foam.

关键词： Nanocomposites Cellulose whiskers Tensile Compressive Thermal

An implementation assessment of China's Environmental Information Disclosure Decree

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journal of Environmental Sciences 2010年第10期22卷 1649-1656页

作者： Lei Zhang arthur E j Mol Guizhen He Yonglong Lu School of Environment and Natural Resources Renmin University of China Beijing 100872 China Environmental Policy Group Wageningen University Hollandseweg 1 6706 KN Wageningen The Netherlands State Key Laboratory of Urban and Regional Ecology Research Center for Eco-Environmental Sciences Chinese Academy of Sciences Beijing 100085 China

China＇s 2007 Open Government Information Regulations is widely considered as a milestone in the country＇s information policy history and is praised as a ＂sunshine program＂. The Environmental Information Disclosure Decree was the first to operationalize these general regulations into a sectorai information disclosure system on environment. This study assessed the implementation of the environmental information disclosure system about six months after the Decree took effect on May 1, 2008. Through reviewing the websites of all 31 provincial Environmental Protection Bureaus and the Ministry of Environmental Protection, conducting an experiment with actual information disclosure request, and through interviews with all provincial Environmental Protection Bureaus, this article concluded that the implementation of the environmental information disclosure system still fails short. Future improvements should focus on further publicity of the regulations and decree to enhance public participation, the establishment of an independent evaluation and supervision system for information disclosure, the exchange of experiences and best practices among provincial Environmental Protection Bureaus, and on strengthening the legal status of environmental information disclosure.

关键词： environmental information disclosure environmental governance