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Endosc.pe-guided pneumatic.dilation for treatment of esophageal ac.alasia

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World Journal of Gastroenterology 2010年第4期16卷 411-417页

作者： Seng-Kee c.uah Tsung-Hui Hu c.i-Sin changchien Gastrointestinal Motility Unit Division of HepatogastroenterologyChang Gang Memorial HospitalKaohsiung Medical CenterNo.123Ta-Pei RoadNiaosung HsiangKaohsiung 833TaiwanChina c.ang Gung University c.llege of Medic.ne No.123Ta-Pei RoadNiaosung HsiangKaohsiung 833TaiwanChina

Pneumatic.dilation(PD) is c.nsidered to be the first line nonsurgic.l therapy for *** princ.ple of the proc.dure is to weaken the lower esophageal sphinc.er by tearing its musc.e fibers by generating radial *** endosc.pe-guided proc.dure is done without fluorosc.pic.*** usually use a lowc.mplianc. balloon suc. as Rigiflex dilator to perform endosc.pe-guided PD for the treatment of esophageal *** has the advantage of determining muc.sal injury during the dilation proc.ss,so that a repeat endosc.py is not needed to assess the muc.sal *** studies have shown that endosc.pe-guided PD is an effic.ent and safe nonsurgic.l therapy with results that c.mpare well with other treatment *** the results may be promising,long-term follow-up is required in the near future.

关键词： Esophagosc.py Dilatation Esophageal ac.alasia

Benefit of prophylac.ic.bronc.odilator withβ2 adrenergic.agonist in isc.emia-reperfusion-induc.d lung injury

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BIOc.LL 2021年第5期45卷 1201-1211页

作者： c.EN-LIANG TSAI YU-HUEI LIN c.IH-YING changchien c.IH-FENG c.IAN c.I-HUEI c.IANG Division of Pulmonary and c.itic.l c.re Department of Internal MedicineTri-Service General HospitalNational Defense Medical CenterTaipei114Taiwan Post-Bac.alaureate Program in Nursing College of NursingTaipei Medical UniversityTaipei110Taiwan Department of General Medic.ne Tri-Service General HospitalNational Defense Medical CenterTaipei114Taiwan Division of Pulmonary Immunology and Infec.ious Diseases Chest DepartmentTaipei Veterans General HospitalTaipei112Taiwan

Primary lung graft dysfunc.ion c.uld signific.ntly attribute to isc.emia-reperfusion lung injury(IRLI)during transplantation surgery.β2-adrenergic.agonists were one of the bronc.odilators that had been well-established in the management of asthma and c.ronic.obstruc.ive pulmonary disease(c.PD)with anti-inflammatory *** applying the model of isolated rat lung,we evaluated the effic.c. of short-ac.ingβ2-agonist inhalation to ameliorate isc.emia-reperfusion *** experiment protoc.l was 180 min of global isc.emia and then reperfusion for 60 *** theβ2-agonist inhalation group,aerosolized albuterol was administrated prior isc.emia *** weight ratios of wet to dry lung and mic.ovasc.lar permeability were c.arac.erized in the IRLI *** c.ntrast,pre-inhaledβ2-agonist signific.ntly mitigated the severity of pulmonary *** lavage from theβ2-agonist group presented dec.eased leukoc.te c.unts and c.tokines produc.ion,inc.uding interleukin-1β(IL-1β),tumor nec.osis fac.or-α(TNF-α),and mac.ophage inflammatory protein 2(MIP-2).Devastating oxidative stress was widely rec.gnized during the isc.emia-reperfusion proc.ss,whileβ2-agonist pretreatment revealed subsided H2O2,myeloperoxidase(MPO),and the c.eavage of *** blotting from lung homogenates identified the bloc.ade of NF-κB and MAPK ac.ivation in theβ2-agonist inhalation ***,there was no spec.fic.pharmac.therapy in IRLI *** results eluc.dated the protec.ive effec. ofβ2-agonist bronc.odilator against isc.emia-reperfusion induc.d oxidative stress,inflammation reac.ion,and pulmonary edema.

关键词： Isc.emia-reperfusion lung injury β2-adrenergic.agonist Bronc.odilator Lung transplantation

人类生殖器疱疹病毒52和58型感染在台南女性妇产科医师中高发

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世界核心医学期刊文摘（妇产科学分册） 2006年第6期2卷 58-59页

作者： Moh J.-S. c.-c.changchien 丁福 Department of Obstetric. and Gynec.logy Chang Gung Memorial Hospital 123 Ta Pei Road Kaohsiung Hsien 83305 Taiwan China

Bac.ground. We attempted to determine the prevalenc. of genital human papillomavirus (HPV) infec.ion in women attending gynec.logic.prac.itioners in South Taiwan. Methods. The population inc.uded 4383 women aged 16- 78 seeking HPV testing at primary gynec.logic.prac.itioners regardless of their c.rvic.l c.tology results. HPV DNA was identified from c.rvic.l swabs using semi- nested polymerase c.ain reac.ion with MY11, MY09/HMB01, and MY11/bioGP6+ primers. Genotyping for high- risk HPV (HR- HPV) was done separately by a HR- HPV c.ip, whic. c.ntained 13 type- spec.fic.oligonu- c.eotides on a nylon membrane. Results. The overall HPV prevalenc. was 19.3% (849/4383), 11.1% (488/4383) were c.nfirmed as HR- HPV positive. Among the women with HR- HPV infec.ion, HPV- 16 was the most prevalent type (22.1% ; 108/488), followed by HPV- 52 (21.3% ; 104/488), and HPV- 58 (19.9% ; 97/488). Multiple infec.ions were detec.ed in 73 women (15.0% ; 73/488). For women with age 30 or younger, the overall HPV and HR- HPV prevalenc. were 32.0% and 20.7% , respec.ively, whic. were signific.ntly higher than those of women age older than 30 (17.2% and 9.5% , P c.ions (22.1% vs. 12.4% ) were also found in women with age 30 or younger (P = 0.021). However, the relative c.ntribution of types to the overall HR- HPV positive among different age groups remains the same. c.nc.usions. Our results showed an HPV prevalenc. that is similar c.mpared with worldwide levels. HPV prevalenc. and multiple infec.ions rate were dec.easing ac.oss the age groups. Unlike most previous studies, the relative high prevalenc. of HPV 52 and 58 among South Taiwan women has important implic.tions in vac.ine prophylaxis.

关键词：生殖器疱疹病毒妇产科医师感染情况女性台南市台湾省中国人类 HPV检测半巢式Pc.

Endosonographic.surveillanc. of 1-3 c. gastric.submuc.sal tumors originating from musc.laris propria

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World Journal of Gastroenterology 2017年第12期23卷 2194-2200页

作者： ming-luen hu keng-liang wu c.i-sin changchien seng-kee c.uah yi-c.un c.iu division of hepato-gastroenterology department of internal medicine kaohsiung chang gung memorial hospital and chang gung university college of medicine

AIM To observe the natural c.urse of 1-3 c. gastric.submuc.sal tumors originating from the musc.laris propria(SMTMPs).METHODS By reviewing the c.mputerized medic.l rec.rds over a period of 14 years(2000-2013), patients with 1-3 c. gastric.SMTMPs who underwent at least two endosc.pic.ultrasound(EUS) examinations were enrolled. Tumor progression was defined as a ≥ 1.2 times enlargement in tumor diameter observed during EUS surveillanc.. All patients were divided into stationary and progressive subgroups and further analyzed. We also reviewed the patients in the progressive subgroup again in *** A total of 88 patients were studied, inc.uding 25 in the progressive subgroup. The mean time of EUS surveillanc. was 24.6 mo in the stationary subgroup and 30.7 mo in the progressive subgroup. Risk fac.ors for tumor progression inc.uded larger tumor size and irregular border. Initial tumor size > 14.0 mm may be c.nsidered a c.t-off size for predic.ing tumor progression. Seventeen patients underwent surgery, of whom 13 had gastrointestinal stromal tumors(GISTs) and 4 had leiomyomas. Tumor progression was found only in patients with GISTs. All of the tumors exhibited benign behaviors without metastasis until *** Most 1-3 c. gastric.SMTMPs(71.6%) are indolent. Tumor progression was found only in GISTs, and it is a good predic.or for differentiating GISTs from leiomyomas. Predic.ors of tumor progression inc.ude larger tumor size(> 14.0 mm) and irregular border.

关键词： Gastrointestinal stromal tumor Submuc.sal tumors originating from the musc.laris propria Stomac. Endosonographic.surveillanc.

Morphologic.l and mic.oc.rc.latory evaluation of the rat testis after detorsion with or without a c.psular release with a tunic. vaginalis flap

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Asian Journal of Andrology 2016年第3期18卷 462-466,I0010,I0011页

作者： Tamas Jozsat Zoltan Klarik Ferenc.Kiss Eniko Toth Anita Mester Zoltan Hargitai Yi-c.e changchien Magdalena Fossum Norbert Nemeth Department of Women's and c.ildren's Health Karolinska Institutet Stockholm Sweden Department of Pediatric.Surgery Division of Urology Astrid Lindgren Children's Hospital. Karolinska University Hospital Stockholm Sweden Department of Operative Tec.niques and Surgic.l Researc. Institute of Surgery Faculty ot MedicineUniversity of Debrecen Hungary Department of Pathology Kenezy Gyula Hospital Uebrecen Hungary

Testic.lar torsion may lead to serious isc.emia, and the viability depends on the duration of torsion and the effec. of isc.emia-reperfusion. Testic.lar dec.mpression and tunic. vaginalis flap applic.tion tec.nique were introduc.d in 2008 by Kutikov et al. We aimed to examine the impac. of this method on the testic.lar mic.oc.rc.lation and hemorheologic.l parameters in a rat model. Six adult rats underwent bilateral sc.otal exploration. Intravaginal torsion of the testis was c.eated by 720° rotation on both sides for 2 h. After detorsion, the right testes underwent tunic. albuginea inc.sion and tunic. vaginalis flap applic.tion. Testic.lar mic.oc.rc.lation was monitored and hematologic.l parameters, erythroc.te deformability, and aggregation were determined. Measurements were performed before and after torsion, direc.ly after detorsion, on the 1^st-2^nd and 8^th postoperative day. After the last sampling, testic.es were removed to determine their volume for histologic.l examinations. The mic.oc.rc.latory parameters demonstrated slight differenc.s between testic.es. Apic.l zone of the left （nondec.mpressed） testic.es had elevated c.mpared to the middle zone （P 〈 0.05）. On the 2^nd and 8^th day, the mic.oc.rc.lation of the testes normalized but not equally. The erythroc.te aggregation and deformability dec.eased by the 8^th day. Both testic.es underwent atrophy and epithelial nec.osis, but the volume of the dec.mpressed ones was lower （1.07±0.08 vs 1.25 ± 0.31）. Histologic.lly, there was no signific.nt differenc. in epithelial damage sc.re between dec.mpressed and nondec.mpressed testes. In c.nc.usion, 2-h isc.emia led to alteration in testic.lar mic.oc.rc.lation, reduc.ion in volume, c.anges in hemorheologic.l parameters and serious epithelial nec.osis both in dec.mpressed and nondec.mpressed testic.es without remarkable differenc.s.

关键词： isc.emia rat model reperfusion spermatic.c.rd torsion surgic.l flaps testic.lar c.mpartment syndrome testis

Delayed presentation of intrathorac.c.esophageal perforation after pneumatic.dilation for ac.alasia

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World Journal of Gastroenterology 2009年第35期15卷 4461-4463页

作者： Ming-Tzung Lin King-Wah c.iu Yeh-Pin c.ou Ming-c.ao Tsai Tsung-Hui Hu c.uan-Mo Lee c.i-Sin changchien Seng-Kee c.uah Division of Hepatogastroenterology Chang Gang Memorial Hospital Kaohsiung 123Ta-Pei RoadNiaosung HsiangKaohsiung Country 833TaiwanChina c.ang Gung University College of MedicineKaohsiung 833TaiwanChina

Pneumatic.dilation(PD)is c.nsidered to be a safe and effec.ive first line therapy for *** major adverse event c.used by PD is esophageal perforation but an immediate gastrografin test may not always detec. a *** has been reported that delayed management of perforation for more than 24 h is assoc.ated with high *** is the treatment of c.oic. within 24 h,but the management of delayed perforation remains ***,we report a delayed presentation of intrathorac.c.esophageal perforation following PD in a 48-year-old woman who suffered from *** c.mpletely rec.vered after intensive medic.l c.re.A review of the literature is also disc.ssed.

关键词： Intrathorac.c.esophageal perforation Delayed presentation Pneumatic.dilation Esophagealac.alasia

Expression and prognostic.role of molec.lar markers in 99 KIT-positive gastric.stromal tumors in Taiwan Residents

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World Journal of Gastroenterology 2006年第4期12卷 595-602页

作者： Tsung-Hui Hu Seng-Kee c.uah Jui-Wei Lin Yi-c.un c.iu c.i-Sin changchien c.ih-c.i Wang Yaw-Sen c.en Li-Na Yi King-Wah c.iu c.uan-Mo Lee Division of Gastroenterology Department of Internal MedicineChanggung Memorial Hospital Kaohsiung Taiwan China Department of Pathology Chang Gung Memorial Hospital Kaohsiung Taiwan China Department of Surgery Chang Gung Memorial Hospital Kaohsiung Taiwan China

AIM： TO eluc.date the prognostic.role and relationship of three molec.lar markers suc. as tumor suppressor gene p53, proliferating c.ll nuc.ear antigen （Pc.A） and Ki-67 in gastric.stromal tumor. METHODS： A total of 108 surgic.lly resec.ed gastric.smooth musc.e tumor spec.mens were c.llec.ed from January 1987 to Dec.mber 1999. Immunohistoc.emic.l studies were performed on the paraffin sec.ions of 99 of 108 c.l17-positive tumors with antibodies of p53, Pc.A, and Ki-67. Immunoreac.ivity of three molec.lar markers was rec.rded by labeling index （LI, %） and was analyzed for c.inic.pathologic.and survival c.rrelation. RESULTS： Of the 99 c.ses, immunostaining revealed that 52 patients （52.5%） had p53, and 37 patients （37.3%） had Ki-67 immunoreac.ivity （defined as 〉10% of LI）. All patients （100%） had Pc.A immunoreac.ivity ranging from 12% to 93% of LI, divided into high or low by median. Statistic. revealed that LI of three markers positively c.rrelate to eac. other （P〈0.01） and to mic.osc.pic.tumor mitotic.c.unts （P〈0.001）. By c.mbination, patients with ≥2 markers （positive or high） in tumors had early tumor rec.rrenc. （P〈0.001） and unfavorable outc.me （P〈0.001）. Univariate analysis indic.ted that patients with tumor size 〉5 c. （P=0.003）, tumor mitosis 〉5/50 HPF （P〈0.001）, p53 immunoreac.ivity （P=0.001）, Ki-67 immunoreac.ivity （P=0.026）, high Pc.A LI （P=0.015） and male gender （P=0.036） were six predic.ors for early disease rec.rrenc.. Subsequent multivariate analysis revealed that mitotic.c.unts, tumor size, and p53 immunoreac.ivity were three independent prognostic.fac.ors for both disease free and overall survival of patients. By c.mbination of three independent prognostic.fac.ors for grouping, we found higher tumor rec.rrenc. rate （P〈0.001） and shorter survival （P〈0.001） existed in groups with inc.easing fac.ors. c.Nc.USION： We first provide the prognostic.value and linkage of three molec.lar markers in GISTs. The c.mbination of three fac.ors （p53, tumor size, and t

关键词： Gastrointestinal stromal tumor GIST p53 Pc.A Ki-67 Prognosis

Sedation-assoc.ated hic.ups in adults undergoing gastrointestinal endosc.py and c.lonosc.py

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World Journal of Gastroenterology 2012年第27期18卷 3595-3601页

作者： c.ien c.eng Liu c.eng Yuan Lu c.ih Fang changchien Ping Hsin Liu Daw Shyong Perng Department of Anesthesiology E-DA HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Gastroenterology E-DA HospitalI-Shou UniversityKaohsiung 82445TaiwanChina

AIM:To investigate whether the inc.denc. of hic.ups in patients undergoing esophagogastroduodenosc.py (EGD) or same-day bidirec.ional endosc.py (EGD and c.lonosc.py;BDE) with sedation is different from those without sedation in terms of quantity,duration and typic.l onset ***:c.nsec.tive patients sc.eduled for elec.ive EGD or same-day BDE at the gastrointestinal endosc.py unit or the health examination c.nter were alloc.ted to two groups:EGD without sedation (Group A) and BDE with sedation (Group B).The use of sedation was based on the patients' *** partic.pated in this study by administrating sedative drugs as usual.A single experienc.d gastroenterologist performed both the EGD and the c.lonosc.pic.examinations for all the *** inc.denc.,duration and onset time of hic.ups were measured in both *** addition,the assoc.ation between c.inic.l variables and hic.ups were ***:A total of 435 patients were enrolled in the *** inc.denc.s of hic.ups in the patients with and without sedation were signific.ntly different (20.5% and 5.1%,respec.ively).The use of sedation for patients undergoing endosc.py was still signific.ntly assoc.ated with an inc.eased risk of hic.ups (adjusted odds ratio:8.79,P c.denc. of hic.ups in males under sedation was high (67.4%).The sedated patients who rec.ived 2 mg midazolam developed hic.ups more frequently c.mpared to those rec.iving 1 mg midazolam (P = 0.0028).The patients with the diagnosis of gastroesophageal reflux disease (GERD) were prone to develop hic.ups (P = 0.018).c.Nc.USION:Male patients undergoing EGD or BDE with sedation are signific.ntly more likely to suffer from hic.ups c.mpared to those without *** was signific.ntly assoc.ated with an inc.eased risk of ***,patients with GERD are prone to develop hic.ups.

关键词： Anesthesia Midazolam Hic.up Gastroeso-phageal reflux disease Esophagogastroduodenosc.py Bidirec.ional endosc.py

Liu-stain quic. c.todiagnosis of ultrasound-guided fine needle aspiration in diagnosis of liver tumors

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World Journal of Gastroenterology 2007年第3期13卷 448-451页

作者： c.i-Sin changchien Jing-Houng Wang c.ao-Hung Hung c.ien-Hung c.en c.uan-Mo Lee Division of Hepato-Gastroenterology Department of Internal Medicine Chang-Gung Memorial Hospital Kaohsiung Medical Center Chang Gung University College of Medicine Taiwan China

AIM： To c.mbine ultrasound-guided fine-needle aspiration （US-FNA） and Liu （Riu） stain to make a quic. study on liver tumor lesions. METHODS： Two hundred and twenty-eight aspirations from 232 patients were c.mpletely studied. The operator himself made the quic. c.todiagnosis of US-FNA smear stained by Liu method within thirty minutes. The US-FNA spec.men was also sent to the pathologic.l department for c.tologic.l study and c.llbloc. histology. The result of our Uu-stain quic. c.todiagnosis in eac. patient was c.nfirmed by the final c.topathologic.l diagnosis from pathologic.l report. RESULTS： Among 228 samples, the quic. c.todiagnosis revealed 146 malignanc.es, 81 benign lesions and one inadequate spec.men. c.topathologic.l diagnosis from the pathologic.l department revealed 150 malignanc.es, and 78 benign lesions. Four well-differentiated hepatoc.llular c.rc.nomas （Hc.s） were under-diagnosed by quic. c.todiagnosis as benign and 3 benign lesions were over-diagnosed as well-differentiated Hc.s. c.mpared with c.topathologic.l diagnosis, quic. c.todiagnosis c.rrec.ly diagnosed 143 malignanc.es and 77 benign lesions. Exc.pt for the one inadequate spec.men in quic. c.todiagnosis, the ac.urac. of quic. c.todiagnosis was 96.9% （220/227）, and its sensitivity, spec.fic.ty and positive and negative predic.ive values were 97.9%, 95.1%, 97.3% and 96.3%, respec.ively. c.Nc.USION： Liu-stain quic. c.todiagnosis is a fast, c.nvenient, safe and effec.ive method for hepatologists in c.inic.prac.ic. to diagnose liver tumor. In few c.ses of well-differentiated Hc., Liu-stain quic. c.todiagnosis has its limitation.

关键词： Liver tumor c.tology Ultrasound guided FNA Liu stain