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Traumatic transection of main stem bronchus with unexpected clinicalpresentation- A case report

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Journal of Acute Disease 2017年第5期6卷 232-234页

作者： chao-Kun Chen Ying-Chieh Su Chu-Li Tu chien-ming chao Yao Fong Department of Thoracic Surgery Chi Mei Medical CenterTainanTaiwan Department of Intensive Care Medicine Chi Mei Medical CenterLiouyingTainanTaiwan

Tracheobronchial injury is very challenging in diagnosis and treatment. Highly suspicious airway injury and early diagnosis is recommended. We present a case of 39 years-old woman suffering from acute respiratory failure with bilateral hemo-pneumothorax and diffuse subcutaneous emphysema initially. She weaned from ventilator a few days later, but dyspnea recurred due to delayed diagnosis of complete disruption of right main bronchus. However, the image study was incompatible with clinical findings. It showed collapse of left lower lung and hyperinflation of right lung, instead of right pneumothorax or fallen-lung sign. Under the assistance of veno-venous extracorporeal membrane oxygenation, primary repair of right main bronchial injury was performed successfully. Finally, she recovered well uneventfully. In tracheobronchial injury, early diagnosis is a positive prognostic factor. The other important point is primary repair, instead of lobectomy or pneumonectomy.

关键词： Trauma Bronchial transection ECMO

A single center analysis of long-term outcomes and survival related risk factors in liver retransplantation

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 425-443,I0011页

作者： Zhihao Li Yi Ping Sng chao-Long Chen Chih-Che Lin Shih-Ho Wang Chee-chien Yong Liver Transplantation Center and Department of Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung

Background:Liver retransplant is the only option to save a patient with liver graft ***,it is controversial due to its poor survival outcome compared to primary *** deceased organ donation in Taiwan leads to high waitlist ***,living-donor grafts offer a valuable alternative for *** study aims to analyze the single center’s outcome in living donor liver retransplantation(re-LDLT)and deceased donor liver retransplantation(re-DDLT)as well as the survival related confounding risk ***:This is a single center retrospective study including 32 adults who underwent liver retransplantation(re-LT)from June 2002 to April *** cohort was divided into a re-LDLT and a re-DDLT group and survival outcomes were *** outcomes over different periods,the effect of timing on survival,and multivariate analysis for risk factors were also demonstrated Results:Of the 32 retransplantations,the re-LDLT group(n=11)received grafts from younger donors(31.3 vs.43.75 years,P=0.016),with lower graft weights(688 vs.1,457.2 g,Pming of retransplantation(early ***)did not affect patient *** analysis revealed that prolonged warm ischemia time(WIT)and intraoperative blood transfusion were related to poor long-term ***:Retransplantation with living donor graft demonstrated good long-term outcomes with acceptable complications to both recipient and *** may serve as a choice in areas lacking deceased *** timing of retransplantation did not affect the long-term *** effort should be made to reduce WIT and massive blood transfusion as they contributed to poor survi

关键词： Retransplantation living donor liver retransplantation(re-LDLT) deceased donor liver retransplantation(re-DDLT) timing of retransplantation long-term outcome

Beyond the Rex: an innovative meso-intrahepatic portal vein bypass for late-onset extrahepatic portal vein occlusion after living donor liver transplantation

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 662-668页

作者： Chee-chien Yong Hsu-Ting Yen Yu-Fan Cheng Leona Bettina Dungca Raymond Joseph De Vera Itsuko Chih-Yi Chen chao-Long Chen Department of Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Department of Cardiovascular Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Department of Diagnostic Radiology Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung

The Meso-Rex bypass(MRB)is recognized as an effective treatment for portal hypertension secondary to extrahepatic portal vein occlusion(EHPVO)both in the pediatric and adult population,within or outside the context of liver *** is the preferred surgical treatment in most centers because not only does it addresses the portal hypertension,but also restores physiologic portal hepatopetal ***,the Rex recess,the landmark for this technique,may not be safely accessible in some *** present a 22-year-old male who underwent living donor liver transplant(LDLT)for neonatal *** presented with variceal bleeding due to EHPVO at 13 years after *** endoscopic,radiologic,and surgical interventions were employed to address the recurrent gastrointestinal bleeding,but results have been *** performed a meso-intrahepatic portal vein bypass(MIPVB),an innovative alternative to the MRB,for this patient with extensive post-operative adhesions,perihilar collaterals,and cavernous *** creation in patients where the Rex recess is inaccessible is technically *** with a multidisciplinary team approach,meticulous preoperative planning,and close follow-up,the authors have demonstrated that it is a safe and feasible option for patients with late-onset EHPVO after liver transplantation.

关键词： Meso-Rex bypass(MRB) portal vein occlusion liver transplantation(LT)

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土壤胶体对蛋白质的吸附

土壤学报 1964年第4期 411-420页

作者：蒋劍敏趙家骅中国科学院土壤研究所

黑土、灰褐土与红壤等土壤胶体都有吸附两性胶体蛋白质的能力。吸附蛋白质的数量与土壤胶体中粘土矿物的组成有关,2:1型大于1:1型,也与粘土矿物上负电荷数量有关,负电荷愈多,吸附愈多。斑脱土对明胶的吸附是一种难于可逆的交换吸附,也... 详细信息

黑土、灰褐土与红壤等土壤胶体都有吸附两性胶体蛋白质的能力。吸附蛋白质的数量与土壤胶体中粘土矿物的组成有关,2:1型大于1:1型,也与粘土矿物上负电荷数量有关,负电荷愈多,吸附愈多。斑脱土对明胶的吸附是一种难于可逆的交换吸附,也可能有非极性的吸附。蒙脱胶体吸附明胶时,既有外表面的吸附,又有内表面的吸附。内表面吸附量易受作用条件的影响。蒙脱吸附明胶可形成憎水性的微团聚体,促使其X射线衍射强度降低。

关键词：土壤胶体胶体吸附明胶黑土分散剂地带性土壤硅酸盐矿物粘土矿物粘粒矿物蛋白质

Prognostic factors of early recurrence after complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Clinical Cases 2024年第27期12卷 6057-6069页

作者： chao-Yu Chen Tzu-Hao Huang Li-Wen Lee Jrhau Lung Yu-Che Ou chien-Hui Hung Huei-Chieh Chuang Min-Chi Chen Ting-Yao Wang Department of Obstetrics and Gynecology Chang Gung Memorial HospitalChiayi 613Taiwan Graduate Institute of Clinical Medical Sciences College of MedicineChang Gung UniversityTaoyuan 333Taiwan Department of Early Childhood Care and Education Shu-Zen Junior College of Medicine and ManagementKaohsiung 821Taiwan Division of General Surgery Department of SurgeryChang Gung Memorial HospitalChiayi 613Taiwan Department of Diagnostic Radiology Chang Gung Memorial HospitalChiayi 613Taiwan College of Medicine Chang Gung UniversityTaoyuan 333Taiwan Department of Medical Research and Development Chang Gung Memorial HospitalChiayi 613Taiwan Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan Department of Anatomic Pathology Chang Gung Memorial HospitalChiayi 613Taiwan Department of Public Health Chang Gung UniversityTaoyuan 333Taiwan Division of Hematology and Oncology Department of Internal MedicineChang Gung Memorial HospitalChiayi 613Taiwan

BACKGROUND Although cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)offer the potential for long-term survival in peritoneal carcinomatosis,outcomes following CRS/HIPEC vary *** To identify the clinical factors associated with progression-free survival(PFS)after complete CRS/HIPEC in patients with colorectal/high-grade appendiceal,ovarian,and gastric *** We retrospectively evaluated the risk of recurrence within 1 year after CRS/HIPEC and its impact on overall survival(OS)in patients recruited between 2015 and *** regression models were used to assess the prognostic factors for the risk of recurrence within 1 ***–Meier survival curves and Cox proportional hazards models were used to evaluate the association between recurrence and *** Of the 80 enrolled patients,39 had an unfavorable PFS(12 was associated with a lower rate of achieving CC-0(P=0.027).The favorable PFS group had a significantly longer OS(median 81.7 mo vs 17.0 mo,P<0.001).CONCLUSION Achieving CC-0 was associated with a lower early recurrence rate and improved long-term *** study underscores the importance of selecting appropriate candidates for CRS/HIPEC to manage peritoneal carcinomatosis.

关键词： Peritoneal metastasis Cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Predictor Recurrence

Hepatitis B virus infection and renal transplantation

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World Journal of Gastroenterology 2010年第31期16卷 3878-3887页

作者： ming-chao Tsai Yen-Ta Chen Yu-Shu chien Tsung-Hui Hu Division of Hepato-Gas-troenterology Department of Internal MedicineChang Gung Memorial HospitalKaohsiung Medical CenterChang Gung University College of Medicine123Ta-Pei RoadNiao-Sung HsiangKaohsiung Hsien 833Taiwan China Department of Urology Chang Gung Memorial HospitalKaohsiung Medical CenterChang Gung University College of Medicine123Ta-Pei RoadNiao-Sung HsiangKaohsiung Hsien 833 TaiwanChina Division of Nephrology De-partment of Internal MedicineChang Gung Memorial HospitalKaohsiung Medical CenterChang Gung University College of Medicine123Ta-Pei RoadNiao-Sung HsiangKaohsiung Hsien 833Taiwan China

Although the prevalence of chronic hepatitis B virus (HBV) infection has declined in renal transplant recipients (RTRs), it remains a relevant clinical problem with high morbidity and mortality in long-term follow up. A thorough evaluation, including liver biopsy as well as assessment of HBV replication in serum (i.e. hepatitis B e antigen and/or HBV DNA) is required before transplantation. Interferon should not be used in this setting because of low efficacy and precipitation on acute allograft rejection. The advent of effective antiviral therapies offers the opportunity to prevent the progression of liver disease after renal transplantation. However, as far as we are aware, no studies have compared prophylactic and preemptive strategies. To date, the majority of RTRs with HBV-related liver disease have had a high virological and biochemical response to lamivudine use. However, lamivudine resistance is frequent with a prolonged course of therapy. Considering long-term treatment, antiviral agents with a high genetic barrier to resistance and lack of nephrotoxicity are suggested. The optimal strategy in RTRs with HBV infection remains to be established in the near future.

关键词： Hepatitis B Renal transplantation Lamivudine resistance

First report of furuncular myiasis caused by the larva of botfly,Dermatobia hominis,in a Taiwan Residents traveler

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Asian Pacific Journal of Tropical Biomedicine 2013年第3期3卷 229-231页

作者： Je-ming Hu Chih-chien Wang Li-Lian chao Chung-Shinn Lee chien-ming Shih Department of Surgery and Orthopaedics Tri-Service General Hospital Department of Parasitology and Tropical Medicine National Defense Medical Center Research Center for Biotechnology and Medicine Policy

A case of furuncular myiasis was reported for the first time in a 29-year-old young Taiwan Residents traveler returning from an ecotourism in ***-like lesions were observed on the top of his head and he complained of crawling sensations within his *** invasive larva of botfly,Dermatobia hominis,was extruded from the furuncular lesion of the *** of cutaneous myiasis for clinicians should be considered for a patient who has a furuncular lesion and has recently returned from a botfly-endemic area.

关键词： Furuncular myiasis Botfly Traveler Taiwan

Usefulness of fecal lactoferrin in predicting and monitoring the clinical severity of infectious diarrhea

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World Journal of Gastroenterology 2011年第37期17卷 4218-4224页

作者： chien-Chang Chen Chee-Jen Chang Tzou-Yien Lin ming-Wei Lai Hsun-Chin chao Man-Shan Kong Division of Gastroenterology Department of Pediatrics Chang Gung Memorial Hospital Taoyuan 333 Taiwan China Department of Medicine Chang Gung University College of Medicine Taoyuan 333 Taiwan China Graduate Institute of Clinical Medical Sciences Clinical Informatics and Medical Statistics Research Center Chang Gung Memorial Hospital Taoyuan 333 Taiwan China

AIM:To explore the value of fecal lactoferrin in predicting and monitoring the clinical severity of infectious ***:Patients with acute infectious diarrhea ranging from 3 mo to 10 years in age were enrolled,and one to three stool samples from each subject were *** parameters,including white blood cells /differential count,C-reactive protein,fecal mucus,fecal pus cells,duration of fever,vomiting,diarrhea and severity(indicated by Clark and Vesikari scores),were recorded and *** lactoferrin was determined by enzyme-linked immunosorbent assay and compared in different pathogen and disease *** estimating equations(GEE) were also used for ***:Data included 226 evaluations for 117 individuals across three different time *** lactoferrin was higher in patients with Salmonella(11.17 μg/g ± 2.73 μg/g) or Campylobacter(10.32 μg/g ± 2.94 μg/g) infections and lower in patients with rotavirus(2.82 μg/g ± 1.27 μg/g) or norovirus(3.16 μg/g ± 1.18 μg/g) *** of fecal lactoferrin were significantly elevated in patients with severe(11.32 μg/g ± 3.29 μg/g) or moderate(3.77 μg/g ± 2.08 μg/g) disease activity compared with subjects with mild(1.51 μg/g ± 1.36 μg/g) disease activity(P < 0.05).GEE analysis suggests that this marker could be used to monitor the severity and course of gastrointestinal infections and may provide information for disease ***:Fecal lactoferrin increased during bacterial infection and with greater disease severity and may be a good marker for predicting and monitoring intestinal inflammation in children with infectious diarrhea.

关键词： Lactoferrin Diarrhea Generalized estimating equations Vesikari scores Clark scores

Spontaneous small bowel perforation secondary to Vibrio parahaemolyticus infection:A case report

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World Journal of Clinical Cases 2021年第5期9卷 1210-1214页

作者： Shih-Chun chien Chih-Chung Chang Shih-chao chien Department of Emergency Medicine Mackay Memorial HospitalTaipei 104Taiwan Department of Emergency Medicine Taitung Mackay Memorial HospitalTaitung 950Taiwan

BACKGROUND Vibrio pararhaemolyticus(***),a pathogen that commonly causes gastroenteritis,could potentially lead to a pandemic in *** pathogenesis and molecular mechanisms vary,and the severity of illness can be diverse,ranging from mild gastroenteritis,requiring only supportive care,to *** SUMMARY We outline a case of a 71-year-old female who experienced an acute onset of severe abdominal tenderness after two days of vomiting and diarrhea prior to her emergency department visit.A small bowel perforation was diagnosed using computed *** ascites cultured revealed infection due to *** CONCLUSION Our case is the first reported case of ***-induced gastroenteritis resulting in small bowel perforation.

关键词： Vibrio parahaemolyticus Gastroenteriti Small bowel perforation Bacteria Infections Case report