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Delayed ischemic gangrene change of distal limb despite optimal decompressed colostomy constructed in obstructedsigmoid colon cancer:A case report

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World Journal of Gastroenterology 2006年第6期12卷 993-995页

作者： Wen-Shih Huang Kuang-Wen Liu Paul Y Lin ching-chuan hsieh Jeng-Yi Wang Division of Colon and Rectal Surgery Department of SurgeryChang Gung Memorial Hospital ChiayiTaiwan Graduate Institute of Clinical Medicine Chang Gung UniversityTaoyuanTaiwanChina Department of Surgery E-Da Hospital/Ⅰ-Shou University KaohsiungTaiwanChina Division of Anatomical Pathology Department of Pathology Chang Gung Memorial HospitalChiayiTaiwanChina Division of General Surgery Department of Surgery Chang Gung Memorial HospitalChiayiTaiwanChina Division of Colon and Rectal Surgery Department of Surgery Chang Gung Memorial HospitalChiayiTaiwanChina

Creating blow-hole colostomy for decompression could provide a time-saving and efficient surgical procedure for a severely debilitated case with a completely obstructed colorectal cancer. Complications are reported as prolapse, retraction, and paracolostomal abscess. However, complication with an ischemic distal limb has not been reported. We report a case of critical intra-abdominal disease after decompressed colostomy for relieving malignant sigmoid colon obstruction; a potential fatal condition should be alerted. A 76-year-old male visited our emergency department for symptoms related to obstructed sigmoid colon tumor with foul-odor vomitus containing fecal-like materials. An emergent blow-hole colostomy proximal to an obstructed sigmoid lesion was created, and resolution of complete colon obstruction was pursued. Unfortunately, extensive abdominal painful distention with board-like abdomen and sudden onset of high fever with leukocytopenia developed subsequently. Such surgical abdomen rendered a secondary laparotomy with resection of the sigmoid tumor along with an ischemic colon segment located proximally up to the previously created colostomy. Eventually, the patient had an uneventful postoperative hospital stay. In the present article, we have described an emergent condition of sudden onset of distal limb ischemia after blow-hole colostomy and concluded that despite the decompressed colostomy would resolve acute malignant colon obstruction efficiently; impending ischemic bowel may progress with a possible irreversible peritonitis. Any patient, who undergoes a decompressed colostomy without resection of the obstructed lesion, should be monitored with leukocyte count and abdominal condition survey frequently.

关键词： Colorectal cancer obstruction Colostomy IschemJc colitis Laparotomy

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Management of patients with stercoral perforation of the sigmoid colon:Report of five cases

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World Journal of Gastroenterology 2006年第3期12卷 500-503页

作者： Wen-Shih Huang Chia-Siu Wang ching-chuan hsieh Paul Y Lin Chih-Chien Chin Jeng-Yi Wang Divisionof Colon and Rectal Surgery Chang Gung Memorial Hospital Putzu 613 Taiwan China Division of GeneralSurgery Chang Gung Memorial Hospital Pu-tzu 613 TaiwanChina Division of Anatomical Pathology Chang GungMemorial Hospital Pu-tzu 613 Taiwan China Graduate Institute of Clinical Medicine Chang Gung University Kwei-Shan Taiwan China

To our knowledge, stercoral perforation of the colon is rarely seen with fewer than 90 cases reported in the literature till date. We explored the principles of management to prevent impending mortality in five patients with this condition. Five patients, two males and three females, whose median age was 64 years, had sustained stercoral perforation of the sigmoid colon. Chronic constipation was the common symptom among these patients. Three patients underwent a Hartmann＇s procedure and another two were treated with segmental colectomy with anastomosis and diverting colostomy. There was one surgical mortality and the other patients had an uneventful hospital stay. Timely intervention to prevent and/or treat any associated sepsis along with extensive peritoneal lavage and surgical intervention to remove diseased colonic tissue at the primary stercoral ulceration site coupled with aggressive therapy for peritonitis are key treatment modalities in salvaging patients presenting with stercoral perforation of the colon.

关键词： Stercoral perforation Colon Management

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Analysis of risk factors for central venous port failure in cancer patients

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World Journal of Gastroenterology 2009年第37期15卷 4709-4714页

作者： ching-chuan hsieh Hsu-Huei Weng Wen-Shih Huang Wen-Ke Wang Chiung-Lun Kao Ming-Shian Lu Chia-Siu Wang Division of General Surgery Department of Surgery ChangGung Memorial Hospital Chiayi 613 Taiwan China GraduateInstitute of Clinical Medical Science College of MedicineChang Gung University Taoyuan 333 Taiwan China Department of Diagnostic Radiology ChangGung Memorial Hospital Chiayi 613 Taiwan China Division of Colon and Rectal Surgery Department of Surgery Chang Gung Memorial Hospital Chiayi613 Taiwan China Division of Thoracic andCardiovascular Surgery Department of Surgery Chang GungMemorial Hospital Chiayi 613 Taiwan China Division of General Surgery Department ofSurgery Chang Gung Memorial Hospital Chiayi 613 TaiwanChina

AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.

关键词： Central venous port Chemotherapy Risk factor Cancer patient Multivariate analysis

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Hepatic immune tolerance induced by hepatic stellate cells

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World Journal of Gastroenterology 2015年第42期21卷 11887-11892页

作者： ching-chuan hsieh Chien-Hui Hung Lina Lu Shiguang Qian Department of Surgery Chang Gung Memorial Hospital at Chiayi Graduate Institute of Clinical Medical Sciences Chang Gung University Department of Immunology Lerner Research Institute Transplantation Center Digestive Disease Institute Cleveland Clinic Department of General Surgery Transplantation Center Digestive Disease Institute Cleveland Clinic

The liver, which is a metabolic organ, plays a pivotal role in tolerance induction. Hepatic stellate cells(Hp SCs), which are unique non-parenchymal cells, exert potent immunoregulatory activity during cotransplantation with allogeneic islets effectively protecting the islet allografts from rejection. Multiple mechanisms participate in the immune tolerance induced by Hp SCs, including the marked expansion of myeloid-derived suppressor cells(MDSCs), attenuation of effector T cell functions and augmentation of regulatory T cells. Hp SC conditioned MDSC-based immunotherapy has been conducted in mice with autoimmune disease and the results show that this technique may be promising. This article demonstrates how Hp SCs orchestrate both innate immunity and adaptive immunity to build a negative network that leads to immune tolerance.

关键词： Hepatic stellate cells Myeloid-derived suppressor

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Management of retroperitoneal high-grade serous carcinoma of unknown origin:A case report

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World Journal of Clinical Cases 2024年第6期12卷 1190-1195页

作者： Wen-Lin hsieh Dah-ching Ding Department of Obstetrics and Gynecology Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTzu Chi UniversityHualien 970Taiwan Institute of Medical Sciences Tzu Chi UniversityHualien 970TaiwanTaiwan

BACKGROUND Retroperitoneal high-grade serous carcinoma(HGSC)of unknown origin is a sporadic tumor that can originate from ovarian ***,we report the case of a woman with retroperitoneal HGSC of unknown origin and describe how she was diagnosed and *** SUMMARY A 71-year-old female presented with the tumor marker CA125 elevated to 1041.9 U/mL upon a regular health *** tomography revealed retroperitoneal lymph node ***,positron emission tomography scanning revealed lesions with increased F-18 fluorodeoxyglucose uptake at the *** a result,she underwent laparoscopic lymph node resection,and pathology revealed metastatic adenocarcinoma with CK7(+),PAX8(+),WT1(+),PR(-),and p53 mutational loss of expression,indicating that the origin may be from the *** patient was admitted to our ward and underwent laparoscopic staging;however,the pathological results were *** the suspicion of retroperitoneal HGSC of unknown origin,chemotherapy and targeted therapy were *** marker levels decreased after *** We present a case of HGSC of unknown origin managed using retroperitoneal lymphadenectomy,staging surgery,chemotherapy,and targeted therapy.

关键词： High-grade serous carcinoma Retroperitoneum Origin Chemotherapy Lymph node Case report

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Origins of perturbations in dayside equatorial ground magnetograms

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Earth and Planetary Physics 2024年第1期8卷 215-221页

作者： Syau-Yun W.hsieh David G.Sibeck The Johns Hopkins University Applied Physics Laboratory LaurelMarylandUSA NASA Goddard Space Flight Center GreenbeltMarylandUSA

To determine the cause(s)of perturbations seen in dayside equatorial ground magnetograms,we conducted a systematic survey of simultaneous ground-based and geosynchronous satellite-based observations during the 90-day period from December 1,2020 to February 28,*** examined Huancayo ground magnetometer observations from 14:00:00 to 20:00:00 UT each day,during which Huancayo passed through local *** those data we chose perturbation events selected on the basis of large(>20 nT)event amplitude and classified the selected events as responding primarily to solar wind pressure,or to variations in the north/south component of the interplanetary magnetic field(IMF Bz),or perhaps in part to *** results show that an equivalent number of events were identified for each model during this 90-day *** in the lagged solar wind dynamic pressure routinely correspond to nearly simultaneous sudden impulses recorded at both geosynchronous orbit and on the *** in IMF Bz produce erosion signatures at geosynchronous orbit and can correspond to ground events if lag times for reconnection to enhance convection in the magnetosphere are taken into account.

关键词： dayside magnetosphere dayside equatorial ionosphere geosynchronous magnetic field

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Automated and miniaturized screening of antibiotic combinations via robotic-printed combinatorial droplet platform

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Acta Pharmaceutica Sinica B 2024年第4期14卷 1801-1813页

作者： Fangchi Shao Hui Li Kuangwen hsieh Pengfei Zhang Sixuan Li Tza-Huei Wang Department of Biomedical Engineering Johns Hopkins UniversityBaltimoreMD 21218USA Department of Mechanical Engineering Johns Hopkins UniversityBaltimoreMD 21218USA

Antimicrobial resistance(AMR)has become a global health crisis in need of novel *** this end,antibiotic combination therapies,which combine multiple antibiotics for treatment,have at-tracted significant attention as a potential approach for combating *** facilitate advances in anti-biotic combination therapies,most notably in investigating antibiotic interactions and identifying synergistic antibiotic combinations however,there remains a need for automated high-throughput plat-forms that can create and examine antibiotic combinations on-demand,at scale,and with minimal reagent *** address these challenges,we have developed a Robotic-Printed Combinatorial Droplet(RoboDrop)platform by integrating a programmable droplet microfuidic device that generates antibiotic combinations in nanoliter droplets in automation,a robotic arm that arranges the droplets in an array,and a camera that images the array of thousands of droplets in *** further implement a resazurin-based bacterial viability assay to accelerate our antibiotic combination *** a demonstration,we use RoboDrop to corroborate two pairs of antibiotics with known interactions and subsequently identify a new synergistic combination of cefsulodin,penicillin,and oxacillin against a model *** *** therefore envision RoboDrop becoming a useful tool to efficiently identify new synergistic antibiotic combinations toward combating AMR.

关键词： Droplet microfluidics Antimicrobial resistance Antibiotic combinatorial screening Contact printing Robotics Pharmaceutical analysis High-throughput Antibiotic interactions

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Adaptive Fourier Decomposition of the First Three SARS-CoV-2 Infection Waves with Epidemic Intervention—London,UK,2020-2022

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China CDC weekly 2024年第21期6卷 478-486,I0006-I0008页

作者： Zige Liu Guibin Lu Cheokieng Vong Zhiqi Zeng Wei He Zhijie Lin Cuiyun Lin Kaichin hsieh Zifeng Yang Arlindo L.Oliveira Chitin Hon Department of Engineering Science Faculty of Innovation EngineeringMacao University of Science and TechnologyMacao SARChina Queen Ethelburga’s Collegiate Thorpe Underwood EstateYorkUK State Key Laboratory of Respiratory Disease National Clinical Research Center for Respiratory DiseaseGuangzhou Institute of Respiratory HealthThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou CityGuangdong ProvinceChina Respiratory Disease AI Laboratory on Epidemic and Medical Big Data Instrument Applications Department of Engineering ScienceFaculty of Innovation EngineeringMacao University of Science and TechnologyMacao SARChina Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases KingMed School of Laboratory MedicineGuangzhou Medical UniversityGuangzhou CityGuangdong ProvinceChina Faculty of Innovation Engineering School of Computer Science and EngineeringMacao University of Science and TechnologyMacao SARChina University College London UCL Faculty of Engineering SciencesLondonUK Guangzhou Laboratory Guangzhou CityGuangdong ProvinceChina Instituto de Engenharia de Sistemas e Computadores:Investigação e Desenvolvimento em Lisboa LisboaPortugal Instituto Superior Técnico Universidade de LisboaLisboaPortugal

Background:This study provides a detailed analysis of the daily fluctuations in coronavirus disease 2019(COVID-19)case numbers in London from January 31,2020 to February 24,*** primary objective was to enhance understanding of the interactions among government pandemic responses,viral mutations,and the subsequent changes in COVID-19 case ***:We employed the adaptive Fourier decomposition(AFD)method to analyze diurnal changes and further segmented the AFD into novel multi-component groups consisting of one to three *** restructured components were rigorously evaluated using Pearson correlation,and their effectiveness was compared with other signal analysis *** study introduced a novel approach to differentiate individual components across various time-frequency scales using basis decomposition ***:Analysis of London’s daily COVID-19 data using AFD revealed a strong correlation between the“stay at home”directive and high-frequency components during the first epidemic *** indicates the need for sustained implementation of vaccination policies to maintain their ***:The AFD component method provides a comprehensive analysis of the immediate and prolonged impact of governmental policies on the spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).This robust tool has proven invaluable for analyzing COVID-19 pandemic data,offering critical insights that guide the formulation of future preventive and public health strategies.

关键词： offering sustained London

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Interpenetrated Structures for Enhancing Ion Diffusion Kinetics in Electrochemical Energy Storage Devices

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Nano-Micro Letters 2024年第11期16卷 718-728页

作者： Xinzhe Xue Longsheng Feng Qiu Ren Cassidy Tran Samuel Eisenberg Anica Pinongcos Logan Valdovinos Cathleen hsieh Tae Wook Heo Marcus A.Worsley Cheng Zhu Yat Li Department of Chemistry and Biochemistry University of California1156 High StreetSanta CruzCA 95064USA Lawrence Livermore National Laboratory 7000 East AvenueLivermoreCA 94550USA

The architectural design of electrodes offers new opportunities for next-generation electrochemical energy storage devices(EESDs)by increasing surface area,thickness,and active materials mass loading while maintaining good ion diffusion through optimized electrode ***,conventional thick electrodes increase ion diffusion length and cause larger ion concentration gradients,limiting reaction *** demonstrate a strategy for building interpenetrated structures that shortens ion diffusion length and reduces ion concentration *** free-standing device structure also avoids short-circuiting without needing a *** feature size and number of interpenetrated units can be adjusted during printing to balance surface area and ion *** with a 3D-printed interpenetrated polymer substrate,we metallize it to make it *** substrate has two individually addressable electrodes,allowing selective electrodeposition of energy storage *** a Zn//MnO_(2) battery as a model system,the interpenetrated device outperforms conventional separate electrode configurations,improving volumetric energy density by 221%and exhibiting a higher capacity retention rate of 49%compared to 35%at temperatures from 20 to 0℃.Our study introduces a new EESD architecture applicable to Li-ion,Na-ion batteries,supercapacitors,etc.

关键词： Interpenetrated structure 3D printing Electrochemical energy storage Ion diffusion length Inter-electrode distance

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Characteristics and prognosis of small bowel tumors:A retrospective study

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World Journal of Clinical Cases 2024年第34期12卷 6696-6704页

作者： Fang-Chen Liu ching-Hsiang Wang Peng-Jen Chen Yu-Lueng Shih Hsuan-Hwai Lin Jung-Chun Lin Wei-Kuo Chang Tsai-Yuan hsieh Gen-Min Lin Tien-Yu Huang Division of Gastroenterology Department of Internal MedicineTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Department of Internal Medicine Taoyuan Armed Forces General HospitalTaoyuan 325208Taiwan Department of Medicine Tri-Service General Hospital and National Defense Medical CenterTaipei 114Taiwan Department of Medicine Hualien Armed Forces General HospitalHualien 970Taiwan Taiwan Association for the Study of Small Intestinal Diseases Taoyuan 33305Taiwan

BACKGROUND Small bowel tumors(SBTs)are a heterogeneous group of difficult-to-diagnose tumors that account for 2%-5%of all gastrointestinal ***-balloon enteroscopy greatly enhances the diagnosis and treatment of ***,few epidemiological studies have been conducted in Taiwan to determine the clinical profile of *** To investigate the clinical characteristics,managements and prognosis of SBTs in a medical center in *** The study enrolled 51 patients aged 58.9±8.8 years(range,22-93)diagnosed with SBTs from November 2009 to July *** retrospectively recorded clinical characteristics,indications,endoscopic findings,pathological results,management,and outcomes for further *** A male preponderance was observed(56.8%).The most common indications were suspected small intestinal tumors(52.9%)and obscure gastrointestinal bleeding(39.2%).The most common tumor location was the ileum(41.2%).The performance of imaging studies(P=0.004)and the types of findings(P=0.005)differed significantly between malignant and benign *** most frequent imaging finding was a small intestinal mass(43.1%).The top three malignant tumor types were gastrointestinal stromal tumors(GISTs),adenocarcinomas,and ***,the proportions of benign and malignant tumors were 27.5%and 72.5%,*** survival rates of patients with malignant tumors in the GIST and non-GIST groups differed significantly(P=0.015).Kaplan–Meier survival analysis showed a significant difference in survival between patients in the malignant and benign groups(P=0.04).All patients with lymphoma underwent chemotherapy(n=7/8,87.5%),whereas most patients with GISTs underwent surgery(n=13/14,92.8%).CONCLUSION Patients with GISTs have a significantly higher survival rate than those with other malignant ***,a large-scale nationwide study is warranted to evaluate the population-based epidemiology of SBTs.

关键词： Gastrointestinal bleeding Intestinal neoplasms Single-balloon enteroscopy,survival rate

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