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World Journal of Gastroenterology 2005年第30期11卷 4764-4765页

作者： Ming-Jen Chen ching-chung lin Wen-Hsiung Chang Fei-Shih Yang Division of Gastroenterology Department of Radiation

Biloma is an encapsulated bile collection outside the biliary tree due to a bile leak. It is occasionally found following traumatic liver injury or iatrogenic injury to the biliary tract, induced either during an endoscopic or surgical procedure. It is a rare complication of transcatheter arterial embolization (TAE). Although biloma can be shrunk by appropriate aspiration or drainage in majority of cases,we report a case of intrahepatic biloma following repeated TAE for hepatocellular carcinoma (HCC) and complicated by infection and intrahepatic stones. This particular constellation of problems has not been reported before and the intrahepatic stones need to be removed by percutaneous procedure.

关键词： Biloma Biliary tract Transcatheter Arterial embolization

Outcome of simple use of mechanical lithotripsy of difficult common bile duct stones

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World Journal of Gastroenterology 2005年第4期11卷 593-596页

作者： Wen-Hsiung Chang Cheng-Hsin Chu Tsang-En Wang Ming-Jen Chen ching-chung lin Division of Gastroenterology Department of Internal Medicine Mackay Memorial HospitalMackay MedicineNursing and Management college TaipeiTaiwan

AIM: The usual bile duct stone may be removed by means of Dormia basket or balloon catheter, and results are quite good. However, the degree of difficulty is increased when stones are larger. Studies on the subject reported many cases where mechanical lithotripsy is combined with a second technique, e.g. electrohydraulic lithotripsy (EHL), where stones are crushed using baby-mother scope electric shock. The extracorporeal shock-wave lithotripsy (ESWL) or laser lithotripsy also yields an excellent success rate of greater than 90%. However, the equipment for these techniques are very expensive; hence we opted for the simple mechanical lithotripsy and evaluated its performance. METHODS: During the period from August 1996 to December 2002, Mackay Memorial Hospital treated 304 patients suffering from difficult bile duct stones (stone>1.5 cm or stones that could not be removed by the ordinary Dormia basket or balloon catheter). These patients underwent endoscopic papillotomy (EPT) procedure, and stones were removed by means of the Olympus BML-4Q lithotripsy. A follow-up was conducted on the post-treatment conditions and complications of the patients. RESULTS: Out of the 304 patients, bile duct stones were successfully removed from 272 patients, a success rate of about 90%. The procedure failed in 32 patients, for whom surgery was needed. Out of the 272 successfully treated patients, 8 developed cholangitis, 21 developed pancreatitis, and 10 patients had delayed bleeding, and no patient died. Among these 272 successful removal cases, successful bile duct stone removal was achieved after the first lithotripsy in 211 patients, whereas 61 patients underwent multiple sessions of lithotripsy. As for the 61 patients that underwent multiple sessions of mechanical lithotripsy, 6 (9.8%) had post-procedure cholangitis, 12 (19.6%) had pancreatitis, and 9 patients (14.7%) had delayed bleeding. Compared with the 211 patients undergoing a single session of mechanical lithotripsy, 3 (1.4

关键词： Common bile duct stones Mechanical lithotripsy

Acute transient hepatocellular injury in cholelithiasis and cholecystitis without evidence of choledocholithiasis

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World Journal of Gastroenterology 2009年第30期15卷 3788-3792页

作者： Chen-Wang Chang Wen-Hsiung Chang ching-chung lin Cheng-Hsin Chu Tsang-En Wang Shou-Chuan Shih Wen-Hsiung Chang Ching-Chung Lin Cheng-Hsin Chu Tsang-En Wang Division of Gastroenterology Department of Intemal Medicine Mackay Memorial Hospital Mackay Medicine Nursing and Management College Taipei 10449 Taiwan China Division of Gastroenterology Department of Internal Medicine Health Evaluation Center Mackay Memorial Hospital Mackay Medicine Nursing and Management College Taipei 10449 Taiwan China

AIM： To investigate acute transient hepatocellular injury in patients with cholelithiasis and cholecystitis but no evidence of choledocholithiasis.METHODS： The medical records of patients with cholelithiasis who underwent cholecystectomy between July 2003 and June 2007 were retrospectively reviewed. Imaging studies to detect common bile duct （CBD） stones were performed in 186 patients, who constituted the study population. Biochemical liver tests before and after surgery, and with the presence or absence of CBD stones were analyzed.RESULTS： In 96 patients with cholelithiasis and cholecystitis without evidence of CBD stones, 49 （51.0%） had an alanine aminotransferase level elevated to 2-3 times the upper limit of normal, and 40 （41.2%） had an elevated aspartate aminotransferase level. Similar manifestations of hepatocellular injury were, as would be expected, even more obvious in the 90 patients with CBD stones. These markers of hepatocellular injury resolved almost completely within 2 wk to 1 mo after cholecystectomy. Compared to 59 patients with histologically less severe cholecystitisin the group undergoing urgent surgery （total 74 patients）, the 15 patients with a gangrenous gallbladder had a higher mean level of total bilirubin （2.14 ± 1.27 mg/dL vs 2.66 ± 2.97 mg/dL, P 〈 0.001） and white cell count （9480 ± 4681/μL vs 12840 ± 5273/μL, P = 0.018）.CONCLUSION： Acute hepatocellular injury in cholelithiasis and cholecystitis without choledocholithiasis is mild and transient. Hyperbilirubinemia and leukocytosis may predict severe inflammatory changes in the gallbladder.

关键词： Acute transient hepatitis Cholelithiasis Cholecystitis Hyperbilirubinemia Leukocytosis

Training gastroenterology fellows to perform gastric polypectomy using a novel ex vivo model

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World Journal of Gastroenterology 2011年第41期17卷 4619-4624页

作者： Ming-Jen Chen ching-chung lin Chia-Yuan Liu Chih-Jen Chen Chen-Wang Chang ching-Wei Chang Chien-Wei Lee Shou-Chuan Shih Horng-Yuan Wang Division of Gastroenterology Department of Internal MedicineMackay Memorial Hospital Mackay Medicine Nursing and Management College Clinical Skills Training Center Department of Medical EducationMackay Memorial Hospital Mackay Medical College

AIM:To evaluate the effect of hands-on training of gastroenterology fellows in gastric polypectomy using an ex vivo ***:Eight gastroenterology fellows at Mackay Memorial Hospital,Taipei were evaluated in gastricpolypectomy techniques using a pig stomach with artificial polyps created by a rubber band ligation *** performance of four second year(year-2)fellows who had undergone one year of clinical training was compared with that of four f irst year(year-1)fellows both before and after a 4-h workshop using the ex vivo *** workshop allowed for hands-on train-ing in the removal of multiple artif icial polyps and the placement of hemoclips at the excision *** included observation of technical skills,procedure time,and the fellows' conf idence ***:One week after the workshop,the year-1 fellows were re-evaluated and had significantly im-proved mean performance scores(from 17.9 ± 1.8 to 22.5 ± 0.7),conf idence scale(from 4.5 ± 1.0 to 7.8 ± 0.5)and procedure time(from 615.0 ± 57.4 s to 357.5 ± 85.0 s)compared with their baseline *** 4 h of training using the ex vivo simulator,the skills of the year-1 fellows were statistically similar to those of the year-2 ***:Use of this ex vivo simulator significantly improved the endoscopic gastric polypectomy skills of gastroenterology fellows who had not had previous clinical training in gastric polypectomy.

关键词： Ex vivo Animal tissue model Hands-on training Pig stomach Polypectomy

Etoposide sensitizes CT26 colorectal adenocarcinoma to radiation therapy in BALB/c mice

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World Journal of Gastroenterology 2005年第31期11卷 4895-4898页

作者： Chia-Yuan Liu Hui-Fen Liao Tsang-En Wang Shee-Chan lin Shou-Chuan Shih Wen-Hsuing Chang Yuh-Cheng Yang ching-chung lin Yu-Jen Chen Division of Gastroenterology Department of Internal Medicine Mackay Memorial Hospital Taipei Taiwan China Department of Medical Research Mackay Memorial HospitalTaipei Taiwan China Department of Molecular Biology and Biochemistry National Chiayi University Chiayi 300 Taiwan China Nursingand Management College Taipei Taiwan China Department of Radiation Oncology Mackay Memorial Hospital Taipei Taiwan China

AIM： To investigate the combined effect of etoposide and radiation on CT26 colorectal adenocarcinoma implanted into BALB/c mice. METHODS： We evaluated the radiosensitizing effect of etoposide on CT26 colorectal adenocarcinoma in a syngeneic animal model. BALB/c mice were subcutaneously implanted with CT26 cells and divided into four groups： Gonlyol （intra-peritoneal saline×2） group, etoposide （5 mg/kg intra-peritoneally×2） group, radiation therapy （RT 5 Gy×2 fractions） group, and combination therapy with etoposide （5 mg/kg intra-peritoneally 1 h before radiation） group. RESULTS： Tumor growth was significantly inhibited by RT and combination therapy. The effect of combination therapy was better than that of RT. No significant changes were noted in body weight, plasma alanine aminotransferase, or creatinine in any group. The leukocyte count significantly but transiently decreased in the RT and combination therapy groups, but not in the etoposide and control groups. There was no skin change or hair loss in the RT and combination therapy groups. CONCLUSION： Etoposide can sensitize CT26 colorectal adenocarcinoma in BALB/c mice to RT without significant toxicity.

关键词： Etoposide (VP-16) Colorectal adenocarcinoma CT26 BALB/c mice Radiosensitization

Clinical predictors of severe gallbladder complications in acute acalculous cholecystitis

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世界胃肠病学杂志：英文版 2003年第12期9卷 2821-2823页

作者： Ay-Jiun Wang Tsang-En Wang ching-chung lin Shee-Chan lin Shou-Chuan Shih Division of GastrOenterology Department of Internal MedicineMackay Memorial HospitalTaipeiTaiwanChina

AIM: To evaluate the relationship between clinical information (including age, laboratory data, and sonographic findings) and severe complications, such as gangrene,perforation, or abscess, in patients with acute acalculous cholecystitis (AAC).METHODS: The medical records of patients hospitalized from January1997 to December 2002 with a diagnosis of acute cholecystitis were retrospectively reviewed to find those with AAC, confirmed at operation or by histologic examination. Data collected included age, sex, white blood cell count, AST, total bilirubin, alkaline phosphatase,bacteriology, mortality, and sonographic findings. The sonographic findings were recorded on a 3-point scale with 1 point each for gallbladder distention, gallbladder wall thickness ＞3.5 mm, and sludge. The patients were divided into 2 groups based on the presence (group A) or absence (group B) of severe gallbladder complications, defined as perforation, gangrene, or ***: There were 52 cases of AAC, accounting for 3.7% of all cases of acute cholecystitis. Males *** patients were diagnosed by ultrasonography (48 of 52) or computed tomography (17 of 52). Severe gallbladder complications were present in 27 patients (52 %, group A) and absent in 25(group B).Six patients died with a mortality of 12 %.Four of the 6 who died were in group *** in group A were significantly older than those in group A were significantly older than those in group B (mean 60.88 y vs. 54.12 y, P=0.04) and had a significantly higher white blood cell count (mean 15 885.19 vs. 9 948.40,P=0.0005). All the 6 patients who died had normal white blood cell counts with an elevated percentage of band *** most commonly cultured bacteria in both blood and bile were E. Coli and Klebsiella pneurnoniae. The cumulative sonographic points did not reliably distinguish between groups A and B, even though group A tended to have more ***: Older patients with a high white cell count are more li

关键词：急性胆囊炎并发症临床特点早期诊断急腹症

Ten- year follow- up investigation of stroke risk in systemic lupus erythematosus

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Stroke & Vascular Neurology 2024年第1期9卷 1-7页

作者： Jin-An Huang ching-Heng lin Ming-Ju Wu Yi-Hsing Chen Kuo-Cheng Chang chung-Wei Hou Division of Neurology Neurological InstituteTaichung Veterans General HospitalTaichungTaiwan Department of Health Business Administration Hungkuang UniversityTaichungTaiwan Department of Medical Research Taichung Veterans General HospitalTaichungTaiwan Division of Nephrology Department of Internal MedicineTaichung Veterans General HospitalTaichungTaiwan School of Medicine Chung Shan Medical UniversityTaichungTaiwan College of Medicine National Chung Hsing UniversityTaichungTaiwan Division of Allergy Immunology and RheumatologyDepartment of Internal MedicineTaichung Veterans General HospitalTaichungTaiwan School of Medicine National Yang-Ming Chiao Tung UniversityTaichungTaiwan

Background and purpose To analyse the long-term risk of ischaemic stroke and the clinical effects of antithrombotics on the risk of haemorrhagic stroke in patients with systemic lupus erythematosus(SLE).Methods A retrospective cohort study was conducted using a population-based database taken from Taiwan National Health Insurance Research *** with SLE between 2000 and 2008 were registered and matched with two controls by the index date,age,gender and Charlson Comorbidity Index(CCI).These subjects were followed until either stroke event or 31 December *** HRs(aHRs)for strokes were estimated with Cox regression models,and the cumulative incidence of ischaemic stroke was analysed by log-rank test and Kaplan-Meier survival *** In total,8310 patients with SLE and 16620 patients without SLE were *** general,patients with SLE had higher rates of ischaemic stroke(5.4%vs 3.3%)and haemorrhagic stroke(1.5%vs 0.6%)than in *** multivariate analysis adjusted to age,gender,CCI,urbanisation level and antithrombotics uses,aHRs of all strokes,ischaemic stroke and haemorrhagic stroke were 1.73(95%CI:1.54 to 1.94),1.65(95%CI:1.45 to 1.87)and 2.24(95%CI:1.71 to 2.95),respectively,in patients with *** with SLE were significantly more likely to suffer ischaemic stroke than patients without SLE,even 10 years after SLE diagnosis(6.12%vs 3.50%,p<0.001).Antiplatelet use increased the risk of haemorrhagic stroke in SLE group(aHR=1.74,95%CI:1.18 to 2.57).Conclusions Patients with SLE are at greater risk of developing ischaemic stroke that lasts for 10 *** should be carefully administered to prevent cardiovascular events in patients with SLE due to the risk of haemorrhagic stroke.

关键词： erythematosus diagnosis likely

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

Data-driven Static Equivalence with Physics-informed Koopman Operators

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CSEE Journal of Power and Energy Systems 2024年第1期10卷 432-438页

作者： Wei lin Changhong Zhao Maosheng Gao C.Y.chung Department of Electrical Engineering The Hong Kong Polytechnic UniversityHong Kong SARChina Department of Information Engineering The Chinese University of Hong KongHong Kong SARChina School of Electrical Engineering Chongqing UniversityChongqing 400044China

With deployment of measurement units,fitting static equivalent models of distribution networks(DNs)by linear regression has been recognized as an effective method in power flow analysis of a transmission *** volatility of measurements caused by variable distributed renewable energy sources makes it more difficult to accurately fit such equivalent *** tackle this challenge,this letter proposes a novel data-driven method to improve equivalency accuracy of DNs with distributed energy *** letter provides a new perspective that an equivalent model can be regarded as a mapping from internal conditions and border voltages to border power *** mapping can be established through 1)Koopman operator theory,and 2)physical features of power flow equations at the root node of a *** of the proposed method is demonstrated on the IEEE 33-bus and IEEE 136-bus test systems connected to a 661-bus utility system.

关键词： Data-driven distribution network Koopman operator theory static equivalent model

Mechanically driven assembly of biomimetic 2D-material microtextures with bioinspired multifunctionality

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Nano Research 2024年第2期17卷 663-678页

作者： Yang Li lin Jing Joshua M.Little Haochen Yang Tsai-Chun chung Po-Yen Chen Department of Chemical and Biomolecular Engineering University of MarylandCollege ParkMD 20740USA Maryland Robotics Center University of MarylandCollege ParkMD 20742USA School of Materials Science and Engineering Nanyang Technological University50 Nanyang AvenueSingapore 639798Singapore

Nature provides a wealth of bio-inspiration for advanced material *** various nanomaterials into biomimetic microtextures with bioinspired functionalities has spurred increasing research interests and facilitated technological advances in various *** recent years,two-dimensional materials(2DMs)have emerged as important building block units in the biomimicry field due to their distinct chemical,physical,electrical,electrochemical,and catalytic *** this review article,various mechanically driven assembly approaches are summarized to fabricate various genealogies of biomimetic 2DM microtextures with bio-inspired ***,sequential deformation strategies are discussed to programmably construct higher dimensional 2DM microtextures,ranging from wrinkles/crumples(one-time deformation)to multiscale hierarchies(multiple deformations).Next,the current progress using higher dimensional 2DM microtextures to imitate different biological structures and/or induce bio-inspired multifunctionality is systematically *** showcases of bio-inspiration and biomimicry using different 2DM nanosheets are highlighted:(1)wrinkle patterns of an earthworm that spur the design of strain sensors with programmable working ranges and sensitivities,(2)wrinkle appearance of a Shar-Pei dog that motivates the fabrication of stretchable energy storage devices,(3)hierarchical scale textures of a desert lizard that inspire cation-induced gelation platforms for 2DM aerogels,and(4)wrinkle skin of an elephant that influences the development of 2DM protective skin for soft ***,challenges and future opportunities of adopting 2DM nanosheets to assemble biomimetic microstructures with synergistic functionalities are discussed.

关键词： two-dimensional(2D)materials mechanically driven assembly biomimetic microtextures functional nanocomposite bio-inspired multifunctionality