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Irritable bowel syndrome:The evolution of multi-dimensional looking and multidisciplinary treatments

World Journal of Gastroenterology 2014年第10期20卷 2499-2514页

作者： full-young chang Environmental Health and Safety Office and Division of Gastroenterology Taipei Veterans General Hospitaland National Yang-Ming University School of Medicine Taipei 11217 Taiwan

Irritable bowel syndrome(IBS)is common in the *** the putative pathogeneses,gut dysmotility results in pain and disturbed *** latter is probably caused by the effect of abnormal gut water *** interaction between abnormal gas accumulation,abdominal pain and bloating remains *** hypersensitivity and its modification along with the central transmission are the characteristics of IBS *** identification of biologic markers based on genetic polymorphisms is *** gut microbiota may alter epithelial permeability to activate nociceptive sensory pathways which in turn lead to *** food constituents may exacerbate bowel *** impact of adult and childhood abuses on IBS is *** the concept of biopsychosocial dysfunction can integrate multidimensional *** plus stool consistency modifiers to treat the major symptoms and defecation are the first-line drug *** drugs targeting receptors governing bowel motility,sensation and secretion can be considered,but clinicians must be aware of their potential serious side *** drugs and modalities may be the final options for treating intractable *** of multi-species preparations are safe and worth to be considered for the *** are promising but their longterm safety and effectiveness are *** therapy including exclusion of certain food constituents is an economic *** relatively safe complementary and alternative medicines(CAMs)may be optional to those patients who failed classical *** conclusion,IBS is a heterogeneous disorder with multidimensional *** medicines with multidisciplinary approaches using different classes of drugs,psychiatric measures,probiotics and antibiotics,dietary therapy,and finally CAMs,can be considered.

关键词： Antispasmodics Biopsychosocial dysfunction Comorbidity Genetics Irritable bowel syndrome Microbiota Probiotics Visceral hyperalgesia

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Life-threatening hemobilia caused by hepatic artery pseudoaneurysm: A rare complication of chronic cholangitis

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World Journal of Gastroenterology 2003年第12期9卷 2883-2884页

作者： Tsu-Te Liu Ming-Chih Hou Han-ChiehLin full-young chang Shou-Dong Lee Division of Gastroenterology Department of MedicineTaipei-Veterans General Hospitaland School of MedicineNational Yang Ming UniversityTaipeiTaiwanChina

Hemobilia is one of the causes of obscure gastrointestinal haemorrhage. Most cases of hemobilia are of iatrogenic or traumatic origin. Hemobilia caused by a hepatic artery pseudoaneurysm due to ascending cholangitis is very rare and its mechanism is undear. We report a 74-year-old woman with a history of surgery for choledocholithiasis 30 years ago, suffering from a protracted course of life-threatening gastrointestinal bleeding. A small intestines series and endoscopic retrograde cholangiopancreatography revealed a chronic cholangitis with marked contrast reflux into the biliary tree. Angiography confirmed the bleeding from a pseudoaneurysm of the middle hepatic artery. Coil embolization achieved successful hemostasis. We discussed the mechanism and reviewed the literature.

关键词：胆道出血肝动脉假动脉瘤并发症慢性胆管炎

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World Journal of Gastroenterology 2005年第47期11卷 7494-7498页

作者： Shih-Chao Kang Shinn-Jang Hwang Shiang-Ho Lee full-young chang Shou-Dong Lee Division of Family Medicine I-Lan HospitalDepartment of HealthI-LanTaiwanChina Department of Family Medicine Taipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina Shiang-Ho Clinic TaipeiTaiwanChina Division of Gastroenterology Department of MedicineTaipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina

AIM. To evaluate health-related quality of life （HRQOL） in Chinese patients with chronic hepatitis C （CH-C）, and the impact of antiviral treatment. METHODS： Short Form 36 （SF-36） Health-related Quality of Life Questionnaires to interview CH-C patients, and age- and sex-matched control subjects at outpatient clinics of a medical center in Taiwan were used. Data were transformed to scores for comparisons of eight major SF-36 domains. We also enrolled consecutive CH-C patients who completed one course of antiviral treatment （interferon α with ribavirin）, and measured the HRQOL before, at the 12m wk of treatment, at the end of treatment, and at mo 6, after stopping the treatment to evaluate the impact of antiviral treatment. RESULTS： A total of 371 outpatients were enrolled, including 182 with CH-C and 189 age- and sex-matched subjects without CH-C. CH-C subjects had obviously lower educational status （P〈0.01）. Mean scores of domains in general health, physical functioning, role-physical, role-emotional, vitality, and mental health of the SF-36 were significantly lower in subjects with CH-C than those without CH-C （P〈0.05）. In an analysis of 47 CH-C patients who received and completed the whole course of antiviral treatment, mean scores of all domains were significantly lower at wk 12 of treatment compared to baseline. The scores returned to pretreatment values by the end of treatment, but were significantly increased at mo 6 after stopping the treatment. Among the 47 CH-C patients, 21 had sustained responses and 26 had nonsustained responses to antiviral treatment. Compared to pretreatment values, subjects with sustained responses had significantly lower social functioning scores at wk 12 of treatment, and scores for all SF-36 domains returned to pretreatment values, and increased significantly at mo 6 after stopping the treatment. For non-sustained virological responders, scores of all SF-36 domains significantly decreased at wk 12 of treatment, and did not increa

关键词： Hepatitis C Quality of life Questionnaire

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Esomeprazole tablet vs omeprazole capsule in treating erosive esophagitis

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World Journal of Gastroenterology 2005年第20期11卷 3112-3117页

作者： Chih-Yen Chen Ching-Liang Lu Jiing-Chyuan Luo full-young chang Shou-Dong Lee Yung-Ling Lai Division of Gastroenterology Department of Medicine Taipei Veterans General Hospital and School of MedicineNational Yang-Ming University Taipei Taiwan China AstraZeneca Taiwan Limited Taipei Taiwan China

AIM: Esomeprazole, an oral S-form of omeprazole, has been a greater acid inhibitor over omeprazole in treating acid-related diseases. Only less published data is available to confirm its efficacy for Asian people. Therefore, a perspective, double-blind, randomized comparison of esomeprazole tablets 40 mg (Nexium(?)) vs omeprazole capsules 20 mg (Losec(?)) in treating Chinese subjects with erosive/ulcerative reflux esophagitis (EE) was conducted. METHODS: A total of 48 EE patients were enrolled and randomized into two treatment groups under 8-wk therapy: 25 receiving esomeprazole, while another 23 receiving omeprazole treatment. Finally, 44 completed the whole 8-wk therapy. RESULTS: The difference in healing EE between two groups was 22.7% (72.7% vs 50.0%), not reaching significant value (P = 0.204). The median of the first time needed in relieving heartburn sensation was 1 d for both groups and the remission rates for heartburn on the 1st d after treatment were 77.3% and 65%, respectively (NS). The scores of various reflux relieving symptoms evaluated either by patients or by investigators were not different. Regarding drug safety, 28% of esomeprazole group and 26.1% of omeprazole group reported at least one episode of adverse effects, while constipation and skin dryness were the common side effects in both groups (NS). CONCLUSION: Esomeprazole 40 mg is an effective and safe drug at least comparable to omeprazole in treating Chinese EE patients.

关键词： Esomeprazole Someprazole Esophagitis

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Hematemesis as the initial complication of pancreatic adenocarcinoma directly invading the duodenum: A case report

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World Journal of Gastroenterology 2005年第5期11卷 767-769页

作者： Yueh-Hung Lin Chih-Yen Chen Chih-Ping Chen Tien-Yin Kuo full-young chang Shou-Dong Lee Division of Gastroenterology Department of Medicine Taipei Veterans General Hospital and School of MedicineNational Yang-Ming UniversityTaipeiTaiwanChina Department of HealthTao-Yuan General Hospital Tao-Yuan TaiwanChina Division of Gastroenterology

Pancreatic carcinoma is a debilitating disease and carries a poor prognosis. It is a rare cause of upper gastrointestinal bleeding, even though pancreas, stomach, duodenum and jejunum are adjacent organs. The incidence of pancreatic adenocarcinoma directly invading the gastrointestinal tract leading to gastrointestinal hemorrhage is very low, and most of them present with melena and hematochezia. Here, we describe one unique case manifesting characteristically severe and unremitting hematemesis as an initial presentation of pancreatic adenocarcinoma. This tumor directly invaded the duodenal mucosa as a bleeding protruding tumor mass. Our MEDLINE search has confirmed that this is the first reported case with an initial manifestation of hematemesis from pancreatic adenocarcinoma in *** adenocarcinoma directly invading duodenum complicated by hemorrhage can be a rare cause of hematemesis, and clinicians should be reminded of it while they are making differential diagnosis.

关键词： Pancreatic adenocarcinoma Duodenum tumor Hematemesis Neoplasm invasiveness

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Response of blood endothelin-1 and nitric oxide activity in duodenal ulcer patients undergoing Helicobacter pylori eradication

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World Journal of Gastroenterology 2005年第7期11卷 1048-1051页

作者： full-young chang Chih-Yen Chen Ching-Liang Lu Jiing-Chyuan Luo Rei-Hwa Lu Shou-Dong Lee Division of Gastroenterology

AIM: To investigate the effect of Helicobacter pylori eradication on endothelin-1 (ET-1) and nitric oxide (NO) in duodenal ulcer (DU) patients. METHODS: Sixty-six Hpylori-infected active DU patients were consecutively enrolled to receive one-week triple therapy (rabeprazole, amoxicillin and metronidazole) and then one-month rabeprazole therapy. They were asked back to determine ulcer and Hpylori status using endoscopy one month later. Thirty-seven healthy controls (H pylori +/-:17/20) were enrolled for comparison. Blood samples were collected in each visit to measure plasma ET-1 and nitrate/nitrite levels using an enzyme immunoassay kit. RESULTS: Sixty DU patients finished trial per protocol. The ulcer healing and Hpylori-eradication rates were 86.7% and 83.3%, respectively. Plasma ET-1 level in DU patients was higher than that of Hpylori-negative and positive controls (3.59±0.96 vs0.89±0.54 vs0.3±0.2 pg/mL,P<0.01), while nitrate/nitrite levels among them were also significantly different (8.55±0.71 vs5.27±0.68 vs 6.39±0.92 μmol/L, P<0.05). H pylori eradication diminished ET-1 levels (3.64±0.55 vs2.64±0.55 pg/mL, P<0.01) but elevated nitrate/ nitrite level (8.16±0.84 vs11.41±1.42 umol/L,P<0.05). CONCLUSION: Both plasma ET-1 and nitrate/nitrite levels increase in active DU patients. After an effective H pylori eradication, DU healing is associated with diminished blood ET-1 level and elevated nitrate/nitrite level.

关键词： Duodenal ulcer Endothelin-1 Helicobacter pylori Nitric oxide

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Surgical resection of duodenal lymphangiectasia: A case report

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World Journal of Gastroenterology 2003年第12期9卷 2880-2882页

作者： Chih-Ping Chen Yee Chao Chung-Pin Li Wen-Ching Lo Chew-Wun Wu Shyh-Haw Tsay Rheun-Chuan Lee full-young chang Division of Gastroenterology Department of MedicineTaipei Veterans General Hospital and Institute of Clinical MedicineNational Yang-Ming University School of MedicineTaipeiTaiwanChina Cancer Center Taipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina Division of General Surgery Department of SurgeryTaipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina Department of Pathology Taipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina Department of Radiology Taipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina

Intestinal lymphangiectasia, characterized by dilatation of intestinal lacteals, is rare. The major treatment for primary intestinal lymphangiectasia is dietary modification. Surgery to relieve symptoms and to clarify the etiology should be considered when medical treatment failed. This article reports a 49-year-old woman of solitary duodenal lymphangiectasia, who presented with epigastralgia and anemia. Her symptoms persisted with medical *** was finally performed to relieve the symptoms and to exclude the existence of underlying etiologies, with satisfactory effect. In conclusion, duodenal lymphangiectasia can present clinically as epigastralgia and chronic blood loss. Surgical resection may be resorted to relieve pain,control bleeding, and exclude underlying diseases in some patients.

关键词：十二指肠淋巴管扩张外科治疗十二指肠切除术临床症状病例报告

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Spider angiomas in patients with liver cirrhosis: Role of vascular endothelial growth factor and basic fibroblast growth factor

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World Journal of Gastroenterology 2003年第12期9卷 2832-2835页

作者： Chun-Pin Li Fa-Yauh Lee Shinn-Jang Hwang Rei-Hwa Lu Wei-Ping Lee Yee Chao Sung-Sang Wang full-young chang Jacqueline Whang-Peng Shou-Dong Lee Division of Gastroenterology Department of MedicineTaipei Veterans General Hospital and Institute of Clinical MedicineNational Yang-Ming University School of MedicineTaipeiTaiwanChina Cancer Center Taipei Veterans General Hospital and National Yang-Ming University School of MedicineTaipeiTaiwanChina Cancer Research Division National Health Research Institutes and Institute of Clinical MedicineNational Yang-Ming University School of MedicineTaipeiTaiwanChina

AIM: To investigate whether vascular endothelial growth factor (VEGF) and basic fibroblastic growth factor (bFGF) are associated wibh spider angiomas in patients wibh liver cirrhosis. METHODS: Eighty-six patients with liver cirrhosis were enrolled and the number and size of the spider angiomas were recorded. Fifty-three healthy subjects were selected as controls. Plasma levels of VEGF and bFGF were measured in both the cirrhotics and the controls. RESULTS: Plasma VEGF and bFGF were increased in cirrhotics compared with controls (122±13 vs. 71±11 pg/mL, P=0.003 for VEGF; 5.1±0.5 vs. 3.4±0.5 pg/mL, P=0.022 for bFGF). In cirrhotics, plasma VEGF and bFGF were also higher in patients with spider angiomas compared with patients without spider angiomas (185±28 vs. 90±10 pg/mL, P=-0.003 for VEGF; 6.8±1.0 vs. 4.1±0.5 pg/mL, P=0.017 for bFGF). Multivariate logistic regression showed that young age and increased plasma levels of VEGF and bFGF were the most significant predictors for the presence of spider angiomas in cirrhotic patients (odds ratio [OR]=6.64, 95% confidence interval[CI]=2.02-21.79, P=0.002; OR=4.35, 95% CI=1.35-14.01,P=0.014; OR=5.66, 95% CI=1.72-18.63, P=0.004, respectively). CONCLUSION: Plasma VEGF and bFGF are elevated inpatients with liver cirrhosis. Age as well as plasma levels of VEGF and bFGF are significant predictors for spider angiomas in cirrhotic patients.

关键词：血管内皮生长因子基质纤维原细胞生长因子肝硬化蛛形血管瘤作用机制

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Indolocarbazole-Based Small Molecule Cathode-Active Material Exhibiting Double Redox for High-Voltage Li-Organic Batteries

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Energy & Environmental Materials 2024年第5期7卷 90-98页

作者： Hyunji Park Hyojin Kye Jong-Sung Lee young-chang Joo Dong Joo Min Bong-Gi Kim Soo young Park Ji Eon Kwon Laboratory for Supramolecular Optoelectronic Materials (LSOM) Department of Materials Science and Engineering Research Institute of Advanced Materials (RIAM) Seoul National University Functional Composite Materials Research Center Jeonbuk Institute of Advanced Composite Materials Korea Institute of Science and Technology (KIST) Department of Organic and Nano System Engineering Konkuk University Department of Materials Science and Engineering Seoul National University Department of JBNU-KIST Industry Academia Convergence Research Jeonbuk National University

Most organic electrode materials （OEMs） for rechargeable batteries employ n-type redox centers, whose redox potentials are intrinsically limited <3.0 V versus Li+/Li. However, p-type materials possessing high redox potentials experience low specific capacities because they are capable of only a single redox reaction within the stable electrochemical window of typical ***, we report 5,11-diethyl-5,11-dihydroindolo[3,2-b]carbazole （DEICZ） as a novel p-type OEM, exhibiting stable plateaus at high discharge potentials of3.44 and 4.09 V versus Li+/Li. Notably, the second redox potential of DEICZ is within the stable electrochemical window. The mechanism of the double redox reaction is investigated using both theoretical calculations and experimental measurements, including density functional theory calculations, ex situ electron spin resonance, and X-ray photoelectron spectroscopy. Finally,hybridization with single-walled carbon nanotubes （SWCNT） improves the cycle stability and rate performance of DEICZ owing to theπ–πinteractions between the SWCNT and co-planar molecular structure of DEICZ, preventing the dissolution of active materials into the electrolyte. The DEICZ/SWCNT composite electrode maintains 70.4%of its initial specific capacity at 1-C rate and also exhibits high-rate capability, even performing well at 100-C rate.

关键词： composite electrodes flexible batteries indolocarbazoles organic rechargeable batteries p-type

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Long-term outcome of stem cell transplantation with and without anti-tumor necrotic factor therapy in perianal fistula with Crohn’s disease

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World Journal of Stem Cells 2024年第3期16卷 257-266页

作者： Min young Park Yong Sik Yoon Jae Ha Park Jong Lyul Lee chang Sik Yu Division of Colon and Rectal Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722South Korea Division of Colon and Rectal Surgery Department of SurgeryUniversity of Ulsan College of MedicineAsan Medical CenterSeoul 05505South Korea

BACKGROUND Stem cell transplantation is a promising therapeutic option for curing perianal fistula in Crohn’s disease(CD).Anti-tumor necrotic factor(TNF)therapy combined with drainage procedure is effective as ***,previous studies are limited to proving whether the combination treatment of biologics and stem cell transplantation improves the effect of fistula *** This study aimed to evaluate the long-term outcomes of stem cell transplantation and compare Crohn’s perianal fistula(CPF)closure rates after stem cell transplantation with and without anti-TNF therapy,and to identify the factors affecting CPF closure and *** The patients with CD who underwent stem cell transplantation for treating perianal fistula in our institution between Jun 2014 and December 2022 were *** data were compared according to anti-TNF therapy and CPF *** A total of 65 patients were *** median age of females was 26 years(range:21-31)and that of males was 29(44.6%).The mean follow-up duration was 65.88±32.65 months,and complete closure was observed in 50(76.9%)*** closure rates were similar after stem cell transplantation with and without anti-TNF therapy(66.7%vs 81.6%at 3 year,P=0.098).The patients with fistula closure had short fistulous tract and infrequent proctitis and anorectal stricture(P=0.027,0.002,and 0.008,respectively).Clinical factors such as complexity,number of fistulas,presence of concurrent abscess,and medication were not significant for *** cumulative 1-,2-,and 3-year closure rates were 66.2%,73.8%,and 75.4%,*** Anti-TNF therapy does not increase CPF closure rates in patients with stem cell ***,both refractory and non-refractory CPF have similar closure rates after additional anti-TNF *** tract length,proctitis,and anal stricture are risk factors for non-closure in patients with CPF after stem cell transplantation.

关键词： Crohn’s disease Anus Fistula Stem cell transplantation Tumor necrosis factor-alpha inhibitors Infliximab

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