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World journal of Gastrointestinal Surgery 2021年第8期13卷 734-755页

作者： Frederick H Koh jason MW Chua joselyn Lj Tan fung-j.on foo Winson j Tan Sharmini S Sivarajah Leonard Ming Li Ho Bin-Tean Teh Min-Hoe Chew Division of Surgery Sengkang General HospitalSingapore 544886Singapore Institute of Molecular and Cell Biology Agency for Science Technology and ResearchSingapore 138673Singapore Duke-NUS Graduate Medical School National Cancer Centre SingaporeSingapore 169610Singapore

A growing body of evidence has demonstrated the prognostic significance of sarcopenia in surgical patients as an independent predictor of postoperative complications and *** included an increased risk of total complications,major complications,re-admissions,infections,severe infections,30 d mortality,longer hospital stay and increased hospitalization expenditures.A program to enhance recovery after surgery was meant to address these complications;however,compliance to the program since its introduction has been less than *** the last decade,the concept of prehabilitation,or"pre-surgery rehabilitation",has been *** presurgical period represents a window of opportunity to boost and optimize the health of an individual,providing a compensatory"buffer"for the imminent reduction in physiological reserve *** results have been *** review the literature to critically review the utility of prehabilitation,not just in the clinical realm,but also in the scientific realm,with a resource management point-of-view.

关键词： Sarcopenia Prehabilitation Surgery Frailty Value Gastrointestinal surgery

Evaluation of carbon-based nanosorbents synthesised by ethylene decomposition on stainless steel substrates as potential sequestrating materials for nickel ions in aqueous solution

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journal of Environmental Sciences 2012年第9期24卷 1559-1568页

作者： X.j.Lee L.Y.Lee L.P.Y.foo D.G.Hassell Department of Chemical and Environmental Engineering University of Nottingham Malaysia CampusJalan Broga43500 SemenyihSelangor Darul EhsanMalaysia.

The present work covers the preparation of carbon-based nanosorbents by ethylene decomposition on stainless steel mesh without the use of external catalyst for the treatment of water containing nickel ions （Ni2＋）. The reaction temperature was varied from 650 to 850℃, while reaction time and ethylene to nitrogen flow ratio were maintained at 30 rain and 1：1 cma/min, respectively. Results show that nanosorbents synthesised at a reaction temperature of 650℃ had the smallest average diameter （75 nm）, largest BET surface area （68.95 m2/g） and least amount of impurity （0.98 wt.% Fe）. A series of batch sorption tests were performed to evaluate the effects of initial pH, initial metal concentration and contact time on Ni2~ removal by the nanosorbents. The equilibrium data fitted well to Freundlich isotherm. The kinetic data were best correlated to a pseudo second-order model indicating that the process was of chemisorption type. Further analysis by the Boyd kinetic model revealed that boundary layer diffusion was the controlling step. This primary study suggests that the prepared material with Freundiich constants compared well with those in the literature, is a promising sorbent for the sequestration of Ni2＋ in aqueous solutions.

关键词： adsorption nanosorbent nickel ions isotherms kinetics

Claudin-11 and occludin are major contributors to Sertoli cell tight junction function, in vitro

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Asian journal of Andrology 2016年第4期18卷 620-626页

作者： Mark j McCabe Caroline FH foo Marcel E Dinger Peter M Smooker Peter G Stanton Male Fertility Regulation Laboratory Hudson Institute of Medical Research Monash Medical Centre Clayton Victoria 3168 Australia School of Applied Sciences Royal Melbourne Institute of Technology University Bundoora Victoria 3088 Australia Kinghorn Centre for Clinical Genomics Garvan Institute of Medical Research Darlinghurst New South Wales 2010 Australia St Vincent's Clinical School UNSW Sydney New South Wales 2052 Australia.

The Sertoli cell tight junction （T j） is the key component of the blood-testis barrier, where it sequesters developing germ cells undergoing spermatogenesis within the seminiferous tubules. Hormonally regulated claudin-11 is a critical transmembrane protein involved in barrier function and its murine knockout results in infertility. We aimed to assess quantitatively the significance of the contribution of claudin-11 to Tj function, in vitro, using siRNA-mediated gene silencing. We also conducted an analysis of the contribution of occludin, another intrinsic transmembrane protein of the Tj. Silencing of claudin-11 and/or occludin was conducted using siRNA in an immature rat Sertoli cell culture model. Transepithelial electrical resistance was used to assess quantitatively Tj function throughout the culture. Two days after siRNA treatment, cells were fixed for immunocytochemical localization of junction proteins or lyzed for RT-PCR assessment of mRNA expression. Silencing of claudin-11, occludin, or both resulted in significant decreases in Tj function of 55% （P 〈 0.01）, 51% （P 〈 0.01）, and 62% （P 〈 0.01）, respectively. Data were concomitant with significant decreases in mRNA expression and marked reductions in the localization of targeted proteins to the Sertoli cell Tj. We provide quantitative evidence that claudin-11 contributes significantly （P 〈 0.01） to Sertoli cell Tj function in vitro. Interestingly, occludin, which is hormonally regulated but not implicated in infertility until late adulthood, is also a significant （P 〈 0.01） contributor to barrier function. Our data are consistent with in vivo studies that clearly demonstrate a role for these proteins in maintaining normal Tj barrier structure and function.

关键词： blood-testis barrier claudin-11 occludin Sertoli cell tight junction siRNA

Pyogenic liver abscess:An audit of 10 years’experience

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World journal of Gastroenterology 2011年第12期17卷 1622-1630页

作者： Tony CY Pang Thomas fung jaswinder Samra Thomas j Hugh Ross C Smith Upper Gastrointestinal Surgical Unit Royal North Shore HospitalUniversity of SydneySt Leonards NSW 2065Australia

AIM:To describe our own experience with pyogenic liver abscesses over the past 10 years and investigate the risk factors associated with failure of initial percutaneous ***:A retrospective study of records of 63 PLA patients presenting between 1998 and 2008 to Australian tertiary referral centre,were *** and hydatid abscesses were ***,clinical,radiological,and microbiological characteristics,as well as surgical/radiological interventions,were ***:Sixty-three patients(42 males,21 females) aged 65(±14) years[mean±(SD) ]had prodromal symptoms for a median(interquartile range;IQR) of 7(5-14) *** 59%of patients were febrile at presentation;however,the serum C-reactive protein was elevated in all 47 in whom it was *** function tests were non-specifically abnormal.67%of patients had a solitary abscess,while 32%had>3 abscesses with a median(IQR) diameter of 6.3(4-9) *** organisms were:Streptococcus milleri 25%,Klebsiella pneumoniae 21%,and Escherichia coli 16%.A presumptive cryptogenic cause was most common (34%).Four patients died in this series:one from sepsis,two from advanced cancer,and one from acute myocardial *** initial procedure was radiological aspiration±drainage in 54 and surgery in two patients.17%underwent surgical management during their *** hypoalbuminaemia[mean (95%CI) :32(29-35) g/L vs 28(25-31) g/L,P=0.045] on presentation was found to be the only factor related to failure of initial percutaneous therapy on univariate ***:PLA is a diagnostic challenge,because the presentation of this condition is *** antibiotics and radiological drainage in the first instance allows resolution of most PLAs;However,a small proportion of patients still require surgical drainage.

关键词： Pyogenic liver abscess Image guided drainage Surgical drainage C-reactive protein Hypoalbuminaemia

Is colonic lavage a suitable alternative for left-sided colonic emergencies?

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World journal of Gastrointestinal Surgery 2021年第4期13卷 379-391页

作者： Hui Yu Tham Wen Hui Lim Sneha Rajiv jain Cheng Han Mg Snow Yunni Lin jie Ling Xiao fung j.on foo Kar Yong Wong Choon Seng Chong Department of Surgery University Surgical ClusterNational University HospitalSingapore 11759Singapore Department of Medicine Yong Loo Lin School of MedicineNational University of SingaporeSingapore 11759Singapore Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of General Surgery Sengkang HealthSingapore 544886Singapore Colorectal Surgery Service Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Division of Colorectal Surgery University Surgical ClusterNational University Health SystemSingapore 119228Singapore Department of General Surgery Yong Loo Lin School of MedicineNational University of SingaporeSingapore 119228Singapore

BACKGROUND The use of intra-operative colonic lavage(IOCL)with primary anastomosis remains controversial in the emergency left-sided large bowel pathologies,with alternatives including Hartmann’s procedure,manual decompression and subtotal *** To compare the peri-operative outcomes of IOCL to other *** Electronic databases were searched for articles employing IOCL from inception till july 13,*** ratio and weighted mean differences(WMD)were estimated for dichotomous and continuous outcomes ***-arm meta-analysis was conducted using DerSimonian and Laird random *** Of 28 studies were included in this meta-analysis,involving 1142 undergoing IOCL,and 634 other *** leads to comparable rates of wound infection when compared to Hartmann’s procedure,and anastomotic leak and wound infection when compared to manual *** was a decreased length of hospital stay(WMD=-7.750;95%CI:-13.504 to-1.996;P=0.008)compared to manual decompression and an increased operating ***-arm meta-analysis found that overall mortality rates with IOCL was 4%(CI:0.03-0.05).Rates of anastomotic leak and wound infection were 3%(CI:0.02-0.04)and 12%(CI:0.09-0.16)*** IOCL leads to similar rates of post-operative complications compared to other *** extensive studies are needed to assess the outcomes of IOCL for emergency left-sided colonic surgeries.

关键词： Colon Colonic irrigation Intra-operative colonic lavage Anastomosis Emergency surgery Colonic neoplasm

Benchmarking graph neural networks for materials chemistry

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npj Computational Materials 2021年第1期7卷 739-746页

作者： Victor fung jiaxin Zhang Eric juarez Bobby G.Sumpter Center for Nanophase Materials Sciences Oak Ridge National LaboratoryOak RidgeTNUnited States Computer Science and Mathematics Division Oak Ridge National LaboratoryOak RidgeTNUnited States

Graph neural networks(GNNs)have received intense interest as a rapidly expanding class of machine learning models remarkably well-suited for materials *** date,a number of successful GNNs have been proposed and demonstrated for systems ranging from crystal stability to electronic property prediction and to surface chemistry and heterogeneous ***,a consistent benchmark of these models remains lacking,hindering the development and consistent evaluation of new models in the materials ***,we present a workflow and testing platform,MatDeepLearn,for quickly and reproducibly assessing and comparing GNNs and other machine learning *** use this platform to optimize and evaluate a selection of top performing GNNs on several representative datasets in computational materials *** our investigations we note the importance of hyperparameter selection and find roughly similar performances for the top models once *** identify several strengths in GNNs over conventional models in cases with compositionally diverse datasets and in its overall flexibility with respect to inputs,due to learned rather than defined *** several weaknesses of GNNs are also observed including high data requirements,and suggestions for further improvement for applications in materials chemistry are discussed.

关键词： field chemistry intense

Liver transplantation in patients with incidental hepatocellular carcinoma/cholangiocarcinoma and intrahepatic cholangiocarcinoma： a single-center experience

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Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 264-270页

作者： Mohammed Elshamy Naftali Presser Abdulrahman Y Hammad Daniel j Firl Christopher Coppa john fung Federico N Aucejo Hepatobiliary and Transplant Surgery Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA Imaging Institute Cleveland Clinic Cleveland OH USA

BACKGROUND： Reports of fiver transplantation （LT） in patients with mixed hepatocellular carcinoma/cholangiocarcinoma （HCC/CC） and intrahepatic cholangiocarcinoma （ICC） are modest and have been mostly retrospective after pathological categorization in the setting of presumed HCC. Some studies suggest that patients undergoing LT with small and unifocal ICC or mixed HCC/CC can achieve about 40%-60% 5-year post-transplant survival. The study aimed to report our experience in patients undergoing LT with explant pathology revealing HCC/CC and ICC. METHODS： From a prospectively maintained database, we performed cohort analysis. We identified 13 patients who underwent LT with explant pathology revealing HCC/CC or ICC. RESULTS： The observed recurrence rate post-LT was 31% （4/13） and overall survival was 85%, 51%, and 51% at 1, 3 and 5 years, respectively. Disease-free survival was 68%, 51%, and 41% at 1, 3 and 5 years, respectively. In our cohort, four patients would have qualified for exception points based on updated HCC Organ Procurement and Transplantation Network imaging guidelines. CONCLUSIONS： Lesions which lack complete imaging characteristics of HCC may warrant pre-LT biopsy to fully elucidate their pathology. Identified patients with early HCC/CC or ICC may benefit from LT if unresectable. Additionally, incorporating adjunctive perioperative therapies such as in the case of patients undergoing LT with hilar cholangiocarcinoma may improve outcomes but this warrants further investigation.

关键词： mixed hepatocellular carcinoma/ cholangiocarcinoma liver transplantation survival outcomes

Endoscopic ultrasound in chronic liver disease

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World journal of Hepatology 2020年第6期12卷 262-276页

作者： Brian M fung Alexander P Abadir Armen Eskandari Michael j Levy james H Tabibian Department of Medicine Olive View-UCLA Medical CenterSylmarCA 91342United States Department of Medicine University of California Irvine Medical CenterOrangeCA 92868United States Division of Gastroenterology and Hepatology University of California Davis Medical CenterSacramentoCA 95817United States Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55905United States Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCA 91342United States

Endoscopic ultrasound(EUS)is a minimally invasive diagnostic and therapeutic modality with a number of established as well as evolving uses in patients with chronic liver *** to other diagnostic tools such as cross-sectional imaging or conventional endoscopy,EUS has been shown to increase diagnostic sensitivity and therapeutic success for many clinical scenarios and applications with a low rate of adverse *** this review,we discuss and focus on the current and growing role of EUS in the evaluation and/or treatment of hepatobiliary masses,hepatic parenchymal disease,portal hypertension,esophageal and other varices,and indeterminate biliary strictures.

关键词： Endoscopy Cirrhosis Liver mass Liver biopsy Variceal bleeding

Biliary endoscopy in the management of primary sclerosing cholangitis and its complications

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Liver Research 2019年第2期3卷 106-117页

作者： Brian M.fung james H.Tabibian University of California Los Angeles-Olive View Internal Medicine Residency Program SylmarCAUSA Division of Gastroenterology Department of MedicineOlive View-University of California Los Angeles Medical CenterSylmarCAUSA

Primary sclerosing cholangitis(PSC)is a chronic,idiopathic,cholestatic liver disease characterized by inflammation and fibrosis of the intrahepatic and/or extrahepatic bile *** can affect individuals of all age groups and gender,has no established pharmacotherapy,and is associated with a variety of neoplastic(***)and non-neoplastic(*** strictures)hepatobiliary *** these considerations,endoscopy plays a major role in the care of patients with *** this review,we discuss and provide updates regarding endoscopic considerations in the management of hepatobiliary manifestations and complications of *** evidence is limited,we suggest pragmatic approaches based on currently available data and expert opinion.

关键词： Primary sclerosing cholangitis(PSC) Biliary tract disease Balloon dilation Cholangioscopy Dominant stricture Cholangiocarcinoma(CCA) Endoscopic retrograde cholangiopancreatography(ERCP)

Bioartificial liver assist devices in support of patients with liver failure

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Hepatobiliary & Pancreatic Diseases International 2002年第1期1卷 18-25页

作者： john F.PatzerⅡ Roberto C.Lopez George V.Mazariegos john j.fung From the Thomas E Starzl Transplantation Institute

Bioartificial liver assist devices (BALs) offer anopportunity for critical care physicians and transplantsurgeons to stabilize patients prior to orthotopic livertransplantation. Such devices may also act as a bridgeto transplant, providing liver support to patientsawaiting transplant, or as support for patients post liv-ing-related donor transplant. Four BAL devices thatrely on hepatocytes cultured in hollow fiber membranecartridges (Circe Biomedical HepatAssist (r), VitagenELADTM, Gerlach BELS, and Excorp Medical BLSS)are currently in various stages of clinical evalua-tion. Comparison of the four devices shows that severalunique approaches based upon the same overall systemarchitecture are possible. Preliminary results of theExcorp Medical BLSS Phase I safety evaluation at theUniversity of Pittsburgh, after treating four patients(F, 41, acetominophen-induced, two support periods;M, 50, Wilson's disease, one support period; F, 53, a-cute alcoholic hepatitis, two support periods; F, 24,chemotherapy-induced, one support period) are pre-sented. All patients presented with hypoglycemia andtransient hypotension at the start of extracorporealperfusion. Hypoglycemia was treated by IV dextroseand the transient hypotension responded positively toIV fluid bolus. Heparin anticoagulation was used onlyin the second patient. No serious or adverse eventswere noted in the four patients. Moderate biochemicalresponse to support was noted in all patients. Morecomplete characterization of the safety of the BLSSrequires completion of the Phase I safety evaluation.

关键词： bioartificial liver acute liver failure hepatocytes