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Combined resection and multi-agent adjuvant chemotherapy for desmoplastic small round cell tumor arising in the abdominal cavity:Report of a case

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World Journal of Gastroenterology 2006年第5期12卷 800-803页

作者： Chang-Cheng Chang Jun-Te Hsu jeng-Hwei Tseng Tsann-Long Hwang Han-Ming Chen Yi-Yin Jan Department of Surgery Chang Gung Memorial Hospital Taoyuan Taiwan China Department of Radiology Chang Gung Memorial Hospital Taoyuan Taiwan China

Desmoplastic small round cell tumor （DSRCT） is a rare, highly aggressive malignancy with distinctive histological features： a nesting pattern of cellular growth within dense desmoplastic stroma, occurring in young population with male predominance. The mean survival period is only about 1.5-2.5 years. The tumor has co-expressed epithelial, muscle, and neural markers in immunohistochemical studies. This work reports a 27-year-old man presenting with hematemesis and chronic constipation. Serial studies including endoscopy, upper gastrointestinal series, abdominal computed tomography and barium enema study showed disseminated involvement of visceral organs. The patient underwent aggressive surgery and received postoperative adjuvant chemotherapy consisting of 5-fluorouracil, cyclophosphamide, etoposide, doxorubicin, and cisplatin. He survived without any disease for 20 mo after the surgery. No standard treatment protocol has been established. Aggressive surgery combined with postoperative multi-agent adjuvant chemotherapy is justified not only to relieve symptoms but also to try to improve the outcome in this advanced DSRCT young patient.

关键词： Desmoplastic small round cell tumor Surgery, Chemotherapy

Role of proton pump inhibitors in the management of peptic ulcer bleeding

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2010年第2期1卷 51-53页

作者： Hwai-jeng Lin Department of Medicine Division of GastroenterologyChanghua Christian Hospital

Peptic ulcer bleeding is a serious medical problem with significant morbidity and *** therapy significantly reduces further bleeding,surgery and mortality in patients with bleeding peptic ulcers and is now recommended as the first hemostatic modality for these *** efficacy of large-dose proton pump inhibitor(PPI) therapy in reducing re-bleeding after endoscopic therapy has been supported by evidence derived from randomized controlled *** may be premature to recommend small-dose intravenous injection PPI after endoscopic hemostasis in patients with bleeding *** updated systematic review shows that PPI therapy before endoscopy significantly reduces the proportion with major stigmata and requirement for endoscopic therapy at index *** studies show that there is no significant difference between oral and intravenous PPIs in raising intragastric ***,clinical data is lacking in patients with peptic ulcer bleeding to date.

关键词： Proton pump inhibitor Peptic ulcer bleeding Re-bleeding Hemostasis Endoscopic therapy

Does surgical resection of hepatocellular carcinoma accelerate cancer dissemination?

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World Journal of Gastroenterology 2004年第1期10卷 31-36页

作者： I-ShyanSheen Kuo-Shyangjeng Shou-ChuanShih Po-ChuanWang Wen-HsiungChang horng-YuanWang Li-RungShyung Shee-ChanLin Chin-RoaKao Yi-ChunTsai Tsu-YenWu DivisionsofHepatogastroenterology ChangGungMemorialHospitalTaipeiTaiwanChina DepartmentsofSurgery MackayMemorialHospitalTaipeiTaiwanChina DepartmentofIntemalMedicine MackayMemorialHospitalTaipeiTaiwanChina MedicalResearch MackayMemorialHospitalTaipeiTaiwanChina

AIM: This study was to investigate whether surgery could increase cancer dissemination and postoperative recurrence in patients with hepatocellular carcinoma (HCC) by detection of human α-fetoprotein messenger RNA (hAFP mRNA), hAFP mRNA in the peripheral blood of patients with HCC has been considered as a surrogate marker for circulating tumor cells. METHODS: Eighty-one consecutive patients who underwent curative resection for HCC entered this prospective cohort study. We examined hAFP mRNA from the peripheral blood obtained preoperatively, perioperatively, and postoperatively to correlate the prognosis after curative resections from HCC patients and from the control subjects. Detection of hAFP mRNA by reverse transcriptase and polymerase chain reaction amplification (RT-PCR) was performed with primers specifically. The relations between the clinical variables (age,sex, associated liver cirrhosis, hepatitis B virus infection,hepatitis C virus infection, serum α-fetoprotein and ChildPugh class), the histological variables (size, capsule, vascular permeation, grade of differentiation, and daughter nodules),hAFP mRNA in peripheral blood of 3 different sessions, and postoperative course (recurrence, and recurrence related death) were analysed. RESULTS: No hAFP mRNA was detected in control group subjects. Twenty-two (27%), 24 (30%) and 19 (23%) of 81 HCC patients had hAFP mRNA positivity in the preoperative,perioperative and postoperative peripheral blood. The preoperative presence did not influence the risk of HCC recurrence (55% vs 41%, P=0.280). In contrast, patients with postoperative presence had a significantly higher recurrence (90% vs31%, P<0.001; odds ratio 19.2; 95% confidence interval: 4.0-91.7). In the multivariate analysis by COX proportional hazards model, postoperative positivity had a significant influence on recurrence (P=0.067) and recurrence related mortality (P=-0.017). Whereas, the perioperative positivity of hAFP mRNA did not increase HCC recurrence

关键词：肝细胞癌肿瘤切除术肿瘤转移 RT-PCR 肝动脉灌注化疗栓塞

Cosmetic outcome of femtosecond laserassisted pterygium surgery

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Eye and Vision 2021年第1期8卷 59-66页

作者： Darren Shu jeng Ting Yu-Chi Liu Yi Fang Lee Angel Jung Se Ji Tien-En Tan Hla M.Htoon Jodhbir S.Mehta Academic Ophthalmology Division of Clinical NeuroscienceSchool of MedicineUniversity of NottinghamNottinghamUK Department of Ophthalmology Queen’s Medical CentreNottinghamUK Singapore Eye Research Institute SingaporeSingapore Singapore National Eye Centre 11 Third Hospital AvenueSingapore 168751Singapore Duke-NUS Graduate Medical School SingaporeSingapore.

Background:To examine the cosmetic outcome of femtosecond laser-assisted pterygium surgery(FLAPS)with conjunctival autograft(CAG)and its potential predictive ***:This was a prospective interventional case series(NCT02866968).We included 29 patients(29 eyes)with primary pterygium who underwent *** outcome was graded by two graders(an ophthalmology resident and an experienced ophthalmologist)using Hirst classification system(1-4=excellent-poor).Weighted Cohen’s kappa analysis was performed to examine the intra-and inter-rater *** relationship between cosmetic outcome and various factors were determined by Spearman’s correlation coefficients(r).Results:The preoperative severity of pterygium(Tan grading system)was mild/atrophic(7%),moderate/intermediate(62%),and severe/fleshy(31%).An ultrathin CAG(mean thickness of 74.5±9.8μm)was fashioned *** excellent cosmetic outcome of FLAPS(median±IQR)was observed at 3 months(1.0±1.0)and remained similar at 6months(1.0±0.0)and 12months(1.0±0.0)*** final follow-up,27(93%)patients achieved good-to-excellent cosmetic outcome,with 1(3%)patient having a poor outcome due to incomplete pterygium *** kappa analysis of Hirst grading system showed excellent intra-rater(κ=0.86-0.95)and inter-rater reliability(κ=0.84-0.88).There was a weak and borderline significant correlation between good cosmetic outcome and reduced postoperative CAG thickness(r=0.38,P=0.06)but not with age,gender,preoperative pterygium severity,or intraoperative CAG ***:FLAPS can result in an excellent cosmetic outcome,which may be attributed to the beneficial effect of an ultrathin CAG.

关键词： Cosmesis Cosmetic outcome Femtosecond laser Pterygium Pterygium surgery

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新生儿高血压

中华高血压杂志 2014年第2期22卷 104-108页

作者： Ru-jeng Teng Division of Neonatology Department of PediatricsMedical College of Wisconsin

虽然高血压不是新生儿的常见病，但往往预示着一些严重的医疗问题。在新生儿重症监护病房，高血压的发生率为1％～2％，其中大部分是无症状的。血压超过正常上限的第95百分位数即可诊断高血压。新生儿高血压的最常见病因包括血栓栓塞、... 详细信息

虽然高血压不是新生儿的常见病，但往往预示着一些严重的医疗问题。在新生儿重症监护病房，高血压的发生率为1％～2％，其中大部分是无症状的。血压超过正常上限的第95百分位数即可诊断高血压。新生儿高血压的最常见病因包括血栓栓塞、肾实质疾病、肾血管疾病、先天性心脏病和药物影响等。询问病史对于找出潜在的病因非常重要。高血压通常可以通过药物控制，但有关血压的正常值及长期预后的资料目前还很缺乏。血管紧张素转换酶抑制剂是治疗新生儿高血压最常用的药物，肼屈嗪是治疗高血压急性发作最常用的药物。

关键词：新生儿高血压病因诊断治疗

Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor:A case report and review of the literature

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World Journal of Clinical Cases 2021年第4期9卷 838-846页

作者： Yi-Lun Hsieh Wen-Hung Hsu Ching-Chun Lee Chun-Chieh Wu Deng-Chyang Wu jeng-Yih Wu Division of Gastroenterology Department of Internal MedicineKaohsiung Medical University HospitalKaohsiung 807Taiwan Division of Colorectal Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung 807Taiwan Department of Pathology Kaohsiung Medical University HospitalKaohsiung 807Taiwan

BACKGROUND Gastric gastrointestinal stromal tumor(GIST)is the most common etiology of gastroduodenal *** gastroduodenal intussusception caused by gastric GIST is mostly treated by surgical resection,the first case of gastroduodenal intussusception caused by gastric GIST was treated by endoscopic submucosal dissection(ESD)in Japan in *** SUMMARY An 84-year-old woman presented with symptoms of postprandial fullness with nausea and occasional vomiting for a ***,she visited a local clinic for help,where abdominal sonography revealed a space-occupying lesion around the liver,so she was referred to our hospital for further *** sonography was repeated,which revealed a mass with an alternating concentric echogenic ***(EGD)was performed under the initial impression of gastric cancer with central necrosis and showed a tortuous distortion of gastric folds down from the lesser curvature side to the duodenal bulb with stenosis of the gastric *** was barely passed through to the 2nd portion of the duodenum and a friable ulcerated mass was *** differential diagnoses were suspected,including gastroduodenal intussusception,gastric cancer invasion to the duodenum,or pancreatic cancer with adherence to the gastric antrum and *** computed tomography for further evaluation was arranged and showed gastroduodenal intussusception with a long stalk polypoid mass 5.9 cm in the duodenal *** the impression of gastroduodenal intussusception,ESD was performed at the base of the gastroduodenal intussusception;unfortunately,a gastric perforation was found after complete resection was accomplished,so gastrorrhaphy was performed for the perforation and retrieval of the huge polypoid *** gastric tumor was pathologically proved to be a *** the operation,there was no digestive disturbance and the patient was discharged uneventfully on the 10th day following the op

关键词： Gastric gastrointestinal stromal tumor Endoscopic submucosal dissection Gastro-duodenal intussusception Elderly Esophagogastroduodenoscopy Gastrointestinal obstruction Case report

Familial hemophagocytic lymphohistiocytosis type 2 in a female Chinese neonate:A case report and review of the literature

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World Journal of Clinical Cases 2021年第21期9卷 6056-6066页

作者： Shao-Hua Bi Liang-Liang Jiang Li-Ying Dai Li-Li Wang Guang-Hui Liu Ru-jeng Teng Division of Neonatology Department of PediatricsThe First Affiliated Hospital of Anhui Medical UniversityHefei 230022Anhui ProvinceChina Department of Neonatology Anhui Provincial Children's HospitalHefei 230022Anhui ProvinceChina Department of Pediatric Neurology Anhui Provincial Children's HospitalHefei 230022Anhui ProvinceChina Department of Pediatrics Medical College of WisconsinWauwatosaWI 53226United States

BACKGROUND Familial hemophagocytic lymphohistiocytosis type 2(FHL2)is a rare genetic disorder presenting with fever,hepatosplenomegaly,and pancytopenia secondary to perforin-1(PRF1)***2 has been described in Chinese but usually presents after 1 year *** describe a female Chinese neonate with FHL2 secondary to compound heterozygous PRF1 mutation with symptom onset before 1 mo *** review Chinese FHL2 patients in the literature for *** SUMMARY A 15-d-old female neonate was referred to our hospital for persistent fever and thrombocytopenia with diffuse *** was born to a G5P3 mother at 39 wk and 4 d via cesarean section secondary to breech *** resuscitation was required at *** was described to be very sleepy with poor appetite since *** developed a fever up to 39.5°C at 7 d of ***,anemia,and thrombocytopenia were detected at a local medical facility CONCLUSION A literature review identified 75 Chinese FHL2 patients,with only five presenting in the first year of *** and frameshift mutations are the most common PRF1 mutations in Chinese,with 24.8%having c.1349C>T followed by 11.6%having *** c.658G>C mutation has only been reported once in the literature and our case suggests it can be pathogenic,at least in the presence of another pathogenic mutation such as c.1066C>T.

关键词： Hemophagocytic lymphohistiocytosis Familial hemophagocytic lymphohistiocytosis Perforin-1 Neonate Compound heterozygous Case report

Comparison of childhood hepatic malignancies in a hepatitis B hyper-endemic area

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World Journal of Gastroenterology 2005年第34期11卷 5289-5294页

作者： jeng-Chang Chen Ming-Ling Chang Jer-Nan Lin Hong-Shiee Lai Chiu-Chiang Chen Wei-Jao Chen Wen-Tsung Hung Department of Surgery Chang Gung Children's Hospital Taoyuan Taiwan China Division of Gastroenterology Department of Medicine Chang Gung Memorial Hospital Taoyuan Taiwan China Department of Surgery National Taiwan University Hospital Taipei. Taiwan China

AIM： To examine the differences of clinical behaviors between hepatocellular carcinomas （HCC） and hepatoblastomas （HB） in children. METHODS： From 1979 to 1997, we collected 73 HCC and 54 HB from two major medical centers in Taiwan. Demographic, laboratory and radiological data, and survival curves were statistically compared. RESULTS： HCC clinically differed from HB in mean age （10.6 vs2.5 years; P〈0.001）, status of hepatitis B infection （56/56 vs4/35, P〈0.001） and accompanying liver cirrhosis （26/40 vs 0/30, P〈0.001）, portal vein thrombi （22156 vs 5/38, P=0.006） and para-aortic lymphadenopathy （10/56 vs 1/38, P=0.026）. Due to a higher recurrence rate （7/12 vs 2/13, P=0.041）, stage I HCC compared poorly in survivals with stage I HB （P=0.0183）. Chemotherapy could only benefit HB as evidenced by 66.7% of resectability conversion and improve survivals for advanced HB, even with unsuccessful conversion. The survival difference between stage I HB and advanced HB with delayed complete resection was of borderline insignificance （P=0.0507）. CONCLUSION： I-ICC and HB were preliminarily distinguishable by some dinical dues. Delayed resection after chemotherapy was only possible for HB. However, further studies are needed to strengthen our observation that appropriate reliance upon chemotherapy to subsequently resect advanced HB could achieve the comparable survival to that of stage I HB.

关键词： Chemotherapy Children Hepatitis B Hepatoblastoma Hepatocellular carcinoma

Properties of Concrete Incorporating Bed Ash from Circulating Fluidized Bed Combustion and Ground Granulates Blast-furnace Slag

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Journal of Wuhan University of Technology(Materials Science) 2011年第2期26卷 348-354页

作者：鄭安 Department of Civil Engineering National Ilan UniversityIlan 26046TaiwanChina

The properties of concrete incorporating circulating fluidized bed combustion （CFBC） bed ash and ground granulates blast-furnace slag （GGBS） were *** strength,drying shrinkage,mercury intrusion porosimetry （MIP）,scanning electronic microscopy （SEM）,and X-ray diffraction （XRD） of concrete samples containing CFBC bed ash and GGBS were *** work used initial surface absorption test （ISAT） and rapid chloride penetration test （RCPT） on concrete to measure the absorption and the ability of concrete to resist chloride ion characteristics for different concrete samples containing CFBC bed ash and *** circuit potential （OCP）,direct current polarization resistance were obtained to evaluate rebar *** CFBC bed ash was X-ray amorphous and consist of SiO2,Al2O3 and CaO *** the replacement of CFBC for sand increases,the rate of initial surface absorption （ISA） increases but compressive strength *** the content of CFBC bed ash replacement for sand maintains constant,the replacement of GGBS for cement increases,compressive strength increases but the rate of ISA *** and corrosion resistance of rebar significantly improve by utilizing a proper amount of CFBC bed ash and GGBS in concrete.

关键词： corrosion absorption chloride circulating fluidized bed combustion GGBS