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Optimal injection volume of epinephrine for endoscopic treatment of peptic ulcer bleedinq

World Journal of Gastroenterology 2006年第19期12卷 3108-3113页

作者： Tai-Cherng Liou Shee-Chan Lin horng-yuan wang Wen-Hsiung Chang Division of Gastroenterology Department of Internal Medicine Mackay Memorial HospitalMackay MedicineNursing and Management CollegeTaipeiTaiwanChina

AIM： To define the optimal injection volume of epinephrine with high efficacy for hemostasis and low complication rate in patients with actively bleeding ulcers. METHODS： This prospective, randomized, comparative trial was conducted in a medical center. A total of 228 patients with actively bleeding ulcers （spurting or oozing） were randomly assigned to three groups with 20, 30 and 40 mL endoscopic injections of an 1：10000 solution of epinephrine. The hemostatic effects and clinical outcomes were compared between the three groups. RESULTS： There were no significant differences in all background variables between the three groups. Initial hemostasis was achieved in 97.4%, 98.7% and 100% of patients respectively in the 20, 30 and 40 mL epinephrine groups. There were no significant differences in the rate of initial hemostasis between the three groups. The rate of peptic ulcer perforation was significantly higher in the 40 mL epinephrine group than in the 20 and 30 mL epinephrine groups （P 〈 0.05）. The rate of recurrent bleeding was significantly higher in the 20 mL epinephrine group （20.3%） than in the 30 （5.3%） and 40 mL （2.8 %） epinephrine groups （P 〈 0.01）. There were no significant differences in the rates of surgical intervention, the amount of transfusion requirements, the days of hospitalization, the deaths from bleeding and 30 d mortality between the three groups. The number of patients who developed epigastric pain due to endoscopic injection, was significantly higher in the 40 mL epinephrine group （51/76） than in the 20 （2/76） and 30 mL （5/76） epinephrine groups （P 〈 0.001）. Significant elevation of systolic blood pressure after endoscopic injection was observed in the 40 mL epinephrine group （P 〈 0.01）. Significant decreasing and normalization of pulse rates after endoscopic injections were observed in the 20 mL and 30 mL epinephrine groups （P 〈 0.01）.CONCLUSION： Injection of 30 mL diluted epinephrine （1：10000） can effectively prevent recurrent bleedin

关键词： Endoscopic injection Epinephrine Volume Peptic ulcer bleeding

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Carcinoid tumor of the duodenum and accessory papilla associated with polycythemia vera

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World Journal of Gastroenterology 2005年第24期11卷 3794-3796页

作者： horng-yuan wang Ming-Jen Chen Tsen-Long Yang Ming-Chih Chang Yu-Jan Chan Division of Gastroenterology Department of Surgery Division of Hematology Department of Pathology

Carcinoid tumors have been reported in a wide range of organs but most frequently involve the gastrointestinal tract; however, duodenal carcinoid tumors are rare. We report a 50-year-old male patient complaining of multiple melenas for 3 wk. The panendoscopy and endoscopic retrograde cholangiopancreaticography revealed swelling accessory papilla with an ulcer. The biopsy taken showed a carcinoid tumor. The lesion was removed by wide resection. Patient was found to have an abnormal blood cell count during the follow-up period with elevated levels of hemoglobin and hematocrit of 21.2 g/dL and 63.5%,respectively, thrombocytosis of 501 000/μL, and leukocytosis of 20 410/μL. He was diagnosed as a polycythemia vera by a hematologist after further evaluation. He received periodic phlebotomy and hydroxyurea treatment. The response was good and his hematocrit was stabilized by periodic phlebotomy in the range of 44-49% during the last 2 years. The possible origin of UGI bleeding by a duodenal carcinoid tumor, although rare, should be considered. There has been one case report of a duodenal carcinoid tumor that involved accessory papilla of the pancreas divisum and one case report of metastatic carcinoid tumor associated with polycythemia vera. It is different in our patient as compared with the latter report, which mentioned a polycythemia vera patient who was found to have a metastatic carcinoid in the 17 years follow-up period. Chemotherapy had been given before the carcinoid tumor was revealed. Our patient had no previous chemotherapy for polycythemia vera before he was found to have duodenal carcinoid tumor; this excludes the possibility of chemotherapy induced carcinoid tumor, although it had been suspected in the previous report. In our patient, the existence of both diseases may be by predisposition of each other since both diseases have an increased incidence of other neoplasm, or they may be coexistent incidentally.

关键词： Carcinoid tumor Accessory papilla Polycythemia vera

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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

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Ultrasonography of splenic abnormalities

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World Journal of Gastroenterology 2005年第26期11卷 4061-4066页

作者： Ming-Jen Chen Ming-Jer Huang Wen-Hsiung Chang Tsang-En wang horng-yuan wang Cheng-Hsin Chu Shee-Chan Lin Shou-Chuan Shih Division of Gastroenterology Department of Internal Medicine Mackay Memorial Hospital Mackay Medicine Nursing and Management College Taipei Taiwan China Division of Hematology and Oncology Department of Internal Medicine Mackay Memorial Hospital Taipei Taiwan China

AIM: This report gives a comprehensive overview of ultrasonography of splenic abnormalities. Certain ultrasonic features are also discussed with pathologic ***: We review the typical ultrasonic characteristics of a wide range of splenic lesions, illustrating them with images obtained in our institution from 2000 to *** hundred and three patients (47 men, 56 women),with a mean age of 54 years (range 9-92 years), were found to have an abnormal ultrasonic pattern of ***: We describe the ultrasonic features of various splenic lesions such as accessory spleen, splenomegaly,cysts, cavernous hemangiomas, lymphomas, abscesses,metastatic tumors, splenic infarctions, hematomas, and rupture, based on traditional gray-scale and color Doppler ***: Ultrasound is a widely available, noninvasive,and useful means of diagnosing splenic abnormalities. A combination of ultrasonic characteristics and clinical data may provide an accurate diagnosis. If the US appearance alone is not enough, US may also be used to guide biopsy of suspicious lesions.

关键词： Ultrasonography Ultrasound Splenic abnormalities Spleen

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Management of Helicobacter pylori infection after gastric surgery

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World Journal of Gastroenterology 2014年第18期20卷 5274-5282页

作者： Yang-Sheng Lin Ming-Jen Chen Shou-Chuan Shih Ming-Joug Bair Ching-Ju Fang horng-yuan wang Division of Gastroenterology Department of Internal MedicineMackay Memorial Hospital Medical Library and Evidence Base Medicine Center Department of Medical EducationMackay Memorial Hospital Mackay Junior College of Medicine Nursing and ManagementTaipei 104Taiwan Mackay Medical College Meiho University

The Maastricht IV/Florence Consensus Report and the Second Asia-Pacific Consensus Guidelines strongly recommend eradication of Helicobacter pylori(***)in patients with previous gastric neoplasia who have undergone gastric ***,the guidelines do not mention optimal timing,eradication regimens,diagnostic tools,and follow-up strategies for patients undergoing gastrectomy and do not indicate if eradication of *** reduces the risk of marginal ulcer or stump cancer in the residual stomach after *** purpose of this review is to provide an update which may help physicians to properly manage *** infection in patients who have undergone gastric *** review focuses on(1)the microenvironment change in the stomach after gastrectomy;(2)the phenomenon of spontaneous clearance of *** after gastrectomy;(3)the effects of *** on gastric atrophy and intestinal metaplasia after gastrectomy;(4)incidence and clinical features of ulcers developing after gastrectomy;(5)does eradication of *** reduce the risk of gastric stump cancer in the residual stomach?(6)does eradication of *** reduce the risk of secondary metachronous gastric cancer in the residual stomach?and(7)optimal timing and regimens for *** eradication,diagnostic tools and follow-up strategies for patients undergoing gastrectomy.

关键词： Helicobacter pylori Gastrectomy Gastric stump Treatment outcome Stomach neoplasms Stomach ulcer Atrophic gastritis Metaplasia

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Expression patterns of transforming growth factor-beta and its receptors in gastric mucosa of patients with refractory gastric ulcer

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World Journal of Gastroenterology 2005年第1期11卷 136-141页

作者： Shou-Chuan Shih Kwang-Wen Tseng Shee-Chan Lin Chin-Roa Kao Sun-Yen Chou horng-yuan wang Wen-Hsiung Chang Cheng-Hsin Chu Tsang-En wang Chung-Liang Chien Division of Gastroenterology Department of Anatomy and Cell Biology

AIM: Transforming growth factor-β (TGF-β) plays a regulatory role in tissue repair. In a previous study, we found that TGF-β and its receptors were expressed in gastric mucosa of patients with well-healed gastric ulcers, as demonstrated by immunohistochemistry. To further characterize the role of TGF-β and its receptors in repairing gastric ulcers, we investigated the expression patterns of TGF-β and its receptors in gastric mucosa by in situ hybridization and reverse transcriptase-polymerase chain reaction (RT-PCR).METHODS: Seventy-four patients with endoscopically proven gastric ulcers were eligible for participation in this study. All patients had routine biopsies on initial endoscopy and were then treated for 12 wk with an H2 blocker. Repeat endoscopy was then performed. There were 8 patients with poorly healed ulcers, and biopsies were taken from the margin of the residual ulcers. These tissue samples, along with biopsy of gastric mucosa near the original ulcers from 8 randomly selected patients with well-healed ulcers were examined for TGF-β and TGF-β receptor Ⅱ mRNA by RT-PCR and in situ hybridization, as well as ***: TGF-β and TGF-β receptor Ⅱ were strongly expressed in tissues from patients with well-healed *** of the 8 patients with poor healing had low or absent expression of TGF-β or TGF-β receptor Ⅱ mRNA. All cases positive by RT-PCR assay were confirmed by in situ hybridization as well as ***: It is suggested that TGF-β and its receptors are important for gastric ulcer healing. These results may have implications for further investigation of the healing process and in predicting response to therapy.

关键词： Gastric Ulcer Transforming growth factor-beta Transforming growth factor-beta receptor

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Effects of Helicobacter pylori infection in gastrointestinal tract malignant diseases:From the oral cavity to rectum

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World Journal of Gastrointestinal Oncology 2022年第1期14卷 55-74页

作者： Yang-Che Kuo Lo-Yip Yu horng-yuan wang Ming-Jen Chen Ming-Shiang Wu Chun-Jen Liu Ying-Chun Lin Shou-Chuan Shih Kuang-Chun Hu Division of Gastroenterology Department of Internal MedicineMacKay Memorial HospitalTaipei 10449TaiwanChina Department of Internal Medicine Healthy Evaluation CenterMackay Memorial HospitalTaipei 10449TaiwanChina Department of Internal Medicine National Taiwan University HospitalTaipei 10051TaiwanChina Department of Internal Medicine Institute of Clinical MedicineNational Taiwan University College of MedicineTaipei 10051TaiwanChina Department of Anesthesia MacKay Memorial HospitalTaipei 10449TaiwanChina Division of Gastroenterology Department of Internal MedicineHealth Evaluate CenterMackay Memorial HospitalTaipei 10449TaiwanChina Department of Internal Medicine Healthy Evaluation CenterMackay Memorial HospitalMacKay Junior College of MedicineNursingand ManagementTaipei 10038TaiwanChina

Helicobacter pylori(***)has infected approximately fifty percent of humans for a long period of ***,improvements in the public health environment have led to a decreased chance of *** ***,a high infection rate is noted in populations with a high incidence rate of gastric cancer(GC).The worldwide fraction of GC attributable to *** is greater than 85%,and a high *** prevalence is noted in gastric mucosa-associated lymphoid tissue lymphoma *** results indicate that the majority of GC cases can be prevented if *** infection is *** *** exhibits oral-oral or fecal-oral transmission,the relationship between this microorganism and other digestive tract malignant diseases has also attracted *** review article provides an overview of *** and the condition of the whole gastrointestinal tract environment to further understand the correlation between the pathogen and the host,thus allowing improved realization of disease presentation.

关键词： Helicobacter pylori Gastrointestinal tract Malignant disease

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Nonalcoholic fatty liver disease:Updates in noninvasive diagnosis and correlation with cardiovascular disease

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World Journal of Gastroenterology 2014年第24期20卷 7718-7729页

作者： Kuang-Chun Hu horng-yuan wang Sung-Chen Liu Chuan-Chuan Liu Chung-Lieh Hung Ming-Jong Bair Chun-Jen Liu Ming-Shiang Wu Shou-Chuan Shih Mackay Medical College Division of Gastroenterology Department of Internal MedicineHealth Evaluation CenterMackay Memorial Hospital Graduate Institute of Clinical Medicine National Taiwan University College of Medicine Division of Endocrine Department of Internal MedicineDM CenterMackay Memorial Hospital Division of Cardiology Department of Internal MedicineMackay Memorial Hospital Gastroenterology Division Department of Internal MedicineMackay Memorial HospitalTaitung Branch

Nonalcoholic fatty liver disease(NAFLD)refers to the accumulation of fat(mainly triglycerides)within *** 20%-30%of adults in the general population in developed countries have NAFLD;this trend is increasing because of the pandemicity of obesity and diabetes,and is becoming a serious public health *** percent of individuals with NAFLD develop chronic hepatic inflammation[nonalcoholic steatohepatitis(NASH)],which can be associated with the development of cirrhosis,portal hypertension,and hepatocellular carcinoma in a minority of *** thus,the detection and diagnosis of NAFLD is important for general *** biopsy is the gold standard for diagnosing NAFLD and confirming the presence of ***,the invasiveness of this procedure limits its application to screening the general population or patients with contraindications for liver *** development of noninvasive diagnostic methods for NAFLD is of paramount *** review focuses on the updates of noninvasive diagnosis of ***,we review clinical evidence supporting a strong association between NAFLD and the risk of cardiovascular disease because of the cross link between these two disorders.

关键词： Nonalcoholic fatty liver disease Noninvasive diagnosis Laboratory biochemistry Image assessment Cardiovascular disease

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Robustness of the octupole collectivity in 144Ba within the cranking covariant density functional theory in 3D lattice

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Nuclear Science and Techniques 2024年第8期35卷 124-131页

作者： Ze‑Kai Li yuan‑yuan wang Mathematics and Physics Department North China Electric Power UniversityBeijing 102206China Hebei Key Laboratory of Physics and Energy Technology North China Electric Power UniversityBaoding 071000China

The octupole deformation and collectivity in octupole double-magic nucleus 144Ba are investigated using the Cranking covariant density functional theory in a three-dimensional lattice *** reduced B(E3)transition probability is implemented for the first time in semiclassical approximation based on the microscopically calculated electric octupole *** available data,including the I-ωrelation and electric transitional probabilities B(E2)and B(E3)are well ***,it is shown that the ground state of 144Ba exhibits axial octupole and quadrupole deformations that persist up to high spins(I≈24h).

关键词： Octupole collectivity Cranking covariant density functional theory Rotational spectrum Electric transitional probabilities

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Collective Molecular Machines: Multidimensionality and Reconfigurability

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Nano-Micro Letters 2024年第8期16卷 309-340页

作者： Bin wang yuan Lu Department of Chemical Engineering Tsinghua UniversityBeijing 100084People’s Republic of China Key Laboratory of Industrial Biocatalysis Ministry of EducationTsinghua UniversityBeijing 100084People’s Republic of China

Molecular machines are key to cellular activity where they are involved in converting chemical and light energy into efficient mechanical *** the last 60 years,designing molecular structures capable of generating unidirectional mechanical motion at the nanoscale has been the topic of intense *** progress has been made,attributed to advances in various fields such as supramolecular chemistry,biology and nanotechnology,and ***,individual molecular machines are only capable of producing nanometer work and generally have only a single *** order to address these problems,collective behaviors realized by integrating several or more of these individual mechanical units in space and time have become a new *** this review,we comprehensively discuss recent developments in the collective behaviors of molecular *** particular,collective behavior is divided into two *** is the appropriate integration of molecular machines to efficiently amplify molecular motions and deformations to construct novel functional *** other is the construction of swarming modes at the supramolecular level to perform nanoscale or microscale *** discuss design strategies for both modes and focus on the modulation of features and ***,in order to address existing challenges,the idea of transferring experience gained in the field of micro/nano robotics is presented,offering prospects for future developments in the collective behavior of molecular machines.

关键词： Molecular machines Collective control Collective behaviors DNA Biomolecular motors

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