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International Journal of Otolaryngology and Head & Neck Surgery 2015年第4期4卷 309-316页

作者： Weizhong Ernest Fu Ming Yann lim khoon Leong Chuah li-chung mark khoo Department of Otolaryngology Tan Tock Seng Hospital Singapore City Singapore Department of Pathology Tan Tock Seng Hospital Singapore City Singapore

Background: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive human malignancies with a mean survival time of 6 months regardless of treatment. Aim: To present a case of locally advanced anaplastic thyroid carcinoma with long-term survival. A 10-year literature review of locally advanced ATC with long-term survival (more than 2 years) is also presented. Case presentation: We present a case of locally advanced anaplastic thyroid carcinoma (ATC) with tracheal invasion in a 67-year-old elderly Chinese man who was treated with radical surgery encompassing total thyroidectomy, neck dissection and tracheal resection followed by adjuvant radiotherapy. Long-term disease-free survival is more than 7 years to date. Conclusion: The prognosis of ATC remains poor as it is characterized by aggressive and extensive disease at presentation, the inability in most patients to perform radical enough surgery in order to achieve clear margins, high morbidity of complete extirpation and limited response to radiotherapy or chemotherapy. However, if complete surgical resection is possible, patients should be treated aggressively with a combination of surgery and adjuvant radiotherapy.

关键词： Anaplastic Thyroid Survival Trachea

Foregut bypass *** bariatric procedures for nonalcoholic fatty liver disease:a meta-analysis of 3,355 individuals

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Hepatobiliary Surgery and Nutrition 2023年第5期12卷 658-670,I0001-I0003页

作者： Wen Hui lim Snow Yunni lin Cheng Han Ng Darren Jun Hao Tan Jieling Xiao Jie Ning Yong Phoebe Wen lin Tay Nicholas Syn Yip Han Chin Kai En Chan Chin Meng khoo Nicholas Chew Roger S.Y.Foo Asim Shabbir Eunice X.Tan Daniel Q.Huang Mazen Noureddin Arun J.Sanyal Mohammad Shadab Siddiqui mark D.Muthiah Yong Loo lin School of Medicine National University of SingaporeSingaporeSingapore Division of Endocrinology Department of MedicineNational University HospitalSingaporeSingapore Department of Cardiology National University Heart CentreNational University HospitalSingaporeSingapore Division of General Surgery(Upper Gastrointestinal Surgery) Department of SurgeryNational University HospitalSingaporeSingapore Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingaporeSingapore National University Centre for Organ Transplantation National University Health SystemSingaporeSingapore Cedars-Sinai Fatty liver Program Division of Digestive and Liver DiseasesDepartment of MedicineComprehensive Transplant CenterCedars-Sinai Medical CentreLos AngelesCAUSA Division of Gastroenterology Hepatology and NutritionDepartment of Internal MedicineVirginia Commonwealth UniversityRichmondVAUSA

Background:Bariatric surgery represents an important treatment option for severely obese patients with nonalcoholic fatty liver disease(NAFLD).However,there remains inadequate data regarding the effects of different bariatric procedures on various NAFLD parameters,especially for histological ***,this meta-analysis aimed to compare the effects of restrictive bariatric procedures and foregut bypass on the metabolic,biochemical,and histological parameters for patients with ***:Medline and Embase were searched for articles relating to bariatric procedures and *** meta-analysis was conducted to compare efficacy of bariatric procedures ***-procedure with subgroup analysis to further compare restrictive against foregut bypass ***:Thirty-one articles involving 3,355 patients who underwent restrictive bariatric procedures(n=1,460)and foregut bypass(n=1,895)were *** foregut bypass(Pline non-significant decrease in fibrosis score(P=0.06)and significantly lower steatosis score(Plic parameters,foregut bypass significantly lowered body mass index(P=0.003)and low-density lipoprotein(P=0.008)compared to restrictive *** significant differences were observed between both procedures for aspartate aminotransferase(P=0.17)and alkaline phosphatase(P=0.61).However,foregut bypass resulted in significantly lower gamma-glutamyl transferase than restrictive procedures(P=0.01)while restrictive procedures resulted in significantly lower alanine transaminase than foregut bypass(P=0.02).Conclusions:The significant histological and metabolic advantages and comparable improvements in biochemical outcomes support the choice of foregut bypass over restrictive bariatric procedures in NAFLD management.

关键词： Bariatric surgery non-alcoholic fatty liver disease(NAFLD) obesity fibrosis endoscopy

Factors early in life associated with hepatic steatosis

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World Journal of Hepatology 2022年第6期14卷 1235-1247页

作者： Sabrina Xin Zi Quek Eunice Xiang-Xuan Tan Yi Ping Ren mark Muthiah Evelyn Xiu ling Loo Elizabeth Huiwen Tham Kewin Tien Ho Siah Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingapore 119228Singapore National University Centre for Organ Transplantation National University Health SystemSingapore 119228Singapore Yong Loo lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Medicine National University HospitalSingapore 119228Singapore Department of Paediatrics Yong Loo Lin School of MedicineNational University of SingaporeKhoo Teck Puat-National University Children's Medical InstituteNational University HospitalNational University Health SystemSingapore 119228Singapore Singapore Institute for Clinical Sciences Agency for ScienceTechnology and ResearchSingapore 117609Singapore

BACKGROUND The rise in prevalence of non-alcoholic fatty liver disease(NAFLD)mirrors the obesity *** is insidious but may gradually progress from simple steatosis to steatohepatitis,fibrosis and cirrhosis and/or hepatocellular *** strategies to ameliorate developmental programming of NAFLD may be more efficacious during critical windows of developmental *** To review the early developmental factors associated with *** Databases MEDliNE via PubMed,and EMBASE and Reference Citation Analysis were searched and relevant publications up to April 30,2021 were *** research studies that included risk factors associated with early development of NAFLD in human subjects were *** factors include:Maternal factors,intrauterine and prenatal factors,post-natal factors,genetic and ethnic predisposition,childhood and adolescence environmental *** were excluded if they were review articles or animal studies,case reports or conference abstracts,or if NAFLD was not clearly defined and assessed *** Of 1530 citations identified by electronic search,420 duplicates were *** the 1110 citations screened from title and abstract,80 articles were included in the final *** polymorphisms such as patatin-like phospholipase domain-containing protein 3(PNPLA3)and membrane-bound O-acyltransferase domain-containing protein 7(MBOAT7)were associated with increased risk of *** factors such as maternal obesogenic environment and parental history of hepatic steatosis was associated with offspring *** duration of exclusive breastfeeding in infancy was associated with a lower risk of developing NAFLD later in life while metabolic dysfunction and/or obesity in adolescence was associated with increased risk of *** relating to socioeconomic factors and its association with NAFLD reported confounding *** Maternal metabolic dysfunction during pr

关键词： Epidemiology Natural history Obesity Fatty liver Developmental

Validation of genetic variants associated with metabolic dysfunctionassociated fatty liver disease in an ethnic Chinese population

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World Journal of Hepatology 2020年第12期12卷 1228-1238页

作者： Guan Huei Lee Wah Wah Phyo Wai Mun Loo Raymond Kwok Taufique Ahmed Asim Shabbir Jimmy So Calvin Jianyi Koh Juanda Leo Hartono mark Muthiah Kieron lim Poh Seng Tan Yin Mei Lee Seng Geelim Yock Young Dan Division of Gastroenterology and Hepatology Department of MedicineNational University Health SystemSingapore 119228Singapore Yong Loo lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Medicine Khoo Teck Puat HospitalSingapore 768828Singapore Department of Surgery National University Health SystemSingapore 119228Singapore

BACKGROUND Genetic factors play an important role in the pathogenesis and development of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To study the association of single nucleotide polymorphisms(SNPs),previously identified in Western populations,with the risk of MAFLD in a Singapore Chinese population and their interactions with environmental and medical risk *** A retrospective case-control study was conducted with 72 MAFLD cases and 72 controls with no hepatic steatosis on computed tomography,magnetic resonance imaging,or controlled attenuation parameter *** were recruited from two tertiary *** alleles such as NCAN,GCKR,LYPLAL1,PNPLA3,PPP1R3B,FDFT1,COL13A1,EFCAB4B,PZP,and TM6SF2 were genotyped using the TaqMan®Predesigned SNP Genotyping *** Weight and body mass index(BMI)were 1.2-times higher in patients(70.6 kg,95%confidence interval[CI]:57.1-84.1 vs 60.8 kg,95%CI:48.5-73.1,Plitus in patients was 40.3%and 20.8%in controls(P=0.011).Patients had higher mean triglycerides than controls(Plikely to be associated with MAFLD(43.4%CC vs 69.7%GG,P=0.017,and 44.8%CG vs 69.7%GG,P=0.022).In multivariable analysis,hypertriglyceridemia(odds ratio[OR]:2.0495%CI:1.3-3.1,P=0.001),BMI(OR:1.295%CI:1.1-1.4,P<0.001)and PNPLA3 GG(OR:3.495%CI:1.3-9.2,P=0.014)were associated with MAFLD(area under the receiver operating characteristic curve of 0.823).CONCLUSION Among the Chinese population of Singapore,PNPLA3 homozygous GG allele is a strong predictor of MAFLD,whereas LYPLAL1,GCKR,FDFT1,COL13A1,PZP,and TM6SF2 are not significantly ***,high BMI,and PNPLA3 GG are independent predictors of MAFLD.

关键词： Single nucleotide polymorphism PNPLA3 Genotyping Metabolic dysfunction-associated fatty liver disease Non-alcoholic steatohepatitis Hypertriglyceridemia Body mass index Waist-hip ratio,Screening Hepatic steatosis