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Hepatitis B virus infection and renal transplantation

World Journal of Gastroenterology 2010年第31期16卷 3878-3887页

作者： Ming-Chao Tsai Yen-Ta Chen Yu-Shu Chien Tsung-Hui Hu Division of Hepato-Gas-troenterology Department of Internal MedicineChang Gung Memorial HospitalKaohsiung Medical CenterChang Gung University College of Medicine123Ta-Pei RoadNiao-Sung HsiangKaohsiung Hsien 833Taiwan China Department of Urology Chang Gung Memorial HospitalKaohsiung Medical CenterChang Gung University College of Medicine123Ta-Pei RoadNiao-Sung HsiangKaohsiung Hsien 833 TaiwanChina Division of Nephrology De-partment of Internal MedicineChang Gung Memorial HospitalKaohsiung Medical CenterChang Gung University College of Medicine123Ta-Pei RoadNiao-Sung HsiangKaohsiung Hsien 833Taiwan China

Although the prevalence of chronic hepatitis B virus (HBV) infection has declined in renal transplant recipients (RTRs), it remains a relevant clinical problem with high morbidity and mortality in long-term follow up. A thorough evaluation, including liver biopsy as well as assessment of HBV replication in serum (i.e. hepatitis B e antigen and/or HBV DNA) is required before transplantation. Interferon should not be used in this setting because of low efficacy and precipitation on acute allograft rejection. The advent of effective antiviral therapies offers the opportunity to prevent the progression of liver disease after renal transplantation. However, as far as we are aware, no studies have compared prophylactic and preemptive strategies. To date, the majority of RTRs with HBV-related liver disease have had a high virological and biochemical response to lamivudine use. However, lamivudine resistance is frequent with a prolonged course of therapy. Considering long-term treatment, antiviral agents with a high genetic barrier to resistance and lack of nephrotoxicity are suggested. The optimal strategy in RTRs with HBV infection remains to be established in the near future.

关键词： Hepatitis B Renal transplantation Lamivudine resistance

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Cecal lipoma with subclinical appendicitis: A case report

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World Journal of Clinical Cases 2019年第2期7卷 209-214页

作者： Kuen-Jang tsai Yun-Sheng Tai chao-ming Hung Yue-Chiu Su Department of Surgery E-Da Cancer Hospital I-Shou University Department of Surgery E-Da Hospital I-Shou University Department of Pathology E-Da Cancer Hospital I-Shou University

BACKGROUND Colonic lipomas are rare, slow-growing benign tumors. Colonic lipomas are generally asymptomatic and are found incidentally. Although cases of cecal lipoma have been sporadically reported in the literature, the disease has not been systematically reviewed.CASE SUMMARY We present a 44-year-old man who underwent a routine physical check-up during which colonoscopic examination revealed an asymptomatic 1.5-cm cecal mass at the appendiceal orifice. Laparoscopic exploration was performed that also demonstrated a congested and erythematous appendix. En bloc resection of both the cecum and vermiform appendix was performed because of the suspicion of malignancy. Histopathological examination revealed a cecal lipoma composed of mature adipose tissue, and the appendix showed subclinical inflammation.Our procedures and findings were discussed, along with relevant English literature that was retrieved from the PubMed database from 2000 to 2017.Twenty-six cases, including ours, were reported. Consistent with the findings of the literature, it is difficult to obtain a definitive diagnosis by colonoscopic biopsy.CONCLUSION Surgery remains the treatment of choice for this condition. Intraoperative frozen pathological sectioning helped the surgeon decide the extent of surgery, and radical surgery was avoided. Excision of benign lesions occupying the appendiceal orifice may be indicated for the prevention of later development of acute appendicitis. The prognosis is generally good, with only one of the 26 reported patients complicated with acute appendicitis, who subsequently succumbed due to severe comorbidities and sepsis.

关键词： Cecal lipoma Appendicitis Intussusception Case report

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Coagulation factor Ⅶ gene polymorphisms are not associated with the occurrence or the survival of hepatocellular carcinoma:a report of 37 cases

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Cancer Biology & Medicine 2018年第3期15卷 275-281页

作者： Chih-Che Lin Chun-Hsien Wu Li-Yu Chen Ming-Chao Tsai Ahmed M.Elsarawy Kuang-Tzu Huang Liver Transplantation Center Department of Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Institute for Translational Research in Biomedicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Division of Hepato-Gastroenterology Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

Objective: Coagulation factor VII(FVII) triggers the extrinsic pathway of blood coagulation. In our previous study, we showed that FVII plays an important role in tumorigenesis of hepatocellular carcinoma(HCC). However, the role of FVII polymorphism in HCC is still unknown. The present study aimed to investigate the relationship between HCC carcinogenesis and single nucleotide polymorphism of FVII.Methods: Thirty-seven HCC patients and 30 healthy donors were recruited in this study. Four common FVII gene polymorphisms– a decanucleotide insertion at position –323(–323 ins10-bp), a G to T substitution at position –401(–401 G/T), a G to A substitution at position –402(–402 G/A), and a T to C substitution at position –122(–122 T/C) – were analyzed by sequencing or commercialized assays using genomic DNA isolated from blood samples. Clinicopathological parameters between control and HCC subjects were compared according to the specific genotypes.Results: The most common nucleotide variation was –402 G/A. However, no statistically significant difference was observed between healthy controls and HCC subjects for all four polymorphisms in terms of genotype distribution and allele frequencies,indicating that these polymorphisms may not affect HCC tumorigenesis. Furthermore, no association was found between–402 G/A polymorphisms and tumor stage, recurrence, and overall survival.Conclusions: Our results indicate that FVII polymorphisms may not be a key factor that clinically impact tumorigenesis and outcomes of HCC, although further investigations should be conducted to confirm our findings.

关键词：等位基因频率多型性凝结案例 HCC 调查结果核苷酸位置

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Living donor liver transplantation for Barcelona clinic liver cancer (BCLC) intermediate-stage hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 169-182页

作者： ming chao tsai Chee-Chien Yong Chih-Che Lin Wei-Chen Lee Chih-Chi Wang chao-Hung Hung I-Hsuan Chen Yu-Fan Cheng Chang-Chun Hsiao Tsung-Hui Hu chao-Long Chen Division of Hepato-Gastroenterology Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung School of Medicine College of MedicineNational Sun Yat-sen UniversityKaohsiung Liver Transplantation Center and Department of Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung Division of Liver and Transplantation Surgery Chang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuan Liver Transplantation Center and Department of Diagnostic Radiology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung Graduate Institute of Clinical Medical Sciences College of MedicineChang Gung UniversityDivision of Pulmonary and Critical Care MedicineKaohsiung Chang Gung Memorial HospitalKaohsiung

Background:Barcelona clinic liver cancer(BCLC)stage B(intermediate stage)hepatocellular carcinoma(HCC)is highly heterogeneous;thus,identifying the most effective treatment for individual patients represents a significant clinical challenge.However,transarterial chemoembolization(TACE)is the only recommended treatment option.Therefore,we aimed to investigate the patient characteristics and outcomes of living donor liver transplantation(LDLT)for BCLC stage B HCC.Methods:A total of 516 patients with BCLC stage B HCC who underwent LDLT(n=104)or did not undergo LDLT(non-LDLT;n=412)between 2004 to 2018 were analyzed by propensity score matching(PSM;1:4)analysis.Factors influencing overall survival(OS)and recurrence were analyzed using Cox’s proportional hazards models.Results:Patients treated with LDLT achieved better OS than the non-LDLT group,including liver-and non-liver related survival(all P60 years(P=0.006),a neutrophil-lymphocyte ratio(NLR)>4(P=0.016)and>3 locoregional therapies(LRT)before LDLT(P60 years(P3 LRT before LDLT(P=0.001)were independent risk factors for OS.Using a combination of age,NLR,and LRT before liver transplantation(LT),the patients can be divided into low-risk(none of risk),intermediate-risk(one of risk),and high risk(more than two of risk)groups.There were significant differences in the cumulative HCC recurrence(P<0.001)and mortality(P<0.001)rates among the three groups.Conclusions:LDLT may represent a valuable therapeutic option for selected patients with BCLC stage B HCC.

关键词： Living donor liver transplantation(LDLT) Barcelona clinic liver cancer stage B(BCLC stage B) intermediate stage hepatocellular carcinoma(HCC)

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Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection

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World Journal of Gastroenterology 2010年第18期16卷 2265-2271页

作者： chao-Hung Hung Jing-Houng Wang Tsung-Hui Hu Chien-Hung Chen Kuo-Chin Chang Yi-Hao Yen YuanHung Kuo Ming-Chao Tsai Chuan-Mo Lee Division of Hepatogastroenterology Department of Internal MedicineChang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of Medicine

AIM:To elucidate the role of insulin resistance(IR) and serum adiponectin level in hepatocellular carcinoma(HCC) associated with chronic hepatitis C.METHODS:Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC.Homeostasis model assessment of IR(HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus(HCV) infection.RESULTS:Among HCC patients,type 2 diabetics(DM) was more prevalent in HCV subjects(35.6%,n = 59) compared to hepatitis B virus(HBV;12.7%,n = 63) or non-HBV,non-HCV cases(7.1%,n = 28).In patients with chronic hepatitis C,HCC subjects had higher blood sugar(P < 0.001),insulin level(P = 0.003) and HOMAIR(P = 0.018) than those with chronic hepatitis and advanced fibrosis.Age,male sex and body mass index were significantly associated with serum adiponectin level,whereas HOMA-IR was not.Based on stepwise logistic regression analysis,age(OR:1.124,P < 0.001),serum insulin level(OR:1.585,P < 0.001),HOMA-IR(OR:0.495,P = 0.001),DM(OR:11.601,P = 0.002) and male sex(OR:3.877,P = 0.016) were independently associated with HCC.This result was similar even if the diabetic subjects were excluded for analysis.CONCLUSION:Insulin resistance measured by HOMAIR,regardless of the presence of diabetes,is significantly associated with HCC development in patients with chronic HCV infection.

关键词： Hepatitis C virus Hepatocellular carcinoma Insulin resistance Diabetes Adiponectin

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Prediction of early-stage hepatocellular carcinoma using Onco Scan chromosomal copy number aberration data

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World Journal of Gastroenterology 2017年第44期23卷 7818-7829页

作者： ming-Chin Yu chao-Wei Lee Yun-Shien Lee Jang-Hau Lian Chia-Lung tsai Yi-Ping Liu Chun-Hsing Wu Chi-Neu tsai Department of Surgery Chang Gung Memorial Hospital Department of Surgery Xiamen Chang Gung Hospital Graduate Institute of Clinical Medical Sciences Chang Gung University Genomic Medicine Core Laboratory Chang Gung Memorial Hospital Department of Biotechnology Ming-Chuan University Department of Pediatrics Chang Gung Memorial Hospital

AIM To identify chromosomal copy number aberrations(CNAs) in early-stage hepatocellular carcinoma(HCC) and analyze whether they are correlated with patient prognosis.METHODS One hundred and twenty patients with early-stage HCC were enrolled in our study, with the collection of formalin fixed, paraffin-embedded(FFPE) specimens and clinicopathological data. Tumor areas were marked by certified pathologists on a hematoxylin and eosinstained slide, and cancer and adjacent non-cancerous tissues underwent extraction of DNA, which was analyzed with the Affymetrix Onco Scan platform to assess CNAs and loss of heterozygosity(LOH). Ten individuals with nonmalignant disease were used as the control group. Another cohort consisting of 40 patients with stage Ⅰ/Ⅱ HCC were enrolled to analyze gene expression and to correlate findings with the Onco Scan data.RESULTS Copy number amplifications occurred at chromosomes 1 q21.1-q44 and 8 q12.3-24.3 and deletions were found at 4 q13.1-q35.2, 8 p 23.2-21.1, 16 q23.3-24.3, and 17 p13.3-12, while LOH commonly occurred at 1 p32.3, 3 p21.31, 8 p23.2-21.1, 16 q22.1-24.3, and 17 p 13.3-11 in early-stage HCC. Using Cox regression analysis, we also found that a higher percentage of genome change(≥ 60%) was an independent factor for worse prognosis in early-stage HCC(P = 0.031). Among the 875 genes in the Onco Scan Gene Chip, six were independent predictors of worse disease-free survival, of which three were amplified(MYC, ELAC2, and SYK) and three were deleted(GAK, MECOM, and WRN). Further, patients with HCC who exhibited ≥ 3 CNAs involving these six genes have worse outcomes compared to those who had < 3 CNAs(P < 0.001). Similarly, Asian patients with stage I HCC from The Cancer Genome Atlas harboring CNAs with these genes were also predicted to have poorer outcomes.CONCLUSION Patients with early-stage HCC and increased genome change or CNAs involving MYC, ELAC2, SYK, GAK, MECOM, or WRN are at risk for poorer outcome after resection.

关键词：早阶段的 hepatocellular 癌拷贝数字错误预后 OncoScan 分子的倒置探查

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Delayed presentation of intrathoracic esophageal perforation after pneumatic dilation for achalasia

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World Journal of Gastroenterology 2009年第35期15卷 4461-4463页

作者： ming-Tzung Lin King-Wah Chiu Yeh-Pin Chou Ming-Chao Tsai Tsung-Hui Hu Chuan-Mo Lee Chi-Sin Changchien Seng-Kee Chuah Division of Hepatogastroenterology Chang Gang Memorial Hospital Kaohsiung 123Ta-Pei RoadNiaosung HsiangKaohsiung Country 833TaiwanChina Chang Gung University College of MedicineKaohsiung 833TaiwanChina

Pneumatic dilation(PD)is considered to be a safe and effective first line therapy for achalasia.The major adverse event caused by PD is esophageal perforation but an immediate gastrografin test may not always detect a perforation.It has been reported that delayed management of perforation for more than 24 h is associated with high mortality.Surgery is the treatment of choice within 24 h,but the management of delayed perforation remains controversial.Hereby,we report a delayed presentation of intrathoracic esophageal perforation following PD in a 48-year-old woman who suffered from achalasia.She completely recovered after intensive medical care.A review of the literature is also discussed.

关键词：穿孔弛缓食管延迟气囊局部放电死亡率治疗

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Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: SF-36 health survey questionnaire

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World Journal of Gastrointestinal Endoscopy 2023年第3期15卷 163-176页

作者： chao-ming Hung Kuo-Chuan Hung Hon-Yi Shi Shih-Bin Su Hui-ming Lee Meng-Che Hsieh Cheng-Hao Tseng Shung-Eing Lin Chih-Cheng Chen chao-ming Tseng Ying-Nan tsai Chi-Zen Chen Jung-Fa tsai Chong-Chi Chiu Department of General Surgery E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina School of Medicine College of MedicineI-Shou UniversityKaohsiung 82445TaiwanChina Department of Anesthesiology Chi Mei Medical CenterTainan 71004TaiwanChina Department of Hospital and Health Care Administration College of Recreation and Health ManagementChia Nan University of Pharmacy and ScienceTainan 71710TaiwanChina Department of Healthcare Administration and Medical Informatics Kaohsiung Medical UniversityKaohsiung 80708TaiwanChina Department of Business Management National Sun Yat-Sen UniversityKaohsiung 80424TaiwanChina Department of Medical Research Kaohsiung Medical University HospitalKaohsiung 80756TaiwanChina Department of Medical Research China Medical University HospitalChina Medical UniversityTaichung 40402TaiwanChina Department of Occupational Medicine Chi Mei Medical CenterLiouying 73657TaiwanChina Department of Occupational Medicine Chi Mei Medical CenterTainan 71004TaiwanChina Department of Leisure Recreation and Tourism ManagementSouthern Taiwan University of Science and TechnologyTainan 71005TaiwanChina College of Medicine I-Shou UniversityKaohsiung 82445TaiwanChina Department of Hematology-Oncology E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Gastroenterology and Hepatology E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Gastroenterology and Hepatology E-Da HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Colon and Rectal Surgery E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Gastroenterology and Hepatology E-Da Dachang HospitalI-Shou UniversityKaohsiung 80794TaiwanChina Department of Medical Education and Research E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of General Surgery Chi Mei Medical CenterLiouying 73657TaiwanChina

BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different conclusions.AIM To explore the medium-term effect of postoperative HRQoL in such patients.METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups.HRQoL was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(SF-36)Health Survey questionnaire,emphasizing eight specific items.RESULTS This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical procedures.More episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR group.The results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo postoperatively.Only the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 mo.CONCLUSION Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo postoperatively.Patients should undergo LR if there is no contraindication.

关键词： Health-related quality of life Medium-term result Laparoscopic Open surgery Non-metastatic colorectal cancer

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Hot water-extracted Lycium barbarum and Rehmannia glutinosa inhibit proliferation and induce apoptosis of hepatocellular carcinoma cells

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World Journal of Gastroenterology 2006年第28期12卷 4478-4484页

作者： Jane C-J chao Shih-Wen Chiang Ching-Chiung Wang Ya-Hui tsai ming-Shun Wu School of Nutrition and Health Sciences TaipJMedical University Taipei110 Taiwan China School of Pharmacy Taipei MedicalUniversity Taipei 110 Taiwan China Division of Internal Medicine Taipei Medical University-Wan Fang Hospital Taipei 116 Taiwan China

瞄准：在老鼠或人的肝细胞癌(HCC ) 在房间增长和 apoptosis 上调查热提取水的 Lycium 倒刺海芋属植物(LBE ) 和 Rehmannia glutinosa (RGE ) 的效果房间。方法：老鼠(H-4-II-E ) 和 HCC (HA22T/VGH ) 房间衬里的人与热提取水的 LBE 和 ... 详细信息

瞄准：在老鼠或人的肝细胞癌(HCC ) 在房间增长和 apoptosis 上调查热提取水的 Lycium 倒刺海芋属植物(LBE ) 和 Rehmannia glutinosa (RGE ) 的效果房间。方法：老鼠(H-4-II-E ) 和 HCC (HA22T/VGH ) 房间衬里的人与热提取水的 LBE 和 RGE 的各种各样的集中(0-10 g/L ) 被孵化。在 6-24 h 孵化以后，房间增长(n = 6 ) 被比色法测量。apoptotic 房间(n = 6 ) 被流动血细胞计数检测。p53 蛋白质的表示(n = 3 ) 被 SDS 页并且西方的弄污决定。结果：粗略的 LBE (2-5 g/L ) 和 RGE (2-10 g/L ) dose-dependently 在 11% 禁止了 H-4-II-E 房间的增长(P < 0.05 ) 到 85%(P < 0.01 ) 在 6-24 h 处理以后。在 5 g/L 的剂量的粗略的 LBE 在 6-24 h 孵化以后比粗略的 RGE 更有效地压制了 H-4-II-E 房间的房间增长(P < 0.01 ) 。粗略的 LBE (2-10 g/L ) 和 RGE (2-5 g/L ) dose-dependently 也由 14%-43% 禁止了 HA22T/VGH 房间的增长(P < 0.01 ) 在 24 h 以后。在 10 g/L 的剂量的粗略的 LBE 比粗略的 RGE 更有效地禁止了 HA22T/VGH 房间的增长(56.8%+/-1.6% 对 70.3%+/-3.1% 控制， P = 0.0003 < 0.01 ) 。apoptotic 房间显著地与粗略的 LBE (2-5 g/L ) 和 RGE (5-10 g/L ) 的更高的剂量在 24 h 处理以后在 H-4-II-E 房间增加了(P < 0.01 ) 。在 H-4-II-E 房间的 p53 蛋白质的表达式是 119% 控制组和 143% 与相比对待 LBE (2， 5 g/L ) 组，和 110% 控制和 132% 组与 RGE 相比对待(5， 10 g/L ) 在 24 h 以后的组。结论：热提取水的粗略的 LBE (2-5 g/L ) 和 RGE (5-10 g/L ) 禁止增长并且在 HCC 房间刺激调停 p53 的 apoptosis。

关键词：地黄细胞凋亡肝细胞癌肿瘤细胞

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The Potential of Detecting Radio-flaring Ultracool Dwarfs at L band in the FAST Drift-scan Survey

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Research in Astronomy and Astrophysics 2022年第6期22卷 126-141页

作者： Jing Tang chao-Wei tsai Di Li CAS Key Laboratory of FAST National Astronomical ObservatoriesChinese Academy of SciencesBeijing 100101China University of Chinese Academy of Sciences Beijing 100049China NAOC-UKZN Computational Astrophysics Centre University of Kwa Zulu-NatalDurban 4000South Africa

The Five-hundred-meter Aperture Spherical radio Telescope(FAST)completed its commissioning and began the Commensal Radio Astronomy Fas T Survey(CRAFTS),a multi-year survey to cover 60%of the sky,in 2020.We present predictions for the number of radio-flaring ultracool dwarfs(UCDs)that are likely to be detected by CRAFTS.Based on the observed flaring UCDs from a number of unbiased,targeted radio surveys in the literature,we derive a detection rate of≥3%.Assuming a flat radio spectrumνLν∝ν^(β+1) withβ=-1.0 for UCD flares,we construct a flare luminosity function dN/dL∝L^(-1.96±0.45)(here L=νLν).CRAFTS is found to be sensitive enough for flares from UCDs up to~180 pc.Considering the Galactic thin disk,we carry out a 3D Monte Carlo simulation of the UCD population,which is then fed to mock CRAFTS observations.We estimate that~170 flaring UCDs would be detected through transient searches in circular polarization.Though only marginally sensitive to the scale height of UCDs,the results are very sensitive to the assumed spectral indexβ.Forβfrom 0 to-2.5,the number of expected detections increases dramatically from~20 to~3460.We also contemplate the strategies for following up candidates of flaring UCDs,and discuss the implications of survey results for improving our knowledge of UCD behavior at L band and dynamos.

关键词： surveys-(stars:)brown dwarfs-stars flare-stars low-mass-stars magnetic field-radio continuum stars

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