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Efferent limb of gastrojejunostomy obstruction by a whole okra phytobezoar:Case report and brief review

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World Journal of Gastrointestinal Endoscopy 2012年第5期4卷 197-200页

作者： Thant Zin myat maw Dinker Ramananda Pai Rosaini Binti Paijan Myo Kyi Department of Surgery Melaka Manipal Medical College75150 MelakaMalaysia Department of Surgery Hospital Pakar Sultanah FatimahMuar JohorMalaysia

A phytobezoar is one of the intraluminal causes of gastric outlet obstruction,especially in patients with previous gastric surgery and/or gastric motility *** the proton pump inhibitor era,vagotomy,pyloroplasty,gastrectomy and gastrojejunostomy were commonly performed procedures in peptic ulcer *** of the sequelae of gastrojejunostomy is phytobezoar ***,a bezoar causing gastric outlet obstruction is rare even with giant gastric *** report a rare case of gastric outlet obstruction due to a phytobezoar obstructing the efferent limb of the gastrojejunostomy *** phytobezoar which consisted of a whole piece of okra(lady finger vegetable) was successfully removed by endoscopic *** the best of our knowledge,this is the first case of okra bezoar-related gastrojejunostomy efferent limb obstruction reported in the literature.

关键词： Efferent limb obstruction Gastrojejunostomy Okra phytobezoar

Informing policy makers in developing countries:Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry

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Asian Pacific Journal of Tropical Medicine 2024年第1期17卷 21-29,I0001-I0003页

作者： Ahlam Sundus Renukha Sellappans Tan maw Pin Kulliyyah of Pharmacy International Islamic University MalaysiaJalan Sultan Ahmad ShahKuantanPahangMalaysia School of Pharmacy Faculty of Health and Medical SciencesTaylor’s UniversitySubang JayaSelangorMalaysia Department of Medicine Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia

Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric ***:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public *** purpose of the interviews was to explore challenges faced by them in the delivery of geriatric ***:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare ***,it faces challenges such as the lack of outcome monitoring,formal training,and workforce *** these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its ***,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare *** order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be ***:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR *** considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.

关键词： Home medication review Older adults Malaysia Pharmacists Low-to-middle-income countries

Preoperative diagnosis of colonic angiolipoma: A case report

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World Journal of Gastroenterology 2005年第32期11卷 5087-5089页

作者： maw-Soan Soon Division of Hepatogas-troenterologyChanghua Christian Hospital ChanghuaTaiwanChina

Angiolipoma, a common benign tumor mostly seen in the subcutaneous tissue, is a rare pathological condition in the gastrointestinal tract that is usually diagnosed postoperatively. In this case report, an angiolipoma was diagnosed preoperatively by imaging （including CT scans, abdominal echo, barium enema, and colonoscopy）. This pathology was confirmed postoperatively. Computed tomography scan, abdominal echo, and barium enema images were presented.

关键词： Angiolipoma Colon Computed tomography Sonography Contrast barium enema

Neuroprotective action of lithium in disorders of the central nervous system

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中南大学学报（医学版） 2011年第6期36卷 461-475页

作者： Chi-Tso CHIU De-maw CHUANG Section on Molecular Neurobiology National Institute of Mental HealthNational Institutes of Health

Substantial in vitro and in vivo evidence of neurotrophic and neuroprotective effects of lithium suggests that it may also have considerable potential for the treatment of neurodegenerative ***'s main mechanisms of action appear to stem from its ability to inhibit glycogen synthase kinase-3 activity and also to induce signaling mediated by brain-derived neurotrophic *** in turn alters a wide variety of downstream effectors,with the ultimate effect of enhancing pathways to cell *** addition,lithium contributes to calcium *** inhibiting N-methyl-D-aspartate receptor-mediated calcium influx,for instance,it suppresses the calcium-dependent activation of pro-apoptotic signaling *** inhibiting the activity of phosphoinositol phosphatases,it decreases levels of inositol 1,4,5-trisphosphate,a process recently identified as a novel mechanism for inducing *** mechanisms allow therapeutic doses of lithium to protect neuronal cells from diverse insults that would otherwise lead to massive cell ***,moreover,has been shown to improve behavioral and cognitive deficits in animal models of neurodegenerative diseases,including stroke,amyotrophic lateral sclerosis,fragile X syndrome,and Huntington's,Alzheimer's,and Parkinson's *** lithium is already FDA-approved for the treatment of bipolar disorder,our conclusions support the notion that its clinical relevance can be expanded to include the treatment of several neurological and neurodegenerative-related diseases.

关键词：《中南大学学报:医学版》期刊摘要编辑部

Regenerable adsorbent for removing ammonia evolved from anaerobic reaction of animal urine

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Journal of Environmental Sciences 2006年第6期18卷 1176-1181页

作者： CHOU Liang-hsing TSAI Ru-in CHANG Jen-ray LEE maw-tien Department of Civil and Water Resource Engineering "National" Chiayi UniversityChia-YiTaiwanChina Department of Chemical Engineering "National" Chung Cheng UniversityChia-YiTaiwanChina Department of Applied Chemistry "National" Chiayi UniversityChia-YiTaiwanChina.

The waste gas evolved from biodegradation of animal urine contains ammonia causing environmental concerns. A new and effective method for removing ammonia from such waste gas using reactive adsorption is presented. In the process, activated carbon impregnated with H2SO4（H2SO4/C） is employed. Ammonia in the waste gas reacts with H2SO4 on the adsorbent instantaneously and completely to form （NIL）2SO4. The H2SO4/C adsorbent is high in NH3 adsorption capacity and regenerable. The NH3 removal capacity of this regenerable adsorbent is more than 30 times that of the adsorbents used normally in the industry. The spent H2SO4/C is regenerated by flowing low-pressure steam through the adsorbent bed to remove the （NH4）2SO4 from the adsorbent. The regeneration by-product is concentrated （NH4）2SO4 solution, which is a perfect liquid fertilizer for local use. Re-soaking the activated carbon with H2SO4 solution rejuvenates the activity of the adsorbent. Thus the H2SOJC can be reused repeatedly. In the mechanism of this reactive adsorption process, trace of H20 in the waste gas is a required, which lends itself to treating ammonia gas saturated with moisture from biodegradation of animal urine.

关键词： ammonia removal regenerable adsorbent reactive adsorption biodegradation of animal urine activated carbon

Appendicitis-mimicking presentation in fishbone induced microperforation of the distal duodenum:A case report

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World Journal of Gastrointestinal Surgery 2020年第2期12卷 77-84页

作者： Daniel Lim Cheng-maw Ho Department of Surgery National Taiwan University HospitalTaipei 100Taiwan College of Medicine and Veterinary Medicine University of EdinburghEdinburgh EH164TJUnited Kingdom Victoria Hospital Kirkcaldy NHS LothianSouth-East Scotland Deanery KY25AHUnited Kingdom

BACKGROUND Upper gastrointestinal fishbone microperforations are rare and not commonly reported in medical *** the increasing use of computer tomography(CT)imaging and the employment of the Alvardo criteria,misdiagnosis of acute appendicitis can still *** report the rare case of an elderly Chinese gentleman who had a fish-bone induced microperforation of the duodenum that closely mimicked the symptoms of acute *** SUMMARY This 79-year-old man presented with migratory lower abdominal pain that localized at his periumbilical region and right lower *** had associated pyrexia,general malaise and was noted to have an elevated white cell *** investigations initially revealed a distended appendix which was resected laparoscopically but showed no obvious signs of gross *** patient then deteriorated clinically and had increased oxygen requirements immediately after the *** prompted further investigations.A further review of his CT scan revealed a fine fishbone microperforation in the distal duodenum associated with retroperitoneal abscess formation and seepage extending into the right lower *** was then started on broad spectrum intravenous antibiotics and subsequently underwent a laparotomy 12 h later to manage the obscure aetiology and to drain the *** post-operative course was uneventful and he was discharged 11 d later including a 2-d stay in the intensive care *** This case offers an insight into a potential mimic of acute appendicitis and the diagnostic difficulties experienced in such presentations.

关键词： Fish bone Duodenal microperforation Acute appendicitis mimic Case report Observer error

Extracting DC bus current information for optimal phase correction and current ripple in sensorless brushless DC motor drive

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Journal of Zhejiang University-Science C(Computers and Electronics) 2014年第4期15卷 312-320页

作者： Zu-sheng HO Chii-maw UANG Ping-chieh WANG Department of Electronic Engineering I-Shou University

Brushless DC motor(BLDCM) sensorless driving technology is becoming increasingly established. However, optimal phase correction still relies on complex calculations or algorithms. In finding the correct commutation point, the problem of phase lag is introduced. In this paper, we extract DC bus current information for auto-calibrating the phase shift to obtain the correct commutation point and optimize the control of BLDC sensorless driving. As we capture only DC bus current information, the original shunt resistor is used in the BLDCM driver and there is no need to add further current sensor components. Software processing using only simple arithmetic operations successfully accomplishes the phase correction. Experimental results show that the proposed method can operate accurately and stably at low or high speed, with light or heavy load, and is suitable for practical applications. This approach will not increase cost but will achieve the best performance/cost ratio and meet market expectations.

关键词： Brushless motors Electric motors Motor drives Phase control Phase estimation Sensorless control

Successful endoscopic sclerotherapy for cholecystojejunostomy variceal bleeding in a patient with pancreatic head cancer

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World Journal of Gastroenterology 2010年第1期16卷 123-125页

作者： Yu-Chun Hsu Hsu-Heng Yen maw-Soan Soon Department of Gastroenterology Changhua Christian Hospital

Variceal bleeding outside the esophagus and stomach is rare but important because of its difficult diagnosis and *** from cholecystojejunostomy varices has been reported to be a late complication of palliative biliary surgery for chronic *** ectopic variceal bleeding has never been reported after palliative surgery for pancreatic cancer,probably because of the limited lifespan of these patients. Herein,we report our successful experience using endoscopic cyanoacrylate sclerotherapy to treat bleeding from cholecystojejunostomy varices in a 57-year-old man with pancreatic head *** our knowledge,this is the first case report in the literature of this rare complication.

关键词： Ectopic varix Pancreatic cancer Cholecystojejunostomy Sclerotherapy

Endoscopic ultrasonographic appearance of gastric emphysema

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World Journal of Gastroenterology 2005年第11期11卷 1719-1721页

作者： maw-Soan Soon Hsu-Heng Yen Anny Soon Otto S Lin Department of Gastroenterology Gastroenterology Section

Emphysematous gastritis (or phlegmonous gastritis) and gastric emphysema (or gastric pneumatosis) are variations of conditions associated with the presence of intramural air in the stomach. The presence of air in the gastric wall is a very rare clinical condition, associated with bacterial infection, increased intragastric pressure from gastric outlet obstruction, gastric mucosal disruption or air dissection from the mediastinum. In adults, this can occur in the setting of instrumentation-related injury, gastric outlet obstruction by gastric, duodenal or pancreatic malignancies or bowel ischemia. Here we describe a case of gastric emphysema related to repeated biliary stenting and partial duodenal obstruction in a patient with inoperable periampullary cancer, and provide the first description of the endoscopic ultrasonographic findings of gastric emphysema in the literature. In our case, endoscopic ultrasound showed a band of bright echogenicity arising from the submucosa layer, representing air in the gastric wall.

关键词： Endoscopic ultrasound Gastric emphysema Gastric pneumatosis