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Acute liver injury in a COVID-19 infected woman with mild symptoms:A case report

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World Journal of Clinical Cases 2023年第2期11卷 472-478页

作者： pei-Hsuan Lai Dah-ching Ding Department of Obstetrics and Gynecology Hualien Tzu Chi HospitalHualien 970Taiwan

BACKGROUND Coronavirus disease 2019(COVID-19)has spread rapidly,resulting in a pandemic in January 2020.Few studies have focused on the natural history and consequences of acute liver injury(ALI)in mild or asymptomatic COVID-19 patients,manifested by elevated aminotransferase levels.ALI is usually expected for severe COVID-19 cases.Here,we present a COVID-19 case with mild respiratory symptoms and significantly elevated alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels.CASE SUMMARY A 60-year-old woman without medical history or chronic illness received three COVID-19 vaccinations since the start of the pandemic.The patient was infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and presented with mild symptoms on July 12th,2022.Post-recovery,she underwent an examination at our hospital on August 30th,2022.AST and ALT levels in the liver function test were 207 U/L(normal value<39,5.3-fold increase)and 570 U/L(normal value<52,10.9-fold increase),respectively.The patient was diagnosed with ALI,and no treatment was prescribed.The following week,blood tests showed a reduction in both levels(ALT 124 U/L,AST 318 U/L).Two weeks later,AST and ALT levels had decreased to near the expected upper limits(ALT 40 U/L,AST 76 U/L).CONCLUSION Clinicians should pay attention to liver function testing during COVID-19 recovery regardless of the disease’s severity.

关键词： COVID-19 Hepatitis Pneumonia Aspartate aminotransferase Alanine aminotransferase Case report

Management of synchronous lateral pelvic nodal metastasis in rectal cancer in the era of neoadjuvant chemoradiation: A systemic review

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World Journal of Gastrointestinal Surgery 2020年第5期12卷 247-258页

作者： Jolene Si Min Wong Grace Hwei ching Tan Claramae Shulyn Chia Chin-Ann Johnny ong Melissa ching ching Teo Department of Sarcoma Peritoneal and Rare Tumours(SPRinT)Division of Surgery and Surgical OncologyNational Cancer Centre SingaporeSingapore 169610Singapore Duke-NUS Medical School 8 College RoadSingapore 169857Singapore Laboratory of Applied Human Genetics Division of Medical SciencesNational Cancer Centre SingaporeSingapore 169610Singapore Institute of Molecular and Cell Biology A*STAR Research Entities61 Biopolis DriveSingapore 138673Singapore

BACKGROUND Lateral pelvic lymph node(LLN)metastasis(LLNM)occur in up to 28%of patients with low rectal tumours.While prophylactic lateral pelvic lymph node dissection(LLND)has been abandoned by most western institutions in the era of neoadjuvant chemoradiation therapy(CRT),the role of selective LLND in patients with enlarged LLN on pre-CRT imaging remains unclear.Some studies have shown improved survival and recurrence outcomes when LLNs show"response"to CRT.However,no management algorithm exists to differentiate treatment for"responders"vs"non-responders".AIM To determine if selective LLND in patients with enlarged LLNs results in improved survival and recurrence outcomes.METHODS A systemic search of Pub Med and Embase databases for studies reporting on patients with synchronous radiologically suspicious LLNM(s-LLNM)in rectal cancer receiving preoperative-CRT was performed.RESULTS Fifteen retrospective,single-centre studies were included.793 patients with sLLNM were evaluated:456 underwent TME while 337 underwent TME with7,LLND post-CRT.In the TME group,local recurrence(LR)rates range from 12.5%to 36%.Five-year disease free survival(DFS)was 42%to 75%.In the TME with LLND group,LR rates were 0%to 6%.Five years DFS was 41.2%to 100%.Radiological response was seen in 58%.Pathologically positive LLN was found in up to 94%of non-responders vs 0%to 20%in responders.Young age,low tumour location and radiological non-response were associated with final positive LLNM and lowered DFS.CONCLUSION LLND is associated with local control in patients with s-LLNM.It can be performed in radiological non-responders given a large majority represent true LLNM.Its role in radiological responders should be considered in selected high risk patients.

关键词： Lateral pelvic lymph node Colorectal cancer Lateral pelvic lymph node dissection

Ruptured teratoma mimicking a pelvic inflammatory disease and ovarian malignancy:A case report

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World Journal of Clinical Cases 2023年第16期11卷 3852-3857页

作者： pei-Hsuan Lai Dah-ching Ding Department of Obstetrics and Gynecology Hualien Tzu Chi HospitalTzu Chi UniversityHualien 970Taiwan

BACKGROUND We report a case of ruptured ovarian teratoma mimicking pelvic inflammatory disease(PID)and ovarian malignancy.The case indicates the need for reviewing the information on ovarian teratomas,as the symptoms are vague,and,therefore,diagnosis and treatment had to be structured accordingly.CASE SUMMARY A 60-year-old woman was admitted to the emergency department with acute lower abdominal pain.She experienced weight loss and increased abdominal girth.Pelvic ultrasound and computed tomography revealed a 14-cm pelvic tumor.Laboratory examination revealed leukocytosis(white blood cell count:12620/μL,segment:87.7%)and high levels of C-reactive protein(18.2 mg/dL).Elevated levels of the tumor marker cancer antigen 19-9(367.8 U/mL,normal value<35 U/mL)were also noted.Due to the impression of a ruptured tuboovarian abscess or a tumor with malignancy,she immediately underwent an exploratory laparotomy.A ruptured ovarian tumor with fat balls,hair strands,cartilage,and yellowish fluid was observed on the right side.Right salpingooophorectomy was performed.A pathological examination revealed a mature cystic teratoma.The patient recovered after surgery and was discharged on postoperative day three.No antibiotics were administered.CONCLUSION This case illustrates the differential diagnosis of an ovarian tumor.Therefore,surgery is the mainstay for treating a ruptured teratoma.

关键词： Teratoma Ovarian cancer Pelvic inflammatory disease Ruptured Peritonitis Case report

Impregnation of carbonaceous nanofibers into glassy polymer-based composite membrane for CO_2 separation

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Chinese Journal of Chemical Engineering 2018年第11期26卷 2385-2390页

作者： Pannir Selvam Murugiah pei ching Oh Kok Keong Lau CO_2 Research Centre Institute of Contaminant ManagementChemical Engineering DepartmentUniversiti Teknologi PETRONAS

The development of defect-free composite membrane(CM) is often challenging due to poor dispersion and distribution of filler particles in the polymer matrix. Despite the attractive physicochemical properties and gas separation performance of carbon nanotube(CNT) based CM, CNT displayed poor dispersion characteristics in most polymer matrix domain. Instead of incorporating CNT, a viable alternative, carbon nanofiber(CNF) which exhibits similar properties as CNT, but improved dispersion quality in the polymer matrix is found. In this work,CNF particles were incorporated in poly(2,6-dimethyl-1,4-phenylene oxide)(PPOdm) polymer continuous phase for CM development. The optimum gas separation performance of the PPOdm-CNF CM(11.25 at 197.02 barrer of CO_2 permeability) was obtained at 3 wt% of CNF loading. Compared to pristine PPOdmmembrane,CO_2 permeability and CO_2/CH_4 selectivity of PPOdm-3 wt% CNF CM were enhanced by 180% and 55%, respectively.At 3 wt% CNF loading, the filler particles were dispersed and distributed more homogenously, in which no obvious CNF agglomeration was observed. In addition, the incorporation of CNF particles also enhanced the mechanical and thermal properties of the resultant CM.

关键词： Carbon nanofiber Composite membrane Carbon dioxide Gas separation

Starch metabolism and grain chalkiness under high temperature stress

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National Science Review 2016年第3期3卷 280-282页

作者： pei-ching Lo Li Hu Hidemi Kitano Makoto Matsuoka Graduate School of Bioagricultural Sciences Nagoya University Bioscience and Biotechnology Center Nagoya University

Rice is one of the most important staple crops,demand for which is increasing with population growth all over the world,especially in Asia.Because of recent global warming,significant reduction in yield and quality of rice has now become a serious problem.One of the most common damages incurred by high temperature(HT) stress is grain chalkiness.Chalky grains show loosely packed

关键词： QTLs GBSSI Starch metabolism and grain chalkiness under high temperature stress high

Turning in a Bipedal Robot

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Journal of Bionic Engineering 2013年第3期10卷 292-304页

作者： Jau-ching Lu Jing-Yi Chen pei-Chun Lin Department of Mechanical Engineering National Taiwan University Taipei 106 Taiwan

We report the development of turning behavior on a child-size bipedal robot that addresses two common scenarios： turning in place and simultaneous walking and turning. About turning in place, three strategies are investigated and compared, including body-first, leg-first, and body/leg-simultaneous, These three strategies are used for three actions, respectively： when walking follows turning immediately, when space behind the robot is very tight, and when a large turning angle is desired. Concerning simultaneous walking and turning, the linear inverted pendulum is used as the motion model in the single-leg support phase, and the polynomial-based trajectory is used as the motion model in the double-leg support phase and for smooth motion connectivity to motions in a priori and a posteriori single-leg support phases. Compared to the trajectory generation of ordinary walking, that of simultaneous walking and turning introduces only two extra parameters： one for determining new heading direction and the other for smoothing the Center of Mass （COM） trajectory. The trajectory design methodology is validated in both simulation and experimental environments, and successful robot behavior confirms the effectiveness of the strategy.

关键词： turning biped humanoid trajectory planning robot

Quantification of Carpaine and Antioxidant Properties of Extracts from Carica Papaya Plant Leaves and Stalks

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Journal of Bioresources and Bioproducts 2021年第4期6卷 350-358页

作者： Jing Ying Yap ching Lik Hii Sze Pheng ong Kuan Hon Lim Faridah Abas Kar Yong Pin Future Food Malaysia Department of Chemical and Environmental EngineeringFaculty of Science and EngineeringUniversity of Nottingham MalaysiaJalan Broga43500 SemenyihSelangor Darul EhsanMalaysia School of Pharmacy Faculty of Science and Engineering University of Nottingham MalaysiaJalan Broga43500 SemenyihSelangor Darul EhsanMalaysia Department of Food Science Universiti Putra Malaysia43400 SerdangSelangor Darul EhsanMalaysia Forest Research Institute Malaysia 52109 Kuala LumpurSelangor Darul EhsanMalaysia

Significance increase in dengue cases have been recorded worldwide every year and South East Asian countries have been badly affected.Currently,antiviral drug to treat dengue is still not available but papaya leaves extract(PLE)have been successfully used in treating dengue patients.Carpaine in PLE is the major active compounds that contributes to the anti-thrombocytopenic activity(raising platelet count in patient’s blood).The PLE also contains polyphenols that contribute to antioxidant properties.Studies were carried out to extract and quantify carpaine from young leaves,old leaves and stalks of papaya plant.Carpaine crystalline powders were successfully purified and confirmed by ^(1)H and ^(13)C NMR(Nuclear Magnetic Resonance).Young papaya leaves recorded significantly higher amount of carpaine(P<0.05)as compared with old leaves and stalks.Blending treatment showed significant effect(P<0.05)on the amount of carpaine extracted from the young and old leaves and blended young leaves showed significantly much higher amount of carpaine as compared with the unblended samples(P<0.05).In terms of total polyphenols content(TPC),young leaves(both unblended and blended samples)contained significantly higher amount of TPC(P<0.05)followed by the old leaves and stalks.Results also showed relationship between the TPC and the 1,1-diphenyl-2-picrylhydrazyl(DPPH)assay scavenging activities namely IC_(50)(R^(2)=0.9743)and acid equivalent antioxidant capacity(AEAC)(R^(2)=0.9581).Both young and old leaves also showed significantly higher(P<0.05)DPPH scavenging activities as compared with the stalks in both unblended and blended samples.Young papaya leaves were recommended as source of material to extract carpaine for future development of drug in dengue treatment.

关键词： Antioxidants Carica papaya Carpaine Dengue Total polyphenols

Perceptions of Malaysian medical students from different academic years on primary care:a qualitative research

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Family Medicine and Community Health 2020年第1期8卷 1-7页

作者： Sook ching Chan Jaya Vinoshairine Ganeson Jee Tat ong Sandheep Sugathan Community Based Department Faculty of MedicineUniversiti Kuala Lumpur Royal College of Medicine PerakIpohPerakMalaysia Hospital Sultanah Bahiyah Alor SetarKedah Darul AmanMalaysia Hospital Kuala Pilah Kuala PilahNegeri SembilanMalaysia Department of Community Medicine Quest International University PerakIpohPerakMalaysia

Objective To explore the perception of medical students from a private medical college in Perak,Malaysia,on primary care practice and induce the factors influencing their perception and willingness to consider primary care as a career pathway.Design Qualitative study using focus group discussions.Participants’responses were audio recorded,transcribed,grouped under various domains and listed out and analysed.Setting A private medical college in Perak state,Malaysia.Participants Forty-six medical students from years 2 to 5 were included.Eight focus groups were formed with two focus groups from each academic year(six students each in seven groups and four students in one group).Students were informed through their respective student leader of each year and received a participant information sheet and an informed consent form which were completed and returned if they decided to participate in the focus group discussions.results The participants had different levels of understanding of primary care depending on their level of exposure to primary care.Senior students with more exposure had a better understanding about primary care and its services.Attractive factors towards choosing primary care as a career included short working hours with a more balanced family and social life,being able to treat patients as a whole with continuity of care and closer relationship with patients.Unattractive factors included routine,unchallenging and boring practice,poor salary,work overload and administrative work in government clinics,being less recognised by other specialties;and the poor perception by other doctors that those pursuing primary care were not‘brilliant enough’for more‘sophisticated disciplines like surgery or paediatrics’.Conclusion This study showed that the medical students’level of exposure to primary care played a crucial role in determining their understanding of primary care practice and their choice of career in primary care.Issues to be addressed include remuneration,workload and the prejudice against primary

关键词： discussions qualitative enough

Smart Dynamic Resource Allocation Model for Patient-Driven Mobile Medical Information System Using C4.5 Algorithm

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Journal of Electronic Science and Technology 2019年第3期17卷 231-241页

作者： ching-Kan Lo Hsing-Chung Chen pei-Yuan Lee Ming-Chou Ku Lidia Ogiela Cheng-Hung Chuang the Department of Orthopedics and the Department of Information Show-Chwan Health Care SystemChanghua 50008 the Department of Computer Science and Information Engineering and the Department of Bioinformatics and Medical Engineering Asia UniversityTaichung 41354 the Department of Orthopedics Show-Chwan Health Care SystemChanghua 50008 the Department of Applied Informatics Akademia Gorniczo-Hutnicza University of Science and TechnologyKrakow 30-059

A mobile medical information system (MMIS) is an integrated application (app) of traditional hospital information systems (HIS) which comprise a picture archiving and communications system (PACS), laboratory information system (LIS), pharmaceutical management information system (PMIS), radiology information system (RIS), and nursing information system (NIS). A dynamic resource allocation table is critical for optimizing the performance to the mobile system, including the doctors, nurses, or other relevant health workers. We have designed a smart dynamic resource allocation model by using the C4.5 algorithm and cumulative distribution for optimizing the weight of resource allocated for the five major attributes in a cooperation communications system. Weka is used in this study. The class of concept is the performance of the app, optimal or suboptimal. Three generations of optimization of the weight in accordance with the optimizing rate are shown.

关键词： Dynamic resource allocation electronic health record hospital information system mobile medical information system