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Anesthetic management for intraoperative acute pulmonary embolism during inferior vena cava tumor thrombus surgery:A case report

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World Journal of Clinical Cases 2022年第15期10卷 5111-5118页

作者： Pei-Yu hsu En-Bo Wu Department of Anesthesiology China Medical University HospitalChina Medical UniversityTaichung 404Taiwan Department of Anesthesiology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung 833Taiwan

BACKGROUND Acute pulmonary embolism(APE)is a rare and potentially life-threatening condition,even with early detection and prompt *** APE required specific ways for detecting since classic symptoms of APE in the awake patient could not be observed or self-reported by the patient under general *** SUMMARY A 44-year-old man with a history of hepatic cell carcinoma was admitted for radical nephrectomy and tumor thrombectomy due to a newly found kidney tumor with inferior vena cava(IVC)tumor *** that occurred during tumor thrombectomy with hypercapnia and *** capnography combined with the transesophageal echocardiography(TEE)provided a crucial differential diagnosis during the *** patient was continuously managed with aggressive intravenous fluid resuscitation and blood transfusion under continuous cardiac output monitoring to maintain hemodynamic *** completed the surgery under stable hemodynamics and was extubated after percutaneous mechanical thrombectomy by a certified *** were no significant symptoms and signs or obvious discomfort in the patient’s self-report during visits to the general *** Under general anesthesia for IVC tumor thrombus surgery,a sudden decrease in end-tidal carbon dioxide is the initial indicator of APE,which occurs before hemodynamic *** intraoperative APE is suspected,TEE is useful in the diagnosis and monitoring before computer tomography pulmonary *** clinical impression and supportive treatment and intervention should be conducted to obtain a better prognosis.

关键词： Acute pulmonary embolism Anesthesia End-tidal carbon dioxide Inferior vena cava tumor thrombus Transesophageal echocardiography Case report

Botulinum toxin injection for Cockayne syndrome with muscle spasticity over bilateral lower limbs:A case report

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World Journal of Clinical Cases 2021年第18期9卷 4728-4733页

作者： Lin-Chieh hsu po-Ying Chiang Wei-Pin Lin Yao-Hong Guo Pei-chun Hsieh Ta-Shen Kuan Wei-Chih Lien Yu-Ching Lin Department of Physical Medicine and Rehabilitation National Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainan 704Taiwan Department of Physical Medicine and Rehabilitation College of MedicineNational Cheng Kung UniversityTainan 704Taiwan Medical Device Innovation Center National Cheng Kung UniversityTainan 704Taiwan

BACKGROUND Cockayne syndrome(CS)is a rare inherited disease characterized by progressive motor symptoms including muscle weakness,joint contracture,ataxia,and *** neurotoxin type A has been used for conditions such as dystonia and spasticity,but it has rarely been used in patients with *** SUMMARY We report a 6-year-and-9-mo old girl diagnosed with CS who received an injection of botulinum neurotoxin type A to manage her difficulty with walking.A total dose of 210 units of botulinum neurotoxin type A was administered into the bilateral tibialis posterior and gastrocnemius *** evaluate the treatment effects on spasticity,joint contracture,pain,and ataxia,measurement tools including the Modified Ashworth Scale,the passive range of motion,the Faces Pain Scale-Revised,and the Scale for the Assessment and Rating of Ataxia,were *** first week after the injection,the Modified Ashworth Scale score for the plantar flexors and foot invertors improved bilaterally,along with advancements in the passive range of motion of the bilateral ankles and a lower score for the Faces Pain *** treatment effects persisted to the 8th week post-injection,but returned to baseline values at the 12th week post-injection,except for the pain *** Botulinum toxin injection can thus be considered as a treatment option for lower extremity spasticity,joint contracture,and pain derived from CS.

关键词： Cockayne syndrome Botulinum toxin Spasticity Pain Ataxia Case report

Conservative management of chronic gastric volvulus:44 cases over 5 years

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World Journal of Gastroenterology 2010年第33期16卷 4200-4205页

作者： Yao-chun hsu Chin-Lin Perng Jai-Jen Tsai Hwai-Jeng Lin chun-Ku Chen Division of Gastroenterology Department of MedicineLotung Poh-Ai HospitalIlan 26546TaiwanChina Division of Gastroenterology Department of MedicineVeterans General Hospital-Taipeiand School of MedicineNational Yang-MingUniversityTaipei 11217TaiwanChina Depar tment of Radiology Veterans General Hospital-TaipeiTaipei 11217TaiwanChina Department of Medicine NationalYang-Ming University HospitalIlan 26042TaiwanChina Division of Gastroenterology Department of MedicineChanghuaChristian HospitalChanghua 50006TaiwanChina

AIM:To investigate clinical outcomes of patients with chronic gastric volvulus(GV)who were managed conservatively over a 5-year ***:A total of 44 consecutive patients with chronic GV,as diagnosed by barium study between October 2002 and July 2008 were *** of these patients received conservative management initially without anatomical *** clinical manifestations,diagnostic work-ups,and clinical outcomes were *** sought to identify independent risk factors for poor outcome by using the Cox proportional hazards ***:The enrolled patients were predominantly male(n=37,84%)and of advanced age(median: 71 years old,interquartile range:57.5-78 years).Abdominal pain and fullness were the most common *** the follow-up period(median:16 mo,up to 69 mo),there was no severe complication,but symptomatic recurrence was noted in 28 patients(64%).Only one patient turned to elective surgery for frequent *** adhesion was the only independent risk factor associated with recurrence(hazard ratio:2.58,95%CI:1.08-6.13,P=0.033).CONCLUSION:Symptomatic recurrence of chronic GV is very common although serious complications infrequently occur with conservative *** adhesion is independently associated with recurrence.

关键词： Conservative treatment Gastric volvulus Upper gastrointestinal tract Barium study Peritoneal adhesion

Dynamics of cytokines predicts risk of hepatocellular carcinoma among chronic hepatitis C patients after viral eradication

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World Journal of Gastroenterology 2022年第1期28卷 140-153页

作者： Ming-Ying Lu Ming-Lun Yeh Ching-I Huang Shu-Chi Wang Yi-Shan Tsai Pei-Chien Tsai Yu-Min Ko Ching-Chih Lin Kuan-Yu Chen Yu-Ju Wei po-Yao hsu Cheng-Ting hsu Tyng-Yuan Jang Ta-Wei Liu po-Cheng Liang Ming-Yen Hsieh Zu-Yau Lin Shinn-Cherng Chen chung-Feng Huang Jee-Fu Huang Chia-Yen Dai Wan-Long Chuang Ming-Lung Yu Hepatitis Center and Hepatobiliary Division Department of Internal MedicineKaohsiung Medical University HospitalKaohsiung 80708Taiwan School of Medicine and Hepatitis Research Center College of MedicineCenter for Cancer Research and Center for Liquid BiopsyKaohsiung Medical UniversityKaohsiung 80708Taiwan Department of Medical Laboratory Science and Biotechnology Kaohsiung Medical UniversityKaohsiung 80708Taiwan Health Management Center Department of Community MedicineKaohsiung Medical University HospitalKaohsiung 80708Taiwan Institute of Biomedical Sciences National Sun Yat-Sen UniversityKaohsiung 80708Taiwan

BACKGROUND Chronic hepatitis C virus(HCV)infection induces profound alterations in the cytokine and chemokine signatures in peripheral *** of HCV by antivirals results in host immune modification,which may interfere with immune-mediated cancer *** HCV patients who remain at risk of hepatocellular carcinoma(HCC)following HCV eradication remains an unmet *** hypothesized that antiviral therapy-induced immune reconstruction may be relevant to HCC *** To investigate the impact of differential dynamics of cytokine expression on the development of HCC following successful antiviral *** One hundred treatment-naïve HCV patients with advanced fibrosis(F3/4)treated with direct-acting antivirals(DAAs)or peginterferon/ribavirin who achieved sustained virologic response[SVR,defined as undetectable HCV RNA throughout 12 wk(SVR12)for the DAA group or 24 wk(SVR24)for the interferon group after completion of antiviral therapy]were enrolled since *** primary endpoint was the development of new-onset *** HCC surveillance(abdominal ultrasound andα-fetoprotein)was performed every six months during the ***,64 serum cytokines were detected by the multiplex immunoassay at baseline and 24 wk after *** HCC developed in 12 of the 97 patients over 459 person-years after HCV *** univariate analysis,the Fibrosis-4 index(FIB-4),hemoglobin A1c(HbA1c),the dynamics of tumor necrosis factor-α(TNF-α),and TNF-like weak inducer of apoptosis(TWEAK)after antiviral therapy were significant HCC *** multivariate Cox regression model showed thatΔTNF-α(≤-5.7 pg/mL)was the most important risk factor for HCC(HR=11.54,95%CI:2.27-58.72,P=0.003 in overall cases;HR=9.98,95%CI:1.88-52.87,P=0.007 in the interferon group).An HCC predictive model comprising FIB-4,HbA1c,ΔTNF-α,andΔTWEAK had excellent performance,with 3-,5-,10-,and 13-year areas under the curve of 0.882,0.864,0.903,and 1.000,r

关键词： Hepatitis C virus Hepatocellular carcinoma Sustained virologic response Tumor necrosis factor-α Tumor necrosis factor-like weak inducer of apoptosis Cytokine

Artificial intelligence system for the detection of Barrett’s esophagus

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World Journal of Gastroenterology 2023年第48期29卷 6198-6207页

作者： Ming-Chang Tsai hsu-Heng Yen Hui-Yu Tsai Yu-Kai Huang Yu-Sin Luo Edy Kornelius Wen-Wei Sung chun-Che Lin Ming-Hseng Tseng Chi-Chih Wang Division of Gastroenterology and Hepatology Department of Internal MedicineChung Shan Medical University HospitalTaichung 402TaiwanChina School of Medicine Chung Shan Medical UniversityTaichung 402TaiwanChina Division of Gastroenterology Changhua Christian HospitalChanghua 500TaiwanChina Artificial Intelligence Development Center Changhua Christian HospitalChanghua 500TaiwanChina Department of post-Baccalaureate Medicine College of MedicineNational Chung Hsing UniversityTaichung 400TaiwanChina Department of Medical Informatics Chung Shan Medical UniversityTaichung 402TaiwanChina Department of Internal Medicine Chung Shan Medical University HospitalTaichung 402TaiwanChina Department of Endocrinology and Metabolism Chung-Shan Medical University HospitalTaichung 402TaiwanChina Department of Urology Chung Shan Medical University HospitalTaichung 402TaiwanChina Information Technology Office Chung Shan Medical University HospitalTaichung 402TaiwanChina

BACKGROUND Barrett’s esophagus(BE),which has increased in prevalence worldwide,is a precursor for esophageal *** there is a gap in the detection rates between endoscopic BE and histological BE in current research,we trained our artificial intelligence(AI)system with images of endoscopic BE and tested the system with images of histological *** To assess whether an AI system can aid in the detection of BE in our *** Endoscopic narrow-band imaging(NBI)was collected from chung Shan Medical University Hospital and Changhua Christian Hospital,resulting in 724 cases,with 86 patients having pathological *** senior endoscopists,who were instructing physicians of the Digestive Endoscopy Society of Taiwan,independently annotated the images in the development set to determine whether each image was classified as an endoscopic *** test set consisted of 160 endoscopic images of 86 cases with histological *** Six pre-trained models were compared,and EfficientNetV2B2(accuracy[ACC]:0.8)was selected as the backbone architecture for further evaluation due to better ACC *** the final test,the AI system correctly identified 66 of 70 cases of BE and 85 of 90 cases without BE,resulting in an ACC of 94.37%.CONCLUSION Our AI system,which was trained by NBI of endoscopic BE,can adequately predict endoscopic images of histological *** ACC,sensitivity,and specificity are 94.37%,94.29%,and 94.44%,respectively.

关键词： Barrett’s esophagus Artificial intelligence system Endoscopy Narrow-band imaging Gastroesophageal reflux disease

Precise Object Detection Using Iterative Superpixels Grouping Method

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Journal of Electronic Science and Technology 2017年第2期15卷 153-160页

作者： Cheng-Chang Lien Yu-Wei Lin Huan-po hsu Kun-Ming Yu Ming-Yuan Lei Department of Computer Science and infonnation Engineering chung Hua University Hsinchu 300 Architecture and Building Research lnstitute New Taipci Citv 100

The region completeness of object detection is very crucial to video surveillance, such as the pedestrian and vehicle identifications. However, many conventional object detection approaches cannot guarantee the object region completeness because the object detection can be influenced by the illumination variations and clustering backgrounds. In order to overcome this problem, we propose the iterative superpixels grouping （ISPG） method to extract the precise object boundary and generate the object region with high completeness after the object detection. First, by extending the superpixel segmentation method, the proposed ISPG method can improve the inaccurate segmentation problem and guarantee the region completeness on the object regions. Second, the multi- resolution superpixel-based region completeness enhancement method is proposed to extract the object region with high precision and completeness. The simulation results show that the proposed method outperforms the conventional object detection methods in terms of object completeness evaluation.

关键词： Index Terms-lterative superpixels grouping method (ISPG) object completeness object detection superpixel video surveillance.

Defect inspection of indoor components in buildings using deep learning object detection and augmented reality

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Earthquake Engineering and Engineering Vibration 2023年第1期22卷 41-54页

作者： Shun-Hsiang hsu Ho-Tin Hung Yu-Qi Lin Chia-Ming Chang Department of Civil and Environmental Engineering University of Illinois at Urbana-ChampaignUSA Department of Civil Engineering Taiwan University(NTU)TaiwanChina

Visual inspection is commonly adopted for building operation,maintenance,and *** durability and defects of components or materials in buildings can be quickly assessed through visual ***,implementations of visual inspection are substantially time-consuming,labor-intensive,and error-prone because useful auxiliary tools that can instantly highlight defects or damage locations from images are not ***,an advanced building inspection framework is developed and implemented with augmented reality(AR)and real-time damage detection in this *** this framework,engineers should walk around and film every corner of the building interior to generate the three-dimensional(3D)environment through ***,a trained YOLOv5 model real-time detects defects during this process,even in a large-scale field,and the defect locations indicating the detected defects are then marked in this 3D *** defects areas can be measured with centimeter-level accuracy with the light detection and ranging(LiDAR)on *** required damage information,including defect positions and sizes,is collected at a time and can be rendered in the 2D and 3D ***,this visual inspection can be efficiently conducted,and the previously generated environment can also be loaded to re-localize existing defect marks for future maintenance and change ***,the proposed framework is also implemented and verified by an underground parking lot in a building to detect and quantify surface defects on concrete *** seen in the results,the conventional building inspection is significantly improved with the aid of the proposed framework in terms of damage localization,damage quantification,and inspection efficiency.

关键词： visual inspection damage detection augmented reality damage quantification deep learning

Enhancement of matrix metalloproteinases 2 and 9 accompanied with neurogenesis following collagen glycosaminoglycan matrix implantation after surgical brain injury

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Neural Regeneration Research 2018年第6期13卷 1007-1012页

作者： Wei-Cherng hsu chun-Hsien Yu Woon-Man Kung Kuo-Feng Huang Department of Ophthalmology Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation School of Medicine Buddhist Tzu Chi University Department of Pediatrics Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Division of Neurosurgery Department of Surgery Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation Department of Exercise and Health Promotion College of Education Chinese Culture University

Surgical brain injury may result in irreversible neurological deficits. Our previous report showed that partial regeneration of a traumatic brain lesion is achieved by implantation of collagen glycosaminoglycan（CGM）. Matrix metalloproteinases（MMPs） may play an important role in neurogenesis but there is currently a lack of studies displaying the relationship between the stimulation of MMPs and neurogenesis after collagen glycosaminoglycan implantation following surgical brain trauma. The present study was carried out to further examine the expression of MMP2 and MMP9 after implantation of collagen glycosaminoglycan（CGM） following surgical brain trauma. Using the animal model of surgically induced brain lesion, we implanted CGM into the surgical trauma. Rats were thus divided into three groups：（1） sham operation group： craniotomy only;（2） lesion（L） group： craniotomy ＋ surgical trauma lesion;（3） lesion ＋ CGM（L ＋ CGM） group： CGM implanted following craniotomy and surgical trauma lesion. Cells positive for SOX2（marker of proliferating neural progenitor cells） and matrix metalloproteinases（MMP2 and MMP9） in the lesion boundary zone were assayed and analyzed by immunofluorescence and ELISA commercial kits, respectively. Our results demonstrated that following implantation of CGM after surgical brain trauma, significant increases in MMP2^＋/SOX2^＋ cells and MMP9^＋/SOX2^＋ cells were seen within the lesion boundary zone in the L ＋ CGM group. Tissue protein concentrations of MMP2 and MMP9 also increased after CGM scaffold implantation. These findings suggest that implantation of a CGM scaffold alone after surgical brain trauma can enhance the expression of MMP2 and MMP9 accompanied by neurogenesis.

关键词： collagen glycosaminoglycan matrix metalloproteinases surgical brain trauma neurogenesis neural regeneration

KREEP-rich breccia in Chang'E-5 regolith and its implications

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Science China Earth Sciences 2023年第11期66卷 2473-2486页

作者： Aoxin MEI Yun JIANG Shiyong LIAO Jinting KANG Fang HUANG Weibiao hsu CAS Key Laboratory of Planetary Sciences Purple Mountain ObservatoryChinese Academy of SciencesNanjing 210023China School of Astronomy and Space Sciences University of Science and Technology of ChinaHefei 230026China Center for Excellence in Comparative Planetology Chinese Academy of SciencesHefei 230026China CAS Key Laboratory of Crust-Mantle Materials and Environments School of Earth and Space SciencesUniversity of Science and Technology of ChinaHefei 230026China Institute of Deep Space Sciences Deep Space Exploration LaboratoryHefei 230026China

Lunar breccias provide crucial insights into the lithological diversity,shock processing and evolution of the lunar ***,we report a unique regolith breccia(CE5C0000YJYX070GP,hereafter CE5C)returned from the Chang'E-5(CE-5)***5C is one of the largest CE-5 breccias with a wide variety of lithologies,dominated by basaltic and mineral fragments as well as impact-melted clasts(including mid-Ti glasses,high-Al glasses,and crystal-bearing impact melt clasts).A comprehensive study of petrology and mineralogy on several representative clasts was conducted by integrating Scanning Electron Microscopy(SEM),Tescan Integrated Mineral Analysis(TIMA),Electron Probe Microanalysis(EPMA)and Laser Ablation Inductively Coupled Plasma Mass Spectrometry(LA-ICP-MS)*** is sufficient that CE5C is a mixed mare-highland regolith breccia,with a high percentage of KREEPy material(>20 vol.%),which has not been previously reported in other CE-5 *** mid-Ti impact glasses are characterized by high FeO(24.0 wt.%)and intermediate TiO_(2)(5.5 wt.%)contents,while the high-Al impact glasses have a chemical composition compatible with *** with the regional geological context of the CE-5 landing site,we propose that CE5C is likely derived from a mixed region between the P58/Em4 mare unit and its contiguous eastern *** the difficulty in assessing the representativeness of CE5C,the substantial presence of KREEPy material may provide valuable clues to the provenance of exotic ejecta,including the identification of unrecognized source craters situated in the eastern periphery of the sampling unit.

关键词： Chang'E-5 Regolith breccia Impact glasses KREEP Mare basalts