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Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience

World Journal of Gastrointestinal Surgery 2024年第9期16卷 2787-2795页

作者： Yu-Hong Liu tzu-chiao lin Chao-Yang Chen Ta-Wei Pu Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan

BACKGROUND Stapled hemorrhoidopexy(SH)is currently a widely accepted method for treating the prolapse of internal *** anal stenosis is a critical complication of SH.A remedy for this involves the removal of the circumferential staples of the anastomosis,followed by the creation of a hand-sewn *** studies have reported modified SH procedures to improve *** hypothesized that our modified SH technique may help reduce complications of anal stenosis after *** To compare outcomes of staple removal at the 3-and 9-o’clock positions during modified SH in patients with mixed *** This was a single-center,retrospective,observational *** with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015,and January 1,2020,were *** operation time,blood loss,length of hospital stay,and incidence of minor or major complic-ations were *** Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015 and January 1,2020,were *** time,blood loss,length of hospital stay,and incidence of minor or major complications were *** investigated 187 patients(mean age,50.9 years)who had undergone our modified SH and 313 patients(mean age,53.0 years)who had undergone standard *** the modified SH group,54%of patients had previously undergone surgical intervention for hemorrhoids,compared with the 40.3%of patients in the standard SH *** modified SH group included five(2.7%)patients with anal stenosis,while 21(6.7%)patients in the standard SH group had complications of anal *** was a significant relationship between the rate of postoperative anal stenosis and the modified SH:0.251(0.085-0.741)and 0.211(0.069-0.641)in multiple regression *** modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in

关键词： Anal canal Hemorrhoids Prolapse Stapled hemorrhoidopexy Postoperative anal stenosis Modified stapled hemorrhoidopexy

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Emergent use of tube tip in pharynx technique in“cannot intubate cannot oxygenate”situation:A case report

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World Journal of Clinical Cases 2022年第34期10卷 12631-12636页

作者： tzu-chiao lin Yu-Wen Lai Shang-Hung Wu Department of Anesthesiology China Medical University HospitalTaichung City 404Taiwan

BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen *** this paper,we describe airway management in a patient with an extended parotid tumor that invaded the airways during CICO using the endotracheal tube tip in the pharynx(TTIP)*** SUMMARY A 43-year-old man was diagnosed with parotid tumor for>10 *** tomography and nasopharyngeal fiberoptic examination revealed a substantial mass from the right parotid region with a deep extension through the lateral pharyngeal region to the retropharyngeal region and obliteration of the nasopharynx to the *** excision was ***,we encountered CICO during anesthesia *** endotracheal tube was used as an emergency supraglottic airway device(TTIP)to ventilate the patient in a CICO situation where other tools such as laryngeal mask airway or mask ventilation were not suitable for this complicated and difficult *** patient did not experience desaturation despite sudden loss of definite *** tracheostomy,the pulse oximetry remained 100%with our technique of ventilating the *** arterial blood gas analysis revealed PaCO_(2)35.7 mmHg and PaO2242.5 mmHg upon 50%oxygenation *** Using an endotracheal tube as a supraglottic airway device,patients may have increased survival without experiencing life-threatening desaturation.

关键词： Tube tip in pharynx Difficult airway Difficult intubation Cannot intubate cannot oxygenate Case report

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Preservation of superior rectal artery in laparoscopically assisted subtotal colectomy with ileorectal anastomosis for slow transit constipation

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World Journal of Gastroenterology 2021年第22期27卷 3121-3129页

作者： Chien-Wei Wu Ta-Wei Pu Jung-Cheng Kang Cheng-Wen Hsiao Chao-Yang Chen Je-Ming Hu Kuan-Hsun lin tzu-chiao lin Department of Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colon and Rectal Surgery Department of SurgerySongshan BranchTri-Service General HospitalNational Defense Medical CenterTaipei 10581Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 10556Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colorectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan

BACKGROUND Slow transit constipation(STC)has traditionally been considered as a functional ***,evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic *** the patient does not meet the diagnosis of pelvic outlet obstruction and poorly response to conservative treatment,surgical intervention with subtotal colectomy may be *** most unwanted complication of the procedure is anastomotic leakage,however,preservation of the superior rectal artery(SRA)may reduce its *** To evaluate the preservation of the SRA in laparoscopically assisted subtotal colectomy with ileorectal anastomosis in STC *** This was a single-center retrospective observational *** was diagnosed after a series of examinations which included a colonic transit test,anal manometry,a balloon expulsion test,and a barium *** patients underwent laparoscopically assisted total colectomy with ileorectal anastomosis and were examined between January 2016 and January *** operation time,blood loss,time to first flatus,length of hospital days,and incidence of minor or major complications were *** A total of 32 patients(mean age,42.6 years)who had received laparoscopic assisted subtotal colectomy with ileorectal artery anastomosis and preservation of the *** patients were diagnosed with STC after a series of *** mean operative time was 151 min and the mean blood loss was 119 *** mean day of first time to flatus was 3.0 d,and the mean hospital stay was 10.6 *** were no any patients conversions to ***-operative minor complications including 1 wound infection and 1 case of *** was no surgical *** anastomosis leakage was noted in any of the *** Laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the SRA can significantly improve bowel function with careful patient selection

关键词： Slow transit constipation Superior rectal artery Anastomosis leakage Laparoscopic-assisted colorectal surgery Iliorectal anastomosis Colonic transit time

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World Journal of Clinical Cases 2024年第1期12卷 176-179页

作者： Hsin-Chia Angela lin Kam-Fai Lee tzu Hao Huang Division of General Surgery Department of SurgeryChang Gung Memorial HospitalChiayi 613Taiwan Department of Anatomic Pathology Chang Gung Memorial HospitalChiayi 613Taiwan

BACKGROUND Gastric IgG4-related disease(IgG4-RD)is rarely encountered in clinical practice,and especially more so among pediatric *** our knowledge,this is the first report of IgG4-RD presenting as a calcifying gastric mass in a *** describe how this entity was difficult to differentiate from a gastrointestinal stromal tumor(GIST)imaging-based ***,this case highlights the importance of considering IgG4-RD in the differential diagnosis of gastric tumor before performing surgical resection,especially to distinguish it from malignancy to avoid unnecessary *** SUMMARY The patient suffered from epigastric pain for several *** and computed tomography scan revealed a submucosal *** diagnoses included GIST,leiomyoma,teratoma,and mucinous ***,laparoscopic proximal gastrectomy allowed for the definitive diagnosis of IgG4-related stomach *** We emphasize the importance of considering IgG4-RD in the differential diagnosis of gastric submucosal tumors before performing surgical resection.

关键词： IgG4-related disease Gastrointestinal stromal tumor Child Pediatric Case report

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Add-on perceptual learning on refractive amblyopia in children

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International Journal of Ophthalmology(English edition) 2024年第10期17卷 1850-1856页

作者： Heng-chiao Huang Wan-Hua Cho Po-Chiung Fang Pei-Wen lin Yi-Hao Chen Hsiu-Mei Huang Department of Ophthalmology Chang Gung Memorial HospitalChiayi 613TaiwanChina Department of Ophthalmology Chi-Mei Medical CenterTainan 710TaiwanChina Department of Ophthalmology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung City 833TaiwanChina School of Medicine Chang Gung UniversityTaoyuan City 333TaiwanChina

AIM:To evaluate the visual outcomes of standard amblyopic treatment add-on training via perceptual learning in refractive amblyopic children and to identify the risk factors for treatment ***:Retrospective charts were reviewed in children with refractive amblyopia who received standard treatment and add-on Cambridge Visual Stimulator(CAM)*** add-on CAM group that was enrolled had worn full-corrected glasses for at least 2mo before training.A control group received only the standard *** success was defined as best-corrected visual acuity(BCVA)≥20/*** age,sex,initial BCVA,refractive errors,sessions and duration of training,and final BCVA were ***:A total of 209 children(129 children in add-on CAM group and 80 children in control group)were ***-six percent of unilateral and 87%of bilateral amblyopic children achieved treatment *** children with unilateral or bilateral moderate amblyopia,the duration to reach BCVA≥20/25 was significantly shorter in add-on CAM group than in control *** initial BCVA(P<0.001)and high astigmatism(P=0.007)were risk factors for treatment failure after add-on CAM ***,sex,and types of refractive error were not associated with treatment ***:Add-on CAM training is an effective strategy for visual improvement and can shorten the treatment course when the effect of standard treatment is limited in amblyopic children.

关键词： amblyopia amblyopic children add-on Cambridge Visual Stimulator training astigmatism

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Clinical associations of corneal neuromas with ocular surface diseases

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Neural Regeneration Research 2024年第1期19卷 140-147页

作者： Charmaine Jan Li Toh Chang Liu Isabelle Xin Yu Lee Molly tzu Yu lin Louis Tong Yu-Chi Liu Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore Singapore Eye Research Institute Singapore Department of Cornea and External Eye Disease Singapore National Eye CentreSingapore Ophthalmology and Visual Sciences Academic Clinical Program Duke-NUS Medical SchoolSingapore

Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or *** formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ***,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas *** recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface *** neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and *** this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment *** current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more *** imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.

关键词： cornea corneal diseases corneal nerve corneal neuropathy in vivo confocal microscopy microneuroma neuroma ocular surface diseases

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Parathyroidectomy restored bone mineral density in a neglected femoral neck fracture with renal osteodystrophy:A case report

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World Journal of Clinical Cases 2024年第25期12卷 5761-5768页

作者： tzu-Ching lin Shih-Wei lin Kuang-Ting Yeh Department of Education Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualien 970473Taiwan ProvinceChina Department of Orthopedics Ten-Chan Medical GroupTaoyuan 320003Taiwan ProvinceChina Department of Orthopedics Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationHualien 970473Taiwan ProvinceChina Department of Graduate Institute of Clinical Pharmacy Tzu Chi UniversityHualien 970374Taiwan ProvinceChina

BACKGROUND This case report contributes to the medical literature by highlighting the successful management of a neglected femoral neck fracture in a patient with renal osteodystrophy and secondary hyperparathyroidism(SHPTH)who was on dialysis due to end-stage renal disease(ESRD).It underscores the efficacy of parathyroidectomy(PTX)in restoring bone mineral density(BMD)and promoting fracture healing,addressing a significant complication in ESRD *** SUMMARY A 36-year-old female with renal osteodystrophy and on dialysis due to ESRD presented with a history of left patellar tendon rupture and later,a right achilles tendon avulsion *** right hip pain led to the discovery of a neglected right femoral neck fracture,which was initially overlooked due to the patient’s complex medical *** months post-achilles tendon repair,the patient underwent PTX to manage the refractory *** postoperative course included rehabilitation and weight-bearing ***,2 years after osteosynthesis,radiographic assessments indicated a solid union of the periprothesis fracture and significant improvement in BMD,showcasing the efficacy of the treatment *** PTX,combined with appropriate rehabilitation,is crucial for improving BMD and fracture healing in ESRD patients with SHPTH.

关键词： Secondary hyperparathyroidism Parathyroidectomy Fracture Renal osteodystrophy Case report

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English Speaking Online in the Turkish Teaching Context:A Theoretical Approach

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Sino-US English Teaching 2024年第5期21卷 222-226页

作者： Zehra Betul Turkmen tzu Yu Allison lin Gaziantep University GaziantepTurkey

The world initiated a new era with the emergence of the Covid-19 *** all around the globe,including Turkey,was impacted to a great *** teachers and learners were required to adapt to online education within a short period of *** previous studies had focused on the impacts of teaching English in general for teachers and learners,studies focusing on teaching of the speaking skills online particularly in the Turkish context was absent in the ***,the gap which was to be considered appropriate for this research is related to comprehending the perceptions and challenges EFL teachers confronted while attempting to teach the speaking skills online within the Turkish *** article aims to have a theoretical contribution to the current research,in order to see the significance of the Turkish context,as online teaching of English speaking was to be considered beneficial for learners,as it increased confidence for the interaction.

关键词： English teaching speaking online higher education Covid-19 pandemic

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A fast forward computational method for nuclear measurement using volumetric detection constraints

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Nuclear Science and Techniques 2024年第2期35卷 47-63页

作者： Qiong Zhang lin-Lv lin University of Electronic Science and Technology of China Chengdu 610000China

Owing to the complex lithology of unconventional reservoirs,field interpreters usually need to provide a basis for interpretation using logging simulation *** the various detection tools that use nuclear sources,the detector response can reflect various types of information of the *** Monte Carlo method is one of the primary methods used to obtain nuclear detection responses in complex ***,this requires a computational process with extensive random sampling,consumes considerable resources,and does not provide real-time response ***,a novel fast forward computational method(FFCM)for nuclear measurement that uses volumetric detection constraints to rapidly calculate the detector response in various complex environments is ***,the data library required for the FFCM is built by collecting the detection volume,detector counts,and flux sensitivity functions through a Monte Carlo ***,based on perturbation theory and the Rytov approximation,a model for the detector response is derived using the flux sensitivity function method and a one-group diffusion *** environmental perturbation is constrained to optimize the model according to the tool structure and the impact of the formation and borehole within the effective detection ***,the method is applied to a neutron porosity tool for *** various complex simulation environments,the maximum relative error between the calculated porosity results of Monte Carlo and FFCM was 6.80%,with a rootmean-square error of 0.62 *** field well applications,the formation porosity model obtained using FFCM was in good agreement with the model obtained by interpreters,which demonstrates the validity and accuracy of the proposed method.

关键词： Nuclear measurement Fast forward computation Volumetric constraints

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Enhancing Safety in Autonomous Vehicle Navigation:An Optimized Path Planning Approach Leveraging Model Predictive Control

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Computers, Materials & Continua 2024年第9期80卷 3555-3572页

作者： Shih-lin lin Bo-Chen lin Graduate Institute of Vehicle Engineering National Changhua University of EducationChanghua50007TaiwanChina

This paper explores the application of Model Predictive Control(MPC)to enhance safety and efficiency in autonomous vehicle(AV)navigation through optimized path *** evolution of AV technology has progressed rapidly,moving from basic driver-assistance systems(Level 1)to fully autonomous capabilities(Level 5).Central to this advancement are two key functionalities:Lane-Change Maneuvers(LCM)and Adaptive Cruise Control(ACC).In this study,a detailed simulation environment is created to replicate the road network between Nantun andWuri on National Freeway No.1 in *** MPC controller is deployed to optimize vehicle trajectories,ensuring safe and efficient *** onboard sensors,including vehicle cameras and millimeterwave radar,are used to detect and respond to dynamic changes in the surrounding environment,enabling real-time decision-making for LCM and *** simulation resultshighlight the superiority of the MPC-based approach in maintaining safe distances,executing controlled lane changes,and optimizing fuel ***,the MPC controller effectively manages collision avoidance,reduces travel time,and contributes to smoother traffic flow compared to traditional path planning *** findings underscore the potential of MPC to enhance the reliability and safety of autonomous driving in complex traffic *** research will focus on validating these results through real-world testing,addressing computational challenges for real-time implementation,and exploring the adaptability of MPC under various environmental *** study provides a significant step towards achieving safer and more efficient autonomous vehicle navigation,paving the way for broader adoption of MPC in AV systems.

关键词： Autonomous driving model predictive control(MPC) lane change maneuver(LCM) adaptive cruise control(ACC)

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