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Role of artificial intelligence in early detection and screening for pancreatic adenocarcinoma

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Artificial Intelligence in Medical Imaging 2022年第2期3卷 21-32页

作者： Kenneth Weicong Lin tiing Leong Ang James Weiquan Li Department of Gastroenterology and Hepatology Changi General HospitalSingapore 529889Singapore

Pancreatic adenocarcinoma remains to be one of the deadliest malignancies in the world despite treatment advancement over the past few *** low survival rates and poor prognosis can be attributed to ambiguity in recommendations for screening and late symptom onset,contributing to its late *** the recent years,artificial intelligence(AI)as emerged as a field to aid in the process of clinical decision *** efforts have been made in the realm of AI to screen for and predict future development of pancreatic ductal *** review discusses the use of AI in early detection and screening for pancreatic adenocarcinoma,and factors which may limit its use in a clinical setting.

关键词： Artificial intelligence Pancreatic cancer Pancreatic adenocarcinoma screening Early detection

Proton pump inhibitor use increases mortality and hepatic decompensation in liver cirrhosis

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World Journal of Gastroenterology 2019年第33期25卷 4933-4944页

作者： Marianne Anastasia De Roza Lim Kai Jia Wen Kam Yiong Huak Chan Andrew Kwek tiing Leong Ang John Chen Hsiang Department of Gastroenterology and Hepatology Changi General HospitalSinghealth 529889Singapore Clinical Trials and Research Unit Changi General HospitalSinghealth 529889Singapore Biostatistics Unit Yong Loo Lin School of MedicineNational University of SingaporeSingapore 160608Singapore

BACKGROUND Proton pump inhibitors(PPIs)are widely prescribed,often without clear *** are conflicting data on its association with mortality risk and hepatic decompensation in cirrhotic ***,PPI users and PPI exposure in some studies have been poorly defined with many confounding *** To examine if PPI use increases mortality and hepatic decompensation and the impact of cumulative PPI dose *** Data from patients with decompensated liver cirrhosis were extracted from a hospital database between 2013 to *** users were defined as cumulative defined daily dose(cDDD)≥28 within a landmark period,after hospitalisation for hepatic *** regression analysis for comparison was done after propensity score *** risk of hepatic decompensation was analysed by Poisson *** Among 295 decompensated cirrhosis patients,238 were PPI users and 57 were *** users had higher mortality compared to non-users[adjusted HR=2.10,(1.20-3.67);P=0.009].Longer PPI use with cDDD>90 was associated with higher mortality,compared to non-users[aHR=2.27,(1.10-5.14);P=0.038].PPI users had a higher incidence of hospitalization for hepatic decompensation[aRR=1.61,(1.30-2.11);P90 increases the risk of mortality.

关键词： Proton pump inhibitor Liver cirrhosis Mortality Hospitalisation Complications Portal hypertension Variceal bleeding Ascites Spontaneous bacterial peritonitis Hepatic encephalopathy

Evidence based review of the impact of image enhanced endoscopy in the diagnosis of gastric disorders

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世界胃肠内镜杂志：英文版（电子版） 2016年第20期8卷 741-755页

作者： Ikram Hussain tiing Leong Ang Department of Gastroen-terology and Hepatology Changi General Hospital

Gastric cancer is the third most common cause of cancer-related *** stages of gastric cancersgenerally have grim ***,good prognosis can be achieved if such cancers are detected,diagnosed and resected at early ***,early gastric cancers and its precursors often produce only subtle mucosal changes and therefore quite commonly remain elusive at the conventional examination with white light ***-enhanced endoscopy makes mucosal lesions more conspicuous and can therefore potentially yield earlier and more accurate *** years have seen growing work of research in support of various types of image enhanced endoscopy(IEE) techniques(e.g.,dye-chromoendoscopy;magnification endoscopy;narrow-band imaging;flexible spectral imaging color enhancement;and I-SCAN) for a variety of gastric *** this review,we will examine the evidence for the utilization of various IEE techniques in the diagnosis of gastric disorders.

关键词： Gastritis Gastric cancer Image enhanced endoscopy Chromoendoscopy Narrow band imaging

Second and third line treatment options for Helicobacter pylori eradication

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World Journal of Gastroenterology 2014年第6期20卷 1517-1528页

作者： Mingjun Song tiing Leong Ang Department of Gastroenterology Changi General Hospital

Helicobacter pylori is a highly successful bacterium with a high global prevalence and the infection carries significant disease burden. It is also becoming increasingly difficult to eradicate and the main reason for this is growing primary antibiotic resistance rates in a world where antibiotics are frequently prescribed and readily available. Despite knowing much more about the bacterium since its discovery, such as its genomic makeup and pathogenesis, we have seen declining treatment success. Therefore, clinicians today must be prepared to face one, two or even multiple treatment failures, and should be equipped with sufficient knowledge to decide on the appropriate salvage therapy when this happens. This article discusses the factors contributing to treatment failure and reviews the second and thirdline treatment strategies that have been investigated. Established empiric second line treatment options include both bismuth based quadruple therapy and levofloxacin based triple therapy. Antibiotic testing is recommended prior to initiating third line treatment. In the event that antibiotic susceptibility testing is unavailable, third line treatment options include rifabutin, rifaximin and sitafloxacin based therapies.

关键词： Helicobacter pylori Treatment failure Salvage ther

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内镜超声引导下组织获取和引流治疗现状

中华消化杂志 2021年第7期41卷 436-445页

作者：洪颋樑樟宜综合医院消化肝脏科新加坡国立大学Duke-NUS医学院SingHealth Duke-NUS学术医学中心新加坡国立大学Yong Loo Lin医学院新加坡

Endoscopic ultrasound(EUS)has both diagnostic and therapeutic clinical *** review article focuses on recent advances in two commonly performed procedures:EUS-guided tissue acquisition and EUS-guided *** is a shift from acquiring aspirates for cytology to obtaining tissue cores for histological diagnoses and molecular *** is growing interest and research about artificial intelligence in *** intelligence may potentially be useful to guide clinical decision making if biopsy results are *** range of EUS-guided drainage procedures has ***-guided drainage of walled-off pancreatic fluid collections is an accepted first line treatment ***-guided palliative drainage of malignant biliary obstruction after unsuccessful endoscopic retrograde cholangiopancreatography(ERCP)is now an accepted alternative to percutaneous transhepatic biliary ***-guided gallbladder drainage for management of acute cholecystitis is now a preferred option over percutaneous cholecystostomy for non-surgical *** EUS-created gastrointestinal anastomoses such as EUS-guided gastroenterostomy in the context of gastric outlet obstruction,and EUS-directed transgastric ERCP for Roux-en-Y gastric bypass are now technically feasible,but further prospective randomized studies are needed to establish the actual clinical impact.

关键词： Endoscopic ultrasound Histology Drainage treatment Gastrointestinal anastomoses

雷琼地区地壳及浅部地慢结构的背景噪声层析成像（英文）

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雷琼地区地壳及浅部地慢结构的背景噪声层析成像（英文）

Long-term albumin infusion in decompensated cirrhosis:A review of current literature

2019年中国地球科学联合学术年会

作者： Mohan Pan tiing Yang Yuhang Dai Le Ba Manh Southern University of Science and Technology Tongji University

＜正＞The region of Leizhou Peninsula and Hainan Island in Southern China, or Lei-Qiong for short, has seen extensive volcanic activities since late Cenozoic. Several lines of evidence from geophysics and geochemistry indicate the Hainan mantle plume, which likely originates from the lower mantle, is responsible for the large-flux, intraplate volcanisms in this region. However, the interactions between the rising mantle materials and the overlaying plate, in particular how surface volcanos connect with their deep

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World Journal of Hepatology 2021年第4期13卷 421-432页

作者： Yu Jun Wong Rahul Kumar Yu Jing Jonathan Chua tiing Leong Ang Department ofGastroenterology and Hepatology Changi General HospitalSingapore 529889Singapore Department of Internal Medicine Yong Loo Lin School of MedicineSingapore 117597Singapore

Decompensated cirrhosis is characterized by chronic inflammation and severe portal hypertension leading to systemic circulatory *** infusion has been widely used in decompensated cirrhosis in patients with spontaneous bacterial peritonitis,large-volume paracentesis and hepatorenal *** data suggest long-term albumin infusion has both oncotic and non-oncotic properties which may improve the clinical outcomes in decompensated cirrhosis *** review the current literature on both the established and potential role of albumin,and specifically address the controversies of long-term albumin infusion in decompensated cirrhosis patients.

关键词： Albumin Cirrhosis Hepatic encephalopathy Hepatorenal syndrome Acuteon-chronic liver failure Spontaneous bacterial peritonitis Large-volume paracentesis

磁振灌流造影:对“流动敏感交互反转恢复”的评论(英文)

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波谱学杂志 2010年第3期27卷 289-297页

作者：萧庭毅张程中研院生物医学科学研究所功能性微米磁振造影核心实验室台湾台北11571 台湾大学医学院医学系台湾台北10051

磁振造影在过去的数十年內取得了长足的进步,除了可提供生物解剖构造的资讯外,如今更可以进行组织灌流造影.磁振灌流造影主要可分成2种:动态磁感对比(Dynamic susceptibility Contrast)和动脉标记(Arterial Spin Labeling) .相较于动态... 详细信息

磁振造影在过去的数十年內取得了长足的进步,除了可提供生物解剖构造的资讯外,如今更可以进行组织灌流造影.磁振灌流造影主要可分成2种:动态磁感对比(Dynamic susceptibility Contrast)和动脉标记(Arterial Spin Labeling) .相较于动态磁感对比,动脉标记能非侵入性地观测灌流.动脉标记包括了数种技术:如CASL (continu-ous arterial spinlabeling) ,EPISTAR(echo planar imaging and signal targeting with al-ternating radiofrequency) ,PICORE(proxi mal inversion with a control for off-resonance effects)和FAIR(flow-sensitive alternating inversion recovery) .该文主要提供流动磁感交互反转恢复(FAIR)技术的综合介绍,包括其理论基础和实践,特别针对T1法在FAIR定量上的使用.定量上的困难亦将会在文章中被讨论.文章的最后总结FAIR之实际应用情形.

关键词： MRI 灌流造影 FAIR T1定量

Clinical utility,safety and tolerability of capsule endoscopy in urban Southeast Asian population

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World Journal of Gastroenterology 2003年第10期9卷 2313-2316页

作者： tiing-Leong Ang Kwong-Ming Fock Tay-Meng Ng Eng-Kiong Teo Yi-Lyn Tan Division of Gastroenterology Changi General HospitalSingapore

AIM:Capsule endoscopy has demonstrated its clinical utility in the evaluation of small bowel pathology in several Western studies. In this prospective study, we aimed to determine the clinical utility, safety and tolerability of capsule endoscopy in the evaluation of suspected small bowel disease in an urban Southeast Asian ***: We used the given (M2A) capsule endoscopy system in 16 consecutive patients with suspected small bowel pathology. In 9 patients the indication was obscure gastrointestinal bleeding, while in 6 patients it was to determine the extent of small bowel involvement in Crohn's disease. One patient underwent capsule endoscopy for evaluation of chronic abdominal pain. Patient's tolerability to the procedure was evaluated by standardized questionnaires and all patients were reviewed at one week to ensure that the capsule had been excreted without any adverse ***: Abnormal findings were present in 8 patients (50%). The cause of obscure gastrointestinal bleeding was determined in 5 out of 9 patients. Findings included 2 cases of angiodysplasia, 2 cases of jejunal ulcers and 1 case of both angiodysplasia and jejunal ulcer. One patient had small bowel erosions and foci of erythema of doubtful *** lesions were diagnosed in 2 out of 6 patients with Crohn's disease. Capsule endoscopy was well tolerated by all patients. One patient with Crohn's disease had a complication of capsule retention due to terminal ileum stricture. The capsule eventually passed out spontaneously after 1 ***: Our study, which represented the first Asian series, further confirms the diagnostic utility, safety and tolerability of wireless capsule endoscopy.

关键词：小肠疾病胶囊内窥镜检查耐受性安全性东南亚地区