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Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor:A case report and review of the literature

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World Journal of Clinical Cases 2021年第4期9卷 838-846页

作者： Yi-Lun Hsieh wen-hung hsu Ching-Chun Lee Chun-Chieh Wu Deng-Chyang Wu Jeng-Yih Wu Division of Gastroenterology Department of Internal MedicineKaohsiung Medical University HospitalKaohsiung 807Taiwan Division of Colorectal Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung 807Taiwan Department of Pathology Kaohsiung Medical University HospitalKaohsiung 807Taiwan

BACKGROUND Gastric gastrointestinal stromal tumor(GIST)is the most common etiology of gastroduodenal *** gastroduodenal intussusception caused by gastric GIST is mostly treated by surgical resection,the first case of gastroduodenal intussusception caused by gastric GIST was treated by endoscopic submucosal dissection(ESD)in Japan in *** SUMMARY An 84-year-old woman presented with symptoms of postprandial fullness with nausea and occasional vomiting for a ***,she visited a local clinic for help,where abdominal sonography revealed a space-occupying lesion around the liver,so she was referred to our hospital for further *** sonography was repeated,which revealed a mass with an alternating concentric echogenic ***(EGD)was performed under the initial impression of gastric cancer with central necrosis and showed a tortuous distortion of gastric folds down from the lesser curvature side to the duodenal bulb with stenosis of the gastric *** was barely passed through to the 2nd portion of the duodenum and a friable ulcerated mass was *** differential diagnoses were suspected,including gastroduodenal intussusception,gastric cancer invasion to the duodenum,or pancreatic cancer with adherence to the gastric antrum and *** computed tomography for further evaluation was arranged and showed gastroduodenal intussusception with a long stalk polypoid mass 5.9 cm in the duodenal *** the impression of gastroduodenal intussusception,ESD was performed at the base of the gastroduodenal intussusception;unfortunately,a gastric perforation was found after complete resection was accomplished,so gastrorrhaphy was performed for the perforation and retrieval of the huge polypoid *** gastric tumor was pathologically proved to be a *** the operation,there was no digestive disturbance and the patient was discharged uneventfully on the 10th day following the op

关键词： Gastric gastrointestinal stromal tumor Endoscopic submucosal dissection Gastro-duodenal intussusception Elderly Esophagogastroduodenoscopy Gastrointestinal obstruction Case report

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CYP2C19 polymorphism influences Helicobacter pylori eradication

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World Journal of Gastroenterology 2014年第43期20卷 16029-16036页

作者： Chao-hung Kuo Chien-Yu Lu Hsiang-Yao Shih Chung-Jung Liu Meng-Chieh Wu Huang-Ming Hu wen-hung hsu Fang-Jung Yu Deng-Chyang Wu Fu-Chen Kuo Division of Gastroenterology Department of Internal MedicineKaohsiung Medical University Hospital Department of Medicine Faculty of MedicineCollege of Medicine and Center for Stem Cell ResearchKaohsiung Medical University Department of Internal Medicine Kaohsiung Municipal Hsiao-Kang Hospital Graduate Institute of Public Health Kaohsiung Medical University School of Medicine College of MedicineE-Da HospitalI-Shou University

The known factors that have contributed to the decline of Helicobacter pylori (H. pylori) eradication rate include antibiotic resistance, poor compliance, high gastric acidity, high bacterial load, and cytochrome P450 2C19 (CYP2C19) polymorphism. Proton pump inhibitor (PPI) is important in the eradication regimen. The principal enzyme implicated in the metabolism of PPIs is CYP2C19. The effects of PPI depend on metabolic enzyme, cytochrome P450 enzymes, and CYP2C19 with genetic differences in the activity of this enzyme (the homozygous EM, heterozygous EM (HetEM), and poor metabolizer). The frequency of the CYP2C19 polymorphism is highly varied among different ethnic populations. The CYP2C19 genotype is a cardinal factor of H. pylori eradication in patients taking omeprazole- based or lansoprazole-based triple therapies. In contrast, the CYP2C19 polymorphism has no significant effect on the rabeprazole-based or esomeprazole-based triple therapies. The efficacy of levofloxacin-based rescue triple therapy might be also affected by the CYP2C19 polymorphism, but CYP2C19 genotypes did not show obvious impact on other levofloxacin-based rescue therapies. Choice of different PPIs and/or increasing doses of PPIs should be individualized based on the pharmacogenetics background of each patient and pharmacological profile of each drug. Other possible factors influencing gastric acid secretion (e.g., IL-1β- 511 polymorphism) would be also under consideration.

关键词： Helicobacter pylori CYP2C19 Polymorphism Eradication Rabeprazole Omeprazole Lansoprazole Pantoprazole Esomeprazole

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Impact of cap-assisted colonoscopy during transendoscopic enteral tubing:A randomized controlled trial

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World Journal of Gastroenterology 2020年第39期26卷 6098-6110页

作者： Quan wen Kang-Jian Liu Bo-Ta Cui Pan Li Xia Wu Min Zhong Lu Wei Hua Tu Yu Yuan Da Lin wen-hung hsu Deng-Chyang Wu Hong Yin Fa-Ming Zhang Medical Center for Digestive Diseases The Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210011Jiangsu ProvinceChina Department of Spleen and Stomach Diseases Hubei Provincial Hospital of Traditional Chinese MedicineWuhan 430061Hubei ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou 510080Guangdong ProvinceChina Division of Gastroenterology Department of Internal MedicineKaohsiung Medical University HospitalKaohsiung 807Taiwan Department of Gastroenterology Zigong Fourth People’s HospitalZigong 643000Sichuan ProvinceChina

BACKGROUND Colonic transendoscopic enteral tubing(TET)requires double cecal intubation,raising a common concern of how to save cecal intubation time and make the tube *** hypothesized that cap-assisted colonoscopy(CC)might reduce the second cecal intubation time and bring potential benefits during the TET *** To investigate if CC can decrease the second cecal intubation time compared with regular colonoscopy(RC).METHODS This prospective multicenter,randomized controlled trial was performed at four ***≥7 years needing colonic TET were recruited from August 2018 to January *** subjects were randomly assigned to two *** primary outcome was the second cecal intubation *** outcomes included success rate,insertion pain score,single clip fixation time,purpose and retention time of TET tube,length of TET tube inserted into the colon,and all procedurerelated(serious)adverse *** A total of 331 subjects were randomized to the RC(n=165)or CC(n=166)*** median time of the second cecal intubation was significantly shorter for CC than RC(2.2 min vs 2.8 min,P<0.001).In patients with constipation,the median time of second cecal intubation in the CC group(n=50)was shorter than that in the RC group(n=43)(2.6 min vs 3.8 min,P=0.004).However,no difference was observed in the CC(n=42)and RC(n=46)groups of ulcerative colitis patients(2.0 min vs 2.5 min,P=0.152).The insertion pain score during the procedure in CC(n=14)was lower than that in RC(n=19)in unsedated colonoscopy(3.8±1.7 vs 5.4±1.9;P=0.015).Multivariate analysis revealed that only CC(odds ratio[OR]:2.250,95%confidence interval[CI]:1.161-4.360;P=0.016)was an independent factor affecting the second cecal intubation time in difficult *** did not affect the colonic TET tube’s retention time and length of the tube inserted into the ***,multivariate analysis found that only endoscopic clip number(OR:2.201,95%CI:1.541-3.143;P<0.001)was an independe

关键词： Transendoscopic enteral tube Endoscopy Colonoscopy Fecal microbiota transplant Washed microbiota transplant Colon

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Dual specimens increase the diagnostic accuracy and reduce the reaction duration of rapid urease test

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World Journal of Gastroenterology 2010年第23期16卷 2926-2930页

作者： wen-hung hsu Sophie SW Wang Chiao-Yun Chen Ching-wen Chang Jaw-Yuan Wang Yuan-Chieh Yang Deng-Chyang Wu Ming-Tsang Wu Division of Gastroenterology Department of Internal MedicineKaohsiung Medical University Hospital Division of Internal Medicine Kaohsiung Municipal Hsiao-Kang Hospital Cancer Center Kaohsiung Medical University Hospital Department of Medical Imaging Kaohsiung Medical University Hospital Division of Gastrointestinal and General Surgery Department of SurgeryKaohsiung Medical University Hospital Department of Laboratory Medicine Kaohsi-ung Medical University Hospital Department of Internal Medicine Faculty of MedicineCollege of MedicineKaohsiung Medical University Graduate Institute of Occupational Safety and Health Kaohsiung Medical University

AIM:To evaluate the influence of multiple samplings during esophagogastr oduodenoscopy(EGD) on the accuracy of the rapid urease test,and the validity of newly developed rapid urease tests,HelicotecUT plus test and HelicotecUT test,CLO test and ProntoDry ***:A total of 355 patients undergoing EGD for dyspepsia were *** Helicobacter pylori(***) treatment status was either nave or *** biopsy specimens from antrum and gastric body,respectively,were obtained during *** antral specimens and dual(antrum+body) specimens were *** status of *** was evaluated by three different tests:culture,histology,and four different commercially available rapid urease tests(RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test,and established CLO test and ProntoDry *** status was defined as positive when the culture was positive or if there were concordant positive results among histology,CLO test and ProntoDry ***:When dual specimens were applied,sensitivity was enhanced and RUT reaction time was signif icantly reduced,regardless of their treatment *** minutes were enough to achieve an agreeable positive rate in all the *** newly developed RUTs showed comparable sensitivity,specif icity and accuracy to the established RUTs,regardless of patient treatment status,RUT reaction duration,and EGD biopsy ***:Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.

关键词： Rapid urease test Helicobacter pylori eradication HelicotecUT plus test HelicotecUT test Esophagogastroduodenoscopy

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Interannual variability of boreal summer intraseasonal oscillation over the northwestern Pacific influenced by the Pacific Meridional Mode

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Atmospheric and Oceanic Science Letters 2025年第1期18卷 6-11页

作者： Haoyu Zhou Pang-Chi hsu Lin Chen Yitian Qian Key Laboratory of Meteorological Disaster Ministry of Education/Joint International Research Laboratory of Climate and Environmental Change/Collaborative Innovation Center on Forecast and Evaluation of Meteorological DisastersNanjing University of Information Science and TechnologyNanjingChina

During the boreal summer,intraseasonal oscillations exhibit significant interannual variations in intensity over two key regions:the central-western equatorial Pacific(5°S-5°N,150°E-150°W)and the subtropical Northwestern Pacific(10°-20°N,130°E-175°W).The former is well-documented and considered to be influenced by the ENSO,while the latter has received comparatively less attention and is likely influenced by the Pacific Meridional Mode(PMM),as suggested by partial correlation analysis *** elucidate the physical processes responsible for the enhanced(weakened)intraseasonal convection over the subtropical northwestern Pacific during warm(cold)PMM years,the authors employed a moisture budget *** findings reveal that during warm PMM years,there is an increase in summer-mean moisture over the subtropical northwestern *** increase interacts with intensified vertical motion perturbations in the region,leading to greater vertical moisture advection in the lower troposphere and consequently resulting in convective *** a process is pivotal in amplifying intraseasonal convection *** observational findings were further verified by model experiments forced by PMM-like sea surface temperature patterns.

关键词： Boreal summer intraseasonal oscillation Interannual variability Pacific Meridional Mode Moisture budget analysis

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Particle Trajectories in Nonlinear Water Wave on Uniform Current

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China Ocean Engineering 2008年第4期22卷 611-621页

作者： hung-Chu hsu Yang-Yih CHEN Chia-Yan CHENG wen-Jer TSENG Tainan Hydraulics Laboratory National Cheng Kung University Department of Marine Environment and Engineering National Sun Yat-Sen University Coastal and Offshore Resources Research Center Fisheries Research Institute Department of Civil Engineering Cheng Shiu University

The study in this paper is focusing on trajectories of particles in the irrotational progressive water waves coexisting with uniform current. The parametric equations of particle trajectories over a range of levels in a Lagrangian type of description are developed analytically via the Euler-Lagrange transformation. The Lagrangian wave period of particle motion differing from the Eulerian wave period and the mass transport can also be obtained directly. The third-order solution of particle trajectory exhibits that they do not move in closed orbital motion but represent a net movement that decreases exponentially with the water depth. Uniform current is found to have significant effect on the trajectories and drift velocity of gravity waves. Overall, the influence of increased uniform current is to increase the relative horizontal distance traveled by a particle, as well as the magnitude of the time-averaged drift velocity on the free surface. For adverse current cases, a reverse behavior is found. The obtained third-order solutions satisfy the irrotational condition contrasted to the Gerstner waves and are verified by reducing to those of two-dimensional gravity waves in Lagrangian coordinates.

关键词： wave current Lagrangian Euler- Lagrange transformation particle trajectory

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Generate basic conceptual solutions for 3DPVS via utilizing TRIZ

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Bio-Design and Manufacturing 2019年第2期2卷 76-95页

作者： Haobo Yuan Ke Xing hung-Yao hsu School of Engineering University of South AustraliaMawson Lakes BlvdSalisbury 5095Australia

For cell culture scaffold innovation,3DPVS,namely 3D printed vibratory scaffold,was indicated as a future novel product,and it currently stands at conceptual development *** essential part for 3DPVS design is innovation,and TRIZ(algorithm of inventive problem solving)was studied as promising method for generating novel conceptual *** study targets designing and solving 3DPVS problems using TRIZ in the new *** aim to utilize TRIZ to conduct a multi-layer problem-solving process,which is to address design concerns of 3DPVS,especially at super-system to system *** this connection,TRIZ is used to address basic constraints and contradictions inside regarding trinity of 3D printing,3D scaffold and bio-based vibratory *** the study,five basic conceptual solutions for potential 3DPVS,namely magnetic,electric,mechanical,light and thermal based,have been generated.A brief evaluation has also been conducted,where magnetic-based 3DPVS shows the relatively highest applicability as potential *** with traditional experimental-oriented processes for biodesign,the approach of utilizing TRIZ can be inspiring and reinvigorating,which prepares a ground for future 3DPVS design to address detailed sub-system *** study might,to some extent,fill a gap in scaffold design and TRIZ literature and hopefully provide a comprehensive perspective of a timely topic.

关键词： 3DPVS 3D scaffold 3D printing Scaffold innovation Biodesign TRIZ Concept generation

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Perspectives on the combination of radiotherapy and targeted therapy with DNA repair inhibitors in the treatment of pancreatic cancer

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World Journal of Gastroenterology 2016年第32期22卷 7275-7288页

作者： Shih-hung Yang Ting-Chun Kuo hsu Wu Jhe-Cyuan Guo Chiun hsu Chih-hung hsu Yu-wen Tien Kun-Huei Yeh Ann-Lii Cheng Sung-Hsin Kuo Department of Oncology National Taiwan University Hospital and National Taiwan University Cancer Center Taipei 100 Taiwan Department of Internal Medicine National Taiwan University Hospital and National Taiwan University Cancer Center Taipei 100 Taiwan Institute of Clinical Medicine National Taiwan University Hospital and National Taiwan University Cancer Center Taipei 100 Taiwan Department of Traumatology National Taiwan University Hospital and National Taiwan University Cancer Center Taipei 100 Taiwan Department of Oncology National Taiwan University Hospital Yun-Lin Branch Yunlin 655 Taiwan Graduate Institute of Oncology National Taiwan University College of Medicine Taipei 100 Taiwan Department of Surgery National Taiwan University Hospital and National Taiwan University Cancer Center Taipei 100 Taiwan

Pancreatic cancer is highly lethal. Current research that combines radiation with targeted therapy may dramatically improve prognosis. Cancerous cells are characterized by unstable genomes and activation of DNA repair pathways, which are indicated by increased phosphorylation of numerous factors, including H2 AX, ATM, ATR, Chk1, Chk2, DNA-PKcs, Rad51, and Ku70/Ku80 heterodimers. Radiotherapy causes DNA damage. Cancer cells can be made more sensitive to the effects of radiation(radiosensitization) through inhibition of DNA repair pathways. The synergistic effects, of two or more combined non-lethal treatments, led to coadministration of chemotherapy and radiosensitization in BRCA-defective cells and patients, with promising results. ATM/Chk2 and ATR/Chk1 pathways are principal regulators of cell cycle arrest, following DNA doublestrand or single-strand breaks. DNA double-stranded breaks activate DNA-dependent protein kinase, catalytic subunit(DNA-PKcs). It forms a holoenzyme with Ku70/Ku80 heterodimers, called DNA-PK, which catalyzes the joining of nonhomologous ends. This is the primary repair pathway utilized in human cells after exposure to ionizing radiation. Radiosensitization, induced by inhibitors of ATM, ATR, Chk1, Chk2, Wee1, PP2 A, or DNA-PK, has been demonstrated in preclinical pancreatic cancer studies. Clinical trials are underway. Development of agents that inhibit DNA repair pathways to be clinically used in combination with radiotherapy is warranted for the treatment of pancreatic cancer.

关键词： Radiotherapy Pancreatic cancer DNA damage DNA repair Molecular targets

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Interactions of nonlinear gravity waves and uniform current in Lagrangian system

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Acta Oceanologica Sinica 2009年第1期28卷 89-98页

作者： hsu hung-Chu CHEN Yang-Yih LI Meng-Syue TSENG wen-Jer Tainan Hydraulics Laboratory National Cheng Kung University Department of Marine Environment and Engineering National Sun Yat-Sen University Department of Civil Engineering Cheng Shiu University

The particle trajectory on a weakly nonlinear progressive surface wave obliquely interacting with a uniform current is studied by using an Euler-Lagrange *** third-order asymptotic solution is a periodic bounded function of Lagrangian labels and time,which imply that the entire solution is *** explicit parametric solution highlights the trajectory of a water particle and mass transport associated with a particle displacement can now be obtained directly in Lagrangian *** angular frequency and Lagrangian mean level of the particle motion in Lagrangian form differ from those of the *** variations in the water particle orbits resulting from the oblique interaction with a steady uniform current of different magnitudes are also investigated.

关键词： Lagrangian particle trajectory nonlinear water wave current drift velocity

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Patients with cirrhosis during the COVID-19 pandemic:Current evidence and future perspectives

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World Journal of Clinical Cases 2021年第13期9卷 2951-2968页

作者： hung-Yuan Su Yin-Chou hsu Department of Emergency Medicine E-DA HospitalI-Shou UniversityKaohsiung 82445Taiwan China School of Chinese Medicine for Post Baccalaureate I-Shou UniversityKaohsiung 82445Taiwan China

The outbreak of coronavirus disease-2019(COVID-19)has resulted in a global public health *** with cirrhosis were deemed more susceptible to viral infection because of their dysregulated immune *** to the general population,cirrhotic patients exhibit various degrees of COVID-19-related liver injury,which could be attributed to direct virus cytotoxicity,systemic immune system activation,drug-related liver injury,reactivation of pre-existing liver disease,and hypoxic *** clinical symptoms in patients with cirrhosis and COVID-19 were similar to those in the general population with COVID-19,with a lower proportion of patients with gastrointestinal *** respiratory failure is the predominant cause of mortality in cirrhotic patients with COVID-19,a significant proportion of them lack initial respiratory *** evidence has shown that cirrhotic patients have relatively higher rates of morbidity and mortality associated with *** cirrhosis was also proposed as an independent factor affecting a poor prognosis and the need to consider COVID-19 palliative *** measures implemented to prevent the transmission of the virus are also essential for cirrhotic patients,and they should also receive standard cirrhosis care with minimal *** efficacy of the available COVID-19 vaccines in cirrhotic patients still needs investigation.

关键词： COVID-19 SARS-CoV-2 Cirrhosis Acute liver injury Prognosis Therapy

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