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Revisiting an Old Surgical Approach to the management of Tophaceous Gout

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Surgical Science 2017年第10期8卷 436-443页

作者： Lok Wah Noah So margaret woon man fok Kenny Yat Hong Kwan Kwok Keung Boris Fung Department of Orthopaedics and Traumatology Queen Mary Hospital Hong Kong China The University of Hong Kong Hong Kong China

The management of gouty tophi has generally shifted from surgical excision to conservative therapy due to surgery’s traditional association with high wound complication rate. Yet there are still patients who are indicated for surgical excision of gouty tophi, including for functional or cosmetic reasons. We describe our surgical technique and clinical outcomes in patients who underwent gouty tophi excision. This technique includes near complete excision of non-infected gouty tophi with preservation of important soft tissue structures. We have performed 44 elective tophi excision surgery in ten patients with an average follow-up of 29 months. The overall patients’ satisfaction rate was 90%. Only one post-operative infection was noted. No recurrence was observed. Our results suggested that this technique is a safe and effective option for a selected group of patients suffering from tophaceous gout.

关键词： Gout Tophus Surgical Procedures

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

Impact of gut–brain interaction in emerging neurological disorders

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World Journal of Clinical Cases 2023年第1期11卷 1-6页

作者： Muh-Shi Lin Yao-Chin Wang Wei-Jung Chen woon-man Kung Division of Neurosurgery Department of SurgeryKuang Tien General HospitalTaichung 43303Taiwan Department of Biotechnology and Animal Science College of BioresourcesNational Ilan UniversityYilan 26047Taiwan Department of Biotechnology College of Medical and Health CareHung Kuang UniversityTaichung 43302Taiwan Department of Health Business Administration College of Medical and Health CareHung Kuang UniversityTaichung 43302Taiwan Department of Emergency Min-Sheng General HospitalTaoyuan 33044Taiwan Graduate Institute of Injury Prevention and Control College of Public HealthTaipei Medical UniversityTaipei 11031Taiwan Division of Neurosurgery Department of SurgeryTaipei Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationNew Taipei City 23142Taiwan Department of Exercise and Health Promotion College of Kinesiology and HealthChinese Culture UniversityTaipei 11114Taiwan

The central nervous system(CNS)is a reservoir of immune *** immune glial cells are responsible for maintenance and defense against foreign *** blood–brain barrier(BBB)prevents detrimental pathogens and potentially overreactive immune cells from entering the *** the double-edged neuroinflammatory response is overloaded,it no longer has the protective function of promoting ***,microbiota and its derivatives may emerge as pathogen-associated molecular patterns of brain pathology,causing microbiome–gut–brain axis dysregulation from the *** dysbiosis of the gastrointestinal flora leads to subsequent alterations in BBB permeability,peripheral immune cells are recruited to the *** results in amplification of neuroinflammatory circuits in the brain,which eventually leads to specific neurological *** treatment strategies for gastrointestinal disorders may protect against specific immune responses to gastrointestinal disorders,which can lead to potential protective effects in the ***,this study investigated the mutual effects of microbiota and the gut–brain axis,which may provide targeting strategies for future disease treatment.

关键词： Neuroinflammation Blood–brain barrier Microbiota Gut–brain axis Neurological disorders

Therapeutic DC vaccination with IL-2 as a consolidation therapy for ovarian cancer patients： a phase Ⅰ/Ⅱ trial

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Cellular & Molecular Immunology 2015年第1期12卷 87-95页

作者： Soyoung Baek Yong-man Kim Sung-Bae Kim Choung-Soo Kim Seog-woon Kwon Yongman Kim HyunSoo Kim Hyunah Lee Office of Biomedical Professors Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea Department of Gynecology Asan Medical Center University of Ulsan College of Medicine Seoul Korea Department of Oncology Asan Medical Center University of Ulsan College of Medicine Seoul Korean Department of Urology Asan Medical Center University of Ulsan College of Medicine Seoul Korean Department of Laboratory Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea FCB-Pharmicell Co Ltd Seoul Korea

While ovarian cancer （OvCa） responds well to surgery and conventional chemotherapy, a high recurrence rate of advanced OvCa is observed. In this phase Ⅰ/Ⅱ study, 10 OvCa patients with minimal residual disease were treated with autologous dendritic cells （DCs） and IL-2 to evaluate the safety and feasibility of this therapeutic strategy and to characterize the antigen-specific immune alterations induced through this treatment. Approximately 4 months after initial debulking and chemotherapy, patients received two subcutaneous doses of autologous monocyte-derived DCs pulsed with autologous tumor lysate and keyhole limpet hemocyanin （KLH） at 4-week intervals. After each DC inoculation, low-dose （200 mlU） IL-2 was introduced for 14 consecutive days as an immune adjuvant. The vaccination was well tolerated. In three out of 10 patients, the inclusion status after the initial therapy showed the maintenance of complete remission （CR） after DC vaccination for 83, 80.9 and 38.2 months without disease relapse. One patient with stable disease （SD） experienced the complete disappearance of tumor after DC vaccination, and this status was maintained for 50.8 months until tumor recurrence. In two patients with partial response （PR） was not responding to DC vaccination and their disease recurred. In the three patients with disease free long-term survival, significant immune alterations were observed, including increased natural killer （NK） activity, IFN-γ-secreting T cells, immune-stimulatory cytokine secretion and reduced immune-suppressive factor secretion after DC vaccination. Thus, in patients with NED status and increased overall survival, DC vaccination induced tumor-related immunity, potentially associated with long-term clinical responses against OvCa.

关键词： dendritic cell vaccine immune response ovarian cancer phase Ⅰ/Ⅱ trial

Muscular atrophy and weakness in the lower extremities in Behçet’s disease: A case report and review of literature

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World Journal of Clinical Cases 2021年第20期9卷 5647-5654页

作者： Koh-woon Kim Jae-Heung Cho Department of Korean Medicine Rehabilitation College of Korean MedicineKyung Hee UniversitySeoul 02447South Korea

BACKGROUND In Behçet’s disease(BD),very few cases of muscular involvement have been reported *** natural history and therapeutic protocol for muscular involvement in BD are obscure due to the low incidence of peripheral neuropathy or myopathy in *** purpose of our study was to report a rare case of BD with chronic,focal forms of neuromyopathy and review the relevant *** SUMMARY We herein report the case of a 54-year-old man who presented with progressive muscular atrophy and weakness of both thighs 2 years after the presentation of the cardinal symptoms of *** past medical history,electrophysiological study,neurological examination,blood tests,magnetic resonance imaging study,and histological exam were performed for the differential *** literature on muscular involvement in BD was *** examination revealed that muscular involvement was predominantly localized in the proximal parts of the lower *** enhancement of several thigh muscles was observed on magnetic resonance imaging,which corresponded with the clinical *** study of one of the enhanced muscles showed denervation atrophy of the muscle with superimposed myopathic changes,while electrophysiological studies only suggested *** To our knowledge,this is the first case of neurogenic muscular atrophy with a specific set of clinical,radiological,electrophysiological,and histological findings reported in BD.

关键词： Behçet’s disease Muscular atrophy Muscular weakness Neuropathy Myopathy Case report

Iatrogenic giant pseudomeningocele of the cervical spine:A case report

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World Journal of Clinical Cases 2021年第31期9卷 9686-9690页

作者： Koh-woon Kim Jae-Heung Cho Department of Korean Medicine Rehabilitation College of Korean MedicineKyung Hee UniversitySeoul 02447South Korea

BACKGROUND Only a few cases of giant pseudomeningoceles have been reported in the ***,we report a giant pseudomeningocele of the cervical spine that was found after cervical laminectomy for an epidural hematoma following epidural *** SUMMARY A 47-year-old man presented with recurrent neck pain and posterior neck swelling after spinal *** resonance imaging of the cervical spine revealed fluid collection(5.6 cm×6.6 cm×11.2 cm)at the C3-6 level;this proved to be a *** related to the pseudomeningocele resolved following dural repair and fat graft *** Although rare,pseudomeningocele is a possibility in patients with recurrent back pain,radicular pain,or a persistent headache following spinal *** attention should be paid throughout the spinal procedure,whether conservative or non-conservative.

关键词： Iatrogenic spinal pseudomeningocele Giant pseudomeningocele Cervical spine C3-6 level Cervical laminectomy Case report

Single hepatocellular carcinoma ≤ 3 cm in left lateral segment:Liver resection or radiofrequency ablation?

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World Journal of Gastroenterology 2014年第14期20卷 4059-4065页

作者： Jong man Kim Tae Wook Kang Choon Hyuck David Kwon Jae-Won Joh Justin Sangwook Ko Jae Berm Park Hyunchul Rhim Joon Hyeok Lee Sung Joo Kim Seung woon Paik Department of Surgery Samsung Medical CenterSungkyunkwan University School of Medicine Department of Radiology and Center for Imaging Science Samsung Medical CenterSungkyunkwan University School of Medicine Department of Anesthesiology and Pain Medicine Samsung Medical CenterSungkyunkwan University School of Medicine Division of Gastroenterology Department of MedicineSamsung Medical CenterSungkyunkwan University School of Medicine

AIM: To evaluate the long-term results of radiofrequency ablation (RFA) compared to left lateral sectionectomy (LLS) in patients with Child-Pugh class A disease for the treatment of single and small hepatocellular car... 详细信息

关键词： Small hepatocellular carcinoma Left lateral segment Radiofrequency ablation Liver resection Tumor recurrence Survival

Secondary craniofacial necrotizing fasciitis from a distant septic emboli: A case report

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World Journal of Clinical Cases 2022年第31期10卷 11630-11637页

作者： Da-woon Lee Si-Hyun Kwak Hwan-Jun Choi Department of Plastic and Reconstructive Surgery College of MedicineSoonchunhyang UniversityCheonan-si 31151South Korea Institute of Tissue Regeneration College of MedicineSoonchunhyang UniversityCheonan-si 31151South Korea

BACKGROUND Craniofacial necrotizing fasciitis(CNF)is an uncommon but fatal infection that can spread rapidly through the subfascial planes in the head and neck *** usually progress rapidly,and early management is necessary to optimize *** SUMMARY A 43-year-old man visited our hospital with left hemifacial swelling involving the buccal and submandibular *** patient had fever for approximately 10 d before visiting the hospital,but did not report any other systemic *** tomography scan demonstrated an abscess with gas *** surgical drainage of the facial abscess,the patient’s systemic condition worsened and progressed to septic *** examination revealed pulmonary and renal *** percutaneous catheter drainage was performed at the renal abscess site,which caused improvement of *** patient showed no evidence of systemic complications during the 4-mo post-operative follow-up *** As the patient did not improve with conventional CNF treatment and symptoms only resolved after controlling the infection,the final diagnosis was secondary CNF with septic *** surgical decompression is important for CNF ***,if symptoms worsen despite early diagnosis and management,such as pus drainage and surgical intervention,clinicians should consider the possibility of a secondary abscess from internal organs.

关键词： Craniofacial necrotizing fasciitis Septic emboli Klebsiella pneumoniae Secondary Case report

Anaphylactic shock induced by polyethylene glycol after bowel preparation for the colorectal cancer surgery:A case report

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世界临床病例杂志 2023年第23期11卷 5589-5594页

作者： Go woon Park Nahyeon Park Jung Cheol Kuk Eung Jin Shin Dae Ro Lim Department of General Surgery Soonchunhyang Bucheon HospitalBucheon 14584South Korea

BACKGROUND Polyethylene glycol(PEG)is widely used as an additive because of its hydrophilic and chemically inert ***,there are been increasing reports of PEG allergies,including anaphylaxis,although they are still *** case report aims to raise awareness,that the commonly used bowel cleansing agent containing PEG can cause serious allergic *** SUMMARY Prior to surgery for sigmoid colon cancer,a 63-year-old man was prescribed a bowel cleansing agent containing *** 30 min of ingestion,he developed symptoms of anaphylactic shock and did not respond to initial intramuscular epinephrine *** diagnosis of anaphylaxis to PEG,he was stabilized with fluid hydration and continuous norepinephrine *** While allergic reactions to PEG are rare,they can be ***,it is crucial for clinicians to be aware of this possibility and to diagnose and resuscitate patients immediately.

关键词： Polyethylene glycol Anaphylaxis Sigmoid colon cancer Bowel preparation Case report