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Endoscopic foregut surgery and interventions:The future is *** state-of-the-art and my personal journey

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World journal of Gastroenterology 2019年第1期25卷 1-41页

作者： kenneth j chang H.H.Chao Comprehensive Digestive Disease Center University of CaliforniaIrvine Medical CenterOrangeCA 92868United States

In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic,the content will progress as follows: "lessons learned", "technical considerations"and "future opportunities". Lessons learned will provide a brief background and update on the most current literature. Technical considerations will include my personal experience, including tips and tricks that I have learned over the ***, future opportunities will address current unmet needs and potential new areas of development. The foregut is defined as "the upper part of the embryonic alimentary canal from which the pharynx, esophagus, lung, stomach, liver,pancreas, and part of the duodenum develop". Foregut surgery is well established in treating conditions such as gastroesophageal reflux disease(GERD), achalasia, esophageal diverticula, Barrett's esophagus(BE) and esophageal cancer, stomach cancer, gastric-outlet obstruction, and obesity. Over the past decade, remarkable progress in interventional endoscopy has culminated in the conceptualization and practice of endoscopic foregut surgery for various clinical conditions summarized in this paper. Regarding GERD, there are now several technologies available to effectively treat it and potentially eliminate symptoms, and the need for long-term treatment with proton pump *** the first time, fundoplication can be performed without the need for open or laparoscopic surgery. Long-term data going out 5-10 years are now emerging showing extended durability. In respect to achalasia, per-oral endoscopic myotomy(POEM) which was developed in japan, has become an alternative to the traditional Heller's myotomy. Recent meta-analysis show that POEM may have better results than Heller, but the issue of post-POEM GERD still needs to be addressed. There is now a resurgence of endoscopic tre

关键词： Endoscopy Foregut diseases Gastroesophageal reflux disease Endoscopic sleeve gastroplasty Endoscopic submucosal dissection Per-oral endoscopic myotomy Endo-hepatology

Endoscopic Ultrasonography and Fine-Needle Aspiration

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Endoscopic Ultrasonography and Fine-Needle Aspiration

Generalized polynomial chaos expansion by reanalysis using static condensation based on substructuring

第一届全球华人消化内镜学术大会

作者： kenneth j.chang

＜正＞Endoscopic ultrasonography （EUS） was first developed in the early 1980s by investigators in japan, Germany, and the United States, predominantly because of the limitations of transabdominal ultrasonography （US） in imaging the pancreas. However, prior to the development of EUS-guided fine needle aspiration （FNA） , EUS as an imaging modality （ without biopsy or intervention capabilities） had major limitations. For example, EUS alone cannot distinguish high specificity metastatic lymph nodes from benign

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Applied Mathematics and Mechanics(English Edition) 2024年第5期45卷 819-836页

作者： D.LEE S.chang j.LEE Department of Automotive Engineering Hanyang UniversitySeoul 04763Republic of Korea School of Mechanical Engineering Chungnam National UniversityDaejeon 34134Republic of Korea Department of Mechanical Robotics and Energy EngineeringDongguk UniversitySeoul 04620Republic of Korea

This paper presents a new computational method for forward uncertainty quantification(UQ)analyses on large-scale structural systems in the presence of arbitrary and dependent random *** method consists of a generalized polynomial chaos expansion(GPCE)for statistical moment and reliability analyses associated with the stochastic output and a static reanalysis method to generate the input-output data *** the reanalysis,we employ substructuring for a structure to isolate its local regions that vary due to random *** allows for avoiding repeated computations of invariant substructures while generating the input-output data *** substructuring with static condensation further improves the computational efficiency of the reanalysis without losing ***,the GPCE with the static reanalysis method can achieve significant computational saving,thus mitigating the curse of dimensionality to some degree for UQ under high-dimensional *** numerical results obtained from a simple structure indicate that the proposed method for UQ produces accurate solutions more efficiently than the GPCE using full finite element analyses(FEAs).We also demonstrate the efficiency and scalability of the proposed method by executing UQ for a large-scale wing-box structure under ten-dimensional(all-dependent)random inputs.

关键词： forward uncertainty quantification(UQ) generalized polynomial chaos expansion(GPCE) static reanalysis method static condensation substructuring

Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience

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World journal of Gastrointestinal Endoscopy 2019年第11期11卷 531-540页

作者： Rintaro Hashimoto john G Lee kenneth j chang Nabil El Hage Chehade jason B Samarasena H.H.Chao Comprehensive Digestive Disease Center Division of Gastroenterology and Hepatology Department of Medicine University of CaliforniaIrvine

BACKGROUND Establishing a diagnosis of pancreatic cystic lesions(PCLs)preoperatively still remains ***,endoscopic ultrasound(EUS)-through-the-needle biopsy(EUS-TTNB)using microforceps in PCLs has been made *** To assess the efficacy and safety of EUS-TTNB in the diagnosis of *** We retrospectively collected data of patients with PCLs who underwent both EUS-fine-needle aspiration(FNA)for cytology and EUS-TTNB at our institution since ***-FNA for cytology was followed by EUS-TTNB in the same *** of the cyst location,primary diagnosis,adverse events,and comparison between the cytologic fluid analyses and histopathology was *** success of EUS-TTNB was defined as visible tissue present after *** success was defined as the presence of a specimen adequate to make a histologic or cytologic *** A total of 56 patients(mean age 66.9±11.7,53.6%females)with PCLs were enrolled over the study *** mean cyst size was 28.8 mm(12-85 mm).The EUS-TTNB procedure was technically successful in all patients(100%).The clinical success rate using EUS-TTNB was much higher than standard EUS-FNA,respectively 80.4%(45/56)vs 25%(14/56).Adverse events occurred in 2 patients(3.6%)who developed mild pancreatitis that resolved with medical *** TTNB specimens,23 of 32 cases(71.9%)with intraductal papillary mucinous neoplasm were further differentiated into gastric type(19 patients)and pancreaticobiliary type(4 patients)based on immunochemical *** EUS-TTNB for PCLs was technically feasible and had a favorable safety ***,the diagnostic yield for PCLs was much higher with EUS-TTNB than standard EUS-FNA cytology and fluid carcinoembryonic *** should be considered as an adjunct to EUS-FNA and cytologic analysis in the diagnosis and management of PCLs.

关键词： Pancreatic cyst lesion Endoscopic ultrasound Endoscopic ultrasound-guided fine needle aspiration Cyst fluid Biopsy

Scoring microvascular invasion in hepatocellular carcinoma:are we meeting the grade?

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 184-187页

作者： Derek j.Erstad kenneth K.Tanabe Division of Surgical Oncology Baylor College of MedicineHoustonTXUSA Division of Gastrointestinal and Oncologic Surgery Harvard Medical School and Massachusetts General HospitalBostonMAUSA

Hepatocellular carcinoma(HCC)is the second leading cause of cancer-related mortality and has rising global incidence(1).A perplexing aspect of this disease is the high rate of recurrence(50-70%)after curative-intent,margin negative surgical resection(2).While de novo HCC arising from baseline chronic liver injury is a driver of late recurrences,most recurrences occur over a short interval and are thought to be spread from the index malignancy.

关键词： Microvascular invasion(MVI) hepatocellular carcinoma(HCC) hepatectomy

Effect of heat treatment on microstructure and mechanical properties of selective laser-melted PH13-8Mo stainless steel

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journal of Iron and Steel Research International 2024年第4期31卷 945-955页

作者： Yuan Zhang Xiang Liu chang-jun Wang chang Liu School of Material Science and Engineering Kunming University of Science and TechnologyKunming 650093YunnanChina Central Iron&Steel Research Institute Co. Ltd.Beijing 100081China

PH13-8Mo stainless steel powder with high sphericity and well fluidity was prepared by the plasma rotating electrode *** formed parts with ultra-high purity were manufactured by selective laser *** tensile and impact mechanical properties of the printed parts under three heat treatment regimes were compared to those without heat *** microstructure,grain orientation and phase composition were characterized by electron-backscatter diffraction,X-ray diffraction and transmission electron *** characterization results reveal that the addition of heat treatment makes the grains enlarge,and after different heat treatments,the average grain size from 1.51μm in the printed state increases to 2.78,3.09 and 2.06μm,*** formed parts are mainly composed of martensite and retained ***,the NiAl and M23C precipitates form,which are the major strengthening phases of PH13-8Mo stainless *** optimal heat treatment process is 925℃×1 h water cooling(WC)+0℃×2 h air cooling(AC)+540℃×4 h *** this heat treatment process,PH13-8Mo formed parts have the optimal comprehensive mechanical properties:the tensile strength,yield strength and impact energy KU2 are 1492 MPa,1432 MPa and 63 j,*** strengthening and toughening via heat treatment are mainly attributed to dislocation strengthening,the formation of NiAl and M23Co precipitates and the change of volume fraction of the retained austenite.

关键词： High-strength stainless steel-Selective laser melting-Heat treatment Microstructure Mechanical property

Individual and geospatial factors associated with receipt of colorectal cancer screening:a state-wide mixed-level analysis

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Family Medicine and Community Health 2024年第S2期12卷 18-25页

作者： jennifer E Bayly Mara A Schonberg Marcia C Castro kenneth j Mukamal Beth Israel Deaconess Medical Center BostonMassachusettsUSA Harvard Medical School BostonMassachusettsUSA Department of Global Health and Population Harvard T H Chan School of Public HealthBostonMassachusettsUSA

Background Colorectal cancer(CRC)is the second leading cause of cancer death in US adults but can be reduced by *** roles of individual and contextual factors,and especially physician supply,in attaining universal CRC screening remains *** We used data from adults 50-75 years old participating in the 2018 New York(NY)Behavioural Risk Factor Surveillance System linked to county-level covariates,including primary care physician(PCP)density and gastroenterologist(GI)*** were analysed in *** analyses included(1)ecological and geospatial analyses of county-level CRC screening prevalence and(2)individual-level Poisson regression models of receipt of screening,adjusted for socioeconomic and county-level contextual *** Mean prevalence of up-to-date CRC screening was 71%(95%CI 70%to 73%)across NY’s 62 ***-level CRC screening demonstrated significant spatial patterning(Global Moran’s I=0.14,p=0.04),consistent with the existence of county-level contextual *** both county-level and individual-level analyses,lack of health insurance was associated with lower likelihood of up-to-date screening(?−1.09(95%CI−2.00 to-0.19);adjusted prevalence ratio 0.68(95%CI 0.60 to 0.77)),even accounting for age,race/ethnicity and *** contrast,county-level densities of both PCPs and GIs were completely unassociated with screening at either the county or individual *** expected,other determinants at the individual level included education status and *** In this state-wide representative analysis,physician density was completely unassociated with CRC screening,although health insurance status remains strongly *** similar screening environments,broadened insurance coverage for CRC screening is likely to improve screening far more effectively than increased physician supply.

关键词： state screening county

Addressable structured light system using metasurface optics and an individually addressable VCSEL array

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Photonics Research 2024年第6期12卷 1129-1137页

作者： CHENYANG WU XUANLUN HUANG YIPENG jI TINGYU CHENG jIAXING WANG NAN CHI SHAOHUA YU CONNIE j.chang-HASNAIN School of Information Science and Technology Fudan UniversityShanghai 200433China Berxel Photonics Co. Ltd.Shenzhen 518071China Peng Cheng Laboratory Shenzhen 518055China Chinese University of Hong Kong Shenzhen 518172China

Structured-light(SL)based 3D sensors have been widely used in many *** SL is the most widely deployed among all SL sensors due to its light weight,compact size,fast video rate,and low *** transmitter(known as the dot projector)consists of a randomly patterned vertical-cavity surface-emitting laser(VCSEL)array multiplicated by a diffractive optical element(DOE)with a fixed repeated *** that the separation of any two speckles is only one known and fixed number(albeit random),there are no other known scales to cal-ibrate or ***,typical SL sensors require extensive in-factory calibrations,and the depth resolution is limited to 1 mm at-60 cm *** this paper,to the best of our knowledge,we propose a novel dot projector and a new addressable SL(ASL)3D sensor by using a regularly spaced,individually addressable VCSEL array,multiplicated by a metasurface-DOE(MDOE)into a random pattern of the *** turning on or off the VCSELs in the array provides multiple known distances between neighboring speckles,which is used as a“built-in caliper”to achieve higher accuracy of *** as a precise“vernier caliper,”the addressable VCSEL array enables fine control over speckle positions and high detection *** experimentally dem-onstrated that the proposed method can result in sub-hundred-micron level *** new concept opens new possibilities for applications such as 3D computation,facial recognition,and wearable devices.

关键词： speckle light surface

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儿童常见实体肿瘤分子学进展

临床与实验病理学杂志 2024年第7期40卷 673-679页

作者：殷敏智 kenneth Tou En chang 上海交通大学医学院附属上海儿童医学中心病理科 200127 Department of Pathology and Laboratory Medicine KK Women’s and Children’s HospitalSingapore 229899 Duke-NUS Medical School Singapore 169857

儿童肿瘤包含一大类罕见肿瘤,虽然只占全年龄段肿瘤患者的极小比例,但却是儿童患者致死的主要原因。成人恶性肿瘤主要起源于上皮,儿童肿瘤通常来源于中胚层或神经外胚层,在肿瘤的发生、发展、治疗和预后等均与成人肿瘤明显不同,WHO(2023... 详细信息

儿童肿瘤包含一大类罕见肿瘤,虽然只占全年龄段肿瘤患者的极小比例,但却是儿童患者致死的主要原因。成人恶性肿瘤主要起源于上皮,儿童肿瘤通常来源于中胚层或神经外胚层,在肿瘤的发生、发展、治疗和预后等均与成人肿瘤明显不同,WHO(2023)肿瘤分类中首次将儿童肿瘤进行独立归类。研究者认为肿瘤的本质是一种基因病,2018年有文献从基因层面指出儿童肿瘤和成人肿瘤有诸多不同[1-2]:成人由于后天环境等因素的影响,使细胞长期连续遭遇“打击”(大部分为基因突变),最终发展为肿瘤。

关键词：肿瘤儿童分子学