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Effect of nocturia in patients with different severity of obstructive sleep apnea on polysomnography: A retrospective observational study

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Asian Journal of Urology 2024年第3期11卷 486-496页

作者： Chin-Heng Lu Hung-min Chang Kuang-Hsi Chang Yen-Chuan Ou Chao-Yu Hsu min-che tung Frank cheau-Feng Lin Stella Chin-Shaw Tsai Division of Urology Department of SurgeryTungs’Taichung Metroharbor HospitalTaichungTaiwanChina Rong Hsing Research Center for Translational Medicine Chung Hsing UniversityTaichungTaiwanChina College of Life Sciences Chung Hsing UniversityTaichungTaiwanChina Department of Otolaryngology Tungs’Taichung Metroharbor HospitalTaichungTaiwanChina Department of Medical Research Tungs’Taichung Metroharbor HospitalTaichungTaiwanChina General Education Center Jen-Teh Junior College of MedicineNursing and ManagementMiaoliTaiwanChina Graduate Institute of Biomedical Sciences China Medical UniversityTaichungTaiwanChina Department of Post-Baccalaureate Medicine College of MedicineChung Hsing UniversityTaichungTaiwanChina Department of Nursing Jen-Teh Junior College of MedicineNursing and ManagementMiaoliTaiwanChina Department of Surgery Chung Shan Medical UniversityTaichungTaiwanChina College of Medicine Chung Shan Medical UniversityTaichungTaiwanChina

Patients with suspected OSA were examined using *** were divided into two groups based on the presence of *** was defined as a patient who needed to void at least *** index(AHI)was employed to classify patients according to degrees of severity:AHIminimum arterial blood oxygenation saturation(p=0.046),and decreased AHI of non-rapid eye movement(p=0.047),AHI of total sleep time(p=0.010),and desaturation index(p=0.012).In moderate OSA patients,nocturia related to increased age(p<0.001),awake time(p=0.025),stage 1 sleep(p=0.033),and sleep latency(p=0.033),and decreased height(p=0.044),weight(p=0.025),and sleep efficiency(p=0.003).In severe OSA patients,nocturia related to increased weight(p=0.011),body mass index(p=0.009),awake time(p=0.008),stage 1 sleep(p=0.040),arousal number(p=0.030),arousal index(p=0.013),periodic limb movement number(p=0.013),and periodic limb movement index(p=0.004),and decreased baseline arterial blood oxygenation saturation(p=0.046).Conclusion:Our study revealed that there were more correlated factors related to nocturia with increasing severity of *** study helps in clinical education and treatment for OSA patients with different severity.

关键词： Nocturia Obstructive sleep apnea Polysomnography Apneaehypopnea index International Prostate Symptom Score

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Concurrent occurrence of adenocarcinoma and urothelial carcinoma of the prostate gland:A case report

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World Journal of Clinical Cases 2024年第26期12卷 5952-5959页

作者： Jhe Yuan Hsu Yi Sheng Lin Li Hua Huang Tang Yi Tsao Chao Yu Hsu Yen Chuan Ou min che tung Division of Urology Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung 435403Taiwan Department of Pathology Tungs'Taichung MetroHarbor HospitalTaichung 435403Taiwan

BACKGROUND Adenocarcinoma is the most common subtype of prostate *** urothelial carcinoma(UC)typically originates from the prostatic *** concurrent occurrence of adenocarcinoma and UC of the prostate gland is *** SUMMARY We present the case of an 82-year-old male patient with simultaneous adenocarcinoma and UC of the prostate *** patient underwent a transrectal ultrasound-guided biopsy,and the pathology test revealed ***,transurethral laser prostatectomy was performed,and the pathology test indicated adenocarcinoma of the prostate with a Gleason score of 3+4 and highgrade ***,the patient was treated with androgen deprivation therapy,systemic chemotherapy,and *** resonance imaging performed during follow-up revealed a prostate tumor classified as cT2cN1M0,stage ***,the patient underwent robotic-assisted radical prostatectomy and bilateral pelvic lymph node *** final pathology test of the prostate gland revealed acinar-type adenocarcinoma,Gleason pattern 4+3,pT2N0M0,and high-grade *** patient regularly presented to the clinic for postoperative follow-up *** did not experience any urinary *** According to our literature review,this is the first reported case of coexisting adenocarcinoma and UC of the prostate gland.

关键词： Adenocarcinoma Urothelial carcinoma Prostate Coexist Case report

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Improvement of lenvatinib-induced nephrotic syndrome after adaptation to sorafenib in thyroid cancer:A case report

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World Journal of Clinical Cases 2020年第20期8卷 4883-4894页

作者： che Hseuh Yang Kuo tung chen Yi Sheng Lin Chao Yu Hsu Yen Chuan Ou min che tung Division of Urology Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung City 435403Taiwan Division of General Surgery Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung City 435403Taiwan

BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain *** sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory differentiated thyroid cancer(DTC).Lenvatinib is more effective in cancers'control than sorafenib,but causes more nephrotoxicity than sorafenib *** case is the second published case about the serial adaptions from lenvatinib to sorafenib for improving the proteinuria and,meanwhile,achieving the therapeutic *** SUMMARY A 56-year-old man suffered from bilateral edematous lower extremities after 1-mo prescription of lenvatinib of 20 mg/d for RAI-refractory *** from this symptom,he also developed *** laboratory showed grade-3 proteinuria(estimated 24-h urine protein:9993 mg),hypoalbuminemia and ***-vascular endothelial growth factor(VEGF)therapyinduced nephrotic syndrome was *** reduced dosage of lenvatinib of 10 mg/d and related symptomatic drugs,limited improvement was observed in both adverse effects and caner *** this condition,we substituted sorafenib of 400 mg/d for lenvatinib of 10 mg/*** a 5-mo prescription,not only hypertension and peripheral edema were greatly improved,but also proteinuria was improved from grade three to grade one(estimated 24-h urine protein:962 mg).At the same time the cancer control was achieved,judged from computed tomography and laboratory evidence[thyroglobulin(Tg)before prescription of sorafenib:354.7 ng/m L;Tg after prescription of sorafenib:108.9 ng/m L].CONCLUSION Adaption from lenvatinib to sorafenib is a feasible method to improve the antiVEGF therapy-induced nephrotic syndrome and achieve the therapeutic goal at the same time.

关键词： Molecular targeted therapy/methods Receptors Vascular endothelial growth factor/drug effects Vascular endothelial growth factor/therapeutic use Vascular endothelial growth factor A/drug effects Nephrotic syndrome/drug therapy Case report

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Renal pseudoaneurysm after rigid ureteroscopic lithotripsy:A case report

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World Journal of Clinical Cases 2022年第27期10卷 9954-9960页

作者： Yi Hong Li Yi Sheng Lin Chao Yu Hsu Yen Chuan Ou min che tung Division of Urology Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung 43503Taiwan

BACKGROUND Ureteroscopic lithotripsy(URSL) is a common surgical treatment for ureteral *** flexible ureteroscopy can be used to treat ureteral and renal stones in a single procedure,rigid ureteroscopy can only be used to treat ureteral stones;nonetheless,rigid ureteroscopy remains mainstream in Taiwan owing to its late introduction and flexible ureteroscopy is not covered by national health *** is a common complication that occurs when the scope passes through stricture sites or when mucosal damage occurs during lithotripsy,but this is usually *** hematuria requiring intervention is termed persistent *** hematuria is less common and few studies have reported the development and etiology of renal pseudoaneurysm after flexible ureteroscopy for renal ***,we present the first reported case of renal pseudoaneurysm after rigid URSL for ureteral *** SUMMARY The patient was a 57-year-old man who developed renal pseudoaneurysm with active bleeding after rigid *** presented with gross hematuria and intolerable left flank pain after left *** anemia was noted(hemoglobin level,6.8 g/d L).Contrast enhanced computed tomography revealed one pseudoaneurysm each in the upper and lower renal *** was managed via transcatheter arterial embolization with microcoils,which relieved the *** To the best of our knowledge,ours is the first case report on renal pseudoaneurysm after rigid *** renal pseudoaneurysms are difficult to access,underlying hypertension,clinical signs such as refractory flank pain,and gross hematuria should be carefully monitored following similar endourological procedures.

关键词： Aneurysm False Ureteroscopy Lithotripsy Intraoperative complication Embolization Therapeutic Case report

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Biochemical recurrence of pathological T2+localized prostate cancer after robotic-assisted radical prostatectomy:A 10-year surveillance

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World Journal of Clinical Cases 2021年第5期9卷 1026-1036页

作者： che Hseuh Yang Yi Sheng Lin Yen Chuan Ou Wei Chun Weng Li Hua Huang Chin Heng Lu Chao Yu Hsu min che tung Division of Urology Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung 435403Taiwan

BACKGROUND pT2+prostate cancer(PCa),a term first used in 2004,refers to organ-confined PCa characterized by a positive surgical margin(PSM)without extracapsular *** with a PSM are vulnerable to biochemical recurrence(BCR)following radical prostatectomy(RP);however,whether adjuvant radiotherapy(aRT)is imperative to PSM after RP remains *** study had the longest follow-up on pT2+PCa after robotic-assisted RP since ***,we discussed our viewpoints on pT2+PCa based on real-world *** To conclude a 10-year surveillance on pT2+PCa and compare our results with those of the published *** Forty-eight patients who underwent robotic-assisted RP between 2008 and 2011 were *** serial tests of prostate specific antigen(PSA)≥0.2 ng/mL were defined as *** designed factors were analyzed using statistical tools for BCR *** 9.4 was applied and significance was defined as P<***,multivariate,linear regression,and receiver operating characteristic(ROC)curve analyses were performed for statistical *** With a median follow-up period of 9 years,25(52%)patients had BCR(BCR group),and the remaining 23(48%)patients did not(non-BCR group).The median time for BCR test was 4 years from the first postoperative PSA *** PSA was significantly different between the BCR and non-BCR groups(P<0.001),and ROC curve analysis of preoperative PSA suggested a cutoff value of 19.09 ng/mL(sensitivity,0.600;specificity:0.739).The linear regression analysis showed no correlation between time to BCR and preoperative PSA(Pearson’s correlation,0.13;adjusted R2=0.026).CONCLUSION Robotic-assisted RP in pT2+PCa of worse conditions can provide better BCR-free survival.A surgical technique limiting the PSM in favorable situations is warranted to lower the pT2+PCa BCR *** PSA cut-off value of 19.09 ng/mL is a predictive factor for *** on our experiences and review of the literat

关键词： Prostatectomy/methods Robotic surgical procedures Prostatic neoplasms/pathology Prostate-specific antigen/metabolism Margins of excision Retrospective study

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The surgical learning curve for robotic-assisted laparoscopic radical prostatectomy： experience of a single surgeon with 500 cases in Taiwan, China

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Asian Journal of Andrology 2014年第5期16卷 728-734,I0009页

作者： Yen-Chuan OU Chun-Kuang Yang Kuangh-Si Chang John Wang Siu-Wan Hung min-che tung Ashutosh K Tewari Vipul R Patel Division of Urology Department of Surgery Taichung Veterans General Hospital Taichung Taiwan China School of Medicine National Yang-Ming University Taipei Taiwan China Department of Research Taichung Veterans General Hospital Taichung Taiwan China Department of Pathology Taichung Veterans General Hospital Taichung Taiwan China Department of Radiation Taichung Veterans General Hospital Taichung Taiwan China Division of Urology Department of Surgery Tungs' Taichung MetroHarbor Hospita Taichung Taiwan China New York Presbyterian Hospital Weill Cornell Medical College New York NY USA Global Robotics Institute Florida Hospital Orlando Florida USA

To analyze the learning curve for cancer control from an initial 250 cases （Group I） and subsequent 250 cases （Group II） of robotic-assisted laparoscopic radical prostatectomy （RALP） performed by a single surgeon. Five hundred consecutive patients with clinically localized prostate cancer received RALP and were evaluated. Surgical parameters and perioperative complications were compared between the groups, Positive surgical margin （PSM） and biochemical recurrence （BCR） were assessed as cancer control outcomes. Patients in Group II had significantly more advanced prostate cancer than those in Group I （22.2% vs 14.2%, respectively, with Gleason score 8-10, P = 0.033; 12.8% vs 5.6%, respectively, with clinical stage T3, P = 0.017）. The incidence of PSM in pT3 was decreased significantly from 49% in Group I to 32.6% in Group Ih A meaningful trend was noted for a decreasing PSM rate with each consecutive group of 50 cases, including pT3 and high-risk patients. Neurovascular bundle （NVB） preservation was significantly influenced by the PSM in high-risk patients （84.1% in the preservation group vs 43.9% in the nonpreservation group）. The 3-year, 5-year, and 7-year BCR-free survival rates were 79.2%, 75.3%, and 70.2%, respectively. In conclusion, the incidence of PSM in pT3 was decreased significantly after 250 cases. There was a trend in the surgical learning curve for decreasing PSM with each group of 50 cases. NVB preservation during RALP for the high-risk group is not suggested due to increasing PSM.

关键词： cancer control learning curve prostate cancer prostatectomy robotics surgical margin

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<i>Survivin</i>promoter rs9904341 polymorphism is associated with tumor stage and grade in patients with bladder cancer

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Advances in Bioscience and Biotechnology 2013年第1期4卷 1-5页

作者： Zhon-min Huang Yi-Te Chiang min-che tung Chia-Chang Wu Kuan-Chou chen ming-Te Huang Yuan-Hung Wang cheng-Huang Shen Department of Urology Chia-Yi Christian Hospital Chiayi City Taiwan Department of Urology Shuang Ho Hospital Taipei Medical University New Taipei City Taiwan Department of Urology Tung’s Taichung MetroHarbor Hospital Taichung County Taiwan Division of General Surgery Department of Surgery Shuang Ho Hospital Taipei Medical University Taipei Taiwan Division of General Surgery Department of Urology Shuang Ho Hospital Taipei Medical University New Taipei City Taiwan

Survivin is an inhibitor of apoptosis protein and also plays a important role in the development of several malignancies. To investigate the association between survivin promoter –31 G/C (rs9904341) polymorphism and bladder cancer (BC) risk. A total of 200 pathologically confirmed BC cases and 200 unrelated cancer-free controls were recruited in Chiayi Christian Hospital from August 2002 to May 2009. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to determine the –31 G/C polymorphism at survivin promoter region. There was a significant difference in the frequency distribution of survivin promoter –31 G/C polymorphism in BC cases as compared to controls. Among BC cases, individuals with the C/C genotype of survivin promoter have a significantly higher prevalence of invasive (T2-T4) or high-grade (G2-G3) tumors as compared to those who carried the G/G genotype. In conclusion, our findings suggest that the survivin promoter –31 G/C polymorphism was not only associated with clinical stage and pathological grade but also involved in the development of bladder cancer.

关键词： Survivin Bladder Cancer Polymorphism Apoptosis

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Improvement of hepatic fibrosis after tenofovir disoproxil fumarate switching to tenofovir alafenamide for three years

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World Journal of Hepatology 2024年第7期16卷 1009-1017页

作者： tung Huynh Delana MyAn Bui Tina Xiwen Zhou Ke-Qin Hu Department of Pharmacy University of California Irvine Medical CenterOrangeCA 92868United States University of Houston HoustonTX 77204United States Chicago Medical School at Rosalind Franklin University North ChicagoIL 60064United States Division of Gastroenterology and Hepatology University of California IrvineSchool of MedicineOrangeCA 92868United States

BACKGROUND Both tenofovir alafenamide(TAF)and tenofovir disoproxil fumarate(TDF)are the first-line treatments for chronic hepatitis B(CHB).We have showed switching from TDF to TAF for 96 weeks resulted in further alanine aminotransferase(ALT)improvement,but data remain lacking on the long-term benefits of TDF switching to TAF on hepatic *** To assess the benefits of TDF switching to TAF for 3 years on ALT,aspartate aminotransferase(AST),and hepatic fibrosis improvement in patients with *** A single center retrospective study on 53 patients with CHB who were initially treated with TDF,then switched to TAF to determine dynamic patterns of ALT,AST,AST to platelet ratio index(APRI),fibrosis-4(FIB-4)scores,and shear wave elastography(SWE)reading improvement at switching week 144,and the associated *** The mean age was 55(28-80);45.3%,males;15.1%,clinical cirrhosis;mean baseline ALT,24.8;AST,25.7 U/L;APRI,0.37;and FIB-4,*** 144 weeks TDF switching to TAF,mean ALT and AST were reduced to 19.7 and 21,*** baseline to switching week 144,the rates of ALT and AST60 mL/min was increased from 86.5%at baseline to 88.2%at switching week *** Our data confirmed that switching from TDF to TAF for 3 years results in not only persistent ALT/AST improvement,but also hepatic fibrosis improvement by APRI,FIB-4 scores,as well as SWE reading,the important clinical benefits of long-term hepatitis B virus antiviral treatment with TAF.

关键词： Tenofovir alafenamide Tenofovir disoproxil fumarate Switching Hepatic fibrosis improvement Aspartate aminotransferase to platelet ratio index Fibrosis-4 Shear wave elastography

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Application of Choquet Integral-Importance-Performance Analysis and TOPSIS Methods in Approaching the Preference Factors of Calligraphy and Seal Engraving Imagery

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Journal of Contemporary Educational Research 2024年第5期8卷 276-288页

作者： Yu Hsuan Chang Jiann Sheng Jiang min min Lin Graduate Institute of Cultural and Creative Design Tung-Fang Design UniversityKaohsiung 83044Taiwan ProvinceChina Department of Art and Design Shaoguan UniversityShaoguan 512000Guangdong ProvinceChina

Classical Chinese characters,presented through calligraphy,seal engraving,or painting,can exhibit different aesthetics and essences of Chinese characters,making them the most important asset of the Chinese *** and seal engraving,as two closely related systems in traditional Chinese art,have developed through the *** to changes in lifestyle and advancements in modern technology,their original functions of daily writing and verification have gradually ***,they have increasingly played a significant role in commercial *** study utilizes the Evaluation Grid Method(EGM)and the Analytic Hierarchy Process(AHP)to research the key preference factors in the application of calligraphy and seal engraving *** from the traditional 5-point equal interval semantic questionnaire,this study employs a non-equal interval semantic questionnaire with a golden ratio scale,distinguishing the importance ratio of adjacent semantic meanings and highlighting the weighted emphasis on visual ***,the study uses Importance-Performance Analysis(IPA)and Technique for Order Preference by Similarity to Ideal Solution(TOPSIS)to obtain the key preference sequence of calligraphy and seal engraving ***,the Choquet integral comprehensive evaluation is used as a reference for IPA *** is hoped that this study can provide cultural imagery references and research methods,injecting further creativity into industrial design.

关键词： Evaluation Grid Method Analytic Hierarchy Process Calligraphy Seal engraving Importance-Performance Analysis Choquet integral TOPSIS

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Adult metaplastic hutch diverticulum with robotic-assisted diverticulectomy and reconstruction:A case report

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World Journal of Clinical Cases 2020年第20期8卷 4895-4901页

作者： che H Yang Yi S Lin Yen C Ou Wei C Weng Li H Huang Chin H Lu Chao Y Hsu min C tung Department of Surgery Division of UrologyTungs’Taichung MetroHarbor HospitalTaichung City 435403Taiwan

BACKGROUND Hutch diverticulum arises from the compromised muscular development at the ureteral *** is a congenital disease and extremely rare in adult,only accounting for about 3%occurrence *** can be either symptomatic or asymptomatic,and relies on image tools for diagnosis and preoperative *** for surgery are dependent on the complications from the *** is about 10%among those with hutch diverticulum,and it still has chances turning into malignancy,especially urothelial cell *** SUMMARY A 27-year-old man was presented with frequently recurrent urinary tract infection for one year,and had suffered from intermittent right flank pain for 3 *** past medical histories were recorded *** obvious abnormalities on laboratory data and urine examination were *** ultrasound,right hydronephrosis was seen and an anatomical abnormality was observed on intravenous *** computed tomography urogram showed one diverticulum seated at superolateral side of right ureteral *** was done and biopsy results showed focal *** discussing with him,roboticassisted diverticulectomy with reconstruction was *** hydronephrosis was greatly improved after *** has completed his 1.5-year follow-ups,and no malignancies were seen from urine cytology and image of intravenous *** Robotic-assisted diverticulectomy and reconstruction to hutch diverticulum is a safe and efficient operation,providing several advantages over open and laparoscopic ones.

关键词： Diverticulum complications Urinary bladder abnormalities Diverticulum surgery Robotic surgical procedures methods Treatment outcome Case report

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