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Risk factors and metabolic abnormality of patients with non-alcoholic fatty liver disease: Either non-obese or obese Chinese population

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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 45-48页

作者： Shou-Wu lee teng-yu lee Sheng-Shun Yang Chun-Fang Tung Hong-Zen Yeh Chi-Sen Chang Division of Gastroenterology Department of Internal Medicine Taichung Veterans General Hospital

Background: Non-alcoholic fatty liver disease(NAFLD) occurs not only in obese individuals but also in non-obese ones. The aim of this study was to focus on the association between NAFLD and metabolic events in a non-obese or obese Chinese ***: Data collected from subjects registered at Taichung Veterans General Hospital from January to December 2009 were analyzed. The exclusion criteria were alcoholics, chronic hepatitis B or C. Patients included in analyses were assigned to four groups according to sonography of their liver(normal or NAFLD), and body mass index(BMI) levels(non-obese if BMI < 25 kg/m~2 or obese if BMI ≥ 25 kg/m~2).Results: There were 745, 208, 770 and 285 patients enrolled in four groups labeled non-obese normal liver(group A), non-obese NAFLD(group B), obese normal liver(group C) and obese NAFLD(group D),respectively. The highest ratio of metabolic syndrome existed in the group B(26.9%), followed by group A(11.7%), group D(10.9%) and finally the group C(5.2%). The positive association with NAFLD in non-obese individuals was significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02) and glucose(OR = 1.02; 95% CI:1.01–1.03), while the positive association with NAFLD in obese subjects was only significant in triglyceride(OR = 1.01; 95% CI: 1.01–1.02). The positive association was most significant in all cases(adjusted OR = 2.41; 95% CI: 1.78–3.24), especially in non-obese individuals(OR = 2.81; 95% CI: 1.92–4.12).Conclusions: Non-obese NAFLD subjects displayed a higher proportion of metabolic abnormality. Hyperlipidemia and hyperglycemia had the most positive strength association with NAFLD.

关键词： Fatty liver Non-alcoholic fatty liver disease Obese Chinese population

The association of non-alcoholic fatty liver disease and metabolic syndrome in a Chinese population

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Hepatobiliary & Pancreatic Diseases International 2017年第2期16卷 176-180页

作者： Shou-Wu lee teng-yu lee Sheng-Shun Yang Yen-Chun Peng Hong-Zen Yeh Chi-Sen Chang Division of Gastroenterology Department of Internal Medicine Taichung Veterans General Hospital Taichung Taiwan China

BACKGROUND： Non-alcoholic fatty liver disease（NAFLD） is associated with features of metabolic syndrome. The aim of this study was to investigate the association between NAFLD and metabolic syndrome in a Chinese population. METHODS： Data from subjects were retrospectively collected from 2006 to 2009. The exclusion criteria included significant consumption of alcohol and chronic hepatitis B and C. The patients were assigned to two groups according to ultrasound findings： normal group and fatty liver group. The liver function of patients was determined by assessing serum alanine aminotransferase（ALT）. Metabolic syndrome was diagnosed based on the 2005 International Diabetes Federation criteria. RESULTS： A total of 7568 subjects were enrolled and 5736（75.8%） and 1832（24.2%） patients were assigned to the normal and fatty liver groups, respectively. The fatty liver group had significant male predominance（69.7% vs 56.0%）, higher body mass index（mean, 26.67 vs 23.55 kg/m^2） compared with the normal group. There were 441（7.7%） and 377（20.6%） cases with metabolic syndrome in the normal and fatty liver groups, respectively, with significant difference（P=0.001）, and the subgroup of 385 cases with fatty liver and elevated ALT had higher prevalence（28.8%） of metabolic syndrome. The strongest association of an individual component of metabolic syndrome with NAFLD was hyperlipidemia（adjusted OR=2.55, 95% CI： 2.22-2.94）.CONCLUSION： The individuals with NAFLD had a higher ratio of metabolic syndrome. Hyperlipidemia had the strongest positive association with NAFLD.

关键词： fatty liver hyperlipidemia metabolic syndrome

Heartburn and regurgitation have different impacts on life quality of patients with gastroesophageal reflux disease

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World Journal of Gastroenterology 2014年第34期20卷 12277-12282页

作者： Shou-Wu lee Han-Chung Lien teng-yu lee Sheng-Shun Yang Hong-Jeh Yeh Chi-Sen Chang Division of Gastroenterology and Hepatology Department of Internal MedicineTaichung Veterans General Hospital Department of Medicine Chung Shan Medical University Department of Medicine Yang Ming University School of Medicine

AIM: To investigate the impact of heartburn and regurgitation on the quality of life among patients with gastroesophageal reflux disease (GERD).

关键词： Erosive esophagitis Gastroesophageal reflux disease Gender Life quality Non-erosive reflux disease

Lower serum folate is associated with development and invasiveness of gastric cancer

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World Journal of Gastroenterology 2014年第32期20卷 11313-11320页

作者： teng-yu lee En-Pei Chiang Yin-Ting Shih Hsien-yuan Lane Jaw-Town Lin Chun-Ying Wu Graduate Institute of Clinical Medical Science China Medical University Department of Medicine Chung Shan Medical University Division of Gastroenterology and Hepatology Taichung Veterans General Hospital Department of Food Science and Biotechnology National Chung Hsing University Chiang Agricultural Biotechnology Center National Chung-Hsing University Department of Psychiatry China Medical University HospitalTaichung 404 Taiwan School of Medicine Fu Jen Catholic University Faculty of Medicine School of Medicine National Yang-Ming University Department of Life Sciences National Chung Hsing University Department of Public Health China Medical University

AIM: To evaluate the associations of serum folate levelwith development, invasiveness and patient survival of gastric cancer. METHODS: In this nested case-control study, patients with newly diagnosed gastric cancer undergoing gastrectomy were enrolled, and patients receiving chemotherapy prior to surgery, with other concurrent malignancy, or of the aboriginal and alien populations were excluded. In total, 155 gastric cancer patients and 149 healthy controls were enrolled for determination of serum folate levels and their correlation with gastric cancer. Using the median value of serum folate computed among the overall population as the cutoff value, the associations between serum folate and gastric cancer in all cases and different age and gender subgroups were analyzed by multivariate logistic regression analysis. In the patient cohort of gastric cancer, receiver-operating characteristic analyses were performed to calculate the best cutoff values of serum folate, and the associations between serum folate levels and clinicopathological features were further analyzed by multivariate regression analysis. Survival analyses were conducted using the Cox proportional hazards ***: The mean serum folate level was significantly lower in gastric cancer patients than that in controls(3.71 ± 0.30 ng/mL vs 8.00 ± 0.54 ng/mL, P < 0.01), and folate levels were consistently lower in gastric cancer patients regardless of age and gender(all P < 0.01). Using the median serum folate value as the cutoff value, low serum folate was significantly associated with gastric cancer risk in the whole population(OR = 19.77, 95%CI: 10.54-37.06, P < 0.001) and all strata(age < 60 years OR = 17.39, 95%CI: 7.28-41.54, age ≥ 60 years(OR = 21.67, 95%CI: 8.27-56.80), males(OR = 17.95, 95%CI: 7.93-40.62), and females(OR = 20.95, 95%CI: 7.66-57.31); all P < 0.001. In the patient cohort of gastric cancer, the respective cutoff values showed that low serum folate levels were significantly associa

关键词： Folic acid Folate Plasma Metastasis Invasion

Risk factors and therapeutic response in Chinese patients with peptic ulcer disease

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World Journal of Gastroenterology 2010年第16期16卷 2017-2022页

作者： Shou-Wu lee teng-yu lee Hong-Zen Yeh Chun-Fang Tung Yen-Chun Peng Division of Gastroenterology and Hepatology Department of Internal MedicineTaichung Veterans General Hospital

AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in ***:Patients with peptic ulcers,diagnosed by upper endoscopy,were retrospectively collected between January 2008 and December *** differences were ***:Among all 448 cases,254(56.6%) and 194(43.4%) patients had gastric ulcers and duodenal ulcers *** with gastric ulcers were younger than those with duodenal *** more men existed,there was a female predominance in middle-aged *** with duodenal ulcers had a higher rate of Helicobacter pylori(***) infection(62.4% vs 43.3%,P = 0.001),and those with gastric ulcers owned a significantly higher amount of aspirin and nonsteroidal anti-inflammatory drug(NSAID) use(7.5% vs 1.5%,6.7% vs 2.1%,P = 0.001).Tobacco smoking and alcohol drinking had no different impact between these two ***-pump inhibitors and H2-receptor antagonists(H2RA) were effective,but significantly less so in cases with duodenal ulcers receiving H2RAs,or in those with *** infection and a history of NSAID ***:Patients with gastric ulcers had lower *** infection but more aspirin or NSAID *** therapy was ineffective in gastric ulcers underwent H2RA treatment,and cases combined *** infection and NSAID use.

关键词： Epidemiology Peptic ulcer disease Therapy

Adenosine deaminase activity in tuberculous peritonitis among patients with underlying liver cirrhosis

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World Journal of Gastroenterology 2012年第37期18卷 5260-5265页

作者： Yi-Jun Liao Chun-Ying Wu Shou-Wu lee Chia-Ling lee Sheng-Shun Yang Chi-Sen Chang teng-yu lee Division of Gastroenter- ology and Hepatology Department of Internal Medicine Taic- hung Veterans General Hospital Taichung 407 Taiwan China Chun-Ying Wu Teng-Yu Lee Graduate Institute of Clinical Medical Science China Medical University Taichung 407 Tai- wan China Graduate Institute of Clinical Medical Science China Medical University Taichung 407 Tai- wan China Medical Record Room Taichung Veterans Ge- neral Hospital Taichung 407 Taiwan China Medical Record Room Taichung Veterans Ge-neral Hospital Taichung 407 Taiwan China

AIM:To investigate the value of adenosine deaminase (ADA) for early detection of tuberculous peritonitis (TBP) among cirrhotic patients METHODS:We retrospectively analyzed 22 patients with TBP from July 1990 to June 2010 Twenty-five cirrhotic patients with uninfected ascites were prospectively enrolled as the cirrhosis control group from July 2010 to June 2011 An additional group of 217 patients whose ascites ADA levels were checked in various clinical conditions were reviewed from July 2008 to June 2010 as the validation group RESULTS:The mean ascites ADA value of cirrhoticpatients with TBP (cirrhotic TBP group, n = 8) was not significantly different from that of non-cirrhotic patients (non-cirrhotic TBP group, n = 14; 58 1 ± 18 8 U/L vs 70 6 ± 29 8 U/L, P = 0 29), but the mean ascites ADA value of the cirrhotic TBP group was significantly higher than that of the cirrhosis control group (58 1 ± 18 8 U/L vs 7 0 ± 3 7 U/L, P < 0 001) ADA values were correlated with total protein values (r = 0 909, P < 0 001) Using 27 U/L as the cut-off value of ADA, the sensitivity and specificity were 100% and 93.3%, respectively, for detecting TBP in the validation group CONCLUSION:Even with lower ADA activity in ascites among cirrhotic patients, ADA values were significantly elevated during TBP, indicating that ADA can still be a valuable diagnostic tool.

关键词： Extrapulmonary Tuberculosis Ascites Cir-rhosis Peritonitis

The impact of intravenous cefazolin to the outcomes of cirrhotic patients with esophageal varices bleeding

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Open Journal of Gastroenterology 2013年第3期3卷 190-195页

作者： Shou-Wu lee teng-yu lee Sheng-Shun Yang Chung-Wang Ko Hong-Zen Yeh Chi-Sen Chang Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Chung Shan Medical University Taichung Chinese Taipei Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Chung Shan Medical University Taichung Chinese Taipei Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei Department of Internal Medicine Yang-Ming University School of Medicine Taipei Chinese Taipei

Background and Method: Prophylatic antibiotics in cirrhotic patients with acute esophageal varices (EV) bleeding has been shown to increase survival and decrease the rate of bacterial infections and recurrent bleeding. This study aimed to compare the outcome of intravenous cefazolin, a first-generation cephalosporin, in the cirrhotic patients with EV bleeding. 92 consecutive cirrhotic patients with EV bleeding but without evidence of infection were retrospectively analyzed from December 2006 to February 2009, and 50 with cefazolin prophylaxis and 42 without antibiotic prophylaxis were enrolled in the antibiotic prophylaxis group and control group respectively. The outcomes were compared between both groups. Results: The incidence of infection was significantly lesser in the antibiotic prophylaxis group than that of the control group (6% vs. 33.3%, P prophylaxis group when compared with control group (6.6 vs. 7.8 days). Conclusion: Intravenous cefazolin can effectively reduce the rate of infection in cirrhotic patients with acute EV bleeding, but cannot significant benefit for preventing recurrent EV bleeding and mortality within 10 days after initial bleeding.

关键词： Cirrhosis Esophageal Variceal Hemorrhage Mortality Rebleeding

Etiologies of Dyspepsia among a Chinese Population: One Hospital-Based Study

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Open Journal of Gastroenterology 2014年第6期4卷 249-254页

作者： Shou-Wu lee Han-Chung Lien teng-yu lee Sheng-Shun Yang Hong-Zen Yeh Chi-Sen Chang Division of Gastroenterology and Hepatology Department of Internal Medicine Taichung Veterans General Hospital Taichung Chinese Taipei

Background and Methods: Dyspepsia refers to a collection of upper gastrointestinal symptoms, and the causes may be either organic or functional. The aim of this study was to investigate the etiologies of dyspepsia among a Chinese population in Taiwan. Patients who underwent upper endoscopy for symptoms of dyspepsia were retrospectively analyzed between January and December 2008. Exclusion criteria included cirrhosis with varices, heart-burn sensation as the main symptom, gastrointestinal bleeding, hepatobiliary abnormalities, prior gastric surgery, and use of anti-acid medication for more than 2 months. Patients were classified according to the findings of upper endoscopy. Results: Data from the medical records of 2062 patients were collected and retrospectively analyzed. Normal endoscopic findings, gastritis, gastric ulcers, duodenal ulcers, reflux esophagitis and esophageal or gastric malignancy accounted for 1174 (56.9%), 215 (10.4%), 254 (12.3%), 194 (9.4%), 182 (8.8%) and 43 (2.1%) cases, respectively. The overall ratio of H. pylori infection was 28.4%. The ratio was the highest in duodenal ulcers and the lowest in reflux esophagitis. A significantly higher ratio of patients with gastric ulcers had a history of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) usage. Conclusion: Patients with organic dyspepsia, compared to those with functional dyspepsia, were older, male, and had a higher H. pylori infection ratio, a positive relationship with aspirin or NSAIDs usage, and more risk factors. These findings demonstrate that upper endoscopy has a high diagnostic yield in patients in this group.

关键词： Duodenal Ulcer Dyspepsia Gastric Ulcer Gastritis Malignancy

Pan-TRK positive uterine sarcoma in immunohistochemistry without neurotrophic tyrosine receptor kinase gene fusions:A case report

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World Journal of Clinical Cases 2025年第2期13卷 39-49页

作者： Seungmee lee yu-Ra Jeon Changmin Shin Sun-Young Kwon Sojin Shin Department of Obstetrics and Gynecology Keimyung University School of MedicineDaegu 42601South Korea Department of Pathology and Institute for Cancer Research Keimyung University School of MedicineDaegu 42601South Korea

BACKGROUND The classification of uterine sarcomas is based on distinctive morphological and immunophenotypic characteristics,increasingly supported by molecular genetic *** on neurotrophic tyrosine receptor kinase(NTRK)gene fusionpositive uterine sarcoma,potentially aggressive and morphologically similar to fibrosarcoma,are limited due to its recent ***-TRK immunohistochemistry(IHC)analysis serves as an effective screening tool with high sensitivity and specificity for NTRK-fusion *** SUMMARY We report a case of a malignant mesenchymal tumor originating from the uterine cervix,which was pan-TRK IHC-positive but lacked NTRK gene fusions,accompanied by a brief literature review.A 55-year-old woman presented to the emergency department with abdominal pain and distension,exhibiting significant ascites and multiple solid pelvic *** examination revealed a tumor encompassing the uterine cervix,extending to the vagina and uterine corpus.A punch biopsy of the cervix indicated NTRK sarcoma with positive immunochemical pan-TRK ***,subsequent next generation sequencing revealed no NTRK gene fusion,leading to a diagnosis of poorly differentiated,advanced-stage *** The clinical significance of NTRK gene fusion lies in potential treatment with TRK inhibitors for positive *** such rare tumors is crucial due to the potential applicability of tropomyosin receptor kinase inhibitor treatment.

关键词： Uterine sarcoma Cervical sarcoma Neurotrophic tyrosine receptor kinase gene fusion Next generation sequencing Case report