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Case Reports in Clinical medicine 2024年第8期13卷 304-308页

作者： Yong-Hui Liu You-Wen wu department of Neurosurgery Shin Kong Wu Ho-Su Memorial Hospital Taipei City department of Psychiatry Shin Kong Wu Ho-Su Memorial Hospital Taipei City

We present the case of a 64-year-old man with cervical ossification of the posterior longitudinal ligament (OPLL) experiencing chronic neck pain and radiculopathy for 6 months. A catheter-assisted interlaminar Cervical Epidural Steroid Injection (CESI) was performed under fluoroscopic guidance, targeting the affected C2-C6 levels. Significant improvement was observed after this procedure, with decreased pain scores (visual analogue scale (VAS) 8 to 2) and improved mobility. This technique not only enhances the effectiveness of CESI but also reduces the likelihood of complications such as stroke or epidural hematoma and thus provides an alternative treatment option for patients with multiple stenotic levels who are unsuitable for surgery or are unresponsive to conservative therapy such as medication or physical therapy.

关键词： Catheter-Assisted Interlaminar Cervical Epidural Steroid Injection Ossification of Posterior Longitudinal Ligament Cervical Stenosis

Spontaneous superior mesenteric artery dissection following upper gastrointestinal panendoscopy: A case report and literature review

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World Journal of Clinical Cases 2019年第20期7卷 3276-3281页

作者： Chih-Ming Ou Yang Yu-Tong Yen Chai-hock Chua Chin-Chu wu Kuan-En Chu Tsung-I Hung department of General surgery Shin Kong Wu Ho-Su Memorial HospitalTaipei 111Taiwan department of Cardiovascular surgery Shin Kong Wu Ho-Su Memorial HospitalTaipei 111Taiwan department of Radiology Shin Kong Wu Ho-Su Memorial HospitalTaipei 111Taiwan department of internal medicine Division of GastroenterologyShin Kong Wu Ho-Su Memorial HospitalTaipei 111Taiwan

BACKGROUND Complications associated with upper gastrointestinal(UGI)endoscopy are uncommon,and rarely involve those of cardiovascular *** report herein a unique case of spontaneous superior mesenteric artery dissection(SMAD)after UGI *** suMMARY A 45-year-old man who had previously undergone UGI panendoscopy and colonoscopy during a voluntary health check-up at our facility was admitted to the emergency room(ER)at the same facility due to persistent epigastric pain with radiation to the *** the ER,the patient did not present notable abnormalities upon physical,conscious,or laboratory examinations apart from mild tenderness in the epigastric *** abdominal aortic dissection was suspected,and abdominal contrast-enhanced computed tomography confirmed *** was then transferred to the cardiovascular ward and treated conservatively with fasting,prostaglandin E1,and *** patient recovered and returned home soon after,and was symptom-free 6 months after discharge from the *** SMAD after UGI panendoscopic procedure is a previously unreported *** of this complication and associated sequela is warranted.

关键词： Upper gastrointestinal panendoscopy Spontaneous superior mesenteric artery dissection Case report

Early diagnosis of Gitelman syndrome in a young child:A case report

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World Journal of Clinical Cases 2022年第9期10卷 2844-2850页

作者： Chun-Yen wu Ming-Hsein Tsai Chia-Chun Chen Chuan-hong Kao department of Pediatrics Far Eastern Memorial HospitalNew Taipei City 220Taiwan department of internal medicine Shin-Kong Wu Ho-Su Memorial HospitalTaipei 111Taiwan

BACKGROUND Gitelman syndrome(GS)is an autosomal recessive renal tubular disorder characterized by renal wasting hypokalemia,metabolic alkalosis,hypomagnesemia,and *** is usually caused by mutations in the gene SLC12A3,which encodes the thiazide-sensitive Na-Cl *** is not usually diagnosed until late childhood or *** suMMARY Here,we report the case of a one-year-old girl who was brought to the emergency department due to persistent vomiting for two *** admission to our hospital,generalized weakness was observed,and laboratory investigations revealed severe hypokalemia(1.9 mmol/L).however,persistent hypokalemia was observed during outpatient *** of the GS phenotype was assessed via the patient’s clinical presentation,family history,and biochemical analysis of blood and *** genetic analysis was performed for her and her family by exon-wide sequencing analysis of the gene *** genetic diagnosis of GS was established in the Taiwan region family with three affected individuals,two of whom were children(7 years/17 years)without obvious symptoms,with the youngest being only one year old(patient in our case).CONCLUSION We successfully demonstrated the early diagnosis of GS using family genetic *** instances of hypokalemia should not be neglected,as early detection of GS with suitable treatment can prevent patients from potentially lifethreatening complications.

关键词： Children Hypokalemia Hypomagnesemia SLC12A3 Gitelman syndrome Case report

Application of quantitative estimates of fecal hemoglobin concentration for risk prediction of colorectal neoplasia

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World Journal of Gastroenterology 2013年第45期19卷 8366-8372页

作者： Chao-Sheng Liao Yu-Min Lin Hung-Chuen Chang Yu-Hung Chen Lee-Won Chong Chun-Hao Chen Yueh-Shih Lin Kuo-Ching Yang Chia-Hui Shih Division of Gastroenterology Department of Internal Medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan School of medicine Fu Jen Catholic University New Taipei City 24205 Taiwan department of Family medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan Health Management Center Shin Kong Wu HoSu Memorial Hospital Taipei 111 Taiwan Chang Gung Institute of Technology School of Nursing Tao-Yuan 333 Taiwan

AIM:To determine the role of the fecal immunochemical test(FIT),used to evaluate fecal hemoglobin concentration,in the prediction of histological grade and risk of colorectal ***:We enrolled 17881 individuals who attended the two-step colorectal cancer screening program in a single hospital between January 2010 and October *** was recommended to the participants with an FIT of≥12 ngHb/mL *** classified colorectal lesions as cancer(C),advanced adenoma(AA),adenoma(A),and others(O)by their colonoscopic and histological *** linear regression analysis adjusted for age and gender was used to determine the association between the FIT results and colorectal tumor *** risk of adenomatous neoplasia was estimated by calculating the positive predictive values for different FIT ***:The positive rate of the FIT was 10.9%(1948/17881).The attendance rate for colonoscopy was 63.1%(1229/1948).The number of false positive results was *** these 1229 cases,the numbers of O,A,AA,and C were 759,221,201,and 48,*** analysis revealed a positive association between histological grade and FIT concentration(β=0.088,P0.95,P<0.001).CONCLUSION:Higher FIT concentrations are associated with more advanced histological *** prediction for colorectal neoplasia based on individual FIT concentrations is significant and may help to improve the performance of screening programs.

关键词： Colorectal cancer Fecal immunochemical test Screening Risk prediction Performance

successful treatment of liver abscess secondary to foreign body penetration of the alimentary tract: A case report and literature review

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World Journal of Gastroenterology 2014年第13期20卷 3703-3711页

作者： Lee-Won Chong Cheuk-Kwan sun Chin-Chu wu Cheuk-Kay sun Division of Hepatology and Gastroenterology Department of Internal MedicineShin Kong Wu Ho-Su Memorial Hospital Institute of Clinical medicine School of MedicineNational Yang Ming University department of Radiology Shin Kong Wu Ho-Su Memorial Hospital department of Emergency medicine E-Da HospitalI-Shou University School of medicine Chung Shan Medical University School of medicine College of MedicineFu Jen Catholic University School of medicine College of MedicineTaipei Medical University

Hepatic abscess caused by foreign body penetration of the alimentary tract is rare. We report a case of gastric antrum penetration due to a toothpick complicated by liver abscess formation. A 41-year-old man was admitted to our hospital with the chief complaint of upper abdominal pain for 2 mo. Esophagogastroduodenoscopy performed at a local clinic revealed a toothpick penetrating the gastric antrum. Computed tomography (CT) of the abdomen at our hospital revealed a gastric foreign body embedded in the posterior wall of gastric antrum with regional phlegmon over the lesser sac and adhesion to the pancreatic body without notable vascular injury, and a hepatic abscess seven cm in diameter over the left liver lobe. Endoscopic removal of the foreign body was successfully performed without complication. The liver abscess was treated with parenteral antibiotics without drainage. The patient’s recovery was uneventful. Abdominal ultrasonography demonstrated complete resolution of the hepatic abscess six months after discharge. Relevant literature from the PubMed database was reviewed and the clinical presentations, diagnostic modalities, treatment strategies and outcomes of 88 reported cases were analyzed. The results showed that only 6 patients received conservative treatment with parenteral antibiotics, while the majority underwent either image-guided abscess drainage or laparotomy. Patients receiving abscess drainage via laparotomy had a significantly shorter length of hospitalization compared with those undergoing image-guided drainage. There was no significant difference in age between those who survived and those who died, however, the latter presented to hospitals in a more critical condition than the former. The overall mortality rate was 7.95%.

关键词： Hepatic abscess Foreign body Endoscopy Laparotomy Drainage

Sonographic fatty liver and hepatitis B virus carrier status: Synergistic effect on liver damage in Taiwan Residents adults

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World Journal of Gastroenterology 2007年第12期13卷 1805-1810页

作者： Yu-Cheng Lin Shu-Tin Hsiao Jong-Dar Chen department of Family medicine and Center for Environmental and Occupational medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei Taiwan China Institute of Occupational medicine Industrial Hygiene National Taiwan University Taipei Taiwan China

AIM: To examine the epidemiology of hepatitis B virus carrier status (HBVC) and sonographic fatty liver (SFL) in Taiwan Residents adults, and to evaluate their possible interaction in inducing liver damage (LD). From an epidemiological viewpoint, we analyzed previous studies which indicated that fatty liver sensitizes host immune response to HBV infection and enhances liver ***: A cross-sectional retrospective analysis of health records including medical history, physical examination, abdominal sonogram, blood biochemistry and hepatic virological tests. We utilized the Student's t-test, chi-square, multivariate logistic regression and synergy index to assess risks for ***: Among a total of 5406 Taiwan Residents adults (mean age 46.2 years, 51.5% males), the prevalence of LD, HBVC and SFL were 12.3%, 15.1% and 33.4%, respectively; 5.1% of participants had SFL plus HBVC. Multivariate logistic regression analysis demonstrated that male gender (odds ratio (OR) = 2.8, 95% confidence interval (CI): 2.3-3.5), overweight state (OR = 1.6, 95% CI: 1.3-2.0), HBVC (OR = 2.5, 95% CI: 2.0-3.1) and SFL (OR = 4.2, 95% CI: 2.2-5.3) were independently associated with LD. Synergism analysis showed that the adjusted OR for LD in adults with HBVC-alone was 3.3 (95% CI: 2.4-4.6), SFL-alone, 4.7 (95% CI: 3.7-6.1) and combined HBVC and SFL, 9.5 (95% CI: 6.8-13.3); the synergy index was 1.4 (95% CI: 1.001-2.0).CONCLUSION: In Taiwan Residents adults, SFL plus HBVC have a significant synergistic association with LD.

关键词： Fatty liver Hepatitis B virus Sonography Synergism

Multiple primary malignancies including colon, stomach, lung, breast, and liver cancer： a case report and literature review

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Chinese Medical Journal 2009年第24期122卷 3091-3093页

作者： Nien-Chih Hu Shih-Chung Hsieh Tong-Jong Chen Jun-Yih Chang department of Family medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan China department of internal medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan China department of Pathology Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan China

Multiple primary malignancies in a single patient are relatively rare but have increase in frequency in recent decades. This may be a result of medical advancements in diagnostic and therapeutic strategies, a possible effect of new carcinogens in the industrial environment, and longer life span allowing another primary cancer to develop. Among those with multiple primary malignancies, double cancer is commonly seen, while triple cancers occur in 0.5% of patients, and quadruple or quintuple cancers occur in only less than 0.1% of the population.

关键词： multiple primary malignancies, quadruple cancer quintuple cancer

Low-dose testosterone treatment decreases oxidative damage in TM3 Leydig cells

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Asian Journal of Andrology 2011年第3期13卷 432-437,512页

作者： Thomas IS Hwang Tien-Ling Liao Ji-Fan Lin Yi-Chia Lin Shu-Yu Lee Yen-Chun Lai Shu-Huei Kao department of Urology Taipei Medical University Taipei Taiwan China department of Urology School of Medicine Fu-Jen Catholic University Taipei Taiwan China Division of Urology Department of Surgery Shin Kong Wu Ho-Su Memorial Hospital Taipei Taiwan China School of Medical Laboratory Science and Biotechnology Taipei Medical University Taipei Taiwan China Central Laboratory Shin Kong Wu Ho-Su Memorial Hospital Taipei Taiwan China

Testosterone replacement therapy has benefits for aging men and those with hypogonadism. however, the effects of exogenous testosterone on Leydig cells are still unclear and need to be clarified. In this report, we demonstrate that testosterone supplementation can reduce oxidative damage in Leydig cells. The TM3 Leydig cell line was used as an in vitrocell model in this study. Cytoprotective effects were identified with 100-nmol l-1 testosterone treatment, but cytotoxic effects were found with ≥ 500-nmol l-1 testosterone supplementation. Significantly reduced reactive oxygen species （ROS） generation, lipid peroxide contents and hypoxia induction factor （HIF）-lα stabilization and activation were found with lO0-nmol 1-1 testosterone treatment. There was a 1.72-fold increase in ROS generation in the 500-nmol l-1 compared to the lO0-nmol l-1 testosterone treatment. A 1.58-fold increase in steroidogenic acute regulatory protein （STAR） expression was found in 50-nmol l-1 testosterone-treated cells （P〈0.01）. Chemically induced hypoxia was attenuated by testosterone supplementation. Leydig cells treated with low-dose testosterone supplementation showed cytoprotection by decreasing ROS and lipid peroxides, increasing StAR expression and relieving hypoxia stress as demonstrated by HIF-1α stabilization. Increased oxidative damage was found with ≥ 500-nmol l-1 testosterone manipulation. The mechanism governing the differential dose effects of testosterone on Leydig cells needs further investigation in order to shed light on testosterone replacement therapy.

关键词： Leydig cells oxidative damage reactive oxygen species testosterone

Achalasia combined with esophageal intramural hematoma:Case report and literature review

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World Journal of Gastroenterology 2010年第42期16卷 5391-5394页

作者： Yin-Yi Chu Kai-Feng sung Soh-Ching Ng Hao-Tsai Cheng Cheng-Tang Chiu Division of Gastroenterology Department of Internal MedicineShin Kong Wu Ho-Su Memorial HospitalTaipei 111TaiwanChina department of Gastroenterology and Hepatology Chang Gung Memorial HospitalChang Gung University College of MedicineKweishanTaoyuan 333TaiwanChina department of Gastroenterology and Hepatology Chang Gung Memorial HospitalChang Gung University College of Medicine KweishanTaoyuan 333TaiwanChina department of internal medicine Chang Gung Memorial HospitalChang Gung University College of MedicineKeelung 204TaiwanChina

A 62-year-old male patient was admitted to our hospital due to severe chest pain,odynophagia,and *** computed tomography showed an esophageal submucosal ***(EGD) revealed a longitudinal purplish bulging tumor of the *** ultrasound(EUS) showed a mixed echoic tumor with partial liquefaction from the submucosal *** patient was diagnosed with esophageal intramural hematoma as well as achalasia by upper gastrointestinal endoscopy,esophagography and esophageal *** patient was managed conservatively with intravenous nutrition,and oral feeding was ***-up EGD and EUS showed complete recovery of the esophageal wall,and finally,the patient underwent endoscopic dilatation for *** patient was symptom free at the time when we wrote this manuscript.

关键词： Esophageal intramural hematoma Achalasia Endoscopic ultrasound

CHAP-Hyaluronic Acid (CHAP-HA) Filler as an Optimal Candidate for Forehead Filler Augmentation Using a 3-Point Injection Technique

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Journal of Cosmetics, Dermatological Sciences and Applications 2021年第2期11卷 76-83页

作者： Hsiao-Tung Lee Haw-Yueh Thong department of Radiology Shin-Kong Wu Ho-Su Memorial Hospital Taiwan department of Dermatology Shin-Kong Wu Ho-Su Memorial Hospital Taiwan

Minimally invasive forehead augmentation is becoming increasingly popular in Asia. however, treatment of the glabella is associated with injection-related complications. The safety of injections can be increased through a thorough understanding of the anatomy and precise injection planes. The authors propose a 3-point injection technique for forehead augmentation in Asian patients that uses CHAP-hyaluronic acid (CHAP-HA) filler. The longevity of the filler was assessed using high-resolution ultrasound (HRU) imaging. Fifteen patients were examined using HRU before and immediately after treatment and at 1 month, 3 months, 6 months, and 12 months. As evident in HRU imaging, CHAP-HA remained visible within surrounding tissue for 6.4 ± 3.7 months. The mean Global Aesthetic Improvement Scale rating was 2.4 ± 0.5 immediately after treatment, 2.8 ± 0.3 at 1 month, 2.7 ± 0.5 at 3 months, 2.1 ± 0.6 at 6 months, and 1.5 ± 0.6 at 12 months. Minimal side effects were reported. The authors demonstrated that CHAP-HA filler may be an optimal candidate for forehead filler augmentation using a 3-point injection technique.

关键词： CHAP-Hyaluronic Acid (CHAP-HA) Filler High-Resolution Ultrasound (HRU) Forehead Augmentation