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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

Endoscopic fibrin sealant closure of duodenal perforation after endoscopic retrograde cholangiopancreatography

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World Journal of Gastroenterology 2015年第45期21卷 12976-12980页

作者： Hsin-Yeh Yang Jui-Hao Chen Division of Gastroenterology Department of Internal Medicine Shin Kong Wu Ho-Su Memorial Hospital Faculty of medicine Taipei Medical University

Traditionally, perivaterian duodenal perforation can be managed conservatively or surgically. If a large volume of leakage results in fluid collection in the retroperitoneum, surgery may be necessary. Our case met the surgical indication for perivaterian duodenal perforation after endoscopic retrograde cholangiopancreatography(ERCP) with sphincterotomy and endoscopic papillary balloon dilatation. The patient developed a retroperitoneal abscess after the procedures, and a perivaterian perforation was suggested on computed tomography(CT). CT-guided abscess drainage was performed immediately. We unsuccessfully attempted to close the perforation with hemoclips initially. Subsequently, we used fibrin sealant(Tisseel) injection to occlude the perforation. Fibrin sealant injections have been previously used during endoscopy for wound closure and fistula repair. Based on our report, fibrin sealant injection can be considered as an alternative method for the treatment of ERCPrelated type Ⅱ perforations.

关键词： Perivaterian duodenal perforation Endoscopic retro

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

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

Sonographic fatty liver, overweight and ischemic heart disease

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World Journal of Gastroenterology 2005年第31期11卷 4838-4842页

作者： Yu-Cheng Lin Huey-Ming Lo Jong-Dar Chen department of Family medicine and Center for Environmental and Occupational medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan China department of internal medicine Shin Kong Wu Ho-Su Memorial Hospital School of medicine Fu Jen Catholic University Taioei 111 Taiwan China

AIM: To demonstrate the prevalence of sonographic fatty liver, overweight and ischemic heart disease (IHD) among the male workers in Taiwan, and to investigate the possible association of these three ***: From July to September 2003, a total of 2 088 male aircraft-maintenance workers aged from 22to 65 years (mean 40.5) underwent an annual health examination, including anthropometrical evaluation, blood pressure measurement, personal medical history assessment,biochemical blood analysis, abdominal ultrasonographic examination and digital electrocardiography (ECG). The Student's t-test, x2 test and multivariate logistic regression analysis were utilized to evaluate the relationship between IHD and salient risk ***: The all-over prevalence of overweight was 41.4%, and that of fatty liver was 29.5% (mild, moderate and severe fatty liver being 14.5%, 11.3%, and 3.7%,respectively); while the prevalence of ischemic changes on ECG was 17.1% in this study. The abnormal rates for conventional IHD risk factors including hypertension,dyslipidemia, hyperglycemia and overweight increased in accordance with the severity of fatty liver. Overweight and severity of fatty liver were independently associated with increased risks for developing IHD. Overweight subjects had a 1.32-fold (95%CI: 1.01-1.73) increased IHD risk. Participants with mild, moderate, and severe fatty liver had a 1.88-fold (95%CI: 1.37-2.6), 2.37-fold (95%CI: 1.66-3.37) and 2.76-fold (95%CI: 1.62-4.72)increased risk for developing IHD. The prevalence of ischemic ECG for the fatty liver-affected subjects with or without overweight was 30.1% and 19.1%, while that of overweight subjects free from fatty liver was 14.4%.Compared to the subjects without fatty liver nor overweight,IHD risk for the three subgroups above was as follows:OR: 2.95 (95%CI:2.31-4.09), OR: 1.60 (95%CI: 1.07-2.39)and OR: 1.11 (95%CI: 0.78-1.56), ***: The presence of fatty liver and its severity should be

关键词： Fatty liver Ischemic heart disease Overweight Male Middle-aged

Self-expandable metallic stents for malignant biliary obstruction:Efficacy on proximal and distal tumors

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World Journal of Gastroenterology 2006年第1期12卷 119-122页

作者： Jui-Hao Chen Cheuk-Kay Sun Chao-Sheng Liao Chain-Smoke Chua department of Gastroenterology Shin-Kong WuHo-Su Memorial HospitalTaipeiTaiwanChina

AIM： To compare the efficacy of self-expandable metallic stents （EMS） in the treatment of distal and proximal stricture of malignant biliary tumors. METHODS： From March 1995 to June 2004, 61 patients （40 males, 21 females） with malignant biliary obstruction who received self-expandable metallic stent implantation were reviewed retrospectively. The stents were inserted by an endoscopic or percutaneous transhepatic method. We tried to place two stents in the biliary system in T or Y configuration in cases of hilar tumors with bilateral hepatic duct obstruction. The end points of the study were stent occlusion or patient death. RESULTS： The mean time of stent patency was 421 ± 67 d in the group of proximal stricture（ group Ⅰ） and 168 ± 18 d in the group of distal stricture （group Ⅱ）. The difference was significant in borderline between the two groups （P = 0.0567）. The mean survival time was 574 ± 76 d in group I and 182 ± 25 d in group II. There was a significant difference between the two groups （P = 0.0005）. CONCLUSION： EMS implantation is a feasible, palliative method for unresectable malignant biliary obstruction. The clinical efficacy of EMS in patients with proximal hilar tumors is better than that in patients with distal tumors.

关键词： Metallic stent Biliary malignancy

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