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Transmesocolic hernia with strangulation in a patient without surgical history: Case report

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World Journal of Gastroenterology 2013年第12期19卷 1997-1999页

作者： Peel Jung Min Dae Kim Tae Hyun Ryu Sung Ho Choi Han Se Kim Kang Hun Lee Jhong Hyun Park Department of Internal Medicine Bongseng Memorial Hospital Department of Gastroenterology Bongseng Memorial Hospital Department of General Surgery Bongseng Memorial Hospital

Transmesenteric hernias have bimodal distribution and occur in both pediatric and adult patients. In the adult population, the cause is iatrogenic, traumatic, or inflammatory. We report a case of transmesocolic hernia in an elderly person without any preoperative history. An 84-year-old Korean female was admitted with midabdominal pain and distension for 1 d. On abdominal computed tomography, we diagnosed transmesocolic hernia with strangulated small bowel obstruction, and performed emergency surgery. The postoperative period was uneventful and she was discharged 11 d after surgery. Hence, it is important to consider the possibility of transmesocolic hernia in elderly patients with signs and symptoms of intestinal obstruction, even in cases with no previous surgery. 2013 Baishideng. All rights reserved.

关键词： Transmesocolic hernia Strangulation Operation Abdominal computed tomography Small bowel obstruction Internal hernia

Mesenteric ischemia with intrasplenic gas:A case report

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World Journal of Clinical Cases 2025年第7期13卷 52-56页

作者： Hsiang-Yu Tsang Chee-Chien Yong Hao-Ping Wang Department of Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiung 833401Taiwan

BACKGROUND Acute mesenteric ischemia is a life-threatening *** gas is an extremely rare finding in such *** SUMMARY We report a case of a 79-year-old woman with a history of end-stage renal disease on hemodialysis for approximately 20 years,type 2 diabetes mellitus,and atrial fibrillation who presented with two days of epigastric pain.A computed tomography scan of the abdomen revealed intraperitoneal free air and significant intrasplenic *** revealed diffuse intestinal gangrene,and acute superior mesenteric ischemia was *** patient died within 24 hours owing to profound *** Intrasplenic gas is an extremely rare finding on computed tomography imaging in cases of acute mesenteric ischemia.

关键词： Acute mesenteric ischemia Spleen Hepatic portal venous gas Pneumatosis cystoides intestinalis Prognosis Case report

FANCA D1359Y mutation in a patient with gastric polyposis and cancer susceptibility: A case report and review of literature

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World Journal of Gastroenterology 2018年第38期24卷 4412-4418页

作者： Jeffrey Peng Huang Johnson Lin Chi-Yuan Tzen Wen-Yu Huang Chia-Chi Tsai Chih-Jen Chen Yen-Jung Lu Kuei-Fang Chou Ying-Wen Su Division of Hematology and Medical Oncology Department of Internal Medicine Mackay Memorial Hospital Department of Pathology Mackay Memorial Hospital Laboratory of Good Clinical Research Center Mackay Memorial Hospital Tamsui Branch Department of General Surgery Mackay Memorial Hospital Division of Gastroenterology Department of Internal Medicine Mackay Memorial Hospital ACT Genomics Co. Ltd.

Gastric polyposis is a rare disease. Not all polyps progress to cancer. Monoallelic mutation in Fanconi anemia(FA) genes, unlike biallelic gene mutations that causes typical FA phenotype, can increase risks of cancers in a sporadic manner. Aberrations in the FA pathway were reported in all molecular subtypes of gastric cancer. We studied a patient with synchronous gastric cancer from gastric polyposis by conducting a 13-year long-term follow up. Via pathway-driven massive parallel genomic sequencing, a germline mutation at FANCA D1359Y was identified. We identified several recurrent mutations in DNA methylation(TET1, V873I), the β-catenin pathway(CTNNB1, S45F) and RHO signaling pathway(PLEKHG5, R203C) by comparing the genetic events between benign and malignant gastric polyps. Furthermore, we revealed gastric polyposis susceptible genes and genetic events promoting malignant transformation using pathway-driven targeted gene sequencing.

关键词： Gastric polyposis Gastric cancer Adenocarcinoma Fanconi’s anemia Malignant transformation

Peliosis hepatis complicated by portal hypertension following renal transplantation

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World Journal of Gastroenterology 2014年第9期20卷 2420-2425页

作者： Chia-Ying Yu Liang-Che Chang Li-Wei Chen Tsung-Shih Lee Rong-Nan Chien Ming-Fang Hsieh Kun-Chun Chiang Department of Gastroenterology Chang Gung Memorial Hospital and University at Keelung Department of Pathology Chang Gung Memorial Hospital and University at Keelung Division of Nephrology Department of Gastroenterology Chang Gung Memorial Hospital and University at Keelung Department of General Surgery Chang Gung Memorial Hospital and University at Keelung

Peliosis hepatis(PH)is a vascular lesion of the liver that mimics a hepatic *** is often associated with underlying conditions,such as chronic infection and tumor malignancies,or with the use of anabolic steroids,immunosuppressive drugs,and oral *** patients with PH are asymptomatic,but some present with abdominal distension and *** some cases,PH may induce intraperitoneal hemorrhage and portal *** study analyzed a 46-year-old male who received a transplanted kidney nine years prior and had undergone long-term immunosuppressive therapy following the renal *** patient experienced progressive abdominal distention and pain in the six months prior to this ***,imaging studies revealed multiple liver tumor-like abnormalities,which were determined to be PH by pathological *** the hepatic lesions were progressively enlarged,the patient suffered from complications related to portal hypertension,such as intense ascites and esophageal varices *** the patient was scheduled to undergo liver transplantation,he suffered hepatic failure and died prior to availability of a donor organ.

关键词： Peliosis hepatis Liver neoplasm Portal hypertension Renal failure Renal transplantation

Unique case of oligoastrocytoma with recurrence and grade progression:Exhibiting differential expression of high mobility group-A1 and human telomerase reverse transcriptase

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World Journal of Clinical Cases 2016年第9期4卷 296-301页

作者： Puneet Gandhi Richa Khare Kavita Niraj Nitin Garg Sandeep K Sorte Hanni Gulwani Department of Research Bhopal Memorial Hospital and Research Centre Department of Neurosurgery Bhopal Memorial Hospital and Research Centre and Bansal Hospital Department of Pathology Bhopal Memorial Hospital and Research Centre

Mixed gliomas, primarily oligoastrocytomas, account for about 5%-10% of all gliomas. Distinguishing oligoastrocytoma based on histological features alone has limitations in predicting the exact biological behavior, necessitating ancillary markers for greater specificity. In this case report, human telomerase reverse transcriptase(hT ERT) and high mobility group-A1(HMGA1); markers of proliferation and stemness, have been quantitatively analyzed in formalin-fixed paraffin-embedded tissue samples of a 34 years old patient with oligoastrocytoma. Customized florescence-based immunohistochemistry protocol with enhanced sensitivity and specificity is used in the study. The patient presented with a history of generalized seizures and his magnetic resonance imaging scans revealed infiltrative ill-defined mass lesion with calcified foci within the left frontal white matter, suggestive of glioma. He was surgically treated at our center for four consecutive clinical events. Histopathologically, the tumor was identified as oligoastrocytoma-grade Ⅱ followed by two recurrence events and final progression to grade Ⅲ. Overall survival of the patient without adjuvant therapy was more than 9 years. Glial fibrillary acidic protein, p53, Ki-67, nuclear atypia index, pre-operative neutrophillymphocyte ratio, are the other parameters assessed. Findings suggest that hT ERT and HMGA1 are linked to tumor recurrence and progression. Established markers can assist in defining precise histopathological grade in conjuction with conventional markers in clinical setup.

关键词： Human telomerase reverse transcriptase High mobility group-A1 Oligoastrocytoma Recurrence Tumor grade

Improving postoperative outcomes in patients with pancreatic cancer:Inflammatory and nutritional biomarkers

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World Journal of Clinical Oncology 2025年第1期16卷 59-64页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng Department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305Taiwan Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561Taiwan Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan Department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328Taiwan

This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic *** et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term *** biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk *** PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.

关键词： Pancreatic cancer Prognostic nutritional index Systemic immune-inflammation index Postoperative recovery Prognosis

Chronic hepatitis E: A brief review

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World Journal of Hepatology 2015年第19期7卷 2194-2201页

作者： Arvind R Murali Vikram Kotwal Saurabh Chawla Department of Gastroenterology and Hepatology University of Iowa Hospitals and Clinics Department of Gastroenterology St. Mary’s Hospital grady memorial hospital and Division of Digestive Diseases Department of Medicine Emory University School of Medicine

Hepatitis E viral infection has traditionally been considered an acute, self-limited, water borne disease similar to hepatitis A, endemic to developing countries. However, over the past decade, zoonotic transmission and progression to chronicity in human patients has been identified, resulting in persistently elevated transaminase levels, progressive liver injury and cirrhosis. In addition to liver injury, neurological, renal and rheumatological manifestations have also been reported. Chronic hepatitis E occurs mainly in immunosuppressed individuals such as transplant recipients, human immunodeficiency virus patients with low CD4 counts and in patients with hematological malignancies receiving chemotherapy. Diagnosis is established by persistent elevation of hepatitis E virus RNA in the stool or serum. This population often requires treatment with antiviral agents, particularly ribavirin, as spontaneous clearance with reduction in immunosuppression occurs only in about a third of the patients. The purpose of this review, is to further discuss the clinical presentation, and recent advances in diagnosis, treatment and prophylaxis of chronic hepatitis E.

关键词： Hepatitis E virus Chronic liver disease Solid orga

Microplastic and nanoplastic exposure and risk of diabetes mellitus

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World Journal of Clinical Cases 2025年第3期13卷 24-29页

作者： Hui-Yi Hsiao Chung-Yi Nien Ruei-Feng Shiu Wei-Chun Chin Tzung-Hai Yen Department of Biomedical Sciences College of MedicineChang Gung UniversityTaoyuan 33302TaiwanChina Center for Tissue Engineering Chang Gung Memorial HospitalLinkouTaoyuan 33305TaiwanChina Department of Life Sciences National Central UniversityZhongli 320317TaoyuanTaiwanChina Center of Excellence for The Oceans Taiwan Ocean UniversityKeelung 20224TaiwanChina Institute of Marine Environment and Ecology Taiwan Ocean UniversityKeelung 20224TaiwanChina Department of Chemical and Materials Engineering University of California MercedMercedCA 95343United States Department of Nephrology Clinical Poison CenterChang Gung Memorial HospitalLinkou 33305TaoyuanTaiwanChina School of Traditional Chinese Medicine College of MedicineChang Gung UniversityTaoyuan 33302TaiwanChina

The issue of plastic pollutants has become a growing *** microplastics(MPs)(particle size<5 mm)and nanoplastics(NPs)(particle size<1μm)can cause DNA damage,cytotoxicity,and oxidative stress in various *** primary known impacts of microplastic/nanoplastic are observed in the liver and respiratory system,leading to hepatotoxicity and chronic obstructive pulmonary *** research on the effects of MPs and NPs on diabetes is still in its early stages,there are potential *** editorial highlights the risk to diabetics from co-exposure to contaminants and MPs/NPs,supported by evidence from animal studies and the various chemical compositions of MPs/NPs.

关键词： Microplastics Nanoplastics Plastic pollution,Diabetes mellitus Insulin resistance

Hepatocellular carcinoma in patients with chronic kidney disease

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World Journal of Gastroenterology 2013年第16期19卷 2466-2472页

作者： Chern-Horng Lee Sen-Yung Hsieh Ja-Liang Lin Maw-Sen Liu Tzung-Hai Yen College of Medicine Chang Gung University Department of General Internal Medicine and Geriatrics Chang Gung Memorial Hospital Liver Research Unit Chang Gung Memorial Hospital Department of Nephrology Chang Gung Memorial Hospital

AIM: To investigate outcomes of hepatocellular carcinomas (HCCs) in patients with chronic kidney disease (CKD). METHODS: Four hundred and forty patients referred between 2000 and 2002 for management of HCCs were categorized according to their CKD stage, i.e. , estimated glomerular filtration rate (eGFR) > 90 (stage 1), 60-90 (stage 2), 30-60 (stage 3), 15-30 (stage 4), and < 15 (stage 5) mL/min per 1.73 m 2 , respectively. Demographic, clinical and laboratory data were collected and mortality rates and cause of mortality were analyzed. The mortality data were examined with Kaplan-meier method and the significance was tested using a log-rank test. An initial univariate Cox regression analysis was performed to compare the frequency of possible risk factors associated with mortality. To control for possible confounding factors, a multivariate Cox regression analysis (stepwise backward approach) was performed to analyze those factors that were significant in univariate models (P < 0.05) and met the assumptions of a proportional hazard model. RESULTS: Most HCC patients with CKD were elderly, with mean age of diagnosis of 60.6 ± 11.9 years, and mostly male (74.8%). Hepatitis B, C and B and C coinfection virus were positive in 61.6%, 45.7% and 14.1% of the patients, respectively. It was found that patients with stages 4 and 5 CKD were not only older (P = 0.001), but also had higher hepatitis C virus carrier rate (P = 0.001), lower serum albumin level (P = 0.001), lower platelet count (P = 0.037), longer prothrombin time (P = 0.001) as well as higher proportions of advanced cirrhosis (P = 0.002) and HCCs (P = 0.001) than patients with stages 1 and 2 CKD. At the end of analysis, 162 (36.9%) patients had died. Kaplan-Meier analysis revealed that patients with stages 4 and 5 CKD suffered lower cumulative survival than stages 1 and 2 CKD (log-rank test, χ 2 = 11.764, P = 0.003). In a multivariate Cox-regression model, it was confirmed that CKD stage [odds ratio (OR) = 1.988, 95

关键词： Hepatocellular carcinoma Hepatitis B virus Hepatitis C virus Chronic kidney disease End-stage renal disease