检索结果-南通市图书馆

Current knowledge for the risk factors of early permanent pacemaker implantation following transcatheter aortic valve replacement and what is next for the primary prevention?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Cardiology 2024年第2期16卷 54-57页

作者： Gen-Min Lin Wei-Chun Huang Chih-Lu Han Department of Medicine Hualien Armed Forces General HospitalHualien 970Taiwan Cardiovascular Center Kaohsiung Veterans General HospitalKaohsiung 81346Taiwan Department of Medicine Taipei Veterans General HospitalTaipei 112Taiwan

In this editorial,we comprehensively summarized the preoperative risk factors of early permanent pacemaker implantation after transcatheter aortic valve replacement(TAVR)among patients with severe aortic stenosis from several renowned clinical studies and focused on the primary prevention of managing the modifiable factors,e.g.,paroxysmal atrial fibrillation before the TAVR.

关键词： Permanent pacemaker implantation Transcatheter aortic valve replacement Interventricular conduction delay Diabetes Supraventricular arrhythmia

Endoscopic intramural cystogastrostomy for treatment of peripancreatic fluid collection: A viewpoint from a surgeon

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2024年第6期30卷 610-613页

作者： Chen-Guo Ker Department of general Surgery E-Da HospitalI-Shou UniversityKaohsiung 824Taiwan

Percutaneous or endoscopic drainage is the initial choice for the treatment of peripancreatic fluid collection in symptomatic patients.Endoscopic transgastric fenestration(ETGF)was first reported for the management of pancreatic pseu-docysts of 20 patients in 2008.From a surgeon’s viewpoint,ETGF is a similar procedure to cystogastrostomy in that they both produce a wide outlet orifice for the drainage of fluid and necrotic debris.ETGF can be performed at least 4 wk after the initial onset of acute pancreatitis and it has a high priority over the surgical approach.However,the surgical approach usually has a better success rate because surgical cystogastrostomy has a wider outlet(>6 cm vs 2 cm)than ETGF.However,percutaneous or endoscopic drainage,ETGF,and surgical approach offer various treatment options for peripancreatic fluid collection patients based on their conditions.

关键词： Pancreatitis Pancreatic pseudocyst Endoscopic cystogastrostomy Surgical cystogastrostomy Peripancreatic fluid collection Fenestration for pancreatic cyst

Machine learning-based comparison of factors influencing estimated glomerular filtration rate in Chinese women with or without nonalcoholic fatty liver

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2024年第15期12卷 2506-2521页

作者： I-Chien Chen Lin-Ju Chou Shih-Chen Huang Ta-Wei Chu Shang-Sen Lee Department of Nursing Kaohsiung Armed Forces General HospitalKaohsiung 802Taiwan Department of Obstetrics and Gynecology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Chief Executive Officer's Office MJ Health Research FoundationTaipei 114Taiwan Department of Urology Taichung Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTaichung 427Taiwan School of Medicine Tzu Chi UniversityHualian 970Taiwan Department of Urology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND The prevalence of non-alcoholic fatty liver(NAFLD)has increased recently.Subjects with NAFLD are known to have higher chance for renal function impairment.Many past studies used traditional multiple linear regression(MLR)to identify risk factors for decreased estimated glomerular filtration rate(eGFR).However,medical research is increasingly relying on emerging machine learning(Mach-L)methods.The present study enrolled healthy women to identify factors affecting eGFR in subjects with and without NAFLD(NAFLD+,NAFLD-)and to rank their importance.AIM To uses three different Mach-L methods to identify key impact factors for eGFR in healthy women with and without NAFLD.METHODS A total of 65535 healthy female study participants were enrolled from the Taiwan MJ cohort,accounting for 32 independent variables including demographic,biochemistry and lifestyle parameters(independent variables),while eGFR was used as the dependent variable.Aside from MLR,three Mach-L methods were applied,including stochastic gradient boosting,eXtreme gradient boosting and elastic net.Errors of estimation were used to define method accuracy,where smaller degree of error indicated better model performance.RESULTS Income,albumin,eGFR,High density lipoprotein-Cholesterol,phosphorus,forced expiratory volume in one second(FEV1),and sleep time were all lower in the NAFLD+group,while other factors were all significantly higher except for smoking area.Mach-L had lower estimation errors,thus outperforming MLR.In Model 1,age,uric acid(UA),FEV1,plasma calcium level(Ca),plasma albumin level(Alb)and T-bilirubin were the most important factors in the NAFLD+group,as opposed to age,UA,FEV1,Alb,lactic dehydrogenase(LDH)and Ca for the NAFLD-group.Given the importance percentage was much higher than the 2nd important factor,we built Model 2 by removing age.CONCLUSION The eGFR were lower in the NAFLD+group compared to the NAFLD-group,with age being was the most important impact factor in both groups of healthy Chinese women,followed by LDH,UA,FEV1 and

关键词： Non-alcoholic fatty liver Estimated glomerular filtration rate Machine learning Chinese women

Plasmacytosis mimicking multiple myeloma in angioimmunoblastic T-cell lymphoma:A case report and review of literature

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2024年第17期12卷 3226-3234页

作者： Chia-Ching Lin Hsu-Lin Lee Hsin-Yi Chuo Tuo-An Chen Ming-Yueh Liu Li-Mien Chen Division of Cardiovascular Surgery Department of SurgeryKaohsiung Armed Forces General HospitalKaohsiung 802Taiwan Division of Cardiovascular Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Hematology and Oncology Department of Internal MedicineTaichung Armed Forces General HospitalTaichung 411Taiwan Division of Hematology and Oncology Department of Internal MedicineTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Internal Medicine Taichung Armed-Forces General HospitalTaichung 411Taiwan Department of Pathology Taichung Armed-Forces General HospitalTaichung 411Taiwan Department of Radiation Oncology Taichung Armed-Forces General HospitalTaichung 411Taiwan Department of Radiation Oncology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND Angioimmunoblastic T-cell lymphoma(AITL)is a common subtype of peripheral T-cell lymphoma.Approximately half of patients with AITL may concurrently present with hypergammaglobulinemia.Increased numbers of plasma cells in the bone marrow are commonly observed at diagnosis.These tumors mimic plasma cell myelomas,hindering a conundrum of clinical diagnoses and potentially delaying appropriate treatment.CASE SUMMARY A 78-year-old woman experienced poor appetite,weight loss of 5 kg,fatigue 2 months before presentation,and shortness of breath 2 d before presentation,but no fever or night sweats.Physical examination revealed splenomegaly and many palpable masses over the bilateral axillary regions,approximately>2 cm in size,with rubbery consistency and no tenderness.Blood tests revealed anemia and thrombocytopenia,lactate dehydrogenase level of 153 U/L,total protein level of 10.9 g/dL,albumin to globulin ratio of 0.2,and immunoglobulin G level more than the upper limit of 3000 mg/dL.The free kappa and lambda light chain concentrations were 451 and 614 mg/L,respectively.A pathological examination confirmed the diagnosis of AITL.The initial treatment was the cyclophosphamide,epirubicin,vincristine,and prednisolone regimen.Following this treatment,pleural effusion was controlled,and the patient was discharged in a stable condition and followed up in our outpatient department.CONCLUSION This report highlights the importance of differentiating reactive plasmacytosis from plasma cell myeloma in patients with hypergammaglobulinemia.A precise diagnosis of AITL requires a comprehensive evaluation,involving clinical,immunophenotypic,and histological findings conducted by a multidisciplinary team to ensure appropriate treatment.

关键词： Angioimmunoblastic T-cell lymphoma Plasmacytosis Multiple myeloma Lymphoma,Hypergammaglobulinemia Case report

Single-incision laparoscopic surgery to treat hepatopancreatobiliary cancer:A technical review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2022年第27期28卷 3359-3369页

作者： Shu-Hung Chuang Shih-Chang Chuang Division of general and Digestive Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung 80708Taiwan School of Medicine College of MedicineKaohsiung Medical UniversityKaohsiung 80708Taiwan

Single-incision laparoscopic surgery(SILS),or laparoendoscopic single-site surgery,was launched to minimize incisional traumatic effects in the 1990s.Minor SILS,such as cholecystectomies,have been gaining in popularity over the past few decades.Its application in complicated hepatopancreatobiliary(HPB)surgeries,however,has made slow progress due to instrumental and technical limitations,costs,and safety concerns.While minimally invasive abdominal surgery is pushing the boundaries,advanced laparoscopic HPB surgeries have been shown to be comparable to open operations in terms of patient and oncologic safety,including hepatectomies,distal pancreatectomies(DP),and pancreaticoduodenectomies(PD).In contrast,advanced SILS for HPB malignancy has only been reported in a few small case series.Most of the procedures involved minor liver resections and DP;major hepatectomies were rarely described.Singleincision laparoscopic PD has not yet been reported.We herein review the published SILS for HPB cancer in the literature and our three-year experience focusing on the technical aspects.

关键词： Hepatectomy Hepatopancreatobiliary cancer Laparoendoscopic single-site surgery Pancreatectomy Pancreaticoduodenectomy Single-incision laparoscopic surgery

Effects of intravascular photobiomodulation on motor deficits and brain perfusion images in intractable myasthenia gravis: A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2022年第24期10卷 8718-8727页

作者： Chiao-Hsin Lan Yu-Che Wu Cheng-Chun Chiang Shin-Tsu Chang School of Medicine National Defense Medical CenterTaipei 114201Taiwan Department of Medical Education and Research Kaohsiung Veterans General HospitalKaohsiung 813414Taiwan Department of Physical Medicine and Rehabilitation Kaohsiung Veterans General HospitalKaohsiung 813414Taiwan Department of Physical Medicine and Rehabilitation Tri-Service General HospitalTaipei 114202Taiwan

BACKGROUND Myasthenia gravis(MG)is an autoimmune disorder caused by neuromuscular junction failure characterized by muscle weakness and fatigability.We herein report a case of MG that received intravascular laser irradiation of blood(ILIB)interventions and regained muscle power and better quality of life.To our knowledge,no previous study has investigated the benefits of ILIB treatment on patients with MG.We also evaluated the changes in brain perfusion scan and the MG activities of daily living(MG-ADL)and quantitative MG(QMG)scales.CASE SUMMARY A 59-year-old man presented to our outpatient hospital experiencing ptosis,diplopia,fibromyalgia,muscle fatigue,and fluctuating weakness in his limbs for 1 year.Based on his history,physical examination,and laboratory investigations,the final diagnosis was a flare-up of MG with poor endurance and muscle fatigue.The patient agreed to receive ILIB.Brain single-photon emission computed tomography(SPECT)was performed both before and after ILIB therapy.After receiving three courses of ILIB,the brain SPECT images showed greatly increased perfusion of the frontal lobe and anterior cingulate gyri.The patient’s MG-ADL scale score decreased markedly from 17/24 to 3/24.The QMG scale score also decreased remarkably from 32/39 to 9/39.The symptoms of MG became barely detectable and the patient was able to perform his activities of daily living and regain muscle power.CONCLUSION ILIB might have beneficial effects on MG,and brain SPECT images provided direct evidence of a positive correlation between ILIB and clinical performance.

关键词： Myasthenia gravis Intravascular laser irradiation of blood Myasthenia gravisactivities of daily living scale Quantitative myasthenia gravis scale Single-photon emission computed tomography Case report

Coexistence of urinary tuberculosis and urothelial carcinoma:A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2023年第16期11卷 3921-3928页

作者： Yu-Chi Tsai Chiao-Ching Li Bing-Tau Chen Chien-Yao Wang Division of Infectious Diseases Department of Internal MedicineKaohsiung Armed Forces General HospitalKaohsiung 802301Taiwan Division of Infectious Diseases and Tropical Medicine Department of Internal MedicineTri-Service General HospitalNational Defense Medical CenterTaipei 114202Taiwan Division of Urology Department of SurgeryPingtung branchKaohsiung Armed Forces General HospitalPingtung 900048Taiwan Division of Urology Department of SurgeryKaohsiung Armed Forces General HospitalKaohsiung 802301Taiwan Division of Urology Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114202Taiwan Division of Urology Department of SurgeryKaohsiung Veterans General HospitalKaohsiung Veterans General HospitalKaohsiung 813414Taiwan

BACKGROUND Taiwan has a high prevalence of tuberculosis and urothelial carcinoma.However,the simultaneous occurrence of both disorders in one patient is uncommon.Tuberculosis and urothelial carcinoma share some common risk factors and could demonstrate overlapping clinical manifestations.CASE SUMMARY Herein,we report the case of a patient who presented with fever,persistent hematuria,and pyuria.Chest computed tomography scans revealed a bilateral upper lobes cavitary lesion with fibrosis.Severe hydronephrosis of the right kidney and renal stones and cysts in the left kidney were observed.Initial microbiological testing was negative;however,a polymerase chain reaction assay of the urine confirmed a urinary tuberculosis infection.The patient was started on an anti-tuberculosis regimen.Ureteroscopy performed to resolve obstructive nephropathy revealed the incidental finding of a left middle-third ureteral tumor.Examination after biopsy and transurethral resection of the bladder tumor indicated urothelial carcinoma.The patient underwent laparoscopic nephroureterectomy,with bladder cuff excision for the right kidney and ureter,and holmium laser ablation of the ureteral lesion to preserve the left kidney and ureter.He has remained stable after the procedures.CONCLUSION Although establishing a causal relationship between tuberculosis and cancer is difficult,medical personnel should consider their correlation.

关键词： Urinary tuberculosis Urothelial carcinoma Fever Hematuria Taiwan Case report

Disseminated peritoneal leiomyomatosis with malignant transformation involving right ureter:A case report

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2022年第5期10卷 1639-1644页

作者： Chen-Yueh Wen Herng-Sheng Lee Jen-Tai Lin Chia-Cheng Yu Division of Urology Department of SurgeryKaohsiung Veterans General HospitalKaohsiung 81346Taiwan Lee Department of Pathology and Laboratory MedicineKaohsiung Veterans General HospitalKaohsiung 81346Taiwan School of Medicine National Yang-Ming UniversityTaipei 814Taiwan Department of Pharmacy Tajen UniversityPingtung 900Taiwan

BACKGROUND Disseminated peritoneal leiomyomatosis(DPL)with myxoid leiomyosarcoma is a rare variant of leiomysosarcoma,and hematuria as a presenting symptom has never been reported.Through this case report,we emphasize the investigation of the etiology,clinical presentation,diagnosis,treatment,and prognosis of DPL with malignant changes mimicking metastatic urinary tract cancer and to help develop further clinical management.CASE SUMMARY We describe a case of DPL with malignant transformation involving the right ureter after laparoscopic hysterectomy.An exploratory laparotomy was performed and all visible nodules were surgically removed.DPL with focal malignant transformation to myxoid leiomyosarcoma was confirmed based on pathology results.CONCLUSION Professionals who preoperatively diagnose DPL with malignant change to myxoid leiomyosarcoma involving the genitourinary tract should consider symptoms of abdominal pain,hematuria,and imaging of disseminated pelvic tumors in women,especially those with prior history of laparoscopic hysterectomy.Early complete removal of all tumors is the cornerstone to prevent DPL from malignant changes.

关键词： Disseminated peritoneal leiomyomatosis Leiomyosarcoma Laparoscopic hysterectomy Hematuria Ureteroneocystostomy Case report

Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients:A technical review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2023年第9期11卷 1939-1950页

作者： Bo-Ya Chiu Shu-Hung Chuang Shih-Chang Chuang Kung-Kai Kuo School of Post-baccalaureate Medicine College of MedicineKaohsiung Medical UniversityKaohsiung 80708Taiwan Division of general and Digestive Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Medical UniversityKaohsiung 80708Taiwan School of Medicine College of MedicineKaohsiung Medical UniversityKaohsiung 80708Taiwan

Situs inversus(SI)is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs.Since the 1990s,more than one hundred SI patients have been reported to have successfully undergone laparoscopic cholecystectomy.In these cases,the major problem is to overcome is the left-right condition for right-handed surgeons.Laparoscopic common bile duct exploration(LCBDE),an alternative to treat patients with bile duct stones,has shown equivalent efficacy and is less likely to cause pancreatitis than endoscopic retrograde cholangiopancreatography.Recent updated meta-analyses revealed that a shorter postoperative hospital stay,fewer procedural interventions,cost-effectiveness,a higher stone clearance rate,and fewer perioperative complications are additional advantages of LCBDE.However,the technique is technically demanding,even for skilled laparoscopic surgeons.Conducting LCBDE in patients with difficult situations,such as SI,is more complex than usual.We herein review published SI patients with choledocholithiasis treated by LCBDE,including our own experience,and this paper focuses on the technical aspects.

关键词： Choledocholithiasis Choledochotomy Laparoscopic common bile duct exploration Single incision Situs inversus Transcystic