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Bleeding gastric varices: Results of endoscopic injection with cyanoacrylate at King Chulalongkorn memorial hospital

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World Journal of Gastroenterology 2005年第47期11卷 7531-7535页

作者： Phadet Noophun Pradermchai Kongkam Sutep Gonlachanvit Rungsun Rerknimitr Division of Gastroenterology Department of Internal MedicineKing Chulalongkorn Memorial HospitalChulalongkorn UniversityBangkokThailand

AIM: To evaluate the efficacy and safety of gastric varices injection with cyanoacrylate in patients with gastric variceal ***: Twenty-four patients (15 males, 9 females) with gastric variceal bleeding underwent endoscopic treatment with cyanoacrylate injection. Successful hemostasis, rebleeding rate, and complications were retrospectively reviewed. Followed up endoscopy was performed and repeat cyanoacrylate injection was given until gastric varices were obliterated. RESULTS: Seventeen patients achieved definite hemostasis. Of these, 14 patients had primary success after initial endoscopic therapy. Ten patients developed recurrent bleeding. Repeated cyanoacrylate injection stopped rebleeding in three patients. Transjugular intrahepatic portosystemic shunt (TIPS) was performed to control rebleeding in one patient which occured after repeat endoscopic therapy. Six patients died (three from uncontrolled bleeding, two from sepsis, and one from mesenteric vein thrombosis). Minor complications occurred in 11 patients (six epigastric discomfort and five post injection ulcers). Cyanoacrylate embolism developed in two patients. One of these patients died from mesenteric vein thrombosis. The other had pulmonary embolism which resolved spontaneously. Advanced cirrhosis and hepatocellular carcinoma (HCC) were major risk factors for uncontrolled ***: Endoscopic treatment for bleeding gastric varices with cyanoacrylate injection is effective for immediate hemostasis. Repeat cyanoacrylate injection has a lower success rate than the initial *** embolism is not a common serious complication.

关键词：胃疾病血管损伤内窥镜氰基丙烯酸盐粘合剂

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Hepatic resection for hepatocellular carcinoma in end-stage renal disease patients: Two decades of experience at Chang Gung memorial hospital

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World Journal of Gastroenterology 2005年第14期11卷 2067-2071页

作者： Chun-Nan Yeh Wei-Chen Lee Miin-Fu Chen Department of General Surgery Chang Gung memorial hospital Chang Gung UniversityTaoyuanTaiwanChina

AIM: Hepatocellular carcinoma (HCC) is a common disease in Taiwan. The prevalence of viral hepatitis infection and the subsequent development of HCC are well known to be higher in patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) or peritoneal dialysis (PD) than among the general population. However, information on hepatic resection for ESRD-HCC patients is limited. METHODS: The clinical features of 26 ESRD-HCC patients who underwent hepatic resection from 1982 to 2001 were retrospectively reviewed. Meanwhile, the clinicopathological features and the outcome of 1 198 HCC patients without ESRD undergoing hepatic resection were used for comparison. RESULTS: Of 1 224 surgically resected HCC patients, 26 (4.2%) were ESRD-HCC. Univariate analysis revealed more associated disease, more physical signs of anemia and postoperative complications, lower hemoglobin, platelet, α-fetoprotein, elevated blood urea nitrogen (BUN) and creatinine levels, smaller tumors, lower HBsAg positivity, higher HCV positivity, and longer hospital stays in the ESRDHCC group compared with the HCC group. Furthermore, multivariate stepwise logistic regression analysis revealed that elevated BUN and creatinine levels were the only two independently significant factors in the patients in the ESRD-HCC group. Overall and disease-free survival rates were similar between the ESRD-HCC and HCC ***: Elevated BUN and creatinine were the only two main independent factors differentiating ESRD-HCC from HCC patients. ESRD should not be a contraindication of hepatic resection in HCC patients; however, careful operative techniques and perioperative care are crucial to achieving lower morbidity and mortality. Comparable overall survival and disease-free survival can be achieved in selected ESRD-HCC patients undergoing hepatic resection when compared with conventional HCC patients.

关键词：肝切除手术肝细胞癌肾脏疾病疾病终末期

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Seroprevalence of Hepatitis B Virus (HBV) among Voluntary Healthy Blood Donors at Tellewonyan memorial hospital Voinjama, Lofa County, Liberia

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Journal of Biosciences and Medicines 2021年第8期9卷 113-119页

作者： Ezekiel Kanue Fardolo Emmanuel Timothy Cooper Caroline Nyawira Wahome Jean K. Kaly Junior S. Puiyoe Department of Medical Laboratory Science School of Medicine Kenyatta University Nairobi Kenya Department of Medical Laboratory Science Mother Patern College of Health Sciences Stella Maris Polytechnic University Monrovia Liberia USAID Infectious Diseases Research Monrovia Liberia Department of Biochemistry Microbiology and Biotechnology Kenyatta University Nairobi Kenya Medical Department Telewonyan Memorial Hospital Lofa Liberia

Background: The prevalence of transfusion associated hepatitis B virus (HBV) infection differs across different population geographically. Ascertaining the seroprevalence of HBV infection is vital to informing the way of precautionary and control strategies. This study sought to establish the seroprevalence of hepatitis B surface antigen (HBVsAg) among blood donors in Yelewonyan memorial hospital Lofa, Liberia. Methods: This was a retrospective study which involved reviewing of blood donation records for the year 2020 at Telewonyan memorial hospital in Lofa County. The data obtained from the records were analyzed. Data analysis was done using SPSS version 12 for windows. Results: A total of 584 voluntary blood donors were screened for donation in 2020. Out of 584, 554 (95.9%) were males while the rest were females. Prevalence of 3.3% was observed among blood donors in Telewonyan memorial hospital. There is a significant difference between gender and age with HBV seropositivity among blood donors. Conclusion: The findings of this study suggest that the study site is of low endemicity with HBV infection. Usually, males are more probably to be HBVsAg seropositive than their female’s counterpart. Planning more extensive study and educational programs would help minimize the spread of HBV infection among the general population.

关键词： Liberia Blood Donors Seropositivity HBV Infection Blood Transfusion Lofa

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Iridium Implantation in T1 and T2 Cancers of Anterior Tongue: Report from B. P. Koirala memorial Cancer hospital, Nepal

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2012年第3期1卷 73-77页

作者： Vijayakumar Narayanan Bibek Acharya Chaurasia Pradumna Prasad Dejkumar Gautam Clinical Director Cancer Care Kenya Nairobi Kenya Department of Otorhinolaryngology B. P. Koirala Memorial Cancer Hospital Bharatpur Nepal Department of Radiation Oncology B. P. Koirala Memorial Cancer Hospital Bharatpur Nepal

Early stage cancers of tongue are treated traditionally with a wide local excision or hemiglossectomy, but the preservation of normal speech and swallowing are hampered. Most of the patients are treated with external beam irradiation to achieve the best locoregional control as only a limited number of tongue cancers can be excised. Underdeveloped nations with finite resources are still dependent on cobalt based external beam radiotherapy and sometimes a Linear Accelerator with two dimensional planning. This treatment has many limitations, as the large radiation fields irradiate not only the tumor but also normal tissue. The sequalae include mucositis, dry mouth, teeth and gum injury, spinal cord damage and rarely mandibular necrosis. Intensity modulated radiotherapy, which can abrogate these side effects, is not available to these patients. Irradiation using implanted solid radioactive sources into the tumor tissue is a viable option in this context. This kind of treatment is termed as brachytherapy and if the implant is introduced into the tissue then it is interstitial brachytherapy. This report details our experience in interstitial implantation, planning, dosimetry and treatment. Diagnosed cancers of anterior 2/3rd of lateral border of tongue with T1 N0M0 or T2 N0M0 stages were subjected to Iridium implantation under general anesthesia. Orthogonal films were taken and planning done with brachyvision treatment planning system. High dose rate radiotherapy was delivered as per the prescription. Excellent local control of the tumor was achieved with no undue morbidity to the adjacent structures. The patients were asked to undergo regular follow up. Surgical salvage was advised in cases of nodal recurrence. Interstitial implantation is a treatment that can be safely administered in early stage cancers of the tongue. This has remarkable efficacy and is also a patient friendly procedure.

关键词： Oral Cavity Cancer Interstitial Brachytherapy Implantation Remote After loader

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Small intestine angioleiomyoma as a rare cause of perforation:A case report

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World Journal of Clinical Cases 2024年第12期12卷 2116-2121页

作者： Teng-Yuan Hou Wei-Juo Tzeng Pei-Hang Lee Department of General Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan Department of Anatomical Pathology Kaohsiung Chang Gung Memorial HospitalKaohsiung 833Taiwan

BACKGROUND Angioleiomyoma is a rare and benign stromal tumor typically found in subcutaneous *** rarely occurs in the gastrointestinal *** the reported cases,the most common complication was gastrointestinal *** has only been reported as a complication in the last few *** SUMMARY This case report detailed the discovery of intestinal angioleiomyoma in a 47-yearold male presenting with abdominal pain that had persisted for 3 *** suspecting hollow organ perforation,surgical intervention involving intestinal resection and anastomosis was *** The report underscores the significance of early surgical intervention in effectively treating angioleiomyoma while emphasizing the pivotal role of timely and appropriate measures for favorable outcomes.

关键词： Angioleiomyoma Intestinal perforation Abdomen Acute Diarrhea Case report

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World Journal of Clinical Cases 2024年第1期12卷 176-179页

作者： Hsin-Chia Angela Lin Kam-Fai Lee Tzu Hao Huang Division of General Surgery Department of SurgeryChang Gung Memorial HospitalChiayi 613Taiwan Department of Anatomic Pathology Chang Gung Memorial HospitalChiayi 613Taiwan

BACKGROUND Gastric IgG4-related disease(IgG4-RD)is rarely encountered in clinical practice,and especially more so among pediatric *** our knowledge,this is the first report of IgG4-RD presenting as a calcifying gastric mass in a *** describe how this entity was difficult to differentiate from a gastrointestinal stromal tumor(GIST)imaging-based ***,this case highlights the importance of considering IgG4-RD in the differential diagnosis of gastric tumor before performing surgical resection,especially to distinguish it from malignancy to avoid unnecessary *** SUMMARY The patient suffered from epigastric pain for several *** and computed tomography scan revealed a submucosal *** diagnoses included GIST,leiomyoma,teratoma,and mucinous ***,laparoscopic proximal gastrectomy allowed for the definitive diagnosis of IgG4-related stomach *** We emphasize the importance of considering IgG4-RD in the differential diagnosis of gastric submucosal tumors before performing surgical resection.

关键词： IgG4-related disease Gastrointestinal stromal tumor Child Pediatric Case report

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Diseases of bile duct in children

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World Journal of Gastroenterology 2024年第9期30卷 1043-1072页

作者： Sutha Eiamkulbutr Chomchanat Tubjareon Anapat Sanpavat Teerasak Phewplung Nimmita Srisan Palittiya Sintusek Department of Pediatrics King Chulalongkorn Memorial HospitalBangkok 10330Thailand Department of Pediatrics Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkok 10330Thailand Department of Pathology Chulalongkorn UniversityBangkok 10330Thailand Department of Radiology Chulalongkorn UniversityBangkok 10330Thailand Department of Surgery Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkok 10330Thailand Center of Excellence in Thai Pediatric Gastroenterology Hepatology and ImmunologyDivision of GastroenterologyDepartment of PediatricsKing Chulalongkorn Memorial HospitalChulalongkorn UniversityBangkok 10330Thailand

Several diseases originate from bile duct *** studies on these diseases,certain etiologies of some of them still cannot be *** most common disease of the bile duct in newborns is biliary atresia,whose prognosis varies according to the age of surgical *** diseases such as Alagille syndrome,inspissated bile duct syndrome,and choledochal cysts are also time-sensitive because they can cause severe liver damage due to *** majority of these diseases present with cholestatic jaundice in the newborn or infant period,which is quite difficult to differentiate regarding clinical acumen and initial *** cholangiography is potentially necessary to make an accurate diagnosis,and further treatment will be performed synchronously or planned as findings *** article provides a concise review of bile duct diseases,with interesting cases.

关键词： Bile duct Cholestasis Biliary atresia Biliary hypoplasia Biliary imaging Inspissated bile syndrome Choledochal cyst

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Aberrant bile duct communicating with the cystic duct:From early detection to management of late surgical complications

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 412-416页

作者： Phonthep Angsuwatcharakon Pradermchai Kongkam Wiriyaporn Ridtitid Panida Piyachaturawat Phuphat Vongwattanakit Prooksa Ananchuensook Natee Faknak Kunvadee Vanduangden Rungsun Rerknimitr Department of Anatomy Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkokThailand Division of Gastroenterology Department of MedicineFaculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkokThailand Department of Surgery Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkokThailand Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology Faculty of MedicineChulalongkorn UniversityBangkokThailand

The aberrant hepatic duct is classified by Huang et al.[1]into type A(right intrahepatic duct variant)and type B(left intrahepatic duct variant).Type A and B are further classified into 5(A1-5)and 6(B1-6)subtypes,*** variation of cystic duct involves only in type *** A1 or classic arrangement refers to the formation of the common hepatic duct(CHD)by the left hepatic duct(LHD)and the right hepatic duct(RHD).The RHD has two tributaries composed of the right anterior hepatic duct(RAHD)and the right posterior hepatic duct(RPHD).Then,the common bile duct(CBD)is formed when the cystic duct joins with the CHD(Fig.1).Type A2 refers to the RAHD and RPHD joining with LHD at hepatic hilum,and the absence of the *** A3 refers to the RAHD or RPHD directly draining to the *** A4 refers to the RAHD or RPHD directly draining to the *** A5 refers to the RAHD,RPHD or RHD directly draining to the cystic duct(or aberrant bile duct communicating with the cystic duct,ACC)(Fig.1)[1].

关键词： bile hepatic RPH

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Development of a radiomics model to discriminate ammonium urate stones from uric acid stones in vivo:A remedy for the diagnostic pitfall of dual-energy computed tomography

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Chinese Medical Journal 2024年第9期137卷 1095-1104页

作者： Junjiong Zheng Jie Zhang Jinhua Cai Yuhui Yao Sihong Lu Zhuo Wu Zhaoxi Cai Aierken Tuerxun Jesur Batur Jian Huang Jianqiu Kong Tianxin Lin Department of Urology Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene RegulationGuangdong Provincial Clinical Research Center for Urological DiseasesGuangzhouGuangdong 510120China Department of Neurology Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhouGuangdong 510120China Department of Radiology Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhouGuangdong 510120China Department of Urology The First People’s Hospital of Kashgar PrefectureKashgarXinjiang 844000China

Background:Dual-energy computed tomography(DECT)is purported to accurately distinguish uric acid stones from non-uric acid ***,whether DECT can accurately discriminate ammonium urate stones from uric acid stones remains ***,we aimed to explore whether they can be accurately identified by DECT and to develop a radiomics model to assist in distinguishing ***:This research included two *** the first purpose to evaluate the accuracy of DECT in the diagnosis of uric acid stones,178 urolithiasis patients who underwent preoperative DECT between September 2016 and December 2019 were *** model construction,93,40,and 109 eligible urolithiasis patients treated between February 2013 and October 2022 were assigned to the training,internal validation,and external validation sets,*** features were extracted from non-contrast CT images,and the least absolute shrinkage and selection operator(LASSO)algorithm was used to develop a radiomics ***,a radiomics model incorporating the radiomics signature and clinical predictors was *** performance of the model(discrimination,calibration,and clinical usefulness)was ***:When patients with ammonium urate stones were included in the analysis,the accuracy of DECT in the diagnosis of uric acid stones was significantly ***-two percent of ammonium urate stones were mistakenly diagnosed as uric acid stones by DECT.A radiomics model incorporating the radiomics signature,urine pH value,and urine white blood cell count was *** model achieved good calibration and discrimination{area under the receiver operating characteristic curve(AUC;95%confidence interval[CI]),0.944(0.899-0.989)},which was internally and externally validated with AUCs of 0.895(95%CI,0.796-0.995)and 0.870(95%CI,0.769-0.972),*** curve analysis revealed the clinical usefulness of the ***:DECT cannot accurately differentiate amm

关键词： Ammonium urate Dual-energy scanned projection radiography Radiomics Uric acid Urolithiasis

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Transcription factor EHF interacting with coactivator AJUBA aggravates malignancy and acts as a therapeutic target for gastroesophageal adenocarcinoma

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Acta Pharmaceutica Sinica B 2024年第5期14卷 2119-2136页

作者： Li Peng Yanyi Jiang Hengxing Chen Yongqiang Wang Qiusheng Lan Shuiqin Chen Zhanwang Huang Jingyuan Zhang Duanqing Tian Yuntan Qiu Diankui Cai Jiangyun Peng Daning Lu Xiaoqing Yuan Xianzhu Yang Dong Yin Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Guangdong-Hong Kong Joint Laboratory for RNA MedicineSun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Medical Research Center Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Hefei Institutes of Physical Science Chinese Academy of SciencesHefei 230031China Department of Gastrointestinal Surgery Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Department of Hepatobiliary Surgery Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China School of Biomedical Sciences and Engineering South China University of TechnologyGuangzhou International CampusGuangzhou 511442China

Transcriptional dysregulation of genes is a hallmark of tumors and can serve as targets for cancer drug ***,it is extremely challenging to develop small-molecule inhibitors to target abnormally expressed transcription factors(TFs)except for the nuclear receptor family of *** is known about the interaction between TFs and transcription cofactors in gastroesophageal adenocarcinoma(GEA)or the therapeutic effects of targeting TF and transcription cofactor *** this study,we found that ETS homologous factor(EHF)expression is promoted by a core transcriptional regulatory circuitry(CRC),specifically ELF3-KLF5-GATA6,and interference with its expression suppressed the malignant biological behavior of GEA ***,we identified Ajuba LIM protein(AJUBA)as a new coactivator of EHF that cooperatively orchestrates transcriptional network activity in ***,we identified KRAS signaling as a common pathway downstream of EHF and ***,dual targeting of EHF and AJUBA by lipid nanoparticles cooperatively attenuated the malignant biological behaviors of GEA in vitro and in *** conclusion,EHF is upregulated by the CRC and promotes GEA malignancy by interacting with AJUBA through the KRAS *** of both EHF and its coactivator AJUBA through lipid nanoparticles is a novel potential therapeutic strategy.

关键词： EHF AJUBA KRAS pathway Enhancer Core transcriptional regulatory circuitry Gastroesophageal adenocarcinoma Gastric adenocarcinoma Esophageal adenocarcinoma Transcription factor Coactivator Lipid nanoparticles

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