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Management of urethral atrophy after implantation of artificial urinary sphincter:what are the weaknesses?

Asian Journal of Andrology 2020年第1期22卷 60-63页

作者： Nathaniel H Heah Ronny BW Tan Department of Urology Tan Tock Seng Hospital308433 Singapore A dvanced Urology Mount Elizabeth Hospital228510 Singapore

The use of artificial urinary sphincter(AUS)for the treatment of stress urinary incontinence has become more prevalent,especially in the“prostate-specific antigen(PSA)-era”,when more patients are treated for localized prostate *** first widely accepted device was the AMS 800,but since then,other devices have also entered the *** efficacy has increased with improvements in technology and technique,and patient satisfaction is high,AUS implantation still has inherent risks and complications of any implant surgery,in addition to the unique challenges of urethral complications that may be associated with the ***,the unique nature of the AUS,with a control pump,reservoir,balloon cuff,and connecting tubing,means that mechanical complications can also arise from these individual *** article aims to present and summarize the current literature on the management of complications of AUS,especially urethral *** conducted a literature search on PubMed from January 1990 to December 2018 on AUS complications and their *** review the various potential complications and their *** complications are either mechanical or nonmechanical *** complications usually involve malfunction of the *** complications include infection,urethral atrophy,cuff erosion,and *** exist especially in the management of urethral atrophy,with both tandem implants,transcorporal cuffs,and cuff downsizing all postulated as potential *** complications from AUS implants are not common,knowledge of the management of these issues are crucial to ensure care for patients with these *** studies are needed to further evaluate these techniques.

关键词： artificial urinary sphincter artificial urinary sphincter complications tandem cuffs transcorporal cuffs urethral atrophy

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Associations between irritable bowel syndrome and non-alcoholic fatty liver disease:A systematic review

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World Journal of Hepatology 2023年第7期15卷 925-938页

作者： Jareth Jun Jie Ng Wai Mun Loo Kewin Tien Ho Siah Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore AliveoMedical Mount Alvernia and Mount Elizabeth HospitalsSingapore 574623Singapore Department of Medicine National University HospitalSingapore 119228Singapore

BACKGROUND Irritable bowel syndrome(IBS)is associated with obesity and metabolic *** and non-alcoholic fatty liver disease(NAFLD)are highly prevalent entities worldwide and may share similar mechanisms including gut dysbiosis,impaired intestinal mucosal barrier and immune system *** To systematically review their association according to the Preferred Reporting Items for Systemic Review and Meta-analyses *** PubMed,EMBASE and Cochrane Database of Systematic Reviews were searched for relevant *** searches were also *** Six studies were *** IBS and NAFLD subjects had significantly more metabolic risk factors like hypertension,obesity,dyslipidaemia and *** review showed that 23.2%to 29.4%of NAFLD patients had *** was significantly higher in NAFLD patients compared with patients without NAFLD(23.2%vs 12.5%,P<0.01).A higher proportion of IBS patients had NAFLD(65.8%to 74.0%).IBS patients were three times more likely to have NAFLD compared with non-IBS patients(P<0.001).Two studies showed a significant correlation between the severity of IBS and *** proportion of NAFLD subjects with IBS increased with NAFLD *** Further prospective studies are warranted to evaluate the relationship and shared pathways between IBS and NAFLD,potentially leading to the development of future therapeutics.

关键词： Irritable bowel syndrome Functional gastrointestinal disorder Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Gut dysbiosis Metabolic syndrome

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Benign prostatic hyperplasia and male lower urinary symptoms:A guide for family physicians

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Asian Journal of Urology 2017年第3期4卷 181-184页

作者： Farhad Fakhrudin Vasanwala Michael Yuet Chen Wong Henry Sun Sien Ho Keong Tatt Foo Department of Family Medicine Sengkang Hospital at Alexandra HospitalSingHealthSingapore International Urology Fertility and Gynaecology CentreMount Elizabeth Medical CentreSingapore Department of Urology Singapore General HospitalSingHealthSingapore

Male patients with lower urinary tract symptoms(LUTS)and benign prostatic hyperplasia(BPH)are increasingly seen by family physicians worldwide due to ageing demographics.A systematic way to stratify patients who can be managed in the community and those who need to be referred to the urologist is thus very *** history taking,physical examination,targeted blood or urine tests,and knowing the red flags for referral are the mainstay of stratifying these *** selection is always key in clinical practice and in the setting of the family *** best patient to manage is one above 40 years of age,symptomatic with nocturia,slower stream and sensation of incomplete voiding,has a normal prostatespecific antigen level,no palpable bladder,and no haematuria or pyuria on the *** roles of α blockers,5-α reductase inhibitors,and antibiotics in a primary care setting to manage this condition are also discussed.

关键词： Benign prostatic hyperplasia Male lower urinary tract symptoms Guideline Family physicians

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NUMB maintains bone mass by promoting degradation of PTEN and GLI1 via ubiquitination in osteoblasts

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Bone Research 2018年第4期6卷 368-382页

作者： Ling Ye Feng Lou Fanyuan Yu Demao Zhang Chenglin Wang Fanzi Wu Xin Li Yilin Ping Xiao Yang Jing Yang Dian Chen Bo Gao Dingming Huang Peng Liu State Key Laboratory of Oral Disease West China Hospital of Stomatology Sichuan University The mount Sinai Bone Program Department of MedicineMount Sinai School of Medicine

The adaptor protein NUMB is involved in asymmetric division and cell fate determination and recognized as an antagonist of *** studies have proved that Notch activation in osteoblasts contributes to a high bone mass. In this study, however, an osteopenic phenotype was found in 9-week-old mice using osteoblastic specific Col1a1–2.3-Cre to ablate both Numb and its homologue Numbl. The trabecular bone mass decreased dramatically while the cortical bone mass was unaffected. Here, the Notch signal was not activated,while the tensin homologue deleted on human chromosome 10(PTEN), which dephosphorylates phosphatidylinositide 3-kinases, was elevated, attenuating protein kinase B(Akt). The ubiquitination assay revealed that NUMB may physiologically promote PTEN ubiquitination in the presence of neural precursor cell-expressed developmentally downregulated protein 4–1. In addition, the deficiency of Numb/Numbl also activated the Hedgehog pathway through GLI1. This process was found to improve the ratio of the receptor activator of nuclear factor-k B ligand to osteoprotegerin, which enhanced the differentiation of osteoclasts and bone resorption. In conclusion, this study provides an insight into new functons of NUMB and NUMBL on bone homeostasis.

关键词： NUMB maintains bone mass by promoting degradation of PTEN and GLI1 via ubiquitination in osteoblasts GLI RANKL

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Time for the world to move beyond the percutaneous endoscopic gastrostomy

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World Journal of Gastroenterology 2011年第23期17卷 2877-2878页

作者： Ah San Pang LP Surgery Mount Alvernia Hospital820 Thomson RoadSingapore 574623Singapore

Percutaneous endoscopic gastrostomy (PEG) is a proven feeding tube,just as the nasogastric tube is proven to be able to deliver enteral *** long-term use,both patient and caregiver want *** is desired is the LOOPPEG? 3G tube,more secure than the PEG,and less risky to change than the nasogastric *** clinical research should focus on this high-comfort low-risk tube.

关键词： Tube feeding Enteral nutrition Dysphagia Stroke

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Burning Mouth Syndrome

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International Journal of Oral Science 2010年第1期2卷 1-4页

作者： David Mock Deepika Chugh Faculty of Dentistry University of TorontoWasser Pain Management CentreMount Sinai Hospital

Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain on one or more oral mucosal surfaces. Unlike most other clinical conditions presenting in a dental office, burning mouth syndrome is poorly understood with few evidence based remedies. More recently, advances have been made towards clarifying the possible etiology of the disorder and testing the possible therapeutic modalities available. This article attempts to summarize the ＂state of the art＂ today.

关键词： orofacial pain burning mouth syndrome (BMS),stomatodynia neuropathic pain

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Boceprevir early-access for advanced-fibrosis/cirrhosis in Asia-pacific hepatitis C virus genotype 1 non-responders/relapsers

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World Journal of Gastroenterology 2015年第28期21卷 8660-8669页

作者： Wattana Sukeepaisarnjaroen Tri Pham Tewesak Tanwandee Saroja Nazareth Sam Galhenage Lindsay Mollison Leanne Totten Alan Wigg Rosalie Altus Anton Colman Brenda Morales Sue Mason Tracey Jones Nadine Leembruggen Vince Fragomelli Cheryl Sendall Richard Guan Dede Sutedja Soek Siam Tan Yock Young Dan Yin Mei Lee Widjaja Luman Eng Kiong Teo Yin Min Than Teerha Piratvisuth Seng Gee Lim Srinagarind hospital Cabramatta Practice Siriraj hospital Bangkok Royal Perth hospital Fremantle hospital Flinders Medical Centre Royal Adelaide hospital Austin hospital Royal Prince Alfred hospital John Hunter hospital Nepean hospital Cairns Base hospital mount elizabeth Medical Centre Gleneagles hospital Selayang hospital National University Health System Yong Loo Lin School of Medicine National University of Singapore Changi General hospital NKC Institute of Gastroenterology and Hepatology Prince of Songkla University

AIM:To examined the efficacy and safety of treatment with boceprevir,PEGylated-interferon and ribavirin(PR)in hepatitis C virus genotype 1(HCVGT1) PR treatmentfailures in ***:The Boceprevir Named-Patient Program provided boceprevir to HCVGT1 PR *** physicians were invited to contribute data from their patients:baseline characteristics,ontreatment responses,sustained virological response at week 12(SVR12),and safety were collected and *** analysis was performed to determine predictors of ***:150 patients were enrolled from Australia,Malaysia,Singapore and Thailand(Asians = 86,Caucasians = 63).Overall SVR12 was 61%(Asians= 59.3%,Caucasians = 63.5%).SVR12 was higher in relapsers(78%) compared with non-responders(34%).On-treatment responses predicted SVR,with undetectable HCVRNA at week 4,8 and 12 leading to SVR12 s of 100%,87%,and 82%respectively,and detectable HCVRNA at week 4,8 and 12,leading to SVR12 s of 58%,22%and 6%*** patients were similar to Caucasian patients with regards to on-treatment *** with cirrhosis(n= 69) also behaved in the same manner with regards to on-treatment *** with the IL28 B CC genotype(80%) had higher SVRs than those with the CT/TT(56%) genotype(P = 0.010).Multivariate analysis showed that TW8 and TW12 responses were independent predictors of *** adverse events occurred in 18.6%:sepsis(2%),decompensation(2.7%) and blood transfusion(14%).Discontinuations occurred in 30.7%,with 18.6%fulfilling stopping ***:Boceprevir can be used successfully in PR treatment failures with a SVR12 > 80%if they have good on-treatment responses;however,discontinuations occurred in 30%because of virological failure or adverse events.

关键词： Chronic hepatitis C Treatment failure Rapid virological response Lead-in Null response Partial response Relapse Cirrhosis Response guidedtherapy

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Role of endoscopic ultrasound in idiopathic pancreatitis

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World Journal of Gastroenterology 2017年第38期23卷 6952-6961页

作者： Piyush Somani Tagore Sunkara Malay Sharma Department of Gastr-oenterology Jaswant Rai Speciality Hospital Department of Gastroenterology and Hepatology The Brooklyn Hospital Center Clinical Affliate of The Mount Sinai Hospital

Recurrent acute pancreatitis(RAP) is defined based on the occurrence of two or more episodes of acute pancreatitis. The initial evaluation fails to detect the cause of RAP in 10%-30% of patients, whose condition is classified as idiopathic RAP(IRAP). Idiopathic acute pancreatitis(IAP) is a diagnostic challenge for gastroenterologists. In view of associated morbidity and mortality, it is important to determine the aetiology of pancreatitis to provide early treatment and prevent recurrence. Endoscopic ultrasound(EUS) is an investigation of choice for imaging of pancreas and biliary tract. In view of high diagnostic accuracy and safety of EUS, a EUS based management strategy appears to be a reasonable approach for evaluation of patients with a single/recurrent idiopathic pancreatitis. The most common diagnoses by EUS in IAP is biliary tract disease. The present review aims to discuss the role of EUS in the clinical management and diagnosis of patients with IAP. It elaborates the diagnostic approach to IAP in relation to EUS and other different modalities. Controversial issues in IAP like when to perform EUS, whether to perform after first episode or recurrent episodes, comparison among different investigations and the latest evidence significance are detailed.

关键词： Endoscopic ultrasound Pancreatitis ERCP MRCP USG CT Idiopathic recurrent pancreatitis Ascariasis Pancreatic cancer Biliary sludge Gallstones Microlithiasis Common bile duct stones

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Hepatobiliary strongyloidiasis presenting as an ampullary lesion on esophagogastroduodenoscopy/endoscopic ultrasound

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Gastroenterology Report 2019年第5期7卷 367-370,I0003页

作者： Emmanuel Ofori Daryl Ramai Alisha Khan Philip Xiao Madhavi Reddy Ghulamullah Shahzad Division of Gastroenterology and Hepatology The Brooklyn Hospital CenterAcademic Affiliate of The Icahn School of Medicine at Mount SinaiClinical Affiliate of The Mount Sinai HospitalBrooklynNY 11201USA St.George’s University School of Medicine True BlueGrenadaWI Department of Pathology The Brooklyn Hospital CenterAcademic Affiliate of The Icahn School of Medicine at Mount SinaiClinical Affiliate of The Mount Sinai HospitalBrooklynNY 11201USA

Strongyloidiasis is an intestinal infection caused by the parasitic nematodes of the Strongyloides species,most commonly Strongyloides *** report a case of a 66-year-old immigrant male from Haiti who presented with complaints of diarrhea and an unintentional 80-lb weight loss over the past 5 *** examination was positive for *** albendazole therapy,esophagogastroduodenoscopy(EGD)showed a unique ampullary *** of the ampullary lesion showed reactive epithelium with Strongyloides *** addition,endoscopic ultrasound(EUS)detected a large pancreatic *** these findings were absent on EGD 5 years previously,prior to the onset of his *** paper documents a rare case of an ampullary lesion and pancreatic cyst secondary to hepatobiliary strongyloidiasis in a non-Human Immunodeficiency Virus(HIV)*** review the epidemiology,life cycle,clinical presentation and treatment of strongyloidiasis.

关键词： strongyloidiasis Strongyloides stercoralis ampulla of Vater pancreatic cyst hepatobiliary endoscopy

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Chinese herbal medicine Yougui Pill reduces exogenous glucocorticoid-induced apoptosis in anterior pituitary cells

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Neural Regeneration Research 2016年第12期11卷 1962-1968页

作者： Yong-zhi Ji Long Geng Hong-bo Zhou Hua-chen Wei Hong-duo Chen Department of Dermatology Second Hospital of Jilin University Department of Dermatology First Hospital of China Medical University Department of Dermatology Mount Sinai Medical Center

Long-term glucocorticoid use may result in sustained suppression of one or more secreted components from the hypothalamo-pituitary-adrenal axis, and often results in apoptosis. Yougui Pill（YGP）, a 10-component traditional Chinese herbal medicine, has been shown to be clinically effective for glucocorticoid-induced suppression of the hypothalamo-pituitary-adrenal axis. However, the pharmacological and molecular mechanisms remain unclear. We hypothesized that YGP would exert an anti-apoptosis effect on dexamethasone-treated anterior pituitary cells. In vivo experiments showed that YGP significantly reduced the number of apoptotic cells, down-regulated m RNA expression of cytochrome c, caspase-3, and caspase-9, and up-regulated m RNA expression of Bcl-2. These findings suggest that YGP reduced glucocorticoid-induced apoptosis in rat anterior pituitary cells by regulating the mitochondria-mediated apoptosis pathway.

关键词： nerve regeneration Yougui Pill glucocorticoid apoptosis Bcl-2 cytochrome c caspase-3 caspase-9 mitochondrial membrane potential neural regeneration

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