Effects of Codeine on Esophageal Peristalsis in Patients With Ineffective Esophageal Motility: Studies Using High-resolution Manometry

Wei-Yi Lei,Tso-Tsai Liu,Wei-Chuan Chang,Chih-Hsun Yi,Jui-Sheng Hung,Ming-Wun Wong,Shu-Wei Liang,Lin Lin,Chien-Lin Chen 대한소화기 기능성질환∙운동학회 2024 Journal of Neurogastroenterology and Motility (JNM Vol.30 No.1

Background/AimsThis study aims to evaluate the effects of acute codeine administration on primary and secondary esophageal peristalsis in patients with ineffective esophageal motility (IEM). MethodsEighteen IEM patients (8 women; mean age 37.8 years, range 23-64 years) were enrolled in the study. The patients underwent high-resolution manometry exams, consisting of 10 single wet swallows, multiple rapid swallows, and ten 20 mL rapid air injections to trigger secondary peristalsis. All participants completed 2 separate sessions, including acute administration of codeine (60 mg) and placebo, in a randomized order. ResultsCodeine significantly increased the distal contractile integral (566 ± 81 mmHg∙s∙cm vs 247 ± 36 mmHg∙s∙cm, P = 0.001) and shortened distal latency (5.7 ± 0.2 seconds vs 6.5 ± 0.1 seconds, P < 0.001) for primary peristalsis compared with these parameters after placebo treatment. The mean total break length decreased significantly after codeine treatment compared with the length after placebo (P = 0.003). Codeine significantly increased esophagogastric junction-contractile integral (P = 0.028) but did not change the 4-second integrated relaxation pressure (P = 0.794). Codeine significantly decreased the frequency of weak (P = 0.039) and failed contractions (P = 0.009), resulting in increased frequency of normal primary peristalsis (P < 0.136). No significant differences in the ratio of impaired multiple rapid swallows inhibition and parameters of secondary peristalsis were detected. ConclusionsIn IEM patients, acute administration of codeine increases contraction vigor and reduces distal latency of primary esophageal peristalsis, but has no effect on secondary peristalsis. Future studies are required to further elucidate clinical relevance of these findings, especially in the setting of gastroesophageal reflux disease with IEM.

Impact of Stress Engineering on the Electron Mobility and the Balistic Current for Strained Si NMOSFETs

Shu-Tong Chang,Shu-Hui Liao,Wei-Ching Wang,Chung-Yi Lin,Jun-Wei Fan 한국물리학회 2008 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.53 No.2

The physical mechanisms of electron mobility and balistic drain curent enhancement by stress are investigated. From modified higher-order k·p band calculations, the stress-induced split of the conduction band edge and the effective mass change are quantitatively evaluated. It was experimentaly and theoreticaly demonstrated that the energy surface of 2-fold valeys in Si NMOSFETs on a (001) wafers is especially warped due to a uniaxial [110] stress, resulting in a lighter transverse effective mass of the 2-fold valleys parallel to the stress. The physical reasons for the warped subband structure and the abnormal mobility enhancement caused by the uniaxial stres are investigated. The rates of variation of the experimental electron mobility in NMOSFETs on wafers with (01) orientations undera <110> uniaxial stress as a function of the channel direction is theoretically studied. The limits of electron mobility enhancement and the effectiveness of stress enginering in enhancing the balistic drain current of NMOSFETs are also discussed.

Intra-Arterial Treatment in Patients with Acute Massive Gastrointestinal Bleeding after Endoscopic Failure: Comparisons between Positive versus Negative Contrast Extravasation Groups

Wei-Chou Chang,Chang-Hsien Liu,Hsian-He Hsu,Guo-Shu Huang,Ho-Jui Tung,Tsai-Yuan Hsieh,Shih-Hung Tsai,Chung-Bao Hsieh,Chih-Yung Yu 대한영상의학회 2011 Korean Journal of Radiology Vol.12 No.5

Objective: To determine whether treatment outcome is associated with visualization of contrast extravasation in patients with acute massive gastrointestinal bleeding after endoscopic failure. Materials and Methods: From January 2007 to December 2009, patients that experienced a first attack of acute gastrointestinal bleeding after failure of initial endoscopy were referred to our interventional department for intra-arterial treatment. We enrolled 79 patients and divided them into two groups: positive and negative extravasation. For positive extravasation, patients were treated by coil embolization; and in negative extravasation, patients were treated with intra-arterial vasopressin infusion. The two groups were compared for clinical parameters, hemodynamics, laboratory findings, endoscopic characteristics, and mortality rates. Results: Forty-eight patients had detectable contrast extravasation (positive extravasation), while 31 patients did not (negative extravasation). Fifty-six patients survived from this bleeding episode (overall clinical success rate, 71%). An elevation of hemoglobin level was observed in the both two groups; significantly greater in the positive extravasation group compared to the negative extravasation group. Although these patients were all at high risk of dying, the 90-day mortality rate was significantly lower in the positive extravasation than in the negative extravasation (20% versus 42%, p < 0.05). A multivariate analysis suggested that successful hemostasis (odds ratio [OR] = 28.66) is the most important predictor affecting the mortality in the two groups of patients. Conclusion: Visualization of contrast extravasation on angiography usually can target the bleeding artery directly, resulting in a higher success rate to control of hemorrhage. Objective: To determine whether treatment outcome is associated with visualization of contrast extravasation in patients with acute massive gastrointestinal bleeding after endoscopic failure. Materials and Methods: From January 2007 to December 2009, patients that experienced a first attack of acute gastrointestinal bleeding after failure of initial endoscopy were referred to our interventional department for intra-arterial treatment. We enrolled 79 patients and divided them into two groups: positive and negative extravasation. For positive extravasation, patients were treated by coil embolization; and in negative extravasation, patients were treated with intra-arterial vasopressin infusion. The two groups were compared for clinical parameters, hemodynamics, laboratory findings, endoscopic characteristics, and mortality rates. Results: Forty-eight patients had detectable contrast extravasation (positive extravasation), while 31 patients did not (negative extravasation). Fifty-six patients survived from this bleeding episode (overall clinical success rate, 71%). An elevation of hemoglobin level was observed in the both two groups; significantly greater in the positive extravasation group compared to the negative extravasation group. Although these patients were all at high risk of dying, the 90-day mortality rate was significantly lower in the positive extravasation than in the negative extravasation (20% versus 42%, p < 0.05). A multivariate analysis suggested that successful hemostasis (odds ratio [OR] = 28.66) is the most important predictor affecting the mortality in the two groups of patients. Conclusion: Visualization of contrast extravasation on angiography usually can target the bleeding artery directly, resulting in a higher success rate to control of hemorrhage.

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

( Shu-Chen Wei ),( Ting-An Chang ),( Te-Hsin Chao ),( Jinn-Shiun Chen ),( Jen-Wei Chou ),( Yenn-Hwei Chou ),( Chiao-Hsiung Chuang ),( Wen-Hung Hsu ),( Tien-Yu Huang ),( Tzu-Chi Hsu ),( Chun-Chi Lin ) 대한장연구학회 2017 Intestinal Research Vol.15 No.3

Ulcerative colitis (UC) is an inflammatory bowel disease characterized by chronic mucosal inflammation of the colon, and the prevalence and incidence of UC have been steadily increasing in Taiwan. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of UC taking into account currently available evidence and the expert opinion of the committee. Accurate diagnosis of UC requires thorough clinical, endoscopic, and histological assessment and careful exclusion of differential diagnoses, particularly infectious colitis. The goals of UC therapy are to induce and maintain remission, reduce the risk of complications, and improve quality of life. As outlined in the recommended treatment algorithm, choice of treatment is dictated by severity, extent, and course of disease. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to immunosuppressive treatment, especially with steroids and biologic agents, and should be regularly monitored for reactivation of latent infection. These consensus statements are also based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of UC in Taiwan. (Intest Res 2017;15:266-284)

Energy and force transition between atoms and continuum in quasicontinuum method

Chang, Shu-Wei,Liao, Ying-Pao,Huang, Chang-Wei,Chen, Chuin-Shan Techno-Press 2014 Interaction and multiscale mechanics Vol.7 No.1

We present a full energy and force formulation of the quasicontinuum method with non-local and local transition elements. Non-local transition elements are developed to transmit inhomogeneity from the atomistic to the continuum regions. Local transition elements are developed to resolve the mathematical mismatch between non-local atoms and the local continuum. The rationale behind these transition elements is provided by analyzing the energy and force transitions between atoms and continuum under the Cauchy-Born rule. We show that breakdown of the Cauchy-Born rule occurs for slaved atoms of local elements within the cutoff of non-local atoms. The inadequacy of the Cauchy-Born rule at the transition region naturally leads to the need of atomistic treatment of transition slaved and transition representative atoms. Such an atomistic treatment together with a full or cutoff sampling allows non-local transition elements containing these transition entities to transmit inhomogeneity. Different force formulations for transition representative atoms and pure local representative atoms allow the local transition elements to resolve non-local and local mismatches. The method presented herein is validated by force calculations in an unstressed perfect crystal as well as an unrelaxed grain boundary model. A nanoindentation simulation in 3D is conducted to demonstrate the accuracy and efficiency of the proposed method.

Transient Hiatal Separation During Straight Leg Raise Can Predict Reflux Burden in Gastroesophageal Reflux Disease Patients With Ineffective Esophageal Motility

Wei-Yi Lei,Shu-Wei Liang,Taher Omari,Wei-Chuan Chang,Ming-Wun Wong,Jui-Sheng Hung,Chih-Hsun Yi,Tso-Tsai Liu,Lin Lin,C Prakash Gyawali,Chien-Lin Chen 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.4

Background/Aims Straight leg raise (SLR) can be utilized to evaluate the integrity of the esophagogastric junction during high-resolution manometry (HRM). We aim to assess the value of transient hiatal separation during SLR in symptomatic reflux patients. Methods Consecutive reflux patients undergoing esophageal HRM and pH monitoring were included. Transient hiatal separation was defined by a ≥ 1 cm separation between the lower esophageal sphincter and crural diaphragm during SLR. We compared esophageal motor patterns and reflux monitoring parameters between patients with normal, transiently abnormal and consistently abnormal esophagogastric junction morphology during SLR. Results Of 85 (56.3% female, mean age: 46.7 ± 12.3 years) completed SLR, esophagogastric junction morphology was normal in 31 (36.5%), transient hiatal separation in 19 (22.3%), and consistently hiatal hernia in 35 (41.2%). The values of total acid exposure time (P = 0.016), longest acid reflux episodes (P = 0.024), and DeMeester scores (P = 0.016) were higher in hiatal hernia compared to patients with non-transient hiatal separation, but there were no differences between those with and without transient hiatal separation. Within ineffective esophageal motility, the presence of transient hiatal separation during SLR significantly associated with a higher total acid exposure time (P = 0.014), higher DeMeester scores (P = 0.019), higher total acid reflux events (P = 0.037), and higher longest acid reflux episodes (P = 0.006). Conclusion Our work suggests that SLR may have value as a provocative test during HRM, and future outcome studies are warranted to elucidate the clinical relevance of motor abnormalities depicted from SLR.

Management of Crohn`s disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

( Shu-Chen Wei ),( Ting-An Chang ),( Te-Hsin Chao ),( Jinn-Shiun Chen ),( Jen-Wei Chou ),( Yenn-Hwei Chou ),( Chiao-Hsiung Chuang ),( Wen-Hung Hsu ),( Tien-Yu Huang ),( Tzu-Chi Hsu ),( Chun-Chi Lin ) 대한장연구학회 2017 Intestinal Research Vol.15 No.3

Crohn`s disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD. Computed tomography and magnetic resonance imaging are complementary to endoscopic evaluation for disease staging and detecting complications. The goals of CD management are to induce and maintain remission, reduce the risk of complications, and improve quality of life. Corticosteroids are the mainstay for inducing re-mission. Immunomodulating and biologic therapies should be used to maintain remission. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to treatment and receive regular surveillance for cancer. These consensus statements are based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of patients with CD in Taiwan. (Intest Res 2017;15:285-310)

RNAi-based Knockdown of Multidrug Resistance-associated Protein 1 is Sufficient to Reverse Multidrug Resistance of Human Lung Cells

Shao, Shu-Li,Cui, Ting-Ting,Zhao, Wei,Zhang, Wei-Wei,Xie, Zhen-Li,Wang, Chang-He,Jia, Hong-Shuang,Liu, Qian Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.24

Up-regulation of multidrug resistance-associated protein 1 (MRP1) is regarded as one of the main causes for multidrug resistance (MDR) of tumor cells, leading to failure of chemotherapy-based treatment for a multitude of cancers. However, whether silencing the overexpressed MRP1 is sufficient to reverse MDR has yet to be validated. This study demonstrated that RNAi-based knockdown of MRP1 reversed the increased efflux ability and MDR efficiently. Two different short haipin RNAs (shRNAs) targeting MRP1 were designed and inserted into pSilence-2.1-neo. The shRNA recombinant plasmids were transfected into cis-dichlorodiamineplatinum-resistant A549 lung (A549/DDP) cells, and then shRNA expressing cell clones were collected and maintained. Real time PCR and immunofluorescence staining for MRP1 revealed a high silent efficiency of these two shRNAs. Functionally, shRNA-expressing cells showed increased rhodamine 123 retention in A549/DDP cells, indicating reduced efflux ability of tumor cells in the absence of MRP1. Consistently, MRP1-silent cells exhibited decreased resistance to 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) and DDP, suggesting reversal of MDR in these tumor cells. Specifically, MRP1 knockdown increased the DDP-induced apoptosis of A549/DDP cells by increased trapping of their cell cycling in the G2 stage. Taken together, this study demonstrated that RNAi-based silencing of MRP1 is sufficient to reverse MDR in tumor cells, shedding light on possible novel clinical treatment of cancers.

Prevalence of Enterobius vermicularis Infection among Preschool Children in Kindergartens of Taipei City, Taiwan in 2008

Tso-Kang Chang,Chien-Wei Liao,Ying-Chieh Huang,Chun-Chao Chang,Chia-Mei Chou,Hsin-Chieh Tsay,Alice Huang,Shu-Fen Guu,Ting-Chang Kao,Chia-Kwung Fan 대한기생충학열대의학회 2009 The Korean Journal of Parasitology Vol.47 No.2

A Study on the Influence of the GSCM Establishment Factor by Chinese Import-Export Manufacturers on Customer Satisfaction

Chang-bong Kim(김창봉),Shu-wei Wang(왕수위),Jong-keon Lee(이종건) 한국국제상학회 2018 國際商學 Vol.33 No.4

Ⅰ. 서 론 Ⅱ. 이론적 배경 및 선행연구 Ⅲ. 연구모형 및 가설설정 Ⅳ. 가설의 검증결과 Ⅴ. 결론 및 시사점 참고문헌 글로벌 무역환경의 변화에 따라 GSCM구축에 의한 기업들의 외부환경 대응성 관리가 중요해 지고 있다. 이에 본 연구에서는 중국의 200개 수출입 기업들을 대상으로 GSCM구축요인이 대응성 및 고객만족에 미치는 영향을 실증분석하여 연구결과를 도출하고 실무적 및 학문적 시사점을 제시하였다. 본 연구는 기업운영의 외부환경에 영향을 미치는 다양한 요인을 고찰하여 연구모형을 설계하였고, 구조방정식모형 분석을 통해 다음과 같은 연구결과를 도출하였다. 첫째, 기업의 신뢰성 요인은 기업의 표준화 요인에 정(+)의 영향을 미치는 것으로 나타났다. 둘째, 기업의 신뢰성 요인은 외부환경 대응성에 유의한 정(+)의 영향을 미치는 것으로 나타났다. 셋째, 기업의 표준화 요인은 외부환경 대응성에 유의한 정(+)의 영향을 미치는 것으로 나타났다. 넷째, 기업의 표준화 요인은 고객만족 성과요인에 유의한 정(+)의 영향을 미치는 것으로 나타났다. 다섯째, 대응성 요인은 고객만족에 유의한 정(+)의 영향을 미치는 것으로 나타났다. 본 연구결과의 시사점으로 기업운영을 살펴보고 급변하는 외부환경에 대한 대응성 요인을 분석함으로써 고객만족으로 연결되기까지의 과정을 통해 GSCM구축요인인 신뢰성과 표준화 요인에 대한 중요성을 제시한다.