중국과 대만의 통일정책과 양안간 교류협력

한종수,주유진 국제문화학회 2005 Vol. No.

Outcomes of limited period of adalimumab treatment in moderate to severe Crohn’s disease patients: Taiwan Society of Inflammatory Bowel Disease Study

( Wei-chen Lin ),( Jen-wei Chou ),( Hsu-heng Yen ),( Wen-hung Hsu ),( Hung-hsin Lin ),( Jen-kou Lin ),( Chiao-hsiung Chuang ),( Tien-yu Huang ),( Horng-yuan Wang ),( Shu-chen Wei ),( Jau-min Wong ) 대한장연구학회 2017 Intestinal Research Vol.15 No.4

Background/Aims: In Taiwan, due to budget limitations, the National Health Insurance only allows for a limited period of biologics use in treating moderate to severe Crohn’s disease (CD). We aimed to access the outcomes of CD patients following a limited period use of biologics, specifically focusing on the relapse rate and remission duration; also the response rate to second use when applicable. Methods: This was a multicenter, retrospective, observational study and we enrolled CD patients who had been treated with adalimumab (ADA) according to the insurance guidelines from 2009 to 2015. Results: A total of 54 CD patients, with follow-up of more than 6 months after the withdrawal of ADA, were enrolled. The average period of treatment with ADA was 16.7±9.7 months. After discontinuing ADA, 59.3% patients suffered a clinical relapse. In the univariate analysis, the reason for withdrawal was a risk factor for relapse (P=0.042). In the multivariate analysis, current smoker became an important risk factor for relapse (OR, 3.9; 95% CI, 1.2-14.8; P=0.044) and male sex was another risk factor (OR, 2.9; 95% CI, 1.1-8.6; P=0.049). For those 48 patients who received a second round of biologics, the clinical response was seen in 60.4%, and 1 anaphylaxis occurred. Conclusions: Fifty-nine percent of patients experienced a relapse after discontinuing the limited period of ADA treatment, and most of them occurred within 1 year following cessation. Male sex and current smoker were risk factors for relapse. Though 60.4% of the relapse patients responded to ADA again. (Intest Res 2017;15:487-494)

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.

2022 Taiwan clinical multicenter expert consensus and recommendations for thyroid radiofrequency ablation

Wei-Che Lin,Wen-Chieh Chen,Pei-Wen Wang,Yi-Chia Chan,Yen-Hsiang Chang,Harn-Shen Chen,Szu-Tah Chen,Wei-Chih Chen,Kai-Lun Cheng,Shun-Yu Chi,Pi-Ling Chiang,Chen-Kai Chou,Feng-Fu Chou,Shun-Chen Huang,Feng 대한초음파의학회 2023 ULTRASONOGRAPHY Vol.42 No.3

Radiofrequency ablation (RFA) is a minimally invasive management strategy that has been widely applied for benign and recurrent malignant thyroid lesions as an alternative to surgery in Taiwan. Members of academic societies for specialists in interventional radiology, endocrinology, and endocrine surgery collaborated to develop the first consensus regarding thyroid RFA in Taiwan. The modified Delphi method was used to reach a consensus. Based on a comprehensive review of recent and valuable literature and expert opinions, the recommendations included indications, pre-procedural evaluations, procedural techniques, post-procedural monitoring, efficacy, and safety, providing a comprehensive review of the application of RFA. The consensus effectively consolidates advice regarding thyroid RFA in clinical practice for local experts.

A large symptomatic jejunal subepithelial tumor treated with endoloop-assisted polypectomy using spiral enteroscopy

( Jen Wei Chou ),( Ken Sheng Cheng ),( Ching Pin Lin ) 대한장연구학회 2016 Intestinal Research Vol.14 No.1

Pulmonary embolism in an immunocompetent patient with acute cytomegalovirus colitis

( Jen Wei Chou ),( Ken Sheng Cheng ) 대한장연구학회 2016 Intestinal Research Vol.14 No.2

Acute cytomegalovirus (CMV) infection occurs commonly in immunocompromised and immunocompetent patients, but is usually asymptomatic in the latter. Vascular events associated with acute CMV infection have been described, but are rare. Hence, such events are rarely reported in the literature. We report a case of pulmonary embolism secondary to acute CMV colitis in an immunocompetent 78-year-old man. The patient presented with fever and diarrhea. Colonic ulcers were diagnosed based on colonoscopy findings, and CMV was the proven etiology on pathological examination. The patient subsequently experienced acute respiratory failure. Pulmonary embolism was diagnosed based on the chest radiography and computed tomography findings. A diagnosis of acute CMV colitis complicated by pulmonary embolism was made. The patient was successfully treated with intravenous administration of unfractionated heparin and intravenous ganciclovir. (Intest Res 2016;14:187-190)

Seasonal yeast compositions in Forcipomyia taiwana (Diptera: Ceratopogonidae)

Hung-Wei Chen,Jui-Yu Chou,Chung-Chi Lin,Yu-Der Wen,Wei-Lung Wang 한국응용곤충학회 2016 Journal of Asia-Pacific Entomology Vol.19 No.2

Forcipomyia taiwana, a biting midge, is one of the most annoying blood-sucking pests in Taiwan. The larvae of Forcipomyia species feed primarily on algae, and the adults feed on nectar for nutrition. After mating with male adults, females bite humans and digest blood for the formation and development of their eggs. The bites often cause human itching, swelling, skin lesion and even fatal shock. Harassment from this biting pest has become a serious problem and has influenced the quality of outdoor recreational activities. Thus, it is necessary to understand the ecology of F. taiwana to develop an effective control strategy. This study showed the seasonal variation of yeast compositions in the interior of F. taiwana. Furthermore, we found that Aureobasidium spp. appeared the most during collection times and these yeasts are able to decompose the cellulose, a major component in the cell wall of algae and Oomycete fungi. These fungi infect a broad range of host and have adverse effect on fitness of the biting midges. Thus, Aureobasidium spp. play a crucial role in the defense system of F. taiwana against pathogens. The study provides useful information that could be used in the development of biocontrol strategy in the future.

Capsule retention caused by duodenal metastases from primary appendiceal adenocarcinoma

( Jen-wei Chou ),( Ken-sheng Cheng ) 대한장연구학회 2017 Intestinal Research Vol.15 No.1

Metastatic small bowel cancers are extremely rare in clinical practice. Primary appendiceal adenocarcinoma with gastrointestinal metastasis is seldom reported in the literature. Here, we describe the case of an 80-year-old male patient with primary appendiceal adenocarcinoma, who presented to China Medical University Hospital with mid-gastrointestinal tract bleeding. Capsule endoscopy revealed stenotic bowel lumen, but the capsule was retained in the distal duodenum. Double-balloon enteroscopy demonstrated erosive and erythematous mucosa in the region of capsule retention. The retained capsule was retrieved successfully by using an electrosurgical snare. Histological examination and immunohistochemical staining of the biopsy specimen from the duodenal lesion strongly supported the diagnosis of metastatic appendiceal adenocarcinoma. (Intest Res 2017;15:130-132)

An unusual cause of distal duodenal bleeding

( Jen Wei Chou ),( Ken Sheng Cheng ),( Shih Chieh Chuang ) 대한장연구학회 2016 Intestinal Research Vol.14 No.2

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)