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.

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.

Speculation and Commodity Prices

Chang, Young Ho,Zhen Chuan Chua,Qiu Xia Eu,Shaun Wong Wei Xiang 이화여자대학교 사회과학연구소 2013 사회과학연구논총 Vol.29 No.1

This paper attempts to identify the role of financial speculation in commodity price movements, while exploring other possible influences such as the role of spare capacity and the role of rapidly developing countries, through intensive commodity import surges. Both fundamentals and speculation appear to jointly determine crude oil prices. Speculative activity does play a supporting role in price determination but it is not the only driver. Fundamentals such as net imports, the result of consumption and production dynamics, are important in price determination. Attempts at investigating the role of spare capacity, however, found that capacity bottle neck is not an important cause of recent price movements. A production level is still primarily the most important driver on prices of wheat and is heavily reliant on weather. Speculation does not have a significant effect of prices, but position limits may disrupt hedging activity that helps stabilize wheat prices. Even though speculation have some influence on crude oil prices, setting an across the board position limit may harm the price stability in wheat markets. Market wide position limits should consider the impacts on the futures market as a whole rather than piecemeal.

Ultrasound imaging for inguinal hernia: a pictorial review

Wei-Ting Wu,Ke-Vin Chang,Chih-Peng Lin,Chi-Chuan Yeh,Özçakar Levent 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.3

Inguinal hernia is the most prevalent type of abdominal wall hernia. Indirect inguinal hernia is twice as common as direct inguinal hernia. Computed tomography and magnetic resonance imaging can be used to evaluate inguinal hernia, but these modalities are greatly limited by their cost and availability. Ultrasonography has emerged as the most convenient imaging tool for diagnosing inguinal hernia due to its advantages, such as portability and absence of radiation. The present pictorial review presents an overview on the use of ultrasonography in the evaluation of inguinal hernia with a particular emphasis on the regional anatomy, relevant scanning tips, identification of subtypes, postoperative follow-up, and diagnosis of pathologies mimicking inguinal hernia.

Anti-fatigue activity of dripped spent hens chicken essence in ICR mice

Chang Ti Chun,Chen Wei Cheng,Huang Chao Wei,Lin Liang Chuan,Lin Jen Shinn,Cheng Fu Yuan 아세아·태평양축산학회 2023 Animal Bioscience Vol.36 No.2

Objective: Chicken essence and branched chain amino acid (BCAA) supplementation has been recognized to significantly relieve fatigue. To obtain chicken essence with high amounts of BCAA, spent hens herein was used to prepare dripped chicken essence (SCE) and compared with commercial dripped chicken essence (CCE) for in vivo anti-fatigue effect. Methods: To determine the effect on anti-fatigue by dripped chicken essence, the exhaustive swimming was performed. Thirty-two 7-week ICR mice were divided into four groups, which included the control group (CG), CCE, SCE-1X and SCE-2X. The mice were given daily oral administration (0.012 mL/g body weight/d). The fatigue index analysis was conducted weekly. Results: The results showed that SCE had a higher BCAA level as expected, and mice treated with dripped chicken essence (CCE and SCE) could significantly improve exercise performance. The lower blood lactate level, blood urea nitrogen level and creatine phosphokinase activity were found in the supplement of SCE group compared with the CCE group, which suggested that the SCE possessed strong anti-fatigue ability. This could possibly be due to the higher content of BCAA. Conclusion: In this study, SCE promoted recovery from physical fatigue in mice and elevated endurance ability. Among them, the double dose (SCE-2X) showed the strongest antifatigue ability. Taken together, spent chickens could be a good source of chicken essence to improve the effect of anti-fatigue.

Parameter Optimization of Micromilling Brass Mold Inserts for Microchannels with Taguchi Method

Pin-Chuan Chen,Yu-Chieh Chen,Chang-Wei Pan,Kuan-Ming Li 한국정밀공학회 2015 International Journal of Precision Engineering and Vol. No.

Achieving excellent quality of micromilled surfaces usually requires additional efforts and cost, and Taguchi methodology is anefficient tool in the parameter optimization process. The aim of this study is to explore the optimal cutting parameters for minimalsurface roughness of a micromilled brass mold inset, and the controlling parameters included coolant, spindle speed, feed rate, depthof cut, and the stepover. An orthogonal array and factor analysis were carried out to identify the optimal cutting combination, andthis combination included air coolant, spindle speed of 45,000 rpm, feed rate of 100 mm/min, stepover of 10% of milling bit diameter,and the depth of cut of 5 μm. To further confirm the analysis, multiple confirmation runs were realized and the averagely measuredsurface roughness was 0.03 μm with a stand deviation of 0.004 μm.

Speculation and Commodity Prices

Youngho Chang,Zhen Chuan Chua,Qiu Xia Eu,Shaun Wong Wei Xiang 이화여자대학교 이화사회과학원 2013 사회과학연구논총 Vol.29 No.1

This paper attempts to identify the role of financial speculation in commodity price movements, while exploring other possible influences such as the role of spare capacity and the role of rapidly developing countries, through intensive commodity import surges. Both fundamentals and speculation appear to jointly determine crude oil prices. Speculative activity does play a supporting role in price determination but it is not the only driver. Fundamentals such as net imports, the result of consumption and production dynamics, are important in price determination. Attempts at investigating the role of spare capacity, however, found that capacity bottle neck is not an important cause of recent price movements. A production level is still primarily the most important driver on prices of wheat and is heavily reliant on weather. Speculation does not have a significant effect of prices, but position limits may disrupt hedging activity that helps stabilize wheat prices. Even though speculation have some influence on crude oil prices, setting an across the board position limit may harm the price stability in wheat markets. Market wide position limits should consider the impacts on the futures market as a whole rather than piecemeal.

Optimization of Micromilling Microchannels on a Polycarbonate Substrate

Pin-Chuan Chen,Chang-Wei Pan,Wei-Chen Lee,Kuan-Ming Li 한국정밀공학회 2014 International Journal of Precision Engineering and Vol. No.

Rapidly prototyping a polymer microfluidic device is a growing interest for various applications and micromilling is one of the common approaches to manufacture polymer microfluidic devices. The advantages of using micromilling for polymer microfluidic devices include shorter fabrication process, lower cost, easier user interface, and being capable of fabricating complicated structures, which make micromilling a perfect tool in research idea testing and validation. The aim of this study is to understand the impact of each micromilling parameter to the surface roughness on a polycarbonate substrate, followed by the factor analysis to determine the optimal cutting conditions. The parameters included spindle speed, feed rate, and the depth of cut, and the roughness was measured by a stylus profilemeter. The smallest roughness achieved was 0.127 µm with the spindle speed of 20,000 rpm, feed rate of 300 mm/min, and the depth of cut of 10 µm. Factor analysis was used to determine that the spindle speed has the largest impact while the depth of cut has the minimized impact to the surface quality. To further confirm the optimal cutting conditions, twelve reservoirs were micromilled with the optimal cutting conditions and the average roughness is 0.14 µm with a stand deviation of 0.08 µm.

Rotary Inductive Power Transfer for LED Lighting Systems

Chung-Chuan Hou,Chia-Ming Chang,Wei-Hsiang Cheng,Hsien-Ching Huang 전력전자학회 2019 ICPE(ISPE)논문집 Vol.2019 No.5

Rotary inductive power transfer (RIPT) systems have the advantages in wireless power transfer capability, unlimited angular position operation, and flexible light-emitting diode (LED) lighting application. Therefore, this study discusses the performances of RIPT for LED lighting systems in the frequency domain and time domain. The characteristics of the RIPT for LED lighting systems are measured under varied air gap, changed load, and so on. The simulation and experimental results are presented to validate the performances of the proposed scheme.

Common Mode Voltage Reduction in Four-Leg Inverter with Multicarrier PWM Scheme

Chung-Chuan Hou,Po-Wei Wang,Ching-Chen Chen,Chen-Wei Chang 전력전자학회 2019 ICPE(ISPE)논문집 Vol.2019 No.5

Three-phase three-leg inverter has an inherent common mode voltage (CMV) problem. Therefore, threephase four-leg inverter is presented to mitigate the CMV of the inverter. This study discusses the characteristics of multicarrier pulse width modulation (PWM) for threephase four-leg inverter. The multicarrier PWM scheme is utilized to reduce the CMV of the inverter. The analysis of sinusoidal PWM and space vector PWM with multicarrier is discussed. The experimental results are utilized to validate the performances of the proposed multicarrier PWM scheme.