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.

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.

Esophageal Bolus Domain Pressure and Peristalsis Associated With Experimental Induction of Esophagogastric Junction Outflow Obstruction

( Wei-yi Lei ),( Taher Omari ),( Tso-tsai Liu ),( Ming-wun Wong ),( Jui-sheng Hung ),( Chih-hsun Yi ),( Shu-wei Liang ),( Charles Cock ),( Chien-lin Chen ) 대한소화기기능성질환·운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.1

Background/Aims Intrabolus pressures are important for esophageal bolus transport and may detect obstructed bolus flow. This study measured the effect esophageal outflow obstruction experimentally induce by a leg-lift protocol. Methods Twenty-five gastroesophageal reflux disease patients referred for esophageal manometry and a normal motility diagnosis were included. Supine liquid swallows were tested. Leg-lift protocol generated esophageal outflow obstruction by increasing abdominal pressure. Esophageal pressure topography and intrabolus pressure metrics were calculated. These included, (1) mid-domain bolus distension pressure during esophageal emptying (DPE, mmHg) and (2) ramp pressure (mmHg/sec), generated by compression of the bolus between the peristaltic contraction and esophagogastric junction (EGJ). Results EGJ relaxation pressure was increased by leg-lift from 13 (11-17) to 19 (14-30) mmHg (P < 0.005) and distal contractile integral also increased from 1077 (883-1349) to 1620 (1268-2072) mmHgㆍcmㆍsec (P < 0.001) as a physiological response to obstruction. All bolus pressures were increased by leg lift; DPE increased from 17 (15-20) to 27 (19-32) mmHg (P < 0.001), and ramp pressure increased from 3 (1-4) to 5 (2-9) mmHg/sec (P < 0.05). Conclusion Measuring pressures within the intrabolus domain can quantify changes related to obstruction to outflow and may serve as adjunct measures for confirming a diagnosis EGJ outflow obstruction. (J Neurogastroenterol Motil 2022;28:62-68)

Fermentation process development for hyaluronic acid production by Streptococcus zooepidemicus ATCC 39920

Shu-Jen Chen,Jia-Ling Chen,Wei-Chih Huang,Hsin-Liang Chen 한국화학공학회 2009 Korean Journal of Chemical Engineering Vol.26 No.2

The development of a fermentation strategy for hyaluronic acid (HA) production by Streptococcus zooepidemicus ATCC 39920 has been explored. The specific HA productivity (YP/X) was affected by the medium carbon-tonitrogen (C/N) ratio rather than the specific growth rate of cells. Accordingly, HA fermentation should be performed in a balanced medium with an optimum C/N ratio of 2 : 1 in a batch culture. To improve the performance of the batch culture, the operation conditions for the fill-and-draw culture were investigated. It was found that the timing of medium exchange is critical for successfully performing fill-and-draw operations. Since streptococcal cells at the stationary phase might lose the capacity of HA synthesis, the displacement of the medium in a fill-and-draw culture should be started at the late exponential growth phase.

Development and Preliminary Evaluation of Psychometric Properties of Symptom-Management Self-Efficacy Scale for Breast Cancer Related to Chemotherapy

Shu-Yuan Liang,Wei-Wen Wu,Chiu-Ya Kuo,Yu-Ying Lu 한국간호과학회 2015 Asian Nursing Research Vol.9 No.4

Purpose: The purpose of this study was to develop and preliminarily evaluate the reliability and validity of the Symptom-Management Self-Efficacy ScaleeBreast Cancer (SMSES-BC) related to chemotherapy. Methods: The study included three stages. This paper presents the results of stage 2 and stage 3. In total, 34 items in the SMSES-BC were found during stage 1 from qualitative findings, a literature review, and expert suggestions; the 34 items were used for the psychometric properties test. Test-retest reliability and Cronbach a were assessed in the first sample, which included 45 participants for the pilot test (stage 2). The second sample, which included 152 patients, was used to assess the construct validity and concurrent validity (stage 3). Results: The pilot test results revealed a test-retest reliability of .73 (p < .001) and Cronbach a coefficient of .96 for the total scale. Three factors (managing chemotherapy-related symptoms, acquiring problem solving, and managing emotional and interpersonal disturbances) were identified from exploratory factor analysis. Correlation coefficient r was .40 (p < .001), which supported the association between SMSES-BC and the General Self-Efficacy Scale for concurrent validity. Conclusions: The study results demonstrate acceptable reliability and validity for the SMSES-BC that was developed for measuring symptom-management self-efficacy related to chemotherapy for patients with breast cancer. This study suggests further research to validate the construct of the SMSES-BC.

Enhanced photoactivity of N-doped TiO2 for Cr(VI) removal: Influencing factors and mechanism

Shu Qin Wang,Wen Bo Liu,Peng Fu,Wei Liang Cheng 한국화학공학회 2017 Korean Journal of Chemical Engineering Vol.34 No.5

To further enhance the photoactivity of virgin TiO2, we prepared N-doped TiO2 (N-TiO2) by sol-gel method and used it to remove Cr(VI) ions from water under visible light. The catalysts were characterized by TEM, XRD, BET and UV-vis techniques. Better crystalline structure, larger specific surface area and decreased band-gap width were obtained after the insertion of N atoms into TiO2 lattice. Several influencing factors were also investigated. The removal efficiency of Cr(VI) increases with the decrease of initial Cr(VI) concentration or the increase of catalyst dosage. Addition of glucose or some inorganic ions (Mg2+, Al3+) can promote the photoreduction process by improving the quantum efficiency. The kinetics and mechanism were discussed as well.

Evolution of ALPPS: The Simpler, Safer and Effective One---TELPP

( Shu You Peng ),( Xu An Wang ),( Cong Yun Huang ),( You Yong Zhang ),( Jiang Tao Li ),( De Fei Hong ),( Xiu Jun Cai ),( Yi Fang Wang ),( Xiao Liang ),( Jian Wei Wang ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: The characteristic of associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) carries high mortality and morbidity. There is room for improvement. We suggest Terminal Branches Portal Vein Embolization (TBPVE) as a way to compart the liver. As a result, only a single surgical operation is required.This method is termed Terminal branches portal vein Embolization Liver Partition Planned hepatectomy (TELPP). Methods: Patients with unresectable primary or metastatic liver tumor were performed with TELPP. The procedure of TELPP was that in addition to PVE, embolization agent was infused to the terminal branches of portal vein of S5,S8 or S4. CT scan was taken one or two weeks later, and standard liver volume(SLV), FLR and FLR/SLV are calculated. Two weeks later when the FLR and liver function is appropriate, open or laparoscopic hepatectomy is performed. Results: The study included 11patients including hepatocellular carcinoma: n =8, intrahepatic cholangiocarcinoma: n = 1, hilarcholangiocarcinoma: n =1, colorectal liver metastasis: n =1. After a waiting period of 14 days, the volume of theFLR had increased from 382mlto 578ml, representing a median volume increase of 51% (range =32.5%-86.7%). Of the 11patients with hepatectomy, right hemihepatectomy (n=2), extended right hemihepatectomy (n=5), right trisecmentectomy(2), extended left hemihepatectomy (n=1) and left trisecmentectomy(1). No patient died, and no serve perioperative morbidity occurred. Conclusions: ALPPS and all modifications need two-stage operations with a high morbidity and mortality rate. It seems that TELPP is very promising. It has the merit of ALPPS as extraordinarily rapid increasement of FLRvolume, yet the morbidity and mortality is much lower, owing to the fact that unlike ALPPS, there is no two liver raw surfaces left behind in the abdominal cavity to produce bile leak, as only single surgical operation is required

Study on the mechanism of desulfurization and denitrification catalyzed by TiO2 in the combustion with biomass and coal

Shu Qin Wang,Ming-Zhu Liu,Li-Li Sun,Wei Liang Cheng 한국화학공학회 2017 Korean Journal of Chemical Engineering Vol.34 No.6

The effects of Ca/S molar ratio, catalyst type, catalyst dosage, temperature on desulfurization and denitrification efficiency were investigated in the coal-powder combustion with corn cobs as biomass. The thermal characteristics of Shanxi coal and corn cob blends with V-TiO2 were evaluated by thermogravimetric analyzer. The catalytic mechanisms of V-TiO2 on combustion, desulfurization and denitrification were discussed, suggesting that the mechanisms are in good agreement with the experimental data. The results show that the control parameters of the ideal desulfurization and denitrification efficiency should follow that the dosage of V-TiO2 catalyst is 8% with a Ca/S ratio of 2.3 at a treatment temperature 850 oC. Meanwhile, the combustion efficiency could be effectively improved with the mixture of corn cob and V-TiO2. The thermal characteristics of coal char and corn cob char blends with V-TiO2 were evaluated using thermogravimetric analysis and derivative thermogravimetry methods to discuss the heterogeneous NO reduction mechanisms. The results show that the biomass chars were more active than coal chars in reducing NO, and the specific surface area of the chars was increased with V-TiO2, which indicates that V-TiO2 exhibits significant influence on catalytic combustion, desulfurization and denitrification.

p62 Sequestosome 1/Light Chain 3b Complex Confers Cytoprotection on Lung Epithelial Cells after Hyperoxia

Liang, Xiaoliang,Wei, Shu-Quan,Lee, Seon-Jin,Fung, James K.,Zhang, Meng,Tanaka, Akihiko,Choi, Augustine M. K.,Jin, Yang American Thoracic Society 2013 American journal of respiratory cell and molecular Vol.48 No.4

Efficient photocatalytic removal of aqueous Cr(VI) by N-F-Al tri-doped TiO2

Shu Qin Wang,Yixiao Xie,Wei Liang Cheng,Jian Gao 한국화학공학회 2017 Korean Journal of Chemical Engineering Vol.34 No.9

As chromium is a common heavy metal contaminant in water, we have prepared N-F-Al tri-doped TiO2 catalyst for Cr(VI) removal under visible light. The sample was prepared via a sol-gel method and was characterized by XRD, BET, UV-vis DRS, XPS and SEM techniques. In the photocatalytic experiments, effects of Al/Ti ratio, F/Ti ratio, calcination temperature and different dopants were investigated. The optimum Al/Ti molar ratio, F/Ti ratio and calcination temperature proved to be 0.01, 0.1 and 500 oC, respectively, which is in accordance with the characterization analysis. Catalysts prepared under this condition showed a high photoactivity for Cr(VI) removal in water.