Background: Sedation during gastrointestinal endoscopy is often achieved using propofol or midazolam in general population. However, impaired protein synthesis, altered drug metabolism, and compromised hepatic blood flow in patients with liver cirrhosis might affect the pharmacokinetics of sedatives, placing cirrhotic patients undergoing endoscopy at a greater risk of adverse events. The objective of this study was to assess comparative efficacies and safety of propofol and midazolam in cirrhotic patients undergoing endoscopy.
View Article and Find Full Text PDFPurpose: Although endophthalmitis secondary to pyogenic liver abscess (PLA) is becoming a globally emerging infectious disease, population-based investigations evaluating the relationship between PLA and endogenous endophthalmitis remain scarce. This study aimed to investigate the incidence and risk of endogenous endophthalmitis in patients with PLA compared with unaffected individuals by using a nationwide, population-based dataset.
Design: Retrospective, cohort study.
Background: Itraconazole is believed to carry a low risk of hepatic toxicity owing to its low affinity for the human P-450 enzyme. Therefore, hepatic failure caused by itraconazole is exceedingly rare.
Objectives: We report the case of a 46-year-old woman who developed hepatic failure related to itraconazole that was administered for the treatment of onychomycosis.
Background And Purpose: Reflux esophagitis (RE) is the most common manifestation of gastro-esophageal reflux disease with esophageal injury. To the best of our knowledge, there has been no specific study to evaluate the risk of stroke after diagnosis of RE in young adults. This study aims to evaluate the risk of stroke among RE patients aged 18 to 50 years during a 1-year period after diagnosis of RE compared to a cohort of non-RE patients during the same period.
View Article and Find Full Text PDFObjective: The objective of the study was to determine whether maternal peptic ulcer disease (PUD) is associated with increased risk of adverse pregnancy outcomes, using a nationwide population-based dataset.
Study Design: We identified a total of 2120 women who gave birth from 2001 to 2003 with a diagnosis of PUD during pregnancy. Then 10,600 unaffected pregnant women were matched with cases in age and year of delivery.
Background: To examine the seasonal variation in the incidence of gastroesophageal reflux disease (GERD) for different gender and age groups and its association with climatic parameters (ambient temperature, relative humidity, atmospheric pressure, rainfall, and hours of sunshine).
Methods: A total of 76,636 ambulatory care visits for the treatment of GERD between 2001 and 2006 were included. Monthly GERD incidence rates per 10,000 people were calculated over 72 months and categorized by gender and age groupings (19-44, 45-64, and >or=65 years).
Objectives: As the prevalence of ulcerative colitis (UC) is much higher in Western countries than in Asian countries, previous investigations of pregnancy outcomes for women with UC were limited to people of European descent. This study was aimed at examining the risk of adverse pregnancy outcomes (low birth weight (LBW), preterm birth, small for gestational age (SGA), and cesarean section (CS)) among Asian women with UC.
Methods: Using a 3-year nationwide population-based database, we identified a total of 196 women who gave birth from 2001 to 2003, who were diagnosed with UC within 2 years before their index deliveries.
Background: Removal of colorectal neoplastic polyps can reduce the incidence of colorectal cancers. It is important to distinguish neoplastic from nonneoplastic polyps. We compared the ability of a trainee and an experienced endoscopist in distinguishing between neoplastic polyps and nonneoplastic polyps by conventional white-light, magnifying narrow-band imaging (NBI), and magnifying chromoendoscopy.
View Article and Find Full Text PDFObjective: In this pilot study, we attempted to determine the optimal dosage regimens of esomeprazole for treatment of GERD with minimal influence of the CYP2C19 polymorphism through a study of the pharmacokinetics and pharmacodynamics of esomeprazole given at 3 different dosage regimens with the same total daily dose.
Methods: Each of the 3 genotypes of CYP2C19, homozygous extensive metabolizers (homEMs), heterozygous EMS (hetEMs), and poor metabolizers (PMs) were recruited in this clinical trial. Subjects were given a placebo followed by the administration of esomeprazole, at a dose of 40 mg once daily (40QD), 20 mg twice daily (20TD), or 10 mg 4 times daily (10Q4D) for 7 days.
J Gen Intern Med
October 2008
Background: No study has explored the volume-outcome relationship for peptic ulcer treatment.
Objective: To investigate the association between peptic ulcer case volume per hospital, on the one hand, and in-hospital mortality and 14-day readmission rates, on the other, using a nationwide population-based dataset.
Design: A retrospective cross-sectional study, set in Taiwan.
Background And Objectives: The variability of the prognosis of gastric carcinoma drives extensive researches for novel prognostic markers. The aims of this study were to correlate the expression of protein kinase Calpha (PKCalpha) mRNA with clinicopathological parameters and to evaluate the significant value of PKCalpha in gastric carcinoma prognosis.
Methods: PKCalpha mRNA levels were analyzed in tumor/non-tumor pairs of gastric tissues from surgical specimens of 41 patients with gastric carcinoma employing quantitative real-time polymerase chain reaction.
J Microbiol Immunol Infect
October 2007
The consumption of raw fish fillets is increasing in Taiwan. A male Taiwanese aged 30 years presented after passing a flat, white noodle-like worm. Strobila examination showed that most proglottids were wider than they were long, with the genital pore located at the posterior edge of the cirrus.
View Article and Find Full Text PDFJ Gastroenterol Hepatol
November 2007
Background: Adult intussusception is a rare clinical entity. The presentations and optimal management of adult intussusception in Asians have seldom been reported. The purpose of this study was to determine the causes and management of adult intussusception in Taiwan.
View Article and Find Full Text PDFMost cases of esophageal cancer and colorectal cancer in Taiwan are diagnosed in the advanced stage and treated by surgery or concurrent chemoirradiation. The detection rates of early esophageal cancer and early colorectal cancer are still low in Taiwan. Metachronous early esophageal cancer and early colorectal cancer have rarely been reported.
View Article and Find Full Text PDFIt is difficult to remove a large early gastric cancer (> or = 3 cm) in one-piece resection using conventional endoscopic mucosal resection. We tried to use an insulation-tipped (IT) diathermic knife to dissect these lesions. IT-endoscopic submucosal dissection (ESD) was performed in four aging patients with gastric malignancy.
View Article and Find Full Text PDFAim: To assess the efficacy of premedicaton with pronase or N-acetylcysteine (NAC) at 20 min before upper gastrointestinal (UGI) endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test.
Methods: A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility (MV) with scores ranged from 1 to 4 at four sites in the stomach.
Aim: To investigate the effectiveness of 4 d' anti-Helicobacter pylori therapy on the H pylori-infected Mongolian gerbils based on physiological and pathological changes.
Methods: We used 6-wk-old male gerbils orally inoculated with H pylori (ATCC43504, 2X10(8) CFU/mL). Seven weeks after H pylori inoculation, the animals of study group received 4 d' anti-H pylori triple therapy (H pylori-eradicated group).
Aim: To examine the effect of eradication of Helicobacter pylori prior to usage of NSAIDs, by investigating gastric inflammatory activity, myeloperoxidase (MPO) activity, prostaglandin (PG) E2 synthesis in H pylori-infected, and H pylori-eradicated gerbils followed by administration of indomethacin and rofecoxib.
Methods: Six-week-old male gerbils were orally inoculated with H pylori. Seven weeks later, anti-H pylori triple therapy and vehicle were given to gerbils respectively and followed by oral indomethacin (2 mg/kg.
We report a case of distal common bile duct adenoma presenting with acute cholangitis. A 47-year-old woman suffered from right upper abdominal pain with persistent fever for 4 days. Abdominal ultrasonography showed mild dilatation of common bile duct and bilateral intrahepatic ducts.
View Article and Find Full Text PDFZhonghua Yi Xue Za Zhi (Taipei)
October 2002
Background: Dental plaque has been suggested as a permanent reservoir of Helicobacter pylori (H. pylori) and a potential source of reinfection. The aims of this study were to investigate the presence of H.
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