AIM:To evaluate the efficacy and safety of N-butyl-2-cyanoacrylate in treating acute bleeding of gastric varices in children.METHODS:The retrospective study included 21 children with 47 episodes of active gastric vari...AIM:To evaluate the efficacy and safety of N-butyl-2-cyanoacrylate in treating acute bleeding of gastric varices in children.METHODS:The retrospective study included 21 children with 47 episodes of active gastric variceal bleeding who were treated by endoscopic injection of N-butyl-2-cyanoacrylate at Asan Medical Center Children's Hospital between August 2004 and December 2011.To reduce the risk of embolism,each injection consisted of 0.1-0.5 mL of 0.5 mL N-butyl-2-cyanoacrylate diluted with 0.5 or 0.8 mL Lipiodol.The primary outcome was incidence of hemostasis after variceal obliteration and the secondary outcome was complication of the procedure.RESULTS:The 21 patients experienced 47 episodes of active gastric variceal bleeding,including rebleeding,for which they received a total of 52 cyanoacrylate injections.Following 42 bleeding episodes,hemostasis was achieved after one injection and following five bleeding episodes it was achieved after two injections.The mean volume of each single aliquot of cyanoacrylate injected was 0.3 ± 0.1 mL(range:0.1-0.5 m L).Injection achieved hemostasis in 45 of 47(95.7%) episodes of acute gastric variceal bleeding.Eleven patients(52.4%) developed rebleeding events,with the mean duration of hemostasis being 11.1 ± 11.6 mo(range:1.0-39.2 mo).No treatment-related complications such as distal embolism were noted with the exception of abdominal pain in one patient(4.8%).Among four mortalities,one patient died of variceal rebleeding.CONCLUSION:Endoscopic variceal obliteration using a small volume of aliquots with repeated cyanoacrylate injection was an effective and safe option for the treatment of gastric varices in children.展开更多
AIM To evaluate the use of fully covered self-expandable metal stents(FCSEMSs) for pancreatic duct strictures in children with chronic pancreatitis.METHODS Eight patients with refractory benign dominant stricture of t...AIM To evaluate the use of fully covered self-expandable metal stents(FCSEMSs) for pancreatic duct strictures in children with chronic pancreatitis.METHODS Eight patients with refractory benign dominant stricture of the main pancreatic duct(MPD) were enrolled through chart reviews between December 2014 and June 2017 in a single center. Endoscopic retrograde cholangiopancreatography(ERCP) with placement of a 6-mm FCSEMS with dual flaps was performed. Endoscopic removal of FCSEMSs was performed with a snare or rat-tooth forceps. All procedures were performed by a pediatric gastroenterologist. For the assessment of outcomes, technical and clinical success, adverse events, and stent patency were evaluated retrospectively.RESULTS The placement and removal of the FCSEMSs were successful in all 8 patients. Five patients were boys and 3 were girls. The median age at initial FCSEMS placement was 12 years(range, 5-18 years). The diameters of all the inserted stents were 6 mm, and the lengths were 4-7 cm. The median indwelling time was 6 mo(range, 3-10 mo). No pancreatic sepsis, pancreatitis, cholestasis, or mortality occurred. There was no proximal and distal migration. All subjects showed a patent stent. On follow-up ERCP, the mean diameter of the stricture improved from 1.1 mm to 2.8 mm(P < 0.05), whereas that of upstream dilation improved from 8.4 mm to 6.3 mm(P < 0.05).CONCLUSION This initial experience showed that temporary FCSEMS placement is feasible and safe for the management of refractory benign MPD stricture in children.展开更多
BACKGROUND Bloodstream infection(BSI)is one of the most significantly adverse events that can occur after liver transplantation(LT)in children.AIM To analyze the profile of BSI according to the postoperative periods a...BACKGROUND Bloodstream infection(BSI)is one of the most significantly adverse events that can occur after liver transplantation(LT)in children.AIM To analyze the profile of BSI according to the postoperative periods and assess the risk factors after pediatric LT.METHODS Clinical data,collected from medical charts of children(n=378)who underwent primary LT,were retrospectively reviewed.The primary outcome considered was BSI in the first year after LT.Univariate and multivariate analyses were performed to identify risk factors for BSI and respective odds ratios(ORs).RESULTS Of the examined patients,106(28%)experienced 162 episodes of pathogen-confirmed BSI during the first year after LT.There were 1.53±0.95 episodes per children(mean±SD)among BSIcomplicated patients with a median onset of 0.4 mo post-LT.The most common pathogenic organisms identified were Coagulase-negative staphylococci,followed by Enterococcus spp.and Streptococcus spp.About half(53%)of the BSIs were of unknown origin.Multivariate analysis demonstrated that young age(≤1.3 year;OR=2.1,P=0.011),growth failure(OR=2.1,P=0.045),liver support system(OR=4.2,P=0.008),and hospital stay of>44 d(OR=2.3,P=0.002)were independently associated with BSI in the year after LT.CONCLUSION BSI was frequently observed in patients after pediatric LT,affecting survival outcomes.The profile of BSI may inform clinical treatment and management in high-risk children after LT.展开更多
AIM: To investigate whether children with congenital common bile duct dilatation(CBDD) differ from children with obstructive CBDD in cholangiographic characteristics.METHODS: In this retrospective cohort study, the ba...AIM: To investigate whether children with congenital common bile duct dilatation(CBDD) differ from children with obstructive CBDD in cholangiographic characteristics.METHODS: In this retrospective cohort study, the baseline data and the results of imaging analyses were reviewed among children who had endoscopic retrograde cholangiopancreatography(ERCP) due to CBDD. ERCP was performed on all pediatric patients by experienced pediatric endoscopists. The maximal transverse diameter of the common bile duct(CBD) was measured on ERCP. To assess whether ageadjusted CBDD could be used for differential diagnosis, a CBDD severity index(SI) was calculated by dividing the measured CBD diameter by the age-corrected maximal diameter of a normal CBD. RESULTS: A retrospective medical chart review revealed that 85 consecutive children under 16 years of age with hepatobiliary disease and CBDD were referred to Seoul Asan Medical Center. Fiftyfive(64.7%) children had congenital CBDD and 30(35.3%) had obstructive CBDD. The two groups did not differ significantly in terms of clinical characteristics except for sex. The congenital and obstructive CBDD groups did not differ significantly in terms of mean CBD diameter(19.3 ± 9.6 mm vs 12.2 ± 4.1 mm, P > 0.05). However, congenital CBDD cases had a significantly higher mean SI than obstructive CBDD cases(3.62 ± 1.64 vs 1.98 ± 0.71, P = 0.01). In multivariate analysis, an SI value ≥ 2.32 and comorbidity with anomalous union of pancreaticobiliary duct(APBDU) in ERCP independently predicted congenital CBDD.CONCLUSION: Measuring the CBD may aid the differential diagnosis of both CBDD and APBDU in children.展开更多
Endocrine Disrupting Chemicals(EDCs)are a group of molecules that can influence hormonal balance,causing disturbance of the reproductive system and other health problems.Despite the efforts to eliminate EDC in the env...Endocrine Disrupting Chemicals(EDCs)are a group of molecules that can influence hormonal balance,causing disturbance of the reproductive system and other health problems.Despite the efforts to eliminate EDC in the environment,all current approaches are inefficient and expensive.In previous research,studies revealed that laccase-producing microorganisms may be a potential candidate for EDC degradation,as laccases have been found to be able to degrade many kinds of EDCs effectively and steadily.Here,we created two recombinant laccases,each fused with secretion peptide,Novel Signal Peptide 4(NSP4),and expressed them in Escherichia coli(E.coli,BL21),together with one laccase without secretion peptide.We first optimized the culture condition of expressing these laccases.Then,we test the activity of the recombinant laccases of decolorizing of a synthetic dye,indigo carmine.Finally,we confirmed the secreted can degrade one of the EDCs,β-estradiol,showing the potential of using the laccase secretion system to degrade toxic compounds.展开更多
Current fire retardants are known to be toxic to humans and our environment.As environmental-friendly flame retardants(FRs),protein-based flame retardants have been studied extensively recently,even though they are no...Current fire retardants are known to be toxic to humans and our environment.As environmental-friendly flame retardants(FRs),protein-based flame retardants have been studied extensively recently,even though they are not durable.In this study,we designed,synthesized and tested a durable protein-based FR through the fusion of the adhesion domain from either mussel foot protein-5(mfp-5)or cellulose-binding domain(CBD)with flame retardant protein(SR protein and alpha casein).We first verified the expression of the recombinant proteins in Escherichia coli using Western blot.Then,we coated the fusion protein(carrying cell lysates)to cotton fabrics and wood and verified with Infrared(IR)spectroscopy.Using a vertical burning test and wood flammability test,we confirmed the flame retardancy of the materials after the protein coating.In the vertical burning test,the SR protein and alpha casein flame retardant proteins with the CBD adhesion domain showed a 50.0%and 43.3%increase in flame retardancy.The data is also consistent in the wood flame retardancy test.Confocal imaging experiments also suggested these new fire retardants can be preserved on the materials well even after washing.Overall,our results showed that flame-retardant proteins with adhesion domains are high potential candidates of green alternative flame retardants.展开更多
We discuss the uniqueness and the perturbation analysis for sparse non-negative tensor equations arriving from data sciences. By two different techniques, we may get better ranges of parameters to guarantee the unique...We discuss the uniqueness and the perturbation analysis for sparse non-negative tensor equations arriving from data sciences. By two different techniques, we may get better ranges of parameters to guarantee the uniqueness of the solution of the tensor equation. On the other hand, we present some perturbation bounds for the tensor equation. Numerical examples are given to show the efficiency of the theoretical results.展开更多
In this paper,we propose a bound for ratio of the largest eigenvalue and second largest eigenvalue in module for a higher-order tensor.From this bound,one may deduce the bound of the second largest eigenvalue in modul...In this paper,we propose a bound for ratio of the largest eigenvalue and second largest eigenvalue in module for a higher-order tensor.From this bound,one may deduce the bound of the second largest eigenvalue in module for a positive tensor,and the bound can reduce to the matrix cases.展开更多
文摘AIM:To evaluate the efficacy and safety of N-butyl-2-cyanoacrylate in treating acute bleeding of gastric varices in children.METHODS:The retrospective study included 21 children with 47 episodes of active gastric variceal bleeding who were treated by endoscopic injection of N-butyl-2-cyanoacrylate at Asan Medical Center Children's Hospital between August 2004 and December 2011.To reduce the risk of embolism,each injection consisted of 0.1-0.5 mL of 0.5 mL N-butyl-2-cyanoacrylate diluted with 0.5 or 0.8 mL Lipiodol.The primary outcome was incidence of hemostasis after variceal obliteration and the secondary outcome was complication of the procedure.RESULTS:The 21 patients experienced 47 episodes of active gastric variceal bleeding,including rebleeding,for which they received a total of 52 cyanoacrylate injections.Following 42 bleeding episodes,hemostasis was achieved after one injection and following five bleeding episodes it was achieved after two injections.The mean volume of each single aliquot of cyanoacrylate injected was 0.3 ± 0.1 mL(range:0.1-0.5 m L).Injection achieved hemostasis in 45 of 47(95.7%) episodes of acute gastric variceal bleeding.Eleven patients(52.4%) developed rebleeding events,with the mean duration of hemostasis being 11.1 ± 11.6 mo(range:1.0-39.2 mo).No treatment-related complications such as distal embolism were noted with the exception of abdominal pain in one patient(4.8%).Among four mortalities,one patient died of variceal rebleeding.CONCLUSION:Endoscopic variceal obliteration using a small volume of aliquots with repeated cyanoacrylate injection was an effective and safe option for the treatment of gastric varices in children.
文摘AIM To evaluate the use of fully covered self-expandable metal stents(FCSEMSs) for pancreatic duct strictures in children with chronic pancreatitis.METHODS Eight patients with refractory benign dominant stricture of the main pancreatic duct(MPD) were enrolled through chart reviews between December 2014 and June 2017 in a single center. Endoscopic retrograde cholangiopancreatography(ERCP) with placement of a 6-mm FCSEMS with dual flaps was performed. Endoscopic removal of FCSEMSs was performed with a snare or rat-tooth forceps. All procedures were performed by a pediatric gastroenterologist. For the assessment of outcomes, technical and clinical success, adverse events, and stent patency were evaluated retrospectively.RESULTS The placement and removal of the FCSEMSs were successful in all 8 patients. Five patients were boys and 3 were girls. The median age at initial FCSEMS placement was 12 years(range, 5-18 years). The diameters of all the inserted stents were 6 mm, and the lengths were 4-7 cm. The median indwelling time was 6 mo(range, 3-10 mo). No pancreatic sepsis, pancreatitis, cholestasis, or mortality occurred. There was no proximal and distal migration. All subjects showed a patent stent. On follow-up ERCP, the mean diameter of the stricture improved from 1.1 mm to 2.8 mm(P < 0.05), whereas that of upstream dilation improved from 8.4 mm to 6.3 mm(P < 0.05).CONCLUSION This initial experience showed that temporary FCSEMS placement is feasible and safe for the management of refractory benign MPD stricture in children.
基金Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)Ministry of Health&Welfare,Republic of Korea,No.HR21C0198。
文摘BACKGROUND Bloodstream infection(BSI)is one of the most significantly adverse events that can occur after liver transplantation(LT)in children.AIM To analyze the profile of BSI according to the postoperative periods and assess the risk factors after pediatric LT.METHODS Clinical data,collected from medical charts of children(n=378)who underwent primary LT,were retrospectively reviewed.The primary outcome considered was BSI in the first year after LT.Univariate and multivariate analyses were performed to identify risk factors for BSI and respective odds ratios(ORs).RESULTS Of the examined patients,106(28%)experienced 162 episodes of pathogen-confirmed BSI during the first year after LT.There were 1.53±0.95 episodes per children(mean±SD)among BSIcomplicated patients with a median onset of 0.4 mo post-LT.The most common pathogenic organisms identified were Coagulase-negative staphylococci,followed by Enterococcus spp.and Streptococcus spp.About half(53%)of the BSIs were of unknown origin.Multivariate analysis demonstrated that young age(≤1.3 year;OR=2.1,P=0.011),growth failure(OR=2.1,P=0.045),liver support system(OR=4.2,P=0.008),and hospital stay of>44 d(OR=2.3,P=0.002)were independently associated with BSI in the year after LT.CONCLUSION BSI was frequently observed in patients after pediatric LT,affecting survival outcomes.The profile of BSI may inform clinical treatment and management in high-risk children after LT.
文摘AIM: To investigate whether children with congenital common bile duct dilatation(CBDD) differ from children with obstructive CBDD in cholangiographic characteristics.METHODS: In this retrospective cohort study, the baseline data and the results of imaging analyses were reviewed among children who had endoscopic retrograde cholangiopancreatography(ERCP) due to CBDD. ERCP was performed on all pediatric patients by experienced pediatric endoscopists. The maximal transverse diameter of the common bile duct(CBD) was measured on ERCP. To assess whether ageadjusted CBDD could be used for differential diagnosis, a CBDD severity index(SI) was calculated by dividing the measured CBD diameter by the age-corrected maximal diameter of a normal CBD. RESULTS: A retrospective medical chart review revealed that 85 consecutive children under 16 years of age with hepatobiliary disease and CBDD were referred to Seoul Asan Medical Center. Fiftyfive(64.7%) children had congenital CBDD and 30(35.3%) had obstructive CBDD. The two groups did not differ significantly in terms of clinical characteristics except for sex. The congenital and obstructive CBDD groups did not differ significantly in terms of mean CBD diameter(19.3 ± 9.6 mm vs 12.2 ± 4.1 mm, P > 0.05). However, congenital CBDD cases had a significantly higher mean SI than obstructive CBDD cases(3.62 ± 1.64 vs 1.98 ± 0.71, P = 0.01). In multivariate analysis, an SI value ≥ 2.32 and comorbidity with anomalous union of pancreaticobiliary duct(APBDU) in ERCP independently predicted congenital CBDD.CONCLUSION: Measuring the CBD may aid the differential diagnosis of both CBDD and APBDU in children.
文摘Endocrine Disrupting Chemicals(EDCs)are a group of molecules that can influence hormonal balance,causing disturbance of the reproductive system and other health problems.Despite the efforts to eliminate EDC in the environment,all current approaches are inefficient and expensive.In previous research,studies revealed that laccase-producing microorganisms may be a potential candidate for EDC degradation,as laccases have been found to be able to degrade many kinds of EDCs effectively and steadily.Here,we created two recombinant laccases,each fused with secretion peptide,Novel Signal Peptide 4(NSP4),and expressed them in Escherichia coli(E.coli,BL21),together with one laccase without secretion peptide.We first optimized the culture condition of expressing these laccases.Then,we test the activity of the recombinant laccases of decolorizing of a synthetic dye,indigo carmine.Finally,we confirmed the secreted can degrade one of the EDCs,β-estradiol,showing the potential of using the laccase secretion system to degrade toxic compounds.
基金We thank Prof.Leo Tsz On LEE Prof.Ruiyu XIE and Prof.Tzu-Ming LIU for discussions and conceptual support,Stephanie Pei Wen NG and Weng I LEI for technical support,and all other members/contributors in the PuiChing 2020 team(Ieng Chon LI,Yi Fan XIANG,Sin Mei CHEONG,Cho Cheng SHE,Weng Seong LEI,Pak Chong CHEONG,Chan In NG,Nga Chi LEONG,Teng Wai HOI,Weng Si CHIO,Lok Hang CHIU,Hou IONG,Weng In LAI,Jeremy HU,Franklin YEUNG,Hao Nian MIN,Hau Yin LEUNG and Yating MO)for helping this project.We also thank the Wynn Care,Science and Technology Development Fund(FDCT)(Grand code:0016/2020/PS),Institute for the Development and Quality(IDQ)and Faculty of Health Sciences,University of Macao for supporting this work.
文摘Current fire retardants are known to be toxic to humans and our environment.As environmental-friendly flame retardants(FRs),protein-based flame retardants have been studied extensively recently,even though they are not durable.In this study,we designed,synthesized and tested a durable protein-based FR through the fusion of the adhesion domain from either mussel foot protein-5(mfp-5)or cellulose-binding domain(CBD)with flame retardant protein(SR protein and alpha casein).We first verified the expression of the recombinant proteins in Escherichia coli using Western blot.Then,we coated the fusion protein(carrying cell lysates)to cotton fabrics and wood and verified with Infrared(IR)spectroscopy.Using a vertical burning test and wood flammability test,we confirmed the flame retardancy of the materials after the protein coating.In the vertical burning test,the SR protein and alpha casein flame retardant proteins with the CBD adhesion domain showed a 50.0%and 43.3%increase in flame retardancy.The data is also consistent in the wood flame retardancy test.Confocal imaging experiments also suggested these new fire retardants can be preserved on the materials well even after washing.Overall,our results showed that flame-retardant proteins with adhesion domains are high potential candidates of green alternative flame retardants.
基金The authors would like to thank the referees for their helpful comments. The first author was supported by the Opening Project of Guangdong Province Key Laboratory of Computational Science at the Sun Yat-sen University （Grant No. 2018008） the second author was supported by the National Natural Science Foundation of China （Grant Nos. 11671185, 11771159）, and Major Project （Grant No. 2016KZDXM025）, and Innovation Team Project （Grant No. 2015KCXTD007） of Guangdong Provincial Universities+1 种基金 the third author was supported in part by HKBGC GRF 1202715, 12306616, 12200317 and HKBU RC-ICRS/16-17/03 the fourth author was supported by University of Macao （Grant No. MYRG2017-00098-FST） and the Macao Science and Technology Development Fund （050/2017/A）.
文摘We discuss the uniqueness and the perturbation analysis for sparse non-negative tensor equations arriving from data sciences. By two different techniques, we may get better ranges of parameters to guarantee the uniqueness of the solution of the tensor equation. On the other hand, we present some perturbation bounds for the tensor equation. Numerical examples are given to show the efficiency of the theoretical results.
基金the National Natural Science Foundation of China(Nos.11271144 and 11671158)The third author was supported in part by University of Macao(No.MYRG2015-00064-FST).
文摘In this paper,we propose a bound for ratio of the largest eigenvalue and second largest eigenvalue in module for a higher-order tensor.From this bound,one may deduce the bound of the second largest eigenvalue in module for a positive tensor,and the bound can reduce to the matrix cases.
