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.

Geometry Optimization of a Metallic Flexor for Flat Wipers

Huang Ting Chuan,Tsai Jian Wei,Liao Kuo Chi 한국자동차공학회 2021 International journal of automotive technology Vol.22 No.3

In recent years, flat wipers are gradually adopted in the industry of transportation due to the rather simple structure than the standard wiper. A procedure is developed to evaluate the appropriateness of the geometry of a metallic flexor, one of major components of the flat wiper, in this study. The flexor is compressed against a level surface and the corresponding pressure distribution under the flexor is measured by using piezoelectric sensors. Several geometry parameters built in a three-dimensional flexor model are investigated to appraise their influences on the corresponding pressure distribution. A process automation software linked to a computer-aided drawing and a finite element analysis commercial packages are utilized, based on the self-defined performance index, to pursue parameter arrangements proper for the pressure distribution. The present procedures are next applied to a curved windshield glass to evaluate optimized flexor geometries at various locations. Appropriate flexors for the windshield glass are then determined and practically sampled. Dynamic wiping simulations of the integrated flat wiper on the windshield glass are furthermore carried out and the pressure distributions over the sweep range are estimated. Wiping capabilities of the wiper are experimentally observed and compared with the associated numerical results.

Unusual Disc Dislodgement of a Björk-Shiley Valve after Long-term Implantation

Pao-Yen Lin,Wei-Chuan Tsai,Ju-Yi Chen 대한심장학회 2017 Korean Circulation Journal Vol.47 No.6

Development of human IgE biosensor using Sezawa-mode SAW devices

Ying-Chung Chen,Wei-Tsai Chang,Chien-Chuan Cheng,Jing-Yi Shen,Kuo-Sheng Kao 한국물리학회 2014 Current Applied Physics Vol.14 No.4

This paper reports Sezawa-mode surface acoustic wave (SAW) devices with via-isolated cavity to construct the allergy biosensor. To fabricate Sezawa-mode SAW devices, the RF magnetron sputtering method for the growth of piezoelectric ZnO thin films are adopted and influences of the sputtering parameters are investigated. The optimal substrate temperature of 300 C, RF power of 120 W and sputtering pressure of 2 Pa were used to deposit piezoelectric ZnO films with a smooth surface, uniform grain size and strongly c-axis-orientated crystallization. A back-etched SAW resonator is used in this study. The wet etching of (100)-oriented silicon wafers is used to form a back-side cavity which is critical to the formation of a hopper cavity for holding bio-analytes. The remaining membrane structure silicon thickness was 25 mm. In this report, the chrome (Cr, 12 nm)/gold (Au, 66 nm) layer was initially deposited onto the sensing area of SAW devices as the binding layer for biochemical sensor. The resonance frequency of the Sezawa-mode SAW device is 1.497 GHz. The maximum sensitivity of the Sezawa-mode is calculated to be 4.44 106 cm2/g for human immunoglobulin-E (IgE) detection. The stability for human IgE detection is calculated to be 80% and the variation of the stability 3% was obtained after several tests.

Catalytic green energy production based on engineered active water innovatively prepared using sunlight-illuminated gold nanoparticles

Shih-Hao Yu,Fu-Der Mai,Wei-Yu Kao,Hui-Yen Tsai,Yu-Chuan Liu 한국공업화학회 2023 Journal of Industrial and Engineering Chemistry Vol.127 No.-

Water is the most common solvent in our daily lives. This solvent has advantages of green environmentalprotection and low cost. Water is conventionally considered to be an inert solvent, yet it is relatively polarand can form a large number of hydrogen bonds (HBs). But this property also inhibits the dissolution ofmany non-polar gases, causing many important electrocatalytic reactions performed in it to have lowefficiencies. In this work, we propose an innovative application of solar energy-generated active purewater (APW) with reduced HBs to enhance chemical reactions and physical procedures. Compared toconventional deionized water (DIW), the generated APW possessed a lower specific heat of ca. 0.96. The swelling degree of artificial skin in APW significantly increased by ca. 29%. Moreover, the densityof an ethanol/APW solution significantly increased by 0.21% due to more free water molecules beingavailable in APW to form stronger HBs with ethanol. Encouragingly, efficiencies of hydrogen evolutionreactions performed in an APW-based acidic solution and oxygen evolution reactions performed in anAPW-based basic solution significantly increased by 42% and 17%, respectively, compared to DIWbasedsolutions. The developed APW based on utilizing solar energy can create a more-effective greenprocess.