Meng Shun Sun - Academia.edu (original) (raw)

Papers by Meng Shun Sun

Endocrine Practice, 2020

Objective. Diabetes mellitus (DM) is a risk factor for pancreatic cancer but its prognostic impac... more Objective. Diabetes mellitus (DM) is a risk factor for pancreatic cancer but its prognostic impact remains controversial. We aimed to investigate the association between long-standing DM and the risk of mortality. Methods. This population-based cohort study analyzed data from the national healthcare database in Taiwan. We identified all patients diagnosed with pancreatic cancer and excluded those who were diagnosed with DM within 2 years of the cancer diagnosis. Eligible patients were grouped into long-standing DM (>2 years) and non-diabetic controls, and were compared for overall survival using a Cox proportional hazard model. Sensitivity tests stratified by cancer stages (as indicated by specific treatment) were performed. Results. Patients with long-standing DM were significantly older (mean age, 71.38 vs. 66.0 years, P < 0.0001) and had a higher Charlson comorbidity index (9.53 vs. 6.78, P < 0.0001) and diabetes comorbidity severity index (2.38 vs. 0.82, P < 0.0001) ...

Copyright © 2013 Wen-Hsin Hsu et al.This is an open access article distributed under the Creative... more Copyright © 2013 Wen-Hsin Hsu et al.This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. Endoscopic submucosal dissection (ESD) for early colorectal neoplasms is regarded as a difficult technique and should commence after receiving the experiences of ESD in the stomach. The implementation of colorectal ESD in countries where early gastric cancer is uncommon might therefore be difficult. The aim is to delineate the feasibility and the learning curve of colorectal ESDperformedby a colonoscopistwith limited experience of gastric ESD.Methods.Thefirst fifty cases of colorectal ESD,whichwere performed by a single colonoscopist between July 2010 andApril 2013, were enrolled. Results.Themean of age was 64 (±9.204) years with mean size of neoplasm at 33 (±12.63)mm.Themean of procedure time was 70.5 (±48.9)min.The rates o...

Biliopancreatic Endoscopy

Biliary and pancreatic diseases are common, but accurate image diagnosis is often challenging due... more Biliary and pancreatic diseases are common, but accurate image diagnosis is often challenging due to the complexities of structures and locations. Transabdominal ultrasonography, multiple detector computed tomography (MDCT), or magnetic resonance imaging (MRI) may help to detect the location and spreading of the lesions but cannot provide the detailed information (such as lymph node involvement, nature of lesions), histological diagnosis, or local therapy. Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive but useful method for the diagnosis and management of biliary and pancreatic diseases, but it only can detect the ductal lesions, and its’ diagnostic and therapeutic roles are limited in some patients with complete ductal obstruction and surgical altered anatomy. Endoscopic ultrasound (EUS) is a sensitive method for detecting pancreatico-biliary lesions. The echoendoscope can approach to the pancreatico-biliary region and provide high-spatial resolution ultrasound (US) images around this area. After the introduction, EUS has been established as a useful diagnostic tool for the tumor identification, tumor staging, tumor characterization, and tissue acquisition of malignant pancreatico-biliary diseases [1]. With the continuing improvement of EUS and the development of accessories, EUS plays a more important role as an interventional modality for tumor ablation and management of tumor-associated complications.

Background: Colorectal cancer (CRC) is a common cancer and results in high mortality worldwide, o... more Background: Colorectal cancer (CRC) is a common cancer and results in high mortality worldwide, owing to cancer progression, e.g., metastasis. However, the molecular mechanism underlying the metastatic evolution of CRC remains largely unknown. In this study, we investigated the clinical relevance and oncogenic function of RGL2 in CRC.Methods: Cellular migration ability was assessed by transwell cultivation. The metastatic potential was estimated by lung colony-forming assay. DNA-binding activity of transcription factors was determined by luciferase-based reporter assay. RGL2 expression was analyzed by immunohistochemistry in human CRC specimens. RGL2 mRNA expression from the Cancer Genome Atlas (TCGA) CRC database was compared between the primary tumors and normal tissues.Results: The upregulation of Ral Guanine Nucleotide Dissociation Stimulator Like 2 (RGL2) was commonly detected in primary tumors compared with normal tissues and is significantly associated with a poorer prognosis...

Formosan Journal of Surgery, 2006

Objective: The vascular endothelial growth factor (VEGF) is thought to take an important role in ... more Objective: The vascular endothelial growth factor (VEGF) is thought to take an important role in tumor angiogenesis. The present study examined VEGF expression in the liver cancer cell lines and human liver cancer of various differetiated degrees. Methods: Four human hepatocellular carcinoma cell lines with varying degrees of differentiation, namely: Hep 3B (well differentiated), J5 (moderately differentiated), and Mahlavu plus SK-Hep-I (poorly differentiated) were used. For measuring VEGF, culture cells (5-7.5×10^5/ml) were seeded onto 100mm dishes for 24 hours. The amount of secreted VEGF in the culture medium of the cells was measured by the enzymelinked immunosorbent assay (ELISA) method. Forty-three male patients of hepatocellular carcinoma (HCC) were encountered for measuring the serum VEGF level with relationship with cancer cell differentiation. Results: In all four cell lines, VEGF was secreted to the culture supernatants. After 24-hour culture, the VEGF secretion levels we...

Benign neural sheath tumor, schwannoma, is mostly found in cranial and peripheral nerves; only 3%... more Benign neural sheath tumor, schwannoma, is mostly found in cranial and peripheral nerves; only 3% occurring in the retroperitoneum. Preoperative diagnosis is difficult because of the varying appearance of tumors and the lack of specific imaging feature. We report here a 33-year-old woman with an incidentally noted pancreatic head neoplasm, in size of 4.9×4.7 cm. Since the computed tomography and tumor markers in the serum could not make definite diagnosis, endoscopic ultrasound (EUS)-guided fine-needle aspiration biopsy (FNAB) was performed. The pathology of FNAB revealed benign spindle cells with positive stain for S-100 protein, suggesting a diagnosis of schwannoma. The preoperative tissue diagnosis changed the operation technique from Whipple procedure to simple tumor resection. The final histology of surgical specimen confirmed the diagnosis. The EUS-guided FNAB could be a valuable method for preoperative diagnosis of retroperitoneal schwannoma.

Purpose: The early detection of hepatocellular carcinoma (HCC) is of tremendous importance to pre... more Purpose: The early detection of hepatocellular carcinoma (HCC) is of tremendous importance to prevent this devastating and frequently reported cancer. Therefore, it is required to identify novel and specific HCC diagnostic marker(s) to distinguish HCC patients from non-HCC patients at the early stage of HCC development. We employed surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) to analyze protein profiles in the serum of Taiwanese HCC and healthy, non-HCC subjects.Materials and Methods: The SELDI-Chip-System was used to determine a specific protein pattern in serum samples obtained from Taiwanese HCC and non-HCC subjects. The initial training group consisted of 63 subjects from whom serum was collected at the Yuan's General Hospital (Taiwan). To validate a potential marker pattern, a second group of 63 Taiwanese subjects was enrolled from whom serum samples were also collected, randomized, and used in a blind validation study. Serum ...

Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and may be difficult to treat surgi... more Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and may be difficult to treat surgically when the tumors involve papilla of Vater. We describe a 70-year-old woman presenting with epigastric pain and syncope due to ulceration and bleeding from a duodenal GIST. Surgical resection of the tumor was abandoned because the tumor was too close to papilla of Vater. We performed an endoloop-and-let-go technique using a standard single-accessory channel endoscope and a detachable endoloop to reduce the tumor size and relieve the patient's symptoms. Follow-up of the patient for 4 years revealed no progression of the tumor or recurrence of bleeding. Although the risks of incomplete tumor reduction and recurrence may exist, this endolooping technique may be considered as a safe alternative treatment for patients with GIST not fit for complete surgical resection.

Ultrasound in Medicine & Biology, 2017

devices lead to expansion of its targets, such as bile duct, gallbladder, pancreatic duct, and so... more devices lead to expansion of its targets, such as bile duct, gallbladder, pancreatic duct, and so on. EUS-guided celiac plexus neurolysis (EUS-CPN) was reported as the first EUS-guided injection/ablation. During EUS-CPN, ethanol is injected into celiac plexus under the guide of EUS to relieve pain in patients with an upper abdominal cancer. EUS-CPN reportedly achieved more pain relief than using narcotic drugs alone. Modification of this technique such as ganglia neurolysis and broad plexus neurolysis further improved its efficacy. Ethanol injection recently expanded for ablation of cystic or solid tumors in the pancreas. EUS-guided radiofrequency ablation is currently applied to ablation of these tumors. Moreover, EUS-guided coiling has been used for embolization of gastric varices. In conclusion, interventional EUS became essential or rescue treatment of various digestive diseases. Its target is expected to expand to the other more fields in the future.

Advances in Digestive Medicine, Dec 1, 2017

Muir‐Torre Syndrome (MTS) was first coined by Muir et al in 1967 and Torre in 1968. It is an auto... more Muir‐Torre Syndrome (MTS) was first coined by Muir et al in 1967 and Torre in 1968. It is an autosomal‐dominant disorder characterized by combination of visceral disorder and sebaceous neoplasms. This syndrome is a subtype of hereditary nonpolyposis colorectal cancer. In most cases, it arises from germline mutation encoding mismatch repair (MMR) proteins. We encountered a case of MTS and relevant literatures were reviewed.

臺灣消化醫學雜誌, Sep 1, 2011

Background and Aims: Detection rates of hepatocellular carcinomas (HCC) smaller than 2 cm in diam... more Background and Aims: Detection rates of hepatocellular carcinomas (HCC) smaller than 2 cm in diameter are increasing because high risk patients are receiving more regular screenings. The aim of this study was to determine whether radiofrequency ablation (RFA) or percutaneous ethanol injection (PEI) is better for a patient with very small HCC.Materials and Methods: We retrospectively obtained data on patients with very small HCC from the database of Yuan's General Hospital. Of the 770 patients with HCC who were treated between January 1, 2002, and June 30, 2009, those who received PEI (n=22) or RFA (n=19) as the first-line nonsurgical treatment became subjects for further analysis. We compared the patients' baseline characteristics as well as the hospital stay, mean cost, complication rate, local tumor progression and new recurrent rate, recurrence free survival, and overall survival rate by group until the end of follow-up on June 30, 2010.Results: Analysis of baseline characteristics revealed no statistically significant differences between the two groups. Nevertheless, the RFA group had a higher mean cost (37,278 versus 14,269 new Taiwan dollars, P＜0.001). Hospital stay, complication rate, local tumor progression and new recurrent rate, recurrence free survival, and overall survival between these two groups were not significantly different.Conclusions: Based on the current result derived from small sample size, for patients with very small single HCC (＜ 2 cm diameter), RFA resulted in significantly higher costs without significant differences in hospital stay, complication rate, recurrence free survival, or overall survival compared to PEI.

Gastrointestinal Endoscopy, 2012

Gastrointestinal Endoscopy, 2010

核子醫學雜誌, 2008

Received 9/10/2007; revised 10/1/2007; accepted 10/1/2007. For correspondence and reprints contac... more Received 9/10/2007; revised 10/1/2007; accepted 10/1/2007. For correspondence and reprints contact: Shih-Ya Ma, MD, Department of Nuclear Medicine, Yuan's General Hospital, 162 Cheng-Kung 1st Road, Kaohsiung 802, Taiwan. Tel: (886)7-2692101, Fax: ...

Advances in Digestive Medicine, Sep 1, 2017

Advances in Digestive Medicine