Chiao-Hsiung Chuang

National Cheng Kung University, 臺南市, Taiwan, Taiwan

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Publications (30)136.09 Total impact

  • Chiung-Yu Chen · Chiao-Hsiung Chuang · Hong-Ming Tsai

    No preview · Article · Apr 2015 · Gastroenterology
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    ABSTRACT: Adequate bowel preparation is an important quality indicator of colonoscopy. This study validated whether the bowel cleansing quality and adenoma detection rate (ADR) could be different between two bowel preparation schedules in individuals receiving health examinations.
    No preview · Article · Mar 2015
  • Wei-Chun Cheng · Yen-Cheng Chiu · Chiao-Hsiung Chuang · Chiung-Yu Chen
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    ABSTRACT: The management of acute cholecystitis is still based on clinical expertise. This study aims to investigate whether the outcome of acute cholecystitis can be related to the severity criteria of the Tokyo guidelines and additional clinical comorbidities. A total of 103 patients with acute cholecystitis were retrospectively enrolled and their medical records were reviewed. They were all classified according to therapeutic modality, including early cholecystectomy and antibiotic treatment with or without percutaneous cholecystostomy. The impact of the Tokyo guidelines and the presence of comorbidities on clinical outcome were assessed by univariate and multivariate regression analyses. According to Tokyo severity grading, 48 patients were Grade I, 31 patients were Grade II, and 24 patients were Grade III. The Grade III patients had a longer hospital stay than Grade II and Grade I patients (15.2 days, 9.2 days, and 7.3 days, respectively, p < 0.05). According to multivariate analysis, patients with Grade III Tokyo severity, higher Charlson’s comorbidity score, and encountering complications had a longer hospital stay. Based on treatment modality, surgeons selected the patients with less severity and fewer comorbidities for cholecystectomy, and these patients had a shorter hospital stay. In addition to the grading of the Tokyo guidelines, comorbidities had an additional impact on clinical outcomes and should be an important consideration when making therapeutic decisions.
    No preview · Article · Sep 2014 · The Kaohsiung journal of medical sciences
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    ABSTRACT: The incidence of inflammatory bowel disease is increasing worldwide, but data of epidemiological trends from low-endemic area are limited. As one of the low-endemic countries, we describe the trends of this disease in Taiwan over time. This study was based on data obtained from the Catastrophic Illnesses Registration in the National Health Insurance Research Database, which covers more than 98% of the people in Taiwan. Every certificate of catastrophic illness must be approved by 2 expert gastroenterologists. Thirteen years (1998-2010) of data were analyzed for the trends of Crohn's disease (CD) and ulcerative colitis (UC). A total of 2915 incident cases (1818 men and 1097 women) were identified, including 2357 cases of UC and 558 cases of CD. The mean annual incidence rates were 0.80 for UC and 0.19 for CD per 100,000 inhabitants, with lifetime risks for those 20 to 79 years of age of 0.066% and 0.013%, respectively. The mean annual prevalence was 4.59 for UC and 1.05 for CD per 100,000 inhabitants. Poisson regression showed significantly increased trends during the observation period for both diseases, with a men/women ratio of 1.50 in UC and 2.14 in CD (P < 0.01). The mean age of individuals at diagnosis was higher for UC as compared with CD (44.7 versus 37.9, P < 0.001). Inflammatory bowel diseases are still relatively uncommon in Taiwan, but the incidence and prevalence rates are increasing.
    Full-text · Article · Oct 2013 · Inflammatory Bowel Diseases
  • Lily Yeh · Susan J Fetzer · Shu-Yin Chen · Feng-Hwa Lu · Chiao-Hsiung Chuang · Ching-Huey Chen
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    ABSTRACT: To explore Taiwanese caregivers' decision making experiences of accepting a percutaneous endoscopic gastrostomy tube for their family member. A phenomenological approach was used for the interview and analysis. Semi-structured, in-depth interviews were conducted with a purposive sample of 26 caregivers of patients who had percutaneous endoscopic gastrostomy tube in southern Taiwan. Five themes were recognized to reflect caregivers' decision making experiences with a percutaneous endoscopic gastrostomy: awareness of suffering, awareness of options, uncertainty, opportunity, and contentment with the decision. Caregivers' decisions to proceed with a percutaneous endoscopic gastrostomy procedure were mediated by desires to relieve patients' suffering. To empower caregivers to make enteral feeding decisions, nurses must provide sufficient information about percutaneous gastrostomy tubes and their care, support decision making and help to identify an opportunity for gastrostomy tube placement.
    No preview · Article · Feb 2013 · Journal of the Formosan Medical Association
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    ABSTRACT: Osteopontin (OPN) is involved in the gastric cancer progression. The study validated whether OPN expressions correlate with Helicobacter pylori-related chronic gastric inflammation and the precancerous change as intestinal metaplasia (IM). This study included 105 H. pylori-infected patients (63 without and 42 with IM) and 29 H. pylori-negative controls. In each subject, the gastric OPN expression intensity was evaluated by immunohistochemistry, and graded from 0 to 4 for the epithelium, lamina propria, and areas with IM, respectively. For the H. pylori-infected subjects, the gastric inflammation was assessed by the Updated Sydney System. Forty-nine patients received follow-up endoscopy to assess OPN change on gastric mucosa after H. pylori eradication. The in vitro cell-H. pylori coculture were performed to test the cell origin of OPN. The H. pylori-infected patients had higher gastric OPN expression than the noninfected controls (p < .001). For the H. pylori-infected patients, an increased OPN expression correlated with more severe chronic gastric inflammation (p < .001) and the presence of IM (OR: 2.6, 95% CI: 1.15-5.94, p = .02). Within the same gastric bits, lamina propria expressed OPN stronger than epithelium (p < .001), suggesting OPN predominantly originates from inflammatory cells. The in vitro assay confirmed H. pylori stimulate OPN expression in the monocytes, but not in the gastric epithelial cells. After H. pylori eradication, the gastric OPN expression could be decreased only in areas without IM (p < .05). Increased gastric OPN expression by H. pylori infection can correlate with a more severe gastric inflammation and the presence of IM.
    Full-text · Article · Jun 2011 · Helicobacter
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    ABSTRACT: Nearly all Taiwanese H. pylori stains are cagA-genopositive and encode CagA protein. In this study, we evaluated whether different intensity of tyrosine phosphorylated-CagA (p-CagA) had an impact on the clinical diseases and histological outcomes in this area. We enrolled 469 dyspeptic patients and prospectively obtained the gastric biopsy specimens and the H. pylori isolates. These patients were categorized according to the clinical diseases, such as duodenal ulcer, gastric ulcer, gastric cancer, and gastritis with or without intestinal metaplasia. Their gastric specimens were reviewed by the updated Sydney's system. Furthermore, a total of 146 patients were randomly selected from each clinical category for evaluation of their isolates' p-CagA intensity by in vitro AGS cells co-culture. The p-CagA was sparse in 30 (20.5%), weak in 59 (40.5%), and strong in 57 (39%) isolates. The isolates from the patients of gastric cancer or gastritis with intestinal metaplasia had stronger p-CagA intensity than those of gastritis without intestinal metaplasia (p ≤ 0.002). Moreover, the patients infected with isolates with strong or weak p-CagA intensity had a higher risk of gastric intestinal metaplasia (p < 0.05, odds ratio 3.09~15.26) than those infected with sparse p-CagA isolates. Infection with H. pylori stains with stronger p-CagA intensity may lead to an increased risk of gastric intestinal metaplasia and cancer.
    Full-text · Article · May 2011 · BMC Microbiology
  • Chiao-Hsiung Chuang · Jen-Ru Chen · Chiung-Yu Chen

    No preview · Article · Apr 2011 · Gastrointestinal Endoscopy
  • Chiao-Hsiung Chuang · Ai-Wen Kao

    No preview · Article · Jan 2011 · Gastroenterology

  • No preview · Article · May 2010 · Gastroenterology
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    Hong-Ming Tsai · Chiao-Hsiung Chuang · Xi-Zhang Lin · Chiung-Yu Chen
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    ABSTRACT: To identify factors that were related to the short term effectiveness of percutaneous transhepatic biliary drainage in cholangiocarcinoma patients and to evaluate the impact of palliative drainage on their survival. Seventy-four patients with hilar cholangiocarcinoma who underwent percutaneous biliary drainage were enrolled in the study. The demographic and laboratory data as well as the imaging characteristics were retrospectively analyzed to correlate with the bile output and reduction rate of serum bilirubin 1 wk after drainage. Patients with more bile duct visualized on percutaneous transhepatic cholangiography or absence of multiple liver metastases on imaging studies had more bile output after biliary drainage [odds ratio (OR): 8.471, P = 0.010 and OR: 1.959, P = 0.022, respectively]. Patients with prolonged prothrombin time had a slow decrease in serum bilirubin (OR: 0.437, P = 0.005). The median survival time was not significantly different in patients with low or high bile output (75 d vs 125 d, P = 0.573) or in patients with slow or rapid reduction of serum bilirubin (88 d vs 94 d, P = 0.576). The short term effectiveness of percutaneous biliary drainage was related to patient's prothrombin time or the extent of tumor involvement. It, however, had no impact on survival.
    Preview · Article · Nov 2009 · World Journal of Gastroenterology
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    ABSTRACT: Peristomal infection is common after percutaneous endoscopic gastrostomy. This study aims to evaluate the correlation between airway and peristomal infected pathogens. Before the procedure, sputum cultures were prospectively performed for the patients with airway symptoms. All the patients received prophylactic antibiotics. Once peristomal infection occurred, the wound cultures were obtained to analyze the antibiotic susceptibilities of the pathogens. The paired isolates, with concordance between sputum and wound cultures, were validated for their clone identity using pulsed-field gel electrophoresis. One hundred twelve patients were enrolled, and 30 patients had peristomal infection. The 31 patients with airway pathogens had a 10-fold higher risk of peristomal infection than the other 81 without airway pathogens (95% CI, 3.85-26.4, p < 0.001). Among patients collected with paired isolates from wound and sputum, 85% had concordant microorganism species. In the paired concordant isolates, 94% had indistinguishable antibiogram, and nearly 90% were clonally identical in pulsed-field gel electrophoresis. Patients with airway infection have an increased risk of peristomal infection after percutaneous endoscopic gastrostomy. Concerning the high concordance between infected wound and sputum isolates of such patients, the selection of appropriate prophylactic antibiotics could be individual to cover the microorganisms isolated from sputum.
    No preview · Article · Oct 2009 · Journal of Gastrointestinal Surgery
  • Yen-Cheng Chiu · Chiao-Hsiung Chuang · Hon-Ming Tsai · Chiung-Yu Chen
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    ABSTRACT: Hepatic infarction is a rare complication of radiofrequency ablation (RFA) for hepatocellular carcinoma. Hepatic infarction is thought to be caused by injury to either the hepatic arterial system or to both the hepatic arterial and portal venous supply. The efficacy of RFA is reduced in the presence of nearby vessels larger than 3 mm in diameter due to a heat-sink effect. Such an effect can be diminished by performing percutaneous pure ethanol injection prior to RFA. Although larger vessels are unlikely to be ablated or obliterated by RFA alone, it can happen and cause massive liver damage, particularly if RFA was preceded by other therapies such as percutaneous pure ethanol injection and/or transcatheter arterial embolization. Here, we report a case of massive liver infarction after sequential use of both treatment modalities for hepatocellular carcinoma.
    No preview · Article · Apr 2009 · The Kaohsiung journal of medical sciences
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    ABSTRACT: Both ghrelin and leptin are important appetite hormones secreted from the stomach. We examined whether demographic background, Helicobacter pylori infection, or its related gastritis severity could be associated with circulating ghrelin and leptin levels. This study prospectively enrolled 341 dyspeptic patients (196 females, 145 males), who had received endoscopy to provide the gastric specimens over both antrum and corpus for histology reviewed by the updated Sydney's system. The fasting blood sample of each patient was obtained for total ghrelin and leptin analysis. Without H. pylori infection, there were similar ghrelin levels between female and male patients. In the H. pylori-infected patients, the males had lower plasma ghrelin levels than females (1053 vs. 1419 pg/mL, p < .001). Only in males, not in females, the H. pylori infection and its related acute and chronic inflammation scores were significantly associated with a lower ghrelin level (p < or = .04). The multivariate regression disclosed that only the chronic inflammation score independently related to a lower ghrelin level. Only in males, the ghrelin levels ranked in a downward trend for the gastritis feature as with limited-gastritis, with antrum-predominant gastritis, and with corpus-gastritis (1236, 1101, and 977 pg/mL). Leptin level was not related to H. pylori-related gastritis, but positively related to body mass index. There should be a gender difference to circulating total ghrelin levels, but not leptin levels, in response to H. pylori infection and its related chronic gastritis.
    No preview · Article · Feb 2009 · Helicobacter
  • Chiao-Hsiung Chuang · Chiung-Yu Chen · Hong-Ming Tsai
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    ABSTRACT: The rendezvous technique, combining percutaneous and endoscopic procedures, is a safe and effective method to achieve biliary cannulation if an endoscopic approach fails. The two procedures in this technique can be carried out simultaneously or in stages. A simultaneous approach is reported to be associated with fewer complications, and patients undergoing this approach can recover and be discharged more rapidly. Here, we report a complication of pneumoperitoneum in a patient who underwent percutaneous and endoscopic procedures simultaneously for the removal of a common bile duct stone. It was supposed that prolonged air insufflation during endoscopy forced intestinal air to track into the peritoneal cavity through the bile ducts and the puncture tract. Accordingly, a short wait before removing the percutaneous catheter to deflate the intestinal air will be helpful to avoid such a complication.
    No preview · Article · Dec 2008 · The Kaohsiung journal of medical sciences
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    ABSTRACT: Long-term surveillance of pyogenic liver abscess remains unavailable. We thus aimed to identify the recurrence rates of pyogenic liver abscess among various etiologies and pathogens, and to elucidate the factors related with this recurrence. Six-hundred and one patients with pyogenic liver abscess were prospectively enrolled to observe abscess recurrence during a mean follow-up period of up to 6.06 years. On the basis of the etiology of the initial abscess, patients were divided into different subgroups as follows: there were 152 (25.3%) patients classified as cryptogenic, 229 (38.1%) with diabetes mellitus, 144 (24%) with underlying biliary tract disease, and 76 (12.6%) with other organic diseases or mixed subgroups. The cumulative recurrence rates of pyogenic liver abscess were lower in both the cryptogenic (2.0%) and diabetic (4.4%) groups than in the underlying biliary tract disease (23.8%) group (log-rank test, P<0.001). The diabetic group had a higher rate of Klebsiella pneumoniae infection and a lower rate of Escherichia coli infection than the biliary tract group (P<0.001). For patients infected with K. pneumoniae, the recurrence rate of pyogenic liver abscess was as low as that of the diabetes and the cryptogenic groups (P>0.05). Pyogenic liver abscess is more commonly recurrent in patients with underlying biliary tract disease. Irrespective of diabetic status or cryptogenic etiology, the recurrence of K. pneumoniae-infected liver abscess is low in the long-term.
    No preview · Article · May 2008 · Journal of clinical gastroenterology
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    ABSTRACT: To test the impact of vitamin C supplementation on triple therapy for H. pylori eradication. A total of 171 H. pylori-infected patients were randomized to receive different one-week triple therapies, including 20 mg omeprazole, 1 g amoxicillin, plus the following twice daily: (1) 250 mg clarithromycin (C250 group, n=55); (2) 250 mg clarithromycin and 500 mg vitamin C (V-C250 group, n=61); (3) 500 mg clarithromycin (C500 group, n=55). Six weeks after treatment, the success of H. pylori eradication was assessed by a 13C-urea breath test. Each collected H. pylori strain was defined as either clarithromycin susceptible or resistant by E-test. The demographic background, clarithromycin susceptibility of H. pylori, and drug compliance were similar among the three groups (p=NS). For clarithromycin susceptible infection, the V-C250 group had a higher eradication rate than the C250 group (ITT: 85% vs. 68% and PP: 90% vs. 73%, p = 0.03), but had an equivalent rate to the C500 group (p=NS). For clarithromycin resistant infection, all three groups had a similarly poor eradication rate of less than 34%. Adding vitamin C to one-week triple therapy can reduce the dosage of clarithromycin, but preserve the high eradication efficacy for clarithromycin susceptible H. pylori infection.
    No preview · Article · Jan 2007 · Hepato-gastroenterology
  • Hsin-I Shih · Hsin-Chun Lee · Chiao-Hsiung Chuang · Wen-Chien Ko
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    ABSTRACT: Procedure-related bacterial infections may complicate esophageal variceal ligation in cirrhosis patients. Here, we report a 58-year-old man with underlying diabetes and liver cirrhosis who developed Klebsiella pneumoniae meningitis and brain abscess with gas formation in brain parenchyma and ventricles after this procedure. Despite administration of appropriate antimicrobial therapy, he became comatose on the 3rd day of acute illness and died on the 4th day of hospitalization. This case highlights the indication for antimicrobial prophylaxis in cirrhotic patients with gastrointestinal bleeding, and the need for early and heightened awareness of central nervous system infections in cirrhotic patients with hepatic encephalopathy.
    No preview · Article · Nov 2006 · Journal of the Formosan Medical Association
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    ABSTRACT: Background: Sonographic diagnosis of acute cholecystitis remains equivocal at times. The variance of gallbladder ejection fraction may be useful in diagnosis. This study evaluated the ejection fraction difference between cholecystitis patients and a control group, and also determined the diagnostic cutoff level. Patients and Methods: Twenty patients with a diagnosis of acute cholecystitis, subsequently confirmed by pathologic findings after cholecystectomy, and 20 control patients with asymptomatic gallbladder stones were included in this study. A commercial formula, 475 Kcal with 43% lipids, was used for the test meal. All subjects received serial sonography to analyze gallbladder volume and ejection fraction before and 15, 30, 45 and 60 minutes after the test meal. Results: Before the test meal, the mean gallbladder volume of the cholecystitis group was larger than that of the control group (54.5 mL vs. 20.1 mL, p=0.002). The cholecystitis group had significantly lower ejection fraction than the control group at all time points after the test meal (15 minutes, -7.8% vs. 48.4%; 30 minutes, -0.9% vs. 65.8%; 45 minutes, 6.5% vs. 62.7%; 60 minutes, 6.6% vs. 71.4%; p<0.001). Using 40% ejection fraction as the cutoff level, patients with cholecystitis could be differentiated entirely from the control group at 45 or 60 minutes after the test meal. Conclusion: Patients with acute cholecystitis have bigger gallbladder volume before a meal and lower ejection fraction after a fatty meal, compared with controls. From 45 to 60 minutes after a fatty meal, 40% ejection fraction can be used as the cutoff level to differentiate patients with acute cholecystitis from those who do not.
    Preview · Article · Dec 2005 · Journal of Medical Ultrasound
  • Chiao-Hsiung Chuang · Chiung-Yu Chen · Hong-Ming Tsai

    No preview · Article · Dec 2005 · Clinical Gastroenterology and Hepatology

Publication Stats

311 Citations
136.09 Total Impact Points


  • 2003-2015
    • National Cheng Kung University
      • Department of Internal Medicine
      臺南市, Taiwan, Taiwan
  • 2002-2011
    • National Cheng Kung University Hospital
      • Department of Pediatrics
      臺南市, Taiwan, Taiwan