Fang Chia Bin’s research while affiliated with Irmandade da Santa Casa da Misericórdia de Santos and other places

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Publications (62)


RECTAL LACERATION FOLLOWING FISTING PRACTICE
  • Article
  • Full-text available

April 2025

Journal of Coloproctology

Vitoria Vicentin Giordano

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Fernanda Bellotti Formiga

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Natalia Ferreira Cardoso de Oliveira

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[...]

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Fang Chia Bin
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Fig. 1 Bowel obstruction on CT (yellow arrow).
Fig. 2 Non-necrotizing granulomas-giant Langhans-like cells (yellow arrow).
Fig. 3 Tuberculosis implant (Archives of Discipline of ColoproctologySanta Casa de Sao Paulo).
Fig. 4 Ziehl-Neelsen stain results positive evidencing mycobacteria (red arrow).
Fig. 5 Ziehl-Neelsen stain results positive evidencing mycobacteria (red arrow).
Differential Diagnosis for Intestinal Tuberculosis in Elder Patient – Case Report

April 2025

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3 Reads

Journal of Coloproctology

Introduction Intestinal tuberculosis (ITB) presents with clinical features that often mimic malignant or inflammatory diseases. Diagnosis is established through a combination of endoscopic, radiological, and pathological findings. Case A 76-year-old woman presented with acute, diffuse abdominal pain. Computed tomography (CT) of the abdomen revealed subocclusion due to wall thickening at the ileocecal transition. A colonoscopy biopsy showed ulcerated granulomatous lesions, with negative results for AFB. Enterography suggested the possibility of a neoplastic disease. Due to the subocclusion, the patient underwent a segmental right ileocolectomy and ileocolostomy with a double-barrel stoma. Histopathological analysis of the resected specimen, including frozen section examination, confirmed ITB. Conclusion The diagnosis of ITB is challenging due to its clinical, endoscopic, radiologic, and histopathologic features, which overlap with neoplasms and inflammatory bowel disease. Therefore, establishing an appropriate therapeutic approach requires the integration of multiple diagnostic findings.


Flowchart for the in vivo neuroimaging study in patients and for the postmortem neuropathological analysis in cadaver samples.
Morphometric alterations in human cachectic brain detected by VBM analyses. (a) (i) Increased grey matter regions in CC; (ii) decreased grey matter regions in CC. Coloured bar represents the T‐value (post‐hoc tests) for the voxel of maximum statistical significance within each cluster. x, y, z: coordinates; Nb, number; Vx, voxel; R, right; L, left; Med, medial; Sup, superior; Inf, inferior. (b) Increased ROIs in CC patients; (c) nonparametric Spearman correlation analysis between biological variables and ROIs: (i) correlations in WSC patients and (ii) correlations in CC patients. Each scatterplot on the panel corresponds to the pair of variables indicated on the labels on the horizontal and vertical axes. The value of the Spearman coefficient (ρ) is indicated by colour according to the colour scale on the right. BM, body mass; CC, cancer cachexia, n = 10; CRP, c‐reactive protein; IL: interleukin; L, left; ORF, orbitofrontal cortex; R, right; WSC, weight stable cancer; n = 12.
Disrupted functional connectivity in cachectic human brain assessed with rsfMRI. The FC maps display the parametric statistics (Gaussian random field theory) cluster threshold: p < 0.05 cluster‐size p‐FDR corrected; voxel threshold: p < 0.001 p‐uncorrected. AC, anterior cingulate gyrus; Ant. or a, anterior; FG, frontal gyrus; FG oper, frontal gyrus pars opercularis; FG tri, frontal gyrus pars triangularis; FO, frontal operculum; FP, frontal pole; i, inferior; IC, insular cortex; left; ICC, intracalcarine cortex; ITG, inferior temporal gyrus; ; LG, lateral gyrus; L or l, left; LH, hemisphere; LOC, lateral occipital cortex; Mid, middle; LiG, lingual gyrus; MTG, middle temporal gyrus; OFC, orbitofrontal cortex; OFG, occipital fusiform gyrus; PaCiG, paracingulate gyrus; PC, posterior cingulate gyrus; PCu, precuneous; PreCG, precentral gyrus; Post or p, posterior.; PostCG, postcentral gyrus; R or r, right; RH, right hemisphere; RPFC, right prefrontal cortex; s, superior; SFG, superior frontal gyrus; SMG, supramarginal gyrus; SPL, superior parietal lobule; WM, white matter.
Neuropathological analyses in postmortem human brain reveals differences in cachexia. 400x magnification optic microscopy images. Significant differences between the groups were tested using unpaired T‐test. WSC, weight stable cancer, n = 6; CC: Cancer Cachexia, n = 10. (a) H&E staining in human brain, → showing altered neuronal structures; (b) Neuronal density (neurons/mm²) data in Cohort 2; (c) automated quantification in the regions of interest using Qupath v.0.1.2; (d) left panel: CD68 staining in ROIs; right panel: Iba1 staining in ROIs; lower panel: T‐test statistics of CD68 and Iba1 staining; (e) GFAP staining analyses in ROIs.
Semiquantitative mTOR pathway analyses in human brain tissue. 400x magnification optic microscopy images. Data expressed as mean ± SEM. Significant differences between the groups were tested using unpaired T‐test. WSC, weight stable cancer, n = 4–6; CC, cancer cachexia, n = 6–10. (a, b) Upstream mTOR pathway‐TSC1 and TSC2 staining and statistics in ROIs; (c, d) mTOR pathway core‐ mTOR and p‐mTOR staining and statistics in ROIs; (e, f) downstream mTOR pathway‐p70S6K and p‐p70S6K staining and statistics in ROIs; mTOR, mechanistic targeting pathway of rapamycin; p70S6K, ribosomal protein S6 kinase; p‐p70S6K, phosphorylated p70S6K; p‐mTOR, phosphorylated mTOR; TSC1, hamartin; TSC2, tuberin.
Cachexia Alters Central Nervous System Morphology and Functionality in Cancer Patients

February 2025

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38 Reads

Background Cachexia is a clinically challenging multifactorial and multi‐organ syndrome, associated with poor outcome in cancer patients, and characterised by inflammation, wasting and loss of appetite. The syndrome leads to central nervous system (CNS) function dysregulation and to neuroinflammation; nevertheless, the mechanisms involved in human cachexia remain unclear. Methods We used in vivo structural and functional magnetic resonance imaging (Cohort 1), as well as postmortem neuropathological analyses (Cohort 2) in cachectic cancer (CC) patients compared to weight stable cancer (WSC) patients. Cohort 1 included treatment‐naïve adults diagnosed with colorectal cancer, further divided into WSC (n = 12; 6/6 [male/female], 61.3 ± 3.89 years) and CC (n = 10; 6/4, 63.0 ± 2.74 years). Cohort 2 was composed by human postmortem cases where gastrointestinal carcinoma was the underlying cause of death (WSC n = 6; 3/3, 82.7 ± 3.33 years and CC n = 10; 5/5, 84.2 ± 2.28 years). Results Here we demonstrate that the CNS of CC patients presents regional structural differences within the grey matter (GM). Cachectic patients presented an augmented area within the region of the orbitofrontal cortex, olfactory tract and the gyrus rectus (coordinates X, Y, Z = 6, 20,−24; 311 voxels; pFWE = 0.023); increased caudate and putamen volume (−10, 20, −8; 110 voxel; pFWE = 0.005); and reduced GM in superior temporal gyrus and rolandic operculum (56,0,2; 156 voxels; pFWE = 0.010). Disrupted functional connectivity was found in several regions such as the salience network, subcortical and temporal cortical areas of cachectic patients (20 decreased and 5 increased regions connectivity pattern, pFDR < 0.05). Postmortem neuropathological analyses identified abnormal neuronal morphology and density, increased microglia/macrophage burden, astrocyte profile disruption and mTOR pathway related neuroinflammation (p < 0.05). Conclusions Our results indicate that cachexia compromises CNS morphology mostly causing changes in the GM of cachectic patients, leading to alterations in regional volume patterns, functional connectivity, neuronal morphology, neuroglia profile and inducing neuroinflammation, all of which may contribute to the loss of homeostasis control and to deficient information processing, as well as to the metabolic and behavioural derangements commonly observed in human cachexia. This first human mapping of CNS cachexia responses will now pave the way to mechanistically interrogate these pathways in terms of their therapeutic potential.


Citations (13)


... Seown-En et al. [34] führten bei 12 TaTME-Patienten mit Karzinomen im unteren Rektumdrittel eine verzögerte handgenähte Anastomose durch und fanden in der gematchten Vergleichsgruppe funktionell (Wexner-und LARS-Score) keinen signifikanten Unterschied zur laparoskopischen und robotischen TME mit primärer koloanaler Stapler-Anastomose. Eine aktuellere Metaanalyse konnte für die verzögerte Anastomose nach onkologischer tiefer anteriorer Resektion auch eine signifikant niedrigere Insuffizienzrate nachweisen (15,4 % vs. 23,5 %; OR 0,55; 95 % KI 0,31-0,97; p = 0,04; [35]). ...

Reference:

Intersphinktäre Resektion zum Schließmuskelerhalt beim ultratiefen Rektumkarzinom – Ein UpdateIntersphincteric resection for sphincter preservation in ultra-low rectal cancer—An update
Turnbull-Cutait pull-through coloanal anastomosis versus standard coloanal anastomosis plus diverting ileostomy for low anterior resection: a meta-analysis and systematic review

Langenbeck's Archives of Surgery

... In our review, males gender predominated development of SARS-CoV-2 illness in CRC patients, a finding suggested in most of the reports [9, 11, 14, 16, 17, 25, 27, 28, 30, 32-35, 47, 52-59, 61, 62, 71, 72, 74, 75, 77, 81-85] and in contradiction with data from other reports suggesting an equal proportion of COVID-19 cases in CRC patients for both genders [14,23,29,31,60,80] or patients with CRC and SARS-CoV-2 illness were mostly females [11,36,46,49,50,66,67,76]. This review reflects previous studies in showing that the overall incidence of CRC is higher in males than in females [99][100][101]. ...

Cenário das Cirurgias Colorretais Oncológicas Eletivas em Meio à Pandemia de Covid-19
  • Citing Conference Paper
  • December 2021

Journal of Coloproctology

... LPS-induced TLR4 expression reversed depot-specific variation, and increased p65 levels in both explants were associated with the overexpression of IL-1β. Together, the results indicate that adipose tissue in CAC is involved in inflammation and its depot-specific regulation [27]. ...

Activation of the Adipose Tissue NLRP3 Inflammasome Pathway in Cancer Cachexia

... Postoperative mortality did not significantly differ among the four periods, consistent with international studies [1,20,30,31,[33][34][35][36][37]. This is also consistent with the research of Vicente et al., who suggests that during this period, surgical intervention for the treatment of colon cancer can be performed without a significant impact on postoperative mortality [38]. Despite this, variations in parameters influencing patient prognosis were identified. ...

Scenario of Elective Colorectal Oncology Surgeries During the COVID-19 Pandemic

Journal of Coloproctology

... 6 Acadêmico de Medicina pela Universidade Federal do Amapá. 7 Cirurgião Coloproctologista pela Real e Benemérita Sociedade Portuguesa de Beneficência do Rio de Janeiro. 8 ...

Estudo comparativo entre a amputação de reto na posição clássica de Lloyd-Davies e em decúbito ventral.

Revista do Colégio Brasileiro de Cirurgiões

... Kim et al. [10] also reported an overall agreement of 63% between the clinical and pathological assessments. Other investigators [15] compared the clinical and pathologic N stages based on the receipt of neoadjuvant therapy. While patients who proceeded directly to surgery had an accuracy of MRI in determining lymph node involvement equal to 82.7%, close to our result, the accuracy was reduced by 21% in patients who received neoadjuvant therapy. ...

Impact of neoadjuvant therapy in downstaging of lower rectal adenocarcinoma and the role of pelvic magnetic resonance in staging

Revista do Colégio Brasileiro de Cirurgiões

... 3,7,6,9,10 El TCG suele manifestarse entre la cuarta y sexta década de la vida y su prevalencia es mayor en las mujeres que en los hombres, con una relación de 1,5:1, no encontrándose diferencias entre razas. 4,6,10,11 Generalmente el TCG se presenta como una lesión única, aunque también pueden aparecer múltiples lesiones de forma sincrónica o metacrónica en un 10-15 % de los casos. 3 La extirpación local con márgenes libres es el tratamiento de elección en la localización perianal y, en aquellos pacientes con afectación de ganglios linfáticos, se recomienda la resección de los mismos durante la cirugía. ...

Granular cell tumor of rectal submucosa: Case report

Journal of Coloproctology

... It is a characteristic of this tumor to present intestinal obstruction, bleeding (hematochezia, enterorrhagia), change in bowel habits, and systemic settings such as significant weight loss. 1,3,12,13 The prevention of sporadic SCRC involves three phases of action in health as follows: the primary phase aims to prevent the development of the disease, such as eating an adequate diet, physical exercise training, and absence of tobacco and alcohol consumption 5,12 ; the secondary phase is the prevention through an early diagnosis by means of a physical examination performed by a proctologist, laboratory tests (fecal occult blood test, carcinoembryonic antigen CEA test), and imaging screenings (colonoscopy, proctosigmoidoscopy) 1,3 ; and the tertiary phase is the prevention of sporadic SCRC with relief of the symptoms and prevention of consequences. 7 In Brazil there is a shortage of detailed population data in SCRC. ...

Sinais sintomas do câncer colorretal e diagnostico precoce
  • Citing Article
  • January 1991

... PJS is associated with a 15-fold increased relative risk of malignancies compared to the general population [12]. Colonic cancer (57 %), accounts for the majority of neoplasm in patients with PJS, followed by breast (45 %), pancreatic (36 %), stomach (29 %), ovary (21 %), small intestine (13 %), and uterine (10 %) tumors [13]. Some extragastrointestinal epithelial malignancies of the lungs, thyroid, and ovaries are also reported. ...

Diagnostic difficulty in Peutz–Jeghers syndrome

Journal of Coloproctology