94 results on '"Yao-Jong Yang"'
Search Results
2. The composition of the maternal breastmilk microbiota influences the microbiota network structure during early infancy
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Jhen-Wei Ruan, Yi-Chu Liao, Pei-Chen Chen, Yen-Ju Chen, Yi-Hsiu Tsai, Pei-Jane Tsai, Yao-Jong Yang, Chi-Chang Shieh, Yung-Chieh Lin, and Chia-Yu Chi
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Breast milk ,Microbiota ,Microbiota maturation ,Early infancy ,Staphylococcus caprae ,Microbiology ,QR1-502 - Abstract
Background/purpose(s): Human breastmilk (BM) is important for microbiome maturation in infants across different body sites. Streptococcus and Staphylococcus are considered universally predominant genera in the BM microbiota. However, whether the differential abundance of Streptococcus and Staphylococcus in BM can differentially affect microbiome maturation in infants remains unclear. Methods: We recruited exclusively breastfeeding mothers from among the donors of the human milk bank established at National Cheng-Kung University Hospital. The donor mothers provided 35 BM samples at three months (3 M; before introducing children to complementary feeding) and 23 BM samples at six months (6 M; after introducing children to complementary feeding) postpartum. At both time points, samples from different body sites, including nasal swabs, oral swabs and stool, were collected from the mothers and their infants. Results: Maternal BMI was inversely associated with coagulase-negative Staphylococcus (CoNS) abundance in breastmilk. Staphylococcus caprae representation in BM CoNS showed a negative correlation with Streptococcus abundance. Network analysis revealed that infants fed Staphylococcus-dominated BM had better gut and nasal microbiota networks than infants fed Streptococcus-abundant BM during early infancy. Conclusion: Our work suggests that maternal metabolic status plays a crucial role in Staphylococcus/Streptococcus competition in BM, which in turn can impact the development of the infant microbiota. Our microbiota co-occurrence network analysis might serve as a helpful bioinformatic tool to monitor microbiota maturation during early infancy.
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- 2023
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3. Evolution of the Correa's cascade steps: A long-term endoscopic surveillance among non-ulcer dyspepsia and gastric ulcer after H. pylori eradication
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Hsiu-Chi Cheng, Yao-Jong Yang, Hsiao-Bai Yang, Yu-Ching Tsai, Wei-Lun Chang, Chung-Tai Wu, Hsin-Yu Kuo, Yu-Ting Yu, Er-Hsiang Yang, Wei-Chun Cheng, Wei-Ying Chen, and Bor-Shyang Sheu
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Atrophic gastritis ,Helicobacter pylori ,precancerous Conditions ,Stomach neoplasms ,Medicine (General) ,R5-920 - Abstract
Background: This study is aimed toward investigating the evolution of each Correa's step after Helicobacter pylori eradication in a long-term follow-up and exploring the factors correlated with a high-risk of gastric cancer. Methods: A total of 1824 H. pylori-infected subjects were enrolled to receive screening endoscopy. Among them, 491 received surveillance endoscopy. The patients were divided into Correa's steps I to VI, from normal to gastric cancer. A group-based trajectory model was used to classify patients as persistent high-risk status or not. Results: The prevalence rates of positive corpus-predominant gastritis index (CGI) were 20%–40% in all age groups and Correa's steps IV-V increased >35% after 50 years based on screening endoscopy. Successful eradication of H. pylori regressed CGI after the 1st year-and-thereafter (P
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- 2023
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4. The accuracy of magnetic resonance cholangiopancreatography in the diagnosis of biliary atresia in preterm infants with cholestasis
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Wei-Che Chen, Hsiao-Yu Lo, Yi-Shan Tsai, and Yao-Jong Yang
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biliaryatresia ,magnetic resonance cholangiopancreatography ,preterm ,Pediatrics ,RJ1-570 - Abstract
Background: Magnetic resonance cholangiopancreatography (MRCP) is a useful and non-invasive method to diagnose biliary atresia (BA) in term infants, however few studies have investigated its use in preterm infants. This study aimed to evaluate the accuracy of MRCP in the diagnosis of BA in preterm infants with cholestasis. Methods: Infants aged less than 6 months who received MRCP for cholestasis at a tertiary medical center were enrolled from 2011 to 2020. Demographic and laboratory data were retrospectively obtained. One pediatric radiologist reviewed the MRCP images. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRCP to diagnose BA based on surgical proof or at least 6 months of follow-up were assessed. Results: A total of 80 infants (36 preterm and 44 term) were analyzed. The mean post-chronological age was 1.8 months, and the female-to-male ratio was 0.78. Six (16.7%) preterm and 16 (36.4%) term infants were confirmed to have BA. BA was obscured by a choledochal cyst preoperatively in two term infants. In the preterm infants, the sensitivity, specificity, PPV, NPV, and accuracy of MRCP to diagnose BA were 100%, 77%, 46%, 100%, and 81%, respectively, compared to 81%, 86%, 76%, 89%, and 84% in the term infants. Using MRCP to differentiate BA from other cholestasis in the preterm infants had superior sensitivity (100% vs. 81%) and NPV (100% vs. 89%), and lower specificity (77% vs. 86%) and PPV (46% vs. 76%) than in the term infants. Conclusions: Negative MRCP findings can be used to exclude BA in preterm infants with cholestasis based on a favorable NPV.
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- 2023
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5. Enzyme replacement therapy for children with acid sphingomyelinase deficiency in the real world: A single center experience in Taiwan
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Yu-Wen Pan, Meng-Che Tsai, Chiao-Yu Yang, Wen-Hao Yu, Bow Wang, Yao-Jong Yang, and Yen-Yin Chou
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ASMD ,Niemann-Pick disease ,Enzyme replacement therapy ,Liver stiffness ,Olipudase alfa ,Medicine (General) ,R5-920 ,Biology (General) ,QH301-705.5 - Abstract
Background: Acid sphingomyelinase deficiency (ASMD) is a lysosomal storage disease with multi-systemic involvement, with no disease-modifying treatment available. Olipudase alfa is an investigational enzyme product developed to replace the deficient acid sphingomyelinase in ASMD patients. Several clinical trials have reported promising safety and efficacy results in adult and pediatric patients. However, no data have been reported outside of the clinical trial setting yet. This study aimed to evaluate major outcomes in pediatric chronic ASMD patients receiving olipudase alfa in the real-world setting. Materials and methods: Two children with type A/B (chronic neuropathic) ASMD have received olipudase alfa treatment since May 2021. Clinical parameters, including height, weight, complete blood count, liver function tests, lipid profiles, biomarkers, abdominal ultrasonography with shear wave elastography, chest computed tomography, nerve conduction studies, neurodevelopmental evaluations, and six-minute walk tests, were checked at baseline and every three to six months in the first year of enzyme replacement therapy (ERT) to assess its efficacy and safety. Results: The two patients in our study started olipudase alfa treatment at the age of 5 years and 8 months and 2 years and 6 months. During the first year of treatment, both patients saw a reduction in their hepatic and splenic volumes as well as liver stiffness. Height z-score, weight z-score, lipid profiles, biomarker levels, interstitial lung disease scores, and bone mineral densities also improved over time. The six-minute walk test showed a gradual increase in walking distance in both patients. There were no obvious improvements or deterioration in neurocognitive function and peripheral nerve conduction velocities after treatment. No severe infusion-associated reactions were noted during the first year of treatment. One patient had two episodes of transient but significantly elevated liver enzymes during the dose-escalation phase. The patient was asymptomatic, and the impaired liver function resolved spontaneously within two weeks. Conclusion: Our results provide real-world experience that olipudase alfa is safe and effective in improving major systemic clinical outcomes for pediatric chronic ASMD patients. Monitoring of liver stiffness by shear wave elastography is a noninvasive procedure that can monitor treatment efficacy during ERT.
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- 2023
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6. A Culture-Based Strategy Is More Cost Effective Than an Empiric Therapy Strategy in Managing Pediatric Helicobacter pylori Infection
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Chi-Wen Hung, Solomon Chih-Chen Chen, Li-Jung Elizabeth Ku, Bor-Shyang Sheu, and Yao-Jong Yang
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H. pylori treatment ,child ,cost-effectiveness ,culture-based ,empiric therapy ,Pediatrics ,RJ1-570 - Abstract
BackgroundHelicobacter pylori infection is a major cause of peptic ulcers and gastric cancer. This study aimed to compare the eradication rate and essential costs of culture-based and empiric therapy strategies in treating pediatric H. pylori infection.MethodsWe retrospectively enrolled patients aged
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- 2022
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7. Successful Montelukast Treatment in an Infant with Steroid-Resistant Eosinophilic Colitis
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Nai-Wei Wang, Hsuan Hsieh, and Yao-Jong Yang
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eosinophilic colitis ,montelukast ,steroid-sparing therapy ,diarrhea ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Eosinophilic colitis (EC) belongs to a group of idiopathic diseases called eosinophilic gastrointestinal disorders, which are characterized by eosinophil-predominant inflammation in the gastrointestinal tract. Corticosteroids is the first-line pharmacotherapy for EC refractory to diet therapy. We report an infant with steroid-resistant EC, who successfully returned to a healthy growth trajectory under the combined therapy of montelukast and ketotifen. An 8-month-old boy presented with bloody diarrhea, anemia, and failure to thrive (FTT) that started 6 days after birth. The patient has no known allergies. A trial of elementary diet was unsuccessful. The results of several stool cultures were unremarkable. Similarly, lower gastrointestinal series failed to identify anything significant. At 3 months of age, an esophagogastroduodenoscopy with biopsies from the distal duodenum and proximal jejunum were unremarkable. The diarrhea and FTT persisted. A rectosigmoidoscopy with biopsies was performed; the results led to the diagnosis of EC at 5 months of age. Oral prednisolone 1 mg/kg/day was prescribed; however, 3 months into the treatment, persistent bloody diarrhea and FTT were still noted. Montelukast and ketotifen were added, after which diarrhea and weight gain started to improve. Prednisolone and montelukast/ketotifen were tapered off 6 months after. He remains symptom free and has normal growth and development in a 5-year follow-up.
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- 2021
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8. Differential H. pylori-Induced MAPK Responses Regulate Lewis Antigen Expression and Colonization Density on Gastric Epithelial Cells Between Children and Adults
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Yao-Jong Yang, Chia-Ling Lu, and Bor-Shyang Sheu
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H. pylori ,colonization ,Lewis antigen ,MAPK ,age ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Helicobacter pylori causes gastrointestinal diseases, the manifestations of diseases are more serious in adults than in children. Lewis antigen expressions on the gastric epithelium serves as receptors targeted by H. pylori. Moreover, the MAPK signaling pathway involves glycoprotein synthesis of Lewis antigens. We aimed to investigate whether differences in H. pylori-induced MAPK responses mediate gastric Lewis antigens expression and colonization density differently in children and adults. We used human stomach fetal epithelium (HSFE) and SV40-immortalized human normal gastric epithelial (GES-1) cell lines to mimic primary gastric epithelium of children and adults, respectively. H. pylori colonization intensity and Lewis antigens were significantly higher in GES-1 than in HSFE cells, whereas IL-8 and IL-6 levels were significantly higher in HSFE than in GES-1 cells after infection. c-Jun N-terminal kinase (JNK) siRNA and inhibitor (SP600125) experiments showed that Lewis antigen expression and H. pylori colonization were reduced in GES-1 cells but increased in HSFE cells. Furthermore, p-p38 intensity was significantly higher in the superficial epithelium of the children than in the adults with/without H. pylori infection. The overexpression of p38 in GES-1 cells downregulated H. pylori-induced JNK activity mimicking H. pylori infection in children. In conclusion, a higher p38 expression in gastric epithelium counteracting JNK activity in children may contribute to lower Lewis antigen expression and colonization density than in adults after H. pylori infection.
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- 2022
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9. Changes in epidemiology and antimicrobial susceptibility of nontyphoid Salmonella in children in southern Taiwan, 1997–2016
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Hsiao-Yu Lo, Fu-Ping Lai, and Yao-Jong Yang
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Nontyphoid Salmonella ,Resistance ,Serogroup ,Children ,Microbiology ,QR1-502 - Abstract
Background: This study aimed to investigate the changing trends in serogroup distribution and antimicrobial susceptibility of nontyphoid Salmonella (NTS) isolated from children in the past two decades in Taiwan. Methods: This retrospective study enrolled patients aged younger than 18 years with culture-proven NTS infection in a tertiary medical center from 1997 to 2016. Data on age, Salmonella serogroup, culture sample, and antimicrobial susceptibility were obtained from medical records. The rates of Salmonella serogroups and antimicrobial resistance were compared between period 1 (1997–2006) and period 2 (2007–2016). Results: A total of 2075 NTS isolates were identified from 1997 to 2016 (1036 in period 1, 1039 in period 2). The major isolates were from feces (89.1%) and blood (10.4%). The most common serogroup was serogroup B (54.8%), followed by serogroup D (18.8%). There was a significant decline in the proportion of serogroup B with a concomitant rise in serogroup D in the past two decades. In period 2, resistance to cefotaxime and cefixime increased remarkably among serogroup B, whereas resistance to ampicillin increased notably among serogroup D. Furthermore, the incidence of multidrug-resistant (≥3 antibiotics) NTS significantly decreased in both serogroup B and serogroup D in period 2. Conclusion: This study revealed a significant rise in serogroup D with a concomitant decline in serogroup B NTS infection in Taiwanese children. Moreover, antimicrobial resistance to third-generation cephalosporins increased in serogroup B. Continuous surveillance of NTS serogroup distribution and antimicrobial susceptibility is mandatory to formulate therapeutic strategies for NTS infections.
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- 2020
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10. Maternal H. pylori seropositivity is associated with gestational hypertension but is irrelevant to fetal growth and development in early childhood
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Fu-Ping Lai, Yi-Fang Tu, Bor-Shyang Sheu, and Yao-Jong Yang
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Growth and development ,Ghrelin ,H. pylori ,Insulin-like growth factor-1 ,Gestational hypertension ,Child ,Pediatrics ,RJ1-570 - Abstract
Abstract Background Helicobacter pylori infection is known to alter growth-related hormones and affect growth in young children. However, it is still unknown whether maternal H. pylori infection has an impact on the levels of cord blood growth-related hormones and whether this can predict intrauterine growth restriction and poor physical and neurodevelopmental outcomes in children. This study aimed to examine associations between maternal H. pylori infection and pregnancy-related adverse events, fetal growth and early childhood development. Methods In this prospective cohort study, we recruited singleton pregnant women without major medical illnesses from January 2014 to January 2015. Seropositivity for H. pylori was defined as > 12 U/ml of anti-H. pylori IgG in maternal serum. Demographic data and pregnancy-related medical issues of the cohort were documented. Cord blood levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, and ghrelin were determined using ELISA. The growth of the included neonates was monitored annually for up to 3 years, and cognitive development was assessed using the comprehensive developmental inventory for infants and toddlers (CDIIT) test 3 years after birth. Results Of the 106 enrolled women, 25 (23.6%) were H. pylori-seropositive. Maternal H. pylori seropositivity was correlated with a higher risk of developing gestational hypertension (GH) (12% vs. 1.2%, p = 0.04) and lower cord blood levels of IGF-1 (
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- 2019
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11. The relationship between nonalcoholic fatty liver disease and pediatric congenital hypothyroidism patients
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Yu‐Wen Pan, Meng‐Che Tsai, Yao‐Jong Yang, Ming‐Yin Chen, Shou‐Yen Chen, and Yen‐Yin Chou
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congenital hypothyroidism ,nonalcoholic fatty liver disease ,obesity ,Medicine (General) ,R5-920 - Abstract
Abstract Previous studies have shown hypothyroidism was independently associated with nonalcoholic fatty liver disease (NAFLD) in adults, but few studies examined their relationships in pediatric populations. This study aimed to investigate the prevalence of NAFLD in pediatric congenital hypothyroidism (CHT) patients and to identify the association between CHT and NAFLD. This study enrolled pediatric CHT patients receiving levothyroxine treatment at one medical center from 2013 to 2014. Euthyroid subjects (ET) and transient hypothyroidism (THT) patients weaned off medication successfully after age 3 were selected for further comparison. Laboratory data including thyroid functions, liver functions, and metabolic profiles were obtained. The major outcome was the occurrence of NAFLD, diagnosed based on the findings of abdominal ultrasonography. One‐hundred and twenty‐nine subjects (47 in CHT, 47 in THT, and 35 in ET groups) were enrolled. The analysis showed higher fasting serum glucose, insulin, thyroxine (T4), and mean thyroid‐stimulating hormone (TSH) levels in the CHT group. NAFLD prevalence was higher in the CHT (23.4%) group than in the THT (8.5%) and the ET (5.7%) groups, demonstrating an increasing trend across three strata (X2linear‐by‐linear = 5.9, P
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- 2019
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12. Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection
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Kai‐Pi Cheng, Yao‐Jong Yang, Hao‐Chang Hung, Ching‐Han Lin, Chung‐Tai Wu, Mei‐Hui Hung, Bor‐Shyang Sheu, and Horng‐Yih Ou
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Diabetes ,Glycemic control ,Helicobacter eradication ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Aims/Introduction Helicobacter pylori infection is associated with insulin resistance and glycemia in non‐diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. Materials and Methods A total of 549 diabetes patients were recruited for sequential two‐step approach (immunoglobulin G [IgG] serology followed by 13C‐urea breath test [UBT]) to discriminate “active” (IgG+ and UBT+) from “non‐active” (UBT− or IgG−) H. pylori infection, and “past” (IgG+ but UBT−) from “never/remote” (IgG−) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between participants with and without 10‐day eradication therapy were compared after 3 months. Results Despite no between‐group difference in A1C, the “active” infection group (n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3% vs 50.4%, P
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- 2019
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13. Case Report: Successful Use of Biliary Stent for Iatrogenic Esophageal Perforation Following Balloon Dilation in a 7-Month-Old Infant
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Meng-Chuan Liu, Yao-Sheng Wang, Yao-Jong Yang, and Fu-Ping Lai
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endoscopic balloon dilation ,esophageal perforation ,endoscopic therapy ,esophageal stent ,pediatrics—infants ,biliary stent ,Pediatrics ,RJ1-570 - Abstract
Esophageal perforation is a rare but critical emergency that requires early detection and prompt management. In the pediatric population, iatrogenic injury is the most common etiology of esophageal perforation, and the majority of cases come from stricture dilation. Treatment options include medical management, endoscopic therapy, and surgery. Usually, conservative treatment is appropriate in most carefully selected patients, especially in the setting of early diagnosis and with the absence of severe sepsis. A surgical approach is reserved for a large tear with mediastinum contamination, or clinical deterioration after unsuccessful conservative management. With the advancement of the endoscopy technique, endoscopy therapy using esophageal stents is an available choice for adult populations who have a complicated protracted healing course or comorbidities precluding surgical attempts. However, this procedure is seldom implemented in children, especially in young infants, owing to unavailable equipment and experts. We report our successful use of a fully-covered self-expandable metal biliary stent in managing esophageal perforation in a seven-month-old infant. In light of this encouraging achievement, this model can be applied to more children who have the same problem.
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- 2020
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14. The prevalence and characteristics of cow's milk protein allergy in infants and young children with iron deficiency anemia
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Fu-Ping Lai and Yao-Jong Yang
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cow's milk protein allergy ,iron deficiency anemia ,hypoalbuminemia ,endoscopy ,Pediatrics ,RJ1-570 - Abstract
Background: The clinical presentation of cow's milk protein allergy (CMPA) in children varies. This retrospective study aimed to investigate the prevalence and clinical manifestations of CMPA in young children who visited for evaluation of iron deficiency anemia (IDA). Methods: Patients aged
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- 2018
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15. Variants in Maternal Effect Genes and Relaxed Imprinting Control in a Special Placental Mesenchymal Dysplasia Case with Mild Trophoblast Hyperplasia
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Tien-Chi Huang, Kung-Chao Chang, Jen-Yun Chang, Yi-Shan Tsai, Yao-Jong Yang, Wei-Chun Chang, Chu-Fan Mo, Pei-Hsiu Yu, Chun-Ting Chiang, Shau-Ping Lin, and Pao-Lin Kuo
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placental mesenchymal dysplasia ,hydatidiform mole ,genomic imprinting ,maternal effect genes ,trophoblast ,Biology (General) ,QH301-705.5 - Abstract
Placental mesenchymal dysplasia (PMD) and partial hydatidiform mole (PHM) placentas share similar characteristics, such as placental overgrowth and grape-like placental tissues. Distinguishing PMD from PHM is critical because the former can result in normal birth, while the latter diagnosis will lead to artificial abortion. Aneuploidy and altered dosage of imprinted gene expression are implicated in the pathogenesis of PHM and also some of the PMD cases. Diandric triploidy is the main cause of PHM, whereas mosaic diploid androgenetic cells in the placental tissue have been associated with the formation of PMD. Here, we report a very special PMD case also presenting with trophoblast hyperplasia phenotype, which is a hallmark of PHM. This PMD placenta has a normal biparental diploid karyotype and is functionally sufficient to support normal fetal growth. We took advantage of this unique case to further dissected the potential common etiology between these two diseases. We show that the differentially methylated region (DMR) at NESP55, a secondary DMR residing in the GNAS locus, is significantly hypermethylated in the PMD placenta. Furthermore, we found heterozygous mutations in NLRP2 and homozygous variants in NLRP7 in the mother’s genome. NLRP2 and NLRP7 are known maternal effect genes, and their mutation in pregnant females affects fetal development. The variants/mutations in both genes have been associated with imprinting defects in mole formation and potentially contributed to the mild abnormal imprinting observed in this case. Finally, we identified heterozygous mutations in the X-linked ATRX gene, a known maternal–zygotic imprinting regulator in the patient. Overall, our study demonstrates that PMD and PHM may share overlapping etiologies with the defective/relaxed dosage control of imprinted genes, representing two extreme ends of a spectrum.
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- 2021
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16. Male non-insulin users with type 2 diabetes mellitus are predisposed to gastric corpus-predominant inflammation after H. pylori infection
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Yao-Jong Yang, Chung-Tai Wu, Horng-Yih Ou, Chin-Han Lin, Hsiu-Chi Cheng, Wei-Lun Chang, Wei-Ying Chen, Hsiao-Bai Yang, Cheng-Chan Lu, and Bor-Shyang Sheu
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H. Pylori ,Type 2 diabetes mellitus ,Gastric cancer ,Gender ,Insulin ,Medicine - Abstract
Abstract Background Both H. pylori infection and diabetes increase the risk of gastric cancer. This study investigated whether patients with type 2 diabetes mellitus (T2DM) and H. pylori infection had more severe corpus gastric inflammation and higher prevalence of precancerous lesions than non-diabetic controls. Methods A total of 797 patients with type 2 diabetes mellitus were screened for H. pylori, of whom 264 had H. pylori infection. Of these patients, 129 received esophagogastroduodenoscopy to obtain topographic gastric specimens for gastric histology according to the modified Updated Sydney System, corpus-predominant gastritis index (CGI), Operative Link on Gastritis Assessment, and Operative Link on Gastric Intestinal Metaplasia Assessment. Non-diabetic dyspeptic patients who had H. pylori infection confirmed by esophagogastroduodenoscopy were enrolled as controls. Results The male as well as total T2DM patients had higher acute/chronic inflammatory and lymphoid follicle scores in the corpus than non-diabetic controls (p
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- 2017
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17. Investigating Whether Screening or Testing for the Variation Status of UGT 1A1 Gene is Helpful in Managing Neonatal Hyperbilirubinemia
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Yao-Jong Yang
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Pediatrics ,RJ1-570 - Published
- 2020
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18. Gut microbiota and pediatric obesity/non-alcoholic fatty liver disease
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Yao-Jong Yang and Yen-Hsuan Ni
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Medicine (General) ,R5-920 - Abstract
Huge amount microorganisms resides in human intestine, and many contribute to the maturation and homeostasis of immune system. The diversity of gut ecology are affected by the gestational age, delivery type, feeding sources, and antibiotics use in neonates. Recent studies pointed out that disturbance of gut microbiota, so called dysbiosis, could result in several pediatric diseases including obesity, non-alcoholic fatty liver disease (NAFLD), metabolic syndromes, allergic diseases, and inflammatory bowel diseases. However, there are no single species can be proven to play a key factor in pediatric obesity and NAFLD at present. Various probiotics may confer benefit to these gut microbiota-related pediatric diseases. The clinical application is still limited. This review article aimed to elucidate evidently the relationship between gut microbiota and pediatric obesity/NAFLD and to discuss the potential probiotics use in pediatric obesity and NAFLD. Keywords: Microbiota, Obesity, Non-alcoholic fatty liver disease, Immunity, Probiotics
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- 2019
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19. Probiotics-Containing Yogurt Ingestion and H. pylori Eradication Can Restore Fecal Faecalibacterium prausnitzii Dysbiosis in H. pylori-Infected Children
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Yao-Jong Yang, Peng-Chieh Chen, Fu-Ping Lai, Pei-Jane Tsai, and Bor-Shyang Sheu
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H. pylori ,F. prausnitzii ,gut microbiota ,probiotics ,next generation sequencing ,Biology (General) ,QH301-705.5 - Abstract
This study investigated the compositional differences in fecal microbiota between children with and without H. pylori infection and tested whether probiotics-containing yogurt and bacterial eradication improve H. pylori-related dysbiosis. Ten H. pylori-infected children and 10 controls ingested probiotics-containing yogurt for 4 weeks. Ten-day triple therapy plus yogurt was given to the infected children on the 4th week. Fecal samples were collected at enrollment, after yogurt ingestion, and 4 weeks after successful H. pylori eradication for cytokines and microbiota analysis using ELISA and metagenomic sequencing of the V4 region of the 16S rRNA gene, respectively. The results showed H. pylori-infected children had significantly higher levels of fecal TGF-β1 than those who were not infected. Eight of 295 significantly altered OTUs in the H. pylori-infected children were identified. Among them, the abundance of F. prausnitzii was significantly lower in the H. pylori-infected children, and then increased after yogurt ingestion and successful bacterial eradication. We further confirmed probiotics promoted F. prausnitzii growth in vitro and in ex vivo using real-time PCR. Moreover, F. prausnitzii supernatant significantly ameliorated lipopolysaccharide-induced IL-8 in HT-29 cells. In conclusions, Probiotics-containing yogurt ingestion and H. pylori eradication can restore the decrease of fecal F. prausnitzii in H. pylori-infected children.
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- 2020
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20. Characteristics and Diagnostic Yield of Pediatric Colonoscopy in Taiwan
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Chien-Ting Wu, Chih-An Chen, and Yao-Jong Yang
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child ,colonoscopy ,colorectal polyp ,lower gastrointestinal bleeding ,Pediatrics ,RJ1-570 - Abstract
Colonoscopy of the lower gastrointestinal tract has diagnostic and therapeutic value. This retrospective study aimed to investigate the indications, complications, and diagnostic yield of diagnostic colonoscopy among Taiwanese children. Methods: The application of colonoscopy performed on children aged < 18 years between 1998 and 2010 in a referral tertiary center in Southern Taiwan was reviewed. Data on age, gender, indications, complications, and colonoscopic and final diagnoses were collected and analyzed. Results: One hundred and ninety-two children with 201 colonoscopies and 27 sigmoidoscopies were enrolled. The rate of successful ileocecal approach was 77.5%. The most common indication was lower gastrointestinal bleeding (LGIB; 53.5%), followed by chronic abdominal pain (20.6%), iron deficiency anemia (IDA; 11.8%), and chronic diarrhea (11.4%). There were 144 patients (75%) with a conclusive diagnosis in their first colonoscopy, including nonspecific colitis (23.4%), polyp (20.4%), and inflammatory bowel disease (8.3%). The diagnostic yields of colonoscopy according to the major indications were 77.3% in LGIB, 68.1% in chronic abdominal pain, 66.7% in IDA, and 79.2% in chronic diarrhea. Among the patients with LGIB, juvenile polyp (26.4%) was the most common etiology. There were no major procedure-related complications. Conclusion: LGIB is the most common indication for pediatric colonoscopy. Pediatric colonoscopy is most effective in diagnosing pediatric LGIB and chronic diarrhea.
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- 2015
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21. Multidrug-resistant Salmonella enterica serovar Panama carrying class 1 integrons is invasive in Taiwanese children
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Shu-Ching Huang, Cheng-Hsun Chiu, Chien-Shun Chiou, and Yao-Jong Yang
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multidrug resistance ,class 1 integrons ,invasiveness ,Salmonella ,Medicine (General) ,R5-920 - Abstract
An increase in group D Salmonella isolates with high antimicrobial resistant rates is being seen in Taiwan. This study aimed to determine the multidrug-resistant (MDR, more than three antibiotics) phenotype, genotype, and the correlation between the presence of class 1 integrons and its invasiveness of Salmonella panama and Salmonella enteritidis isolated from children. Methods: Twenty S. panama and 59 S. enteritidis isolates were examined for minimal inhibitory concentrations of ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline by agar dilution method. The presence of blaPSE-1, floR, aadA2, sul1, and tet(G) resistance genes, class 1 integrons, and Salmonella genomic island 1 (SGI1) was identified by polymerase chain reaction. The adhesion and invasion assays of S. panama to Caco-2 cells were determined using the pour plate method. Results: All S. panama and 15 (25.4%) of the S. enteritidis isolates displayed MDR phenotype. Furthermore, MDR genotype was present in 70.0% of S. panama and 6.8% of S. enteritidis. Class 1 integrons were present in 40.0% of S. panama and 11.9% of S. enteritidis. None contained SGI1 or SGI1 variants. Strains carrying class 1 integrons were more frequently isolated from bacteria with MDR (73.3% vs. 37.5%; odds ratio, 4.6; 95% confidence interval, 1.3-16.0; p=0.01) and isolated from blood and cerebrospinal fluid (46.7% vs. 21.9%; odds ratio, 3.1; 95% confidence interval, 1.0-10.1; p=0.05) than noncarriers. S. panama carrying class 1 integrons were more invasive to Caco-2 cells than those without (p=0.01). Conclusion: S. panama and S. enteritidis with class 1 integrons are significantly related to the presence of MDR phenotype. Moreover, S. panama with class 1 integrons may present more invasiveness than those without.
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- 2013
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22. Allergic Colitis in Infants Related to Cow’s Milk: Clinical Characteristics, Pathologic Changes, and Immunologic Findings
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Man-Chun Yu, Chia-Lun Tsai, Yao-Jong Yang, Sing-San Yang, Li-Hui Wang, Chung-Ta Lee, Ren-Long Jan, and Jiu-Yao Wang
- Subjects
allergic colitis ,IgE ,IgG subclass ,milk protein allergy ,skin prick test ,Pediatrics ,RJ1-570 - Abstract
Allergic colitis (AC) is an inflammatory condition characterized by eosinophils infiltrating the colonic wall. It can be a benign and/or severe illness among gastrointestinal diseases in infants. Methods: We report five infants who, since January 2009, in whom AC under fibrotic endoscopic examinations has been diagnosed. The criterion for histopathologic diagnosis of AC in this study was five or more eosinophils per high-power field. Patients’ clinical symptoms, pathologic findings, and immunologic studies, such as specific antibodies against component of cow’s milk protein, were compared with those of allergic children without AC and those of nonatopic control children. Results: Histopathologic examinations of biopsy specimens revealed acute inflammation with characteristic eosinophilic infiltration of lamina propria (5–15 eosinophils per high-power field) in all five patients. They all had strongly positive skin prick tests against milk protein, which were not correlated with in vitro allergen-specific immunoglobulin (Ig) E levels. In contrast, there were significantly higher levels of IgE antibodies, and lower specific IgG4 and IgA levels to components and whole milk proteins in AC, as compared to control children without AC. Conclusion: Endoscopic biopsy specimens of intestine confirm the diagnosis of AC. However, allergen skin prick test and IgE antibody to milk protein components also provide helpful diagnostic tools for this rare disease in children.
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- 2013
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23. Differential Expression of the Activator Protein 1 Transcription Factor Regulates Interleukin-1ß Induction of Interleukin 6 in the Developing Enterocyte.
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Catherine M Cahill, Weishu Zhu, Elias Oziolor, Yao-Jong Yang, Bosco Tam, Susruthi Rajanala, Jack T Rogers, and W Allan Walker
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Medicine ,Science - Abstract
The innate immune response is characterized by activation of transcription factors, nuclear factor kappa B and activator protein-1 and their downstream targets, the pro-inflammatory cytokines including interleukin 1β and interleukin 6. Normal development of this response in the intestine is critical to survival of the human neonate and delays can cause the onset of devastating inflammatory diseases such as necrotizing enterocolitis. Previous studies have addressed the role of nuclear factor kappa B in the development of the innate immune response in the enterocyte, however despite its central role in the control of multiple pro-inflammatory cytokine genes, little is known on the role of Activator Protein 1 in this response in the enterocyte. Here we show that the canonical Activator Protein 1 members, cJun and cFos and their upstream kinases JNK and p38 play an essential role in the regulation of interleukin 6 in the immature enterocyte. Our data supports a model whereby the cFos/cJun heterodimer and the more potent cJun homodimer downstream of JNK are replaced by less efficient JunD containing dimers, contributing to the decreased responsiveness to interleukin 1β and decreased interleukin 6 secretion observed in the mature enterocyte. The tissue specific expression of JunB in colonocytes and colon derived tissues together with its ability to repress Interleukin-1β induction of an Interleukin-6 gene reporter in the NCM-460 colonocyte suggests that induction of JunB containing dimers may offer an attractive therapeutic strategy for the control of IL-6 secretion during inflammatory episodes in this area of the intestine.
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- 2016
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24. Etiology and Treatment of Childhood Peptic Ulcer Disease in Taiwan: A Single Center 9-Year Experience
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Shu-Ching Huang, Bor-Shyang Sheu, Shui-Cheng Lee, Hsiao-Bai Yang, and Yao-Jong Yang
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child ,Helicobacter pylori ,non-steroidal anti-inflammatory drugs ,peptic ulcer ,Medicine (General) ,R5-920 - Abstract
Peptic ulcer disease (PUD) in children is relatively rare as compared with adults. This study aimed to assess the etiology, clinical and histological characteristics, and treatment of PUD in children. Methods: All children aged < 18 years with an endoscopic diagnosis of PUD were enrolled in a tertiary referral center. The demographic data, clinical, endoscopic, and histological findings were compared between patients with different causes of PUD. Results: From 1234 endoscopic examinations, 67 (5.4%) children (median age, 11.4 years) with gastric ulcer (GU; n = 27) or duodenal ulcer (DU; n = 40) were included. Thirty-two (47.7%) of them had Helicobacter pylori infection and 11 (16.5%) had previous use of non-steroidal anti-inflammatory drugs (NSAIDs). Non-H. pylori, non-NSAID PUD was found in 24 (35.8%) patients. Children with H. pylori-related PUD had a significantly higher mean age, antral chronic inflammatory score, rate of familial PUD, and presence of DU and nodular gastritis than those with NSAID-related and non-H. pylori, non-NSAID PUD (p < 0.01). In contrast, children with NSAID-related PUD had a higher rate of upper gastrointestinal bleeding, associated with acute febrile disease, than those with H. pylori-related and non-H. pylori, non-NSAID PUD (p < 0.05). All but two patients with non-H. pylori, non-NSAID PUD were disease free after H. pylori eradication and proton pump inhibitor treatment for 1–2 months. Conclusion: In children, H. pylori-related PUD is associated with familial peptic ulcer and the presence of DU. However, short-term NSAID use is correlated highly with GU. The outcome of childhood PUD is good.
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- 2010
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25. Rectal Prolapse in a Child: An Unusual Presentation of Clostridium difficile–Associated Pseudomembranous Colitis
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Shu-Ching Huang, Yao-Jong Yang, and Chung-Ta Lee
- Subjects
child ,Clostridium difficile ,pseudomembranous colitis ,rectal prolapse ,Pediatrics ,RJ1-570 - Abstract
Pseudomembranous colitis after short-course antibiotics is rare in children. We report a 14-month-old girl who presented with rectal prolapse complicated with Clostridium difficile–associated pseudomembranous colitis after a 4-day course of oral cefuroxime for treatment of acute otitis media. Abdominal sonogram showed a pelvic mass, and computed tomography revealed thickened wall of the rectum. Sigmoidoscopy demonstrated discrete yellowish plaques adherent to an edematous mucosa. Stool cultures for C difficile were positive and C difficile toxins A and B were detected in her stool. Histological examination of colonic biopsy showed superficial erosion of the mucosa and the adherent pseudomembranes. She achieved a full recovery after discontinuing cefuroxime. Our case implied that C difficile infection should be considered in children presenting with rectal prolapse, especially when they are taking or have recently received antibiotic therapy. Supportive therapy and discontinuation of antibiotics are generally sufficient for patients with C difficile–associated pseudomembranous colitis who present with mild diarrheal illness.
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- 2011
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26. Infantile hepatitis B in immunized children: risk for fulminant hepatitis and long-term outcomes.
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Yu-Ru Tseng, Jia-Feng Wu, Man-Shan Kong, Fu-Chang Hu, Yao-Jong Yang, Chun-Yan Yeung, Fu-Chen Huang, I-Fei Huang, Yen-Hsuan Ni, Hong-Yuan Hsu, Mei-Hwei Chang, and Huey-Ling Chen
- Subjects
Medicine ,Science - Abstract
BACKGROUND: Infantile hepatitis B after neonatal immunoprophylaxis is a rare yet distinct disease. This study aimed to analyze the long-term outcomes and risk factors in immunized infants with hepatitis B. METHODS: The clinical parameters and outcomes of 41 infants born after universal immunization, and admitted for HBV-positive hepatitis were studied. All patients were followed for at least 6 months (median = 4.4 years, range 0.6-18.1 years). Patient survival, changes of HBsAg and HBeAg status, and complications were analyzed. RESULTS: Among the 41 cases (32 males, 9 females), 21 presented with fulminant hepatitis (FH), and 20 with non-fulminant hepatitis (NFH). Ninety-five percent (36/38) of the mothers were positive for hepatitis B surface antigen (HBsAg). Multivariate analyses revealed younger age of onset (age
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- 2014
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27. Metabolic Interaction of Helicobacter pylori Infection and Gut Microbiota
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Yao-Jong Yang and Bor-Shyang Sheu
- Subjects
H. pylori ,microbiota ,metabolic interaction ,insulin resistant ,diabetes ,Biology (General) ,QH301-705.5 - Abstract
As a barrier, gut commensal microbiota can protect against potential pathogenic microbes in the gastrointestinal tract. Crosstalk between gut microbes and immune cells promotes human intestinal homeostasis. Dysbiosis of gut microbiota has been implicated in the development of many human metabolic disorders like obesity, hepatic steatohepatitis, and insulin resistance in type 2 diabetes (T2D). Certain microbes, such as butyrate-producing bacteria, are lower in T2D patients. The transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome, but the exact pathogenesis remains unclear. H. pylori in the human stomach cause chronic gastritis, peptic ulcers, and gastric cancers. H. pylori infection also induces insulin resistance and has been defined as a predisposing factor to T2D development. Gastric and fecal microbiota may have been changed in H. pylori-infected persons and mice to promote gastric inflammation and specific diseases. However, the interaction of H. pylori and gut microbiota in regulating host metabolism also remains unknown. Further studies aim to identify the H. pylori-microbiota-host metabolism axis and to test if H. pylori eradication or modification of gut microbiota can improve the control of human metabolic disorders.
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- 2016
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28. The Optimal Timing of Enterostomy Closure in Preterm Infants
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Yao-Jong Yang
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Pediatrics ,RJ1-570 - Published
- 2014
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29. Current Pediatric Endoscopy Training Situation in the Asia-Pacific Region: A Collaborative Survey by the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition Endoscopy Scientific Subcommittee.
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Nuthapong Ukarapol, Narumon Tanatip, Ajay Sharma, Maribel Vitug-Sales, Lopez, Robert Nicholas, Malik, Rohan, Ruey Terng Ng, Shuichiro Umetsu, Songpon Getsuwan, Tak Yau Stephen Lui, Yao-Jong Yang, Yeoun Joo Lee, Katsuhiro Arai, and Kyung Mo Kim
- Subjects
PEDIATRIC gastroenterology ,PERCUTANEOUS endoscopic gastrostomy ,ENDOSCOPY ,HEPATOLOGY ,NUTRITION - Abstract
Purpose: To date, there is no region-specific guideline for pediatric endoscopy training. This study aimed to illustrate the current status of pediatric endoscopy training in Asia-Pacific region and identify opportunities for improvement. Methods: A cross-sectional survey, using a standardized electronic questionnaire, was conducted among medical schools in the Asia-Pacific region in January 2024. Results: A total of 57 medical centers in 12 countries offering formal Pediatric Gastroenterology training programs participated in this regional survey. More than 75% of the centers had an average case load of <10 cases per week for both diagnostic and therapeutic endoscopies. Only 36% of the study programs employed competency-based outcomes for program development, whereas nearly half (48%) used volume-based curricula. Foreign body retrieval, polypectomy, percutaneous endoscopic gastrostomy, and esophageal variceal hemostasis, that is, sclerotherapy or band ligation (endoscopic variceal sclerotherapy and endoscopic variceal ligation), comprised the top four priorities that the trainees should acquire in the autonomous stage (unconscious) of competence. Regarding the learning environment, only 31.5% provided formal hands-on workshops/simulation training. The direct observation of procedural skills was the most commonly used assessment method. The application of a quality assurance (QA) system in both educational and patient care (Pediatric Endoscopy Quality Improvement Network) aspects was present in only 28% and 17% of the centers, respectively. Conclusion: Compared with Western academic societies, the limited availability of cases remains a major concern. To close this gap, simulation and adult endoscopy training are essential. The implementation of reliable and valid assessment tools and QA systems can lead to significant development in future programs. [ABSTRACT FROM AUTHOR]
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- 2024
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30. MOCHI: a comprehensive cross-platform tool for amplicon-based microbiota analysis
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Jun-Jie Zheng, Po-Wen Wang, Tzu-Wen Huang, Yao-Jong Yang, Hua-Sheng Chiu, Pavel Sumazin, and Ting-Wen Chen
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Statistics and Probability ,Computational Mathematics ,Computational Theory and Mathematics ,RNA, Ribosomal, 16S ,Microbiota ,High-Throughput Nucleotide Sequencing ,Sequence Analysis, DNA ,Molecular Biology ,Biochemistry ,Phylogeny ,Computer Science Applications - Abstract
Motivation Microbiota analyses have important implications for health and science. These analyses make use of 16S/18S rRNA gene sequencing to identify taxa and predict species diversity. However, most available tools for analyzing microbiota data require adept programming skills and in-depth statistical knowledge for proper implementation. While long-read amplicon sequencing can lead to more accurate taxa predictions and is quickly becoming more common, practitioners have no easily accessible tools with which to perform their analyses. Results We present MOCHI, a GUI tool for microbiota amplicon sequencing analysis. MOCHI preprocesses sequences, assigns taxonomy, identifies different abundant species and predicts species diversity and function. It takes either taxonomic count table or FASTQ of partial 16S/18S rRNA or full-length 16S rRNA gene as input. It performs analyses in real time and visualizes data in both tabular and graphical formats. Availability and implementation MOCHI can be installed to run locally or accessed as a web tool at https://mochi.life.nctu.edu.tw. Supplementary information Supplementary data are available at Bioinformatics online.
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- 2022
31. Changes in epidemiology and antimicrobial susceptibility of nontyphoid Salmonella in children in southern Taiwan, 1997–2016
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Fu Ping Lai, Yao Jong Yang, and Hsiao Yu Lo
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0301 basic medicine ,Microbiology (medical) ,Salmonella ,Cefotaxime ,Adolescent ,medicine.drug_class ,Resistance ,030106 microbiology ,Cephalosporin ,Antibiotics ,Taiwan ,lcsh:QR1-502 ,Nontyphoid Salmonella ,Microbial Sensitivity Tests ,Serogroup ,medicine.disease_cause ,lcsh:Microbiology ,Microbiology ,Tertiary Care Centers ,Feces ,03 medical and health sciences ,0302 clinical medicine ,Antibiotic resistance ,Drug Resistance, Multiple, Bacterial ,Ampicillin ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Child ,Children ,General Immunology and Microbiology ,business.industry ,Incidence (epidemiology) ,Infant ,General Medicine ,bacterial infections and mycoses ,Anti-Bacterial Agents ,Gastroenteritis ,Infectious Diseases ,Child, Preschool ,Salmonella Infections ,business ,Cefixime ,medicine.drug - Abstract
Background This study aimed to investigate the changing trends in serogroup distribution and antimicrobial susceptibility of nontyphoid Salmonella (NTS) isolated from children in the past two decades in Taiwan. Methods This retrospective study enrolled patients aged younger than 18 years with culture-proven NTS infection in a tertiary medical center from 1997 to 2016. Data on age, Salmonella serogroup, culture sample, and antimicrobial susceptibility were obtained from medical records. The rates of Salmonella serogroups and antimicrobial resistance were compared between period 1 (1997–2006) and period 2 (2007–2016). Results A total of 2075 NTS isolates were identified from 1997 to 2016 (1036 in period 1, 1039 in period 2). The major isolates were from feces (89.1%) and blood (10.4%). The most common serogroup was serogroup B (54.8%), followed by serogroup D (18.8%). There was a significant decline in the proportion of serogroup B with a concomitant rise in serogroup D in the past two decades. In period 2, resistance to cefotaxime and cefixime increased remarkably among serogroup B, whereas resistance to ampicillin increased notably among serogroup D. Furthermore, the incidence of multidrug-resistant (≥3 antibiotics) NTS significantly decreased in both serogroup B and serogroup D in period 2. Conclusion This study revealed a significant rise in serogroup D with a concomitant decline in serogroup B NTS infection in Taiwanese children. Moreover, antimicrobial resistance to third-generation cephalosporins increased in serogroup B. Continuous surveillance of NTS serogroup distribution and antimicrobial susceptibility is mandatory to formulate therapeutic strategies for NTS infections.
- Published
- 2020
32. Differential
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Yao-Jong, Yang, Chia-Ling, Lu, and Bor-Shyang, Sheu
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Adult ,Lewis Blood Group Antigens ,Helicobacter pylori ,Stomach ,Humans ,Epithelial Cells ,Child ,Helicobacter Infections - Published
- 2022
33. Enzyme Replacement Therapy for Children with Acid Sphingomyelinase Deficiency in the Real World: A Single Center Experience in Taiwan
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Yu-Wen Pan, Meng-Che Tsai, Chiao-Yu Yang, Wen-Hao Yu, Bow Wang, Yao-Jong Yang, and Yen-Yin Chou
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History ,Endocrinology ,Polymers and Plastics ,Genetics ,Business and International Management ,Molecular Biology ,Industrial and Manufacturing Engineering - Published
- 2022
34. The relationship between nonalcoholic fatty liver disease and pediatric congenital hypothyroidism patients
- Author
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Yao Jong Yang, Shou Yen Chen, Ming Yin Chen, Yu Wen Pan, Yen Yin Chou, and Meng Che Tsai
- Subjects
Adult ,Blood Glucose ,Male ,nonalcoholic fatty liver disease ,medicine.medical_specialty ,obesity ,Adolescent ,medicine.medical_treatment ,Levothyroxine ,Thyrotropin ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Risk Factors ,Internal medicine ,Nonalcoholic fatty liver disease ,Prevalence ,Humans ,Insulin ,Medicine ,Euthyroid ,Child ,Metabolic Syndrome ,lcsh:R5-920 ,medicine.diagnostic_test ,business.industry ,Thyroid ,congenital hypothyroidism ,General Medicine ,medicine.disease ,Obesity ,Congenital hypothyroidism ,Thyroxine ,Cross-Sectional Studies ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Abdominal ultrasonography ,Female ,030211 gastroenterology & hepatology ,business ,lcsh:Medicine (General) ,medicine.drug - Abstract
Previous studies have shown hypothyroidism was independently associated with nonalcoholic fatty liver disease (NAFLD) in adults, but few studies examined their relationships in pediatric populations. This study aimed to investigate the prevalence of NAFLD in pediatric congenital hypothyroidism (CHT) patients and to identify the association between CHT and NAFLD. This study enrolled pediatric CHT patients receiving levothyroxine treatment at one medical center from 2013 to 2014. Euthyroid subjects (ET) and transient hypothyroidism (THT) patients weaned off medication successfully after age 3 were selected for further comparison. Laboratory data including thyroid functions, liver functions, and metabolic profiles were obtained. The major outcome was the occurrence of NAFLD, diagnosed based on the findings of abdominal ultrasonography. One‐hundred and twenty‐nine subjects (47 in CHT, 47 in THT, and 35 in ET groups) were enrolled. The analysis showed higher fasting serum glucose, insulin, thyroxine (T4), and mean thyroid‐stimulating hormone (TSH) levels in the CHT group. NAFLD prevalence was higher in the CHT (23.4%) group than in the THT (8.5%) and the ET (5.7%) groups, demonstrating an increasing trend across three strata (X2linear‐by‐linear = 5.9, P
- Published
- 2019
35. Variants in Maternal Effect Genes and Relaxed Imprinting Control in a Special Placental Mesenchymal Dysplasia Case with Mild Trophoblast Hyperplasia
- Author
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Chun Ting Chiang, Yao Jong Yang, Tien-Chi Huang, Kung Chao Chang, Jen Yun Chang, Pao Lin Kuo, Yi Shan Tsai, Pei Hsiu Yu, Shau-Ping Lin, Wei Chun Chang, and Chu Fan Mo
- Subjects
0301 basic medicine ,placental mesenchymal dysplasia ,QH301-705.5 ,Medicine (miscellaneous) ,Aneuploidy ,Biology ,Article ,General Biochemistry, Genetics and Molecular Biology ,Placental Mesenchymal Dysplasia ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Placenta ,medicine ,GNAS complex locus ,Imprinting (psychology) ,Biology (General) ,ATRX ,030219 obstetrics & reproductive medicine ,maternal effect genes ,Trophoblast ,medicine.disease ,trophoblast ,genomic imprinting ,hydatidiform mole ,030104 developmental biology ,medicine.anatomical_structure ,embryonic structures ,biology.protein ,Genomic imprinting - Abstract
Placental mesenchymal dysplasia (PMD) and partial hydatidiform mole (PHM) placentas share similar characteristics, such as placental overgrowth and grape-like placental tissues. Distinguishing PMD from PHM is critical because the former can result in normal birth, while the latter diagnosis will lead to artificial abortion. Aneuploidy and altered dosage of imprinted gene expression are implicated in the pathogenesis of PHM and also some of the PMD cases. Diandric triploidy is the main cause of PHM, whereas mosaic diploid androgenetic cells in the placental tissue have been associated with the formation of PMD. Here, we report a very special PMD case also presenting with trophoblast hyperplasia phenotype, which is a hallmark of PHM. This PMD placenta has a normal biparental diploid karyotype and is functionally sufficient to support normal fetal growth. We took advantage of this unique case to further dissected the potential common etiology between these two diseases. We show that the differentially methylated region (DMR) at NESP55, a secondary DMR residing in the GNAS locus, is significantly hypermethylated in the PMD placenta. Furthermore, we found heterozygous mutations in NLRP2 and homozygous variants in NLRP7 in the mother’s genome. NLRP2 and NLRP7 are known maternal effect genes, and their mutation in pregnant females affects fetal development. The variants/mutations in both genes have been associated with imprinting defects in mole formation and potentially contributed to the mild abnormal imprinting observed in this case. Finally, we identified heterozygous mutations in the X-linked ATRX gene, a known maternal–zygotic imprinting regulator in the patient. Overall, our study demonstrates that PMD and PHM may share overlapping etiologies with the defective/relaxed dosage control of imprinted genes, representing two extreme ends of a spectrum.
- Published
- 2021
36. Helicobacter pylorieradication improves glycemic control in type 2 diabetes patients with asymptomatic activeHelicobacter pyloriinfection
- Author
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Kai Pi Cheng, Mei Hui Hung, Chung Tai Wu, Bor Shyang Sheu, Horng Yih Ou, Yao Jong Yang, Ching Han Lin, and Hao Chang Hung
- Subjects
Blood Glucose ,Male ,Endocrinology, Diabetes and Metabolism ,Type 2 diabetes ,Gastroenterology ,Serology ,Glycemic control ,0302 clinical medicine ,030212 general & internal medicine ,Aged, 80 and over ,medicine.diagnostic_test ,biology ,Diabetes ,Articles ,General Medicine ,Middle Aged ,Prognosis ,Helicobacter eradication ,Anti-Bacterial Agents ,Clinical Science and Care ,Drug Therapy, Combination ,Female ,Original Article ,030211 gastroenterology & hepatology ,medicine.symptom ,Adult ,medicine.medical_specialty ,Asymptomatic ,Diseases of the endocrine glands. Clinical endocrinology ,Helicobacter Infections ,Young Adult ,03 medical and health sciences ,Insulin resistance ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Aged ,Glycemic ,Glycated Hemoglobin ,Breath test ,Helicobacter pylori ,business.industry ,RC648-665 ,medicine.disease ,biology.organism_classification ,Hypoglycemia ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Glycemic Index ,Hyperglycemia ,business ,Biomarkers ,Follow-Up Studies - Abstract
Aims/Introduction Helicobacter pylori infection is associated with insulin resistance and glycemia in non‐diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. Materials and Methods A total of 549 diabetes patients were recruited for sequential two‐step approach (immunoglobulin G [IgG] serology followed by 13C‐urea breath test [UBT]) to discriminate “active” (IgG+ and UBT+) from “non‐active” (UBT− or IgG−) H. pylori infection, and “past” (IgG+ but UBT−) from “never/remote” (IgG−) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between participants with and without 10‐day eradication therapy were compared after 3 months. Results Despite no between‐group difference in A1C, the “active” infection group (n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3% vs 50.4%, P
- Published
- 2019
37. Probiotics-Containing Yogurt Ingestion and H. pylori Eradication Can Restore Fecal Faecalibacterium prausnitzii Dysbiosis in H. pylori-Infected Children
- Author
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Fu Ping Lai, Pei Jane Tsai, Peng Chieh Chen, Yao Jong Yang, and Bor Shyang Sheu
- Subjects
0301 basic medicine ,Medicine (miscellaneous) ,Faecalibacterium prausnitzii ,Gut flora ,H. pylori ,Article ,General Biochemistry, Genetics and Molecular Biology ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,Ingestion ,Medicine ,F. prausnitzii ,lcsh:QH301-705.5 ,Feces ,next generation sequencing ,biology ,gut microbiota ,business.industry ,food and beverages ,Fecal microbiota ,biology.organism_classification ,medicine.disease ,030104 developmental biology ,probiotics ,lcsh:Biology (General) ,030211 gastroenterology & hepatology ,business ,Dysbiosis ,Ex vivo - Abstract
This study investigated the compositional differences in fecal microbiota between children with and without H. pylori infection and tested whether probiotics-containing yogurt and bacterial eradication improve H. pylori-related dysbiosis. Ten H. pylori-infected children and 10 controls ingested probiotics-containing yogurt for 4 weeks. Ten-day triple therapy plus yogurt was given to the infected children on the 4th week. Fecal samples were collected at enrollment, after yogurt ingestion, and 4 weeks after successful H. pylori eradication for cytokines and microbiota analysis using ELISA and metagenomic sequencing of the V4 region of the 16S rRNA gene, respectively. The results showed H. pylori-infected children had significantly higher levels of fecal TGF-&beta, 1 than those who were not infected. Eight of 295 significantly altered OTUs in the H. pylori-infected children were identified. Among them, the abundance of F. prausnitzii was significantly lower in the H. pylori-infected children, and then increased after yogurt ingestion and successful bacterial eradication. We further confirmed probiotics promoted F. prausnitzii growth in vitro and in ex vivo using real-time PCR. Moreover, F. prausnitzii supernatant significantly ameliorated lipopolysaccharide-induced IL-8 in HT-29 cells. In conclusions, Probiotics-containing yogurt ingestion and H. pylori eradication can restore the decrease of fecal F. prausnitzii in H. pylori-infected children.
- Published
- 2020
38. The prevalence and characteristics of cow's milk protein allergy in infants and young children with iron deficiency anemia
- Author
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Yao Jong Yang and Fu Ping Lai
- Subjects
Male ,medicine.medical_specialty ,Prevalence ,Milk allergy ,Gastroenterology ,Pallor ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,hemic and lymphatic diseases ,030225 pediatrics ,Internal medicine ,medicine ,Animals ,Humans ,Eosinophilia ,Hypoalbuminemia ,cow's milk protein allergy ,endoscopy ,Retrospective Studies ,Skin Tests ,iron deficiency anemia ,Anemia, Iron-Deficiency ,biology ,business.industry ,lcsh:RJ1-570 ,Infant ,hypoalbuminemia ,lcsh:Pediatrics ,Milk Proteins ,Prognosis ,medicine.disease ,Surgery ,Ferritin ,Iron-deficiency anemia ,Child, Preschool ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,Failure to thrive ,biology.protein ,Cattle ,Female ,Milk Hypersensitivity ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Background: The clinical presentation of cow's milk protein allergy (CMPA) in children varies. This retrospective study aimed to investigate the prevalence and clinical manifestations of CMPA in young children who visited for evaluation of iron deficiency anemia (IDA). Methods: Patients aged
- Published
- 2018
39. Ten days of levofloxacin-containing concomitant therapy can achieve effective Helicobacter pylori eradication in patients with type 2 diabetes
- Author
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Cheng Chan Lu, Wei Lun Chang, Wei Ying Chen, Bor Shyang Sheu, Yao Jong Yang, Hsiu Chi Cheng, Chin Han Lin, Horng Yih Ou, Chung Tai Wu, and Hsiao Bai Yang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Levofloxacin ,Microbial Sensitivity Tests ,Gastroenterology ,Helicobacter Infections ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Clarithromycin ,Metronidazole ,Internal medicine ,Drug Resistance, Bacterial ,Concomitant Therapy ,medicine ,Humans ,Prospective Studies ,Adverse effect ,Aged ,Breath test ,Helicobacter pylori ,biology ,medicine.diagnostic_test ,business.industry ,Amoxicillin ,General Medicine ,Middle Aged ,Tetracycline ,bacterial infections and mycoses ,biology.organism_classification ,Anti-Bacterial Agents ,Surgery ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,030220 oncology & carcinogenesis ,Drug Therapy, Combination ,Female ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
This study investigated whether levofloxacin-containing concomitant therapy can effectively eradicate Helicobacter pylori infection in patients with type 2 diabetes mellitus (T2DM).A total of 797 T2DM patients were screened for anti-H. pylori IgG antibodies, and the presence of H. pylori infection was confirmed byThe H. pylori eradication rates with concomitant therapy were higher than sequential therapy in both intention-to-treat (96.4% versus 81.4%, p = 0.012) and per-protocol (100% versus 85.4%, p = 0.006) analysis. The adverse effects in both groups were similarly mild. In the patients who received sequential therapy, clarithromycin resistance was significantly associated with eradication failure (p = 0.02). There were no significant differences in the antibiotic-resistant rates to amoxicillin, clarithromycin, metronidazole, tetracycline, and levofloxacin between the patients with and without T2DM.Ten days of levofloxacin-containing concomitant therapy is an effective and well-tolerated treatment to eradicate H. pylori infection for T2DM patients. Key messages Ten days of levofloxacin-containing concomitant therapy is well tolerated and superior to clarithromycin-containing sequential therapy for first-line H. pylori eradication in patients with type 2 diabetes. Clarithromycin resistance to H. pylori is the main factor associated with eradication failure in clarithromycin-containing sequential therapy in diabetic patients.
- Published
- 2017
40. Maternal H. pylori seropositivity is associated with gestational hypertension but irrelevant to fetal growth and development in early childhood
- Author
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Fu-Ping Lai, Yi-Fang Tu, Bor-Shyang Sheu, and Yao-Jong Yang
- Abstract
Background: Helicobacter pylori infection is known to alter growth-related hormones and cause growth faltering in young children. It is still unknown if maternal H. pylori infection has an impact on the levels of cord blood growth-related hormones and can predict intrauterine growth restriction and poor physical and neurodevelopmental outcomes in children. This study aimed to examine the associations between maternal H. pylori infection and pregnancy-related adverse events, fetal growth and early childhood development. Methods: The prospective cohort study recruited singleton pregnant women without major medical illnesses from January 2014 to January 2015. Seropositivity for H. pylori was defined by >12 U/ml of anti- H. pylori IgG in the maternal serum. Demographic data and pregnancy-related medical issues of the cohort were documented. Cord blood levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, and ghrelin were determined using ELISA test. The growth of eligible neonates was monitored annually for up to 3 years, and cognitive development was assessed using the comprehensive developmental inventory for infants and toddlers (CDIIT) test 3 years after birth. Results: Of the 106 enrolled women, 25 (23.6%) were H. pylori -seropositive. Maternal H. pylori seropositivity was correlated with a higher risk of developing gestational hypertension (GH) (12% vs. 1.2%, p =0.04) and lower cord blood levels of IGF-1 (
- Published
- 2019
41. Quantitative analysis of tissue inflammation and responses to treatment in immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome, and review of literature
- Author
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Wan Chen Chung, Hans D. Ochs, Chih An Chen, Yung Chieh Lin, Yao Jong Yang, Chi Chang Shieh, and Yuan Yow Chiou
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Male ,0301 basic medicine ,Pathology ,Kidney ,medicine.disease_cause ,T-Lymphocytes, Regulatory ,Autoimmunity ,0302 clinical medicine ,Immunology and Allergy ,Enteropathy ,Intestinal Mucosa ,Child ,T helper 2 cells ,GATA3 ,FOXP3 ,Forkhead Transcription Factors ,Genetic Diseases, X-Linked ,General Medicine ,Nuclear Receptor Subfamily 1, Group F, Member 3 ,Immunohistochemistry ,regulatory T cells ,Infectious Diseases ,Immune System Diseases ,030220 oncology & carcinogenesis ,Rituximab ,Immunosuppressive Agents ,Diarrhea ,Microbiology (medical) ,medicine.medical_specialty ,GATA3 Transcription Factor ,Biology ,Tacrolimus ,03 medical and health sciences ,Th2 Cells ,Immune system ,immune dysregulation ,Immunology and Microbiology(all) ,medicine ,Humans ,Immunosuppression Therapy ,Autoimmune disease ,General Immunology and Microbiology ,X-Linked syndrome ,Th1 Cells ,Immune dysregulation ,IPEX syndrome ,medicine.disease ,Gastrointestinal Tract ,Diabetes Mellitus, Type 1 ,030104 developmental biology ,enteropathy ,Immunology ,Th17 Cells ,polyendocrinopathy ,T-Box Domain Proteins - Abstract
Background/Purpose Immune dysregulation, polyendocrinopathy, enteropathy, X-linked ( IPEX) syndrome is a severe autoimmune disease that is caused by regulatory T cell deficiency due to FOXP3 gene mutations. The long-term outcome can be variable depending on the extent of tissue damage caused by autoimmunity and infections, the use of immunosuppressive treatment or sequela of bone marrow transplantation. Methods We used immunohistochemical staining to analyze cell types infiltrating the tissue of affected organs from a classic IPEX patient with a splicing mutation (c.736-2A>C) in the FOXP3 gene. Expression of transcription factors that are critical for immune responses including T-bet, GATA-3, RORγt, and FOXP3 were evaluated in various tissue samples. For objective analysis of the distribution of different cell types in tissues, we used an automated microscope-based image acquiring system to assess quantitatively the different cell types by investigating the histopathological changes in the patient's biopsy samples obtained from the intestine and the kidneys before and after treatment. Results The percentages of cells expressing the T H 2-associated transcription factor GATA3 were higher in the IPEX patient before treatment than in controls, suggesting that T H 2-type cells contribute to the tissue inflammation of the gut and kidneys in IPEX syndrome. Immunosuppressive treatment effectively decreased the number of effector cells in the kidneys and intestine of the IPEX patient. Conclusion This study provides quantitative evidence that the inflamed intestinal and renal tissues of the IPEX patient contain T H 2-type immune effector cells, which decreased in number after immunosuppressive treatment was initiated and the clinical symptoms had improved.
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- 2016
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42. Male non-insulin users with type 2 diabetes mellitus are predisposed to gastric corpus-predominant inflammation after H. pylori infection
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Wei Ying Chen, Wei Lun Chang, Hsiu Chi Cheng, Cheng Chan Lu, Bor Shyang Sheu, Yao Jong Yang, Hsiao Bai Yang, Chin Han Lin, Chung Tai Wu, and Horng Yih Ou
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Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Clinical Biochemistry ,Taiwan ,lcsh:Medicine ,Gastroenterology ,Helicobacter Infections ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Type 2 diabetes mellitus ,medicine ,Humans ,Insulin ,Pharmacology (medical) ,Molecular Biology ,Aged ,Retrospective Studies ,Inflammation ,Helicobacter pylori ,medicine.diagnostic_test ,business.industry ,Esophagogastroduodenoscopy ,Research ,lcsh:R ,Biochemistry (medical) ,Gender ,Type 2 Diabetes Mellitus ,Cancer ,Cell Biology ,General Medicine ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Diabetes Mellitus, Type 2 ,Gastritis ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,H. Pylori ,medicine.symptom ,Gastric cancer ,business - Abstract
Background Both H. pylori infection and diabetes increase the risk of gastric cancer. This study investigated whether patients with type 2 diabetes mellitus (T2DM) and H. pylori infection had more severe corpus gastric inflammation and higher prevalence of precancerous lesions than non-diabetic controls. Methods A total of 797 patients with type 2 diabetes mellitus were screened for H. pylori, of whom 264 had H. pylori infection. Of these patients, 129 received esophagogastroduodenoscopy to obtain topographic gastric specimens for gastric histology according to the modified Updated Sydney System, corpus-predominant gastritis index (CGI), Operative Link on Gastritis Assessment, and Operative Link on Gastric Intestinal Metaplasia Assessment. Non-diabetic dyspeptic patients who had H. pylori infection confirmed by esophagogastroduodenoscopy were enrolled as controls. Results The male as well as total T2DM patients had higher acute/chronic inflammatory and lymphoid follicle scores in the corpus than non-diabetic controls (p
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- 2017
43. Heteroresistance of Helicobacter pylori from the same patient prior to antibiotic treatment
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Wei Lun Chang, Pin Yi Song, Bor Shyang Sheu, Ay Huey Huang, Shew Meei Sheu, Cheng Yen Kao, Jiunn Jong Wu, Yao Jong Yang, and Ai Yun Lee
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Microbiology (medical) ,medicine.drug_class ,Antibiotics ,Microbial Sensitivity Tests ,Drug resistance ,Biology ,Microbiology ,Helicobacter Infections ,Macrolide Antibiotics ,Antibiotic resistance ,Bacterial Proteins ,Levofloxacin ,23S ribosomal RNA ,Clarithromycin ,Drug Resistance, Bacterial ,Genetics ,medicine ,Humans ,Molecular Biology ,Ecology, Evolution, Behavior and Systematics ,Helicobacter pylori ,Genetic Variation ,Sequence Analysis, DNA ,Nitroreductases ,biology.organism_classification ,Virology ,Anti-Bacterial Agents ,Infectious Diseases ,Mutation ,medicine.drug - Abstract
Antibiotic resistance among Helicobacter pylori strains has been increasing worldwide and has affected the efficacy of current treatments. The aim of this study was to evaluate whether treatment failure was due to the presence of antibiotic-susceptible and -resistant H. pylori simultaneously within the same host before eradication. In order to discover H. pylori with antibiotic heteroresistance in the same patient, we examined the antibiotic susceptibility of H. pylori isolated from 412 patients without H. pylori eradication. The E-test was used to determine the minimal inhibitory concentration of these strains. The results showed 19 (4.6%) of patients harbored antibiotic heteroresistant H. pylori , resistant to levofloxacin (5/19), clarithromycin (1/19) and metronidazole (16/19). Among them, three patients’ isolates showed heteroresistance to two antibiotics. The genetic diversity of each isolate was evaluated by random amplified polymorphic DNA PCR and the results showed that only 1 patient’ isolate (5.3%) had a different pattern while the others showed identical or similar fingerprinting patterns. Mutations in the genes responsible for antibiotic resistance were investigated by direct sequencing and compared between strains within each pair. All 5 levofloxacin-resistant isolates had mutations in GyrA at the QRDR region (N87 or D91). Strain 1571R with clarithromycin resistance had a A2042G substitution in its 23S rRNA. There were 15 metronidazole-resistant strains (100%) with isogenic variation of RdxA, and 6 strains (40%) contained FrxA variation (excluded pair 1159). These results suggest that the treatment failure of heteroresistant H. pylori mostly develops from high genomic variation of pre-existing strains through long term evolution rather than mixed infection with different strains.
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- 2014
44. Phthalate exposure alters gut microbiota composition and IgM vaccine response in human newborns
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Yao Jong Yang, Yu-Tsun Su, Yung-Ning Yang, Jau-Ling Suen, I-Hsuan Lin, Hung-Yun Lin, San-Nan Yang, Ying-Yu Chen, Yu-Chen S. H. Yang, and Chien-Yi Wu
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Male ,endocrine system ,Allergy ,Bifidobacterium longum ,medicine.drug_class ,Antibiotics ,Physiology ,Gut flora ,Toxicology ,03 medical and health sciences ,chemistry.chemical_compound ,0404 agricultural biotechnology ,Immune system ,Plasticizers ,Diethylhexyl Phthalate ,Humans ,Medicine ,Hepatitis B Vaccines ,Infusions, Intravenous ,Prospective cohort study ,030304 developmental biology ,0303 health sciences ,biology ,Respiratory distress ,business.industry ,Infant, Newborn ,Phthalate ,04 agricultural and veterinary sciences ,General Medicine ,biology.organism_classification ,medicine.disease ,040401 food science ,Gastrointestinal Microbiome ,Immunoglobulin M ,chemistry ,Fluid Therapy ,Female ,business ,Food Science - Abstract
Postnatal exposure to di-(2-ethylhexyl) phthalate (DEHP), a common plasticizer, is associated with allergy development in childhood, suggesting that DEHP exposure may dysregulate immune response in infants. We investigated whether DEHP exposure in newborns through medical treatment affected the gut microbiota pattern and vaccine response, which are both related to immune development. In this prospective cohort study from May 1, 2016 through July 31, 2017, newborns with respiratory distress who were given intravenous infusions (IVs) were enrolled as the DEHP group, and newborns who did not receive IVs were enrolled as the control group. We excluded patients with perinatal maternal probiotics, vaginal delivery, antibiotic treatment, and exclusive human milk or formula feeding. Of 118 infants, urinary phthalate metabolite analysis revealed that the calculated DEHP concentrations of the newborns treated with IVs (n = 15) were higher than those in the control group (n = 10) (p = 0.0001). DEHP exposure altered bacterial communities both in composition and diversity, particularly decreases in Rothia sp. and Bifidobacterium longum in the DEHP group. Furthermore, DEHP exposure significantly enhanced anti-HBsAg-IgM responses in the DEHP group (p = 0.013). Early-life DEHP exposure alter gut microbiota of newborns and may change their immune responses in later life.
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- 2019
45. Correspondence
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Sunil Rathi, Jagdish Mandliya, Sushil Mathew John, Kirubah Vasandhi David, N. Arlappa, B. P. Ravikumar, S. C. Singhal, Panna Choudhury, Vijay Yewale, K. Rajmohan, P. Ramesh Menon, Shu-Ching Huang, and Yao-Jong Yang
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medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Lactation ,Pediatrics, Perinatology and Child Health ,medicine ,business ,Surgery - Published
- 2011
46. Effects of the infant stool color card screening program on 5-year outcome of biliary atresia in taiwan
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Tien-Hau, Lien, Mei-Hwei, Chang, Jia-Feng, Wu, Huey-Ling, Chen, Hung-Chang, Lee, An-Chyi, Chen, Mao-Meng, Tiao, Tzee-Chung, Wu, Yao-Jong, Yang, Chieh-Chung, Lin, Ming-Wei, Lai, Hong-Yuan, Hsu, Yen-Hsuan, Ni, and Te-Kuei, Hsieh
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Male ,medicine.medical_specialty ,Pediatrics ,Stool color ,Color ,Portoenterostomy, Hepatic ,Logistic regression ,Total serum bilirubin ,Gastroenterology ,Disease-Free Survival ,Cohort Studies ,Feces ,Neonatal Screening ,Biliary Atresia ,Biliary atresia ,Internal medicine ,medicine ,Humans ,Survival rate ,Hepatology ,business.industry ,Infant, Newborn ,Infant ,medicine.disease ,Treatment Outcome ,Cohort ,Female ,business - Abstract
In Taiwan, a screening system using an infant stool color card to promote the early diagnosis of biliary atresia (BA) was established in 2002. This study aimed to investigate the 5-year outcome of BA before and after using the screening program. BA patients were divided into three cohorts according to their birth dates. The patients in cohort A (n = 89) were born before the stool card screening program (1990-2000); those in cohort B (n = 28) were screened by the stool card regional screening program (2002-2003); and those in cohort C (n = 74) were screened by the stool card universal screening program (2004-2005). The relative odds ratios were computed using logistic regression to compare the different factors affecting survival time. The rate of age at Kasai operation
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- 2010
47. Universal screening for biliary atresia using an infant stool color card in Taiwan
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Chieh-Chung Lin, Mao-Meng Tiao, Beng-Huat Lau, Hung-Chang Lee, Ming-Wei Lai, Mei-Hwei Chang, Cheng-Hui Hsiao, Huey-Ling Chen, Yao Jong Yang, An-Chyi Chen, Tzee-Chung Wu, and Chia-Hsiang Chu
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Male ,Pediatrics ,medicine.medical_specialty ,Referral ,Stool color ,Taiwan ,Color ,Child health ,Feces ,Liver disease ,Biliary Atresia ,Biliary atresia ,Internal medicine ,medicine ,Humans ,Mass Screening ,Postoperative outcome ,Registries ,Hepatology ,business.industry ,Age Factors ,Infant, Newborn ,medicine.disease ,Hospitalization ,Clinical trial ,Treatment Outcome ,Female ,business - Abstract
Biliary atresia is the most common cause of death from liver disease in children. Although the Kasai operation before 60 days of age can significantly improve prognosis, delay in referral and surgery remains a formidable problem worldwide because of difficulties in differentiating it from benign prolonged neonatal jaundice. We established a universal screening system using an infant stool color card to promote the early diagnosis and treatment of biliary atresia. After a pilot regional study in 2002–2003, a national stool color screening system was established by integrating the infant stool color card into the child health booklet given to every neonate in Taiwan since 2004. Within 24 hours of the discovery of an abnormal stool color, this event is reported to the registry center. The annual incidence of biliary atresia per 10,000 live births in 2004 and 2005 was 1.85 (40/216,419) and 1.70 (35/205,854), respectively. The sensitivity of detecting biliary atresia using stool cards before 60 days of age was 72.5% in 2004, which improved to 97.1% in 2005. The national rate of the Kasai operation before 60 days of age increased from 60% in 2004 to 74.3% in 2005. The jaundice-free rate (
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- 2007
48. Helicobacter pylori infection can change the intensity of gastric Lewis antigen expressions differently between adults and children
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Jiunn Jong Wu, Bor Shyang Sheu, Cheng Chang Lu, Yao Jong Yang, Chia Ru Chen, and Hsiao Bai Yang
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Colony Count, Microbial ,Lewis X Antigen ,Oligosaccharides ,Gastroenterology ,Helicobacter Infections ,Lewis Blood Group Antigens ,Antigen ,Internal medicine ,medicine ,Gastric mucosa ,Humans ,Pharmacology (medical) ,Dyspepsia ,Child ,Sialyl Lewis X Antigen ,Molecular Biology ,Antrum ,Aged ,Helicobacter pylori ,biology ,Stomach ,Biochemistry (medical) ,Histology ,Cell Biology ,General Medicine ,Middle Aged ,biology.organism_classification ,Immunohistochemistry ,Intensity (physics) ,medicine.anatomical_structure ,Gastric Mucosa ,Child, Preschool ,Immunology ,Female - Abstract
This study tested whether there were different expressions of gastric Lewis antigens between children and adults with Helicobacter pylori infection, and whether the difference was related to the infection outcome. About 68 dyspeptic children and 110 dyspeptic adults were enrolled to check H. pylori infection, its colonization density, and the related histology. Gastric Lewis antigens b (Le(b)), x (Le(x)), and sialyl-Lewis x (sialyl-Le(x)) were immunohistochemically stained and scored for the intensity. The H. pylori-infected adults, but not the children, had a lower Le(b) intensity over the antrum (p=0.019) but higher Le(b) intensity over the corpus (p=0.001) than the non-infected ones. Over the antrum, both the H. pylori-infected children and adults had a lower Le(x) and higher sialyl-Le(x) intensity than those non-infected ones (p
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- 2007
49. The association between rainfall rate and occurrence of an enterovirus epidemic due to a contaminated well
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M. C. Huang, How Ran Guo, Jiin-Shuh Jean, Yao Jong Yang, Wen Tsan Chang, Shun Hua Chen, and Chia Chuan Liu
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Veterinary medicine ,Genes, Viral ,Rain ,Southern taiwan ,Taiwan ,Biology ,medicine.disease_cause ,Logistic regression ,Applied Microbiology and Biotechnology ,Disease Outbreaks ,Water Supply ,Enterovirus Infections ,medicine ,Humans ,Developing Countries ,Enterovirus ,Groundwater contamination ,Public well ,Reverse Transcriptase Polymerase Chain Reaction ,Water Pollution ,Outbreak ,General Medicine ,Contamination ,Virology ,Logistic Models ,Public Health ,Biotechnology - Abstract
Aims: To determine the association between rainfall rate and occurrence of enterovirus infection related to contamination of drinking water. Methods and Results: One fatality case and three cases of severe illness were observed during the enterovirus epidemic in a village in southern Taiwan from 16 September to 3 October 1998. Groundwater samples were collected from the public well in the village after heavy rainfall to test for enterovirus using the reverse transcription-polymerase chain reaction (RT-PCR) assay. The RT-PCR assay detected the enterovirus in the groundwater sample collected on 26 September 1998. The logistic regression model also revealed a statistically significant association between the rainfall rate and the observation of cases of enterovirus infection. Conclusions: According to the fitted logistic regression model, the probability of detecting cases of enterovirus infection was greater than 50% at rainfall rates >31 mm h−1. The higher the rainfall rate, the higher the probability of enterovirus epidemic. Significance and Impact of the Study: Contamination of drinking water by the enterovirus may lead to epidemics that cause deaths and severe illness, and such contamination may be caused by heavy rainfall. The major finding in this study is that the enterovirus could be flushed to groundwater in an unconfined aquifer after a heavy rainfall. This work allows for a warning level so that an action can be taken to minimize future outbreaks and so protect public health.
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- 2006
50. Pretreatment with Lactobacillus- and Bifidobacterium-containing yogurt can improve the efficacy of quadruple therapy in eradicating residual Helicobacter pylori infection after failed triple therapy
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Jiunn Jong Wu, Ai Wen Kao, Hsiu Chi Cheng, Hsiao Bai Yang, Yao Jong Yang, Bor Shyang Sheu, and Shan Tair Wang
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Male ,medicine.medical_specialty ,Spirillaceae ,Medicine (miscellaneous) ,Drug resistance ,Gastroenterology ,Helicobacter Infections ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,Antibiosis ,Drug Resistance, Bacterial ,medicine ,Humans ,Combined Modality Therapy ,Ingestion ,Bifidobacterium ,Breath test ,Carbon Isotopes ,Nutrition and Dietetics ,Helicobacter pylori ,biology ,medicine.diagnostic_test ,business.industry ,Probiotics ,food and beverages ,Middle Aged ,Anti-Ulcer Agents ,Yogurt ,biology.organism_classification ,Anti-Bacterial Agents ,Surgery ,Lactobacillus ,Treatment Outcome ,Breath Tests ,Patient Compliance ,Female ,business - Abstract
BACKGROUND Lactobacillus- and Bifidobacterium-containing yogurt (AB-yogurt) can suppress Helicobacter pylori. Improvement of the eradication rate by quadruple therapy of residual H. pylori after failed triple therapy is needed. OBJECTIVE We tested whether prior treatment with AB-yogurt improved the efficacy of quadruple therapy in eradicating residual H. pylori after failed triple therapy. DESIGN One hundred thirty-eight patients in whom triple therapy failed were enrolled for a culture study of H. pylori to assess antimicrobial resistance. These patients were then randomly assigned in equal numbers to either a yogurt-plus-quadruple therapy group or a quadruple therapy-only group. The patients received 1 wk of quadruple therapy with or without a 4-wk pretreatment with AB-yogurt (400 mL/d). In the yogurt-plus-quadruple group, excessive delta(13)CO(2)/mL values of the (13)C-urea breath test were collected before and every 2 wk during the 4-wk ingestion of yogurt. For both groups, a (13)C-urea breath test was conducted > or =6 wk after the quadruple therapy to assess the outcome of residual H. pylori eradication. RESULTS For the patients in the yogurt-plus-quadruple therapy group infected with either antibiotic-sensitive or -resistant H. pylori, the excessive delta(13)CO(2)/mL values of the (13)C-urea breath test were significantly decreased after the 4-wk ingestion of AB-yogurt (P < 0.0001). The yogurt-plus-quadruple therapy group had a higher H. pylori eradication rate than did the quadruple therapy-only group (intention-to-treat analysis: 85% compared with 71.1%, P < 0.05; per-protocol analysis: 90.8% compared with 76.6%, P < 0.05). CONCLUSION A 4-wk pretreatment with AB-yogurt can decrease H. pylori loads despite antimicrobial resistance, thus improving the efficacy of quadruple therapy in eradicating residual H. pylori.
- Published
- 2006
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