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Dive into the research topics where Cheng-Kuan Lin is active.

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Featured researches published by Cheng-Kuan Lin.


The Journal of Infectious Diseases | 2015

Advanced Hepatic Fibrosis and Steatosis Are Associated With Persistent Alanine Aminotransferase Elevation in Chronic Hepatitis C Patients Negative for Hepatitis C Virus RNA During Pegylated Interferon Plus Ribavirin Therapy

Cheng-Chao Liang; Chen-Hua Liu; Chen-Shuan Chung; Cheng-Kuan Lin; Tung-Hung Su; Hung-Chih Yang; Chun-Jen Liu; Pei-Jer Chen; Ding-Shinn Chen; Jia-Horng Kao

BACKGROUND Clinical implications of persistent alanine aminotransferase (ALT) elevation and associated factors in chronic hepatitis C (CHC) patients who achieved undetectable hepatitis C virus (HCV) RNA during pegylated interferon plus ribavirin (peg-IFN/RBV) therapy remain unknown. METHODS A total of 1113 CHC patients with undetectable HCV RNA during peg-IFN/RBV therapy were enrolled. Baseline characteristics associated with persistent on-treatment ALT elevation (POAE), and its impact on treatment outcomes, were investigated. RESULTS Of 1113 CHC patients, 254 (22.8%) had POAE. Among patients with HCV genotype 1 (HCV-1) who had complete early virologic response (EVR) and received 48 weeks of therapy, patients with POAE had a lower rate of sustained virologic response (SVR) than those without POAE (44.1% vs 74.0%; P = .0002). Multivariate analyses showed that body mass index ≥ 27 kg/m(2), ALT level ≥3 times the upper limit of normal, aspartate aminotransferase to platelet ratio index score ≥1.5, hepatic fibrosis ≥F3, and hepatic steatosis ≥S2 were independent factors associated with POAE after viral clearance. CONCLUSIONS POAE is common in CHC patients during therapy. HCV-1 patients with POAE have a lower SVR rate to 48-week therapy if they achieve complete EVR. Advanced hepatic fibrosis, obesity, and steatosis are factors associated with POAE in these patients.


Advances in Digestive Medicine | 2016

A modified bowel preparation protocol improves the quality of bowel cleansing for colonoscopy

Wei-Fan Hsu; Cheng-Chao Liang; Cheng-Kuan Lin; Tzong-Hsi Lee; Chen-Shuan Chung

Adequate colonic cleansing is essential for a high quality colonoscopy. Few studies have investigated the association between patient education and quality of bowel preparation. The control group comprised 165 participants who underwent colonoscopy after a standard bowel preparation protocol during the period September–October 2013 and the study group comprised 251 individuals who underwent colonoscopy after a modified bowel preparation protocol during the period January–February 2014. The modified bowel preparation protocol included an instructional video and leaflet, a dietician‐designed 2‐day low fiber diet, a follow‐up phone message, and information to confirm stool characteristics. The Aronchick Bowel Preparation Scale was used to define the quality of bowel preparation. The endoscopists who performed the procedures were blinded to the preparation protocols. The percentage of participants with excellent bowel preparation quality was significantly higher in the study group than in the control group (35.9% vs. 21.8%, p = 0.002). Also, the percentage of participants with poorly prepared bowels was significantly higher in the control group than in the study group (3% vs. 0.8%, p = 0.042). Moreover, the adenoma detection rate was significantly higher in the study group (35.1% vs. 24.8%, p = 0.028). The results show that the quality of bowel cleansing can be improved by providing patients with a modified bowel preparation protocol.


Journal of Gastroenterology and Hepatology | 2018

Identification of risk factors for neoplastic colonic polyps in young adults with bloody stool in comparison with those without symptom: Risk factors for neoplastic colonic polyps

Kuan-Chih Chen; Chen-Shuan Chung; Wei-Fan Hsu; Tien-Yu Huang; Cheng-Kuan Lin; Tzong-Hsi Lee; Meng-Tzu Weng; Cheng-Ming Chiu; Li-Chun Chang; Han-Mo Chiu

The incidence and disease burden of colorectal cancer (CRC) in young adults were increasing. However, there was a dearth of advice on how to identify young population at risk for neoplastic colonic polyps (NCPs) and CRC. We aimed to identify risk factors for NCPs and CRC in young adults presenting with bloody stool.


Gastrointestinal Endoscopy | 2018

An atypical infection of the esophagus mimicking malignancy

Ssu-Han Wang; Cheng-Kuan Lin; Yu-Chen Chang; Tzong-Hsi Lee; Chen-Shuan Chung

A 49-year-old man, who was an outdoor builder, had habitual consumption of cigarette, alcohol, and betel nut. He had dysphagia and hoarseness, accompanied with a weight loss of about 5 to 6 kg within 6 months. His esophagogastroduodenoscopy (EGD) (GIF-Q260, Olympus Medical Systems, Tokyo, Japan) demonstrated numerous granular lesions with some erosions and ulcers, mainly distributed at the middle to lower esophagus as seen by white-light imaging.


Advances in Digestive Medicine | 2017

Detection of rectal neuroendocrine tumor during screening colonoscopy and its difference from colonic adenocarcinoma

Cheng-Kuan Lin; Chen-Shuan Chung; Tsung-Hsien Chiang; Chia-Hung Tu; Cheng-Chao Liang

The incidence of rectal neuroendocrine tumors (NETs) diagnosed during screening colonoscopy is rising. The features and outcomes of these patients and their difference from colonic adenocarcinoma are unknown.


Journal of Gastroenterology and Hepatology | 2015

Education and Imaging. Gastroenterology: Pneumomediastinum and pneumoperitoneum after peroral endoscopic myotomy: Complications or normal post-operative changes?

C‐S Chung; Cheng-Kuan Lin; W‐F Hsu; T‐H Lee; Huai-Yung Wang; Liang Cc

A 58-year-old man suffered from dysphagia, halitosis, postprandial chest pain and vomiting with undigested food over more than 30 years. Moreover, he had become cachexic in recent decade. A barium esophagogram disclosed markedly dilated and tortuous sigmoid-shaped megaesophagus with bird-bead appearance of esophagogastric junction (ECJ), and an esophagogastroduodenoscopy (EGD) showed high resistance during intubation through the ECJ (left panel, Fig. 1). The clinical manifestation and radiological findings suggested sigmoid-type achalasia. Peroral endoscopic myotomy (POEM) was performed with carbon dioxide for insufflation and triangle-tip knife (KD-640L, Olympus, Japan) for myotomy. Total procedure time was 112 minutes. No immediate complication develop during the operation. However, severe subcutaneous emphysema, pneumomediastinum and pneumoperitoneum were found upon the chest X-ray one day after POEM procedure (left panel, Fig. 2). Fortunately, the complications resolved rapidly 2 days later after conservative treatment with nasal cannula oxygen supplement and pain control (right panel, Fig. 2). The follow-up EGD and barium esophagogram 3 months later demonstrated markedly improvement of megaesophagus and patulous ECJ (right panel, Fig. 1). His dysphagia symptom dramatically improved and gained weight by about 7% in 6 months after POEM procedure. Esophageal achalasia is a motility disorder characterized by aperistaltic esophagus associated with an impaired relaxation, and usually elevated pressure of lower esophageal sphincter. Poor passage of food bolus through the ECJ may lead to malnutrition, and complications after repeated vomiting, such as bleeding, perforation or aspiration often occur. A curative treatment for achalasia is currently unavailable and medical treatment is impossible. Traditionally, Heller myotomy was considered as the standard surgical treatment; however, recurrence or complications may develop. Endoscopic therapy, including botulinum toxin injection, balloon dilation and recently introduced POEM procedure, aims to destroy or weaken the lower esophageal sphincter and provides better outcome and quality of life when compared with surgical intervention. However, a high rates (28–48%) of subcutaneous emphysema, pneumomediastinum and pneumoperitoneum could be identified by chest computed scan after POEM procedure. Those post-operative changes were deemed as indications for surgical intervention. Nevertheless, recent studies have demonstrated those post-operative radiological findings were not associated with severe complications and poorer clinical outcome. In this case, pneumomediastinum and pneumoperitoneum rapidly resolved spontaneously after conservative management. We believed that endoscopic insufflations with carbon dioxide and adequate closure of mucosa incision wound by endoclipping are crucial to prevent severe complications, and those radiological changes could be regarded as normal post-operative changes.


Advances in Digestive Medicine | 2015

Ileal ulcers in a patient with Henoch-Schönlein purpura

Ying-Yu Shih; Cheng-Chao Liang; Cheng-Kuan Lin; Wei-Fan Hsu; Chien-Sheng Wu; Chen-Shuan Chung

Henoch‐Schönlein purpura (HSP) is a systemic vasculitis characterized by a classic tetrad of nonthrombocytopenic palpable purpura, arthritis, gastrointestinal, and renal involvement. The most common gastrointestinal complaint is abdominal pain. The characteristic endoscopic findings are ulcers seen in the second portion of the duodenum. We present the case of a 45‐year‐old man suffering from abdominal pain. Erythematous purpura over bilateral lower extremities and soreness of the joints developed 3 days before abdominal pain. An abdominal computed tomography showed an edematous change of the intestinal wall and the distal part of the ileum. A retrograde single balloon enteroscopy revealed several discrete ulcers and hyperemic mucosa in the distal ileum. The middle, proximal, and terminal ileum and ileocecal valve to the rectum were not affected. Under the impression of HSP, nonsteroidal anti‐inflammatory drugs and prednisolone were administered. We concluded that balloon‐assisted enteroscopy is helpful for differential diagnosis of small bowel lesions in adult patients with HSP.


Advances in Digestive Medicine | 2015

An 86-year-old man with intermittent fever for 1 month

Wei-Fan Hsu; Chia-Jui Yang; Cheng-Kuan Lin

An 86-year-old man presented with intermittent fever for 1 month. He had dull abdominal pain in the right upper quadrant for 2 weeks. The patient denied a productive cough, chest pain, and dysuria. He had no recent travel history and no body weight loss. He had no underlying systemic disease, such as diabetes mellitus. Physical examinations were not remarkable. Laboratory data revealed leukocytosis (white blood cells: 21.34 10/mL, neutrophils: 83.6%). Aspartate and alanine aminotransferase levels were 23 IU/L and 19 IU/L (normal range: < 31 IU/L), respectively, and total bilirubin was 0.3 mg/dL (normal range: 0.2e1.5 mg/dL). His alkaline phosphatase was 117 IU/L (normal range: 40e129 IU/L). Hepatitis B surface


臺灣消化醫學雜誌 | 2009

Colonoscopic Diagnosis of Ancylosto Ma Ceylanicum Infection: Report of a Case

Cheng-Kuan Lin; Chun-Hsing Liao; Kua-Eyre Su; Tzong-Hsi Lee

Ancylostoma ceylanicum is a rare zoonotic parasite normally found in dogs and cats. The hookworm infection causes abdominal pain, diarrhea, or anemia. Herein, we report the case of a 44-year-old male who suffered from persistent diarrhea, abdominal pain, and bloody stool due to A. ceylanicum infection, possibly transmitted from stray dogs. Hemogram revealed eosinophilia, but no parasite ova were found in the stool. Colonoscopy revealed mobile, blood-filled worms from the transverse to the ascending colon and terminal ileum accompanied by multiple mucosal erosions. The worms were caught by biopsy forceps and were identified as A. ceylanicum by morphologic characteristics. The patient was treated with mebendazole for three days. His symptoms subsided after treatment and no more parasites or ova were detected in the stool one month later. Hence, A. ceylanicum infection should be kept in mind in humans in Taiwan that have close contact with dogs or cats who show symptoms of abdominal pain, diarrhea, or even bloody stool. Diagnosis by colonoscopy is considered if fecal examination is inconclusive.


Digestive Diseases and Sciences | 2011

Acute Hemorrhagic Rectal Ulcer: An Important Cause of Lower Gastrointestinal Bleeding in the Critically Ill Patients

Cheng-Kuan Lin; Cheng-Chao Liang; Hou-Tai Chang; Fang-Ming Hung; Tzong-Hsi Lee

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Tzong-Hsi Lee

Memorial Hospital of South Bend

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Chen-Shuan Chung

Memorial Hospital of South Bend

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Cheng-Chao Liang

Memorial Hospital of South Bend

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Wei-Fan Hsu

Memorial Hospital of South Bend

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Chen-Shuan Chung

Memorial Hospital of South Bend

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Chien-Chu Lin

Memorial Hospital of South Bend

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Kuang-Chau Tsai

Memorial Hospital of South Bend

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Meng-Tzu Weng

Memorial Hospital of South Bend

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Tien-Yu Huang

Memorial Hospital of South Bend

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Chen-Hua Liu

National Taiwan University

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