兒消_2020年會Abstract___Prorgam__PDF檔_.pdf

Transcript

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   cѧjอ̹̏ؐ዗ਜیඩی༩ɚݬ໮ 2020 Annual meeting of Taiwan Society of Pediatric Gastroenterology, Hepatology and Nutrition 2020 台灣小兒消化醫學會 第八屆第二次年會暨第二十屆學術演講會 2020 台灣小兒消化醫學會 第八屆第二次年會暨第二十屆學術演講會 Program & Abstracts
3. ͦcc፽ 台灣小兒消化醫學會第八屆理監事名單 ............................................. 2 理事長的話 .............................................................................................. 3 Program .................................................................................................... 4 Moderator ............................................................................................... 14 Taiwan Children Liver Foundation Lecture ............................................... 16 Special Lecture / Mini-Symposium ........................................................... 17 Lunch Symposium .................................................................................... 24 Free Papers (I) .......................................................................................... 26 Free Papers (II) ......................................................................................... 32 Poster Session .......................................................................................... 38 會場平面圖 .............................................................................................. 50 地圖及交通 .............................................................................................. 51 銘謝 .......................................................................................................... 52
4. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　2 台灣小兒消化醫學會各委員會組織名單 ( 任期 : 108 年 9 月 ~111 年 9 月 ) 第八屆理監事會 理 事 長 :　　陳慧玲 常務理事 :　　李宏昌、倪衍玄 理 事 :　　刁茂盟、方旭彬、朱家祥、林隆煌、林捷忠、陳安琪 　　　　　　　陳建彰、許宏遠、黃清峯、楊俊仁、趙舜卿、劉明發 常務監事 :　　張美惠 監 事 :　　施相宏、陳慧文、黃一菲、賴明瑋 秘 書 長 :　　楊燿榮 副秘書長 :　　王秉菴、吳嘉峯、林裕誠 財 務 長 :　　劉明發 行政委員會 （負責資格審查，醫療相關事務） 主　　委 ：　　李宏昌、陳安琪 委　　員 :　　王秉菴、余俊賢、林隆煌、陳建彰、陳慧文、黃一菲 學術教育委員會 （負責教育及節目工作） 主　　委 ：　　許宏遠、林捷忠 委　　員 :　　刁茂盟、文萬欣、倪衍玄、林裕誠、施相宏、賴明瑋 國際交流委員會 （加強國際間小兒腸胃學之學術交流） 主　　委 ：　　張美惠、倪衍玄 委　　員 :　　方旭彬、朱家祥、黃福辰、楊俊仁、趙舜卿、劉明發 健保委員會 （健保相關之公文及案件規劃） 主　　委 ：　　楊俊仁、黃清峯 委　　員 :　　江椿彬、林文騰、陳建彰、陳世彥、陳和昇、蔡璟忠
5. 　　　 3　　　 理事長的話 　　感謝小兒消化醫學會的各位理監事及會員的支持與鼓勵， 讓我能有機會為兒消大家庭服務。台灣小兒消化學會自從 1998 年張美惠教授創立已來，經過歷任理事長及理監事、秘書處的 努力，在專科醫師訓練、考試證書、繼續教育、年會及學術研 討會、論文發表各方面，均日益精進。師長們更在國際學術團 體包括世界兒消學會 (FISPGHAN) 及亞太兒消學會 (APPSPGHAN) 參與重要職務，推動世界兒消學術發展，台灣小兒消化學會 (TSPGHAN) 曾主辦亞太兒消及世界兒消會議 (WCPGHAN 2012)， 近年也首創並共同舉辦多次台日韓醫師學術交流會議，TSPGHAN 已具有堅實的專業 能力及國際聲望。 　　2020 是非常特別的一年，COVID-19 的疫情在短短幾個月內完全改變了我們熟悉 的世界，今年六月原訂於丹麥哥本哈根舉辦的第六屆世界兒消大會，台灣已有 50 多 名醫師預備前往，40 篇的口頭及壁報論文被接受，實力及團隊參與度皆可觀，可惜 大會因歐洲疫情而取消，而意外的也讓本次年會 free paper 發表更豐富。儘管台灣疫 情相對穩定，但仍有山雨欲來之感，本會在四月以最快時間整理 COVID19 消化道相 關資訊提供會員參考，並在此次年會邀請知名感染專家演講時事主題，兩位邀請來賓 國外講者也改為使用視訊演講。COVID-19 影響深遠，在此期間醫療工作者的身體健 康以及專業能力的更新至關重要，期待與大家緊密合作以克服挑戰。 　　特別感謝楊燿榮秘書長、三位副秘書長、劉明發財務長及秘書處卓媽的專業經 驗，讓會務進行順利。此次年會，林裕誠副秘書長及亞東醫院在會場籌備上提供了最 大協助。 展望未來， 我們將繼續在臨床醫療、 學術研究與社會關懷的基礎上持續精進， 並積極推展國際交流。 敬祝大家身體健康！平安如意！ 台灣小兒消化醫學會第八屆理事長 2020.9.12
6. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　4 Program September 12 (Saturday), 2020 Time Topic Moderator 12:30 Registration 報到 13:20 Opening Remarks Huey-Ling Chen 陳慧玲 理事長 (President of TSPGHAN) Yu-Cheng Lin 林裕誠 副祕書長 (Assistant Secretary-General) 13:30-14:30 Free Paper I Shih-Yen Chen 陳世彥 ( 雙和醫院 ) Ching-Chung Tsai 蔡璟忠 ( 義大醫院 ) 14:30-15:30 Free Paper II Mao-Meng Tiao 刁茂盟 ( 高雄長庚醫院 ) Wen-Terng Lin 林文騰 ( 恩主公醫院 ) 15:30-15:50 Break Time Topic Speaker Moderator 15:50-16:15 Cyclic Vomiting Syndrome and Migraine Associated GI Disorders 週期性嘔吐及偏頭痛相關的腸胃道 疾患 Pi-Chuan Fan 范碧娟 台大兒童醫院 Chun-Yan Yeung 楊俊仁 馬偕兒童醫院 16:15-16:40 Food Allergy and Functional Abdominal Pain in Children 食物過敏與兒童功能性腹痛 Ching-Feng Huang 黃清峯 台北榮總 Jia-Feng Wu 吳嘉峯 台大兒童醫院 16:40-17:05 The Management of Acute Abdomen and The Application of Minimal Invasive Surgery in Children 腹部急症的處理及微創手術在小外 的適用範圍 Yun Chen 陳芸 亞東紀念醫院副院長 Pi -Feng Chang 張碧峰 亞東紀念醫院 17:05-17:40 <Special lecture> Video talk Pediatric Gastrointestinal Endoscopy: Current Progress and Future Development. 兒科內視鏡新進展：現況與未來發 展 Prof. Nakayama Yoshiko 中山佳子 Chief of Gastroenterology Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan Yen-Hsuan Ni 倪衍玄 台灣大學醫學院院長 17:40-18:00 Panel Discussion 綜合討論 【Mini-Symposium】 常見的臨床挑戰 : 腹痛攻略解碼 !
7. 　　　 5　　　 Program September 13 (Sunday), 2020 Time Topic Speaker Moderator 8:20 報到 9:00-9:30 Pediatric Nonalcoholic Fatty Liver Disease: What is New? 兒童非酒精性脂肪肝疾病之新進展 Yu-Cheng Lin 林裕誠 亞東紀念醫院 Chieh-Chung Lin 林捷忠 中國醫藥大學兒童醫院 9:30-10:00 Gastrointestinal Symptoms of Respiratory Tract Infection 呼吸道感染的腸胃症狀— 小心 ! 可能不是腸胃炎 Ping-Ing Lee 李秉穎 台大兒童醫院 Yao-Jong Yang 楊燿榮 成大醫院 10:00-10:25 Break 10:25-11:10 Management of Pediatric Obesity: Ten Lessons for Healthcare Education 兒童青少年減肥：衛教十堂課 Walter Chen 陳偉德 中國醫藥大學校務顧 問 Hung-Chang Lee 李宏昌 馬偕兒童醫院院長 台灣兒科醫學會理事長 11:10-12:00 【Taiwan Children Liver Foundation Lecture 兒童肝膽防治基金會特別講 座】Video talk Portal Hypertension in Children: Different Aspects from Adults 兒童門脈高壓 : 與成人相異之特點 Prof. Kyung Mo Kim Professor and Head, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Seoul, Korea Mei-Hwei Chang 張美惠 中央研究院院士 台灣大學醫學院小兒 科特聘講座教授 12:10:12:50 <Lunch Symposium> Gangliosides Update in Infant’s Immunity and Gut Health 神經節苷脂於嬰兒免疫及腸道健康 新進展 Chun-Yan Yeung 楊俊仁 馬偕兒童醫院 Huey-Ling Chen 陳慧玲 台灣小兒消化醫學會 理事長 13:00-13:30 TSPGHAN Business Meeting 會員大會 13:30-14:00 會員聯誼時間
8. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　6 September 12 (Saturday), 2020 Time Topic 12:30 Registration 報到 13:20 Opening Remarks Huey-Ling Chen 陳慧玲 (President of TSPGHAN) Yu-Cheng Lin 林裕誠 (Assistant Secretary-General) Free Paper I Moderators: Shih-Yen Chen 陳世彥 ( 雙和醫院 ) ; Ching-Chung Tsai 蔡璟忠 ( 義大醫院 ) 13:30-13:37 O-1 Gastrointestinal Manifestations of Food Allergy Related with Atopic Diseases in Children and Adolescents in Taiwan 台灣兒童及青少年食物過敏與過敏疾病和腸胃道症狀的相關性 Ying-Chi Wong1, Zhe Ying Liu1,2, Chih Kang Huang1, Shih Kuan Li 1,3, Tzee-Chung Wu 1, Ching-Feng Huang1 黃映齊1, 劉喆瑩1,2, 黃治綱1, 李士寬1,3, 吳子聰1, 黃清峯1 1Division of Paediatrics Gastroenterology & Nutrition, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan 2Department of Paediatrics, Taipei Municipal Wanfang Hospital, Taipei, Taiwan 3Department of Paediatrics, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan 1台北榮民總醫院兒童腸胃科 ; 2台北市立萬芳醫院兒科部 ; 3永和耕莘醫院小兒科 13:37-13:44 O-2 Common Food Allergens and Allergic Symptoms for Medical Attention in Taiwan 台灣尋求醫療協助常見食物過敏原與症狀 Yii-Shiuan Lee, Ying-Chi Wong, Chih Kang Huang, Tzee-Chung Wu, Ching-Feng Huang 李苡萱，黃映齊，黃治綱，吳子聰，黃清峯 Division of Pediatric Gastroenterology & Nutrition, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan 臺北榮民總醫院兒童醫學部兒童胃腸科 13:44-13:51 O-3 Perforated Peptic Ulcer Disease in Childen: the Experience in a Territory Center 南臺灣關於穿孔性消化性潰瘍危險因子探討 Wan-Tz Lai1, Yi-Wen Tsai2, Yi-Ting Lu1, Yu-Hsuan Liao1, Arthor Chen1, Kuo-Shu Tang1, Ying-Hsien Huang1, Mao-Meng Tiao1, Sin-Yi Li2, Chun-Hong Chiang2, Fu-Chen Huang1 賴宛孜1, 蔡逸文2, 盧怡庭1, 廖祐玄1, 陳智仁1, 唐國書1, 黃瀛賢1, 刁茂盟1 , 李信儀2, 江俊宏2, 黃福辰1 1Department of Pediatric Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan 2Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan 高雄長庚兒童胃腸科1, 高雄長庚小兒外科2 13:51-13:58 O-4 Roles of Vitamin D on Gut Integrity and Zonulin Expression in a Mouse Model 維生素 D 對小鼠腸道完整性和 Zonulin 的表現 Tsung-Hua Hsieh1, Chun-Yan Yeung1,2,3, Hung-Chang Lee1,2,3, Wai-Tao Chan1,2,3, Chuen-Bin Jiang1,2,3, Szu-Wen Chang1,2,3, Jen-Shiu Chiang Chiau2, Mei-Lein Cheng2, Chia-Yuan Liu2,3,4, Ching-Wei Chang2,3,4 謝宗樺1, 楊俊仁1,2,3, 李宏昌1,2,3, 陳偉燾1,2,3, 江椿彬1,2,3, 張思玟1,2,3, 江謝正雄2, 鄭美蓮2, 劉家源2,3,4, 張經緯2,3,4 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan 3Department of Medicine, MacKay Medical College, New Taipei City, Taiwan 4Department of Hepatology and Gastroenterology, MacKay Memorial Hospital, Taipei, Taiwan 1 1馬偕兒童醫院 兒童腸胃科 ; 2馬偕紀念醫院 醫學研究部 ; 3馬偕醫學院 醫學系 ; 4馬偕紀念醫院 胃腸肝膽科
9. 　　　 7　　　 13:58-14:05 O-5 YqiC is Required for Electron Transport Chain, Glycolysis capacity, and Antioxidation of Salmonella typhimurium 鼠傷寒沙門氏菌之電子傳遞鏈，醣解能力，及抗氧化力需要 yqiC 基因 Hung-Yen Cheng1, Pei-Ru Chang1,2, Ying-Hsiu Lin1,2, Wei-Chiao Chang3, Lauderdale Tsai-Ling Yang4, Shiuh-Bin Fang1,2,3* 鄭弘彥1, 張珮茹1,2, 林盈秀1,2, 張偉嶠3, 楊采菱4, 方旭彬1,2,3* 1Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; 2Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 3Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; 4National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan 1臺北醫學大學部立雙和醫院小兒部小兒消化科 2臺北醫學大學醫學院醫學系小兒學科 3臺北醫學大學藥學院臨床藥物基因體學暨蛋白質體學碩士學位學程 4國家衛生研究院感染症與疫苗研究所 14:05-14:12 O-6 Clostridium Difficile Infection Rates in Paediatric Inflammatory Bowel Disease is on the Rise – A Single Centre Study in Asia 小兒發炎性腸症的困難梭菌感染率正在上升 － 亞洲的單一中心研究 Mu-Ming Chien1,2, Mei-Hwei Chang1,3, Kai-Chi Chang1, Yu-Chun Chiu1,4, Huey-Ling Chen1,3,6, Yen-Hsuan Ni1,3,5, Hong-Yuan Hsu1,6, Jia-Feng Wu1 簡睦旼1,2, 張美惠1,3, 張凱琪1, 邱郁淳1,4, 陳慧玲1,3,6, 倪衍玄1,3,5, 許宏遠1,6, 吳嘉峯1 1Department of Pediatrics, National Taiwan University Children’s Hospital, National Taiwan University, Taipei, Taiwan 2Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan 3Hepatitis Research Center, 4Department of Medical Education, 5Department of Medical Genetics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan 6Department of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan 1臺大兒童醫院小兒部 ,2台北醫學大學附設醫院兒科部 3臺大醫院 肝炎研究中心 ,4臺大醫院 教學部 ,5臺大醫院基因醫學部 6臺灣大學醫學院醫學教育暨生醫倫研究所 15:12-15:30 <Free Paper I > Discussion Free Paper II Moderators: Mao-Meng Tiao 刁茂盟 ( 高雄長庚醫院 ) ; Wen-Terng Lin 林文騰 ( 恩主公醫院 ) 14:30-14:37 O-7 Impact of Antibiotic Treatment on the Gut Microbiota in Kawasaki Disease 抗生素對川崎症病人腸道菌種的影響 Chen-Chen Wen1, Chuen-Bin Jiang 1, Chun-Yan Yeung1, Wai-Tao Chan1, Hung-Chang Lee1,Jen-Shiu Chiang Chiau2 温晨辰1, 江椿彬1, 楊俊仁1 , 陳偉燾1 , 李宏昌1, 江謝正雄2 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan. 2Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan. 馬偕兒童醫院 兒童腸胃科；2馬偕紀念醫院 醫學研究部 14:37-14:44 O-8 Alterations in the Gut Microbiota of Children with Ascending Cholangitis: Preliminary Report 兒童急性上升性膽管炎的腸道微生物菌叢研究分析：初步報告 Mi-Chi Chen, Ming-Wei Lai, Hsun-Chin Chao, Hung-Yu Yeh, Hung-Hsiang Lai, Chien-Chang Chen 陳米琪、賴明瑋、趙舜卿、葉宏瑀、賴宏香、 陳建彰 Department of Pediatric Gastroenterology, Linkou Chang Gung Memorial Hospital, Taiwan 林口長庚紀念醫院 兒童胃腸科
10. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　8 14:44-14:51 O-9 Clinical and Genetic Features of Patients with Alagille Syndrome in Taiwanese Children 台灣病童罹患阿拉吉歐症候群之臨床及基因特徵 Che-Ming Chiang 1,2, Yung-Ming Jeng 3, Ming-Chih Ho 4, Ming-Wei Lai 5, Huei-Ying Li 6, Pei-Lung Chen 7,8, Ni-Chung Lee 1,7, Jia-Feng Wu 1, Yu-Chun Chiu 1, Bang-Yu Liou 1, Yen-Hsuan Ni 1, Hong-Yuan Hsu 1, Mei-Hwei Chang 1, Huey-Ling Chen 1 江哲銘1,2, 鄭永銘3, 何明志4, 賴明瑋5, 李慧瑛6, 陳沛隆7,8, 李妮鐘1,7, 吳嘉峯1, 邱郁淳1, 劉邦渝1, 倪衍玄1, 許宏遠1, 張美惠1, 陳慧玲1 Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan 1 ; Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan 2; Department of Pathology 3 and Surgery 4, National Taiwan University Hospital, Taipei, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taiwan 5 ; Medical Microbiome Center, National Taiwan University College of Medicine, Taipei, Taiwan 6 Department of Medical Genetics7 and Internal Medicine8, National Taiwan University Hospital, Taipei, Taiwan 台大醫院小兒部1；國防醫學院三軍總醫院小兒部2；台大醫院病理部3； 台大醫院外科部4；林口長庚紀念醫院兒童胃腸科5； 台大醫院醫學微生物體核心實驗室6；基因醫學部7；內科部8 14:51-14:58 O-10 The Cardiometabolic Risks in Severe Obese Children and Adolescents in Taiwan 台灣兒童青少年嚴重肥胖與心血管代謝性風險的關聯性研究 Po-Sheng, Chang1,2, Pi-Feng, Chang1,2, Yu-Cheng Lin1,2 張博勝1,2, 張碧峰1,2, 林裕誠1,2 1Department of Pediatrics, Far-Eastern Memorial Hospital, New Taipei City, Taiwan 2Division of Pediatrics Gastroenterology, Department of Pediatrics, Far-Eastern Memorial Hospital, New Taipei City, Taiwan 亞東紀念醫院 兒科部 14:58-15:05 O-11 Identification of Novel Lipid Biomarkers of Childhood Obesity in Taiwanese Children by Lipidomics 以脂質體學找出關於台灣兒童肥胖的新脂質標記 Ching-Chung Tsai1,2, Ming-Chun Yang1, Ming-Hsien Tsai3, Hsien-Kuan Liu1, Wen-Li Hsu4,5, Yu-Tsun Su1,2 蔡璟忠1,2、楊明浚1、蔡明憲3、劉賢冠1、許文俐4,5、蘇有村1,2 Department of Pediatrics, E-Da Hospital1, School of Medicine, College of Medicine, I-Shou University2, Department of Child Care, National Pingtung University of Science and Technology3, Emerging Compounds Research Center, General Research Service Center, National Pingtung University of Science and Technology4, Research Institute for Life Support Innovation, Research Organization for Nano & Life Innovation, Waseda University5 義大醫院兒童醫學部1; 義守大學學士後醫學系外國專班2; 國立屏東科技大學幼兒保育系3; 國立屏東科技大學新興汙染物研究中心 , 綜合研究服務中心4; 早稻田大學生命支持創新研究所 , 奈米與生命創新研究機構5
11. 　　　 9　　　 15:05-15:12 O-12 Overexpression of MicroRNA-29a in Diet-Induced Non-alcoholic Steatohepatitis Mouse Model Attenuates Liver Fibrosis and Mitochondrial Proteostatic Stress through Inhibition of GSK3β 過度表達微糖體核酸 29a 通過抑制 GSK3β 減輕飲食誘導的非酒精性脂肪 性肝炎小鼠模型中的肝纖維化和粒線體蛋白穩態壓力 Ya-Ling Yang1, Ying-Hsien Huang2 楊雅玲1, 黃瀛賢2 Department of Anesthesiology1, and Pediatrics2, Kaohsiung Chang Gung Memorial Hospital, Taiwan 高雄長庚醫院 麻醉部1, 兒童內科部2 15:12-15:30 <Free Paper II> Discussion 15:30-15:50 Break Time Topic Speaker Moderator 15:50-16:15 Cyclic Vomiting Syndrome and Migraine Associated GI Disorders 週期性嘔吐及偏頭痛相關的腸胃道 疾患 Pi-Chuan Fan 范碧娟 台大兒童醫院 Chun-Yan Yeung 楊俊仁 馬偕兒童醫院 16:15-16:40 Food Allergy and Functional Abdominal Pain in Children 食物過敏與兒童功能性腹痛 Ching-Feng Huang 黃清峯 台北榮總 Jia-Feng Wu 吳嘉峯 台大兒童醫院 16:40-17:05 The Management of Acute Abdomen and The Application of Minimal Invasive Surgery in Children 腹部急症的處理及微創手術在小外 的適用範圍 Yun Chen 陳芸 亞東紀念醫院副院長 Pi -Feng Chang 張碧峰 亞東紀念醫院 17:05-17:40 <Special lecture> Video talk Pediatric Gastrointestinal Endoscopy: Current Progress and Future Development. 兒科內視鏡新進展：現況與未來發 展 Pro. Nakayama Yoshiko 中山佳子 Chief of Gastroenterology Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan Yen-Hsuan Ni 倪衍玄 台灣大學醫學院院長 17:40-18:00 Panel Discussion 綜合討論 【Mini-Symposium】 常見的臨床挑戰 : 腹痛攻略解碼 !
12. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　10 September 13 (Sunday), 2020 Time Topic Speaker Moderator 8:20 報到 9:00-9:30 Pediatric Nonalcoholic Fatty Liver Disease: What is New? 兒童非酒精性脂肪肝疾病之新進展 Yu-Cheng Lin 林裕誠 亞東紀念醫院 Chieh-Chung Lin 林捷忠 中國醫藥大學兒童醫 院 9:30-10:00 Gastrointestinal Symptoms of Respiratory Tract Infection 呼吸道感染的腸胃症狀— 小心 ! 可能不是腸胃炎 Ping-Ing Lee 李秉穎 台大兒童醫院 Yao-Jong Yang 楊燿榮 成大醫院 10:00-10:25 Break 10:25-11:10 Management of Pediatric Obesity: Ten Lessons for Healthcare Education 兒童青少年減肥：衛教十堂課 Walter Chen 陳偉德 中國醫藥大學校務顧問 Hung-Chang Lee 李宏昌 馬偕兒童醫院院長 台灣兒科醫學會理事長 11:10-12:00 【Taiwan Children Liver Foundation Lecture 兒童肝膽防治基金會特別講座】 Video talk Portal Hypertension in Children: Different Aspects from Adults 兒童門脈高壓 : 與成人相異之特點 Prof. Kyung Mo Kim Professor and Head, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Seoul, Korea Mei-Hwei Chang 張美惠 中央研究院院士 台灣大學醫學院小兒 科特聘講座教授 12:10:12:50 <Lunch Symposium> Gangliosides Update in Infant’s Immunity and Gut Health 神經節苷脂於嬰兒免疫及腸道健康 新進展 Chun-Yan Yeung 楊俊仁 馬偕兒童醫院 Huey-Ling Chen 陳慧玲 台灣小兒消化醫學會 理事長 13:00-13:30 TSPGHAN Business Meeting 會員大會 13:30-14:00 會員聯誼時間
13. 　　　 11　　　 <Poster> 90cm( 寬 ) x 120cm( 高 ) Poster Session: September 12, 12:30-September 13, 12:00 Poster 1 Intestinal Obstruction Caused by Fad Diet in an Adolescent 一青少年由流行性減肥法引起的腸阻塞 Liang-Chun Chen1,2, Hung-Chang Lee1, Nien-Lu Wang3, Wai-Tao Chan1, Chun-Yan Yeung1, Chuen-Bin Jiang1, Szu-Wen Chang1 陳亮君1,2、李宏昌1、王念陸3、陳偉燾1、楊俊仁1、江椿彬1、張思玟1 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taiwan 3Department of Pediatric Surgery, MacKay Children’s Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科、2衛生福利部臺北醫院 小兒科、3馬偕兒童醫院 兒童外科 Poster 2 A Rare Cause of Refractory Anemia -Blue Rubber Bleb Nevus Syndrome 反覆貧血的罕見原因 - 藍色橡皮泡泡痣 Liang-Chun Chen1,2, Chun-Yan Yeung1, Chen-Wang Chang3, Hung-Chang Lee1, Wai-Tao Chan1, Chuen-Bin Jiang1, Szu-Wen Chang1 陳亮君1,2、楊俊仁1、章振旺3、李宏昌1、陳偉燾1、江椿彬1、張思玟1 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan; 2Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan; 3Department of Hepatology and Gastroenterology, MacKay Memorial Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科、2衛生福利部臺北醫院 小兒科、 3馬偕紀念醫院 胃腸肝膽科 Poster 3 Colocolic Intussusception Induced by a Huge Sigmoid Colon Hyperplastic Polyp- A Rare Case Report 乙狀結腸的巨大增生性息肉造成兒童腸套疊 - 罕見案例報告 Tsung-Hua Hsieh1, Chuen-Bin Jiang1, Hung-Chang Lee 1, Wai-Tao Chan1, Chun-Yan Yeung1, Paul Chia-Yu Chang 2 謝宗樺1, 江椿彬1, 李宏昌1, 陳偉燾1, 楊俊仁1 , 張嘉宇2 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Pediatric Surgery, MacKay Children’s Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科 2馬偕兒童醫院 兒童外科 Poster 4 A Rare Case of Hepatocellular Carcinoma in a 6-Year-Old Boy with Chronic Hepatitis B Infection under Entecavir to Achieve HBeAg Seroconversion 肝細胞癌之慢性 B 型肝炎 6 歲男童經貝樂克治療達 HBeAg 血清轉化的罕見病例 Yi-Ting Lu, Mao-Meng Tiao, Ying-Hsien Huang, Kuo-Shu Tang, Chih-Jen Chen, Yu-Hsuan Liao, Wan-Tz Lai,Fu-Chen Huang 盧怡庭 , 刁茂盟 , 黃瀛賢 , 唐國書 , 陳智仁 , 廖祐玄 , 賴宛孜 , 黃福辰 Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Taiwan 高雄長庚 兒童胃腸肝膽科 Poster 5 Coexistence of Congenital Short Bowel with Malrotation and Hirschsprung’s Disease: A Case Report 先天性短腸症併轉位異常及先天性巨結腸症個案分享 Chen-Chen Wen, Hung-Chang Lee 温晨辰 , 李宏昌 Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital,Taipei, Taiwan 馬偕兒童醫院 兒童腸胃科
14. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　12 Poster 6 A Rare Case of Abdominal Tumor in Children 兒童罕見腹部腫瘤之病例報告 King-Jun Koh1,2, Lung-Huang Lin2,3, Chin-Su Liu4,6, Yi-Ting Yeh4,6, Chin-Chen Pan5,6 許慶俊1,2、林隆煌2,3、劉君恕4,6、葉奕廷4,6、潘競成5,6 1Department of Pediatrics, Sijhih Cathay General Hospital, 2School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. 3Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan. 4Division of Pediatric Surgery, Department of Surgery, 5Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 6School of Medicine, National Yang-Ming University, Taipei, Taiwan 1汐止國泰綜合醫院 小兒科 2輔仁大學醫學院 3國泰綜合醫院 小兒科 4臺北榮民總醫院外科部 兒童外科 5臺北榮民總醫院 病理檢驗部 6國立陽明大學醫學院 Poster 7 Incidence and Risk of Sepsis Following Appendectomy 切除闌尾對日後敗血症風險的影響 Tzu-Han Liao1,2, Meng-Che Wu1, Yen-Chu Huang1, Jui-Ju Tseng1, Jiaan-Der Wang1, Cheng-Chung Wei3 廖子涵1,2, 吳孟哲1, 黃彥筑1, 曾瑞如1, 王建得1, 魏正宗3 1 Division of Pediatric Gastroenterology, Children’s Medical Center, Taichung Veterans General Hospital 2 Department of Pediatrics, Chen-Chin Hospital, Chung Kang branch, Taichung 3 Institute of Medicine, Chung Shan Medical University 1台中榮民總醫院兒童醫學中心 兒童肝膽腸胃科 2澄清醫院中港分院 兒童醫學部 3中山醫學大學 醫研所 Poster 8 Intestinal Volvulus Leaded by a Duplication Cyst of Ileum- A Rare Case Report 迴腸囊腫引起的腸扭轉 - 罕見的病例報告 Yu-Chen Huang1, Chuen-Bin Jiang1, Hung-Chang Lee1, Jin-Cherng Sheu2 黃宇辰1, 江椿彬1, 李宏昌1, 許錦城2 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Pediatric Surgery, MacKay Children’s Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科 , 2馬偕兒童醫院 兒童外科 Poster 9 A Congenital Portosystemic Venous Shunt was Found in a Down Syndrome Newborn- A Rare Case Report 唐氏症新生兒發現肝門靜脈與腔靜脈系統之間的分流導管 - 罕見案例報告 Yu-Chen Huang1, Chia-Huei Chen2, Hung-Chang Lee1 黃宇辰1, 陳佳慧2, 李宏昌 1 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital,Taipei, Taiwan 2Department of Neonatology, MacKay Children’s Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科 2馬偕兒童醫院 新生兒科
15. 　　　 13　　　 Poster 10 Early Onset Wilson’s Disease in a 2-year-old Girl— A Case Report 一位二歲病童診斷早發性威爾森氏症— 案例報告 Yu-Hsuan Liao, Mao-Meng Tiao, Ying-Hsien Huang, Kuo-Shu Tang, Chih-Jen Chen, Wan-Tz Lai, Yi-Ting Lu, Fu-Chen Huang 廖祐玄、刁茂盟、黃瀛賢、唐國書、陳智仁、賴宛孜、盧怡庭、黃福辰 Department of Pediatric Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan 高雄長庚醫院 兒童肝膽腸胃科 Poster 11 Ultrasound Rectal Size Measurement to Differentiate Diagnosis of Constipation and Other Abdominal Complaints in Toddler and Young Children – A Single Medical Center Experience 腹部超音波直腸大小的測量來鑑別診斷幼童便秘及其他腹部不適 — 一間醫學中心的 經驗 Yu Yin Chou1,2, Beng Huat Lau1, Tien Lin Kuo1, Cheng Hu Lin1 周昱吟1,2、劉明發1 、郭恬伶1 、林姃慧1 Department of Pediatrics, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan1; Taiwan Adventist Hospital, Taipei, Taiwan2 新光吳火獅紀念醫院 小兒科1、臺安醫院 小兒科2
16. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　14 Huey-Ling Chen, M.D., Ph.D. 陳慧玲 President of TSPGHAN Professor, Department of Pediatrics, National Taiwan University Children Hospital, Taipei, Taiwan Mei-Hwei Chang, M.D. 張美惠 Distinguished Chair Professor, Department of Pediatrics, National Taiwan University Children Hospital, Taipei, Taiwan Hung-Chang Lee, M.D. 李宏昌 Superintendent, MacKay Children's Hospital, Taipei, Taiwan Yen-Hsuan Ni, M.D., Ph.D. 倪衍玄 Distinguished Professor of Pediatrics, Dean, College of Medicine, National Taiwan University, Taipei, Taiwan Chun-Yan Yeung, M.D., Ph.D. 楊俊仁 Associate Professor, Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan Jia-Feng Wu, M.D., Ph.D. 吳嘉峯 Professor, Department of Pediatrics, National Taiwan University Children Hospital, Taipei, Taiwan Pi-Feng Chang M.D., 張碧峰 Chief, Division of Pediatric Gastroenterology and & Hepatology, Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan Chieh-Chung Lin, M.D. 林捷忠 Division of Pediatric Gastroenterology, Department of Pediatrics, China Medical University Children's Hospital, Taichung, Taiwan Moderator
17. 　　　 15　　　 Yao-Jong Yang, M.D., Ph.D. 楊燿榮 Associate Professor, Department of Pediatrics College of Medicine National Cheng Kung University & Hospital Tainan, Taiwan Yu-Cheng Lin, M.D., Ph.D. 林裕誠 Associate Professor, Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan Mao-Meng Tiao, M.D. 刁茂盟 Professor of Pediatrics and Gastroenterohepatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University Kaohsiung, Taiwan Shih-Yen Chen, M.D., Ph.D. 陳世彥 Chief of Department of Pediatrics, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, Taiwan Ching-Chung Tsai, M.D.,Ph.D. 蔡璟忠 Chief of the Department of Pediatrics, E-Da Hospital, Kaohsiung, Taiwan Wen-Terng Lin, M.D. 林文騰 Chief of the Department of Pediatrics, En Chu Kong Hospital, New Taipei City, Taiwan Moderator
18. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　16 【Taiwan Children Liver Foundation Lecture】 Date: September 13, Time: 11:10-12:00 Portal Hypertension in Children: Different Aspects from Adults 兒童門脈高壓 : 與成人相異之特點 Running title: Management of Variceal Bleeding The etiologies of portal hypertension in children are different from that in adults. Therefore management strategies are also different. Variceal bleeding results in significant morbidity and mortality in both children and adults. The guidelines for the management of variceal bleeding are well established in adults but not in children as there have been insufficient pediatric studies of this disorder. In addition, the adult guidelines for treatment of variceal bleeding cannot be applied directly to children as the etiology and natural course of this disease differs between children and adults. As for variceal bleeding in children from cirrhotic condition, primary prophylaxis is not recommended, whereas endoscopic variceal ligation as secondary prophylaxis is recommended. As for extrahepatic portal vein obstruction, a meso-Rex shunt operation is recommended for primary and secondary prophylaxis and even for pre-primary prophylaxis. In this lecture, I will discuss the portal hypertension in children. Speaker Kyung-Mo Kim, M.D., Ph.D. Professor and Head, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Seoul, Korea
19. 　　　 17　　　 < Special Lecture > 【Mini-Symposium】 Date: September 12, Time: 17:05-17:40 Speaker Yoshiko Nakayama, M.D., Ph.D. ʕʆԳɿ Associate Professor & Chief of Gastroenterology Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan Pediatric Gastrointestinal Endoscopy: Current Progress and Future Development 兒科內視鏡新進展：現況與未來發展 The increasing incidences of pediatric inflammatory bowel disease and eosinophilic gastrointestinal disorder have resulted in increasing numbers of gastrointestinal (GI) endoscopies in Japanese children. There have been significant technological developments in GI endoscopy over the last several decades, including availability of pediatric-size equipment or enabling comprehensive investigation of the GI tract in children. The most remarkable development is capsule endoscopy or balloon-assisted enteroscopy for small intestinal disease. Capsule endoscopy is performed in infants at least 10 months old with body weight of 7 kg. The capsule endoscope delivery device, AdvanCE, can be used with high efficacy and safety in patients who cannot swallow the capsule endoscope. Double-balloon enteroscopy has markedly increased the intubation depth into the small intestine. As the double-balloon enteroscope has excellent maneuverability with interventional capability, it is practical not only for diagnosis but also for treatment. The development of therapeutic enteroscopy has changed the treatment strategy for Peutz- Jeghers syndrome and juvenile polyposis syndrome, even in cases complicated with small intestinal intussusception. Taking recent advances into consideration, the Japanese Society for Pediatric Gastroenterology, Hepatology, and Nutrition developed clinical guidelines for pediatric GI endoscopy and sedation/ anesthesia in 2017. This promoted GI endoscopy for pediatricians and adult gastroenterologists. On the other hand, formal training courses for pediatric GI endoscopy are still under consideration. Even the largest institutions performed less than 500 procedures in 2017, which suggests that there are not enough pediatric cases for trainees to gain experience in performing pediatric GI endoscopy compared with institutions in Western countries. To accelerate training of advanced GI endoscopy, we promoted collaboration with adult gastroenterologists in the clinical setting and board certification system.
20. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　18 【Mini-Symposium】 Date: September 12, Time: 15:50-16:15 Speaker Pi-Chuan Fan, M.D., Ph.D. ߪ၀ࢇ Associate Professor, Division of Pediatric Neurology, National Taiwan University Children Hospital, Taipei, Taiwan 台大兒童醫院 小兒神經科 Cyclic Vomiting Syndrome and Migraine Associated GI Disorders 週期性嘔吐及偏頭痛相關的腸胃道疾患 Migraine is a complex, disabling disorder of the brain that is characterized by attacks of often severe, throbbing headache with sensory sensitivity to light, sound and head movement. It is the second most common cause of primary headaches in children and adolescents, with an estimated prevalence of more than 7%. The third edition of the International Classification of Headache Disorders (ICHD- 3) defines diagnostic criteria and four migraine equivalents (precursors) for pediatric migraine: cyclic vomiting syndrome (CVS), abdominal migraine, benign paroxysmal vertigo, and benign paroxysmal torticollis. Pediatric onset CVS has a higher prevalence in females and longer delay in diagnosis. The vomiting must occur at least 4 times in an hour for at least an hour. The duration varies from an hour to 5 days. An underlying mitochondrial or metabolic disorders such as fatty acid oxidation disorder, genetic conditions, or endocrine abnormalities should be carefully excluded. Abdominal migraine was designated a childhood periodic syndrome characterized by attacks of moderate to severe, midline or poorly localized abdominal pain without presence of headache. The duration of the attacks varies from 1-72 hour. During the attacks there must be 2 of the following symptoms: nausea, vomiting, anorexia, or pallor. As with CVS, treatment with a migraine preventive may be worth consideration. Recent reports also demonstrate an increased frequency of gastrointestinal (GI) disorders in patients with migraine compared with the general population, including functional dyspepsia, irritable bowel syndrome (IBS) and functional constipation. These results strongly suggest that the reason for this specific relationship is a common pathophysiological mechanism that is centered on pain genesis, since only functional GI disorders involving pain had any association with migraine. Noxious stimuli from the GI tract are relayed to the Nucleus tractus solitaries (NTS) in the brain stem, which is located close to the trigeminal nucleus caudalis (TNC), one of the key centers in migraine pathogenesis. Central sensitization mediated by repetitive unpleasant GI stimuli may result in receptive field expansion, decreased activation thresholds, and increased response magnitude in the NTS. Consequently, via NTS-TNC inter-connections, the TNC may also receive frequent impulses. TNC activation may, through antidromic conduction, result in neurogenic inflammation in the dura mater and, therefore, headache disorders ensue. This neural pathway could serve as one proposed explanation for the co-morbidity of GI disorders and primary headache disorders.
21. 　　　 19　　　 【Mini-Symposium】 Date: September 12, Time: 16:15-16:40 Speaker Ching-Feng Huang, M.D., Ph.D. ර૶䄣 Chief, Division of Gastroenterology & Nutrition, Children＇s Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan Associate Professor, National Defense Medical Center, Taipei, Taiwan 台北榮民總醫院 兒童醫學部 Food Allergy and Functional Abdominal Pain in Children 食物過敏與兒童功能性腹痛 Food allergies (FA) are an increasing problem especially in children, affecting around 10% of young children. It is an abnormal immune response to allergic food. According to the mechanism of the allergic response, FA are classified into three groups, including IgE-mediated, non-IgE mediated and mix type immune responses. FA usually presents in many gastrointestinal manifestations, including abdominal pain, vomiting, nausea, dysmotility related regurgitation and constipation, dysphagia, diarrhea, haematochezia, food refusal, protein-losing enteropathy and failure to thrive. In general, the role of FA on functional abdominal pain and infantile colic are still controversial. Anaphylaxis is an IgE-mediated, immediate, potentially lethal and multi-systemic allergic reactions. Possible abdominal cramps, nausea, vomiting and diarrhea also attack within few minutes to hours after allergic food ingestion. Eosinophilic gastrointestinal disorders are mixed pathophysiology IgE disorders. Eosinophilic esophagitis (EoE) typically presents with symptoms like GERD such as intermittent vomiting, food refusal. However, patients with EoE frequently complaint for abdominal pain. Non-IgE mediated food allergic disorders result from cell-mediated hypersensitivities, such as food protein-induced enterocolitis syndrome (FPIES), food protein-induced proctocolitis (FPIAP) and food protein-induced enteropathy (FPE) seldom complaints for abdominal pain at early stage without complication. Food allergy may induce intestinal dysmotility. Motility dysfunction is a possible cause for infantile colic, irritable bowel syndrome and constipation. Abdominal colic is common manifestation in these disorders. However, the exact mechanism of dysmotility caused by food allergens remains poorly comprehended. Pro-inflammatory cytokines and inflammatory cells in gastrointestinal tract might interact with enteric nervous system, which induce intestinal dysmotility and abdominal pain. Allergic reactions also possibly stimulate intestinal afferent nerve circuits via the brainstem which might impede sphincter tone and trigger gastrointestinal symptoms. The possible relationship between FA and infantile colic derives from the intestinal dysmotility with visceral hypersensitivity and dysbiosis. Several clinical studies have elucidated a therapeutic benefit of hypoallergenic diet and infants with colic. Elimination of the allergic foods from diet is the standard policy for patients with food allergy at present. The role of gut microbiota and therapeutic effects of probiotics on food allergy and consequent abdominal colic require further assessment.
22. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　20 【Mini-Symposium】 Date: September 12, Time: 16:40-17:05 Speaker Yun Chen, M.D., Ph.D. ௓ ڄ Vice President, Far Eastern Memorial Hospital, New Taipei City, Taiwan 亞東紀念醫院 副院長 The Management of Acute Abdomen and The Application of Minimal Invasive Surgery in Children 腹部急症的處理及微創手術在小外的適用範圍 　　嘔吐、腹痛在兒科是常見的主訴，大部分的嘔吐腹痛是來自腸胃炎，然而比較嚴重的嘔吐 腹痛，要與急性腹症做鑑別診斷。嬰幼兒與學齡兒童最常見的造成腸阻塞的急性腹症以急性闌 尾炎、腸套疊、和嵌閉性腹股溝疝氣為主，佔兒童急性腹症的 90% 以上，其他如莫克式憩室炎、 膽道囊腫、腸道複製囊腫、腸系膜囊腫、硬纖維瘤雖不常見，但也須列入鑑別診斷，較少見的 如中腸扭結、大腸穿孔、胃潰瘍穿孔雖不常發生，但需要很緊急的手術治療，也需特別考量。 新生兒的嘔吐腸阻塞以腸閉鎖、胎糞性腹膜炎、胎糞性腸阻塞、長節巨結腸症為主，有些則來 自胃扭結，若發生膽汁性嘔吐，中腸扭結要列入鑑別診斷。 　　診斷上，除了病史詢問與理學檢查外，腹部超音波是第一線協助診斷的工具，腹部 x- 光檢 查、上下消化道攝影可以協助判斷，而腹部電腦斷層檢查則是針對困難診斷的個案一個有效的 工具。小兒外科微創腹腔鏡手術或腹腔鏡輔助手術常第一線用來協助診斷與治療急性腹症，提 出經驗分享。
23. 　　　 21　　　 Date: September 13, Time: 9:00-9:30 Speaker Yu-Cheng Lin, M.D., Ph.D. ؍༃༐ Associate Professor, Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan 亞東紀念醫院 小兒部 Pediatric Nonalcoholic Fatty Liver Disease: What is New? 兒童非酒精性脂肪肝疾病之新進展 Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of conditions ranging from simple hepatic steatosis to potentially fatal nonalcoholic steatohepatitis and cirrhosis. Concurrent with the epidemic of childhood obesity, pediatric NAFLD is an emerging health issue in Taiwan. The pathogenesis of NAFLD is multifactorial; it is strongly associated with obesity and insulin resistance. However, not all obese children develop NAFLD, suggesting that genetic and environmental factors modify individual susceptibility to NAFLD. In the past decade, we have discovered several important susceptibility genes, including uridine 5’-diphosphate-glucuronosyl transferase 1A1 (UGT1A1), patatin-like phospholipase domain- containing-3 (PNPLA3), peroxisome proliferator-activated receptor-γ coactivator-1α (PPARGC1A), glucokinase regulatory protein (GCKR), transmembrane 6 superfamily member 2 (TM6SF2), and immunity-related GTPase family M (IRGM) genes. Our finding has important implications for global comparison with genetic data from other ethnic origins, including Europeans, Africans, and Hispanics. The identification of these genetic variants may be useful in identifying the risk of non-alcoholic fatty liver disease in obese children and adolescents. In recent years, our understanding of NAFLD has greatly improved, and important progress has been made in diagnosis, etiology, genetics and management. However, improving the future care of children with NAFLD requires more understanding of the natural history and pathogenesis of the disease, with particular attention to the interaction of diet, genetics, microbiome and environmental factors. These advances can help to determine which children will benefit most from intensive multidisciplinary care and treatment. Currently, lifestyle interventions are still the cornerstone of obesity and NAFLD treatment. However, in clinical practice, it is not common to rely on lifestyle interventions to achieve meaningful and sustained weight loss. At present, although many pharmacological strategies have been tested in pediatric NAFLD clinical studies, no drugs have been officially approved. For future research and monitoring patient response to treatment, the development and validation of noninvasive biomarkers and imaging modalities will be invaluable.
24. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　22 Date: September 13, Time: 9:30-10:00 Speaker Ping-Ing Lee, M.D., Ph.D. ҽ٢጑ Associate Professor, Division of Pediatric Infectious Disease, National Taiwan University Children Hospital, Taipei, Taiwan 台大兒童醫院小兒感染科 台灣疫苗推動協會榮譽理事長 Gastrointestinal Symptoms of Respiratory Tract Infection 呼吸道感染的腸胃症狀—小心 ! 可能不是腸胃炎 Gastrointestinal symptoms are not uncommon in various respiratory tract infections. Vomiting and abdominal pain induced by increased intracranial pressure or lobar pneumonia may lead to an erroneous impression and inappropriate managements of the patient. Respiratory symptoms are not uncommon in viral gastroenteritis. Both rotavirus and norovirus infections prevail not only in low-income countries, but also in high-income countries. This is quite different from that most bacterial enterocolitis prevail only in low-income countries. It is possible that the so-called enteric viruses by be transmitted by respiratory droplets or by contact. It is known that many respiratory tract infections may be associated with gastrointestinal symptoms. Some of these respiratory viruses may be able to invade gastrointestinal tract, depending on their acid stability and their ability to infect enterocyte. Other factors may also contribute to gastrointestinal symptoms associated with respiratory tract infections, including medicine and inflammatory activity.
25. 　　　 23　　　 Date: September 13, Time: 10:25-11:10 Speaker Walter Chen, M.D., M.S. ௓ਃᅃ Chair Professor of Pediatrics, School of Medicine China Medical University & Hospitals, Taichung, Taiwan 中國醫藥大學 校務顧問 講座教授 Management of Pediatric Obesity: Ten Lessons for Healthcare Education 兒童青少年減肥：衛教十堂課 　　肥胖有害，所以要減肥。 　　減肥必須按歩就班，先理解飲食、營養與健康的基本知識，再大略了解肥胖的成因，然後 選擇可持久使用的方法，有恆的去執行，才能有成效；道聽途說一些所謂速成的秘方，也許短 期有效，但長期下來可能反而傷害身體。 　　以下十堂課是依據 20 多年前在台北市立忠孝醫院所寫的「小兒肥胖與居家治療」小册所改 编而成，不要小看它，因為實證研究顯示，認真研讀而且遵循執行肥胖兒少及其家人，一年後 追踪，49% 的個案其肥胖程度有改善（臺灣醫誌 1993）；去年，應國家衛生研究院的邀請，重 組有經驗的教授、醫師、營養師，根據新的證據或指引，重寫了大部份內容，只希望它更有效益； 國衛院也已將相關資料置於其官網上（https://chrc.nhri.org.tw/ forparents/body-weight/）。 　　減肥很難，知難行更難；不過，花點時間精進正確的營養認知，必將有助於維護健康。
26. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　24 < Lunch Symposium > Date: September 13, Time: 12:10:12:50 Speaker Chun-Yan Yeung, M.D., Ph.D. เڲʠ Associate Professor, Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 馬偕兒童醫院 小兒胃腸科 Gangliosides Update in Infant’s Immunity and Gut Health 神經節苷脂於嬰兒免疫及腸道健康新進展 Human milk is the ideal source of nutrition for infants. It provides all of the resources necessary for postnatal growth and is considered the “gold standard” for early life nutrition. Infant’s immune and digestive systems are not fully developed at birth, making babies more susceptible to illness. Strengthening the inner defenses is critical during early childhood. Human milk contains bioactive components that provide health benefits to the developing baby, which help to promote a healthy gut microbiota and prevent pathogens invasion. This potential mechanism may explain lower illness rates in breastfed infants. However, in situations where breastfeeding is not an option or when milk is unavailable, formula feeding becomes the staple diet. The feasibility of using biologically active compounds in infant formula has been the focus of much research to date. Gangliosides are acid glycosphingolipids and bioactive factor widely distributed in most vertebrate tissues and fluids, including breast milk. Gangliosides are integral to the structure and function of cell membranes. Their concentration is higher in human breast milk compared with normal bovine milk and milk formula. In human milk, the content and individual distribution of gangliosides changes during lactation, GD3 being the most abundant ganglioside in colostrum, while in mature milk, GM3 is the major individual species. Gangliosides are thought to promote a healthy gut microbiota and may act as a decoy to help prevent pathogens from attaching to the intestine. These bioactive factors are one of the ways breast milk may support baby’s inner defenses. Gangliosides have been shown to play important roles in neuronal development, neuropathologic processes and receptor functions with respect to protein hormones, interferon, and bacterial toxins. Ganglioside-supplemented infant formula has been reported to modify the intestinal ecology of preterm newborns, increasing the Bifidobacteria content and lowering that of Escherichia coli. Gangliosides may have an important role in the modification of intestinal microflora and the promotion of intestinal immunity development in the neonate, and consequently in the prevention of infections during early infancy. However, further studies are required to clarify the mechanisms involved in these actions and the relevance of this finding to clinical outcomes in neonates. Breast milk feeding remains the best option for infants’ nutrition and development. Whenever breast milk is not adequate or unavailable, infant formula supplemented with gangliosides might be considered as a desirable alternative. The presence of gangliosides in infant formula brings the composition closer to that of breast milk.
28. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　26 Date: September 12, Time:13:30-13:37 Free Papers (I) O-1 Gastrointestinal Manifestations of Food Allergy Related with Atopic Diseases in Children and Adolescents in Taiwan 台灣兒童及青少年食物過敏與過敏疾病和腸胃道症狀的相關性 Ying-Chi Wong1, Zhe Ying Liu1,2, Chih Kang Huang1, Shih Kuan Li 1,3, Tzee-Chung Wu 1, Ching-Feng Huang1 黃映齊1, 劉喆瑩1,2, 黃治綱1, 李士寬1,3, 吳子聰1, 黃清峯1 1Division of Paediatrics Gastroenterology & Nutrition, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan 2Department of Paediatrics, Taipei Municipal Wanfang Hospital, Taipei, Taiwan 3Department of Paediatrics, Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan 1台北榮民總醫院 兒童腸胃科 2台北市立萬芳醫院 兒科部 3永和耕莘醫院 小兒科 Background: Manifestations of food allergy (FA) include gastrointestinal (GI), dermatologic, dysautonomic, and respiratory symptoms. In children and adolescents diagnosed with atopic diseases, FA presented by GI symptoms alone is correlated with specific food allergens. Objective: To compare various inducing food allergens which cause GI symptoms of FA, and correlation with different atopic diseases. Methods: This is a nationwide, cross-sectional, randomized questionnaire survey. Atopic diseases include allergic rhinitis (AR), asthma, atopic dermatitis (AD) and urticaria. Diagnosis of FA is based on medical documentation. GI symptoms of FA include diarrhea, nausea, vomiting, and abdominal pain. Non-GI symptoms include respiratory, dermatologic, and dysautonomic symptoms. Results: 9,982 questionnaires were enrolled. 2,286 respondents with atopic diseases reported GI and non-GI symptoms of FA. The majority of FA symptoms in children and adolescents diagnosed with atopic diseases (total of 2089) were mostly non-GI (91.4%); GI and non-GI symptoms were experienced in 1579 (69.0%); only 564 reported GI symptoms alone (8.5%). FA with GI symptoms alone were related to 1.26 ± 0.41 types of atopic diseases. Those with non-GI symptoms (total of 1722) had 1.09 ± 0.36 atopic disorders. The most common atopic disease related with GI symptoms of FA is AR (36.8%), followed by AD (12.5%), asthma (9.0%), and urticaria (8.3%). FA to fish without shells, soybeans, and dairy are the top three food allergens related with GI symptoms alone (15.4%, 12.9%, and 11.8% respectively). FA to peanut, shellfish, and fruits (92.9%, 92.4%, and 92.2% respectively) caused mostly non-GI symptoms. Conclusions: Certain food allergens tend to emphasize the GI symptoms of FA, including fish without shells, soybeans, and dairy. Among children and adolescents in Taiwan, the presentation of FA by GI symptoms alone is associated with more kinds of atopic diseases than non-GI symptoms. The most commonly associated atopic disease is AR.
29. 　　　 27　　　 Date: September 12, Time:13:37-13:44 Free Papers (I) O-2 Common Food Allergens and Allergic Symptoms for Medical Attention in Taiwan 台灣尋求醫療協助常見食物過敏原與症狀 Yii-Shiuan Lee, Ying-Chi Wong, Chih Kang Huang, Tzee-Chung Wu, Ching-Feng Huang 李苡萱 , 黃映齊 , 黃治綱 , 吳子聰 , 黃清峯 Division of Pediatric Gastroenterology & Nutrition, Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan 臺北榮民總醫院 兒童醫學部兒童胃腸科 Background: Prevalence of food allergy (FA) is gradually increasing, which becomes a rising concern. This study aims to assess the frequent triggers among patients requring medical attention. The variation of triggers between patients seeking and those not seeking medical attention is also analyzed. Methods: This is a nationwide, cross-sectional, randomized questionnaire survey. Interviewee and their family members were enrolled. Patients who knew their food allergens were addressed and analyzed. Results: A total of 19,609 questionnaires were enrolled. 3,170 patients knew their food allergens. Among them, 1,501 patients (47.35%) sought medical attention. Shellfish is the most common food allergen in patients seeking medical attention (70.62%). Shrimp and crab were the top two allergens (55.96% and 35.78%, respectively). Nut, soybean and wheat were the three least frequent allergens (3.6%, 1.67% and 1.27%, respectively). Most patients seeking medical attention received treatment. Among them, 70.81% had shellfish allergy. In respondents with shellfish allergy, 47.81% sought medical attention, which was comparable to respondents whom reported allergy to egg and milk allergy (49.61% and 45.61%, respectively). On the other hand, those with vegetable, fruit, meat, nut, soybean and wheat allergy preferred not seeking medical attention (40.7%, 40.56%, 35.84%, 34.39%, 32.05%, and 18.81%, respectively). Skin itchiness and skin rash were the top two complaints in patients seeking medical attention (66.56% and 48.43%, respectively), which were also the most common reasons requiring medical intervention (71.68% and 57.3%, respectively). Most patients suffering from shortness of breath sought medical advice (60.53%) while those with headache didn’t (41.77%). There was no significant difference in those with gastrointestinal symptoms. Conclusion: Shellfish is the most common food allergen in patients seeking medical attention in Taiwan.
30. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　28 Date: September 12, Time:13:44-13:51 Free Papers (I) O-3 Perforated Peptic Ulcer Disease in Childen: The Experience in a Territory Center 南臺灣關於穿孔性消化性潰瘍及危險因子探討 Wan-Tz Lai1, Yi-Wen Tsai2, Yi-Ting Lu1, Yu-Hsuan Liao1, Arthor Chen1, Kuo-Shu Tang1 , Ying-Hsien Huang1, Mao-Meng Tiao1, Sin-Yi Li2, Chun-Hong Chiang2, Fu-Chen Huang1 賴宛孜1, 蔡逸文2, 盧怡庭1, 廖祐玄1, 陳智仁1, 唐國書1, 黃瀛賢1, 刁茂盟1, 李信儀2, 江俊宏2, 黃福辰1 1Department of Pediatric Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan 2Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan 高雄長庚 兒童胃腸科1, 高雄長庚 小兒外科2 Background: The location that peptic ulcer disease usually involves are stomach and proximal duodenum. The occurrence of peptic ulcer disease is relatively rare in pediatric group as compared with adults, and perforated peptic ulcer (PPU) disease is even rare. Perforated peptic ulcer disease may lead to the development of sepsis, and further cause the mortality and morbidity, therefore deserved attention. Objective: This study aimed to analyze the clinical features of perforated ulcer disease in pediatric groups and identify the potential risk factors. Methods: The medical charts of children diagnosed with PPU at Kaosiung Chang Gung hospital from January 2004 to December 2019 were reviewed. Thirteen patients were involved in this study. We retrospectively reviewed the medical records and basic information of the patients. The data were analyzed using the Mann-Whitney test, Chi-square test for possible risk factors. Results: There were a total of 13 patients with 14 perforated episodes included in the study. These patients were all male gender, aged from 3 to17 years old (mean, 12.94 years old). Ten patients were adolescents (76.9%). All of these patients manifested acute abdominal pain. Ten patients (76.9%) had peritoneal signs. Radiography showed pneumoperitoneum in 10 patients (76.9%); this was the most important method to establish the diagnosis of PPU. The remanding patients were diagnosed by abdominal sonography, computed tomography, or even operation. One patients died (7.7%). One patient had recurrent perforated peptic ulcer disease. Chi-square test showed that the duration from symptom onset to operation was significantly associated with hospital stay (P < 0.05). Evidence of pneumoperitoneum on X-rays, negatively correlated with length of hospital stay. Conclusions: Young male patients who manifested with abdominal pain and peritoneal sign, perforated peptic ulcer disease should be included to differential diagnosis immediately.
31. 　　　 29　　　 Date: September 12, Time:13:51-13:58 Free Papers (I) O-4 Roles of Vitamin D on Gut Integrity and Zonulin Expression in a Mouse Model 維生素 D 對小鼠腸道完整性和 Zonulin 的表現 Tsung-Hua Hsieh1, Chun-Yan Yeung1,2,3, Hung-Chang Lee1,2,3, Wai-Tao Chan1,2,3, Chuen-Bin Jiang1,2,3, Szu-Wen Chang1,2,3, Jen-Shiu Chiang Chiau2, Mei-Lein Cheng2, Chia-Yuan Liu2,3,4, Ching-Wei Chang2,3,4 謝宗樺1, 楊俊仁1,2,3, 李宏昌1,2,3, 陳偉燾1,2,3, 江椿彬1,2,3, 張思玟1,2,3, 江謝正雄2, 鄭美蓮2, 劉家源2,3,4, 張經緯2,3,4 1Department of Pediatric Gastroenterology, Hepatology and Nutrition,MacKay Children’s Hospital, Taipei, Taiwan 2Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan 3Department of Medicine, MacKay Medical College, New Taipei City, Taiwan 4Department of Hepatology and Gastroenterology, MacKay Memorial Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科 ; 2馬偕紀念醫院 醫學研究部 ; 3馬偕醫學院 醫學系 ; 4馬偕紀念醫院 胃腸肝膽科 Background: Vitamin D (VD) plays important role not only in mineral balance and skeletal maintenance but also in immune modulation. Previous studies had shown VD insufficiency or deficiency was strongly correlated with gut integrity and immune response. VD status was also found correlated with the pathophysiology and severity of inflammatory bowel diseases. Epithelial barrier function is primarily regulated by the tight junction proteins. We can foresee the translocation of pathogens to intestine once dysfunction of tight junction occurs.In this study, we try to investigate the effects of VD deficient diet on gut integrity and zonulin expression in a mouse model. Method: Male C57BL/6 mice were administered either VDD diet (1,25(OH)2 D3 0 IU/per mouse) or VD sufficient diet (VDS group, 1,25(OH)2 D3 37.8 IU/per mouse) for 7 weeks. After sacrificed, villus length and crypt depth of jejunum as well as mucosa thickness of colon were measured. Serum VD and zonulin levels, various pro-inflammatory cytokines and tight junction (TJ) proteins were assessed. Serum level of zonulin and mRNA expression of jejunum zonulin were also investigated. Results: We found mice fed VDD diet had indeed lower serum level of VD. VDD mice significantly had less weight gain (p=0.005) and less diet intake (p=0.027) after 7 weeks. Significantly decreased colon mucosa thickness was found in VDD mice compared to VDS group (P=0.022). Marked increase in serum pro-inflammatory cytokine levels and decrease in tight junction proteins expressions were demonstrated in the VDD mice. Significantly higher levels of mRNA expression of jejunum zonulin and serum zonulin were found in VDD group (p=0.043 and p=0.001, respectively). Conclusion: In this study, we successfully established an animal model by raising mice fed VDD diet and elucidated the role of VD in gut morphology and barrier function. We demonstrated that VD could maintain intestinal epithelial integrity, alleviate structural damage and inflammation and prevent intestinal barrier dysfunction in this mice model. Thus, VD supplementation may serve as an alternative therapeutic strategy for the prevention or management of various human diseases with intestinal barrier dysfunction in the future. To our knowledge, this is the first to demonstrate VDD could lead to a significant up-regulation in mRNA expression of jejunum zonulin in a mouse model.
32. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　30 Date: September 12, Time:13:58-14:05 Free Papers (I) O-5 YqiC is Required for Electron Transport Chain, Glycolysis Capacity, and Antioxidation of Salmonella typhimurium 鼠傷寒沙門氏菌之電子傳遞鏈 , 醣解能力 , 及抗氧化力需要 yqiC 基因 Hung-Yen Cheng1, Pei-Ru Chang1,2, Ying-Hsiu Lin1,2, Wei-Chiao Chang3, Lauderdale Tsai-Ling Yang4, Shiuh-Bin Fang1,2,3* 鄭弘彥1, 張珮茹1,2, 林盈秀1,2, 張偉嶠3, 楊采菱4, 方旭彬1,2,3* 1Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; 2Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 3Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan; 4National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan 1臺北醫學大學部立雙和醫院小兒部小兒消化科；2臺北醫學大學醫學院醫學系小兒學科 3臺北醫學大學藥學院臨床藥物基因體學暨蛋白質體學碩士學位學程 4國家衛生研究院感染症與疫苗研究所 Background and Objective: yqiC is required for colonization of Salmonella Typhimurium (S. Typhimurium) in human cells and for menaquinone biosynthesis (Front Microbiol 2016;7:1614). We aimed to examine the effects of yqiC on glycolysis capacity and reserve, reactive oxidative stress, and electron transport chain in S. Typhimurium. Methods: For Glycolysis Stress Test (GST), mid-log cultures of S. Typhimurium wild-type SL1344, its yqiC- deleted mutant ΔyqiC, and its yqiC-complemented strain ΔyqiC' were incubated in Seahorse XFp Analyzer for 173.2 min. Glucose, oligomycin, and 2-deoxyglucose (2-DG) were individually injected into the wells at 28 min, 54.4 min, and 80.8 min, respectively. Extracellular acidification rates (ECAR) and GST profile including glycolysis, glycolytic capacity, and glycolytic reserve were measured. For NADH/NAD+ ratio assays, mid-log cultures of the three strains were lysed in a sonicator. The lysates were measured for concentrations of NADH and NAD+ to calculate the ratios. Similarly, the lysates were sonicated and H2 O2 concentrations were quantified. The OD565 nm values at different time were calculated into amounts of H2 O2 . Results: In GST without injection of glucose, oligomycin, and 2-DG, there were no significance with time between wild-type SL1344, ΔyqiC, and ΔyqiC' in ECARs. However, the glycolysis and glycolysis capacity of ΔyqiC were significantly lower than those of wild-type SL1344 and ΔyqiC' after injection of glucose and oligomycin (38.9 vs 63.6 & 69.3, p = 0.005 & 0.004; 26.4 vs 79.7 & 86.1, p = 0.006 & 0.002, respectively). The glycolysis reserve of ΔyqiC was significantly decreased compared with that of ΔyqiC' (-12.5 vs 16.7, p = 0.012). yqiC deletion leads to impaired glycolytic capacity and reserve compared to preserved glycolytic capacity and reserve in wild-type SL1344 and ΔyqiC'. In NADH/NAD+ assays, ΔyqiC had significantly lower NADH/NAD+ ratio than wild-type SL1344 after 15 min (1.11 vs 2.37, p = 0.0414). In H2 O2 assays, ΔyqiC had significantly higher amounts of H2 O2 compared with wild-type SL1344 (1.0 vs 0.4 at 0 min, p = 0.001, 1.13 vs 0.64 at 10 min, p = 0.004, 1.31 vs 0.87 at 20 min, p = 0.001, 1.45: 1.08 at 30 min, p = 0.01). Conclusion: yqiC depletion blocks electron transport chain to hinder glycolysis capacity/reserve and induce reactive oxidative stress in S. Typhimurium.
33. 　　　 31　　　 Date: September 12, Time:14:05-14:12 Free Papers (I) O-6 Clostridium Difficile Infection Rates in Paediatric Inflammatory Bowel Disease is on the Rise – A Single Centre Study in Asia 小兒發炎性腸症的困難梭菌感染率正在上升 － 亞洲的單一中心研究 Mu-Ming Chien1,2, Mei-Hwei Chang1,3, Kai-Chi Chang1, Yu-Chun Chiu1,4, Huey-Ling Chen1,3,6, Yen-Hsuan Ni1,3,5, Hong-Yuan Hsu1,6, Jia-Feng Wu1 簡睦旼1,2, 張美惠1,3, 張凱琪1, 邱郁淳1,4, 陳慧玲1,3,6, 倪衍玄1,3,5, 許宏遠1,6, 吳嘉峯1 1Department of Pediatrics, National Taiwan University Children’s Hospital, National Taiwan University, Taipei, Taiwan 2Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan 3Hepatitis Research Center, 4Department of Medical Education, 5Department of Medical Genetics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan 6Department of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan 1臺大兒童醫院 小兒部 2台北醫學大學附設醫院 兒科部 3臺大醫院 肝炎研究中心 ,4臺大醫院 教學部 ,5臺大醫院基因醫學部 6臺灣大學醫學院醫學教育暨生醫倫理研究所 Background : The infection rate of Clostridium difficile is on the rise worldwide, and the pediatric patients with inflammatory bowel disease (IBD) is exceptionally susceptible to the infection. Objective: This study aims to evaluate the incidence rate of Clostridium difficile infection (CDI) in IBD and non-IBD pediatric population from 2006 to 2017 in a tertiary center in Taiwan. Method: We retrospectively collected patients from 1 to 18 years old who visited or admitted to our hospital within 2006~2017. Seventy-three patients were diagnosed with IBD in this period. Results: Over the 11 years, a total of 284 cases of CDI were identified. Among the 73 IBD patients, 32 (43.8%) ever had an episode of CDI. The overall incidence rate of community-acquired CDI (CA-CDI) increased from 0.020 cases per 1,000 patient visits in 2006 to 0.167 cases per 1,000 patient visits in 2017. Compared to 2006-2011, the average incidence rate of CDI in 2012-2017 increased 483% in non-IBD patients (from 0.006 to 0.035 cases per 1,000 visits) and 837% in IBD patients (from 1.55 to 14.53 cases per 1,000 visits). Healthcare facility-onset CDI (HO-CDI) increased from 0.88 per 10,000 patient-days in 2007 to 5.69 per 10,000 patient-days in 2017. In terms of cases per 1,000 hospitalization, the incidence rate would be 0.82 in 2007 and 4.50 per 1,000 hospitalization in 2017. Compared to 2007-2012, the average incidence rate of HO-CDI in 2013-2017 increased 184% in non-IBD patients (from 0.81 to 2.29 cases per 10,000 patient-days), and 534% in IBD patients (from 15.70 to 99.63 cases per 10,000 patient-days). Conclusion: Both CA-CDI and HO-CDI in pediatric population were on the rise in Taiwan, and the incidence rates were especially higher in IBD patients.
34. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　32 Date: September 12, Time:14:30-14:37 Free Papers (II) O-7 Impact of Antibiotic Treatment on the Gut Microbiota in Kawasaki Disease 抗生素對川崎症病人腸道菌種的影響 Chen-Chen Wen1, Chuen-Bin Jiang 1, Chun-Yan Yeung1, Wai-Tao Chan1, Hung-Chang Lee1, Jen-Shiu Chiang Chiau2 温晨辰1, 江椿彬1, 楊俊仁1 , 陳偉燾1 , 李宏昌1, 江謝正雄2 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan. 2Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan. 1馬偕兒童醫院 兒童腸胃科；2馬偕紀念醫院 醫學研究部 Background: Kawasaki disease (KD) is an acute febrile illness of childhood seen worldwide with highest incidence occurring in Asian children. KD is a vasculitis with a predilection for the coronary arteries. The cause of KD remains unknown, but certain epidemiologic and clinical features support an infectious origin. The gut microbiota plays important roles in nutrient absorption, immune system development and pathogen colonization resistance. Antibiotics are among the many factors that influence the development of the microbiota. Objective: To investigate the effect of antibiotic therapy on the gut microbiota and clinical finding in KD patients. Methods: In this prospective study, the medical record of 54 children diagnosed with KD at Mackay Children’s hospital was collected between January 1, 2017 and December 31, 2018. The clinical findings between the KD with antibiotic therapy group (n=12) and without antibiotic therapy group (n=42) were compared. Fecal samples were collected after IVIG treatment. Gut microbiota was analyzed with Next- Generation Sequencing (NGS) and CLC Genomics Workbench system. Results: We found that the microbial diversity (alpha diversity) was significantly decreased in KD patients with antibiotic treatment compared to KD patients without antibiotic treatment (Shannon entropy, p-value=0.03). The Prevotella, Ruminococcus, Bifidobacterium, Staphylococcus and Bacteroides have been found in the stools of KD children with antibiotic therapy by Heatmap analysis. Of the children with KD, 22.2% (12/54) received treatment with intravenous antibiotics before the diagnosis of KD was assigned. There was no significant difference in diarrhea (p=0.117), development of coronary complications (p=0.33) and length of hospital stay (p=0.14) between two groups. Conclusions: We found that the microbial diversity was decreased in KD patients with antibiotic treatment. Decreased microbial diversity in KD patients did not affect the response to treatment, coronary artery outcome, length of hospital day and gastrointestinal symptoms, such as diarrhea.
35. 　　　 33　　　 Date: September 12, Time:14:37-14:44 Free Papers (II) O-8 Alterations in the Gut Microbiota of Children with Ascending Cholangitis: Preliminary Report 兒童急性上升性膽管炎的腸道微生物菌叢研究分析：初步報告 Mi-Chi Chen, Ming-Wei Lai, Hsun-Chin Chao, Hung-Yu Yeh, Hung-Hsiang Lai, Chien-Chang Chen 陳米琪、賴明瑋、趙舜卿、 葉宏瑀、 賴宏香、 陳建彰 Department of Pediatric Gastroenterology, Linkou Chang Gung Memorial Hospital, Taiwan 林口長庚紀念醫院 兒童胃腸科 Background: Acute cholangitis often occurs in patients with disrupted biliary tract barrier mechanisms and primarily caused by ascending enteric bacteria. Specific pathogenic bacteria overgrowth may lead to the infection. This study aimed to identify the changes in gut microbiota during biliary tract infections (BTI). Objective: Pediatric patients diagnosed with BTI were included. Methods: Biliary tract infection was diagnosed when the patients presented fever, abdominal pain, or jaundice with leukocytosis, cholestasis, and elevated aminotransferases. Fecal microbiota was analyzed in children with BTI and the age-matched healthy children without diarrhea. Individual microbial diversity and composition were analyzed via PCR and sequencing using a modified version adapted for the Illumina MiSeq. The V4 region of the 16S rRNA gene were amplified with region-specific primers that included the Illumina flowcell adapter sequences. Results: Eleven patients, median age 10.2 years of age (2 months – 26 years of age), with total of 14 episodes of BTI were included. Nine patients had biliary atresia, and 2 patients had choledochal cyst. One patient’s blood culture yielded Escherichia coli. A comparison of the taxonomic data revealed that the children with BTI exhibited relatively high abundances of Proteobacteria at the phylum level and a relative underrepresentation of the phylum Bacteroidetes and Firmicutes. At the family and genus level, we observed significant increases in the numbers of Enterobacteriaceae, Escherichia/Shigella, and Enterococcus in the BTI. In the analysis of alpha diversity, the Chao1 index of the BTI patients was lower than health control, 269.6 versus 291.3, and the Shannon index of the BTI patients was also lower than health control, 3.64 versus 3.79, respectively. Conclusions: This study showed that BTI was associated with compositional changes in the gut microbiota, and the microbial dysbiosis of the host may play a role in the disease course of cholangitis.
36. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　34 Date: September 12, Time:14:44-14:51 Free Papers (II) O-9 Clinical and Genetic Features of Patients with Alagille Syndrome in Taiwanese Children 台灣病童罹患阿拉吉歐症候群之臨床及基因特徵 Che-Ming Chiang 1,2, Yung-Ming Jeng 3, Ming-Chih Ho 4, Ming-Wei Lai 5,Huei-Ying Li 6, Pei-Lung Chen 7,8, Ni-Chung Lee 1,7, Jia-Feng Wu 1, Yu-Chun Chiu 1, Bang-Yu Liou 1, Yen-Hsuan Ni 1, Hong-Yuan Hsu 1, Mei-Hwei Chang 1,Huey-Ling Chen 1 江哲銘1,2, 鄭永銘3, 何明志4, 賴明瑋5, 李慧瑛6, 陳沛隆7,8, 李妮鐘1,7, 吳嘉峯1, 邱郁淳1, 劉邦渝1, 倪衍玄1, 許宏遠1, 張美惠1, 陳慧玲1 Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan1 Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan 2 Department of Pathology3 and Surgery4, National Taiwan University Hospital, Taipei, Taiwan Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taiwan 5 Medical Microbiome Center, National Taiwan University College of Medicine, Taipei, Taiwan 6 Department of Medical Genetics7 and Internal Medicine 8, National Taiwan University Hospital, Taipei, Taiwan 台大醫院小兒部1；國防醫學院三軍總醫院小兒部2；台大醫院病理部3；台大醫院外科部4； 林口長庚紀念醫院兒童胃腸科5；台大醫院醫學微生物體核心實驗室6；基因醫學部7；內科部8 Background: Alagille syndrome (ALGS) is an autosomal dominant complex multisystem disorder. Patients with ALGS have chronic cholestasis and may progress to cirrhosis and liver failure. Data in Taiwanese children is limited. Objective: This study aimed to investigate the clinical features, outcomes, and genetic mutations in Taiwanese ALGS patients. Methods: We retrospectively reviewed and analyzed a total of 24 Taiwanese children diagnosed with ALGS by clinical criteria. Clinical characteristics, outcomes, and molecular analysis of candidate genes using Sanger sequencing or next generation sequencing were thoroughly analyzed. In addition, we analyzed the pathology scores in the explant liver of ALGS patients and those age-matched children with biliary atresia (BA) at the time of liver transplantation. Results: Cardiac disease was the most common manifestation (24/24, 100%), followed by cholestasis (22/24, 91.7 %), characteristic face (22/24, 91.7%), butterfly vertebrae (17/22, 77.3 %), and posterior embryotoxon (5/17, 29.4%). The native liver survival and overall survival at 10 years were 42.7 % and 84.9 %, respectively. We identified 16 different JAG1 mutations (3 large deletions, 2 inframe deletion, 4 frameshifts, 5 nonsense, and 2 splicing mutation) in 17 patients, with 8 novel mutations. Three unrelated probands were found to have the same mutation in JAG1, c.2122_2125delCAGT. All these three children had a relatively favorable course, who were jaundice-free at follow-up. Ten children with ALGS underwent liver transplantation. Compared with age-matched BA children receiving transplantation, ALGS children have higher serum albumin levels and lower Metavir scores in liver pathology. Conclusion: The majority of Taiwanese ALGS children were identified to have Jag1 mutation. We presented the potential de novo hot spot mutation c.2122_2125delCAGT in the JAG1 gene associated with mild chronic cholestasis course. The severity of cirrhosis is less in ALGS than BA patients at the time of liver transplantation. Clinical awareness is important for diagnosis of ALGS.
37. 　　　 35　　　 Date: September 12, Time:14:51-14:58 Free Papers (II) O-10 The Cardiometabolic Risks in Severe Obese Children and Adolescents in Taiwan 台灣兒童青少年嚴重肥胖與心血管代謝性風險的關聯性研究 Po-Sheng, Chang1,2, Pi-Feng, Chang1,2, Yu-Cheng Lin1,2 張博勝1,2, 張碧峰1,2, 林裕誠1,2 1Department of Pediatrics, Far-Eastern Memorial Hospital, New Taipei City, Taiwan 2Division of Pediatrics Gastroenterology, Department of Pediatrics, Far-Eastern Memorial Hospital, New Taipei City, Taiwan 亞東紀念醫院 兒科部 Background: The prevalence of obese children has risen dramatically in recent decades. Children with more severe obesity may have greater risk of cardiometabolic complications. Objective: To investigate the prevalence of cardiometabolic risk factors in severe obese children. Methods: We analyzed a cross-sectional cohort of 6 to 18-year-old children recruited in the Nutrition and Health Survey in Taiwan (NAHSIT) from 2010 to 2012 to evaluate the prevalence of cardiometabolic risk factors stratified by the severity of obesity. According to age-specific and sex-specific BMI percentiles, the weight categories were as follows: over-weight (≥85th to <95th percentile), class I obesity (≥95th percentile to <120% of the 95th percentile), class II obesity (≥120% to <140% of the 95th percentile, or BMI ≥35, whichever was lower), and class III obesity (≥140% of the 95th percentile, or BMI ≥40, whichever was lower). Severe obesity was defined as either class II or class III obesity. We assessed total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, uric acid, fasting glucose and blood pressure to identify the influence of obesity severity on the cardiometabolic risks. Results: Among 2895 children and adolescents, 7% were underweight, 64% were normal weight, 13.3% were overweight, 10.9% had class I obesity, 3.9% had class II obesity, and 0.8% had class III obesity. With the severity of obesity, abnormal blood lipid profiles, uric acid and blood pressures were more prevalent in more severe groups. Furthermore, compared with class I obesity, the cardiometabolic risks were significantly higher in subjects with severe obesity (class II + class III). Conclusions: In this study cohort of Taiwanese children and adolescents, severe obesity is associated with much higher cardiometabolic risks. Our study may have important implications for developing a feasible strategy to screen obese children at higher risk.
38. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　36 Date: September 12, Time:14:58-15:05 Free Papers (II) O-11 Identification of Novel Lipid Biomarkers of Childhood Obesity in Taiwanese Children by Lipidomics 以脂質體學找出關於台灣兒童肥胖的新脂質標記 Ching-Chung Tsai1,2, Ming-Chun Yang1, Ming-Hsien Tsai3, Hsien-Kuan Liu1, Wen-Li Hsu4,5, Yu-Tsun Su1,2 蔡璟忠1,2、楊明浚1、蔡明憲3、劉賢冠1、許文俐4,5、蘇有村1,2 Department of Pediatrics, E-Da Hospital1, School of Medicine, College of Medicine, I-Shou University2, Department of Child Care, National Pingtung University of Science and Technology3, Emerging Compounds Research Center, General Research Service Center, National Pingtung University of Science and Technology4, Research Institute for Life Support Innovation, Research Organization for Nano & Life Innovation, Waseda University5 義大醫院兒童醫學部1; 義守大學學士後醫學系外國專班2; 國立屏東科技大學幼兒保育系3; 國立屏 東科技大學新興汙染物研究中心 , 綜合研究服務中心4; 早稻田大學生命支持創新研究所 , 奈米與 生命創新研究機構5 Background: The rising prevalence of obesity among children and adolescents is an important public health issue worldwide. Childhood obesity not only affects physical and mental development, but also increases the risk of obesity-related morbidities in adulthood, including hyperlipidemia, metabolic syndrome, type 2 diabetes mellitus, nonalcoholic fatty liver disease, and cardiovascular diseases. Objective: The identification of novel lipid biomarkers that contribute to childhood obesity is of timely importance in the present scenario. Methods: Pediatric subjects, aged 10-18 years, were recruited between 2015 and 2016 at E-Da hospital, Kaohsiung, Taiwan. A total of 103 participants were enrolled in this study, of which 52 and 51 subjects were categorized into obese and non-obese groups, respectively, on the basis of anthropometric measures and obesity-related biochemical parameters. The serum samples were subjected to lipidomics analyses by liquid chromatography combined with time-of-flight mass spectrometry (LC/ MS/MS). Univariate and multivariate analyses were performed for assessing the association between certain lipids and obesity. Results: A total of 3246 lipid signals were recognized by LC/MS/MS. Of these, 10 signals were significantly different between the obese and non-obese groups, as evaluated by the Mann-Whitney U test. Subsequent univariate and adjusted multivariate logistic regression assays confirmed that the differences were statistically significant for 5 lipids. The odd ratios and 95% CI values were: phosphatidylcholine (18:0/20:3) [PC (18:0/20:3)] (OR=1.228, 1.022-1.474), GlcCer (d18:1/24:0) (OR=1.907, 1.123-3.238), ceramides (d14:1(4E)/24:0(2OH)) [Cer (d14:1(4E)/24:0(2OH))] (OR=1.301, 1.074-1.576), ceramides (d18:0/20:0 (2OH)) [Cer (d18:0/20:0(2OH))] (OR=1.172, 1.044-1.315), 3-deoxyvitamin D3 (OR=0.801, 0.647-0.991). Conclusions: The results of this study demonstrated that PC (18:0/20:3), GlcCer (d18:1/24:0), Cer (d14:1(4E)/24:0(2OH)), and Cer (d18:0/20:0(2OH)) were positively associated with childhood obesity, while 3-deoxyvitamin D3 was negatively associated with childhood obesity. The results provide a novel paradigm for further investigations into this rising global epidemic.
39. 　　　 37　　　 Date: September 12, Time:15:05-15:12 Free Papers (II) O-12 Overexpression of MicroRNA-29a in Diet-Induced Non-alcoholic Steatohepatitis Mouse Model Attenuates Liver Fibrosis and Mitochondrial Proteostatic Stress through Inhibition of GSK3β 過度表達微糖體核酸 29a 通過抑制 GSK3β 減輕飲食誘導的非酒精性脂肪性肝炎 小鼠模型中的肝纖維化和粒線體蛋白穩態壓力 Ya-Ling Yang1, Ying-Hsien Huang2 楊雅玲1, 黃瀛賢2 Department of Anesthesiology1, and Pediatrics2, Kaohsiung Chang Gung Memorial Hospital, Taiwan 高雄長庚醫院 麻醉部1, 兒童內科部2 Background: MicroRNA-29a (miR-29a) has been shown to ameliorate hepatocellular damage, such as in the context of non-alcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) and cholestatic injury. Objective: The mechanism mediating the hepatoprotective effect of miR-29a in diet-induced NASH remain elusive and we want to clarify it. Methods: C57BL/6 mice of wild type (WT) or miR-29a overexpression were fed with methionine- choline sufficient (MCS) or methionine-choline deficient (MCD) diet for four weeks. Results: C57BL/6 mice harboring miR-29a overexpression presented reduced plasma AST, hepatic CD36, steatosis and fibrosis induced by MCD. TargetScan Release7.2-based bioinformatic analysis, KEGG pathway analysis and luciferase reporter assay confirmed that miR-29a targets 3′UTR of Gsk3b mRNA in HepG2 hepatocyte cell line. Furthermore, miR-29a overexpression in the MCD-fed group resulted in inhibition of Gsk3b mRNA and GSK3β protein level in the liver. This expression manner of GSK3β went hand in hand with the extent of aggregated protein, which was then identified to be associated with mitochondrial unfolded protein response (UPRmt), but not with endoplasmic reticulum UPR (UPRER). Finally, the implication of SIRT1-mediated mitochondrial biogenesis in the perturbation of proteostasis was observed. Conclusions: In summary, this study provides a novel insight into a hepatoprotective pathway whereby miR-29a inhibits GSK3β to repress SIRT1-mediated mitochondrial biogenesis, leading to alleviation of mitochondrial proteostatic stress and UPRmt in the context of NASH. miR-29a, GSK3β and SIRT1 could serve as possible therapeutic targets to improve the treatment of NAFLD/NASH.
40. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　38 < Poster 1 > Intestinal Obstruction Caused by Fad Diet in an Adolescent 一青少年由流行性減肥法引起的腸阻塞 Liang-Chun Chen1,2, Hung-Chang Lee1, Nien-Lu Wang3, Wai-Tao Chan1, Chun-Yan Yeung1, Chuen-Bin Jiang1, Szu-Wen Chang1 陳亮君1,2、李宏昌1、王念陸3、陳偉燾1、楊俊仁1、江椿彬1、張思玟1 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taiwan 3Department of Pediatric Surgery, MacKay Children’s Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科、2衛生福利部臺北醫院 小兒科、3馬偕兒童醫院 兒童外科 Background: Intestinal obstruction is not uncommon among pediatric patients while foreign bodies or bezoars are commonly the cause. As obesity grows, fad diets for weight control influence children increasingly. Case presentation: A 15 years old girl had intermittent epigastralgia and heartburn for one month, and relieved when bending. Non-bilious vomiting, progressive abdominal pain and little stool passage occurred one week before admission. Physical examinations revealed soft and flat abdomen, tenderness on her epigastrium and right lower quadrant of abdomen. Laboratory tests revealed microcytic anemia, left shifted leukocytosis, but balanced electrolytes. Abdominal sonography showed segmental intestinal dilation and ileus at ileocecal area. Abdominal CT found segmental dilated bowel loops probably from distal jejunum to proximal ileum, a 6.3cm tubular lesion in mixed density at one end suspiciously distal impaction with a bezoar. NPO, fluid supply, parenteral nutrition, empiric antibiotics and gastric decompression were applied. Considering intestinal obstruction, laparoscopic exploration was performed. Two segments of dilated ileum were found with content being easily pushed through into the cecum but no definite bezoar. After operation, she confessed that she had been eating the fillings from her cotton quilt since 3 years ago after knowing cotton ball diet was a way for weight control. Her stool was examined and much fibrin-like substance was found. She recovered smoothly after operation and was soon discharged. Discussion and Conclusions: There are many forms of fad diet which contain foods, drugs and inedible materials. Cotton ball diet involves eating cotton balls that dipper in juice to fill the stomach and make one feel full leading to less calories intake. Harms from cotton ball diet were reported after its popularity raised around 2013. Not only insufficient nutrition intake should be considered, mortality or morbidity related to fad diet could happen. It is important for pediatricians to know the harmful potential of fad diet.
41. 　　　 39　　　 < Poster 2 > A Rare Cause of Refractory Anemia -Blue Rubber Bleb Nevus Syndrome 反覆貧血的罕見原因 - 藍色橡皮泡泡痣 Liang-Chun Chen1,2, Chun-Yan Yeung1, Chen-Wang Chang3, Hung-Chang Lee1, Wai-Tao Chan1, Chuen-Bin Jiang1, Szu-Wen Chang1 陳亮君1,2、楊俊仁1、章振旺3、李宏昌1、陳偉燾1、江椿彬1、張思玟1 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan; 2Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan; 3Department of Hepatology and Gastroenterology, MacKay Memorial Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科、2衛生福利部臺北醫院 小兒科、3馬偕紀念醫院 胃腸肝膽科 Background: Refractory anemia without significant hemorrhagic sign revealed possibility of gastrointestinal tract bleeding. Aside from infection or intestinal malrotation related bleeding, vascular malformation should be considered. Blue rubber bleb nevus syndrome (BRBNS) is a rare vascular disorder consisting of multiple venous malformations. Lesions are most commonly found on the skin and the gastrointestinal tract. The most common clinical presentation is symptomatic anemia due to GI bleeding, both overt and occult. Patients with BRBNS may also present with GI complications, such as intussusception, perforation, volvulus with occasional associated mortality. Case presentation: A 11 years old boy came to our OPD with pallor appearance and weakness one year ago. Iron-deficiency anemia (IDA) was diagnosed and underwent blood transfusion once followed by oral iron supplement for 3 months However he was lost to follow-up. Pallor appearance with tachycardia and hypotension were noted in recent one month. On physical examination, pallor face and a bluish nodule above tongue were noted. Lab data revealed severe iron deficiency anemia (Hb: 4.6g/dL, MCV: 53.6fL, serum iron: <10ug/dL, TIBC:407 ug/dL) but no thalassemia or immune deficiency related abnormality were found. Esophagogastroduodenoscopy revealed gastritis, duodenitis and suspected angiodysplastic lesion. Due to refractory anemia, colonoscopy was arranged and several bluish vascular polypoid lesions were found over terminal ileum and sigmoid colon regions. Computed Tomography angiography later revealed no significant abnormality. Capsule endoscopic examination revealed some lymphoid hyperplasia and dark brown lesions over ileum area. Since anemia and pallor appearance persisted, retrograde single-balloon enteroscopy was arranged and multiple sessile polypoid/ vascular lesions (7-10mm) were disclosed over ileum. Hemoclips and argon plasma coagulation were applied for hemostasis. Pathology report revealed lymphoid polyp, mucosal tag, focal lymphoid and hyperplastic polyp at different locations from terminal ileum to colon. According to the clinical manifestations and endoscopic findings, BRBNS was finally diagnosed. Discussion and Conclusions: BRBNS is a rare syndrome consisting of numerous venous malformations of the skin, mucous membranes, and gastrointestinal tract. Considering the multi-organ involvement in BRBNS, diagnosis and management requires a multidisciplinary approach. The treatment includes conservative, medical, endoscopic and surgical options. Management generally depends on the extent of intestinal involvement and presence of other organ involvement.
42. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　40 < Poster 3 > Colocolic Intussusception Induced by a Huge Sigmoid Colon Hyperplastic Polyp- A Rare Case Report 乙狀結腸的巨大增生性息肉造成兒童腸套疊 - 罕見案例報告 Tsung-Hua Hsieh1, Chuen-Bin Jiang1, Hung-Chang Lee 1, Wai-Tao Chan1 , Chun-Yan Yeung1, Paul Chia-Yu Chang 2 謝宗樺1, 江椿彬1, 李宏昌1, 陳偉燾1, 楊俊仁1 , 張嘉宇2 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Pediatric Surgery, MacKay Children’s Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科 2馬偕兒童醫院 兒童外科 Background: Colocolic intussusception is an uncommon type of intussusception in children that is usually associated with a pathologic lead point. Hyperplastic polyps are the most common type of colorectal polyp in adults, but they are rare in children. We report a 4-year-old boy presented colocolic intussusception induced by a huge hyperplastic polyp of the sigmoid colon. Case presentation: A 4-year-old boy was admitted for intermittent abdominal pain of 1-day duration. The patient had absolute constipation for the last 4 months and repeated episodes of passing blood and mucus in the faeces. He was brought to a local hospital, where constipation was diagnosed. Then, he was brought to our hospital and megacolon series was arranged. However, paradoxymal abdomen pain was noted the next day. The abdominal ultrasound showed a segment of target sign from left lower abdomen to pelvic area. Colocolonic intussusception was suspected. The megacolon series demonstrated findings concerning for opacification of rectum. Highly suspected a lead point, he received abdominal computed tomography and colocolic intussusception was impressed. We tried hydrostatic reduction with barium enema twice, but it failed. Surgical intervention was indicated. After laparoscopic exploration, sigmoid-sigmoid intussusception was noted. In addition, a large polyp (1.8 cm x 1.5cm x1.3 cm size) based mesenteric side was palpated. Enterotomy and polypectomy were performed. Post-operatively the child recovered quickly. The patient was discharged on the 5th postoperative day. The pathologic report showed a hyperplastic polyp. Conclusions: A huge hyperplastic polyp of the sigmoid colon presenting as a lead point of intussusception is a rare condition. He is the youngest patient identified in the literature review. According to British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines, they recommend that people without high-risk findings should not undergo further surveillance colonoscopy.
43. 　　　 41　　　 < Poster 4 > A Rare Case of Hepatocellular Carcinoma in a 6-Year-Old Boy with Chronic Hepatitis B Infection under Entecavir to Achieve HBeAg Seroconversion 肝細胞癌之慢性 B 型肝炎 6 歲男童經貝樂克治療達 HBeAg 血清轉化的罕見病例 Yi-Ting Lu, Mao-Meng Tiao, Ying-Hsien Huang, Kuo-Shu Tang, Chih-Jen Chen, Yu-Hsuan Liao, Wan-Tz Lai, Fu-Chen Huang 盧怡庭 , 刁茂盟 , 黃瀛賢 , 唐國書 , 陳智仁 , 廖祐玄 , 賴宛孜 , 黃福辰 Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Taiwan 高雄長庚 兒童胃腸肝膽科 Hepatocellular carcinoma (HCC) is a rare malignancy in pediatrics with a poor survival rate. It is different from the adult HCC in the etiology, biological behavior, and the presence of cirrhosis. HCC commonly associated with chronic hepatitis B (CHB). Therefore, the clinical status against chronic hepatitis B virus (HBV) infection is important in preventing HCC in children. Following the mass immunization against HBV in Taiwan, the incidence of new cases of pediatric HCC has fallen largely. Herein, we reported a case of a 6-year-old boy with CHB with initial HBV DNA above 8×107 IU/mL, abnormal alpha-fetoprotein(αFP), and abnormal liver function before treatment. After treatment with entecavir for one year, accomplishing HBeAg seroconversion and undetectable serum HBV DNA, he was diagnosed with HCC during routine follow-up. The hepatic tumor (3x2.5cm) was first detected by sonography and later confirmed by abdominal CT. An S4b monosegmentectomy and cholecystectomy were then performed. HCC stage Ⅱ (pT2 Nx) was pathologically confirmed. He had an uneventful post- operative recovery without the need of chemotherapy. In conclusion, the reversion of immunization against HBV dose not completely rule out the occurrence of HCC. Although undetectable HBV DNA with HBeAg seroconversion was achieved after entecavir treatment, HCC may still occur thereafter. Therefore, regular follow-up with sonography of liver and serum levels of αFP assists in early detection of malignancy.
44. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　42 < Poster 5 > Coexistence of Congenital Short Bowel with Malrotation and Hirschsprung’s Disease: A Case Report 先天性短腸症併轉位異常及先天性巨結腸症個案分享 Chen-Chen Wen, Hung-Chang Lee 温晨辰, 李宏昌 Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 馬偕兒童醫院 兒童腸胃科 Background: Congenital short bowel syndrome is a rare gastrointestinal disorder caused by intrauterine reduction of small bowel length whose etiology is still unknown. Hirschsprung’s disease is a congenital disorder of distal intestinal motility which absence of ganglionic innervation of the affected bowel. This is the first case of coexistence of congenital short bowel with malrotation and Hirschsprung’s disease. Case presentation: A 30-day-old boy presented with bilious vomiting for 3 days and failure to thrive. He was born with a vaginal delivery of 2691 grams at 37th+5 gestational week from a 40-year-old mother. The mother had an uneventful antenatal period. There was no failure to pass meconium since birth. The mother complained that the baby had easy regurgitation of breast milk since birth and bilious vomiting for 3 days before admission. On examination, the baby weighed 2694 grams and his length was 49.5 cm. His abdomen was soft with mild distension. The remainder of the physical exam was normal. Blood gas showed metabolic acidosis and coagulopathy was noted. CBC and serum chemistry tests are in normal limits. Small bowel series showed segmental dilated jejunal loops and slow small bowel movement with prolong transit time. Initial management included hydration, corrected coagulopathy and antibiotic coverage including ampicillin, gentamicin and metronidazole. Serial abdominal radiographs showed persistent bowel loops distension. Owing to signs suggestive of GI obstruction, exploratory laparotomy was performed. The small bowel was 70 cm in length with malrotation. The biopsy of descending-sigmoid colon showed absence of ganglion cells with calretinin- negative. Sigmoid colostomy was performed after confirming of Hirschsprung’s disease. He received central parenteral nutrition and oral feeding with elementary formula, Progestimil®. The feeding amount gradually increased as the PN diminished. He was discharged at the age of 4 months with total enteral formula feed. The baby weighed 4908 grams and his length was 58 cm. Conclusions: Congenial short bowel and Hirschsprung’s disease present abdominal distension, feeding intolerance and bilious emesis in newborn stage. But two diseases have different etiology and pathogenesis. Our patient, the first reported case of coexistence two diseases, was able to successfully wean off PN within a few months.
45. 　　　 43　　　 < Poster 6 > A Rare Case of Abdominal Tumor in Children 兒童罕見腹部腫瘤之病例報告 King-Jun Koh1,2, Lung-Huang Lin2,3, Chin-Su Liu4,6, Yi-Ting Yeh4,6, Chin-Chen Pan5,6 許慶俊1,2、林隆煌2,3、劉君恕4,6、葉奕廷4,6、潘競成5,6 1Department of Pediatrics, Sijhih Cathay General Hospital, 2School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. 3Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan. 4Division of Pediatric Surgery, Department of Surgery, 5Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, 6School of Medicine, National Yang-Ming University, Taipei, Taiwan 1汐止國泰綜合醫院 小兒科 2輔仁大學醫學院 3國泰綜合醫院 小兒科 4臺北榮民總醫院外科部 兒童外科 5臺北榮民總醫院 病理檢驗部 6國立陽明大學醫學院 Background: This is a girl two years and eleven months old with normal growth and development. Her mother found an obvious lump in her upper right abdomen. The patient had normal appetite and no symptoms of nausea, vomiting, constipation, or abdominal pain. Physical examination upon admission confirmed a solid mass in the abdomen with dullness percussion at right upper quadrant. Results: Blood tests showed normal blood hemogram, but C-reactive protein (1.7 mg/dL), lactate dehydrogenase (399 IU/L) and alpha-fetoprotein (821 ng/mL) were elevated. X-ray examination revealed a soft tissue mass in the upper right abdominal cavity. Ultrasound examination showed a heterogeneous tumor with a diameter of 12 cm. Abdominal computed tomography also confirmed a huge calcified tumor with uneven density between the liver and right kidney. Further laboratory examinations revealed high neuron-specific enolase (34.47 ng/mL), cortisol (27.4 μg/dL), ferritin (359.4 ng/mL) and 24-hour urine vanillyl mandelic acid ( 38.8 mg/day). Conclusions: Later, surgery was arranged to remove the tumor. Postoperative pathological diagnosis was adrenocortical carcinoma. Histology showed immunoreactivity to Melan-A. The tumor also consists of liver-like differentiated tissues as well as neuroendocrine and yolk sac-like tumor cells. After the operation, the patient received subsequent chemotherapy and radiation therapy. Discussions: The prevalence of adrenocortical carcinoma is very low, with a median age of 55 years at diagnosis. The prognosis is poor and the risk of recurrence is high. Complete surgical resection is essential for the cure. Multidisciplinary strategies combining adjuvant chemotherapy and surgery can improve survival.
46. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　44 < Poster 7 > Incidence and Risk of Sepsis Following Appendectomy 切除闌尾對日後敗血症風險的影響 Tzu-Han Liao1,2, Meng-Che Wu1, Yen-Chu Huang1, Jui-Ju Tseng1, Jiaan-Der Wang1, Cheng-Chung Wei3 廖子涵1,2, 吳孟哲1, 黃彥筑1, 曾瑞如1, 王建得1, 魏正宗3 1 Division of Pediatric Gastroenterology, Children’s Medical Center, Taichung Veterans General Hospital 2 Department of Pediatrics, Chen-Chin Hospital, Chung Kang branch, Taichung 3 Institute of Medicine, Chung Shan Medical University 1台中榮民總醫院兒童醫學中心 兒童肝膽腸胃科 2澄清醫院中港分院 兒童醫學部 3中山醫學大學 醫研所 Background: Appendectomy is one of the most frequently performed emergent and abdominal surgical procedures worldwide; however, the possible long-term consequences have not been fully explored. The aim of this study was to determine whether patients undergoing appendectomy have an increased risk of developing sepsis by using a nationwide longitudinal population-based cohort. Methods: Patients who received appendectomy (ICD-9-CM Procedure Code: 47.0 and 47.1) were assigned to the exposed cohort. Participants without appendectomy were assigned to the unexposed cohort. We identified 252688 patients with appendectomy and 252472 matched controls between 2000 and 2013 from the National Health Insurance Research Database in Taiwan. Propensity score analysis was used for matching age, sex, index year and comorbidities at a ratio of 1:1. Multiple Cox regression analysis was used to estimate the adjusted hazard ratio (aHR) of getting sepsis. Furthermore, sensitivity tests and a stratified analysis were conducted. Results: Patients undergoing appendectomy had 1.29 times significantly higher risk of developing sepsis than those without appendectomy. Stratified analysis revealed that patients aged 20-49 years had a 1.58-fold higher risk of getting sepsis in the appendectomy cohort. In patients aged 50-64 and ≥ 65 years, there was 1.40 and 1.13-fold risk of getting sepsis in the exposed cohort compared to the unexposed cohort. Also, once receiving appendectomy, patients would have a higher potential of getting sepsis regardless of gender and with or without any comorbidities. When followed for less than 1 years, there was 1.98-fold risk of getting sepsis in appendectomy cohort. For patients whose years of follow-up were 1-4 and ≧ 5 years, there was 1.29 and 1.11-fold risk of getting sepsis. Furthermore, cumulative incidence of sepsis among patients receiving appendectomy significantly raised with time. Conclusion: Patients undergoing appendectomy had significantly higher risk of developing sepsis than those without appendectomy.
47. 　　　 45　　　 < Poster 8 > Intestinal Volvulus Leaded by a Duplication Cyst of Ileum- A Rare Case Report 迴腸囊腫引起的腸扭轉 - 罕見的病例報告 Yu-Chen Huang1, Chuen-Bin Jiang1, Hung-Chang Lee 1, Jin-Cherng Sheu2 黃宇辰1, 江椿彬1, 李宏昌1, 許錦城2 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Pediatric Surgery, MacKay Children’s Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科 , 2馬偕兒童醫院 兒童外科 Background: Gastrointestinal duplication cyst is a rare congenital malformation usually found in mesenteric side of gastrointestinal tract, which can occur anywhere from mouth to anus. The incidence is 1 in 4500 live births. Gastrointestinal duplication cyst presenting as small bowel volvulus is an even rare. Case presentation: This 5 year-old boy experienced abdomen pain with 3 times vomiting in a month. Abdominal echo revealed a hypoechoic homogeneous lesion (size: 5.03 x 3.56 x 5.10 cm) right side to urinary bladder and above rectum on early October. However, on 10/31, he presented diffuse intermittent abdomen pain, nausea and vomiting. At ER, his vital sign was stable with blood pressure of 105/64 mmHg and pulse rate of 82 beat/min. The abdomen was soft and no distended with normoactive bowel sounds. Abdomen supine view reveal stool impaction over descending colon. His blood laboratory tests was within normal limit including WBC10000/uL, sodium 132 mmol/L and potassium 4.2 mmol/L. Computed tomography scan reveal a whirlpool appearance in the right lower abdomen and duplication cyst of ileal loop. Laparoscopy was performed and it found segmental volvulus due to a large duplication cyst. The surgeon reduced the small bowel and there was no ischemia of intestine. The duplication cyst was located at 48cm proximal to ileocecal valve and it was resected. The histopathology showed a duplication cyst measuring 6 x 4 x 4 cm in size. The patient was discharged on 9th day post-operatively and followed-up after a week with an uneventful course. Conclusions: Alimentary tract duplications are considered to be benign lesions, usually asymptomatic, but may result in morbidity if left untreated. Treatment can vary depending on the presence of symptoms. They may also be a diagnostic challenge when they present with complications such as intestinal volvulus.
48. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　46 < Poster 9 > A Congenital Portosystemic Venous Shunt was Found in a Down Syndrome Newborn- A Rare Case Report 唐氏症新生兒發現肝門靜脈與腔靜脈系統之間的分流導管 -罕見案例報告 Yu-Chen Huang1, Chia-Huei Chen2, Hung-Chang Lee1 黃宇辰1, 陳佳慧2, 李宏昌 1 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children’s Hospital, Taipei, Taiwan 2Department of Neonatology, MacKay Children's Hospital, Taipei, Taiwan 1馬偕兒童醫院 兒童腸胃科 2馬偕兒童醫院 新生兒科 Background: Congenital portosystemic venous shunts (CPSS) allow intestinal blood to reach the systemic circulation bypassing the liver, resulting in a variety of complications. We present a Down syndrome infant with CPSS. Case presentation: This infant boy born to a 46-y-old mother (gravid 3, para 1) via Cesarean section due to breech presentation delivery at 38+4 wks’ gestation scored 9 and 10 on the APGAR scale at 1 and 5mins, respectively. His birth weight was 2198gm, small for gestational age. His mother received regular antepartum examination and both regular ultrasound and level II ultrasound revealed normal. Trisomy 21 (47, XY, +21) was diagnosed by amniocentesis. Antepartum genetic consulting was done and family insist delivered the baby due to advanced age. After birth, he suffered from subcostal retraction and was hospitalized to sick baby room. Laboratory tests was generally normal(hemoglobin 18.7 g/dL; platelets 156 x 103/uL; white-cell count 9.3 x 103/uL). CXR revealed hazy linear opacities radiating from bilateral hilar. However, his respiratory rates can still be observed with 60times/min on 3-day-old. Heart echo revealed 1. continuous bidirectional flow through a large PDA (0.384-0.426 cm) 2. dilated IVC (0.51cm) with systolic regurgitation. Abdomen echo revealed engorgement of hepatic vein with engorgement of left portal vein, and portal vein aneurysm or portal-hepatic arteriovenous malformation can not be ruled out. Dynamic CT on liver revealed abnormal venous connection (3mm in diameter) between the intrahepatic IVC and Lt intrahepatic portal vein. During the hospitalization, he received PDA ligation on 11-day-old and discharged on 24-day-old. Before discharge, arterial Ammonia revealed 53 ug/dL. Conclusions: Early diagnosis of CPSS is important because its’ complications may manifest in infancy, including cholestasis, liver tumors, encephalopathy, pulmonary arterial hypertension, and hepatopulmonary syndrome. We report the asymptomatic baby with Down syndrome presenting with intrahepatic CPSS and only few report uncover the topics.
49. 　　　 47　　　 < Poster 10 > Early Onset Wilson’s Disease in a 2-year-old Girl— A Case Report 一位二歲病童診斷早發性威爾森氏症— 案例報告 Yu-Hsuan Liao, Mao-Meng Tiao, Ying-Hsien Huang, Kuo-Shu Tang, Chih-Jen Chen, Wan-Tz Lai, Yi-Ting Lu, Fu-Chen Huang 廖祐玄、刁茂盟、黃瀛賢、唐國書、陳智仁、賴宛孜、盧怡庭、黃福辰 Department of Pediatric Gastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan 高雄長庚醫院 兒童肝膽腸胃科 Background: Wilson’s disease is due to a genetic abnormality inherited in an autosomal recessive manner that leads to impairment of cellular copper transport. Impaired biliary copper excretion leads to accumulation of copper in several organs, most notably the liver, brain, and cornea. The prognosis in patients with Wilson’s disease is excellent in all but those with advanced disease and those who present with rapidly progressive liver failure and hemolysis. The objective of this case report is an unusual case of early onset Wilson’s disease. Methods: A case report from chart review. Results: A 6-month-old girl was brought to our OPD for choledochal cyst revealed by perinatal echo. Lab survey including liver function test were within normal limit except mild microcytic anemia at first visit. Initial abdominal echo showed dilatation of extra-hepatic bile duct (0.4cm, portal 0.4cm). She had been regularly follow-up at OPD. However, abnormal liver function test was found at her 1-year-10- month old. (AST: 62 U/L, ALT: 87 U/L). After series survey, low ceruloplasmin (<1.86 mg/dL) and whole- gene sequencing revealing two heterozygous mutations c.2333G>T(p.R778L) and c.3446G>A(p.G1149E) of ATP7B gene were found with clinical association were noted. Other etiological investigations of hypertransaminasemia (hepatitis A virus, hepatitis B virus, hepatitis C virus, cytomegalovirus, Epstein- Barr virus, autoimmune hepatitis, AFP) were negative. According to the Ferenci score, the patient was diagnosed as Wilson’s disease at 2-year old. After confirmed diagnosis, treatment with zinc acetate monotherapy has been applied. We regularly followed up serum zinc/copper levels, urinary zinc/copper 24-hour excretion and liver biochemical tests. The response of the patient to the zinc monotherapy is well. Liver function test gradually improved to normal range with treatment. The patient remains asymptomatic and there was no any side effect nor complications so far. Conclusions: Wilson’s disease is a progressive but treatable disease, so early detection and intervention could prevent advanced disease. Therefore, although the majority of patients with Wilson’s disease are diagnosed between the ages of 5 and 35 years, early onset Wilson’s disease (especially younger than 3-years-old) should always be considered.
50. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　48 < Poster 11 > Ultrasound Rectal Size Measurement to Differentiate Diagnosis of Constipation and Other Abdominal Complaints in Toddler and Young Children – A Single Medical Center Experience 腹部超音波直腸大小的測量來鑑別診斷幼童便秘及其他腹部不適 — 一間醫學 中心的經驗 Yu Yin Chou1,2, Beng Huat Lau1, Tien Lin Kuo1, Cheng Hu Lin1 周昱吟1,2、劉明發1 、郭恬伶1 、林姃慧1 Department of Pediatrics, Shin Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan1 ; Taiwan Adventist Hospital, Taipei, Taiwan2 新光吳火獅紀念醫院 小兒科1、臺安醫院 小兒科2 Background: The correct diagnosis of constipation in toddler and young children with abdominal complaints who visited outpatient department was not clearly defined with radiologic image or ultrasound. And, most of the toddler and young children with constipation had fecal holding experience and rectal dilatation during the rectal examination. The aim of this study was to compare the rectal size between constipated and non-constipated toddler and young children by using transabdominal ultrasound. Methods: We conducted a prospective, cohort study, 135 children, age 1 to 4 years old, 52 children with constipation (fulfill the criteria of ROME IV) and 83 children with other abdominal complaints (control group) at outpatient department. All patients underwent a thorough medical history, physical examination and transabdominal ultrasonography (convex transducer 1-5 MHz, Philips) to detect rectal diameter at the transverse plane of inverted trapezoid bladder shape and ureteral orifice anteriorly. All rectal diameters were measured by same physician. Results: The characteristic between constipation and control group were as following, the age (28.9 vs. 35.5 months), boys to girls ratio (18/34 vs. 48/35) and mean body weight (12.6 vs. 13.9 kilograms). The result showed mean rectal diameters were 26 mm (95% CI 23.7~28.2mm) in constipation group and 14 mm (95% CI 12.9~15.2mm) in control group. Constipated toddler and young children group had a significantly larger rectal diameter (P < 0.001). Conclusion: In our study, using transabdominal ultrasonography by detecting rectal diameter may be a reliable tool to differentiate diagnosis toddler and young children with constipation and other abdominal complaints at the outpatient department.
52. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　50 亞東紀念醫院 14樓國際會議廳(南棟) 會場平面圖 Venue Floor Plan
53. 　　　 51　　　 會場位置圖 Venue Location Map 板南線 環狀線 捷運線 浮洲橋 從樹林來 往台北 往中和 新店 文化路 從台北來 華江橋 從台北來 萬板大橋 從台北來 華翠大橋 從台北來 光復橋 萬板路 縣民大道 中山路 中原 橋和 江子翠 新北市 市政府 新埔 民生 板新 府中 板橋 中和交流道 土城交流道 新埔 海山 土城 永寧 頂埔 往土城 中和 民 生 路 四 川 路 北二高 大 漢 橋 從 新 莊 來 往 新 莊 五 股 漢 生 西 路 頭 前 庄 新 海 大 橋 從 新 莊 來 板橋 出口 亞東醫院站 中 央 路 新 海 路 中 華 路 從 三 峽 來 環 河 路 南 雅 南 路 遠東路 高爾富路 台 65 線 快 速 道 路 台鐵 高鐵 H P 亞東醫院 • 捷運 板南線(藍線)，於亞東醫院站下車。 • 公車 1. 亞東技術學院站下車(四川路)：57、796、234、 265、656、705、1070(基隆-板橋) 桃園機場乘車：1962(大有巴士)、9103(大溪-台北) 2. 亞東醫院站下車(南雅南路)：51、99、F501、805、 812、843、848、889、810、847、藍37、藍38 • 火車、高鐵 台鐵、高鐵板橋站轉乘捷運板南線往頂埔方向至亞東醫 院站下車。 • 自行開車 1. 由北二高下土城交流道， 經土城市區-中央路-南雅南路- 亞東醫院。 2. 由台北市經華江橋、萬板大橋等往南雅南路-亞東醫院。 3. 由新莊區經新海大橋、大漢橋往南雅南路-亞東醫院。 交 通 資 訊
54. 2020 Annual Meeting of TSPGHAN 第八屆第二次年會暨第二十屆學術演講會 　　　52 2020 台灣小兒消化醫學會 第八屆第二次年會暨第二十屆學術演講會 承蒙 下列廠商贊助 使大會得以順利舉行 ~ 特此感謝 ~ 台灣雀巢股份有限公司 台灣雀巢股份有限公司惠氏營養品 永信藥品工業股份有限公司 美強生營養品股份有限公司 美商亞培股份有限公司台灣分公司 裕心企業有限公司 躍聯生命科學股份有限公司 ( 依首字筆劃順序排列 )