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Juan CH, Chen MH, Lin FH, Wong CS, Chien CC, Chen MH. In Vitro Differentiation of Human Placenta-Derived Multipotent Cells into Schwann-Like Cells. Biomolecules 2020; 10:biom10121657. [PMID: 33322066 PMCID: PMC7763858 DOI: 10.3390/biom10121657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/31/2022] Open
Abstract
Human placenta-derived multipotent stem cells (PDMCs) resembling embryonic stem cells can differentiate into three germ layer cells, including ectodermal lineage cells, such as neurons, astrocytes, and oligodendrocytes. The favorable characteristics of noninvasive cell harvesting include fewer ethical, religious, and legal considerations as well as accessible and limitless supply. Thus, PDMCs are attractive for cell-based therapy. The Schwann cell (SC) is the most common cell type used for tissue engineering such as nerve regeneration. However, the differentiation potential of human PDMCs into SCs has not been demonstrated until now. In this study, we evaluated the potential of PDMCs to differentiate into SC-like cells in a differentiation medium. After induction, PDMCs not only exhibited typical SC spindle-shaped morphology but also expressed SC markers, including S100, GFAP, p75, MBP, and Sox 10, as revealed by immunocytochemistry. Moreover, a reverse transcription-quantitative polymerase chain reaction analysis revealed the elevated gene expression of S100, GFAP, p75, MBP, Sox-10, and Krox-20 after SC induction. A neuroblastoma cell line, SH-SY5Y, was cultured in the conditioned medium (CM) collected from PDMC-differentiated SCs. The growth rate of the SH-SY5Y increased in the CM, indicating the function of PDMC-induced SCs. In conclusion, human PDMCs can be differentiated into SC-like cells and thus are an attractive alternative to SCs for cell-based therapy in the future.
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Affiliation(s)
- Chung-Hau Juan
- Department of Anesthesiology, Cathay General Hospital, Taipei 106438, Taiwan; (C.-H.J.); (C.-S.W.); (C.-C.C.)
- Department of Biomedical Sciences, National Central University, Taoyuan 32001, Taiwan
| | - Mei-Hsiu Chen
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220216, Taiwan;
- Department of Biomedical Engineering, Ming Chuan University, Taoyuan 333321, Taiwan
| | - Feng-Hui Lin
- Department of Biomedical Engineering, National Taiwan University, Taipei 106319, Taiwan;
| | - Chih-Shung Wong
- Department of Anesthesiology, Cathay General Hospital, Taipei 106438, Taiwan; (C.-H.J.); (C.-S.W.); (C.-C.C.)
| | - Chih-Cheng Chien
- Department of Anesthesiology, Cathay General Hospital, Taipei 106438, Taiwan; (C.-H.J.); (C.-S.W.); (C.-C.C.)
| | - Ming-Hong Chen
- Department of Neurosurgery, Taipei Municipal Wangfang Hospital, Taipei 116081, Taiwan
- Department of Biomedical Sciences, Graduate Institute of Nanomedicine and Medical Engineering, Taipei Medical University, Taipei 110301, Taiwan
- Correspondence:
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Lin C, Lin PF, Wang CH, Juan CH, Tran TT, Pham VT, Nien CT, Lin YJ, Wang CY, Yeh CH, Lo MT. Probing age-related changes in cardio-respiratory dynamics by multimodal coupling assessment. Chaos 2020; 30:033118. [PMID: 32237792 DOI: 10.1063/1.5134868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/13/2020] [Indexed: 06/11/2023]
Abstract
Quantifying respiratory sinus arrhythmia (RSA) can provide an index of parasympathetic function. Fourier spectral analysis, the most widely used approach, estimates the power of the heart rate variability in the frequency band of breathing. However, it neglects the time-varying characteristics of the transitions as well as the nonlinear properties of the cardio-respiratory coupling. Here, we propose a novel approach based on Hilbert-Huang transform, called the multimodal coupling analysis (MMCA) method, to assess cardio-respiratory dynamics by examining the instantaneous nonlinear phase interactions between two interconnected signals (i.e., heart rate and respiration) and compare with the counterparts derived from the wavelet-based method. We used an online database. The corresponding RSA components of the 90-min ECG and respiratory signals of 20 young and 20 elderly healthy subjects were extracted and quantified. A cycle-based analysis and a synchro-squeezed wavelet transform were also introduced to assess the amplitude or phase changes of each respiratory cycle. Our results demonstrated that the diminished mean and standard deviation of the derived dynamical RSA activities can better discriminate between elderly and young subjects. Moreover, the degree of nonlinearity of the cycle-by-cycle RSA waveform derived from the differences between the instantaneous frequency and the mean frequency of each respiratory cycle was significantly decreased in the elderly subjects by the MMCA method. The MMCA method in combination with the cycle-based analysis can potentially be a useful tool to depict the aging changes of the parasympathetic function as well as the waveform nonlinearity of RSA compared to the Fourier-based high-frequency power and the wavelet-based method.
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Affiliation(s)
- Chen Lin
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
| | - Pei-Feng Lin
- Department of Geriatrics, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan
| | - Chen-Hsu Wang
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
| | - Chung-Hau Juan
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
| | - Thi-Thao Tran
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
| | - Van-Truong Pham
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
| | - Chun-Tung Nien
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
| | - Yenn-Jiang Lin
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Cheng-Yen Wang
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
| | - Chien-Hung Yeh
- School of information and Electronics Engineering, Beijing Institute of Technology, Beijing 100081, China
| | - Men-Tzung Lo
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan 320, Taiwan
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Yeh CH, Juan CH, Yeh HM, Wang CY, Young HWV, Lin JL, Lin C, Lin LY, Lo MT. The critical role of respiratory sinus arrhythmia on temporal cardiac dynamics. J Appl Physiol (1985) 2019; 127:1733-1741. [PMID: 31647722 DOI: 10.1152/japplphysiol.00262.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Temporal cardiac properties provide alternative information in analyzing heart rate variability (HRV), which may be disregarded by the standard HRV analyses. Patients with congestive heart failure (CHF) are known to have distinct temporal features from the healthy individuals. However, the underlying mechanism leading to the variation remains unclear. Whether or not these parameters can finely classify the severity for CHF patients is uncertain as well. In this work, an electrocardiogram was monitored in advanced CHF patients using 24-h Holter in four conditions, including baseline, one and three months after atenolol therapy, and healthy individuals. Slope and area under the curve (AUC) of multiscale entropy (MSE) curve over short (scales 1-5) and long (scales 6-20) scales, and detrended fluctuation analysis (DFA) scaling exponents at short (4-11 beats) and intermediate (>11 beats) window sizes were calculated. The results show that short-time scale MSE-derived parameters (slope: -0.08 ± 0.10, -0.03 ± 0.10, 0.02 ± 0.06, 0.08 ± 0.06; AUC: 4.03 ± 2.11, 4.69 ± 1.28, 4.73 ± 0.94, and 6.17 ± 1.23) and short-time scale DFA exponent (0.79 ± 0.16, 0.95 ± 0.22, 1.11 ± 0.19, and 1.35 ± 0.20) can hierarchically classify all four conditions. More importantly, simulated R-R intervals with different fractions and amplitude of respiratory sinus arrhythmia (RSA) components were examined to validate our hypothesis regarding the essentiality of RSA in the improvement of cardiovascular function, and its tight association with unpredictability and fractal property of HRV, which is in line with our hypothesis that RSA contributes significantly to the generation of the unpredictability and fractal behavior of HR dynamics.NEW & NOTEWORTHY Temporal cardiac properties provide useful diagnostic parameters for patients with congestive heart failure (CHF). Our study hierarchically classified CHF patients with β-blocker treatment by using multiscale entropy and detrended fluctuation analysis. Also, we provided the evidence to validate the critical role of respiratory sinus arrhythmia in the fractal properties of heart rate variability.
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Affiliation(s)
- Chien-Hung Yeh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Chung-Hau Juan
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan.,Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Huei-Ming Yeh
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Yen Wang
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
| | - Hsu-Wen Vincent Young
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan.,Department of Applied Mathematics, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Jiunn-Lee Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen Lin
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
| | - Lian-Yu Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Men-Tzung Lo
- Department of Biomedical Sciences, National Central University, Taoyuan, Taiwan
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Lin C, Yeh CH, Wang CY, Shi W, Serafico BMF, Wang CH, Juan CH, Vincent Young HW, Lin YJ, Yeh HM, Lo MT. Robust Fetal Heart Beat Detection via R-Peak Intervals Distribution. IEEE Trans Biomed Eng 2019; 66:3310-3319. [PMID: 30869605 DOI: 10.1109/tbme.2019.2904014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Monitoring fetal heart rate during pregnancy is essential to assist clinicians in making more timely decisions. Non-invasive monitoring of fetal heart activities using abdominal ECGs is useful for diagnosis of heart defects. However, the extracted fetal ECGs are usually too weak to be robustly detected. Thus, it is a necessity to enhance fetal R-peak since their peaks may be hidden within the signal due to the immaturity of the fetal cardiovascular system. Therefore, to improve the detection of the fetal heartbeat, a novel fetal R-peak enhancement technique was proposed to statistically generate the weighting mask according to the distribution of the neighboring temporal intervals between each pair of peaks. Two sets of simulations were designed to validate the reliability of the method: challenges with different levels of (1) noise contamination and (2) R-peak interval changing rate. The simulation results showed that the weighting mask improved the accuracy of the R-peak detection rate by 25% and decreased the false alarm rate by 20% with white noise contamination, and ensured high R-peak detection rate (>80%), especially with mild noise contamination (noise amplitude ratio <1.5 and noise rate per minute <25%). For the simulations with continuous R-peak intervals changing, the masking process can still effectively eliminate noise contamination especially when the amplitude of the sinusoidal fetal R-R intervals is lower than 50 ms. For the real fetus ECGs, the detection rate was increased by 3.498%, whereas the false alarm rate was decreased by 3.933%. Next, we implemented the fetal R-peak enhancement technique to investigate fractal regulation and multiscale entropy of the real fetal heartbeat intervals. Both scaling exponent (∼0.6 to ∼1 in scale 4-15) and entropy measure (scale 6-10) increased with gestational ages (22-40 weeks). The results confirmed fractal slope and complexity of fetal heartbeat intervals can reflect the maturation of fetus organism.
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Fregni F, Nitsche MA, Loo CK, Brunoni AR, Marangolo P, Leite J, Carvalho S, Bolognini N, Caumo W, Paik NJ, Simis M, Ueda K, Ekhitari H, Luu P, Tucker DM, Tyler WJ, Brunelin J, Datta A, Juan CH, Venkatasubramanian G, Boggio PS, Bikson M. Regulatory Considerations for the Clinical and Research Use of Transcranial Direct Current Stimulation (tDCS): review and recommendations from an expert panel. Clin Res Regul Aff 2015; 32:22-35. [PMID: 25983531 PMCID: PMC4431691 DOI: 10.3109/10601333.2015.980944] [Citation(s) in RCA: 174] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The field of transcranial electrical stimulation (tES) has experienced significant growth in the past 15 years. One of the tES techniques leading this increased interest is transcranial direct current stimulation (tDCS). Significant research efforts have been devoted to determining the clinical potential of tDCS in humans. Despite the promising results obtained with tDCS in basic and clinical neuroscience, further progress has been impeded by a lack of clarity on international regulatory pathways. We therefore convened a group of research and clinician experts on tDCS to review the research and clinical use of tDCS. In this report, we review the regulatory status of tDCS, and we summarize the results according to research, off-label and compassionate use of tDCS in the following countries: Australia, Brazil, France, Germany, India, Iran, Italy, Portugal, South Korea, Taiwan and United States. Research use, off label treatment and compassionate use of tDCS are employed in most of the countries reviewed in this study. It is critical that a global or local effort is organized to pursue definite evidence to either approve and regulate or restrict the use of tDCS in clinical practice on the basis of adequate randomized controlled treatment trials.
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Affiliation(s)
- F Fregni
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - M A Nitsche
- Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany
| | - C K Loo
- School of Psychiatry & The Black Dog Institute, University of New South Wales, Sydney, Australia
| | - A R Brunoni
- Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil and Division of Neurology, Santa Casa Medicak School, Sao Paulo, Brazil
| | - P Marangolo
- Department of Experimental and Clinical Medicine, University Politecnica delle Marche, Ancona, and IRCCS Fondazione Santa Lucia, Roma, Italy
| | - J Leite
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA ; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar, Braga, Portugal
| | - S Carvalho
- Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA ; Neuropsychophysiology Laboratory, CIPsi, School of Psychology (EPsi), University of Minho, Campus de Gualtar, Braga, Portugal
| | - N Bolognini
- Department of Psychology, University of Milano Bicocca, and Laboratory of Neuropsychology, IRCC Instituto Auxologico Italiano, Milano, Italy
| | - W Caumo
- Laboratory of Pain & Neuromodulation at Hospital de Clínicas de Porto Alegre at UFRGS
| | - N J Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - M Simis
- Service of Interdisciplinary Neuromodulation, Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil and Division of Neurology, Santa Casa Medicak School, Sao Paulo, Brazil
| | - K Ueda
- National Cardiovascular Center, Osaka, Japan
| | - H Ekhitari
- Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran ; Neurocognitive Laboratory, Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - P Luu
- Electrical Geodesics, Inc., and University of Oregon, Eugene, Oregon, USA
| | - D M Tucker
- Electrical Geodesics, Inc., and University of Oregon, Eugene, Oregon, USA
| | - W J Tyler
- Virginia Tech Carilion Research Institute, Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, and School of Biomedical Engineering and Sciences, Virginia Tech, Roanoke, VA USA
| | - J Brunelin
- EA 4615, Centre Hospitalier le Vinatier, Université de Lyon, F-69003, Université Claude Bernard Lyon I, Bron, France
| | - A Datta
- Department of Biomedical Engineering, Neural Engineering Laboratory, The City College of the City University of New York New York, NY, USA
| | - C H Juan
- Institute of Cognitive Neuroscience, National Central University, Taiwan
| | - G Venkatasubramanian
- Translational Psychiatry Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - P S Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Healthy and Biological Sciences, Mackenzie Presbyterian University, Sao Paulo, Brazil
| | - M Bikson
- Department of Biomedical Engineering, Neural Engineering Laboratory, The City College of the City University of New York New York, NY, USA
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Abstract
The aim of this study was to investigate differences in organic anion transporting polypeptide 1A2 activity among the Taiwanese population via an analysis of 3 pharmacokinetic studies completed in a total of 103 healthy male Taiwanese subjects. The pharmacokinetics of fexofenadine was measured as an indicator of organic anion transporting polypeptide 1A2 activity. Using the Kolmogorov-Smirnov test and quantile plots, the frequency distributions of area under the concentration-time curve and concentration were shown to be tri-modal and to represent 3 pharmacokinetic phenotypes. In a comparison with published data, the mean area under the concentration-time curve of fexofenadine in the Taiwanese subjects was similar to that in American, German, and Indian subjects, but significantly different from that in some Asian populations, including Korean and Japanese ethnic groups. These results suggested that Taiwanese subjects showed genetic variation in fexofenadine pharmacokinetics that was associated with differences in organic anion transporting polypeptide 1A2 activity.
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Shi HY, Uen YH, Yen LC, Culbertson R, Juan CH, Hou MF. Two-year quality of life after breast cancer surgery: a comparison of three surgical procedures. Eur J Surg Oncol 2011; 37:695-702. [PMID: 21664099 DOI: 10.1016/j.ejso.2011.05.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 04/22/2011] [Accepted: 05/16/2011] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To analyze longitudinal changes in each subscale of a quality of life (QOL) measure and to explore their relationships to effective QOL predictors in breast cancer surgery patients. PATIENTS AND METHODS This prospective study analyzed 172 patients at two tertiary academic hospitals. All patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its supplementary breast cancer measure (QLQ-BR23) at baseline and at 1 and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation (GEE) before and after surgery. RESULTS A 2-year follow-up survey of the examined population revealed significant (P < 0.05) improvement in each QOL subscale. In both postoperative surveys, effect size was largest in the QLQ subscales for patients who had received mastectomy with reconstruction and lowest in those who had received modified radical mastectomy. After adjusting for time effects and baseline predictors, GEE approaches revealed the following explanatory variables for QOL: time, type of surgical procedure, age, chemotherapy, radiotherapy, hormone therapy, and preoperative functional status. CONCLUSIONS When evaluating QOL after breast cancer surgery, several factors other than the surgery itself should be considered. Patients should also be advised that their postoperative QOL might depend not only on the success of their operations, but also on their preoperative functional status.
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Affiliation(s)
- H Y Shi
- Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 807 Kaohsiung, Taiwan, ROC
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Abstract
We report a child with a retained welded tracheal stent scheduled for removal developing refractory bradycardia and cardiac arrest during attempt to remove the stent. Cardiac massage and pacing were necessary to reestablish circulation. The same type of arrhythmia occurred three times in the postanesthetic care unit after tracheal suction or coughing.
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Affiliation(s)
- Chung-Hau Juan
- Department of Anesthesiology, Taipei-Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
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Huang YY, Lee HK, Juan CH, Hastorf P, Tsai SK, Tsou MY. Conscious sedation in gastrointestinal endoscopy. Acta Anaesthesiol Taiwan 2005; 43:33-8. [PMID: 15869002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
In recent years, the incidences of stomach and colon cancers have ranked within the top fives of all malignancies in Taiwan. To say healthwise, regular gastrointestinal (GI) endoscopic examinations are recommended, as they are the best way for early detection. However, unpleasantness of and terrible experience from the examination greatly discourage the acceptance of many people even of the suspected groups. Now, the administration of sedative or analgesic to achieve the so called "conscious sedation" during GI endoscopy which brings about better tolerability and improves general acceptance offers a more satisfactory service. In this article, the related issues about preprocedure evaluation, preparation, medications and complications of conscious sedation in GI endoscopy are discussed after review.
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Affiliation(s)
- Yu-Yin Huang
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Hsin ST, Yin YC, Juan CH, Hu JS, Tsou MY, Tsai SK. Myofascial pain syndrome induced by malpositioning during surgery--a case report. Acta Anaesthesiol Sin 2002; 40:37-41. [PMID: 11989047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
It is a real challenge to the anesthesiologists to differentiate brachial plexus injury (BPI) from myofascial pain syndrome (MPS). The possibility of MPS should be suspected in a patient with complaints of pain and dysfunction of the upper arm immediately after surgery. Here we report a case of gallstone with cervical ankylosing spondylitis who sustained myofascial pain syndrome (MPS) immediately after open cholecystectomy. We utilized dry needle stimulation to deactivate the trigger point of the pectoris minor muscle and stretching the muscle to relieve the muscle pain after the diagnosis was made. The patient completely recovered 2 weeks later.
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Affiliation(s)
- Shih-Tai Hsin
- Department of Anesthesiology, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Hsin ST, Chen CH, Juan CH, Tseng KW, Oh CH, Tsou MY, Tsai SK. A modified method for intubation of a patient with ankylosing spondylitis using intubating laryngeal mask airway (LMA-Fastrach)--a case report. Acta Anaesthesiol Sin 2001; 39:179-82. [PMID: 11840584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
We present an instance of successful use of an intubating laryngeal mask airway (LMA-Fastrach) and a Cook airway exchanger (CAE) for ventilation and intubation in a patient with severe ankylosing spondilitis (AS) receiving total hip arthroplasty. This measure may serve as an effective alternative for airway management in patients with difficult airway. A 61-year-old male was scheduled for right total hip arthroplasty because of degenerative osteoarthritis. He had been suffering from extensive ankylosing spondylitis, with the cervical spine markedly fixed in anterior flexion. Besides he could not open his mouth widely (35 mm when fully open) also because of ankylosis of jaw. Although we advised an awake fiberoptic tracheal intubation for anesthesia but he refused owing to a previous painful experience. After induction of anesthesia with glycopyrrolate, fentanyl, thiamylal sodium and succinylcholine, we inserted a # 5 Fastrach ILMA for primary airway maintenance. Then through the lumen of the ILMA we introduced the CAE as a guide for endotracheal tube (ETT) intubation. After applying the RAPI-FIT adapter to the CAE, we connected it to the capnography monitor for the confirmation of airway. We finally inserted an endotracheal tube into the trachea using the CAE as a guide. The whole procedure was uneventful and smooth. In sum, the modified Fastrach intubation method may facilitate tracheal intubation in patients with severe ankylosing spondilitis. It may be an alternative way for successful airway management in patients with difficult airway.
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Affiliation(s)
- S T Hsin
- Department of Anesthesiology, Taipei Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
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Abstract
We recently reported three periods when single-pulse transcranial magnetic stimulation (TMS) of the occipital pole impaired performance on a forced-choice visual letter-identification task. TMS-induced suppression during these periods is best explained by a blink-associated covering of the pupils and by a direct interference with letter-processing neural activity. We now report TMS-induced suppression at times that seem too late for the suppression to be explained by the first mechanism and too early for the suppression to be explained by the second mechanism. The most likely explanation is a blink-associated interference with letter-processing neural activity.
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Affiliation(s)
- E Corthout
- Department of Experimental Psychology, University of Oxford, UK
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Chen AF, Chen SL, Chang CH, Ou CW, Juan CH, Yang YC, Lin YH. Prenatal diagnosis of intracardiac rhabdomyoma: a case report. J Formos Med Assoc 1991; 90:1128-30. [PMID: 1687063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We report on a case of intracardiac rhabdomyoma diagnosed prenatally from two-dimensional echocardiograms. The tumor was diagnosed by intrauterine echocardiography at the 38th week of gestation. Autopsy proved that the intracardiac tumor was a rhabdomyoma. Tuberous sclerosis spots in the brain tissue were also found.
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Affiliation(s)
- A F Chen
- Department of Obstetrics and Gynecology, Taipei Municipal Women and Children Hospital, Taiwan, R.O.C
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