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Hsieh CY, Tsai CY, Chou YF, Hsu CJ, Wu HP, Wu CC. Otoprotection against aminoglycoside- and cisplatin-induced ototoxicity focusing on the upstream drug uptake pathway. J Chin Med Assoc 2024; 87:17-24. [PMID: 37962398 DOI: 10.1097/jcma.0000000000001023] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
Aminoglycoside- and cisplatin-induced ototoxicity, which is a significant issue owing to the widespread use of these drugs in clinical practice, involves the entry of aminoglycosides and cisplatin into the endolymph and hair cells via specific channels or transporters, followed by reactive oxygen species (ROS) generation and hair cells apoptosis. Current strategies focalize primarily on interference with downstream ROS effects; however, recent evidence has demonstrated that inhibiting the uptake of aminoglycosides and cisplatin by hair cells is another promising strategy for tackling the upstream drug uptake pathway. With advances in structural biology, the conformations of certain aminoglycoside and cisplatin channels and transporters, such as the mechanoelectrical transduction channel and organic cation transporter-2, have been largely elucidated. These channels and transporters may become potential targets for the introduction of new otoprotective strategies. This review focuses on the strategies for inhibiting ototoxic drugs uptake by auditory hair cells and provides potential targets for recent developments in the field of otoprotection. Molecular dynamics (MD) simulations of these proteins could help identify the molecules that inhibit the uptake of aminoglycosides and cisplatin by hair cells. Integrating upstream drug uptake pathway targets and MD simulations may help dissect molecular mechanisms and develop novel otoprotective strategies for aminoglycoside- and cisplatin-induced ototoxicity.
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Affiliation(s)
- Cheng-Yu Hsieh
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, ROC
| | - Cheng-Yu Tsai
- Graduate Institute of Medical Genomics and Proteomics, National Taiwan University College of Medicine, Taipei, Taiwan, ROC
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Yi-Fan Chou
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
| | - Chuan-Jen Hsu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Hung-Pin Wu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, ROC
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, ROC
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan, ROC
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Lin WC, Chang YW, Kang TY, Ye CN, Wu HP, Lin CC. Balloon Eustachian Tuboplasty Combined or Not with Myringotomy in Eustachian Tube Dysfunction. J Pers Med 2023; 13:1527. [PMID: 38003842 PMCID: PMC10672311 DOI: 10.3390/jpm13111527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Eustachian tube dysfunction (ETD) is a common disorder causing ear pressure, pain, and hearing loss. Balloon Eustachian tuboplasty (BET) is an emerging technique for dilating the Eustachian tube and treating ETD. Whether adding myringotomy improves BET efficacy is controversial. METHODS This retrospective study included 95 ETD patients undergoing BET alone (n = 44) or BET with myringotomy (BET + M; n = 51) between June 2020 and August 2021 at a single medical center. The primary outcome was the change in ETDQ-7 symptom scores from baseline to 6 months after treatment. Secondary outcomes included audiometry, endoscopy, Valsalva maneuver, and complications. RESULTS The ETDQ-7 scores improved significantly after treatment in both groups (p < 0.001), without significant between-group differences (p = 0.417). No significant differences occurred in the audiometry, endoscopy, and Valsalva results or in most complications between groups. One BET + M patient had a persistent tympanic membrane perforation. CONCLUSIONS Both BET alone and BET + M effectively and safely improved the subjective and objective ETD outcomes. However, adding myringotomy did not further improve the outcomes over BET alone, while it incurred risks such as persistent perforation. BET alone may sufficiently treat ETD without requiring myringotomy in this cohort. Further randomized controlled trials should identify optimal candidates for BET alone versus combined approaches.
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Affiliation(s)
- Wei-Chieh Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (W.-C.L.); (Y.-W.C.); (T.-Y.K.); (C.-N.Y.); (H.-P.W.)
| | - Yao-Wen Chang
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (W.-C.L.); (Y.-W.C.); (T.-Y.K.); (C.-N.Y.); (H.-P.W.)
| | - Ting-Ya Kang
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (W.-C.L.); (Y.-W.C.); (T.-Y.K.); (C.-N.Y.); (H.-P.W.)
| | - Ciou-Nan Ye
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (W.-C.L.); (Y.-W.C.); (T.-Y.K.); (C.-N.Y.); (H.-P.W.)
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (W.-C.L.); (Y.-W.C.); (T.-Y.K.); (C.-N.Y.); (H.-P.W.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Chung-Ching Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (W.-C.L.); (Y.-W.C.); (T.-Y.K.); (C.-N.Y.); (H.-P.W.)
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Liu B, Lin ZR, Luo SR, Fang X, Xiao XW, Xie ZW, Yan L, Li XZ, Dong N, Shang XM, Liu ZS, Wu HP. [Topography-guided transepithelial corneal collagen cross-linking by sequential ultraviolet A irradiation in different diameters for progressive keratoconus in adults]. Zhonghua Yan Ke Za Zhi 2023; 59:791-804. [PMID: 37805413 DOI: 10.3760/cma.j.cn112142-20221216-00642] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To compare the efficacy and safety of a novel customized topography-guided transepithelial corneal collagen cross-linking (TG-CXL) procedure by sequential ultraviolet A irradiation in different diameters and conventional transepithelial corneal collagen cross-linking (TE-CXL) in adult patients with progressive keratoconus. Methods: A prospective cohort study was conducted. Adult patients diagnosed with progressive keratoconus in the Affiliated Xiamen Eye Center of Xiamen University were continuously recruited and randomly assigned to receive the TG-CXL or TE-CXL procedure from March 2020 to March 2021. Patients in the TE-CXL group were irradiated in the central 9-mm zone of the cornea (total energy, 7.2 J/cm2; irradiance, 45 mW/cm2), while patients in the TG-CXL group were first irradiated with the protocol used in the TE-CXL group, and further irradiated in the central 6-mm zone (total energy, 3.6 J/cm2; irradiance, 9 mW/cm2). The subjective symptom of pain and corneal fluorescein sodium staining were scored within postoperative 3 days. Slit lamp examination, measurements of uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), corneal topography, anterior segment optical coherence tomography, in vivo corneal confocal microscopy, corneal endothelial cell count, and non-contact tonometry were performed before surgery and at 3, 6, and 12 months after surgery. Results: A total of 66 patients were enrolled (mean age, 23.0±3.3 years old), with 33 patients (33 eyes) in each group. No statistically significant differences were found in age, gender, and maximum keratometry (Kmax) between the two groups (P>0.05). On day 1 after surgery, the average pain score of the TG-CXL group (2.21±0.45) was significantly higher than that of the TE-CXL group (1.32±0.33) (P<0.05). The pain was rapidly alleviated in both groups on days 2 and 3. On days 1 and 2, the corneal fluorescein sodium staining scores in the TG-CXL group (4.15±0.83 and 2.21±0.60, respectively) were significantly higher than those in the TE-CXL group (1.76±0.56 and 0.85±0.51, respectively, P<0.001), while there was no significant difference between the two groups at day3 (P=0.184). The UCVA and BCVA of the TG-CXL group at 3, 6, and 12 months after surgery were significantly improved when compared with the baseline. At 3, 6, and 12 months, the BCVA (LogMAR) of the TG-CXL group (0.21±0.15, 0.22±0.16, and 0.22±0.16, respectively) were significantly improved when compared with those of the TE-CXL group(0.32±0.15, 0.34±0.15, and 0.36±0.16, respectively, P<0.01). However, there was no significant difference in UCVA between groups at any time point after surgery (P>0.05). The spherical and cylindrical power values of the TG-CXL group were improved when compared with the baseline (P<0.05). However, no significant difference in spherical power values was found between the two groups at any time point after surgery (P>0.05). Meanwhile, there were significant differences in cylindrical power values between the two groups at 6 and 12 months after surgery (P<0.05). The Kmax in the TG-CXL group was improved at all of the time points after surgery when compared with the baseline (P<0.001), while no significant difference in Kmax was found at any time point after surgery in the TE-CXL group when compared with the baseline (P>0.05). At 6 and 12 months after surgery, the Kmax values in the TG-CXL group were significantly lower than the TE-CXL group (P<0.05). No significant differences were found in flat keratomety, steep keratometry, the minimal thickness of the cornea, endothelial cell density, and intraocular pressure between the two groups at any time point after surgery (P>0.05). Within one month after surgery, optical coherence tomography revealed the increased density in the anterior stroma in both groups. In most patients in the TG-CXL group, a demarcation line was visible in the central and para-central corneal stroma, representing a clear and continuous, high-signal arc-shaped linear structure, which was deeper in the central cornea than the para-central cornea. In contrast, a demarcation line, fuzzy and focally discontinuous, was visible only in a few patients in the TE-CXL group, with an almost uniform depth in the central and the para-central cornea. Confocal microscopy demonstrated an apparent mesh-like cross-linked collagen structure in the superficial and intermediate corneal stroma at all time points after surgery in the TG-CXL group, with thickening stromal collagen fibers and an increased number of interconnections. In contrast, the mesh-like structure and number of interconnections in the superficial corneal stroma were significantly reduced at 12 months after surgery in the TE-CXL group, with no cross-linking structure in the intermediate corneal stroma at any time point after surgery. No serious complications such as corneal infection, sterile corneal ulcer, and persistent epithelial defect were observed in both groups during the follow-up of 12 months. Conclusions: The TG-CXL procedure by sequential irradiation in two different diameters with ultraviolet A light was effective and safe in the management of progressive keratoconus in adults, achieving significant refractive improvement. This might be a good technical alternative for refractive corneal cross-linking surgery.
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Affiliation(s)
- B Liu
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - Z R Lin
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - S R Luo
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - X Fang
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - X W Xiao
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - Z W Xie
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - L Yan
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - X Z Li
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - N Dong
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - X M Shang
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - Z S Liu
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
| | - H P Wu
- Xiamen Eye Center of Xiamen University, Fujian Provincial Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Surface & Corneal Diseases, Xiamen Municipal Key Laboratory of Ocular Diseases, Xiamen Clinical Research Center for Eye Diseases, Xiamen 361002, China
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Chung WH, Wu HP, Wu MY, Lin YN, Chen JY, Lin KH, Chang KC. Correlations between myocardial injury current and lead performance in His bundle pacing compared with left bundle branch area pacing and right ventricular septum pacing. J Interv Card Electrophysiol 2023; 66:1349-1358. [PMID: 36198845 DOI: 10.1007/s10840-022-01385-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 09/25/2022] [Indexed: 10/10/2022]
Abstract
BACKGROUND Conduction system pacing by implanting the lead in the His bundle (HBP) region or in the left bundle branch area (LBBAP) has gained popularity. Myocardial injury current (IC) is useful for predicting adequate lead fixation in right ventricular septal pacing (RVSP). OBJECTIVES AND METHODS We compared the correlations between IC and lead performance among patients receiving HBP (n = 41), LBBAP (n = 53), and historical RVSP (n = 88). LBBAP was an alternative if optimal HBP was not achieved. A positive IC (STpost-screw-in - STpre-screw-in) was defined as > 0.2 mV or a > 25% ST elevation and prolongation of the ventricular electrograms > 10 ms from baseline. RESULTS HBP patients with a positive IC (48%, 0.84 ± 0.4 V/0.4 ms) exhibited a similar pacing threshold to their LBBAP counterparts (76%, 0.75 ± 0.3 V/0.4 ms, p = 0.329), but a higher pacing threshold than their RVSP counterparts (67%, 0.50 ± 0.1 V/0.4 ms, p < 0.001) at implantation. The R-wave (5.70 ± 3.4 mV) and impedance (660.91 ± 140.8 Ω) were both lower than those of LBBAP (10.35 ± 6.0 mV, p = 0.002; 822.36 ± 235.8 Ω, p = 0.005) and RVSP (11.24 ± 4.9 mV, p < 0.001; 754.27 ± 126.4 Ω, p = 0.006) patients respectively at implantation. The trend of electrical parameter comparisons remained unchanged during follow-up (3.56 ± 1.4 months). Notably, HBP patients without ICs had a higher pacing threshold (1.24 ± 0.6 V/0.4 ms) compared to their LBBAP (0.73 ± 0.3 V/0.4 ms, p = 0.009) and RVSP (0.53 ± 0.1 V/0.4 ms, p < 0.001) counterparts at implantation and during follow-up. CONCLUSIONS The detection of positive changes of myocardial ICs during HBP was associated with a better capture threshold equivalent to the LBBAP counterpart both at implantation and during short-term follow-up. Further large-scale studies with longer follow-up are necessary to confirm these findings.
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Affiliation(s)
- Wei-Hsin Chung
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Hung-Pin Wu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Jan-Yow Chen
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Kuo-Hung Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan
| | - Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yude Road, Taichung, 40447, Taiwan.
- School of Medicine, China Medical University, Taichung, Taiwan.
- Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan.
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Tung CC, Liang HY, Lai YC, Shen MY, Lin KH, Chang KC, Wu HP. Early Experience of Patients with left Bundle Branch Block Corrected through Left Bundle Branch Area Pacing Compared with Conventional Right Ventricular Pacing: A Single-Center Retrospective Study. Acta Cardiol Sin 2023; 39:394-405. [PMID: 37229337 PMCID: PMC10203727 DOI: 10.6515/acs.202305_39(3).20221104b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/04/2022] [Indexed: 05/27/2023]
Abstract
Background Left bundle branch area pacing (LBBAP) has the advantages of narrow QRS duration, rapid peak left ventricular (LV) activation, and LV dyssynchrony correction with a low, stable pacing output. Here we report our experience with patients undergoing LBBAP with a left bundle branch block (LBBB) for clinically indicated pacemaker or cardiac resynchronization therapy implantation. We compared the initial follow-up data of these patients and patients undergoing conventional right ventricular pacing (RVP). Methods This retrospective study was performed between January 2017 and December 2020 and recruited 19 consecutive patients (mean age: 63 years; 8 women, 11 men) who underwent LBBAP (13 LBBAP only and 6 LBBAP + LV pacing), and 14 consecutive patients (mean age: 75 years; 8 women, 6 men) who underwent RVP. Demographic data, QRS durations, and echocardiographic parameters were compared before and after the procedures. Results LBBAP substantially shortened the QRS duration and improved LV dyssynchrony echocardiographic parameters. However, RVP was not significantly associated with prolonged QRS duration and worse LV dyssynchronization. LBBAP improved cardiac contractility in selected patients. We did not find adverse effects of LBBAP on patients with preserved systolic function, possibly due to the limited number of patients and follow-up time. However, two of the 11 patients with preserved systolic function at baseline who underwent conventional RVP developed heart failure after implantation. Conclusions In our experience, LBBAP improves LBBB-related ventricular dyssynchrony. However, LBBAP requires greater skill, and doubts remain about lead extraction. LBBAP may be an option for patients with LBBB when performed by an experienced operator, however further studies are needed to verify our findings.
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Affiliation(s)
- Cheng-Chang Tung
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University
| | - Hsin-Yueh Liang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University
- Department of Biomedical Imaging and Radiological Science
| | - Yi-Ching Lai
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University
| | - Ming-Yi Shen
- Graduate Institute of Biomedical Sciences, China Medical University
- Department of Medical Research, China Medical University Hospital
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Kuo-Hung Lin
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University
| | - Kuan-Cheng Chang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University
| | - Hung-Pin Wu
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital and College of Medicine, China Medical University
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Hsieh CY, Lin JN, Kang TY, Wen YH, Yu SH, Wu CC, Wu HP. Otoprotective Effects of Fucoidan Reduce Cisplatin-Induced Ototoxicity in Mouse Cochlear UB/OC-2 Cells. Int J Mol Sci 2023; 24:ijms24043561. [PMID: 36834972 PMCID: PMC9959567 DOI: 10.3390/ijms24043561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023] Open
Abstract
Cisplatin is a widely used standard chemotherapy for various cancers. However, cisplatin treatment is associated with severe ototoxicity. Fucoidan is a complex sulfated polysaccharide mainly derived from brown seaweeds, and it shows multiple bioactivities such as antimicrobial, anti-inflammatory, anticancer, and antioxidant activities. Despite evidence of the antioxidant effects of fucoidan, research on its otoprotective effects remains limited. Therefore, the present study investigated the otoprotective effects of fucoidan in vitro using the mouse cochlear cell line UB/OC-2 to develop new strategies to attenuate cisplatin-induced ototoxicity. We quantified the cell membrane potential and analyzed regulators and cascade proteins in the apoptotic pathway. Mouse cochlear UB/OC-2 cells were pre-treated with fucoidan before cisplatin exposure. The effects on cochlear hair cell viability, mitochondrial function, and apoptosis-related proteins were determined via flow cytometry, Western blot analysis, and fluorescence staining. Fucoidan treatment reduced cisplatin-induced intracellular reactive oxygen species production, stabilized mitochondrial membrane potential, inhibited mitochondrial dysfunction, and successfully protected hair cells from apoptosis. Furthermore, fucoidan exerted antioxidant effects against oxidative stress by regulating the Nrf2 pathway. Therefore, we suggest that fucoidan may represent a potential therapeutic agent for developing a new otoprotective strategy.
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Affiliation(s)
- Cheng-Yu Hsieh
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
| | - Jia-Ni Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
| | - Ting-Ya Kang
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
| | - Yu-Hsuan Wen
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Department of Otolaryngology, Head and Neck Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien 970473, Taiwan
| | - Szu-Hui Yu
- Department of Music, Tainan University of Technology, Tainan 710302, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100225, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100225, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300195, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Correspondence:
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Lin WC, Kuo YH, Hsu CJ, Wu HP, Hsu YJ. Worsening Rhinosinusitis as a Prognostic Factor for Patients with Nasopharyngeal Carcinoma: A Retrospective Study. Biomedicines 2022; 10:biomedicines10123235. [PMID: 36551991 PMCID: PMC9775390 DOI: 10.3390/biomedicines10123235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
Rhinosinusitis is common in patients with nasopharyngeal carcinoma (NPC). Our study aimed to explore the role of rhinosinusitis severity in NPC prognosis. Medical records and radiologic examinations of 90 patients with NPC at a single medical center from 2009−2016 were retrospectively analyzed. The Lund−Mackay (L−M) score was obtained for each patient before and after 6 months of treatment. Rhinosinusitis diagnosis was based on L−M scores of ≥4. L−M score differences were calculated as pre-treatment rhinosinusitis (PRRS) minus post-treatment rhinosinusitis (PSRS). L−M score difference was sub-grouped into “L−M scores > 0”, “L−M scores = 0”, and “L−M scores < 0”. Clinical staging of our patients based on the American Joint Committee on Cancer 7th edition were: stage I in nine, stage II in seventeen, stage III in twenty-two, and stage IV in forty-two patients; twenty-seven (30%) patients had died. PRRS incidence was 34.4%, and PSRS was 36.7%. Median of L−M scores difference was 0 (−2.2). L−M score difference was an independent prognostic factor for the overall survival of patients with NPC (p < 0.05). Therefore, worsening rhinosinusitis was a prognostic factor for patients with NPC. Clinicians should consider NPC as a warning sign of poor prognosis during routine follow-ups.
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Affiliation(s)
- Wei-Chieh Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
| | - Yu-Hung Kuo
- Department of Research, Taichung Tzu Chi Hospital, Taichung 427, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Yuan-Jhen Hsu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
- Correspondence: ; Tel.: +886-4-3606-0666; Fax: +886-4-3606-5928
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8
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Lin WC, Hsieh CY, Yu SH, Chang YW, Hsu CJ, Wu HP. Balloon Eustachian Tuboplasty with or Without Inferior Turbinectomy for Chronic Nasal Obstruction with Obstructive Eustachian Tube Dysfunction. B-ENT 2022. [DOI: 10.5152/b-ent.2022.21849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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9
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Chang CJ, Sun CH, Hsu CJ, Chiu T, Yu SH, Wu HP. Cochlear implant mapping strategy to solve difficulty in speech recognition. J Chin Med Assoc 2022; 85:874-879. [PMID: 35666612 DOI: 10.1097/jcma.0000000000000748] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cochlear implants (CIs) are viable treatment options in patients with severe to profound hearing loss. Speech recognition difficulties were reported in some CI recipients even with a good-aided hearing threshold. The aim of this study was to report a mapping strategy based on different target-aided hearing thresholds to achieve optimal speech recognition and maximize functional outcomes. The safety and efficacy of the mapping strategy were also inspected in the article. METHODS This prospective repeated measures study enrolled 20 adult CI recipients with postlingual deafness using the MED-EL CI system. Word and sentence discrimination assessment and administration of a questionnaire pertaining to comfort level were conducted at the end of each session. The electrophysiological features of the CI mapping were recorded. RESULTS The correlation between audiometry results and word and sentence recognition was not high. CIs performed best at an audiometry threshold between 25 and 35 dB. CONCLUSION CI performance with the best perception relies on a balance between minimizing the hearing threshold and maximizing the dynamic range while maintaining an appropriate comfort level, which was achieved when the target hearing threshold was set at 25-35 dB in this study.
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Affiliation(s)
- Chan-Jung Chang
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
| | - Chuan-Hung Sun
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
| | - Ting Chiu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
| | - Szu-Hui Yu
- Department of Music, Tainan University of Technology, Tainan, Taiwan, ROC
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
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10
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Lin PH, Wu HP, Wu CM, Chiang YT, Hsu JS, Tsai CY, Wang H, Tseng LH, Chen PY, Yang TH, Hsu CJ, Chen PL, Wu CC, Liu TC. Cochlear Implantation Outcomes in Patients with Auditory Neuropathy Spectrum Disorder of Genetic and Non-Genetic Etiologies: A Multicenter Study. Biomedicines 2022; 10:biomedicines10071523. [PMID: 35884828 PMCID: PMC9313466 DOI: 10.3390/biomedicines10071523] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 01/04/2023] Open
Abstract
With diverse etiologies and clinical features, the management of pediatric auditory neuropathy spectrum disorder (ANSD) is often challenging, and the outcomes of cochlear implants (CIs) are variable. This study aimed to investigate CI outcomes in pediatric patients with ANSD of different etiologies. Thirty-six children with ANSD who underwent cochlear implantation between 2001 and 2021 were included. Comprehensive etiological analyses were conducted, including a history review, next-generation sequencing-based genetic examinations, and imaging studies using high-resolution computed tomography and magnetic resonance imaging. Serial behavioral and speech audiometry were performed before and after surgery, and the outcomes with CI were evaluated using the Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores. By etiology, 18, 1, 1, and 10 patients had OTOF-related, WFS1-related, OPA1-related, and cochlear nerve deficiency (CND)-related ANSD, respectively. Six patients had no definite etiology. The average CI-aided behavioral threshold was 28.3 ± 7.8 dBHL, and those with CND-related ANSD were significantly worse than OTOF-related ANSD. The patients’ median CAP and SIR scores were 6 and 4, respectively. Favorable CI outcomes were observed in patients with certain etiologies of ANSD, particularly those with OTOF (CAP/SIR scores 5–7/2–5), WFS1 (CAP/SIR score 6/5), and OPA1 variants (CAP/SIR score 7/5). Patients with CND had suboptimal CI outcomes (CAP/SIR scores 2–6/1–3). Identifying the etiologies in ANSD patients is crucial before surgery and can aid in predicting prognoses.
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Affiliation(s)
- Pei-Hsuan Lin
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; (P.-H.L.); (P.-L.C.)
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Otolaryngology, National Taiwan University Hospital Yunlin Branch, Yunlin 64041, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
| | - Che-Ming Wu
- Department of Otolaryngology & Head and Neck Surgery, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 23652, Taiwan;
- Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taoyuan 33305, Taiwan
| | - Yu-Ting Chiang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Jacob Shujui Hsu
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Cheng-Yu Tsai
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
| | - Han Wang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Li-Hui Tseng
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Pey-Yu Chen
- Department of Otolaryngology, MacKay Memorial Hospital, Taipei 10449, Taiwan;
- Department of Audiology and Speech-Language Pathology, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Ting-Hua Yang
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
| | - Chuan-Jen Hsu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 42743, Taiwan;
| | - Pei-Lung Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10002, Taiwan; (P.-H.L.); (P.-L.C.)
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 10051, Taiwan;
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 10002, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30261, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30261, Taiwan
- Hearing and Speech Center, National Taiwan University Hospital, Taipei 10002, Taiwan
- Correspondence: (C.-C.W.); (T.-C.L.)
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 10002, Taiwan; (Y.-T.C.); (C.-Y.T.); (H.W.); (L.-H.T.); (T.-H.Y.); (C.-J.H.)
- Correspondence: (C.-C.W.); (T.-C.L.)
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11
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Hsieh CY, Hsu CJ, Wu HP, Sun CH. Comparison Benefit between Hydrogen Peroxide and Adrenaline in Tonsillectomy: A Randomized Controlled Study. J Clin Med 2022; 11:jcm11102723. [PMID: 35628850 PMCID: PMC9145324 DOI: 10.3390/jcm11102723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 01/22/2023] Open
Abstract
This study aimed to further evaluate the benefit of topical hemostasis agents in tonsillectomy. We compared the clinical effects of topical application between hydrogen peroxide and adrenaline in tonsillectomy. Overall, 60 patients (120 tonsils) were prospectively enrolled for tonsillectomy between February 2018 and December 2020. The patients were randomly assigned to either the hydrogen peroxide or adrenaline group. Then, tonsillectomy was performed using hydrogen peroxide as a hemostatic agent on the assigned side, while adrenaline was applied to the other side. All procedures were performed by a surgeon who was blinded to the randomization. The outcome measurements of operation time, intraoperative blood loss, postoperative pain, and hemorrhage events were analyzed. The intraoperative blood loss was significantly lower in the hydrogen peroxide group than in the adrenaline group (9.99 ± 4.51 mL vs. 13.87 ± 6.32 mL; p = 0.0). The median operation time was also significantly lower in the hydrogen peroxide group (8.02 ± 3.59 min vs. 9.22 ± 3.88 min; p = 0.019). Meanwhile, the visual analogue scale (VAS) scores were significantly higher in the hydrogen peroxide group (4.98 ± 1.94 vs. 4.27 ± 1.97; p = 0.001). The topical application of hydrogen peroxide as a hemostatic agent effectively decreases the operation time and intraoperative blood loss. Thus, hydrogen peroxide can be used as a routine hemostatic agent for bleeding control in tonsillectomy.
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Affiliation(s)
- Cheng-Yu Hsieh
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (C.-Y.H.); (C.-J.H.); (H.-P.W.)
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (C.-Y.H.); (C.-J.H.); (H.-P.W.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (C.-Y.H.); (C.-J.H.); (H.-P.W.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Chuan-Hung Sun
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (C.-Y.H.); (C.-J.H.); (H.-P.W.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
- Correspondence: ; Tel.: +886-4-3606-0666; Fax: +886-4-3606-5928
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12
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Chang KC, chung W, Wu HP, Wu MY, Lin YN, Chen JY, Lin KH. PO-708-03 CORRELATIONS BETWEEN INJURY CURRENT AND LEAD PERFORMANCE IN HIS BUNDLE PACING COMPARED WITH LEFT BUNDLE BRANCH AREA PACING AND RIGHT VENTRICULAR SEPTUM PACING. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.1101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Kang TY, Hsu CJ, Lin JN, Wu CC, Wang JS, Lin HY, Yu SH, Wu RS, Wen YH, Tseng GF, Wu HP. Bisdemethoxycurcumin-mediated Attenuation of Apoptosis Prevents Gentamicin-induced Ototoxicity in Mouse Cochlear UB/OC-2 Cells. In Vivo 2022; 36:1095-1105. [PMID: 35478148 DOI: 10.21873/invivo.12807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/18/2022] [Accepted: 04/01/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Gentamicin has been widely prescribed since the last two decades despite its ototoxicity and nephrotoxicity. Bisdemethoxycurcumin (BDMC) is an affordable and safe curcuminoid with medicinal properties. We aimed to understand the effects of BDMC on the gentamicin-induced hair cell damage in mouse cochlear UB/OC-2 cells, in order to elucidate the therapeutic potential of BDMC against gentamicin-induced ototoxicity. MATERIALS AND METHODS We quantified the cell membrane potential and examined the regulators and cascade proteins in the intrinsic pathway of hair cell apoptosis. Mouse cochlear UB/OC-2 cells were treated with BDMC before exposure to gentamicin. The effects of BDMC on hair cell viability, mitochondrial function, and apoptosis-related proteins were examined by flow cytometry, western blot, and fluorescent staining. RESULTS Our results revealed that BDMC reversed gentamicin-mediated cycle arrest at the G2/M phase, stabilizing the mitochondrial membrane potential, decreasing cleaved caspase proteins, and successfully reversing hair cell apoptosis. CONCLUSION BDMC is a potential agent for reducing gentamicin-induced ototoxicity.
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Affiliation(s)
- Ting-Ya Kang
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C
| | - Chuan-Jen Hsu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C.,Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, R.O.C
| | - Jia-Ni Lin
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.,Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.,Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan, R.O.C
| | - Jen-Shu Wang
- Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C.,School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C
| | - Hui-Yi Lin
- School of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan, R.O.C
| | - Szu-Hui Yu
- Department of Music, Tainan University of Technology, Tainan, Taiwan, R.O.C
| | - Rong-Shuan Wu
- Department of Economics, National Tsing Hua University, Hsinchu, Taiwan, R.O.C
| | - Yu-Hsuan Wen
- School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C.,Department of Otolaryngology, Head and Neck Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, R.O.C.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, R.O.C
| | - Guo-Fang Tseng
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, R.O.C.,Department of Anatomy, Tzu Chi University, Hualien, Taiwan, R.O.C
| | - Hung-Pin Wu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C.; .,School of Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, R.O.C
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14
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Lin JN, Wang JS, Lin CC, Lin HY, Yu SH, Wen YH, Tseng GF, Hsu CJ, Wu HP. Ameliorative effect of taxifolin on gentamicin-induced ototoxicity via down-regulation of apoptotic pathways in mouse cochlear UB/OC-2 cells. J Chin Med Assoc 2022; 85:617-626. [PMID: 35286283 DOI: 10.1097/jcma.0000000000000708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Taxifolin is a flavanonol with efficacious cytoprotective properties, such as anti-inflammatory, antioxidant, anticancer, hepatoprotective, and nephroprotective effects. However, the potential protective effects of taxifolin against gentamicin-induced ototoxicity have not been confirmed. In this study, the possible mechanisms underlying the effects of taxifolin on gentamicin-induced death of UB/OC-2 cochlear cells were investigated. METHODS Mouse cochlear UB/OC-2 cells with or without taxifolin pretreatment were exposed to gentamicin, and the effects on cytotoxicity, reactive oxygen species (ROS) production, mitochondrial permeability transition, and apoptotic marker expression were examined using biochemical techniques, flow cytometry, western blotting, and fluorescent staining. RESULTS Little or no apparent effect of taxifolin on cell viability was observed at concentrations less than 40 μM. Further investigations showed that gentamicin significantly inhibited cell viability in a concentration-dependent manner. Pretreatment with taxifolin attenuated gentamicin-induced lactate dehydrogenase release, as well as cellular cytotoxicity. In addition, taxifolin significantly prevented gentamicin-induced cell damage by decreasing ROS production, stabilizing mitochondrial membrane potential, and downregulating the mitochondrial pathway of apoptosis. CONCLUSION In summary, pretreatment with taxifolin is effective for mitigating gentamicin-induced apoptotic cell death mediated by the mitochondrial pathway. Our data suggest that taxifolin provides a new approach to combat gentamicin-induced ototoxicity.
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Affiliation(s)
- Jia-Ni Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
| | - Jen-Shu Wang
- Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
| | - Chung-Ching Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
| | - Hui-Yi Lin
- School of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan, ROC
| | - Szu-Hui Yu
- Department of Music, Tainan University of Technology, Tainan, Taiwan, ROC
| | - Yu-Hsuan Wen
- School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC
- Department of Otolaryngology, Head and Neck Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, ROC
| | - Guo-Fang Tseng
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC
- Department of Anatomy, Tzu Chi University, Hualien, Taiwan, ROC
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, ROC
- School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan, ROC
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15
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Wen YH, Lin HY, Lin JN, Tseng GF, Hwang CF, Lin CC, Hsu CJ, Wu HP. 2,3,4',5‑Tetrahydroxystilbene‑2‑O‑β‑D‑glucoside ameliorates gentamicin‑induced ototoxicity by modulating autophagy via Sesn2/AMPK/mTOR signaling. Int J Mol Med 2022; 49:71. [PMID: 35348190 PMCID: PMC8989425 DOI: 10.3892/ijmm.2022.5127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/10/2022] [Indexed: 11/07/2022] Open
Abstract
Gentamicin is an important aminoglycoside antibiotic used in the treatment of gram-negative bacterial infections, but nephrotoxicity and ototoxicity reduce its utility. The autophagy pathway is involved in damage of auditory hair cells. With the aim of developing new strategies for attenuating gentamicin ototoxicity, the present study investigated the otoprotective mechanism of 2,3,4′,5-tetrahydroxystilbene-2-O-β-D-glucoside (THSG) in vitro using the mouse cochlear cell line UB/OC-2. MTT assay demonstrated that gentamicin reduced UB/OC-2 cell viability and western blotting showed that gentamicin upregulated autophagy-related proteins, such as Beclin, autophagy related 5 and LC3-II. THSG significantly attenuated gentamicin-induced cytotoxicity, clearly reduced LDH release observed by LDH assay and decreased the expression of autophagy-related proteins. Reverse-transcription-quantitative (RT-q) PCR and western blotting showed that THSG against gentamicin-induced autophagy via suppressing the expression of Sesn2, at both the mRNA and protein level and a possible involvement of AMP-activated protein kinase (AMPK)/mTOR signaling response. Collectively, the present study demonstrated that THSG decreased gentamicin-induced ototoxicity in UB/OC-2 cochlear cells via the autophagic signaling in regulating Sesn2/AMPK/mTOR pathway. These results suggested that THSG might be a new therapeutic agent with the potential to attenuate gentamicin ototoxicity.
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Affiliation(s)
- Yu-Hsuan Wen
- Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan, R.O.C
| | - Hui-Yi Lin
- School of Pharmacy, College of Pharmacy, China Medical University, Taichung 404328, Taiwan, R.O.C
| | - Jia-Ni Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan, R.O.C
| | - Guo-Fang Tseng
- Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan, R.O.C
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833401, Taiwan, R.O.C
| | - Chung-Ching Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan, R.O.C
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan, R.O.C
| | - Hung-Pin Wu
- Institute of Medical Sciences, Tzu Chi University, Hualien 970374, Taiwan, R.O.C
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16
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Lin CC, Chiu T, Chiou HP, Chang CM, Hsu CJ, Wu HP. Residual hearing preservation for cochlear implantation surgery. Tzu Chi Med J 2021; 33:359-364. [PMID: 34760631 PMCID: PMC8532579 DOI: 10.4103/tcmj.tcmj_181_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/21/2020] [Accepted: 09/11/2020] [Indexed: 11/25/2022] Open
Abstract
Cochlear implantation (CI) has developed for more than four decades. Initially, CI was used for profound bilateral hearing impairment. However, the indications for CI have expanded in recent years to include children with symptomatic partial deafness. Therefore, CI strategies to preserve residual hearing are important for both patients and otologists. The loss of residual low-frequency hearing is thought to be the result of many factors. All surgical methods have the same goal: protect the delicate intracochlear structures and preserve residual low-frequency hearing to improve speech perception abilities. Fully opening the round window membrane, a straight electrode array, slower insertion speed, and the use of corticosteroids result in a higher rate of hearing preservation. Several factors, like the way of surgical approaches, length of arrays and timing of activation, may not affect the residual hearing preservation. Therefore, the classic atraumatic technique, including the very slow and delicate insertion and administration of intraoperative corticosteroids, can improve hearing outcomes.
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Affiliation(s)
- Chung-Ching Lin
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ting Chiu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Hong-Ping Chiou
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Chu-Man Chang
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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17
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Lin YH, Wu PC, Tsai CY, Lin YH, Lo MY, Hsu SJ, Lin PH, Erdenechuluun J, Wu HP, Hsu CJ, Wu CC, Chen PL. Hearing Impairment with Monoallelic GJB2 Variants: A GJB2 Cause or Non-GJB2 Cause? J Mol Diagn 2021; 23:1279-1291. [PMID: 34325055 DOI: 10.1016/j.jmoldx.2021.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/23/2021] [Accepted: 07/07/2021] [Indexed: 12/26/2022] Open
Abstract
Recessive variants in GJB2 are the most common genetic cause of sensorineural hearing impairment. However, in many patients, only one variant in the GJB2 coding region is identified using conventional sequencing strategy (eg, Sanger sequencing), resulting in nonconfirmative diagnosis. Conceivably, there might be other unidentified pathogenic variants in the noncoding region of GJB2 or other deafness-causing genes in these patients. To address this, a next-generation sequencing-based diagnostic panel targeting the entire GJB2 gene and the coding regions of 158 other known deafness-causing genes was designed and applied to 95 patients with nonsyndromic sensorineural hearing impairment (including 81 Han Taiwanese and 14 Mongolian patients) in whom only a single GJB2 variant had been detected using conventional Sanger sequencing. The panel confirmed the genetic diagnosis in 24 patients (25.3%). Twenty-two of them had causative variants in several deafness-causing genes other than GJB2, including MYO15A, MYO7A, TECTA, POU4F3, KCNQ4, SLC26A4, OTOF, MT-RNR1, MITF, WFS1, and USH2A. The other two patients had causative variants in GJB2, including a Taiwanese patient with a mosaic maternal uniparental disomy c.235delC variant (approximately 69% mosaicism) and a Mongolian patient with compound heterozygous c.35dupG and c.35delG variants, which occurred at the same site. This study demonstrates the utility of next-generation sequencing in clarifying the genetic diagnosis of hearing-impaired patients with nonconfirmative GJB2 genotypes on conventional genetic examinations.
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Affiliation(s)
- Yi-Hsin Lin
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan; Institute of Molecular Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ping-Che Wu
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Yu Tsai
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institutes of Medical Genomic, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yin-Hung Lin
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institutes of Medical Genomic, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Yu Lo
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan; Institute of Molecular Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shu-Jui Hsu
- Graduate Institutes of Medical Genomic, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Hsuan Lin
- Department of Otolaryngology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Jargalkhuu Erdenechuluun
- Department of Otolaryngology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; The EMJJ Otolaryngology Hospital, Ulaanbaatar, Mongolia
| | - Hung-Pin Wu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan; Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan; Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Pei-Lung Chen
- Institute of Molecular Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institutes of Medical Genomic, National Taiwan University College of Medicine, Taipei, Taiwan; Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Genetics, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University Hospital, Taipei, Taiwan.
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18
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Lin YT, Huang WL, Wu HP, Chang MP, Chen CC. Association of Mean and Variability of HbA1c with Heart Failure in Patients with Type 2 Diabetes. J Clin Med 2021; 10:jcm10071401. [PMID: 33915706 PMCID: PMC8037774 DOI: 10.3390/jcm10071401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 12/28/2022] Open
Abstract
Heart failure (HF) is a common presentation in patients with type 2 diabetes mellitus (T2DM). Previous studies revealed that the HbA1c level is significantly associated with HF. However, little is known about the association between HbA1c variability and HF. We aimed to evaluate the association of mean and variability of HbA1c with HF in patients with T2DM. Using Diabetes Share Care Program data, patients with T2DM who had mean HbA1c (HbA1c-Mean), and HbA1c variability (tertiles of HbA1c-SD and HbA1c-adjSD) within 12–24 months during 2001–2008 were included. The cutoffs of HbA1c-Mean were set at <7%, 7–7.9%, and ≥8%. Hazard ratios (HRs) for HF during 2008–2018 were estimated using Cox proportional hazard models. A total of 3824 patients were included, of whom 315 patients developed HF during the observation period of 11.72 years. The associated risk of HF increased with tertiles of HbA1c variability and cutoffs of HbA1c-Mean. In mutually adjusted models, HbA1c-Mean showed a consistent dose-response association with HF, while the association of HbA1c variability with HF disappeared. Among patients with HbA1c-Mean <7%, the associated risk of HF in patients with HbA1c variability in tertile 3 was comparable to patients with HbA1c-Mean ≥8%. In conclusion, mean HbA1c was an independent predictor of HF and not explained by HbA1c variability. In addition to absolute HbA1c level, targeting on stability of HbA1c in patients with good glycemic control was also important for the development of HF in patients with T2DM.
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Affiliation(s)
- You-Ting Lin
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (Y.-T.L.); (W.-L.H.)
- Department of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Wei-Lun Huang
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (Y.-T.L.); (W.-L.H.)
- Department of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Hung-Pin Wu
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan;
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Man-Ping Chang
- Department of Nursing, National Taichung University of Science and Technology, Taichung 40354, Taiwan;
| | - Ching-Chu Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan; (Y.-T.L.); (W.-L.H.)
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Correspondence: ; Tel.: +886-4-2206-2121 (ext. 4676)
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19
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Hsieh HS, Lee CY, Wu HP, Zhuo MY, Hwang CF. Pressure ulcers and skin infections after cochlear implantation: A delayed yet serious issue. Int J Pediatr Otorhinolaryngol 2020; 138:110241. [PMID: 32705991 DOI: 10.1016/j.ijporl.2020.110241] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Skin flap infection is one of the most common complications of cochlear implantation (CI). We identified the causes of skin flap pressure ulcer over the antenna site and proposed wound management strategies. METHODS A total of 250 consecutive pediatric patients who underwent CI to treat profound hearing loss were retrospectively assessed. Data on demographic characteristics, the cause of skin infection, and the time of onset were obtained. RESULTS Seventeen patients (17/250, 6.8%) had a total of 23 skin pressure injuries in the area covering the antenna. We used the National Pressure Ulcer Advisory Panel pressure injury staging system to grade injury severity. Twelve patients had 16 (16/23, 69.6.%) stage 1 pressure injuries; the skin reaction resolved after the patients stopped wearing the device for a brief period, loosened the magnet to relieve pressure on the coil, and received topical antibiotics. Five patients with six (6/23, 26.1%) stage 2 pressure injuries and one (1/23, 4.3%) stage 3 injury, were treated with oral antibiotics. The patient with the stage 3 injury was instructed not to wear the external device for 10-14 days. The incidence of skin reactions associated with the ESPrit speech processor (0/17, 0%) was significantly lower than that associated with the Freedom (2/17, 11.8%), N5 (8/17, 47.1%), and N6 (7/17, 41.1%; p < 0.05) processors. Pressure injuries were more common in younger children (≤7 years, 100%) than in older children (>7 years, 0%; p < 0.05) most likely due to their thinner scalps. CONCLUSIONS Early detection and treatment can prevent implant-threatening infections, particularly in younger children. We believe that better antenna designs will reduce this complication.
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Affiliation(s)
- Hui-Shan Hsieh
- Department of Otolaryngology, Xiamen Chang Gung Hospital, Fujian, 361000, China
| | - Chee-Yee Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, 42743, Taiwan
| | - Hung-Pin Wu
- Department of Otorhinolaryngology-Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, 42743, Taiwan; School of Medicine, College of Medicine, Tzu Chi University, Hualien, 97071, Taiwan
| | - Ming-Ying Zhuo
- Department of Otolaryngology, Xiamen Chang Gung Hospital, Fujian, 361000, China
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan.
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20
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Lee CY, Lin WC, Lin CC, Hsu CJ, Wu HP. Management Options for Patients With Nasopharyngeal Carcinoma Undergoing Cochlear Implantation. Ear Nose Throat J 2020:145561320947274. [PMID: 32790586 DOI: 10.1177/0145561320947274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/17/2022] Open
Abstract
OBJECTIVES Cochlear implantation (CI) has been successfully used to restore hearing in patients with severe to profound hearing loss. In addition to hearing loss, irradiated patients with nasopharyngeal carcinoma (NPC) also often have chronic otitis media and Eustachian tube (ET) dysfunction. These features may result in difficulties in CI. We conducted this study to review the management options for irradiated patients with NPC undergoing CI. Furthermore, we investigated the results of CI in irradiated patients with NPC with chronic otitis media and obstructive ET dysfunction, accordingly to different treatment strategies. METHODS We retrospectively reviewed the data of patients with NPC who underwent CI in our hospital between 2006 and 2020. All subjects were found to be eligible according to the following inclusion criteria: had NPC, received irradiation, underwent cochlear implant surgery, and had chronic otitis media with obstructive ET dysfunction. RESULTS A total of 9 patients with obstructive ET dysfunction and chronic otitis media underwent cochlear implant surgery. Seven patients with an inflamed ETs underwent a 2-stage operation. Two patients with obliterated ETs, we performed a single-stage CI surgery. Only 1 patient had otitis media effusion after the surgery. CONCLUSION With the proper management of chronic otitis media and ET dysfunction, cochlear implant is an effective treatment for irradiated patients with NPC when conventional hearing aids failed.
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Affiliation(s)
- Chee-Yee Lee
- Department of Otolaryngology-Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung
- School of Medicine, College of Medicine, Tzu Chi University, Hualien
| | - Wei-Chieh Lin
- Department of Otolaryngology-Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung
| | - Chung-Ching Lin
- Department of Otolaryngology-Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung
| | - Chuan-Jen Hsu
- Department of Otolaryngology-Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung
- School of Medicine, College of Medicine, Tzu Chi University, Hualien
- Department of Otolaryngology, National Taiwan University Hospital, Taipei
| | - Hung-Pin Wu
- Department of Otolaryngology-Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung
- School of Medicine, College of Medicine, Tzu Chi University, Hualien
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21
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Gotamco GL, Sun CH, Chou YF, Hsu CJ, Wu HP. Effect of Round Window Opening Size on Residual Hearing Preservation in Cochlear Implantation. Otolaryngol Head Neck Surg 2020; 163:375-381. [PMID: 32204664 DOI: 10.1177/0194599820912032] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aims to compare the hearing preservation outcomes in cochlear implant surgery following slit versus full opening of the round window membrane. SETTING Tertiary referral center. STUDY DESIGN Comparative study. SUBJECTS AND METHODS Seventy patients (mean, 26.3 years; range, 2-69 years) who underwent cochlear implantation via the round window approach were included in the study. Thirty-five subjects were prospectively enrolled for cochlear implantation via the open round window technique between August 2018 and January 2019. Thirty-five patients who underwent cochlear implantation from January 2017 to July 2018 via the slit round window opening, frequency matched by sex and age, were retrospectively enrolled. Pre- and postoperative thresholds were obtained. The percentage of hearing preservation was computed with the HEARRING Network formula and classified into complete, partial, and minimal hearing preservation. The results between the groups were compared and analyzed at 6 months postoperatively. RESULTS The rate of complete hearing preservation in the open group was statistically significant (P = .030) at 71.4% (n = 25) as compared with 45.7% (n = 16) in the slit group. CONCLUSIONS The widely opened round window may be an optional technique that surgeons can utilize to improve hearing preservation outcomes.
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Affiliation(s)
- Giselle L Gotamco
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,Section of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines
| | - Chuan-Hung Sun
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yi-Fan Chou
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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22
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Wu TY, Lin JN, Luo ZY, Hsu CJ, Wang JS, Wu HP. 2,3,4',5-Tetrahydroxystilbene-2- O-β-D-Glucoside (THSG) Activates the Nrf2 Antioxidant Pathway and Attenuates Oxidative Stress-Induced Cell Death in Mouse Cochlear UB/OC-2 Cells. Biomolecules 2020; 10:biom10030465. [PMID: 32197448 PMCID: PMC7175305 DOI: 10.3390/biom10030465] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 12/16/2019] [Revised: 03/02/2020] [Accepted: 03/16/2020] [Indexed: 12/12/2022] Open
Abstract
Oxidative stress plays a critical role in the pathogenesis of hearing loss, and 2,3,4′,5-tetrahydroxystilbene-2-O-β-D-glucoside (THSG) exerts antioxidant effects by inhibiting reactive oxygen species (ROS) generation. With the aim of developing new therapeutic strategies for oxidative stress, this study investigated the protective mechanism of THSG in vitro using a normal mouse cochlear cell line (UB/OC-2). The THSG and ascorbic acid have similar free radical scavenger capacities. H2O2, but not THSG, reduced the UB/OC-2 cell viability. Moreover, H2O2 might induce apoptosis and autophagy by inducing morphological changes, as visualized by microscopy. As evidenced by Western blot analysis and monodansylcadaverine (MDC) staining, THSG might decrease H2O2-induced autophagy. According to a Western blotting analysis and Annexin V/PI and JC-1 staining, THSG might protect cells from H2O2-induced apoptosis and stabilize the mitochondrial membrane potential. Furthermore, THSG enhanced the translocation of nucleus factor erythroid 2-related factor 2 (Nrf2) into the nucleus and increased the mRNA and protein expression of antioxidant/detoxifying enzymes under H2O2-induced oxidative stress conditions. Collectively, our findings demonstrate that THSG, as a scavenging agent, can directly attenuate free radicals and upregulate antioxidant/detoxifying enzymes to protect against oxidative damage and show that THSG protects UB/OC-2 cells from H2O2-induced autophagy and apoptosis in vitro.
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Affiliation(s)
- Tien-Yuan Wu
- Department of Pharmacology, School of Medicine, College of Medicine, Tzu Chi University, Hualien 970, Taiwan;
- Department of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
| | - Jia-Ni Lin
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (J.-N.L.); (Z.-Y.L.); (C.-J.H.)
| | - Zi-Yao Luo
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (J.-N.L.); (Z.-Y.L.); (C.-J.H.)
| | - Chuan-Jen Hsu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (J.-N.L.); (Z.-Y.L.); (C.-J.H.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan;
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Jen-Shu Wang
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan;
- Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan; (J.-N.L.); (Z.-Y.L.); (C.-J.H.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan;
- Correspondence:
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23
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Hsieh CY, Sun CH, Lin WL, Gotamco GL, Hsu CJ, Wu HP. Modified transcanal cochlear implantation in CHARGE syndrome: A case report. Medicine (Baltimore) 2019; 98:e18283. [PMID: 31852103 PMCID: PMC6922572 DOI: 10.1097/md.0000000000018283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Cochlear implantation (CI) in CHARGE syndrome is technically challenging because of the anatomical anomalies. This case aims to report a successful case of CI in CHARGE syndrome by using the modified transcanal approach with external auditory canal (EAC) obliteration. PATIENT CONCERNS The 3-year-old girl presented at the outpatient department with bilateral hearing loss and nasal obstruction since birth. DIAGNOSIS The patient had bilateral profound sensorineural hearing loss, patent ductus arteriosus, atresia of the choanae, middle and inner ear anomalies, and growth retardation, fulfilling the criteria for typical CHARGE syndrome. High resolution temporal bone computed tomography scan revealed a poorly developed mastoid cavity, cochlear dysplasia, hypoplastic semicircular canals, ossicular chain malformation, and sigmoid sinus engorgement. Magnetic resonance imaging revealed a narrow internal auditory canal and a hypoplastic cochlear nerve. INTERVENTIONS Modified transcanal approach with external auditory canal obliteration OUTCOMES:: CI was successfully done and there are no intraoperative or postoperative complications occurred after 1 year of follow up. LESSONS The modified transcanal approach is a reasonable and safer option for CI in CHARGE syndrome.
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Affiliation(s)
- Cheng-Yu Hsieh
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
| | - Chuan-Hung Sun
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Wei-Lin Lin
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
| | - Giselle L. Gotamco
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
- School of Medicine, Tzu Chi University, Hualien, Taiwan
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24
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Lin WL, Chou YF, Sun CH, Lin CC, Hsu CJ, Wu HP. Evaluation of thirty patients with eustachian tube dysfunction in Taiwan by questionnaire survey. J Formos Med Assoc 2019; 119:621-626. [PMID: 31540815 DOI: 10.1016/j.jfma.2019.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/13/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Eustachian tube dysfunction (ETD) is a common otolaryngological disorder. The seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) was used for the assessment of symptoms related to ETD and treatment outcome. Currently, there is no traditional Chinese version of the ETDQ-7 to diagnose ETD in Taiwan. We aim to verify the reliability and validity of the traditional Chinese version of the ETDQ-7 in a clinical setting. METHODS The traditional Chinese version of the ETDQ-7 was completed by 60 adult subjects composed of 30 healthy controls and 30 subjects diagnosed with ETD. The internal consistency was evaluated using the Cronbach's α coefficient. The discriminant validity was calculated by receiver operating characteristic (ROC) curve as an accuracy measure. RESULTS The overall Cronbach's α coefficient of the traditional Chinese version ETDQ-7 was 0.717. The mean ETDQ-7 total score was 26.97 in the ETD group and 9.27 in the control group. The area under the ROC curve (AUC) was 99.8%, and the sensitivity and specificity of the traditional Chinese ETDQ-7 was 100% and 99.9%, respectively. CONCLUSION The traditional Chinese version of the ETDQ-7 is a valid and reliable, disease-specific rating scale that can be used to quantitatively evaluate the severity of subjective symptoms of ETD in adult patients.
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Affiliation(s)
- Wei-Lin Lin
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Yi-Fan Chou
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chuan-Hung Sun
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chung-Ching Lin
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan; School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan.
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25
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Sun CH, Chang CJ, Hsu CJ, Wu HP. Feasibility of early activation after cochlear implantation. Clin Otolaryngol 2019; 44:1004-1010. [PMID: 31487432 DOI: 10.1111/coa.13427] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/04/2019] [Accepted: 08/30/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of the study is to investigate feasibility of early activation after cochlear implantation by evaluating long-term impedance change and speech perception. DESIGN Case-control study SETTING: Between July 2015 and December 2016, we prospectively enrolled 20 subjects for early activation (within 24 hours after cochlear implantation). On the other hand, from November 2013 to July 2015, 20 age- and sex-matched control subjects from the database of cochlear implantees treated with conventional activation schedule (4 weeks after surgery) were retrospectively enrolled. PARTICIPANT Forty patients who underwent cochlear implantation surgeries. MAIN OUTCOME MEASURES The series impedance and speech perception score of both groups were compared. RESULTS No statistical difference in long-term follow-up between the two groups was found using GEEs and multivariate analysis. In the early activation group, impedance reached a steady level by the 2nd postoperative week, and the hearing perception ability significantly improved by the 4th postoperative week. CONCLUSION This comparative study illustrated sequential impedance data during early activation (24 hours) and conventional activation (4 weeks) after CI surgery. There were no major complications in either group, and the safety of early activation with respect to impedance changes, postoperative residual hearing preservation and speech perception scores were non-inferior to that of the conventional group. Therefore, in this study, we established the feasibility of early activation 24 hours after cochlear implantation.
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Affiliation(s)
- Chuan-Hung Sun
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chan-Jung Chang
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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Abstract
Objective: Whereas the nature of otosclerosis has been extensively investigated, treatment modalities in advanced otosclerosis with the sensorineural hearing loss (SNHL) are relatively unexplored. Materials and Methods: This article presents a retrospective case series study of nine patients who received a one-stage piston coupled with Vibrant Soundbridge® vibroplasty in treating otosclerosis with moderate-to-severe SNHL. Results: The findings suggest that hearing loss could be restored across frequencies and no significant change in the bone-conduction threshold were measured. Conclusion: One-stage piston surgery coupled with incus vibroplasty is a safe procedure and has sufficient efficacy to restore hearing loss in patients with otosclerosis with moderate-to-severe SNHL.
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Affiliation(s)
- Chan-Jung Chang
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Hsuan Wen
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Chuan-Hung Sun
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | | | - Hung-Pin Wu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
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Lin ZR, Wu HP, Xie ZW, Luo SR, Fang X, Yan L, Liu ZS, Dong N, Shang XM. [Efficacy of deproteinized calf blood extract eye drops on early recovery after pterygium surgery]. Zhonghua Yan Ke Za Zhi 2019; 55:134-140. [PMID: 30772993 DOI: 10.3760/cma.j.issn.0412-4081.2019.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of deproteinized calf blood extract eye drops on early postoperative recovery in primary pterygium patients. Methods: This is a prospective randomized controlled study. Patients diagnosed with primary pterygium in single eye at affiliated Xiamen Eye Center of Xiamen University during March 2016 to May 2016 were enrolled. After Pterygium excision with autologous conjunctival transplantation, patients were randomly assigned into four groups by a random number table, treated with anti-inflammaroty drugs only (control group) or combined with the following agents: deproteinized calf blood extract eye drops (DCBE group), carboxymethylcellulose sodium eye drops (CMC group), and recombinant human epidermal growth factor eye drops (rEGF group). Short-form McGill pain questionnaire, slit lamp and corneal fluorescein sodium staining, non-contact intraocular pressure, uncorrected visual acuity (UCVA) and best corrected visual acquity (BCVA) as well as redness score of bulbar conjunctiva were performed before surgery (d0) and on day 1 (d1), day 2 (d2), day 3 (d3), day 7 (d7) and day 14 (d14) after surgery. Results: One hundred and fourteen patients including 43 males and 71 females, aged (48.9±12.5) years, were eventually included in this study. The McGill scores gradually decreased after surgery in all groups. On d2, the McGill score in DCBE group, control group, CMC group and rEGF group was (1.42±0.67), (2.21±0.88), (1.93±1.08) and (1.77±1.18), respectively; On d3, the score was (1.32±0.54), (1.93±0.72), (1.79±0.87) and (1.52±0.77), respectively. On d2 and d3, statistical difference was recorded among groups (d2, F=3.43, P=0.019; d3, F=4.047, P=0.009), and the McGill score of DCBE group was significantly lower than that of CMC group (d2, P=0.047, d3, P=0.017). On d2, the percentage of corneal epithelium defect in DCBE group, control group, CMC group and rEGF group was 8.6%±1.9%, 11.7%±1.7%, 11.5%±1.9% and 10.4%±1.8%, respectively; On d3, the percentage was 4.5%±2.2%, 9.2%±2.4%, 7.4%±2.5% and 5.9%±2.3%, respectively. On d2 and d3, statistical difference of corneal epithelium defect percentage was recorded among groups (d2, F=17.17, P<0.001; d3, F=21.4, P<0.001). On d2, the percentage of corneal epithelium defect in DCBE group was significantly lower than the other three groups (P<0.01); On d3, the percentage of corneal epithelium defect in DCBE group was significantly lower than control group and CMC group (P<0.001), while no difference was found between DCBE group and rEGF group (P>0.05). However, no statistical differences were recorded in the number of patients with vision improvement among the groups (P>0.05). The intraocular pressure remained stable. No differences in the conjunctival redness score were found among the groups after surgery (P>0.05). Conclusion: Our data demonstrated the efficacy of deproteinized calf blood extract eye drops on the postoperative management in patients with primary patients, with faster pain relief and promoted epithelium recovery. (Chin J Ophthalmol, 2019, 55:134-140).
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Affiliation(s)
- Z R Lin
- Department of Ocular Surface and Corneal Diseases, the Affiliated Xiamen Eye Center of Xiamen University, Xiamen 361001, China
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Chang CJ, Sun CH, Chen TS, Wu HP. Navigation-assisted endoscopic endonasal surgery of a glomangiopericytoma with intraorbital extension: A case report and literature review. Tzu Chi Med J 2018; 30:119-121. [PMID: 29875594 PMCID: PMC5968740 DOI: 10.4103/tcmj.tcmj_161_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A glomangiopericytoma, or sinonasal type hemangiopericytoma, is a rare lesion which accounts for <0.5% of all sinonasal tumors. The mainstay treatment is wide excision. Instead of traditional open surgical approaches, such as midfacial degloving or lateral rhinotomy, we offer a case of 21-year-old male with diagnosis of glomangiopericytoma with skull base and intraorbital invasion and received navigation-assisted endoscopic excision of a glomangiopericytoma.
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Affiliation(s)
- Chan-Jung Chang
- Department of Otolaryngology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chuan-Hung Sun
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Tzu-Sheng Chen
- Department of Pathology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
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29
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Lin ZR, Wu HP, Luo SR, Liu ZS, Dong N, Shang XM, Xie ZW, Yan L, Fang X. [Accelerated transepithelial corneal collagen cross-linking for progressive keratoconus with a thin cornea: one-year results]. Zhonghua Yan Ke Za Zhi 2017; 53:694-700. [PMID: 28926888 DOI: 10.3760/cma.j.issn.0412-4081.2017.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the clinical results of keratoconic eyes with a thin cornea treated with accelerated transepithelial corneal collagen cross-linking (A-TE-CXL) within 1 year. Methods: Nineteen eyes of 19 patients with progressive keratoconus with a minimum corneal thickness from 380 μm to 420 μm (including the epithelium) were included in this prospective, nonrandomized clinical study and treated with A-TE-CXL. Scoring of pain and foreign body sensation, slit lamp examination, uncorrected visual acuity, best corrected distance visual acuity, corneal topography, anterior segment optical coherence tomography, in vivo corneal confocal microscopy and endothelial cell count were assessed before surgery and at 1, 3, 6 and 12 months postoperatively. Paired t test was applied for statistical analysis. Results: Mild pain and moderate foreign body sensation were reported by most patients within postoperative 24 hours, but rapidly disappeared on day 2. Extremely mild epithelial damage was observed within postoperative 24 hours, and the epithelium fully recovered on day 2. Improvement of visual acuity was recorded at 3 and 12 months. Pentacam corneal topography revealed a significant reduction of the thickness of the thinnest location from(395.2±13.8)μm preoperatively to (378.9±17.1)μm at 1 month postoperatively (t=2.982, P<0.01). Front curvature values were reduced postoperatively. K(MAX) was significantly decreased at 12 months (55.67±4.91) compared with (57.35±5.54) preoperatively, while K2 was also significantly decreased at 12 months (52.18±3.70) compared with (52.70±3.56) preoperatively (K(MAX), t=3.044, P<0.01. K2, t=2.384, P<0.05) . Within 1 month postoperatively, optical coherence tomography exhibited an increase of reflectance with a demarcation line in the anterior stroma. In vivo confocal microscopy also showed significant thickening and increased connections of collagen fibers with a maximal depth at about 90 to 120 μm. The corneal endothelial cell density remained stable (t=0.692, P>0.05). None of the patients showed postoperative complications such as corneal infection, scarring and ulceration. Conclusions: Within 1 year postoperatively, A-TE-CXL was effective and safe for the management of progressive keratoconus with a thin cornea. A-TE-CXL showed the advantages of very short time consuming in surgery, rapid recovery and very few complications, and had the potential to become a valid alternative for the treatment of keratoconus. (Chin J Ophthalmol, 2017, 53: 694-700).
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Affiliation(s)
- Z R Lin
- Department of Ocular Surface and Corneal Diseases, Eye Institute & Affiliated Xiamen Eye Center of Xiamen University, Xiamen 361001, China
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Wu KH, Wu HP, Lin HJ, Wang CH, Chen HY, Weng T, Peng CT, Chao YH. Concurrent hypopituitarism and leukemic retinopathy in a child with B-precursor acute lymphoblastic leukemia and isolated central nervous system relapse. Curr Oncol 2016; 23:e431-4. [PMID: 27536191 DOI: 10.3747/co.23.3006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/15/2022] Open
Abstract
Hypopituitarism in leukemia is very rare. In addition, central nervous system (cns) relapse and leukemic retinopathy in childhood acute lymphoblastic leukemia (all) have declined with the use of modern systemic chemotherapy that includes cns prophylaxis. Here, we report the case of a 4-year-old girl who received chemotherapy and intrathecal therapy without cns radiation after a diagnosis of B-precursor all without cns involvement. Three months after chemotherapy completion, she presented with lower-extremity weakness and was diagnosed with an isolated cns relapse. Concurrent hypopituitarism and leukemic retinopathy were also found. After receiving craniospinal radiotherapy and systemic chemotherapy, her retinopathy and vision improved. She is now in complete remission, and she is still on chemotherapy according to the guideline from the Pediatric Oncology Group. Although rare, hypopituitarism and leukemic retinopathy should be taken into consideration in patients with cns involvement by leukemia.
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Affiliation(s)
- K H Wu
- School of Post Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung; Division of Pediatric Hematology-Oncology, Children's Hospital, China Medical University, Taichung
| | - H P Wu
- Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan; College of Medicine, Chang Gung University, Taoyuan
| | - H J Lin
- Department of Ophthalmology, China Medical University Hospital, Taichung; Department of Medical Research, China Medical University Hospital, Taichung
| | - C H Wang
- Division of Genetics and Metabolism, Children's Hospital, China Medical University, Taichung
| | - H Y Chen
- Department of Radiology, China Medical University Hospital, Taichung
| | - T Weng
- Division of Pediatric Hematology-Oncology, Children's Hospital, China Medical University, Taichung
| | - C T Peng
- Division of Pediatric Hematology-Oncology, Children's Hospital, China Medical University, Taichung; Department of Biotechnology and Bioinformatics, Asia University, Taichung
| | - Y H Chao
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Guo YC, Wang H, Wu HP, Zhang MQ. Multi-modulus algorithm based on global artificial fish swarm intelligent optimization of DNA encoding sequences. Genet Mol Res 2015; 14:17511-8. [PMID: 26782395 DOI: 10.4238/2015.december.21.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Aimed to address the defects of the large mean square error (MSE), and the slow convergence speed in equalizing the multi-modulus signals of the constant modulus algorithm (CMA), a multi-modulus algorithm (MMA) based on global artificial fish swarm (GAFS) intelligent optimization of DNA encoding sequences (GAFS-DNA-MMA) was proposed. To improve the convergence rate and reduce the MSE, this proposed algorithm adopted an encoding method based on DNA nucleotide chains to provide a possible solution to the problem. Furthermore, the GAFS algorithm, with its fast convergence and global search ability, was used to find the best sequence. The real and imaginary parts of the initial optimal weight vector of MMA were obtained through DNA coding of the best sequence. The simulation results show that the proposed algorithm has a faster convergence speed and smaller MSE in comparison with the CMA, the MMA, and the AFS-DNA-MMA.
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Affiliation(s)
- Y C Guo
- Jiangsu Key Laboratory of Meteorological Observation and Information Processing, Nanjing University of Information Science & Technology, Nanjing, Jiangsu, China.,Jiangsu Collaborative Innovation Center on Atmospheric Environment and Equipment Technology, Nanjing, China
| | - H Wang
- Jiangsu Key Laboratory of Meteorological Observation and Information Processing, Nanjing University of Information Science & Technology, Nanjing, Jiangsu, China
| | - H P Wu
- Jiangsu Key Laboratory of Meteorological Observation and Information Processing, Nanjing University of Information Science & Technology, Nanjing, Jiangsu, China
| | - M Q Zhang
- Jiangsu Key Laboratory of Meteorological Observation and Information Processing, Nanjing University of Information Science & Technology, Nanjing, Jiangsu, China
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Wu KH, Wu HP, Weng T, Peng CT, Chao YH. Dasatinib for a child with Philadelphia chromosome-positive acute lymphoblastic leukemia and persistently elevated minimal residual disease during imatinib therapy. ACTA ACUST UNITED AC 2015; 22:303-6. [PMID: 26300669 DOI: 10.3747/co.22.2719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 12/13/2022]
Abstract
Imatinib has improved outcomes in patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (all). Minimal residual disease (mrd) is a useful tool for predicting leukemia relapse. However, there is no consensus on how to treat children with elevation of BCR-ABL transcripts but no evidence of hematologic relapse during chemotherapy combined with imatinib. Here, we report the case of a child with Ph+ all who had persistent elevation of mrd, but no evidence of hematologic relapse while receiving imatinib plus intensive chemotherapy. Dasatinib was substituted for imatinib because no suitable donor for allogeneic hematopoietic stem-cell transplantation (hsct) was available. Less-intensive chemotherapy with methotrexate and 6-mercaptopurine was administered concomitantly. No serious adverse events were encountered. With continuous dasatinib combined with chemotherapy, but no allogeneic hsct, our patient reached complete molecular remission and has been in complete molecular remission for more than 13 months. This report is the first about the long-term use of dasatinib in patients with Ph+ all and mrd elevation but hematologic remission during imatinib chemotherapy. In a similar situation, chemotherapy combined with dasatinib instead of allogeneic hsct could be considered to avoid hsct-related mortality and morbidity. Clinical trials are needed.
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Affiliation(s)
- K H Wu
- School of Chinese Medicine, China Medical University, Taichung, Taiwan; ; Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan
| | - H P Wu
- Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Taichung Branch, Taichung, Taiwan
| | - T Weng
- Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan
| | - C T Peng
- School of Chinese Medicine, China Medical University, Taichung, Taiwan; ; Department of Pediatrics, Children's Hospital, China Medical University, Taichung, Taiwan; ; Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan
| | - Y H Chao
- Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; ; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Wang YC, Wu HP, Lo PH, Liang HY, Chang KC. Impact of Prolonged Door-to-Balloon Times on the Diastolic Function in Acute ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention. Acta Cardiol Sin 2015; 31:281-91. [PMID: 27122884 PMCID: PMC4804924 DOI: 10.6515/acs20140821e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Emerging evidence indicates that diastolic left ventricular (LV) function is a powerful outcome predictor after acute ST-elevation myocardial infarction (STEMI). We hypothesized that shorter door-to-balloon (D2B) times with early restoration of coronary perfusion may preserve diastolic LV function in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). METHODS This study enrolled 340 consecutive STEMI patients who underwent PPCI with D2B times of < 90 min in 232 patients and D2B times ≥ 90 min in 108 patients, who all received subsequent echocardiographic examination within 48 hours of hospitalization. RESULTS Although the LV ejection fraction was similar (50.92% vs. 51.66%, p = 0.573), the proportion of E/E' ratio > 15 was greater in patients with D2B times ≥ 90 min compared to those with D2B times < 90 min (44.4% vs. 30.6%, p = 0.013). Logistic regression analysis revealed that D2B time ≥ 90 min [odds ratio (OR): 1.82, 95% confidence interval (Cl): 1.04-3.17, p = 0.035] was an independent predictor for LV diastolic dysfunction. The effect was more prominent in patients ≥ 65 years of age (OR: 2.77, 95% CI: 1.09-7.00, p = 0.032), in whom the fraction of LV diastolic dysfunction increased proportionally with prolonged D2B times. CONCLUSIONS Prolonged D2B time of greater than 90 min predicted LV diastolic dysfunction, particularly in aged subjects. D2B times shortening is important to preserve diastolic heart function after PPCI. KEY WORDS Acute myocardial infarction; Diastolic dysfunction; Door-to-balloon time; Primary percutaneous coronary intervention.
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Affiliation(s)
- Yu-Chen Wang
- Graduate Institute of Clinical Medical Science, China Medical University;
,Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Pin Wu
- Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ping-Hang Lo
- Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-Yueh Liang
- Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Cheng Chang
- Graduate Institute of Clinical Medical Science, China Medical University;
,Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
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Li MC, Wu HP, Yang CY, Chen PC, Lambert GH, Leon Guo Y. Gestational exposure to polychlorinated biphenyls and dibenzofurans induced asymmetric hearing loss: Yucheng children study. Environ Res 2015; 137:65-71. [PMID: 25490244 DOI: 10.1016/j.envres.2014.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/28/2014] [Accepted: 12/01/2014] [Indexed: 05/28/2023]
Abstract
INTRODUCTION In 1979, approximately 2000 people in central Taiwan were exposed to polychlorinated biphenyls and dibenzofurans (PCBs/PCDFs) due to ingestion of contaminated rice oil. The children born to mothers exposed to PCBs/PCDFs were called Yucheng children. We conducted a follow-up study to examine the association between gestational PCBs/PCDFS exposure and auditory function in Yucheng children's early adulthood. METHODS In 1985 and early 1992, Yucheng children and their age, gender, socio-economic matched unexposed referent children were recruited for physical examination and long-term follow-ups. In 2007, Yucheng children and referent children were invited to participate in a health examination, including assessment of pure-tone air-conduction thresholds and distortion product otoacoustic emissions (DPOAEs) test. Gestational exposure to PCBs/PCDFs in Yucheng children were estimated by back-extrapolation of their mother's serum concentration to the time of childbirth. RESULTS A total of 86 Yucheng children (51.2% males) and 97 referent children (50.5% males) were included for analysis. No difference was found in demographic characteristics between two groups. Among the Yucheng children, 53 had estimated PCBs/PCDFs concentrations. We found that Yucheng children were at higher risk of having elevated hearing threshold at low frequencies in the right ear. Estimated maternal concentrations of 2,3,4,7,8-pnCDF at the time of birth were associated with increased hearing thresholds and decreased DPOAEs amplitudes at low frequencies in the right ear. CONCLUSION Gestational exposure to PCBs/PCDFs caused adverse asymmetrical hearing effects detectable even in early adulthood.
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Affiliation(s)
- Ming-Chieh Li
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Graduate Institute of Law and Interdisciplinary Studies, National Chengchi University College of Law, Taipei, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, Buddhist Tzuchi General Hospital, Taichung Branch, Taichung, Taiwan; School of Medicine, Tzuchi University, Hualien, Taiwan; Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chiu-Yueh Yang
- Department of Health Business Administration, Hung-Kuang University, Taichung, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - George H Lambert
- Retired Director NIH/NIEH Children Center, Rutgers, The State University of New Jersey, USA
| | - Yue Leon Guo
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
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Sun CH, Hsu CJ, Chen PR, Wu HP. Residual hearing preservation after cochlear implantation via round window or cochleostomy approach. Laryngoscope 2015; 125:1715-9. [DOI: 10.1002/lary.25122] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Chuan-Hung Sun
- Department of Otolaryngology; Buddhist Tzu Chi General Hospital; Hualien Taiwan
| | - Chuan-Jen Hsu
- Department of Otolaryngology; Taichung Tzuchi General Hospital, The Buddhist Tzuchi Medical Foundation; Taichung Taiwan
- School of Medicine; Tzu Chi University; Hualien Taiwan
| | - Peir-Rong Chen
- Department of Otolaryngology; Buddhist Tzu Chi General Hospital; Hualien Taiwan
- School of Medicine; Tzu Chi University; Hualien Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology; Taichung Tzuchi General Hospital, The Buddhist Tzuchi Medical Foundation; Taichung Taiwan
- School of Medicine; Tzu Chi University; Hualien Taiwan
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Chang KC, Wang YC, Ko PY, Wu HP, Chen YW, Muo CH, Sung FC, Li TC, Hsu CY. Increased risk of first-ever stroke in younger patients with atrial fibrillation not recommended for antithrombotic therapy by current guidelines: a population-based study in an East Asian cohort of 22 million people. Mayo Clin Proc 2014; 89:1487-97. [PMID: 25444485 DOI: 10.1016/j.mayocp.2014.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/15/2014] [Accepted: 08/21/2014] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess the risk of first-ever ischemic stroke in younger patients with atrial fibrillation (AF) who have none of the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category [female sex]) risk factors (excluding female sex) by using the National Health Insurance research database in Taiwan. PATIENTS AND METHODS From 22,842,778 insured people, we identified 24,612 hospitalized patients with newly diagnosed AF between January 1, 2002, and December 31, 2004, as the AF group and randomly selected 98,448 age- and sex-matched persons without AF as the non-AF group. Both groups were followed up until December 31, 2010, to estimate ischemic stroke incidences in relation to other stroke risk factors. RESULTS During a follow-up period of 89,468 person-years, the stroke rate was higher in patients with AF than in those without AF (5.79 per 100 person-years vs 2.25 per 100 person-years). The higher prevalence of CHA2DS2-VASc comorbidities (heart failure, hypertension, diabetes, coronary artery disease, and peripheral artery disease) in patients with AF further increased the stroke risk. In 790 patients with AF aged 30 to 55 years who had none of the CHA2DS2-VASc comorbidities at baseline and retained a "low risk," that is, those with a CHA2DS2-VASc score of 0 in men and 1 in women during follow-up, the stroke rate remained considerably higher than that in their non-AF counterparts (1.00 per 100 person-years vs 0.25 per 100 person-years), with a sex-adjusted hazard ratio of 4.09 (95% CI, 2.97-5.62). CONCLUSION This study finds an increased risk of stroke in younger patients with AF who are not recommended for prevention of thromboembolism by current guidelines. Better stroke risk stratification tools are needed to prioritize younger patients with AF for thromboprophylactic therapy in this population.
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Affiliation(s)
- Kuan-Cheng Chang
- Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Yu-Chen Wang
- Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Po-Yen Ko
- Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Pin Wu
- Division of Cardiology, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Wei Chen
- Department of Neurology, Landseed Hospital, Taoyuan, Taiwan
| | - Chih-Hsin Muo
- Department of Public Health, China Medical University, Taichung, Taiwan; China Medical University Hospital Management Office for Health Data, Taichung, Taiwan
| | - Fung-Chang Sung
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan
| | - Chung Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
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Huang CH, Chang YL, Wang CP, Wu HP. Positive immunostaining of thyroid transcription factor-1 in primary nasopharyngeal papillary adenocarcinoma. J Formos Med Assoc 2013; 114:473-4. [PMID: 23810701 DOI: 10.1016/j.jfma.2013.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 04/24/2013] [Accepted: 04/29/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Chen-Hsuan Huang
- Department of Otolaryngology, Buddhist Tzu Chi General Hospital, Taipei Branch, New Taipei City, Taiwan
| | - Yih-Leong Chang
- Department of Pathology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
| | - Cheng-Ping Wang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan; Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan
| | - Hung-Pin Wu
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; Department of Otolaryngology, Buddhist Tzu Chi General Hospital, Taichung Branch, Taichung, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
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Chou YF, Chen PR, Kuo IJ, Yu SH, Wen YH, Wu HP. Comparison of intermittent intratympanic steroid injection and near-continual transtympanic steroid perfusion as salvage treatments for sudden sensorineural hearing loss. Laryngoscope 2013; 123:2264-9. [DOI: 10.1002/lary.23909] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/12/2022]
Affiliation(s)
- Yi-Fan Chou
- Department of Otolaryngology; Buddhist Tzuchi General Hospital; Taichung Branch; Taichung
| | | | - Ian-Jiun Kuo
- Department of Otolaryngology; Buddhist Tzuchi General Hospital Taipei Branch; Taipei
| | - Szu-Hui Yu
- Department of Music; Tainan University of Technology; Tainan
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Chen BY, Chan CC, Han YY, Wu HP, Guo YL. The risk factors and quality of life in children with allergic rhinitis in relation to seasonal attack patterns. Paediatr Perinat Epidemiol 2012; 26:146-55. [PMID: 22324501 DOI: 10.1111/j.1365-3016.2011.01203.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A questionnaire survey was conducted to examine whether risk factors and allergic rhinitis (AR)-related quality of life (QOL) were different among children with different seasonal patterns of AR. Participants were students enrolled in elementary and middle schools in Taipei County, Taiwan. Using moving average and principal component analysis, children with current AR were grouped by attack seasons. The effects of personal and environmental factors on AR seasonality were assessed by logistic regression models. AR severity and AR-related QOL were compared within AR seasonal subtypes. Among 4221 children who completed the questionnaire, 1144 and 1605 children were current AR cases and healthy controls, respectively. Four AR subtypes were categorised as follows: perennial, spring, summer/fall, and winter. Age, gender, parental education, maternal passive smoking during pregnancy, breast feeding, and mouldy walls were found to contribute differentially to different AR subtypes. Children suffering from perennial and winter AR were found to have more severe symptoms and significantly lower QOL score compared with other subtypes. Specific personal and environmental risk factors could contribute to different AR seasonal subtypes. Active allergen avoidance and symptomatic treatment should be the focus of management aiming to improve the QOL among children with perennial and winter subtype.
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Affiliation(s)
- Bing-Yu Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
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Chou YF, Chen PR, Yu SH, Wen YH, Wu HP. Using multi-stimulus auditory steady state response to predict hearing thresholds in high-risk infants. Eur Arch Otorhinolaryngol 2011; 269:73-9. [PMID: 21512805 DOI: 10.1007/s00405-011-1604-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 04/06/2011] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to investigate whether multi-stimulus auditory steady-state responses were capable of estimating hearing thresholds in high-risk infants. A retrospective chart review study. Three tertiary referral centers. Infants born between January 2004 and December 2006 who met the criteria for risk factors of congenital hearing loss were enrolled in the study. While under sedation, the multi-stimulus auditory steady-state response was used to determine multi-channel auditory steady-state response thresholds for high-risk infants younger than 13 months. Conditioned play audiometry was then applied to these children at 23-48 months of age to obtain pure tone audiograms. Auditory steady-state response thresholds and pure tone thresholds were then compared. A total of 249 high-risk infants were enrolled in the study. 39 infants were lost during follow-up. The remaining 216 infants completed both examinations. The Pearson correlation coefficients (r) between the ASSR levels and pure tone thresholds were 0.88, 0.94, 0.94 and 0.97 at 500, 1,000, 2,000 and 4,000 Hz, respectively. The strength of the relationship between the auditory steady-state responses and pure tone thresholds increased with more severe degrees of hearing loss and higher frequencies. We conclude that initial multichannel ASSR thresholds measured under sedation are highly correlated with pure tone thresholds obtained 2 or 3 years later. ASSR can be used to predict the frequency-specific hearing thresholds of high-risk infants and can provide information for early hearing intervention.
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Affiliation(s)
- Yi-Fan Chou
- Department of Otolaryngology, Buddhist Tzuchi General Hospital, Taipei branch, Taipei, Taiwan
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Chen BY, Chao HJ, Chan CC, Lee CT, Wu HP, Cheng TJ, Chen CC, Guo YL. Effects of ambient particulate matter and fungal spores on lung function in schoolchildren. Pediatrics 2011; 127:e690-8. [PMID: 21339279 DOI: 10.1542/peds.2010-1038] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Studies examining the combined health effects of both have been relatively lacking. We conducted a longitudinal study to investigate whether exposure to air pollutants and fungal spores might exacerbate childhood respiratory health. METHODS Study participants were 100 elementary and middle-school students in Taipei County, Taiwan. A structured respiratory health questionnaire was administered in September 2007, followed by monthly spirometry from October 2007 to June 2008. During the study period, complete daily monitoring data for criteria air pollutants were obtained from the Environmental Protection Administration monitoring station and Aerosol Supersite. Fungal spores were measured from Sunday to Saturday in the week when lung-function measurements were made for each study month. Lung-function measurements were compared with air pollutants and fungal spores using mixed-effects models with 1-day-lag modeling. RESULTS The particulate matter with an aerodynamic diameter of 2.5 μm or less level 1 day before the lung function measurements was negatively associated with forced vital capacity. The fungal spore level was negatively associated with both forced expiratory vital capacity and forced expiratory volume in 1 second. O(3) level was negatively associated with forced expiratory flow at 25%, 50%, and 75% of forced vital capacity, and average expiratory flow over the middle half of forced vital capacity. CONCLUSIONS This study suggested that exposure to particulate matter with an aerodynamic diameter of 2.5 μm or less and fungal spores might cause adverse effects on the vital capacity of schoolchildren. Exposure to O(3) adversely affected small airway function.
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Affiliation(s)
- Bing-Yu Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
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Wu HP, Guo YL, Cheng TJ, Hsu CJ. Chronological changes in compromised olivocochlear activity and the effect of insulin in diabetic Wistar rats. Hear Res 2010; 270:173-8. [DOI: 10.1016/j.heares.2010.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2010] [Revised: 07/08/2010] [Accepted: 07/24/2010] [Indexed: 01/12/2023]
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Wu HP, Hsu CJ, Cheng TJ, Guo YL. N-acetylcysteine attenuates noise-induced permanent hearing loss in diabetic rats. Hear Res 2010; 267:71-7. [DOI: 10.1016/j.heares.2010.03.082] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 03/21/2010] [Accepted: 03/23/2010] [Indexed: 01/12/2023]
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Luo X, Fu QJ, Wu HP, Hsu CJ. Concurrent-vowel and tone recognition by Mandarin-speaking cochlear implant users. Hear Res 2009; 256:75-84. [PMID: 19595753 DOI: 10.1016/j.heares.2009.07.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 06/25/2009] [Accepted: 07/08/2009] [Indexed: 12/31/2022]
Abstract
In Mandarin Chinese, tonal patterns are lexically meaningful. In a multi-talker environment, competing tones may create interference in addition to competing vowels and consonants. The present study measured Mandarin-speaking cochlear implant (CI) users' ability to recognize concurrent vowels, tones, and syllables in a concurrent-syllable recognition test. Concurrent syllables were constructed by summing either one Chinese syllable each from one male and one female talker or two syllables from the same male talker. Each talker produced 16 different syllables (4 vowels combined with 4 tones); all syllables were normalized to have the same overall duration and amplitude. Both single- and concurrent-syllable recognition were measured in 4 adolescent and 4 adult CI subjects, using their clinically assigned speech processors. The results showed no significant difference in performance between the adolescent and adult CI subjects. With single syllables, mean vowel recognition was 90% correct, while tone and syllable recognition were only 63% and 57% correct, respectively. With concurrent syllables, vowel, tone, and syllable recognition scores dropped by 40-60 percentage points. Concurrent-syllable performance was significantly correlated with single-syllable performance. Concurrent-vowel and syllable recognition were not significantly different between the same- and different-talker conditions, while concurrent-tone recognition was significantly better with the same-talker condition. Vowel and tone recognition were better when concurrent syllables contained the same vowels or tones, respectively. Across the different vowel pairs, tone recognition was less variable than vowel recognition; across the different tone pairs, vowel recognition was less variable than tone recognition. The present results suggest that interference between concurrent tones may contribute to Mandarin-speaking CI users' susceptibility to competing-talker backgrounds.
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Affiliation(s)
- Xin Luo
- Department of Speech, Language, and Hearing Sciences, Purdue University, 500 Oval Drive, West Lafayette, IN 47907, USA.
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Abstract
OBJECTIVES/HYPOTHESIS The purpose of this study is to investigate whether diabetes impairs the recovery from noised-induced temporary hearing loss. METHODS Twenty-eight male Wistar rats were divided into three groups: control, diabetes with insulin control (DI), and diabetes without insulin control (DM). Diabetes was induced by intraperitoneal injection of streptozotocin. All animals were exposed to white noise at 110 dB SPL for 8 hours. Auditory brainstem response (ABR) thresholds and distortion product otoacoustic emission (DPOAE) amplitudes were measured for all animals 1 day prior to noise exposure to obtain a baseline for hearing function, and then 1 hour, 1 day, 2 days, 4 days, 7 days, and 14 days after noise exposure. RESULTS One hour post exposure, ABR thresholds shifted markedly, and DPOAE was reduced similarly in all groups. Both ABR thresholds and DPOAE returned to the baseline in the control group at day 1, but they were not back to the baseline in the DM group even by day 14. Compared with the control group, the ABR threshold shifts and DPOAE returned to baseline more slowly in the DI group. CONCLUSIONS The present study suggests that diabetic patients need proper blood sugar control and probably need more effective preventive measures to preserve their hearing from the effects of noise. Laryngoscope, 2009.
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Affiliation(s)
- Hung-Pin Wu
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
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Zhu XG, Tao L, Mei ZR, Wu HP, Jiang ZW. Aspisol inhibits tumor growth and induces apoptosis in breast cancer. Exp Oncol 2008; 30:289-294. [PMID: 19112426] [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: 05/27/2023]
Abstract
UNLABELLED Nonsteroidal anti-inflammatory drugs inhibit cell proliferation and induce apoptosis in various cancer cell lines, which is considered to be an important mechanism for their anti-tumor activity and cancer prevention. However, the molecular mechanisms through which these compounds induce apoptosis are not well understood. AIM to determine the effects of nonselective cyclooxygenase-2 (COX-2) inhibitor, aspisol on breast cancer cells in vitro and in vivo. METHODS The cytotoxic activity of aspisol was evaluated by MTT assay. The apoptosis index of cells was measured by flow cytometry. Immunohistochemical staining was used to detect expressions of COX-2 and caspase-3 in MDA-MB-231 cells. The expression of bcl-2 and bax was analyzed by Western blot analysis. The content of prostaglandin E2 (PGE2) in MDA-MB-231 cells was estimated by ELISA. In vivo apoptosis of the tumor cells was detected by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). RESULTS Our results showed that aspisol reduced viability of MDA-MB-231 cells in time- and dose- dependent fashions and induced apoptosis by increase of caspase-3 and bax expressions while decrease of COX-2 and bcl-2 expression in vitro. In addition, exposure to aspisol decreased the basal release of PGE2. In vivo, aspisol also inhibited the proliferation of breast cancer cells and induced their apoptosis. CONCLUSIONS Our in vitro and in vivo data indicated that the antitumor effects of aspisol on breast cancer cells was probably mediated by the induction of apoptosis, and it could be linked to the downregulation of the COX-2 or bcl-2 expression and up-regulation of caspase-3 or bax expression.
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Affiliation(s)
- X G Zhu
- Department of Pharmacology, Pharmacy Department, Bengbu Medical College, Bengbu 233003, China
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Wen YH, Yang RH, Chen PR, Sheen TS, Wu HP. Hepatocellular Carcinoma Metastatic to the Palatine Tonsil. Tzu Chi Med J 2008. [DOI: 10.1016/s1016-3190(08)60040-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lin YH, Ho HC, Wu HP. Comparison of auditory steady-state responses and auditory brainstem responses in audiometric assessment of adults with sensorineural hearing loss. Auris Nasus Larynx 2008; 36:140-5. [PMID: 18620826 DOI: 10.1016/j.anl.2008.04.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2008] [Revised: 03/29/2008] [Accepted: 04/26/2008] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Many of the medico-legal patients who claimed compensation may exaggerate hearing loss that varies in degree, nature, and laterality. The purpose of this study was to investigate whether Auditory Steady-State Response (ASSR) could be used to predict the hearing level of adults, and whether ASSR could become a better testing method than Auditory brainstem response (ABR) in audiometric assessment of adults with sensorineural hearing loss. METHODS This was a prospective study, which was conducted in a tertiary referral hospital. From January to June 2007, 142 subjects (284 ears) with varying degrees of sensori-neural hearing impairment were included in this study. Four commonly used frequencies (500, 1000, 2000, 4000Hz) were evaluated. All subjects received pure-tone audiometry, multi-channel ASSR, and ABR tests for threshold measurement. The correlation of pure tone thresholds with ASSR and ABR thresholds were assessed. RESULTS Between multi-channel ASSR and pure tone thresholds, a difference of less than 15dB was found in 71% while a difference of less than 25dB was found in 89% of patients. The correlation coefficient (r) of multi-channel ASSR and pure tone thresholds were 0.89, 0.95, 0.96, and 0.97 at 500, 1000, 2000, and 4000Hz, respectively. The strength of the relationship increased with increasing frequency. On the other hand, between ABR and pure-tone thresholds, a difference of less than 15dB was found in 31%; a difference of less than 25dB was found in 62% of patients. The r correlation value for ABR and pure tone thresholds was 0.83. CONCLUSION ASSR is a more reliable test for the accurate prediction of auditory thresholds than ABR. It can be a powerful and convenient electro-physiologic examination tool for clinically assessing of adults with sensorineural hearing loss.
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Affiliation(s)
- Yu-Hsing Lin
- Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
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Liu JF, Yin S, Wu HP, Zeng YW, Hu XR, Wang YW, Lv GL, Jiang JZ. Wurtzite-to-Rocksalt Structural Transformation in Nanocrystalline CoO. J Phys Chem B 2006; 110:21588-92. [PMID: 17064112 DOI: 10.1021/jp0648238] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Hexagonal CoO nanocrystals are coarsened under hydrothermal conditions to investigate the effect of particle size on phase transformation and stability property. Structural stability and phase transformation of the hexagonal CoO phase have been investigated by X-ray powder diffraction with Rietveld refinement, transmission electron microscopy, X-ray absorption fine structure, and differential scanning calorimeter. It is found that the hexagonal CoO phase is a metastable phase, which increases its grain size from 50 to 250 nm for refluxing times from 1 to 6 h at 200 degrees C. After 12 h, cubic-structured CoO grains with an average grain size of 20 nm are observed, which spread around big hexagonal CoO grains. After about 24 h, only the cubic CoO phase with an average grain size of 25 nm is detected. The onset temperature of hexagonal-to-cubic phase transformation in CoO is estimated to be 378 degrees C by DSC, using a heating rate of 20 deg/min. The results obtained indicate that the hexagonal-to-cubic phase transformation in nanocrystalline CoO is by nucleation and growth mechanism, starting from the surface to the center of the hexagonal grains.
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Affiliation(s)
- J F Liu
- Laboratory of New-Structured Materials, Department of Materials Science and Engineering, Zhejiang University, Hangzhou 310027, People's Republic of China
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