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Wu JM, Yang H, Li Q, Luo TF, Yang P, Huang WC. [Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:849-856. [PMID: 37805801 DOI: 10.3760/cma.j.cn501225-20230420-00134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To investigate the clinical efficacy of local injection of platelet-rich plasma (PRP) combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity. Methods: A retrospective observational study was conducted. From December 2017 to October 2022, 16 patients were admitted to Department of Orthopaedic Trauma of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, and 32 patients were admitted to Department of Burns and Plastic Surgery of Guiyang Steel Factory Staff Hospital. All the patients had wounds with exposed tendon on extremity caused by various reasons and met the inclusion criteria. There were 39 males and 9 females, aged 26 to 58 years. The patients were divided into PRP alone group, artificial dermis alone group, and PRP+artificial dermis group, with 16 patients in each group. The wounds were treated with autologous PRP, double-layer artificial dermis, or thei combination of autologous PRP and double-layer artificial dermis, followed by autologous split-thickness scalp grafting after good growth of granulation tissue. On the 7th day after the secondary surgery, the autograft survival was observed, and the survival rate was calculated. The wound healing time and length of hospital stay of patients were recorded. At 3 and 6 months after wound healing, the Vancouver scar scale (VSS) was used to score the pigmentation, height, vascularity, and pliability of scars, and the total score was calculated. Adverse reactions during the entire treatment process were recorded. Data were statistically analyzed with chi-square test, Fisher's exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis H test, Nemenyi test, and Bonferroni correction. Results: On the 7th day after the secondary surgery, there was no statistically significant difference in the autograft survival rate of patients among PRP alone group, artificial dermis alone group, and PRP+artificial dermis group (P>0.05). The wound healing time and length of hospital stay of patients in PRP+artificial dermis group were (20.1±3.0) and (24±4) d, respectively, which were significantly shorter than (24.4±5.5) and (30±8) d in PRP alone group (P<0.05) and (24.8±4.9) and (32±8) d in artificial dermis alone group (P<0.05). At 3 and 6 months after wound healing, the pliability scores of patients in PRP+artificial dermis group were significantly lower than those in PRP alone group (with Z values of 12.91 and 15.69, respectively, P<0.05) and artificial dermis alone group (with Z values of 12.50 and 12.91, respectively, P<0.05). There were no statistically significant differences in pigmentation, vascularity, height scores, and total score of scar of patients among the three groups (P>0.05). In artificial dermis alone group, one patient experienced partial liquefaction and detachment of the double-layer artificial dermis due to local infection of Staphylococcus epidermidis, which received wound dressing change, second artificial dermis transplantation, and subsequent treatment as before. No adverse reactions occurred in the remaining patients during the whole treatment process. Conclusions: Local injection of PRP combined with double-layer artificial dermis is effective in treating wounds with exposed tendon on extremity, which can not only significantly shorten wound healing time and length of hospital stay, but also improve scar pliability after wound healing to some extent in the long term. It is a clinically valuable treatment technique that is worth promoting and applying.
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Affiliation(s)
- J M Wu
- Department of Burns and Plastic Surgery, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - H Yang
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - Q Li
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - T F Luo
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - P Yang
- Department of Orthopaedic Trauma, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China
| | - W C Huang
- Department of Orthopaedic Trauma, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China
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Yang FA, Lin CL, Huang WC, Wang HY, Peng CW, Chen HC. Effect of Robot-Assisted Gait Training on Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Neurorehabil Neural Repair 2023; 37:228-239. [PMID: 37078621 DOI: 10.1177/15459683231167850] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
BACKGROUND In recent meta-analyses, robot-assisted gait training for patients with multiple sclerosis (MS) have yielded limited clinical benefits compared with conventional overground gait training. OBJECTIVE To investigate the effect of robot-assisted gait training for patients with MS on clinical outcomes through a systematic review and meta-analysis. METHODS We searched for relevant studies in the PubMed, EMBASE, Cochrane Library, and Physiotherapy Evidence Database databases from their inception to April 7, 2022. We selected studies that (1) included participants with MS, (2) used robot-assisted gait training as the intervention, (3) included conventional overground gait training or another gait training protocol as control treatment, and (4) reported clinical outcomes. Continuous variables are expressed as standardized mean differences with 95% confidence intervals. Statistical analyses were performed using RevMan 5.4 software. RESULTS We included 16 studies enrolling 536 participants. Significant improvement was observed in the intervention group, with low heterogeneity at the end of the intervention with regard to walking velocity (standardized mean difference [SMD]: 0.38, 95% confidence interval [CI]: [0.15, 0.60]), walking endurance (SMD: 0.26, 95% CI [0.04, 0.48]), mobility (SMD: -0.37, 95% CI [-0.60, -0.14]), balance (SMD: 0.26, 95% CI [0.04, 0.48]), and fatigue (SMD: -0.27, 95% CI [-0.49, -0.04]). The results of subgroup analyses revealed improvements in these outcomes for the intervention group using grounded exoskeletons. No significant differences were noted in all the outcomes between the groups at follow-up. CONCLUSIONS Robot-assisted gait training with grounded exoskeletons exerts a positive short-term effect and is an adequate treatment option for patients with MS.
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Affiliation(s)
- Fu-An Yang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei
- Department of Medical Education, China Medical University Hospital, Taichung
| | - Chien-Lin Lin
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung
| | - Wan-Chien Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City
| | - Hsun-Yi Wang
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City
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Wu X, Yu H, He LY, Wang CQ, Xu HM, Zhao RQ, Jing CM, Chen YH, Chen J, Deng JK, Shi J, Lin AW, Li L, Deng HL, Cai HJ, Chen YP, Wen ZW, Yang JH, Zhang T, Xiao FF, Cao Q, Huang WC, Hao JH, Zhang CH, Huang YY, Ji XF. [A multicentric study on clinical characteristics and antibiotic sensitivity in children with methicillin-resistant Staphylococcus aureus infection]. Zhonghua Er Ke Za Zhi 2020; 58:628-634. [PMID: 32842382 DOI: 10.3760/cma.j.cn112140-20200505-00469] [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 clinical characteristics of pediatric methicillin-resistant Staphylococcus aureus (MRSA) infection and the antibiotic sensitivity of the isolates. Methods: The clinical data of children with MRSA infection and antibiotic sensitivity of the isolates from 11 children's hospitals in Infectious Diseases Surveillance of Paediatrics (ISPED) group of China between January 1, 2018 and December 31, 2018 were collected retrospectively. The children's general condition, high-risk factors, antimicrobial therapy and prognosis, differences in clinical disease and laboratory test results between different age groups, and differences of antibiotic sensitivity between community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA were analyzed. The t test and Wilcoxon rank sum test were used for statistical analysis of the quantitative data and Chi-square test were used for comparison of rates. Results: Among the 452 patients, 264 were males and 188 were females, aged from 2 days to 17 years. There were 233 cases (51.5%) in the ≤1 year old group, 79 cases (17.5%) in the>1-3 years old group, 29 cases (6.4%) in the >3-5 years old group, 65 cases (14.4%) in the >5-10 years old group, and 46 cases (10.2%) in the>10 years old group. The main distributions of onset seasons were 55 cases (12.2%) in December, 47 cases (10.4%) in February, 46 cases (10.2%) in November, 45 cases (10.0%) in January, 40 cases (8.8%) in March. There were 335 cases (74.1%) CA-MRSA and 117 (25.9%) cases HA-MRSA. Among all cases, 174 cases (38.5%) had basic diseases or long-term use of hormone and immunosuppressive drugs. During the period of hospitalization, 209 cases (46.2%) received medical interventions. There were 182 patients (40.3%) had used antibiotics (β-lactams, glycopeptides, macrolides, carbapenems, oxazolones, sulfonamides etc) 3 months before admission. The most common clinical disease was pneumonia (203 cases), followed by skin soft-tissue infection (133 cases), sepsis (92 cases), deep tissue abscess (42 cases), osteomyelitis (40 cases), and septic arthritis (26 cases), suppurative meningitis (10 cases). The proportion of pneumonia in the ≤1 year old group was higher than the >1-3 years old group,>3-5 years old group,>5-10 years old group,>10 years old group (57.5% (134/233) vs. 30.4% (24/79), 31.0% (9/29), 38.5% (25/65), 23.9% (11/46), χ(2)=17.374, 7.293, 7.410, 17.373, all P<0.01) The proportion of skin and soft tissue infections caused by CA-MRSA infection was higher than HA-MRSA (33.4% (112/335) vs. 17.9% (21/117), χ(2)=10.010, P=0.002), and the proportion of pneumonia caused by HA-MRSA infection was higher than CA-MRSA (53.0% (62/117) vs. 42.1% (141/335), χ(2)=4.166, P=0.041). The first white blood cell count of the ≤1 year old group was higher than that children > 1 year old ((15±8)×10(9)/L vs. (13±7)×10(9)/L, t=2.697, P=0.007), while the C-reactive protein of the ≤1 year old group was lower than the 1-3 years old group,>5-10 years old group,>10 years old group (8.00 (0.04-194.00) vs.17.00 (0.50-316.00), 15.20 (0.23-312.00), 21.79(0.13-219.00) mg/L, Z=3.207, 2.044, 2.513, all P<0.05), there were no significant differences in procalcitonin (PCT) between different age groups (all P>0.05). After the treatment, 131 cases were cured, 278 cases were improved, 21 cases were not cured, 12 cases died, and 10 cases were abandoned. The 452 MRSA isolates were all sensitive to vancomycin (100.0%), linezolid (100.0%), 100.0% resistant to penicillin, highly resistant to erythromycin (85.0%, 375/441), clindamycin (67.7%, 294/434), less resistant to sulfonamides (5.9%, 23/391), levofloxacin (4.5%, 19/423), gentamicin (3.2%, 14/438), rifampicin (1.8%, 8/440), minocycline (1.1%, 1/91). The antimicrobial resistance rates were not significantly different between the CA-MRSA and HA-MRSA groups (all P>0.05). Conclusions: The infection of MRSA is mainly found in infants under 3 years old. The prevalent seasons are winter and spring, and MRSA is mainly acquired in the community. The main clinical diseases are pneumonia, skin soft-tissue infection and sepsis. No MRSA isolate is resistant to vancomycin, linezolid. MRSA isolates are generally sensitive to sulfonamides, levofloxacin, gentamicin, rifampicin, minocycline, and were highly resistant to erythromycin and clindamycin. To achieve better prognosis. clinicians should initiate anti-infective treatment for children with MRSA infection according to the clinical characteristics of patients and drug sensitivity of the isolates timely and effectively.
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Affiliation(s)
- X Wu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - H Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - L Y He
- Department of Microbiology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - C Q Wang
- Department of Microbiology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - H M Xu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - R Q Zhao
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - C M Jing
- Department of Clinical Laboratory Center, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Y H Chen
- Department of Infectious Diseases, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China
| | - J Chen
- Department of Infectious Diseases, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China
| | - J K Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - J Shi
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - A W Lin
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - L Li
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - H L Deng
- Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an 710003, China
| | - H J Cai
- Department of Clinical Laboratory Center, Xi'an Children's Hospital, Xi'an 710003, China
| | - Y P Chen
- Department of Pediatric Infectious Diseases, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Z W Wen
- Department of Pediatric Infectious Diseases, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - J H Yang
- Department of Microbiology, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - T Zhang
- Department of Gastroenterology and Infectious Diseases, Children's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai 200040, China
| | - F F Xiao
- Department of Gastroenterology and Infectious Diseases, Children's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai 200040, China
| | - Q Cao
- Department of Infectious Diseases, Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - W C Huang
- Department of Infectious Diseases, Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J H Hao
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - C H Zhang
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - Y Y Huang
- Department of Pediatrics, Bethune First Hospital of Jilin University, Changchun 130021, China
| | - X F Ji
- Department of Pediatrics, Bethune First Hospital of Jilin University, Changchun 130021, China
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Cacciamani GE, Shakir A, Tafuri A, Gill K, Han J, Ahmadi N, Hueber PA, Gallucci M, Simone G, Campi R, Vignolini G, Huang WC, Taylor J, Becher E, Van Leeuwen FWB, Van Der Poel HG, Velet LP, Hemal AK, Breda A, Autorino R, Sotelo R, Aron M, Desai MM, De Castro Abreu AL. Best practices in near-infrared fluorescence imaging with indocyanine green (NIRF/ICG)-guided robotic urologic surgery: a systematic review-based expert consensus. World J Urol 2019; 38:883-896. [PMID: 31286194 DOI: 10.1007/s00345-019-02870-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [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: 05/15/2019] [Accepted: 07/03/2019] [Indexed: 01/06/2023] Open
Abstract
PURPOSE The aim of the present study is to investigate the impact of the near-infrared (NIRF) technology with indocyanine green (ICG) in robotic urologic surgery by performing a systematic literature review and to provide evidence-based expert recommendations on best practices in this field. METHODS All English language publications on NIRF/ICG-guided robotic urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus® and Web of Science™ databases (up to April 2019). Experts in the field provided detailed pictures and intraoperative video-clips of different NIRF/ICG-guided robotic surgeries with recommendations for each procedure. A unique QRcode was generated and linked to each underlying video-clip. This new exclusive feature makes the present the first "dynamic paper" that merges text and figure description with their own video providing readers an innovative, immersive, high-quality and user-friendly experience. RESULTS Our electronic search identified a total of 576 papers. Of these, 36 studies included in the present systematic review reporting the use of NIRF/ICG in robotic partial nephrectomy (n = 13), robotic radical prostatectomy and lymphadenectomy (n = 7), robotic ureteral re-implantation and reconstruction (n = 5), robotic adrenalectomy (n = 4), robotic radical cystectomy (n = 3), penectomy and robotic inguinal lymphadenectomy (n = 2), robotic simple prostatectomy (n = 1), robotic kidney transplantation (n = 1) and robotic sacrocolpopexy (n = 1). CONCLUSION NIRF/ICG technology has now emerged as a safe, feasible and useful tool that may facilitate urologic robotic surgery. It has been shown to improve the identification of key anatomical landmarks and pathological structures for oncological and non-oncological procedures. Level of evidence is predominantly low. Larger series with longer follow-up are needed, especially in assessing the quality of the nodal dissection and the feasibility of the identification of sentinel nodes and the impact of these novel technologies on long-term oncological and functional outcomes.
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Affiliation(s)
- Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - A Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Tafuri
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Urology, University of Verona, Verona, Italy
| | - K Gill
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J Han
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - N Ahmadi
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Uro-Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - P A Hueber
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Gallucci
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - G Simone
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - R Campi
- Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Vignolini
- Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - W C Huang
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, USA
| | - J Taylor
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, USA
| | - E Becher
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, USA
| | - F W B Van Leeuwen
- Department of Urology, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Interventional Molecular Imaging Laboratory, Leiden University Medical center, Leiden, The Netherlands.,Orsi Academy, Melle, Belgium
| | - H G Van Der Poel
- Department of Urology, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L P Velet
- Department of Urology, Wake Forest University, Winston-Salem, NC, USA
| | - A K Hemal
- Department of Urology, Wake Forest University, Winston-Salem, NC, USA
| | - A Breda
- Fundació Puigvert, Department of Urology, Autonomous University of Barcelona, Barcelona, Spain
| | - R Autorino
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA
| | - R Sotelo
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Aron
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M M Desai
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A L De Castro Abreu
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Sung PH, Huang WC, Wu CJ, Yip HK. P3427Intra-coronary administration of tacrolimus improves myocardial perfusion and LV function in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P H Sung
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
| | - W C Huang
- Kaohsiung Veterans General Hospital, Department of Critical Care Medicine, Kaohsiung, Taiwan ROC
| | - C J Wu
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
| | - H K Yip
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
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Wake N, Chandarana H, Huang WC, Taneja SS, Rosenkrantz AB. Application of anatomically accurate, patient-specific 3D printed models from MRI data in urological oncology. Clin Radiol 2016; 71:610-4. [PMID: 26983650 DOI: 10.1016/j.crad.2016.02.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/09/2015] [Accepted: 02/11/2016] [Indexed: 12/31/2022]
Affiliation(s)
- N Wake
- The Center for Advanced Imaging Innovation and Research (CAI(2)R) and The Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA; The Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY, USA.
| | - H Chandarana
- The Center for Advanced Imaging Innovation and Research (CAI(2)R) and The Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - W C Huang
- The Department of Urology, Division of Urologic Oncology, New York University School of Medicine, New York, NY, USA
| | - S S Taneja
- The Department of Urology, Division of Urologic Oncology, New York University School of Medicine, New York, NY, USA
| | - A B Rosenkrantz
- The Center for Advanced Imaging Innovation and Research (CAI(2)R) and The Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
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Chen CL, Chou KJ, Fang HC, Hsu CY, Huang WC, Huang CW, Huang CK, Chen HY, Lee PT. Progenitor-like cells derived from mouse kidney protect against renal fibrosis in a remnant kidney model via decreased endothelial mesenchymal transition. Stem Cell Res Ther 2015; 6:239. [PMID: 26631265 PMCID: PMC4668678 DOI: 10.1186/s13287-015-0241-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 10/01/2014] [Revised: 03/09/2015] [Accepted: 11/17/2015] [Indexed: 12/20/2022] Open
Abstract
Introduction Pathophysiological changes associated with chronic kidney disease impair angiogenic processes and increase renal fibrosis. Progenitor-like cells derived from adult kidney have been previously used to promote regeneration in acute kidney injury, even though it remained unclear whether the cells could be beneficial in chronic kidney disease (CKD). Methods In this study, we established a CKD model by five-sixths nephrectomy and mouse kidney progenitor-like cells (MKPCs) were intravenously administered weekly for 5 weeks after establishing CKD. We examined the impact of MKPCs on the progression of renal fibrosis and the potential of MKPCs to preserve the angiogenic process and prevent endothelial mesenchymal transition in vivo and in vitro. Results Our results demonstrate that the MKPCs delayed interstitial fibrosis and the progression of glomerular sclerosis and ameliorated the decline of kidney function. At 17 weeks, the treated mice exhibited lower blood pressures, higher hematocrit levels, and larger kidney sizes than the control mice. In addition, the MKPC treatment prolonged the survival of the mice with chronic kidney injuries. We observed a decreased recruitment of macrophages and myofibroblasts in the interstitium and the increased tubular proliferation. Notably, MKPC both decreased the level of vascular rarefaction and prevented endothelial mesenchymal transition (EndoMT) in the remnant kidneys. Moreover, the conditioned medium from the MKPCs ameliorated endothelial cell death under hypoxic culture conditions and prevented TGF-β-induced EndoMT through downregulation of phosphorylated Smad 3 in vitro. Conclusions MKPCs may be a beneficial treatment for kidney diseases characterized by progressive renal fibrosis. The enhanced preservation of angiogenic processes following MKPC injections may be associated with decreased fibrosis in the remnant kidney. These findings provide further understanding of the mechanisms involved in these processes and will help develop new cell-based therapeutic strategies for regenerative medicine in renal fibrosis. Electronic supplementary material The online version of this article (doi:10.1186/s13287-015-0241-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C L Chen
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - K J Chou
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - H C Fang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - C Y Hsu
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - W C Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - C W Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - C K Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - H Y Chen
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - P T Lee
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
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Tsai MJ, Tsai SK, Huang MC, Liou DY, Huang SL, Hsieh WH, Huang WC, Huang SS, Cheng H. Acidic FGF promotes neurite outgrowth of cortical neurons and improves neuroprotective effect in a cerebral ischemic rat model. Neuroscience 2015; 305:238-47. [PMID: 26241340 DOI: 10.1016/j.neuroscience.2015.07.074] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [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: 03/03/2015] [Revised: 06/30/2015] [Accepted: 07/16/2015] [Indexed: 02/06/2023]
Abstract
Acidic fibroblast growth factor (aFGF) is a neurotrophic factor which is a powerful neuroprotective and neuroregenerative factor of the nervous system. Prior study had shown that levels of FGFs significantly increase following ischemic injury, reflecting a physiological protection mechanism. However, few reports demonstrated the efficacy of applying aFGF in cerebral ischemia. A recent report showed that the intranasal aFGF treatment improved neurological functional recovery; however, it did not significantly reduce the lesion size in ischemic rats. The present study examines the neuroprotective effect of aFGF on cortical neuron-glial cultures under oxygen glucose deprivation (OGD)-induced cell damage and investigates whether epidural application of slow-released aFGF could improve benefit on ischemic stroke injury in conscious rats. We used a topical application of aFGF mixed in fibrin glue, a slow-release carrier, over the peri-ischemic cortex and examined such treatment on cerebral infarction and behavioral impairments of rats subjected to focal cerebral ischemia (FCI). Results demonstrate that aFGF effectively protected cortical neuron-glial cultures from OGD-induced neuronal damage. Neurite extension from cortical neurons was significantly enhanced by aFGF, mediated through activation of AKT and ERK. In addition, topical application of fibrin glue-mixed aFGF dose-dependently reduced ischemia-induced brain infarction and improved functional restoration in ischemic stroke rats. Slow-released aFGF not only protected hippocampal and cortical cell loss but reduced microglial infiltration in FCI rats. Our results suggest that aFGF mixed in fibrin glue could prolong the protective/regenerative efficacy of aFGF to the damaged brain tissue and thus improve the functional restorative effect of aFGF.
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Affiliation(s)
- M J Tsai
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - S K Tsai
- Cheng Hsin General Hospital, Taipei, Taiwan.
| | - M C Huang
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - D Y Liou
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - S L Huang
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - W H Hsieh
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
| | - W C Huang
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - S S Huang
- Department of Pharmacology and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - H Cheng
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Huang WC, Huo L, Tian G, Qian HR, Gao XS, Qin MH, Liu JM. Multi-step magnetization of the Ising model on a Shastry-Sutherland lattice: a Monte Carlo simulation. J Phys Condens Matter 2012; 24:386003. [PMID: 22927561 DOI: 10.1088/0953-8984/24/38/386003] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The magnetization behaviors and spin configurations of the classical Ising model on a Shastry-Sutherland lattice are investigated using Monte Carlo simulations, in order to understand the fascinating magnetization plateaus observed in TmB(4) and other rare-earth tetraborides. The simulations reproduce the 1/2 magnetization plateau by taking into account the dipole-dipole interaction. In addition, a narrow 2/3 magnetization step at low temperature is predicted in our simulation. The multi-step magnetization can be understood as the consequence of the competitions among the spin-exchange interaction, the dipole-dipole interaction, and the static magnetic energy.
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Affiliation(s)
- W C Huang
- Institute for Advanced Materials, South China Academy of Advanced Photonics Engineering, South China Normal University, Guangzhou 510006, People's Republic of China
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Chen KN, Cheng CA, Huang WC, Ko CT. Bonding temperature optimization and property evolution of SU-8 material in metal/adhesive hybrid wafer bonding. J Nanosci Nanotechnol 2011; 11:6969-6972. [PMID: 22103107 DOI: 10.1166/jnn.2011.4202] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Bonding temperature optimization of SU-8 material for metal/adhesive hybrid bonding was investigated. The good bond quality of SU-8 adhesive can be achieved with the bonding temperature between 150 degrees C and 250 degrees C, while bond failures of SU-8 wafers are observed starting from 275 degrees C. IR transmittance spectra measurements indicate the crosslinks inside SU-8 break and further bond failure is observed due to the large decomposition of epoxy rings and phenyl in plane bending above 275 degrees C. This research provides guidelines of material selection and bonding parameters for heterogeneous integration, 3DIC and MEMS applications using metal/adhesive hybrid bonding.
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Affiliation(s)
- K N Chen
- Department of Electronics Engineering, National Chiao Tung University, Hsinchu 300, Taiwan
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Huang JY, Zhuang WZ, Huang WC, Su KW, Huang KF, Chen YF. Hybrid Q-switched Yb-doped fiber laser. Opt Express 2011; 19:9364-9370. [PMID: 21643192 DOI: 10.1364/oe.19.009364] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We investigate the performance of a hybrid Q-switched (HQS) fiber laser that is constructed with a low RF-power driven acousto-optic (AO) Q-switch and an AlGaInAs semiconductor saturable absorber. Compared to a pure passively Q-switched (PQS) fiber laser, the ratio of timing jitter to pulse period can be significantly reduced from 2% to 0.3% in the regime of far above threshold. On the other hand, the prelasing effect in a pure actively Q-switched fiber laser can be considerably improved. More importantly, the maximum pulse energy of the HQS fiber laser can be increased approximately 25% in comparison with the result of the PQS fiber laser. At a pump power of 24 W, the highest pulse energy is up to 0.56 mJ with the pulse duration of 50 ns at the repetition rate of 23 kHz.
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Affiliation(s)
- J Y Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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Wu KJ, Zhang C, Huang WC, Li LM, Ren QS. Current research of C-Sight visual prosthesis for the blind. Annu Int Conf IEEE Eng Med Biol Soc 2011; 2010:5875-8. [PMID: 21096928 DOI: 10.1109/iembs.2010.5627521] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Electrical stimulation of the optic nerve with penetrating electrode array for visual recovery had been proposed by C-Sight group. This paper presents the latest progress of various component parts of visual prosthesis, including design and testing of neural stimulator, fabrication of multi-channel flexible microelectrode array. According to the experiment data, the linearity between practical stimulator output and the setting parameters has been validated. The temporal properties of EEP evoked by optic nerve stimulation with penetrating electrodes will be introduced briefly according to in vivo electrophysiological study.
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Affiliation(s)
- K J Wu
- Department of Biomedical Engineering, Shanghai Jiao Tong University, 200240 China.
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13
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Zhuang WZ, Huang WC, Chiang PY, Su KW, Huang KF, Chen YF. Millijoule-level Yb-doped photonic crystal fiber laser passively Q-switched with AlGaInAs quantum wells. Opt Express 2010; 18:27910-27915. [PMID: 21197064 DOI: 10.1364/oe.18.027910] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report on a millijoule-level Yb-doped photonic crystal fiber (PCF) laser passively Q-switched with AlGaInAs quantum wells (QWs). Three types of AlGaInAs devices with different QW numbers are fabricated to investigate the performance. With 50 groups of three AlGaInAs QWs as a saturable absorber (SA), the PCF laser generates an average power of 7.1 W with a pulse repetition rate of 6.5 kHz at a pump power of 16 W, corresponding to the pulse energy of 1.1 mJ. The maximum peak power is up to 110 kW.
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Affiliation(s)
- W Z Zhuang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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Mosley PJ, Huang WC, Welch MG, Mangan BJ, Wadsworth WJ, Knight JC. Ultrashort pulse compression and delivery in a hollow-core photonic crystal fiber at 540 nm wavelength. Opt Lett 2010; 35:3589-3591. [PMID: 21042359 DOI: 10.1364/ol.35.003589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We have fabricated a bandgap-guiding hollow-core photonic crystal fiber (PCF) capable of transmitting and compressing ultrashort pulses in the green spectral region around 532 nm. When propagating subpicosecond pulses through 1 m of this fiber, we have observed soliton-effect temporal compression by up to a factor of 3 to around 100 fs. This reduces the wavelength at which soliton effects have been observed in hollow-core PCF by over 200 nm. We have used the pulses delivered at the output of the fiber to machine micrometer-scale features in copper.
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Affiliation(s)
- P J Mosley
- Centre for Photonics and Photonic Materials, Department of Physics, University of Bath, Bath, BA2 7AY, UK.
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Zhuang WZ, Huang WC, Huang YP, Su KW, Chen YF. Passively Q-switched photonic crystal fiber laser and intracavity optical parametric oscillator. Opt Express 2010; 18:8969-8975. [PMID: 20588742 DOI: 10.1364/oe.18.008969] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We report on a passively Q-switched photonic crystal fiber (PCF) laser with Cr(4+):YAG as a saturable absorber. Under a pump power of 14.2 W, the maximum pulse energy is up to 630 microJ with a pulse width of 36 ns at a repetition rate of 5.6 kHz. With an intracavity optical parametric oscillator, the passively Q-switched PCF laser is used to generate the signal wave at 1515 nm. The output pulse energy of the signal wave is found to be 140 microJ with a pulse width as short as 1.0 ns at a repetition rate of 3.3 kHz. The very short pulse width leads to the peak power up to 140 kW.
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Affiliation(s)
- W Z Zhuang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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16
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Liang HC, Huang YJ, Huang WC, Su KW, Chen YF. High-power, diode-end-pumped, multigigahertz self-mode-locked Nd:YVO4 laser at 1342 nm. Opt Lett 2010; 35:4-6. [PMID: 20664654 DOI: 10.1364/ol.35.000004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We report on a high-power, diode-pumped, self-mode-locked laser at 1342 nm with the Kerr effect arising from large third-order nonlinearity of Nd:YVO(4) crystal. At the pump power of 10.2 W, the average output power of 1.2 W was generated with a repetition rate in the range of 2-6 GHz. The mode-locked pulse width can be smoothly varied from 11.5 to 37 ps by controlling the amount of spatial hole burning.
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Affiliation(s)
- H C Liang
- Department of Electrophysics, National Chiao Tung University, 1001 TA Hsueh Rd., Hsinchu, Taiwan 30050
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Chung CC, Huang WC, Chiou KR, Lin KL, Kuo FY, Cheng CC, Hsiao SH, Liu CP. Ratio of early mitral inflow peak velocity to flow propagation velocity predicts training effects of cardiac rehabilitation in patients after acute myocardial infarction. J Rehabil Med 2010; 42:232-8. [DOI: 10.2340/16501977-0514] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Huang JY, Zhuang WZ, Huang WC, Su KW, Hu C, Huang KF, Chen YF. Comparative studies for Cr4+:YAG crystal and AlGaInAs semiconductor used as a saturable absorber in Q-switched Yb-doped fiber lasers. Opt Express 2009; 17:20800-20805. [PMID: 19997313 DOI: 10.1364/oe.17.020800] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We demonstrate comparative studies for Cr(4+):YAG crystal and AlGaInAs quantum-well (QW) used as a saturable absorbers in passively Q-switched Yb-doped fiber lasers. Both saturable absorbers were designed to be possessed of nearly the same initial transmission. Under a pump power of 24 W, the average output powers were up to 14.4 W and 13.8 W obtained with the AlGaInAs QWs and with the Cr(4+):YAG crystal, respectively. The maximum pulse energies obtained with the Cr(4+):YAG crystal and with the AlGaInAs QWs were found to be 0.35 mJ and 0.45 mJ, respectively.
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Affiliation(s)
- J Y Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
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Huang JY, Huang WC, Zhuang WZ, Su KW, Chen YF, Huang KF. High-pulse-energy, passively Q-switched Yb-doped fiber laser with AlGaInAs quantum wells as a saturable absorber. Opt Lett 2009; 34:2360-2362. [PMID: 19649097 DOI: 10.1364/ol.34.002360] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We demonstrate an efficient, high-pulse-energy, passively Q-switched Yb-doped fiber laser with AlGaInAs quantum wells (QWs) as a saturable absorber. The AlGaInAs QW material is designed to provide a large modulation change and a quite-low nonsaturable loss. At an incident pump power of 7.6 W, an average output power of 3.8 W, pulse energy of 300 microJ, pulse repetition rate of 12.5 kHz, and pulse duration of 30 ns was obtained.
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Affiliation(s)
- J Y Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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Wang Y, Huang WC, Wang CY, Tsai CC, Chen CL, Chang YT, Kai JI, Lin CF. Inhibiting glycogen synthase kinase-3 reduces endotoxaemic acute renal failure by down-regulating inflammation and renal cell apoptosis. Br J Pharmacol 2009; 157:1004-13. [PMID: 19508392 DOI: 10.1111/j.1476-5381.2009.00284.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND PURPOSE Excessive inflammation and apoptosis are pathological features of endotoxaemic acute renal failure. Activation of glycogen synthase kinase-3 (GSK-3) is involved in inflammation and apoptosis. We investigated the effects of inhibiting GSK-3 on lipopolysaccharide (LPS)-induced acute renal failure, nuclear factor-kappaB (NF-kappaB), inflammation and apoptosis. EXPERIMENTAL APPROACH The effects of inhibiting GSK-3 with inhibitors, including lithium chloride (LiCl) and 6-bromo-indirubin-3'-oxime (BIO), on LPS-treated (15 mg x kg(-1)) C3H/HeN mice (LiCl, 40 mg x kg(-1) and BIO, 2 mg x kg(-1)) and LPS-treated (1 microg x mL(-1)) renal epithelial cells (LiCl, 20 mM and BIO, 5 microM) were studied. Mouse survival was monitored and renal function was analysed by histological and serological examination. Cytokine and chemokine production, and cell apoptosis were measured by enzyme-linked immunosorbent assay and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling staining, respectively. Activation of NF-kappaB and GSK-3 was determined by immunostaining and Western blotting, respectively. KEY RESULTS Mice treated with GSK-3 inhibitors showed decreased mortality, renal tubular dilatation, vacuolization and sloughing, blood urea nitrogen, creatinine and renal cell apoptosis in response to endotoxaemia. Inhibiting GSK-3 reduced LPS-induced tumour necrosis factor-alpha (TNF-alpha) and CCL5/RANTES (released upon activation of normal T-cells) in vivo in mice and in vitro in murine kidney cortical collecting duct epithelial M1 cells. Inhibiting GSK-3 did not block TNF-alpha-induced cytotoxicity in rat kidney proximal tubular epithelial NRK52E or in M1 cells. CONCLUSIONS AND IMPLICATIONS These results suggest that GSK-3 inhibition protects against endotoxaemic acute renal failure mainly by down-regulating pro-inflammatory TNF-alpha and RANTES.
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Affiliation(s)
- Y Wang
- Department of Microbiology and Immunology, National Cheng Kung University Medical College, Tainan 701, Taiwan
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Huang CT, Huang WC, Shih JY, Yang PC. Primary mediastinal large B-cell lymphoma mimicking liposarcoma. Med Oncol 2007; 25:284-6. [PMID: 18066682 DOI: 10.1007/s12032-007-9032-0] [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] [Received: 10/16/2007] [Accepted: 11/19/2007] [Indexed: 11/24/2022]
Abstract
A 78-year-old man consulted for acute exacerbation of chronic obstructive pulmonary disease (COPD) and an incidental finding of an anterior mediastinal tumor on chest radiograph was noted on admission. Chest computed tomography (CT) revealed a fat-containing mediastinal mass with solid component. Mediastinal liposarcoma was the initial diagnosis based on image characteristics but histopathologic examination of the excised tumor revealed lymphoma infiltration of the mediastinal adipose tissue. To our knowledge, this is the first case report of lymphomatous growth in mediastinal lipomatosis.
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Affiliation(s)
- C T Huang
- Department of Internal Medicine, Division of Pulmonary Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, Taipei 100, Taiwan
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Affiliation(s)
- W C Huang
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
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Hsu CC, Lai PH, Lee C, Huang WC. Automated nasopharyngeal carcinoma detection with dynamic gadolinium-enhanced MR imaging. Methods Inf Med 2001; 40:331-7. [PMID: 11552346] [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: 02/21/2023]
Abstract
OBJECTIVES The purpose of this research is to develop an automatic medical diagnosis for segmenting nasopharyngeal carcinoma (NPC) with dynamic gadolinium-enhanced MR imaging. METHODS This system is a multistage process, involving motion correction, head mask generation, dynamic MR data quantitative evaluation, rough segmentation, and rough segmentation refinement. Two approaches, a relative signal increase method and a slope method, are proposed for the quantitative evaluation of dynamic MR data. RESULTS The NPC detection results obtained using the proposed methods had a rating of 85% in match percent compared with these lesions identified by an experienced radiologist. The match percent for the two proposed methods did not have significant differences. However, the computation cost for the slope method was about twelve times faster than the relative signal increase method. CONCLUSIONS The proposed methods can identify the NPC regions quickly and effectively. This system can enhance the performance of clinical diagnosis.
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Affiliation(s)
- C C Hsu
- Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan, R.O.C
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Abstract
1. To study the role of protein kinase C (PKC) in the increase in manganese superoxide dismutase (Mn-SOD) gene expression following transient hypoxia in glial cells, we examined the mRNA levels of Mn-SOD using northern blot analysis. 2. The Mn-SOD mRNA levels were markedly increased after exposure to nitrogen gas for 5 min. 3. Pretreatment with chelerythrine or GF109203x, inhibitors of PKC, attenuated the increase in Mn-SOD mRNA following hypoxia in a concentration-dependent manner. 4. Incubation with phorbol 12-myristate 13-acetate, the PKC activator, enhanced the increase in Mn-SOD gene expression in response to transient hypoxia. 5. The results suggest that hypoxia increases Mn-SOD gene expression in cultured glial cells mainly through activation of a PKC pathway.
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Affiliation(s)
- W C Huang
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Kildal M, Wei FC, Chang YM, Huang WC, Chang KJ. Reconstruction of bilateral extensive composite mandibular defects after osteoradionecrosis with two fibular osteoseptocutaneous free flaps. Plast Reconstr Surg 2001; 108:963-7. [PMID: 11547154 DOI: 10.1097/00006534-200109150-00022] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M Kildal
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taipei, Taiwan
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Abstract
OBJECTIVES To examine the role of endogenous nitric oxide (NO) in the pathogenesis of hypertension and insulin resistance in chronic hyperinsulinemic rats. METHODS Sustained hyperinsulinemia was achieved by insulin infusion (21.5 pmol/kg per min) via subcutaneous osmotic minipump for 6 weeks. NO synthase inhibitor, Nomega-nitro-L-arginine methyl ester (L-NAME, 5 mg/kg per day) was given orally after 4 weeks of vehicle or insulin infusion. The systolic blood pressure (SBP) was measured under conscious state by an electrosphygmomanometer before and after drug treatments. RESULTS Insulin infusion alone significantly increased SBP from 134 +/- 3 to 156 +/- 2 mmHg by week 4 and further to 158 +/- 3 mmHg by week 6 of insulin infusion. The insulin-infused rats had markedly decreased insulin sensitivity, as reflected by an elevated steady-state plasma glucose level estimated by the insulin suppression test. There were no significant differences in plasma glucose and triglyceride levels between rats with and without insulin infusion. When hypertension had been established in rats receiving insulin infusion for 4 weeks, superimposed L-NAME on insulin infusion for additional 2 weeks further increased SBP by 18 +/- 2 mmHg (from 157 +/- 2 to 175 +/- 2 mmHg). Plasma levels of NO metabolites (NOx) significantly decreased from 13.7 +/- 1.1 micromol/l during the control period to 6.1 +/- 0.6 micromol/l after 4 weeks of insulin infusion and further reduced to 4.1 +/- 0.5 micromol/l after combined infusion of L-NAME and insulin. L-NAME treatment alone for 2 weeks in control rats significantly increased SBP by 33 +/- 2 mmHg (from 133 +/- 2 to 166 +/- 2 mmHg) and plasma insulin levels, as a consequence of insulin resistance. Despite marked increases in blood pressure due to infusion of insulin alone or in combination with L-NAME, the sodium balance, urinary sodium and water excretions, water intake and body weight gain of insulin/L-NAME-treated rats were not significantly different from rats without insulin infusion. CONCLUSIONS Sustained hyperinsulinemia causes partial impairment of NO production that may contribute to the development of insulin resistance and hypertension. Additional inhibition of NO synthesis by L-NAME accentuates the blood pressure elevation and insulin resistance in hyperinsulinemic rats. Furthermore, a rightward shift of the renal arterial pressure-natriuretic function relationship occurred in this hypertensive model.
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Affiliation(s)
- T C Fang
- Department of Internal Medicine, Tzu Chi General Hospital, Hualien, Taiwan, Republic of China
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Lee YH, Huang WC, Tsai JY, Chen JS, Huang JK. In vitro effect of hyperbaric oxygen on the chemolysis of infective stones. Zhonghua Yi Xue Za Zhi (Taipei) 2001; 64:292-8. [PMID: 11499339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND In order to extend the feasibility of hyperbaric oxygen therapy in the urological field, the present study aimed to investigate the dissolution activity of human infective stones in UROCITRA solution under hyperbaric oxygen condition. METHODS The dissolution activity of 7 struvite and 11 mixed struvite and carbonate apatite stones in UROCITRA solution were studied under 2.5 atmosphere (atm) hyperbaric oxygen (HBO) status in a Sigma I N-124 monoplace chamber. Another 7 struvite and 10 mixed struvite and carbonate apatite stones were also studied under normal condition. Chemolysis was performed in a drip device with a 150-ml/hour continuous flow rate. RESULTS Under 2.5 atm HBO status, the PO2 of UROCITRA solution was 365 +/- 44 mmHg, which was significantly higher than that of tap water (113 +/- 62 mmHg) and UROCITRA solution (125 +/- 12 mmHg) under normobaric condition (p < 0.001). The decreases in the stone weight of struvite under normobaric condition were 31 +/- 8.8% after 2 h and 48 +/- 15% after 4 h of treatment. The HBO-enriched UROCITRA solution did not increase the dissolution activity as reflected by comparable decreases in the dried stone weight (31.2 +/- 14.6% and 54 +/- 19% at the 2nd and 4th post-treatment hours, respectively, p > 0.05). Similarly, there was no significant difference in the percent stone weight decrease of the mixed struvite and carbonate apatite stones under either HBO or normobaric condition. The dissolution responsiveness of struvite was significantly greater than that of the mixed struvite and carbonate apatite stones. CONCLUSIONS The chemolysis of struvite in UROCITRA solution is significantly greater than that of the mixed struvite and carbonate apatite stones. However, the UROCITRA solution enriched with HBO does not enhance the dissolution of infective stones.
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Affiliation(s)
- Y H Lee
- Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan.
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Hsu YW, Chi KH, Huang WC, Lin WW. Ceramide inhibits lipopolysaccharide-mediated nitric oxide synthase and cyclooxygenase-2 induction in macrophages: effects on protein kinases and transcription factors. J Immunol 2001; 166:5388-97. [PMID: 11313375 DOI: 10.4049/jimmunol.166.9.5388] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The goal of this study was to elucidate whether triggering the sphingomyelin pathway modulates LPS-initiated responses. For this purpose we investigated the effects of N-acetylsphingosine (C(2)-ceramide) on LPS-induced production of NO and PGE(2) in murine RAW 264.7 macrophages and explored the signaling pathways involved. We found that within a range of 10-50 microM, C(2)-ceramide inhibited LPS-elicited NO synthase and cyclooxygenase-2 induction accompanied by a reduction in NO and PGE(2) formation. By contrast, a structural analog of C(2)-ceramide that does not elicit functional activity, C(2)-dihydroceramide, did not affect the LPS response. The nuclear translocation and DNA binding study revealed that ceramide can inhibit LPS-induced NF-kappaB and AP-1 activation. The immunocomplex kinase assay indicated that IkappaB kinase activity stimulated by LPS was inhibited by ceramide, which concomitantly reduced the IkappaBalpha degradation caused by LPS within 1-6 h. In concert with the decreased cytosolic p65 protein level, LPS treatment resulted in rapid nuclear accumulation of NF-kappaB subunit p65 and its association with the cAMP-responsive element binding protein. Ceramide coaddition inhibited all the LPS responses. In addition, LPS-induced PKC and p38 mitogen-activated protein kinase activation were overcome by ceramide. In conclusion, we suggest that ceramide inhibition of LPS-mediated induction of inducible NO synthase and cyclooxygenase-2 is due to reduction of the activation of NF-kappaB and AP-1, which might result from ceramide's inhibition of LPS-stimulated IkappaB kinase, p38 mitogen-activated protein kinase, and protein kinase C.
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Affiliation(s)
- Y W Hsu
- Department of Pharmacology, National Taiwan University College of Medicine, Taipei, Taiwan
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Hsieh PS, Huang WC. Neonatal chemical sympathectomy attenuates fructose-induced hypertriglyceridemia and hypertension in rats. CHINESE J PHYSIOL 2001; 44:25-31. [PMID: 11403517] [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: 02/20/2023] Open
Abstract
Experiments were performed to determine the pathogenic contribution of the peripheral sympathetic nervous system to fructose-induced hypertriglyceridemia, hyperinsulinemia and hypertension in rats. Neonatal chemical sympathectomy was performed in neonatal Sprague-Dawley rats (1-week old) by administration of guanethidine (50 microg/g, i.p.) 5 times per week for consecutive 3 weeks and nerve-intact rats were served as controls. Both groups of rats were fed a fructose-enriched diet for 9 weeks. The systolic blood pressure (SBP) and body weight were measured weekly and arterial blood samples were taken weekly for determinations of plasma insulin, glucose and triglyceride levels. The results showed that fructose feeding for one week significantly increased SBP in intact rats and sympathectomized rats (116+/-1 to 119+/-1 mmHg and 116+/-1 to 120+/-1 mmHg, respectively). SBP further increased thereafter in both groups. However, the increased SBP levels were significantly higher in intact group than in sympathectomized group after 5 weeks of fructose feeding. Fructose feeding for one week concurrently produced hypertriglyceridemia that preceded the appearance of hyperinsulinemia in both groups. The elevated plasma triglyceride levels were significantly lower in sympathectomized rats than in intact rats after 3 weeks of fructose feeding, whereas the elevated plasma insulin concentrations were not different between groups throughout fructose feeding period. Plasma glucose concentrations of both groups were comparable and remained unchanged throughout the study. These data indicate that neonatal chemical sympathectomy attenuated, but did not prevent, fructose-induced elevations in blood pressure and plasma triglyceride levels, suggesting a partial dependency of fructose-induced hypertriglyceridemia and hypertension on the integrity of the peripheral sympathetic nervous system (SNS) in rats.
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Affiliation(s)
- P S Hsieh
- Department of Physiology and Biophysics, National Defense Medical Center, Taipei, Taiwan, ROC
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Wang YN, Ma XM, Li H, Zhang XY, Huang WC. [Effect of experimental infection with Schistosoma japonicum on the pregnancy of mice]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 2001; 19:233-5. [PMID: 12571973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To understand the effect of Schistosoma infection on the gestation in mice. METHODS Female mice infected with Schistosoma japonicum cercariae, and mated with male mice (uninfected) at 40 d and 100 d post-infection, the changes during pregnant period and the growth of offspring were observed until birth. The serum level of estradiol and progesterone of the infected mice was measured by RIA at oestrus. RESULTS The level of estradiol and progesterone, and the pregnant rate were much lower in schistosome infected group than that of the control. The rate of abortion, the mortality of pregnant mice and the death rate due to abortion of infected mice increased significantly. The mortality increased with the time of merging male and female mice in one cage prolonged. The body weight and length of the offspring in both infected and control groups were found no significant difference. CONCLUSION The results revealed that schistosome infection may suppress estradiol and progesterone secretion, decrease the rate of pregnancy, and that it may also increase the complications and mortality during the gestation periods.
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Affiliation(s)
- Y N Wang
- Department of Parasitology, Jiangxi Medical College, Nanchang 330006
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Abstract
Bacillus subtilis DB1005 is a temperature-sensitive (Ts) sigA mutant containing double-amino-acid substitutions (I198A and I202A) on the hydrophobic face of the promoter -10 binding helix of sigma(A) factor. We have analyzed the structural and functional properties of this mutant sigma(A) factor both in vivo and in vitro. Our data revealed that the Ts sigma(A) factor possessed predominantly a multimeric structure which was prone to aggregation at restrictive temperature. The extensive aggregation of the Ts sigma(A) resulted in a very low core-binding activity of the Ts sigma(A) factor and a markedly reduced sigma(A)-RNA polymerase activity in B. subtilis DB1005, suggesting that extensive aggregation of the Ts sigma(A) is the main trigger for the temperature sensitivity of B. subtilis DB1005. Partial proteolysis, tryptophan fluorescence and 1-anilinonaphthalene-8-sulfonate-binding analyses revealed that the hydrophobic face of the promoter -10 binding helix and also the hydrophobic core region of the Ts sigma(A) factor were readily exposed on the protein surface. This hydrophobic exposure provides an important cue for mutual interaction between molecules of the Ts sigma(A) and allows the formation of multimeric Ts sigma(A). Our results also indicate that Ile-198 and Ile-202 on the hydrophobic face of the promoter -10 binding helix are essential to ensure the correct folding and stabilization of the functional structure of sigma(A) factor.
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Affiliation(s)
- Y D Wen
- Institute of Biochemistry, National Chung-Hsing University, Taiwan, Republic of China
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Abstract
AIMS Experiments were performed to assess the effects of intracerebroventricular (ICV) angiotensin (ANG) III on blood pressure and renal function in rats with normal and high sodium intake and to compare these effects with those produced by ICV ANG II. METHODS Male Sprague-Dawley rats on a normal sodium (0.3%) diet and a normal sodium diet plus 1% NaCl as drinking water were administered ANG II and ANG III ICV through a chronically implanted cannula. Blood pressure and renal clearance function responses were measured before and during peptide administrations. The effect of ICV ANG III on the renal efferent nerve activity was also evaluated. RESULTS ICV injections of ANG II and ANG III at 5 pmol in rats on a normal sodium diet did not significantly alter the blood pressure, but significantly increased renal plasma flow, glomerular filtration rate, urine flow, and absolute and fractional excretions of sodium and potassium. Increased doses of ANG II and III (10, 50 and 100 pmol) significantly increased blood pressure and further enhanced these renal functional indices. Central ANG-III-induced increases in blood pressure and renal functional indices were not significantly different from those produced by ANG II at each corresponding dose. The pressor and renal effects of ANG III were blunted by a specific antagonist, Ile(7)-ANG III. ICV administration of ANG III decreased the renal efferent nerve activity. In rats with dietary NaCl loading, ICV injections of ANG II and III also significantly enhanced renal function. CONCLUSIONS Centrally administered ANG III is as potent as ANG II in causing pressor and renal effects in rats on normal and high sodium intake. As ANG II, brain ANG III reduced renal efferent nerve activity which may be partly accounted for the augmented renal function.
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Affiliation(s)
- C Y Chen
- Department of Radiology, Military Tauyuan General Hospital, Graduate Institute of Nuclear Science, National Tsing-Hua University Hsinchu, Hualien, Taiwan, Republic of China
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Abstract
OBJECTIVE To evaluate the role of nitric oxide (NO) in the development and unclipping-induced reversal of blood pressure and bilateral renal function in two-kidney, one clip (2K1C) Goldblatt hypertensive rats. METHODS Goldblatt hypertensive rats were prepared by clipping the left renal artery 4 weeks before unclipping experiments. NG-nitro-L-arginine methyl ester (L-NAME) was administered after clipping and during unclipping to inhibit nitric oxide (NO) synthesis. Blood pressure and bilateral renal responses were measured. RESULTS Chronic L-NAME treatment accelerated and aggravated blood pressure elevations and increased plasma nitrite and nitrate levels in 2K1C rats. Surgical removal of the renal artery clip induced profound reductions in blood pressure in rats with and without L-NAME treatment. However, the magnitude of the unclipping-induced depressor response at the first post-unclipping hour was significantly smaller in L-NAME-treated rats compared to those without L-NAME administration (15 +/- 1 versus 22 +/- 1%, P < 0.05). Two hours after unclipping, blood pressure of both groups fell to a comparable, normal level. Acute intravenous infusion of L-NAME in established 2K1C hypertensive rats further increased blood pressure. Subsequent unclipping caused a depressor response similar to that observed in hypertensive rats treated chronically with L-NAME. Despite the marked decreases in blood pressure, unclipping induced striking increases in glomerular filtration rate (GFR), urine flow and sodium and potassium excretion rates in the ipsilateral kidney. However, the magnitudes of increases in GFR and the diuretic and natriuretic responses in rats without L-NAME treatment were significantly greater than in rats with L-NAME administration. In contrast, unclipping reduced these function indices in the contralateral kidney to a similar level in rats with and without L-NAME treatment. CONCLUSIONS NO exerts vasodilator action and thereby lessens renal artery clipping-induced blood pressure elevation. Furthermore, unclipping-induced release of NO partially contributes to the early reduction in blood pressure and changes in bilateral renal function but does not directly mediate the normalization of blood pressure after unclipping in this hypertension model.
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Affiliation(s)
- W C Huang
- Graduate Institute of Medical Science, Tzu Chi College of Medicine and Humanities, Hualien, Taiwan, Republic of China.
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Abstract
The effect of trans-cinnamaldehyde (CNMA) on the release of noradrenaline (NA) from nerve terminal was investigated using isolated ileal synaptosomes of guinea-pig. Release was determined as the amount of NA, quantified by h.p.l.c.-electrochemical detection, from samples incubated with CNMA minus that in parallel blanks treated with same volume of vehicle. CNMA stimulated the secretion of NA in a concentration-dependent manner from 5 microM to 50 microM, while the value of lactate dehydrogenase in the incubated medium was not influenced by CNMA. However, trans-cinnamic acid, cinnamoyl chloride and cinnamamide failed to produce similar effect. Specific action of CNMA can thus be considered. Guanethidine inhibited the release of NA by CNMA in a concentration- dependent manner. Saxitoxin attenuated the action of CNMA at concentrations sufficient to block sodium channels. The depolarizing effect of CNMA on the membrane potential was also illustrated by a concentration-dependent increase in the fluorescence of bisoxonol, a potential sensitive dye. The NA releasing action of CNMA was deleted by removal of calcium chloride from the bathing medium. This action of CNMA was also attenuated by Rp-cAMP at concentrations sufficient to inhibit the action of cyclic AMP. These findings suggest that CNMA can depolarize the membrane to result in a calcium-dependent and cyclic AMP-related release of NA from noradrenergic terminals.
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Affiliation(s)
- J T Cheng
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan, ROC.
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Abstract
We have studied the hydration and dynamics of RNA C2'-OH in a DNA. RNA hybrid chimeric duplex [d(CGC)r(aaa)d(TTTGCG)](2). Long-lived water molecules with correlation time tau(c) larger than 0.3 ns were found close to the RNA adenine H2 and H1' protons in the hybrid segment. A possible long-lived water molecule was also detected close to the methyl group of 7T in the RNA-DNA junction but not to the other two thymine bases (8T and 9T). This result correlates with the structural studies that only DNA residue 7T in the RNA-DNA junction adopts an O4'-endo sugar conformation (intermediate between B-form and A-form), while the other DNA residues including 3C in the DNA-RNA junction, adopt C1'-exo or C2'-endo conformations (in the B-form domain). Based on the NOE cross-peak patterns, we have found that RNA C2'-OH tends to orient toward the O3' direction, forming a possible hydrogen bond with the 3'-phosphate group. The exchange rates for RNA C2'-OH were found to be around 5-20 s(-1), compared to 26.7(+/-13.8) s(-1) reported previously for the other DNA.RNA hybrid duplex. This slow exchange rate may be due to the narrow minor groove width of [d(CGC)r(aaa)d(TTTGCG)](2), which may trap the water molecules and restrict the dynamic motion of hydroxyl protons. The distinct hydration patterns of the RNA adenine H2 and H1' protons and the DNA 7T methyl group in the hybrid segment, as well as the orientation and dynamics of the RNA C2'-OH protons, may provide a molecular basis for further understanding the structure and recognition of DNA.RNA hybrid and chimeric duplexes.
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Affiliation(s)
- S T Hsu
- Division of Structural Biology and Biomedical Science Department of Life Science, National Tsing Hua University, Hsinchu 300, Taiwan, ROC
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Abstract
In this 24-week multicenter, double-blind, randomized, fixed-dose trial, 361 patients having type 2 diabetes received daily preprandial treatment with placebo (n = 75), repaglinide 1 mg (n = 140), or repaglinide 4 mg (n = 146). By a last-observation carried-forward calculation, repaglinide 1 mg or 4 mg treatment decreased mean fasting plasma glucose (FPG) values (by -47 mg/dL or -49 mg/dL) while the placebo group had increased FPG values (by 19 mg/dL). For the repaglinide treatment groups at the end of the study, changes in HbA1c from baseline values ranged from 1.8 to 1.9 percentage points lower than the placebo group. There were no events of severe hypoglycemia. Nearly all hypoglycemic symptom episodes had blood glucose levels above 45 mg/dL. Repaglinide was well tolerated in a preprandial fixed-dose regimen of 1 mg or 4 mg, assigned without adjustment for clinical parameters.
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Affiliation(s)
- L Jovanovic
- Sansum Medical Research Institute, Santa Barbara, California 93105, USA
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Marbury TC, Ruckle JL, Hatorp V, Andersen MP, Nielsen KK, Huang WC, Strange P. Pharmacokinetics of repaglinide in subjects with renal impairment. Clin Pharmacol Ther 2000; 67:7-15. [PMID: 10668848 DOI: 10.1067/mcp.2000.103973] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate the effect of renal impairment and renal failure on the pharmacokinetics and safety of repaglinide. METHODS We conducted a phase I, multicenter, parallel-group, pharmacokinetic comparison trial with single and multiple doses of repaglinide in subjects with various degrees of renal impairment. Subjects with normal renal function (n = 6) and subjects with renal impairment (mild to moderate, n = 6; severe, n = 6) received treatment with 2 mg repaglinide for 7 days. Subjects in the hemodialysis group (n = 6) received two single doses of 2 mg repaglinide separated by a 7- to 14-day washout period. All subjects had repaglinide serum pharmacokinetic profiles measured for the first and last doses administered. Serum steady-state levels, urine levels, and dialysate levels were also measured. RESULTS Pharmacokinetic parameters did not show significant changes after single or multiple doses of repaglinide, although the elimination rate constant in the group with severe renal impairment decreased after 1 week of treatment. Subjects with severe impairment had significantly higher area under the curve values after single and multiple doses of repaglinide than subjects with normal renal function. No significant differences in values for maximum serum concentration or time to reach maximum concentration were detected between subjects with renal impairment and those with normal renal function. Hemodialysis did not significantly affect repaglinide clearance. CONCLUSIONS Repaglinide was safe and well tolerated in subjects with varying degrees of renal impairment. Although adjustment of starting doses of repaglinide is not necessary for renal impairment or renal failure, severe impairment may require more care when upward adjustments of dosage are made.
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Affiliation(s)
- T C Marbury
- Orlando Clinical Research Center, Fla 32806, USA
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Abstract
An association between the Arg allele of the p21WAF1/CIP1 codon 31 polymorphism and lung cancer has been reported. However, the genotype distribution of the p21 codon 31 polymorphism, as well as the association of this polymorphism with lung cancer risk and prognosis, remain undefined in the Taiwanese population. Therefore, we investigated the genotype distribution of the p21 codon 31 polymorphism in 155 lung cancer patients and 189 non-cancer controls. The genotype frequencies in the Taiwanese non-cancer controls were 0.51 (Ser) and 0.49 (Arg). Chi2 analysis indicated significant differences in Taiwanese genotype distribution of p21 from those reported for Swedes (P=0.001), Caucasians (P=0.001), Indians (P=0.001), and African-Americans (P=0.001). However, our data did not demonstrate an association of the Arg allele of the p21 polymorphism with lung cancer risk in Taiwan. Lung cancer patients with Ser/Arg and Arg/Arg genotypes were at a nonsignificant 1.15-fold increased risk of lung cancer when compared to individuals with the Ser/Ser genotype (95%CI, 0.70-1.86). In addition, although p21 is a downstream target of p53, we found no significant correlation of the p21 polymorphism with the p53 polymorphism and p53 gene mutation in lung cancer patients. We further investigated the association of the p21 polymorphism with prognosis in 154 lung cancer patients. Patients with the Ser/Ser genotype tended to have a poorer prognosis than those with the Ser/Arg and Arg/Arg genotypes (P=0.097, by the log rank test). Our data suggest that the p21 codon 31 polymorphism may not play a significant role in cancer susceptibility and the prognosis of lung cancer patients in Taiwan.
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Affiliation(s)
- C M Shih
- Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan, ROC
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Wong WY, Huang WC, Miller R, McGinty K, Whisnant JK. Clinical efficacy and recovery levels of recombinant FVIIa (NovoSeven) in the treatment of intracranial haemorrhage in severe neonatal FVII deficiency. Haemophilia 2000; 6:50-4. [PMID: 10632743 DOI: 10.1046/j.1365-2516.2000.00345.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The use of replacement FVII is critical to the successful treatment of life-threatening bleeds in newborns and infants with severe FVII deficiency (<1%). However, the clinical efficacy, optimum dosage and pharmacologic recovery of rFVIIa in such children has not been studied systematically. This report is a case of an infant with severe FVII deficiency (FVII:C at 0%) and massive intracranial haemorrhage in which successful use of rFVIIa (NovoSeven) was carefully monitored. The drug was administered by intravenous bolus through a central line every 4 h at each of three dose levels: 15 microg kg-1, 22 microg kg-1 and 30 microg kg-1. FVII:C was >100% between 30 and 180 min after each infusion with mean trough levels above 25% for all three dose levels. There was no evidence of hyper-coagulation as indicated by measurements of the platelet count, D-dimer, plasma protamine paracoagulant and fibrinogen levels in spite of high FVII:C concentration. In this infant, rFVIIa was well-tolerated, maintained effective haemostasis with good clinical outcome, and produced consistent therapeutic mean trough levels above 25% FVII:C even at 15 microg kg-1 every 4 h.
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Affiliation(s)
- W Y Wong
- Division of Hematology-Oncology, Childrens Hospital of Los Angeles, Los Angeles, California 90027-6016, USA
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Huang WC, Juang SW, Liu IM, Chi TC, Cheng JT. Changes of superoxide dismutase gene expression and activity in the brain of streptozotocin-induced diabetic rats. Neurosci Lett 1999; 275:25-8. [PMID: 10554976 DOI: 10.1016/s0304-3940(99)00704-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In an attempt to discover the changes of superoxide dismutase (SOD) in the brain of diabetic state, we investigated the level of SOD in streptozotocin-induced diabetic rats (STZ-diabetic rats) using enzyme activity assay, Northern blotting analysis of mRNA levels and Western blotting of enzyme amount. Five discrete brain regions, cerebrocortex, hypothalamus, hippocampus, the remaining non-cortex cerebrum (NCC area) and cerebellum, were examined in STZ-diabetic rats to compare with age-matched normal rats. Higher levels of Mn-SOD including the activity, mRNA expression and immunoblot of enzyme were found in all areas of the brain from STZ-diabetic rats as compared with that in Wistar rats. Except in the cerebellum, similar changes of Cu,Zn-SOD were found in the brain of STZ-diabetic rats. These results indicate an increase of SOD both gene expression and activity in the brain of STZ-diabetic rats. This alteration of SOD may be one of the important factors for the vulnerability of the brain to oxygen free radicals or may be related to the pathophysiology of diabetes.
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Affiliation(s)
- W C Huang
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
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Lai PH, Yang CF, Pan HB, Wu MT, Chu ST, Ger LP, Huang WC, Hsu CC, Lee CN. Recurrent inverted papilloma: diagnosis with pharmacokinetic dynamic gadolinium-enhanced MR imaging. AJNR Am J Neuroradiol 1999; 20:1445-51. [PMID: 10512227 PMCID: PMC7657741] [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: 02/14/2023]
Abstract
BACKGROUND AND PURPOSE Dynamic gadolinium-enhanced MR imaging has been used successfully to identify post-treatment recurrence or postoperative changes in rectal and cervical carcinoma. Our purpose was to evaluate the usefulness of dynamic gadolinium-enhanced MR imaging for distinguishing recurrent inverted papilloma (IP) from postoperative changes. METHODS Fifteen patients with 20 pathologically proved lesions (recurrent IP, 12; fibrosis or granulation tissue, eight) were enrolled in the study. Three observers, blinded to pathologic results, independently evaluated conventional MR images, including T1-weighted (unenhanced and postcontrast), proton-density-weighted, and T2-weighted spin-echo images. Results then were determined by consensus. Dynamic images were obtained using fast spin-echo sequences at 5, 30, 60, 90, 120, 150, 180, and 300 seconds after the injection of gadolinium-diethylene-triamine penta-acetic acid. Time-signal intensity curves of suspected lesions were analyzed by a pharmacokinetic model. The calculated amplitude and tissue distribution time were used to characterize tissue, and their values were displayed as a color-coded overlay. RESULTS T2-weighted images yielded a sensitivity of 67%, a specificity of 75%, and an accuracy of 70% in the diagnosis of recurrent IP. Contrast-enhanced T1-weighted images yielded a sensitivity of 75%, a specificity of 50%, and an accuracy of 65%. Pharmacokinetic analysis showed that recurrent IP had faster (distribution time, 41 versus 88 seconds) and higher (amplitude, 2.4 versus 1.2 arbitrary units) enhancement than did fibrosis or granulation tissue. A cut-off of 65 seconds for distribution time and 1.6 units for amplitude yielded a sensitivity of 100% and a specificity of 100% for diagnosing recurrent IP. CONCLUSION Dynamic MR imaging can differentiate accurately recurrent IP from postoperative changes and seems to be a valuable diagnostic tool.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming College, Taiwan, ROC, USA
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Affiliation(s)
- W C Huang
- Department of Management Information Science, Chia-Nan College of Pharmacy and Science, Tainan, Taiwan.
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Abstract
Although ischemic injury to skeletal muscle is a matter of great clinical importance, relatively little is known about the mechanisms which determine systemic responses. One purpose of this study is to elucidate the systemic antioxidant status following an episode of acute ischemic limb injury and subsequent reperfusion. Twelve New Zealand white rabbits were used in this study. After the animals were anesthetized, an ischemic insult was created in the right hind limb for twelve hours, followed by four hours of reperfusion. Several series of blood samples were obtained. At the end of the experiment, the animals were killed and necropsies undertaken in order to evaluate the antioxidant status of various visceral organs. The results link ischemia and reperfusion injury to a significant decline in antioxidative activity in various tissues. The weakening in antioxidant status after ischemic limb injury was most pronounced in the heart tissue, followed in descending order by the spleen, skeletal muscle, lung, liver, and kidney tissue. The levels of specific antioxidants and reactive oxygen species in various organs changed significantly, and the changes were tissue specific. Endogenous radical scavenging systems were not entirely overwhelmed in most of the tissues studied. But higher levels of malondialdehyde (MDA) found in cardiac tissue suggest that the production of oxygen free radicals is accelerated by an ischemic injury. Based on the study, we believe that the cardiac tissue is particularly susceptible to the effects of ischemia and reperfusion injury. Damage to cardiac tissue is probably the major cause of mortality following acute ischemic injury in a limb.
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Affiliation(s)
- J S Sun
- Department of Orthopedic Surgery, National Taiwan University Hospital, College of Medicine, Taipei, ROC.
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Wung CH, Hsu YH, Liou DY, Huang WC, Lin NS, Chang BY. Identification of the RNA-binding sites of the triple gene block protein 1 of bamboo mosaic potexvirus. J Gen Virol 1999; 80 ( Pt 5):1119-1126. [PMID: 10355757 DOI: 10.1099/0022-1317-80-5-1119] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The triple gene block protein 1 (TGBp1) encoded by open reading frame 2 of bamboo mosaic potexvirus (BaMV) was overexpressed in Escherichia coli and purified in order to test its RNA-binding activity. UV crosslinking assays revealed that the RNA-binding activity was present mainly in the soluble fraction of the refolded TGBp1. The binding activity was nonspecific and salt concentration-dependent: activity was present at 0-50 mM NaCl but was almost abolished at 200 mM. The RNA-binding domain was located by deletion mutagenesis to the N-terminal 3-24 amino acids of TGBp1. Sequence alignment analysis of the N-terminal 25 amino acids of the TGBp1 homologues of potexviruses identified three arginine residues. Arg-to-Ala substitution at any one of the three arginines eliminated most of the RNA-binding activity, indicating that they were all critical to the RNA-binding activity of the TGBp1 of BaMV.
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Lee YH, Huang WC, Tsai JY, Huang JK. The efficacy of potassium citrate based medical prophylaxis for preventing upper urinary tract calculi: a midterm followup study. J Urol 1999; 161:1453-7. [PMID: 10210371] [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: 02/12/2023]
Abstract
PURPOSE We examined the efficacy of potassium citrate based medical prophylaxis for preventing upper urinary calculous recurrence, and compared it with the stone recurrence rate in patients who only received intermittent or no medical prophylaxis. MATERIALS AND METHODS We retrospectively reviewed the records of 493 patients with upper urinary calculi, of whom 237 men and 76 women with a mean age of 56.1 and 51.4 years, respectively, were enrolled in the study. Of the 313 participants 64 (group 1, 20.4%) received regular medical prophylaxis for 24 to 42 months (mean 27.8), 80 (group 2, 25.6%) received intermittent medical prophylaxis for 1.5 to 19 months (mean 7.9) and 169 (group 3, 54%) did not receive any medical prophylaxis. RESULTS At midterm followup of 24 to 60 months 107 patients (34.2%) had stone recurrence. In group 1 the stone recurrence rate was 7.8%, which was significantly less (p <0.001) than in groups 2 (30%) and 3 (46.2%). Similarly new calculous events in patients with a history of multiple stone recurrence were less frequent in group 1 than in groups 2 and 3 (9.7, 47.4 and 52.2%, respectively, p <0.001). Multiple stone recurrence history, hypercalciuria, hyperuricosuria and calcium oxalate dihydrate calculi were independent risk factors for stone recurrence. CONCLUSIONS Regular medical prophylaxis may effectively prevent stone recurrence regardless of previous treatment modalities, stone composition, metabolic abnormalities and stone-free status. Cost effectiveness, patient compliance and gastrointestinal upset may limit patient acceptability and clinical use of medical prophylaxis. However, patients with a history of multiple stone recurrence, calcium oxalate dihydrate stones, hypercalciuria and hyperuricosuria benefit from regular medical prophylaxis.
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Affiliation(s)
- Y H Lee
- Department of Surgery, Veterans General Hospital-Kaohsiung, Taiwan, Republic of China
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Abstract
Pharmacokinetic profiles of single- and multiple-dose regimens of repaglinide were evaluated in 12 elderly subjects with type 2 diabetes. On day 1, following a 10-hour fast, subjects received a single 2-mg dose of repaglinide. Starting on day 2 and continuing for 7 days, each subject received a 2-mg dose of repaglinide 15 minutes before each of the three main meals. On day 9, subjects received a single 2-mg dose of repaglinide. Pharmacokinetic profiles, including area under the curve (AUC), log(AUC), maximal concentration (Cmax), log(Cmax), time to maximal concentration (Tmax), and half-life (T(1/2)), were determined at completion of the single- and multiple-dose regimens (days 1 and 9, respectively). Trough repaglinide values were collected on days 2 through 7. The mean log(AUC) values after multiple dosing were significantly higher than the values obtained after a single dose. The mean values for log(Cmax), and Tmax were comparable after each dosing regimen. The T(1/2) of repaglinide after multiple dosing was 1.7 hours. The trough values for repaglinide were low. No hypoglycemic events were reported. The pharmacokinetic profiles of repaglinide after single- and multiple-dose regimens were similar, and repaglinide was well tolerated by elderly subjects with type 2 diabetes.
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Affiliation(s)
- V Hatorp
- Novo Nordisk Pharmaceuticals, Princeton, NJ, USA
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47
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Abstract
In this open-label, single-center, pharmacokinetic study of repaglinide, 12 healthy volunteers (6 men, 6 women) were enrolled in each of 2 groups (total, 24 volunteers). One group consisted of young adult subjects (18 to 40 years), and the other group consisted of elderly subjects (> or = 65 years). On day 1, after a 10-hour fast, all 24 subjects received a single 2-mg dose of repaglinide. Starting on day 2 and continuing for 7 days, subjects received a 2-mg dose of repaglinide 15 minutes before each of 3 meals. On day 9, subjects received a single 2-mg dose of repaglinide. Pharmacokinetic profiles, including area under the curve, maximum concentration (Cmax), time to Cmax, and half-life, were determined at completion of the single-dose and multiple-dose regimens (days 1 and 9, respectively). Trough repaglinide values were collected on days 2 through 7 to assess steady state. The single-dose and multiple-dose pharmacokinetic variables of serum repaglinide were not significantly different between young adult and elderly subjects. Repaglinide was well tolerated in both groups. Hypoglycemic events occurred in 5 young adult and 5 elderly subjects. This study demonstrates that the pharmacokinetics of repaglinide are similar in healthy young adult and elderly subjects.
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Affiliation(s)
- V Hatorp
- Novo Nordisk Pharmaceuticals Inc., Princeton, New Jersey 08540, USA
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48
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Abstract
This prospective, 1-year, multicenter, double-blind, randomized, parallel-group study was designed to show that repaglinide was at least equivalent to glyburide in patients with type 2 diabetes. Five hundred and seventy-six patients with type 2 diabetes of at least 6 months' duration were randomized to receive monotherapy with repaglinide (n = 383) or glyburide (n = 193). During weeks 1-8, doses were gradually increased to achieve a target fasting plasma glucose (FPG) range of 80-140 mg/dl. The final adjusted dose was maintained for 12 months. Repaglinide patients received a starting dose of 0.5 mg three times/day preprandially, adjusted as necessary to 1, 2 or 4 mg before breakfast, lunch and dinner. Glyburide patients received a starting dose of 2.5 mg before breakfast and placebo before lunch and dinner. Glyburide was increased as necessary to 5 or 10 mg before breakfast (placebo before lunch and dinner) or to 15 mg (10 mg before breakfast, placebo before lunch, and 5 mg before dinner). After study drug was stopped, patients were transferred to an appropriate therapy, as recommended by the investigator. Efficacy was assessed by changes from baseline in glycemic control parameters and in C-peptide, insulin, and lipid profiles. Repaglinide provided glycemic control that was at least as effective and potentially safer than that provided by glyburide. The glucose-lowering effect of repaglinide was most pronounced in pharmacotherapy-naive patients, who showed rapid and marked decreases in mean glycosylated hemoglobin levels from baseline (9.4%) to month 3 (7.6%) and month 12 (7.9%). Mean FPG levels also decreased overall in this group, from 222 mg/dl at baseline, to 175 mg/dl at month 3, to 188 mg/dl at month 12. At endpoint, morning C-peptide levels had increased significantly in glyburide-treated patients compared with those treated with repaglinide, but morning fasting insulin levels did not differ significantly between the two groups. Repaglinide efficacy was sustained over 1 year and was not influenced by age or sex. Overall safety and changes in lipid profile and body weight were similar with both agents, with no significant change after extended pharmacotherapy. Weight gain data for the subset of pharmacotherapy-naïve patients suggest that patients given repaglinide may gain less weight than those given glyburide. Repaglinide, at doses of 0.5-4.0 mg administered three times preprandially, was well tolerated and provided safe and consistently effectiveglycemic control during this 1-year study. Patients using repaglinide received the same therapeutic benefits as those using glyburide, and may have received additional benefits.
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Affiliation(s)
- T Marbury
- Private Practice, Orlando Clinical Research Center, FL, USA
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Strange P, Schwartz SL, Graf RJ, Polvino W, Weston I, Marbury TC, Huang WC, Goldberg RB. Pharmacokinetics, pharmacodynamics, and dose-response relationship of repaglinide in type 2 diabetes. Diabetes Technol Ther 1999; 1:247-56. [PMID: 11475269 DOI: 10.1089/152091599317143] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 11/12/2022]
Abstract
BACKGROUND The pharmacodynamics and dose-response relationship of repaglinide, a novel oral hypoglycemic agent, were evaluated in steady-state treatment of patients with type 2 diabetes. METHODS Efficacy of repaglinide (0.25 mg, 0.5 mg, 1 mg, 2 mg, and 4 mg) was compared to that of placebo in a double-blind, randomized, parallel-group, 4-week dose-response clinical trial in 143 patients. Repaglinide was administered 15 minutes before meals (breakfast, lunch, and dinner). Efficacy of repaglinide therapy was assessed by measuring changes from baseline in mean levels of blood glucose (BGmean), fasting serum glucose (FSG), and mean levels of serum insulin (INSmean). RESULTS Blood concentrations of repaglinide were proportional to the dose administered. INSmean values increased in all repaglinide treatment groups (by 6.7 to 12.9 microU/mL). All doses of repaglinide significantly decreased values of BGmean and FSG as compared with the placebo group. BGmean values stabilized between the second and third week of repaglinide treatment. A well-defined dose-response relationship was observed for BGmean and FSG values. All doses of repaglinide were well tolerated, and there were no serious adverse events. CONCLUSIONS These findings show that the therapeutic reduction of serum glucose levels produced by repaglinide is dose-dependent for the 0.25- to 4-mg dose range. All doses of repaglinide tested were effective and well tolerated in patients with type 2 diabetes.
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Affiliation(s)
- P Strange
- Novo Nordisk Pharmaceuticals, Inc., Princeton, New Jersey, USA.
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50
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Abstract
OBJECTIVE To investigate the role of angiotensin II in the pathogenesis of hyperinsulinemia-induced hypertension in rats. MATERIALS AND METHODS Chronic hyperinsulinemia was achieved by infusing insulin (3 mU/kg per min) subcutaneously by an osmotic minipump for 6 weeks. An angiotensin converting enzyme inhibitor (fosinopril, 10 mg/kg per day) was added in drinking water and the angiotensin II subtype 1 receptor antagonist losartan (3.5 microg/kg per min) was co-infused via the minipump. Control rats were administered the vehicle only. The rats were housed in individual metabolic cages and fed a sodium-controlled diet. Food and water intake and urine output were measured daily. Systolic blood pressure and heart rate were measured by the tail-cuff method twice a week. RESULTS By the end of weeks 4 and 6 of the sustained insulin infusion, systolic blood pressure had increased significantly (P < 0.05), from 134+/-1 to 157+/-2 and 158+/-2 mmHg, respectively, and the heart rate had increased significantly (P< 0.05), from 380+/-9 to 423+/-7 and 426+/-6 beats/min, respectively. The plasma insulin concentration increased by 2-2.5 times but no significant changes in plasma glucose and triglyceride levels were noted. Concomitant treatment with fosinopril prevented the rises in systolic blood pressure and heart rate in the insulin-infused rats. When the insulin-induced hypertension had become established (systolic blood pressure increased from 132+/-3 to 155+/-2 mmHg 4 weeks after the infusion, P< 0.05 ), subsequent fosinopril or losartan treatment for 2 weeks reversed the elevated systolic blood pressure and heart rate to the control levels. There were no significant differences in water intake, urine flow, sodium gain and body weight gain between the control and the insulin-infused rats. CONCLUSIONS Angiotensin converting enzyme inhibition or angiotensin II type 1 receptor antagonism can prevent and reverse insulin-induced hypertension in rats, suggesting that angiotensin II itself or an angiotensin II-dependent mechanism has an etiological influence in the pathogenesis of this hypertension model.
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Affiliation(s)
- T C Fang
- Department of Internal Medicine, Tzu Chi General Hospital, and Graduate Institute of Medical Sciences, Tzu Chi College of Medicine and Humanities, Hualien, Taiwan, Republic of China
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