1
|
Cui Q, Li ZK, Li B, Wang C, Su CH. [A case of delayed peripheral neuropathy caused by diquat poisoning]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:309-312. [PMID: 37248189 DOI: 10.3760/cma.j.cn121094-20220314-00130] [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: 05/31/2023]
Abstract
Diquat is a kind of conductive contact-killing herbicides. The damage of central nervous system is relatively common, but the peripheral neuropathy caused by diquat has not been reported yet. In September 2021, we treated a patient with diquat poisoning. During the hospitalization, the patient was diagnosed with peripheral neuropathy. Therapy for peripheral nerve injury was given on the basis of conventional treatment of poisoning. The patient was discharged after his condition was stable. The follow-up showed that the peripheral neuropathy of patient was better than before. According to the condition of this patient, it is suggested that we should not only protect the function of gastrointestinal tract, liver, kidney, and central nervous system early, but should also pay attention to the damage of peripheral nervous system in clinical work. We should intervene earlier to improve the prognosis of patients.
Collapse
Affiliation(s)
- Q Cui
- School of Clinical Medicine, Weifang Medical University, Weifang 261053, China
| | - Z K Li
- Emergency Department, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou 253000, China
| | - B Li
- Emergency Department, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou 253000, China
| | - C Wang
- Emergency Department, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou 253000, China
| | - C H Su
- Emergency Department, Qilu Hospital of Shandong University Dezhou Hospital, Dezhou 253000, China
| |
Collapse
|
2
|
Zhang LZ, Du LL, Zhao HD, Yu L, He F, Chen JS, Su CH, Zhao XL, Chen DJ. [Outcomes of the second pregnancy after Triple-P procedure in women complicated with placenta accreta spectrum disorders]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:44-48. [PMID: 36720614 DOI: 10.3760/cma.j.cn112141-20220825-00536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objective: To investigate the safety of the Triple-P procedure in women complicated with severe placenta accreta spectrum disorders (PAS) and its influence on second pregnancy. Methods: From January 2015 to December 2017, the outcomes of the second pregnancy after the Triple-P procedure in 11 pregnant women complicated with PAS in the Third Affiliated Hospital of Guangzhou Medical University and the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. Results: By December 2021, a total of 11 pregnant women who underwent the Triple-P procedure for PAS had a second pregnancy, with a median interval of 3 years (2-3 years). Of the 11 pregnant women, 7 delivered after 36 weeks of gestation. The median gestational age was 38 weeks, and 4 terminated within the first trimester. PAS recurred in 1 of 7 pregnant women (1/7) and was associated with placenta previa. All of the 7 pregnant women were delivered by cesarean section, with a median postpartum blood loss of 300 ml (200-450 ml), and only one pregnant woman required blood transfusion. None of the pregnant women were transferred to the intensive care unit, and there were no uterine rupture, bladder injury, puerperal infection, and neonatal adverse outcomes. Conclusion: Pregnant women who underwent the Triple-P procedure for severe PAS could be considered for second pregnancy with strictly management by an experienced multidisciplinary team, which may result in a good outcome.
Collapse
Affiliation(s)
- L Z Zhang
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou 510150, China
| | - L L Du
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou 510150, China
| | - H D Zhao
- Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University, Obstetric Emergency and Critical Care Medicine of Henan Province, Zhengzhou 450052, China
| | - L Yu
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou 510150, China
| | - F He
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou 510150, China
| | - J S Chen
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou 510150, China
| | - C H Su
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou 510150, China
| | - X L Zhao
- Department of Obstetrics, the First Affiliated Hospital of Zhengzhou University, Obstetric Emergency and Critical Care Medicine of Henan Province, Zhengzhou 450052, China
| | - D J Chen
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangzhou 510150, China
| |
Collapse
|
3
|
Chou YH, Lee YN, Su CH, Yeh HI, Wu YJ. AD-9308 ameliorates the impacts of 4-HNE on the progress of pulmonary arterial hypertension in aldehyde dehydrogenase 2*1*2 knock-in mice. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.3062] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Endothelial dysfunctions play a critical role on the development of pulmonary arterial hypertension (PAH). It has been reported that the one-year mortality rate is still up to 15% even with PAH-targeted therapy, implying that there may be untargeted pathways. 4-hydroxynenonal (4-HNE), an unsaturated aldehyde, is highly induced in the lungs of PAH animals and its serum levels were also reported to be higher in PAH patients. 4-HNE is metabolized by mitochondrial aldehyde dehydrogenase (ALDH2), which is dysfunctional in near 40% of East Asian people. Currently, the impacts of 4-HNE on endothelial dysfunctions in the development of PAH are unclear. In terms of translational medicine, we proposed that modulation of 4-HNE level may alleviate the progress of PAH patients with ALDH2 deficiency.
We found that 4-HNE alone was not sufficient to induce pulmonary artery endothelial cell (PAEC) functional changes, including proliferation, migration and tube formation, whereas their effects emerge from the depletion of ALDH2. We further mimicked human ALDH2 functional deficiency by using daidzin (DZN), an inhibitor which is able to block the substrate binding site of ALDH2. ALDH2 functional inhibition alone did not induce any PAEC functional change, while an add-on of 4-HNE impaired PAEC functions. In addition, 4-HNE significantly reduced eNOS activity with combined DZN treatment. Consistent with the mechanism of ALDH2 activity-mediated angiogensis, ALDH2 enhancers Alda-1 and AD-5591 completely reverse the anti-angiogenic effects of 4-HNE in the presence of DZN. To further confirm whether ALDH2 functional deficiency impact on PAH development in mammals, heterozygous ALDH2*1/*2 transgenic and wild-type mice were subjected to chronic hypoxia to induce PAH. ALDH2*1/*2 transgenic mice had similar right ventricular systolic pressure (RVSP) as wild-type mice. However, after exposure to chronic hypoxia, ALDH2*1/*2 transgenic mice indeed developed a significantly higher RVSP than that in wild-type mice. Furthermore, we demonstrated that 4-HNE expression was profoundly enhanced in ALDH2*1/*2 transgenic mice by chronic hypoxia-induced PAH with pulmonary artery smooth muscle cell hyperplasia. More importantly, we found that AD-9308, an enhancer of ALDH2 significantly decreased hypoxia-induced RVSP elevation in heterozygous ALDH2*1/*2 transgenic mice.
Taken together, our data demonstrate that 4-HNE and ALDH2 functional deficiency potentially contribute to PAH development and worsening, and that ALDH2 enhancers may be promising as a PAH adjunct therapy, particularly for patients with ALDH2 nonfunctional alleles.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology, Taiwan
Collapse
Affiliation(s)
- Y H Chou
- Mackay Medical College, Institute of Biomedical Sciences , New Taipei , Taiwan
| | - Y N Lee
- Mackay Memorial Hospital, Departments of Medical Research , Taipei , Taiwan
| | - C H Su
- Mackay Memorial Hospital, Cardiovascular Center , Taipei , Taiwan
| | - H I Yeh
- Mackay Memorial Hospital, Cardiovascular Center , Taipei , Taiwan
| | - Y J Wu
- Mackay Medical College, Department of Medicine , New Taipei , Taiwan
| |
Collapse
|
4
|
Zhou YM, Sun W, Lin L, Su CH, Zhang CF, Yu L, Liu J, Wang XY, He F, Chen DJ. [Analysis of the efficacy and related influencing factors of pelvic packing in the treatment of intractable postpartum hemorrhage after emergency perinatal hysterectomy]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:504-509. [PMID: 35902784 DOI: 10.3760/cma.j.cn112141-20220222-00116] [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: 06/15/2023]
Abstract
Objective: To investigate the effect of pelvic packing on the control of intractable postpartum hemorrhage after emergency perinatal hysterectomy (EPH). Methods: Eleven cases with complete clinical data of pelvic packing due to failure of hemostasis after EPH were collected to evaluate the outcome, complications, hospital stay of pregnant women, and to analyze the factors affecting the effect of pelvic packing. The cases included patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University after pelvic packing treatment in the other hospital due to continuous bleeding after EPH or who were referred to our hospital for pelvic packing treatment due to continuous bleeding after EPH from January 2014 to August 2021. Results: The median gestational week of 11 pregnant women was 38.3 weeks(38.0-39.9 weeks) , and the methods of termination of pregnancy were cesarean section in 7 cases (7/11) and vaginal delivery in 4 cases (4/11). The median time between postpartum hemorrhage and pelvic tamponade was 10 hours (5-57 hours), the median amount of bleeding was 8 500 ml(4 800-15 600 ml) , the median number of pelvic tamponade was 3 pieces (2-7 pieces), and the median retention time of gauze pad was 6.0 days (3.0-6.0 days). The median frequency of laparotomy in this pregnancy was 3 times (2-3 times), with a maximum of 4 among the 11 cases, the first pelvic packing was successful in hemostasis in 9 cases, and the final successful treatment in all of the 11 cases. All parturients had hemorrhagic shock (11/11) and disseminated intravascular coagulation (11/11) before pelvic packing. Other common complications were multiple organ dysfunction syndrome (9/11), cardiac arrest (4/11), deep vein thrombosis (3/11), septic shock (3/11), and intestinal obstruction (1/11). All parturients took out the gauze after the coagulation function returned to normal and there was no active bleeding. The recovery time of coagulation function in 11 cases was 3 days (3-5 days), the retention time of gauze pad was 6 days (3-6 days), the median length of stay in intensive care unit was 14 days (11-26 days), and the median total length of stay was 22 days (16-49 days). Conclusions: Pelvic packing could be used as a temporary strategy for intractable postpartum hemorrhage after EPH, which provides a key time for injury control resuscitation for patients with unstable vital signs. This technology provides an opportunity for referral to superior medical institutions and further treatment.
Collapse
Affiliation(s)
- Y M Zhou
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - W Sun
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - L Lin
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - C H Su
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - C F Zhang
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - L Yu
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - J Liu
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - X Y Wang
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - F He
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| | - D J Chen
- Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Guangzhou Medical University, Key Laboratory of Obstetrics Major Diseases of Guangdong Province, Guangzhou 510150, China
| |
Collapse
|
5
|
Su CH, Lo CH, Tsai CF. CHA2DS2-VASc score as independent outcome predictor in patients with acute ischemic stroke with and without atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2740] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Atrial fibrillation (AF) was a significant independent risk factor for 1-year mortality of first acute ischemic stroke. The CHA2DS2-VASc scores were initially developed to assess the risk of stroke or systemic embolism in patients with AF. Recently, this scoring system have been demonstrated to have clinical value for predicting the severity of infarction and long-term clinical outcomes in acute ischemic stroke but the evidence is not strong enough due to limited numbers and single center data.
Purpose
This large-scale prospective cohort study aimed to investigate the independent predictive value of CHA2DS2-VASc scores and AF in such patients.
Materials and methods
We included patients from Taiwan Stroke Registry (TSR) with ischemic stroke within 2006 to 2016 as the present study population. Patients were mainly divided in atrial fibrillation (AF) group and non-AF group. We future classified patient by CHA2DS2-VASc (congestive heart failure, hypertension, age≥75 years, diabetes, previous stroke, vascular disease, age 65–74 years, sex category) score 0–1 and ≥2. The primary outcome was major adverse cardiovascular events (MACE), which include re-stroke, myocardial infarction and cardiovascular death, occurred within 1 year after the onset of stroke. The secondary outcome was the all-cause mortality.
Results
We defined 2972 patients with MACE and 61,937 patients without MACE. With adjusting with the confounding of CHA2DS2-VASc scores, The AF group was associated with increased MACE (OR=1.15; 95% CI=1.00, 1.33), myocardial infarction (adjusted OR=3.89; 95% CI=1.81, 8.34), CV death (OR=5.73; 95% CI=3.77, 8.69) and all-cause mortality (OR=1.50; 95% CI=1.37, 1.65) but not in re-stroke (adjusted OR=1.02; 95% CI=0.88, 1.18). After controlling for AF, patients with CHA2DS2-VASc scores ≥2 had significantly higher odds of MACE (OR=1.28; 95% CI=1.16, 1.41), re-stroke (OR=1.27; 95% CI=1.16, 1.40) and all-cause mortality (OR=2.26; 95% CI=2.06, 2.48) than that of patients with CHA2DS2-VASc scores 0–1. The survival curve revealed both AF and CHA2DS2-VASc scores are independent risk factors of 1 year MACE and mortality. By investigating the individual risk factor of CHA2DS2-VASc score, diabetes, hypertension and age over 65 years old increase the risk of MACE significantly.
Conclusions
CHA2DS2-VASc scores appear to have potent independent value as AF for predicting 1 year MACE and all-cause mortality in patients of acute ischemic stroke.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
Collapse
Affiliation(s)
- C H Su
- Chung Shan Medical University Hospital, Division of Cardiology, Department of Internal Medicine, Taichung, Taiwan
| | - C H Lo
- Chung Shan Medical University Hospital, Division of Cardiology, Department of Internal Medicine, Taichung, Taiwan
| | - C F Tsai
- Chung Shan Medical University Hospital, Division of Cardiology, Department of Internal Medicine, Taichung, Taiwan
| |
Collapse
|
6
|
Bai CQ, Ouyang J, Su CH, Cui QQ, Liu D, Gao ZH, Chen SY, Zhao YY. [Association of hyperuricemia-induced renal damage with sirtuin 1 and endothelial nitric oxide synthase in rats]. Zhonghua Yi Xue Za Zhi 2021; 101:429-434. [PMID: 33611893 DOI: 10.3760/cma.j.cn112137-20200620-01900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the association of hyperuricemia-induced renal damage with sirtuin 1 (SIRT1) and endothelial nitric oxide synthase (eNOS) in rats. Methods: Using the random number table method, 32 Sprague-Dawley rats were randomly divided into 4 groups: control group, model A group (the model was generated using oxonic acid potassium salt alone), model B group (hyperuricemia model was generated using oxonic acid potassium salt combined with uric acid) and resveratrol group, with 8 rats in each group. The experiment lasted 12 weeks. Serum uric acid and cystatin C levels were monitored regularly. In week 12, serum creatinine and urea nitrogen levels were measured, and the kidneys were extracted. The expression of SIRT1 and eNOS in renal tissues was measured and determined by immunohistochemistry, quantitative reverse-transcription polymerase chain reaction (RT-qPCR) and western blotting. Immunohistochemistry of alpha-smooth muscle actin combined with Masson staining was employed to evaluate the degree of renal fibrosis, and pathological changes were observed based on hematoxylin and eosin staining. Results: In week 12, the uric acid levels in both the model A and model B groups were higher than those in the control group [(316±43) μmol/L, (297±40) μmol/L vs (118±44) μmol/L, both P<0.05]. The levels of cystatin C in the model A, model B, and resveratrol groups were all higher than those in the control group [(156±20) ng/ml, (143±29) ng/ml, (128±26) ng/ml vs (62±18) ng/ml, all P<0.05]. Creatinine levels were higher in the model A and model B groups than those in the control group [(68.5±10.3) μmol/L, (64.5±13.9) μmol/L vs (43.2±10.6) μmol/L, both P<0.05]. The levels of uric acid, cystatin C and creatinine in the resveratrol group were lower than those in the model A group (all P<0.05). Immunohistochemistry, RT-qPCR, and Western blotting for renal SIRT1 and eNOS showed that the expression in the model A and model B groups was inhibited, while the expression in the resveratrol group was not significantly inhibited, compared with that in the control group. Microscopically, obvious abnormalities were not found in the renal tissue of the control group. Renal inflammatory cell aggregation and edema occurred, and interstitial fibrosis was obvious in both the model A and model B groups, while these lesions in the resveratrol group were significantly improved. Conclusions: Hyperuricemia may cause renal injury by inhibiting the expression of SIRT1 and eNOS.
Collapse
Affiliation(s)
- C Q Bai
- Department of Nephrology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - J Ouyang
- Endocrine Laboratory, Institute of Medicine, University of Zhengzhou, Zhengzhou 450000, China
| | - C H Su
- Department of Nephrology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Q Q Cui
- Department of Nephrology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - D Liu
- Department of Nephrology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Z H Gao
- Department of Nephrology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - S Y Chen
- Department of Nephrology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Y Y Zhao
- Department of Nephrology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| |
Collapse
|
7
|
Koch M, Hung SH, Su CH, Lee KS, Iro H, Mantsopoulos K. Intraductal lithotripsy in sialolithiasis with two different Ho:YAG lasers: presetting parameters, effectiveness, success rates. Eur Rev Med Pharmacol Sci 2020; 23:5548-5557. [PMID: 31298306 DOI: 10.26355/eurrev_201907_18288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare two different Ho:YAG laser systems in relation to the preset parameters and their effectiveness for intraductal fragmentation of the salivary stones. PATIENTS AND METHODS We made a retrospective study in two tertiary referral centers (Department of ENT, Head and Neck Surgery, University of Erlangen-Nuremberg, Germany and the MacKay Memorial Hospital, Taipei, Taiwan). Patients with a diagnosis of sialolithiasis were treated in Erlangen and Taipei. The Erlangen patients were treated using the Calculase II™ Ho:YAG laser (Karl Storz, Tuttlingen, Germany) at 4 Hz, 1.2 J (4.8 W) and the MacKay patients were treated using the VersaPulse® PowerSuite™ Ho:YAG laser (Lumenis Ltd., Yokneam, Israel) at 6 Hz, 0.5 J (3 W). RESULTS A total of 12 patients with 12 stones were treated in Erlangen and 54 with 75 stones in Taipei. The submandibular stones were present in 50% and 86.7% of cases, respectively. The complete fragmentation was achieved in all of the treated stones in both groups; 100% and 92.6% of the patients were stone-free, 100% and 94.4% of the patients became symptom-free, respectively. 33% of the Erlangen patients had multimodal treatments. The glands were preserved in all cases in both centers. CONCLUSIONS The Ho:YAG laser proved to be effective in the treatment of sialolithiasis. Stone size, location, and involved gland were important additional parameters. Our experience and the literature results show that the laser presetting with a frequency of 3-6 Hz, an energy level of 0.5-1.2 J, and effective power of between 3 and 4.8 W is sufficient to achieve maximum success without any increased risk for complications.
Collapse
Affiliation(s)
- M Koch
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
| | | | | | | | | | | |
Collapse
|
8
|
Su CH, Jian XD, Zhang QB, Liu YG, Li HY, Liu JQ. [One case successfully rescued acute poisoning caused by misadministration of large amount of glufosinate]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2020; 38:288-290. [PMID: 32447895 DOI: 10.3760/cma.j.cn121094-20190412-00149] [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 report a case of acute glufosinate-ammonium poisoning cause respiratory cardiac arrest and grass amine poisoning cases of successful rescue. Methods: The clinical data of a case of acute glufosinate-ammonium poisoning admitted to a third-class a hospital in April 2018 were analyzed and summarized. Results: The patient was poisoned by oral administration of a large amount of glufosinate-ammonium. Respiratory and cardiac arrest occurred during treatment and resuscitation was successful Later, the nervous system showed impaired function, The patients were treated with complete gastrointestinal cleansing, hemoperfusion, and the protection of important organs. Conclusion: For a large number of patients with oral glufosinate-ammonium poisoning, we should pay close attention to the damage of nervous system while taking active and conventional detoxification treatment.
Collapse
Affiliation(s)
- C H Su
- Emergency Department, Dezhou People's Hospital, Dezhou 253014, China
| | - X D Jian
- Emergency Department of Poisoning and Occupational Diseases, Qilu Hospital, Shandong University, Jinan 250000, China
| | - Q B Zhang
- Emergency Department, Dezhou People's Hospital, Dezhou 253014, China
| | - Y G Liu
- Emergency Department, Dezhou People's Hospital, Dezhou 253014, China
| | - H Y Li
- Lingcheng Town Health Hospital, Dezhou 253500, China
| | - J Q Liu
- Emergency Department, Dezhou People's Hospital, Dezhou 253014, China
| |
Collapse
|
9
|
Lai YH, Liu YM, Liu ME, Su CH, Yeh HI, Hung CL. P5294Metabolically healthy obese is associated with better left atrial function and lower risk of adverse cardiovascular events including atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0265] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
Metabolic syndrome (MetS) and obesity are both crucial risk factors for heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF). However, the prognostic value of utilizing left atrial (LA) deformation imaging in metabolically healthy obese (MHO) or metabolically unhealthy normal weight (MUNW) subjects remains largely unexplored.
Methods
Speckle-tracking echocardiography was used to evaluate LA strain and strain rate among 3,915 subjects free from clinical heart failure (mean age: 50.0±10.6 years, 66.2% male) undergoing annual cardiovascular health survey. Metabolically unhealthy was defined by the presence of at least one MetS component or history of cardiovascular disease. Participants were categorized as: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy overweight/obese (MUO).
Results
Markedly decreased LA strain, early-diastolic LA strain rate and increased LA stiffness were observed with metabolic disorders (all trend p: <0.05). During a median follow-up period of 3.68 years, significantly higher risk of primary endpoints (death, heart failure, major cardiovascular events) was observed in MUO vs. MHO (HR=1.87, p=0.005) and MUNW vs. MHNW (HR=2.82, p=0.004). Similar patterns with incident AF (MUO vs MHO: HR=3.05, p=0.001, MUNW vs MHNW: HR=4.04, p=0.002) were also observed. After multivariate adjustment, risk of AF remained associated with low LA strain (β=−0.07, p<0.001), systolic LA strain rate (β:−0.05, p=0.007) and high LA stiffness (β=0.18, p<0.001).
Comparison between metabolic groups MHNW (N=1107) MUNW (N=255) p (MUNW vs MHNW) MHO (N=1859) MUO (N=694) p (MUO vs MHO) Age 48±10.57 54.29±11.52 <0.001 49±10.02 54.21±10.49 <0.001 LA GLS (%) 40.6±7.68 37.16±7.5 <0.001 36.77±7.66* 33.58±8.01‡ <0.001 LA SRs 1.79±0.41 1.76±0.48 NS 1.63±0.39* 1.55±0.41‡ <0.001 LA SRe 2.11±0.62 1.8±0.63 <0.001 1.68±0.55* 1.48±0.52‡ <0.001 LA stiffness 0.17±0.08 0.22±0.12 <0.001 0.21±0.11* 0.25±0.13‡ <0.001 *p<0.001 for MHO vs MHNW, ‡p<0.001 for MUO vs MUNW. LA GLS = left atrial global longitudinal strain, LA SRs = left atrial systolic strain rate, LA SRe = left atrial early-diastolic strain rate, NS = non-significant.
Kaplan-Meier curves of adverse events
Conclusion
Metabolic abnormality may contribute to certain aspects of mechanistic LA dysfunction tightly linked to clinical events, even with normal lean body mass. Our observations may be insightful for targeted interventions in higher-risk patients with subclinical atrial dysfunction.
Collapse
Affiliation(s)
- Y H Lai
- Hsinchu MacKay Memorial Hospital, Department of Internal Medicine, Division of Cardiology, Hsinchu, Taiwan
| | - Y M Liu
- Hsinchu MacKay Memorial Hospital, Department of Internal Medicine, Division of Cardiology, Hsinchu, Taiwan
| | - M E Liu
- Hsinchu MacKay Memorial Hospital, Department of Internal Medicine, Division of Cardiology, Hsinchu, Taiwan
| | - C H Su
- Mackay Memorial Hospital, Department of Internal Medicine, Division of Cardiology, Taipei, Taiwan
| | - H I Yeh
- Mackay Memorial Hospital, Department of Internal Medicine, Division of Cardiology, Taipei, Taiwan
| | - C L Hung
- Mackay Memorial Hospital, Department of Internal Medicine, Division of Cardiology, Taipei, Taiwan
| |
Collapse
|
10
|
Sun W, Wang XY, Yu L, Lin L, Zhang HL, Zhou YM, Su CH, Chen DJ. [Ratio of transfer cesarean section after trial of labor and maternal-fetal adverse outcomes based on Robson classifications]. Zhonghua Fu Chan Ke Za Zhi 2019; 54:512-515. [PMID: 31461806 DOI: 10.3760/cma.j.issn.0529-567x.2019.08.002] [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 ratio of transfer cesarean section after trial of labor and maternal-fetal outcomes based on Robson classifications. Methods: The delivery data by cesarean section in Third Affiliated Hospital of Guangzhou Medical University from January 1st, 2009 to December 31st, 2015 (gestational age ≥28 weeks and newborn birth weight >1 000 g) were retrospectively collected. The ratio of transfer cesarean section after trial of labor and maternal-fetal adverse outcomes were analyzed by weighted adverse outcome score in different Robson classifications. Results: (1) The highest ratio of transfer cesarean section after trial of labor was classification 9 (all abnormal lies, including previous cesarean section and breech were excluded) reached 47.31% (431/911) , followed by classification 2 (nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation who had labour induced) accounted for 44.90%(409/911). (2)The tops of weighted adverse outcome score of transfer cesarean section after trial of labor were classification 10 (single cephalic pregnancy at <37 weeks gestation, including women with previous cesarean delivery) 24.55, classification 5 (single cephalic pregnancy multiparous women, with at least one previous cesarean delivery, ≥37weeks gestation) 3.64. Conclusion: Carefully evaluating the delivery mode and emphasizing the intrapartum management in nulliparous women with a single cephalic pregnancy, at ≥37 weeks gestation who had labour induced and trial of labor after cesarean section is essential to reduce the risk of adverse outcomes in transfer cesarean section after trial of labor.
Collapse
Affiliation(s)
- W Sun
- Department of Obstetrics and Gynecology, Key Laboratory of Obstetric Major Diseases, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Lo CH, Wei JCC, Tsai CF, Li LC, Huang SW, Su CH. Syncope caused by complete heart block and ventricular arrhythmia as early manifestation of systemic lupus erythematosus in a pregnant patient: a case report. Lupus 2018; 27:1729-1731. [PMID: 29954280 DOI: 10.1177/0961203318782425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Systemic lupus erythematosus (SLE) can affect all heart structures including the conduction system, with either reversible or permanent derangement. However, only a few cases of adult SLE and complete atrioventricular (AV) block have been reported. We describe a young pregnant woman who initially presented with complete AV block on electrocardiography before the diagnosis of SLE. Syncope subsequently developed during the postpartum period due to frequent nonsustained polymorphic ventricular tachycardia, suggesting lupus myocarditis. The ventricular arrhythmia was successfully treated by intravenous corticosteroids, lidocaine and implantation of a permanent pacemaker. This may represent the first report of complete AV block with polymorphic ventricular tachycardia, which was identified before the other clinical features of SLE fully manifested. SLE should be considered if a patient presents with complete AV block without other clinical features. It may warn for early diagnosis and appropriate treatment of SLE including lupus-related heart disease.
Collapse
Affiliation(s)
- C H Lo
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - J C C Wei
- 2 Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital; Institute of Medicine, Chung Shan Medical University; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - C F Tsai
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.,3 School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - L C Li
- 4 Department of Internal Medicine, Da Chien General Hospital, Miao Li City, Taiwan
| | - S W Huang
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - C H Su
- 1 Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.,3 School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| |
Collapse
|
12
|
Yu L, Tang M, Fan XH, Du HM, Tang H, Chen P, Xing SL, Su CH, Chen DJ. [Analysis of 2 204 stillbirths in 11 hospitals of Guangdong province]. Zhonghua Fu Chan Ke Za Zhi 2017; 52:805-810. [PMID: 29325263 DOI: 10.3760/cma.j.issn.0529-567x.2017.12.003] [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 analyze the incidence and causes of stillbirth in 11 hospitals of Guangdong province, and to explore the appropriate interventions. Methods: Clinical data of stillbirth in 11 hospitals of Guangdong province were collected from January 2014 to December 2016. The gestational weeks, causes, maternal conditions and other factors were analyzed. Results: (1) From 2014 to 2016, 103 472 newborns were delivered in the 11 hospitals, and the number of stillbirth was 2 204, with the incidence of 2.13%. Among them, 0.71%(738/103 472) was therapeutic induction, 1.42%(1 066/103 472) was natural stillbirth. At different gestational age (<28 weeks, 28-<37 weeks and ≥37 weeks), the incidence of stillbirth was 55.63% (1 226/2 204), 28.45% (627/2 204) and 15.92% (351/2 204), respectively, with statistically significant difference (P<0.01). (2) For stillbirth<28 weeks, the first reason was therapeutic induction, accounting for 53.34% (654/1 226). For stillbirth during 28-37 weeks, pre-eclampsia was the major cause, accounting for 40.67% (255/627). And for full-term stillbirth, the causes were umbilical cord factors (19.37%, 68/351), abnormal labor (17.09%, 60/351). (3) In all the stillbirth cases, the incidence of fetal growth restriction (FGR) <28 weeks was significantly higher than that during 28-37 weeks [23.49% (288/1 226) vs 18.02% (113/627) , P<0.01]. (4) The stillbirth rate during labor was significantly higher in women ≥35 years old than in younger women [63.88% (191/299) vs 36.12% (108/299) ; χ(2)=9.346, P=0.000]. For the causes of stillbirth during labor, the incidence of severe maternal obstetrical complications [61.11% (33/54) vs 38.89% (21/54) ; χ(2)=3.323, P=0.002], abnormal labor [65.82% (52/79) vs 34.18% (27/79) ; χ(2)=4.067, P=0.001] and abnormal fetal position [66.63% (26/39) vs 33.37% (13/39) ; χ(2)=3.002, P=0.013] were higher in women ≥35 years old than in younger women. (5) Cesarean section during labor accounted for 33.77% (101/299) of stillbirth, including 76 cases of emergency cesarean section or converted to cesarean section during labor. Conclusions: (1) The incidence of stillbirth in the 11 hospitals is high, and the causes are different at different gestational ages, therefore, different interventions are needed to reduce the incidence in different gestational weeks. Supervision of therapeutic induction should be strengthened <28 gestational weeks; standard management of pregnancy might decrease the occurrence of natural death ≥28 weeks. (2) Attention should be paid to fetal body weight during pregnancy, especially FGR. (3) The stillbirth rate is high in elderly pregnant women, so it is important to strengthen the management of the elderly pregnant women.
Collapse
Affiliation(s)
- L Yu
- Department of Obstetrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Huang FH, Li LP, Su CH, Qin W, Xu M, Wang LM, Jiang YS, Qiu ZB, Xiao LQ, Zhang C, Shi HW, Chen X. [Late reoperations after repaired Stanford type A aortic dissection]. Zhonghua Wai Ke Za Zhi 2017; 55:266-269. [PMID: 28355763 DOI: 10.3760/cma.j.issn.0529-5815.2017.04.006] [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 summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years. In these patients, first time operations were ascending aorta replacement procedure in 3 patients, ascending aorta combined with partial aortic arch replacement in 4 patients, aortic root replacement (Bentall) associated with Marfan syndrome in 3 patients, aortic valve combined with ascending aorta replacement (Wheat) in 1 patient, ascending aorta combined with Sun's procedure in 1 patient, Wheat combined with Sun's procedure in 1 patient, Bentall combined with Sun's procedure in 1 patient. The interval between two operations averaged 0.3 to 10.0 years with a mean of (4.8±3.1) years. The reasons for reoperations included part anastomotic split, aortic valve insufficiency, false aneurysm formation, enlargement of remant aortal and false cavity. The selection of reoperation included anastomotic repair, aortic valve replacement, total arch replacement and Sun's procedure. Results: Of the 14 patients, the cardiopulmonary bypass times were 107 to 409 minutes with a mean of (204±51) minutes, cross clamp times were 60 to 212 minutes with a mean of (108±35) minutes, selective cerebral perfusion times were 16 to 38 minutes with a mean of (21±11) minutes. All patients survived from the operation, one patient died from severe pulmonary infection 50 days after operation. Three patients had postoperative complications, including acute renal failure of 2 patients and pulmonary infection of 1 patient, and these patients were recovered after treatment. Thirteen patients were finally recovered from hospital. The patients were followed up for 16 to 45 months, and no aortic rupture, paraplegia and death were observed in the follow-up. Conclusions: Patients for residual aortic dissection after initial operations on Stanford type A aortic dissection should be attached great importance and always need emergency surgery, but the technique is demanding and risk is great for surgeons and patients, which need enough specification and accurate on aortic operation. More importantly, the Sun's procedure also should be performed on the treatment of residual aortic dissection or distal arch expansion, and obtains the short- and long-term results in the future.
Collapse
Affiliation(s)
- F H Huang
- Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing First Hospital, Nanjing Cardiovascular Disease Research Institute, Nanjing 210006, China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Fang XB, Chen DJ, He F, Su CH, Ren LW, Chen J, Liang YL. [Risk factors analysis of reversible posterior leukoencephalopathy syndrome in pre-eclampsia or eclampsia gravida]. Zhonghua Fu Chan Ke Za Zhi 2017; 52:40-46. [PMID: 28190314 DOI: 10.3760/cma.j.issn.0529-567x.2017.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pre-eclampsia or eclampsia gravida. Methods: This study was conducted in the Third Affiliated Hospital of Guangzhou Medical University between January 2013 and March 2016. A total of 100 patients who had no severe neurological diseases and were diagnosed pre-eclampsia or eclampsia, and underwent brain MRI were collected retrospectively. They were divided into 2 groups according to the MRI results, the RPLS group (n=49) and the non-RPLS group (n=51). The medical history, clinical symptoms and the results of laboratory examination were analyzed by the logistic regression, in order to explore the risk factors. Results: In single factor analysis, HELLP syndrome, pregnancy associated with other diseases, poor prenatal care, grade 3 hypertension, elevated systolic blood pressure or diastolic blood pressure, elevated WBC, aspartate transaminase (AST), alanine aminotransferase (ALT), uric acid (UA) and lactate dehydrogenase (LDH), decreased platelet (PLT), headache, visual changes, seizures and conscious disturbance were more frequent in the RPLS group than those in the non-RPLS group (all P<0.05). According to the multivariate logistic regression analysis, the elevated WBC (OR=1.291, 95% CI: 1.058-1.575, P=0.012), UA (OR=1.008, 95% CI: 1.001-1.016, P=0.032) and headache (OR=18.260, 95% CI: 3.562-93.607, P=0.000) were the independent risk factors. Conclusions: Maternal history, clinical symptoms and some laboratory examinations might help in the early diagnosis of RPLS in pre-eclampsia or eclampsia gravida. Headache, the elevation of WBC and UA were the most significant factors.
Collapse
Affiliation(s)
- X B Fang
- Department of Neurology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | | | | | | | | | | | | |
Collapse
|
15
|
Yu L, Su CH, Wang XY, Gong JJ, Chen P, Du HM, Quan QH, Li LL, Chen DJ. [Multi-centric clinical study of trial of labor after cesarean section]. Zhonghua Fu Chan Ke Za Zhi 2017; 51:581-5. [PMID: 27561936 DOI: 10.3760/cma.j.issn.0529-567x.2016.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To study the feasibility and safety of trial of labor after cesarean section (TOLAC). METHODS Retrospective analysis of five medical center of Guangdong province from January 2011 to December 2015 hospitalized delivery information, compare the same scar TOLAC (research group) with the scar pregnancy (control group) pregnancy outcomes, to study the feasibility and safety of TOLAC. RESULTS (1) During 2011-2015, total delivery 95 600 cases in five medical center, 13 824 cases of thme with uterine scar pregnancy, including 12 027 cases elective repeat cesarean section and 1 797 cases (13.00%, 1 797/13 824) with scar uterus vaginal trial of labor. Among 1 308 cases of vaginal delivery, the success for trial of labor rate was 72.79% (1 308/1 797). From 2011 to 2015, there were increased rate of pregnancy after cesarean section, which were respectively 10.71%, 13.28%, 14.45%, 15.54% and 16.98%. The will of vaginal birth were rising and the rate were respectively 11.85%, 12.25%, 13.49%, 13.82% and 12.93%. (2) There were 489 (27.21%, 489/1 797) cases of scar uterus maternal emergency cesarean section in the trial of labor, reason for "social factors" require for cesarean delivery have 68 cases, the percentage was 13.91% (68/489), compared with control group (7.18%, 206/2 869), the difference was statistically significant difference (χ(2)=27.356, P=0.000). Doctors diagnosed as "aura uterine rupture" in the labor was 11.86% (58/489), compared with that in control group (1.43%, 41/2 869), the differences were statistically significant difference (χ(2)=1 578.223, P=0.000). (3) The incidence of uterine rupture of the research group (0.74%, 9/1 211) was significantly higher than that of control group (0.01%,2/31 200; χ(2)> 2 000, P=0.000). The incidence of postpartum hemorrhage in research group was 6.94% (84/1 211), compared with that in the control group (3.05%, 951/31 200), there was statistically significant difference (χ(2)=16.328, P=0.000). While, there were no statistical significancefor the labor time limit, birth rate of severe asphyxia and neonatal birth weight average differences between two groups (P>0.05). CONCLUSIONS The rate of pregnancy after cesarean section is increasing year by year, and the will of vaginal birth is increasing, while it still are generally low. TOLAC is safe and feasible, but also significantly higher risk, strictly labor monitoring and can proceed fast cesarean delivery in delivery room is an important guarantee of safe delivery.
Collapse
Affiliation(s)
- L Yu
- Department of Obstetrics, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Zhang QB, Jian XD, Su CH. [A case of respiatory failue caused by inalation of dichlorvos and chlorpyrifos poisoning]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2016; 34:692. [PMID: 27866551 DOI: 10.3760/cma.j.issn.1001-9391.2016.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
17
|
Su CH, Tseng H, Lee KS, Tseng TM, Hung SH. Experiences in the treatment of obstructive sialoadenitis with sialendoscopy. B-ENT 2016; 12:199-206. [PMID: 29727124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
PURPOSE The success of stone removal with sialendoscopic lithotripsy in the management of lithiasis-related obstructive sialoadenitis has been reported, but the proper management for patients with non-lithiasis obstructive sialoadenitis remains unclear. This study aims to report experiences in sialendoscopy for the management of obstructive sialoadenitis with and without the presence of stones. METHODS Data from 71 procedures in 66 patients who underwent sialendoscopy for obstructive sialoadenitis were recorded and compared in terms of clinical data, computed tomography (CT) findings, procedural techniques and outcomes. RESULTS The overall specificity rate of CT for detecting sialolithiasis was 91.6%. The complete remission rate was 100% for patients with confirmed sialolithiasis successfully treated with stone removal after endoscopic lithotripsy. For patients with non-sialolithiasis obstructive sialoadenitis of the submandibular gland, the complete remission rate dropped to 22% if no additional treatments were done after a diagnostic sialendoscopy. If sialostents were inserted, the complete remission rate increased to 55%. However, this improvement was very limited in terms of the overall management of the affected parotid gland. CONCLUSION For patients with obstructive sialoadenitis and salivary gland stones, removal of the stones under sialendoscopy will most likely provide complete remission. Patients without stones have much worse treatment outcomes compared to those with true sialolithiasis. Sialostent placement may have the potential to improve treatment outcomes in the management of non-lithiasis obstructive sialoadenitis.
Collapse
|
18
|
Su CH, Lee KS, Tseng TM, Hung SH. Endoscopic Holmium:YAG laser-assisted lithotripsy: A Preliminary Report. B-ENT 2015; 11:57-61. [PMID: 26513949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
PROBLEM/OBJECTIVE Laser-assisted lithotripsy under sialendoscopy has the potential to overcome the limitations of traditional sialendoscopic lithotripsy when facing salivary stones. In this preliminary study, we report our experience with Holmium:YAG laser-assisted lithotripsy. METHODS Data from 11 Asian patients receiving sialendoscopies for laser-assisted lithotripsy performed in our department from August 2013 to June 2014 were recorded and reviewed. RESULTS A total of 18 procedures were performed in 11 Taiwanese patients with symptoms of obstructive sialoadenitis who were diagnosed with sialolithiasis. The sizes of the stones ranged between 3 mm and 13 mm. The endoscopic lithotomy procedures were performed in all 11 patients, and stone fragmentation with the Holmium:YAG laser was done successfully in all patients. All patients were followed for a minimum of 3 months, and there was no evidence of complications or recurrences over the follow up period. CONCLUSION The Holmium:YAG laser allowed successful fragmentation of stones in all 11 patients. Our experience with this procedure supports the use of Holmium:YAG laser-assisted lithotripsy through sialendoscopy in Asian patients.
Collapse
|
19
|
Zheng T, Su CH, Zhao J, Zhang XJ, Zhang TY, Zhang LR, Kan QC, Zhang SJ. Effects of CYP3A5 and CYP2D6 genetic polymorphism on the pharmacokinetics of diltiazem and its metabolites in Chinese subjects. Pharmazie 2013; 68:257-260. [PMID: 23700791] [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: 06/02/2023]
Abstract
PURPOSE To assess the possibility of using CYP2D6 10 +/- CYP3A5*3 as biomarkers to predict the pharmacokinetics of diltiazem and its two metabolites among healthy Chinese subjects. METHODS 41 healthy Chinese were genotyped for CYP3A5 3 and CYP2D6 10, and then received a single oral dose of diltiazem hydrochloride capsules (300 mg). Multiple blood samples were collected over 48 h, and the plasma concentrations of diltiazem, N-desmethyl diltiazem and desacetyl diltiazem were determined by HPLC-MS/MS. The relationships between the genotypes and pharmacokinetics were investigated. RESULTS The pharmacokinetics of diltiazem, N-desmethyl diltiazem were not significantly affected by both CYP3A5 3 and CYP2D6*10 alleles. However, the systemic exposure of the pharmacologyically active metabolites, desacetyl diltiazem, was 2-fold higher in CYP2D6 10/10 genotype carriers than in 1/10 or 1/1 ones (AUC(o-inf) of CYP2D6 1/1, 1/10 and 10/10 are 398.2 +/- 162.9, 371,0 69.2 and 726.2 +/- 468.1 respectively, p <0.05). CONCLUSIONS Two of the most frequent alleles, CYP3A5 3 and CYP2D6 10, among Chinese do not have major impacts on the disposition of diltiazem and N-desmethyl diltiazem. However, the desacetyl diltiazem showed 2-fold accumulation in individuals with CYP2D6 10/10 genotype. Despite this, the effect of genotype of CYP2D6 on clinical outcome of diltiazem treatment is expected to be limited.
Collapse
Affiliation(s)
- T Zheng
- Frontage Laboratories, Inc., Zhengzhou, Henan Province, China
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Tseng YY, Su CH, Lui TN, Yeh YS, Yeh SH. Prospective comparison of the therapeutic effect of teriparatide with that of combined vertebroplasty with antiresorptive agents for the treatment of new-onset adjacent vertebral compression fracture after percutaneous vertebroplasty. Osteoporos Int 2012; 23:1613-22. [PMID: 21769661 PMCID: PMC3332357 DOI: 10.1007/s00198-011-1730-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Accepted: 06/17/2011] [Indexed: 01/25/2023]
Abstract
UNLABELLED Most post-vertebroplasty new-onset adjacent vertebral compression fractures (VCFs) occur within 2-3 months, and antiresorptive agents do not significantly reduce the risk of their occurrence. In opposite mechanism, teriparatide directly stimulates bone formation and improves bone strength and quality faster. The therapeutic effect of teriparatide is better than that of vertebroplasty combined with an antiresorptive treatment and is a potentially useful therapy for new-onset adjacent VCFs after vertebroplasty. INTRODUCTION Following vertebroplasty, patients are at increased risk of new-onset adjacent-level VCFs. The therapeutic effect of antiresorptive agents is too slow, and they are associated with the risk of new VCFs. Teriparatide markedly increases bone formation and strength and reduces the incidence of new-onset VCFs. This prospective cohort study compared the therapeutic effects of teriparatide with those of combined vertebroplasty and an anti-resorber for treating new-onset adjacent VCFs after vertebroplasty. METHODS Fifty patients with adjacent VCFs were randomly assigned to two groups: teriparatide only (group A) and additional vertebroplasty combined with an antiresorptive agent (group B). Relevant clinical data of the two groups were prospectively compared. RESULTS The 22 patients in group A were at higher risk of new VCFs than those in group B (22 patients); they were older and had more pre-existing fractures (p < 0.05). Patients treated with teriparatide had a significantly lower incidence of new-onset VCFs (odds ratio = 0.21; 95% confidence interval, 0.02-2.10). Teriparatide-mediated VCF reduction was 78.57%, which was markedly better than that of group B. The teriparatide group had a significant decrease in the visual analog scale and an increase in the Japanese Orthopedic Association low back pain score after 6 months of treatment (p < 0.05). The increase in lumbar spine BMD was marked in the teriparatide group (21.70% vs. 6.87%) after an 18-month treatment. CONCLUSIONS Treatment of post-vertebroplasty adjacent VCFs with teriparatide (no new vertebroplasty) was more effective than that of repeated vertebroplasties combined with an anti-resorber.
Collapse
Affiliation(s)
- Y-Y Tseng
- Department of Neurosurgery, Shuang Ho Hospital, Taipei Medical University, No 291, Jhongjheng Rd, Jhonghe, New Taipei City, 23561 Taiwan, Republic of China.
| | | | | | | | | |
Collapse
|
21
|
Abstract
The purpose of this study was to explore the influencing factors in the substantive theory of home care for people with schizophrenia in Taiwan. The grounded theory of Strauss and Corbin approach was used. Semi-structured one-to-one in-depth interviews were utilized to collect data. Constant comparative analysis continued during the open, axial and selective coding processes until data saturation occurred. Participants were selected using theoretical sampling, and the final sample in this study consisted of a total of 29 community nurses (18 public health nurses and 11 home health nurses) who provided community mental health home-visiting services. The public health nurses and home health nurses both conducted a total of 16 (eight carers and eight clients) home visits. Four categories and 12 subcategories of influencing factors were identified; these factors have both positive and negative effects on nursing roles and the functions of public health nurses in the mental health home-visiting service in Taiwan. The influencing factors identified support the importance of home care services.
Collapse
Affiliation(s)
- J-F Cheng
- School of Nursing, Department of Nursing, China Medical University Hospital, Taichung, Taiwan
| | | | | | | |
Collapse
|
22
|
Hung TC, Lu SK, Su CH, Wu YJ, Hsieh CL, Lee WH, Tsai CH, Yeh HI. Remodeling of rabbit abdominal aorta and Cx43 gap junctions after stent placement: effect of balloon injury plus cholesterol-enriched diet. INT ANGIOL 2012; 31:62-69. [PMID: 22330626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To examine the effect of stenting and cholesterol-enriched diet (CED) on vascular remodeling, including the expression of connexin43 (Cx43) gap junctions in smooth muscle cells (SMC). METHODS Rabbits abdominal aortae were either implanted stent made of 316 stainless steel (group 1) or denuded followed by stent placement 28 days later (groups 2 and 3). Animals were given normal chow except those of group 3, which were fed CED after the denudation. Eight weeks later, the development of neointima and the expression of connexin43 (Cx43) were examined. In parallel, human aortic SMC were grown on 316 stainless steel or treated with C-reactive protein (CRP) followed by analysis of Cx43. RESULTS The results showed that, serum CRP levels became transiently elevated after denudation and stent implantation. For the stented aortic segments, the dimensions of neointima were group 3 > group 2 > group 1 (P<0.05). In groups 1 and 2, Cx43 gap junctions are less in amount in neointima of the stented segment, compared to the unstented upstream neointima or medial layer (all P<0.01). In culture experiments, Cx43 in SMC grown on stent material was up-regulated in growth medium but down-regulated in differentiation medium, and CRP did not affect Cx43 expression. CONCLUSION Vascular remodeling post stent implantation varied according to the presence of balloon injury, CED, or both. Cx43 expression in SMC is altered after exposure to stent and the regulation depended on the milieu.
Collapse
MESH Headings
- Angioplasty, Balloon/instrumentation
- Animals
- Aorta, Abdominal/injuries
- Aorta, Abdominal/metabolism
- Aorta, Abdominal/pathology
- C-Reactive Protein/metabolism
- Cell Culture Techniques
- Cells, Cultured
- Cholesterol, Dietary/blood
- Connexin 43/metabolism
- Disease Models, Animal
- Gap Junctions/metabolism
- Gap Junctions/pathology
- Hypercholesterolemia/blood
- Hypercholesterolemia/complications
- Hypercholesterolemia/etiology
- Male
- Muscle, Smooth, Vascular/injuries
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Neointima/etiology
- Neointima/metabolism
- Neointima/pathology
- Prosthesis Design
- Rabbits
- Stainless Steel
- Stents
- Time Factors
- Vascular System Injuries/etiology
- Vascular System Injuries/metabolism
- Vascular System Injuries/pathology
Collapse
Affiliation(s)
- T C Hung
- Department of Internal Medicine and Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Su CH, Yu FJ, Tsai HL, Wang JY. Endoscopic closure of colonic fistulas in colon cancer patients using a combination of hemoclips and endoloops: two case reports. Tech Coloproctol 2011; 18:205-8. [PMID: 22124764 DOI: 10.1007/s10151-011-0793-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 11/16/2011] [Indexed: 10/15/2022]
Abstract
Chronic colon fistulas, which commonly result from operative complications, are generally managed surgically. We present an endoscopic technique of fistula closure that involves the combined use of hemoclips and endoloops. Two consecutive patients with colonic fistulas that were refractory to conservative treatment were successfully managed with this new endoluminal technique. This minimally invasive treatment modality affords accurate localization of the fistula orifice and results in a low mortality and morbidity rates.
Collapse
Affiliation(s)
- C-H Su
- Division of Gastrointestinal and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | | | | |
Collapse
|
24
|
Chen RS, Yang TH, Chen HY, Chen LC, Chen KH, Yang YJ, Su CH, Lin CR. Photoconduction mechanism of oxygen sensitization in InN nanowires. Nanotechnology 2011; 22:425702. [PMID: 21934198 DOI: 10.1088/0957-4484/22/42/425702] [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: 05/10/2023]
Abstract
The photoconduction (PC) mechanism in indium nitride (InN) nanowires (NWs) has been investigated via environment-, temperature-, and power-dependent measurements. The adsorbed oxygen-induced modulation of the surface state is proposed to be the leading factor in the long lifetime or high gain transport and in sensitizing photocurrent generation in the InN NWs. The electron trapping effect by adsorbed oxygen can be verified by the increased activation energy from 33 ± 4 (in vacuum) to 58 ± 2 meV (in oxygen). The observed supralinear power dependence of photocurrent also suggests the presence of acceptor states that influence the carrier recombination behavior and compensate the thermal carriers in the InN NWs. The potential influence of native oxide on the molecule-sensitive PC in this nitride nanomaterial is also inferred.
Collapse
Affiliation(s)
- R S Chen
- Graduate Institute of Applied Science and Technology, National Taiwan University of Science and Technology, Taipei 10607, Taiwan.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
|
26
|
Luo CW, Lee CC, Li CH, Shih HC, Chen YJ, Hsieh CC, Su CH, Tzeng WY, Wu KH, Juang JY, Uen TM, Chen SP, Lin JY, Kobayashi T. Ordered YBCO sub-micron array structures induced by pulsed femtosecond laser irradiation. Opt Express 2008; 16:20610-20616. [PMID: 19065200 DOI: 10.1364/oe.16.020610] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We report on the formation of organized sub-micron YBa(2)Cu(3)O(7) (YBCO) dots induced by irradiating femtosecond laser pulses on YBCO films prepared by pulse laser deposition with fluence in the range of 0.21 approximately 0.53 J/cm(2). The morphology of the YBCO film surface depends strongly on the laser fluences irradiated. At lower laser fluence (approximately 0.21 J/cm(2)) the morphology was pattern of periodic ripples with sub-micrometer spacing. Slightly increasing the laser fluence to 0.26 J/cm(2) changes the pattern into organized sub-micron dots with diameters ranging from 100 nm to 800 nm and height of 150 nm. Further increase of the laser fluence to over 0.32 J/cm(2), however, appeared to result in massive melting and led to irregular morphology. The mechanism and the implications of the current findings will be discussed. Arrays of YBCO sub-micron dots with T(c) = 89.7 K were obtained.
Collapse
Affiliation(s)
- C W Luo
- Department of Electrophysics, National Chiao-Tung University, Hsinchu, Taiwan, ROC.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Untch M, Gelber RD, Jackisch C, Procter M, Baselga J, Bell R, Cameron D, Bari M, Smith I, Leyland-Jones B, de Azambuja E, Wermuth P, Khasanov R, Feng-Yi F, Constantin C, Mayordomo JI, Su CH, Yu SY, Lluch A, Senkus-Konefka E, Price C, Haslbauer F, Suarez Sahui T, Srimuninnimit V, Colleoni M, Coates AS, Piccart-Gebhart MJ, Goldhirsch A. Estimating the magnitude of trastuzumab effects within patient subgroups in the HERA trial. Ann Oncol 2008; 19:1090-6. [PMID: 18296421 DOI: 10.1093/annonc/mdn005] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Trastuzumab (Herceptin(R)) improves disease-free survival (DFS) and overall survival for patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. We aimed to assess the magnitude of its clinical benefit for subpopulations defined by nodal and steroid hormone receptor status using data from the Herceptin Adjuvant (HERA) study. PATIENTS AND METHODS HERA is an international multicenter randomized trial comparing 1 or 2 years of trastuzumab treatment with observation after standard chemotherapy in women with HER2-positive breast cancer. In total, 1703 women randomized to 1-year trastuzumab and 1698 women randomized to observation were included in these analyses. Median follow-up was 23.5 months. The primary endpoint was DFS. RESULTS The overall hazard ratio (HR) for trastuzumab versus observation was 0.64 [95% confidence interval (CI) 0.54-0.76; P < 0.0001], ranging from 0.46 to 0.82 for subgroups. Estimated improvement in 3-year DFS in subgroups ranged from +11.3% to +0.6%. Patients with the best prognosis (those with node-negative disease and tumors 1.1-2.0 cm) had benefit similar to the overall cohort (HR 0.53, 95% CI 0.26-1.07; 3-year DFS improvement +4.6%, 95% CI -4.0% to 13.2%). CONCLUSIONS Adjuvant trastuzumab therapy reduces the risk of relapse similarly across subgroups defined by nodal status and steroid hormone receptor status, even those at relatively low risk for relapse.
Collapse
Affiliation(s)
- M Untch
- Helios Klinikum Berlin Buch, Academic Hospital of the University Charite Berlin, Berlin, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
The 14-3-3sigma, upregulated by p53 in response to DNA damage, can have a positive-feedback impact driving p53 activities and is a human cancer epithelial marker downregulated in various tumors. However, the precise roles of 14-3-3sigma during tumorigenesis are not well characterized. Here, we show that 14-3-3sigma is a critical regulator of murine double minute oncogene (MDM2). 14-3-3sigma interacts with MDM2 at the RING domain. The C-terminal region of 14-3-3sigma binds to MDM2 very efficiently. Importantly, 14-3-3sigma overexpression leads to destabilization of MDM2 through enhancing MDM2 self-ubiquitination and accelerating turnover rate. Conversely, loss of 14-3-3sigma results in a significant increase in MDM2 protein. Moreover, live-cell images indicated that 14-3-3sigma can affect the location of MDM2 from the nucleus to the cytoplasm, and that MDM2-mediated cytoplasmic localization of p53 can be reversed by the presence of 14-3-3sigma. Significantly, we further showed that 14-3-3sigma causes MDM2 downregulation, thereby stabilizing p53 and inhibiting tumor growth in animal tumors. Also, 14-3-3sigma blocks MDM2-mediated retinoblastoma degradation and p53 NEDDylation. Our results provide evidence that 14-3-3sigma is a pivotal MDM2 regulator involved in blocking a variety of activities of MDM2.
Collapse
Affiliation(s)
- H-Y Yang
- Department of Molecular and Cellular Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Su CH, Hsieh YW, Gau CS. Spontaneous ADRs Reports of Drug-Induced Renal and Urinary Disorders in Taiwan. Drug Saf 2007. [DOI: 10.2165/00002018-200730100-00083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
30
|
Abstract
Here we report the phase behavior of poly(9,9-di-n-hexyl-2,7-fluorene) (PFH), which previously received little attention as compared to its homologues poly(9,9-di-n-octyl-2,7-fluorene) (PFO) and poly(9,9-di-(2'-ethylhexyl)-2,7-fluorene) (PFEH). By means of differential scanning calorimetry, X-ray diffraction, and electron microscopy, we show that there exist four different phases in PFH. The as-cast film is mainly composed of a mesomorphic beta phase with layer spacing of ca. 1.4 nm. This beta phase is inherently metastable and, upon heating above 175 degrees C, transforms into a crystalline (alpha) form that melts into a nematic (N) liquid above 250 degrees C. Upon stepwise cooling, the nematic melt crystallizes into the alpha phase first, followed by solid-solid transformation into another crystalline (alpha') form. Unit cell structure of the alpha form is monoclinic whereas that of the alpha' form is triclinic, but departures from strict orthogonality are slight (by ca. 6 degrees). These observations not only support our previous assignment of two crystalline forms (both orthorhombic in structure) in PFO but also provide insights to the crystalline nature of the polyfluorene series.
Collapse
Affiliation(s)
- S H Chen
- Department of Materials Science and Engineering, National Dong Hwa University, Hualien 974, Taiwan
| | | | | | | |
Collapse
|
31
|
Akowuah EF, Gray C, Lawrie A, Sheridan PJ, Su CH, Bettinger T, Brisken AF, Gunn J, Crossman DC, Francis SE, Baker AH, Newman CM. Ultrasound-mediated delivery of TIMP-3 plasmid DNA into saphenous vein leads to increased lumen size in a porcine interposition graft model. Gene Ther 2005; 12:1154-7. [PMID: 15829995 DOI: 10.1038/sj.gt.3302498] [Citation(s) in RCA: 43] [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: 11/09/2022]
Abstract
Progressive saphenous vein graft (SVG) narrowing and occlusion remains a major limitation of coronary artery bypass grafting and is an important target for gene therapy. Ex vivo adenoviral gene transfer of tissue inhibitor of metalloproteinase 3 (TIMP-3) reduces adverse SVG remodelling postarterialization, but concerns remain over the use of viral vectors in patients. Ultrasound exposure (USE) in the presence of echocontrast microbubbles (ECM) substantially enhances nonviral gene delivery. We investigated the effects of ultrasound-enhanced gene delivery (UEGD) of TIMP-3 plasmid on vascular remodelling in porcine SVG. Maximal luciferase activity (3000-fold versus naked plasmid alone) and TIMP-3 transgene expression in porcine vascular smooth muscle cells in vitro was achieved using USE at 1 MHz, 1.8 mechanical index (MI), 6% duty cycle (DC) in the presence of 50% (v/v) BR14 ECM (Bracco). These conditions were therefore utilized for subsequent studies in vivo. Yorkshire White pigs received carotid interposition SVG that were untransfected or had undergone ex vivo UEGD of lacZ (control) or TIMP-3 plasmids. At 28 d postgrafting, lumen and total vessel area were significantly greater in the TIMP-3 group (10.1+/-1.2 and 25.5+/-2.2 mm2, respectively) compared to untransfected (6.34+/-0.5 and 20.8+/-1.9 mm2) or lacZ-transfected (6.1+/-0.7 and 19.7+/-1.2 mm2) controls (P<0.01). These data indicate that nonviral TIMP-3 plasmid delivery by USE achieves significant biological effects in a clinically relevant model of SV grafting, and is the first study to demonstrate the potential for therapeutic UEGD to prevent SVG failure.
Collapse
Affiliation(s)
- E F Akowuah
- Cardiovascular Research Unit, Division of Clinical Sciences (North), Clinical Sciences Centre, University of Sheffield, Northern General Hospital, Sheffield, UK
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Abstract
We obtain analytical solutions for the perturbed shock paths induced by time-varying random motions of a piston moving inside an adiabatic tube of constant area. The variance of the shock location grows quadratically with time for early times and switches to linear growth for longer times. The analytical results are confirmed by stochastic numerical simulations, and deviations for large random piston motions are established.
Collapse
Affiliation(s)
- G Lin
- Division of Applied Mathematics, Brown University, 182 George Street, Providence, RI 02912, USA
| | | | | |
Collapse
|
33
|
Lee CS, Lee YJ, Liu HF, Su CH, Chang SC, Wang BR, Chen TL, Liu TL. Association of CTLA4 gene A-G polymorphism with rheumatoid arthritis in Chinese. Clin Rheumatol 2004; 22:221-4. [PMID: 14505215 DOI: 10.1007/s10067-003-0720-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2002] [Accepted: 03/14/2003] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the allelic association of a single nucleotide polymorphism in exon 1 of the cytotoxic T-lymphocyte antigen-4 (CTLA4) gene with rheumatoid arthritis (RA) in Chinese people. One hundred and eighty-six unrelated adults with RA and 203 randomly selected normal adults were studied. All were ethnic Chinese living in Taiwan. The CTLA4 A-G polymorphism was genotyped with a polymerase chain reaction (PCR) and digestion with the restriction enzyme BstEII. The genotype and allele frequencies of CTLA4 in patients with rheumatoid arthritis differed significantly from those of adult controls (P=0.022 and P=0.037, respectively). Genotype CTLA4 49 G/G and allele G were associated with an increased risk of RA (RR=1.72, 95% CI=1.15-2.57, P=0.008; RR=1.39, 95% CI=1.02-1.89, P=0.037, respectively), whereas genotype A/G and allele A were associated with protection against RA (RR=0.58, 95% CI=0.39-0.87, P=0.008 and RR=0.72, 95% CI=0.53-0.98, P=0.037, respectively). We concluded that, the CTLA4 49 A-G polymorphism is associated with RA in Chinese patients from Taiwan.
Collapse
Affiliation(s)
- C-S Lee
- Department of Rheumatology, Mackay Memorial Hospital, Section 2, Chung-San N. Road, Taipei 10449, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Chen SC, Cheung YC, Su CH, Chen MF, Hwang TL, Hsueh S. Analysis of sonographic features for the differentiation of benign and malignant breast tumors of different sizes. Ultrasound Obstet Gynecol 2004; 23:188-193. [PMID: 14770402 DOI: 10.1002/uog.930] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To analyze the value of various sonographic features in differentiating benign from malignant breast tumors of different sizes to improve the diagnostic accuracy in small lesions. METHODS The sonographic features of 1203 histologically confirmed solid breast lesions were prospectively documented with respect to anteroposterior (AP) diameter/width ratio, shape, margin, echogenicity, echotexture, posterior echo and bilateral refraction sign. The sensitivity, specificity and accuracy of breast ultrasound were calculated for lesions grouped according to size (< or = 1, 1.1-2 and > 2 cm). Univariate and multiple logistic regression analyses including calculation of odds ratios for single sonographic features were used to analyze the significance of the different diagnostic features. RESULTS The accuracy of breast sonography in differentiating between benign and malignant tumors < or = 1, 1.1-2 and > 2 cm in size was 75.6%, 86.4% and 88.4%, respectively. Univariate analysis demonstrated that all sonographic features were significant in tumors > or = 1.1 cm. Shape, margin, echogenicity and echotexture were the significant factors in those tumors < or = 1 cm. Multiple logistic regression analysis demonstrated that margin, shape, posterior echo and echogenicity were the significant factors for differential diagnosis in tumors > 2 cm. Echogenicity, margin, shape, bilateral refraction sign and echotexture were the significant factors for tumors 1.1-2 cm. On multiple regression analysis, margin was the only significant factor for tumors < or = 1 cm. CONCLUSION Tumor margin is the most important sonographic feature in evaluating breast lesions in any size group. With the combination of significant factors and emphasis on specific features according to size of lesion, the diagnostic accuracy of ultrasound for the differential diagnosis of malignant and benign tumors may be improved.
Collapse
Affiliation(s)
- S-C Chen
- Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan, Republic of China.
| | | | | | | | | | | |
Collapse
|
35
|
Chen SC, Cheung YC, Lo YF, Chen MF, Hwang TL, Su CH, Hsueh S. Sonographic differentiation of invasive and intraductal carcinomas of the breast. Br J Radiol 2003; 76:600-4. [PMID: 14500273 DOI: 10.1259/bjr/55630504] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [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: 11/05/2022] Open
Abstract
The purpose of this study is to evaluate the diagnostic ability of ultrasound and define the sonographic features of symptomatic intraductal and invasive breast carcinoma. To achieve this the ultrasound features of 488 invasive carcinomas and 65 non-screening detected intraductal carcinomas were compared retrospectively. The features included size, AP/W (anteroposterior diameter/width) ratio, shape, margin, internal echogenicity, internal echotexture, posterior acoustic transmission, bilateral edge shadowing sign and calcifications. The sensitivity and specificity of the detection of calcifications by ultrasound in comparison with mammography were also studied. The accuracy of ultrasound diagnosis is 92.0% for invasive carcinoma of breast and 84.8% for intraductal carcinoma. Differentiation of ultrasound features of intraductal and invasive carcinoma can be based on the internal hypoechogenicity, loss of bilateral edge shadowing, posterior acoustic transmission, irregular shape and non-uniform internal echotexture with odds ratio of 0.3, 0.3, 0.4, 0.5 and 0.5, respectively. Internal echogenicity was the only significant differentiating factor on multiple logistic regression analysis. Non-comedo type ductal carcinoma in situ can be differentiated from comedo type by irregular shape with odds ratio of 0.3. The sensitivity, specificity and accuracy rate for the detection of calcifications in invasive carcinomas by ultrasound were 65.1%, 61.9% and 63.2%; in comedo type intraductal carcinoma 62.5%, 66.7% and 63.6%, and in non-comedo type intraductal carcinoma 30.0%, 86.7% and 64.0%, respectively. The ultrasound appearance of non-screening detected intraductal carcinoma is relatively isoechoic in comparison with invasive carcinoma. More than 60% of microcalcifications in comedo type intraductal carcinoma can be accurately demonstrated by ultrasound. However, the role of ultrasound in detecting symptomatic intraductal carcinoma warrants further study.
Collapse
Affiliation(s)
- S-C Chen
- Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan
| | | | | | | | | | | | | |
Collapse
|
36
|
Tao PL, Yeh GC, Su CH, Wu YH. Co-administration of dextromethorphan during pregnancy and throughout lactation significantly decreases the adverse effects associated with chronic morphine administration in rat offspring. Life Sci 2001; 69:2439-50. [PMID: 11681630 DOI: 10.1016/s0024-3205(01)01316-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [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: 11/24/2022]
Abstract
In this study, we have focused our investigation of the facts whether co-administration of a NMDA antagonist dextromethorphan (DM) with morphine during pregnancy and throughout lactation could prevent the adverse effects associated with chronic morphine administration in rat offspring. Adult female Sprague-Dawley rats were randomly separated into four groups and were received subcutaneous injection of either saline, morphine, morphine + dextromethorphan or dextromethorphan twice a day and progressively increased 1 mg/kg at 7-day intervals from a beginning dose of 2 mg/kg for both morphine and dextromethorphan. The rats were mated between days 7 and 8. Administration of drugs was continued during pregnancy. After rat offspring were born, the doses of morphine or dextromethorphan injected into the maternal rats were increased by 1 mg/kg every two weeks till the offspring were 30 day old. The results showed that mortality of morphine group is much higher than control group. The offspring of morphine group weighed significantly less than control group on postnatal day 14 (p14), p30 or p60. The antinociceptive effect of morphine on p14 rats was reduced in the morphine group and indicated the development of morphine tolerance. The hippocampal NMDA receptor densities have been shown decreased on p14 rats. The precipitated withdrawal symptoms were assessed on p7 rats. Rats in morphine group showed greater frequency of abdominal stretch and wet dog shake in 2 hr than control group. On the other hand, co-administration of DM with morphine effectively prevented all these adverse effects of morphine to the offspring rats. DM co-administered with morphine also partially prevented the development of morphine tolerance in maternal rats. If this effect of dextromethorphan is applied to clinical pregnant patients with morphine addiction or chronic pain, it will have a great value for the benefit of their children.
Collapse
Affiliation(s)
- P L Tao
- Department of Pharmacology, National Defense Medical Center, Taipei, Taiwan, Republic of China.
| | | | | | | |
Collapse
|
37
|
Wang JC, Hu SH, Su CH, Lee TM. Antitumor and immunoenhancing activities of polysaccharide from culture broth of Hericium spp. Kaohsiung J Med Sci 2001; 17:461-7. [PMID: 11842649] [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: 02/23/2023] Open
Abstract
The fruiting body and culture broth of many edible mushrooms contain water-soluble polysaccharides. Numerous researchers have reported that these polysaccharides have immunoenhancing effects. In this study, Hericium erinaceus and Hericium laciniatum were separately cultivated in a shaker at 25 degrees C for 25 days. Polysaccharides were extracted from the culture broth. The molecular weights were larger than 1 x 10(5) k Da and their polysaccharide components were mainly glucose in H. erinaceus and galactose in H. laciniatum. Furthermore, we investigated these two purified water-soluble polysaccharides for their anti-artificial pulmonary metastatic tumor and immunoenhancing effects in ICR mice. The results revealed that both polysaccharides had significant anti-artificial pulmonary metastatic tumor effects in mice (p < 0.05). Additionally, the polysaccharide from H. erinaceus was more effective than that from H. laciniatum. However, both of the polysaccharides enhanced the increase of T cells and macrophages. The numbers of CD4+ cells and macrophages were significantly higher in the test group than in the control group (p < 0.05). From our results, no differences were found between the two purified water-soluble polysaccharides in the antitumor effects and immunoenhancing activities (p > 0.05).
Collapse
Affiliation(s)
- J C Wang
- Department of Food Sanitation, Tajen Institute of Technology, 20, Wei-Shin Rd., Shin-Erh Villege, Yen-Pu Hsing, Ping Tung, Taiwan.
| | | | | | | |
Collapse
|
38
|
Ou MC, Pang CC, Chen FM, Su CH, Ou D. Antibiotic treatment for threatened abortion during the early first trimester in women with previous spontaneous abortion. Acta Obstet Gynecol Scand 2001; 80:753-6. [PMID: 11531620 DOI: 10.1034/j.1600-0412.2001.080008753.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 11/23/2022]
Abstract
BACKGROUND We retrospectively examined the usefulness of antibiotic therapy for management of first-trimester threatened abortion in women with previous spontaneous abortion. METHODS From 1993 through 1999, women with first-trimester threatened abortion received antibiotic therapy. Only those with gestational age less than 9 weeks and previous spontaneous abortion were included in this analysis. Women with mild abdominal cramping received amoxicillin plus erythromycin for 1 week; those with severe abdominal pain received amoxicillin plus clindamycin for 1 week. Recurrence was documented on the basis of either lower abdominal pain or vaginal bleeding. RESULTS Of the 23 women included, 15 (65%) had abnormal vaginal flora (a score above 4, Nugent's criteria). Seven of 16 women who received amoxicillin plus clindamycin and three of seven who received amoxicillin plus erythromycin had complete resolution of lower abdominal pain and vaginal bleeding without recurrence (p=1). The recurrence rate was higher, though not significantly, in women with abnormal bacterial vaginal flora (8/15 vs. 2/8, p=0.379). Twenty-two (96%) of the 23 pregnancies were carried to term, with no identifiable neonatal anomalies. CONCLUSIONS These results suggest the usefulness of early antibiotic therapy in preventing pregnancy loss in women with threatened abortion early in the first trimester, and warrant further clinical trials.
Collapse
Affiliation(s)
- M C Ou
- Department of Obstetrics and Gynecology, Su Woman Hospital, Taipei 108, Taiwan
| | | | | | | | | |
Collapse
|
39
|
Shyr YM, Su CH, Wu CW, Lui WY. Randomized trial of gastrojejunostomy with duodenal partition versus antrectomy in unresectable periampullary cancer. Zhonghua Yi Xue Za Zhi (Taipei) 2001; 64:443-50. [PMID: 11720142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND A newly-designed gastrojejunostomy with duodenal partition was hypothesized to be a relatively easier and safer gastric bypass procedure in interrupting the "food reentry", as compared with antrectomy, for patients with unresectable periampullary cancer. METHODS Thirty patients with unresectable periampullary malignancy were randomized to receive gastrojejunostomy with either duodenal partition or antrectomy, in addition to biliary bypass, to compare surgical risk and efficacy of the gastric bypass between these two groups. RESULTS Gastrojejunotomy with either duodenal partition or antrectomy could significantly shorten the gastric emptying time 6 weeks after operation. There was no significant difference between these two groups in gastric outlet obstruction (GOO) symptoms, gastric emptying time, and time for resuming oral diet intake after operation. The median operation time was shorter in the duodenal partition group (180 min) than in the antrectomy group (240 min), p < 0.01. The median blood loss was less in the duodenal partition group (250 ml) than in the antrectomy group (400 ml), (p = 0.01). Complications occurred in 3 (20%) patients with duodenal partition and in 7 (47%) patients with antrectomy, (p = 0.25). One duodenal stump leakage occurred in antrectomy group. Surgical mortality occurred in 2 patients with antrectomy. CONCLUSIONS Duodenal partition, with shorter operation time and less blood loss, had similar efficacy with antrectomy in correction of GOO. Therefore, duodenal partition could be a relatively easier and safer alternative to antrectomy in interrupting the "food reentry" in gastrojejunostomy for patients with unresectable periampullary cancer.
Collapse
Affiliation(s)
- Y M Shyr
- Department of Surgery, Taipei Veterans General Hospital, Taiwan, ROC.
| | | | | | | |
Collapse
|
40
|
Abstract
SACCHACHITIN membrane, a weavable skin substitute made from the residual fruiting body of Ganoderma tsugae, has been demonstrated to promote skin wound healing. Prior to its clinical application, it is critical to learn more about any possible cytotoxicity, immunogenicity, or allergy response, and at least some of its mechanism(s) of action(s). In the present studies, it has been found that SACCHACHITIN suspension at less than 0.05% shows no cytotoxicity to the primary culture of rat fibroblasts. However, at higher concentrations (> or = 0.1%), it does reduce the growth of fibroblasts, based on MTT assays. This might be caused by positive charges on chitin molecules that are too strong, and may be harmful to the cell membrane. SACCHACHITIN showed no immunogenicity after it was inoculated into rats three times; however, the unmodified, purified rabbit type I and type II collagens did. Subcutaneous injection of SACCHACHITIN suspension into rats showed no gross allergic responses on skin. Nevertheless, it did cause local acute inflammation, as observed by histological investigation. This is similar to what occurred in the wound site covered with SACCHACHITIN membrane. The chemotactic effect of SACCHACHITIN was exhibited in both intact and wounded skin tissues. This may be one of the initial beneficial effects of SACCHACHITIN membrane to wound healing. The rapid acute inflammatory process was followed by the appearance of angiogenesis and granulation tissue formation, which occurred earlier than it normally would. Coverage of the wound area with SACCHACHITIN membrane also induced an earlier formation of scar tissue to replace the granulation tissue. A 1.5 x 1.5 cm(2) wound area covered by SACCHACHITIN completely healed by 21 days, while that covered with cotton gauze did not. Therefore, SACCHACHITIN is a safe biomaterial for use as a wound dressing for skin healing. Its promoting action for wound healing might be due to its chemotactic effect for inflammatory cells. This, in turn, may facilitate subsequent angiogenesis, granulation tissue formation, and faster new tissue formation, leading to faster wound healing.
Collapse
Affiliation(s)
- W S Hung
- Graduate Institute of Cell and Molecular Biology, Taipei Medical University, 250 Wu-Hsing Street, Taipei, Taiwan 110
| | | | | | | | | | | |
Collapse
|
41
|
Chen KT, Su YC, Lin JG, Hsin LH, Su YP, Su CH, Li SY, Cheng JH, Mao SJ. Identification of Atractylodes plants in Chinese herbs and formulations by random amplified polymorphic DNA. Acta Pharmacol Sin 2001; 22:493-7. [PMID: 11747753] [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: 02/22/2023] Open
Abstract
AIM An efficient, precise, and sensitive method for identifying Atractylodes plants has been established and will contribute significantly to quality control and scientific analysis in Chinese traditional medicine. METHODS Twenty primers were applied for setting up the RAPD (randomly amplified polymorphic DNA) markers of Atractylodes plants, Atractylodes lancea DC (A lancea DC), Atractylodes japonica Koidz (A japonica K), and Atractylodes ovata DC (A ovata DC). The primer OPF03, OPF05, and OPF14 could discriminate them successfully. The results were also able to apply on the Chinese formulations with Atractylodes purchased from local markets. RESULTS RAPD was used to investigate phylogenetic relationships among and within closely related species. RAPD analysis reflects heritable changes in the nucleotides sequence in both the coding and noncoding regions, because it is conducted directly from the DNA level. This work first conducted RAPD analysis of Atractylodes plants to establish their RAPD makers. CONCLUSION The RAPD markers could be applied extensively in the Chinese herbal formulations.
Collapse
Affiliation(s)
- K T Chen
- Department of Cosmetics Application and Management, Department of Chemical Engineering, Chin-min College, Miao-li 351, Taiwan, China
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Wu JJ, Huang MS, Tang GJ, Kao WF, Shih HC, Su CH, Lee CH. Hemodynamic Response of Modified Fluid Gelatin Compared with Lactated Ringer's Solution for Volume Expansion in Emergency Resuscitation of Hypovolemic Shock Patients: Preliminary Report of a Prospective, Randomized Trial. World J Surg 2001; 25:598-602. [PMID: 11369986 DOI: 10.1007/s002680020081] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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: 10/26/2022]
Abstract
The objective of this study was to compare the cardiac and hemodynamic responses to a rapid infusion of 1000 ml of modified fluid gelatin (group A) or 1000 ml of lactated Ringer's solution (group B) in emergency room patients suffering from shock. This prospective, randomized, open, noncrossover study was performed at a medical center university hospital in a surgical resuscitation room in the emergency department. The subjects were 34 patients with either hypovolemic or neurogenic shock who were admitted to the emergency room. A resuscitation protocol according to Advanced Trauma Life Support (ATLS) with an additional central venous line or Swan-Ganz catheters for hemodynamic monitoring was used. Physical parameters and hemodynamic variables were measured at baseline and 15 minutes, 30 minutes, and 1 hour after the infusion of each fluid. In both groups the mean arterial blood pressure (MAP), systolic and diastolic pressure, central venous pressure (CVP), and pulmonary artery occlusion pressure (PAOP) increased significantly. The CVP and PAOP increased significantly more in the modified fluid gelatin resuscitation group. In patients with traumatic or neurogenic shock due to acute volume deficiency, there was significantly better hemodynamic improvement, judged by CVP and PAOP measurements using the modified fluid gelatin for volume replacement than with lactated Ringer's solution during the first hour of resuscitation.
Collapse
Affiliation(s)
- J J Wu
- Emergency Department, Veterans General Hospital-Taipei, National Yang-Ming University, No. 201, Shih-pai Road, Section 2, Taipei, Taiwan.
| | | | | | | | | | | | | |
Collapse
|
43
|
Su CH, Yang YZ, Ho HO, Hu CH, Sheu MT. High-performance liquid chromatographic analysis for the characterization of triterpenoids from Ganoderma. J Chromatogr Sci 2001; 39:93-100. [PMID: 11277258 DOI: 10.1093/chromsci/39.3.93] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
A high-performance liquid chromatographic (HPLC) analysis of triterpenoids from Ganoderma is developed and validated in an attempt to explore a way to differentiate a number of species of the genus Ganoderma. Results show that 64 samples examined in this study could be divided into 18 groups based on characteristics of the HPLC pattern of triterpenoids. This result also conforms with those of the morphological examination and the interfertility test by di-monokaryotic mating. The HPLC analysis of triterpenoids further reveals that differentiation among samples from three different regions each of the two species G. lucidum and G. tsugae is workable. Even then, an incorrect designation is found for two of the groups of samples that were originally classified as G. resinaceum but showed different morphological characteristics and mating incompatibility. In conclusion, an HPLC analysis of triterpenoids is a simple and easy way to differentiate among different species of the genus Ganoderma.
Collapse
Affiliation(s)
- C H Su
- Center for Biotechnical Development and Research, Taipei Medical University, Taiwan, ROC
| | | | | | | | | |
Collapse
|
44
|
Shyr YM, Su CH, Wu CW, Lui WY. Reappraisal of surgical risk and prognosis for periampullary lesions after pancreaticoduodenectomy. Zhonghua Yi Xue Za Zhi (Taipei) 2001; 64:84-94. [PMID: 11355332] [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 Pancreaticoduodenectomy remains a high-risk and formidable challenge to many surgeons. This study reappraised the surgical risk and prognosis for periampullary lesions in patients undergoing pancreaticoduodenectomy before and after 1990. METHODS Data on 308 patients with periampullary lesions undergoing pancreaticoduodenectomy were analyzed. The surgical risk was assessed by a variety of factors. Prognoses for periampullary cancers were determined and compared. RESULTS The overall surgical mortality, morbidity and pancreatic leakage were 12.7%, 47.7% and 14.9% respectively. Surgical morbidity (43.5% vs. 51.6%) and pancreatic leakage (12.9% vs. 16.8%) did not change significantly before 1990 and after 1990. Surgical mortality significantly decreased from 17.1% before 1990 to 8.7% after 1990 (p = 0.043). Surgeons having more experience in performing pancreaticoduodenectomy (count > 20) made significantly lowest rates of surgical mortality, pancreatic leakage and bile leakage, as compared with those having performed this surgery with medium count (10-20) or low count (< 10). Statistically, pancreatic leakage was highly associated with operative mortality, (p < 0.001). As analysed by multivariate logistic regression, the most independent risk factor of surgical mortality after pancreaticoduodenectomy was pancreatic leakage (odds ratio = 12.1), followed by date of operation (odds ratio = 2.5). The 5-year survival rate for overall periampullary cancers was 23.0%, with the highest in ampulla of Vater cancer (32.7%), followed by duodenal cancer (18.0%), distal common bile duct cancer (12.3%) and pancreatic head cancer (5.5%) (p < 0.001). CONCLUSIONS Surgical morbidity following pancreaticoduodenectomy remains high and unchanged while surgical mortality has significantly reduced. Pancreatic leakage is the most independent risk factor of surgical mortality. Patients with periampullary lesions appear to benefit from the experience of surgeons. The overall 5-year survival is most favorable for ampulla of Vater cancer and worst for pancreatic head cancer.
Collapse
Affiliation(s)
- Y M Shyr
- Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan
| | | | | | | |
Collapse
|
45
|
Yang CS, Shyr YM, Chiu CT, Su CH, Lin CP, Lin JT. Non-functioning islet cell tumors of the pancreas--a multicentric clinical study in Taiwan. Hepatogastroenterology 2000; 47:1747-9. [PMID: 11149047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND/AIMS Islet cell tumors of the pancreas are rare. Functioning tumors are characterized by the symptoms induced by the hormones they secrete. The clinical behaviors of non-functioning tumors are quite different. In this retrospective study, we scrutinized 16 patients with non-functioning islet cell tumor in three tertiary university hospitals in Taiwan during a 20-year period. METHODOLOGY There were 12 women and 4 men with a mean age of 47 years. Body-weight loss, abdominal pain and palpable mass were the most frequent symptoms. RESULTS The mean size of these tumors was 8.9 cm in diameter. Ten tumors were located at the tail of pancreas, the other 6 located at the head. Except for hyperbilirubinemia in 2 patients, none of the patients with non-functioning islet cell tumor showed abnormalities of laboratory data including serum tumor markers. Preoperative detection of these tumors by imaging modalities was not difficult due to the large size of the tumors. However, differentiation with functioning tumor or ductal cell carcinoma required clinical and imaging correlation. Fourteen tumors were malignant including 8 with regional lymph nodes involvement, 3 with locally microscopic invasion, 2 with hepatic metastasis and 2 with nearby organ invasion. CONCLUSIONS Even with its malignant behavior, non-functioning islet cell tumor still possessed a good prognosis after adequate surgical removal in comparison with a higher mortality rate of ductal carcinoma of the pancreas.
Collapse
Affiliation(s)
- C S Yang
- Department of Internal Medicine, En Chu Kong Hospital, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
46
|
Sheu JR, Hsiao G, Lee C, Chang W, Lee LW, Su CH, Lin CH. Antiplatelet activity of Staphylococcus aureus lipoteichoic acid is mediated through a cyclic AMP pathway. Thromb Res 2000; 99:249-58. [PMID: 10942791 DOI: 10.1016/s0049-3848(00)00244-9] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, Gram-positive Staphylococcus aureus lipoteichoic acid (LTA) dose dependently (0.1-1.0 microg/mL) and time dependently (10-60 min) inhibited platelet aggregation in human platelets stimulated by agonists (i.e., thrombin and collagen). LTA also dose dependently inhibited intracellular Ca(2+) mobilization in human platelets stimulated by collagen. In addition, LTA (0.5 and 1.0 microg/mL) dose dependently increased the formation of cyclic AMP but not cyclic GMP in platelets. LTA (0.5 and 1.0 microg/mL) did not significantly increase the production of nitrate within a 10-min incubation period. Rapid phosphorylation of a platelet protein of M(r) 47,000, a marker of protein kinase C activation, was triggered by PDBu (0.03 microM). This phosphorylation was dose dependently inhibited by LTA (0.5 and 1.0 microg/mL) within a 10-min incubation period. Furthermore, LTA (0.5 and 1.0 microg/mL) also inhibited platelet aggregation induced by PDBu (0.03 microM) in human platelets. These results indicate that the antiplatelet activity of LTA may be involved in the increase of cyclic AMP, leading to inhibition of intracellular Ca(2+) mobilization and protein kinase C activity. Therefore, LTA-mediated alteration of platelet function may contribute to bleeding diathesis in septicemic and endotoxemic patients.
Collapse
Affiliation(s)
- J R Sheu
- Graduate Institute of Medical Sciences, Department of Pharmacology, Taipei Medical College, Taipei, Taiwan.
| | | | | | | | | | | | | |
Collapse
|
47
|
Liu KY, Shyr YM, Su CH, Wu CW, Lee LY, Lui WY. Splenic abscess--a changing trend in treatment. S AFR J SURG 2000; 38:55-7. [PMID: 11392197] [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]
Abstract
Fifteen patients with splenic abscesses were evaluated between 1985 and 1995. The most common predisposing factors were remote infection, diabetes mellitus and heart disease. Common clinical presentations included leucocytosis, fever, left upper quadrant abdominal pain and left pleural effusion. Four patients with splenic abscesses smaller than 4 cm in diameter were treated with antibiotics alone, and 1 in this treatment group died. Among the 10 patients with splenic abscesses larger than 4 cm in diameter receiving percutaneous drainage, 9 (90%) were successfully cured, including 8 with unilocular abscesses and 1 with multilocular abscesses. Two patients underwent splenectomy. In conclusion, percutaneous drainage using ultrasound or computed tomography guidance may be recommended as the treatment of choice for splenic abscess larger than 4 cm in diameter. Antibiotics alone may sometimes be considered for splenic abscesses smaller than 4 cm in diameter. Splenectomy is reserved for those cases where medical treatment has failed.
Collapse
Affiliation(s)
- K Y Liu
- Department of Surgery, Veterans General Hospital, Taipei, National Yang Ming University, Taipei, Taiwan, Republic of China
| | | | | | | | | | | |
Collapse
|
48
|
Chiu EJ, Shyr YM, Su CH, Wu CW, Lui WY. Diverticular disease of the small bowel. Hepatogastroenterology 2000; 47:181-4. [PMID: 10690606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND/AIMS The clinical picture of small bowel diverticula has not been well-clarified because of its infrequent incidence and limited case number in most published reports. We evaluated a large series of small bowel diverticula and further compared the clinical picture of the diverticula at different parts of small bowel. METHODOLOGY The medical records of 88 patients with diverticular disease of the small bowel were reviewed from 1979-1997. This study included all diverticula from duodenum to ileum. RESULTS The most common small bowel diverticulum was duodenal diverticulum (45%), followed by Meckel's diverticulum (23%). The most common clinical presentation was abdominal pain (48.9%), followed by gastrointestinal bleeding (29.5%). However, among the Meckel's diverticula, gastrointestinal bleeding (60%) was the most common presentation. The accurate diagnostic rate for diverticula, overall, was 25.0%. Thirty-nine (44.3%) of the diverticula were found incidentally. Twenty-three cases (26.1%) were diagnosed by gastrointestinal barium study. Thirty-eight (42.1%) diverticula were left alone without any sequela, and the remaining 55 (56.8%) diverticula needed either bowel resection (30.7%) or diverticulectomy (26.1%). All of the Meckel's diverticula were treated by surgery. Postoperative complication occurred in 9 (10.3%) patients. Hospital mortality rate was 3.4%. CONCLUSIONS Duodenal diverticulum was the most common small bowel diverticulum. Abdominal pain and gastrointestinal bleeding were the most common clinical presentations. The small bowel diverticula, except for Meckel's diverticulum, did not need to be treated if there were no significant symptoms.
Collapse
Affiliation(s)
- E J Chiu
- Department of Surgery, Veterans General Hospital-Taipei, National Yang Ming University, Taiwan, Republic of China
| | | | | | | | | |
Collapse
|
49
|
Abstract
Controversy persists regarding the role of prophylactic gastrojejunostomy in patients with unresectable periampullary adenocarcinoma. In review of the retrospective series, presence of gastric outlet obstruction (GOO) has been claimed to be a bad prognostic sign. This prospective study aimed to clarify the necessity of routine prophylactic gastrojejunostomy in patients with unresectable periampullary adenocarcinoma. The incidence and prognostic significance of GOO were also evaluated. Sixty-six patients with unresectable periampullary adenocarcinoma were enrolled. They were divided into 2 groups to receive either a single biliary bypass or a double bypass (concomitant gastric and biliary bypasses) if they had GOO. The single bypass group was followed up to assess the incidence of GOO and subsequent need of a gastric bypass. Prognostic factors were evaluated by univariate and multivariate analyses. Forty-four (67%) of the overall 66 patients presented with GOO at the time of diagnosis. There was no statistical difference regarding the morbidity and mortality between the 2 groups, except longer (7 days) hospital stay in the double bypass group. Seven (31.8%) of the 22 patients in the single bypass group subsequently developed GOO an average of 6.2 +/- 1.0 months after their initial biliary bypass. By univariate analysis, significant prognostic factors for unresectable periampullary adenocarcinoma were: GOO (p = 0.0379), pancreatic head origin (p = 0. 0146 by univariate analysis), and distant metastasis (p < 0.0001). After multivariate analysis, only pancreatic head origin and distant metastasis remained significant independent factors of poor prognosis. In conclusion, gastrojejunostomy should be performed prophylactically in addition to a biliary bypass in patients with unresectable periampullary adenocarcinoma. The presence of GOO is not an independent factor of poor prognosis, but a reflection of the aggressive biologic behavior of pancreatic head adenocarcinoma.
Collapse
Affiliation(s)
- Y M Shyr
- Department of Surgery, Veterans General Hospital-Taipei, National Yang Ming University, 201 Shih-Pai Road, Sec. 2, Taipei 112, Taiwan, Republic of China
| | | | | | | |
Collapse
|
50
|
Shyr YM, Su CH, Lee CH, Wu CW, Lui WY. Glucagonoma syndrome: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 62:639-43. [PMID: 10502856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Glucagonoma is a very rare islet cell tumor of the pancreas. We present a case of pancreatic tail tumor with the typical glucagonoma syndrome of necrolytic migratory erythema (NME), diabetes mellitus (DM), anemia, weight loss and glossitis. After complete resection of the pancreatic tumor, the glucagonoma syndrome subsided. In reviewing 120 cases of glucagonoma in the literature, the average tumor diameter was 3.6 cm. Most (68.1%) of the tumors occurred in the pancreatic tail. Two-thirds of the reported glucagonomas were malignant and 53.5% metastasized to other organs. The curative resection rate was 45.8%. A triad of pancreatic tumor, NME and DM should lead to the diagnosis of glucagonoma.
Collapse
Affiliation(s)
- Y M Shyr
- Department of Surgery, Veterans General Hospital-Taipei, Taiwan, ROC
| | | | | | | | | |
Collapse
|