Buddhist Dalin Tzuchi General Hospital


Buddhist Dalin Tzuchi General Hospital

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Yew T.-L.,National Yang Ming University | Hung Y.-T.,National Yang Ming University | Hung Y.-T.,Buddhist Dalin Tzuchi General Hospital | Li H.-Y.,National Yang Ming University | And 12 more authors.
Cell Transplantation | Year: 2011

Wound healing can be improved by transplanting mesenchymal stem cells (MSCs). In this study, we have demonstrated the benefits of the conditioned medium derived from human MSCs (CM-MSC) in wound healing using an excisional wound model. CM-MSC accelerated wound closure with increased reepithelializ-ation, cell infiltration, granulation formation, and angiogenesis. Notably, CM-MSC enhanced epithelial and endothelial cell migration, suggesting the contribution of increased cell migration to wound healing enhanced by CM-MSC. Cytokine array, ELISA analysis, and quantitative RT-PCR revealed high levels of IL-6 in CM-MSC. Moreover, IL-6 added to the preconditioned medium enhanced both cell migration and wound healing, and antibodies against IL-6 blocked the increase in cell motility and wound closure by CM-MSC. The IL-6 secretory pathway of MSCs was inhibited by SB203580, an inhibitor of p38 MAPK or siRNA against p38 MAPK, suggesting IL-6 secretion by MSCs is mediated through the activation of p38 MAPK. Inactivation of p38 MAPK also reduced the expression and production of IL-8 and CXCL1 by MSCs, both of which were also demonstrated to enhance cell migration and wound closure. Thus, our data suggest MSCs promote wound healing through releasing a repertoire of paracrine factors via activation of p38 MAPK, and the CM-MSC may be applied to enhance wound healing. © 2011 Cognizant Comm. Corp.

Chuang M.-H.,Kaohsiung Medical University | Chuang M.-H.,Buddhist Dalin Tzuchi General Hospital | Lin C.-L.,Taiwan Buddhist Tzuchi Foundation | Wang Y.-F.,Buddhist Dalin Tzuchi General Hospital | Cham T.-M.,Kaohsiung Medical University
Journal of Managed Care Pharmacy | Year: 2010

BACKGROUND: One approach to help elderly and low-literacy patients understand instructions for medication use is to use pictographs or pictorial diagrams. However, most of these pictographs are designed by medical professionals and may not be optimal for such patients. OBJECTIVE: To compare low-literacy patients with medical staff in dimensions of preference and comprehension of pictographs intended to illustrate medication use instructions for medical clinic ambulatory patients. METHODS: Following 2 pilot tests, the first with small samples (5 pharmacists and 5 patients) and the second with 100 patients with low literacy, a survey of pictograph understanding and preference was conducted between May and October 2008. The survey used a third version of 3 sets of pictographs in 4 medication instruction categories for 250 low-literacy patients and 250 members of the medical staff in a teaching hospital in southern Taiwan. The 4 medication instruction categories were (a) route of administration for external use; (b) time of day for medication administration; (c) medication administration before, after, or with meals; and (d) administration quantity. The measure of preference was which pictograph in each subset best described the instruction, and the measure of comprehension was the percentage of participants who understood the meaning of the pictograph. Differences between the 2 groups in pictograph choice and comprehension were calculated using Fisher's exact test. RESULTS: All patients were considered low literacy (never attended school or grade 6 education or less). The preference of pictographs was significantly different between patients and medical staff for each of the 12 sets of pictographs. Comprehension was significantly different between patients and medical staff for pictographs in the categories of medication administration time of day and medication administration associated with meals. For pictographs representing "at bedtime," "after meals," and "with meals," the percentage of patients who chose "do not understand" was significantly higher than the percentage of medical staff choosing this item. The 3 patient age groups were 60 years or younger (43.2%), aged 61 to 70 years (26.4%), and aged 71 years or older (30.4%). Preference was found to be significantly different among the 3 patient age groups in pictographs for medication administration time "before meals" (P = 0.002), "after meals" (P = 0.007), "with meals" (P = 0.037), and in the pictographs representing "half tablet" (P = 0.012) in the category of administration quantity. Comprehension was found to differ among the 3 patient age groups in pictographs representing "at bedtime" (P = 0.040), "before meal" (P = 0.022), "after meals" (P = 0.025), and "with meals" (P = 0.014) and for "one, two, or three tablets" (P = 0.041). CONCLUSION: Patients and medical staff had significant differences in preference for all categories of medical instruction pictographs and had significant differences in comprehension for the pictographs in the categories of medication administration time of day and medication administration associated with meals. Patients' preferences for and comprehension of the medical instruction pictographs were age-related. For successful development of a comprehensible prescription drug label, a diverse sample of patients should be consulted to ensure that the pictographs depicting medication use instructions are useful to all individuals, including those with low literacy. Copyright © 2010, Academy of Managed Care Pharmacy. All rights reserved.

Chuang M.-H.,Kaohsiung Medical University | Chuang M.-H.,Buddhist Dalin Tzuchi General Hospital | Wang Y.-F.,Buddhist Dalin Tzuchi General Hospital | Wang Y.-F.,Tzuchi University | And 2 more authors.
Journal of Medical Systems | Year: 2012

This study evaluated the effectiveness of implementation of an improved storage label and an errorreducing process on the incidence of drug-dispensing errors. A total of 27 pharmacists (11 male and 16 female) were included. Questionnaires were distributed to pharmacists to measure their degree of satisfaction with the format and content of the labels. The questionnaires were completed before and one month after implementation of new label. Pharmacists were also requested to follow a new error-reducing dispensing process by circling the following items on the new storage label: drug name, appearance, packaging, dose, and formulation. The pharmacists' degrees of satisfaction increased significantly after implementation of the new label with respect to these questionnaire items: all label format items, edition appropriateness, use of capital fonts to distinguish similar drug names, reminder images to help with drug differentiation, and complete label information. The outpatient monthly drugdispensing error rate was significantly decreased. © Springer Science+Business Media, LLC 2010.

Chiou W.Y.,Buddhist Dalin Tzu Chi General Hospital | Chiou W.Y.,Tzu Chi University | Lee M.S.,Buddhist Dalin Tzu Chi General Hospital | Lee M.S.,Tzu Chi University | And 10 more authors.
Indian Journal of Cancer | Year: 2013

Background and Purpose: To evaluate the relationship of emotional status and health-related quality of life (HRQOL) in disease-free head and neck cancer (HNC) patients post treatment and to explore their predictive factors. Materials and Methods: Seventy-three HNC patients, post treatment at least 1 year, were recruited to complete three questionnaires, EORTC QLQ-C30, EORTC-H&N35 cancer module, and the Beck Depression Inventory-II (BDI-II). Results: Patients with depression demonstrated significantly poor global health status/QoL (score 41.7 vs. 71.9, P<0.001) and almost all functioning, except for role functioning. Besides, depressive patients presented statistically significant worse symptoms in all QLQ-C30 items, except constipation and financial problems, and in all QLQ-H&N35 symptoms except for teeth and coughing problems. Depression was significantly negative correlated with all functional scales and global health status/QoL (r = -0.341 to -0.750, all P<0.05), and was significantly positive correlated with symptom scales (r = 0.348 to 0.793, all P<0.05), except for constipation. Stepwise multiple linear regression analyses showed that physical functioning and physical distressful symptoms play an important role in the perception of HRQOL (total 46% explained). Global health status and impaired social functioning could explain depression in addition to emotional functioning (total 64% explained). Conclusions: HNC patients with depression were noted to have poorer HRQOL in almost every functioning symptom. HNC patients may get benefit from early interventions to improve HRQOL, emotional status, or both by a more rapid and friendly questionnaire to earlier identify patients with poor HRQOL or depressive status.

Tai T.-W.,National Cheng Kung University | Su F.-C.,National Cheng Kung University | Chien J.-T.,Buddhist Dalin Tzuchi General Hospital | Lee J.-S.,National Cheng Kung University | And 4 more authors.
Spine Journal | Year: 2015

Background context Healthy nerves are able to stretch and glide as responses to normal physiological movement. Injury to the nerve may alter the nerve's mechanical properties and result in neuropathy. Whether cauda equina compression alters the mechanical properties of the sciatic nerve is still unclear. Purpose The purpose of this study was to demonstrate the changes in excursions and strains of the sciatic nerve in vivo after acute cauda equina compression was induced by epidural balloon compression. Study design An animal comparative study with induced cauda equina compression was designed for in situ measurements of nerve properties. Methods Twenty-six adult Sprague-Dawley rats were divided into three groups. The balloon group (n=10) underwent epidural compression induced by inflation of an embolectomy balloon catheter that was inserted through an L6 laminotomy. The control group (n=10) underwent laminotomy but without compression. The normal group (n=6) received no back surgery. This model of neuropathy was confirmed with electrophysiological examination. The excursions and strains of the sciatic nerve in response to the modified straight leg-raising (SLR) test were measured in situ and analyzed. Results The scales of the excursions were lower in the balloon group than in the other two groups, in both 90°flexion and extension of the knee. The balloon group was more sensitive to positional changes. The strain was significantly higher under the condition of epidural balloon compression. Conclusions We concluded that cauda equina compression decreased the excursion and increased the strain of the sciatic nerve in response to a modified SLR test. These findings might indicate one of the mechanisms of the pain provoked by the SLR test and also possibly contribute to an understanding of the pathogenesis of the neuropathy in the lower limbs of patients with cauda equina compression. © 2015 Elsevier Inc. All rights reserved.

Wu Z.-S.,Buddhist Dalin Tzuchi General Hospital | Li S.-C.,Buddhist Dalin Tzuchi General Hospital | Ho H.-C.,Buddhist Dalin Tzuchi General Hospital | Tseng J.-E.,Buddhist Dalin Tzuchi General Hospital | And 4 more authors.
Japanese Journal of Clinical Oncology | Year: 2011

Primary tympanic membrane cancer is very rare; metastatic cancer to the tympanic membrane is extremely rare and presents diagnostic challenges. We report a case of metastatic hepatocellular carcinoma in the tympanic membrane. The presenting symptom was hearing loss. Physical examination revealed a friable granulomatous mass over the left anterior tympanic membrane extended from the external auditory canal. Computed tomography scan of the temporal bone revealed one soft tissue mass involving the left external auditory canal and tympanic membrane. A left middle ear mass biopsy was performed. The tumor cells were uniformly positive for cytokeratin and hepatocyte paraffin-1, confirming a diagnosis of metastatic tympanic membrane. A tympanic membrane mass might easily be misdiagnosed and improperly treated. This case serves as a reminder that the differential diagnosis of acute hearing loss in cancer patients should include the metastasis occurring in the auditory canal or tympanic membrane, and that tissue biopsies are necessary to establish the definitive diagnosis for such lesions. © The Author (2010). Published by Oxford University Press. All rights reserved.

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