Buddhist Tzu Chi General Hospital

Hualian, Taiwan

Buddhist Tzu Chi General Hospital

Hualian, Taiwan

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Objective: We designed this study to investigate the changes of regional homogeneity (ReHo) after a 6-week duloxetine therapy in first-episode drug-naïve major depressive disorder with panic disorder (FEMDDPD) patients. Method: 3T magnetic resonance imaging (MRI) scanning and ReHo functional MRI analysis were performed on 15 patients (male: 5; female: 10; age: 35.87 ± 9.59 years old) at baseline and remitted status (sixth week) compared with 15 healthy control subjects (male: 4; female: 11; age: 34.30 ± 9.87 years old) which were scanned twice within 6 weeks. The ReHo was analyzed by the REST toolbox (resting-state functional MRI data analysis toolbox). The ReHos of different time-points were compared by using paired t test function of REST. Results: ReHo increased in right superior frontal cortex, right medial frontal cortex and decreased in right superior temporal cortex (uncorrected p < 0.00005, cluster threshold > 20, surface connected theory) after remission of symptoms in these FEMDDPD patients within 6 weeks (improvements of clinician rating and self rating scale scores; post-hoc corrected p < 0.001). No significant changes of ReHo were observed in the controls within 6 weeks (uncorrected p < 0.1, no cluster threshold setting, surface connected theory). The changes of ReHo value were mildly correlated with improvements of clinical rating scales with age, gender, depression and anxiety severity as covariates. Conclusion: Our study suggested that differential modulations inside the default mode network probably were associated with remission of FEMDDPD symptoms after duloxetine therapy. © 2011 Elsevier B.V. All rights reserved.


Lai C.-H.,Buddhist Tzu Chi General Hospital | Wu Y.-T.,National Yang Ming University
Journal of Affective Disorders | Year: 2012

Objective: There is no voxel-based morphometry study for first-episode, drug-naïve and very late-onset panic disorder patients. Besides, differences of onset age might represent different clinical subgroups. Therefore we designed this study to investigate gray matter deficits in this subgroup of patients. Method: 30 patients and 21 normal controls were enrolled into our study. They all received 3 T magnetic resonance imaging acquisition for the structural imaging of brain. All the structural images were processed and analyzed to estimate the differences of gray matter volumes between patients and controls. We utilized optimized voxel-based morphometry function implemented in the FSL (FMRIB Software Library) with the agoraphobia, global brain volume, age, gender and duration of illness as covariates. We also performed the voxel-wise linear regression between clinical rating scale scores and gray matter volumes of brain to confirm results of optimized voxel-based morphometry and significant region for physiopathology of very late-onset PD. Results: First-episode, drug-naïve and very late-onset panic disorder patients had lower gray matter volumes in left orbitofrontal cortex, left inferior frontal cortex, left superior temporal gyrus and right insula when they were compared to controls (corrected p < 0.005, multiple comparisons, cluster threshold: 30 voxels). A negative correlation between PDSS and GMV was observed in right insula using general linear model voxel-wise analysis with age and gender corrected. Conclusion: Fronto-temporo-insula gray matter deficits might represent the structural pathophysiology of first-episode, drug-naïve and very late-onset panic disorder. © 2012 Elsevier B.V. All rights reserved.


Shie J.-H.,Buddhist Tzu Chi General Hospital | Kuo H.-C.,Buddhist Tzu Chi General Hospital
BJU International | Year: 2011

What's known on the subject? and What does the study add? Interstitial cystitis/painful bladder syndrome (IC/PBS) is considered to result from long-standing inflammation of the bladder. Urothelial dysfunction and increased urothelial permeability are known to result in clinical symptoms such as pain and urgency, however the actual pathophysiology remains unclear. This study demonstrated increased cell apoptosis, decreased cell proliferation, increased mast cell activation, and impaired expression of E-cadherin were significant in IC/PBS bladders. There was a significant correlation between mast cell activation and urothelial cell apoptosis and the reduced E-cadherin expression was significantly correlated with clinical pain VAS scale, suggesting the barrier defect of the bladder wall may lead to increasing bladder sensitivity and pain. Objective: To investigate the relationships between suburothelial inflammation and urothelial dysfunction in interstitial cystitis/painful bladder syndrome (IC/PBlS). Materials and methods: Immunofluorescence staining of ki-67 (to assess cell proliferation), junction protein E-cadherin, tryptase (to assess mast cell activation) and TUNEL (to assess urothelial apoptosis) were performed in bladder tissues from 20 patients with IC/PBlS and from 6 control patients. The fluorescence intensity of E-cadherin was measured using the ImageJ method. The percentage of apoptotic cells, proliferated cells and activated mast cells were measured and quantified as positive cells (±SD) per area unit (4 μm2). Results: The ratio of ki-67-positive cells in the bladder tissue of the patients with IC/PBlS was significantly down-regulated compared with that of the control patients (0.559 ± 0.658 vs. 1.23 ± 1.28, P= 0.001). TUNEL staining revealed a significantly higher number of apoptotic cells in the IC/PBlS bladder tissue compared with control bladder tissue (2.26 ± 2.04 v 0.051 ± 0.124, P= 0.000). The tryptase signal was significantly stronger in the IC/PBlS bladder tissue compared with that of control patients (6.16 ± 4.35 v 1.15 ± 0.436, P= 0.000). The apoptotic cell number in IC/PBlS bladder tissue correlated significantly with mast cell activation (P= 0.021). Immunofluorescence also showed a significantly lower distribution of E-cadherin in IC/PBlS bladder tissue compared with that of control patients (8.50 ± 6.83 v 17.2 ± 11.9, P= 0.000). Lower expression of E-cadherin in IC/PBlS bladder tissue was significantly correlated with higher visual analogue pain scores in patients with IC/PBlS (P= 0.008). Conclusions: The Results: of the present study suggest that urothelial homeostasis in IC/PBlS bladders was impaired, and abnormal urothelial function was significantly associated with chronic inflammation. The junctions between urothelial cells in IC/PBlS bladders were abnormal, which was associated with the patient's self-report pain scales. © 2010 BJU International.


Aims Intravesical onabotulinumtoxinA (BoNT-A) injection is a promising treatment for refractory detrusor overactivity (DO). This study investigated the long-term success rate of BoNT-A injection for patients with idiopathic DO and its association with reduction of urgency severity. Methods This study was a retrospective analysis of 174 patients with idiopathic DO who received first-time 100 U BoNT-A injections. The patients were collected from several previous clinical trials. The therapeutic effects were classified as significant sensory effects with urgency severity score reductions of ≥2 and/or significant motor effects with cystometric bladder capacity increases of ≥25%. The treatment results based on patients' perceptions of bladder conditions and long-term success rates were analyzed among the different therapeutic-effect subgroups. Results A successful outcome was reported by 138 (79.3%) patients at 3 months. Seventy-seven (44.3%) patients had both sensory and motor effects, 5 (2.9%) had sensory effects alone, 83 (47.7%) had motor effects alone, and 9 (5.2%) had no sensory or motor effect. All 82 patients with sensory with/without motor effects reported a successful result. In contrast, only 50 (60.2%) patients with motor effects alone reported success at 3 months. Increased cystometric bladder capacity and postvoid residual and decreased voiding efficiency were noted in patients with motor with/without sensory effects. The therapeutic results lasted significantly longer in patients with sensory with/without motor effects than those with motor effects alone. Conclusions Improvement of urgency severity is significantly associated with a higher success rate at 3 months and longer therapeutic duration after intravesical BoNT-A injection for IDO. © 2011 Wiley Periodicals, Inc.


Lo R.Y.,Buddhist Tzu Chi General Hospital | Jagust W.J.,University of California at Berkeley
Neurology | Year: 2012

Objective: To investigate predictors of missing data in a longitudinal study of Alzheimer disease (AD). Methods: The Alzheimer's Disease Neuroimaging Initiative (ADNI) is a clinic-based, multicenter, longitudinal study with blood, CSF, PET, and MRI scans repeatedly measured in 229 participants with normal cognition (NC), 397 with mild cognitive impairment (MCI), and 193 with mild AD during 2005-2007. We used univariate and multivariable logistic regression models to examine the associations between baseline demographic/clinical features and loss of biomarker follow-ups in ADNI. Results: CSF studies tended to recruit and retain patients with MCI with more AD-like features, including lower levels of baseline CSF Aβ 42. Depression was the major predictor for MCI dropouts, while family history of AD kept more patients with AD enrolled in PET and MRI studies. Poor cognitive performance was associated with loss of follow-up in most biomarker studies, even among NC participants. The presence of vascular risk factors seemed more critical than cognitive function for predicting dropouts in AD. Conclusion: The missing data are not missing completely at random in ADNI and likely conditional on certain features in addition to cognitive function. Missing data predictors vary across biomarkers and even MCI and AD groups do not share the same missing data pattern. Understanding the missing data structure may help in the design of future longitudinal studies and clinical trials in AD. Copyright © 2012 by AAN Enterprises, Inc.


Patent
Buddhist Tzu Chi General Hospital | Date: 2012-03-29

A method for expansion of human embryonic stem (hES) cells in a medium including human umbilical cord-derived mesenchymal stem cells (HUCMSCs) as a feeder is provided. The human embryonic stem cells (hES) maintain the features of embryonic stem cells in the medium, such as pluripotency, unlimited undifferentiated proliferation and normal karyotypes. Also provided is a method for non-tumorigenic expansion of the human embryonic stem cells (hES) that is free from forming teratoma.


Yang C.-H.,Buddhist Tzu Chi General Hospital
Journal of Microbiology, Immunology and Infection | Year: 2011

A case of nonpigmented Chromobacterium violaceum bacteremic cellulitis after fish bite in Taiwan is reported. The patient was successfully treated with ciprofloxacin and doxycycline for an extended period. Chromobacterium violaceum should be listed in the differential diagnosis of patients with nonspecific cellulitis associated with marked leukocytosis and rapid progression to septicemia either with or without a distinct history of exposure to water or soil. A combination of prompt diagnosis, optimal antimicrobial therapy, and adequate therapeutic duration for C violaceum infection is the key for successful therapy. © 2011.


Patent
Buddhist Tzu Chi General Hospital | Date: 2012-10-24

A method for expansion of human embryonic stem (hES) cells in a medium including human umbilical cord-derived mesenchymal stem cells (HUCMSCs) as a feeder is provided. The human embryonic stem cells (hES) maintain the features of embryonic stem cells in the medium, such as pluripotency, unlimited undifferentiated proliferation and normal karyotypes. Also provided is a method for non-tumorigenic expansion of the human embryonic stem cells (hES) that is free from forming teratoma.


Patent
Buddhist Tzu Chi General Hospital | Date: 2012-11-07

A novel use of a neuropeptide for treating brain injury in a subject in need thereof is provided. The present invention also provides various amenable routes of administering urocortin, that is, via injection intracerebroventricularly and intraperitoneally, and via intravenous bolus administration.


Patent
Buddhist Tzu Chi General Hospital | Date: 2011-09-06

An endometrial polyp stem cell is disclosed in the present invention. The endometrial polyp stem cell is isolated from an endometrial polyp tissue, expresses vimentin, CD13, CD29, CD44, and CD90, and has no expression of CD1q, CD3, CD34, and CD45.

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