Chi Mei Foundation Hospital

Tainan, Taiwan

Chi Mei Foundation Hospital

Tainan, Taiwan
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Lee C.-W.,Chang Gung University | Huang H.-W.,Graduate Institute of Natural Products | Wu T.-H.,Health Bureau of Kaohsiung County Government | Tzeng W.-S.,Chi Mei Foundation Hospital | And 2 more authors.
Journal of Agricultural and Food Chemistry | Year: 2012

Resveratrol (RES), a well-known antioxidant and anti-inflammatory compound, is abundant in red wine and exerts numerous pharmacological effects, including hepatoprotection and cadioprotection. Unfortunately, RES is restricted in clinical application due to poor dissolution property and adsorption. In addition, red wine as a supplement for preventing disease is not recommended for patients with alcohol-related disorders. To address these limitations, we successfully developed a novel RES nanoparticle system (RESN) and demonstrated that RESN could circumvent the physicochemical drawbacks of raw RES with respect to dissolution, such as the reduction of particle size, amorphous transformation, and hydrogen-bond formation. In addition, we employed an animal model of CCl4-induced hepatotoxicity to estimate the potential of the nanoparticle formulation to improve the hepatoprotective effect of orally administered RES. Our results demonstrated that RESN can diminish liver function markers (aspartate aminotransferase and alanine aminotransferase) by decreasing hepatocyte death due to CCl4-induced hepatotoxicity in rats, when compared with RES administration. The effect was achieved by reducing oxidative stress (decreased reactive oxygen species and lipid peroxidation) and lowering inflammatory cytokines (decreased tumor necrosis factor-α and interleukin 1β) and protein expression (cyclooxygenase-2, inducible nitric oxide synthase, cytosolic phospholipase A2, and caspase-3). In conclusion, enhancement of the dissolution of RES through a nanoparticle engineering process can result in increased hepatoprotective effects mediated by antioxidant and anti-inflammatory activities. Consequently, we suggest that RESN deserves further study, perhaps in prophylaxis of chronic liver diseases. © 2012 American Chemical Society.

Tzeng C.-W.,Kaohsiung Medical University | Yen F.-L.,Kaohsiung Medical University | Wu T.-H.,Health Bureau of Kaohsiung County Government | Ko H.-H.,Kaohsiung Medical University | And 3 more authors.
Journal of Agricultural and Food Chemistry | Year: 2011

Kaempferol (KAE) is a strong antioxidant flavonoid compound, but its clinical application is limited by quantity and poor dissolution property.However, the dissolution mechanismof a kaempferol nanoparticle formulation (KAEN) has not yet been elucidated. The aim of the present study was therefore to use a nanoparticle engineering process to resolve the dissolution problem. Our data indicated that KAEN effectively increased the dissolution percentage by particle size reduction, high encapsulation efficiency, amorphous transformation, and hydrogen-bond formation with excipients. In addition, we used several different antioxidant activity assays to evaluate KAE and KAEN. The data indicated that KAEN retained potent antioxidant activity after the nanoparticle engineering process and showed better antioxidant activity than KAE dissolved in water (P < 0.05). According to these findings, we concluded that KAEN could be a low-dose alternative to KAE in health food and future clinical research. © 2011 American Chemical Society.

Hsu C.-C.,Chi Mei Foundation Hospital | Wang J.-J.,Fu Jen Catholic University
Transplantation Proceedings | Year: 2012

Objectives: The Pringle maneuver is a surgical procedure to minimize hemorrhage during hepatectomy, which however, can induce production of reactive oxygen species causing remote organ injury. We sought to study the impact of the Pringle maneuver on cardiac function as well as the protective effects of L-ascorbic acid and α-tocopherol pretreatments. Methods: Rats were divided into four study groups: L-ascorbic acid (60 mg/kg/d) or α-tocopherol (200 mg/kg/d), and surgical interventions (Sham-operated or liver ischemia-reperfusion [I/R]). Liver ischemia was performed by clamping the hepatic artery and portal vein for 30 minutes, followed by reperfusion by releasing the clamps for 2 hours. Cardiac function was evaluated by a high-fidelity pressure-volume catheter positioned in the left ventricle. Myocardial injury was assessed through plasma creatine kinase-MB (CKMB) and troponin I (cTnI). Cardiac lipid peroxidation and systemic hydroxyl radical levels were assessed by cardiac tissue malondialdehyde and plasma methylguanidine, respectively. Results: Cardiac function was significantly depressed in the I/R group, where plasma CKMB and cTnI were markedly increased (P <.05). L-ascorbic acid and α-tocopherol pretreatments improved cardiac function and significantly reduced cardiac injury (P <.05). L-ascorbic acid pretreatment demonstrated better heart protection than α-tocopherol, in terms of cTnI and CKMB (P <.05), but no significant difference in terms of cardiac functional improvement. Conclusions: L-ascorbic acid and α-tocopherol pretreatment 3 days prior to the Pringle maneuver attenuated myocardial injury and protected cardiac function by scavenging hydroxyl radical and reducing lipid peroxidation. L-ascorbic acid demonstrated better protection than α-tocopherol. © 2012 Elsevier Inc.

Long C.-Y.,Kaohsiung Medical University | Wu M.-P.,Chi Mei Foundation Hospital | Wu M.-P.,Taipei Medical University | Wu M.-P.,Chia Nan University of Pharmacy and Science
Gynecology and Minimally Invasive Therapy | Year: 2013

Surgery with synthetic mesh or graft materials has become increasingly popular over the past decade due to the excellent short-term success rate. However, concern about mesh-related complications still exists. Here we report a case experiencing sexual pain after a transvaginal mesh repair with a total Prolift procedure. Also, her husband experienced painful intercourses due to a vertical adhesion band between the anterior and posterior vaginal wall. Under local anesthesia, the adhesion band was dissected. She restarted her sexual life 3 weeks after the procedure without any further complaint. A postoperative vaginal adhesion band formation may occur during the healing process, which may cause postoperative sexual dysfunction. This rare complication may aid in preoperative counseling about the potential adverse events on postoperative sexual function. © 2013.

Wu N.-C.,Chi Mei Foundation Hospital | Wang J.-J.,Fu Jen Catholic University
Transplantation Proceedings | Year: 2014

Objective Acute respiratory distress syndrome (ARDS) is a common scenario associated with hepatic warm ischemia and reperfusion (I/R) injury after shock or hemorrhage. Inflammation of lung parenchyma and increase in matrix metalloprotease 9 (MMP-9) activity have been implicated in ARDS. In this study, we aimed to investigate the protective efficacy of curcumin treatment against hepatic I/R-induced lung function impairment. Methods Thirty Sprague-Dawley male rats were evenly divided into 3 groups: a sham group, a hepatic I/R group, and a group treated with curcumin (15 mg/kg/d) 15 minutes before ischemia and every 24 hours for the next 48 hours. Ischemia was induced by occluding the hepatic artery and portal vein for 30 minutes. The clamps were then released and the abdominal incision was closed. Pulmonary function test was conducted after 48 hours of reperfusion. We also examined serum alanine transaminase (ALT) level and degrees of tumor necrosis factor α (TNF-α) and MMP-9 activity in the lung tissue. Results Hepatic I/R injury decreased the ratio of residual volume to total lung capacity (RV/TLC), chord compliance (Cchord), and maximum midexpiratory flow (MMEF; P <.05), and increased inspiratory resistance (RI; P <.05), characterized as combined obstructive and restrictive lung disease. Treatment with curcumin markedly improved RV/TLC, Cchord, and MMEF and decreased RI (P <.05). In addition, curcumin treatment reduced serum ALT level and degrees of TNF-α level and MMP-9 activity in the lungs. Conclusions Curcumin attenuated hepatic I/R-induced combined restrictive and obstructive lung disease by reducing lung inflammation and MMP-9 activity. © 2014 by Elsevier Inc. All rights reserved.

Wu M.-P.,Chi Mei Foundation Hospital | Wu M.-P.,Taipei Medical University | Huang K.-H.,Chang Gung University | Long C.-Y.,Kaohsiung Medical University | And 2 more authors.
Journal of Minimally Invasive Gynecology | Year: 2010

Study Objective: To estimate the trends in various types of hysterectomy (abdominal, vaginal, laparoscopic, and subtotal) and their distribution according to patient age, surgeon age, and hospital accreditation in Taiwan. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Population-based National Health Insurance (NHI) database. Patients: Women with NHI in Taiwan undergoing various types of hysterectomy to treat noncancerous lesions. Interventions: Data for this study were obtained from the Inpatient Expenditures by Admissions files of the NHI research database, released by the NHI program in Taiwan for 1996-2005. Measurements and Main Results: A total of 234. 939 women who underwent various types of hysterectomy were identified for analysis. The number of hysterectomies performed annually remained stationary during the 10-year study. Total abdominal hysterectomies decreased significantly (77.33% in 1996 vs 45.68% in 2005), laparoscopic hysterectomies increased significantly (5.20% vs 40.40%), vaginal hysterectomies decreased (14.70% vs 8.86%), and subtotal abdominal hysterectomies increased (2.76% vs 5.06%). Laparoscopic hysterectomy was more commonly performed in middle-aged women; vaginal hysterectomy was more common in older women; and subtotal abdominal hysterectomy was more common in younger women. Laparoscopic hysterectomy was performed more commonly in regional hospitals (33.11%), followed by medical centers (30.17%) and local hospitals (17.78%). Laparoscopic hysterectomy was performed more commonly in not-for-profit hospitals (30.25%), followed by private hospitals (29.32%) and government-owned hospitals (25.91%). Conclusion: There has been considerable change in the types of surgery used for hysterectomy in Taiwan over the past 10 years. As a minimally invasive approach, laparoscopic hysterectomy represents a profound change for both patients and surgeons. © 2010 AAGL.

Wu M.-P.,Chi Mei Foundation Hospital | Wu M.-P.,Taipei Medical University | Wu M.-P.,Chia Nan University of Pharmacy and Science | Lee C.-L.,Chang Gung University
Gynecology and Minimally Invasive Therapy | Year: 2012

The use of minimally invasive surgery (MIS) has grown over the past two decades in Taiwan and worldwide. Laparoscopic surgery has been applied to manage the adnexal mass, and ectopic pregnancy since 1989, followed by the first case series of laparoscopic-assisted vaginal hysterectomy (LAVH) in 1992 in Taiwan. These cases successfully advanced the development of the laparoscopic field. The most significant finding for hysterectomy is the significant increase of laparoscopic hysterectomy (LH) from 5.75% to 37.50%, which is accompanied by the decrease of total abdominal hysterectomies (TAH) from 77.93% to 48.12%, in 1997 and 2007, respectively. Laparoscopic surgery increased significantly from 35.78% to 71.66% for benign ovarian tumor; laparoscopic procedures significantly increased from 18.9% in 1997 to 73.95% in 2007 for ectopic pregnancy. Surgeon acceptance and a rapid evolution of instrumentation have enabled the use of laparoscopy to flourish in recent years. Based on nationwide population-based studies, the choices of surgical procedures are found to be dependent on patient factors, surgeon factors, and hospital factors. The academic activities launched by the MIS-related medical associations significantly lower the threshold for entering the field of endoscopy for gynecologists. This review demonstrates a considerable shift in the use of laparoscopic surgery as MIS in the approaches of benign gynecologic conditions, hysterectomy, ovarian tumor, and ectopic pregnancy, during the past 15 years in Taiwan. As a minimally invasive approach, laparoscopic surgery represents a profound change in patients, surgeons, and hospitals where the surgeries were performed. © 2012.

Li J.-F.,National Dong Hwa University | Huang Y.,National Dong Hwa University | Chen R.-L.,Chi Mei Foundation Hospital | Lee H.-J.,National Dong Hwa University
Anticancer Research | Year: 2010

Background: Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), a member of the tumor necrosis factor (TNF) family, has shown potent and high selective antitumor activity as a promising therapy for cancer. We have developed an arginine-rich intracellular delivery (AID) peptide-mediated system for nontoxic and efficient gene transfer in cells. Materials and Methods: To evaluate antitumor activity and therapeutic potential of TRAIL gene, a bifunctional expression plasmid was constructed encoding the secretory signal peptide of human immunoglobulin kappa (IgK) light chain, the extracellular portion (amino acids 95-281) of human TRAIL and the humanized green fluorescent protein (GFP). Results: We demonstrated that AID peptides were able to effectively deliver TRAIL gene into human lung carcinoma A549 cells. Soluble TRAIL-GFP protein purified from media after gene delivery was further evaluated regarding selective induction of apoptosis in cells. Conclusion: AID peptide-mediated DNA transfer provides a potential and convenient tool in nonviral gene therapy.

Wu M.-P.,Chi Mei Foundation Hospital | Wu M.-P.,Taipei Medical University
Journal of Experimental and Clinical Medicine | Year: 2010

Pelvic organ prolapse (POP), like stress urinary incontinence, has a significant impact on women's quality of life. POP results from a defect of the uterosacral/cardinal ligament complex, anterior vaginal wall, and other supportive tissues. However, there is a paucity of information about the etiology and pathophysiology of POP because of its multifactorial and heterogeneous risk factors. Recent reports of women with POP identified changes in the status of the connective tissue, of which the extracellular matrix (ECM) comprises the major component. Accelerated remodeling in patients with POP is caused by biochemical changes of the ECM, e.g., collagen, elastin, and stromal cells. Myofibroblasts play a role in ECM remodeling and can be modulated by matricellular regulators, e.g., transformation growth factor (TGF)-β, thrombospondin (TSP)-1, and matrix metalloproteases (MMPs). The homeostasis of MMPs with the lysyl oxidase family and fibulin ensure ECM integrity. Disturbances in the balance between synthesis/assembly and degradation of ECM proteins in the pelvic floor may result in POP. The high recurrence rate after pelvic reconstructive surgery necessitates the use of an adjuvant synthetic mesh. With the establishment of an in vitro model, our study showed that the interplay among the ECM, myofibroblasts, and a synthetic mesh can determine the usefulness of the synthetic mesh in pelvic reconstructive surgery. It was hypothesized that accelerated remodeling in patients with POP is caused by biochemical changes in ECM proteins, myofibroblasts, and their regulators. Further studies are needed to elucidate the following issues: first, whether women with POP have abnormal synthesis and/or degradation of the ECM, and different amounts of stromal cells (myofibroblasts); second, whether myofibroblasts exhibit different ECM protein productions under the regulation of MMP, TSP-1, and TGF-β; and third, whether ECM matricellular proteins, e.g., TSP-1 and TGF-β, can modulate the biologic responses of host stromal cells to a synthetic mesh used in pelvic reconstructive surgery. This will be very informative for the further advancement of our understanding and treatment of pelvic floor reconstruction. © 2010 Taiwan Medical University.

Wu M.-P.,Chi Mei Foundation Hospital | Hsu Y.-W.,Chi Mei Foundation Hospital | Weng S.-F.,Chi Mei Foundation Hospital | Ho C.-H.,Chi Mei Foundation Hospital | And 2 more authors.
Urology | Year: 2013

Objective: To investigate the healthcare-seeking prevalence of those with lower urinary tract symptoms (LUTS) among National Health Insurance enrollees in Taiwan. Materials and Methods: Data from the National Health Insurance Research Database were obtained from a random population sample of about one million as a representative cohort from 2000 to 2009. Subjects aged ≥18 years with ≥1 outpatient service claim and coding for a LUTS-related diagnosis were identified and analyzed annually. Results: The healthcare-seeking prevalence for LUTS increased from 23.11‰ in 2000 to 38.37‰ in 2009. Similar trends were found for storage symptoms and voiding symptoms (P <.0001). In 2009, the age distribution of LUTS was 4.32%, 5.82%, 10.92%, 19.23%, 21.25%, and 38.47% in those aged 18-29, 30-39, 40-49, 50-59, 60-69, and ≥70 years, respectively. The overall LUTS prevalence was more common in men (54.45‰) than in women (21.73‰). For LUTS subtypes, storage symptoms were more common in women (19.46‰) than in men (13.13‰); however, the trend was reversed in the population >60 years old. Voiding and mixed symptoms were more common in men (4.69‰, and 0.83‰, respectively) than in women (2.80‰ and 0.58‰, respectively). Conclusion: In the present cohort study, patients with LUTS seeking medical help increased annually from 2000 to 2009 in Taiwan. The occurrence of LUTS subtypes varied according to age and sex. LUTS is becoming a substantial healthcare burden as the number of aged people who want to maintain a good quality of life increases. © 2013 Elsevier Inc. All Rights Reserved.

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