Lai C.-C.,Chi Mei Medical Center |
Hsueh P.-R.,National Taiwan University Hospital
Future Microbiology | Year: 2014
The isolation rate of nontuberculous mycobacteria (NTM) species and the prevalence of NTM-associated diseases are on the rise in Asian, as well as in Western countries; however, the species distribution of NTM isolates and the types of diseases caused by NTM species vary from region to region. In this review, we present an update on the epidemiology of NTM in Asia. We demonstrate that the distribution of NTM species varies within Asia and differs from that in North America and Europe. In addition, the clinical manifestations of NTM diseases include respiratory tract infections, disseminated infections, skin and soft tissue infections, lymphadenitis, empyema, ocular infections, CNS infections and genitourinary infections. Finally, the rate of adaptive resistance of anti-NTM antimicrobial agents remains high and may be associated with a poor outcome for patients with NTM diseases. © 2014 Future Medicine Ltd.
Shen H.-N.,Chi Mei Medical Center |
Shen H.-N.,National Cheng Kung University
Critical Care Medicine | Year: 2016
OBJECTIVES:: To examine the risk of recurrence in adults who survived first-episode severe sepsis for at least 3 months. DESIGN:: A matched cohort study. SETTING:: Inpatient claims data from Taiwan’s National Health Insurance Research Database. SUBJECTS:: We analyzed 10,818 adults who survived first-episode severe sepsis without recurrence for at least 3 months in 2000 (SS group; mean age, 62.7 yr; men, 54.7%) and a group of age/sex-matched (1:1) population controls who had no prior history of severe sepsis. All subjects were followed from the study entry to the occurrence of end-point, death, or until December 31, 2008, whichever date came first. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Primary end-point was severe sepsis that occurred after January 1, 2001 (the study entry). Relative risk of the end-point was assessed using competing risk regression model. During the follow-up period, severe sepsis and death occurred in 35.0% and 26.5% of SS group and in 4.3% and 18.6% of controls, respectively, representing a covariate-adjusted sub–hazard ratio of 8.89 (95% CI, 8.04–9.83) for the risk of recurrence. In stratified analysis by patient characteristics, the sub–hazard ratios ranged from 7.74 in rural area residents to 23.17 in young adults. In subgroup analysis by first-episode infection sites in SS group, the sub–hazard ratios ranged from 4.82 in intra-abdominal infection to 9.99 in urinary tract infection. CONCLUSIONS:: Risk of recurrence after surviving severe sepsis is substantial regardless of patient characteristics or infection sites. Further research is necessary to find underlying mechanisms for the high risk of recurrence in these patients. Copyright © by 2016 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Tu M.Y.,Chi Mei Medical Center
Nutrition and cancer | Year: 2012
We assessed which nutrition evaluation method [subjective global assessment (SGA); malnutrition universal screening tool (MUST); nutritional risk index (NRI)] provided the most efficacious combination of high validity, low cost, and ease of use to examine and improve the status of malnutrition for colorectal cancer (CRC) patients. The SGA, MUST, and NRI scales were used to analyze the preoperative status of malnutrition for 45 CRC patients in a medical center in Taiwan. Differences in the reliability of the 3 methods were compared using the kappa (κ) coefficient of agreement. Lengths of hospital stays were compared using the Mann-Whitney U test to examine the effect of malnutrition in CRC patients. The SGA κ coefficient was higher with the MUST than with the NRI. Preoperative and postoperative weight losses were significantly different on the NRI, and the longer the length of the hospital stay, the greater was the weight loss. Although the SGA had a higher validity and lower cost than the NRI, we recommend using the MUST method for a routine nutrition evaluation because it is easier to use and is less expensive than the SGA and the NRI.
Huan S.K.,Chi Mei Medical Center
Molecules (Basel, Switzerland) | Year: 2012
Cantharidin, an active component in mylabris, is used in traditional Chinese medicine (TCM) to treat scabies and hepatoma, but accompanied by hemorrhagic cystitis. Evidence shows that cantharidin induces human bladder carcinoma cell death through COX-2 overexpression in vitro. In TCM, Scutellaria baicalensis is usually used to cure mylabris-induced hematuria. This work was undertaken to determine the mechanisms of cantharidin-induced rat hemorrhagic cystitis and explore the uroprotective effect of S. baicalensis. In vitro results showed cantharidin could induce cytotoxicity through prostaglandin (PG)E 2 overproduction of T24 cells. Boiling-water extract of S. baicalensis (SB-WE) could significantly inhibit PGE 2 production and COX-2 expression in lipo-polysaccharide-induced RAW 264.7 cells, indicating obvious anti-inflammatory abilities. In vivo results indicated that cantharidin caused rat hemorrhagic cystitis with hematuria via c-Fos and COX-2 overexpression. SB-WE was given orally to cantharidin-treated rats, whereby hematuria level, elevated PGE 2 and COX-2 protein overexpression were significantly and dose-dependently inhibited by SB-WE. The anti-inflammatory components of SB-WE are baicalin and wogonin, whose contents were 200.95 ± 2.00 and 31.93 ± 0.26 μg/mg, respectively. In conclusion, cantharidin induces rat cystitis through c-Fos and COX-2 over-expression and S. baicalensis can prevent the resulting hematuria because of its anti-inflammatory effects.
Pan J.-W.,National Chiao Tung University |
Pan J.-W.,Chi Mei Medical Center
Optics Express | Year: 2012
Modified testing equipment for adjusting the back focal length of a compact camera module (CCM) is proposed. The advantages of this modified testing equipment which includes a conversion lens are that it saves on testing space, offers a smaller sized testing chart, as well as high speed chart changing, and variable object distances. The modified testing equipment can produce a test chart of 38.32 mm compared to an equivalent testing chart of 5000 mm with the conventional testing equipment. At the regular object distance of 2000 mm, both total track and testing chart size for the modified test equipment were 8.3% that of the conventional testing equipment. By using this testing equipment, the testing space can be shrunk significantly. © 2012 Optical Society of America.