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Tsai C.-T.,Da Chien General Hospital | Hsieh L.-F.,Fu Jen Catholic University | Kuan T.-S.,National Cheng Kung University | Kao M.-J.,Taipei Medical University Hospital | And 2 more authors.
American Journal of Physical Medicine and Rehabilitation | Year: 2010

Objective: To investigate the remote effect of dry needling on the irritability of a myofascial trigger point in the upper trapezius muscle. Design: Thirty-five patients with active myofascial trigger points in upper trapezius muscles were randomly divided into two groups: 18 patients in the control group received sham needling, and 17 patients in the dry-needling group received dry needling into the myofascial trigger point in the extensor carpi radialis longus muscle. The subjective pain intensity, pressure pain threshold, and range of motion of the neck were assessed before and immediately after the treatment. Results: Immediately after dry needling in the experimental group, the mean pain intensity was significantly reduced, but the mean pressure threshold and the mean range of motion of cervical spine were significantly increased. There were significantly larger changes in all three parameters of measurement in the dry-needling group than that in the control group. Conclusions: This study demonstrated the remote effectiveness of dry needling. Dry needling of a distal myofascial trigger point can provide a remote effect to reduce the irritability of a proximal myofascial trigger point. © 2009 by Lippincott Williams & Wilkins.

Chang N.-Y.,Da Chien General Hospital | Wang J.,Taichung Veterans General Hospital | Wen M.-C.,Taichung Veterans General Hospital | Lee F.-Y.,Taichung Veterans General Hospital
International Journal of Surgical Pathology | Year: 2014

Langerhans cell sarcoma (LCS) is a rare malignancy requiring differential diagnosis from other high-grade nonhematologic and hematologic tumors. The pathogenesis of LCS remains unknown. Notably, LCS and its benign counterpart, Langerhans cell histiocytosis (LCH), are frequently associated with other malignancies. To the best of our knowledge, we describe the first case of LCS in a chronic myelogenous leukemia (CML) patient undergoing imatinib mesylate therapy. We performed molecular cytogenetic analyses for investigating the association between LCS and CML. In our case, molecular cytogenetic analysis did not reveal BCR-ABL1 fusion and BRAF V600E mutation, suggesting that LCS may be coincident in this patient. However, recurrent BRAF V600E mutation has been found in LCH. Published reports have revealed the clonal relationship between LCH/LCS and other hematologic malignancies, especially lymphoid neoplasms. However, there are only 2 reports demonstrating the clonal relationship between LCH and myeloid neoplasms. The association of LCH/LCS with myeloid neoplasms and the role of BRAF V600E mutation in LCS are discussed. © The Author(s) 2013.

Chang W.-D.,China Medical University at Taichung | Lai P.-T.,Da Chien General Hospital | Tsou Y.-A.,China Medical University at Taichung
American Journal of Chinese Medicine | Year: 2014

Lateral epicondylalgia is a common orthopedic disorder. In traditional Chinese medicine, acupuncture is often used for treating lateral epicondylalgia. Laser acupuncture, compared with manual acupuncture, has more advantages because it is painless, aseptic and safe. However, the analgesic effect of manual acupuncture and laser acupuncture on lateral epicondylalgia has rarely been explored. We conducted a systematic review and meta-analysis to compare the analgesic effect of laser acupuncture and manual acupuncture for the treatment of lateral epicondylalgia. We investigated studies published in the Medline, PubMed, and CINAHL databases from January 1980 to December 2013. This review included 9 randomized articles. Six of them examined manual acupuncture and the others focused on laser acupuncture. We analyzed the meta-analysis results regarding the analgesic effect of the treatment, and observed substantial differences in 4 articles related to manual acupuncture. Manual acupuncture is effective in short-term pain relief for the treatment of lateral epicondylalgia; however, its long-term analgesic effect is unremarkable. A suitable acupuncture point and depth can be used to treat lateral epicondylalgia. Manual acupuncture applied on lateral epicondylalgia produced stronger evidence of an analgesic effect than did laser acupuncture, and further study on the analgesic effect of laser acupuncture is required. © 2014 World Scientific Publishing Company & Institute for Advanced Research in Asian Science and Medicine.

Lee J.-P.,Da Chien General Hospital | Chen W.,I - Shou University | Wu H.-T.,National Cheng Kung University | Lin K.-C.,Chi Mei Medical Center | And 3 more authors.
Hormone and Metabolic Research | Year: 2011

Metformin is widely used in clinic for handling the diabetic disorders. However, action mechanisms of metformin remain obscure. It has recently been indicated that guanidinium derivatives are ligands to activate type-2 imidazoline receptors (I-2 receptors) that can improve diabetes through increment in skeletal muscle glucose uptake. Also, activation of I-2 receptors can increase the release of β-endorphin in diabetic animals. Because metformin is a guanidinium derivative, we were interested in the effect of metformin on I-2 receptors. In the present study, the marked blood glucose-lowering action of metformin in streptozotocin-induced type-1 like diabetes rats was blocked by specific I-2 receptor antagonist, BU224, in a dose-dependent manner. Also, the increase of β-endorphin release by metformin was blocked by BU224 in same manner. A specific competition between metformin and BU224 was observed in isolated adrenal medulla. Otherwise, amiloride at the dose sufficient to block I-2A receptor abolished the metformin-induced β-endorphin release, but only the blood glucose-lowering action of metformin was markedly reduced. In addition, the blood glucose-lowering action of metformin in bilateral adrenalectomized rats was diminished by amiloride at higher doses. These results suggest that metformin might activate imidazoline I-2 receptors while I-2A receptors link the increase of β-endorphin release and I-2B receptors couple to the other actions for lowering of blood glucose in type-1 like diabetic rats. © Georg Thieme Verlag KG Stuttgart - New York.

Chen S.-C.,Da Chien General Hospital | Chen S.-C.,Tungnan University | Chen K.-L.,China University of Science and Technology | Chen K.-H.,China University of Science and Technology | And 2 more authors.
World Journal of Pediatrics | Year: 2013

Background: Childhood tuberculosis (TB) accounts for a significant proportion of the global tuberculosis disease burden. However, current and previous efforts to develop better diagnostic, therapeutic, and preventive interventions have focused on TB in adults, and childhood TB has been relatively neglected. The purpose of this review is to provide an update on the diagnostic and therapeutic recommendations for childhood TB with an emphasis on intrathoracic disease. Data sources: The literature from a range of sources was reviewed and synthesized to provide an overview of the contemporary approaches for the diagnosis and treatment of childhood TB. Results: This review summarizes the clinical, radiological, bacteriological, and immunological approaches to diagnose TB infection and disease in children. In addition, we summarize the updated guidelines for the treatment of TB in children. Conclusions: The development of better diagnostic and therapeutic methods for childhood TB remains a significant challenge. As the strategies for diagnosis and treatment of childhood TB continue to improve and the knowledge base increases, the implementation of these strategies will be crucial. © 2013 Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg.

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