Time filter

Source Type

Evens A.M.,Northwestern University | Jovanovic B.D.,Northwestern University | Jovanovic B.D.,Dalin Tzu Chi General Hospital | Su Y.-C.,Dalin Tzu Chi General Hospital | And 15 more authors.
Annals of Oncology | Year: 2011

Background: Rituximab has been associated with hepatitis B virus reactivation (HBV-R). However, the characteristics and scope of this association remain largely undefined. Methods: We completed a comprehensive literature search of all published rituximab-associated HBV-R cases and from the Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) MedWatch database. Literature and FDA cases were compared for completeness, and a meta-analysis was completed. Results: One hundred and eighty-three unique cases of rituximab-associated HBV-R were identified from the literature (n = 27 case reports, n = 156 case series). The time from last rituximab to reactivation was 3 months (range 0-12), although 29% occurred >6 months after last rituximab. Within FDA data (n = 118 cases), there was a strong signal for rituximabassociated HBV-R [proportional reporting ratio = 28.5, 95% confidence interval (CI) 23.9-34.1; Empiric Bayes Geometric Mean = 26.4, 95% CI 21.4-31.1]. However, the completeness of data in FDA reports was significantly inferior compared with literature cases (P < 0.0001). Among HBV core antibody (HBcAb(+)) series, the pooled effect of rituximab-based therapy showed a significantly increased risk of HBV-R compared with nonrituximab-treated patients (odds ratio 5.73, 95% CI 2.01-16.33; Z = 3.33, P = 0.0009) without heterogeneity (χ2 = 2.12, P = 0.5473). Conclusions: The FDA AERS provided strong HBV-R safety signals; however, literature-based cases provided a significantly more complete description. Furthermore, meta-analysis of HBcAb(+) series identified a more than fivefold increased rate of rituximab-associated HBV-R. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.


Huang T.-T.,University of Texas Health Science Center at San Antonio | Huang T.-T.,Changhua Christian Hospital | Huang T.-T.,National Chung Cheng University | Gonzales C.B.,University of Texas Health Science Center at San Antonio | And 13 more authors.
Carcinogenesis | Year: 2013

DNA hypermethylation of promoter CpG islands is associated with epigenetic silencing of tumor suppressor genes in oral squamous cell carcinomas (OSCCs). We used a methyl-CpG-binding domain protein capture method coupled with next-generation sequencing (MBDCap-seq) to survey global DNA methylation patterns in OSCCs with and without nodal metastasis and normal mucosa (total n = 58). Of 1462 differentially methylated CpG islands identified in OSCCs relative to normal controls, MBDCap-seq profiling uncovered 359 loci linked to lymph node metastasis. Interactive network analysis revealed a subset of these loci (n = 23), including the anaplastic lymphoma kinase (ALK) gene, are potential regulators and effectors of invasiveness and metastatic progression. Promoter methylation of ALK was preferentially observed in OSCCs without node metastasis, whereas relatively lower methylation levels were present in metastatic tumors, implicating an active state of ALK transcription in the latter group. The OSCC cell line, SCC4, displayed reduced ALK expression that corresponded to extensive promoter CpG island methylation. SCC4 treatment with demethylating agents induced ALK expression and increased invasion and migration characteristics. Inhibition of ALK activity in OSCC cells with high ALK expression (CAL27, HSC3 and SCC25), decreased cell growth and resulted in changes in invasive potential and mesenchymal marker expression that were cell-line dependent. Although ALK is susceptible to epigenetic silencing during oral tumorigenesis, overwriting this default state may be necessary for modulating invasive processes involved in nodal metastases. Given the complex response of OSCC cells to ALK inhibition, future studies are required to assess the feasibility of targeting ALK to treat invasive OSCCs. © The Author 2013. Published by Oxford University Press. All rights reserved.


Wang A.-Y.,Yuanpei University | Kuo C.-L.,Mackay Memorial Hospital | Lin J.-L.,Yuanpei University | Fu C.-M.,National Taiwan University | Wang Y.-F.,Dalin Tzu Chi General Hospital
Journal of Radioanalytical and Nuclear Chemistry | Year: 2010

This study examined the applications of novel non-polymer magnetic ferrite nanoparticles (Fe3O4 NPs) labeled with 99mTc-pertechnetate (99mTcO4 -). The radiochemistry, chemistry, and biodistribution of Fe3O4 NPs labeled with 9mTcO4 - were analyzed. This paper employed instant thin layer chromatography and magnetic adsorption to evaluate the labeling efficiency and stability of 99mTc-Fe 3O4 at various reaction conditions. A scanning electron microscope, X-ray diffractometer, Fourier transform infrared spectrometer, laser particle size analyzer, and superconducting quantum interference device magnetometer were used to analyze the physical and chemical properties of the Fe3O4 and 99Tc-Fe3O4 nanoparticles. The biodistribution and excretion of 99mTc-Fe 3O4 were also investigated. Radiochemical analyses showed that the labeling efficiency was over 92% after 1 min in the presence of a reducing agent. Hydroxyl and amine groups covered the surface of the Fe 3O4 particles. Therefore, 99Tc (VII) reduced to lower oxidation states and might bind to Fe3O4 NPs. The sizes of the 99Tc-Fe3O4 NPs were about 600 nm without ultrasound vibrations, and the particle sizes were reduced to 250 nm under ultrasound vibration conditions. Nonetheless, Fe3O4 NPs and 99Tc-Fe3O4 NPs exhibited superparamagnetic properties, and the saturation magnetization values were about 55 and 47 emu/g, respectively. The biodistribution showed that a portion of the 99mTc-Fe3O4 nanoparticles might embolize in a pulmonary capillary initially; the embolism radioactivity was cleared from the lungs and was then taken up by the liver. 99mTc-Fe3O 4 metabolized very slowly only 1-2% of the injected dose (ID) was excreted in urine and about 2.37% ID/g was retained in the liver 4 h after injection. Radiopharmaceutically, 99mTc-Fe3O4 NPs displayed long-term retention, and only 99mTc-Fe 3O4 NPs that dissociated to free pertechnetate could be excreted in urine. This research evaluated the feasibility of non-polymer magnetic ferrite NPs labeled with technetium as potential radiopharmaceuticals in nuclear medicine. © 2010 Akadémiai Kiadó.


Hsu H.,Taichung Veterans General Hospital | Gueng M.,Taichung Veterans General Hospital | Tseng Y.,Dalin Tzu Chi General Hospital | Wu C.,Taichung Veterans General Hospital | And 2 more authors.
Journal of Clinical Ultrasound | Year: 2011

Gastrointestinal tract duplications are uncommon congenital abnormalities. Carcinoma arising from duplication cyst is extremely rare, not to mention metastasis to other organs. We present a case of adenocarcinoma arising from a colonic duplication cyst with invasion of the serosa and metastasis to the omentum in a 40-year-old man. Duplication cysts should be included in the differential diagnosis of cystic masses of the gastrointestinal tract. Because these lesions occur so infrequently, they are often not suspected until encountered intraoperatively. The specific findings and advantages of sonography are reviewed. © 2010 Wiley Periodicals, Inc.


Lyu S.-R.,Dalin Tzu Chi General Hospital | Lyu S.-R.,Tzu Chi University | Lee C.-C.,Dalin Tzu Chi General Hospital | Lee C.-C.,Tzu Chi University | Hsu C.-C.,Dalin Tzu Chi General Hospital
Medicine (United States) | Year: 2015

Knee pain is a prevailing health problem of middle and old age. Medial plica-related medial abrasion syndrome (MAS), although a well-known cause of knee pain in younger individuals, has rarely been investigated in older individuals. This prospective study was conducted to investigate the prevalence and clinical manifestations of this syndrome as a cause of knee pain in middle and old age. The outcomes of arthroscopic treatment for this syndrome were also evaluated. A total of 232 knees of 169 patients >40 years of age (41-82, median: 63 years old) suffering from chronic knee pain were analyzed. The clinical diagnosis, predisposing factors, presenting symptoms, and physical signs were investigated. The sensitivity and specificity of each parameter of the clinical presentation for the diagnosis of MAS were evaluated after confirmation by arthroscopy. For patients with MAS, the roentgenographic and arthroscopic manifestations were investigated, and arthroscopic medial release (AMR) was performed. The outcomes were evaluated by the changes in the pain domain of the Knee Society scoring system and by patient satisfaction. The prevalence of medial plica was 95%, and osteoarthritis (OA) was the most common clinical diagnosis. Symptoms of pain and crepitus in motion and local tenderness during physical examination were the most sensitive parameters for the diagnosis. A history of a single knee injury combined with local tenderness and a palpable band found during physical examination were the most specific parameters for the diagnosis. The majority of patients suffering from this syndrome were successfully treated using AMR, yielding a satisfaction rate of 85.5% after a minimum of 3 years. MAS is a common cause of knee pain in middle and old age and can be effectively treated by AMR. Its concomitance with OA warrants further investigation. © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Chien S.-H.,Dalin Tzu Chi General Hospital | Chien S.-H.,Tzu Chi University | Hsu H.,Dalin Tzu Chi General Hospital | Hsu H.,Tzu Chi University | And 5 more authors.
Annals of Plastic Surgery | Year: 2012

Simultaneous multiple free flaps have become a useful option in head and neck reconstructions. We performed a 10-year retrospective study between 2001 and 2010. There were 58 men and 1 woman. The overall mortality rate was 51.7%. The longest surviving patient is 9 years and 4 months, whereas the shortest surviving patient was 72 days. The mean survival period was 47.1 (6.8) months. Age (P = 0.755) and tumor size (P = 0.115) did not play a major role, but surgical margin, lymph node, and tumor recurrence were significant in patient survival with a P value of 0.026, 0.01, and 0.026, respectively. If wide excision with a margin that can be free of tumor can be performed, lymph nodes are not involved, and this is a primary tumor, then time and effort should be spent in a successful simultaneous multiple free flap reconstruction. Copyright © 2012 by Lippincott Williams & Wilkins.


Chang S.-C.,Dalin Tzu Chi General Hospital | Wang C.-L.,Dalin Tzu Chi General Hospital
Pediatrics and Neonatology | Year: 2010

Neonatal tetanus is a rare disease in developed countries, but remains common in developing countries. Pregnant women immigrating to Taiwan from developing countries may carry a risk of neonatal tetanus to the child, because of inadequate tetanus toxoid immunization and inappropriate postnatal cord care. Many young pediatricians in Taiwan are unfamiliar with this disease. Herein, we describe the clinical course of a newborn with neonatal tetanus, who was admitted with complaints of difficult feeding and muscle rigidity. After mechanical ventilation for 58 days and a prolonged hospital stay, the infant was discharged in good condition. It is important to maintain a high index of suspicion for neonatal sepsis when infants present with seizure-like symptoms, in order to allow its early diagnosis and appropriate treatment. © 2010 Taiwan Pediatric Association.


PubMed | Dalin Tzu Chi General Hospital
Type: Journal Article | Journal: Hu li za zhi The journal of nursing | Year: 2012

Breast cancer is currently the type of cancer with the highest annual incidence among women in Taiwan, resulting in a median age of death of 57 years. Nevertheless, the proportion of Taiwanese women with a history of mammographic screening is relatively low. The international literature associates participation in mammographic screening with factors such as age, education level, ethnicity, and previous cancer history. Few such studies in Taiwan have addressed a cross-section sample that is representative of the overall population.The present study investigated factors associated with non-utilization of mammographic screening in women aged between 50 to 69 years in Taiwan.This study used secondary data analysis to investigate data obtained from the 2005 National Health Interview Survey in Taiwan. Researchers used logistic regression analysis to evaluate factors associated with mammographic screening in Taiwanese women based on the Andersen behavioral model of health services use.Only 24.3% of the survey population had received mammographic screening. Results of multiple logistic regression analysis indicated non-utilization of mammographic screening is associated with a relatively low education level, being currently employed, a relatively low average monthly salary, having no additional insurance coverage outside the National Health Insurance, having no physical examination history, and having no history of menopausal hormone replacement therapy use.Hospitals and health units may use findings from the present study to plan mammographic screening programs. Mammography promotional material should consider the needs of women with lower education levels; screening schedules should be coordinated with employers and made convenient for working women; and promotional materials should target women who have never previously received a physical examination. Enhancing the willingness of women to obtain mammography may reduce the threat of breast cancer to the lives of Taiwanese women.


PubMed | Dalin Tzu Chi General Hospital
Type: Journal Article | Journal: Annals of plastic surgery | Year: 2012

Simultaneous multiple free flaps have become a useful option in head and neck reconstructions. We performed a 10-year retrospective study between 2001 and 2010. There were 58 men and 1 woman. The overall mortality rate was 51.7%. The longest surviving patient is 9 years and 4 months, whereas the shortest surviving patient was 72 days. The mean survival period was 47.1 (6.8) months. Age (P = 0.755) and tumor size (P = 0.115) did not play a major role, but surgical margin, lymph node, and tumor recurrence were significant in patient survival with a P value of 0.026, 0.01, and 0.026, respectively. If wide excision with a margin that can be free of tumor can be performed, lymph nodes are not involved, and this is a primary tumor, then time and effort should be spent in a successful simultaneous multiple free flap reconstruction.


PubMed | Dalin Tzu Chi General Hospital
Type: News | Journal: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation | Year: 2016

Chylous ascites is a rare complication in liver transplant. Few cases have been reported to date. In most cases, chylous ascites is diagnosed within 1 month after surgery because of intraoperative injury of the hilar lymphatic system. Preoperative massive ascites and use of a LigaSure vessel sealing system for hilar dissection have been reported as risk factors. We report a case of chylous ascites after a living-donor liver transplant that was diagnosed after 6 months of uneventful follow-up. Sirolimus was added to cyclosporine early (2 wk after the operation) owing to poor renal function and it was found to be high (> 22 ng/mL) when the chylous ascites occurred. The patient was treated with total parenteral nutrition in combination with Sandostatin and rapid tapering of sirolimus after the failed initial conservative treatment. Residual abdominal fullness after meals and lymphedema of the legs disappeared 1 month after discontinuing sirolimus. This is the first case of delayed-onset chylous ascites after a liver transplant that was successfully treated conservatively.

Loading Dalin Tzu Chi General Hospital collaborators
Loading Dalin Tzu Chi General Hospital collaborators