Ditmanson Medical Foundation Chiayi Christian Hospital

Chiayi, Taiwan

Ditmanson Medical Foundation Chiayi Christian Hospital

Chiayi, Taiwan
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PubMed | China Medical University at Taichung, Chang Gung University, Foundation Medicine, National Chung Cheng University and Ditmanson Medical Foundation Chiayi Christian Hospital
Type: Journal Article | Journal: International journal of molecular sciences | Year: 2016

Oral squamous cell carcinoma (OSCC), an aggressive cancer originating in the oral cavity, is one of the leading causes of cancer deaths in males worldwide. This study investigated the antitumor activity and mechanisms of piperlongumine (PL), a natural compound isolated from Piper longum L., in human OSCC cells. The effects of PL on cell proliferation, the cell cycle, apoptosis, senescence and reactive oxygen species (ROS) levels in human OSCC cells were investigated. PL effectively inhibited cell growth, caused cell cycle arrest and induced apoptosis and senescence in OSCC cells. Moreover, PL-mediated anti-human OSCC behavior was inhibited by an ROS scavenger N-acetyl-l-cysteine (NAC) treatment, suggesting that regulation of ROS was involved in the mechanism of the anticancer activity of PL. These findings suggest that PL suppresses tumor growth by regulating the cell cycle and inducing apoptosis and senescence and is a potential chemotherapy agent for human OSCC cells.

PubMed | Chang Gung Memorial Hospital Kaohsiung Medical Center, China Medical University at Taichung, Taipei Veterans General Hospital, National Cheng Kung University and 4 more.
Type: Journal Article | Journal: Journal of the Formosan Medical Association = Taiwan yi zhi | Year: 2016

This study aims to examine the characteristics of Taiwanese children with chronic kidney disease (CKD) and delineate the factors that lead to disease progression in this population.We reviewed the records of the Taiwan Pediatric Renal Collaborative Study, a multicenter database of Taiwanese children with CKD. Multivariate regression analysis was used to identify the main factors associated with disease progression.A total of 382 children aged 1-18 years were included in the study (median age was 10.6 years; interquartile range: 6.4-13.8). There were 197 males (51.6%) and 185 females. CKD Stage 1 was diagnosed in 159 children (41.6%), Stage 2 in 160 (41.9%), Stage 3 in 51 (13.4%), and Stage 4 in 12 (3.1%). Fifty-six children (14.7%) experienced CKD progression. A multivariate analysis for all patients indicated that the risk for disease progression was increased in children with CKD secondary to a structural abnormality, genetic disease, anemia, elevated diastolic blood pressure, or elevated blood urea nitrogen. Compared with children with Stage 1 CKD, those with Stage 2 and Stage 4 CKD had decreased risk for CKD progression in this short-term cohort follow-up.CKD etiology affects disease progression. Careful monitoring and treatment of anemia and elevated blood pressure in children with CKD may slow disease progression.

PubMed | Ditmanson Medical Foundation Chiayi Christian Hospital, St Josephs Hospital, National University of Tainan and Chung Hwa University of Medical Technology
Type: Journal Article | Journal: Hu li za zhi The journal of nursing | Year: 2016

Perinatal losses are traumatic events for women and may have serious long-term consequences for the psychological health of women and subsequent pregnancies. Therefore, it is important to explore the psychological adaptation process of subsequent pregnancy after loss in order to understand the overall phenomenon of perinatal loss.To explore the childbearing experiences of women who have experienced a prior stillbirth.This qualitative descriptive study targeted a purposive sample of 15 women who had prior personal experiences with stillbirth. A total of 22 in-depth interviews were conducted in order to ensure data saturation. Women who had experienced stillbirth at one of two teaching hospitals in southern Taiwan were recruited. Data were analyzed using content analysis.Three themes were identified that captured the complex feelings of participants regarding their subsequent childbearing experiences: (1) looking forward to another pregnancy but afraid of being hurt again, (2) treading on thin ice, and (3) bearing another child helps heal the loss of the stillborn.The empirical data gathered in the present study helps build a more complete understanding of the process of recovery that women undergo following a stillbirth experience. In addition, the results suggest that healthcare professionals should be aware of and accept the worries and reactions of women during their subsequent pregnancy in order to help these women achieve a positive subsequent childbearing experience.

PubMed | Changhua Christian Hospital, National Taiwan University Hospital, China Medical University at Taichung, Chia Nan University of Pharmacy and Science and 3 more.
Type: Journal Article | Journal: In vivo (Athens, Greece) | Year: 2016

Conventional anthracyclines play an essential role for the treatment of breast cancer and have potent cytotoxic activity, but are associated with severe toxicity. In metastatic breast cancer, pegylated liposomal doxorubicin (PLD) is a formulation with efficacy similar to conventional doxorubicin but with reduced toxicity. This multicenter study evaluated the efficacy and safety of PLD-based adjuvant chemotherapy for women with stage I-III operable breast cancer.One hundred and eighty women with stage I-III breast cancer who received PLD-based adjuvant chemotherapy at six different Institutions in Taiwan from February 2002 to March 2008 were included and followed-up until April 2015. Treatment efficacy was determined by disease-free survival (DFS) rate and safety was evaluated by adverse events.The 5- and 10-year DFS rates were 76.3 and 72.6%, respectively. Univariate analysis revealed that tumor size >5 cm (p=0.045; hazard ratio=3.31) and stage III (hazard ratio=3.54; p=0.019) were each associated with shorter DFS. Only stage III (hazard ratio=5.60; p=0.018) retained statistical significance with regard to DFS in the multivariate analysis. Grade 3/4 hematological toxicity was neutropenia (n=13; 7.2%). The women receiving PLD had low-grade 3 or 4 nausea/vomiting, mucositis, and alopecia. Grade 3 hand-foot syndrome occurred in three patients (1.7%).PLD could be considered an effective and safe alternative to conventional anthracyclines in the treatment of stage I-III operable breast cancer.

PubMed | China Medical University at Taichung, Ditmanson Medical Foundation Chiayi Christian Hospital, Foundation Medicine and National Chiayi University
Type: | Journal: Pharmacological research | Year: 2016

Thyroid cancer is the most common endocrine malignancy, the global incidence rate of which is rapidly rising. Surgery and radioiodine therapies are common and effective treatments only for nonmetastasized primary tumors. Therefore, effective treatment modalities are imperative for patients with radioiodine-resistant thyroid cancer. Honokiol, a biophenolic compound derived from Magnolia spp., has been shown have diverse biological and pharmacological activities, including anti-inflammatory, antioxidative, antiangiogenic, and anticancer properties. In the present study, three human thyroid cancer cell lines, namely anaplastic, follicular, and poorly differentiated thyroid cancer cells, were used to evaluate the chemotherapeutic activity of honokiol. Cell viability, cell cycle, apoptosis, and autophagy induction were determined through flow cytometry and western blot analysis. We found that honokiol treatment can suppress cell growth, induce cell cycle arrest, and enhance the induction of caspase-dependent apoptosis and autophagy in cancer cells. Moreover, honokiol treatment modulated signaling pathways including Akt/mTOR, ERK, JNK, and p38 in the studied cells. In addition, the antitumorigenic activity of honokiol was also confirmed in vitro and in vivo. Our data provide evidence that honokiol has a unique application in chemotherapy for human thyroid cancers.

PubMed | Chang Gung University, Ministry of Health and Welfare Sinying Hospital and Ditmanson Medical Foundation Chiayi Christian Hospital
Type: Journal Article | Journal: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation | Year: 2016

To investigate the associated factors and change trajectories of quality of life (QoL), global outcome, and post-concussion symptoms (PCS) over the first year following mild traumatic brain injury (mTBI).This was a prospective longitudinal study of 100 participants with mTBI from neurosurgical outpatient departments in Chiayi County District Hospitals in Taiwan. The checklist of post-concussion syndromes (CPCS) was used to assess PCS at enrollment and at 1, 3, and 12months after mTBI; the glasgow outcome scale extended (GOSE), the quality of life after brain injured (QOLIBRI), Chinese version, and the Short Form 36 Health Survey (SF-36), Taiwan version, were used to assess mTBI global outcome and QoL at 1, 3, and 12months after mTBI.Latent class growth models (LCGMs) indicated the change trajectories of QOLIBRI, PCS SF-36, MCS SF-36, GOSE, and PCS. Classes of trajectory were associated with age 40years, unemployment at 1month after injury, and educational level 12years. Univariate analysis revealed that employment status at 1month post-injury was correlated with the trajectories of QOLIBRI, PCS SF-36, MCS SF-36, and GOSE, but not PCS.Employment status was the most crucial associated factor for QoL in individuals with mTBI at the 1-year follow-up. Future studies should explore the benefits of employment on QoL of individuals with mTBI.

Pai M.-C.,National Cheng Kung University | Lee C.-C.,National Cheng Kung University | Lee C.-C.,Ditmanson Medical Foundation Chiayi Christian Hospital
PLoS ONE | Year: 2016

Getting lost (GL) is a serious problem for people living with Alzheimer's disease (PwAD), causing psychological distress in both PwAD and caregivers, and increasing the odds of being institutionalized. It is thus important to identify risk factors for the GL events in PwAD. Between April 2009 and March 2012, we invited 185 community-dwelling PwAD and their caregivers to participate in this study. At the baseline, 95 had experienced GL (Group B); the remaining 90 (Group A) had not. We focused on the incidence of GL events and the associated factors by way of demographic data, cognitive function assessed by the Cognitive Ability Screening Instrument (CASI), and spatial navigation abilities as assessed by the Questionnaire of Everyday Navigational Ability (QuENA). After a 2.5-year period, the incidence of GL in Group A was 33.3% and the recurrence of GL in Group B was 40%. Multiple logistic regression analysis revealed that the inattention item on the QuENA and orientation item on the CASI had independent effects on the GL incidence, while the absence of a safety range was associated with the risk of GL recurrence. During the 2.5 years, the PwAD with GL incidence deteriorated more in the mental manipulation item on the CASI than those without. We suggest that before the occurrence of GL, the caregivers of PwAD should refer to the results of cognitive assessment and navigation ability evaluation to enhance the orientation and attention of the PwAD. Once GL occurs, the caregivers must set a safety range to prevent GL recurrence, especially for younger people. © Copyright: 2016 Pai, Lee. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed | National Cheng Kung University and Ditmanson Medical Foundation Chiayi Christian Hospital
Type: Journal Article | Journal: Hu li za zhi The journal of nursing | Year: 2016

Appropriate exposure to sunlight not only contributes to the production of vitamin D, which has been associated with enhanced bone health, mood, and cognitive functions, but also regulates the secretion of melatonin, which has been associated with the mediation of circadian rhythms, improved sleep quality, and optimized physical and social activity in the elderly. However, damage to the skin, eyes, and immune system has also been widely associated with long-term exposure to sunlight. Several studies have shown that many elderly, especially those that reside in institutions, do not receive sufficient sunlight exposure. Institutionalized elderly tend to participate in indoor activities and spend significant periods of time alone and asleep in front of the television. Furthermore, factors such as poor health, environmental design, indoor/outdoor preference, and activity design may impact the access of institutionalized elderly to sunlight more than their non-institutionalized peers. Therefore, we suggest that in addition to obtaining sufficient levels of vitamin D from their diet and from supplements, the elderly should perform outdoor activities for 20-30 minutes a day for five days each week. Furthermore, we suggest that the environment of the care facility should be made be more accessible and that some activities should be held outdoors.

Liao C.-S.,Ditmanson Medical Foundation Chiayi Christian Hospital
Formosan Journal of Surgery | Year: 2012

Spontaneous intestinal perforation due to tuberculous (TB) enteritis is rare, occurring in 1-15%. Much rarer are TB intestinal perforations among patients receiving their course of anti-TB treatment. This is the so-called paradoxical response phenomenon, e.g., the occurrence of clinical or radiological worsening of pre-existing TB lesions, or the development of new lesions not attributable to the normal course of the disease in a patient who initially improves from the anti-TB treatment. A 52-year-old male patient with three episodes of spontaneous small intestinal perforations in a span of 4.5 months while receiving anti-TB treatment is presented here and the intraperitoneal changes in each operation documented. On each occasion, he recovered uneventfully after resection of the involved segment of intestine. The pathological examination of the resected segments of bowel in the second and third operations failed to show remnant TB granuloma. Seven months after his last operation, he resumed his normal work routine and completed his TB treatment without further medical mishap. The number of spontaneous intestinal perforations in such a paradoxical response phenomenon does not appear to have any bearing on his prognosis for cure of the disease. © 2012.

PubMed | Central Taiwan University of Science and Technology, Ditmanson Medical Foundation Chiayi Christian Hospital, National Chung Cheng University and Chung Shan Medical University
Type: Journal Article | Journal: PloS one | Year: 2016

Lung adenocarcinoma, the most commonly diagnosed type of lung cancer, has a poor prognosis even with combined surgery, chemotherapy, or molecular targeted therapies. Most patients are diagnosed with an in-operable advanced or metastatic disease, both pointing to the necessity of developing effective therapies for lung adenocarcinoma. Surfactant protein B (SP-B) has been found to be overexpressed in lung adenocarcinoma. In addition, it has also been demonstrated that human lung adenocarcinoma cells are susceptible to the JC polyomavirus (JCPyV) infection. Therefore, we designed that the JCPyV virus-like particle (VLP) packaged with an SP-B promoter-driven thymidine kinase suicide gene (pSPB-tk) for possible gene therapy of human lung adenocarcinoma. Plasmids expressing the GFP (pSPB-gfp) or thymidine kinase gene (pSPB-tk) under the control of the human SP-B promoter were constructed. The promoters tissue specificity was tested by transfection of pSPB-gfp into A549, CH27, and H460 human lung carcinoma cells and non-lung cells. The JCPyV VLPs gene transfer efficiency and the selective cytotoxicity of pSPB-tk combined with ganciclovir (GCV) were tested in vitro and in a xenograft mouse model. In the current study, we found that SP-B promoter-driven GFP was specifically expressed in human lung adenocarcinoma (A549) and large cell carcinoma (H460) cells. JCPyV VLPs were able to deliver a GFP reporter gene into A549 cells for expression. Selective cytotoxicity was observed in A549 but not non-lung cells that were transfected with pSPB-tk or infected with pSPB-tk-carrying JCPyV VLPs. In mice injected with pSPB-tk-carrying JCPyV VLPs through the tail vein and treated with ganciclovir (GCV), a potent 80% inhibition of growth of human lung adenocarcinoma nodules resulted. The JCPyV VLPs combined with the use of SP-B promoter demonstrates effectiveness as a potential gene therapy against human lung adenocarcinoma.

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