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Chou C.-C.,Chang Gung Memorial Hospital | Bai C.-H.,Taipei Medical University | Bai C.-H.,Central Laboratory | Tsai S.-C.,Graduate Institute of Transition and Leisure Education for Individuals with Disabilities | And 2 more authors.
Internal Medicine

Background Ghrelin has a protective effect on endothelial cells. Endothelial cell dysfunction is associated with cardiovascular disease (CVD) and CVD remains the leading cause of morbidity in hemodialysis (HD) patients. Acylated ghrelin (A-Ghr) is the functional form of ghrelin, so we hypothesized that A-Ghr is associated with the occurrence of CVD in HD patients. Methods We conducted a prospective cohort study in 412 HD patients. The cohort was sub-grouped into low and high A-Ghr groups according to the median A-Ghr level of 4.88 pg/mL. The association between the low/high A-Ghr groups and the incidence of CVD were analyzed. Results The HD patients in a low A-Ghr group had a greater risk of incidental CVD than those in a high A-Ghr ghrelin. This association remained significant after the adjustment for possible confounding factors, including age, gender, HD duration, BMI, diabetes, albumin, nPCR and Charlson's comorbidity index score. Conclusion It appears that a low serum A-Ghr level is associated with the development of CVD in HD patients. © 2010 The Japanese Society of Internal Medicine. Source

Tsai S.-C.,Graduate Institute of Transition and Leisure Education for Individuals with Disabilities
Hormone and Metabolic Research

Previous studies have demonstrated that plasma calcitonin is lower in hypothyroid patients and that thyroxine stimulates the human thyroid to release calcitonin. Therefore, thyroid hormones may regulate the secretion of calcitonin, but further work is needed to address this possibility in more detail. TT cells, a model of human thyroid C cells, were incubated in a medium containing vehicle, thyroxine, or thyroxine methyl-hemisuccinate-bovine serum albumin (BSA-L-T4, thyroxine was immobilized and linked to BSA); then, the levels of secreted calcitonin (hCT), calcitonin mRNA, and cAMP were measured. To study links that connect the cAMP-dependent protein kinase A (PKA) pathway to the observed thyroxine effects, cells were treated with either vehicle or thyroxine plus SQ22536 [an adenylyl cyclase (AC) inhibitor], KT5720 (a PKA inhibitor), or 3-isobutyl-1-methylxanthine (IBMX, a phosphodiesterase inhibitor). The activity levels of AC and PKA, and secreted calcitonin were then measured. The results indicate that thyroxine increases calcitonin secretion, cellular cAMP accumulation, and the activities of AC and PKA, but does not increase hCT mRNA levels in TT cells. BSA-L-T4 also increases calcitonin secretion. These effects are inhibited by SQ22536, and KT5720 and suggest that the nongenomic thyroxine effects that stimulate calcitonin secretion from TT cells involve the cAMP-dependent PKA pathway. © Georg Thieme Verlag KG Stuttgart - New York. Source

Lephart S.M.,University of Pittsburgh | Tsai Y.-S.,Graduate Institute of Transition and Leisure Education for Individuals with Disabilities | Sell T.C.,University of Pittsburgh | Smoliga J.M.,Marywood University | And 2 more authors.
Journal of Orthopaedic and Sports Physical Therapy

Study Design: Controlled laboratory study using a cross-sectional design. OBJECTiVES: To examine the kinematics and kinetics of the trunk and the physical characteristics of trunk and hip in golfers with and without a history of low back pain (LBP). Background: Modified swing patterns and general exercises have been suggested for golfers with back pain. Yet we do not know what contributes to LBP in golfers. To create and validate a low back-specific exercise program to help prevent and improve back injuries in golfers, it may be valuable to understand the differences in biomechanical and physical characteristics of golfers with and without a history of LBP. Methods: Sixteen male golfers with a history of LBP were matched by age and handicap with 16 male golfers without a history of LBP. All golfers underwent a biomechanical swing analysis, trunk and hip strength and flexibility assessment, spinal proprioception testing, and postural stability testing. Results: The group with a history of LBP demonstrated significantly less trunk extension strength at 60°/s and left hip adduction strength, as well as limited trunk rotation angle toward the nonlead side. No significant differences were found in postural stability, trunk kinematics, and maximum spinal moments during the golf swing. Conclusion: Deficits observed in this study may affect a golfer's ability to overcome the spinal loads generated during the golf swing over time. Exercises for improving these physical deficits can be considered, although the cause-effect of LBP in golfers still cannot be determined. Source

Liou C.-M.,Chung Shan Medical University | Yang A.-L.,Graduate Institute of Transition and Leisure Education for Individuals with Disabilities | Kuo C.-H.,Taipei Physical Education College | Tin H.,Chung Shan Medical University | And 4 more authors.
Cell Biochemistry and Function

Objectives Cardiac apoptosis was found in ovariectomized rats without ischemia. Limited information regarding the protective effects of 17β-estradiol (E2) on cardiac Fas-dependent and mitochondria-dependent apoptotic pathways after post-menopause or bilateral oophorectomy in women was available. Methods Forty-eight female Wistar rats at 6-7 months of age were divided into sham-operated group (Sham, n=16) and bilateral ovariectomized group (n=32). After 4 weeks of operation, rats in ovariectomized group were injected intraperitoneally with either saline (OVX, n=16) or 10≤g/kg/day 17β-estradiol (E2) for 10 weeks (OVX-E2, n=16). The excised hearts were measured by Hematoxylin-eosin staining, DAPI staining, positive TUNEL assays, and Western Blotting. Results 17β-estradiol (E2) decreased OVX-induced cardiac widely dispersed TUNEL-positive apoptotic cells. 17β-estradiol (E2) decreased OVX-induced TNF-alpha, Fas ligand (Fas L), Fas death receptors (Fas), Fas-associated death domain (FADD), activated caspase 8, and activated caspase 3 (Fas pathways). 17β-estradiol (E2) decreased OVX-induced proapoptotic t-Bid, Bax, Bax-to-Bcl2 ratio, Bax-to- BclXL ratio, activated caspase 9, and activated caspase 3 as well as increased anti-apoptotic Bcl2 and Bcl-XL relative to OVX (mitochondria pathway). Conclusions Our findings suggest that chronic 17β-estradiol (E2) treatment can prevent ovariectomy-induced cardiac Fas-dependent and mitochondria-dependent apoptotic pathways in rat models. The findings may provide one of possible mechenisms of 17β-estradiol (E2) for potentially preventing cardiac apoptosis after bilateral ovariectomy or menopause. Copyright © 2010 John Wiley & Sons, Ltd. Source

Tsai Y.-L.,Taipei Veterans General Hospital | Tsai S.-C.,Graduate Institute of Transition and Leisure Education for Individuals with Disabilities | Yen S.-H.,Taipei Veterans General Hospital | Yen S.-H.,National Yang Ming University | And 11 more authors.
Child's Nervous System

Objective: External beam radiotherapy (EBRT) is frequently used to improve disease control for pediatric brain tumor patients. However, to facilitate the radiotherapy (RT) procedure, "forced" type interventions including conscious sedation or general anesthesia are frequently used to manage patients' fear and anxiety. The aim of this study was to investigate the effects of therapeutic play (TP) in reducing anxiety for pediatric brain tumor patients treated by EBRT. Methods: Between April 1st and September 30th, 2009, 19 young brain tumor patients, aged 3-15 years and recommended for RT, were recruited: ten to a control group and nine to the study intervention group. The study group was introduced with TP during EBRT. The Beck Youth Anxiety Inventory and the Faces Anxiety Scale were used to evaluate patients' psychological levels of anxiety. The heart rate variability and salivary cortisol concentrations were used to indicate the patients' physical levels of anxiety. Both the psychological and physiological tests were administered to all subjects before and after the RT procedure. Results: The study group had significantly lower anxiety scores and expressed fewer negative emotions than did the control group before EBRT. Conclusions: TP can not only improve the quality of medical services but can also reduce costs and staffing demands. In addition, it can help lower young patients' anxiety and fear during medical procedures. As a result, it further decreases the potential negative impacts of hospitalization on these young patients. © 2013 Springer-Verlag Berlin Heidelberg. Source

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