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Wu K.-G.,Taipei Veterans General Hospital | Li T.H.,Taipei Veterans General Hospital | Li T.H.,Hualien Armed Forces General Hospital | Wang T.Y.,Taipei Veterans General Hospital | And 2 more authors.
International Journal of Immunopathology and Pharmacology | Year: 2012

We assessed the efficacy of loratadine syrup compared with cyproheptadine HCl solution for treating children aged from 2 to 12 years with perennial allergic rhinitis (PAR) in Taiwan. Sixty children with mite-induced PAR were enrolled and randomly placed into two treatment groups: loratadine syrup or cyproheptadine HCl solution. Treatment efficacy and symptom changes from baseline to post-treatment were evaluated by total symptom scores and visual analogue scales (VAS) during a 2-week period. There were no differences in age, gender, height, or weight between the two groups. After 2 weeks of treatment, there was a significantly greater reduction in symptom scores in the loratadine group than in the cyproheptadine group (p<0.001). Clinical and subjective VAS showed significant differences in percentage changes from baseline between the loratadine and cyproheptadine groups at all time points (all p<0.001, in favor of loratadine). Clinical VAS change at week 1: 95.1 vs 11.3; subjective VAS change at week 1: 88.6 vs 13.6; clinical VAS change at week 2: 125.5 vs 18.3; subjective VAS change at week 2: 101.4 vs 7.1. Thus, loratadine was superior to cyproheptadine for alleviating both nasal and non-nasal symptoms of perennial allergic rhinitis in Taiwanese children aged 2-12 years. Copyright © by BIOLIFE, s.a.s.


Wu K.-G.,Taipei Veterans General Hospital | Li T.-H.,Taipei Veterans General Hospital | Li T.-H.,Hualien Armed Forces General Hospital | Peng H.-J.,Taipei Veterans General Hospital
British Journal of Dermatology | Year: 2012

Background Some probiotics can ameliorate childhood atopic dermatitis (AD). Prebiotics have also shown some efficacy, although when combined with probiotics as synbiotics, their efficacy may improve. Objective We compared the effects of Lactobacillus salivarius and fructo-oligosaccharide (synbiotic) with fructo-oligosaccharide alone (prebiotic) on children with moderate to severe AD. Methods We randomly assigned 60 children aged 2-14 years with moderate to severe AD [SCORing AD (SCORAD) > 25] to a treatment (synbiotic) or a control (prebiotic) group (30 per group). They received one capsule twice daily for 8 weeks containing either L. salivarius plus fructo-oligosaccharide (treatment) or fructo-oligosaccharide only (control). SCORAD indices were monitored at weeks 0, 4, 8 and 10 (post-treatment). Laboratory results and AD medication use were also monitored. Results Baseline demographic and clinical characteristics and SCORAD scores were similar between the two groups. At 8 weeks, the treatment group SCORAD scores (27·4 ± 12·7) were significantly lower than for the controls (36·3 ± 14·9) (P = 0·022); this difference remained at 10 weeks. At 8 weeks, treatment group AD intensity was significantly lower (P = 0·013); more children had mild AD in the treatment group (52%; 14/27) than the control group (30%; 8/27) (P = 0·024). Medication use frequency and eosinophil cationic protein levels were significantly reduced in the treatment group at 8 weeks compared with 4 weeks. Conclusion A synbiotic combination of L. salivarius plus fructo-oligosaccharide is superior to the prebiotic alone for treating moderate to severe childhood AD. However, continued follow-up will be necessary to ascertain long-term benefits. © 2011 British Association of Dermatologists.


Lin G.-M.,Tzu Chi University | Lin G.-M.,Hualien Armed Forces General Hospital | Chen Y.-J.,Hualien Armed Forces General Hospital | Chen Y.-J.,Tzu Chi University | And 5 more authors.
Schizophrenia Bulletin | Year: 2013

Background: Both genetic and environmental factors have been reasoned for cancer development in schizophrenia patients. However, the influence of age of onset and duration of schizophrenia on cancer incidence has rarely been emphasized. Besides, bipolar disorder tends to resemble schizophrenia from the perspective of multiple rare mutations. Comparing pattern and risk of cancers between schizophrenia and bipolar patients is illuminating. Methods: This study used the Taiwan National Health Insurance Database. A total of 71 317 schizophrenia and 20 567 bipolar disorder patients from 1997 to 2009 were enrolled. Both cohorts were followed up for cancer during the same period by record linkage with the cancer certification in Taiwan. Age and gender standardized incidence ratios (SIRs) of overall and site-specific cancers were calculated. Results: The SIR for all cancers was 1.17 for the schizophrenia cohort. Increased cancer risk (SIR: 1.31, 95% CI: 1.17-1.48) was observed in females but not males. For the bipolar disorder cohort, the SIR for all cancers was 1.29, but the excess risk was found in males (SIR: 1.42, 95% CI: 1.14-1.77) and not females. Cancer risk decreases as the duration and age of onset of schizophrenia increases. If schizophrenia is diagnosed before 50, the SIRs for colorectal, breast, cervical, and uterine cancers increase but if diagnosed after 50, the SIRs for all cancers decrease except for breast cancer. In bipolar disorder, the SIRs for all site-specific cancers were insignificant. Conclusions: Among schizophrenia patients, overall cancer risk varies inversely with age at diagnosis and disease duration. Besides, gender-specific cancer risks differ between schizophrenia and bipolar disorder. © 2013 The Author.


Lin G.-M.,Tzu Chi University | Lin G.-M.,Hualien Armed Forces General Hospital | Li Y.-H.,Tzu Chi University | Zheng N.-C.,Tzu Chi University | And 5 more authors.
Journal of Cardiology | Year: 2013

Background: Serum uric acid (SUA) has been observed to be highly associated with the development of cardiovascular disease for more than 50 years. Several studies have reported elevated SUA as an independent predictor of mortality in patients with coronary artery disease (CAD) after adjustment for classic risk factors but some studies did not find similar results. Methods: Between January 1997 and December 2003, a prospective cohort study was performed in 1054 patients with angiographically defined CAD, and their classic risk factors and SUA levels were determined at enrollment. The study cohort was followed for an average of 3.2 years, with a median of 3.1 years. The main outcome measure was death from cardiac disease and any cause. Results: Of all study patients, 789 (74.9%) were men and 265 (25.1%) were women. The mean age of the male and female patients was 64.8 and 66.9 years, respectively. The mean SUA level of all patients was 410.4 μmol/L. There were grading effects of SUA quartiles on cardiac and all-cause mortality in univariate and multivariate Cox regression analyses. After adjustment, the multivariate analyses revealed that patients in the highest SUA quartile (>487 μmol/L) had 2.08 (95% CI = 1.19-3.62, p= 0.01) fold increased risk of cardiac death, and 1.68 (95% CI = 1.10-2.57, p= 0.017) fold increase risk of overall mortality compared with the lowest quartile (<315 μmol/L). Conclusions: SUA may be a significant predictor of cardiac and overall mortality, independent of classic risk factors in high-risk patients with obstructive CAD. © 2012 Japanese College of Cardiology.


Lin G.-M.,Tzu Chi University | Lin G.-M.,Hualien Armed Forces General Hospital | Li Y.-H.,Tzu Chi University | Lin C.-L.,Buddhist Tzu Chi General Hospital | And 3 more authors.
Circulation Journal | Year: 2013

Background: Among patients with coronary artery disease (CAD), high-density lipoprotein cholesterol (HDL-C) is a cardiac protective factor. In contrast, body mass index (BMI) is inversely related to mortality, and this is known as the obesity-mortality paradox. The relationship of HDL-C and BMI to mortality, however, has not been clarified well. The aim of this study was to evaluate the impact of HDL-C and BMI on mortality among CAD patients. Methods and Results: A cohort of 1,114 angiographic CAD patients from the ET-CHD registry during 1997-2003 in Taiwan was studied. The subjects were categorized into 4 groups according to BMI ≥25 kg/m2 (overweight/obese) or BMI <25 kg/m2 (normal/underweight), and HDL-C higher or lower than the median of 40 mg/dl in men and 45 mg/dl in women. At a mean follow-up of 5.3 years, cardiac and all-cause death were the primary endpoints. On multivariate analysis, low HDL-C predicted higher cardiac and all-cause mortality in normal/underweight patients (hazard ratio [HR], 1.59; 95% confidence interval [CI]: 1.08-2.33; and 1.65, 95% CI: 1.25-2.19, respectively). In contrast, high BMI predicted lower cardiac and all-cause mortality in patients with low HDL-C (HR, 0.78; 95% CI: 0.54-1.14; and 0.66, 95% CI: 0.49-0.88, respectively). Conclusions: Among CAD patients in Taiwan, those with low HDL-C and normal/underweight had higher risk of mortality.


Wu K.-G.,Taipei Veterans General Hospital | Li T.-H.,Taipei Veterans General Hospital | Li T.-H.,Hualien Armed Forces General Hospital | Chen C.-J.,Taipei Veterans General Hospital | And 2 more authors.
International Journal of Immunopathology and Pharmacology | Year: 2011

Several laboratory parameters have been investigated for assessing disease activity in children with atopic dermatitis (AD). Analyses of the correlation between these parameters and clinical severity can help to choose a convincing tool. This study compared the significance of serum interleukin-16 (IL-16), serum total immunoglobulin E (IgE), serum eosinophil cationic protein (ECP), and total eosinophil count (TEC) in reflecting AD severity to order to identify the most relevant objective tool for assessing AD activity and to assess the correlation between these laboratory parameters. The Severity Scoring of Atopic Dermatitis (SCORAD index) was used for the assessment of disease activity in 48 pediatric patients in the acute exacerbation phase and in the maintenance phase after improvement of clinical findings with conventional treatment for 8 weeks. Serum levels of total IgE, ECP, and IL-16 as well as TEC were measured on the same time points and compared with healthy non-atopic controls. The correlation between SCORAD and each laboratory parameter was tested for significance and compared. Serum levels of ECP and IL-16 of AD patients were significantly higher than those of controls. These serum parameters, except TEC, declined significantly after conventional treatment with clinical improvement. There was positive correlation with SCORAD for serum IgE (r=0.317, p=0.028), TEC(r=0.434, p=0.002), IL-16 (r = 0.321, p=0.026) in the acute exacerbation phase and with SCORAD for serum IgE (r=0.510, p<0.001), TEC(r=0.489, p<0.001), serum ECP (r=0.468, p=0.001) in the maintenance phase. Serum levels of total IgE, IL-16, ECP, and TEC correlated with the SCORAD index in pediatric patients with atopic dermatitis. Thus, they can serve as serum markers for monitoring disease activity in childhood atopic dermatitis. Copyright © by BIOLIFE, s.a.s.


Jiang C.-P.,National formosa University | Chen Y.-Y.,National formosa University | Hsieh M.-F.,Chung Yuan Christian University | Lee H.-M.,Hualien Armed Forces General Hospital
Biomedical Microdevices | Year: 2013

Bone tissue engineering is an emerging approach to provide viable substitutes for bone regeneration. Poly(ethylene glycol) (PEG) is a good candidate of bone scaffold because of several advantages such as hydrophilicity, biocompatibility, and intrinsic resistance to protein adsorption and cell adhesion. However, its low compressive strength limits application for bone regeneration. Poly(ε-caprolactone) (PCL), a hydrophobic nonionic polymer, is adopted to enhance the compressive strength of PEG alone.We aimed to investigate the in-vitro response of osteoblast-like cells cultured with porous scaffolds of triblock PEG-PCL-PEG copolymer fabricated by an air pressure-aided deposition system. A desktop air pressure-aided deposition system that involves melting and plotting PEG-PCL-PEG was used to fabricate three-dimensional scaffolds having rectangular pores. The experimental results showed that PEG-PCL-PEG with a molecular weight of 25,000 can be melted and stably deposited through a heating nozzle at an air pressure of 0.3 MPa and no crack occurs after it solidifies. The scaffolds with pre-determined pore size of 400× 420 μm and a porosity of 79 % were fabricated, and their average compressive strength was found to be 18.2 MPa. Osteoblast-like cells, MC3T3-E1, were seeded on fabricated scaffolds to investigate the in-vitro response of cells including toxicity and cellular locomotion. In a culture period of 28 days, the neutral-red stained osteoblasts were found to well distributed in the interior of the scaffold. Furthermore, the cellular attachment and movement in the first 10 h of cell culture were observed with time-lapse microscopy indicating that the porous PEG-PCL-PEG scaffolds fabricated by air pressure-aided deposition system is non-toxicity for osteoblast-like cells. © 2013 Springer Science+Business Media New York.


Yeh K.-D.,Hualien Armed Forces General Hospital | Popowics T.E.,University of Washington
Archives of Oral Biology | Year: 2011

Objectives: This study investigated the effects of growth and tooth loading on the structural adaptation of the developing alveolar bone adjacent to the tooth root as the tooth erupted into function. Growth and occlusal function were expected to lead to increased alveolar bone density. Meanwhile, the supporting alveolar bone was expected to develop a dominant trabecular orientation (anisotropy) only after occlusal loading. Design: Minipigs with erupting and occluding mandibular first molars (M1's) were used to study the effects of growth and occlusal function on developing alveolar bone structure through comparison of alveolar bone surrounding M1's. A second minipig model with one side upper opponent teeth extracted prior to occlusal contact with the M1 was raised until the non-extraction side M 1's developed full occlusal contact. The comparisons between extraction and non-extraction side M1 alveolar bone were used to emphasize the impact of occlusal loading on alveolar bone structure. Specimens were scanned on a Scanco Medical μCT 20 at a 22 μm voxel resolution for structural analysis. Results: With growth and occlusal function a distinct alveolar bone proper tended to develop immediately adjacent to the tooth root. The cancellous bone had thicker but fewer and more separated trabeculae after growth or occlusal loading. On the other hand, occlusal function did not lead to increased alveolar structural anisotropy. Conclusion: During tooth eruption, growth and masticatory loads effect structural change in alveolar bone. The impact of occlusal function on cancellous bone anisotropy may need a more extensive period of time to demonstrate.


Chen Y.-C.,Tri Service General Hospital | Lin W.-W.,Tri Service General Hospital | Chen Y.-J.,Hualien Armed Forces General Hospital | Mao W.-C.,Tri Service General Hospital | Hung Y.-J.,Tri Service General Hospital
Mediators of Inflammation | Year: 2010

Growing evidence suggests that mood disorder is associated with insulin resistance and inflammation. Thus the effects of antidepressants on insulin sensitivity and proinflammatory responses will be a crucial issue for depression treatment. In this study, we enrolled 43 non-diabetic young depressed males and adapted standard testing procedures to assess glucose metabolism during 4-week hospitalization. Before and after the 4-week antidepressant treatment, participants underwent oral glucose tolerance test (OGTT) and frequently sampled intravenous glucose tolerance test (FSIGT). Insulin sensitivity (S I), glucose effectiveness (S G), acute insulin response, and disposition index (DI) were estimated using the minimal model method. The plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor- (TNF- ), and adiponectin were measured. The Hamilton depression rating scale (HAM-D) total scores were reduced significantly during the course of treatment. There were no significant changes in the parameters of S I, S G, and DI. Compared to drug nave status, the level of plasma IL-6 was significantly elevated (0.77 to 1.30 pg/ml; P=.001) after antidepressant therapy. However, the concentrations of CRP, TNF- , and adiponectin showed no differences during the course of treatment. The results suggest that antidepressants may promote stimulatory effect on the IL-6 production in the early stage of antidepressant treatment. Copyright © 2010 Yi-Chyan Chen et al.


Lin G.-M.,Hualien Armed Forces General Hospital
Cardiovascular and Hematological Disorders - Drug Targets | Year: 2011

Pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to reduce reperfusion injury after coronary revascularization in acute myocardial infarction and severe coronary artery disease had been approved in animal studies and further demonstrated clinical benefits in phase II study: the COMMA trial and phase III study: the PRIMOCABG trial. However, the negative results of pexelizumab were observed in the COMPLY trial and the APEX-AMI trial. In the APEX-AMI trial, the effectiveness of pexelizumab has reasoned to be prominent in high-risk patients. Similarly, an exploratory analysis of the combined PRIMO-CABG I and II data set using an established predictive risk model demonstrated a mortality benefit for high-risk surgical patients. Accordingly, the result of these trials supported a moderational model to explain the usefulness of pexelizumab affected by the baseline risk profiles of patients. In this regard, we have commented that pexelizumab may be hazardous to patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention without using adequate anti-thrombotic agents (glycoprotein IIb-IIIa antiplatelet inhibitors, clopidogrel and haparin non-responders) according to the results of the experiment by professor Røger and coworkers and the mathematic estimations of the relative risks. Herein, we proposed a mediational model to account for the effectiveness of pexelizumab. © 2011 Bentham Science Publishers.

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