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Kaohsiung, Taiwan

Lin W.-Y.,National Cheng Kung University | Chang Y.-C.,Kaohsiung Medical Center | Ho C.-J.,National Cheng Kung University | Huang C.-C.,National Cheng Kung University
Stroke | Year: 2013

Background and Purpose-: The neurovascular unit is a major target of hypoxia-ischemia (HI) injury in the neonatal brain. Although neurons are the cellular target of ischemic preconditioning (IP), vessel tolerance also contributes greatly to protection. Nerves and vessels cross-talk and use common signals during development. Cellular inhibitor of apoptosis 1 (cIAP1) is an important regulator that inhibits apoptosis. This study hypothesized that cIAP1 is a shared molecule underlying IP-mediated neurovascular protection against HI in the neonatal brain. Methods-: In vivo IP was induced by 2-hour reversible occlusion of right carotid artery 24 hours before HI on postpartum day 7 in rat pups. In vitro oxygen-glucose deprivation (OGD) preconditioning was established in SH-SY5Y neuronal cells and in human microvascular endothelial cell-1 vascular endothelial cells. cIAP1 expression was inhibited by cIAP1 small interfering RNA in vivo or by lentivirus-mediated short hairpin RNA in vitro, or was upregulated by the lentiviral expression system. Results-: IP reduced apoptosis, selectively increased cIAP1 in neurons and vascular endothelial cells, and provided long-term neuroprotection against HI. Intracerebroventricular delivery of cIAP1 small interfering RNA significantly attenuated IP-mediated cIAP1 upregulation and neuroprotection in vivo. In vitro, OGD preconditioning induced cIAP1 and protected against OGD cell death in SH-SY5Y neuronal and human microvascular endothelial cells-1. Knockdown of cIAP1 by lentivirus-mediated short hairpin RNA decreased the protective effect of OGD preconditioning in SH-SY5Y and human microvascular endothelial cell-1, whereas overexpression of cIAP1 by lentivirus protected against OGD in these cells. Conclusions-: cIAP1 is a shared molecule underlying IP-induced protection in neurons and vascular endothelial cells against HI in the neonatal brain. © 2012 American Heart Association, Inc.

Lai M.-C.,Chi Mei Medical Center | Huang L.-T.,Chang Gung University | Huang L.-T.,Kaohsiung Medical Center
Pediatrics and Neonatology | Year: 2011

Evidence continues to mount that adverse experiences early in life have an impact on brain functions. Early life stress can program the development of the hypothalamic-pituitary-adrenal axis and cause alterations of neurochemistry and signaling pathways involved in regulating neuroplasticity, with resultant neurobehavioral changes. Early life experiences and genetic factors appear to interact in determining the individual vulnerability to mental health disorders. We reviewed the effects of early life stress on neuroendocrine regulation and the relevance to neurobehavioral development. Copyright © 2011, Taiwan Pediatric Association.

Chuang F.-C.,Kaohsiung Medical Center | Kuo H.-C.,Tzu Chi University
Journal of the Formosan Medical Association | Year: 2010

Background/Purpose: To investigate the prevalence of lower urinary tract symptoms (LUTS), their impact on quality of life, and their association with socioeconomic and lifestyle factors among indigenous and non-indigenous women in Eastern Taiwan. Methods: A total of 376 indigenous women and 509 non-indigenous women aged over 18 years were interviewed concerning LUTS in the recent 6 months using International Prostate Symptom Score questionnaires. Results: Indigenous women had a higher prevalence of one or more LUTS than non-indigenous women (44.9% vs. 31.2%). Indigenous women had a significantly higher prevalence of urgency (7.7% vs. 4.3%, p = 0.024), straining to void (6.1% vs. 3.3%, p = 0.036), and nocturia (37.2% vs. 24.8%, p < 0.001) than non-indigenous women. There was no significant difference in the prevalence of impaired quality of life between indigenous and non-indigenous women (33.8% vs. 31.2%). Lower educational level, alcohol consumption, betel quid chewing, and cigarette smoking, and not difference in race, had significant effect on a higher prevalence of bothersome LUTS in indigenous women than non-indigenous women. Conclusion: Indigenous women with lower educational level and specific lifestyle risk factors have a higher prevalence of LUTS than non-indigenous women in Taiwan. © 2010 Formosan Medical Association & Elsevier.

Chuang F.-C.,Kaohsiung Medical Center | Chuang F.-C.,Chang Gung University | Kuo H.-C.,Buddhist Tzu Chi General Hospital | Kuo H.-C.,Tzu Chi University
PLoS ONE | Year: 2013

Objective:This study was designed to investigate whether increased urothelial cell apoptosis and chronic inflammation might contribute to recurrent urinary tract infection (UTI) in women.Methods:The bladder biopsy specimens were collected from thirty women with recurrent UTI and ten controls. The bladder biopsies were performed at one to two months after UTI episode had been completely resolved and urine analysis and urine culture all showed negative. Immunofluorescence staining of the adhesive protein E-cadherin, mast cell and TUNEL were performed in all the bladder specimens. In addition, western blots were also performed to analyze the inflammatory proteins (phospho-p38, tryptase) and apoptotic protein (Bax) in the bladder mucosa specimens between patients with recurrent UTI and controls.Results:Immunofluorescence staining showed significantly lower E-cadherin in the recurrent UTI bladder tissue compared with the controls (25.4±8.9 v 42.4±16.7, p<0.0001). The mast cell expression was significantly stronger in the recurrent UTI bladder tissue compared with the controls (2.5±1.8 v 1.3±1.2, p = 0.046). TUNEL staining revealed a significantly higher numbers of apoptotic cells in the recurrent UTI bladder tissue compared with the control bladder tissue (1.5±1.8 v 0.08±0.3, p<0.0001). Western blot analysis also showed that the expressions of tryptase and Bax increased in five recurrent UTI specimens compared with two normal control specimens.Conclusion:Chronic inflammation, urothelial cell apoptosis and impairment of barrier function of urothelial cells might contribute to recurrent UTI in women. © 2013 Chuang, Kuo.

Chou W.-J.,Kaohsiung Medical Center
Journal of the Formosan Medical Association | Year: 2010

Background/Purpose: Marriages between Taiwanese men and immigrant women are common in Southern Taiwan. However, little is known about the adjustment of these women to life in Taiwan and their children's development as a result of cross-national marriage. This study evaluated the psychological status and adjustment of the foreign-born mothers in Taiwan, and assessed the influence of their immigrant motherhood on child development. Methods: Ninety-four immigrant mothers (41 Chinese, 37 Vietnamese, and 16 Southeast Asian women) and their 104 children born in Taiwan were enrolled in this study. Information was obtained by a clinical interview for medical history and sociodemographics, and five standardized self-administered questionnaires for maternal general mental health, maternal depression, maternal cognitive functioning, home environment, and child development. Results: Chinese mothers were significantly more educated and less likely to marry via referral agencies than mothers from Vietnam and other countries in Southeast Asia. Husbands of Chinese mothers significantly better educated, less likely to have physical illnesses, and were closer in age to their wives than husbands in the other two groups. Immigrant mothers had high rates of psychological distress (70%) and marked depression (24%). Longer residency in Taiwan predicted a higher likelihood of maternal depression, especially in the Southeast Asian mothers. Chinese mothers had the highest degree of cognitive functioning and provided a better home environment for their children. Childhood developmental delay was predicted by older child age and parental marriage via referral agencies. Conclusion: This study highlights the need to give continuous psychosocial support to immigrant mothers and to identify early developmental delays among their children. © 2010 Formosan Medical Association & Elsevier.

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