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Tainan, Taiwan

Huang S.-C.,Kuo General Hospital | Yang Y.-J.,National Cheng Kung University
Journal of Pediatric Gastroenterology and Nutrition | Year: 2013

OBJECTIVES:: Nonalcoholic fatty liver disease (NAFLD) is identified as a major liver disease in children. The present study aimed to identify the prevalence and predictors of pediatric NAFLD and the correlation between serum retinol-binding protein 4 (RBP4) levels and metabolic characteristics in children. METHODS:: A total of 748 schoolchildren, ages 6 to 12 years, were enrolled in 2009. The body weight and height were measured in the morning before intake. Laboratory tests included overnight fasting serum lipids, insulin, liver enzymes, and RBP4 levels. Hepatic steatosis was determined by ultrasound in 219 volunteers. RESULTS:: The rates of NAFLD were 3% in the normal-weight, 25% in the overweight, and 76% in the obese children. Twenty (22%) of obese children had abnormal alanine aminotransferase (ALT) levels. In children with NAFLD, younger age and higher body mass index (BMI), insulin/homeostasis model of assessment, and male sex rate were associated with abnormal liver function. Stepwise increments in BMI, insulin, homeostasis model of assessment, and ALT were found in children with normal livers to simple steatosis, and to steatosis with abnormal ALT. Multiple logistic regression analysis confirmed that serum RBP4 levels (P = 0.048), ALT (P = 0.048), and BMI (P < 0.001) were independently predictors of pediatric NAFLD. Moreover, multiple linear regression analysis revealed that only serum triglycerides levels were positively related to RBP4 levels (P < 0.001). CONCLUSIONS:: Higher RBP4 and ALT levels as well as BMI are independently associated with pediatric NAFLD in Taiwan. In addition, an increment in RBP4 levels was positively correlated to hypertriglyceridemia in children. Copyright © 2013 by ESPGHAN and NASPGHAN. Source


Lee I.-W.,National Cheng Kung University | Kuo P.-H.,National Taiwan University | Kuo P.-H.,National Cheng Kung University | Su M.-T.,National Cheng Kung University | And 3 more authors.
Human Reproduction | Year: 2011

BACKGROUND: Human spermatogenesis is regulated by complex networks, and estrogens are recognized as one of the significant regulators of spermatogenesis. We tested the associations between variants of estrogen-related genes and semen parameters. Methods We performed genotyping for genetic variants of estrogen-related genes and quantitative trait analysis of fertile and infertile men with well-characterized reproductive phenotypes. Men with known semen parameters (n = 677) were enrolled, including 210 fertile men and 467 infertile men. A total of 17 genetic markers from 10 genes, including 2 estrogen receptors (ER-α, ER-β), 7 estrogen synthesizing/metabolizing genes (CYP19A1, HSD17B1, CYP1A1, CYP1B1, COMT, GSTM1, GSTT1) and 1 transport gene (SHBG) were genotyped. Sperm concentration, motility and morphology were taken as quantitative traits to correlate with genetic variants in the estrogen-related genes. Results Five genes (rs1801132 and rs2228480 of the ER-α gene, rs1256049 and rs4986938 of the ER-β gene, rs605059 of the HSD17B1 gene, rs1799941 of the SHBG gene and rs1048943 and rs4646903 of the CYP1A1 gene) were found to be significantly associated with sperm concentration (P< 0.01), while five genes (rs1801132 of the ER-a gene, rs1256049 of the ER-β gene, rs1048943 of the CYP1A1 gene, rs605059 of the HSD17B1 gene and rs1799941 along with rs6259 of the SHBG gene) were associated with sperm motility (P< 0.01). None of the estrogen-related genes were associated with sperm morphology. With an increasing number of risk alleles, sperm concentration and motility tended to deteriorate and show a loci-dosage effect. CONCLUSIONS Quantitative trait analysis based on a limited number of genetic markers suggests that estrogen-related genes mainly regulate sperm concentration and motility. © The Author 2011. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. Source


Kuo Y.-C.,National Cheng Kung University | Lin Y.-H.,Fu Jen Catholic University | Chen H.-I.,National Cheng Kung University | Wang Y.-Y.,National Cheng Kung University | And 7 more authors.
Human Mutation | Year: 2012

Septins are members of the GTPase superfamily, which has been implicated in diverse cellular functions including cytokinesis and morphogenesis. Septin 12 (SEPT12) is a testis-specific gene critical for the terminal differentiation of male germ cells. We report the identification of two missense SEPT12 mutations, c.266C>T/p.Thr89Met and c.589G>A/p.Asp197Asn, in infertile men. Both mutations are located inside the GTPase domain and may alter the protein structure as suggested by in silico modeling. The p.Thr89Met mutation significantly reduced guanosine-5′-triphosphate (GTP) hydrolytic activity, and the p.Asp197Asn mutation (SEPT12 D197N) interfered with GTP binding. Both mutant SEPT12 proteins restricted the filament formation of the wild-type SEPT12 in a dose-dependent manner. The patient carrying SEPT12 D197N presented with oligoasthenozoospermia, whereas the SEPT12 T89M patient had asthenoteratozoospermia. The characteristic sperm pathology of the SEPT12 D197N patient included defective annulus with bent tail and loss of SEPT12 from the annulus of abnormal sperm. Our finding suggests loss-of-function mutations in SEPT12 disrupted sperm structural integrity by perturbing septin filament formation. © 2012 Wiley Periodicals, Inc. Source


Chang Y.-L.,Kuo General Hospital
Journal of Internal Medicine of Taiwan | Year: 2012

The incidence of hepatocellular carcinoma and relative death is still high in Taiwan. Surgery and local ablation therapy have good effect for treatment of early small tumors. For big tumors or tumors involving major vessels, traditional treatments such as trans-arterial embolization, chemotherapy and radiotherapy has limitation owing to these patients usually have poor performance status at the time. Besides, adverse effects of these treatments induce poor life quality. Target therapy such as Sorafenib has less adverse effect than systemic chemotherapy but its effect for treating hepatocellular carcinoma is not well for many patients. New technique, trans-arterial yttrium-90 (Y90) radioembolization, are gaining acceptance as a potential therapy for hepatocellular carcinoma and liver metastases. Via catheter-based liver-directed therapy, doctor injects micron-sized embolic particles loaded with a radioisotope into specific artery supplies tumor. Local lethal radiation kills tumors without much insult to healthy hepatocytes. With meticulous pretreatment assessment, adverse effect of this treatment is light. Trans-arterial Y90 radioembolization has been adapted in America and many countries for several years, many studies show good effect for controlling hepatocellular carcinoma and liver metastases. Several hospitals in Taiwan apply this new technique to treat proper patients. It may become a common well-tolerable treatment for hepatic tumors in future. Source


Chang Y.-L.,Kuo General Hospital
Journal of Internal Medicine of Taiwan | Year: 2012

Patients with chronic hepatitis C may have extrahepatic manifestations. As medicine science improves and medical service is more available, more diseases are found having relationship to hepatitis C. I reviewed journals and discussed the relationship and possible mechanisms between hepatitis C and hepatic steatosis, insulin resistance and type 2 diabetes mellitus. Hepatitis C core protein influences lipid metabolism in liver cell, so lipid accumulates in liver cell, then causes hepatic steatosis. Treating hepatitis C makes hepatic steatosis recovery. Patients with chronic hepatitis C often have insulin intolerance and often develop type 2 diabetes mellitus. Chronic hepatitis C combines with insulin resistance make hepatic cirrhosis worse. Insulin resistance impairs response of interferon treatment for hepatitis C. To control insulin resistance before or during treatment for hepatitis C with life modification or using some medicines enhance sustained virological response. Beware the relate diseases when we care patients with chronic hepatitis C, control them if they develop. Source

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