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Taichung, Taiwan

Lin H.-H.,Kaohsiung Medical University | Juan C.-W.,Lees Medical Corporation | Juan C.-W.,National Chi Nan University | Chew B.-T.,Tainan Municipal Hospital | Chao J.-H.,Tainan Municipal Hospital
International Journal of Gerontology | Year: 2010

The obturator hernia is a rare form of internal hernia that often presents with a confusing clinical picture. The diagnosis is usually made at laparotomy for small bowel obstruction. It often occurs in elderly, emaciated women. We present a case of obturator hernia in an 89-year-old female. This problem is usually resolved only by surgery. A delay in diagnosis of internal hernia may result in a high probability of morbidity and mortality. Plain abdominal radiography and computed tomography are the most appropriate early diagnostic tools for an obturator hernia. Prompt diagnosis and surgery could have a good clinical result and reduce the mortality rate. Emergency physicians should be alert to the possibility of an obturator hernia. © 2010 Taiwan Society of Geriatric Emergency & Critical Care Medicine. Source


Chen C.-M.,Lees Medical Corporation | Chen C.-M.,Taipei Medical University Hospital | Chen C.-M.,Taipei Medical University | Wu M.-Y.,Taipei Medical University | And 3 more authors.
Pediatrics and Neonatology | Year: 2011

Background: Airway remodeling refers to the structural changes in the airways of asthma. Caveolin-1 reduces cell growth and negatively regulates smooth muscle cell proliferation. The aim was to investigate lung caveolin-1 status in a murine model of acute allergic airway disease. Methods: Six- to eight-week-old female BALB/c mice were sensitized by intraperitoneal injections of phosphate-buffered saline or ovalbumin (OVA) and aluminium hydroxide on Days 0 and 14, challenged with aerosolized saline or OVA (1%) on Days 21-25, 28-32, and 35. The mice were killed 1 day after the last OVA/saline challenge. Serum OVA-specific immunoglobulin E (IgE) was measured by enzyme-linked immunosorbent assay. Peribronchial inflammation was quantified by morphometric analysis. Lung caveolin-1 and Type I collagen mRNA expression was determined by real-time reverse-transcription polymerase chain reaction. Total lung collagen was measured using Sircol Assay Kit. Results: Serum OVA-specific IgE levels were significantly elevated in OVA-challenged mice when compared with saline-challenged mice. Percentage of inflammatory cells in the bronchoalveolar lavage was significantly higher in the OVA-challenged animals. The animals' lungs that were sensitized and challenged with OVA contained large numbers of inflammatory cells concentrated near the airways and in the perivascular areas. The thickness of the bronchial epithelial layer and smooth muscle layer and the numbers of total inflammatory cells and eosinophils significantly increased in OVA-challenged mice. Caveolin-1 mRNA expression significantly decreased and Type I collagen mRNA expression significantly increased in the lung tissue of OVA-challenged mice. Conclusion: These results suggest that caveolin-1 seems to be involved in the pathogenesis of airway remodeling of acute allergic airway disease. © 2011, Taiwan Pediatric Association. Source


Yi Y.-C.,Chung Shan Medical University | Chou P.-T.,Lees Medical Corporation | Chen L.-Y.,Chung Shan Medical University | Kuo W.-H.,Central Taiwan University of Science and Technology | And 3 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2010

Background: The goal of our study was to evaluate the influence of genetic polymorphisms of matrix metalloproteinases (MMP)-2, MMP-3 and MMP-7 on susceptibility to endometrial cancer. Methods: In the present study, we enrolled a total of 118 patients with endometrial cancer confirmed by histopathology, and 229 unrelated healthy individuals. Polymorphism for the MMP-2 (rs2285053), MMP-3 (rs3025058) and MMP-7 (rs11568818) genes was genotyped by polymerase chain reaction-restriction enzyme length polymorphism. Results: The frequencies of MMP-7 -181 G/G and A/G genotypes were found to be significantly higher in cancer patients compared with healthy controls (p=0.017). Stratification showed that individuals with MMP-7 -181 G allele were at increased risk for endometrial cancer when >50 years of age [odds ratios (OR)=2.03; 95% confidence interval (CI) 1.21-3.39], endometrioid (OR=1.80; 95% CI 1.11-2.92), low (stage I-II) (OR=1.73; 95% CI 1.05-2.83) or high stage (stage III-IV) (OR=2.69; 95% CI 1.16-6.24). Compared with the A/A genotype, the A/G+G/G genotype modified the risk of developing endometrial carcinoma and significance was detected in patients over 50 years old, and those with endometrioid type and high stage endometrial cancer. However, no significant difference in MMP-2 (-735 C/T) and MMP-3 (6A/5A) genotypes was observed between endometrial carcinoma cases and controls. Conclusions: This is the first report on the association of MMP-2, MMP-3 and MMP-7 gene polymorphisms in endometrial cancer. Our results suggest that individuals with the MMP-7 -181 G/G and A/G genotype may have an increased risk of developing endometrial cancer. © 2010 by Walter de Gruyter. Source


Liu P.-Y.,Taichung Veterans General Hospital | Liu P.-Y.,Tunghai University | Liu P.-Y.,Tajen University | Shi Z.-Y.,Taichung Veterans General Hospital | And 9 more authors.
Journal of Infection in Developing Countries | Year: 2014

Introduction: The Clinical and Laboratory Standards Institute (CLSI) updated its antimicrobial susceptibility testing interpretation criteria for Enterobacteriaceae. This study assessed the effects of clinical breakpoint changes in the CLSI 2009 to 2012 guidelines on antibiotic susceptibility testing reports. Methodology: In total, 2,076 non-duplicate clinical isolates of Enterobacteriaceae were analyzed. The disk diffusion method was used for susceptibility testing. The CLSI 2009-12 clinical breakpoints were applied to determine susceptibility of cefotaxime and ertapenem. Combined-disk testing was used for phenotypic confirmation of extended-spectrum beta-lactamase (ESBL) production. Results: In total, Enterobacteriaceae resistance rates to cefotaxime increased from 13.1% using the CLSI 2009 guidelines to 23.6% with the CLSI 2010-12 guidelines, and the resistance rates to ertapenem were 0.4%, 1.0% and 0.8% with CLSI 2009, 2011 and 2012, respectively. Based on the 2010-12 CLSI criteria, all ESBL-producing Escherichia coli and Klebsiella pneumoniae were resistant to cefotaxime. Marked differences in susceptibility to ertapenem between the 2009 CLSI criteria and 2012-12 CLSI criteria were noted in ESBL-producing K. pneumoniae. Conclusions: Breakpoints changes in the updated CLSI guidelines resulted in higher resistance rates to cefotaxime and ertapenem. In addition, the effects were different in individual Enterobacteriaceae species. As a result, clinicians may opt to use alternative antimicrobial agents. Upon implementation of the newer CLSI guidelines, laboratories should be aware of the possible consequences and closely monitor the effects. © 2014 Liu et al. Source


Hsu M.-S.,Lees Medical Corporation | Yu J.-C.,Tri Service General Hospital | Wang H.-W.,Academia Sinica, Taiwan | Chen S.-T.,Changhua Christian Hospital | And 6 more authors.
Annals of Surgical Oncology | Year: 2010

Background: Endogenous estrogen is suggested to initiate cell proliferation and cause oxidative DNA damage during breast tumorigenesis. Cells eliminate DNA damage by means of repair enzymes. Genotypic variants of DNA damage repair genes, participating in base excision repair (BER) and nucleotide excision repair (NER) pathways, may act as modifiers that affect the association between estrogen exposure and breast cancer. Methods: In a hospital-based case-control study of female breast cancer, DNA samples were obtained from 401 cases and 533 enrolled healthy controls, all of whom were Chinese women in Taiwan. Genotyping of polymorphisms of XRCC1 (Arg194Trp and Arg399Gln), OGG1 (Ser326Cys and Arg229Gln), ERCC2 Lys751Gln, ERCC4 Ser662Pro, and ERCC5 His1104Asp was performed and used to evaluate breast cancer susceptibility. Results: Of the nonsynonymous polymorphisms, the ERCC5 1104Asp variant was significantly associated with breast cancer (odds ratio = 1.42; 95% confidence interval = 1.08-1.97), and this association was more pronounced in women with lengthy estrogen exposure. A trend toward an increased risk of developing breast cancer was observed in women who carried greater numbers of combined high-risk genotypes of BER and NER genes (P trend = .038). The synergistic effect of multiple genes on the increase of risk was significant in women with a longer period of estrogen exposure (>26 years), greater age at first full-term pregnancy (>26 years), a longer menarche-to-first full-term pregnancy interval (>11 years), and higher body mass index (>22) (all P < .05). Conclusions: This study demonstrates that genotype polymorphisms related to DNA damage repair confer greater susceptibility to endogenous estrogen in the development of breast cancer in women. © 2009 Society of Surgical Oncology. Source

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