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Taipei, Taiwan

Wang C.-W.,New Taipei City Hospital | Wu K.-W.,National Taiwan University Hospital | Wang T.-M.,National Taiwan University Hospital | Huang S.-C.,National Taiwan University Hospital | And 2 more authors.
Clinical Orthopaedics and Related Research | Year: 2014

Background: The Salter osteotomy and Pemberton acetabuloplasty are common procedures for a deficient acetabulum in patients with developmental dysplasia of the hip. However, the degree of increasing retroversion and anterior acetabular coverage of these two procedures remains unanswered. Questions/purposes: The purpose of this study is to show the change in anterior coverage and relevant parameters in measuring pain and function among patients who have undergone either a Salter osteotomy or Pemberton acetabuloplasty. Methods: Forty-two patients who underwent either a Salter or Pemberton procedure at one institution between January 1981 and December 2000 and were available for followup at least 10 years later (mean, 18 years; range, 12-28 years) were evaluated retrospectively. This represented 12% of the Salter and Pemberton procedures performed in patients between 12 and 36 months old at our institution during the study period. We measured vertical-center-anterior margin angle, anterior acetabular head index, and weightbearing zone acetabular index, and we made comparisons using the radiographic parameter ratio (the division of each radiographic measurement of the operative side by that of the nonoperated side). All patients completed SF-36 and Harris hip score questionnaires at followup. Results: In the Salter group, there were no differences in vertical-center- anterior margin angle, anterior acetabular head index, or weightbearing zone acetabular index. In the Pemberton group, there was no difference in vertical-center-anterior margin angle or anterior acetabular head index, but the weightbearing zone acetabular index decreased, suggesting increased anterior acetabular coverage (surgically treated side, 6 [95% CI, 4.84, 7.16]; nonoperated side, 12 [95% CI, 10.07, 13.39]; p < 0.001). Compared with that in the Salter group, the weightbearing zone acetabular index ratio was smaller in the Pemberton group, which means more acquired anterior coverage after a Pemberton acetabuloplasty (Salter procedure, 0.94 [95% CI, 0.70, 1.17], Pemberton procedure, 0.53 [95% CI, 0.40, 0.65]; p < 0.001). Three patients in the Pemberton group had an anterior impingement sign at followup, whereas none in the Salter group did. The SF-36 and Harris hip scores were good and showed no differences between the two groups. Conclusions: Our study suggests the weightbearing zone acetabular index on false profile radiographs of the hip, a parameter focusing on morphologic features of the anterior acetabulum, decreased after Pemberton acetabuloplasty compared with the nonoperated side and after the Salter acetabuloplasty. This suggests that by modifying the shape of the acetabulum with a hinge in the triradiate cartilage, a Pemberton acetabuloplasty may result in increasing acetabular anterior coverage and the risk of hip impingement. However, the functional results with at least 10 years followup were good and similar for both procedures. Level of Evidence: Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence. © The Association of Bone and Joint Surgeons® 2013.

Keller J.,National Taiwan University | Chen Y.-K.,New Taipei City Hospital | Lin H.-C.,Taipei Medical University
Journal of Sexual Medicine | Year: 2012

Introduction. Although the association between epilepsy and sexual disorders has long been known, very few studies have attempted to explore the association between epilepsy and erectile dysfunction (ED). Aim. This population-based case-control study aimed to investigate the association between ED and a prior diagnosis with epilepsy. Methods. This study used data from the Longitudinal Health Insurance Database 2000 in Taiwan. The cases comprised 6,427 patients with a diagnosis of ED and 32,135 controls who were frequency matched with cases based on 10-year age groups and index year. Conditional logistic regression was used to calculate the odds ratios (ORs) for prior epilepsy. Main Outcome Measure. The prevalence and risk of epilepsy between cases and controls. Results. Of the sampled patients, 3,861 (14%) were diagnosed before the index date: 1,358 individuals (19.7%) were cases and 2,503 (12.1%) were controls. After adjusting for hypertension, diabetes, hyperlipidemia, renal disease, coronary heart disease, obesity, alcohol abuse/alcohol dependence syndrome, and socioeconomic status, conditional logistic regression analysis revealed that patients with ED were more likely to have been diagnosed with prior epilepsy than controls (OR=1.83, 95% CI=1.51-2.21). Compared with controls, the adjusted ORs for prior generalized epilepsy and partial epilepsy for cases were 2.13 (95% CI=1.52-3.00) and 1.64 (95% CI=1.31-2.06), respectively. The most pronounced associations were detected in ED cases aged between 30 and 39 who were 3.04 (95% CI=1.67-5.50) times more likely than controls to have been previously diagnosed with epilepsy. Conclusions. Our findings suggest a positive correlation between ED and a prior diagnosis with epilepsy. © 2012 International Society for Sexual Medicine.

Chen S.C.,New Taipei City Hospital | Chen S.C.,Taipei Medical University | Lin Y.L.,National Research Institute of Chinese Medicine | Huang B.,Kaohsiung Medical University | And 3 more authors.
Thrombosis Research | Year: 2011

Introduction: Dysfunction of the endothelium contributes to pathological conditions of the arterial wall including atherosclerosis as a result of immunological and/or inflammatory responses. Salvianolic acid B (Sal B), a pure and active compound extracted from the Chinese herb Salvia miltiorrhizae (SM) was characterized for its anti-inflammatory and anti-oxidant properties on vascular system. Methods and Results: Sal B pretreatment significantly inhibited the IFN-γ-induced phosphorylations of JAK2 (Tyr 1007/1008) and STAT1 (Tyr701 and Ser727). Consistently, IFN-γ-induced STAT1 downstream targets CXC chemokines' IP-10, Mig, and I-TAC were suppressed by Sal B pretreatment. Sal B inhibited promoter activities of IP-10 and the secretion of IP-10 protein. The monocyte adhesion to IFN-γ-treated ECs was observed to be reduced after Sal B pretreatment. ECs treated with Sal B alone also increased the expression of PIAS1 and SOCS1 which may also contribute to its inhibitory effect on JAK-STAT1 signaling pathways. Conclusions: The anti-inflammatory properties of Sal B on IFN-γ-induced JAK-STAT1 activation were demonstrated in the present study which provides a molecular basis for possible therapeutic usage on vascular disorders. © 2011 Elsevier Ltd. All rights reserved.

Chu K.-Y.,New Taipei City Hospital | Yang N.-P.,National Yang Ming University | Chou P.,National Yang Ming University | Chi L.-Y.,National Yang Ming University | Chiu H.-J.,Chung Hwa University of Medical Technology
International Journal of Psychiatry in Medicine | Year: 2011

Objective: Weight gain is common in schizophrenia due to use of the second-generation antipsychotic medicines (SGAs). Studies have also shown that body mass index (BMI) and the side effect of SGAs, such as anticholinergic activity, are related to the risk of dental caries. This study aims to investigate the relationship between BMI, the use of the SGAs, and the decayed, missing, and filled tooth index (DMFT) among hospitalized patients with schizophrenia. Methods: A cross-sectional survey of oral health was conducted in a psychiatric long-term care hospital in Taiwan in 2006. A total of 878 schizophrenic inpatients participated in this survey. The DMFT index was used to assess dental caries, the use of SGAs of subjects were recorded, and the BMI classification was done in accordance with Asian standard scales. Multiple regression models were used to measure the effects of SGAs or BMI on the DMFT index in each subject. Results: Among the subjects with schizophrenia, DMFT is significantly related to independent variables such as age, length of stay, BMI, education, marital status, and grade of disability. Consequent multiple linear regression showed that being underweight (β = 0.07, p = 0.041) and age were the most significant factors that influence the DMFT score. Conclusions: We found that the use of SGAs was not significantly associated with the DMFT index. After adjusting for age, being underweight is a significant factor associated with the increased risk of dental caries in hospitalized patients with schizophrenia. Psychologists and dentists should pay more attention to the relation between BMI and dental caries in this population. © 2011, Baywood Publishing Co., Inc.

Cheng W.-P.,Shin Kong Wu Ho Su Memorial Hospital | Wang B.-W.,Shin Kong Wu Ho Su Memorial Hospital | Chen S.-C.,New Taipei City Hospital | Chen S.-C.,Taipei Medical University | And 3 more authors.
Cardiovascular Research | Year: 2012

Aims The expression of PUMA (p53-up-regulated modulator of apoptosis), an apoptosis-regulating gene, increases during endoplasmic reticulum stress. The mechanisms by which cyclic stretch influences the regulation of PUMA in vascular smooth muscle cells (VSMCs) during apoptosis remain unclear. We hypothesized that cyclic stretch enhances PUMA expression in VSMCs undergoing apoptosis. Methods and Results Human VSMCs grown on a Flexcell I flexible membrane base were stretched via vacuum to 20 of elongation at a frequency of 1 Hz. An in vivo model of volume overload with aorta-caval shunt and pressure overload with aortic banding in adult rats was used to study PUMA expression. Cyclic stretch markedly enhanced PUMA protein and gene expression after stretch. Addition of c-jun N-terminal kinase (JNK) inhibitor SP600125 and interferon-γ (IFN-γ) antibody 30 min before stretch inhibited PUMA expression. Gel shift assay demonstrated that stretch increased the DNA binding activity of interferon regulatory factor-1 (IRF-1). SP600125, JNK small interfering RNA, and IFN-γ antibody attenuated the DNA binding activity induced by stretch. PUMA-Mut plasmid, SP600125, and IRF-1 antibody attenuated the promoter activity. Stretch increased secretion of IFN-γ from VSMCs, and conditioned media from stretched VSMCs increased PUMA protein expression. The in vivo model of aorta-caval shunt and aortic banding also showed increased PUMA protein expression in the aorta. Conclusion Cyclic mechanical stretch increases PUMA expression in cultured human VSMCs. The PUMA expression induced by stretch is mediated by IFN-γ, JNK, and IRF-1 pathways. These findings suggest that PUMA is an important mediator in VSMC apoptosis induced by stretch. © 2011 The Author.

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