Shyu L.-Y.,Chung Shan Medical University |
Yeh T.-M.,National Cheng Kung University |
Chang H.-H.,Chung Shan Medical University |
Lin D.P.-C.,Chung Shan Medical University |
And 4 more authors.
Thrombosis Research | Year: 2012
Macrophage migration inhibitory factor (MIF) is an important cytokine in the modulation of inflammatory and immune responses, but its role in coagulation remains to be elucidated. In this study, we investigated the potential role of MIF in coagulation through its influence on two factors, thrombomodulin (TM) and intercellular adhesion molecule-1 (ICAM-1). Recombinant human MIF was added to human microvascular endothelial cell line (HMEC-1) to investigate its influence on the expression of TM and ICAM-1. The results showed that both TM and ICAM-1 were induced with MIF addition in a dose-dependent and time-dependent manner. The expression of ICAM-1 and TM was increased as MIF doses were increased, with the highest expression seen at 12 hr after 400 ng/ml of MIF treatment. Besides, anti-MIF antibody treatment reduced the TM expression in HMEC-1 cells. In conclusion, our data support a role of MIF as an important factor in the regulation of coagulation. © 2011 Elsevier Ltd.
Chiu C.-T.,Chang Gung Memorial Hospital |
Chiang W.-F.,Chi Mei Medical Center Liouying |
Chuang C.-Y.,Sin Lau Christian Hospital |
Chang S.-W.,Chang Gung Memorial Hospital
Journal of Oral and Maxillofacial Surgery | Year: 2010
Purpose: To offer recommendations of risk factors, prevention, and treatment of oral bisphosphonate and steroid-related osteonecrosis of the jaw (BSRONJ) in Taiwan. Materials and Methods: Twelve patients were clinicopathologically proved to have bisphosphonate-related osteonecrosis of the jaw (BRONJ). All of the patients were taking oral bisphosphonates and were concurrently administered long-term steroids. Of the 12 patients, 3 patients were assigned to the first stage of BRONJ; 5 patients were assigned to the second stage, and 4 patients were assigned to the third stage. The patients' symptoms, localization of necrosis, presence of a fistula, and association with possible triggering factors for onset of the lesion were recorded. Results: The radiologic investigations revealed osteolytic areas and scintigraphy demonstrated increased bone metabolism. Microbiologic analysis showed pathogenic actinomycosis organisms in a majority of patients (91.6%). Antibiotic therapy, minor debridement surgery, and combined hyperbaric oxygen therapy were useful in obtaining short-term symptomatic relief. Conclusions: Comorbidities of steroid use along with bisphosphonates may cause osteonecrosis of the jaw to occur sooner, be more severe, and respond more slowly to a drug discontinuation. The clinical disease of BSRONJ is more severe and more unpredictable to treat than BRONJ. From the data gained from other published studies of BRONJ and our clinical experience with the series of cases of BSRONJ, we offer recommendations of risk factors, prevention, and treatment of BSRONJ in southern Taiwan. © 2010 American Association of Oral and Maxillofacial Surgeons.
Hwang J.-C.,Chi Mei Medical Center |
Wang C.-T.,Chi Mei Medical Center |
Chen C.-A.,Sin Lau Christian Hospital |
Chen H.-C.,Kaohsiung Medical University
Blood Purification | Year: 2011
Background: Both hypokalemia (hypoK) and hyperkalemia (hyperK) are life-threatening to hemodialysis (HD) patients. This study was conducted to compare their clinical characteristics and long-term survival. Methods: Patients were divided into three groups according to the last mid-week predialysis serum potassium concentrations: hypoK (<3.5 mEq/l), normoK (between 3.5 and 5.5 mEq/l), and hyperK (>5.5 mEq/l). The maximal duration of the follow-up period was 54 months. Results: Compared with the hyperK group,patients in the hypoK group were older (p <0.05), had a higher incidence of comorbidity factors, less body weight gain prior to HD (p < 0.05), lower body mass index (BMI, p < 0.05), and higher BUN to creatinine ratio and hs-CRP (p < 0.05). The serum albumin and prealbumin concentrations were also lowest in the hypoK group, compared with the normoK and hyperK groups, respectively (all p < 0.001). A similar finding was also obtained for the normalized protein catabolism rate (nPCR, p < 0.001) among the three groups. Positive linear correlations between serum albumin and potassium concentration were only found in the hypoK and normoK groups (p < 0.001). Multiple logistic regression analysis showed that hypoalbuminemia, low BUN, and phosphate concentrations were significantly correlated with hypoK. HypoK patients also had a lower cumulative survival rate than hyperK patients. Conclusion: HypoK HD patients, with lower serum levels of albumin, prealbumin, nPCR, and BMI, but higher level of hs-CRP, showed a malnutritional and inflammatory status, and caused increased mortality rate. © 2011 S. Karger AG, Basel.
PubMed | Chi Mei Medical Center, St Martin Of Porres Hospital, Sin Lau Christian Hospital, Kaohsiung Chang Gung Memorial Hospital Kaohsiung Medical Center and 4 more.
Type: Journal Article | Journal: Leukemia & lymphoma | Year: 2016
This study retrospectively investigated 54 cases of sporadic Burkitt lymphoma in Taiwan with histopathology review, immunohistochemistry, Epstein-Barr virus (EBV) in situ hybridization (EBER) and fluorescence in situ hybridization (FISH). The great majority revealed typical immunophenotype and 89% (47/53) cases expressed myc protein. EBER was positive in 20% (11/54) of cases, more frequently with nodal presentation, but not significantly associated with age (pediatric vs. adult), abdominal vs. extra-abdominal presentation or overall survival (OS). MYC and IGH were rearranged in 94% (46/49) and 85% (41/48) of cases, respectively. The concordance rate between myc expression and MYC translocation was 83% (40/48). By univariate analysis, OS was statistically associated with age, with or without chemotherapy, central nervous system (CNS) involvement, CNS prophylaxis and leukemic transformation, but not gender, nodal vs. extranodal involvement, stage, immunohistochemistry, EBER, myc expression, MYC translocation or radiotherapy. By multivariate analysis, CNS involvement at presentation and administration of chemotherapy were statistically associated with OS.
Yen J.-M.,Kuo General Hospital |
Lin C.-H.,National Cheng Kung University |
Yang M.-M.,Sin Lau Christian Hospital |
Hou S.-T.,Sin Lau Christian Hospital |
And 2 more authors.
Pediatrics and Neonatology | Year: 2010
Eosinophilia is common in premature infants, though its clinical significance remains unknown. This study investigated the pattern of eosinophilia and related factors in very low birth-weight (VLBW) infants. The medical records of VLBW infants (birth body weight < 1500 g) admitted to the neonatal intensive care unit of a tertiary care center of Cheng Kung University Hospital between January 2005 and June 2007 were analyzed. Complete blood counts (CBC) with differential leukocyte counts were performed weekly. Eosinophilia was defined as an eosinophil count of more than 0.700 × 109/L. The possible related factors were analyzed. A total of 142 infants were recruited into the study. Those who did not survive after the first 28 days and those with less than four available CBCs were excluded, leaving 107 infants and 828 CBC measurements. Overall, 19.0 of CBCs (157/828) indicated eosinophilia and 69.0 of all infants had at least one instance of eosinophilia during their hospital stay. Eosinophilia mainly occurred in the third week of life (27.1), with an average peak eosinophil count of 0.520 × 109/L. There were 37.3 of patients with mild eosinophilia (0.700-0.999 × 10 9/L), 50.7 with moderate eosinophilia (1.000-2.999 × 10 9/L), and 12 with severe eosinophilia (≥3.000 × 10 9/L). The demographic data and perinatal characteristics of infants with and without eosinophilia were comparable. Medical treatments including mechanical ventilation, antibiotic administration, total parenteral nutrition, intravenous catheterization, transfusion, and body weight gains were similar between the two groups. The eosinophil counts in the first week of life were significantly higher in infants with bronchopulmonary dysplasia (p < 0.05). They were also greater in VLBW infants with sepsis at the first, the third, the fourth, the fifth and the seventh weeks (p < 0.05). Eosinophilia is common in VLBW infants and occurs mainly in the third week of life. Higher eosinophil counts were associated with sepsis and family history of atopic eczema. Bronchopulmonary dysplasia was associated with higher eosinophil counts in the first week of life. © 2010 Taiwan Pediatric Association.
Tsai K.-S.,Sin Lau Christian Hospital |
Chang H.-L.,U.S. Center for Disease Control and Prevention |
Chang H.-L.,Chung Cheng Institute of Technology |
Chien S.-T.,Chest Hospital |
And 4 more authors.
Pediatrics and Neonatology | Year: 2013
Despite the existence of a government-run tuberculosis (TB) control program, the current nationwide burden of TB continues to be a public health problem in Taiwan. Intense current and previous efforts into diagnostic, therapeutic, and preventive interventions have focused on TB in adults, but childhood TB has been relatively neglected. Children are particularly vulnerable to severe disease and death following infection, and children with latent infections become reservoirs for future transmission following disease reactivation in adulthood, thus fueling future epidemics. Additional research, understanding, and prevention of childhood TB are urgently needed. This review assesses the epidemiology, diagnosis, treatment, and relevant principles of TB vaccine development and presents efficacy data for the currently licensed vaccines. Copyright © 2013, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.
Wu T.-P.,Sin Lau Christian Hospital |
Huang Y.-L.,Taipei Medical University |
Liang F.-W.,National Cheng Kung University |
Lu T.-H.,National Cheng Kung University
Taiwanese Journal of Obstetrics and Gynecology | Year: 2015
Objective: This study examined the extent to which maternal mortality in Taiwan is underreported in officially published mortality statistics. Materials and methods: We used National Health Insurance claims data collected from two million samples, which were linked with the officially published mortality data, to identify women aged 15-49 years, who were admitted to a hospital with pregnancy-related diagnoses during 2000-2009 and died during the pregnancy or within 42 days after the termination of pregnancy. Results: Based on these linked data, we identified 26 maternal deaths, only nine of which were reported in the original officially published mortality data; thus, the rate of underreporting was 65% [(26 - 9)/26]. The revised maternal mortality ratio was 14.1 deaths per 100,000 live births (95% confidence interval: 8.7-19.5), which was approximately three times higher than the official reported ratio of 4.9 (95% confidence interval: 1.7-8.1). The most common cause of maternal deaths was amniotic fluid embolism (n = 10), followed by eclampsia and preeclampsia (n = 4). Conclusion: Approximately two-thirds of the maternal deaths in Taiwan were unreported in the officially published mortality data. Hence, routine nationwide data linkage is essential to monitor maternal mortality in Taiwan accurately. © 2015.
Sy E.D.,National Cheng Kung University |
Chiu Y.-I.,National Cheng Kung University |
Shan Y.-S.,National Cheng Kung University |
Ong R.L.,Sin Lau Christian Hospital
International Journal of Surgery Case Reports | Year: 2015
Introduction A pneumatic tool or air tool such as blow gun dust cleaner is a tool driven by compressed air and spraying of the perineum can insufflate the colon due to its high pressure and high flow rate.Presentation of case We present a case of 4 year old boy who developed sudden onset of tense abdominal distention and developed peritonitis. Patient's family initially denied a history of trauma. Radiologic examination showed pneumoperitoneum and colon dilatation. Exploratory laparotomy revealed a tension pneumoperitoneum, bloody ascitic fluid, multiple site of ecchymosis and serosal tear of the colon and a minute perforation of transverse colon. Postoperative reinvestigation revealed that the patient's perineum was sprayed, using blow gun dust cleaner.Discussion Air from pneumatic tools produces column of air at pressure of 3.5-8.8 kg/cm2 and pressure greater than the resting anal pressure of 0.109 kg/cm2 force air to enter the colon when the perineum is sprayed. Different degree of colon injury results when airflow is greater than 1.46 L/m, and/or intraluminal pressure greater than 0.109 kg/cm2. In most children, initial anxiety to tell the truth result in difficulty to obtain good history.Conclusion Spraying of the perianal with excessive pneumatic force of greater than the resting anal pressure and high air flow rate causes multiple site colon injury and tension pneumoperitoneum due to colon perforation. Parent should be caution in children playing with high pressure pneumatic tool, and the importance of history is emphases for early correct diagnosis. © 2014 The Authors. Published by Elsevier Ltd.
PubMed | National Cheng Kung University, Ministry of Health and Welfare, Taipei Medical University and Sin Lau Christian Hospital
Type: Journal Article | Journal: PloS one | Year: 2015
To examine the changes in the maternal mortality ratio (MMR) and causes of maternal death in Taiwan based on nationwide linked data sets.We linked four population-based data sets (birth registration, birth notification, National Health Insurance inpatient claims, and cause of death mortality data) to identify maternal deaths for 2004-2011. Subsequently, we calculated the MMR (deaths per 100,000 live births) and the proportion of direct and indirect causes of maternal death by maternal age and year.Based on the linked data sets, we identified 236 maternal death cases, of which only 102 were reported in officially published mortality data, with an underreporting rate of 57% [(236-102) 100 / 236]. The age-adjusted MMR was 18.4 in 2004-2005 and decreased to 12.5 in 2008-2009; however, the MMR leveled off at 12.6 in 2010-2011. The MMR increased from 5.2 in 2008-2009 to 7.1 in 2010-2011 for patients aged 15-29 years. Women aged 15-29 years had relatively lower proportion in dying from direct causes (amniotic fluid embolism and obstetric hemorrhage) compared with their counterpart older women.Approximately two-thirds of maternal deaths were not reported in officially published mortality data. Routine surveillance of maternal mortality by using enhanced methods is necessary to monitor the health status of reproductive-age women. Furthermore, a comprehensive maternal death review is necessary to explore the preventability of these maternal deaths.
PubMed | National Cheng Kung University, Taipei Medical University and Sin Lau Christian Hospital
Type: Journal Article | Journal: Taiwanese journal of obstetrics & gynecology | Year: 2015
This study examined the extent to which maternal mortality in Taiwan is underreported in officially published mortality statistics.We used National Health Insurance claims data collected from two million samples, which were linked with the officially published mortality data, to identify women aged 15-49 years, who were admitted to a hospital with pregnancy-related diagnoses during 2000-2009 and died during the pregnancy or within 42 days after the termination of pregnancy.Based on these linked data, we identified 26 maternal deaths, only nine of which were reported in the original officially published mortality data; thus, the rate of underreporting was 65% [(26 - 9)/26]. The revised maternal mortality ratio was 14.1 deaths per 100,000 live births (95% confidence interval: 8.7-19.5), which was approximately three times higher than the official reported ratio of 4.9 (95% confidence interval: 1.7-8.1). The most common cause of maternal deaths was amniotic fluid embolism (n = 10), followed by eclampsia and preeclampsia (n = 4).Approximately two-thirds of the maternal deaths in Taiwan were unreported in the officially published mortality data. Hence, routine nationwide data linkage is essential to monitor maternal mortality in Taiwan accurately.