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Lan M.-Y.,Taichung Veterans General Hospital and 160 | Lan M.-Y.,National Yang Ming University | Shiao J.-Y.,Taichung Veterans General Hospital and 160
European Archives of Oto-Rhino-Laryngology | Year: 2010

The middle fossa approach is a surgical technique indicated for acoustic neuroma with advantages of complete tumor removal and hearing preservation. Various methods have been developed for identifying internal auditory canal (IAC). Here, we describe a new method, which uses greater superficial petrosal nerve (GSPN) and geniculate ganglion (GG) as the only two landmarks to identify IAC. In this study, the surgical anatomy and relations between GSPN, GG, petrous ridge, and IAC were measured on 20 temporal bone specimens and 40 HRCT scans of normal inner ear structures. The temporal bone study showed that the GSPN is nearly parallel to the petrous ridge, with an average angle of about 6 degrees. The line perpendicular to the GSPN from the tip of the GG to the petrous ridge reaches at the porus acousticus, with an average distance of 12.95 mm. The temporal bone HRCT scan study revealed that the length from the tip of the GG to the midpoint of the IAC portion on the line perpendicular to the petrous ridge is about 9.9 mm. We applied this method on 20 temporal bones by drilling the point away from the tip of the GG about 9.9 mm on a line angled with the GSPN about 96 degrees. All IACs were safely identified without damaging the cochlea, the labyrinthine portion of the facial nerve, or the vestibule. In conclusion, the GSPN and GG can be the only two landmarks for safely identifying the IAC without injury to the inner ear structures in the middle fossa approach. © 2010 Springer-Verlag. Source


Chao T.-H.,Taichung Veterans General Hospital | Chao T.-H.,National Chung Hsing University | Fu P.-K.,Taichung Veterans General Hospital | Fu P.-K.,National Taiwan University | And 4 more authors.
Journal of Ethnopharmacology | Year: 2014

Ethno-pharmacological relevance Traditional Chinese medicine (TCM) is commonly provided to cancer patients, however, the patterns of prescriptions for this type of medicine in Taiwan are unclear. This study aimed to evaluate the use of traditional Chinese medicine products in colon cancer patients post-surgery in Taiwan and to research patterns of TCM. Material and Methods This was a cross-sectional study of newly diagnosed colon cancer patients who received surgery between 2004 and 2008 identified from the National Health Insurance Research Database of Taiwan. The prescription patterns and reasons for the use of TCM for colon cancer were analyzed. Results The results showed that "symptoms, signs and ill-defined conditions" (23.3%) and diseases of the digestive system (16.9%) were the most common reasons for using Chinese herbal medicine. Xiang-sha-liu-jun-zi-tang (7.1%), Bu-zhong-yi-qi-tang (4.3%), Jia-wei-xiao-yao-san (4.1%), Shen-Ling-Bai-Zhu-San (3.7%), Ban-Xia-Xie-Xin-Tang (3.4%), Gui-pi-tang (2.4%), Ping-Wei-San (2.4%), Gan-Lu-Yin (2.0%), Bao-He-Wan (1.9%), and Zhen-Ren-Huo-Ming-Yin (1.8%) were the most commonly prescribed single Chinese herbal formulae (CHF) for colon cancer patients post-surgery. Hedyotis diffusa Willd (Bai Hua She She Cao) (5.1%) and Scutellaria barbata (Ban Zhi Lian)(4.8%) were the most commonly prescribed single Chinese herbs. Conclusions This study identified patterns of TCM use in colon cancer patients post-surgery in Taiwan. The herbal ingredients were most commonly used for stimulate ghrelin secretion to increase food intake and had potential anti-tumor effect. However, further research is required to evaluate any beneficial effects which could identify leads for the development of new treatment strategies using TCM. © 2014 Elsevier Ireland Ltd. All rights reserved. Source


Lan M.-Y.,Taichung Veterans General Hospital | Lan M.-Y.,Taipei Veterans General Hospital | Lan M.-Y.,National Yang Ming University | Shiao J.-Y.,Taichung Veterans General Hospital | And 5 more authors.
European Archives of Oto-Rhino-Laryngology | Year: 2011

Sudden sensorineural hearing loss (SSHL) is a disease with unknown etiology. Recently, several studies revealed that some inherited prothrombotic risk factors are associated with SSHL in western populations. The objective of this study was to investigate the roles of the two most common genetic prothrombotic factors, the factor V Leiden G1691A and prothrombin G20210A in Taiwanese patients with SSHL. Twenty-four patients diagnosed with SSHL of more than 30 dB on average pure tone audiometry (PTA) and thirty-six healthy subjects without a history of hearing loss were enrolled in this study. Genomic DNA was isolated from peripheral blood leukocytes and the single nucleotide polymorphisms (SNPs) genotyping of factor V Leiden G1691A and prothrombin G20210A were analyzed using the TaqMan genotyping assays. Neither factor V Leiden G1691A nor prothrombin G20210A was detected in SSHL patients or in the control subjects. Both the patient group and the control group exhibited wild-type V Leiden 1691GG and wild-type prothrombin 20210GG. In conclusion, the factors V Leiden G1691A and prothrombin G20210A do not seem to play any role in Taiwanese patients with SSHL. Further studies with a large series of patients are needed to identify other possible candidate genes in order to elucidate the pathogenesis of SSHL. © 2010 Springer-Verlag. Source


Liao E.-C.,Taichung Veterans General Hospital and 160 | Liao E.-C.,National Yang Ming University | Tsai J.-J.,Taichung Veterans General Hospital and 160 | Tsai J.-J.,National Yang Ming University | Tsai J.-J.,National Chung Hsing University
Journal of Asthma | Year: 2011

Background. House dust mites are a major source of aeroallergens for patients with allergic rhinitis and asthma. Most patients with allergic rhinitis are simultaneously sensitized by Dermatophagoides pteronyssinus (Dp) and Tyrophagus putrescentiae (Tp). Dp and Tp allergy in allergic rhinitis can be caused by cross-reactivity, and the group 2 mite allergens appear to be the major cross-reactive allergens in mites. We previously demonstrated that local nasal immunotherapy (LNIT) with Dp-coated strips could modulate the serum levels of Dp-specific IgE. The aim of this study was to investigate whether Tp allergy could be modulated by LNIT with Dp. Methods. Both Tyr p2-specific IgE in the sera and its effect on Tyr p2-triggered basophil histamine release (BHR) were measured to evaluate the Tp-mediated allergic reaction before and after LNIT. Results. The results showed that not only was Tyr p2-specific IgE reduced, but also Tyr p2-triggered histamine release in the sera after LNIT with Dp allergen strips. There was a significant reduction of Tyr p2-specific IgG1 and upregulation of IgG4 after LNIT with Dp allergen strips. When the amounts of histamine were compared between the two groups, rDer p2-triggering or rTyr p2-triggering histamine release was significantly reduced in the Dp treatment group compared with the normal saline treatment group. No matter in the rDer p2-triggering or rTyr p2-triggering histamine release, differences between before LNIT and after LNIT were statistically significant in the Dp group. Conclusion. Our study demonstrated that not only was Tyr p2-specific IgE reduced in the sera, but also its biological activity of Tyr p2-triggered BHR after LNIT with Dp strips. It is conceivable that the clinical effectiveness of Tp allergy by LNIT with Dp allergen strips may exist. © 2011 Informa Healthcare USA, Inc. Source


Li J.-R.,Taichung Veterans General Hospital and 160 | Li J.-R.,Chung Shan Medical University | Yang C.-K.,Taichung Veterans General Hospital and 160 | Wang S.-S.,Taichung Veterans General Hospital and 160 | And 7 more authors.
Anticancer Research | Year: 2014

Background: Sequential treatments using various targeted-therapies have been recommended for metastatic renal cell carcinoma. However, regimen selection remains difficult when adapting to various clinical situations. Patients and Methods: From 2006 to 2012, 29 patients who received sequential targeted-therapy at our hospital were included for analysis of the treatment regimens and outcome. Results: Patients who used sunitinib as first-line and axitinib as second-line treatment experienced a similar second-line treatment duration, as those used the same first-line and everolimus as the secondline regimen. The first-line sunitinib treatment duration was longer in the axitinib group. Conclusion: Our data showed a promising sequential treatment result using sunitinibaxitinib and sunitinib-everolimus. In patients whose firstline sunitinib treatment resulted in primary resistance, second-line everolimus was found to still contribute a fair degree of disease control. Patients who responded to first-line sunitinib could also achieved fair disease control using second-line axitinib. © 2014, International Institute of Anticancer Research. All rights reserved. Source

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