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Chen S.-S.,Taipei City Hospital Renai Branch | Chen S.-S.,National Yang Ming University | Huang W.J.,National Yang Ming University | Huang W.J.,Taipei Veterans General Hospital
Journal of the Chinese Medical Association | Year: 2010

Background: Varicocele is characterized by abnormal tortuosity and dilatation of the veins of the pampiniform plexus within the spermatic cord and is one of the causes of male infertility. This study aimed to evaluate the differences in biochemical markers and body mass index (BMI) between patients with and without varicocele. Methods: Between January 2004 and June 2009, 102 patients with varicocele (Group A) were evaluated. Ninety-five age-matched male patients who did not have varicocele were selected as controls (Group B). Varicocele was diagnosed by physical examination and confirmed by Doppler ultrasonography. The range of ages was between 18 and 50 years old. BMI, testosterone, serum alkaline phosphatase, calcium, lactic dehydrogenase, inorganic phosphate, γglutamine transpeptidase, uric acid, albumin, iron, cholesterol, triglyceride, alanine aminotransferase, and aspartate aminotrans-ferase levels were measured for all the subjects. Results: The mean age was 35.4 years in group A and 36.5 years in group B. Of the 102 patients in group A, 20 were grade 1 varicocele, 55 were grade 2 and 27 were grade 3. The BMI (mean ± SD) of patients with varicocele (22.8 ± 3.2) was significantly lower than that of patients without varicocele (24.9 ± 4.1). Patients with varicocele had significantly lower serum levels of cholesterol than patients without varicocele (176.5 ± 31.1 vs. 187.7 ± 42.1 mg/dL). There were no significant differences for the other biochemical markers between the groups. Patients with grade 3 varicocele had a lower BMI than patients with grades 1 and 2 varicocele, but this was not significant. No significant differences were found for the other biochemical markers among the patients with grade 1, 2 or 3 varicocele. Conclusion: Patients with varicocele had significantly lower serum levels of cholesterol than those without varicocele. In addition, the prevalence of varicocele was higher in patients with a lower BMI. Our findings suggest that patients with a greater BMI may have advantages in relieving the nutcracker phenomenon, which causes significant varicoceles. © 2010 Elsevier.


Tai H.-C.,National Taiwan University Hospital | Chang A.-C.,China Medical University at Taichung | Yu H.-J.,National Taiwan University Hospital | Huang C.-Y.,National Taiwan University Hospital | And 6 more authors.
Oncotarget | Year: 2014

Bone metastases of prostate cancer (PCa) may cause intractable pain. Wnt-induced secreted protein-1 (WISP-1) belongs to the CCN family (CTGF/CYR61/NOV) that plays a key role in bone formation. We found that osteoblast-conditioned medium (OBCM) stimulates migration and vascular cell adhesion molecule-1 (VCAM-1) expression in human PCa (PC3 and DU145) cells. Osteoblast transfection with WISP-1 shRNA reduced OBCM-mediated PCa migration and VCAM-1 expression. Stimulation of PCa with OBCM or WISP-1 elevated focal adhesion kinase (FAK) and p38 phosphorylation. Either FAK and p38 inhibitors or siRNA abolished osteoblast-derived WISP-1-induced migration and VCAM-1 expression. Osteoblast-derived WISP-1 inhibited miR-126 expression. Moreover, miR-216 mimic reversed the WISP-1-enhanced migration and VCAM-1 expression. This study suggests that osteoblast-derived WISP-1 promotes migration and VCAM-1 expression in human PCa cells by down-regulating miR-126 expression via avß1 integrin, FAK, and p38 signaling pathways. Thus, WISP-1 may be a new molecular therapeutic target in PCa bone metastasis.


Hsu L.-L.,National Taipei University of Nursing and Health Sciences | Huang Y.-H.,Taipei City Hospital Renai Branch | Hsieh S.-I.,Chang Gung University
Patient Education and Counseling | Year: 2014

Objective: The aim of the study was to determine the effects of a simulated communication training course on nurses' communication competence, self-efficacy, communication performance, myocardial infarction knowledge, and general satisfaction with their learning experience. Methods: A randomized controlled trial was conducted with a pre-test and two post-tests. The experimental group underwent simulated communication training course and the control group received a case-based communication training course. Results: The experimental group made more significant improvement in competence and self-efficacy in communication from pre-test to the second post-test than the control group. Although both groups' satisfaction with their learning experience significantly increased from the first post-test to the second post-test, the experimental group was found to be more satisfied with their learning experience than the control group. No significant differences in communication performance and myocardial infarction knowledge between the two groups were identified. Conclusion: Scenario-based communication training can be more fully incorporated into in-service education for nurses to boost their competence and self-efficacy in communication and enhance their communication performance in myocardial infarction patient care. Practice implications: Introduction of real-life communication scenarios through multimedia in communication education could make learners more motivated to practice communication, hence leading to improved communication capacity. © 2014 Elsevier Ireland Ltd.


Chen L.K.,National Taiwan University | Chen S.S.,National Yang Ming University | Chen S.S.,Taipei City Hospital Renai Branch
International Journal of Andrology | Year: 2012

To assess the possible risk factors for developing pain in normospermic adult varicocoele patients, 42 adult patients with left painful varicocoele (group 1) and 35 age-matched patients with left painless varicocoele (group 2) were recruited to this study. All the patients had normal semen quality (spermatozoa density, motility and morphology). Pain score on a 10-cm visual analogue scale was used to assess the scrotal pain as a result of varicocoele. The severity of pain was defined as follows: mild pain (1-3cm), moderate pain (4-6cm) and severe pain (7-10cm). The parameters for comparison included body mass index (BMI), the distance from the renal hilum to scrotum (DRS), semen quality and pH value, serum concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, testosterone, alkaline phosphatase (Alk-p), lactate dehydrogenase (LDH), testicular volume and discrepancy (%), grade of varicocoele and peak retrograde flow (PRF) and spontaneous venous reflux (SVR) by colour Doppler ultrasound and scrotal temperature (ST). The mean ages were 27.8 and 27.1years old in groups 1 and 2, respectively. By multivariate analysis, patients in group 1 had significantly higher PRF, ST, DRS and rate of SVR, and lower BMI than those in group 2. Furthermore, there were significant differences in PRF, DRS and BMI among patients in group 1 with different degrees of pain. Conclusively, normospermic adult patients with left painful varicocoele had significantly higher peak retrograde flow, ST, distance from the renal hilum to scrotum, and rate of spontaneous venous reflux and lower BMI than those with left painless varicocoele. Furthermore, varicocoele patients with severe pain had significantly higher peak retrograde flow and distance from the renal hilum to scrotum, and lower BMI than those with moderate and mild pain. © 2011 The Authors. International Journal of Andrology © 2011 European Academy of Andrology.


Hsiu H.,National Taiwan University of Science and Technology | Hsu W.-C.,Taipei City Hospital RenAi Branch | Hsu C.-L.,National Taiwan University of Science and Technology | Bau J.-G.,Hungkuang University | And 2 more authors.
Microvascular Research | Year: 2013

Beat-to-beat cardiovascular variability analysis provides important information on the circulatory regulatory activities. Changes in the arterial pulse transmission or the opening condition of arteriolar openings might change the fluctuation pattern of the MBF supply, and thus change the complexity property therein. We performed complexity analysis of beat-to-beat laser Doppler flowmetry (LDF) signals to study the microcirculatory-blood-flow (MBF) response at the needled site (Hegu acupoint) following acupuncture stimulation (AS). LDF signals were measured in male healthy volunteers (n = 29). Each experiment involved recording a 20-minute baseline-data sequence and two sets of effects data recorded 0-20 and 50-70. min after stopping AS. Approximate-entropy (ApEn) analysis, which quantifies the unpredictability of fluctuations in a time series, was performed on each 20-minute beat-to-beat LDF data sequence. The present findings indicate that AS can not only improve the local blood supply but may also increase ApEn values and decrease MBF variability parameters. This was the first attempt to apply complexity analysis to LDF signals in order to elucidate microcirculatory responses following AS. The observed results are probably attributable to the contradictory effects on the MBF supply induced by AS, which might interfere with the microcirculatory regulatory activities so as to increase the complexity of LDF signals. The present findings could help to identify the mechanism underlying the effects of AS, might aid the development of an index for monitoring the induced microcirculatory regulatory responses, and thus provide an evidence-based connection between AS and modern physiology. © 2013 Elsevier Inc.


Hsiu H.,National Taiwan University of Science and Technology | Huang S.-M.,Yuan Ze University | Chen C.-T.,Taipei City Hospital RenAi Branch | Hsu C.-L.,Yuan Ze University | Hsu W.-C.,Taipei City Hospital RenAi Branch
Microvascular Research | Year: 2011

The aim of this study was to determine the effects of acupuncture stimulation (AS) in stroke patients by analyzing the pulsatile waveform and frequency content of skin blood-flow signals recorded simultaneously on the bilateral skin surface of the head. Laser Doppler flowmetry (LDF) signals were obtained in 18 stroke patients. Each assessment involved a 20-min baseline recording, a 20-min AS, and a further 20-min recording. Significant bilateral differences in LDF parameters were noted following AS, with an increased pulsatile component of the microcirculatory blood flow (MBF), decreased blood-flow resistance, and decreased MBF variability in the vascular beds on the stroke-affected side. Spectral analysis revealed that the vasodilation on the stroke-affected side could be partly attributed to decreased sympathetic neural activity. This is the first study to demonstrate the feasibility of evaluating the cerebral MBF conditions induced by AS in stroke patients by noninvasive LDF measurement. The present skull-intact measurement setup could aid the development of noninvasive detection techniques for determining bilateral differences in the cerebral MBF, and could thus become useful for the efficacy evaluation of treatment techniques for stroke. It might also promote understanding of the mechanisms underlying the responses and possible treatment efficacy of AS as applied to stroke patients. © 2011 Elsevier Inc.


Hsiu H.,National Taiwan University of Science and Technology | Hsu C.-L.,National Taiwan University of Science and Technology | Chen C.-T.,Taipei City Hospital RenAi Branch | Hsu W.-C.,Taipei City Hospital RenAi Branch | Lin F.-C.,Taipei City Hospital RenAi Branch
Biorheology | Year: 2013

MOTIVATION: Stroke induces abnormal microcirculatory blood flow perfusion resistance in cerebral vascular beds, which may in turn alter the arterial pulse transmission. This study aimed to determine if the frequency-domain harmonic index for the blood-pressure waveform is useful in monitoring the microcirculatory blood flow perfusion response in cerebral vascular beds of stroke patients following acupuncture stimulation. METHODS: Bilateral radial arterial blood-pressure waveform and laser-Doppler flowmetry signals were obtained noninvasively before and after acupuncture in 17 stroke patients. The amplitude proportion (Cn) for all the acquired pulses and the coefficient of variance (CVn) for harmonics 1-10 were calculated to evaluate the blood-pressure harmonic variability. RESULTS: The laser-Doppler flowmetry parameters showed that the cerebral microvascular blood flow supply could be improved following acupuncture. For the blood pressure waveform harmonic index, there were significant increases in C5 and C 6 and decreases in CV5 and CV7 on the stroke-affected side, but no significant changes on the contralateral side. CONCLUSION: Cn values might reflect changes in arterial pulse transmission, and the blood-pressure-harmonic-variability response might be partly attributable to cardiovascular regulatory activities caused by acupuncture-induced changes in the cerebral microvascular blood flow perfusion. The present findings of blood pressure waveform harmonic analysis may be useful to the development of a noninvasive and real-time technique for evaluating treatment efficacy in stroke patients. © 2013 - IOS Press and the authors. All rights reserved.


Wan K.-S.,Taipei City Hospital Renai Branch | Wu C.-S.,Taipei City Hospital Renai Branch
Endocrine Research | Year: 2013

Background. An autoimmune etiology has been suggested in up to one-third of cases of chronic idiopathic urticaria (CIU), in which it has been proposed that a subset of cases are associated with thyroid autoimmunity. The objective of our present study was to verify the prevalence of thyroid antibodies in the patients with CIU. Methods. Sixty patients aged 12-51 years, who met criteria for CIU, and 40 aged-matched healthy controls (18 males and 22 females) were participated in this study. Serum anti-thyroid antibodies (ATAs), thyroid hormones, total immunoglobulin E (IgE), and food allergen-specific IgE antibodies were measured. The CIU group was treated with anti-H1 and anti-H2 histamines for 3 weeks. Results. The total ATA positive rate was 27.3% (33% males and 25% females) in the CIU group. The prevalence of anti-thyroglobulin antibodies, anti-TSH-receptor antibodies, and anti-thyroid peroxidase antibodies were 16.6%, 83.3%, and 8.3%, respectively. The thyroid hormones, T3, and T4, and the TSH were within the normal limits. The radioallergosorbent test was negative for food allergens, and only 18% of the patients had a total IgE concentration >200 IU/mL. Conclusion. ATAs were found in 27% of the patients with CIU, but these antibodies did not dysregulate thyroid hormone secretion nor did they mediate any clinical manifestations. © 2013 Informa Healthcare USA, Inc.


Wu Y.-L.,Taipei City Hospital Renai Branch
Rheumatology International | Year: 2013

Clinically significant renal involvement is uncommon in primary Sjögren's syndrome, amid which tubulointerstitial disorders, distal renal tubular acidosis (dRTA) particularly, account for the majority. Conversely, Sjögren's syndrome comprises at least half the patients presenting with renal tubular acidosis. While underlying dRTA itself is an important cause of nephrocalcinosis and urolithiasis, nephrocalcinosis is rarely a presenting feature of primary Sjögren's syndrome. I report a 41-year-old female contracting nephrocalcinosis and hypokalemia as complications of primary Sjögren's syndrome with dRTA, hereby to emphasize the importance of alkali therapy. © 2010 Springer-Verlag.


Hsiu H.,National Taiwan University of Science and Technology | Hsu W.-C.,Taipei City Hospital RenAi Branch | Wu Y.-F.,National Taiwan University of Science and Technology | Hsu C.-L.,National Taiwan University of Science and Technology | Chen C.-Y.,Taipei City Hospital RenAi Branch
Microcirculation | Year: 2014

Background: Women with PCOS may present abnormal hemodynamic alterations and thus may develop vascular damage. This study performed LDF measurements on the skin surface around the leg to verify if beat-to-beat waveform and spectral analysis can help to discriminate the MBF characteristics between PCOS and healthy subjects. Methods: ECG and LDF signals were obtained noninvasively in PCOS (n = 16) and control (n = 8) subjects. Beat-to-beat waveform and spectral analysis was performed on the LDF signals to obtain the AD, FDT, FRT, and REC of five frequency bands. Results: FRT was significantly larger, AD was significantly smaller, REC of the myogenic-related band was significantly smaller and REC of the heartbeat-related band was significantly larger in the PCOS than in the control subjects. Conclusion: This study is the first to reveal that time-domain waveform and spectral analysis performed on skin-surface LDF signals can be used to discriminate the differences in the MBF perfusion condition and the microcirculatory regulatory activities at local vascular beds between PCOS and healthy subjects. These findings may aid the noninvasive early detection of PCOS-induced vascular damage. © 2013 John Wiley & Sons Ltd.

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