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Austin P.F.,Washington University in St. Louis | Bauer S.B.,Harvard University | Bower W.,Aarhus University Hospital | Chase J.,Childrens Center | And 9 more authors.
Journal of Urology | Year: 2014

Purpose The impact of the original International Children's Continence Society terminology document on lower urinary tract function resulted in the global establishment of uniformity and clarity in the characterization of lower urinary tract function and dysfunction in children across multiple health care disciplines. The present document serves as a stand-alone terminology update reflecting refinement and current advancement of knowledge on pediatric lower urinary tract function. Materials and Methods A variety of worldwide experts from multiple disciplines in the ICCS leadership who care for children with lower urinary tract dysfunction were assembled as part of the standardization committee. A critical review of the previous ICCS terminology document and the current literature was performed. In addition, contributions and feedback from the multidisciplinary ICCS membership were solicited. Results Following a review of the literature during the last 7 years the ICCS experts assembled a new terminology document reflecting the current understanding of bladder function and lower urinary tract dysfunction in children using resources from the literature review, expert opinion and ICCS member feedback. Conclusions The present ICCS terminology document provides a current and consensus update to the evolving terminology and understanding of lower urinary tract function in children. For the complete document visit http://jurology.com/. © 2014 by American Urological Association Educaton and Research, Inc.


Peng G.-S.,National Defense Medical Center | Chen Y.-C.,Taipei Tzu Chi Hospital | Wang M.-F.,National Defense Medical Center | Lai C.-L.,Chang Gung University | Yin S.-J.,National Defense Medical Center
Pharmacogenetics and Genomics | Year: 2014

It has been well documented that variant alleles of both ADH1B∗2 of alcohol dehydrogenase (ADH) and ALDH2∗2 of aldehyde dehydrogenase (ALDH) protect against the development of alcoholism in East Asians. However, it remains unclear whether ADH1B∗2 contributes significantly toward the accumulation of systemic blood acetaldehyde and whether it plays a critical role in the alcohol flushing reaction. PARTICIPANTS AND METHODS: Sixty-one adult Han Chinese men were recruited and divided into six combinatorial genotypic groups: ALDH2∗1/∗1-ADH1B∗1/∗1 (12), ALDH2∗1/∗1-ADH1B∗1/∗2 (11), ALDH2∗1/∗1-ADH1B∗2/∗2 (11); ALDH2∗1/∗2-ADH1B∗1/∗1 (9), ALDH2∗1/∗2-ADH1B∗1/∗2 (9), and ALDH2∗1/∗2-ADH1B∗2/∗2 (9). After ingesting 0.3â ‰g/kg of alcohol, blood ethanol, acetaldehyde, and acetate concentrations, as well as the facial skin blood flow (FSBF) and pulse rate were measured for 130â ‰min. RESULTS: The ALDH2∗1/∗2 heterozygotes carrying three ADH1B allelotypes showed significantly higher peak levels and areas under the concentration curve (AUCs) of the blood acetaldehyde as well as significantly greater increases in the peak pulse rate and peak FSBF compared with the ALDH2∗1/∗1 homozygotes. However, no significant differences in peak levels and AUCs of blood ethanol, acetaldehyde or acetate, or the peak cardiovascular responses, were found between the ADH1B allelotypes carrying ALDH2∗1/∗1 or between those with ALDH2∗1/∗2. Partial correlation analyses showed that peak blood acetaldehyde, rather than the blood ethanol or acetate, was correlated significantly with the peak responses of pulse rate and FSBF. CONCLUSION: Findings indicate that ALDH2∗2, rather than ADH1B2∗2, is a causal variant allele for the accumulation of blood acetaldehyde and the resultant facial flushing during low alcohol consumption. © 2014 Wolters Kluwer Health | Lippincott Williams and Wilkins.


Cheng H.-C.,Taipei Tzu Chi Hospital | Hsieh Y.-T.,Taipei Tzu Chi Hospital | Hsieh Y.-T.,National Taiwan University Hospital
Optometry and Vision Science | Year: 2014

PURPOSE: To explore short-term refractive and ocular parameter changes and their correlations after cycloplegia with tropicamide. METHODS: This study prospectively enrolled 114 right eyes of 114 participants (mean [±SD] age, 9.1 [±2.8] years). Spherical equivalent of refractive error (SER), axial length (AL), corneal curvature (CC), and anterior chamber depth (ACD) were measured before and after 30 minutes from instillation of 0.4% tropicamide. A partial optical coherence interferometry (Zeiss IOLMaster) was used for ocular parameter measurement. Refractive change and ocular parameter changes after cycloplegia and their correlations were evaluated. RESULTS: Spherical equivalent of refractive error, AL, and ACD all positively shifted significantly at 30 minutes after application of 0.4% tropicamide (p < 0.0001 for each parameter measured). After cycloplegia, 28 eyes (24.6%) had a hyperopic shift of more than 0.25 diopters (D), 3 eyes (2.6%) had a myopic shift of more than 0.25 D, and 83 eyes (72.8%) had their SER changes within -0.25 to 0.25 D. The mean, maximum, and minimum keratometric values all decreased (p = 0.005, 0.03, and 0.05, respectively), whereas corneal astigmatism did not change significantly. The changes in AL, ACD, or mean keratometric values contributed little to the refractive changes after cycloplegia by tropicamide (p > 0.05, pr ≤ 0.01 for all values). CONCLUSIONS: Spherical equivalent of refractive error, AL, and ACD all positively shifted after cycloplegia with tropicamide. Corneal curvature became flattened after cycloplegia with tropicamide, but the corneal astigmatism did not change significantly. Refractive changes did not correlate with changes in AL, ACD, or CC after cycloplegia with tropicamide. © American Academy of Optometry.


Chan L.-W.,Taipei Tzu Chi Hospital | Hsieh Y.-T.,Taipei Tzu Chi Hospital | Hsieh Y.-T.,National Taiwan University Hospital
Optometry and Vision Science | Year: 2014

PURPOSE: To report a patient with circumscribed choroidal hemangioma with serous macular detachment successfully treated with photodynamic therapy (PDT) after being unresponsive to treatment with intravitreal ranibizumab. CASE REPORT: A 63-year-old Asian woman was incidentally found to have a circumscribed choroidal hemangioma without symptoms in the left eye during a routine health examination. Blurred vision of the left eye developed 3.5 years later, and a serous macular detachment was observed. Two consecutive intravitreal ranibizumab injections were administered, but the subretinal fluid (SRF) persisted and the vision did not improve. One PDT session was then given, and the SRF resolved completely within 1 month. The best-corrected visual acuity improved from 20/50 before treatment to 20/25 at 4 months after the PDT. The tumor thickness also decreased from 3.84 mm before treatment to 2.86 mm at 14 months after PDT. CONCLUSIONS: Circumscribed choroidal hemangioma with serous macular detachment may not respond to anti-vascular endothelial growth factor agents. Photodynamic therapy may be an effective choice in such cases to remove SRF and improve vision. © American Academy of Optometry.


Tsai M.-J.,Taipei Tzu Chi Hospital | Hsieh Y.-T.,Taipei Tzu Chi Hospital | Hsieh Y.-T.,National Taiwan University Hospital
Optometry and Vision Science | Year: 2014

PURPOSE: To evaluate the efficacy and safety using fluorescein angiography (FA)-guided half-time photodynamic therapy (PDT) for the treatment of acute or chronic central serous chorioretinopathy (CSC) and to evaluate the prognostic factors for visual acuity. METHODS: Sixteen eyes with CSC treated with the same protocol in a single hospital were retrospectively enrolled in the study; all eyes were treated using FA-guided half-time PDT (42 seconds). Logarithm of the minimal angle of resolution (logMAR) of the best-corrected visual acuity (BCVA) before and 3 months after PDT was measured. The time to complete subretinal fluid resorption was observed. Multiple regression analysis was used to evaluate the prognostic factors for logMAR of BCVA before and at 3 months after PDT and the change in logMAR after PDT. RESULTS: The mean (±SD) follow-up time after PDT was 12.1 (±9.2) months. The mean (±SD) logMAR of BCVA significantly improved from 0.28 (±0.21) before PDT to 0.21 (±0.21) at 3 months after PDT (p = 0.003). All eyes showed complete resolution of subretinal fluid and retinal pigmented epithelium detachment on optical coherence tomography within 5 weeks after PDT. No treatment-related complications were reported. The duration of symptoms before PDT was significantly correlated with the pre-PDT logMAR of BCVA (p = 0.004) and the post-PDT logMAR of BCVA (p = 0.0009) but not with the logMAR change after PDT (p = 0.25). CONCLUSIONS: Fluorescein angiography-guided half-time PDT was safe and effective in treating both acute and chronic CSC. Early treatment was important for preserving visual acuity. © American Academy of Optometry.

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