Taoyuan, Taiwan
Taoyuan, Taiwan

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Wei S.-H.,I - Shou University | Liu C.-C.,Tao Yuan General Hospital | Fan P.-C.,National Taiwan University Hospital
Pediatric Drugs | Year: 2014

Background: Few clinical studies have assessed the efficacy and safety of oxcarbazepine (OXC) oral suspension in Asian pediatric patients and particularly in infants. The aim of this study was to investigate and compare the efficacy, tolerability, and side effects of OXC oral suspension in Taiwanese infants and children with various types of epilepsy. Methods: A retrospective review of the efficacy, tolerability, and side effects of OXC oral suspension in a tertiary medical center in Taiwan was conducted and included children (1-9 years old) and infants (<1 year old) diagnosed with epilepsy, which was classified into idiopathic partial, symptomatic partial, or multifocal subtypes. The OXC oral suspension (Trileptal®; Novartis) was given in a gradual dose titration, from an initial 7.5 mg/kg/day to 30 mg/kg/day within 1 month in all cases. Results: A total of 20 infants and 38 children were identified. There were no statistically significant differences between the children and infants in efficacy (75 vs. 82%, p = 0.734) and adverse effects (30 vs. 21%, p = 0.525) after OXC oral suspension treatment. The efficacy was significantly correlated with the epilepsy subtype (p < 0.01) and the number of combined antiepileptic drugs (AEDs) before OXC treatment (p < 0.01) in both groups. The patients with idiopathic and symptomatic partial epilepsy responded better to OXC oral suspension than those with multifocal epilepsy. Conclusions: OXC oral suspension is effective and well tolerated in both infants and children with partial epilepsy in Taiwan. Treatment efficacy was related to epilepsy subtype and number of combined AEDs before OXC treatment. Monotherapy had an excellent therapeutic response in partial epilepsy but not in multifocal epilepsy. © Springer International Publishing 2013.

Tu Y.-P.,Tao Yuan General Hospital | Chen S.-C.,National Taiwan University Hospital | Liu Y.-H.,National Taiwan University Hospital | Chen C.-F.,National Taiwan University | Hour T.-C.,Kaohsiung Medical University
Life Sciences | Year: 2013

Aims: Studies have shown that heme oxygenase-1 (HO-1) has a protective role in the mechanism underlying hypoxic preconditioning. We used a far-infrared radiation (FIR) heater to investigate the postconditioning protective role of HO-1 against ischemia/reperfusion (I/R) injury in rat testis. Main methods: Forty rats were used. Testis ischemia was mimicked by total obstructive clamping of testis vessels for 1, 2, or 4 h, and concomitant postconditioning with 30 min FIR or heat light during initially 30 min reperfusion. HO-1 expression and apoptosis of testis tissues were examined by immunohistochemistry and in situ terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) assay, respectively. HO-1 protein level and caspase-3 activity were analyzed by Western blotting. Key findings: There was less apoptotic activity in rat testis after FIR, as determined by TUNEL assay. Higher HO-1 protein expression was observed by immunohistochemistry and Western blotting (p < 0.01) in testis cells after FIR postconditioning. In contrast, caspase-3 activity was significantly higher in heat light groups, as compared with FIR groups (p < 0.01). Significance: FIR postconditioning attenuated I/R injury in rat testis by inducing HO-1 expression, which might have a protective role in testis apoptosis after I/R injury. © 2012 Elsevier Inc. All rights reserved.

Ho H.-J.,National Taiwan University | Huang D.-Y.,National Taiwan University | Ho F.-M.,Tao Yuan General Hospital | Ho F.-M.,Chung Yuan Christian University | And 3 more authors.
Cellular Signalling | Year: 2012

Endoplasmic reticulum (ER) stress is induced in infectious and inflammatory conditions, but its role in inflammatory responses still remains elusive. In this study we found tunicamycin (TM) and brefeldin A (BFA), two ER stressors, could attenuate lipopolysaccharide (LPS)-elicited inducible nitric oxide synthase (iNOS) gene expression in murine RAW264.7 macrophages, and this effect was not resulting from the effects on IKK or MAPKs activation. However, ER stressors could block NF-κB binding to the iNOS promoter in late-phase signaling evoked by LPS. Results indicated that inhibition of RelB nuclear translocation and p300 expression are involved in the anti-inflammatory actions of ER stressors. We also found that ER stressors could block LPS- and IFN (α, β, and γ)-mediated STAT1 phosphorylation. Our results suggest that activation of MKP-1 via a Ca/calmodulin/calcineurin pathway accounts for the inhibitory effect of ER stressors on IFN signaling. MKP-1 was downregulated by IFN-γ and is a newly identified protein phosphatase targeting STAT1. Taken together, these results indicate that multiple mechanisms are involved in the inhibition of LPS-induced iNOS gene expression by ER stressors. These include downregulation of RelB and p300, upregulation of MKP-1, and inhibition of the JAK/STAT signaling pathway. © 2012 Elsevier Inc.

Wang C.-H.,National Taiwan University Hospital | Wang C.-H.,National Taiwan University | Chang W.-T.,National Taiwan University Hospital | Huang C.-H.,National Taiwan University Hospital | And 6 more authors.
Resuscitation | Year: 2014

Objective: Studies have shown the detrimental effect of hyperoxia in animals with return of spontaneous circulation (ROSC) after cardiac arrest. To maximize the value of existing clinical studies, we performed the systemic review and meta-analysis of human observational studies to examine the effect of hyperoxia on outcomes of post-ROSC patients. Methods: We searched PubMed and Embase from the inception to October 2013. We selected adult observational studies that compared different levels of partial pressure of arterial oxygen (PaO2) in post-ROSC patients with mortality or neurological status at hospital discharge as outcome. Studies comparing hypoxia with normoxia only were excluded. Results: Fourteen studies were identified from 2982 references. Odds ratio (OR) was used as effect estimate. OR was reconstructed if not provided in original articles. Hyperoxia was defined as a PaO2 >300mmHg. Meta-analysis indicated that hyperoxia appeared to be correlated with increased in-hospital mortality (OR, 1.40; 95% CI, 1.02-1.93; I2, 69.27%; 8 studies) but not worsened neurological outcome (OR, 1.62; 95% CI, 0.87-3.02; I2, 55.61%; 2 studies). However, the results were inconsistent in subgroup and sensitivity analyses. Conclusions: Hyperoxia appears to be correlated with increased in-hospital mortality of post-ROSC patients. This result should be interpreted cautiously because of the significant heterogeneity and limited number of studies analyzed. However, because exposure to hyperoxia had no obvious benefits, clinicians should monitor PaO2 closely and titrate oxygen administration cautiously. © 2014 Elsevier Ireland Ltd.

Yu C.-H.,Tao Yuan General Hospital | Chen P.-Q.,National Taiwan University Hospital | Ma S.-C.,National Taiwan University Hospital | Pan C.-H.,National Taiwan University Hospital
Scoliosis | Year: 2012

Background: In our institution, the fixation technique in treating idiopathic scoliosis was shifted from hybrid fixation to the all-screw method beginning in 2000. We conducted this study to assess the intermediate -term outcome of all-screw method in treating adolescent idiopathic scoliosis (AIS).Methods: Forty-nine consecutive patients were retrospectively included with minimum of 5-year follow-up (mean, 6.1; range, 5.1-7.3 years). The average age of surgery was 18.5 ± 5.0 years. We assessed radiographic measurements at preoperative (Preop), postoperative (PO) and final follow-up (FFU) period. Curve correction rate, correction loss rate, complications, accuracy of pedicle screws and SF-36 scores were analyzed.Results: The average major curve was corrected from 58.0 ± 13.0° Preop to 16.0 ± 9.0° PO(p < 0.0001), and increased to 18.4 ± 8.6°(p = 0.12) FFU. This revealed a 72.7% correction rate and a correction loss of 2.4° (3.92%). The thoracic kyphosis decreased little at FFU (22 ± 12° to 20 ± 6°, (p = 0.25)). Apical vertebral rotation decreased from 2.1 ± 0.8 PreOP to 0.8 ± 0.8 at FFU (Nash-Moe grading, p < 0.01). Among total 831 pedicle screws, 56 (6.7%) were found to be malpositioned. Compared with 2069 age-matched Taiwanese, SF-36 scores showed inferior result in 2 variables: physical function and role physical.Conclusion: Follow-up more than 5 years, the authors suggest that all-screw method is an efficient and safe method. © 2011 Yu et al; licensee BioMed Central Ltd.

Chao C.-T.,National Taiwan University | Wang W.-J.,Tao Yuan General Hospital | Ting J.-T.,Tao Yuan General Hospital
American Journal of Kidney Diseases | Year: 2013

Spontaneous perinephric hemorrhage is a clinically rare life-threatening condition, also known as Wünderlich syndrome. Presentations can be variable, but patients typically display symptoms and signs including flank or abdominal pain, abdominal mass, and hypovolemia. It is important to diagnose the syndrome early because untreated cases carry a high mortality risk, and prompt intervention with an endovascular procedure or surgery is life saving. Causes range from anatomical anomalies, including vascular diseases (vasculitides and aneurysms) and renal tumors, to functional coagulation defect (bleeding tendency). The most common causes of Wünderlich syndrome are renal angiomyolipoma and renal cell carcinoma, constituting 60%∼70% of cases. Vascular causes of Wünderlich syndrome are infrequent, and the culprit most frequently is vasculitis resulting from polyarteritis nodosa. Other vasculitides presenting as Wünderlich syndrome are infrequent. We describe a 39-year-old woman with end-stage renal disease from lupus nephritis and spontaneous renal hemorrhage, ascribed to lupus-related vasculitis after serologic testing, computed tomography, and angiographic studies. © 2012 National Kidney Foundation, Inc.

Chiu L.-Y.,National Taiwan University | Ho F.-M.,Tao Yuan General Hospital | Shiah S.-G.,National Health Research Institute | Chang Y.,Chung Yuan Christian University | Lin W.-W.,National Taiwan University
Biochemical Pharmacology | Year: 2011

The alkylating agent N-methyl-N′-nitro-N′-nitrosoguanidine (MNNG) can cause excess DNA strand breaks that lead to poly(ADP-ribose) polymerase-1 (PARP-1) overactivation and cell death (parthanatos). However, the detail mechanism of MNNG-induced parthanatos was not well-investigated. In this study, we used MNNG-treated mouse embryonic fibroblasts (MEFs) to elucidate the signaling pathways of MNNG-induced parthanatos. We found that MNNG-induced cell death accompanied by rapid PARP-1 activation, c-Jun N-terminal kinase (JNK) activation, biphasic reactive oxygen species (ROS) production and intracellular calcium increase. The early ROS production occurring at 1 min and peaking at 5-15 min after MNNG treatment partially resulted from NADPH oxidase. In contrast, the late phase of ROS production occurring at 30 min and time-dependently increasing up to 6 h after MNNG treatment was generated by mitochondria. The antioxidant, NAC can abrogate all phenomena caused by MNNG. Results indicate that the calcium rise was downstream of early ROS production, and was involved in PARP-1 and JNK activation. Moreover, the PARP inhibitor was able to reduce MNNG-induced late-phase ROS production, calcium elevation, and cell death. Results further indicated the involvement of RIP1 in sustained ROS production and calcium increase. We characterized the interactive roles of ROS, calcium, JNK, and RIP1 in MNNG-induced cell death. We found that in addition to the alkylating property previously demonstrated, ROS production triggered by MNNG results in enhanced DNA damage and PARP-1 activation. Moreover, intracellular calcium elevation and ROS production have mutual amplification effects and thus contribute to PARP-1-mediated parthanatos. © 2010 Elsevier Inc.

Shih K.-M.,Tao Yuan General Hospital | Wang W.-K.,Yuan Ze University
Food Control | Year: 2011

This study investigated the potential factors which may influence implementation of the HACCP system in hospital catering operations in Taiwan. A total of 132 catering managers and operators at 23 hospitals affiliated with the Department of Health (DOH) participated in the study. Three structured questionnaires were used to collect data concerning employee satisfaction, difficulties, and benefits related to HACCP implementation. The results show that differences in gender, age, and job position are factors that may influence HACCP implementation in Taiwanese hospitals. Most of the catering staff in the observed hospitals agreed that HACCP was very beneficial for hospital catering. © 2010.

Chen S.-J.,Tao Yuan General Hospital | Hsu C.-P.,Yuanpei University | Li C.-W.,Yuanpei University | Lu J.-H.,Tao Yuan General Hospital | Chuang L.-T.,Yuanpei University
Food Chemistry | Year: 2011

Pinolenic acid (PNA), a naturally-occurring polyunsaturated fatty acid (PUFA), is found mainly in pine seeds. Although many studies have demonstrated beneficial effects of pine seed oil, there are no reports of the biological effects of PNA on cancer metastasis. The objective of this study was to investigate the effect of PNA on human breast cancer MDA-MB-231 cell proliferation and metastasis in vitro. We found that PNA did not affect cell viability and cell-matrix adhesion, but it inhibited cell metastasis by suppressing cell invasiveness and motility. Suppression could in part be associated with the modification of the n-6 PUFA composition of cells by PNA which significantly decreased the percentage of arachidonic acid (AA) in phospholipids from 12.6% to 4.9%. The lower AA content of the cancer cells might result in less synthesis of prostaglandin E2 (PGE2), and subsequent down-regulation of inducible cyclooxygenase (COX-2) expression. Thus, PNA represents a potential anti-cancer agent. © 2010 Elsevier Ltd. All rights reserved.

Chung Y.-C.,Tao Yuan General Hospital | Lin C.-C.,Yuanpei University | Chou C.-C.,Yuanpei University | Hsu C.-P.,Yuanpei University
European Journal of Clinical Investigation | Year: 2010

Background Polyphenol-rich longan seed extract (LSP) is a free radical scavenger and antioxidant. However, the effect of LSP on the growth of human colorectal carcinoma cells (CRC) has not yet been evaluated. Materials and methods Polyphenols of longan seeds were extracted and measured by colorimetry. Four CRC cell lines (Colo 320DM, SW480, HT-29 and LoVo) were treated with LSP and assessed for viability by trypan blue exclusion, for cell cycle distribution by flow cytometry, for apoptosis by annexin V labelling and for changes in the levels of proteins involved in cell cycle control or apoptosis by immunoblotting. Results Total phenol content of LSP was 695 mg g-1 and total flavonoids were 150 mg g-1. LSP inhibited the proliferation (25 μg mL-1-200 μg mL-1) of Colo 320DM, SW480 and HT-29, but not LoVo. LSP inhibited the proliferation by blocking cell cycle progression during the DNA synthesis phase and inducing apoptotic death. Western blotting indicated that LSP blocks the S phase, reducing the expression of cyclin A and cyclin D1. Colo 320DM and SW480 treated with LSP also showed the activation of caspase 3 and increased Bax : Bcl-2 ratio. Conclusion LSP induces S phase arrest of the cell cycle and apoptotic death in three CRC cell lines. The results indicate that LSP is a potential novel chemoprevention and treatment agent for colorectal cancer. © 2010 Stichting European Society for Clinical Investigation Journal Foundation.

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