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Oceanside, CA, United States

Tri-City Medical Center , founded in 1961, is a full-service, acute-care public hospital in Oceanside, California. Located 40 miles north of San Diego, Tri-City serves the three major cities in the North County section of San Diego County: Oceanside, Vista, and Carlsbad. The hospital also owns and operates nearby outpatient services, as well as the Tri-City Health and Wellness Complex in Carlsbad, home to the Tri-City Wellness Center, a 58,000-square-foot medically integrated training facility.TCMC is administered by the Tri-City Healthcare District, a Health District of California. Wikipedia.

Dake M.D.,Stanford University | Ansel G.M.,Center for Critical Limb Care | Jaff M.R.,Massachusetts General Hospital | Ohki T.,Jikei University School of Medicine | And 7 more authors.
Journal of the American College of Cardiology | Year: 2013

Objectives A prospective, multinational randomized controlled trial (RCT) and a complementary single-arm study evaluated the 2-year safety and effectiveness of a paclitaxel-coated drug-eluting stent (DES) in patients with superficial femoral artery lesions. The RCT compared the DES with percutaneous transluminal angioplasty (PTA) and provisional bare-metal stent (BMS) placement. Background Local drug delivery for superficial femoral artery lesions has been investigated with the intent of limiting restenosis similarly to DES for the coronary arteries. One-year outcomes of DES in the superficial femoral artery are promising, but longer-term benefits have not been established. Methods In the RCT, patients were randomly assigned to primary DES implantation (n = 236) or PTA (n = 238). Acute PTA failure occurred in 120 patients, who underwent secondary randomization to DES (n = 61) or BMS (n = 59) placement. The single-arm study enrolled 787 patients with DES treatment. Results Compared with the control group, the primary DES group demonstrated significantly superior 2-year event-free survival (86.6% vs. 77.9%, p = 0.02) and primary patency (74.8% vs. 26.5%, p < 0.01). In addition, the provisional DES group exhibited superior 2-year primary patency compared with the provisional BMS group (83.4% vs. 64.1%, p < 0.01) and achieved higher sustained clinical benefit (83.9% vs. 68.4%, p = 0.05). Two-year freedom from target lesion revascularization with primary DES placement was 80.5% in the single-arm study and 86.6% in the RCT. Conclusions Two-year outcomes with the paclitaxel-eluting stent support its sustained safety and effectiveness in patients with femoropopliteal artery disease, including the long-term superiority of the DES to PTA and to provisional BMS placement. (Evaluation of the Zilver PTX Drug-Eluting Stent in the Above-the-Knee Femoropopliteal Artery; NCT00120406; Zilver® PTX™ Global Registry; NCT01094678). © 2013 by the American College of Cardiology Foundation. Published by Elsevier Inc.

Tai H.-Y.,Tamkang University | Fu E.,Tri-City Medical Center | Don T.-M.,Tamkang University
Carbohydrate Polymers | Year: 2012

Calcium deficient hydroxyapatite (CDHA) having an average particle size of 45 nm was synthesized by reverse emulsion method. It was converted to the respective biphasic calcium phosphate (BCP, 226 nm) and β-tricalcium phosphate (TCP, 450 nm) by calcination at 800°C and 1000°C, and the BCP consisted of 92% TCP and 8% CDHA. Subsequently, chitosan was mixed with calcium phosphates to prepare CDHA/chitosan, BCP/chitosan, and TCP/chitosan membranes. The initial moduli of the BCP/chitosan and TCP/chitosan membranes were about 1.9 times that of the pure chitosan membrane; and the elongations at break were almost 6 times. The CDHA/chitosan and BCP/chitosan could induce mineralization of apatite on the membranes by increasing 20.6 and 16.3 wt.%, respectively, after 24 days in the simulated body fluid. Moreover, the BCP/chitosan exhibited superior osteoblast cell attachment and proliferation than the other membranes. It has the potential to be used as the barrier membrane for guided bone regeneration. © 2012 Elsevier Ltd. All rights reserved.

Lin J.-G.,China Medical University at Taichung | Chou P.-C.,China Medical University at Taichung | Chu H.-Y.,Tri-City Medical Center
Evidence-based Complementary and Alternative Medicine | Year: 2013

Objective. To explore the existing scientific information regarding safe needling depth of acupuncture points and the needling depth of clinical efficacy. Methods. We searched the PubMed, EMBASE, Cochrane, Allied and Complementary Medicine (AMED), The National Center for Complementary and Alternative Medicine (NCCAM), and China National Knowledge Infrastructure (CNKI) databases to identify relevant monographs and related references from 1991 to 2013. Chinese journals and theses/dissertations were hand searched. Results. 47 studies were recruited and divided into 6 groups by measuring tools, that is, MRI, in vivo evaluation, CT, ultrasound, dissected specimen of cadavers, and another group with clinical efficacy. Each research was analyzed for study design, definition of safe depth, and factors that would affect the measured depths. Depths of clinical efficacy were discussed from the perspective of de-qi and other clinical observations. Conclusions. Great inconsistency in depth of each point measured from different subject groups and tools exists. The definition of safe depth should be established through standardization. There is also lack of researches to compare the clinical efficacy. A well-designed clinical trial selecting proper measuring tools to decide the actual and advisable needling depth for each point, to avoid adverse effects or complications and promote optimal clinical efficacy, is a top priority. © 2013 Jaung-Geng Lin et al.

Liston M.B.,Tri-City Medical Center
Journal of Hospital Librarianship | Year: 2012

Librarian involvement in the Magnet process is vital to an organization attempting to achieve the transformation required for accreditation. Magnet criteria for accreditation are in direct alignment with the Medical Library Association's recommendations for professional librarians to support evidence-based processes and decision-making within a health care environment. Specific criteria required of the New Knowledge, Innovations, and Improvements component of the Magnet process are described along with recommendations for librarian involvement. The framework outlined in this article is one method for librarians to facilitate organizational achievement of Magnet accreditation. © 2012 Copyright Taylor and Francis Group, LLC.

Chen S.-F.,China Medical University at Taichung | Chen S.-F.,Department of National Defence | Nieh S.,Department of National Defence | Jao S.-W.,National Defence Medical Center | And 4 more authors.
Journal of Pathology | Year: 2013

Head and neck squamous cell carcinoma (HNSCC) is one of the leading causes of cancer-related death worldwide. The prognosis of HNSCC is usually poor because of its propensity for extensive invasion, local recurrence and frequent regional lymph node metastasis, even at initial diagnosis. Carcinoma-associated fibroblasts (CAFs), a major type of tumour-surrounding stromal cell, generate mediators through which they interact with tumours and contribute to cancer progression. The orchestration between CAFs and cancer cells is complex. Despite recent studies demonstrating the paracrine effect of stromal cells in the tumour microenvironment on initiation and progression of cancer cells, the major mediator related to CAFs and its underlying mechanism remain unknown. In the present study, we used organotypic culture to investigate CAFs that promote aggressive behaviour of HNSCC cells. Using microarray analysis, we detected abundant expression of interleukin-33 (IL-33) in CAFs and identified IL-33 as a critical mediator in CAF-induced invasiveness. Counteracting IL-33 activity diminished the aggressive phenotype of cancer cells induced by CAFs. Administration of IL-33 promoted cancer cell migration and invasion through induction of epithelial-to-mesenchymal transdifferentiation and increased IL-33 gene expression in cancer cells. In 40 patients with HNSCC, IL-33 expression in CAFs correlated with IL-33 expression in cancer cells. Most cases with a low invasion pattern grading score (IPGS) showed low or no expression of IL-33, whereas most HNSCC cases with high IPGS displayed over-expression of IL-33 in CAFs and cancer cells. High IL-33 expression associated with poor prognosis in terms of nodal metastasis-free survival. These results indicate that CAFs promote cancer invasiveness via paracrine and autocrine effects on microenvironmental IL-33 signalling, and suggest that IL-33 is a potential prognostic biomarker that could be considered in therapeutic strategies for the treatment of patients with HNSCC. Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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