Lo H.-C.,Ming Chuan University |
Hsu Y.-C.,Tungs Taichung MetroHarbor Hospital |
Hsueh Y.-H.,National Yunlin University of Science and Technology |
Yeh C.-Y.,Chung Shan Medical University
Gait and Posture | Year: 2012
The aim of this study is to determine whether short term functional electrical stimulation (FES)-assisted cycling training can affect the postural control of stroke patients, and whether the application of FES can enhance the effect of cycling training. 20 stroke patients were randomly assigned to the FES-cycling group (FES-CG) or the cycling group (CG). Measurements were completed before and immediately after each 20. min training sessions. The measurements included a balance test (to quantify the postural control ability), a Hoffmann's reflex/motor response ratio (H/M ratio) test and a pendulum test (to quantify the muscle tone). In the balance test, some parameters in all directions exhibited significant intervention effects between the FES-CG group and the CG group. The H/M ratios (p=.014; .005, FES-CG and CG respectively) and relaxation index (p=.005; .047, FES-CG and CG respectively) revealed significant difference between FES-CG and CG group. The change ratios of directional control in the forward direction and H/M ratio revealed significant difference (p=.022; .015) between FES-CG and CG among subjects with higher muscle tone. The stroke subjects' postural control was improved while their muscle tone was reduced after the 20. min cycling training program both with and without FES. We conclude that cycling training, with or without FES may reduce spasticity in stroke patients. The application of FES in cycling exercise was shown to be more effective in stroke patients with higher muscle tone. © 2011 Elsevier B.V.
Lee L.-C.,Asia University, Taiwan |
Lee L.-C.,Tungs Taichung MetroHarbor Hospital |
Tsai A.C.,Asia University, Taiwan |
Tsai A.C.,China Medical University at Taichung
British Journal of Nutrition | Year: 2012
Nutrition is a key element in geriatric health and is important for functional ability. The present study examined the functional status-predictive ability of the Mini-Nutritional Assessment (MNA). We analysed the dataset of the Survey of Health and Living Status of the Elderly in Taiwan, a population-based study conducted by the Bureau of Health Promotion of Taiwan. Study subjects (65 years old) who completed both the 1999 and 2003 surveys were rated with the long form and short form of the MNA at baseline and with the Activities of Daily Living (ADL) and the Instrument Activities of Daily Living (IADL) scales 4 years later (end-point). The ability of the MNA to predict ADL or IADL dependency was evaluated with logistic regression models. The results showed that the elderly who were rated malnourished or at risk of malnutrition at baseline generally had significantly higher ADL or IADL scores 4 years later. Lower baseline MNA scores also predicted a greater risk of ADL or IADL dependency. These associations exist even among the elderly who were free of ADL or IADL dependency at baseline. The results clearly indicate that the MNA is able to predict ADL and IADL dependency (in addition to rating current nutritional status) of the elderly. The MNA, especially the short form, should be a valuable tool for identifying elderly at risk of functional decline and/or malnutrition in clinical practice or community programmes. © 2011 The Author.
Chou T.-C.,National Defense Medical Center |
Shih C.-Y.,A-Life Medical |
Chen Y.-T.,Tungs Taichung MetroHarbor Hospital
Journal of Agricultural and Food Chemistry | Year: 2011
Peroxisome proliferator-activated receptors (PPARs) isoforms (α, β/δ, and γ are present in human platelets, and activation of PPARs inhibits platelet aggregation. α-Lipoic acid (ALA), occurring naturally in human food, has been reported to exhibit an antiplatelet activity. However, the mechanisms underlying ALA-mediated inhibition of platelet aggregation remain unknown. The aim of this study was to investigate whether the antiplatelet activity of ALA is mediated by PPARs. ALA itself significantly induced PPARα/γ activation in platelets and increased intracellular amounts of PPARα/γ by blocking PPARα/γ secretion from arachidonic acid (AA)-activated platelets. Moreover, ALA significantly inhibited AA-induced platelet aggregation, Ca2+ mobilization, and cyclooxygenase-1 (COX-1) activity, but increased cyclic AMP production in rabbit washed platelets. Importantly, ALA also enhanced interaction of PPARα/γ with protein kinase Cα (PKCα) and COX-1 accompanied by an inhibition of PKCα activity in resting and AA-activated platelets. However, the above effects of ALA on platelets were markedly reversed by simultaneous addition of selective PPARα antagonist (GW6471) or PPARγ antagonist (GW9662). Taken together, the present study provides a novel mechanism by which ALA inhibition of platelet aggregation is mediated by PPARα/γ-dependent processes, which involve interaction with PKCα and COX-1, increase of cyclic AMP formation, and inhibition of intracellular Ca2+ mobilization. © 2011 American Chemical Society.
Yang C.-T.,Tunghai University |
Chen C.-H.,Tungs Taichung MetroHarbor Hospital |
Yang M.-F.,Tunghai University
Future Generation Computer Systems | Year: 2010
There are two challenges of using the PACS (Picture Archiving and Communications System). First, PACS are limited to certain bandwidths and locations. Second, the high cost of maintaining Web PACS and the difficult management of Web PACS servers. Besides, the quality of transporting images and the bandwidth of accessing large files from different locations are difficult to guarantee. For instance, radiologists make use of PACS information system for achieving high-speed accessing medical images. Physicians, on the other hand, utilize web browsers to indirectly access the PACS information system via non-high-speed network. The insufficient bandwidth may cause bottleneck under a host of querying and accessing. As hospitals exchange large files such as medical images with each other via WANs, the bandwidth cannot support the huge amount of file transportation. In this paper, we propose a PACS based on data grids, and utilize MIFAS (Medical Image File Accessing System) to perform querying and retrieving medical images from the co-allocation data grid. MIFAS is also suitable for data grid environments with a server node and several client nodes. MIFAS can take advantage of the co-allocation modules to reduce the medical image transfer time. Also, we provide experiments to show the performance of MIFAS. Furthermore, in order to enhance the security, stability and reliability in the PACS, we also provide the user-friendly management interface. © 2010 Elsevier B.V. All rights reserved.
Lin J.-W.,National Chung Hsing University |
Chen C.-M.,Tungs Taichung MetroHarbor Hospital |
Chang C.-C.,National Chung Hsing University
Vector-Borne and Zoonotic Diseases | Year: 2011
Bartonella henselae, the etiologic agent of cat-scratch disease, rarely causes back pain and is considered to be transmitted through animal scratches and bites. Here we report a cat-scratch disease case possibly with an unusual route of transmission. The patient was a 32-year-old man, and he was working as a veterinarian in a private veterinary clinic. He sought for clinical help because of unknown fever and persistent back pain for at least a month after an accidental needle puncture. Through serological testing and molecular identifications, this clinical case was confirmed to be caused by B. henselae. © Copyright 2011, Mary Ann Liebert, Inc. 2011.
Ma C.-L.,Tungs Taichung MetroHarbor Hospital |
Chang W.-P.,Taipei Medical University |
Lin C.-C.,Taipei Medical University
Supportive Care in Cancer | Year: 2014
Purpose: This study aimed to explore the relationships among pain, sleep disturbance, and circadian rhythms in advanced cancer patients. Methods: This cross-sectional study was conducted in 68 cancer patients from the oncology inpatient unit of a teaching hospital. Their demographic and medical characteristics, questionnaire surveys, including Brief Pain Inventory-Chinese version and Pittsburgh Sleep Quality Index Taiwanese version, and sleep logs and actigraphic recordings in consecutive 3 days and nights were collected and analyzed. Results: The mean (SD) scores for autocorrelation coefficient at 24 h (r24) and dichotomy index (I
Wu B.-T.,Tungs Taichung MetroHarbor Hospital |
Chen Y.-T.,Tungs Taichung MetroHarbor Hospital
Interactive Cardiovascular and Thoracic Surgery | Year: 2012
Pacemaker implantation is associated with the potential for various acute and late complications. Though they rarely occur, massive pulmonary air embolisms are lethal. We report the case of a 72-year old male with sick sinus syndrome who underwent permanent pacemaker implantation. Sedation was administered due to back pain with the resultant appearance of snoring. The procedure was complicated with repeated massive pulmonary air embolisms. The events occurred after the leads had been placed in the sheaths. The patient was successfully resuscitated with fluid challenge, O2 supplement, vasopressor and catheter aspiration. This case illustrates that in a heavily sedated, snoring patient, the marked negative intrathoracic pressure can overcome the frictional resistance of air to being sucked into the gap between the lead body and sheath's wall. Careful manipulation alone is not enough to prevent pulmonary air embolisms. Aggressive treatment for upper airway obstruction is important. The use of a sheath with a haemostatic valve is strongly recommended if the upper airway obstruction cannot be treated adequately. © 2012 The Author. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Lin L.-F.,Tungs Taichung Metroharbor Hospital
Diagnostic and Therapeutic Endoscopy | Year: 2014
Background. Transpancreatic precut sphincterotomy (TPS) is an option for difficult common bile duct (CBD) access, and the reports are few, with immediate success rate varying from 60 to 96%. The description of relation between the size of TPS and the immediate success rate of CBD cannulation was not found in the literature. The Aim of the Study. To evaluate the relation of large TPS to immediate success rate of CBD cannulation. Methods. A retrospective analysis was performed in prospectively collected data of 20 patients. TPS was performed with traction papillotome in the main pancreatic duct (MPD) directing towards 11 o'clock. Needle knife (NK) was used to enlarge TPS in five patients, and the other 15 cases had large TPS from the beginning of sphincterotomy. Prophylactic pancreatic stent was inserted in 18 cases, with diclofenac given in 12 cases. Results. The immediate success rate of CBD cannulation was 90% and with an eventual success rate of 100%. The failure in one immediate CBD cannulation with large TPS was due to atypical location of CBD orifice, and the other failed immediate CBD cannulation was due to inadequate size of TPS. Complications included 3 cases of post-TPS bleeding and 3 cases of mild pancreatitis. Conclusion. TPS is an effective procedure in patients with difficult biliary access and can have high immediate success rate with large TPS. © 2014 Lien-Fu Lin.
Liu J.-F.,Tungs Taichung MetroHarbor Hospital
Acta Cardiologica Sinica | Year: 2011
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a disease of mutation of family genes associated with exercise-induced syncope or sudden death. We report a case of a 27-year-old female with CPVT who had experienced several episodes of syncope and had been prescribed beta-blocker regularly. Sudden onset of ventricular arrhythmia occurred and the patient was resuscitated but remained in comatose state. During her hospitalization, the refractory intermittent ventricular arrhythmia was finally terminated adjuvantly by use of verapamil, while the current standard therapy for CPVT was definitely not useful. Therefore, we report this case accompanied by a review of the current literature.
Chi C.-S.,Tungs Taichung Metroharbor Hospital
Pediatrics and Neonatology | Year: 2015
Mitochondrial diseases are a heterogeneous group of disorders affecting energy production in the human body. The diagnosis of mitochondrial diseases represents a challenge to clinicians, especially for pediatric cases, which show enormous variation in clinical presentations, as well as biochemical and genetic complexity. Different consensus diagnostic criteria for mitochondrial diseases in infants and children are available. The lack of standardized diagnostic criteria poses difficulties in evaluating diagnostic methodologies. Even though there are many diagnostic tools, none of them are sensitive enough to make a confirmative diagnosis without being used in combination with other tools. The current approach to diagnosing and classifying mitochondrial diseases incorporates clinical, biochemical, neuroradiological findings, and histological criteria, as well as DNA-based molecular diagnostic testing. The confirmation or exclusion of mitochondrial diseases remains a challenge in clinical practice, especially in cases with nonspecific clinical phenotypes. Therefore, follow-up evolution of clinical symptoms/signs and biochemical data is crucial. The purpose of this study is to review the molecular classification scheme and associated phenotypes in infants and children with mitochondrial diseases, in addition to providing an overview of the basic biochemical reactions and genetic characteristics in the mitochondrion, clinical manifestations, and diagnostic methods. A diagnostic algorithm for identifying mitochondrial disorders in pediatric neurology patients is proposed. Copyright © 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.