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Lee SO, Lu CH, Man KM, Cheng KI, Wong CS, Sun WZ. Multimodal Analgesia With Extended-Release Dinalbuphine Sebacate for Perioperative Management: Expert Opinion and Consensus. Asian J Anesthesiol 2023; 61:123-131. [PMID: 38320858 DOI: 10.6859/aja.202309_61(3).0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
BACKGROUND The insufficient treatment of postoperative pain is considered a major barrier to enhanced patient recovery following surgery. Opioids remain the standard therapy for postoperative pain; however, the epidemic crisis of opioid abuse in the US has resulted in opioid-sparing multimodal analgesia (MMA) strategies in anesthesia practice. Complete perioperative pain management, particularly after discharge, may be undermined, resulting in chronic postsurgical pain. Thus, anesthesiologists and pain physicians should provide comprehensive MMA guidance for perioperative pain management. METHODS The Taiwan Pain Society organized a working group, which included experts in the field of anesthesia, pain, and surgery. This group performed an extensive literature search, quality review, and drafted a consensus, which was discussed by experts and edited for feedback. Recommendations covered consent instruction, treatment interventions, intramuscular injection techniques, and prophylaxis for postoperative adverse events. RESULTS This consensus included (1) a comparison of the pharmacology and pharmacokinetics between nalbuphine and dinalbuphine sebacate, (2) recommendations to help clinicians establish MMA with extended-release dinalbuphine sebacate injection, and (3) management of common adverse events during the perioperative pain period. CONCLUSION Extended-release dinalbuphine sebacate combined with the MMA strategy can reduce the medical burden and improve the quality of recovery following surgery.
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Affiliation(s)
- Sing-Ong Lee
- Department of Anesthesiology, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
- Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Chueng-He Lu
- Department of Anesthesiology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Kee-Ming Man
- Department of Anesthesiology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuang-I Cheng
- Department of Anesthesiology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Shung Wong
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Wei-Zen Sun
- Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan
- Health Science and Wellness Center, National Taiwan University, Taipei, Taiwan
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Hou SW, Chen SJ, Shen JD, Chen HY, Wang SJ, Wang CH, Man KM, Liu PL, Tsai MY, Chen YH, Chen WC. Emodin, a Natural Anthraquinone, Increases Uric Acid Excretion in Rats with Potassium Oxonate-Induced Hyperuricemia. Pharmaceuticals (Basel) 2023; 16:789. [PMID: 37375737 DOI: 10.3390/ph16060789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/09/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
The treatment of hyperuricemia and gout is mostly based on lowering serum uric acid levels using drugs, such as allopurinol, or increasing urinary excretion of uric acid. However, some patients still experience adverse reactions to allopurinol and turn to Chinese medicine as an alternative. Therefore, it is crucial to design a preclinical study to obtain more convincing data on the treatment of hyperuricemia and gout with Chinese medicine. This study aimed to explore the therapeutic effect of emodin, a Chinese herbal extract, in a rat model of hyperuricemia and gout. In this study, we used 36 Sprague-Dawley rats, which were randomly divided into six groups for experimentation. Hyperuricemia was induced in rats by intraperitoneal injections of potassium oxonate. The efficacy of emodin in reducing serum uric acid levels was demonstrated by comparing the positive control group with groups treated with three different concentrations of emodin. The inflammatory profiles, including interleukin (IL)-1β, IL-6, and tumor necrosis factor-α levels, were unaffected by emodin treatment. In the experimental results, it was observed that the serum uric acid concentration in the vehicle control group was 1.80 ± 1.14, while the concentrations in the moderate and high concentration emodin groups were 1.18 ± 0.23 and 1.12 ± 0.57, resulting in no significant difference in uric acid concentration between these treatment groups and the control group, indicating that emodin has a therapeutic effect on hyperuricemia. The increase in the fractional excretion of uric acid (FEUA) demonstrated that emodin promoted urinary uric acid excretion without significantly affecting the inflammatory profile. Thus, emodin reduced the serum uric acid concentration to achieve effective treatment of hyperuricemia and gout by increasing urinary excretion. These results were supported by the measured serum uric acid and FEUA levels. Our data have potential implications for the treatment of gout and other types of hyperuricemia in clinical practice.
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Affiliation(s)
- Shen-Wei Hou
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Szu-Ju Chen
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Jing-Dung Shen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Division of Urology, Department of Surgery, Taichung Armed Forces General Hospital, Taichung 411, Taiwan
- National Defense Medical Center, Taipei 114, Taiwan
| | - Huey-Yi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Department of Obstetrics and Gynecology, Department of Medical Research, Department of Urology, China Medical University Hospital, Taichung 404, Taiwan
| | - Shih-Jing Wang
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Chia-Han Wang
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Department of Chinese Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
| | - Kee-Ming Man
- Department of Medicinal Botanicals and Health Applications, College of Biotechnology and Bioresources, Da Yeh University, Changhua 515, Taiwan
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Hsinchu 302, Taiwan
| | - Po-Len Liu
- Department of Respiratory Therapy, College of Medicine, Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Kaohsiung Municipal Feng Shan Hospital-Under the Management of Chang Gung Medical Foundation, Kaohsiung 830, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Department of Obstetrics and Gynecology, Department of Medical Research, Department of Urology, China Medical University Hospital, Taichung 404, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Department of Obstetrics and Gynecology, Department of Medical Research, Department of Urology, China Medical University Hospital, Taichung 404, Taiwan
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Man KM, Lee SO, Lu CH, Wong CS, Sun WZ. Injection Site Reactions Before and After Intramuscular Injection Technique Revision: A Postmarketing Analysis of NALDEBAIN® From 2017 to 2022. Asian J Anesthesiol 2023. [PMID: 37160663 DOI: 10.6859/aja.202305/pp.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The NALDEBAIN® has been available since 2017, and high incidence of injection reactions in the phase 3 study has been reported. Since the first year in the market, the injection site reactions were still the majority of adverse drug reactions (ADRs) in pharmacovigilance reports. The new intramuscular (IM) instruction and package was introduced in the middle of 2018. In this retrospective study, we analyzed the pharmacovigilance data and published postmarketing studies to investigate the impact of IM injection-related reactions in Taiwan between the period of 2017-2022. METHODS Individual case safety reports (ICSRs) and ADRs were classified by system organ class and preferred term. The reporting rate of ICSRs was used to evaluate the impact of the new IM instruction and package. RESULTS A total of 37 ICSRs were identified from pharmacovigilance reports. Among them, 51% of IM injection-related reactions were reported after one single dose of NALDEBAIN administration. The reporting rate of IM injection-related reactions in pharmacovigilance data dropped from 125.00 to 3.56 per ten thousand exposures after IM instruction and package revision in 2018. In addition, the percentage of IM injection-related reactions also reduced in postmarketing studies from 27.5% to 4.5%. There were no serious IM injection-related reactions found in the pharmacovigilance and postmarketing dataset. CONCLUSION Injection site reactions were common after intramuscularly administered oil-based agents during the first year which is later markedly reduced by changing the length of the needle and injection education.
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Affiliation(s)
- Kee-Ming Man
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Sing-Ong Lee
- Department of Anesthesiology, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
| | - Chueng-He Lu
- Department of Anesthesiology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Shung Wong
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Wei-Zen Sun
- Department of Anesthesia, National Taiwan University Hospital, Taipei, Taiwan
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Man KM, Lee SO, Lu CH, Wong CS, Sun WZ. Injection Site Reactions Before and After Intramuscular Injection Technique Revision: A Postmarketing Analysis of NALDEBAIN® From 2017 to 2022. Asian J Anesthesiol 2023; 61:14-20. [PMID: 37160663 DOI: 10.6859/aja.202303_61(1).0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND The NALDEBAIN® has been available since 2017, and high incidence of injection reactions in the phase 3 study has been reported. Since the first year in the market, the injection site reactions were still the majority of adverse drug reactions (ADRs) in pharmacovigilance reports. The new intramuscular (IM) instruction and package was introduced in the middle of 2018. In this retrospective study, we analyzed the pharmacovigilance data and published postmarketing studies to investigate the impact of IM injection-related reactions in Taiwan between the period of 2017-2022. METHODS Individual case safety reports (ICSRs) and ADRs were classified by system organ class and preferred term. The reporting rate of ICSRs was used to evaluate the impact of the new IM instruction and package. RESULTS A total of 37 ICSRs were identified from pharmacovigilance reports. Among them, 51% of IM injection-related reactions were reported after one single dose of NALDEBAIN administration. The reporting rate of IM injection-related reactions in pharmacovigilance data dropped from 125.00 to 3.56 per ten thousand exposures after IM instruction and package revision in 2018. In addition, the percentage of IM injection-related reactions also reduced in postmarketing studies from 27.5% to 4.5%. There were no serious IM injection-related reactions found in the pharmacovigilance and postmarketing dataset. CONCLUSION Injection site reactions were common after intramuscularly administered oil-based agents during the first year which is later markedly reduced by changing the length of the needle and injection education.
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Affiliation(s)
- Kee-Ming Man
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Sing-Ong Lee
- Department of Anesthesiology, Hsinchu Cathay General Hospital, Hsinchu, Taiwan
| | - Chueng-He Lu
- Department of Anesthesiology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Shung Wong
- Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan
| | - Wei-Zen Sun
- Department of Anesthesia, National Taiwan University Hospital, Taipei, Taiwan
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Chen YH, Man KM, Chen WC, Liu PL, Tsai KS, Tsai MY, Wu YT, Chen HY. Platelet-Rich Plasma Ameliorates Cyclophosphamide-Induced Acute Interstitial Cystitis/Painful Bladder Syndrome in a Rat Model. Diagnostics (Basel) 2020; 10:diagnostics10060381. [PMID: 32521683 PMCID: PMC7344907 DOI: 10.3390/diagnostics10060381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Interstitial cystitis/painful bladder syndrome (IC/PBS) could be treated to ameliorate urothelial injury. Here, we investigated the efficacy of intravesical instillation with platelet-rich plasma (PRP) and hyaluronic acid for acute IC/PBS. Methods: The effects of PRP and hyaluronic acid on the proliferation of normal human fibroblast cells (HFCs) were assessed. Additionally, thirty virgin female rats were randomized into five groups: group 1, saline-injected control; group 2, cyclophosphamide (CYP) plus intravesical instillation with normal saline; group 3, CYP plus intravesical instillation with hyaluronic acid (1 mg/mL); group 4, CYP plus intravesical instillation with PRP; and group 5, CYP plus intravesical instillation with PRP plus hyaluronic acid. A cystometry and histological assessments were performed. The expression of cell junction-associated protein zonula occludens-2 (ZO-2) and inflammatory cytokine interleukin 6 (IL-6) was also measured. Results: Low dose PRP increased proliferation in HFCs. The acute IC/PBS rats showed significantly lower voiding interval values. Voiding interval values were significantly higher in the CYP plus intravesical instillation with PRP group than in the CYP-induced acute IC/PBS group. Additionally, the expression of ZO-2 was increased and IL-6 was decreased in the CYP plus intravesical instillation with PRP group compared with the CYP-induced acute IC/PBS group. Conclusion: These findings suggest that PRP modulate urothelial repair, which ameliorate the increase in urination frequency in rats treated with CYP. Overall, PRP may confer potential benefits by acting as urothelial repair modulators.
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Affiliation(s)
- Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; (Y.-H.C.); (W.-C.C.)
- Departments of Medical Research, Urology and Obstetrics and Gynecology, China Medical University Hospital, Taichung 40447, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Kee-Ming Man
- Department of Life Sciences, National Chung Hsing University, Taichung 40227, Taiwan;
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Hsinchu 30272, Taiwan
- Department of Medicinal Botanicals and Health Applications, Da Yeh University, Changhua 51591, Taiwan
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; (Y.-H.C.); (W.-C.C.)
- Departments of Medical Research, Urology and Obstetrics and Gynecology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Po-Len Liu
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Kao-Sung Tsai
- Department of Applied Cosmetology, Hungkuang University, Taichung 43302, Taiwan;
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Yu-Tzu Wu
- Department of Neurology, Kuang Tien General Hospital, Taichung 43303, Taiwan;
| | - Huey-Yi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; (Y.-H.C.); (W.-C.C.)
- Departments of Medical Research, Urology and Obstetrics and Gynecology, China Medical University Hospital, Taichung 40447, Taiwan
- Correspondence:
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Abstract
Thyroid function may alter carbohydrate metabolism via influence of insulin, which may in terms of derangement of thyroid function and insulin function result in the development of type 2 diabetes mellitus (T2D). We investigated the association of thyroid disorders with T2D by a cohort study of the Taiwan nationwide health insurance database.A sub-dataset of the National Health Insurance Research Database (NHIRD) was used in this study. The thyroid disease (both hyper- and hypo-thyroidism) group was chosen from patients older than 18 years and newly diagnosed between 2000 and 2012. The control group consisted of randomly selected patients who never been diagnosed with thyroid disease and 4-fold size frequency matched with the thyroid disease group. The event of this cohort was T2D (ICD-9-CM 250.x1, 250.x2). Primary analysis was performed by comparing the thyroid disease group to the control group and the second analysis was performed by comparing the hyperthyroidism subgroup, hypothyroidism subgroup, and control group.The occurrence of T2D in the thyroid disease group was higher than the control group with hazard ratio (HR) of 1.23 [95% confidence interval (CI) = 1.16-1.31]. Both hyperthyroidism and hypothyroidism were significantly higher than control. Significantly higher HR was also seen in female patients, age category of 18 to 39-year-old (y/o) and 40 to 64 y/o subgroups. Higher occurrence of T2D was also seen in thyroid disease patients without comorbidity than in the control group with HR of 1.47 (95% CI = 1.34-1.60). The highest HR was found in the half-year follow-up.There was a relatively high risk of T2D development in patients with thyroid dysfunctions, especially in the period of 0.5 to 1 year after presentation of thyroid dysfunctions. The results suggest performing blood sugar tests in patients with thyroid diseases for early detection and treatment of T2D.
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Affiliation(s)
- Rong-Hsing Chen
- Departments of Endocrine and Metabolism, Anesthesiology, Obstetrics and Gynecology, Medical Research, Medical Education, and Urology, China Medical University Hospital
| | - Huey-Yi Chen
- Departments of Endocrine and Metabolism, Anesthesiology, Obstetrics and Gynecology, Medical Research, Medical Education, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, College of Medicine, China Medical University
| | - Kee-Ming Man
- Departments of Endocrine and Metabolism, Anesthesiology, Obstetrics and Gynecology, Medical Research, Medical Education, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, College of Medicine, China Medical University
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Hsinchu
| | - Szu-Ju Chen
- Departments of Endocrine and Metabolism, Anesthesiology, Obstetrics and Gynecology, Medical Research, Medical Education, and Urology, China Medical University Hospital
- Department of Surgery, Taichung Veterans General Hospital, Taichung
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Po-Len Liu
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Yung-Hsiang Chen
- Departments of Endocrine and Metabolism, Anesthesiology, Obstetrics and Gynecology, Medical Research, Medical Education, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, College of Medicine, China Medical University
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Wen-Chi Chen
- Departments of Endocrine and Metabolism, Anesthesiology, Obstetrics and Gynecology, Medical Research, Medical Education, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, College of Medicine, China Medical University
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Chen WC, Chou TY, Chen HY, Yang YR, Man KM, Tsai MY, Chen YH. Salvia miltiorrhiza Bunge (Danshen) for Treatment and Prevention of Urolithiasis: A Drosophila Animal Study. Evid Based Complement Alternat Med 2019; 2019:1408979. [PMID: 30800166 PMCID: PMC6360610 DOI: 10.1155/2019/1408979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/05/2018] [Accepted: 01/03/2019] [Indexed: 12/18/2022]
Abstract
Traditional Chinese medicine (TCM) has been prescribed for the treatment of stone disease for thousands of years. Salvia miltiorrhiza (Danshen) was previously shown to have potential for treatment of stone disease in animal and clinical studies. In this study, we further studied the antiurolithiasis effect of Danshen in a fly model. Wild-type male Drosophila melanogaster CS flies were used in this study, with 0.25% ethylene glycol (EG) as a lithogenic agent. 2% potassium citrate (K-citrate) was the positive control agent for prevention (all agents added at the start of experiment) and treatment (drugs added after 2-week addition of lithogenic agent) studies compared with 15, 30, and 60 μg/ml of Danshen extract. In the prevention study, both 2% K-citrate and Danshen (30 and 60 μg/ml) significantly inhibited EG-induced calcium oxalate (CaOx) crystal formation. In the treatment study, only 2% K-citrate and high-dose of Danshen (60 μg/ml) significantly inhibited EG-induced CaOx crystal formation. Survival analysis for EG with Danshen was compared with that for EG with K-citrate. The mean lifespan was significantly reduced by administration of EG, and the results in the Danshen group were similar to those in the control group. In conclusion, Danshen revealed both preventive and treatment effects on CaOx crystal formation in a fly model.
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Affiliation(s)
- Wen-Chi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Yang Chou
- Department of Chinese Medicine, Kaohsiung Municipal Gangshan Hospital, Kaohsiung, Taiwan
| | - Huey-Yi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - You-Rong Yang
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Kee-Ming Man
- Department of Medicinal Botanicals and Health Applications, Da Yeh University, Changhua, Taiwan
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Ming-Yen Tsai
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Departments of Urology, Obstetrics and Gynecology, and Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Man KM, Chen KB, Chen HY, Chiang JH, Su YC, Man SS, Xie DD, Wang Y, Zhang ZQ, Bi LK, Zhang T, Yu DX, Chen WC. Hyperthyroidism is not a significant risk of benign prostatic hyperplasia: A nationwide population-based study. Medicine (Baltimore) 2018; 97:e12459. [PMID: 30278528 PMCID: PMC6181623 DOI: 10.1097/md.0000000000012459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Benign prostatic hyperplasia (BPH) is a common disorder in the aging male population. Despite evidence that thyroid status impacts the prostate, the objective of this study was to examine whether patients with hyperthyroidism were at a greater risk for BPH.This study is a retrospective nationwide population-based cohort study of the Chinese population. Data for this study were retrieved from the Taiwan National Health Insurance Research Database (NHIRD). Overall, 1032 male patients aged 40 years or older with hyperthyroidism diagnosed between 2000 and 2006 were included in the hyperthyroidism group, and 4128 matched controls without hyperthyroidism were included in the non-hyperthyroidism group. Both groups were monitored until the end of 2011. A Cox proportional hazards regression model was used to compute and compare the risk of BPH between study participants with and those without hyperthyroidism.Patients with hyperthyroidism exhibited a greater incidence of BPH (18.51% vs 15.53%) than did the controls. Furthermore, the hazard ratio (HR) of the hyperthyroidism group was 1.24 times that of the control group [95% confidence interval (95% CI 1.05-1.46)] signifying that there is a significant 24% increase in the risk of BPH with the presence of hyperthyroidism. This increased risk of BPH with hyperthyroidism, however, failed to remain significant (adjusted HR = 1.11, 95% CI = 0.94-1.3) after adjusting for covariates of age (adjusted HR = 2.72, 95% CI = 2.32-3.2), diabetes (adjusted HR = 1.4, 95% CI = 1.17-1.68), hypertension (adjusted HR = 1.74, 95% CI = 1.49-2.03), hyperlipidemia (adjusted HR = 1.25, 95% CI = 1.03-1.53), neurogenic bladder, cystitis (adjusted HR = 1.23, 95% CI = 0.58-2.59), urethral stricture (adjusted HR = 2.01, 95% CI = 0.28-14.47), urethritis (adjusted HR = 1.52, 95% CI = 0.72-3.21), and urinary tract infection (adjusted HR = 1.77, 95% CI = 1.31-2.39).After adjustment for comorbidities and covariates, hyperthyroidism was not found to be a significant risk factor of BPH in our male study subjects. Further research is warranted to validate our results and elucidate the association of the pathophysiology of these 2 diseases.
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Affiliation(s)
- Kee-Ming Man
- Graduate Institute of Geriatric Medicine, Anhui Medical University
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Department of Medicinal Botanicals and Health Applications, Da Yeh University, Changhua
- Departments of Anesthesiology, Medical Research, Obstetrics and Gynecology, Management Office for Health Data, and Urology, China Medical University Hospital
| | - Kuen-Bao Chen
- Departments of Anesthesiology, Medical Research, Obstetrics and Gynecology, Management Office for Health Data, and Urology, China Medical University Hospital
| | - Huey-Yi Chen
- Departments of Anesthesiology, Medical Research, Obstetrics and Gynecology, Management Office for Health Data, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Medicine, Chinese Medicine Research Center, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan
| | - Jen-Huai Chiang
- Departments of Anesthesiology, Medical Research, Obstetrics and Gynecology, Management Office for Health Data, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Medicine, Chinese Medicine Research Center, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan
| | - Yuan-Chih Su
- Departments of Anesthesiology, Medical Research, Obstetrics and Gynecology, Management Office for Health Data, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Medicine, Chinese Medicine Research Center, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan
| | - Samantha S. Man
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Dong-Dong Xie
- Graduate Institute of Geriatric Medicine, Anhui Medical University
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yi Wang
- Graduate Institute of Geriatric Medicine, Anhui Medical University
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhi-Qiang Zhang
- Graduate Institute of Geriatric Medicine, Anhui Medical University
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Liang-kuan Bi
- Graduate Institute of Geriatric Medicine, Anhui Medical University
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tao Zhang
- Graduate Institute of Geriatric Medicine, Anhui Medical University
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - De-Xin Yu
- Graduate Institute of Geriatric Medicine, Anhui Medical University
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wen-Chi Chen
- Departments of Anesthesiology, Medical Research, Obstetrics and Gynecology, Management Office for Health Data, and Urology, China Medical University Hospital
- Graduate Institute of Integrated Medicine, College of Medicine, Chinese Medicine Research Center, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan
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Chang YJ, Chen WC, Chiang JH, Su YC, Tsai KS, Man KM, Tsai MY, Chen YH, Chen HY. Traditional Chinese medicine decreases the obstructive uropathy risk in uterovaginal prolapse: A nationwide population-based study. Medicine (Baltimore) 2018; 97:e12369. [PMID: 30235697 PMCID: PMC6160251 DOI: 10.1097/md.0000000000012369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Traditional Chinese medicine (TCM) is a popular treatment for voiding dysfunction in Eastern countries. However, no previous studies have investigated the effects of TCM on preventing obstructive uropathy in uterovaginal prolapse women. We conducted a large-scale nationwide population-based cohort study to investigate the relationship between TCM and obstructive uropathy in uterovaginal prolapse women. This is a retrospective cohort study with the Taiwan National Health Insurance Research Database (NHIRD). The study population was newly diagnosed uterovaginal prolapse patients between 1997 and 2010 year. Among patients, 762 uterovaginal prolapse patients in this cohort. Significant adjusted HRs of urine retention or hydronephrosis in Cox proportional hazard models were uterovaginal prolapse (hazard ratio [HR]: 1.74, 95% confidence intervals [CI]: 1.43-2.14), age 40 to 64 years (1.51, 1.01-2.27), ≥60 years (3.52, 2.32-5.34), DM (1.52, 1.23-1.89), hypertension (1.38, 1.13-1.7), constipation (1.35, 1.05-1.75), urinary tract calculi (1.54, 1.06-2.23), and TCM users (0.34, 0.28-0.41). The Kaplan-Meier analysis showed a higher incidence rate of urine retention or hydronephrosis in the uterovaginal prolapse cohort compared with that of the without uterovaginal prolapse cohort. The results of this nationwide population-based study support a relationship between TCM and a reduced risk of obstructive uropathy in uterovaginal prolapse women.
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Affiliation(s)
- Yin-Jen Chang
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
| | - Wen-Chi Chen
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
| | - Jen-Huai Chiang
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University
| | - Yuan-Chih Su
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University
| | - Kao-Sung Tsai
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Department of Applied Cosmetology, Hungkuang University
| | - Kee-Ming Man
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
| | - Ming-Yen Tsai
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Yung-Hsiang Chen
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Huey-Yi Chen
- Departments of Chinese Medicine, Urology, Medical Research, Obstetrics and Gynecology, and Anesthesiology
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine & Acupuncture
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10
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Ma CM, Lin LH, Chang HY, Chou PC, Liao PC, Chen HY, Man KM, Chiang JH, Chang YJ, Tsai MY, Chen WC, Chen YH. Association of congenital anomalies with fracture of spine, trunk, and upper and lower limbs among young people: A population-based matched cohort study in Taiwan. Medicine (Baltimore) 2017; 96:e7980. [PMID: 28885353 PMCID: PMC6392606 DOI: 10.1097/md.0000000000007980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
According to the Traditional Chinese Medicine (TCM) theory, congenital anomalies are caused by kidney malfunctions, which decreased the bone quality, and may eventually result in bone fractures. This retrospective cohort study investigated the relationship between congenital anomalies and fracture of spine, trunk, and upper and lower limbs in young people. We utilized data from the National Health Insurance Research Database of Taiwan. This study included patients with congenital anomalies (International Classification of Diseases/ICD-9 code: 740-759) and a comparison group of patients without congenital anomalies. Cases evaluated were fracture of spine and trunk (ICD-9 codes: 805-809), fracture of upper limbs (ICD-9 codes: 810-819), and fracture of lower limbs (ICD-9 codes: 820-829). Our study shows that in comparison to the control group, patients with congenital anomalies are 1.11 times more likely to develop fractures. This is the first documented research study that supports the TCM theory that "the Kidney governs the bones, and healthy bones give the body stabilization and prevent fracture."
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Affiliation(s)
- Chia-Man Ma
- Department of Dermatology, Department of Urology, Taichung Veterans General Hospital, Taichung
| | - Lih-Hwa Lin
- Division of Chinese Medicine, An Nan Hospital, China Medical University, Tainan
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, College of Medicine, China Medical University, Taichung
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli
| | - Pei-Chi Chou
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, College of Medicine, China Medical University, Taichung
- Departments of Chinese Medicine, Obstetrics and Gynecology, Anesthesiology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung
| | - Po-Chi Liao
- Department of Dermatology, Department of Urology, Taichung Veterans General Hospital, Taichung
| | - Huey-Yi Chen
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, College of Medicine, China Medical University, Taichung
- Departments of Chinese Medicine, Obstetrics and Gynecology, Anesthesiology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kee-Ming Man
- Departments of Chinese Medicine, Obstetrics and Gynecology, Anesthesiology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung
- Department of Medicinal Botanicals and Health Applications, Da-Yeh University, Changhua
| | - Jen-Huai Chiang
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, College of Medicine, China Medical University, Taichung
- Departments of Chinese Medicine, Obstetrics and Gynecology, Anesthesiology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung
| | - Yin-Jen Chang
- Departments of Chinese Medicine, Obstetrics and Gynecology, Anesthesiology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung
| | - Ming-Yen Tsai
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, College of Medicine, China Medical University, Taichung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Wen-Chi Chen
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, College of Medicine, China Medical University, Taichung
- Departments of Chinese Medicine, Obstetrics and Gynecology, Anesthesiology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung
| | - Yung-Hsiang Chen
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, College of Medicine, China Medical University, Taichung
- Departments of Chinese Medicine, Obstetrics and Gynecology, Anesthesiology, Urology, and Medical Research, Management Office for Health Data, China Medical University Hospital, Taichung
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung , Taiwan
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11
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Chang HY, Man KM, Liao KH, Chiang YY, Chen KB. Rescue patient from tracheal obstruction by dislocated bronchial stent during tracheostomy surgery with readily available tools: A case report. Medicine (Baltimore) 2017; 96:e7841. [PMID: 28885335 PMCID: PMC6393009 DOI: 10.1097/md.0000000000007841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Airway stenting is a well-established method that relieves symptoms and maintains airway patency in patients with airway obstruction. Serious complications caused by airway stents such as stent dislocation and airway obstruction during surgery are life-threatening. PATIENT CONCERNS An 80-year-old man was treated with bronchial stent for left bronchus obstruction caused by metastatic esophageal cancer. During tracheostomy surgery, he suffered from acute tracheal obstruction caused by dislocated bronchial stent. DIAGNOSES Esophageal cancer, left bronchus obstruction, respiratory failure, tracheal obstruction. INTERVENTIONS Threading a 5.0-sized endotracheal tube combined with an Eschmann tracheal tube introducer to prop up the collapsed stent. OUTCOMES The bronchial stent was re-expanded and threaded into right main bronchus and ventilation restored. LESSONS Patient with airway stent undergoing surgery with airway involved should be performed under the support of a backup physician and equipment that are capable of handling potentially life-threatening complications of airway stent. If not, in the emergent situation of tracheal obstruction due to tracheal/bronchial stent, protruding through the stent with a suitable, small-sized endotracheal tube with Eschmann tracheal tube introducer may be an alternative skill for saving life weighted with possible complications.
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Affiliation(s)
- Hung-Yu Chang
- Department of Anesthesiology of China Medical University Hospital
| | - Kee-Ming Man
- Department of Anesthesiology of China Medical University Hospital
- Department of Life Sciences, National Chung Hsing University
| | | | - Yi-Ying Chiang
- Department of Anesthesiology of China Medical University Hospital
| | - Kuen-Bao Chen
- Department of Anesthesiology of China Medical University Hospital
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12
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Wu SY, Shen JL, Man KM, Lee YJ, Chen HY, Chen YH, Tsai KS, Tsai FJ, Lin WY, Chen WC. An emerging translational model to screen potential medicinal plants for nephrolithiasis, an independent risk factor for chronic kidney disease. Evid Based Complement Alternat Med 2014; 2014:972958. [PMID: 25097661 PMCID: PMC4109113 DOI: 10.1155/2014/972958] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 06/16/2014] [Indexed: 12/13/2022]
Abstract
Pharmacological therapy for urolithiasis using medicinal plants has been increasingly adopted for the prevention of its recurrence. A Drosophila melanogaster model developed for translational research of urolithiasis was applied to evaluate agents with potential antilithic effects and calcium oxalate (CaOx) formation. Potential antilithic herbs were prepared in a mixture of food in a diluted concentration of 5,000 from the original extract with 0.5% ethylene glycol (EG) as the lithogenic agent. The control group was fed with food only. After 3 weeks, flies (n ≥ 150 for each group) were killed using CO2 narcotization, and the Malpighian tubules were dissected, removed, and processed for polarized light microscopy examination of the crystals. The crystal formation rate in the EG group was 100.0%. In the study, 16 tested herbal drugs reached the crystal formation rate of 0.0%, including Salviae miltiorrhizae, Paeonia lactiflora, and Carthami flos. Scutellaria baicalensis enhanced CaOx crystal formation. Two herbal drugs Commiphora molmol and Natrii sulfas caused the death of all flies. Our rapid screening methods provided evidence that some medicinal plants have potential antilithic effects. These useful medicinal plants can be further studied using other animal or human models to verify their effects.
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Affiliation(s)
- San-Yuan Wu
- School of Chinese Medicine, Graduate Institute of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan
| | - Jui-Lung Shen
- Center for General Education, Feng Chia University, Taichung 40724, Taiwan
- Department of Dermatology, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Kee-Ming Man
- Department of Medicinal Botanicals and Health Applications, Da-Yeh University, Changhua 51591, Taiwan
- Department of Anesthesiology, Tungs' Taichung Harbor Hospital, Taichung 43304, Taiwan
- Department of Life Sciences, National Chung Hsing University, Taichung 40227, Taiwan
- Graduate Institute of Geriatric Medicine, Anhui Medical University, Hefei 230032, China
| | - Yuan-Ju Lee
- Department of Urology, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Huey-Yi Chen
- School of Chinese Medicine, Graduate Institute of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan
- Departments of Medical Research, Obstetrics and Gynecology, Dermatology, and Urology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Yung-Hsiang Chen
- School of Chinese Medicine, Graduate Institute of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan
- Departments of Medical Research, Obstetrics and Gynecology, Dermatology, and Urology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Kao-Sung Tsai
- School of Chinese Medicine, Graduate Institute of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan
- Departments of Medical Research, Obstetrics and Gynecology, Dermatology, and Urology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Fuu-Jen Tsai
- School of Chinese Medicine, Graduate Institute of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan
- Departments of Medical Research, Obstetrics and Gynecology, Dermatology, and Urology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Wei-Yong Lin
- School of Chinese Medicine, Graduate Institute of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan
- Departments of Medical Research, Obstetrics and Gynecology, Dermatology, and Urology, China Medical University Hospital, Taichung 40447, Taiwan
| | - Wen-Chi Chen
- School of Chinese Medicine, Graduate Institute of Chinese Medicine, Graduate Institute of Integrated Medicine, College of Chinese Medicine, Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung 40402, Taiwan
- Departments of Medical Research, Obstetrics and Gynecology, Dermatology, and Urology, China Medical University Hospital, Taichung 40447, Taiwan
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13
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Shen JL, Man KM, Chen YH, Chang CH, Lee YJ, Chen HY, Tsai KS, Tsai FJ, Chen WC, Kuo HF. Reduced albumin in the renal cortex of ethylene glycol-treated rats. ScienceAsia 2014. [DOI: 10.2306/scienceasia1513-1874.2014.40.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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14
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Wojcik SM, Tantra M, Stepniak B, Man KM, Müller-Ribbe K, Begemann M, Ju A, Papiol S, Ronnenberg A, Gurvich A, Shin Y, Augustin I, Brose N, Ehrenreich H. Baiap3 as a genetic marker associated with anxiety and benzodiazepine abuse in mouse and man. Exp Clin Endocrinol Diabetes 2013. [DOI: 10.1055/s-0033-1359431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Ho CY, Chen YH, Wu PY, Chang CH, Chen HY, Man KM, Shen JL, Tsai FJ, Lin WY, Lee YJ, Chen WC. Effects of commercial citrate-containing juices on urolithiasis in a Drosophila model. Kaohsiung J Med Sci 2013; 29:488-93. [DOI: 10.1016/j.kjms.2013.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 08/10/2012] [Indexed: 11/28/2022] Open
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16
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Chen WC, Lin WY, Chen HY, Chang CH, Tsai FJ, Man KM, Shen JL, Chen YH. Melamine-induced urolithiasis in a Drosophila model. J Agric Food Chem 2012; 60:2753-7. [PMID: 22352299 DOI: 10.1021/jf204647p] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Melamine-tainted food can induce renal stones in both humans and animals. We have previously reported a novel Drosophila model for the study of renal stone disease. In addition to hyperoxaluria-causing agents, we also tested herein the effect of melamine on crystal formation in Drosophila . The results indicate that administration of melamine alone caused crystal formation in a dose-dependent manner. The crystals also appeared after ingestion of melamine for 3 weeks in the Malpighian tubules of Drosophila when viewed with polarized light. Administration of potassium citrate (K citrate) was found to significantly ameliorate the melamine-induced reduction of lifespan. However, administration of K citrate failed to reduce the quantity of crystals. Because calcium oxalate is not the major crystal induced by melamine, the predominant components of melamine-induced crystals and the potential crystal inhibitors warrant further investigation.
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Affiliation(s)
- Wen-Chi Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
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17
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Man KM, Chen WC, Wang HM, Chen HY, Shen JL, Chen LD, Tsai FJ, Chen YH, Yu DX, Chiang FF. A randomized, double-blind, placebo-controlled trial of a Chinese herbal Sophora flower formula in patients with symptomatic haemorrhoids: a preliminary study. Afr J Tradit Complement Altern Med 2012; 10:343-51. [PMID: 24146460 DOI: 10.4314/ajtcam.v10i2.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Dried flowers and buds of Sophora japonica (Huaihua) are used in China, Japan and Korea for treating haematemesis and bleeding haemorrhoids. This study compared the clinical safety and efficacy of a Sophora flower formula with a placebo for the conservative treatment of symptomatic haemorrhoids. The study was a prospective, double-blind, randomized placebo-controlled trial. The clinical effective rate, symptom score and the incidence of important clinical events were used as observation indices to evaluate the effect of the Sophora flower formula. The results showed that after 7 days of treatment, improvement was observed in 87.0% of the patients' major symptoms in the Sophora flower formula group compared with 81.8% of those in the placebo group. After 14 days, 78.2% patients in the Sophora flower formula group were asymptomatic, whereas 40.9% of those in the placebo group exhibited residual symptoms. However, the difference between both groups was not statistically significant. As the bowel habits of the patients improved and as the patients took sitz baths, their symptoms improved drastically, regardless of the use of the Sophora flower formula. These findings indicate that the traditional Chinese Sophora flower formula is clinically safe; however, its effects on haemorrhoids need to be studied in a larger sample size and with different dosages. The present study results may be a potential clinical reference for physicians prescribing medications for patients with symptomatic haemorrhoids.
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Affiliation(s)
- Kee-Ming Man
- Department of Anesthesiology, Tungs' Taichung MetroHarbor Hospital, Taichung 43503, Taiwan ; Graduate Institute of Geriatric Medicine, Department of Urology, First Affiliated Hospital, Anhui Medical University, Hefei 230022, China ; Department of Life Sciences, National Chung Hsing University, Taichung 40227, Taiwan
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18
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Chen YH, Huang PH, Lin FY, Chen WC, Chen YL, Yin WH, Man KM, Liu PL. Magnolol: A multifunctional compound isolated from the Chinese medicinal plant Magnolia officinalis. Eur J Integr Med 2011. [DOI: 10.1016/j.eujim.2011.09.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Lin WC, Ho CY, Chen YH, Chen IC, Chen HY, Tsai FJ, Shen JL, Man SS, Huang PH, Chen YL, Man KM, Chen WC. Impact of shock wave lithotripsy on heart rate variability in patients with urolithiasis. Urol Res 2011; 39:135-140. [PMID: 20924572 DOI: 10.1007/s00240-010-0312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 09/16/2010] [Indexed: 05/30/2023]
Abstract
The physiological response of the cardiac autonomic nervous system during shock wave lithotripsy (SWL) remains unclear. Heart rate variability (HRV) is an index of cardiac autonomic balance. This study aimed to analyze HRV during SWL in patients with urolithiasis. Electrocardiograms of patients who underwent SWL were obtained. Recordings were obtained before and after SWL. For each time point, the recordings were obtained continuously for 6 min, after which R wave-to-R wave (RR) intervals were extracted. The time digital sequence derived from RR intervals was the HRV signal. Time-domain analysis revealed that the mean of RR intervals (MRR) and standard deviation of normal beat-to-normal beat (NN) intervals (SDNN), but not the square root of the mean squared difference of successive NNs (RMSSD) or triangular interpolation of NN intervals (TINN), significantly increased during SWL. The increase in SDNN persisted after SWL but MRR returned to the initial level. Frequency-domain analysis revealed that very low frequency (VLF), low frequency (LF), and LF/high frequency (HF) ratio significantly increased after SWL, while there was no statistically significant difference in HF. Thus, the patients had significantly high MRR and SDNN during SWL and significantly high SDNN, VLF, LF, and LF/HF ratio after SWL. SWL could alter the functioning of the cardiac autonomic nervous system, resulting in reduction in sympathetic activity and increase in parasympathetic activity. Further studies with larger samples are required to confirm these findings and understand the underlying mechanisms.
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Affiliation(s)
- Wu-Chou Lin
- Department of Urology, China Medical University Hospital, Taichung, Taiwan
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20
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Lee CT, Chang YH, Lin WY, Xu JM, Chen HY, Chou PL, Cheng CW, Chen YL, Lin FY, Tsai FJ, Huang HL, Man KM, Liu PL, Liu JT, Chen WC, Chen YH. Applications of Meridian Electrical Conductance for Renal Colic: A Prospective Study. J Altern Complement Med 2010; 16:861-6. [PMID: 20642363 DOI: 10.1089/acm.2009.0273] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Chao-Te Lee
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
- Emergency Department, Lin Shin Hospital, Taichung, Taiwan
- Graduate Institute of Geriatric Medicine, Anhui Medical University, Hefei, China
| | - Yung-Hsien Chang
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Yong Lin
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
| | - Jian-Ming Xu
- Graduate Institute of Geriatric Medicine, Anhui Medical University, Hefei, China
| | - Huey-Yi Chen
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
| | - Pei-Lung Chou
- Emergency Department, Lin Shin Hospital, Taichung, Taiwan
| | | | - Yuh-Lien Chen
- Institute of Anatomy and Cell Biology, School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fen-Yen Lin
- Division of Internal Medicine, Taipei Medical University and Hospital, Taipei, Taiwan
| | - Fuu-Jen Tsai
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
| | - Hann-Luen Huang
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
- Department of Internal Medicine, Cathay General Hospital-Hsinchu Branch, Hsinchu, Taiwan
| | - Kee-Ming Man
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
- Department of Anesthesiology, Tungs' MetroHarbor Hospital, Taichung, Taiwan
| | - Po-Len Liu
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jung-Tung Liu
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine and Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University; Department of Urology, Department of Obstetrics and Gynecology, and Department of Medical Genetics and Pediatrics, China Medical University Hospital, Taichung, Taiwan
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Chen WC, Wu SY, Liu HP, Chang CH, Chen HY, Chen HY, Tsai CH, Chang YC, Tsai FJ, Man KM, Liu PL, Lin FY, Shen JL, Lin WY, Chen YH. Identification of melamine/cyanuric acid-containing nephrolithiasis by infrared spectroscopy. J Clin Lab Anal 2010; 24:92-9. [PMID: 20333762 DOI: 10.1002/jcla.20362] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Melamine-contaminated milk formula caused infant nephrolithiasis in some areas of China. Its combination with cyanuric acid causes crystallization in renal tubules. Following this renal damage and even renal failure that require long-term hemodialysis has been reported. Therefore, correct and timely diagnosis of these complex diseases is critical. Melamine containing stone is a combination of equal molar ratios of common stone compositions that has been reported from previous animal studies. We have previously identified the compositions of urinary tract stones with infrared (IR) spectroscopy. We hypothesized that the absorbance of wavelength of IR can identify melamine/cyanuric acid in the presence of mixing human stone compositions. In this study, we made an artificial stone composition and examine under IR absorbance by mixing equal molar ratios of melamine/cyanuric acid with different types of human urinary stones, and established a reference of IR analysis for the identification of melamine/cyanuric acid-containing human urinary tract stones. Knowledge of the precise stone composition allowed institution of appropriate prophylactic dietary and medical therapy and this may help in the prevention of urinary stone recurrence. The results are promising that melamine and cyanuric acid can be identified clearly in a low percentile (approximately 1%) of stone mixture pellet. Therefore, IR seems to be an ideal tool for the identification of melamine/cyanuric acid-containing stones.
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Affiliation(s)
- Wen-Chi Chen
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Lai KC, Lin WY, Man KM, Tsai CH, Chen HY, Tsai FJ, Chen FJ, Chen HY, Liu HP, Ho TJ, Huang PH, Liu PL, Lin FY, Shen JL, Liu JT, Chen YH, Chen WC. Association of interleukin-18 gene polymorphisms with calcium oxalate kidney stone disease. ACTA ACUST UNITED AC 2009; 44:20-6. [DOI: 10.3109/00365590903449332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kuang-Chi Lai
- Department of Surgery, China Medical University Beigang Hospital, Yunlin, Taiwan
- Department of Anesthesiology, Tungs' MetroHarbor Hospital, Taichung, Taiwan
| | - Wei-Yong Lin
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Kee-Ming Man
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Department of Anesthesiology, Tungs' MetroHarbor Hospital, Taichung, Taiwan
| | - Chou-Haung Tsai
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Huey-Yi Chen
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Department of Anesthesiology, Tungs' MetroHarbor Hospital, Taichung, Taiwan
| | - Fuu-Jen Tsai
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Department of Anesthesiology, Tungs' MetroHarbor Hospital, Taichung, Taiwan
| | - Fun-Jou Chen
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Hsin-Yi Chen
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Department of Anesthesiology, Tungs' MetroHarbor Hospital, Taichung, Taiwan
| | - Hsin-Ping Liu
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Tsung-Jung Ho
- Department of Surgery, China Medical University Beigang Hospital, Yunlin, Taiwan
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Po-Hsun Huang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Po-Len Liu
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Feng-Yen Lin
- Division of Anesthesiology, Department of Anesthesiology, School of Medicine, Taipei Medical University and Hospital, Taipei, Taiwan
| | - Jui-Lung Shen
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan,
| | - Jung-Tung Liu
- School of Medicine, Department of Neurosurgery, Chung-Shan Medical University and Hospital, Taichung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine, Graduate Institute of Chinese Medical Science, Graduate Institute of Acupuncture Science, School of Chinese Medicine, and School of Medicine, College of Chinese Medicine, Department of Ophthalmology, Department of Obstetric and Gynecology, Department of Medical Genetics and Pediatrics, and Department of Urology, China Medical University and Hospital, Taichung, Taiwan
- Department of Anesthesiology, Tungs' MetroHarbor Hospital, Taichung, Taiwan
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23
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Chen YH, Lin FY, Liu PL, Huang YT, Chiu JH, Chang YC, Man KM, Hong CY, Ho YY, Lai MT. Antioxidative and hepatoprotective effects of magnolol on acetaminophen-induced liver damage in rats. Arch Pharm Res 2009; 32:221-8. [PMID: 19280152 DOI: 10.1007/s12272-009-1139-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 12/15/2008] [Accepted: 12/15/2008] [Indexed: 12/31/2022]
Abstract
Acute liver failure (ALF), an often fatal condition characterized by massive hepatocyte necrosis, is frequently caused by drug poisoning, particularly with acetaminophen (N-acetyl-p-aminophenol/APAP). Hepatocyte necrosis is consecutive to glutathione (GSH) depletion and mitochondrial damage caused by reactive oxygen species (ROS) overproduction. Magnolol, one major phenolic constituent of Magnolia officinalis, have been known to exhibit potent antioxidative activity. In this study, the anti-hepatotoxic activity of magnolol on APAP-induced toxicity in the Sprague-Dawley rat liver was examined. After evaluating the changes of several biochemical parameters in serum, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) were elevated by APAP (500 mg/kg) intraperitoneal administration (8 and 24 h) and reduced by treatment with magnolol (0.5 h after APAP administration; 0.01, 0.1, and 1 mug/kg). Histological changes around the hepatic central vein, lipid peroxidation (thiobarbituric acid-reactive substance/TBARS), and GSH depletion in liver tissue induced by APAP were also recovered by magnolol treatment. The data show that oxidative stress followed by lipid peroxidation may play a very important role in the pathogenesis of APAP-induced hepatic injury; treatment with lipid-soluble antioxidant, magnolol, exerts anti-hepatotoxic activity. Our study points out the potential interest of magnolol in the treatment of toxic ALF.
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Affiliation(s)
- Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
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24
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Lu CH, Man KM, Ou-Yang HY, Chan SM, Ho ST, Wong CS, Liaw WJ. Composite Auditory Evoked Potential Index Versus Bispectral Index to Estimate the Level of Sedation in Paralyzed Critically Ill Patients: A Prospective Observational Study. Anesth Analg 2008; 107:1290-4. [DOI: 10.1213/ane.0b013e31818061ae] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Affiliation(s)
- T T Desta
- Divisions of Gastroenterology, UC Davis Medical Center, Sacramento, and St. Mary's Hospital, San Francisco, CA, USA
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Abstract
Two patients with liver failure secondary to isoniazid hepatotoxicity were successfully treated with orthotopic liver transplantation. A 49-year-old man received isoniazid prophylaxis for a positive tuberculin test, and a 60-year-old woman was treated for active pulmonary tuberculosis with isoniazid, rifampin, and pyrazinamide. Both patients developed hepatic failure 4 and 1.5 months after initiation of antituberculous drug therapy, respectively. Liver transplantation was performed for progressive hepatic failure and was successful in both patients. The patient with active pulmonary tuberculosis was successfully treated with a modified antituberculous drug regimen while taking standard doses of immunosuppressive drugs after transplantation. In conclusion, liver transplantation is feasible and effective therapy for patients with isoniazid-induced hepatic failure, and active pulmonary tuberculosis may represent a relative rather than absolute contraindication to transplantation.
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Affiliation(s)
- F J Farrell
- Department of Transplantation, California Pacific Medical Center, San Francisco 94115
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28
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Abstract
A man undergoing evaluation for liver transplantation was found to have an asymptomatic chest mass, which further evaluation revealed to be pulmonary varices. The left hilar lesion was discovered on a screening chest x-ray film and confirmed by a computed tomographic scan of the thoracic cavity. Bronchoscopy was nondiagnostic, and a thoracotomy was required to diagnose the vascular lesion and exclude carcinoma. The pathophysiology of this pulmonary venous anomaly appeared to be related to portal hypertension, since esophagogastric and colonic varices also were present and the pulmonary varices resolved after liver transplantation. This is the first reported case of pulmonary varices caused by portal hypertension.
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Affiliation(s)
- K M Man
- Department of Medicine, California-Pacific Medical Center, San Francisco 94115
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Man KM, Drejet A, Keeffe EB, Garcia-Kennedy R, Imperial JC, Esquivel CO. Primary sclerosing cholangitis and Hodgkin's disease. Hepatology 1993; 18:1127-31. [PMID: 8225218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Three patients with primary sclerosing cholangitis and Hodgkin's disease, a previously unrecognized association, are reported. All three patients were men, and one patient had Crohn's disease of the colon. Primary sclerosing cholangitis was diagnosed 2, 11 and 17 yr before diagnosis of Hodgkin's disease in the three patients, and all three had advanced biliary cirrhosis prompting referral for liver transplantation. The symptoms of Hodgkin's disease were often masked by similar manifestations of primary sclerosing cholangitis, particularly symptoms of recurrent biliary sepsis. Hodgkin's disease is another disorder that may occur in patients with primary sclerosing cholangitis, particularly in the setting of advanced disease, and may be masked by the underlying hepatobiliary disease.
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Affiliation(s)
- K M Man
- Department of Transplantation, California Pacific Medical Center, San Francisco 94115
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Man KM, Keeffe EB, García-Kennedy R, Hansen JE, Verhille MS. Acute appendicitis secondary to metastatic cholangiocarcinoma. Am J Gastroenterol 1993; 88:1966-8. [PMID: 8237955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- K M Man
- Department of Medicine, California Pacific Medical Center, San Francisco
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31
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Abstract
Swallowing normally elicits a superior-anterior excursion of the hyoid that contributes to elevation of the larynx and opening of the upper esophageal sphincter. The magnitude of hyoid movements, however, has not been quantitated with respect to the volume of the swallowed bolus. In this study, we determined the magnitude of superior and anterior movements of the hyoid associated with swallows of barium of different volumes. Lateral videoradiographic images of 2- to 20-ml boluses of barium were obtained in 15 subjects who had no pharyngoesophageal symptoms and had normal pharyngoesophageal motor function. Analysis indicated that a significant direct correlation existed between the volume of the swallowed bolus and the magnitude of the superior and anterior movements of the hyoid. For example, the mean values for these respective movements were 13.0 +/- 5 mm and 13.5 +/- 6 mm for a 2-ml bolus, compared with 14.8 +/- 5 mm and 16.7 +/- 5 mm for a 10-ml bolus. The findings indicate that values of deglutitive movement of the hyoid need to be indexed to the volume of the swallowed bolus. The results imply that the neural program in the brainstem that generates the oral and pharyngeal phases of swallowing is not completely stereotyped, but rather is modulated by volume-dependent sensory feedback.
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Affiliation(s)
- W J Dodds
- Department of Radiology, Medical College of Wisconsin, Milwaukee 53226
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