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Guo JS, Ng KLB, Lee SS, Lai YW, Wu YC. Custom-Made Implant Fabrication for Chin Augmentation Using Piled-Up Expanded Polytetrafluoroethylene Sheets: An Innovative Surgical Technique and Literature Review. Aesthetic Plast Surg 2024:10.1007/s00266-024-03918-1. [PMID: 38499874 DOI: 10.1007/s00266-024-03918-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/08/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Alloplastic chin augmentation is the most common esthetic surgical treatment to reshape the chin. However, factory-made chin implants are typically standardized rather than custom-made and have potential to cause complications. Although the fabrication of custom-made implants by using computer-assisted planning and 3D-printing technology has become widespread, the process has several disadvantages, including long preoperative prosthesis preparation times, high costs, and unsuitability for patients with asymmetric chins or those who undergo combined mandibuloplasty before implant placement. The present study developed an innovative chin augmentation technique involving stacked expanded polytetrafluoroethylene (e-PTFE) sheets that is suitable for most patients and has minimal side effects. MATERIALS AND METHODS A retrospective review of a single surgeon's experience was performed over a 2 year period for patients who underwent a procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. This study analyzed the outcomes, complications (temporary nerve numbness, wound infection, hematoma formation, and implant displacement), and patient satisfaction during follow-up. RESULTS Between January 2018 and December 2020, 38 patients underwent the procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. Six patients (15.8%) experienced nerve-related temporary numbness, and one (2.6%) experienced wound infection. None had developed major complications such as implant displacement or wound infection at follow-up. Moreover, the patients demonstrated a high level of satisfaction with the surgical results. CONCLUSION Piled-up e-PTFE sheets can be used to produce custom-fit porous polyethylene chin implants that result in minimal complications and a very high satisfaction rate. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jing-Song Guo
- The Bishop Clinic, 6F, No.6, Heping E Road, Da'an District, Taipei, Taiwan
| | - Kwan Lok Benjamin Ng
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan
| | - Su-Shin Lee
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Regenerative medicine and cell therapy research centre, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Wei Lai
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan
- The Bishop Clinic, 6F, No.6, Heping E Road, Da'an District, Taipei, Taiwan
| | - Yi-Chia Wu
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
- Regenerative medicine and cell therapy research centre, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Wu YC, Hsieh MCW, Wang WT, Chang YH, Lee SS, Huang SH, Hou MF, Tseng CC, Kuo YR. A novel biodegradable magnesium skin staple: A safety and functional evaluation. Asian J Surg 2024:S1015-9584(24)00360-9. [PMID: 38431472 DOI: 10.1016/j.asjsur.2024.02.098] [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] [Received: 08/01/2023] [Revised: 01/21/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The potential of biodegradable magnesium (Mg) skin staple has recently garnered widespread attention due to their biodegradability and biocompatibility rather than traditional stainless steel staples, the most commonly used in current clinical practice. The aim of this study is to evaluate the safety and mechanical properties of a novel biodegradable Mg skin staple. METHODS A prototype of Mg skin staple was designed using a novel ZK60 Mg alloy. The mechanical properties of the staple were evaluated using a universal testing machine. The cytotoxicity of the staple was examined in vitro and the efficacy of the staple in wound closure was assessed in New Zealand rabbits for one and three weeks, respectively. RESULTS The tensile strength of this Mg alloy is 258.4 MPa with 6.9% elongation. The treatment of HaCaT and L929 cells with the staple extract resulted in over 95% cell viability, indicating no cytotoxicity. In vivo, no tissue irritation was observed. No difference was found in wound healing between the Mg skin staple and the stainless steel staple after one and three weeks in the cutting wound on the back of rabbits. Some Mg skin staples spontaneously dislodged from the skin within three weeks, while others were easily removed. CONCLUSION Our results confirm the safety, biocompatibility, and functionality of the novel Mg skin staple in wound closure. The efficacy of the staple in wound closure was demonstrated to be as effectively as conventional staples, with the added benefit of decreased long-term retention of skin staples in the wounds.
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Affiliation(s)
- Yi-Chia Wu
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan; Department of Plastic Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, 80145, Taiwan; Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan
| | - Meng-Chien Willie Hsieh
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan; Department of Plastic Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, 80145, Taiwan
| | - Wei-Ting Wang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan
| | - Yen-Hao Chang
- Combination Medical Device Technology Division, Medical Devices and Opto-Electronics Equipment Department, Metal Industries Research & Development Centre, Kaohsiung, 82151, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan; Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan; Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, 81267, Taiwan
| | - Ming-Feng Hou
- Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan
| | - Chun-Chieh Tseng
- Combination Medical Device Technology Division, Medical Devices and Opto-Electronics Equipment Department, Metal Industries Research & Development Centre, Kaohsiung, 82151, Taiwan.
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan; Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
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Chang CW, Hsieh MC, Lin IW, Chen RF, Kuo YR, Lee SS. Accreditation of the handheld 3-dimensional scanner and conventional photo images for area measurement. Medicine (Baltimore) 2024; 103:e35376. [PMID: 38335411 PMCID: PMC10860941 DOI: 10.1097/md.0000000000035376] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/05/2023] [Accepted: 09/04/2023] [Indexed: 02/12/2024] Open
Abstract
Accurate assessment of wound areas is crucial in making therapeutic decisions, as the prognosis and changes in the size of the wound over time play a significant role. An ideal assessment method should possess qualities such as speed, affordability, accuracy, user-friendliness for both patients and healthcare professionals, and suitability for daily clinical practice. This study aims to introduce a handheld 3-dimensional (3D) scanner and evaluate its accuracy in measuring wound areas. Engineers from the Industrial Technology Research Institute in Taiwan developed a handheld 3D scanner with the intention of extending its application to the medical field. A project was conducted to validate the accuracy of this 3D scanner. We utilized a smartphone (Asus ZenFone 2 with a 13-million-pixel rear camera), a digital single-lens reflex digital camera (Nikon, D5000, Tokyo, Japan), and the 3D scanner to repeatedly measure square papers of known size that were affixed to the curved surface of life-size facial mask or medical teaching breast models. The "Image J" software was employed for 2-dimensional image measurements, while the "3D Edit" software was used to assess the "area of interest" on 3D objects. By using square papers with predetermined dimensions, the measurement-associated error rate (ER) could be calculated for each image. Three repeated measurements were performed using the "Image J" software for each square paper. The ERs of the 3D scan images were all below 3%, with an average ER of 1.64% in this study. The close-up mode of the smartphone exhibited the highest ER. It was observed that as the area increased, the ER also increased in the digital single-lens reflex camera group. The extension distortion effect caused by the wide-angle lens on the smartphone may increase the ER. However, the definition of a healthy skin edge may vary, and different algorithms for calculating the measurement area are employed in various 3D measurement software. Therefore, further validation of their accuracy for medical purposes is necessary. Effective communication with software engineers and discussions on meeting clinical requirements are crucial steps in enhancing the functionality of the 3D scanner.
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Affiliation(s)
- Chao-Wei Chang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Meng-Chien Hsieh
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - I-Wen Lin
- Department of Nursing, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Rong-Fu Chen
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Cheng TW, Lin YN, Lee SS, Kuo YR. The niche of dermal graft to reconstruct a complex pressure injury wound in sacral region: A case report. Medicine (Baltimore) 2023; 102:e36617. [PMID: 38134078 PMCID: PMC10735093 DOI: 10.1097/md.0000000000036617] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
RATIONALE Pressure ulcers are a common health issue, particularly among elderly and bedridden patients who are vulnerable to pressure injuries in the sacral region. Currently, free flap and local flap surgeries are the gold standard procedures for the reconstruction of such injuries. However, the recurrence rate of flap surgery appears to be high. In this context, we presented a case involving a sacral pressure ulcer reconstructed with dermal grafting. PATIENT CONCERNS A 59-year-old male with a medical history of hepatitis C, brain hemorrhage, hydrocephalus, and multiple fractures presented with a sacral ulcer. Owing to the patient's history of recurrent pressure injuries and the challenges associated with postoperative wound care, the patient and his family were hesitant to proceed with flap surgery. DIAGNOSES The patient was diagnosed with a stage IV pressure ulcer measuring 4 cm × 4 cm in size in the sacral region, according to the National Pressure Ulcer Advisory Panel staging system. INTERVENTIONS Before surgery, the patient received standard wound care with dressing for 4 months, along with short-term oral antibiotics due to a positive wound culture for Pseudomonas aeruginosa. During the surgery, a dermal graft with a size of 35 cm2 and a thickness of 0.014 inches was harvested from the patient's left thigh. The graft was then secured to the wound bed. OUTCOMES Although the dermal graft failed with sloughing after 1 week, the wound bed showed improvement with granulation. After 1.5 months, the wound area had decreased to half of its original size, and the wound eventually healed after 3.5 months. LESSONS Dermal grafts have a niche in reconstructing pressure injury wounds in the sacral region, because of the relative ease of wound care and additional benefits even in cases where the graft fails.
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Affiliation(s)
- Te-Wei Cheng
- Department of General Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Wong NS, Chan DPC, Chan CP, Poon CM, Lee SS. Community burden of hepatitis A infection and risk of transmission in Hong Kong. Hong Kong Med J 2023; 29 Suppl 7:41-46. [PMID: 38148657] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Affiliation(s)
- N S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - D P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C P Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - C M Poon
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong SAR, China
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NG KLB, Liu TH, Lee SS. Three-Dimensional Navigation-Assisted Open Reduction and Internal Fixation of a Subcondylar and Ramus Fracture on a Maxillary Oligodontia Patient. J Craniofac Surg 2023; 35:00001665-990000000-01144. [PMID: 37916844 PMCID: PMC10880933 DOI: 10.1097/scs.0000000000009811] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 08/26/2023] [Indexed: 11/03/2023] Open
Abstract
Treatment of condylar fractures in patients with edentulous mandibles or no-occlusion reference is particularly challenging due to the absence of important anatomical structures and landmark for occlusion analysis. In this case, a 69-year-old female maxillary oligodontia victim suffered from a traumatic accident with a right facial contusion, resulting in a right-side subcondylar and mandibular ramus fracture with right ramus height loss. In the preoperative planning, the 3-dimensionalimage of the left-side mandible was highlighted by the navigation software. A mirror image of the left-side mandible was made and superimposed on the right side of the face. Surgical intervention with an endoscope and 3-dimensional navigation-assisted open reduction and internal fixation of the right-side subcondylar and ramus fracture was performed. The patient recovered well with no restriction in mandibular movement, no limitation in mouth opening, and a satisfied esthetic outcome.
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Affiliation(s)
- Kwan-Lok B. NG
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University
| | - Tsung-Hsien Liu
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital
| | - Su-Shin Lee
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University
- Regenerative Medicine and Cell Therapy Research Centre, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lai YW, Wang YC, Lee SS, Lai CS. Complete Release of High-riding Septum and Constricted Fibers with Fat Graft for Congenital Depressed Upper Eyelid with Multiple Creases. Plast Reconstr Surg Glob Open 2023; 11:e5398. [PMID: 37954214 PMCID: PMC10635607 DOI: 10.1097/gox.0000000000005398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/26/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Ya-Wei Lai
- From the Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Yu-Chi Wang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Sheng Lai
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Jang BG, Huh KH, Yeom HG, Kang JH, Kim JE, Yoon HJ, Yi WJ, Heo MS, Lee SS. Differentiation between Chondrosarcoma and Synovial Chondromatosis of the Temporomandibular Joint Using CT and MR Imaging. AJNR Am J Neuroradiol 2023; 44:1176-1183. [PMID: 37652584 PMCID: PMC10549951 DOI: 10.3174/ajnr.a7980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND AND PURPOSE Chondrosarcoma and synovial chondromatosis of the temporomandibular joint share overlapping clinical and histopathologic features. We aimed to identify CT and MR imaging features to differentiate chondrosarcoma from synovial chondromatosis of the temporomandibular joint. MATERIALS AND METHODS The CT and MR images of 12 and 35 patients with histopathologically confirmed chondrosarcoma and synovial chondromatosis of the temporomandibular joint, respectively, were retrospectively reviewed. Imaging features including lesion size, center, enhancement, destruction/sclerosis of surrounding bone, infiltration into the tendon of the lateral pterygoid muscle, calcification, periosteal reaction, and osteophyte formation were assessed. A comparison between chondrosarcoma and synovial chondromatosis was performed with a Student t test for quantitative variables and the Fisher exact test or linear-by-linear association test for qualitative variables. Receiver operating characteristic analysis was performed to determine the diagnostic performance for differentiation of chondrosarcoma and synovial chondromatosis based on a composite score obtained by assigning 1 point for each of 9 imaging features. RESULTS High-risk imaging features for chondrosarcoma were the following: lesion centered on the mandibular condyle, destruction of the mandibular condyle, no destruction/sclerosis of the articular eminence/glenoid fossa, infiltration into the tendon of the lateral pterygoid muscle, absent or stippled calcification, periosteal reaction, internal enhancement, and size of ≥30.5 mm. The best cutoff value to discriminate chondrosarcoma from synovial chondromatosis was the presence of any 4 of these high-risk imaging features, with an area under the curve of 0.986 and an accuracy of 95.8%. CONCLUSIONS CT and MR imaging features can distinguish chondrosarcoma from synovial chondromatosis of the temporomandibular joint with improved diagnostic performance when a subcombination of 9 imaging features is used.
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Affiliation(s)
- B G Jang
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - K H Huh
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - H G Yeom
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute (H.G.Y.), School of Dentistry, Wonkwang University, Iksan, Korea
| | - J H Kang
- Department of Oral and Maxillofacial Radiology (J.H.K.), Seoul National University Dental Hospital, Seoul, Korea
| | - J E Kim
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - H J Yoon
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - W J Yi
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - M S Heo
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
| | - S S Lee
- From the Department of Oral and Maxillofacial Radiology and Dental Research Institute (B.G.J., K.H.H., J.E.K., H.J.Y., W.J.Y., M.S.H., S.S.L.), School of Dentistry, Seoul National University, Seoul, Korea
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Huang CH, Chen MT, Lee SS. Integration of Three-dimensional Computer Simulation into navigator assisted surgery on fibrous dysplasia patient—case report. Formos J Surg 2023. [DOI: 10.1097/fs9.0000000000000057] [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] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Tai CJ, Lu CK, Lee CY, Lee SS, Yang YH. Real-world evidence of hyperbaric oxygen therapy on cardiovascular outcomes in patients with chronic osteomyelitis. J Infect Public Health 2023; 16:705-712. [PMID: 36940497 DOI: 10.1016/j.jiph.2023.03.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND The effectiveness of hyperbaric oxygen (HBO) therapy for chronic osteomyelitis remains inconclusive. In particular, recent studies have shown that chronic osteomyelitis is a crucial risk factor for cardiovascular diseases. However, the preventive effect of HBO on cardiovascular events has not been reported in patients with chronic osteomyelitis. METHODS We conducted a population-based cohort study to evaluate the impact of HBO on patients with chronic osteomyelitis. Overall, 5312 patients with chronic osteomyelitis were selected from the Taiwan National Health Insurance Database to evaluate the impact of HBO in patients with chronic osteomyelitis. Propensity-score (PS) matching and inverse probability weighting (IPTW) were employed to balance covariates between the HBO and non-HBO groups. The primary outcome was all-cause mortality. The secondary outcomes were myocardial infarction (MI) and stroke hospitalisation. Furthermore, we evaluated the appropriate timing for HBO intervention by the restricted cubic spline (RCS) functions. RESULTS After 1:4 PS-matching, the HBO group (n = 265) was associated with lower 1-year mortality (hazard ratio [HR], 0.49; 95 % confidence interval [CI], 0.25-0.95) than the non-HBO group (n = 994); this was consistent with the IPTW weighting results (HR, 0.25; 95 % CI, 0.20-0.33). The risk of stroke was lower in the HBO group (HR, 0.46; 95 % CI, 0.34-0.63) than that in the non-HBO group. However, HBO therapy failed to reduce the risk of MI. Using the RCS model, patients with intervals within 90 days (HR, 1.38; 95 % CI, 1.04-1.84) presented a significant risk of 1-year mortality. After 90 days, as the length of interval increased, the risk gradually decreased and became insignificant. CONCLUSION The present study revealed that adjunctive HBO could benefit the 1-year mortality and stroke hospitalisation in patients with chronic osteomyelitis. HBO was recommended to be initiated within 90 days of chronic osteomyelitis hospitalisation.
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Affiliation(s)
- Chi-Jung Tai
- Department of Family Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan; Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Kuan Lu
- Department of Orthopedic Surgery, Park One International Hospital, Kaohsiung, Taiwan
| | - Chun-Ying Lee
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Department of Plastic Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan; Department of Surgery, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsin Yang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Lin YN, Wang YC, Lee SS, Hsieh MCW, Lin SD, Huang SH, Lin TM, Kuo YR. The Bridging Effect of Artificial Dermis on Reconstruction of Skin Avulsion Injury. INT J LOW EXTR WOUND 2023:15347346231158175. [PMID: 36814392 DOI: 10.1177/15347346231158175] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Skin avulsion wounds are expected to be swollen and tense after trauma, and skin perfusion can be compromised after primary closure, resulting in wound dehiscence and poor healing. The artificial dermis (AD) serves as a dermal regeneration template that is used to heal skin defects with secondary intention. Therefore, the aim of this study is to evaluate the effect of AD application on traumatic skin avulsion injuries compared to conventional primary closure. A retrospective cohort of 20 patients with skin avulsion injuries were included the study: ten patients were treated with AD and ten patients were managed with primary closure. When compared to the primary closure group, AD group had a shorter average healing time (58.40 ± 26.94 days V 65.50 ± 46.45 days) and significantly higher flap viability (92.00 ± 13.17% V 78.00 ± 13.98%; p = .03). In conclusion, AD is a promising material for the treatment of skin avulsion injury and produces better clinical results.
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Affiliation(s)
- Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Chi Wang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Meng-Chien Willie Hsieh
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Tsai-Ming Lin
- Charming Institute of Aesthetic and Regenerative Surgery (CIARS), Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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12
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Wang YC, Wu YC, Chang CW, Chung CL, Lee SS. An algorithmic approach of reconstruction for cranioplasty failure: A case series. Medicine (Baltimore) 2023; 102:e33011. [PMID: 36827034 DOI: 10.1097/md.0000000000033011] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
RATIONALE Cranioplasty is a surgical procedure used to repair cranial defects for both cosmetic and functional reasons. The complication rate of cranioplasty is between 10% and 50%. The failure of cranioplasty is associated with various factors, including etiologies, types of material, and the timing of cranioplasty. In this study, a case series of managing cranioplasty complications at a single institution. PATIENT CONCERNS Eighteen patients were identified who underwent craniofacial defect reconstruction due to the failure of their initial cranioplasty between January 2010 and May 2020. Five men (27.78%) and thirteen women (72.22%) were included. The mean age was 39.61 years old. The average follow-up duration was 5.94 years. DIAGNOSES The indication for initial cranioplasty included previous decompressive craniectomy (77.78%, n = 14), traumatic cranial defects (16.67%, n = 3), and congenital cranial deformity (5.56%, n = 1). The reported complications were infection (50%, n = 9), implant exposure (50%, n = 9), wound dehiscence (22.22%, n = 4) and cranial deformity (11.11%, n = 2). INTERVENTIONS More than half of the materials used for initial cranioplasty were synthetic [titanium mesh: 44.44%, n = 8; polymethyl metacrylate: 5.56%, n = 1; titanium mesh and polymethyl metacrylate: 5.56%, n = 1], while 44.44% of the patients received autologous bone graft. OUTCOMES Of all reconstructive procedures for cranioplasty failure, 55.56% was local flap with or without skin graft (n = 10), 16.67% was free flap (n = 3), 11.11% was skin graft only (n = 2), 5.56% was regional flap (n = 1). The free flap survival rate was 100% (3/3), and implant removal with sebsquent second cranioplasty was performed on 27.78% (n = 5) of the patients. LESSONS Management of cranioplasty failure can be challenging due to infection, refractory implant exposure, and wound dehiscence. The principles of management are based on adequate infection control and reconstructive ladder. Meanwhile, collaboration with plastic surgery and neurosurgery should be strengthened in order to achieve the best clinical outcomes.
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Affiliation(s)
- Yu-Chi Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Chia Wu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Wei Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Li Chung
- Division of Neurosurgery, Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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13
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Chan HL, Hsieh YH, Lin CF, Liang HY, Lee SS, Weng JC, Lee MJ, Chen YL, Chen VCH, Gossop M. Lower Risk of Burn Injury in Children and Adolescents with Autism Spectrum Disorder: A Nationwide Population-Based Study. J Autism Dev Disord 2023; 53:648-655. [PMID: 33474660 DOI: 10.1007/s10803-020-04859-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 12/17/2022]
Abstract
Little research has examined burn injury in the pediatric population with autism spectrum disorder (ASD). We used data from Taiwan's National Health Insurance Research Database to identify 15,844 participants aged <18 years with ASD and 130,860 participants without ASD. Our results revealed that the hazard ratios differed across three age ranges. The ASD group had a lower risk of burn injury than the non-ASD group when they were less than 6 years of age, a higher risk from 6 years to 12 years of age, and no difference when they were older than 12 years of age. More research is required to study the characteristics and causes of burn injury in the pediatric population with ASD.
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Affiliation(s)
- Hsiang-Lin Chan
- Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsuan Hsieh
- Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan
| | - Chiao-Fan Lin
- Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Yi Liang
- Department of Child Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Surgery, Faculty of Medicine, Collage of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jun-Cheng Weng
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Min-Jing Lee
- Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung, Taiwan.,Department of Psychology, Asia University, Taichung, Taiwan
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung University, Taoyuan, Taiwan. .,Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Michael Gossop
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
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14
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Petersen E, Zumla A, Hui DS, Blumberg L, Valdoleiros SR, Amao L, Ntoumi F, Asogun D, Simonsen L, Haider N, Traore T, Kapata N, Dar O, Nachega J, Abbara A, Al Balushi A, Kock R, Maeurer M, Lee SS, Lucey DR, Ippolito G, Koopmans M. Vaccination for monkeypox prevention in persons with high-risk sexual behaviours to control on-going outbreak of monkeypox virus clade 3. Int J Infect Dis 2022; 122:569-571. [PMID: 35788415 PMCID: PMC9534076 DOI: 10.1016/j.ijid.2022.06.047] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- E Petersen
- Institute for Clinical Medicine, Faculty of Health Sciences, University of Aarhus, Denmark; European Society for Clinical Microbiology and Infectious Diseases [ESCMID] Task Force for Emerging Infections, Basel, Switzerland.
| | - A Zumla
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London; NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
| | - D S Hui
- Department of Medicine & Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - L Blumberg
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Veterinary Science, University of Pretoria, South Africa
| | - S R Valdoleiros
- European Society for Clinical Microbiology and Infectious Diseases [ESCMID] Task Force for Emerging Infections, Basel, Switzerland; Infectious Diseases Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - L Amao
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - F Ntoumi
- Congolese Foundation for Medical Research, Brazzaville, Republic of Congo; Institute of Tropical Medicine, University of Tübingen, Germany
| | - D Asogun
- Irrua Specialized Teaching Hospital, Irrua, Nigeria
| | - L Simonsen
- PandemiX Center, Department of Science and Environment, Roskilde University, Denmark
| | - N Haider
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, United Kingdom
| | - T Traore
- Emergency Preparedness and Response Programme, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - N Kapata
- National Public Health Institute, Ministry of Health, Lusaka, Zambia
| | - O Dar
- Chatham House and UK Public health security agency, London, UK
| | - J Nachega
- Department of Medicine and Center for Infectious Diseases, Stellenbosch University, Cape Town, South Africa; University of Pittsburgh Graduate School of Public Health, Pittsburgh, USA; Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - A Abbara
- UK Syria Public Health Network, and Department of Infection, Faculty of Medicine, Imperial College, London, UK
| | - A Al Balushi
- Infectious Diseases Unit, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - R Kock
- The Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
| | - M Maeurer
- ImmunoSurgery Unit, Champalimaud Centre for the Unknown, Lisbon, Portugal; Medizinische Klinik, Johannes Gutenberg University Mainz, Germany
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, 206 Postgraduate Education Centre, Prince of Wales Hospital, Hong Kong, China
| | - D R Lucey
- Daniel R. Lucey, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - G Ippolito
- Guiseppe Ippolito: Ministry of Health, Rome, Italy.
| | - Mpg Koopmans
- Viroscience Department, Erasmus Medical Center, Rotterdam, Netherlands; Pandemic and Disaster Preparedness Centre, Rotterdam, Netherlands
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15
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Hsieh MCW, Wang WT, Lin CY, Kuo YR, Lee SS, Hou MF, Wu YC. Stem Cell-Based Therapeutic Strategies in Diabetic Wound Healing. Biomedicines 2022; 10:biomedicines10092085. [PMID: 36140185 PMCID: PMC9495374 DOI: 10.3390/biomedicines10092085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/10/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Impaired wound healing and especially the “all-too-common” occurrence of associated diabetic foot ulcers (DFU) are becoming an increasingly urgent and deteriorating healthcare issue, which drastically impact the quality of life and further heighten the risks of infection and amputation in patients with diabetes mellitus. Amongst the multifactorial wound healing determinants, glycemic dysregulation has been identified to be the primary casual factor of poor wound healing. Unfortunately, current therapeutic modalities merely serve as moderate symptomatic relieves but often fail to completely restore the wound site to its pre-injury state and prevent further recurrence. Stem cell-based therapeutics have been employed for its promising potential to address the root of the problem as they not only exhibit the capacity for self-renewal and differentiation towards multiple lineages, but also have been disclosed to participate in mediating variant growth factors and cytokines. Herein we review the current literatures on the therapeutic benefits of using various kinds of stem cells, including embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), mesenchymal stem cells (MSCs), and adipose-derived stem cells (ASCs) in diabetic wound healing by searching on the PubMed® Database for publications. This study shall serve as an overview of the current body of research with particular focus on autologous ASCs and the laboratory expandable iPSCs in hope of shedding more light on this attractive therapy so as to elevate the efficacy of wound healing that is almost always compromised in diabetic patients.
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Affiliation(s)
- Meng-Chien Willie Hsieh
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Plastic Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
| | - Wei-Ting Wang
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Chuang-Yu Lin
- Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yur-Ren Kuo
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Su-Shin Lee
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 81267, Taiwan
| | - Ming-Feng Hou
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Surgery, Division of Breast Oncology and Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Chia Wu
- Department of Surgery, Division of Plastic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Plastic Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Surgery, Division of Breast Oncology and Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101 (ext. 7675)
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16
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Abstract
Dissecting the complex relationships between skin aging and air pollution has been an ongoing effort. The increased exposure to air pollution over time imposed a negative effect on skin. This study explores the correlation between skin aging in the Asian population and levels of air pollutants to show different relationship between the two. This study was retrospective and included 389 patients, age between 30 and 74, who planned to receive a session of laser treatment for skin disorders in Kaohsiung Medical University Hospital (KMUH) from 2006 to 2019. Preoperative skin condition quantified by VISIA Complexion Analysis System (Canfield Imaging Systems, Fierfield, NJ, US). Eight air pollutants such as carbon monoxide (CO), non-methane hydrocarbon (NMHC), nitrogen oxides (NO, NO2, and NOx), particulate matters (PM2.5 and PM10), ozone (O3), sulfur dioxide (SO2) and 8 skin condition such as spots, wrinkles, textures, pores, ultraviolet spots (UV spots), brown spots, red area, and porphyrin were analyzed to explore correlation between air pollution and skin aging. Strong correlation was found between NMHC exposure and texture, pores and brown spots formation. A positive correlation between O3 and better VISIA texture and pores scores was found. Brown spots was found to negatively associate with CO, NMHC, NO2, NOx, PM10, PM2.5, and SO2. The skin condition of population over age 45 affected by CO, NMHC, NO2, NOx, PM2.5, PM10, and SO2. Skin condition of the bottom 10% strongly correlates with exposure to PM10 and SO2, whereas skin condition of the top 10% was affected by PM10. Air pollutants such as CO, NO2, NOx, PM2.5, PM10, SO2, and NMHC were found to correlate with negative skin quality strongly. In contrast, O3 exposure is associated with less texture and pores. Future studies are warranted to further appreciate the relationships between air pollutants and skin condition.
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Affiliation(s)
- Chao-Hsin Huang
- School of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chian Wang
- Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Chen-Feng Wang
- Institute of Electronics, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chih-Hsing Hung
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- *Correspondence: Su-Shin Lee, 19th floor, No.100 Tzyou 1st Rd., San-Min Area, Kaohsiung 80708, Taiwan (e-mail: )
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17
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Hsieh MCW, Wang WT, Yeh JL, Lin CY, Kuo YR, Lee SS, Hou MF, Wu YC. The Potential Application and Promising Role of Targeted Therapy in Pulmonary Arterial Hypertension. Biomedicines 2022; 10:biomedicines10061415. [PMID: 35740436 PMCID: PMC9220101 DOI: 10.3390/biomedicines10061415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/22/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a rare yet serious progressive disorder that is currently incurable. This female-predominant disease unfolds as a pan-vasculopathy that affects all layers of the vessel wall. Five classes of pharmacological agents currently exist to target the three major cellular signaling pathways identified in PAH but are incapable of effectively reversing the disease progression. While several targets have been identified for therapy, none of the current PAH specific therapies are curative and cost-effective as they fail to reverse vascular remodeling and do not address the cancer-like features of PAH. Our purpose is to review the current literature on the therapeutic management of PAH, as well as the molecular targets under consideration for therapy so as to shed light on the potential role and future promise of novel strategies in treating this high-mortality disease. This review study summarizes and discusses the potential therapeutic targets to be employed against PAH. In addition to the three major conventional pathways already used in PAH therapy, targeting PDGF/PDGFR signaling, regulators in glycolytic metabolism, PI3K/AKT pathways, mitochondrial heat shock protein 90 (HSP90), high-mobility group box-1 (HMGB1), and bromodomain and extra-terminal (BET) proteins by using their specific inhibitors, or a pharmacological induction of the p53 expression, could be attractive strategies for treating PAH.
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Affiliation(s)
- Meng-Chien Willie Hsieh
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (M.-C.W.H.); (W.-T.W.); (Y.-R.K.); (S.-S.L.)
- Department of Plastic Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
| | - Wei-Ting Wang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (M.-C.W.H.); (W.-T.W.); (Y.-R.K.); (S.-S.L.)
| | - Jwu-Lai Yeh
- Department of Pharmacology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Chuang-Yu Lin
- Department of Biomedical Science and Environmental Biology, College of Life Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (M.-C.W.H.); (W.-T.W.); (Y.-R.K.); (S.-S.L.)
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (M.-C.W.H.); (W.-T.W.); (Y.-R.K.); (S.-S.L.)
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 81267, Taiwan
| | - Ming-Feng Hou
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Chia Wu
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan; (M.-C.W.H.); (W.-T.W.); (Y.-R.K.); (S.-S.L.)
- Department of Plastic Surgery, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
- Department of Surgery, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101 (ext. 7675)
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18
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Tam G, Wong NS, Lee SS. Serial surveys of Hong Kong medical students regarding attitudes towards HIV/AIDS from 2007 to 2017. Hong Kong Med J 2022; 28:223-229. [PMID: 35765732 DOI: 10.12809/hkmj208838] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION With widespread adoption of antiretroviral therapy, human immunodeficiency virus (HIV) epidemiology has changed since the late 2000s. Accordingly, attitudes towards the disease may also have changed. Because medical students are future physicians, their attitudes have important implications in access to care among patients with HIV/acquired immunodeficiency syndrome (AIDS). Here, we performed a survey to compare medical students' attitudes towards HIV/AIDS between the late 2000s (2007-2010) and middle 2010s (2014- 2017). METHODS From 2007 to 2010, we surveyed three cohorts of medical students at the end of clinical training to assess their attitudes towards HIV/AIDS. From 2014 to 2017, we surveyed three additional cohorts of medical students at the end of clinical training to compare changes in attitudes towards HIV/AIDS between the late 2000s and middle 2010s. Each set of three cohorts was grouped together to maximise sample size; comparisons were performed between the 2007-2010 and 2014-2017 cohorts. RESULTS From 2007 to 2010, 546 medical students were surveyed; from 2014 to 2017, 504 students were surveyed. Compared with students in the late 2000s, significantly fewer students in the mid-2010s initially encountered patients with HIV during attachment to an HIV clinic or preferred to avoid work in a field involving HIV/AIDS; significantly more students planned to specialise in HIV medicine. Student willingness to provide HIV care remained similar over time: approximately 78% of students were willing to provide care in each grouped cohort. CONCLUSION Although medical students had more positive attitudes towards HIV/AIDS, their willingness to provide HIV care did not change between the late 2000s and middle 2010s.
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Affiliation(s)
- G Tam
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - N S Wong
- Department of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - S S Lee
- Department of Medicine, The Chinese University of Hong Kong, Hong Kong
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19
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Affiliation(s)
- Greta Tam
- Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - SS Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong
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20
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Wu CC, Chen YC, Wu YC, Huang SH, Kuo YR, Lee SS. Foraging for the Optimal Dressing Scaffold to Carry Adipose-Derived Stromal/Progenitor Cells for Cell Therapy. Cell Transplant 2022; 31:9636897221113798. [PMID: 35876233 PMCID: PMC9326840 DOI: 10.1177/09636897221113798] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In our daily plastic surgery practice, we have seen many chronic wounds that need new biotechnology to help and improve wound healing. Stem cells play a crucial role in regenerative medicine. Many pre-clinical researches had reported the beneficial paracrine effects of stem cell therapy for chronic wounds. Cell-friendly scaffolds may provide the protection and three-dimensional space required for adherence of stem cells, thus allowing these stem cells to proliferate and differentiate for treatment purpose. A successful scaffold may enhance the effects of stem cell therapy. In this presented series, the authors attempted to identify the most suitable scaffolds from several commercially available wound dressings that could sustain adipose-derived stromal/progenitor cells (ADSCs) survival. Therefore, we isolated ADSCs containing the green fluorescent protein (GFP) from GFP transgenic rats. The GFP (+) ADSCs and their progenies could be easily observed using a fluorescence microscope. Moreover, we analyzed the cytokines secreted in condition medium (CM) to understand the activities of ADSCs in various dressings. Our results showed that the foam dressings, hydrofiber, chitosan, and alginate plus carboxymethylcellulose were identified as the most suitable dressing materials. Higher concentrations of transforming growth factor beta (TGF-β) and vascular endothelial growth factor (VEGF) were observed 48 h after loading them with GFP (+) ADSCs. Therefore, multiple topical cell therapy using ADSCs can be performed by applying suitable dressing scaffolds without repeated needle injections to deliver the stem cells into the wound bed. Based on their fluorescence property, the GFP (+) ADSCs can also possibly be used for testing biocompatibility of medical materials in the future.
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Affiliation(s)
- Chia-Chieh Wu
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Orthopedics & Sports Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan.,Orthopedic Surgery Department, Changhua Christian Hospital, Changhua, Taiwan.,Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Ying-Che Chen
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Yi-Chia Wu
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Hung Huang
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
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21
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McNamara PJ, Lee SS, Stanford AH, Bischoff AR, Rios DR, Giesinger RE. Methodological rigor in both targeted neonatal echocardiography training and study design are essential to understanding the impact of ultrasound on neonatal pain. J Neonatal Perinatal Med 2021; 15:7-9. [PMID: 34957953 DOI: 10.3233/npm-210898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- P J McNamara
- Department of Pediatrics, University of Iowa, Iowa City, USA.,Department of Internal Medicine, University of Iowa, Iowa City, USA
| | - S S Lee
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - A H Stanford
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - A R Bischoff
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - D R Rios
- Department of Pediatrics, University of Iowa, Iowa City, USA
| | - R E Giesinger
- Department of Pediatrics, University of Iowa, Iowa City, USA
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22
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Petersen E, Lee SS, Blumberg L, Kramer LD, Obiero C, Al-Abri S, Abubakar A, Pinto TCA, Yapi BR, Tambyah PA, Holmes AH. International Journal of Infectious Diseases: from the past quarter-century to the next. Int J Infect Dis 2021; 109:36-37. [PMID: 34217873 PMCID: PMC7613580 DOI: 10.1016/j.ijid.2021.06.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- E Petersen
- International Society for Infectious Diseases, Boston, United States.; Institute for Clinical Medicine, Aarhus University, Denmark..
| | - S S Lee
- International Society for Infectious Diseases, Boston, United States.; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - L Blumberg
- International Society for Infectious Diseases, Boston, United States.; Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg 2195, South Africa
| | - L D Kramer
- International Society for Infectious Diseases, Boston, United States.; School of Public Health, State University of New York at Albany, Albany, NY, USA
| | - C Obiero
- International Society for Infectious Diseases, Boston, United States.; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Global Health, University of Amsterdam, Faculty of Medicine, Amsterdam, Noord-Holland, The Netherlands
| | - S Al-Abri
- International Society for Infectious Diseases, Boston, United States.; Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - A Abubakar
- International Society for Infectious Diseases, Boston, United States.; Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - T C A Pinto
- International Society for Infectious Diseases, Boston, United States.; Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Brazil
| | - B R Yapi
- International Society for Infectious Diseases, Boston, United States.; Centre d'Entomologie Médicale et Vétérinaire, CEMV - Université Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - P A Tambyah
- International Society for Infectious Diseases, Boston, United States.; Infectious Diseases Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - A H Holmes
- International Society for Infectious Diseases, Boston, United States.; Department of Infectious Disease, Faculty of Medicine, Imperial College London, United Kingdom
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23
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Lau TC, Chong YS, Loo BKG, Ganapathy S, Ho JMD, Lee SS, Yeo J, Samarasekera DD, Goh DLM. Adapting undergraduate paediatric medical education to the challenges of COVID-19 pandemic: perspective of NUS Medicine. Singapore Med J 2021. [DOI: 10.11622/smedj.2021075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
COVID-19 significantly impacted the teaching-learning-assessment activities in many medical schools. In this article, we discuss the impact of COVID-19 on the Yong Loo Lin School of Medicine, National University of Singapore, focusing on paediatric training and the adaptations of the system and the people. The school developed strategies to promptly disseminate information and safety measures to protect all its staff and students. By leveraging on the school’s infrastructure for technology-enabled learning, good-quality medical training and reliable assessments were able to be carried out swiftly. The paediatric curriculum was crafted based on these principles, and it provided distance-based learning with live and interactive sessions to teach core clinical skills. The faculty also tapped on standardised patients to provide consistent and life-like scenarios. Measures were implemented to minimise challenges with technology-enabled learning. Collectively, efforts from the staff, support from the leadership and students’ adaptations tremendously helped to ease the transition.
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24
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Petersen E, Schlagenhauf P, Lee SS, Blumberg L, Kramer L, Obiero C, Al-Abri S, Cunha F, Petrosillo N, Di Caro A, Gautret P, Shafi S, Abubakar A, Pinto TCA, Memish Z, Hui DSC, Zumla A, Grobusch MP. Mandatory immunization against SARS-CoV-2 of athletes, companions and supporters for the Tokyo Olympics. Int J Infect Dis 2021; 108:156-158. [PMID: 34089881 PMCID: PMC8170875 DOI: 10.1016/j.ijid.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- E Petersen
- European Society for Clinical Microbiology and Infectious Diseases, Emerging Infections Task Force, ESCMID, Basel, Switzerland; International Society for Infectious Diseases, Boston, United States; Institute for Clinical Medicine, Aarhus University, Denmark; European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France.
| | - P Schlagenhauf
- European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France; University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Institute for Epidemiology, Biostatistics and Prevention, Zürich, Switzerland
| | - S S Lee
- International Society for Infectious Diseases, Boston, United States; Stanley Ho Centre for Emerging Infectious Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - L Blumberg
- International Society for Infectious Diseases, Boston, United States; Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg 2195, South Africa
| | - L Kramer
- International Society for Infectious Diseases, Boston, United States; School of Public Health, State University of New York at Albany, Albany, NY, United States
| | - C Obiero
- International Society for Infectious Diseases, Boston, United States; Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Global Health, University of Amsterdam, Faculty of Medicine, Amsterdam, Noord-Holland, The Netherlands
| | - S Al-Abri
- International Society for Infectious Diseases, Boston, United States; Directorate General for Disease Surveillance and Control, Ministry of Health, Muscat, Oman
| | - F Cunha
- European Society for Clinical Microbiology and Infectious Diseases, Emerging Infections Task Force, ESCMID, Basel, Switzerland; Department of Infectious Diseases, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - N Petrosillo
- European Society for Clinical Microbiology and Infectious Diseases (ESCMID), International Affairs Subcommittee, Basel, Switzerland; Clinical and Research Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani', Rome, Italy
| | - A Di Caro
- European Society for Clinical Microbiology and Infectious Diseases, Emerging Infections Task Force, ESCMID, Basel, Switzerland; Clinical and Research Department, National Institute for Infectious Diseases 'Lazzaro Spallanzani', Rome, Italy
| | - P Gautret
- European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France; IHU-Méditerranée Infection, Marseille Cedex 05, France
| | - S Shafi
- Mass Gatherings and Global Health Network, London, United Kingdom
| | - A Abubakar
- International Society for Infectious Diseases, Boston, United States; Department of Community Medicine, Ahmadu Bello University Zaria, Nigeria
| | - T C A Pinto
- International Society for Infectious Diseases, Boston, United States; Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Brazil
| | - Z Memish
- Research & Innovation Centre, King Saud Medical City, Ministry of Health & College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - D S C Hui
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong
| | - A Zumla
- Center for Clinical Microbiology, Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, United Kingdom
| | - M P Grobusch
- European Travel Medicine Network, Méditerranée Infection Foundation, Marseille, France; Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, location AMC, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, The Netherlands
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25
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Wang YC, Lee SS, Ramachandran S, Lin YN, Chen RF, Lin SD, Lai CS, Kuo YR. Attitudes toward face transplantation in Asia: A survey of Taiwanese population. Microsurgery 2021; 41:599-602. [PMID: 34019315 DOI: 10.1002/micr.30755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/07/2021] [Accepted: 05/06/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Yu-Chi Wang
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Savitha Ramachandran
- Department of Plastic and Reconstructive Surgery, KK Women's and Children's Hospital, Singapore.,Academic Clinical Program for Musculoskeletal Sciences, Duke-NUS Graduate Medical School, Singapore.,Department of Plastic and Reconstructive Surgery, Singapore General Hospital, Singapore
| | - Yun-Nan Lin
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Rong-Fu Chen
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Sin-Daw Lin
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Sheng Lai
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic & Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Academic Clinical Program for Musculoskeletal Sciences, Duke-NUS Graduate Medical School, Singapore.,Department of Plastic and Reconstructive Surgery, Singapore General Hospital, Singapore.,Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
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26
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Nedunchezian S, Banerjee P, Lee CY, Lee SS, Lin CW, Wu CW, Wu SC, Chang JK, Wang CK. Generating adipose stem cell-laden hyaluronic acid-based scaffolds using 3D bioprinting via the double crosslinked strategy for chondrogenesis. Mater Sci Eng C Mater Biol Appl 2021; 124:112072. [PMID: 33947564 DOI: 10.1016/j.msec.2021.112072] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 02/26/2021] [Accepted: 03/13/2021] [Indexed: 12/20/2022]
Abstract
Bioprinting of most cell-laden hydrogel scaffolds with the required structural integrity, mechanical modulus, cell adhesion, cell compatibility, and chondrogenic differentiation are still significant issues that affect the application of bioinks in cartilage tissue engineering. This study focuses on constructing printable bioinks by combining adipose-derived stem cells (ADSCs), hyaluronic acid (HA)-based hydrogels and analyzing their ability to induce chondrogenesis using 3D bioprinting technology. First, biotinylated hyaluronic acid was synthesized via an adipic acid dihydrazide (ADH) linker with amide bond formation to form HA-biotin (HAB). Both HAB and the as-received streptavidin were mixed to form a partially cross-linked HA-biotin-streptavidin (HBS) hydrogel through noncovalent bonding. After that, the partially cross-linked HBS hydrogel was mixed with sodium alginate and subsequently printed to form the HBSA hydrogel 3D scaffolds using a bioprinter. Finally, the 3D scaffolds of the HBSA (HBS + alginate) hydrogel were submerged into CaCl2 solution to achieve a stable 3D HBSAC (HBSA + Ca2+) hydrogel scaffold through ion transfer crosslinking. The physical-chemical characteristics of the hybrid bioink compositions have been evaluated to determine the desired 3D bioprinting structure. Cytotoxicity and chondrogenic differentiation were also assessed to confirm that the double cross-linked HBSAC hydrogel scaffold was useful for chondrogenic formation. The results showed that partially crosslinking the biotinylated HA-based hydrogel with streptavidin has a significant effect on printability and structural integrity. Morphological analysis of a suitable 3D printed HBSAC hydrogel scaffold showed visible pores with the desired shape and geometry. We have concluded that the HBSAC hydrogel possesses a favorable biocompatibility profile. The HBSAC hydrogel can also secrete significantly higher amounts of chondrogenic marker genes at day 5 and sulfated glycosaminoglycans (sGAGs) from days 7 to 14 compared to the HA hydrogel, as determined via quantitative real-time PCR assay and Alcian blue staining and the DMMB assay.
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Affiliation(s)
- Swathi Nedunchezian
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Parikshit Banerjee
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Yun Lee
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Ph.D Program in Life Sciences, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Orthopedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Surgery, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Che-Wei Lin
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Che-Wei Wu
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Orthopedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shun-Cheng Wu
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Orthopedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Je-Ken Chang
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Orthopedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Kuang Wang
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung, Taiwan; Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Ph.D Program in Life Sciences, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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27
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Chan CP, Lee SS, Wong NS. Adherence of nurses to annual seasonal influenza vaccination over a 5-year period. J Hosp Infect 2021; 112:6-15. [PMID: 33640372 DOI: 10.1016/j.jhin.2021.02.017] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) are at risk of influenza infection with associated nosocomial transmission. Sustained adherence to seasonal influenza vaccination uptake each year is important in epidemic control. AIM To assess the adherence of nurses to seasonal influenza vaccination over 5 years and its associated factors. METHODS A cross-sectional study was conducted among nurses after the winter influenza season in Hong Kong in March 2019. Based on influenza vaccine uptake rates in the 2014/15-2018/19 seasons, respondents were stratified into three groups: 'full adherence' (vaccine uptake in five seasons), 'partial adherence' (vaccine uptake in one to four seasons) and 'non-adherence' (no vaccine uptake). Stepwise multi-variable logistic regression was performed to determine the associations between adherence to annual influenza vaccination, respondents' characteristics and considerations for vaccination. FINDINGS Of 1306 nurses recruited, the majority were female (88%) with a median age of 36 years (interquartile range 30-46 years). The influenza vaccination uptake rate increased from 36% in the 2014/15 season to 47% in the 2018/19 season. After stratification, 39%, 40% and 21% of respondents were non-adherers, partial adherers and full adherers, respectively. Full adherence was significantly associated with female gender [adjusted odds ratio (aOR) 0.60], age ≥40 years (aOR 2.92), long-term care facility nurse (aOR 0.56), uptake during studentship (aOR 3.83), local prevalence of seasonal influenza (aOR 0.51) and expert opinion (aOR 4.04). CONCLUSIONS A limited proportion of nurses were fully adherent to seasonal influenza vaccination. Monitoring adherence, improving access to vaccines, and interventions targeting less-adherent HCWs are crucial.
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Affiliation(s)
- C P Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - N S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.
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28
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Ghoshani M, Sánchez EH, Lee SS, Singh G, Yaacoub N, Peddis D, Mozaffari M, Binns C, De Toro JA, Normile PS. On the detection of surface spin freezing in iron oxide nanoparticles and its long-term evolution under ambient oxidation. Nanotechnology 2021; 32:065704. [PMID: 33108770 DOI: 10.1088/1361-6528/abc50a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Exchange bias (EB) effects linked to surface spin freezing (SSF) are commonly found in iron oxide nanoparticles, while signatures of SSF in low-field temperature-dependent magnetization curves have been much less frequently reported. Here, we present magnetic properties of dense assemblies of similar-sized (∼8 nm diameter) particles synthesized by a magnetite (sample S1) and a maghemite (sample S2) method, and the influence of long-term (4 year) sample aging under ambient conditions on these properties. The size of the EB field of the different sample (fresh or aged) states is found to correlate with (a) whether a low-temperature hump feature signaling the SSF transition is detected in out-of-phase ac susceptibility or zero-field-cooled (ZFC) dc magnetization recorded at low field and with (b) the prominence of irreversibility between FC and ZFC curves recorded at high field. Sample S1 displays a lower magnetization than S2, and it is in S1 where the largest SSF effects are found. These effects are significantly weakened by aging but remain larger than the SSF effects in S2, where the influence of aging is considerably smaller. A non-saturating component due to spin disorder in S1 also weakens with aging, accompanied by, we infer, an increase in the superspin and the radius of the ordered nanoparticle cores. X-ray diffraction and Mössbauer spectroscopy provide indication of maghemite-like stoichiometry in both aged samples as well as thicker disordered particle shells in aged-S1 relative to aged-S2 (crystallographically-disordered and spin-disordered according to diffraction and Mössbauer, respectively). The pronounced diminution in SSF effects with aging in S1 is attributed to a (long-term) transition, caused by ambient oxidation, from magnetite-like to maghemite-like stoichiometry, and a concomitant softening of the spin-disordered shell anisotropy. We assess the impact of this anisotropy on the nature of the blocking of the nanoparticle superspins.
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Affiliation(s)
- M Ghoshani
- Department of Physics, Faculty of Science, University of Isfahan, Isfahan 81746-73441, Iran
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - E H Sánchez
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - S S Lee
- Institute of Bioengineering and Nanotechnology, 31 Biopolis Way, The Nanos, Singapore 138669, Singapore
| | - G Singh
- School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, NSW 2008, Australia
| | - N Yaacoub
- Institut des Molécules et Materiaux du Mans, CNRS UMR-6283, Université du Maine, F-72085 Le Mans, France
| | - D Peddis
- Istituto di Struttura della Materia, CNR, I-00015 Monterotondo Scalo (RM), Italy
- Dipartimento di Chimica e Chimica Industriale (DCCI), Università of Genova, Via Dopdecanes, I-16134, Genova, Italy
| | - M Mozaffari
- Department of Physics, Faculty of Science, University of Isfahan, Isfahan 81746-73441, Iran
| | - C Binns
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - J A De Toro
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
| | - P S Normile
- Instituto Regional de Investigación Científica Aplicada (IRICA) and Departamento de Física Aplicada, Universidad de Castilla-La Mancha, E-13071 Ciudad Real, Spain
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29
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Lee SS, Wu YC, Huang SH, Chen YC, Srinivasan P, Hsieh DJ, Yeh YC, Lai YP, Lin YN. A novel 3D histotypic cartilage construct engineered by supercritical carbon dioxide decellularized porcine nasal cartilage graft and chondrocytes exhibited chondrogenic capability in vitro. Int J Med Sci 2021; 18:2217-2227. [PMID: 33859530 PMCID: PMC8040423 DOI: 10.7150/ijms.56342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/15/2021] [Indexed: 12/31/2022] Open
Abstract
Augmentative and reconstructive rhinoplasty surgical procedures use autologous tissue grafts or synthetic grafts to repair the nasal defect and aesthetic reconstruction. Donor site trauma and morbidity are common in autologous grafts. The desperate need for the production of grafted 3D cartilage tissues as rhinoplasty grafts without the adverse effect is the need of the hour. In the present study, we developed a bioactive 3D histotypic construct engineered with the various ratio of adipose-derived stem cells (ADSC) and chondrocytes together with decellularized porcine nasal cartilage graft (dPNCG). We decellularized porcine nasal cartilage using supercritical carbon dioxide (SCCO2) extraction technology. dPNCG was characterized by H&E, DAPI, alcian blue staining, scanning electron microscopy and residual DNA content, which demonstrated complete decellularization. 3D histotypic constructs were engineered using dPNCG, rat ADSC and chondrocytes with different percentage of cells and cultured for 21 days. dPNCG together with 100% chondrocytes produced a solid mass of 3D histotypic cartilage with significant production of glycosaminoglycans. H&E and alcian blue staining showed an intact mass, with cartilage granules bound to one another by extracellular matrix and proteoglycan, to form a 3D structure. Besides, the expression of chondrogenic markers, type II collagen, aggrecan and SOX-9 were elevated indicating chondrocytes cultured on dPNCG substrate facilitates the synthesis of type II collagen along with extracellular matrix to produce 3D histotypic cartilage. To conclude, dPNCG is an excellent substrate scaffold that might offer a suitable environment for chondrocytes to produce 3D histotypic cartilage. This engineered 3D construct might serve as a promising future candidate for cartilage tissue engineering in rhinoplasty.
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Affiliation(s)
- Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Regenerative medicine and cell therapy research centre, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Yi-Chia Wu
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Regenerative medicine and cell therapy research centre, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Regenerative medicine and cell therapy research centre, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Che Chen
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | | | - Dar-Jen Hsieh
- Center of Research and Development, ACRO Biomedical Co., Ltd. Kaohsiung, Taiwan
| | - Yi-Chun Yeh
- Center of Research and Development, ACRO Biomedical Co., Ltd. Kaohsiung, Taiwan
| | - Yi-Ping Lai
- Center of Research and Development, ACRO Biomedical Co., Ltd. Kaohsiung, Taiwan
| | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
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Huang CH, Hsieh DJ, Wu YC, Yen KC, Srinivasan P, Lee HC, Chen YC, Lee SS. Reconstruction of the orbital floor using supercritical CO 2 decellularized porcine bone graft. Int J Med Sci 2021; 18:3684-3691. [PMID: 34790040 PMCID: PMC8579291 DOI: 10.7150/ijms.64359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/26/2021] [Indexed: 12/03/2022] Open
Abstract
Orbital floor fractures subsequently lead to consequences such as diplopia and enophthalmos. The graft materials used in orbital floor fractures varied from autografts to alloplastic grafts, which possess certain limitations. In the present study, a novel porcine bone matrix decellularized by supercritical CO2 (scCO2), ABCcolla® Collagen Bone Graft, was used for the reconstruction of the orbital framework. The study was approved by the institutional review board (IRB) of Kaohsiung Medical University Chung-Ho Memorial Hospital (KMUH). Ten cases underwent orbital floor reconstruction in KMUH in 2019. The orbital defects were fixed by the implantation of the ABCcolla® Collagen Bone Graft. Nine out of ten cases used 1 piece of customized ABCcolla® Collagen Bone Graft in each defect. The other case used 2 pieces of customized ABCcolla® Collagen Bone Graft in one defect area due to the curved outline of the defect. In the outpatient clinic, all 10 cases showed improvement of enophthalmos on CT (computerized tomography) at week 8 follow-up. No replacement of implants was needed during follow-ups. To conclude, ABCcolla® Collagen Bone Graft proved to be safe and effective in the reconstruction of the orbital floor with high accessibility, high stability, good biocompatibility, low infection rate and low complication rate.
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Affiliation(s)
- Chao-Hsin Huang
- School of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Dar-Jen Hsieh
- Center of Research and Development, ACRO Biomedical Co., Ltd. Kaohsiung, Taiwan
| | - Yi-Chia Wu
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Regenerative medicine and cell therapy research center, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ko-Chung Yen
- Center of Research and Development, ACRO Biomedical Co., Ltd. Kaohsiung, Taiwan
| | | | - Hsiao-Chen Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ying-Che Chen
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Regenerative medicine and cell therapy research center, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
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Tung YC, Lee MY, Wang YC, Chang CJ, Tsai WC, Lin GT, Li CY, Lee SS, Tu HP. Effect modification of hyperlipidemia and hypertension on the association between type 2 diabetes and gout. Prim Care Diabetes 2020; 14:654-662. [PMID: 32593565 DOI: 10.1016/j.pcd.2020.06.002] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 05/31/2020] [Accepted: 06/07/2020] [Indexed: 11/19/2022]
Abstract
AIMS We evaluated the association between type 2 diabetes and gout by a retrospective cohort study. METHODS Data of 17,259 male and 18,318 female patients with type 2 diabetes were retrieved for the 1998-2010 period. These patients were matched to a comparison group (n=34,518 and n=36,636, respectively) in a 1:2 ratio by age and region. RESULTS We found that patients with type 2 diabetes after adjustment for hyperlipidemia and hypertension had a lower risk of incident gout than the matched population (incidence rate ratio, men: 0.39 [95% CI: 0.36-0.42]; women: 0.78 [0.72-0.84]). Specifically, type 2 diabetes alone without hyperlipidemia and hypertension was associated with a reduced risk of incident gout in men (adjusted relative risk [RR]: 0.29, 95% CI: 0.22-0.39), but not in women (0.86, 95% CI: 0.55-1.36). We found that insulin users with hyperlipidemia and hypertension associated with risk of incident gout and no sex-specific differences were noted (adjusted RR, men: 1.28 [95% CI: 1.11-1.48]; women: 1.32 [95% CI: 1.14-1.53]). Specifically, insulin users alone without hyperlipidemia and hypertension were not statistically significantly associated with gout risk (P≥.0954). CONCLUSIONS The results of this study indicated that hyperlipidemia and hypertension modified the association between type 2 diabetes and gout.
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Affiliation(s)
- Yi-Ching Tung
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mei-Yueh Lee
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan; Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chi Wang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Family Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Chai-Jan Chang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Chan Tsai
- Division of Rheumatology, Departments of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Gau-Tyan Lin
- Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Yang Li
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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To KW, Lee SS. A review of reported cases of HIV pre-exposure prophylaxis failure with resultant breakthrough HIV infections. HIV Med 2020; 22:75-82. [PMID: 33140556 DOI: 10.1111/hiv.12989] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Early randomized controlled trials (RCTs) have confirmed high efficacy of pre-exposure prophylaxis (PrEP) for preventing HIV infection in men who have sex with men (MSM) with high HIV exposure risk. Nevertheless, some PrEP failure cases have been reported despite adequate drug adherence. This review aims to summarize the common features of PrEP failure cases and discuss the implications of upscaling PrEP programmes. METHODS A search based on articles and clinical trials was conducted through Medline and OVID, with keywords for accessing publications reporting 'true' PrEP failure in the presence of documented adherence to daily regimen of co-formulated tenofovir disoproxil fumarate/emtricitabone. RESULTS Ten cases of 'true' PrEP failure were identified, all of which were preceded by continued practice of condomless anal sex, despite documented adherence. Dried blood spot and/or hair analyses provided supporting evidence of adherence in eight cases. There was strong association of PrEP failure with recurrent or multiple sexually transmitted diseases and infection with resistant HIV viruses. Seroconversion was usually atypical or delayed because of significantly suppressed viral load, making diagnosis a clinical challenge. DISCUSSION Although it is uncommon, 'true' PrEP failure can occur in a real-world situation, contrary to the outcome of early RCTs. Failure to identify HIV infection while on PrEP can potentially lead to the emergence of drug-resistant virus. To achieve effective HIV prevention, PrEP programmes should emphasize safer sexual practice in addition to drug adherence. Early identification of PrEP failure is crucial, which requires the development of highly sensitive assays and their clinical application.
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Affiliation(s)
- K W To
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.,Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
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33
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Ng PCI, Chan JYW, Leung RKK, Li J, Ren Z, Chan AWH, Xu Y, Lee SS, Wang R, Ji X, Zheng J, Chan DPC, Yew WW, Lee SMY. Role of oxidative stress in clofazimine-induced cardiac dysfunction in a zebrafish model. Biomed Pharmacother 2020; 132:110749. [PMID: 33017766 DOI: 10.1016/j.biopha.2020.110749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/19/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Clofazimine (CFZ), a riminophenazine, is now commonly used in the treatment of multidrug-resistant tuberculosis. However, its use may be potentially associated with cardiac dysfunction in some individuals. In this study, the zebrafish heart, by merit of its developmental and genetic characteristics being in homology with that of human, was chosen as an animal model for evaluation of such dysfunction. METHODS Morphological and physiological parameters were used to assess cardiac dysfunction. Transcriptome analysis was performed, followed by validation with real-time quantitative PCR, for delineation of the relevant genomics. RESULTS Exposure of 2 dpf zebrafish to 4 mg/L CFZ for 2 days, adversely affected cardiac functions including significant decreases in HR, SV, CO, and FS, with observable pathophysiological developments of pericardial effusion and blood accumulation in the heart, in comparison with the control group. In addition, genes which respond to xenobiotic stimulus, related to oxygen transport, glutathione metabolism and extracellular matrix -receptor interactions, were significantly enriched among the differentially up-regulated genes. Antioxidant response element motif was enriched in the 5000 base pair upstream regions of the differentially expressed genes. Co-administration of N-acetylcysteine was shown to protect zebrafish against the development of CFZ-induced cardiac dysfunction. CONCLUSIONS This study suggests an important role of oxidative stress as a major pathogenetic mechanism of riminophenazine-induced cardiac dysfunction.
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Affiliation(s)
- Phoebe C I Ng
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Judy Y W Chan
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Ross K K Leung
- School of Public Health, University of Hong Kong, Hong Kong, China; Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China
| | - J Li
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Z Ren
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Anthony W H Chan
- Department of Anatomical & Cellular Pathology, Chinese University of Hong Kong, Hong Kong, China
| | - Y Xu
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China
| | - R Wang
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China
| | - Xia Ji
- Faculty of Health Sciences, University of Macau, Macao, China
| | - Jun Zheng
- Faculty of Health Sciences, University of Macau, Macao, China
| | - Denise P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China.
| | - W W Yew
- Stanley Ho Centre for Emerging Infectious Diseases, Chinese University of Hong Kong, Hong Kong, China.
| | - Simon M Y Lee
- State Key Laboratory of Quality Research in Chinese Medicine and Institute of Chinese Medical Sciences, University of Macau, Macao, China.
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Chang YW, Wu YC, Huang SH, Wang HMD, Kuo YR, Lee SS. Correction: Autologous and not allogeneic adipose-derived stem cells improve acute burn wound healing. PLoS One 2020; 15:e0238935. [PMID: 32881935 PMCID: PMC7470251 DOI: 10.1371/journal.pone.0238935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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35
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Tsai CY, Chang NC, Fang HC, Chen YC, Lee SS. A Novel Non-contact Self-Injection-Locked Radar for Vital Sign Sensing and Body Movement Monitoring in COVID-19 Isolation Ward. J Med Syst 2020; 44:177. [PMID: 32845385 PMCID: PMC7447692 DOI: 10.1007/s10916-020-01637-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/15/2020] [Accepted: 08/05/2020] [Indexed: 12/18/2022]
Abstract
Background The outbreak of Coronavirus disease (COVID-19) pandemic has become the most serious global health issue. Isolation policy in hospitals is one of the most crucial protocols to prevent nosocomial infection of COVID-19. It is important to monitor and assess the physical conditions of the patients in isolation. Methods Our institution has installed the novel non-contact wireless sensor for vital sign sensing and body movement monitoring for patients in COVID-19 isolation ward. Results We have collected and compared data between the radar record with the nurse’s handover record of two patients, one recorded for 13 days and the other recorded for 5 days. The P value by Fisher’s exact test were 0.139 (temperature, P > 0.05) and 0.292 (heart beat rate, P > 0.05) respectively. Conclusions This is the first report about the application experience of this equipment. Therefore we attempted to share the experience and try to apply this equipment in COVID-19 patients in future to offer the more reliable and safe policy. Electronic supplementary material The online version of this article (10.1007/s10916-020-01637-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cheng-Yu Tsai
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan
| | - Nai-Chien Chang
- International medical service center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiu-Chen Fang
- International medical service center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Che Chen
- Department of Surgery, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Regenerative medicine and cell therapy research center, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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36
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Yang CC, Lin CI, Lee SS, Wang CL, Dai CY, Chuang HY. The association of blood lead levels and renal effects may be modified by genetic combinations of Metallothionein 1A 2A polymorphisms. Sci Rep 2020; 10:9603. [PMID: 32541800 PMCID: PMC7295782 DOI: 10.1038/s41598-020-66645-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 05/25/2020] [Indexed: 11/28/2022] Open
Abstract
Metallothionein (MT) is a protein with function of heavy metal detoxification. However, studies about how single nucleotide polymorphisms (SNPs) of MT genes influence lead nephropathy are relatively scarce. Therefore, our aim is to investigate the association between blood lead levels and renal biomarkers and to study whether this association is influenced by the combination of MT1A and MT2A SNPs. Blood lead, urinary uric acid (UA), and urinary N-acetyl-beta-d-glucosaminidase (NAG) levels were analyzed from 485 participants. Genotyping were performed on MT1A SNPs (rs11640851 and rs8052394) and MT2A SNPs (rs10636 and rs28366003). The combined MT1A 2A SNPs were divided into 16 groups. Among renal biomarkers, urinary UA was negatively significant associated with the time-weighted index of cumulative blood lead (TWICL), while urinary NAG was positively significant with TWICL. Furthermore, the association between urinary UA and TWICL was significantly modified by group 6 of combined SNPs (MT1A 2 A SNPs combination were AAAGGGAA, ACAGGGAA, and ACGGGGAA). In conclusion, the negative association of urinary UA and TWICL is modified by group 6, which means participants of group 6 are more susceptible to lead nephrotoxicity.
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Affiliation(s)
- Chen-Cheng Yang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Occupational and Environmental Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Department of Family Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan.,Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-I Lin
- Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Health Management Center, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Ling Wang
- Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hung-Yi Chuang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Chakraborty C, Sharma AR, Sharma G, Bhattacharya M, Lee SS. SARS-CoV-2 causing pneumonia-associated respiratory disorder (COVID-19): diagnostic and proposed therapeutic options. Eur Rev Med Pharmacol Sci 2020; 24:4016-4026. [PMID: 32329877 DOI: 10.26355/eurrev_202004_20871] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
SARS-CoV-2 is responsible for the outbreak of severe respiratory illness (COVID-19) in Wuhan City, China and is now spreading rapidly throughout the world. The prompt outbreak of COVID-19 and its quick spread without any controllable measure defines the severity of the situation. In this crisis, a collective pool of knowledge about the advancement of clinical diagnostic and management for COVID-19 is a prerequisite. Here, we summarize all the available updates on the multidisciplinary approaches for the advancement of diagnosis and proposed therapeutic strategies for COVID-19. Moreover, the review discusses different aspects of the COVID-19, including its epidemiology; incubation period; the general clinical features of patients; the clinical features of intensive care unit (ICU) patients; SARS-CoV-2 infection in the presence of co-morbid diseases and the clinical features of pediatric patients infected with the SARS-CoV-2. Advances in various diagnostic approaches, such as the use of real-time polymerase chain reaction (RT-PCR), chest radiography, and computed tomography (CT) imaging; and other modern diagnostic methods, for this infection have been highlighted. However, due to the unavailability of adequate evidence, presently there are no officially approved drugs or vaccines available against SARS-CoV-2. Additionally, we have discussed various therapeutic strategies for COVID-19 under different categories, like the possible treatment plans with drug (antiviral drugs and anti-cytokines) therapy for disease prevention. Lastly, potentials candidates for the vaccines against SARS-CoV-2 infection have been described. Collectively, the review provides an overview of the SARS-CoV-2 infection outbreak along with the recent advancements and strategies for diagnosis and therapy of COVID-19.
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Affiliation(s)
- C Chakraborty
- Institute for Skeletal Aging & Orthopedic Surgery, Hallym University-Chuncheon Sacred Heart Hospital, Chuncheon-si, Gangwon-do, Korea.
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Liu HL, Chuang HY, Hsu CN, Lee SS, Yang CC, Liu KT. Effects of Vitamin D Receptor, Metallothionein 1A, and 2A Gene Polymorphisms on Toxicity of the Peripheral Nervous System in Chronically Lead-Exposed Workers. Int J Environ Res Public Health 2020; 17:E2909. [PMID: 32340109 PMCID: PMC7215364 DOI: 10.3390/ijerph17082909] [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] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 01/23/2023]
Abstract
Chronic exposure to lead is neurotoxic to the human peripheral sensory system. Variant vitamin D receptor (VDR) genes and polymorphisms of metallothioneins (MTs) are associated with different outcomes following lead toxicity. However, no evidence of a relationship between lead neurotoxicity and polymorphisms has previously been presented. In this study, we investigated the relationship between the polymorphisms of VDR, MT1A, and MT2A genes and lead toxicity following chronic occupational lead exposure. We measured vibration perception thresholds (VPT) and current perception thresholds (CPT) in 181 workers annually for five years. The outcome variables were correlated to the subject's index of long-term lead exposure. Polymorphisms of VDR, MT1A, and MT2A were defined. The potential confounders, including age, sex, height, smoking, alcohol consumption, and working life span, were also collected and analyzed using linear regression. The regression coefficients of some gene polymorphisms were at least 20 times larger than regression coefficients of time-weighted index of cumulative blood lead (TWICL) measures. All regression coefficients of TWICL increased slightly. MT1A rs11640851 (AA/CC) was associated with a statistically significant difference in all neurological outcomes except hand and foot VPT. MT1A rs8052394 was associated with statistically significant differences in hand and foot CPT 2000 Hz. In MT2A rs10636, those with the C allele showed a greater effect on hand CPT than those with the G allele. Among the VDR gene polymorphisms, the Apa rs7975232 (CC/AA) single nucleotide polymorphism was associated with the greatest difference in hand CPT. MT2A rs28366003 appeared to have a neural protective effect, whereas Apa (rs7975232) of VDR and MT2A rs10636 increased the neurotoxicity as measured by CPT in the hands. MT1A rs8052394 had a protective effect on large myelinated nerves. MT1A rs11640851 was associated with susceptibility to neurotoxicity.
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Affiliation(s)
- Hsin-Liang Liu
- Division of Internal Medicine, Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Hung-Yi Chuang
- Department of Public Health, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan;
| | - Chien-Ning Hsu
- Department of Pharmacy in Kaohsiung Chang Gung Memorial Hospital, and School of Pharmacy, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Su-Shin Lee
- Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Chen-Cheng Yang
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan;
| | - Kuan-Ting Liu
- Division of Internal Medicine, Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Abstract
Background Persistent tracheocutaneous fistula (TCF) is a complication of prolonged use of tracheostomy tube. Although many procedures exist to correct this issue, there is no consensus regarding its optimal management. We constructed a decision algorithm to determine appropriate surgical strategies for TCF repair. Methods Retrospectively reviewing our hospital’s records, we found fourteen consecutive patients who had received surgical repair of tracheocutaneous fistula (primary closure or advanced local flap) between February 2013 and December 2018 and collected data relevant to their cases. Results We identified 11 male and 3 female patients. Duration of tracheostomy dependence was 8.1±4.7 months, and timespan from decannulation to surgical closure 7.4±6.5 months. Seven patients received primary closures, six received hinged turnover flaps, and one received random and perforator flap reconstruction. There was no perioperative mortality or morbidity except for one patient requiring a repeat tracheostomy 11 months after TCF repair due to pneumonia and subsequent respiratory failure. We used our findings and those reported in the literature to construct a modified risk factor scoring system based on patient’s physical status, major comorbidities, perifistular soft tissue condition, and nutritional status and an algorithm for managing TCF based on the patients’ fistula size and modified risk factor scores. Conclusions In conclusion, we were able to review our cases and those of other studies to create a risk scoring system and a decision algorithm that we believe will help optimize patient-directed surgical management of TCF repair.
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Affiliation(s)
- Chieh-Ni Kao
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Yu-Wei Liu
- Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Po-Chih Chang
- Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Shah-Hwa Chou
- Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung.,Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung.,Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung.,Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung.,Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung
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Lee SS, Kim CJ, Shin MS, Lim BV. Treadmill exercise ameliorates memory impairment through ERK-Akt-CREB-BDNF signaling pathway in cerebral ischemia gerbils. J Exerc Rehabil 2020; 16:49-57. [PMID: 32161734 PMCID: PMC7056476 DOI: 10.12965/jer.2040014.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/12/2020] [Indexed: 02/06/2023] Open
Abstract
Neuronal cell death in the hippocampus by cerebral ischemia causes disability of memory function. Cerebral ischemia also alters the expressions of brain-derived neurotrophic factor (BDNF), cyclic adenosine monophosphate-responsive element binding protein (CREB), extracellular signal-regulated protein kinase (ERK), and phosphatidylinositol 3-kinase/protein kinase B (Akt). In the present study, we investigated the effect of treadmill exercise on cerebral ischemia in relation with ERK-Akt-CREB-BDNF signaling pathway in the hippocampus using gerbils. Induction of cerebral ischemia deteriorated short-term memory with suppression of phosphorylation of ERK-Akt-CREB-BDNF pathway in the hippocampus of gerbils. Enhancement of apoptosis in the hippocampus was accompanied in the ischemia gerbils. Treadmill exercise improved short-term memory through enhancing phosphorylation of ERK-Akt-CREB-BDNF pathway with suppressing apoptosis in the hip-pocampus of the ischemia gerbils. The present results suggest that improvement of memory function after cerebral ischemia by treadmill exercise may be involved in the ERK-Akt-CREB-BDNF signaling pathway, resulting in inhibition of apoptosis in the hippocampus.
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Affiliation(s)
- Su-Shin Lee
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang-Ju Kim
- Department of Physiology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Mal-Soon Shin
- School of Global Sport Studies, Korea University, Sejong, Korea
| | - Baek-Vin Lim
- Division of Leisure & Sports Science, Department of Exercise Prescription, Dongseo University, Busan, Korea
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Chang HY, Hou YP, Yeh FH, Lee SS. The impact of an mHealth app on knowledge, skills and anxiety about dressing changes: A randomized controlled trial. J Adv Nurs 2019; 76:1046-1056. [PMID: 31814140 DOI: 10.1111/jan.14287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/18/2019] [Accepted: 12/03/2019] [Indexed: 12/26/2022]
Abstract
AIMS To evaluate the effectiveness of a mobile health (mHealth) application, based on self-regulation theory, on patients' knowledge of wound care, skills in changing dressings and anxiety. DESIGN A prospective randomized controlled trial. METHODS Seventy patients (or family members) at a 1,500-bed university hospital in Taiwan were randomized into an experimental (N = 35) or control group (N = 35) from March to December 2016. The experimental group used a mHealth application for wound care; the control group received verbal instructions and a booklet. Instruments to collect data were a wound care knowledge scale, wound care skills scale, State-Trait Anxiety Inventory, and a digital heart variability device. Data were collected at baseline, after three additional demonstrations and before discharge. The generalized estimating equation was used for statistical analysis. RESULTS The experimental group showed significantly higher levels of wound care knowledge, improved wound care skills, lower levels of state anxiety, and lower heart rate variability than the control group after baseline data collection. CONCLUSIONS Results support hat a mHealth application may be effective in health education. Clinicians can use the results to promote patients' wound care knowledge, enhance their wound care skills, and reduce anxiety related to dressing changes. IMPACT Lack of wound care knowledge and skills can affect the willingness and ability to perform effective wound dressing changes, producing anxiety and having an impact on a patient's self-care after hospital discharge. mHealth applications (apps) have the potential to deliver health information in targeted and tailored ways that strengthen the self-management of diseases. mHealth app can increase wound care knowledge, improve care skills, and reduce anxiety related to wound care. mHealth app effectively supports self-monitoring of the wound healing process, self-judgement of the wound condition, and self-reaction of wound care accuracy. mHealth app provides step-by-step visual tutorials on wound care that allow patients and family caregivers to take pictures of the wounds and monitor the wound healing process. mHealth app for wound care knowledge is an effective and individualized method for learning. CLINICAL TRIAL This study was registered by U.S. National Library of Medicine, ClinicalTrials.gov (ID: NCT03683303).
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Affiliation(s)
| | - Ya-Ping Hou
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Fu-Hao Yeh
- Department of Information Technology, Fooyin University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Chen TH, Huang JJ, Kung WS, Lee SS, Sun HY, Chuang HY. The Association of Serum TNF-α Levels and Blood Multi-Elements Modified by TNF-α Gene Polymorphisms in Metal Industrial Workers. Int J Environ Res Public Health 2019; 16:ijerph16214079. [PMID: 31652851 PMCID: PMC6862333 DOI: 10.3390/ijerph16214079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/27/2022]
Abstract
Health of the metal industrial workers should be a noteworthy issue due to the hazard of chronic exposure to metals or toxic elements. The interactions among multiple elements are sophisticated and may differ from person to person. Tumor necrosis factor-α (TNF-α) gene polymorphisms were supposed to be involved with the interactions because TNF-α plays an important role in inflammation, a mechanism by which toxic elements cause threats to human health. This research aimed to analyze the influence of TNF-α gene polymorphisms and multi-elements on serum TNF-α level. Blood multi-elements concentrations (lead, cadmium, arsenic, selenium, cobalt, copper, and zinc), serum TNF-α level, and TNF-α single nucleotide polymorphisms (SNPs), including −238G > A (rs361525), −308G > A (rs1800629), −857C > T (rs1799724), −863C > A (rs1800630), and −1031T > C (rs1799964), were measured in 462 metal industrial workers. We applied mixed-effect models to analyze the interactions among multi-elements and TNF-α SNPs. Blood concentration of all elements were positively associated with serum TNF-α level, and the effects may be modified by TNF-α gene polymorphisms. Our study revealed that TNF-α −308A/A and −1031C/C may be susceptible genotypes, and thus we suggest that those workers should take preventive measures against metal toxicity.
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Affiliation(s)
- Tzu-Hua Chen
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan.
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan .
| | - Joh-Jong Huang
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan .
| | - Wei-Shyang Kung
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan 70101, Taiwan.
| | - Su-Shin Lee
- Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
| | - Hung-Yu Sun
- Department of Family Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan.
| | - Hung-Yi Chuang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.
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Abstract
The concept of microautologous fat transplantation (MAFT), proposed by Lin and colleagues in 2007, emphasized that the volume of each delivered parcel should be less than 0.01 mL to avoid potential fat grafting morbidities. The MAFT-GUN facilitates control of the parcel volume and therefore substantially avoids central necrosis and associated complications. In this article, the authors present a simple, reliable, and consistent procedure based on MAFT for profiloplasty. Favorable outcomes with sustainable long-term effectiveness were obtained, further confirming that the MAFT technique is an alternative for facial contouring in the nose and chin.
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Affiliation(s)
- Tsai-Ming Lin
- Charming Institute of Aesthetic and Regenerative Surgery (CIARS), 2F.-1, No. 172, Ziqiang 2nd Road, Qianjin District, Kaohsiung City 801, Taiwan; Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan.
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan; Division of Plastic Surgery, Department of Surgery, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung City, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan
| | - Hidenobu Takahashi
- Department of Surgery, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung City 807, Taiwan, Taiwan
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Huang SH, Lin YN, Lee SS, Huang YH, Takahashi H, Chou CK, Lin TY, Chen RF, Kuo YR, Lai CS, Lin SD, Lin TM. Three Simple Steps for Refining Transcutaneous Lower Blepharoplasty for Aging Eyelids: The Indispensability of Micro-Autologous Fat Transplantation. Aesthet Surg J 2019; 39:1163-1177. [PMID: 30668643 PMCID: PMC7643537 DOI: 10.1093/asj/sjz005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Lower blepharoplasty has been used for rejuvenating lower eyelids, and diverse modifications have been used to treat conjunct deformities at the tear trough/lid-cheek junction. Strategies for recontouring prominent tear trough/lid-cheek junctions, including orbital fat manipulation, have been reported with good results in the literature. Micro-autologous fat transplantation (MAFT) is a previously unevaluated, potentially advantageous approach to blending the prominent tear trough/lid-cheek junction. OBJECTIVES We determined the long-term results after 3-step transcutaneous lower blepharoplasty with MAFT for patients with aging eyelids and prominent tear trough/lid-cheek junctions. METHODS We evaluated 205 patients with aging lower eyelids who underwent transcutaneous lower blepharoplasty with MAFT between October 2010 and September 2016. The 3-step procedure involved a subciliary elliptical skin excision, resection of 3 orbital fat compartments, and MAFT for the tear trough/lid-cheek junction employing a MAFT-GUN under intravenous anesthesia. RESULTS The mean patient age was 52 years (range, 34-78 years). The mean operating time was 61 minutes. The mean fat volumes delivered to the tear trough/lid-cheek junctions were 2.80 mL and 2.76 mL for the left and right sides, respectively. The average weights of the 3 resected orbital fat compartments were 0.58 g for the left side and 0.56 g for the right side. Patients showed significant improvement and maintenance at an average follow-up of 60.2 months (range, 18-90 months). CONCLUSIONS Three-step transcutaneous lower blepharoplasty with MAFT is an effective, reliable, and promising method with high patient satisfaction and minimal risk of complications. Long-term results demonstrated its utility for aging lower eyelid treatment. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | - Hidenobu Takahashi
- Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | - Tsung-Ying Lin
- Traumatology Specialized Surgeon, Division of Traumatology, Department of Emergency, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Rong-Fu Chen
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Sheng Lai
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Tsai-Ming Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Lee SS, Kwan TH, Wong NS, Lee KCK, Chan DPC, Lam TTN, Lui GCY. Piloting a partially self-financed mode of human immunodeficiency virus pre-exposure prophylaxis delivery for men who have sex with men in Hong Kong. Hong Kong Med J 2019; 25:382-391. [PMID: 31619578 DOI: 10.12809/hkmj198030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) 300 mg/emtricitabine (FTC) 200 mg is a proven strategy for preventing human immunodeficiency virus (HIV) transmission in men who have sex with men (MSM). This study aimed to test the feasibility and acceptability of PrEP delivered at a pilot clinic for MSM in Hong Kong, where PrEP service is currently unavailable. METHODS Partially self-financed PrEP was provided to HIV-negative adult MSM with high behavioural risk of HIV transmission after excluding hepatitis B infection and renal insufficiency. Participants received daily TDF/FTC for 30 weeks at 13.3% of the drug cost. Adherence and behaviours were monitored through questionnaires while creatinine and HIV/STI (sexually transmitted infection) incidence were monitored with point-of-care and laboratory tests. Preference for continuing with PrEP was evaluated at the end of the prescription period. RESULTS Seventy-one PrEP-naïve MSM were included in the study, of whom 57 (80%) were retained at the end of 28 weeks. Satisfactory adherence and self-limiting adverse events were reported, while none of the participants contracted HIV. Risk compensation was observed, with an STI incidence of 3.17 per 100 person-years. At the end of the prescription period, a majority (89%) indicated interest in continuing with PrEP. Preference for PrEP was associated with age ≥28 years and peer influence (P=0.04), while stigma was a concern. Price was a deterrent to self-financed PrEP, and only half (51%) considered a monthly cost of ≤HK$500 (US$1=HK$7.8) as reasonable. CONCLUSIONS A partially self-financed mode of PrEP delivery is feasible with good retention in MSM in Hong Kong.
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Affiliation(s)
- S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - T H Kwan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - N S Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K C K Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Psychiatry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - D P C Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - T T N Lam
- School of Pharmacy, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - G C Y Lui
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
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Kwok KO, Li KK, Lee SS, Chng PHY, Wei VWI, Ismail NH, Mosli N, Koh D, Lai A, Lim JW. Multi-centre study on cultural dimensions and perceived attitudes of nurses towards influenza vaccination uptake. J Hosp Infect 2018; 102:337-342. [PMID: 30500386 DOI: 10.1016/j.jhin.2018.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/21/2018] [Indexed: 11/16/2022]
Abstract
This study explored how cultural values affected Health Belief Model (HBM) components and the influenza vaccine uptake among nurses across three Asian populations using a survey conducted in 2017 (N = 3971). The vaccination coverages were 33.5% (Brunei), 35.6% (Hong Kong) and 69.5% (Singapore). Three HBM components (perceived susceptibility, perceived benefits and cues to action) were positively associated with vaccination. A direct negative link and an indirect positive link via HBM were observed between collectivism and vaccination, whereas a negative indirect link via HBM between power distance and vaccination was observed. Cultural values, notably collectivism, advanced HBM to study nurses' vaccination.
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Affiliation(s)
- K O Kwok
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China.
| | - K K Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - S S Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - P H Y Chng
- Nursing Administration (Infection Control), Yishun Community Hospital, Singapore
| | - V W I Wei
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - N H Ismail
- Occupational Health Division, Public Health Services, Ministry of Health, Brunei Darussalam
| | - N Mosli
- Occupational Health Division, Public Health Services, Ministry of Health, Brunei Darussalam
| | - D Koh
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam; NUS Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - A Lai
- Occupational Health Division, Public Health Services, Ministry of Health, Brunei Darussalam; PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Brunei Darussalam
| | - J W Lim
- NUS Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Health for Life Center, Khoo Teck Puat Hospital (KTPH), Singapore
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Simbolon FR, Lee SS, Tsai YC, Tsai WC, Lin GT, Tung YC, Tu HP. Risk of incident gout in kidney transplant recipients: A retrospective cohort study. Int J Rheum Dis 2018; 21:1993-2001. [PMID: 30338664 DOI: 10.1111/1756-185x.13393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/25/2018] [Accepted: 08/24/2018] [Indexed: 01/02/2023]
Abstract
AIM Gout is a common complication in kidney transplant recipients. This study evaluated the association between kidney transplant recipients and the long-term risk of incident gout. METHOD For this age-matched and sex-matched retrospective cohort study, the Catastrophic Illness Certificate Database and the National Health Insurance Research Database were combined between 1997 and 2010. The study included 5917 patients with kidney transplants and 23 668 matched kidney transplant-free subjects. Hazard ratio (HR) for risk of incident gout was calculated using the Cox proportional hazards regression. RESULTS In this study, of the 5917 kidney transplant recipients, 521 (8.8%) had gout. The kidney transplant group had a higher risk of incident gout than those in the matched kidney transplant-free group (adjusted HR = 1.55, 95% confidence intervals [CI] = 1.36-1.77), particularly within 3 years following kidney transplant recipients (adjusted HR = 2.61, 95% CI = 2.13-3.20). We observed that at the >3 to 6 years and the >6 to 9 years follow-up, patients with kidney transplant did not have a significant association with risk of incident gout (adjusted HR = 0.92, P = 0.4806 and adjusted HR = 1.26, P = 0.1901, respectively). CONCLUSION These findings revealed that risk of incident gout increased within 3 years following kidney transplant recipients and the individual's long-term risk of incident gout between kidney transplant recipients and the general population remained similar.
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Affiliation(s)
- Fransiska Romana Simbolon
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chun Tsai
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wen-Chan Tsai
- Division of Rheumatology, Departments of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Gau-Tyan Lin
- Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yi-Ching Tung
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Huang SH, Huang YH, Lin YN, Lee SS, Chou CK, Lin TY, Takahashi H, Kuo YR, Lai CS, Lin SD, Lin TM. Micro-Autologous Fat Transplantation for Treating a Gummy Smile. Aesthet Surg J 2018; 38:925-937. [PMID: 29566216 PMCID: PMC6317576 DOI: 10.1093/asj/sjy069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background A gummy smile is treated using many techniques, including botulinum toxin injection and various surgical interventions. Micro-autologous fat transplantation (MAFT) is a potentially advantageous alternative approach that has not been previously evaluated. Objectives This study sought to determine the long-term results of MAFT in patients with a gummy smile. Methods Seven patients with gummy smiles were evaluated for MAFT treatment between October 2015 and April 2017. Centrifuged purified fat was micro-transplanted into the nasolabial groove, ergotrid, and upper lip areas using the MAFT-GUN while the patients were under total intravenous anesthesia. Results The mean age of the 7 patients was 31 years (range, 23-40 years). The mean operating time for MAFT was 52 minutes (range, 40-72 minutes), and the mean volume of fat delivered to the nasolabial groove, ergotrid, and upper lip was 16.1 mL. The mean decreases of gingival display in the right canine incisor, left canine incisor, right canine, and left canine teeth were 4.9, 4.6, 3.8, and 4.4 mm, respectively. The smiles of the 7 patients showed significant improvement at an average follow-up time of 12.9 months. Conclusions Gummy smile treatment using MAFT is an effective, reliable, and relatively simple method, with high patient satisfaction and minimal risk of complications. Level of Evidence: 4
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Affiliation(s)
- Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital and Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Yun-Nan Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Tsung-Ying Lin
- Division of Traumatology, Department of Emergency, Kaohsiung Medical University
| | | | - Yur-Ren Kuo
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Sheng Lai
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsai-Ming Lin
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
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Wu ZS, Lo JJ, Wu SH, Wang CZ, Chen RF, Lee SS, Chai CY, Huang SH. Early Hyperbaric Oxygen Treatment Attenuates Burn-Induced Neuroinflammation by Inhibiting the Galectin-3-Dependent Toll-Like Receptor-4 Pathway in a Rat Model. Int J Mol Sci 2018; 19:ijms19082195. [PMID: 30060489 PMCID: PMC6121430 DOI: 10.3390/ijms19082195] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 07/22/2018] [Accepted: 07/25/2018] [Indexed: 02/07/2023] Open
Abstract
Hyperbaric oxygen (HBO) treatment has been proven to decrease neuroinflammation in rats. This study aimed to determine the potential mechanism underlying the anti-inflammatory effects of HBO treatment on burn-induced neuroinflammation in rats. Thirty-six adult male Sprague-Dawley (SD) rats were randomly assigned to the following six groups (n = 6 per group): (1) sham burn with sham HBO treatment; (2) sham burn with HBO treatment; (3) burn with one-week sham HBO treatment; (4) burn with two-week sham HBO treatment; (5) burn with one-week HBO treatment; and (6) burn with two-week HBO treatment. SD rats that received third-degree burn injury were used as a full-thickness burn injury model. Subsequently, we analyzed the expression of proteins involved in the galectin-3 (Gal-3)-dependent Toll-like receptor-4 (TLR-4) pathway through enzyme-linked immunosorbent assay (ELISA), immunohistochemistry (IHC) analysis, and Western blotting. A behavior test was also conducted, which revealed that HBO treatment significantly suppressed mechanical hypersensitivity in the burn with HBO treatment group compared to the burn with sham HBO treatment group (p < 0.05). ELISA results showed that tumor necrosis factor α (TNF-α) and interleukin 1 beta (IL-1β) levels in the dorsal horn of the spinal cord and the skin significantly decreased in the burn with HBO treatment group compared with the burn with sham HBO treatment group (p < 0.05). Western blotting results demonstrated that HBO treatment significantly reduced the expression of Gal-3 and TLR-4 in the dorsal horn of the spinal cord in the burn with HBO treatment group compared with the burn with sham HBO treatment group (p < 0.05). IHC analysis showed that the expression of Gal-3, TLR-4, CD68 and CD45 in the dorsal horn of the spinal cord was significantly lower in the burn with HBO treatment group than in the burn with sham HBO treatment group (p < 0.05), and the expression of CD68 and macrophage migration inhibitory factor (MIF) in the right hind paw skin was significantly lower. The expression of vimentin and fibroblast growth factor in the right hind paw skin was significantly higher after HBO treatment (p < 0.05). This study proved that early HBO treatment relieves neuropathic pain, inhibits the Gal-3-dependent TLR-4 pathway, and suppresses microglia and macrophage activation in a rat model.
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Affiliation(s)
- Zong-Sheng Wu
- Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Jing-Jou Lo
- School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Sheng-Hua Wu
- Department of Anesthesiology, Kaohsiung Medical University Hospital, 807 Kaohsiung, Taiwan.
- Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Chau-Zen Wang
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
- Department of Physiology, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, 807 Kaohsiung, Taiwan.
- Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Rong-Fu Chen
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 807 Kaohsiung, Taiwan.
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 807 Kaohsiung, Taiwan.
- Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Chee-Yin Chai
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, 807 Kaohsiung, Taiwan.
- Department of Surgery, School of Medicine, College of Medicine, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
- Hyperbaric Oxygen Therapy Room, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807 Kaohsiung, Taiwan.
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Lee NJ, Shin JH, Lee SS, Park DH, Lee SK, Yoon HK. Transcatheter arterial embolization for iatrogenic bleeding after endoscopic ultrasound-guided pancreaticobiliary drainage. Diagn Interv Imaging 2018; 99:717-724. [PMID: 30033142 DOI: 10.1016/j.diii.2018.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to report the incidence of massive bleeding after endoscopic ultrasound-guided transmural pancreaticobiliary drainage (EUS-TPBD) and the clinical outcomes in patients with this condition treated with transcatheter arterial embolization (TAE). PATIENTS AND METHODS We performed a 9-year retrospective analysis of 797 EUS-TPBD procedures (excluding gallbladder or pseudocysts) in 729 patients. Among them, twelve (12/729, 1.65%) patients were referred for TAE to manage active bleeding adjacent to the TPBD sites. There were 8 men and 4 women with a mean age of 66.1 years±13.4 (SD) (range: 45-89 years). The clinical and procedure data of these 12 patients were reviewed. RESULTS Thirteen TAE procedures in 12 patients were performed. The bleeding sites were the left hepatic artery (n=7), the right hepatic artery (n=3), the left gastric artery (n=1), the left accessory gastric artery (n=1) and gastroduodenal artery (n=1). TAE was performed with gelatin sponge particles (n=1), coil (n=1) and n-butyl-2 cyanoacrylate with/without coils (n=11), with technical and clinical success rates of 100% (13/13) and 85% (11/13), respectively. Re-bleeding following embolization with gelatin sponge particles occurred in one patient. Procedure-related ischemic hepatitis was observed in another patient with pancreatic cancer with portal vein involvement. CONCLUSION On the basis of our results, TAE using n-butyl-2 cyanoacrylate seems safe and effective for the treatment of bleeding after EUS-TPBD procedures. When the portal vein is compromised, TAE of the hepatic artery can cause ischemic liver damage.
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Affiliation(s)
- N J Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
| | - J H Shin
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
| | - S S Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - D H Park
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S K Lee
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H-K Yoon
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea
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