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Wu JM, Yang H, Li Q, Luo TF, Yang P, Huang WC. [Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:849-856. [PMID: 37805801 DOI: 10.3760/cma.j.cn501225-20230420-00134] [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] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To investigate the clinical efficacy of local injection of platelet-rich plasma (PRP) combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity. Methods: A retrospective observational study was conducted. From December 2017 to October 2022, 16 patients were admitted to Department of Orthopaedic Trauma of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, and 32 patients were admitted to Department of Burns and Plastic Surgery of Guiyang Steel Factory Staff Hospital. All the patients had wounds with exposed tendon on extremity caused by various reasons and met the inclusion criteria. There were 39 males and 9 females, aged 26 to 58 years. The patients were divided into PRP alone group, artificial dermis alone group, and PRP+artificial dermis group, with 16 patients in each group. The wounds were treated with autologous PRP, double-layer artificial dermis, or thei combination of autologous PRP and double-layer artificial dermis, followed by autologous split-thickness scalp grafting after good growth of granulation tissue. On the 7th day after the secondary surgery, the autograft survival was observed, and the survival rate was calculated. The wound healing time and length of hospital stay of patients were recorded. At 3 and 6 months after wound healing, the Vancouver scar scale (VSS) was used to score the pigmentation, height, vascularity, and pliability of scars, and the total score was calculated. Adverse reactions during the entire treatment process were recorded. Data were statistically analyzed with chi-square test, Fisher's exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis H test, Nemenyi test, and Bonferroni correction. Results: On the 7th day after the secondary surgery, there was no statistically significant difference in the autograft survival rate of patients among PRP alone group, artificial dermis alone group, and PRP+artificial dermis group (P>0.05). The wound healing time and length of hospital stay of patients in PRP+artificial dermis group were (20.1±3.0) and (24±4) d, respectively, which were significantly shorter than (24.4±5.5) and (30±8) d in PRP alone group (P<0.05) and (24.8±4.9) and (32±8) d in artificial dermis alone group (P<0.05). At 3 and 6 months after wound healing, the pliability scores of patients in PRP+artificial dermis group were significantly lower than those in PRP alone group (with Z values of 12.91 and 15.69, respectively, P<0.05) and artificial dermis alone group (with Z values of 12.50 and 12.91, respectively, P<0.05). There were no statistically significant differences in pigmentation, vascularity, height scores, and total score of scar of patients among the three groups (P>0.05). In artificial dermis alone group, one patient experienced partial liquefaction and detachment of the double-layer artificial dermis due to local infection of Staphylococcus epidermidis, which received wound dressing change, second artificial dermis transplantation, and subsequent treatment as before. No adverse reactions occurred in the remaining patients during the whole treatment process. Conclusions: Local injection of PRP combined with double-layer artificial dermis is effective in treating wounds with exposed tendon on extremity, which can not only significantly shorten wound healing time and length of hospital stay, but also improve scar pliability after wound healing to some extent in the long term. It is a clinically valuable treatment technique that is worth promoting and applying.
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Affiliation(s)
- J M Wu
- Department of Burns and Plastic Surgery, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - H Yang
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - Q Li
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - T F Luo
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - P Yang
- Department of Orthopaedic Trauma, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China
| | - W C Huang
- Department of Orthopaedic Trauma, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China
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Liang CC, Huang WC, Shaw SW, Huang YH, Lee TH. Human amniotic fluid stem cells can alleviate detrusor dysfunction caused by bladder outlet obstruction in rats. Sci Rep 2022; 12:6679. [PMID: 35461349 PMCID: PMC9035144 DOI: 10.1038/s41598-022-10640-y] [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: 09/25/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
The present study examined whether bladder detrusor dysfunction due to partial bladder outlet obstruction (pBOO) could be improved after the treatment of human amniotic fluid stem cells (hAFSCs). 72 female rats were grouped into sham operation, pBOO, and pBOO with hAFSCs treatment (pBOO + hAFSCs) for in vitro and in vivo studies. Bladder weight, bladder wall thickness, the ratio of collagen to smooth muscle and the levels of positive CD11b/c and HIS48 cells was significantly increased after pBOO but improved after hAFSCs treatment. Cystometries showed impaired bladder function after pBOO. Protein and mRNA levels of hypoxia inducible factor-1α, CCL2, interleukin-1β, transforming growth factor-β1 (TGF-β1), connective tissue growth factor (CTGF), α-smooth muscle actin, collagen I and collagen III were increased at 2 and/or 6 weeks, but proteins and mRNA expressions of protein gene product 9.5 were decreased at 2 and 6 weeks after pBOO. These abnormalities were improved after hAFSCs treatment. The expressions of TGF-β1 and CTGF in cultured detrusor cells of pBOO rats were increased but were improved after hAFSCs treatment. The present results showed hAFSCs treatment could improve bladder detrusor dysfunction in pBOO rats, which may be related to the reduction of inflammatory and pro-fibrotic markers in detrusor muscle cells.
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Affiliation(s)
- Ching-Chung Liang
- Female Urology Section, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chu Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Steven W Shaw
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Obstetrics, Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.,Prenatal Cell and Gene Therapy Group, Institute for Women's Health, University College London, London, UK
| | - Yung-Hsin Huang
- Female Urology Section, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan
| | - Tsong-Hai Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fu-Hsing Street, Kweishan, 33333, Taoyuan, Taiwan.
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Huang WC, Lau HH, Su TH. Minimal requirement in urogynecological knowledge for obstetrics and gynecology specialists. Taiwan J Obstet Gynecol 2022; 61:57-62. [PMID: 35181047 DOI: 10.1016/j.tjog.2021.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Accepted: 02/24/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To investigate the current knowledge and practice patterns of obstetrics and gynecology (obs/gyn) physicians regarding the diagnosis, evaluation, and management of pelvic floor disorders (PFD) including stress urinary incontinence (SUI), pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS). The knowledge related to urodynamic study (UDS) is also evaluated. MATERIALS AND METHODS A 25-item questionnaire was developed and sent for the physician members who participated in the annual congress of Taiwan Association of Obstetrics and Gynecology (TAOG). Response to the questionnaire was voluntary and anonymous. The questionnaires were collected prior to the ending of the congress. RESULTS 2000 copies of the questionnaire were sent and 1443 TAOG members responded. 86 poor respondents and 45 copies from urogynecologists were excluded. 1312 copies of the completed questionnaires were analyzed. 77.7% of the respondents were male physicians and 50.6% were over 55 years old. Up to 53.7% of the physicians had completed their residency training for over twenty years. Generally, around half of the respondents didn't reach well a level of well understanding regarding the various PFD. Most of the physicians would like to have further knowledge in urogynecological field for their daily practice. Regular delivery of updated information about various urogynecological diseases is mandatory. CONCLUSION With the aging population worldwide, the need for management of PFD is increasing. The obs/gyn physician plays an important role in the primary evaluation and management of PFD. This study offered important information related to the current investigation, management, practice patterns and future expectation from obs/gyn physicians as references for the future continuing medical education programs.
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Affiliation(s)
- Wen-Chu Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan
| | - Hui-Hsuan Lau
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan
| | - Tsung-Hsien Su
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan.
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Chen CP, Huang WC, Chern SR, Wu FT, Chen SW, Town DD, Wang W. Detection of placental mosaic trisomy 17 in a pregnancy associated with mosaicism for trisomy 17 in a single colony at amniocentesis with a favorable outcome. Taiwan J Obstet Gynecol 2021; 60:1139-1141. [PMID: 34794754 DOI: 10.1016/j.tjog.2021.09.033] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Wen-Chu Huang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Schu-Rern Chern
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Fang-Tzu Wu
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Dai-Dyi Town
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
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Lau HH, Su TH, Huang WC. Effect of aging on lower urinary tract symptoms and urodynamic parameters in women. Taiwan J Obstet Gynecol 2021; 60:513-516. [PMID: 33966738 DOI: 10.1016/j.tjog.2021.03.022] [Citation(s) in RCA: 9] [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: 03/06/2020] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Lower urinary tract symptoms (LUTS) are common in women. However, due to multifactorial etiologies, it is difficult to determine the prevalence, and functional changes with age. The aim of this study is to assess the effect of age on female LUTS, urethral and bladder function after their midlife. MATERIALS AND METHODS This was an observational cohort study conducted at a tertiary referral medical center. Women who visited for bothersome LUTS, valid quality of life questionnaires, and urodynamic tests were recruited into the this study. Patients The patients were divided into four groups (<50, 50-59, 60-69, and >69 years). All LUTS, and urodynamic parameters were reviewed, and compared between groups. RESULTS A total of 364 women were enrolled and analyzed. The urodynamic tests showed the that maximal cystometric bladder capacity, the average and maximal urine flow rate, and pressure of detrusor contractility at maximal urine flow rate were all significantly decreased with age. Besides, the voiding time, and post-voiding residual urine volume significantly increased with age. For urethral competence, the maximal urethral closure pressure deteriorated with age. All storage symptoms did not change with age, except for nocturnal enuresis. However, the effect of age on some voiding symptoms significantly increased with age, including straining to void, hesitancy, and intermittency. CONCLUSIONS Lower urinary tract symptoms, bladder and urethral functions change with age, particularly voiding function. Physicians should be aware of the aging process when counseling and before implementing management strategies, particularly for older people.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College, New Taipei, 252, Taiwan; Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, 104, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Hsinchu, 300, Taiwan
| | - Tsung-Hsien Su
- Department of Medicine, Mackay Medical College, New Taipei, 252, Taiwan; Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, 104, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Hsinchu, 300, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College, New Taipei, 252, Taiwan; Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, 104, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.
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Lee KS, Wang YL, Huang WC, Yang JH, Huang JP. Limited efficacy with additional adverse effect of anti-adhesion barrier at primary cesarean section. J Formos Med Assoc 2021; 121:227-236. [PMID: 33838986 DOI: 10.1016/j.jfma.2021.03.012] [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: 01/07/2021] [Revised: 02/26/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND/PURPOSE In our experience, adhesion after the primary CS is generally minimal or nonexistent. However, adhesion barriers users have experienced more febrile episodes that may require therapeutic antibiotics during the postcesarean period. We evaluated clinical efficacy of HA-CMC and ORC to prevent adhesion at secondary CS and the post-operative outcome at primary and secondary CS. METHODS This retrospective study includes 199 Asian women undergoing primary and secondary cesarean section between January1, 2011, and September 31, 2019. We used linear and logistic regression to analyze risk factors of postcesarean fever. An interaction term analysis was performed to examine the effect of surgical site infection risk factors and use of adhesion barrier on postcesarean fever rates. RESULTS We found that use of adhesion barrier at the primary cesarean section is associated with a significantly higher incidence of postcesarean fever (p = 0.045), which is an independent risk factor of postcesarean fever (adjusted hazard ratio (Adj-HR)= 3.53, 95% CI = 1.03-10.24, p = 0.045). The strongest risk factor for postcesarean fever is the use of anti-adhesion film during emergency cesarean section (p = 0.041). In the subgroup of labor before operation and emergency cesarean section, adhesion barrier user had significant higher risk of postcesarean fever than nonuser (p = 0.018, Adj-HR = 12.12, 95% CI = 1.53-95.78; emergency cesarean section: p = 0.016, Adj-HR = 12.71, 95% CI = 1.62-99.62). CONCLUSION Use of anti-adhesion films during emergency cases and with a significantly higher risk of postcesarean fever which potentially means increased risk of surgical site infection. Therefore, we do not suggest routine application of anti-adhesion films during cesarean deliveries especially in emergency cesarean section or in a woman having labor before operation.
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Affiliation(s)
- Kuan-Sheng Lee
- Department of Obstetrics & Gynecology, MacKay Memorial Hospital, Taipei 104, Taiwan.
| | - Yeou-Lih Wang
- Department of Obstetrics & Gynecology, MacKay Memorial Hospital, Taipei 104, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City 251, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan.
| | - Wen-Chu Huang
- Department of Obstetrics & Gynecology, MacKay Memorial Hospital, Taipei 104, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City 251, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan.
| | - Jia-Hwa Yang
- Taiwan Public Health Association, Taipei 100, Taiwan.
| | - Jian-Pei Huang
- Department of Obstetrics & Gynecology, MacKay Memorial Hospital, Taipei 104, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City 251, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan.
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Tsai CP, Yang JM, Liang SJ, Lin YH, Huang WC, Lin TY, Hsu CS, Chuang FC, Hung MJ. Factors associated with treatment outcomes after intravesical hyaluronic acid therapy in women with refractory interstitial cystitis: A prospective, multicenter study. J Chin Med Assoc 2021; 84:418-422. [PMID: 33784267 DOI: 10.1097/jcma.0000000000000498] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 11/25/2022] Open
Abstract
BACKGROUND Bladder instillation of hyaluronic acid (HA) is an acceptable treatment for bladder pain syndrome/interstitial cystitis (BPS/IC). The treatment is limited by a high proportion of non-responders (~30%-40%). Here, we aimed to evaluate predisposing factors associated with treatment outcomes. METHODS This is a prospective multicenter study. We enrolled a total of 137 (out of 140) women with refractory IC. They all underwent a standard protocol of 6-month intravesical HA therapy (initial 4 weeks, once weekly, followed by once monthly). To assess the outcomes, we used the pain Visual Analog Scale (Pain-VAS), Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI), and a scaled Global Response Assessment (GRA). RESULTS The age of patients was 47.6 ± 27.5 (range 24-77) years. We found statistically significant improvement (p < 0.001) in the Pain-VAS and the ICSI & ICPI scores both after the initial 4-weekly instillations and at the end of 6-month treatment. Those who reported moderate/marked improvement on GRA at the 2 follow-up visits were considered responders: 39.4% (n = 54) at the first follow-up, and 59.9% (n = 82) at the second follow-up. No remarkable side effect was noted. After statistical analyses, treatment outcomes on GRA were positively associated with baseline functional bladder capacity and with Pain-VAS scores. The initial treatment responses optimally (p < 0.001) predicted final treatment outcomes (McNemar). CONCLUSION Intravesical HA therapy is safe and effective for most (~60%) of our patients with refractory IC. Functional bladder capacity and Pain-VAS scores before treatment, and the early treatment responses are helpful predictors of treatment outcomes.
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Affiliation(s)
- Ching-Pei Tsai
- Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Jenn-Ming Yang
- Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei, Taiwan, ROC
| | - So-Jung Liang
- Department of Obstetrics and Gynecology, Wan Fang Hospital, Taipei Medical University, Taiwan, ROC
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
| | - Wen-Chu Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Mackay, Medicine, Nursing and Management College, Taipei, Taiwan, ROC
| | - Tzu-Yin Lin
- Department of Obstetrics and Gynecology, Taipei City Hospital, Branch for Women and Children, Taipei, Taiwan, ROC
| | - Chun-Shuo Hsu
- Department of Obstetrics and Gynecology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan, ROC
| | - Fei-Chi Chuang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC
| | - Man-Jung Hung
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital; Department of Obstetrics and Gynecology, School of Medicine, Colleague of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
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Hwang JC, Huang WC, Su TH, Lau HH. Evaluation of efficacy and safety of single-incision sling versus transobturator sling in women with stress incontinence and intrinsic sphincter deficiency. Int Urogynecol J 2021; 33:985-990. [PMID: 33710432 DOI: 10.1007/s00192-021-04751-9] [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: 10/13/2020] [Accepted: 02/25/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urethral intrinsic sphincter deficiency (ISD) is associated with severe urine leakage and a higher risk of sling failure. The aim of this study is to evaluate the efficacy and safety of single-incision slings (SISs) versus transobturator slings (TOSs) in such patients. METHODS Patients who had stress incontinence and ISD who underwent SIS or TOS procedures from 2010 to 2017 were retrospectively reviewed. The objective and subjective cure rates and surgical adverse events were compared between different slings. Objective cure was defined as no stress urine leakage with a comfortably full bladder. Subjective cure was determined by the patient's satisfaction. Incontinence-related symptom distress and quality of life were evaluated using the short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7). RESULTS Among 111 patients, 37 underwent SIS and 72 underwent TOS with a median follow-up of 21 (range: 12-72) months and 24 (range: 14-84) months (p = 0.265). For both groups, the UDI-6, IIQ-7, and 1-h pad test all significantly improved after surgery (all p < 0.001). The objective and subjective cure rates were comparable after SIS and TOS procedures (objective: 76% vs. 76%, p = 0.837; subjective: 78% vs. 83%, p = 0.212). There were no significant differences in adverse events, except SISs had a shorter surgery time (16.4 ± 9.3 vs. 27.3 ± 12.4 min, p = 0.020) and lower postoperative visual analog scale pain score (1.3 ± 1.1 vs. 3.9 ± 1.4, p < 0.001). CONCLUSION SISs and TOSs had similar surgical results in women with stress incontinence and ISD after at least 1 year of follow-up. However, SISs had a shorter operation time and lower postoperative pain than TOSs.
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Affiliation(s)
- Jiun-Chyi Hwang
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan
| | - Tsung-Hsien Su
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan.,Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan.,Department of Obstetrics and Gynecology, Hsin-Chu Mackay Memorial Hospital, Hsin-Chu, Taiwan
| | - Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College, New Taipei, Taiwan. .,Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan. .,Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Mackay Medical College, Taipei, Taiwan. .,Department of Obstetrics and Gynecology, Hsin-Chu Mackay Memorial Hospital, Hsin-Chu, Taiwan. .,Department of Obstetrics and Gynecology, Division of Urogynecology, Mackay Memorial Hospital, No. 92, Sec. 2 Chung-Shan North Road, Taipei, 104, Taiwan.
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Lin PL, Wang YL, Weng SS, Huang WC. Laparoscopic Repair of the Bladder: A Case of Intrauterine Device Migration to the Urinary Bladder. J Minim Invasive Gynecol 2021; 28:1433-1435. [PMID: 33549733 DOI: 10.1016/j.jmig.2021.01.023] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/17/2021] [Accepted: 01/25/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Ping-Lun Lin
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)
| | - Yeou-Lih Wang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)..
| | - Shih-Shien Weng
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)
| | - Wen-Chu Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)
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Lau HH, Su TH, Chen YY, Huang WC. The Prevalence of Vaginal Flatus in Women With Pelvic Floor Disorders and Its Impact on Sexual Function. J Sex Med 2021; 18:487-492. [PMID: 33504467 DOI: 10.1016/j.jsxm.2020.12.008] [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] [Received: 08/25/2020] [Revised: 12/02/2020] [Accepted: 12/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Vaginal flatus is involuntarily passing gas from the vagina. Women seldom voluntarily report it, and related data are limited. AIM To investigate the prevalence of vaginal flatus in women with pelvic floor disorders and its impact on sexual function. METHODS This was an observational study involving women who visited a urogynecologic clinic in a tertiary medical center. Patients were asked about their experience of vaginal flatus. Other evaluations included urodynamics, genital prolapse stage, and quality-of-life questionnaires, including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. OUTCOMES Clinical characteristics, vaginal anatomic landmarks, stage of prolapse, urodynamic parameters, and quality-of-life scores were compared between women with and without vaginal flatus. RESULTS Among 341 women, 118 (35%) reported vaginal flatus, which was more common in those who were younger (a mean age of 49.3 ± 9.2 years; range 25-74 years vs 49.3 ± 9.2 years; range 25-74 years, P < .001) and sexually active (98% vs 55%, P < .001). Women with vaginal flatus had significantly worse sexual function (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, 16.3 ± 15.9 vs 30.9 ± 8.0, P < .001) and incontinence-related quality of life (Urogenital Distress Inventory, 23.4 ± 10.5 vs 17.8 ± 8.9, P = .039; Incontinence Impact Questionnaire, 25.5 ± 14.5 vs 17.2 ± 12.5, P = .012). For frequency and bother, 48 of 116 (46%) women reported often or always having symptoms during sexual activity, 5 of 34 (15%) when performing daily activities, and 4 of 31 (12%) when exercising, and 70 of 116 (60%) felt least moderate bothersome during sexual activity compared with 2 of 34 (5%) when performing daily activities and 6 of 31 (18%) when exercising. CLINICAL IMPLICATIONS Vaginal flatus is prevalent in women with pelvic floor disorders, particularly in those who are younger and sexually active. STRENGTHS & LIMITATIONS The strength of this study is to evaluate the sexual function with validated questionnaires. The lack of data after pelvic floor management is the major limitation. CONCLUSIONS Among women with pelvic floor disorders, those with vaginal flatus reported poorer sexual function. Routine counseling should be considered for these patients. Lau H-H, Su T-H, Chen Y-Y, et al. The Prevalence of Vaginal Flatus in Women With Pelvic Floor Disorders and Its Impact on Sexual Function. J Sex Med 2021;18:487-492.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan.
| | - Tsung-Hsien Su
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Ying-Yu Chen
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
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11
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Wu X, Yu H, He LY, Wang CQ, Xu HM, Zhao RQ, Jing CM, Chen YH, Chen J, Deng JK, Shi J, Lin AW, Li L, Deng HL, Cai HJ, Chen YP, Wen ZW, Yang JH, Zhang T, Xiao FF, Cao Q, Huang WC, Hao JH, Zhang CH, Huang YY, Ji XF. [A multicentric study on clinical characteristics and antibiotic sensitivity in children with methicillin-resistant Staphylococcus aureus infection]. Zhonghua Er Ke Za Zhi 2020; 58:628-634. [PMID: 32842382 DOI: 10.3760/cma.j.cn112140-20200505-00469] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical characteristics of pediatric methicillin-resistant Staphylococcus aureus (MRSA) infection and the antibiotic sensitivity of the isolates. Methods: The clinical data of children with MRSA infection and antibiotic sensitivity of the isolates from 11 children's hospitals in Infectious Diseases Surveillance of Paediatrics (ISPED) group of China between January 1, 2018 and December 31, 2018 were collected retrospectively. The children's general condition, high-risk factors, antimicrobial therapy and prognosis, differences in clinical disease and laboratory test results between different age groups, and differences of antibiotic sensitivity between community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA were analyzed. The t test and Wilcoxon rank sum test were used for statistical analysis of the quantitative data and Chi-square test were used for comparison of rates. Results: Among the 452 patients, 264 were males and 188 were females, aged from 2 days to 17 years. There were 233 cases (51.5%) in the ≤1 year old group, 79 cases (17.5%) in the>1-3 years old group, 29 cases (6.4%) in the >3-5 years old group, 65 cases (14.4%) in the >5-10 years old group, and 46 cases (10.2%) in the>10 years old group. The main distributions of onset seasons were 55 cases (12.2%) in December, 47 cases (10.4%) in February, 46 cases (10.2%) in November, 45 cases (10.0%) in January, 40 cases (8.8%) in March. There were 335 cases (74.1%) CA-MRSA and 117 (25.9%) cases HA-MRSA. Among all cases, 174 cases (38.5%) had basic diseases or long-term use of hormone and immunosuppressive drugs. During the period of hospitalization, 209 cases (46.2%) received medical interventions. There were 182 patients (40.3%) had used antibiotics (β-lactams, glycopeptides, macrolides, carbapenems, oxazolones, sulfonamides etc) 3 months before admission. The most common clinical disease was pneumonia (203 cases), followed by skin soft-tissue infection (133 cases), sepsis (92 cases), deep tissue abscess (42 cases), osteomyelitis (40 cases), and septic arthritis (26 cases), suppurative meningitis (10 cases). The proportion of pneumonia in the ≤1 year old group was higher than the >1-3 years old group,>3-5 years old group,>5-10 years old group,>10 years old group (57.5% (134/233) vs. 30.4% (24/79), 31.0% (9/29), 38.5% (25/65), 23.9% (11/46), χ(2)=17.374, 7.293, 7.410, 17.373, all P<0.01) The proportion of skin and soft tissue infections caused by CA-MRSA infection was higher than HA-MRSA (33.4% (112/335) vs. 17.9% (21/117), χ(2)=10.010, P=0.002), and the proportion of pneumonia caused by HA-MRSA infection was higher than CA-MRSA (53.0% (62/117) vs. 42.1% (141/335), χ(2)=4.166, P=0.041). The first white blood cell count of the ≤1 year old group was higher than that children > 1 year old ((15±8)×10(9)/L vs. (13±7)×10(9)/L, t=2.697, P=0.007), while the C-reactive protein of the ≤1 year old group was lower than the 1-3 years old group,>5-10 years old group,>10 years old group (8.00 (0.04-194.00) vs.17.00 (0.50-316.00), 15.20 (0.23-312.00), 21.79(0.13-219.00) mg/L, Z=3.207, 2.044, 2.513, all P<0.05), there were no significant differences in procalcitonin (PCT) between different age groups (all P>0.05). After the treatment, 131 cases were cured, 278 cases were improved, 21 cases were not cured, 12 cases died, and 10 cases were abandoned. The 452 MRSA isolates were all sensitive to vancomycin (100.0%), linezolid (100.0%), 100.0% resistant to penicillin, highly resistant to erythromycin (85.0%, 375/441), clindamycin (67.7%, 294/434), less resistant to sulfonamides (5.9%, 23/391), levofloxacin (4.5%, 19/423), gentamicin (3.2%, 14/438), rifampicin (1.8%, 8/440), minocycline (1.1%, 1/91). The antimicrobial resistance rates were not significantly different between the CA-MRSA and HA-MRSA groups (all P>0.05). Conclusions: The infection of MRSA is mainly found in infants under 3 years old. The prevalent seasons are winter and spring, and MRSA is mainly acquired in the community. The main clinical diseases are pneumonia, skin soft-tissue infection and sepsis. No MRSA isolate is resistant to vancomycin, linezolid. MRSA isolates are generally sensitive to sulfonamides, levofloxacin, gentamicin, rifampicin, minocycline, and were highly resistant to erythromycin and clindamycin. To achieve better prognosis. clinicians should initiate anti-infective treatment for children with MRSA infection according to the clinical characteristics of patients and drug sensitivity of the isolates timely and effectively.
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Affiliation(s)
- X Wu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - H Yu
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China
| | - L Y He
- Department of Microbiology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - C Q Wang
- Department of Microbiology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - H M Xu
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - R Q Zhao
- Department of Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - C M Jing
- Department of Clinical Laboratory Center, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
| | - Y H Chen
- Department of Infectious Diseases, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China
| | - J Chen
- Department of Infectious Diseases, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China
| | - J K Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - J Shi
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen 518038, China
| | - A W Lin
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - L Li
- Department of Infectious Diseases, Qilu Children's Hospital of Shandong University, Jinan 250022, China
| | - H L Deng
- Department of Infectious Diseases, Xi'an Children's Hospital, Xi'an 710003, China
| | - H J Cai
- Department of Clinical Laboratory Center, Xi'an Children's Hospital, Xi'an 710003, China
| | - Y P Chen
- Department of Pediatric Infectious Diseases, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Z W Wen
- Department of Pediatric Infectious Diseases, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - J H Yang
- Department of Microbiology, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - T Zhang
- Department of Gastroenterology and Infectious Diseases, Children's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai 200040, China
| | - F F Xiao
- Department of Gastroenterology and Infectious Diseases, Children's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai 200040, China
| | - Q Cao
- Department of Infectious Diseases, Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - W C Huang
- Department of Infectious Diseases, Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - J H Hao
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - C H Zhang
- Department of Infectious Diseases, Kaifeng Children's Hospital, Kaifeng 475000, China
| | - Y Y Huang
- Department of Pediatrics, Bethune First Hospital of Jilin University, Changchun 130021, China
| | - X F Ji
- Department of Pediatrics, Bethune First Hospital of Jilin University, Changchun 130021, China
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12
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Lau HH, Jou QB, Huang WC, Su TH. Amniotic Membrane Graft in the Management of Complex Vaginal Mesh Erosion. J Clin Med 2020; 9:jcm9020356. [PMID: 32012905 PMCID: PMC7074329 DOI: 10.3390/jcm9020356] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/22/2020] [Accepted: 01/26/2020] [Indexed: 11/20/2022] Open
Abstract
Vaginal mesh erosion is a devastating complication after pelvic floor mesh surgery and it can be treated conservatively or with surgical revision. However, the management options following a failed primary revision or complex vaginal erosions are very limited. The aim of this study is to describe a novel treatment using an amniotic membrane as an inlay graft for such patients. Eight patients who failed conservative or primary surgical revision were enrolled. The complex erosions included vaginal agglutination, multiple vaginal erosions, recurrent erosions, and mesh cutting through the urethra. We used an amniotic membrane as a graft to cover the vaginal defect after partial excision of the mesh erosion and we describe the technique in this study. There were no intraoperative complications and none of the patients reported any further symptoms at a mean of 27 months follow-up. Only one patient had recurrent erosion, however, the erosion size was narrower and was subsequently successfully repaired. No further vaginal mesh erosions were noted in the other patients who all had good functional recovery. The use of an amniotic graft can be an economic and alternative method in the management of complex vaginal mesh erosions.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College, New Taipei 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei 251, Taiwan
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu 300, Taiwan
| | - Quan-Bin Jou
- Department of Medicine, Mackay Medical College, New Taipei 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei 251, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College, New Taipei 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei 251, Taiwan
| | - Tsung-Hsien Su
- Department of Medicine, Mackay Medical College, New Taipei 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei 251, Taiwan
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu 300, Taiwan
- Correspondence: ; Tel.: +886-2-2543-3535
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13
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Hung MJ, Tsai CP, Lin YH, Huang WC, Chen GD, Shen PS. Hyaluronic acid improves pain symptoms more than bladder storage symptoms in women with interstitial cystitis. Taiwan J Obstet Gynecol 2019; 58:417-422. [PMID: 31122535 DOI: 10.1016/j.tjog.2018.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 11/26/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Intravesical hyaluronic acid (HA) therapy is one of acceptable methods to treat bladder pain and storage symptoms (i.e., urgency, frequency and nocturia) of interstitial cystitis/bladder pain syndrome (IC/BPS). We aim to assess the impacts of intravesical HA on bladder pain and storage symptoms, respectively, and to investigate their associated factors in patients with IC/BPS. MATERIALS AND METHODS In this prospective, multicenter study, 103 women with refractory IC/BPS undergoing a standard protocol of intravesical HA therapy were enrolled. A pain Visual Analog Scale (VAS) and the Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI) were used to assess symptoms and bother associated with IC/BPS. The Scaled Global Response Assessment (GRA) was used to evaluate patients' perception of overall changes in bladder pain and storage symptoms, respectively, after treatment. RESULTS Mean age of participants was 43.6 ± 11.8 years. The average duration of symptoms was 5.1 ± 5.0 years. Significant improvements in pain VAS, ICSI and ICPI scores were observed after treatment. However, patients reported significantly different rates of moderate/marked improvement in bladder pain and storage symptoms (73.8% vs. 47.6%; P < 0.001) on the GRA, respectively. "Lower pain VAS score" and "reduced functional bladder capacity" were found to be the factors that adversely affected the treatment responses of bladder pain and storage symptoms, respectively, after repeated statistical analyses. CONCLUSION Bladder instillation of HA seemed more efficient in improving bladder pain than storage symptoms associated with IC/BPS. The persistence of bladder storage symptoms after treatment might result from a reduced functional bladder capacity.
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Affiliation(s)
- Man-Jung Hung
- Department of Obstetrics and Gynecology, Asia University Hospital, Taichung, Taiwan; Colleague of Medical and Health Science, Asia University, Taichung, Taiwan.
| | - Ching-Pei Tsai
- Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Hao Lin
- Division of Urogynecology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wen-Chu Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Nursing, Mackay, Medicine, Nursing and Management College, Taipei, Taiwan
| | - Gin-Den Chen
- Department of Obstetrics and Gynecology, Chung Shan Medical University School of Medicine, Taichung, Taiwan
| | - Pao-Sheng Shen
- Department of Statistics, Tunghai University, Taichung, Taiwan
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14
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Lau HH, Enkhtaivan S, Su TH, Huang WC. The Outcome of a Single-Incision Sling versus Trans-Obturator Sling in Overweight and Obese Women with Stress Urinary Incontinence at 3-Year Follow-Up. J Clin Med 2019; 8:jcm8081099. [PMID: 31349577 PMCID: PMC6723533 DOI: 10.3390/jcm8081099] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Being overweight or obese is a risk factor for incontinence and has negative impacts on the surgical outcomes. Compared with trans-obturator sling (TOS), single incision sling (SIS) is a new generation of anti-incontinence surgery. However, the data on SIS in overweight and obese women remains limited. Methods: This retrospective study analyzed the objective and subjective cure rate of overweight and obese women who underwent sling surgeries. Other evaluations included valid questionnaires to assess quality of life and 1-hour pad test to quantify urine leakage. Surgical characteristics and adverse events were also analyzed. Results: A total of 217 patients were analyzed with a median follow-up period of 37.3 months (range, 9–84 months). For overweight and obese patients, the objective and subjective cure rate were comparable (all p > 0.05). However, the SIS group had worse post-operative incontinence-related symptom distress (p < 0.001) and 1-hour pad test (p = 0.047). On the other hand, SIS had a shorter surgery time (p = 0.017) and lower pain score (p < 0.001). Conclusions: Compared with TOS, SIS had non-significant cure rates in the overweight and obese women. SIS had worse urine leakage and incontinence symptoms, but less surgical and wound pain in obese women. Thorough pre-operative counseling is necessary.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City 251, Taiwan
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu 300, Taiwan
| | | | - Tsung-Hsien Su
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan
- Mackay Medicine, Nursing and Management College, New Taipei City 251, Taiwan
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu 300, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan.
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei 104, Taiwan.
- Mackay Medicine, Nursing and Management College, New Taipei City 251, Taiwan.
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15
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Cacciamani GE, Shakir A, Tafuri A, Gill K, Han J, Ahmadi N, Hueber PA, Gallucci M, Simone G, Campi R, Vignolini G, Huang WC, Taylor J, Becher E, Van Leeuwen FWB, Van Der Poel HG, Velet LP, Hemal AK, Breda A, Autorino R, Sotelo R, Aron M, Desai MM, De Castro Abreu AL. Best practices in near-infrared fluorescence imaging with indocyanine green (NIRF/ICG)-guided robotic urologic surgery: a systematic review-based expert consensus. World J Urol 2019; 38:883-896. [PMID: 31286194 DOI: 10.1007/s00345-019-02870-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [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: 05/15/2019] [Accepted: 07/03/2019] [Indexed: 01/06/2023] Open
Abstract
PURPOSE The aim of the present study is to investigate the impact of the near-infrared (NIRF) technology with indocyanine green (ICG) in robotic urologic surgery by performing a systematic literature review and to provide evidence-based expert recommendations on best practices in this field. METHODS All English language publications on NIRF/ICG-guided robotic urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus® and Web of Science™ databases (up to April 2019). Experts in the field provided detailed pictures and intraoperative video-clips of different NIRF/ICG-guided robotic surgeries with recommendations for each procedure. A unique QRcode was generated and linked to each underlying video-clip. This new exclusive feature makes the present the first "dynamic paper" that merges text and figure description with their own video providing readers an innovative, immersive, high-quality and user-friendly experience. RESULTS Our electronic search identified a total of 576 papers. Of these, 36 studies included in the present systematic review reporting the use of NIRF/ICG in robotic partial nephrectomy (n = 13), robotic radical prostatectomy and lymphadenectomy (n = 7), robotic ureteral re-implantation and reconstruction (n = 5), robotic adrenalectomy (n = 4), robotic radical cystectomy (n = 3), penectomy and robotic inguinal lymphadenectomy (n = 2), robotic simple prostatectomy (n = 1), robotic kidney transplantation (n = 1) and robotic sacrocolpopexy (n = 1). CONCLUSION NIRF/ICG technology has now emerged as a safe, feasible and useful tool that may facilitate urologic robotic surgery. It has been shown to improve the identification of key anatomical landmarks and pathological structures for oncological and non-oncological procedures. Level of evidence is predominantly low. Larger series with longer follow-up are needed, especially in assessing the quality of the nodal dissection and the feasibility of the identification of sentinel nodes and the impact of these novel technologies on long-term oncological and functional outcomes.
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Affiliation(s)
- Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - A Shakir
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Tafuri
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Urology, University of Verona, Verona, Italy
| | - K Gill
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J Han
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - N Ahmadi
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Uro-Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - P A Hueber
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Gallucci
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - G Simone
- Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy
| | - R Campi
- Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - G Vignolini
- Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - W C Huang
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, USA
| | - J Taylor
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, USA
| | - E Becher
- Division of Urologic Oncology, Department of Urology, NYU Langone Health, New York, USA
| | - F W B Van Leeuwen
- Department of Urology, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Interventional Molecular Imaging Laboratory, Leiden University Medical center, Leiden, The Netherlands.,Orsi Academy, Melle, Belgium
| | - H G Van Der Poel
- Department of Urology, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - L P Velet
- Department of Urology, Wake Forest University, Winston-Salem, NC, USA
| | - A K Hemal
- Department of Urology, Wake Forest University, Winston-Salem, NC, USA
| | - A Breda
- Fundació Puigvert, Department of Urology, Autonomous University of Barcelona, Barcelona, Spain
| | - R Autorino
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA
| | - R Sotelo
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M Aron
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - M M Desai
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A L De Castro Abreu
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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16
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Liao SC, Huang WC, Su TH, Lau HH. Changes in Female Sexual Function After Vaginal Mesh Repair Versus Native Tissue Repair for Pelvic Organ Prolapse: A Meta-Analysis of Randomized Controlled Trials. J Sex Med 2019; 16:633-639. [PMID: 30926518 DOI: 10.1016/j.jsxm.2019.02.016] [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: 10/03/2018] [Revised: 02/15/2019] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
AIM To evaluate changes in female sexual function after transvaginal mesh (TVM) repair versus native tissue repair for pelvic organ prolapse. METHODS Eligible studies, published through November 2017, were retrieved through searches of ClinicalTrials.gov, MEDLINE, Embase, and Cochrane Review databases and associated bibliographies. We included randomized control trials of transvaginal prolapse surgery with either mesh repair or native tissue repair regarding the outcomes of sexual function, de novo and postoperative dyspareunia with a minimum of 3 months of follow-up. RESULTS Seventeen trials including 2,976 patients (1,488 with TVM repair and 1,488 with native tissue repair) were identified. There was no significant difference in postoperative dyspareunia after TVM repair versus native tissue repair (risk ratio [RR] = 1.07; 95% confidence interval [CI] = 0.76-1.50). Likewise, there was no significant difference in de novo dyspareunia after TVM repair versus native tissue repair (RR = 0.91; 95% CI = 0.52-1.61). There was also no significant difference in the short form Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire score after TVM mesh repair versus native tissue repair (mean difference = 0.26; 95% CI = -1.34 to 1.85). CONCLUSION Sexual function and de novo and postoperative dyspareunia were similar between the patients who underwent TVM repair and those who underwent native tissue repair. Liao S-C, Huang W-C, Su T-H, et al. Changes in Female Sexual Function After Vaginal Mesh Repair Versus Native Tissue Repair for Pelvic Organ Prolapse: A Meta-Analysis of Randomized Controlled Trials. J Sex Med 2019;16:633-639.
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Affiliation(s)
- Sao-Chun Liao
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu City, Taiwan
| | - Wen-Chu Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, New Taipei City, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan
| | - Tsung-Hsien Su
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, New Taipei City, Taiwan; Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu City, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan
| | - Hui-Hsuan Lau
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, New Taipei City, Taiwan; Mackay Medical College, New Taipei City, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan.
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Wang YL, Weng SS, Huang WC. First-trimester abortion complicated with placenta accreta: A systematic review. Taiwan J Obstet Gynecol 2019; 58:10-14. [DOI: 10.1016/j.tjog.2018.11.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2018] [Indexed: 11/28/2022] Open
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18
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Huang MC, Huang WC, Hsieh CH, Kuo TC, Lee MS. Work hours of employed obstetricians in Taiwan. Taiwan J Obstet Gynecol 2018; 57:801-805. [DOI: 10.1016/j.tjog.2018.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2018] [Indexed: 11/29/2022] Open
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Sung PH, Huang WC, Wu CJ, Yip HK. P3427Intra-coronary administration of tacrolimus improves myocardial perfusion and LV function in patients with ST-segment elevation myocardial infarction undergoing primary coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3427] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P H Sung
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
| | - W C Huang
- Kaohsiung Veterans General Hospital, Department of Critical Care Medicine, Kaohsiung, Taiwan ROC
| | - C J Wu
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
| | - H K Yip
- Chang Gung Memorial Hospital Kaohsiung, Division of Cardiology, Department of Internal Medicine, Kaohsiung, Taiwan ROC
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Huang WC, Lau HH, Su TH. Did surgical failure and complications affect incontinence-related quality of life in women after transobturator sling procedure? Taiwan J Obstet Gynecol 2018; 57:295-299. [DOI: 10.1016/j.tjog.2018.02.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 11/16/2022] Open
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Cheng YW, Su TH, Wang H, Huang WC, Lau HH. Risk factors and management of vaginal mesh erosion after pelvic organ prolapse surgery. Taiwan J Obstet Gynecol 2017; 56:184-187. [PMID: 28420505 DOI: 10.1016/j.tjog.2016.02.021] [Citation(s) in RCA: 14] [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] [Accepted: 02/25/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Mesh erosion is a serious and not uncommon complication in women undergoing vaginal mesh repair. We hypothesized that mesh erosion is associated with the patient's comorbidities, surgical procedures, and mesh material. The aims of this study were to identify the risk factors and optimal management for mesh erosion. MATERIALS AND METHODS All women who underwent vaginal mesh repair from 2004 to 2014 were retrospectively reviewed. Data on patients' characteristics, presenting symptoms, treatment and outcomes were collected from their medical records. RESULTS A total of 741 women underwent vaginal mesh repairs, of whom 47 had mesh erosion. The median follow-up period was 13 months (range 3-84 months). Another nine patients with mesh erosion were referred form other hospitals. Multivariate analysis revealed that concomitant hysterectomy (odds ratio 27.02, 95% confidence interval 12.35-58.82; p < 0.01) and hypertension (odds ratio 5.95, 95% confidence interval 2.43-14.49; p < 0.01) were independent risk factors for mesh erosion. Of these 56 women, 20 (36%) were successfully treated by conservative management, while 36 (64%) required subsequent surgical revision. Compared with surgery, conservative treatment was successful if the size of the erosion was smaller than 0.5 cm (p < 0.01). Six patients (17%) had recurrent erosions after primary revision, but all successfully healed after the second surgery. CONCLUSION Concomitant hysterectomy and hypertension were associated with mesh erosion. In the management of mesh erosion, conservative treatment can be tried as the first-line treatment for smaller erosions, while surgical repair for larger erosions. Recurrent erosions could happen and requires repairs several times.
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Affiliation(s)
- Yung-Wen Cheng
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Tsung-Hsien Su
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Taipei Medical University, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan
| | - Hsuan Wang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Wen-Chu Huang
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan
| | - Hui-Hsuan Lau
- Division of Urogynecology, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Taipei Medical University, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan.
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22
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Lau HH, Huang WC, Su TH. Urinary leakage during sexual intercourse among women with incontinence: Incidence and risk factors. PLoS One 2017; 12:e0177075. [PMID: 28542221 PMCID: PMC5443475 DOI: 10.1371/journal.pone.0177075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 04/21/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Coital incontinence is an under-reported disorder among women with urinary incontinence. Women seldom voluntarily report this condition, and as such, related data remains limited and is at times conflicting. AIMS AND OBJECTIVES To investigate the incidence and quality of life in women with coital incontinence and to determine associated predictors. METHODS This observational study involved 505 sexually active women attending the urogynecologic clinic for symptomatic urinary incontinence at a tertiary medical center. All of the patients were consulted about the experience of coital incontinence and completed evaluations including urodynamics, and valid questionnaires including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, the Urogenital Distress Inventory and the Incontinence Impact Questionnaire. RESULTS Of these women, 281 (56%) had coital incontinence, while 224 (44%) did not. Among women with coital incontinence, 181 (64%) had urodynamic-proven stress incontinence, 29 (10%) had mixed incontinence, and 15 (5%) had detrusor overactivity. Only 25 (9%) sought consultation for this disorder before direct questioning. Fifty percent (84/281) of the women rarely or sometimes had incontinence during coitus, while 33% (92/281) often had incontinence, and 17% (48/281) always had incontinence. The frequency of coital incontinence was not different regarding the types of incontinence (p = 0.153). Women with mixed incontinence had the worst sexual quality of life and incontinence-related symptom distress. Based on univariate analysis, higher body mass index (OR 2.47, p = 0.027), and lower maximal urethral closure pressure (≤ 30 cmH2O) (OR 4.56, p = 0.007) were possible predictors for coital incontinence. Multivariate analysis showed lower MUCP was independently significant predictors (OR3.93, p = 0.042). CONCLUSIONS The prevalence of coital intercourse in urinary incontinence women was high. Coital incontinence in these women was associated with abnormal urodynamic diagnosis and urethral dysfunction.
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Affiliation(s)
- Hui-Hsuan Lau
- Department of Medicine, Mackay Medical College; Department of Obstetrics and Gynecology, Mackay Memorial Hospital; Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Wen-Chu Huang
- Department of Medicine, Mackay Medical College; Department of Obstetrics and Gynecology, Mackay Memorial Hospital; Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Tsung-Hsien Su
- Department of Obstetrics and Gynecology, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
- * E-mail:
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Wake N, Chandarana H, Huang WC, Taneja SS, Rosenkrantz AB. Application of anatomically accurate, patient-specific 3D printed models from MRI data in urological oncology. Clin Radiol 2016; 71:610-4. [PMID: 26983650 DOI: 10.1016/j.crad.2016.02.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/09/2015] [Accepted: 02/11/2016] [Indexed: 12/31/2022]
Affiliation(s)
- N Wake
- The Center for Advanced Imaging Innovation and Research (CAI(2)R) and The Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA; The Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY, USA.
| | - H Chandarana
- The Center for Advanced Imaging Innovation and Research (CAI(2)R) and The Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - W C Huang
- The Department of Urology, Division of Urologic Oncology, New York University School of Medicine, New York, NY, USA
| | - S S Taneja
- The Department of Urology, Division of Urologic Oncology, New York University School of Medicine, New York, NY, USA
| | - A B Rosenkrantz
- The Center for Advanced Imaging Innovation and Research (CAI(2)R) and The Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
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24
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Chen CL, Chou KJ, Fang HC, Hsu CY, Huang WC, Huang CW, Huang CK, Chen HY, Lee PT. Progenitor-like cells derived from mouse kidney protect against renal fibrosis in a remnant kidney model via decreased endothelial mesenchymal transition. Stem Cell Res Ther 2015; 6:239. [PMID: 26631265 PMCID: PMC4668678 DOI: 10.1186/s13287-015-0241-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 10/01/2014] [Revised: 03/09/2015] [Accepted: 11/17/2015] [Indexed: 12/20/2022] Open
Abstract
Introduction Pathophysiological changes associated with chronic kidney disease impair angiogenic processes and increase renal fibrosis. Progenitor-like cells derived from adult kidney have been previously used to promote regeneration in acute kidney injury, even though it remained unclear whether the cells could be beneficial in chronic kidney disease (CKD). Methods In this study, we established a CKD model by five-sixths nephrectomy and mouse kidney progenitor-like cells (MKPCs) were intravenously administered weekly for 5 weeks after establishing CKD. We examined the impact of MKPCs on the progression of renal fibrosis and the potential of MKPCs to preserve the angiogenic process and prevent endothelial mesenchymal transition in vivo and in vitro. Results Our results demonstrate that the MKPCs delayed interstitial fibrosis and the progression of glomerular sclerosis and ameliorated the decline of kidney function. At 17 weeks, the treated mice exhibited lower blood pressures, higher hematocrit levels, and larger kidney sizes than the control mice. In addition, the MKPC treatment prolonged the survival of the mice with chronic kidney injuries. We observed a decreased recruitment of macrophages and myofibroblasts in the interstitium and the increased tubular proliferation. Notably, MKPC both decreased the level of vascular rarefaction and prevented endothelial mesenchymal transition (EndoMT) in the remnant kidneys. Moreover, the conditioned medium from the MKPCs ameliorated endothelial cell death under hypoxic culture conditions and prevented TGF-β-induced EndoMT through downregulation of phosphorylated Smad 3 in vitro. Conclusions MKPCs may be a beneficial treatment for kidney diseases characterized by progressive renal fibrosis. The enhanced preservation of angiogenic processes following MKPC injections may be associated with decreased fibrosis in the remnant kidney. These findings provide further understanding of the mechanisms involved in these processes and will help develop new cell-based therapeutic strategies for regenerative medicine in renal fibrosis. Electronic supplementary material The online version of this article (doi:10.1186/s13287-015-0241-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C L Chen
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - K J Chou
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - H C Fang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - C Y Hsu
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - W C Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - C W Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - C K Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - H Y Chen
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
| | - P T Lee
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, School of Medicine, National Yang-Ming University, 386 Ta-Chung 1st Rd, Kaohsiung, 813, Taiwan.
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Tsai MJ, Tsai SK, Huang MC, Liou DY, Huang SL, Hsieh WH, Huang WC, Huang SS, Cheng H. Acidic FGF promotes neurite outgrowth of cortical neurons and improves neuroprotective effect in a cerebral ischemic rat model. Neuroscience 2015; 305:238-47. [PMID: 26241340 DOI: 10.1016/j.neuroscience.2015.07.074] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [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: 03/03/2015] [Revised: 06/30/2015] [Accepted: 07/16/2015] [Indexed: 02/06/2023]
Abstract
Acidic fibroblast growth factor (aFGF) is a neurotrophic factor which is a powerful neuroprotective and neuroregenerative factor of the nervous system. Prior study had shown that levels of FGFs significantly increase following ischemic injury, reflecting a physiological protection mechanism. However, few reports demonstrated the efficacy of applying aFGF in cerebral ischemia. A recent report showed that the intranasal aFGF treatment improved neurological functional recovery; however, it did not significantly reduce the lesion size in ischemic rats. The present study examines the neuroprotective effect of aFGF on cortical neuron-glial cultures under oxygen glucose deprivation (OGD)-induced cell damage and investigates whether epidural application of slow-released aFGF could improve benefit on ischemic stroke injury in conscious rats. We used a topical application of aFGF mixed in fibrin glue, a slow-release carrier, over the peri-ischemic cortex and examined such treatment on cerebral infarction and behavioral impairments of rats subjected to focal cerebral ischemia (FCI). Results demonstrate that aFGF effectively protected cortical neuron-glial cultures from OGD-induced neuronal damage. Neurite extension from cortical neurons was significantly enhanced by aFGF, mediated through activation of AKT and ERK. In addition, topical application of fibrin glue-mixed aFGF dose-dependently reduced ischemia-induced brain infarction and improved functional restoration in ischemic stroke rats. Slow-released aFGF not only protected hippocampal and cortical cell loss but reduced microglial infiltration in FCI rats. Our results suggest that aFGF mixed in fibrin glue could prolong the protective/regenerative efficacy of aFGF to the damaged brain tissue and thus improve the functional restorative effect of aFGF.
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Affiliation(s)
- M J Tsai
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - S K Tsai
- Cheng Hsin General Hospital, Taipei, Taiwan.
| | - M C Huang
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - D Y Liou
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - S L Huang
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan.
| | - W H Hsieh
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
| | - W C Huang
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - S S Huang
- Department of Pharmacology and Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - H Cheng
- Neural Regeneration Laboratory, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Center for Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taiwan; Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Lau HH, Huang WC, Cheng YW, Wang H, Su TH. Changes in urodynamic measurements and bladder neck position after single-incision trans-vaginal mesh for pelvic organ prolapse. Int Urogynecol J 2015; 26:1629-35. [DOI: 10.1007/s00192-015-2753-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 05/26/2015] [Indexed: 11/24/2022]
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27
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Wang YL, Weng SS, Huang WC, Su TH. Laparoscopic management of ectopic pregnancies in unusual locations. Taiwan J Obstet Gynecol 2014; 53:466-70. [DOI: 10.1016/j.tjog.2014.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 10/24/2022] Open
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Huang WC, Huo L, Tian G, Qian HR, Gao XS, Qin MH, Liu JM. Multi-step magnetization of the Ising model on a Shastry-Sutherland lattice: a Monte Carlo simulation. J Phys Condens Matter 2012; 24:386003. [PMID: 22927561 DOI: 10.1088/0953-8984/24/38/386003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The magnetization behaviors and spin configurations of the classical Ising model on a Shastry-Sutherland lattice are investigated using Monte Carlo simulations, in order to understand the fascinating magnetization plateaus observed in TmB(4) and other rare-earth tetraborides. The simulations reproduce the 1/2 magnetization plateau by taking into account the dipole-dipole interaction. In addition, a narrow 2/3 magnetization step at low temperature is predicted in our simulation. The multi-step magnetization can be understood as the consequence of the competitions among the spin-exchange interaction, the dipole-dipole interaction, and the static magnetic energy.
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Affiliation(s)
- W C Huang
- Institute for Advanced Materials, South China Academy of Advanced Photonics Engineering, South China Normal University, Guangzhou 510006, People's Republic of China
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Chen KN, Cheng CA, Huang WC, Ko CT. Bonding temperature optimization and property evolution of SU-8 material in metal/adhesive hybrid wafer bonding. J Nanosci Nanotechnol 2011; 11:6969-6972. [PMID: 22103107 DOI: 10.1166/jnn.2011.4202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Bonding temperature optimization of SU-8 material for metal/adhesive hybrid bonding was investigated. The good bond quality of SU-8 adhesive can be achieved with the bonding temperature between 150 degrees C and 250 degrees C, while bond failures of SU-8 wafers are observed starting from 275 degrees C. IR transmittance spectra measurements indicate the crosslinks inside SU-8 break and further bond failure is observed due to the large decomposition of epoxy rings and phenyl in plane bending above 275 degrees C. This research provides guidelines of material selection and bonding parameters for heterogeneous integration, 3DIC and MEMS applications using metal/adhesive hybrid bonding.
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Affiliation(s)
- K N Chen
- Department of Electronics Engineering, National Chiao Tung University, Hsinchu 300, Taiwan
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Huang JY, Zhuang WZ, Huang WC, Su KW, Huang KF, Chen YF. Hybrid Q-switched Yb-doped fiber laser. Opt Express 2011; 19:9364-9370. [PMID: 21643192 DOI: 10.1364/oe.19.009364] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We investigate the performance of a hybrid Q-switched (HQS) fiber laser that is constructed with a low RF-power driven acousto-optic (AO) Q-switch and an AlGaInAs semiconductor saturable absorber. Compared to a pure passively Q-switched (PQS) fiber laser, the ratio of timing jitter to pulse period can be significantly reduced from 2% to 0.3% in the regime of far above threshold. On the other hand, the prelasing effect in a pure actively Q-switched fiber laser can be considerably improved. More importantly, the maximum pulse energy of the HQS fiber laser can be increased approximately 25% in comparison with the result of the PQS fiber laser. At a pump power of 24 W, the highest pulse energy is up to 0.56 mJ with the pulse duration of 50 ns at the repetition rate of 23 kHz.
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Affiliation(s)
- J Y Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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Wu KJ, Zhang C, Huang WC, Li LM, Ren QS. Current research of C-Sight visual prosthesis for the blind. Annu Int Conf IEEE Eng Med Biol Soc 2011; 2010:5875-8. [PMID: 21096928 DOI: 10.1109/iembs.2010.5627521] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Electrical stimulation of the optic nerve with penetrating electrode array for visual recovery had been proposed by C-Sight group. This paper presents the latest progress of various component parts of visual prosthesis, including design and testing of neural stimulator, fabrication of multi-channel flexible microelectrode array. According to the experiment data, the linearity between practical stimulator output and the setting parameters has been validated. The temporal properties of EEP evoked by optic nerve stimulation with penetrating electrodes will be introduced briefly according to in vivo electrophysiological study.
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Affiliation(s)
- K J Wu
- Department of Biomedical Engineering, Shanghai Jiao Tong University, 200240 China.
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Wang YL, Su TH, Huang WC, Weng SS. Laparoscopic management of placenta increta after late first-trimester dilation and evacuation manifesting as an unusual uterine mass. J Minim Invasive Gynecol 2011; 18:250-3. [PMID: 21354073 DOI: 10.1016/j.jmig.2010.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 10/31/2010] [Accepted: 11/02/2010] [Indexed: 12/23/2022]
Abstract
Placenta increta is a rare and potentially life-threatening complication of pregnancy. The initial symptoms are generally vaginal bleeding during difficult placental removal in the third trimester. However, placenta increta may complicate first- and early second-trimester pregnancy loss. The diagnosis may be difficult during early pregnancy because the lesion is difficult to identify. Herein is reported the case of a woman with a diagnosis of placenta increta that caused prolonged bleeding after a late first-trimester abortion and manifested as an unusual lower segment uterine mass. Management included laparoscopy, and the placental tissue was completely removed successfully and uneventfully.
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Affiliation(s)
- Yeou-Lih Wang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital and Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
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Zhuang WZ, Huang WC, Chiang PY, Su KW, Huang KF, Chen YF. Millijoule-level Yb-doped photonic crystal fiber laser passively Q-switched with AlGaInAs quantum wells. Opt Express 2010; 18:27910-27915. [PMID: 21197064 DOI: 10.1364/oe.18.027910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report on a millijoule-level Yb-doped photonic crystal fiber (PCF) laser passively Q-switched with AlGaInAs quantum wells (QWs). Three types of AlGaInAs devices with different QW numbers are fabricated to investigate the performance. With 50 groups of three AlGaInAs QWs as a saturable absorber (SA), the PCF laser generates an average power of 7.1 W with a pulse repetition rate of 6.5 kHz at a pump power of 16 W, corresponding to the pulse energy of 1.1 mJ. The maximum peak power is up to 110 kW.
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Affiliation(s)
- W Z Zhuang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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Su TH, Liu PE, Lau HH, Huang WC, Lin TY, Hsieh CH. Impact of Prolift procedure on bladder function and symptoms in women with pelvic organ prolapse. Int Urogynecol J 2010; 22:585-90. [DOI: 10.1007/s00192-010-1326-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 11/07/2010] [Indexed: 10/18/2022]
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Liu PE, Su CH, Lau HH, Chang RJ, Huang WC, Su TH. Outcome of tension-free obturator tape procedures in obese and overweight women. Int Urogynecol J 2010; 22:259-63. [DOI: 10.1007/s00192-010-1311-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 10/24/2010] [Indexed: 10/18/2022]
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Mosley PJ, Huang WC, Welch MG, Mangan BJ, Wadsworth WJ, Knight JC. Ultrashort pulse compression and delivery in a hollow-core photonic crystal fiber at 540 nm wavelength. Opt Lett 2010; 35:3589-3591. [PMID: 21042359 DOI: 10.1364/ol.35.003589] [Citation(s) in RCA: 4] [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: 05/30/2023]
Abstract
We have fabricated a bandgap-guiding hollow-core photonic crystal fiber (PCF) capable of transmitting and compressing ultrashort pulses in the green spectral region around 532 nm. When propagating subpicosecond pulses through 1 m of this fiber, we have observed soliton-effect temporal compression by up to a factor of 3 to around 100 fs. This reduces the wavelength at which soliton effects have been observed in hollow-core PCF by over 200 nm. We have used the pulses delivered at the output of the fiber to machine micrometer-scale features in copper.
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Affiliation(s)
- P J Mosley
- Centre for Photonics and Photonic Materials, Department of Physics, University of Bath, Bath, BA2 7AY, UK.
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Huang WC, Lin TY, Lau HH, Chen SS, Hsieh CH, Su TH. Outcome of transvaginal pelvic reconstructive surgery with Prolift after a median of 2 years' follow-up. Int Urogynecol J 2010; 22:197-203. [PMID: 20821308 DOI: 10.1007/s00192-010-1259-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2010] [Accepted: 08/20/2010] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS This study seeks to analyze the medium- to long-term outcome of transvaginal pelvic reconstructive surgery using the Prolift™ system for pelvic organ prolapse. METHODS Sixty-five patients who underwent pelvic floor reconstruction using Prolift™ were followed for 1 to 3 years postoperatively. Assessment included pre- and postoperative Pelvic Organ Prolapse Quantification (POP-Q) stage, Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7) scores. RESULTS The overall anatomic success rate was 97% after a median of 24.5 months and 94% for the 34 women followed for more than 2 years. POP-Q stage, UDI-6, and IIQ-7 scores all improved significantly after surgery. Complications included one bladder perforation (1.5%) and one bowel perforation (1.5%), prolonged catheterization in four patients (6%), and mesh erosion in one (2%). Eight received blood transfusion (12%). CONCLUSIONS Prolift™ surgery yielded a good anatomical outcome and satisfactory symptom improvement that appeared to be durable after 2 years.
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Affiliation(s)
- Wen-Chu Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei, 10449, Taiwan
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Lin TY, Su TH, Huang WC. Polypropylene mesh used for adjuvant reconstructive surgical treatment of advanced pelvic organ prolapse. J Obstet Gynaecol Res 2010; 36:1059-63. [DOI: 10.1111/j.1447-0756.2010.01267.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhuang WZ, Huang WC, Huang YP, Su KW, Chen YF. Passively Q-switched photonic crystal fiber laser and intracavity optical parametric oscillator. Opt Express 2010; 18:8969-8975. [PMID: 20588742 DOI: 10.1364/oe.18.008969] [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] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We report on a passively Q-switched photonic crystal fiber (PCF) laser with Cr(4+):YAG as a saturable absorber. Under a pump power of 14.2 W, the maximum pulse energy is up to 630 microJ with a pulse width of 36 ns at a repetition rate of 5.6 kHz. With an intracavity optical parametric oscillator, the passively Q-switched PCF laser is used to generate the signal wave at 1515 nm. The output pulse energy of the signal wave is found to be 140 microJ with a pulse width as short as 1.0 ns at a repetition rate of 3.3 kHz. The very short pulse width leads to the peak power up to 140 kW.
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Affiliation(s)
- W Z Zhuang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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Liang HC, Huang YJ, Huang WC, Su KW, Chen YF. High-power, diode-end-pumped, multigigahertz self-mode-locked Nd:YVO4 laser at 1342 nm. Opt Lett 2010; 35:4-6. [PMID: 20664654 DOI: 10.1364/ol.35.000004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We report on a high-power, diode-pumped, self-mode-locked laser at 1342 nm with the Kerr effect arising from large third-order nonlinearity of Nd:YVO(4) crystal. At the pump power of 10.2 W, the average output power of 1.2 W was generated with a repetition rate in the range of 2-6 GHz. The mode-locked pulse width can be smoothly varied from 11.5 to 37 ps by controlling the amount of spatial hole burning.
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Affiliation(s)
- H C Liang
- Department of Electrophysics, National Chiao Tung University, 1001 TA Hsueh Rd., Hsinchu, Taiwan 30050
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Chung CC, Huang WC, Chiou KR, Lin KL, Kuo FY, Cheng CC, Hsiao SH, Liu CP. Ratio of early mitral inflow peak velocity to flow propagation velocity predicts training effects of cardiac rehabilitation in patients after acute myocardial infarction. J Rehabil Med 2010; 42:232-8. [DOI: 10.2340/16501977-0514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Su TH, Huang WC, Lee MY, Lin TY, Chang HC, Chen CP. Tension-free vaginal tape-obturator procedure for treatment of severe urodynamic stress incontinence: Subjective and objective outcomes during 2âyears of follow-up. J Obstet Gynaecol Res 2009; 35:1077-82. [DOI: 10.1111/j.1447-0756.2009.01065.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Huang JY, Zhuang WZ, Huang WC, Su KW, Hu C, Huang KF, Chen YF. Comparative studies for Cr4+:YAG crystal and AlGaInAs semiconductor used as a saturable absorber in Q-switched Yb-doped fiber lasers. Opt Express 2009; 17:20800-20805. [PMID: 19997313 DOI: 10.1364/oe.17.020800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We demonstrate comparative studies for Cr(4+):YAG crystal and AlGaInAs quantum-well (QW) used as a saturable absorbers in passively Q-switched Yb-doped fiber lasers. Both saturable absorbers were designed to be possessed of nearly the same initial transmission. Under a pump power of 24 W, the average output powers were up to 14.4 W and 13.8 W obtained with the AlGaInAs QWs and with the Cr(4+):YAG crystal, respectively. The maximum pulse energies obtained with the Cr(4+):YAG crystal and with the AlGaInAs QWs were found to be 0.35 mJ and 0.45 mJ, respectively.
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Affiliation(s)
- J Y Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan, R.O.C
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Huang WC, Su TH, Lin TY, Hsieh CH, Chen SS, Lee MY. Functional and anatomic assessments for transobturator vaginal tape inside-out operation for urodynamic stress incontinence. J Obstet Gynaecol Res 2009; 35:946-52. [DOI: 10.1111/j.1447-0756.2009.01032.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Huang JY, Huang WC, Zhuang WZ, Su KW, Chen YF, Huang KF. High-pulse-energy, passively Q-switched Yb-doped fiber laser with AlGaInAs quantum wells as a saturable absorber. Opt Lett 2009; 34:2360-2362. [PMID: 19649097 DOI: 10.1364/ol.34.002360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We demonstrate an efficient, high-pulse-energy, passively Q-switched Yb-doped fiber laser with AlGaInAs quantum wells (QWs) as a saturable absorber. The AlGaInAs QW material is designed to provide a large modulation change and a quite-low nonsaturable loss. At an incident pump power of 7.6 W, an average output power of 3.8 W, pulse energy of 300 microJ, pulse repetition rate of 12.5 kHz, and pulse duration of 30 ns was obtained.
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Affiliation(s)
- J Y Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, Taiwan
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Su TH, Lau HH, Huang WC, Chen SS, Lin TY, Hsieh CH, Yeh CY. Short term impact on female sexual function of pelvic floor reconstruction with the Prolift procedure. J Sex Med 2009; 6:3201-7. [PMID: 19627464 DOI: 10.1111/j.1743-6109.2009.01399.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The Prolift system is an effective and safe procedure using mesh reinforcement for vaginal reconstruction of pelvic organ prolapse (POP), but its effect on sexual function is unclear. AIM To evaluate the impact of transvaginal pelvic reconstruction with Prolift on female sexual function at 6 months post-operatively. METHODS Thirty-three sexually active women who underwent Prolift mesh pelvic floor reconstruction for symptomatic POP were evaluated before and 6 months after surgery. Their sexual function was assessed by using the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) before and after surgery. The quality of life was also evaluated with the short forms of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) as a control for efficacy of the procedure. The Pelvic Organ Prolapse Quantification system was used to evaluate the degree of prolapse. MAIN OUTCOME MEASURES PISQ-12 scores at 6 months post-operatively. RESULTS The total PISQ-12 score decreased from 29.5 +/- 9.0 to 19.3 +/- 14.7 (P < 0.001), indicating worsening of sexual function 6 months post-operatively. The behavioral, physical, and partner-related domains of PISQ-12 were each significantly reduced (5.2 +/- 3.7 vs. 2.9 +/- 3.7, P = 0.016; 15.4 +/- 4.7 vs. 10.4 +/- 8.6, P = 0.001; 8.9 +/- 3.8 vs. 6.4 +/- 5.5, P = 0.01, respectively). UDI-6 and IIQ-7 scores were significantly improved at the 6-month follow-up, as was anatomic recovery. Of the 33 subjects, 24 (73%) had worse sexual function 6 months after the procedure. CONCLUSION The Prolift procedure provided an effective anatomic cure of POP, but it had an adverse effect on sexual function at 6 months after surgery.
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Affiliation(s)
- Tsung-Hsien Su
- Mackay Memorial Hospital-Division of Urogynecology, Department of Obstetrics and Gynecology, Taipei, Taiwan 92, Chung-San North Road, Section 2, Taipei 104, Taiwan.
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Wang Y, Huang WC, Wang CY, Tsai CC, Chen CL, Chang YT, Kai JI, Lin CF. Inhibiting glycogen synthase kinase-3 reduces endotoxaemic acute renal failure by down-regulating inflammation and renal cell apoptosis. Br J Pharmacol 2009; 157:1004-13. [PMID: 19508392 DOI: 10.1111/j.1476-5381.2009.00284.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND PURPOSE Excessive inflammation and apoptosis are pathological features of endotoxaemic acute renal failure. Activation of glycogen synthase kinase-3 (GSK-3) is involved in inflammation and apoptosis. We investigated the effects of inhibiting GSK-3 on lipopolysaccharide (LPS)-induced acute renal failure, nuclear factor-kappaB (NF-kappaB), inflammation and apoptosis. EXPERIMENTAL APPROACH The effects of inhibiting GSK-3 with inhibitors, including lithium chloride (LiCl) and 6-bromo-indirubin-3'-oxime (BIO), on LPS-treated (15 mg x kg(-1)) C3H/HeN mice (LiCl, 40 mg x kg(-1) and BIO, 2 mg x kg(-1)) and LPS-treated (1 microg x mL(-1)) renal epithelial cells (LiCl, 20 mM and BIO, 5 microM) were studied. Mouse survival was monitored and renal function was analysed by histological and serological examination. Cytokine and chemokine production, and cell apoptosis were measured by enzyme-linked immunosorbent assay and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labelling staining, respectively. Activation of NF-kappaB and GSK-3 was determined by immunostaining and Western blotting, respectively. KEY RESULTS Mice treated with GSK-3 inhibitors showed decreased mortality, renal tubular dilatation, vacuolization and sloughing, blood urea nitrogen, creatinine and renal cell apoptosis in response to endotoxaemia. Inhibiting GSK-3 reduced LPS-induced tumour necrosis factor-alpha (TNF-alpha) and CCL5/RANTES (released upon activation of normal T-cells) in vivo in mice and in vitro in murine kidney cortical collecting duct epithelial M1 cells. Inhibiting GSK-3 did not block TNF-alpha-induced cytotoxicity in rat kidney proximal tubular epithelial NRK52E or in M1 cells. CONCLUSIONS AND IMPLICATIONS These results suggest that GSK-3 inhibition protects against endotoxaemic acute renal failure mainly by down-regulating pro-inflammatory TNF-alpha and RANTES.
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Affiliation(s)
- Y Wang
- Department of Microbiology and Immunology, National Cheng Kung University Medical College, Tainan 701, Taiwan
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Lee SY, Hung CL, Lee JH, Shih SC, Weng YL, Chang WH, Ho YH, Huang WC, Lai YL. Attaining Good End-of-Life Care in Intensive Care Units in Taiwan—The Dilemma And the Strategy. INT J GERONTOL 2009. [DOI: 10.1016/s1873-9598(09)70017-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Lin S, Chien YW, Huang WC, Li CH, Chueh CL, Chen RRL, Hsu TM, Jiang TS, Wu J, Valia KH. Transdermal Nicotine Delivery Systems: Multi-institutional Cooperative Bioequivalence Studies. Drug Dev Ind Pharm 2008. [DOI: 10.3109/03639049309050177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Huang CT, Huang WC, Shih JY, Yang PC. Primary mediastinal large B-cell lymphoma mimicking liposarcoma. Med Oncol 2007; 25:284-6. [PMID: 18066682 DOI: 10.1007/s12032-007-9032-0] [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: 10/16/2007] [Accepted: 11/19/2007] [Indexed: 11/24/2022]
Abstract
A 78-year-old man consulted for acute exacerbation of chronic obstructive pulmonary disease (COPD) and an incidental finding of an anterior mediastinal tumor on chest radiograph was noted on admission. Chest computed tomography (CT) revealed a fat-containing mediastinal mass with solid component. Mediastinal liposarcoma was the initial diagnosis based on image characteristics but histopathologic examination of the excised tumor revealed lymphoma infiltration of the mediastinal adipose tissue. To our knowledge, this is the first case report of lymphomatous growth in mediastinal lipomatosis.
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Affiliation(s)
- C T Huang
- Department of Internal Medicine, Division of Pulmonary Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Rd, Taipei 100, Taiwan
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