Subjects -> MEDICAL SCIENCES (Total: 8642 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (218 journals)
    - ANAESTHESIOLOGY (120 journals)
    - CARDIOVASCULAR DISEASES (338 journals)
    - CHIROPRACTIC, HOMEOPATHY, OSTEOPATHY (21 journals)
    - COMMUNICABLE DISEASES, EPIDEMIOLOGY (234 journals)
    - DENTISTRY (293 journals)
    - DERMATOLOGY AND VENEREOLOGY (164 journals)
    - EMERGENCY AND INTENSIVE CRITICAL CARE (121 journals)
    - ENDOCRINOLOGY (150 journals)
    - FORENSIC SCIENCES (42 journals)
    - GASTROENTEROLOGY AND HEPATOLOGY (188 journals)
    - GERONTOLOGY AND GERIATRICS (138 journals)
    - HEMATOLOGY (157 journals)
    - HYPNOSIS (4 journals)
    - INTERNAL MEDICINE (174 journals)
    - LABORATORY AND EXPERIMENTAL MEDICINE (99 journals)
    - MEDICAL GENETICS (58 journals)
    - MEDICAL SCIENCES (2392 journals)
    - NURSES AND NURSING (364 journals)
    - OBSTETRICS AND GYNECOLOGY (207 journals)
    - ONCOLOGY (384 journals)
    - OPHTHALMOLOGY AND OPTOMETRY (140 journals)
    - ORTHOPEDICS AND TRAUMATOLOGY (170 journals)
    - OTORHINOLARYNGOLOGY (83 journals)
    - PATHOLOGY (100 journals)
    - PEDIATRICS (275 journals)
    - PHYSICAL MEDICINE AND REHABILITATION (158 journals)
    - PSYCHIATRY AND NEUROLOGY (833 journals)
    - RADIOLOGY AND NUCLEAR MEDICINE (192 journals)
    - RESPIRATORY DISEASES (104 journals)
    - RHEUMATOLOGY (79 journals)
    - SPORTS MEDICINE (81 journals)
    - SURGERY (406 journals)
    - UROLOGY, NEPHROLOGY AND ANDROLOGY (155 journals)

MEDICAL SCIENCES (2392 journals)            First | 3 4 5 6 7 8 9 10 | Last

Showing 1201 - 1400 of 3562 Journals sorted alphabetically
Journal of Foot and Ankle Research     Open Access   (Followers: 5)
Journal of Forensic Science and Research     Open Access   (Followers: 2)
Journal of Gandaki Medical College-Nepal     Open Access  
Journal of Generic Medicines     Hybrid Journal   (Followers: 2)
Journal of Geographical Sciences     Hybrid Journal   (Followers: 1)
Journal of Global Antimicrobial Resistance     Hybrid Journal   (Followers: 3)
Journal of Hand Therapy     Hybrid Journal   (Followers: 18)
Journal of Head & Neck Physicians and Surgeons     Open Access   (Followers: 2)
Journal of Health & Medical Informatics     Open Access   (Followers: 61)
Journal of Health and Biological Sciences     Open Access   (Followers: 1)
Journal of Health Design     Open Access   (Followers: 1)
Journal of Health Economics and Outcomes Research     Open Access   (Followers: 1)
Journal of Health Promotion and Behavior     Open Access  
Journal of Health Research and Reviews     Open Access  
Journal of Health Science and Medical Research     Open Access  
Journal of Health Science Research     Open Access  
Journal of Health Sciences     Open Access   (Followers: 1)
Journal of health sciences     Open Access  
Journal of Health Sciences / Sağlık Bilimleri Dergisi     Open Access  
Journal of Health Sciences and Medicine     Open Access  
Journal of Health Sciences and Medicine     Open Access   (Followers: 2)
Journal of Health Sciences and Surveillance System     Open Access  
Journal of Health Sciences Scholarship     Open Access  
Journal of Health Specialties     Open Access  
Journal of Health Studies     Open Access  
Journal of Healthcare Informatics Research     Hybrid Journal   (Followers: 1)
Journal of Heavy Metal Toxicity and Diseases     Open Access  
Journal of Helminthology     Hybrid Journal   (Followers: 2)
Journal of Herbs Spices & Medicinal Plants     Hybrid Journal  
Journal of HIV for Clinical and Scientific Research     Open Access   (Followers: 2)
Journal of Hospital Medicine     Hybrid Journal   (Followers: 10)
Journal of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal  
Journal of Human Hypertension     Hybrid Journal   (Followers: 3)
Journal of Human Rhythm     Open Access  
Journal of Human Transcriptome     Open Access  
Journal of Ideas in Health     Open Access  
Journal of Inflammation     Open Access   (Followers: 2)
Journal of Inflammation Research     Open Access  
Journal of Injury and Violence Research     Open Access   (Followers: 7)
Journal of Innovation in Health Informatics     Open Access   (Followers: 17)
Journal of Institute of Medicine     Open Access  
Journal of Insulin Resistance     Open Access   (Followers: 1)
Journal of Interactional Research in Communication Disorders     Hybrid Journal   (Followers: 5)
Journal of Interferon & Cytokine Research     Hybrid Journal   (Followers: 3)
Journal of International Medical Research     Open Access   (Followers: 4)
Journal of Interventional Medicine     Open Access   (Followers: 1)
Journal of Investigative Medicine     Hybrid Journal   (Followers: 3)
Journal of Islamabad Medical & Dental College     Open Access   (Followers: 1)
Journal of Istanbul Faculty of Medicine     Open Access  
Journal of Karnali Academy of Health Sciences     Open Access   (Followers: 1)
Journal of Kathmandu Medical College     Open Access   (Followers: 1)
Journal of King Abdulaziz University : Medical Sciences     Open Access   (Followers: 2)
Journal of Laboratory Medicine     Hybrid Journal   (Followers: 27)
Journal of Laryngology and Voice     Open Access   (Followers: 11)
Journal of Lasers in Medical Sciences     Open Access  
Journal of Law, Medicine & Ethics     Hybrid Journal   (Followers: 24)
Journal of Legal Medicine     Hybrid Journal   (Followers: 7)
Journal of Limb Lengthening & Reconstruction     Open Access  
Journal of Lumbini Medical College     Open Access   (Followers: 1)
Journal of Mahatma Gandhi Institute of Medical Sciences     Open Access  
Journal of Manipulative and Physiological Therapeutics     Hybrid Journal   (Followers: 6)
Journal of Manmohan Memorial Institute of Health Sciences     Open Access   (Followers: 1)
Journal of Marine Medical Society     Open Access  
Journal of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
Journal of Maternal and Child Health     Open Access  
Journal of Mechanics in Medicine and Biology     Hybrid Journal  
Journal of Medical and Biological Engineering     Hybrid Journal   (Followers: 4)
Journal of Medical and Biomedical Sciences     Open Access   (Followers: 2)
Journal of Medical Case Reports     Open Access   (Followers: 1)
Journal of Medical Cases     Open Access   (Followers: 6)
Journal of Medical Colleges of PLA     Full-text available via subscription  
Journal of Medical Disorders     Open Access  
Journal of Medical Economics     Hybrid Journal   (Followers: 8)
Journal of Medical Education and Curricular Development     Open Access   (Followers: 6)
Journal of Medical Ethics     Partially Free   (Followers: 25)
Journal of Medical Ethics and History of Medicine     Open Access   (Followers: 15)
Journal of Medical Humanities     Hybrid Journal   (Followers: 21)
Journal of Medical Hypotheses and Ideas     Open Access  
Journal of Medical Imaging and Health Informatics     Full-text available via subscription   (Followers: 1)
Journal of Medical Investigation and Practice     Open Access  
Journal of Medical Laboratory and Diagnosis     Open Access  
Journal of Medical Law and Ethics     Full-text available via subscription   (Followers: 15)
Journal of Medical Microbiology     Full-text available via subscription   (Followers: 6)
Journal of Medical Sciences     Open Access  
Journal of Medical Sciences     Open Access  
Journal of Medical Screening     Hybrid Journal   (Followers: 6)
Journal of Medical Signals and Sensors     Open Access   (Followers: 3)
Journal of Medical Society     Open Access  
Journal of Medical Systems     Hybrid Journal  
Journal of Medical Toxicology     Hybrid Journal   (Followers: 6)
Journal of Medical Ultrasound     Open Access   (Followers: 2)
Journal of Medicinal Botany     Open Access  
Journal of Medicinal Chemistry     Hybrid Journal   (Followers: 201)
Journal of Medicine     Open Access   (Followers: 1)
Journal of Medicine and Biomedical Research     Open Access   (Followers: 1)
Journal of Medicine and Philosophy     Hybrid Journal   (Followers: 8)
Journal of Medicine and the Person     Hybrid Journal  
Journal of Medicine in Scientific Research     Open Access  
Journal of Medicine in the Tropics     Open Access  
Journal of Medicine Research and Development     Open Access   (Followers: 3)
Journal of Medicine, Physiology and Biophysics     Open Access   (Followers: 5)
Journal of Medicines Development Sciences     Open Access   (Followers: 1)
Journal of Metabolomics & Systems Biology     Open Access   (Followers: 1)
Journal of Mind and Medical Sciences     Open Access   (Followers: 1)
Journal of Molecular Medicine     Hybrid Journal   (Followers: 11)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1)
Journal of Nanotechnology in Engineering and Medicine     Full-text available via subscription   (Followers: 6)
Journal of Nanotheranostics     Open Access   (Followers: 1)
Journal of Natural Medicines     Hybrid Journal  
Journal of Natural Science, Biology and Medicine     Open Access   (Followers: 3)
Journal of Nature and Science of Medicine     Open Access   (Followers: 4)
Journal of Negative and No Positive Results     Open Access  
Journal of Nepalgunj Medical College     Open Access  
Journal of Neurocritical Care     Open Access  
Journal of Neurodegenerative Diseases     Open Access   (Followers: 2)
Journal of Neurorestoratology     Open Access  
Journal of Neuroscience and Neurological Disorders     Open Access  
Journal of Nobel Medical College     Open Access  
Journal of Obesity and Bariatrics     Open Access   (Followers: 1)
Journal of Occupational Health     Open Access  
Journal of Occupational Therapy Education     Open Access   (Followers: 10)
Journal of Ocular Biology, Diseases, and Informatics     Hybrid Journal  
Journal of Oral Biology and Craniofacial Research     Full-text available via subscription  
Journal of Oral Health and Craniofacial Science     Open Access  
Journal of Orofacial Sciences     Open Access  
Journal of Otorhinolaryngology, Hearing and Balance Medicine     Open Access   (Followers: 1)
Journal of Ovarian Research     Open Access  
Journal of Ozone Therapy     Open Access  
Journal of Palliative Medicine     Hybrid Journal   (Followers: 47)
Journal of Paramedical Sciences & Rehabilitation     Open Access  
Journal of Parkinsonism and Restless Legs Syndrome     Open Access   (Followers: 2)
Journal of Parkinson’s Disease and Alzheimer’s Disease     Open Access   (Followers: 1)
Journal of Participatory Medicine     Open Access  
Journal of Patan Academy of Health Sciences     Open Access  
Journal of Pathogens     Open Access   (Followers: 1)
Journal of Patient Experience     Open Access  
Journal of Patient Safety and Risk Management     Hybrid Journal   (Followers: 2)
Journal of Patient-Centered Research and Reviews     Open Access  
Journal of Patient-Reported Outcomes     Open Access  
Journal of Periodontal Research     Hybrid Journal  
Journal of Personalized Medicine     Open Access   (Followers: 3)
Journal of Pest Science     Hybrid Journal   (Followers: 1)
Journal of Pharmaceutical Policy and Practice     Open Access   (Followers: 4)
Journal of Physiobiochemical Metabolism     Hybrid Journal   (Followers: 2)
Journal of Physiology-Paris     Hybrid Journal   (Followers: 2)
Journal of Pioneering Medical Sciences     Open Access  
Journal of Postgraduate Medicine     Open Access  
Journal of Pregnancy     Open Access   (Followers: 4)
Journal of Prevention & Intervention Community     Hybrid Journal   (Followers: 6)
Journal of Preventive Medicine and Public Health     Open Access  
Journal of Primary Prevention     Hybrid Journal   (Followers: 7)
Journal of Prosthodontic Research     Full-text available via subscription   (Followers: 1)
Journal of Prosthodontics     Hybrid Journal   (Followers: 2)
Journal of Receptor, Ligand and Channel Research     Open Access  
Journal of Regenerative Medicine     Partially Free   (Followers: 4)
Journal of Research in Medical Sciences     Open Access   (Followers: 2)
Journal of Science and Applications : Biomedicine     Open Access   (Followers: 1)
Journal of Science and Technology (Ghana)     Open Access   (Followers: 3)
Journal of Scientific Innovation in Medicine     Open Access  
Journal of Scientific Perspectives     Open Access   (Followers: 1)
Journal of Sensory Studies     Hybrid Journal   (Followers: 4)
Journal of Shaheed Suhrawardy Medical College     Open Access  
Journal of Shoulder and Elbow Arthroplasty     Open Access  
Journal of Sleep Disorders : Treatment & Care     Hybrid Journal   (Followers: 10)
Journal of South American Earth Sciences     Hybrid Journal   (Followers: 5)
Journal of Spinal Cord Medicine     Hybrid Journal   (Followers: 4)
Journal of Spinal Disorders & Techniques     Hybrid Journal   (Followers: 2)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of Stem Cell Therapy and Transplantation     Open Access   (Followers: 1)
Journal of Stomal Therapy Australia     Full-text available via subscription  
Journal of Strength and Conditioning Research     Hybrid Journal   (Followers: 75)
Journal of Substance Use     Hybrid Journal   (Followers: 14)
Journal of Surgical Academia     Open Access   (Followers: 1)
Journal of Surgical and Clinical Research     Open Access  
Journal of Surgical Case Reports     Open Access  
Journal of Surgical Education     Full-text available via subscription   (Followers: 3)
Journal of Surgical Technique and Case Report     Open Access  
Journal of Systemic Therapies     Full-text available via subscription   (Followers: 3)
Journal of Taibah University Medical Sciences     Open Access  
Journal of Telemedicine and Telecare     Hybrid Journal   (Followers: 12)
Journal of The Academy of Clinical Microbiologists     Open Access  
Journal of the American Association for Laboratory Animal Science     Full-text available via subscription   (Followers: 7)
Journal of the American College of Certified Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American College of Clinical Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American Medical Directors Association     Hybrid Journal   (Followers: 5)
Journal of the American Medical Informatics Association : JAMIA     Hybrid Journal   (Followers: 35)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 7)
Journal of the Anatomical Society of India     Full-text available via subscription  
Journal of the Anus, Rectum and Colon     Open Access  
Journal of The Arab Society for Medical Research     Open Access  
Journal of the Australasian College of Nutritional and Environmental Medicine     Full-text available via subscription  
Journal of the Australasian Society of Aerospace Medicine     Open Access   (Followers: 1)
Journal of the Ceylon College of Physicians     Open Access  
Journal of the Chinese Medical Association     Open Access   (Followers: 2)
Journal of the College of Community Physicians of Sri Lanka     Open Access  
Journal of The Egyptian Public Health Association     Open Access   (Followers: 1)
Journal of the Formosan Medical Association     Open Access   (Followers: 2)
Journal of the Georgia Public Health Association     Open Access   (Followers: 3)
Journal of the Ghana Science Association     Full-text available via subscription   (Followers: 3)

  First | 3 4 5 6 7 8 9 10 | Last

Similar Journals
Journal Cover
Journal of the Formosan Medical Association
Journal Prestige (SJR): 0.774
Citation Impact (citeScore): 2
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0929-6646
Published by Elsevier Homepage  [3207 journals]
  • Reduction of blood pressure elevation by losartan in spontaneously
           hypertensive rats through suppression of LARG expression in vascular
           smooth muscle cells

    • Abstract: Publication date: Available online 5 April 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Wei-Chiao Chiu, Jiun-Yang Chiang, Jyh-Ming Juang, Cho-Kai Wu, Chia-Ti Tsai, Yung-Zu Tseng, Ming-Jai Su, Fu-Tien ChiangBackground/PurposeThis study sought to elucidate the mechanism by which losartan inhibits blood pressure (BP) elevation in spontaneously hypertensive rats (SHRs).MethodsFour-week-old Wistar-Kyoto (WKY) rats and SHRs were either treated with losartan (20 mg/kg/day) for 8 weeks or served as untreated controls. BP was measured by the tail-cuff method. At 12 weeks, isometric contraction of the aortic rings of the rats was evaluated with a force transducer and recorder. The mRNA and protein levels of the target Rho guanine nucleotide exchange factors (RhoGEFs), and the extent of myosin phosphatase target subunit 1 (MYPT-1) phosphorylation in the aorta, were determined using quantitative real-time polymerase chain reaction (qPCR) assay and Western blot analysis.ResultsThe BP of the four-week-old SHRs did not differ from that of the age-matched WKY rats, whereas the BP of the twelve-week-old control group SHRs was higher than that of the control group WKY rats. Losartan treatment, however, inhibited BP elevation in both rat strains, doing so to a greater extent in the treatment group SHRs. The contractile force in response to angiotensin II of the aortic rings from the SHRs treated with losartan was significantly lower than that of the aortic rings from the non-treated SHRs. The protein expression of leukemia-associated RhoGEF (LARG) was significantly higher in the non-treated SHRs compared to the non-treated WKY rats.ConclusionThe study results showed that the reduction of BP elevation by losartan in SHRs occurs through the suppression of LARG expression and MYPT-1 phosphorylation in vascular smooth muscle cells.
       
  • Role of mental health in the attitude toward same-sex marriage among
           people in Taiwan: Moderating effects of gender, age, and sexual
           orientation

    • Abstract: Publication date: Available online 3 April 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Yu-Te Huang, Mu-Hong Chen, Huei-Fan Hu, Nai-Ying Ko, Cheng-Fang YenPurposeThe aims of the study were to examine the role of mental health in peoples’ attitude toward same-sex marriage in Taiwan, as well as the moderating effects of gender, age, and sexual orientation on the association between mental health and attitude toward same-sex marriage.MethodsIn total, 3235 participants were recruited through a Facebook advertisement. Each participant completed a questionnaire assessing attitude toward same-sex marriage and a 5-item Brief Symptom Rating Scale (BSRS-5). Multiple regression analysis was performed to investigate the association between mental health and attitude toward same-sex marriage.ResultsPoor mental health was significantly associated with a low level of support for same-sex marriage. Age and sexual orientation moderated the association between mental health state and support for same-sex marriage. A significant association between poor mental health and a low level of support for same-sex marriage was observed only in older participants but not in younger participants. Moreover, a significant association between poor mental health and a low level of support for same-sex marriage was indicated only in heterosexual participants but not in non-heterosexual participants.ConclusionOur findings suggest that poor mental health was significantly associated with opposition to same-sex marriage. This relationship is more pronounced among older and heterosexual people.
       
  • Risk stratification of non-alcoholic fatty liver disease across body mass
           index in a community basis

    • Abstract: Publication date: Available online 2 April 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Jee-Fu Huang, Pei-Chien Tsai, Ming-Lun Yeh, Chung-Feng Huang, Ching-I. Huang, Meng-Hsuan Hsieh, Chia-Yen Dai, Jeng-Fu Yang, Shinn-Chern Chen, Ming-Lung Yu, Wan-Long Chuang, Wen-Yu ChangBackgroundThe features and risk analysis of non-alcoholic fatty liver disease (NAFLD) in a community-based setting remain elusive. The predictors between obese and lean subjects need further clarification. We aimed to assess the characteristics of NAFLD during a community screening. The associated metabolic abnormalities and cardiovascular risk assessment were also analyzed.MethodsA total of 2483 subjects receiving multi-purpose health screening at 10 primary care centers were recruited. They received clinical assessment, including demographic data, laboratory examination, and abdominal sonography.ResultsThe prevalence of NAFLD and metabolic syndrome were 44.5%, and 15.8%, respectively. Among those NAFLD subjects, 1212 (48.8%) subjects were obese (BMI≥ 24 kg/m2). There was an increasing trend of NAFLD according to age, ranging from 25.8% of those aged
       
  • Snakebite (Protobothrops mucrosquamatus)-related myositis

    • Abstract: Publication date: Available online 28 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Po-Hsin Lee, Yan-Chiao Mao, Po-Yu Liu, Chih-Sheng Lai, Kuo-Lung Lai
       
  • miR-1246 as a therapeutic target in oral submucosa fibrosis pathogenesis

    • Abstract: Publication date: Available online 28 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chia-Ming Liu, Yi-Wen Liao, Pei-Ling Hsieh, Chuan-Hang Yu, Pin Ju Chueh, Taichen Lin, Po-Yu Yang, Cheng-Chia Yu, Ming-Yung ChouBackground/purposeOral submucous fibrosis (OSF) is a precancerous condition of oral cancer with a complex etiology. Our previous work has demonstrated that non-coding RNA miR-1246 contributes to the cancer stemness of oral cancer. In the current study, we sought to investigate the effect of the inhibition of miR-1246 on the oral fibrogenesis.MethodsThe expression levels of miR-1246 in OSF tissues and fibrotic buccal mucosal fibroblasts (fBMFs) were examined by qRT-PCR. Collagen gel contraction and migration assays were conducted to evaluate the myofibroblast activities. The relationship between miR-1246 and type I collagen was assessed and the protein expression of type I collagen was determined by Western blot.ResultsMiR-1246 expression was upregulated in both OSF specimen and fBMFs compared to the normal counterparts. Inhibition of miR-1246 successfully suppressed the myofibroblast activities, including collagen gel contractility and migration capacity. Moreover, the expression of miR-1246 was positively correlated with type I collagen and the expression of type I collagen was abrogated by repression of miR-1246.ConclusionMiR-1246 is not only critical to the maintenance of oral stemness but also important to the activation of myofibroblasts. Our results showed that miR-1246 is positively associated with the type I collagen, which may be a downstream effector of miR-1246 and responsible for the fibrosis effect on fBMFs.
       
  • Serum indoxyl sulfate predicts adverse cardiovascular events in patients
           with chronic kidney disease

    • Abstract: Publication date: Available online 28 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Pei-Chun Fan, Jason Chih-Hsiang Chang, Chia-Ni Lin, Cheng-Chia Lee, Yi-Ting Chen, Pao-Hsien Chu, George Kou, Yueh-An Lu, Chih-Wei Yang, Yung-Chang ChenBackground/purposeIndoxyl sulfate (IS) is a protein-binding molecule that exhibits cardiovascular (CV) toxicity. This study determined whether the serum IS level can be used to predict the risk of major adverse CV events (MACEs) in patients with chronic kidney disease (CKD).MethodsWe studied 147 patients with CKD stage 1–5 over a 3-year follow-up period. IS was measured through mass spectrometry. Patients’ demographics were collected and analyzed to predict outcomes by using multivariable Cox regression.ResultsForty-seven (32.0%) patients had MACEs. IS remained significantly associated with MACEs after multivariable regression analysis. The area under the receiver operating characteristic curve for IS levels was 0.708 (95% confidence interval: 0.618–0.798).ConclusionIS may have a critical role in the prediction of CV disease in patients with CKD. Further large-scale investigations are warranted and suggested.
       
  • Major depressive episodes during pregnancy and after childbirth: A
           prospective longitudinal study in Taiwan

    • Abstract: Publication date: Available online 27 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Pan-Yen Lin, Tsan-Hung Chiu, Ming Ho, Jane Pei-Chen Chang, Cherry Hui-Chih Chang, Kuan-Pin SuBackgroundMajor depressive episodes (MDEs) are common during pregnancy and postpartum periods, and the consequences can be severe to mother and offspring. Few studies have investigated the clinical factors associated with the onset and remission of perinatal depression in different time points.MethodsA cohort of 234 pregnant women was recruited and assessed with structured Mini-International Neuropsychiatric Interview (MINI) for diagnoses of MDEs. The severity of mood status was measured with Taiwanese version of the Edinburgh Postnatal Depression Scale (EPDS-T) and the second edition of Beck Depression Inventory (BDI-II) at 16 weeks’ gestation, 28 weeks’ gestation and 4 weeks postpartum. Statistical analysis was conducted by independent t-tests, chi-squared, and Fisher’s exact tests.ResultsThirty-one pregnant women (13.2%) developed MDEs; 11 (4.7%) at the 16th week, 8 (3.4%) at the 28th week of gestation, and 12 (5.1%) at the 4th week of postpartum. Among the 19 women with prenatal MDEs, 9 (47%) experienced remission by the end of pregnancy, and 10 sustained, resulting in the cumulative prevalence of 9.4% (22 out of 234) for postpartum MDEs. Women with lower levels of education, family history of psychiatric disorders, lack of postpartum recuperation, and family-bond stress were more likely to experience MDEs. More preterm birth and lower birth weights were reported in postpartum-onset than pregnancy-onset MDEs. Psychiatric interventions were associated with a higher percentage of remission of MDE during the perinatal period.ConclusionThe findings of this study provide clinical implications for early detection and intervention of MDEs throughout the pregnancy.
       
  • Complication rates after chorionic villus sampling and midtrimester
           amniocentesis: A 7-year national registry study

    • Abstract: Publication date: Available online 27 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Wen-Wei Hsu, Chia-Jung Hsieh, Chien-Nan Lee, Chih-Ling Chen, Ming-Wei Lin, Jessica Kang, Yi-Yun Tai, Kuan-Ying Huang, Shin-Yu LinPurposeTo assess the complication rates following chorionic villus sampling (CVS) and midtrimester amniocentesis in Taiwan.MethodsThis is a national registry-based cohort study from Taiwan. We included all women with singleton pregnancies who received either CVS (n = 1409) or midtrimester amniocentesis (n = 250,566) during 2006–2012. We assessed preterm premature rupture of membranes (PPROM), intrauterine fetal demise (IUFD), infection and spontaneous abortion (SA) that occurred within fourteen days after the procedures. We also assessed the risks of preterm delivery and miscarriage before 24 gestational weeks after amniocentesis. These complications were collected from the Genetic Disease Database of the Ministry of Health and Welfare, Taiwan National Birth Certificate Registry, and the Taiwan National Health Insurance Database. Pearson χ2 tests were used to compare the distributions between groups.ResultsFor patients who underwent midtrimester amniocentesis, the rates of PPROM, IUFD, infection and SA within fourteen days were 0.24%, 0.11%, 0.05%, and 0.05%, respectively. Women with a normal fetal karyotype had a preterm birth rate (
       
  • Characterization of a p.R76H mutation in Cx50 identified in a Chinese
           family with congenital nuclear cataract

    • Abstract: Publication date: Available online 27 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Kai Jie Wang, Jin Da Wang, Dou Dou Chen, Ming Yang Wang, Bo Yun, Si Quan ZhuBackground/purposeA three-generation Chinese family with autosomal dominant congenital nuclear cataract was recruited. This study aimed to identify the disease-causing gene for nuclear cataract with functional dissections of the identified mutant.MethodsDetailed clinical data and family history were recorded. Candidate gene sequencing was performed to identify the disease-causing mutation. Recombinant connexin50 (Cx50) wild type and mutant constructs were synthesized. Triton X-100 solubility and subcellular localization of the recombinant Cx50 proteins were analyzed in HeLa cells. Apoptosis was assayed as the percentage of fragmented nuclei in transfected cells.ResultsAll affected individuals in the family displayed clear phenotypes of dense nuclear cataracts. A c.227 G > A variation was found in the coding region of Cx50, which arginine residue at position 76 was substituted by histidine (p.R76H). This mutation was co-segregated with the disease in the family, and was not observed in 110 unrelated Chinese controls. No statistically significant differences were found in the Triton X-100 solubility and apoptosis rate between wild type and mutant Cx50 in HeLa cells. However, Cx50 mutant was unable to form gap junctional plaques between adjacent cells as the wild type proteins did.ConclusionsThis study identified a novel cataract phenotype caused by the p.R76H mutation in Cx50, providing evidence of further phenotypic heterogeneity associated with this mutation. Functional analysis showed that the mutation affected the formation of gap junction channels and led to opacity in the lens.
       
  • Treatment effectiveness of levamisole plus prednisolone on oral lichen
           planus patients with emphasis on levamisole-induced agranulocytosis or
           pancytopenia

    • Abstract: Publication date: Available online 25 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Shin-Yu Lu, Tzu-Fan Chang, Chih-Jen LinBackground/PurposePhysicians' and dentists' knowledge of levamisole-induced agranulocytosis or pancytopenia remains incomplete. This study aimed to evaluate the treatment effectiveness of levamisole plus prednisolone on oral lichen planus (OLP) patients with emphasis on levamisole-induced hematological changes.MethodsNinety patients with erosive OLP were given 120 mg/day new levamisole (Levazol) and 15 mg/day prednisolone for three consecutive days each week. Three cases with levamisole-induced blood-cytopenias were assessed and treated within one year.ResultsMost patients reported significant pain relief and showed no evidence of erosive OLP after 4–8 weeks of treatment with few side effects; nevertheless, three female patients developed agranulocytosis or granulocytopenia with concomitant thrombocytopenia or pancytopenia within 2–6 weeks after levamisole (Levazol) treatment. One case with previously unknown double episodes of agranulocytosis revealed her first episode following interruption of levamisole (Decaris) treatment for 4 months. High fever and sore throat were the most common symptoms, but two agranulocytosis cases remained asymptomatic one week before diagnosis, and were treated with levamisole withdrawal and empiric antimicrobial initiation as well as utilization of granulocyte colony-stimulating factors. Neutrophil recovery took about 1 week, but over 4 weeks in one of the cases (an elderly patient) with septic shock.ConclusionAgranulocytosis or pancytopenia usually developed within 2 months after levamisole treatment, but it might be delayed. Agranulocytosis was more likely to occur in females and onset was acute. Levamisole is an effective immunomodulator for OLP patients; however, it should be used with caution and administered with regular blood monitoring.
       
  • Similarities and differences between IBS-C and FC with regards to
           symptomatology, sleep quality and psychological attributes

    • Abstract: Publication date: Available online 25 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Hung-Da Chen, Ming-Jong Bair, Wei-Chuan Chang, Ching-Sheng Hsu, Ming-Wun Wong, Jui-Sheng Hung, Tso-Tsai Liu, Chih-Hsun Yi, Wei-Yi Lei, Chien-Lin ChenBackgroundIrritable bowel syndrome (IBS) and functional constipation (FC) are highly prevalent in the general population and have significant symptom overlap, while the clinical associations and psychological links between IBS and FC remains poorly understood. We aimed to compare the clinical, metabolic and psychological factors between patients with FC patients and constipation predominated IBS.MethodsWe consecutively enrolled 360 patients from the outpatient clinics of Hualien Tzu Chi medical center. Constipation-predominant IBS (IBS-C) and FC were diagnosed based on Rome III criteria. All participants completed the Pittsburg Sleep Quality Index (PSQI) score, the State Trait Anxiety Inventory (STAI) score and the Taiwanese Depression Questionnaire (TDQ) score.ResultsFifty-four patients had FC and twenty-three patients had IBS-C. Compared to asymptomatic controls, FC/IBS-C groups had female predominance (p 
       
  • Ethnic disparity in prevalence and associated risk factors of myopia in
           adolescents

    • Abstract: Publication date: Available online 22 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Shang-Yi Chiang, Tzu-Heng Weng, Che-Min Lin, Shih-Min LinBackground/PurposeTo examine ethnic disparity in prevalence and associated factors of myopia in adolescents using the Unites States National Health and Nutrition Examination Survey (NHANES) dataset.MethodsParticipants who were aged 12–19 years were included from NHANES (1999–2008). Logistic regression analyses were applied to identify risk factors associated with myopia after stratification by race.ResultsA total of 9,960 participants were included in the prevalence analysis, and 6,571 in the risk factor analysis. Other race (excluded Mexican American, other Hispanic, non-Hispanic white, non-Hispanic black) participants had the highest frequency of myopia (42.77%). Multivariate analyses of the whole population suggested that the odds of myopia were significantly lower in participants with household smokers (odds ratio [OR] = 0.79, 95% confidence interval [CI]: 0.66–0.97), and significantly greater in Mexican American race (OR = 1.28, 95% CI: 1.01–1.62), other Hispanic (OR = 1.79, 95% CI: 1.10–2.92) and in participants with senior high school graduate education (OR = 1.79, 95% CI: 1.01–3.18), watched 2 hours of television daily (OR = 1.27, 95% CI: 1.02–1.59), used the computer for 1 hour daily (OR = 1.276, 95% CI: 1.02–1.57). When examined by race/ethnicity, 1 hour of computer use increased the odds of myopia in the non-Hispanic White group, in Mexican Americans a higher family poverty income ratio and 2 hours of television time was associated with myopia, and in the Other Hispanic group, a higher family poverty income ratio was associated with myopia, while males and those with a higher sugar had a lower risk of myopia.ConclusionsRisk factors for myopia vary with race/ethnicity.
       
  • Utility of apolipoprotein measurements in predicting incident type 2
           diabetes: A Chinese cohort study

    • Abstract: Publication date: Available online 21 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Yu-Ching Chou, San-Lin You, Chyi-Huey Bai, Yu-Chan Liao, Cheng-Yu Wei, Chien-An SunBackground/purposeThere is conflicting data regarding the utility of measuring apolipoproteins in addition to traditional lipid measures in risk assessment of cardiometabolic diseases. The aim of this study was to determine whether apolipoprotein measurements can improve the ability to predict the future development of type 2 diabetes beyond what is possible based on traditional type 2 diabetes risk factors and clinical routine lipid measurements.MethodsA total of 4,223 Chinese adults without diabetes were followed for a mean duration of 5.42 years. The hazard ratios (HRs) with 95% confidence intervals (CIs) derived from the Cox proportional hazards model were used to analyze the longitudinal associations of apolipoprotein B (apo B), apolipoprotein A-I (apo A-I), and the apo B/apo A-I ratio with the risk of type 2 diabetes. Further, the analysis of the area under receiver operating characteristics curves (AUC) was performed to test the predictive value of apolipoprotein measurements.ResultsAfter adjusting for potential confounders, the HRs of diabetes consistently showed an increasing trend across both the apo B and the apo B/apo A-I ratio quartiles (p for trend = 0.004). In analyses of AUC, the predictive ability for type 2 diabetes risk for the apo B and the apo B/apo A-I ratio was superior to that of routine lipid and lipoprotein measurements.ConclusionsApolipoprotein measurements significantly predict diabetes risk in an Asian population. Furthermore, the predictive ability of apo B alone to detect diabetes was comparable with that of the apo B/apo A-I ratio and better than the routine lipid measurements.
       
  • Role of the IL-15 system in ischemia stroke pathophysiology and
           therapeutic strategies

    • Abstract: Publication date: Available online 16 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Gilbert Aaron Lee, Nan-Shih Liao
       
  • Targeted temperature management in severe middle cerebral artery
           infarction-related out-of-hospital cardiac arrest

    • Abstract: Publication date: Available online 13 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): An-Yi Wang, Tsung-Han Wu, Yung-Ta Kao, Chun-Yao Huang
       
  • The correlation between fatty liver disease and chronic kidney disease

    • Abstract: Publication date: Available online 12 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Po-Chun Chen, Wei-Yu Kao, Yuan-Lung Cheng, Yuan-Jen Wang, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei SuBackground/purposeThe impact of non-alcoholic fatty liver disease (NAFLD) on the prevalence of chronic kidney disease (CKD) is not fully elucidated. We aimed to assess the correlation between NAFLD and CKD in a large population study.MethodsWe included consecutive subjects who had received health check-up service at Taipei Veterans General Hospital from 2002 to 2009. NAFLD was diagnosed with abdominal ultrasound, and advanced liver fibrosis was determined with NAFLD fibrosis score (NAFLD-FS). CKD was defined as estimated glomerular filtration rate (eGFR) 
       
  • Similar outcomes between vitamin K and non-vitamin K antagonist oral
           anticoagulants associated intracerebral hemorrhage

    • Abstract: Publication date: Available online 12 March 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Szu-Ju Chen, Shin-Joe Yeh, Sung-Chun Tang, Shin-Yi Lin, Li-Kai Tsai, Jiann-Shing JengBackgroundThe application of non-vitamin K antagonist oral anticoagulant (NOAC) reduces the risk of intracerebral hemorrhage (ICH) in comparison with vitamin K antagonist (VKA). However, the features and outcomes of NOAC-associated ICH are still unclear, especially for Asian populations.MethodsWe retrospectively analyzed 49 consecutive patients who had spontaneous ICH while using NOAC or VKA. We compared the clinical characteristics, ICH volume, 7-day and 3-month mortality, and functional outcomes at discharge and 3 months post-stroke using the modified Rankin Scale (mRS) between NOAC- and VKA-associated ICH. The clinical features, ICH volume, ICH location, and/or treatment methods were statistically adjusted.ResultsAmong the 49 ICH patients, 15 (30.6%) were using NOAC and 34 (69.4%) were taking VKA. There were no significant differences in the initial ICH volume between groups (mean volume 34.2 ± 43.8 vs. 59.4 ± 46.5 mL, p = 0.061). The percentage of early mortality (within 7 days post-ICH) was significantly lower in the NOAC group (13.3% vs. 44.1%; p = 0.047), but the 3-month mortality was similar (33.3% vs. 47.1%; p = 0.294). The functional outcome was equally poor in both groups at discharge (p = 0.670) and 3 months post-ICH (mean mRS score 4.7 ± 1.3 vs. 4.6 ± 1.7, p = 0.766).ConclusionsThere were no significant differences in initial ICH volume, 90-day mortality, or functional outcomes between NOAC and VKA-associated ICH in Asians.
       
  • Copyright transfer statement

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s):
       
  • Successful treatment of vertical root fracture through intentional
           replantation and root fragment bonding with 4-META/MMA-TBB resin

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Morio Okaguchi, Tienchun Kuo, Yi-Ching HoBackground/PurposeVertical root fracture (VRF) is a complication in endodontically treated teeth. This study aimed to assess the clinical outcomes of treatment of 6 VRF teeth with intentional replantation and root fragment bonding with 4-methacryloxyethyl trimellitate anhydride/methyl methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin.MethodsA series of 6 complete VRF teeth (one incisor, one canine, one premolar, and 3 M) were treated through intentional replantation and root fragment bonding with 4-META/MMA-TBB resin.ResultsThis study included 6 VRF teeth in 6 patients (one man and 5 women; mean age, 44 ± 8 years). All 6 teeth had VRF in the bucco-lingual direction and one tooth had concomitant VRF in the mesio-distal direction. The root thickness was classified as thick in all 6 teeth. Of the 6 VRF teeth, 4 had biting, percussion, or palpation pain, 4 had gingival swelling, 3 had sinus tracts, 3 had discomfort, and one had tooth mobility. Radiographically, 5 of the 6 teeth had periradicular radiolucent lesions, 4 of which exhibited complete regression and one of which exhibited nearly complete regression after root fragment bonding therapy. Because all 6 treated teeth exhibited sound function in the oral cavity after a follow-up period ranging from 33 to 74 (mean, 50 ± 15) months, the clinical outcomes were all considered to be successful.ConclusionFor a VRF tooth, in addition to tooth extraction, intentional replantation combined with root fragment bonding with 4-META/MMA-TBB resin is a successful treatment modality that can be used to preserve a complete VRF tooth.
       
  • Comorbidity profiles among patients with recurrent aphthous stomatitis: A
           case–control study

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Kuan-Chou Lin, Lo Lin Tsai, Edward Chengchuan KO, Kevin Sheng-Po Yuan, Szu-Yuan WuBackground/purposeRecurrent aphthous stomatitis (RAS) is common and associated with certain comorbidities. The aim of this study was to investigate the prevalence of selected comorbidities in patients with RAUs and to compare the risks of comorbidity between the two cohorts of patients with or without RAUs based on the Taiwanese National Health Insurance Research Database.MethodsThis case–control study included patients with recurrent aphthous stomatitis (the RAS cohort) and patients without recurrent aphthous stomatitis using 1:1 matching for year of index date, age, sex, monthly income, geographical location, and urbanization level (the non-RAS cohort). We calculated the prevalence of 31 medical comorbidities based on a modified version of the Elixhauser comorbidity index within 1 year before and after the index date. Conditional logistic regression was conducted to compare the risks of each comorbidity between the two cohorts.ResultsCompared with the non-RAS cohort, the RAS cohort had a significantly higher prevalence of 16 comorbidities, with 2% or higher prevalence difference for hyperlipidemia (2.9%), headaches (6.9%), liver diseases (2.8%), and peptic ulcers (5.4%). The adjusted odds ratios were>1.5 for headaches (1.92), migraines (1.62), hypothyroidism (1.50), rheumatoid arthritis (1.92), ankylosing spondylitis (1.94), systemic lupus erythematosus (1.82), liver diseases (1.51), peptic ulcers (1.69), hepatitis (1.62), depression (1.76), and psychoses (1.50).ConclusionPatients with recurrent aphthous stomatitis were associated with increased risk of specific comorbidities. Physicians should screen for these comorbidities for early detection and treatment.
       
  • The prospects and opportunities of age-friendly Taiwan

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Li-Ju Lin, Yu-Chang Hsu, Hsien-Wen Kuo
       
  • Highlights

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Jia-Horng Kao
       
  • Authorship statement

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s):
       
  • Guide for Authors

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s):
       
  • Noisy breathing sounds – A life-threatening cause of an infant with
           a vallecular cyst

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Fan-Yu Cheng, Ting-An Yen, En-Ting Wu, Ching-Chia Wang
       
  • Prenatal diagnosis of paternal uniparental disomy for chromosome 14 using
           

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Chih-Ling Chen, Chien-Nan Lee, Ming-Wei Lin, Wen-Wei Hsu, Yi-Yun Tai, Shin-Yu LinPaternal uniparental disomy 14 (UDP(14)pat) is a rare imprinting disorder with a set of unique neonatal clinical features documented, including craniofacial abnormalities, thoracic and abdominal wall defects, and polyhydraminos. To date, no studies focus on prenatal diagnosis of uniparental disomy have been published. We report a case of a fetus with abnormal ultrasound features at 18 weeks of gestation and normal karyotype result. Subsequent Single nucleotide polymorphism (SNP)-based Affymetrix 750K Microarray analysis revealed the complete loss of heterozygosity for chromosome 14, identifying a case of uniparental disomy. Postmortem examination of the aborted fetus at 21 weeks, coupled with further Affymetrix 750K microarray analysis on the parents, confirmed the diagnosis of parental uniparental disomy for chromosome 14.
       
  • Calycosin-7-O-β-D-glucoside reduces myocardial injury in heat stroke
           rats

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Cheng-Chia Tsai, Hsing-Hsien Wu, Ching-Ping Chang, Cheng-Hsien Lin, Hsi-Hsing YangBackground/purposeCalycosin-7-O-β-D-glucoside (CG), a calycosin derivative compound derived from Astragali Radix, has protective effect against ischemia/reperfusion injury as well as bacterial endotoxin-induced vascular cell injury. In the present study, we ascertained whether CG could reduce myocardial injury in heatstroke rats.MethodsHeat stroke was induced by exposing anaesthetized rats to heat stress (43 °C for 70 min). Rats were given an i.p. dose of CG (26.8 mg/ml/kg) or vehicle solution (ml/kg) 15 min before the start of heat stress and immediately after termination of heat stress. Left ventricular performance, myocardial injury markers in the blood, and myocardial damage scores were assessed in heat stroke rats treated with or without CG. Additionally, cardiac levels of oxidative stress and inflammatory status were estimated simultaneously.ResultsAt the time point of heat stroke onset, compared with normothermic controls, group rats with vehicle solution had significantly decreased survival rate, increased hyperthermia, decreased left ventricular stress markers, and increased cardiac damage scores. Compared with group rats with vehicle solution, group rats with CG had significantly improved survival rate, decreased hyperthermia, decreased cardiac ischemic, inflammatory, and oxidative damage.ConclusionWe thus conclude that myocardial injury can be a pressing need for the design of diagnostic and therapeutic modalities for heat stroke. In particular, our data indicate that CG protects against heat stroke in rats by mitigating myocardial injury.
       
  • Impact of type D personality on clinical outcomes in Asian patients with
           stable coronary artery disease

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Hsin-Bang Leu, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Hung-I. Yeh, Kuan- Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Jaw-Wen ChenBackgroundSome personality types are associated with cardiovascular (CV) diseases and may be related to clinical outcomes in coronary artery disease (CAD). This study investigates the association between type D personality and clinical outcomes in stable CAD patients in an Asian cohort.MethodsStable CAD patients were enrolled and prospectively followed up for at least 1 year in Taiwan. The inclusion criteria were at least one successful percutaneous coronary intervention (PCI) and stable medical treatment for at least 1 month before enrollment. Vulnerability to psychological distress was measured by the Type D Personality Scale (DS14) after enrollment. The end point was the occurrence of total CV events. Cox regression models of CV events were used to investigate the role of type D personality in clinical outcomes.ResultsThe study included 777 patients, among which 122 (15.77%) had type D personality. Forty-two CV events were identified: 3 cardiac deaths, 5 nonfatal myocardial infarctions, 1 stroke, 4 congestive heart failures (CHF), 6 peripheral arterial occlusive disorder cases, and 23 readmissions for angina/revascularization treatment. Patients with type D personality had significantly higher incidence of future CV events (9.84% vs. 4.58%, p = 0.018%) and admission for angina/revascularization (5.74% vs. 2.44%, p = 0.049). Patients with subsequent CV events were more likely to have type D personality (28.57% vs. 14.97%, p=0.018). After proportional Cox regression analysis, type D personality remained an independent predictor of future CV events (HR: 3.21, 95% CI: 1.06–9.69). In subgroup analyses, type D personality was especially associated with higher risk of total CV events among females, the elderly, hypertension patients, diabetes patients, and non-smokers.ConclusionType D personality was an independent predictor of CV outcomes in an Asian cohort of stable CAD patients. This personality type may be identified in risk stratification for secondary prevention after PCI.
       
  • The association between clinical diagnostic factors and the prevalence of
           vertical root fracture in endodontic surgery

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Wi-Kiong See, Jung-Chun Ho, Chiung-Fang Huang, Wei-Chiang Hung, Chun-Wei ChangBackground/PurposeDiagnosis of vertical root fractures (VRFs) can often be challenging due to the similarity of signs and symptoms with other common dental infectious diseases. This study was aimed at evaluating the potential relationship between VRFs and commonly used clinical diagnostic factors.Methods330 root-filled teeth with endodontic failures were subjected to endodontic microsurgery over a six-year period. VRFs were identified in 61 teeth. A randomly age- and sex-matched retrospective case-control study was conducted on a subset of 59 root-filled teeth with VRFs (cases) and 177 root-filled teeth without VRFs (controls). The strength of association between preoperative signs and radiographic findings and VRFs was evaluated using logistic regression model.ResultsSinus tract, periodontal pocket depth ≥5 mm, periodontal swelling or abscess, and radiological image of J-shaped or “halo” radiolucency were significantly more frequent in cases than in controls (p 
       
  • A single-institution study of predisposing factors of patients with BAVMs
           to flow-related aneurysm

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Wen-Yuan Yang, Chao-Bao Luo, Yuang-Seng Tsuei, Wan-Yuo Guo, Hsiu-Mei Wu, Wen-Yue ChungBackground and purposeThe goal of this study was to assess the potential risk factors leading to flow-related aneurysm (FA) formation in patients with brain arteriovenous malformations (BAVMs) in Taiwanese.MethodsWe recruited 890 patients with BAVMs: 72 had FA(s) and 818 did not. Several factors were assessed including patient's age, gender, BAVM volume and location, and Spetzler-Martin grade.ResultsThe 890 patients with BAVM had a mean age of 30 years (range: 2–84), mean BAVM volume of 10.6 mL (range: 0.13–91.4). BAVMs were ruptured in 42% of patients. Compared to BAVM patients without FAs, the 72 patients with FAs had older age (mean 41 yrs vs 31 yrs, p 
       
  • Mirabegron escalation to 50 mg further improves daily urgency and urgency
           urinary incontinence in Asian patients with overactive bladder

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Chun-Hou Liao, Hann-Chorng KuoPurposeTo investigate the efficacy and safety of mirabegron dose escalation from 25 to 50 mg in Asian patients with overactive bladder (OAB).MethodsA total of 242 patients (mean age: 67 years) with OAB were randomized to two groups: M25 (mirabegron 25 mg daily for 12 weeks) and M50 (mirabegron 25 mg daily for 4 weeks + 50 mg daily for 8 weeks). The primary endpoint was the percentage of patients without urgency or with a reduction of ≥2 in daily urgency episodes after treatment. Secondary endpoints included OAB symptom scores and other voiding parameters. Chi-squared and Wilcoxon signed-rank tests were used for data comparison.ResultsAll OAB symptom scores in both groups improved significantly at 4 and 12 weeks. Both groups showed similar numbers of patients who reached the primary endpoint after treatment (M25: 64.6%, 42/65; M50: 64.9%, 50/77; p = 0.554). Patients in the M50 group with residual daily urgency or urgency urinary incontinence (UUI) episodes after 4 weeks of mirabegron 25 mg had a significantly higher rate of reduction in daily urgency episodes (60.9% vs. 34.5%, p = 0.034) and daily UUI episodes (87.5% vs. 37.5%, p = 0.021). Adverse event (AE) rates were similar between the groups.ConclusionMirabegron 25 mg for 12 weeks and mirabegron dose escalation from 25 to 50 mg exerted similar therapeutic effects. However, the dose escalation further improved the daily urgency and UUI episodes in patients with residual urgency or UUI after the initial treatment with mirabegron 25 mg.
       
  • Multiple subependymal pseudocysts in neonates play a role in later
           attention deficit hyperactivity and autistic spectrum disorder

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Hsi Chang, Chung-Min Tsai, Chun-Yin Hou, Sung-Hui Tseng, Ju-Chin Lee, Min-Lan TsaiBackground/purposeTo assess the long-term neurodevelopmental outcome of normal-term neonates who were accidentally found to exhibit subependymal pseudocysts (SEPCs), frontal horn cysts, or choroid plexus cysts through cranial ultrasound (CUS) examination in a neonatal health examination.MethodsIn total, 5569 neonates received CUS examination as an item in a health examination during the first week of birth between 2002 and 2012. Among them, 5147 infants fulfilled the inclusion criteria. The participants were aged between 5 and 15 years at the time when the data were collected. We retrospectively collected these data and interpreted their statistical significance by using one-way analysis of variance, Chi-square test with Yate's correction and odds ratios.ResultsThe presence of SEPCs was significantly correlated with developmental delay and developmental disability, particularly with attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD). The risk of ADHD or ASD was significantly higher in participants with multiple SEPCs, among whom the odds ratios for ADHD and ASD were 6.50 (95% confidence interval [CI] = 2.27–18.64) and 28.54 (95% CI = 5.98–136.36), respectively, higher than those for the total study population.ConclusionOur data revealed multiple SEPCs in normal-term neonates as a risk factor for neurobehavioral outcome, particularly in ADHD and ASD. Simultaneously, the utility of CUS examination as a health examination item for neonates was confirmed.
       
  • The prevalence and association of patients with impaired left ventricular
           ejection fraction and complete left bundle-branch block in Taiwan

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Hui-Chun Huang, Kuo-Liong Chien, Hung-Ju Lin, Yen-Bin LiuBackground/PurposeA deleterious effect of complete left bundle-branch block (cLBBB) on left ventricular (LV) function has been established. The underutilization of cardiac resynchronization therapy has been noted in Taiwan and the Asian-Pacific area, but the reasons remain unclear. This study aimed to evaluate the prevalence and association of cLBBB and impaired LV ejection fraction (LVEF) in patients at the National Taiwan University Hospital (NTUH).MethodsWe enrolled 164,049 patients who underwent standard 12-lead electrocardiography (ECG) between January 2010 and December 2013 at NTUH. Echocardiographic examinations within one year of the index ECG were analyzed. Baseline clinical characteristics, electrocardiography and ECG parameters, in patients with cLBBB were compared among those with three different LVEFs (EF
       
  • Spectral-domain optical coherence tomography of peripheral lattice
           degeneration of myopic eyes before and after laser photocoagulation

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s): Chia-Ying Tsai, Kuo-Chi Hung, Shih-Wen Wang, Muh-Shy Chen, Tzyy-Chang HoPurposeTo investigate the microstructural characteristics of lattice degenerations before and after laser photocoagulation in myopic eyes by spectral-domain optical coherence tomography (SD-OCT).MethodsTwenty-five eyes of 25 consecutive patients at the High Myopia Clinic of the National Taiwan University Hospital were retrospectively reviewed. Myopic eyes with peripheral lattice degeneration were enrolled in the study. Best-corrected visual acuity (BCVA), axial length measurement, color fundus photography was performed. SD-OCT analyses on the lattice degeneration were performed before and after prophylactic laser photocoagulation. All patients were followed for at least 6 months.ResultsIn total, 25 myopic eyes with peripheral lattice degenerations were studied. The mean refractive error was −9.92 ± 4.77 Diopters (D) with 21 (84%) of the eye being highly myopic (Over −6.0 D). The average axial length was 27.7 ± 1.86 mm. In these myopic eyes, retinal thinning was the most common finding (92%), followed by vitreoretinal traction (72%), retinoschisis (44%), vitreous membrane with deposits (36%), and retinal break with subretinal fluid (4%). A blunting effect of the vitreoretinal tractions was found after laser photocoagulation.ConclusionTo our knowledge we firstly investigated the pre- and post-laser photocoagulation microstructural changes using SD-OCT. It demonstrated a beneficial effect of retinoplasty, which released vitreoretinal tractions after laser photocoagulation. Combined with the findings of subtle microstructural retinal breaks and subretinal fluid, early prophylactic laser treatment warrants sincere consideration in these myopic eyes.
       
  • Checklist

    • Abstract: Publication date: March 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 3Author(s):
       
  • Pitfalls in cerebrospinal fluid analysis: A case report of carcinomatous
           meningitis mimicking infective causes

    • Abstract: Publication date: Available online 28 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Leung William Chun-Yin, Leung Yu Hin Ian, Kwok Hil-Ching Hilary, Chang Richard Shek-Kwan
       
  • First report of a Mongolian family with spinocerebellar ataxia type I

    • Abstract: Publication date: Available online 28 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Munkhzaya Chuluunbat, Delgermaa Tsagaankhuu, Sung-Chun Tang, Lhamsuren Enkhsaikhan
       
  • The role of SLC9A3 in Taiwanese patients with congenital bilateral absence
           of vas deferens (CBAVD)

    • Abstract: Publication date: Available online 21 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Han-Sun Chiang, Ya-Yun Wang, Ying-Hung Lin, Yi-No WuCongenital bilateral absence of vas deferens (CBAVD) is a special entity in obstructive azoospermia. Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene are involved in Taiwanese CBAVD but most heterozygous 5T variant. The solute carrier family 9 isoform 3 (SLC9A3) is the Na+/H+ exchanger, which interacts with CFTR and regulates the Ca2+ homeostasis. Loss of SLC9A3 decreases CFTR protein and causes obstructive azoospermia in mice. It also causes mal-reabsorption by the efferent tubules, which leads to the obstructive phenomenon and eventually results in testicular atrophy. In 6-month old SLC9A3 deficiency mice, the atrophy of their vas deferens and seminal vesicles become more prominent. Decreases of CFTR expression in the reproductive organ in the SLC9A3 deficient (−/−) mice prove the interaction between CFTR and SLC9A3 in the reproductive tract. Most of Taiwanese CBAVD have at least one variant of SLC9A3 deletion and CFTR IVS8-5T, which co-contribute to Taiwanese CBAVD. The report indicates SLC9A3 deficiency can reverse the pathological changes in the gastrointestinal tract of CF mice. Further research can explore the definite mechanism of SLC9A3 and its role interacting with CFTR in different organ systems, which can contribute to novel treatment for the patients with cystic fibrosis and CBAVD.
       
  • Simultaneous auricular reconstruction and transcutaneous bone conduction
           device implantation in patients with microtia

    • Abstract: Publication date: Available online 20 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Kai-Chieh Chan, Christopher Glenn Wallace, Valerie Wai-Yee Ho, Che-Ming Wu, Hsin-Yu Chen, Zung-Chung ChenBackground/PurposeThe Bonebridge (BB) is a newly designed transcutaneous bone conduction hearing implant. We describe, for the first time, simultaneous BB implantation and different surgical techniques of auricular reconstruction for microtia patients with aural atresia/stenosis.MethodsTen patients with unilateral or bilateral microtia underwent BB implantation combined simultaneously with either total auricular reconstruction using bespoke hand-carved Medpor framework or second stage auricular projection using autologous costal cartilage framework. Auditory aided and unaided sound fields were evaluated using (1) a pure-tone average (PTA4), (2) a speech reception threshold (SRT), and (3) a Speech Discrimination Score (SDS) at a sound level of 65 dB SPL.ResultsAll patients and their families were satisfied with the aesthetic outcome of their constructed ears with no requests for further revision. No major complications were encountered. One patient developed minor partial skin graft epidermolysis that healed uneventfully, and another patient had a three month period of auditory acclimatization to the BB device that resolved. Postoperatively, the mean aided PTA4 decreased by 35.35 dB, while the SRT was 54.5 dB HL unaided and 28 dB HL with use of a BB sound processor. The SDS increased by 16.4%–65 dB SPL.ConclusionSimultaneous BB implantation during either total auricular reconstruction or framework projection for microtia patients who have aural atresia/stenosis is feasible and safe. This approach reduces operative stages, thereby minimizing schooling/occupational disruption and time to total microtia reconstruction and auditory rehabilitation.
       
  • Control and prevention of invasive pneumococcal disease in Taiwan: Current
           achievements and future challenges

    • Abstract: Publication date: Available online 15 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Wei-Ju Su, Chin-Hui Yang
       
  • Taiwan's Nationwide Cancer Registry System of 40 years: Past, present, and
           future

    • Abstract: Publication date: Available online 14 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chun-Ju Chiang, Ying-Wei Wang, Wen-Chung Lee
       
  • Cognitive impairment in patients with end-stage renal disease: Accelerated
           brain aging'

    • Abstract: Publication date: Available online 7 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Yen-Ling Chiu, Hsiu-Hui Tsai, Yen-Jun Lai, Hsin-Yi Tseng, Yen-Wen Wu, Yu-Sen Peng, Cheng-Ming Chiu, Yi-Fang ChuangBackgroundChronic kidney disease exhibits a prominent premature aging phenotype in many different organ systems, including the brain. Nevertheless, a comprehensive characterization of brain aging in non-demented patients with end-stage renal disease (ESRD) is lacking and it remains unclear if the collective changes of cognitive functions and brain structures in ESRD is compatible with aging.MethodsWe compared 56 non-demented, independently living dialysis patients (mean age 59.4 ± 11.0 years; mean dialysis vintage of 5.9 years) and 60 non-dialysis controls on a battery of neuropsychological tests, brain MRI T1 imaging and diffusion tensor imaging. Participants with diagnosis of dementia, Mini-Mental State Examination
       
  • Predisposing factors of necrotizing fasciitis with comparison to
           cellulitis in Taiwan: A nationwide population-based case–control study

    • Abstract: Publication date: Available online 6 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Tom J. Liu, Hao-Chih Tai, Kuo-Liong Chien, Nai-Chen ChengBackgroundNecrotizing fasciitis (NF) is a life-threatening soft tissue infection with low incidence that requires prompt surgery. In the initial stage, it is difficult to distinguish NF and cellulitis, and limited population-based reports are available.MethodsWe queried inpatient data sets of National Health Institute Research Database in Taiwan from 2002 to 2011 for all patients with diagnoses of NF. Of them, only patients who underwent surgeries and had been admitted to intensive care units were included as the study group. Age and gender-matched patients with admission diagnoses of cellulitis were enrolled in a ratio of 1:4 as the control group. We calculated annual incidence, mortality rate, risk factors and predictors of mortality of NF.ResultsThe study group consisted of 7391 NF patients. Among them, 4715 patients (64%) were man and 2676 (36%) were women. The overall annual incidence of NF was 3.26 hospitalizations per 100,000 person-years, which rose with age with male predominance. The in-hospital mortality rate, which also rose with age, was 32.2%. Diabetes mellitus (adjusted odds ratio, 2.93; 95% confidence interval, 2.77-3.11; P value < 0.0001), alcoholism (2.64; 2.27-3.08; P 
       
  • Gastric parietal cell and thyroid autoantibodies in patients with atrophic
           glossitis

    • Abstract: Publication date: Available online 5 February 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chun-Pin Chiang, Julia Yu-Fong Chang, Yi-Ping Wang, Yu-Hsueh Wu, Yang-Che Wu, Andy SunBackground/PurposeGastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) are organ-specific autoantibodies. This study mainly assessed the frequencies of presence of serum GPCA, TGA, and TMA in atrophic glossitis (AG) patients.MethodsSerum GPCA, TGA, and TMA levels were measured in 1064 AG patients and in 532 age- and sex-matched healthy control subjects.ResultsWe found that 26.7%, 28.4%, and 29.8% of 1064 AG patients and 2.3%, 2.1%, and 2.6% of 532 healthy control subjects had the serum GPCA, TGA, and TMA positivities, respectively. AG patients had a significantly higher frequency of GPCA, TGA, or TMA positivity than healthy control subjects (all P-values 
       
  • Guide for Authors

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s):
       
  • Association of coffee consumption and liver fibrosis progression in
           patients with HBeAg-negative chronic hepatitis B: A 5-year
           population-based cohort study

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Chien-Lin Chen, Wei-Chuan Chang, Chih-Hsun Yi, Jui-Sheng Hung, Tso-Tsai Liu, Wei-Yi Lei, Ching-Sheng HsuBackground/PurposeAlthough coffee consumption has been associated with decreased risk of liver fibrosis progression, cirrhosis or hepatocellular carcinoma in patients with HCV infection or fatty liver diseases, its effect on hepatitis B patients remains unclear. We aimed to examine the effect of coffee consumption on liver fibrosis progression and cirrhosis-related complications in patients with chronic HBV infection.MethodsCoffee consumption was assessed in 2604 participants who were previously recruited from a population-based GERD survey. The primary endpoints of this study were the impact of coffee consumption on the development of cirrhosis-related complications, including liver cirrhosis, esophageal varices, or hepatocellular carcinoma at the end of 5-year follow-up. The secondary endpoints were the declines of serum predicting indices of liver fibrosis (AST/ALT, APRI, FIB-4, Hui score) or liver function tests (AST, ALT).Results328 patients with chronic HBV infection were enrolled into this study. At baseline, coffee consumption was associated with higher education level, more frequent tobacco use and normal blood pressure (p 
       
  • Comparison of two methods for idiopathic clubfoot treatment: A
           case-controlled study in Taiwan

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Chunho Chen, Ting-Ming Wang, Kuan-Wen Wu, Shier-Chieg Huang, Ken N. KuoBackground/PurposeIn last century, two distinctive methods of manipulation and casting were developed, Kite method and Ponseti method. The purpose of this study is to compare the outcomes of parallel series between two methods in one institution.MethodsFrom 2003 to 2008, two pediatric orthopedic services in one institution treated 57 patients with 88 idiopathic clubfeet. One service continued using Kite casting method consisted of 58 feet, and other service employed Ponseti casting method consisted of 30 feet. There was a minimum of 4 years follow-up.ResultsBoth groups had similar Dimeglio severity scores before treatment. Initial correction was achieved in 40 feet (69%) in the Kite group compared with 27 feet (90%) in the Ponseti group, while 19 feet (63.3%) had percutaneous Achilles tenotomy. The Ponseti method was found to have a significantly higher correction rate (p = 0.028). After a mean follow-up of 72 months, there were 29 relapses (50%) in the Kite group and 8 relapses (26.7%) in the Ponseti group with significant difference (p = 0.036). At the latest follow-up, the outcome measures were 24 feet (41.4%) good, 18 feet (31%) fair and 16 (27.6%) poor in the Kite group and 25 feet (83.3%) good, 3 feet (10%) fair and 2 feet (6.7%) poor in the Ponseti group with significant difference between two groups (p 
       
  • Cerebral blood flow in a migraine patient with fluctuated sensorineural
           hearing loss

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Jen-Tsung Lai, Sheng-Kai Huang, Tien-Chen Liu, Keh-Bin Wang
       
  • Fever and jaundice caused by hemophagocytic syndrome

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Shih-Yi Lee, Che-Wei Wu, Wen-Han Chang, Hui-Chun Ku
       
  • Public knowledge, attitudes and willingness regarding bystander
           cardiopulmonary resuscitation: A nationwide survey in Taiwan

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Edward Pei-Chuan Huang, Wen-Chu Chiang, Ming-Ju Hsieh, Hui-Chih Wang, Chih-Wei Yang, Tsung-Chien Lu, Chih-Hung Wang, Kah-Meng Chong, Chih-Hao Lin, Chan-Wei Kuo, Jen-Tang Sun, Jr-Jiun Lin, Ming-Chin Yang, Matthew Huei-Ming MaBackgroundA low bystander cardiopulmonary resuscitation (CPR) rate is one of the factors associated with low cardiac arrest survival. This study aimed to assess knowledge, attitudes, and willingness towards performing CPR and the barriers for implementation of bystander-initiated CPR.MethodsTelephone interviews were conducted using an author-designed and validated structured questionnaire in Taiwan. After obtaining a stratified random sample from the census, the results were weighted to match population data. The factors affecting bystander-initiated CPR were analysed using logistic regression.ResultsOf the 1073 respondents, half of them stated that they knew how to perform CPR correctly, although 86.7% indicated a willingness to perform CPR on strangers. The barriers to CPR performance reported by the respondents included fear of legal consequences (44%) and concern about harming patients (36.5%). Most participants expressed a willingness to attend only an hour-long CPR course. Respondents who were less likely to indicate a willingness to perform CPR were female, healthcare providers, those who had no cohabiting family members older than 65 years, those who had a history of a stroke, and those who expressed a negative attitude toward CPR.ConclusionThe expressed willingness to perform bystander CPR was high if the respondents possessed the required skills. Attempts should be made to recruit potential bystanders for CPR courses or education, targeting those respondent subgroups less likely to express willingness to perform CPR. The reason for lower bystander CPR willingness among healthcare providers deserves further investigation.
       
  • Checklist

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s):
       
  • Authorship statement

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s):
       
  • Copyright transfer statement

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s):
       
  • Blood loss and operative time associated with orthognathic surgery
           utilizing a novel navigation system in cleft lip and palate patients

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Chi-Yu Tsai, Yu-Jen Chang, Te-Ju Wu, Jui-Pin Lai, Tzu-Ying Chen, Shiu-Shiung LinPurposeThis retrospective study evaluated the volume of blood loss and operative time associated with management of nongrowing patients with cleft lip and palate (CLP) using bimaxillary orthognathic surgery (OGS) designed by a three-dimensional (3D) computer-assisted simulation and navigation for orthognathic surgery (CASNOS) system.MethodsThis study included 53 skeletal Class III nongrowing patients with unilateral CLP who underwent bimaxillary OGS using either the CASNOS protocol (n = 30) or the traditional two-dimensional (2D) method (n = 23). The skeletal parameters of jaw-bone components, the levels of hemoglobin (Hb) and hematocrit (Hct) were measured before and after surgery. The estimated blood loss and actual blood loss (ABL) were also calculated.ResultsThe two groups did not differ significantly with regard to the demographic parameters (age, gender, and body mass index), the preoperative skeletal parameters and surgical changes of jaw-bone components. The mean ABL of the CASNOS group was significantly lower than that of the control group (915.6 ± 280.5 vs. 1204.9 ± 201.0 ml, p 
       
  • Anemia, hematinic deficiencies, and hyperhomocysteinemia in gastric
           

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Chun-Pin Chiang, Julia Yu-Fong Chang, Yi-Ping Wang, Yu-Hsueh Wu, Yang-Che Wu, Andy SunBackground/PurposeApproximately 27% of atrophic glossitis (AG) patients have the serum gastric parietal cell antibody (GPCA) positivity. This study assessed whether the serum GPCA or AG itself was a significant factor causing anemia, hematinic deficiencies, and hyperhomocysteinemia in GPCA-positive AG (GPCA+AG) and GPCA-negative AG (GPCA−AG) patients.MethodsThe mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 284 GPCA+AG, 780 GPCA−AG patients, and 532 healthy control subjects.ResultsBoth 284 GPCA+AG and 780 GPCA−AG patients had significantly higher frequencies of microcytosis, macrocytosis, blood Hb, iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia than 532 healthy control subjects. Moreover, 284 GPCA+AG patients had significantly higher frequencies of macrocytosis, vitamin B12 deficiency, and hyperhomocysteinemia than 780 GPCA−AG patients. Sixty-three (22.2%) of 284 GPCA+AG patients and 139 (17.8%) of 780 GPCA−AG patients had anemia. The normocytic anemia (42.9%), pernicious anemia (34.9%), and iron deficiency anemia (15.9%) were the three most common types of anemia in the 63 anemic GPCA+AG patients. Moreover, the normocytic anemia (64.8%), iron deficiency anemia (14.4%), and thalassemia trait-induced anemia (13.7%) were the three most common types of anemia in 139 anemic GPCA−AG patients.ConclusionThe disease of AG itself is a significant factor causing anemia, hematinic deficiencies, and hyperhomocysteinemia in both GPCA+AG and GPCA−AG patients. The serum GPCA also plays a significant role in causing macrocytosis, vitamin B12 deficiency, and hyperhomocysteinemia in GPCA+AG patients.
       
  • Efficacy and safety of 12 weeks of daclatasvir, asunaprevir plus ribavirin
           for HCV genotype-1b infection without NS5A resistance-associated
           substitutions

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Ming-Lung Yu, Chao-Hung Hung, Yi-Hsiang Huang, Cheng-Yuan Peng, Chun-Yen Lin, Pin-Nan Cheng, Rong-Nan Chien, Shih-Jer Hsu, Chen-Hua Liu, Chung-Feng Huang, Chien-Wei Su, Jee-Fu Huang, Chun-Jen Liu, Jia-Horng Kao, Wan-Long Chuang, Pei-Jer Chen, Ding-Shinn ChenBackground/PurposeTreatment with daclatasvir plus asunaprevir (DCV + ASV) for 24 weeks provided a sustained virologic response (SVR) rate of over 90% in hepatitis C virus genotype 1b (HCV-1b) infected patients without non-structural 5A (NS5A) resistance-associated substitutions (RASs) at the L31 and Y93 sites. In this study, we investigated whether adding ribavirin to the DCV + ASV combination could shorten the original treatment regimen to 12 weeks without compromising the treatment efficacy for HCV-1b patients without NS5A RASs.MethodsIn the prospective, open-label, single-arm, nationwide multi-center phase III study, a total of 70 interferon-naïve or interferon-experienced HCV-1b patients without baseline L31/Y93 RASs received daclatasvir (60 mg/day) and asunaprevir (100 mg twice daily) plus weight-based ribavirin (1000–1200 mg/day) for 12 weeks, with a 12-week post-treatment follow-up. The primary end-point was the rate of undetectable HCV RNA 12 weeks post-treatment (SVR12).ResultsThe SVR12 rate was 97.1% (68/70) and 100% (68/68) in the full-analysis-set and the per-protocol population, respectively. None of the 68 patients who completed the 12-week treatment experienced relapse during post-treatment follow-up. Two patients withdrew from the study at treatment days 21 and 34 due to anorexia and fatigue, which were considered ribavirin-related and resolved post medication cessation. A total of 4 serious adverse events were reported and considered treatment-unrelated. No deaths or grade 4 adverse events requiring hospitalization was observed throughout the study.ConclusionTruncated regimen of DCV + ASV plus ribavirin for 12 weeks was highly effective and safe in HCV-1b patients without NS5A L31/Y93 RAS.
       
  • Optimization of fecal sample processing for microbiome study — The
           journey from bathroom to bench

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Wei-Kai Wu, Chieh-Chang Chen, Suraphan Panyod, Rou-An Chen, Ming-Shiang Wu, Lee-Yan Sheen, Shan-Chwen ChangAlthough great interest has been displayed by researchers in the contribution of gut microbiota to human health, there is still no standard protocol with consensus to guarantee the sample quality of metagenomic analysis. Here we reviewed existing methodology studies and present suggestions for optimizing research pipeline from fecal sample collection to DNA extraction. First, we discuss strategies of clinical metadata collection as common confounders for microbiome research. Second, we propose general principles for freshly collected fecal sample and its storage and share a DIY stool collection kit protocol based on the manual procedure of Human Microbiome Project (HMP). Third, we provide a useful information of collection kit with DNA stabilization buffers and compare their pros and cons for multi-omic study. Fourth, we offer technical strategies as well as information of novel tools for sample aliquoting before long-term storage. Fifth, we discuss the substantial impact of different DNA extraction protocols on technical variations of metagenomic analysis. And lastly, we point out the limitation of current methods and the unmet needs for better quality control of metagenomic analysis. We hope the information provided here will help investigators in this exciting field to advance their studies while avoiding experimental artifacts.
       
  • Using procalcitonin to predict acute kidney injury in septic patients:
           Caveat emptor'

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Chih-Chung Shiao, Yu-Fang Chueh, Li Yang, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure)
       
  • Highlights

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Jia-Horng Kao
       
  • Far-infrared ray radiation promotes neurite outgrowth of neuron-like
           PC12 cells through AKT1 signaling

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Jue-Long Wang, Yong-Chong Lin, Tai-Horng Young, Min-Huey ChenBackground/purposeFar-infrared (FIR) therapy is a safe and noninvasive source for medical applications. Animal study has shown the effects of FIR in promoting nerve repair. However, the cellular mechanism is not well known. Nerve growth factor (NGF) treated neuron-like PC12 cells for neurite outgrowth have been widely employed as the in vitro model for neural regeneration.MethodsIn this study, we tried to evaluate the potential of FIR in promoting neurite outgrowth and related mechanism by using NGF-treated neuron-like PC12 cells as a cellular model. We found that FIR could promote neurites outgrowth of neuron-like PC12 cells at earlier culture period.ResultsThe neurite outgrowth-enhancing effect of FIR irradiation was more obvious when lower NGF concentration (1 ng/ml and 10 ng/ml) was added into the medium. We also found that FIR had no thermal effects on culture medium. The effects of FIR in promoting neurite outgrowth were dose dependent, and higher power density of FIR provided more effects for improving neurite outgrowth. The mechanism of FIR in promoting neurite outgrowth was through AKT1 pathway.ConclusionThe effects of FIR irradiation on promoting neurite outgrowth and neural regeneration of NGF-treated neuron-like PC12 cells are dose dependent and through activation of AKT1 phosphorylation. This study provided important information for understanding the cellular mechanism of FIR in promoting neurite outgrowth and possible neural regeneration for further clinical applications.
       
  • Second victim: Malpractice disputes and quality of life among primary care
           physicians

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Elise Chia-Hui Tan, Duan-Rung ChenPurposeThe health of physicians can have a strong impact on the quality and safety of the health care they provide. Studies have shown a link between work stress, burnout, and depression. The aim of this study was to examine the association between malpractice dispute experiences and the well-being of physicians.MethodsWe conducted a cross-sectional survey to collect information about the malpractice experiences of primary care physicians in 2004. Data on sociodemographic and clinical characteristics and SF-36 measures were also collected. We used propensity score matching to estimate the association of medical malpractice experience with the general health, mental health, and vitality of physicians.ResultsAmong the 1206 primary care physicians who completed the survey (response rate of 13.4%), 25.2% reported having ever experienced a malpractice dispute. After adjustment for baseline variables, physicians who had experienced a malpractice dispute had significantly worse health-related quality of life with regard to general health [−4.85; 95% confidence interval (CI), −7.61 to −1.80; P = 0.0016], mental health (−2.68; 95% CI, −5.03 to −0.34; P = 0.0252), and vitality (−3.28; 95% CI, −6.10 to −0.47; P = 0.0224). The effects were particularly strong among physicians specializing in surgery or obstetrics and gynecology.ConclusionThe results reveal that a malpractice dispute can have a long-term negative effect on the health of physicians. Harm reduction programs for physicians involved in malpractice disputes should be implemented.
       
  • Trends, demographics, and conditions of emergency dental visits in Taiwan
           1997–2013: A nationwide population-based retrospective study

    • Abstract: Publication date: February 2019Source: Journal of the Formosan Medical Association, Volume 118, Issue 2Author(s): Shang-Ming Huang, Jing-Yang Huang, Hui-Chieh Yu, Ni-Yu Su, Yu-Chao ChangBackground/purposeThe disparate or irregular dental care was associated with acute clinical problems that may lead to care seeking for emergency visits. The aim of this study was to determine the time trends, demographics, and conditions of emergency dental (ED) visits in Taiwan.MethodsThis cross-sectional study was conducted to analyze the insurance reimbursement of dental care services in National Health Insurance Research Database. The demographic characteristics and age-period effects of ED visits were estimated by multivariate Poisson regression. In addition, the top causes of ED visits were evaluated and stratified by traumatic and non-traumatic conditions.ResultsThe prevalence of ED visits were 3.18, 5.44, and 4.83 (per 10,000 persons) in 1997, 2002, and 2013, respectively. The primary diagnosis code for ED visits was 522 ‘pulp and periapical tissues’. Pulpitis (522.0), cellulitis (528.3), acute periodontitis (523.3), and caries (521.0) were the top 4 non-traumatic reasons for seeking ED visits. The top 3 traumatic conditions were open wound of internal structures of mouth without mention of complication (873.6), open wound of face without mention of complication (873.4), and loss of teeth due to trauma (525.1). The higher prevalence of ED visits were found in male (aRR = 1.50, 95% CI: 1.49–1.51), 6 y/o group (aRR = 1.56, 95% CI: 1.53–1.59), east region (aRR = 1.27, 95% CI: 1.25–1.29), and dependent coverage group (aRR = 1.16, 95% CI: 1.14–1.19).ConclusionTaken together, these demographic data could serve as a reference for the authorities concerned to improve the current situation of ED in Taiwan.
       
  • Emergency department utilization and resuscitation rate among patients
           receiving maintenance hemodialysis

    • Abstract: Publication date: Available online 31 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Yi-Chih Lin, Hua-Kuei Hsu, Tai-Shuan Lai, Wen-Chih Chiang, Shuei-Liong Lin, Yung-Ming Chen, Chu-Chieh Chen, Tzong-Shinn ChuBackgroundEnd-stage renal disease (ESRD) is a growing global health concern with increased disease burden and high medical costs. Utilization of the emergency department (ED) among dialyzed patients and the associated risk factors remain unknown.MethodsParticipants of this study, selected from the National Health Insurance Database in Taiwan, were aged 19–90 years and received maintenance hemodialysis from January 1, 2010, to December 31, 2010. A control group consisting of individuals who did not receive dialysis, selected from the same data source, were matched for age, sex, and the Charlson Comorbidity Index (CCI). Subgroup analysis with hemodialysis frequency was also performed. ED utilization among enrolled individuals was assessed in 2012. Generalized estimating equations with multiple variable adjustments were used to identify risk factors associated with resuscitation during ED visits.ResultsOne group of 2985 individuals who received maintenance hemodialysis, and another group of 2985 patients that did not receive hemodialysis, between January 1, 2010, and December 31, 2010, were included in this study. There were 4822 ED visits in the hemodialysis group, and 1755 ED visits in the non-dialysis group between January 1, 2012, and December 31, 2012. Analysis of multivariable generalized estimating equations identified the risk associated with resuscitation during ED visits to be greater in individuals who were receiving maintenance hemodialysis, aged older than 55 years, hospitalized in the past year, and assigned first and second degree of triage.ConclusionsPatients receiving maintenance hemodialysis had higher ED utilization and a significantly higher risk of resuscitation during ED visits than those without hemodialysis.
       
  • Modulation of parietal cytokine and chemokine gene profiles by mesenchymal
           stem cell as a basis for neurotrauma recovery

    • Abstract: Publication date: Available online 30 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Cheng-Hsien Lin, Willie Lin, Yu-Chin Su, Yogi Cheng-Yo Hsuan, Yu-Chien Chen, Ching-Ping Chang, Willy Chou, Kao-Chang LinBackground & purposeFollowing traumatic brain injury (TBI), primary mechanical injury to the brain may cause blood-brain-barrier damage followed by secondary injury, ultimately culminating in cell death. We aimed to test whether one injection of mesenchymal stem cells (MSC) derived from the human umbilical cord can modulate brain cytokine and chemokine gene profiles and attenuate neurological injury in rats with TBI.MethodsOne-day post-TBI, the injured rats were treated with one injection of MSC (4 × 106/rat, i.v.). Three days later, immediately after assessment of neurobehavioral function, animals were sacrificed for analysis of neurological injury (evidenced by both brain contusion volume and neurological deficits) and parietal genes encoding 84 cytokines and chemokines in the injured brain by qPCR methods.ResultsThree days post-TBI, rats displayed both neurological injury and upgrade of 11 parietal genes in the ipsilateral brain. One set of 8 parietal genes (e.g., chemokine [C-X-C motif] ligand 12, platelet factor 4, interleukin-7, chemokine [C-C motif] ligand (CCL)19, CCL 22, secreted phosphoprotein 1, pro-platelet basic protein 1, and CCL 2) differentially upgraded by TBI was related to pro-inflammatory and/or neurodegenerative processes. Another set of 3 parietal genes up-graded by TBI (e.g., glucose-6-phosphate isomerase, bone morphogenetic protein (BMP) 2, and BMP 4) was related to anti-inflammatory/neuroregenerative events. Administration of MSC attenuated neurological injury, down-regulated these 8 parietal pro-inflammatory genes, and up-regulated these 3 parietal anti-inflammatory genes in the rats with TBI.ConclusionOur data suggest that modulation of parietal cytokines and chemokines gene profiles by MSC as a basis for neurotrauma recovery.
       
  • Integration of imaging and molecular approaches in selective fetal
           reduction in twin pregnancies with one carrying a pathogenic genomic
           aberration

    • Abstract: Publication date: Available online 29 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): W.J. Wu, L.T. Yeh, G.C. Ma, S.P. Chang, D.J. Lee, M. ChenBackground/purposeWith the evolution of assisted fertility and prenatal diagnostic technology, the prevalence of multi-fetal pregnancy increased, followed by the demand for prenatal intervention if genomic aberration was detected. How to distinguish the affected foetus from the normal co-twin before selective fetal reduction is therefore challenging.ObjectivesWe retrospectively reviewed the cases of dichorionic twins at our centre during 2004–2018, where selective fetal reduction was requested because one foetus carried a pathogenic genomic aberration. Five cases were enrolled, including three foetuses with trisomy 21, one foetus with microduplication and one foetus with microdeletion disorders.MethodWe labelled the affected foetus by prenatal ultrasound and rapid molecular tools. For the twins without discriminating sonographic features (e.g., the same gender and no distinct placentae), interphase fluorescence in situ hybridization, rapid microarray and short tandem repeat markers were applied to identify the affected foetus.ResultsSelective fetal reduction was allocated accurately for all individuals. Two cases delivered at term, while two delivered preterm, and one developed fetal loss of the co-twin.ConclusionsWe proposed a working scheme of integrating imaging and molecular techniques to correctly identify the affected co-twin before selective fetal reduction to ensure the accuracy of the identification.
       
  • Randomized controlled clinical effectiveness of adjunct 660-nm
           light-emitting diode irradiation during non-surgical periodontal therapy

    • Abstract: Publication date: Available online 29 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Yi-Wen Chen, Olivia Hsieh, Yueh-An Chen, Lan-Lin Chiou, Po-Chun ChangBackground/purposeThe irradiation of 660-nm light-emitting diodes (LEDs) has exhibited potential to accelerate oral wound healing and prevent periodontal breakdown in rodents. This study was to evaluate the clinical effectiveness of 660-nm LEDs during non-surgical periodontal therapy (NSPT).MethodsNineteen patients with at least one periodontitis-involved tooth in three quadrants received NSPT, and three protocols of LED light irradiation, including LED light irradiation from initial clinical assessment (T0) until the completion of scaling and root planning (T1) (LED01), LED light irradiation from T1 until re-evaluation (T2) (LED02), and no LED light irradiation (control treatment), were randomly assigned to respective quadrant. Clinical parameters were assessed at T0 and T2, and such biomarkers as IL-1β and MMP-8 from gingival crevicular fluid were assessed at T0, T1, and T2.ResultsAt T2, all examined sites exhibited significantly reduced probing pocket depth (PD), clinical attachment level (CAL), gingival bleeding index, plaque score, and visual analog scale. In the sites with greatest initial PD and CAL, LED01 and LED02 significantly reduced PD and CAL compared with the control treatment. IL-1β and MMP-8 were reduced in all groups at T1 and T2, and the reduction of MMP-8 was the most notable in LED01.ConclusionLED light irradiation during or after scaling and root planing assisted in the recovery of periodontium and can be used as an adjunct treatment during NSPT, specifically for sites with severe periodontal breakdown.
       
  • Reply to: “The type of dyspepsia is important in the context of patients
           with irritable bowel syndrome and gastroesophageal reflux disease”

    • Abstract: Publication date: Available online 28 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Wei-Yi Lei, Chien-Lin Chen
       
  • Successful management of type IV hypersensitivity reactions to human
           insulin analogue with injecting mixtures of biphasic insulin aspart and
           dexamethasone

    • Abstract: Publication date: Available online 28 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Wei-Lun Wen, Kun-Bow Tsai, Yi-Huei Lin, Shang-Jyh Hwang, Pi-Jung Hsiao, Shyi-Jang Shin, Wei-Wen HungAlthough hypersensitivity reaction to insulin was supposed to be less-frequent with current insulin analogue, case reports with different types of allergic reactions to insulin analogue were still reported. The most common form is type I hypersensitivity reaction with IgE-mediated. Besides, type III (IgG and IgM-mediated) and type IV (T-cell mediated delayed reaction) hypersensitivity reactions were also reported. Here we presented a long-standing type 2 diabetes with insulin requirements with hypersensitivity reactions to insulin actrapid, insulin aspart, insulin glargine, insulin detemir, and biphasic insulin aspart 30. Insulin desensitization was performed as initial management but failed as skin biopsy with immunohistochemical staining proved type IV hypersensitivity reaction. We continued with the next treatment approach using subcutaneous injection with the mixture of biphasic insulin aspart 30 and dexamethasone to alleviate allergy, and the result was successful with steroid-free biphasic insulin aspart 30 injection eight months later. Besides, the treatment effect had lasted after ten years even with switched type of insulin analogue from biphasic insulin aspart 30 to insulin glargine and insulin aspart. The case report demonstrated a good example of how clinicians deal with the rare but important questions of hypersensitivity reactions to insulin analogue.
       
  • The type of dyspepsia is important in the context of patients with
           irritable bowel syndrome and gastroesophageal reflux disease

    • Abstract: Publication date: Available online 19 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Rinaldo Pellicano
       
  • The effectiveness of music therapy for individuals with Rett syndrome and
           their families

    • Abstract: Publication date: Available online 19 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Ming-Yi Chou, Nai-Wen Chang, Chieh Chen, Wang-Tso Lee, Yi-Jung Hsin, Ka-Kit Siu, Chih-Jen Chen, Liang-Jen Wang, Pi-Lien HungBackgroundPatients with Rett syndrome (RTT) present characteristic regression in communication and hand skills, which eventually leads to intellectual and physical disability. Moreover, caregivers of patients with RTT face stressors related to patients’ medical and developmental concerns. Given the indications from case reports, this pilot study investigated the effectiveness of music therapy on RTT patients, as well as on parental stress for families of children with RTT.MethodsFamilies in the study group were enrolled in a twice-weekly 120-minute music therapy program for 24 weeks (n = 11), whereas families in the control group did not receive music therapy (n = 12). Participants were administered the Vineland Adaptive Behavior Scales, Rett Syndrome Clinical Severity Scale, Rett Syndrome Motor Behavioral Assessment, and Parenting Stress Index for caregivers of RTT children before and after the music therapy program.ResultsMusic therapy improved receptive language, verbal and non-verbal communication skills, and social interaction for RTT patients. In addition, purposeful hand function, breathing patterns, and eye contact were significantly improved. Of note, music therapy also decreased the frequency of epileptic seizures. Lastly, caregivers in the study group exhibited significantly lower stress following the program.ConclusionThe 24-week music therapy program was effective in improving social interaction, communication skills, eye contact, hand function, and reducing seizure frequency among RTT patients. Additionally, music therapy was effective in relieving parenting stress, which may help healthcare providers initiate early intervention strategies that can prevent parenting stress and reduce the risk of depression.
       
  • Early timing of single balloon enteroscopy is associated with increased
           diagnostic yield in patients with overt small bowel bleeding

    • Abstract: Publication date: Available online 17 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chia-Hung Tu, John Y. Kao, Ping-Huei Tseng, Yi-Chia Lee, Tsung-Hsien Chiang, Chien-Chuan Chen, Hsiu-Po Wang, Han-Mo Chiu, Ming-Shiang WuBackground/purposeAlthough performing balloon enteroscopy soon after the onset of small bowel bleeding appeared to enhance diagnostic rate, the optimal timing was unclear.MethodsA retrospective cohort study in a single referral center. Patients with overt, suspected small bowel bleeding who underwent primary single-balloon enteroscopy (SBE) were evaluated to determine the association between procedure timing and diagnostic yield rates.ResultsA total of 220 patients were enrolled (47.7% males; mean age, 65.6 ± 18.1 years). They were stratified into four groups based on the timing of SBE: emergency (7 days (n = 87). A significant trend of decreasing diagnostic yields was observed across the groups (90.6%, 67.9%, 68.3%, and 44.8%, respectively, P 
       
  • The relationship of anti-phospholipase A2 receptor antibody and C5a
           complement with disease activity and short-term outcome in idiopathic
           membranous nephropathy

    • Abstract: Publication date: Available online 11 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Jyun Ni Chi, Tai Shuan Lai, Ching Fang Wu, Tian Yi Fu, Yu Hsiang Chou, Yen Ling Chiu, Wei Chou Lin, Wen Chih Chiang, Yung Ming Chen, Ming Shiou WuBackgroundThe binding of anti-phospholipase A2 receptor (anti-PLA2R) antibody to podocyte and complement activation is the mechanisms of idiopathic membranous nephropathy (IMN). C5a, a complement activation end product, is a strong inflammatory cell stimulator and can influence the behavior of T cells and dendritic cells. This study examined the etiology–disease relationship and significance of auto-antibody and C5a with short-term remission.MethodPlasma anti-PLA2R antibody and C5a were measured with the blood samples that were collected when patients were admitted for renal biopsy. The deposition of IgA, IgG, IgM, C1q and C3c in glomerulus was graded according to immunofluorescence staining. The relationship of anti-PLA2R antibody with C5a, glomerular immunoglobulin and complement deposition was examined. Antibody and C5a levels as predictors of short-term remission were also examined.ResultsIn 72 IMN patients, 50 patients had positive plasma anti-PLA2R antibody. The antibody had positive correlation to proteinuria. Patients with high grade IgG or C3c, but not IgA/IgM/C1q, deposition had higher anti-PLA2R antibody titers. C5a was increased in IMN patients, but had no correlation with anti-PLA2R antibody or proteinuria. The analysis revealed that C5a, not initial anti-PLA2R antibody, was a predictor associated with 12-month remission in patients receiving immunosuppression with multivariate-adjusted OR 0.74 (95% CI, 0.58–0.94, P = 0.01).ConclusionThis study provides indirect evidences of etiology–disease relationship of anti-PLA2R antibody in IMN patients. The role of C5a, a predictor of remission, in the disease course of MN and the influences on inflammatory cells in MN patients is worth to be clarified.
       
  • Tuberculosis case finding: Supplement intensified case finding among acute
           lower respiratory infection (ALRI) hospitalized patients in Sa Kaeo
           province, Thailand

    • Abstract: Publication date: Available online 10 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Sathapana Naowarat, Chanapong Rojanaworarit, Wanwimon Surinsak, Kanjana Umain, Dara Ruadreaw, Somkid Yuenprakone, Apirak Pisutaporn, Arongrag C. MeeyaiBackground and purposeWe aimed to estimate TB prevalence among in-patients hospitalized with acute lower respiratory infection (ALRI) through a routine TB case finding approach (Patient-Initiated-Pathway, PIP) and among those without initial TB detection by PIP using a supplementary-Intensified-Case-Finding (supplementary-ICF) approach to determine the extent of active TB infection in patients enrolled in population-based surveillance in Sa Keao, Thailand. We also investigated secondary TB transmission through household contacts (HHCs).MethodsThis was a prospective cross-sectional study. Data for hospitalized patients with ALRI were obtained from population-based pneumonia surveillance. PIP was provided in ALRI patients with suspected TB infection; those without initial suspicion of TB infection were evaluated for TB by the supplementary-ICF approach. For each active TB case finding approach, index cases were identified by acid-fast-bacillus testing and the TB prevalence was estimated. HHCs of each TB index case were followed to identify the extent of secondary TB infection.ResultsTB prevalence among ALRI hospitalized patients was 12.2% among those undergoing PIP and 6.8% among those undergoing supplementary-ICF. The total number of active TB cases was doubled after implementing the supplementary-ICF method. Secondary TB infection among HHCs was 3.5 times more common for contacts of index cases identified by routine active TB case finding compared to supplementary-ICF TB.ConclusionSupplementary-ICF among ALRI hospitalizations would be expected to result in improved active TB case detection compared to the current policy of PIP. The supplementary-ICF also enhanced early case detection and showed lower prevalence of secondary infection.
       
  • Outcomes research and quality improvement for the global Asian
           populations: Opportunity for Taiwan

    • Abstract: Publication date: Available online 8 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Yu-Tien Hsu, Ya-Ching Hung, David C. Chang
       
  • Post-transplantation lymphoproliferative disease in pediatric liver
           recipients in Taiwan

    • Abstract: Publication date: Available online 8 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chien-Ting Hsu, Mei-Hwei Chang, Ming-Chih Ho, Hsiu-Hao Chang, Meng-Yao Lu, Shiann-Tarng Jou, Yen-Hsuan Ni, Huey-Ling Chen, Hong-Yuan Hsu, Jia-Feng WuBackgroundPost-transplantation lymphoproliferative disorder (PTLD) is a heterogeneous, potentially life-threatening complication after liver transplantation in children. In this study, the disease characteristics, outcomes, and prognostic factors of PTLD were investigated.MethodsA retrospective, observational study was conducted on 16 pediatric liver transplant (LT) recipients who developed PTLD between February 2001 and December 2013 at a tertiary referral center in Taiwan. The disease characteristics and treatment outcomes of the patients were analyzed.ResultsThe median time from liver transplantation to the development of PTLD was 8 months. Early onset (
       
  • Traumatic dislocation of the mandibular condyle into the middle cranial
           fossa treated by an intraoral approach

    • Abstract: Publication date: Available online 7 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): I. Chen, Chia-Ming Chang, Michael Yuan-Chien Chen, Kwei-Jing ChenDislocation of the mandibular condyle is one of several consequences of facial trauma that can be anticipated. The condylar neck is inherently weak and likely to fracture at the time of impact before dislocating into the middle cranial fossa. A review of the literature revealed that most cases of dislocation of the mandibular condyle into the middle cranial fossa are treated by open reduction and internal fixation via an extraoral approach or are treated conservatively with closed reduction. An intraoral approach is rare. Here we present a patient with traumatic dislocation of the mandibular condyle into the middle cranial fossa who was treated successfully by condylectomy and coronoidectomy through an intraoral approach and intermaxillary fixation followed by mouth-opening exercises and rehabilitation. Stable occlusion and movement of the mandible was achieved and the long-term results have been good. The intraoral approach may be an option in patients with traumatic dislocation of the mandibular condyle into the middle cranial fossa.
       
  • Transient elastography correlated with diffusion-weighted magnetic
           resonance imaging and cholestatic complications

    • Abstract: Publication date: Available online 6 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chai-Zhaou Lee, Steven Shinn-Forng Peng, Chee-Seng Lee, Huey-Ling Chen, Yen-Hsuan Ni, Mei-Hwei Chang, Jia-Feng WuBackground/PurposeThe study aim to investigate the correlation between diffusion-weighted magnetic resonance imaging (DW-MRI) and transient elastography (TE) liver fibrosis findings in children with cholestatic liver diseases, and the utility of TE findings to predict cholestatic complications in children.MethodsThis cross-sectional study enrolled 36 cholestatic children (21 boys and 15 girls). All study subjects underwent TE and DW-MRI studies to assess liver stiffness. All study subjects were followed prospectively, and their cholestatic complications were analyzed. The optimum cut-off TE value for the prediction of cholestatic complications was determined by receiver operating characteristic (ROC) analysis.ResultsA significant negative correlation between liver stiffness measurements (LSMs) and right-liver-to-psoas apparent diffusion coefficient ratios (LTPARs) was found in the study cohort (correlation coefficient = −0.52, p = 0.001). An LSM cut-off> 8.6 kPa was optimal for predicting complications of cholestasis in 6 months of this cohort (p 8.6 kPa was significantly predictive of cholestatic complications in 6 months (hazard ratio = 4.89; 95% CI = 1.41–16.97; p = 0.01).ConclusionsTE and DW-MRI findings showed a similar ability to predict liver fibrosis in cholestatic children. The LSMs measured by TE are predictive of the occurrence of cholestatic complications in 6 months in children with cholestatic liver diseases.
       
  • Factors associated with long-term progression of pediatric chronic kidney
           disease of nonglomerular etiologies

    • Abstract: Publication date: Available online 5 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Chih-Chia Chen, Hsin-Hsu Chou, Yuan-Yow ChiouBackground/PurposeThe aims of this study were to determine the long-term associated factors for chronic kidney disease (CKD) progression in a pediatric group with non-glomerular (non-GN) etiologies.MethodsPediatric patients with a presumptive diagnosis of CKD were enrolled to this study. Recorded information included demographic and laboratory information. We included the patients with non-GN etiologies and investigated the factors including systolic and diastolic blood pressure (BP), proteinuria, and anemia status in association with reductions in the estimated glomerular filtration rate (eGFR).ResultsA total of 308 children were enrolled and the mean duration of follow-up was 4.40 ± 3.53 years. Median baseline age was 5 years old and the males represented 55% of all patients. One-unit increased baseline systolic BP z-score was associated with 1.2 ml/min per 1.73 m2 (95% CI = −2 to −0.5) faster rate of eGFR decline. The presence of baseline proteinuria and anemia were also associated with 4.1 ml/min per 1.73 m2 (95% CI = −5.7 to −2.5) and 2.2 ml/min per 1.73 m2 (95% CI = −3.6 to −0.8) more rapid eGFR declination, respectively. Hypertension, anemia and proteinuria during the follow-up were also associated with 3.25 ml/min per 1.73 m2 (95% CI = −5.32 to −1.18), 4.34 ml/min per 1.73 m2 (95% CI = −7.25 to −1.43) and 4.97 ml/min per 1.73 m2 (95% CI = −8.23 to −1.71) more rapid eGFR declination, respectively.ConclusionElevated systolic BP, proteinuria, and anemia are independently associated with CKD progression in pediatric patients with non-GN etiologies.
       
  • A case of recalcitrant pediatric Vogt-Koyanagi-Harada disease successfully
           controlled with adalimumab

    • Abstract: Publication date: Available online 5 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Emily Su, Vikash S. Oza, Paul LatkanyVogt-Koyanagi-Harada (VKH) disease is uncommon in the pediatric population and can have an aggressive course with serious visual sequelae. A 12-year-old Han Chinese American female, who presented with mild headaches and panuveitis with diffuse serous retinal detachments, was diagnosed with VKH. Despite treatment with a combination of high-dose systemic corticosteroids, intravitreal triamcinolone injection, and mycophenolate mofetil, ocular inflammation was inadequately controlled. Addition of adalimumab allowed for inflammation remission, improvement of vision, and tapering of systemic corticosteroids. Escalation of immunosuppression until remission appears to be critical in this population. Further research is needed to understand the complex pathophysiology of VKH and investigation for similar efficacy of other anti-tumor necrosis factor-alpha agents will need to be performed.
       
  • Survival analysis of extracorporeal membrane oxygenation in neonatal and
           pediatric patients – A nationwide cohort study

    • Abstract: Publication date: Available online 4 January 2019Source: Journal of the Formosan Medical AssociationAuthor(s): Jiun Hsu, Chia-Hsuin Chang, Liang-Ting Chiang, James L. Caffrey, Jou-Wei Lin, Yih-Sharng ChenBackgroundExtracorporeal membrane oxygenation (ECMO) provides short-term cardiopulmonary support for patients with acute cardiac and respiratory failure. This study reported the survival rate for pediatric patients from Taiwan's national cohort.MethodsPatients under the age of 18 who received ECMO from January 1, 2002 to December 31, 2012 were identified from the Taiwan National Health Insurance Research Database. The underlying etiology for ECMO use was categorized into post-operative (n = 410), cardiac (245), pulmonary (146) groups, and others (120). A Cox regression model was used to determine hazard ratios and to compare 30-day and 1-year survival rates using post-operative group as a reference.ResultsThe average age of all 921 patients was 4.83 ± 5.84 years, and 59.1% were male. The overall mortality rate was 29.2% at 1 month, and 46.9% at 1 year. The cardiac origin group, consisting mostly of congenital heart disease without surgical intervention, myocarditis, and heart failure had a better outcome with an adjusted hazard ratio of 0.69 (95% CI 0.49–0.96, p = 0.008) at 30 days and 0.50 (95% CI 0.38–0.66, p 
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 34.238.190.122
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-