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Chia-Yu Hsu,
Chun-Yu Cheng,
Jiann-Der Lee,
Meng Lee,
Ying-Chih Huang,
Chih-Ying Wu,
Huan-Lin Hsu,
Ya-Hui Lin,
Yen-Chu Huang, Hsu-Huei Weng,
Kuo-Lun Huang
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ABSTRACT: OBJECTIVE: Spinal cord infarction (SCI) is a rare complication of vertebral artery dissection (VAD). Its clinical features and outcomes have not yet been well documented. METHODS: In addition to reporting a case with bilateral SCI caused by left VAD, we performed a systematic review of the literature conducted through a PubMed search. RESULTS: A total of 17 cases were reviewed (nine men and eight women). The average age was 40.5±14.6 years. In addition to neck pain or headache (88%), patients with VAD-associated SCI often presented with a sensory level (76%) or Brown-Séquard syndrome (53%). The most common regions of dissection were at the V1 or proximal V2 segments, and the infarcted area of SCI was mainly located at C2-C5 levels. Regarding the vascular territory, posterior spinal artery infarction was noted in 29% of patients, spinal sulcal artery infarction in 42%, and anterior spinal artery (ASA) watershed infarction in 29%. Eleven patients (65%) had a good outcome and six patients (35%) had a poor outcome (including one mortality; 6%). Smoking, age above 50 years, and ASA watershed infarction were associated with a poor outcome, while spinal sulcal artery infarction was associated with a good outcome. CONCLUSION: Neck pain or headache is an important warning symptom of VAD, and the presence of a concomitant sensory level or Brown-Séquard syndrome is helpful for the early diagnosis of SCI caused by VAD. One-third of patients had a poor outcome, and smoking, old age, and ASA watershed infarction represented important risk factors.
Neurological Research 03/2013; · 1.52 Impact Factor
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ABSTRACT: BACKGROUND: Understanding hospital costs and length of stay (LOS) can optimize the in-hospital management of acute stroke. We investigated cost and LOS in first-ever and recurrent stroke patients in Taiwan. METHODS: Data were examined in patients at Chang Gung Memorial Hospital in Chiayi County of Taiwan from April 1, 2005, to March 31, 2007. Predictors of hospital cost and LOS in these patients were studied. RESULTS: The study included 1021 patients with 1084 stroke episodes. Mean age was 68.1 ± 10.8 years (range: 32-93). The average cost was NTD$45,709.30 ± NTD$66,697.40 (US$1408.70 ± US$2084.30; US$1 = NTD$32) and average LOS was 13.9 ± 14.1 days (range: 1-129). After multivariate regression analysis, the significant predictive factors for cost were LOS, smoking, and medication for secondary prevention. The significant predictive factors for LOS were diabetes mellitus, atrial fibrillation, recurrence, and stroke subtype. CONCLUSIONS: Age 65 and over, atrial fibrillation, stroke treatment, and subtypes were the significant predictive factors affecting hospital costs and LOS. Compared to other countries, Taiwan spent the least while Canada had the highest expense. The United States had the shortest LOS (6 days) in contrast to Canada with the longest LOS (34-47 days). Regarding mean daily cost of stroke, the United States had the highest cost per day while China spent the least.
Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association 12/2012;
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ABSTRACT: STUDY DESIGN:: A retrospective analysis of feasibility of intraoperative computed tomography (iCT) navigation for pedicle screw insertion of the thoraco-lumbar spine OBJECTIVES:: This study assessed the feasibility of an iCT navigation system by evaluating the screw insertion time, screw revision time, and learning curve of the iCT surgical team in patients who underwent thoraco-lumbar pedicle screw surgery using this navigation system. SUMMARY OF BACKGROUND DATA:: The iCT navigation system has been reported to improve the accuracy and safety of pedicle screw insertion. However, the assessment of the feasibility of spinal instrumentation guided by iCT navigation system is limited. METHODS:: From the time iCT navigation system was set-up to a period covering 16 months, consecutive patients who underwent thoracic or lumbar spinal pedicle screw surgery were enrolled. The screw insertion and screw revision times were estimated using the system's automatic time recording between the intra-operative CT scans. The insertion time per screw of the first 50 patients not requiring screw revision was also analyzed to evaluate the learning curve of the iCT surgical team. RESULTS:: There were 178 patients with a total of 932 pedicle screws. The cortical breach rate was 3.2% and the screw revision rate was 1.4%. The insertion time per screw was 10.2±6.3▒min and the screw revision time was 13.8±9.9▒min. The learning curve of the iCT surgical team for pedicle screw insertion guided by this navigation system was not steep and experience from less than 10 patients was adequate to provide familiarity with this system. CONCLUSION:: The iCT navigation system is clinically feasible for thoraco-lumbar pedicle screw surgery. It provides high-level safety and accuracy, as well as ease of screw revision when required.
Journal of spinal disorders & techniques 12/2012; · 1.21 Impact Factor
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Ming-Hung Tsai,
Yung-Chang Chen,
Chih-Wei Yang,
Chang-Chi Jenq,
Ji-Tseng Fang,
Jau-Min Lien,
Cheng-Chieh Hung, Hsu-Huei Weng,
Cheng-Shyong Wu,
Yun-Shing Peng,
Chien-Heng Shen,
Shui-Yi Tung,
Ya-Chung Tian
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ABSTRACT: BACKGROUND AND AIMS: Acute renal failure (ARF) is a common complication of liver cirrhosis and severe sepsis. Differentiating functional renal failure from acute tubular necrosis (ATN) has been difficult in this clinical setting. It has been shown urinary interleukin 18 (IL-18) can serve as a sensitive marker for ARF and ATN. This study was aimed to investigate the diagnostic and prognostic values of urinary IL-18 in ARF associated with liver cirrhosis and severe sepsis. METHODS: We prospectively evaluated the relationship between urinary IL-18 and clinical outcomes in 168 consecutive cirrhotic patients with severe sepsis. RESULTS: One hundred eight patients (64.3%) developed ARF at admission to ICU. ARF was associated with higher urinary IL-18 and impaired effective arterial volume. Renal failure was functional in 64 (59.2%), due to acute tubular necrosis (ATN) in 30 (27.7%), and mixed type in 14 (12.9%). Patients with ATN had significantly higher level of urinary IL-18, rates of vasopressor dependency, and hospital mortality than those with functional renal failure. By using the areas under receiver operating characteristic (AUROC) curve, urinary IL-18 demonstrated an excellent discriminative power (AUROC 0.882) for diagnosing tubular injury in those with ARF. Meanwhile, hospital survivors had significantly lower urinary and serum IL-18 levels, compared to non-survivors. In multivariate analysis, urinary IL-18, INR, and mean arterial pressure were independent factors to predict hospital mortality. CONCLUSIONS: Urinary IL-18 can serve as a diagnostic and prognostic marker in cirrhotic patients with severe sepsis.
Journal of Gastroenterology and Hepatology 10/2012; · 2.87 Impact Factor
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ABSTRACT: This study investigated the association between the results of nasopharyngeal (NPX) biopsies and clinical manifestations in patients with suspected nasopharyngeal carcinoma (NPC).
Retrospective cohort study.
Four hundred seventy-three patients with 512 NPX biopsies were enrolled. The statistical analyses were conducted to evaluate clinical significance and screening performance for suspected NPC.
The negative rate of all NPX biopsies was 69.7% (345/495), and the majority of the noncancerous group revealed lymphoid hyperplasias (208/345, 60.3%). The three diagnostic capabilities of NPX mass, epistaxis (EPI), neck mass (NM), EPI-NM, EPI-NPX mass, NM-NPX mass, and EPI-NM-NPX mass were 0.595, 0.557, 0.735, 0.609, 0.566, 0.748, and 0.600, respectively.
Although NPX mass, EPI, and NM were significant to identify suspected NPC, the diagnostic capabilities of combining EPI, NM, and NPX were still low. A large number of noncancerous biopsy results were obtained due to lymphoid hyperplasias often being mistaken as NPC.
The Laryngoscope 07/2012; 122(9):1988-93. · 1.75 Impact Factor
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ABSTRACT: Delirium, dementia and depression are the most prevalent mental disorders in elderly patients, and are associated with higher mortality.
The purpose of this study was to assess 1-year mortality among elderly patients with delirium, dementia, or depression seen by a psychiatry consultation-liaison service in a general hospital.
We consecutively enrolled inpatients 65 years of age and older who were referred for psychiatric consultation (n = 614) from 2002 to 2006: 172 were diagnosed with delirium, 92 with dementia, and 165 with depression. The 1-year mortality rates for the three groups of patients were compared by log-rank test. Logistic regression analysis was used to identify any possible factors associated with mortality.
One-year mortality was significantly higher in the delirium group than in the depression group (p = 0.048), but not significantly different between the delirium and dementia groups (p = 0.206), or dementia and depression groups (p = 0.676). Male patients had a higher mortality rate than female patients in the depression group (p = 0.003), but there was no gender difference in the delirium and dementia groups. Furthermore, the 1-year mortality of all patients was significantly associated with older age (p < 0.001) and length of hospital stay (p < 0.001), but not with gender difference and multiple physical comorbidities.
These results suggest that elderly inpatients with delirium seen by a psychiatric consultation service have significantly higher mortality than elderly inpatients with depression, and that mortality is significantly associated with older age and length of hospital stay.
Psychosomatics 06/2012; 53(5):433-8. · 2.12 Impact Factor
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ABSTRACT: The involvement of brain-derived neurotrophic factor (BDNF) in regulating neuronal survival during neuron differentiation, growth, and maturation, and during the regeneration of injured nerve cells, has already been documented. In experimental Parkinson's disease, chronic exposure to cigarette smoke increased BDNF levels and survival of dopaminergic neurons. BDNF is also elevated in traumatic brain injury (TBI), where it is potentially involved in post-injury repair and regeneration. The aim of this study was to investigate the effects of chronic exposure to cigarette smoke on BDNF expression and apoptosis in rats with TBI. Three groups of rats were compared: rats with TBI after chronic exposure to cigarette smoke, rats with TBI and no exposure to cigarette smoke, and sham-operated rats. BDNF mRNA expression in the hippocampus increased from 2 to 24 h after TBI, and chronic exposure to cigarette smoke upregulated TBI-induced BDNF mRNA elevation at 0, 2, 4, 12, and 24 h after head injury. The BDNF protein levels generally corresponded to the mRNA levels in the hippocampal region. Compared to the TBI group without smoke exposure, chronic cigarette smoke exposure in rats inhibited the decrease of the Bcl-2/Bax ratio and reduced P53 expression and apoptosis 24 h after TBI. In addition, neuronal damage in the parietal and cingulate cortex 7 days after TBI was less extensive in rats exposed to cigarette smoke. In conclusion, although chronic exposure to cigarette smoke is a risk factor for myocardial and pulmonary disease, cigarette smoke exposure increases BDNF expression after TBI and thereby can play a neuroprotective role.
Metabolic Brain Disease 04/2012; 27(2):197-204. · 2.20 Impact Factor
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ABSTRACT: The purpose of this study was to show the investigated prevalence rate of brownish spots of early cancer under narrow band imaging (NBI) in different sites/types of the epithelium.
In all, 125 adults with early mucosal cancer underwent NBI examination. Four types of epithelium were categorized: keratinized thick stratified squamous (type 1), nonkeratinized thin (type 2a) or very thick (type 2b) stratified squamous, and pseudo-stratified ciliated columnar epithelium (type 3).
The prevalence rate of brownish spots in early cancer of the nasopharynx, oral cavity, oropharynx, hypopharynx, and epiglottis were 11.1%, 15.9%, 21.4%, 100%, and 100%, respectively. Type 2a epithelium (odds ratio [OR], 76.45; 95% confidence interval [CI], 9.26-631.14) was a significant predictive factor for the brownish spots.
The brownish spots have higher reliability for screening in early cancer of the mouth floor, hypopharynx, and epiglottis, but not in other mucosal sites. Mucosal sites with type 2a epithelium have a higher tendency of demonstrating brownish spots. © 2012 Wiley Periodicals, Inc. Head Neck, 2012.
Head & Neck 01/2012; 34(11):1574-9. · 2.40 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the incidence of hydrocephalus and understand the influence of hydrocephalus on the functional outcome of patients undergoing decompressive craniectomy for malignant middle cerebral artery (MCA) infarction.
We retrospectively analyzed data of consecutive patients who underwent decompressive craniectomy for malignant MCA infarction. Clinical and imaging data were reviewed to confirm the incidence of hydrocephalus and evaluate the impact of hydrocephalus on functional outcome. The functional outcomes of patients were estimated with the Glasgow outcome score at 1year after stroke onset.
Seventeen patients who received decompressive craniectomy for malignant MCA infarction from January 2003 to December 2006 were enrolled. Persistent hydrocephalus developed in 5 patients. The functional outcomes in these patients were uniformly poor regardless of cerebrospinal fluid diversion surgery. Our data revealed that functional outcome was related to patient age and the duration from infarction to craniectomy.
Persistent hydrocephalus is common in patients who receive decompressive craniectomy for malignant MCA infarction. However, the shunt procedure does not significantly improve the patient's clinical condition. The timing of operation in relation to the functional outcome may be critical.
Clinical neurology and neurosurgery 12/2011; 114(6):555-9. · 1.30 Impact Factor
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ABSTRACT: The purpose of this study is to assess 3-year mortality in delirious patients receiving consultation-liaison service in a general hospital setting.
We consecutively enrolled inpatients 65 years of age and older that were referred for psychiatric consultation (N=614) from 2002 to 2006. One hundred and seventy-two patients were diagnosed with delirium. The exact date of death was based on the registration data from the Department of Health, Executive Yuan, in Taiwan and was used to calculate the mortality rate and time to death (days) after psychiatric consultation. Furthermore, the 1-year, 2-year and 3-year mortality rates of delirious patients were compared to mortality rates of nondelirious patients. Factors (e.g., age, length of hospital stay, gender, physical illness, use of antipsychotics) were analyzed by using the Cox proportional hazard model to identify possible associations with mortality.
Delirious patients had a higher mortality rate each year than nondelirious patients. After analysis, 1-year mortality was significantly higher in the delirious group than in the nondelirious group (P=.043), but 2-year and 3-year mortality rates were not significantly different when comparing the delirious and nondelirious groups (P=.149; P=.439). In the Cox proportional hazard regression analysis, 1-year mortality in delirious patients was significantly associated with older age and length of hospital stay (P<.001), but not with gender, physical comorbidity or use of antipsychotics.
These results suggest that elderly delirious inpatients in psychiatric consultation service had significantly higher mortality than nondelirious inpatients, especially in the first year after consultation. Clinical physicians should pay close attention to delirious patients, especially those with mortality-related risk factors, in order to reduce mortality in these patients.
General hospital psychiatry 11/2011; 34(1):66-71. · 2.67 Impact Factor
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ABSTRACT: The molecular mechanism of hemorrhagic stroke is unclear, and the identification of therapeutic agents for attenuating post-stroke brain damage remains an unresolved challenge. Dexamethasone (DEX) is used clinically to treat spinal cord injury and brain tumor patients by reducing edema formation, but has produced conflicting results in stroke management.
In this study, intracerebral hemorrhage (ICH) was induced in rats by intracranial stereotactic injection of collagenase into the caudate nucleus. DEX was given immediately and 3 days after ICH. The expression of intercellular adhesion molecule-1 (ICAM-1), matrix metalloproteinase-9 (MMP-9), nuclear factor (NF)-κB, and IκB were analyzed by Western blotting, and perihematomal edema formation was evaluated by magnetic resonance imaging.
The results showed that ICH caused an increase of ICAM-1 and MMP-9 expression from 4 h to 7 days, which was inhibited following the administration of DEX. The perihematomal edema volume in ICH rats was high, with two peak periods at 12 h and 3 days, which was also reduced in DEX-treated groups. Furthermore, the administration of DEX not only maintained IκB in cytoplasm, but also decreased NF-κB elevation in the nucleus at 3 and 5 days in ICH rats.
In conclusion, these data show that DEX successfully reduced post-stroke brain edema by decreasing MMP-9 and ICAM-1 levels, partially through the IκB/NF-κB signaling pathway. The timing of DEX administration in relation to the onset of brain injury may be critical.
Acta Neurochirurgica 08/2011; 153(11):2197-203. · 1.52 Impact Factor
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ABSTRACT: To investigate the use of narrow-band imaging (NBI) endoscopy to detect the appearance of a light crest (LC) on the epithelial surface of the nasopharyngeal mucosa, which is suggested to be a distinctive endoscopic finding associated with the presence of adenoid hypertrophy.
Cross-sectional study.
A total of 79 consecutive adults with a high suspicion of malignancy underwent NBI endoscopy and nasopharyngeal biopsy to validate the diagnostic accuracy of the novel endoscopic technique. The degree of correlation between the LC grading and the histologic examinations of lymphoid hyperplasia, including the number of mucin-producing cells and lymphoid follicles, was then assessed.
The appearance of an LC on NBI endoscopy correlated with the histologic evidence of lymphoid hyperplasia with a sensitivity of 92.1%, a specificity of 95.1%, a positive predictive value of 94.6%, a negative predictive value of 92.9%, a false-positive value of 4.9%, a false-negative value of 7.9%, and an accuracy of 93.7%. The screening performance of NBI endoscopy for the presence of adenoid hypertrophy is significantly superior to that of conventional endoscopy (P = .0003). The LC grading was significantly correlated with the number of mucin-producing cells and lymphoid follicles (P < .001).
In NBI endoscopy, observation of an LC on the epithelial surface of the nasopharyngeal mucosa is a highly accurate predictor of the presence of adenoid hypertrophy.
The Laryngoscope 05/2011; 121(5):965-70. · 1.75 Impact Factor
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ABSTRACT: Objectives/Hypothesis:To investigate the use of narrow-band imaging (NBI) endoscopy to detect the appearance of a light crest (LC) on the epithelial surface of the nasopharyngeal mucosa, which is suggested to be a distinctive endoscopic finding associated with the presence of adenoid hypertrophy.Study Design:Cross-sectional study.Methods:A total of 79 consecutive adults with a high suspicion of malignancy underwent NBI endoscopy and nasopharyngeal biopsy to validate the diagnostic accuracy of the novel endoscopic technique. The degree of correlation between the LC grading and the histologic examinations of lymphoid hyperplasia, including the number of mucin-producing cells and lymphoid follicles, was then assessed.Results:The appearance of an LC on NBI endoscopy correlated with the histologic evidence of lymphoid hyperplasia with a sensitivity of 92.1%, a specificity of 95.1%, a positive predictive value of 94.6%, a negative predictive value of 92.9%, a false-positive value of 4.9%, a false-negative value of 7.9%, and an accuracy of 93.7%. The screening performance of NBI endoscopy for the presence of adenoid hypertrophy is significantly superior to that of conventional endoscopy (P =.0003). The LC grading was significantly correlated with the number of mucin-producing cells and lymphoid follicles (P <.001).Conclusions:In NBI endoscopy, observation of an LC on the epithelial surface of the nasopharyngeal mucosa is a highly accurate predictor of the presence of adenoid hypertrophy.
The Laryngoscope 04/2011; 121(5):965 - 970. · 1.75 Impact Factor
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ABSTRACT: To determine the prognostic factors that affect surgical and audiologic outcomes in inlay tympanoplasty after long-term follow-up.
Case series study.
Tertiary referral center.
Sixty-two patients who underwent 71 procedures were enrolled in the study. Patient ages ranged from 31 to 87 years (mean [SD] age, 61.2 [12.9] years). Mean (SD) follow-up was 635.7 (284.7) days. The inclusion criteria were (1) inlay cartilage tympanoplasty performed using local anesthesia via a transcanal route, (2) chronic otitis media with stable perforation, and (3) dry ear without middle ear disease.
The success rate and hearing change at the last follow-up visit.
The overall success rate was 87.3% at the last visit. Using multivariate analysis, sex, age, size of perforation, side of perforation, and the presence of diabetes mellitus and external auditory canal otomycosis did not affect the success. Smoking was the only independent factor for the prognosis of surgical outcome (odds ratio [OR], 8.16; 95% confidence interval [CI], 1.74-36.89; P < .006). On the other hand, age (OR, 6.62; 95% CI, 1.13-38.47; P = .03) and perforation size (OR, 0.11; 95% CI, 0.10-0.79; P = .03) were independent factors for the prognosis of audiologic outcomes.
The frequency of failure was significantly higher for smokers than for nonsmokers. To quit smoking is highly recommended preoperatively for individuals scheduled for chronic otitis media inlay tympanoplasty intervention. Younger patients and those with larger perforations (>50%) were more likely to benefit from this operation.
Archives of otolaryngology--head & neck surgery 03/2011; 137(3):215-9. · 1.92 Impact Factor
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ABSTRACT: The aim of the study was to investigate the novel endoscopic findings in nasopharyngeal carcinoma (NPC) under narrow-band imaging (NBI) and to determine the reliability of screening NPC by NBI. A total of 79 adults underwent nasopharyngeal biopsy. We proposed five distinctly different findings that need to be examined by NBI: Type I: brownish spots, Type II: irregular microvascular pattern (IMVP), Type III: light crests, Type IV: side-difference, Type V: presence of either IMVP or side-difference, of which last three (Type III-V) were a new concept. The results of NPC diagnosis by detecting NBI Type V pattern, the false positive, false negative, sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 6.7%, 2.9%, 97.1%, 93.3%, 91.7%, 97.7%, and 94.9%, respectively. On the other hand, there was a higher prevalence of Type I and IV patterns in T1 category NPC. The nasopharyngeal endoscopy coupled with NBI was able to provide a rapid, convenient, and highly reliable screening for high-risk populations.
Oral Oncology 03/2011; 47(8):736-41. · 2.86 Impact Factor
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ABSTRACT: The objective of this study was to (1) examine the relationship between nitrate (NO₃-N) levels in public water supplies and risk of death from childhood brain tumors (CBT) and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water might modify the effects of NO₃-N on development of CBT. A matched cancer case-control study was used to investigate the relationship between the risk of death attributed to CBT and exposure to NO₃-N in drinking water in Taiwan. All CBT deaths of Taiwan residents from 1999 through 2008 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by gender, year of birth, and year of death. Information on the levels of nitrate-nitrogen NO₃-N, Ca, and Mg in drinking water were collected from Taiwan Water Supply Corporation. The municipality of residence for CBT cases and controls was presumed to be the source of the subject's NO₃-N, Ca, and Mg exposure via drinking water. Relative to individuals whose NO₃-N exposure level was ≤ 0.31 ppm, and the adjusted odds ration (OR) (95% confidence interval [CI]) for CBT occurrence was 1.4 (1.07-1.84) for individuals who resided in municipalities served by drinking water with a NO₃-N exposure > 0.31 ppm. No significant effect modification was observed by Ca and Mg intake via drinking water. Data suggest that exposure to NO₃-N in drinking water is associated with a higher risk of CBT development in Taiwan.
Journal of Toxicology and Environmental Health Part A 01/2011; 74(12):769-78. · 1.83 Impact Factor
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ABSTRACT: Objectives The pathophysiology of perihaematomal oedema (PO) surrounding a primary intracerebral haemorrhage (ICH) is complicated and incompletely understood. We prospectively investigated the components of PO with voxel-based analysis of the apparent diffusion coefficient (ADC) value and assessed its predictive value for functional outcome. Design Forty-six patients with ICH who were enrolled for clinical evaluation underwent MRI scans within 24 h after ICH. Based on the ADC value of the ipsilateral voxels divided by the mean ADC value of the contralateral mirror region of interest, the voxels with oedema were classified into three categories: cytotoxic, vasogenic and undetermined. The percentages of cytotoxic and vasogenic oedema were then calculated and correlated with clinical outcome according to the modified Rankin Scale (mRS) at 6 months after ICH. The intraobserver and interobserver reliability of this method were examined using intraclass correlation coefficients. Results The intraclass correlation coefficients showed that analysis using the voxel-based method is highly reliable. Among the clinical variables tested, age and serum creatinine levels were positively correlated with percentage of cytotoxic oedema. Age, history of coronary artery disease, National Institutes of Health Stroke Scale score and percentage of cytotoxic oedema were all associated with mRS at 6 months after ICH. Conclusions The pathophysiological processes within PO are complicated. Voxel-based analysis of ADC values may help to identify the components of PO and may be beneficial for decision making and predicting outcome.
BMJ open. 01/2011; 1(1):e000230.
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ABSTRACT: To use computed tomography to determine the association of frontal recess cells with the development of frontal sinusitis.
Retrospective analysis.
We retrospectively analyzed various frontal recess cells on spiral computed tomographic images of sinuses between November 2007 and May 2009. Exclusion criteria included previous sinus surgery, sinonasal polyposis, age younger than 18 years, maxillofacial fracture, incomplete sections of computed tomography, and sinonasal malignancy. We used logistic regression analysis to compare the distribution of various frontal recess cells in patients with frontal sinusitis and those without frontal sinusitis.
A total of 192 patients met the criteria, and only 363 sides were distinguishable. The presence of suprabullar cells, supraorbital ethmoid cells, frontal bullar cells, and recessus terminalis was significantly associated with the development of frontal sinusitis by multiple logistic regression models.
The frequency of frontal recess cells analyzed in Taiwanese adult patients was similar to that analyzed in other Asian adult populations (Chinese and Korean). The frontoethmoid cells posterior and posterolateral to the frontal recess (suprabullar cells, frontal bullar cells, and supraorbital ethmoid cells) might reveal a more significant association with the development of frontal sinusitis than those anterior to the frontal recess (agger nasi cells, frontal cell types 1-3). The presence of supraorbital ethmoid cells on computed tomographic images might indicate the highest odds of frontal sinusitis, followed by the presence of suprabullar cells, frontal bullar cells, and recessus terminalis.
The Laryngoscope 12/2010; 120(12):2521-7. · 1.75 Impact Factor
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ABSTRACT: The Janus kinase-signal transducers and activators of transcription (JAK-STAT) pathway is one of the most important components of cytokine signaling cascades. JAK-STAT signaling pathway modulates various fundamental biological processes and cancer pathogenesis. JAK-STAT is controlled by negative regulators that include suppressors of cytokine signaling (SOCS) proteins. Failure of feedback suppression by SOCS proteins may result in activated JAK-STAT signaling. Methylation-mediated silencing of SOCS3 has been reported in non-small lung cancer (NSCLC) and other human cancers. In this study, we restored SOCS3 expression using adenovirus-mediated gene transfer in NSCLC cells. Infection with a SOCS3-expressing vector inhibited the growth of lung cancer cells, with or without SOCS3 expression, at 2-3 days after infection. The growth inhibition of lung cancer cells was associated with suppressing entry into the S-phase. Restoration of SOCS3 expression induced apoptosis of NSCLC cells that did not express SOCS3. In addition, overexpression of SOCS3 by adenoviral transfer enhanced the radiosensitivity of treated NSCLC cells. In conclusion, our findings may provide insights into the development of applications of SOCS3 gene therapy for lung cancer and, possibly, other human cancers.
Oncology Reports 12/2010; 24(6):1605-12. · 1.84 Impact Factor
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ABSTRACT: Traumatic pseudoaneurysm of the internal carotid artery (ICA) is a rare but serious complication following blunt or penetrating trauma. These lesions are difficult to repair surgically. Endovascular management, including parent vessel occlusion, bare stent placement, and stent-assisted coil placement, are reported to be safe and effective but have certain disadvantages. Placement of covered stent grafts has been recently reported but without enough follow-up results to achieve consensus.
In this investigation, we present our experience with seven cases of traumatic ICA dissecting pseudoaneurysm treated with stent graft with follow-up between 1 and 33 months.
Among the seven patients, one patient died due to septic shock 7 days after stenting. Follow-up angiography or Doppler ultrasound of the other six patients revealed optimal result with occluded pseudoaneurysm without restenosis of the ICA.
Our results suggest that placement of stent grafts is a safe and effective method for treating ICA traumatic-dissecting pseudoaneurysm.
Neuroradiology 11/2010; 52(11):1011-6. · 2.82 Impact Factor
