Publications (6)15.4 Total impact
-
Article: Population based study on patients with traumatic brain injury suggests increased risk of dementia.
[show abstract] [hide abstract]
ABSTRACT: The relationship between traumatic brain injury (TBI) and the risk of dementia remains controversial. This population based study was designed to estimate and compare the risk of dementia in TBI and non-TBI individuals during the 5 year period after TBI. This study was a retrospective cohort study. Data were obtained from the Longitudinal Health Insurance Database 2000. We included 44 925 patients receiving ambulatory or hospital care and 224 625 non-TBI patients; patients were matched for sex, age and year of index use of healthcare. Patients <15 years of age and those admitted to the intensive care unit were excluded. Each individual was studied for 5 years to identify the subsequent development of dementia. Data were analysed by Cox proportional hazard regression. During the 5 year follow-up period, 1196 TBI (2.66%) and 224 625 non-TBI patients (1.53%) patients developed dementia. During the 5 year follow-up period, TBI was independently associated with a 1.68 (range 1.57-1.80) times greater risk of dementia after adjusting for sociodemographic characteristics and selected comorbidities. The findings of this study suggest an increased risk of dementia among individuals with TBI. We suggest the need for more intensive medical monitoring and health education in individuals with TBI.Journal of neurology, neurosurgery, and psychiatry 07/2012; 83(11):1080-5. · 4.87 Impact Factor -
Article: Magnesium sulfate and nimesulide have synergistic effects on rescuing brain damage after transient focal ischemia.
[show abstract] [hide abstract]
ABSTRACT: Magnesium sulfate and nimesulide are commonly used drugs with reported neuroprotective effects. Their combination as stroke treatment has the potential benefits of decreasing individual drug dosage and fewer adverse effects. This study evaluated their synergistic effects and compared a low-dose combination with individual drug alone and placebo. Sprague-Dawley rats underwent 90 min of focal ischemia with intraluminal suture occlusion of the middle cerebral artery followed by reperfusion. The rats were randomly assigned to receive one of the following treatments: placebo, magnesium sulfate (MgSO₄; 45 mg/kg) intravenously immediately after the induction of middle cerebral artery occlusion, nimesulide (6 mg/kg) intraperitoneally before reperfusion, and combined therapy. Three days after the ischemia-reperfusion insult, therapeutic outcome was assessed by 2,3,5-triphenyltetrazolium chloride staining and a 28-point neurological severity scoring system. Cyclooxygenase-2, prostaglandin E₂, myeloperoxidase, and caspase-3 expression after treatment were evaluated using Western blot analyses and immunohistochemical staining, followed by immunoreactive cell analysis using tissue cytometry. Only the combination treatment group showed a significant decrease in infarction volume (10.93±6.54% versus 26.43±7.08%, p<0.01), and neurological severity score (p<0.05). Low-dose MgSO₄ or nimesulide showed no significant neuroprotection. There was also significant suppression of cyclooxygenase-2, prostaglandin E₂, myeloperoxidase, and caspase-3 expression in the combination treatment group, suggesting that the combination of the two drugs improved the neuroprotective effects of each individual drug. MgSO₄ and nimesulide have synergistic effects on ischemia-reperfusion insults. Their combination helps decrease drug dosage and adverse effects. Combined treatment strategies may help to combat stroke-induced brain damage in the future.Journal of neurotrauma 02/2012; 29(7):1518-29. · 4.25 Impact Factor -
Article: Management of retained transcranial knife blade in a bipolar disorder patient and changes in cognitive function during a two-year follow-up.
The American surgeon 11/2010; 76(11):1312-4. · 1.28 Impact Factor -
Article: Neurophysiological and histopathological evaluation of low-dose radiation on the cauda equina and postlaminotomy fibrosis: an experimental study in the rat.
[show abstract] [hide abstract]
ABSTRACT: We evaluated the electrophysiological changes to the cauda equina after low-dose external irradiation in a postlaminotomy fibrosis model in rats. To clarify the immediate and long-term electrophysiological responses of antifibrotic radiation therapy in a fibrosis model. Low-dose perioperative radiation therapy inhibits scar formation. However, its efficacy for preventing fibrosis-induced compressive neuropathy and its potential adverse effect on underlying neural structures have not been studied. Twenty-four rats were placed in 3 groups of 8: group I, sham operation (laminar exposure alone) with a single fraction of 700 cGy external irradiation given using a 9-MeV electron beam 24 hours postsurgery; group II, left L5 hemilaminectomy (laminotomy) alone; and group III, left L5 hemilaminectomy with the same radiation protocol as group 1. We recorded mixed-nerve-elicited somatosensory-evoked potentials (M-SSEP)- and dermal (D)-SSEP at the thoracolumbar junction, and L1-L2 interspinous ligament after percutaneously stimulating the posterior tibial nerve at the bilateral medial ankle and L5 dermatomal fields. We compared the potentials recorded immediately before, 30 minutes, 2 weeks, and 1, 2, and 3 months after surgery on the operated and nonoperated sides. We used gross dissection and histologic sections to evaluate the degree of perineural fibrosis and walking-track analysis for neurologic evaluation. Pre- and postoperative (30 minutes and 2 weeks) M- and D-SSEP were not statistically different. In group II, the relative amplitude of D-SSEP (elicited from 5 dermatomes) 1, 2, and 3 months postsurgery was lower; however, the M-SSEP in all groups and D-SSEP of groups I and III remained constant. Histologic evaluation of radiation efficacy showed that the frequency and extent of peridural fibrosis was consistently lower in group II than in group III. Low-dose irradiation reduced peridural fibrosis and prevented fibrosis-induced radiculopathy. The radiation caused no adverse neuropathic complications.Spine 04/2009; 34(5):463-9. · 2.08 Impact Factor -
Article: Orbitozygomatic approach for excisions of orbital tumors with 1 piece of craniotomy bone flap: 2 case reports.
[show abstract] [hide abstract]
ABSTRACT: Orbital tumors are classified as primary and secondary. For primary entities, there are variable pathologies with benign and malignant natures. Many of the orbital tumors should be excised through neurosurgical approaches. We reported 2 cases of orbital tumors, which were clearly disclosed by magnetic resonance imaging. Case 1 was a 70-year-old woman and case 2 was a 57-year-old woman. Both cases were presented with progressive unilateral proptosis. The pathologies were intraorbital cavernous hemangioma and lacrimal mixed adenoma, respectively. With the scalp incision all posterior to the hairline, frontotemporal orbitozygomatic approach with 1 piece of craniotomy bone flap was performed after freeing all the remaining periorbita and other soft tissue attachments. This approach assures maximum exposure for successful en bloc excisions of these tumors with minimal bone loss, so the cosmetic results are satisfactory. Even though most orbital tumors are diagnosed by ophthalmologists, most of them should be operated on by neurosurgeons because neurosurgical approaches offer wide and safe surgical windows.Surgical Neurology 02/2007; 68 Suppl 1:S56-9; discussion S59. · 1.67 Impact Factor -
Article: Two primary brain tumors, meningioma and glioblastoma multiforme, in opposite hemispheres of the same patient.
[show abstract] [hide abstract]
ABSTRACT: We report a case with double primary intracranial tumors of different cell types without phacomatosis. The patient was hospitalized due to progressive memory impairment, headaches, dysarthria and right hemiparesis. Initial computed tomographic (CT) examinations revealed a large hyperdense tumor over the right frontal lobe, suggestive of an extra-axial meningioma. Additionally, there was unusual brain edema in the contralateral hemisphere that subsequently proved to originate from an intrinsic tumor. Staged craniotomies were used to treat the patient. Pathological examinations confirmed the two tumors to be a meningioma and a glioblastoma multiforme, respectively. The patient made an uneventful recovery after treatment. Although meningioma and glioma represent two common primary intracranial tumors, the simultaneous development of the two tumors is rare. A randomly occurring event most likely accounted for this linkage in the patient. We suggest that extraordinary brain edema far remote from the primary brain lesion warrants special attention for identifying other potentially undetected lesions.Journal of Clinical Neuroscience 10/2002; 9(5):589-91. · 1.25 Impact Factor
Top co-authors
Top Journals
Institutions
-
2002–2012
-
National Cheng Kung University Hospital
Tainan, Taiwan, Taiwan
-
