Ping-Wing Lui

East-Taiwan Veterans Hospital, Hua-lien, Taiwan, Taiwan

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Publications (31)33.45 Total impact

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    ABSTRACT: Previous studies have demonstrated that inflammatory cells produce several mediators that can effectively counteract pain. This study was designed to test the hypothesis that exogenous administration of recombinant mouse granulocyte-colony-stimulating factor (rmG-CSF) to enhance the recruitment of inflammatory cells to painful inflamed sites could attenuate pain in a chronic neuropathic pain model in mice. Our results indicate that treatment with rmG-CSF increased several cytokines and opioid peptides content; however, it did not attenuate but exacerbate neuropathic pain. Our study highlights the potent pro-inflammatory potential of G-CSF and suggests they may be targets for therapeutic intervention in chronic neuropathic pain.
    Journal of neuroimmunology 12/2010; 232(1-2):83-93. · 2.84 Impact Factor
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    ABSTRACT: To date, no pilot questionnaire of perioperative anesthetic care has been developed based on psychometric methodology in Taiwan. We describe the development and qualitative and quantitative validation of a pilot version of a psychometric questionnaire designed to measure patient satisfaction with perioperative anesthetic care in Taiwan. A rigorous protocol was followed and involved expert consultation, literature review, development of the interview guide, semi-structured in-depth interviews, pretest and application of Aiken's two quantitative methods to determine the content validity coefficient (V value) and homogeneity reliability coefficient (H value) of each item, and the questionnaire as a whole, to ensure the pilot questionnaire showed high-content validity and reliable homogeneity. Our final pilot questionnaire contained six dimensions with 32 items; five of the domains were similar to those reported in the literature. One dimension entitled anesthesia-related sequelae was new. The V values for the 32 items ranged from 0.80 to 0.97 (p < 0.01) and the mean value (V) of the questionnaire as a whole was 0.90 (p < 0.01). The H values ranged from 0.55 to 0.88 (p < 0.01) and the mean H value (H) of the questionnaire as a whole was 0.71 (p < 0.01). We have developed a valid and reliable pilot questionnaire to measure patient satisfaction with perioperative anesthetic care in Taiwan. The final version of the pilot questionnaire is a 32-item instrument with six dimensions, one of which, anesthesia-related sequelae, is new.
    Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists. 12/2009; 47(4):180-8.
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    ABSTRACT: There is evidence that cyclic adenosine monophosphate (cAMP) transduction is involved in nociceptive processing. We previously showed that intrathecal injection of an adenylate cyclase inhibitor attenuated tactile allodynia caused by partial sciatic nerve ligation (PSNL) in rats. The present study investigates the pre-emptive effects of spinal cAMP transduction on nociceptive processing in a chronic neuropathic pain model. Intrathecal catheterization and PSNL were performed in male Sprague-Dawley rats. Nociceptive responses to mechanical and thermal stimuli were evaluated at the hindpaw at 2 hr and at 3, 7, and 14 days after PSNL. The pre-emptive effects of the intrathecal adenylate cyclase inhibitor, SQ22536 (0.7 mumol x L(-1), 30 min before or after nerve ligation) were assessed. Also, the spatial and temporal expression profiles and immunoreactivity in the spinal cord of the cAMP response element binding protein (CREB) and its phosphorylated proteins (CREB-IR and p-CREB-IR) were analyzed. Compared with the rats treated with the vehicle, allodynia and hyperalgesia were significantly attenuated at 1-3 days by the intrathecal injection of SQ22536 performed either before or after ligation. The expression of CREB was significantly higher after ligation (P < 0.05), but differences were not observed between groups. Intrathecal injection of SQ22536, either before or after ligation, partially reduced p-CREB-IR protein expression in comparison with the vehicle control, especially after the first 3 days (P < 0.05). Our results show a possible association between the increase in p-CREB and PSNL-induced neuropathic pain. However, a pre-emptive effect of adenylate cyclase inhibitor administered before surgery was not observed.
    Canadian Anaesthetists? Society Journal 07/2009; 56(10):763-9. · 2.31 Impact Factor
  • Canadian Journal of Anaesthesia-journal Canadien D Anesthesie - CAN J ANAESTH. 01/2009; 56(10):763-769.
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    ABSTRACT: The ultrasonic cardiac output monitor (USCOM; USCOM Pty. Ltd., Sydney, NSW, Australia) has been accepted as a noninvasive device for measuring cardiac function in various clinical conditions. The present study aimed at comparing the accuracy of this device with that of the thermodilution technique in recipients in the early postoperative period after liver transplantation. Fifteen mechanically ventilated patients were studied on the first postoperative day after liver transplantation. We compared the left-sided and right-sided cardiac output (CO) determined by USCOM with that obtained from the thermodilution technique with a pulmonary artery catheter every 8 hours in the intensive care unit. Each patient received a total of four paired measurements. Bland-Altman analysis was used for bias and precision testing. The CO measured by USCOM and the thermodilution method were considered interchangeable if the limits of agreement lay within +/- 1 L per minute or 20% of the mean CO. Forty-eight paired left-sided CO measurements were obtained from 12 patients. Three patients were excluded due to unacceptable signals. Comparison of these two techniques revealed a bias of 0.13 L per minute and limits of agreement at -0.65 L and 0.92 L per minute. Fifty-six paired right-sided CO measurements were obtained from 14 patients with one patient excluded due to an unobtainable optimal signal. A bias of 0.11 L per minute with limits of agreement at -0.51 L and 0.72 L per minute were found for these two techniques. This is the first study to evaluate the accuracy of USCOM in the post-liver transplant setting. This device is accurate in measuring CO in liver transplant recipients postoperatively. Possible risks of arrhythmia, infection and pulmonary artery rupture can be avoided because of its noninvasive nature. USCOM should be considered as an alternative in hemodynamic monitoring after liver transplantation.
    Acta Anaesthesiologica Taiwanica 01/2009; 46(4):171-7.
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    ABSTRACT: Recent reports have identified a role for cyclic adenosine monophosphate (cAMP) transduction in nociceptive processing. Spinal activation of the cAMP induced gene transcription through the activation of protein kinase A and cAMP response element-binding protein (CREB). Intrathecal injection of protein kinase A inhibitor reversed the mechanical hyperalgesia, whereas injection of CREB antisense attenuated tactile allodynia caused by partial sciatic nerve ligation (PSNL) in rats. In the present study, we aimed to assess the effects of spinal cAMP transduction on the nociceptive processing in a chronic neuropathic pain model. PSNL was performed in male Sprague-Dawley rats 1 wk after intrathecal catheterization. Nociception to mechanical and thermal stimuli was assessed at the hindpaw 2 h, 3, 7, and 14 days after PSNL. The effects of adenylate cyclase inhibitor, SQ22536 (0.7 mumol, intrathecal) on these nociceptions were evaluated. Changes in the expression and immunoreactivity of CREB and its phosphorylated proteins (CREB-IR and pCREB-IR) in the dorsal horn of the spinal cord were also measured. The expression of CREB-IR and pCREB-IR proteins was shown to increase for 2 wk after PSNL. The increase in pCREB was partially reversed by the blockade of the cAMP pathway in the early 3 days, with a parallel increase in mechanical and thermal withdrawal thresholds. These results revealed the possible contribution of an increase in pCREB to the PSNL-induced tactile allodynia and thermal hyperalgesia. Modulation of the cAMP pathway may be clinically relevant if early intervention can be achieved in patients with chronic neuropathic pain.
    Anesthesia and analgesia 01/2008; 105(6):1830-7, table of contents. · 3.08 Impact Factor
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    ABSTRACT: Myocardial infarction (MI) is one of the leading causes of perioperative morbidity. Although evidence to prove significant reduction of perioperative MI with regional anesthesia is lacking, anesthesiologists still prefer this technique over general anesthesia for surgery involving the lower abdomen or lower extremities, especially in patients with cardiac risks. However, high level of sensory block during spinal anesthesia may obscure the referred pain from MI, which could contribute to the delay of diagnosis and treatment of an acute perioperative attack. We report a case of MI which occurred either intraoperatively or postoperatively, with symptoms that were masked by high level of sensory block to T4 by spinal anesthesia. This perioperative MI was only diagnosed when the patient recovered from anesthesia in the post-anesthesia care unit (PACU).
    Acta Anaesthesiologica Taiwanica 01/2007; 44(4):235-8.
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    ABSTRACT: Xiaozendao (meaning "small-needle-knife," in Chinese) is a form of alternative medical instrument shaped like an acupuncture needle with a flat edge on the needle tip. It is widely used for the treatment of many different disorders in Asian countries, especially in the People's Republic of China. Its use has gained increasing popularity. To our knowledge, there are no reports of practitioners' experiences or adverse events related to "small-needle-knifed" therapy until now. We reported the first case of spinal-cord injury with delayed onset of neurologic symptoms from a broken small-needle-knife insertion into the spinal cord.
    The Journal of Alternative and Complementary Medicine 01/2007; 13(1):129-32. · 1.46 Impact Factor
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    ABSTRACT: Strain rate (SR) imaging is an emerging technique for assessing myocardial systolic and diastolic functions. This technique can provide assessment in real time and color mapping; it also can detect ischemia at its earlier stages in comparison with visual estimation of wall motion with other techniques. This study group consisted of 9 patients undergoing elective coronary artery bypass graft (CABG) surgery. After general anesthesia with sevoflurane (end-tidal 1.8%) in air/oxygen mixture, a complete transesophageal echocardiography (TEE) study was performed with an ultrasound machine. Myocardial wall strain rate imaging was then preformed off-line using a customized computer software (Echopac, Windows 2000 version 2.1, General Electric) running on a Compaq P4 computer. The experimental protocol was divided into 6 parts: (1) T1: 30 minutes after general anesthesia completed, (2) T2: after opening the sternum and pericardium, (3) T3: left anterior descending coronary artery(LAD) snared for the preparation of ischemic pre-conditioning (SLAD), (4) T4: after anastomosing left internal mammary artery (LIMA) on LAD, (5) T5: before closing the sternum and pericardium and (6) T6: after closing the sternum and pericardium. From strain rate imaging, peak systolic SRs were reduced or inverted over LAD perfused area during the SLAD period. In apical segments, peak systolic SR changed from -0.45 +/- 0.48 to 0.42 +/- 0.63 (P < 0.05), whereas peak diastolic SR changed from 0.34 +/- 0.61 to -0.80 +/- 1.08 (P < 0.05). In the middle septum, peak systolic SR changed from -0.67 +/- 0.51 to -0.43 +/- 0.50 (P < 0.05), while peak diastolic SR changed from 0.47 +/- 0.44 to -0.64 +/- 0.84 (P < 0.05). After LIMA grafting, peak systolic SR changed from 0.42 +/- 0.63 to -0.61 +/- 0.40 (P < 0.05), as against peak diastolic SR which changed from -0.80 +/- 1.08 to 0.21 +/- 0.44 (P < 0.05) in the apical septum. Peak systolic SR changed from -0.43 +/- 0.50 to -0.75 +/- 0.46 (P < 0.05), whereas peak diastolic SR changed from -0.64 +/- 0.84 to 0.64 +/- 0.88 (P < 0.05) in the middle septum. Postsystolic shortening is a marker for both ischemia and successful myocardial reperfusion. By strain rate imaging, we could detect ischemia with a more sensitive and specific method. For anesthesiologists and surgeons, it can be an intraoperative tool for assessing ventricular function after reperfusion.
    Acta Anaesthesiologica Taiwanica 04/2006; 44(1):11-8.
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    ABSTRACT: Patients suffering from acromegaly are associated with increased risks of difficult airway management. We report a case of acromegaly scheduled for transsphenoidal resection of pituitary adenoma under general anesthesia in whom all possible means failed us in the insertion of the endotracheal tube (ET) through the mouth, a procedure essential for transsphenoidal surgery. The operation was called off and for securing his compromised airway a nasal ET was placed under fiberoptic bronchoscopy. Five days later, awake oral fiberoptic intubation was successful under topical anesthesia. We suggest that oral endotracheal intubation performed awake under topical anesthesia with the aid of a fiberoptic bronchoscope is a choice approach in acromegalic patients with predicated difficult airway who are to receive surgery.
    Acta Anaesthesiologica Taiwanica 04/2006; 44(1):31-4.
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    ABSTRACT: To determine the effects of propofol on vascular functions, plasma and endothelium-derived nitric oxide (EDNO), vascular NO, and cyclic guanosine monophosphate (cGMP), as well as vascular production of superoxide anion (O2*-), in septic animals. Prospective, multiexperimental, randomized, controlled studies. University research laboratory. Male adult Sprague-Dawley rats weighing 350-400 g. Cecal ligation and puncture (CLP), with and without propofol (25 mg/kg/hr) infusion, after sham or CLP (24 hrs postsurgery). Plasma NOx, basal aortic NOx, and cGMP concentrations all increased, whereas acetylcholine-induced endothelium-dependent relaxation (EDR), contractile response, and EDNO all decreased in CLP vs. sham rats (p < .001). Acetylcholine stimulated aortic NOx and cGMP significantly in sham and CLP-propofol (p < .01) but not CLP rats. Thus, propofol ameliorated the CLP-induced increases in plasma NOx, basal aortic NOx, and cGMP. It restored the CLP-induced impairment of EDR, EDNO, and acetylcholine-stimulated aortic NOx and cGMP levels. More O2*- production (measured by lucigenin-enhanced chemiluminescence) was noted in carotid arteries from CLP vs. sham rats (p < .001). Nicotinamide adenine dinucleotide (NADH; 1 mM) stimulated O2*- production in all rings, with significantly more increase in CLP vs. sham (p < .001). Propofol attenuated the excessive increase in O2*- production of CLP rings. Propofol treatment attenuated the overproduction of NO and O2*-, thus restoring the acetylcholine-responsive NO-cGMP pathway in CLP-induced sepsis. It also significantly improved the CLP-impaired EDR and EDNO in a parallel manner. These beneficial effects of propofol could be accounted for by improvement of the disturbed NO/O2*- balance in sepsis.
    Critical Care Medicine 03/2006; 34(2):453-60. · 6.12 Impact Factor
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    ABSTRACT: Continuous axillary brachial plexus block with local anesthetic has been shown to improve tissue perfusion after replantation surgery of the extremity. The present study aimed to investigate whether continuous axillary brachial plexus block with ropivacaine infusion can improve the survival of the reconstructive fingers secondary to an increase in its skin temperature in patients receiving replantation surgery of the crushed fingers. Under general anesthesia, 18 patients received replantation or toe-to-hand transplantation of their crushed digits. They were randomly divided into two groups. Under ultrasound guidance, continuous axillary brachial plexus analgesia was effected by a loading dose of 10 ml 0.75% ropivacaine, followed by an infusion of 4-5 ml per hour for up to three days (Group A). Patients who did not receive continuous analgesia postoperatively served as a control (Group B). An infrared thermometer was used to hourly assess the skin temperature of the surgical and non-surgical sites in both groups for 24 h after the surgery. In addition, the survival (the rate of re-operation or amputation) of the reconstructive digits was also evaluated in both groups. The skin temperature of the digits (T1) on both groups did not show any significant difference at any point of time after the surgery albeit there was a trend of increased skin temperature on the reconstructive digits in patients receiving continuous axillary brachial plexus block (Group A) as compared to those without receiving the block (Group B). Also, the difference in skin temperature (dT) differed slightly at 0, 9 and 21 hours postoperatively in Group A in comparison with Group B (0.75 +/- 0.65 vs. -2.33 +/- 1.24, 0.53 +/- 0.34 vs. -3.02 +/- 1.27, -0.125 +/- 0.55 vs. -2.33 +/- 0.91, p < 0.05). However, no patients in both groups received a second operation or amputation of the graft. The result of this study demonstrated that axillary brachial plexus block with continuous infusion of 0.75% ropivacaine can increase the skin temperature, an index of tissue perfusion, of the reconstructive digits for 24 h after microvascular surgery of the crushed fingers. However, graft survival was good in both groups.
    Chang Gung medical journal 08/2005; 28(8):567-74.
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    ABSTRACT: The aim of this study was to compare the efficacy of axillary brachial plexus block using an ultrasound-guided method with the nerve stimulator-guided method. We also compared the efficacy of ultrasound-guided single-injection with those of double-injection for the quality of the block. Ninety patients scheduled for surgery of the forearm or hand were randomly allocated into three groups (n = 30 per group), i.e., nerve stimulator-guided and double-injection (ND) group, ultrasound-guided and double-injection (UD) group, and ultrasound-guided and single-injection (US) group. Each patient received 0.5 ml kg(-1) of 1.5% lidocaine with 5 mg kg(-1) epinephrine. Patients in the ND group received half the volume of lidocaine injected near the median and radial nerves after identification using a nerve stimulator. Patients in the UD group received half the volume of lidocaine injected around the lateral and medial aspects of the axillary artery, while those in the US group were given the entire volume near the lateral aspect of the axillary artery. The extent of the sensory blockade of the seven nerves and motor blockades of the four nerves were assessed 40 min after the performance of axillary brachial plexus block. Seventy percent of the patients in the ND and US groups as well as 73% of the patients in the UD group obtained satisfactory sensory and motor blockades. The success rate of performing the block was 90% in patients in the ND and UD groups and 70% in the US group. The incidence of adverse events was significantly higher in the ND group (20%) compared with that in the US group and the UD group (0%; p = 0.03). Ultrasound-guided axillary brachial plexus block, using either single- or double-injection technique, provided excellent sensory and motor blockades with fewer adverse events.
    Chang Gung medical journal 07/2005; 28(6):396-402.
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    ABSTRACT: Non-traumatic paraplegia caused by herniation of the cervical intervertebral disc is an uncommon postoperative complication. A patient with claudication and radiculopathy was scheduled for lumbar laminectomy due to spinal stenosis. Postoperatively, numbness below T6 was found in his both legs of the patient. MRI showed a protruded intervertebral disc between C6 and C7. Despite urgent disectomy, the patient's lower extremities remained paralyzed without significant improvement for 3 months. Loss of muscle support during general anesthesia, excessive neck extension during endotracheal intubation and positioning, as well as bucking and agitation are believed as triggering factors for the protrusion of the cervical disc. We suggest that a complete history taking and physical examination be accomplished in patients scheduled for lumbar spine surgery in order to exclude coexisting cervical spine disorders. In addition, skillful endotracheal intubation and careful neck positioning are mandatory for patients receiving surgery in the prone position.
    Chang Gung medical journal 05/2005; 28(4):254-7.
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    ABSTRACT: A case of low back pain syndrome was diagnosed due to spinal metastasis with unknown primary origin. During anesthesia for surgical stabilization, unexpected airway obstruction occurred after endotracheal intubation. Fiber-optic bronchoscopic examination showed narrowing of the trachea and main bronchi caused by extrinsic compression. After administration of neostigmine to reverse neuromuscular blockade, the patient resumed spontaneous breath. Airway obstruction was relieved thereafter. The extrinsic lesion was diagnosed as mediastinal lung cancer. The mechanism and management of this airway compromise caused by mediastinal tumor is discussed.
    Chang Gung medical journal 05/2005; 28(4):258-63.
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    ABSTRACT: In this report, 16 patients with end-stage renal disease undergoing forearm arteriovenous shunt surgery were subjected to an ultrasound-guided axillary approach for brachial plexus nerve block. Two doses of 15 ml lidocaine 1.5% were injected using a double-shot technique The spread of the solution within the plexus sheath could be visualized using a high-resolution 12-MHz imaging probe. Most patients (94%) experienced an excellent analgesia in the regions innervated by median, ulnar and radial nerves with a lower percentage of complete analgesia (63%) in the areas innervated by musculocutaneous nerve. Three patients, who complained of pain during the surgery required further supplements of narcotics. There were no complications such as, nerve injury, puncture of the axillary vessels or other systemic reactions. This technique provides adequate analgesia - without complications and without difficulty - for extremity surgery in patients with end-stage renal diseases.
    Chang Gung medical journal 04/2005; 28(3):180-5.
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    ABSTRACT: The A-line autoregressive modelling with exogenous input index (AAI) is a new method of assessing depth of anesthesia. We examined the effects of tracheal intubation on the AAI and hemodynamics during induction of anesthesia with propofol compared with thiopental in patients aged over 50 yr. 40 patients scheduled for a laminectomy, posterior spinal fusion, vertebroplasty, or total hip replacement, ASA physical status I or II and aged over 50 yr, were randomly divided into two groups. Thiopental 5 mg.kg(-1) iv, fentanyl 2.5 microg.kg(-1) iv, and rocuronium 0.7 mg.kg(-1) iv were used in the thiopental group (n = 20) for anesthetic induction; the same protocol was used in the propofol group (n = 20) except that 2 mg.kg(-1) propofol iv was given instead of thiopental. The AAI, non-invasive blood pressure, and heart rate were measured every minute before induction for three minutes, at 1.5 min post-induction, and then each minute post-intubation for eight minutes. The AAI increased significantly at one and two minutes after intubation in the thiopental group (to 56.5 +/- 18.6 at 1 min and 44.7 +/- 18.7 at 2 min after intubation vs 19.9 +/- 7.5 at 1.5 min after induction; P < 0.05). Thereafter, AAI values gradually decreased three minutes after intubation. The AAI was inhibited continuously after intubation in the propofol group, and no significant elevation was seen. Our results, using the AAI to monitor anesthetic depth during induction and tracheal intubation, suggest that at equipotent doses propofol provided a more stable level of anesthesia than did thiopental.
    Canadian Journal of Anaesthesia 01/2005; 52(7):692-6. · 2.13 Impact Factor
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    ABSTRACT: The purpose of this retrospective study was to determine whether epidural fentanyl-bupivacaine patient-controlled analgesia (PCA) was more efficacious and had fewer adverse effects than epidural or intravenous morphine PCA. We retrospectively retrieved data from 859 patients (mean age 64+/-7 years) who received continuous epidural medication, either morphine or fentanyl-bupivacaine PCA, or intravenous morphine PCA for postoperative pain control after major elective surgery from 1999 to 2000. Pain was assessed postoperatively using a verbal analogue pain scale (VAS, 0-10) during rest, mobilization, and coughing. Adverse effects including nausea, vomiting, pruritus, urinary retention, sedation, motor block, and respiratory depression (< 8 breaths per minute) were recorded. On the third postoperative day, the overall quality of pain control was evaluated using a pain relief scale (PRS, 1-4). There were 201 patients who had epidural morphine PCA, 427 patients who had fentanyl-bupivacaine PCA, and 231 patients who had intravenous morphine PCA. Most patients (> 86%) who received epidural or intravenous PCA, either morphine or fentanyl combined with bupivacaine, experienced good pain relief (VAS, 0-3) during rest, mobilization, and coughing. Nonetheless, patients who received epidural morphine or fentanyl-bupivacaine had greater satisfaction with overall pain relief (PRS = 4) than did those who received intravenous morphine (p<0.05). Nausea and vomiting were most common in the epidural morphine group (p<0.05). Pruritus occurred least often in patients who received epidural fentanyl-bupivacaine analgesia (p < 0.05). There were no differences in other adverse events such as urinary retention, sedation, and motor block among the three groups. No respiratory depression was found in any patient. Patients receiving epidural fentanyl-bupivacaine PCA experienced better overall pain relief, while morphine PCA, either epidurally or intravenously, caused more side effects. It is considered safe to use continuous epidural PCA with fentanyl-bupivacaine in patients receiving major elective surgery.
    Chang Gung medical journal 12/2004; 27(12):877-86.
  • Ping-Wing Lui, Chen-Hwa Lee
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    ABSTRACT: The present study provides an important implication for the management of chronic neuropathic pain, focusing on prostaglandin (PG) and nitric oxide (NO) in the spinal cord. To determine if spinally administered cyclooxygenase (COX) inhibitor or nitric oxide synthase (NOS) inhibitor had preemptive analgesia on thermal hypersensitivity induced by chronic constrictive nerve injury, Sprague-Dawley rats were chronically implanted with an intrathecal (i.t.) catheter. The left sciatic nerve was loosely ligated with 2-mm polyethylene tubing to produce painful mononeuropathy. Animals received tenoxicam (7.5, 15 or 30 micromol/10 microl, i.t.), NS-398 (15 or 30 micromol), or L-NAME (30, 150 or 300 micromol) immediately before the nerve injury, followed by daily injection extending into the four postoperative days. The hindpaw was immersed into a hot (42 degrees C, 44 degrees C and 46 degrees C) or cold (10 degrees C) water bath. The paw immersion test revealed significant thermal hyperalgesia and allodynia 5 day after nerve injury in vehicle control animals. Tenoxicam (7.5, 15 or 30 micromol) or L-NAME (30, 150 or 300 micromol) dose-dependently attenuated hyperalgesia and allodynia. Equimolar dose of NS-398 (15 or 30 micromol) also diminished these nociceptive behaviors. Higher dose of either drug primarily produced longer duration of inhibition. The inhibitory effect of tenoxicam (30 micromol) on hyperalgesia was more effective than that of an equimolar dose of NS-398 or L-NAME. These results demonstrated that intrathecally administered COX inhibitor or NOS inhibitor provides preemptive analgesia on thermal hypersensitivity following chronic constrictive nerve injury in rats.
    Life Sciences 11/2004; 75(21):2527-38. · 2.56 Impact Factor
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    ABSTRACT: The aim of this study was to compare students' satisfaction between problem-based learning (PBL) and lecture-based traditional teaching of anesthesia. One hundred and thirty-seven fifth-year medical students were enrolled in a course which used a hybrid curriculum for teaching about anesthesia. The hybrid curriculum included 9 essential lectures and 3 related PBL case discussions. A Linkert 5-point scale was used for to assess students' satisfaction levels between PBL and lecture-based traditional teaching. Data were collected through a year-end questionnaire over 2 academic years from 2002 to 2003. Scores regarding the satisfaction levels between these 2 teaching methods were analyzed using a 2-sided paired t-test. Most students preferred PBL over the lecture-based traditional teaching in the following 6 aspects: learning about anesthesia, understanding other medical knowledge, being interested in and motivated to learn, training for future work, training of personal abilities, and being confident and satisfied with the teaching method (p < 0.05). However, traditional teaching was superior to PBL in enhancing the speed of learning with greater understanding of a basic knowledge of anesthesia, as well as in providing more solid content with understanding of a greater number of anesthetic techniques (p < 0.05). Satisfaction levels with this curriculum did not generally differ between students enrolled in different classes in 2002 and 2003. Although the assessment tools and content of PBL need to be modified, implementation of PBL for teaching anesthesia showed satisfactory results.
    Chang Gung medical journal 10/2004; 27(9):654-62.

Publication Stats

251 Citations
33.45 Total Impact Points

Institutions

  • 2009
    • East-Taiwan Veterans Hospital
      Hua-lien, Taiwan, Taiwan
  • 2002–2009
    • Chang Gung Memorial Hospital
      • Department of Anesthesiology
      Taipei, Taipei, Taiwan
  • 1989–1995
    • Taipei Veterans General Hospital
      • Department of Anesthesiology
      T’ai-pei, Taipei, Taiwan