185 results on '"Chao-Jan Wang"'
Search Results
2. Takayasu arteritis mimics dilated cardiomyopathy as its initial presentation
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Mao-Sheng Hwang, Hsiang-Ju Hsiao, Chao-Jan Wang, Jaw-Ji Chu, Wen-Jen Su, and Jing-Long Huang
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Pediatrics ,RJ1-570 - Published
- 2024
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3. C1-C2 subluxation in enthesitis-related arthritis: two case reports and literature review of ten cases
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Wing Hin Stanford Siu, Chao-Jan Wang, Chieh-Tsai Wu, Chao-Yi Wu, and Liang-Shiou Ou
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Enthesitis-related arthritis ,Juvenile idiopathic arthritis ,C1-C2 subluxation ,Atlantoaxial subluxation ,Pediatrics ,RJ1-570 ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background C1-C2 subluxation is a rare complication of enthesitis-related arthritis (ERA). If left untreated, it may lead to functional impairment or cervical spinal cord compression. This study aims to highlight key points regarding the management of C1-C2 subluxation in ERA. Case presentation We present two cases of C1-C2 subluxation: an 8-year-old boy with ERA and 16-year-old boy with ERA with bilateral sacroiliitis. Ten cases of ERA in the literature were reviewed. The diagnosis of C1-C2 subluxation is mostly based on radiographs and cervical spine computed tomography. All patients were treated with non-steroidal anti-inflammatory drugs. Six ERA patients were treated surgically for cervical fusion. Most ERA patients with sacroiliitis had cervical collar protection. Neurologic abnormalities after treatment were not reported. Despite the use of cervical collar, cervical fusion and persisting ankylosis were found in two ERA patients with sacroiliitis without surgical treatment. Conclusions Cervical spine protection and ruling out spinal cord compression should be prioritized, in addition to controlling the underlying inflammation in ERA. Cervical halter traction may be applied after severe cervical inflammation is excluded. To reduce the risk of complications, early recognition and appropriate treatments of C1-C2 subluxation in ERA are essential.
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- 2023
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4. The clinical significance of and the factors associated with macrolide resistance and poor macrolide response in pediatric Mycoplasma pneumoniae infection: A retrospective study
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Meng-Hsiu Yen, Dah-Chin Yan, Chao-Jan Wang, Kuo-Chien Tsao, Yi-Chuan Huang, Shao-wen Cheng, Cheng-Hsun Chiu, Yhu-Chering Huang, and Tzou-Yien Lin
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Macrolide resistance ,Mycoplasma pneumoniae ,Pleural effusion ,Poor macrolide response ,Microbiology ,QR1-502 - Abstract
Background: Macrolide-resistant Mycoplasma pneumoniae (MRMP) infection is increasing worldwide. However, its clinical significance is still uncertain. Methods: The data of the Laboratory Medicine Department of Chang Gung Memorial Hospital in northern Taiwan was searched for children with molecular confirmed macrolide-susceptible Mycoplasma pneumoniae (MSMP) and MRMP infections between January 2011 and December 2018. The clinical features, laboratory data, and chest image presentations were compared between patients with MRMP and MSMP infections and between patients with good and poor macrolide response, respectively. Results: Records from 158 patients were recovered. Of the enrolled patients 34 (22%) suffered MRMP infection, 27 (17%) had pleural effusions, and 47 (32%) had poor macrolide response. The macrolide resistance rate was 12% in 2011, 20% between 2015 and 2016, and 50% between 2017 and 2018, respectively. Other than a poor macrolide response, the MRMP and MSMP infections are clinically indistinguishable. The presence of pleural effusion and MRMP infections were found to be independently associated with a poor macrolide response, with odds ratios (95% confidence interval) of 14.3 (4.9–42.0) and 14.6 (5.4–40), respectively. The macrolide resistance rate of the patients with a poor macrolide response was 49% and 18% among all the patients enrolled and the patients with a pleural effusion, respectively. Conclusion: The macrolide resistance rate had possibly increased in recent years in Taiwan and should be continuously monitored. In addition, the macrolide response could be misleading in predicting a macrolide resistance especially for the patients with a pleural effusion.
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- 2023
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5. Totally anomalous pulmonary venous drainage presenting with cardiovocal (Ortner's) syndrome
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Mao-Sheng Hwang, Chao-Jan Wang, Shen-Hao Lai, Wen-Jen Su, Jaw-Ji Chu, and Yi-Jung Chang
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Pediatrics ,RJ1-570 - Published
- 2023
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6. Expectant management of prolonged hemolysis following complete transcatheter coil closure of a patent ductus arteriosus after previous pulmonary artery banding: a case report
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Mao-Sheng Hwang, Ching-Chia Kuo, Hung-Tao Chung, Hsin-Mao Hsu, Jaw-Ji Chu, and Chao-Jan Wang
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Case report ,Coil ,Hemolysis ,Patent ductus arteriosus ,Pulmonary artery banding ,Therapeutic embolization ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Transcatheter coil occlusion has been the treatment of choice for closure of small patent ductus arteriosus (PDA). In spite of its safety, complications such as hemolysis still occasionally occur. And the hemolysis almost always occurs following partial transcatheter closure of PDA; hence, it occurs extremely rarely following complete transcatheter closure of PDA without residual ductal flow. Case presentation Here, we describe a male newborn who developed prolonged hemolysis following complete transcatheter coil closure of his PDA after previous palliative pulmonary artery banding. Over the following days, we corrected his refractory anemia by repeated blood transfusion with packed red blood cells and frequently monitored his hemoglobin, serum total bilirubin, and serum lactate dehydrogenase. We speculated that the high-velocity pulmonary blood flow jet coming into contact with the extruded part of the coil led to red blood cell mechanical injury, thereby resulting in the hemolysis. We adopted expectant management in expectation of the endothelialization of the coil with a resultant reduction in the hemolysis. The hemolysis, as expected, was reduced gradually until it spontaneously resolved 81 days after coil implantation. Conclusions This case reminds us that hemolysis can still potentially occur following complete transcatheter coil closure of PDA. It also highlights the importance of preventing coils from extruding into the pulmonary artery in patients after previous pulmonary artery banding.
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- 2021
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7. Distribution of lymphadenopathy in patients with Kikuchi disease
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Lung-Chiung Chen, Chao-Jan Wang, Yu-Chuan Chang, Shian-Sen Shie, Tzou-Yien Lin, Yu-Chia Hsieh, Kuan-Ying Arthur Huang, Chen-Yen Kuo, Cheng-Hsun Chiu, Yhu-Chering Huang, and Chih-Jung Chen
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Kikuchi disease ,Lymphadenopathy ,Nuclear medicine ,Computed tomography ,Taiwan ,Microbiology ,QR1-502 - Abstract
Background: Cervical lymphadenopathy is among the cardinal manifestations of Kikuchi disease (KD). The incidences and locations of extra-cervical lymph nodes (LNs) involvement in KD have not been comprehensively reported. Methods: From 2003 to 2016, 60 patients with pathologically confirmed KD and with computed tomography and/or whole-body inflammation scans at diagnosis were retrospectively identified. The locations, sizes and characteristics of all affected LNs were analyzed by extensive review of the image studies. The clinical and laboratory parameters were abstracted from medical records and the associations with extra-cervical LNs involvement were identified. Results: Female accounted for 35 (58.3%) patients and the median age of all patients was 21.3 years (ranges, 3–64 years). Of 59 patients with evaluable neck images, 42 (71.2%) and 16 (27.1%) patients presented with unilateral and bilateral nodal involvement, respectively, with the most common locations at level II, III and IV by Som's classification. The largest LNs appeared most commonly in level II. The incidences of extra-cervical lymphadenopathy in abdomen, pelvis, inguina, axilla and mediastinum with available images were respectively 52.9% (9/17), 47.1% (8/17), 41.2% (7/17), 30.6% (11/36) and 14.3% (8/56). When compared to cases with solitary cervical lymphadenopathy, the cases with extra-cervical lymphadenopathy had significantly greater incidences of bilateral cervical lymphadenopathy (P = .0379) and leukopenia (P = .0173). Conclusion: Unilateral cervical lymphadenopathy was the most frequent form of LNs involvement of KD. Extra-cervical lymphadenopathy was not uncommon and was associated with the appearance of bilateral distribution of cervical LNs and leukopenia.
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- 2021
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8. Clinical and endocrinological manifestations of childhood-onset craniopharyngioma before surgical removal: A report from one medical center in Taiwan
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Ching-Chih Huang, Kuang-Lin Lin, Chieh-Tsai Wu, Shih-Ming Jung, Chao-Jan Wang, Yi-Ching Chen, and Fu-Sung Lo
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Craniopharyngioma ,endocrinology ,hypopituitarism ,pediatric obesity ,pediatrics ,Pediatrics ,RJ1-570 - Abstract
Background: Craniopharyngiomas are benign tumors of embryologic origin located in the sellar region. Patients have both neurological and endocrinological symptoms. Symptoms may be subtle in the early clinical course, which leads to delayed diagnosis. This study evaluated the clinical and endocrinological manifestations of childhood-onset craniopharyngioma. Methods: We retrospectively reviewed medical records of 45 children diagnosed as having craniopharyngioma between 1995 and 2019. We collected data on clinical symptoms and signs, height, weight, biochemical and hormone data, images, operation records, and pathology reports. A three-graded classification system was applied to define the degree of hypothalamic damage (HD). We analyzed clinical and endocrinological manifestations among patients with and without obesity, with short and normal stature, and with differing degrees of HD. Results: Clinical endocrinologic manifestations included adrenocortical insufficiency (42%), central hypothyroidism (37%), short stature (31%), obesity (20%), weight
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- 2021
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9. High initial bowel resection rate and very-early-onset inflammatory bowel disease – A challenge in a low-prevalence area
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Pai-Jui Yeh, Chien-Chang Chen, Hsun-Chin Chao, Jin-Yao Lai, Chuen Hsueh, Chao-Jan Wang, and Ming-Wei Lai
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Early-onset ,Monogenic ,Inflammatory bowel disease ,Resection ,Children ,Medicine (General) ,R5-920 - Abstract
Background: Inflammatory bowel diseases (IBD) include ulcerative colitis (UC) and Crohn's disease (CD). The incidence in children and adolescents has risen since the 21st century globally, including Taiwan. The study aimed to disclose the characteristics and outcome of pediatric IBD (pIBD) patients in a tertiary center for the past two decades. Methods: We retrospectively reviewed the charts of pIBD children from 2000 to 2018 in a tertiary center in Northern Taiwan. Demographics, presentations, diagnostic modalities, treatment, and outcomes were analyzed. Results: A total of 38 cases were enrolled, including 27 CD and 11 UC patients. An almost 3-folds increase in incidence after 2010 was observed. Twelve cases (32%) were early-onset, and six of them (16%) were very-early-onset; four of them were detected with single-gene mutations [XIAP, TTC7A (2 siblings), and ZAP70]. Eleven CD patients (40.7%) received bowel resection at the onset, and another two (7.4%) had bowel resection years after the diagnosis. Initial bowel resection was associated with fibrostenotic/penetrating behavior, early-onset disease, and growth failure. Conclusion: This study demonstrated an increased incidence of pIBD in the past two decades in Taiwan, a low-prevalence region. The initial high bowel resection rate in CD was related to the fibrostenotic and/or penetrating behavior, younger age at diagnosis, and growth failure.
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- 2021
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10. Pulmonary function evaluation in pediatric patients with primary immunodeficiency complicated by bronchiectasis
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Chun-Che Chiu, Chao-Jan Wang, Wen-I. Lee, Kin-Sun Wong, Chih-Yung Chiu, and Shen-Hao Lai
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Bronchiectasis ,Children ,Modified reiff scores ,Primary immunodeficiency ,Pulmonary function test ,Microbiology ,QR1-502 - Abstract
Background: Primary immunodeficiency (PID) accompanying with recurrent respiratory infections is thought to have a devastating effect on lung function. However, the associations between the airway structural abnormalities on chest computed tomography (CT), severity of dyspnea, and deterioration of pulmonary function test (PFT) have not been fully addressed. Methods: Children diagnosed with PID in a tertiary referred center in northern Taiwan were enrolled. Demographic and clinical data including age, sex, age at diagnosis of PID, and follow-up period were collected. Chest CT images (modified Reiff scores), parameters of PFT, and life quality questionnaires (mMRC dyspnea scale) were analyzed and correlated using Spearman's rank correlation test. Results: A total of nineteen children with PID were enrolled and thirteen patients were diagnosed as having bronchiectasis based on chest CT scans. Modified Reiff scores of chest CT scan were negatively correlated with FEV1 (% predicted) and FEV1/FVC ratio (P
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- 2020
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11. Association between cardiovascular anomalies and karyotypes in Turner syndrome patients in Taiwan: A local cohort study
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Yu-Yu Chou, Chao-Jan Wang, Chia-Hung Lin, Hung-Tao Chung, and Fu-Sung Lo
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Pediatrics ,RJ1-570 - Abstract
Background: Turner syndrome (TS) is characterized by growth failure, primary ovarian failure, cardiac anomalies, and other anomalies. Cardiovascular abnormalities such as bicuspid aortic valve (BAV), coarctation of the aorta (CoA), aortic stenosis (AS), and aortic dilatation (AD) account for some cases of TS-related early mortality. In this study, we investigated the correlations between cardiovascular phenotypes and karyotypes in TS. Methods: We conducted a retrospective cohort analysis of 105 local patients with TS aged 6–43 years between January 1994 and December 2018. They were categorized into two groups of complete monosomy X (45,X) and other X chromosome abnormalities. Most of the patients underwent echocardiography (n = 88, 83.8%), cardiac computed tomography (CT) angiography, and/or cardiovascular magnetic resonance imaging (MRI) (n = 58, 55.2%). We used independent the Student's t test, chi-square test or Fisher's exact test, and log-rank test to compare differences in continuous data, proportions, and Kaplan–Meier survival analysis results between the two TS groups. Results: 45,X was the most common karyotype (n = 47, 44.8%). Phenotypically, cardiovascular malformations were found in 29 patients with TS (27.6%). BAV (n = 6), CoA (n = 3), AS (n = 2), ASD (n = 1, 2.5%), and PAPVR (n = 1, 2.5%) were found in only the 45,X group. The mean age at AD onset was 25.55 ± 5.78 years (mean ± SD). Survival analysis of age at onset of AD demonstrated no significant difference between the two groups (p = 0.051). Conclusion: Cardiovascular abnormalities, such as BAV, CoA, AS, and AD, are common and potentially progressive in patients with TS, especially those with the 45,X karyotype. They should receive immediate cardiological assessments upon receiving diagnosis, regular assessments, and treatment to carefully control blood pressure, even with no apparent congenital heart disease. Key Words: aortic dilatation, aortic stenosis, bicuspid aortic valve, coarctation of the aorta, turner syndrome
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- 2020
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12. Volumetric Changes after Coblation Ablation Tongue (CAT) in Obstructive Sleep Apnea Patients
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Yi-An Lu, Chao-Jan Wang, Yen-Ting Chiang, and Hsueh-Yu Li
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coblation ablation tongue (CAT) ,tongue volume ,tongue length ,computed tomography ,obstructive sleep apnea ,Medicine - Abstract
Background: Obstruction of the tongue is commonly seen in patients with obstructive sleep apnea (OSA). This study proposed whole tongue treatment using coblation ablation tongue (CAT) and aimed to explore the potential association between the dimensions of a tongue and the severity of OSA, to inspect volumetric changes of the tongue after CAT, and to search for factors that influence outcome of tongue volume change. Methods: The prospective study enrolled 12 OSA patients (all male, average age: 35 years, average apnea/hypopnea index (AHI): 45.5 event/h, average body mass index (BMI): 27.0 kg/m2). All patients received multi-level sleep surgery including septomeatoplasty, uvulopalatopharyngoplasty, and CAT. The CAT used a coblation wand to perform uniform multiple ablations (15 points, body −6, base −9) on dorsal tongue. Three dimensions of the tongue (length, height, and width) and tongue volume were measured from head and neck computed tomography. The perioperative changes in the tongue dimension/volume and AHI were assessed at baseline and 3 months after surgery. Result: The baseline tongue length and AHI had a significant correlation (r = 0.60, p = 0.02). The multi-level surgery significantly improved AHI (43.8 vs. 23.7, p = 0.008). The CAT significantly decreased tongue volume from 91.3 to 85.6 cm3 (p = 0.02), with an average tongue volume reduction of 5.7 cm3 per person and 0.38 cm3 per ablation. Further outcome analysis showed surgical success was significantly higher in patients with non-hypertrophic lingual tonsils (grade I/II) than in those with hypertrophic lingual tonsils (grade III/IV) (p = 0.02). Conclusion: Length of the tongue is associated with the severity of OSA. The CAT significantly decreased the tongue volume in OSA patients. A volumetric reduction of 0.38 cm3 per ablation could be useful in the optimal reduction of tongue for OSA. The CAT significantly enlarged the retroglossal airway volume, which is related to the non-hypertrophic lingual tonsil.
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- 2022
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13. Efficacy of Intravenous Immunoglobulin/Exchange Transfusion Therapy on Gestational Alloimmune Liver Disease
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Pai-Jui Yeh, Shiu-Feng Huang, Ming-Chou Chiang, Chao-Jan Wang, and Ming-Wei Lai
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gestational alloimmune liver disease ,intravenous immunoglobulin ,neonatal hemochromatosis ,hyperbilirubinemia ,neonatal liver failure ,exchange transfusion ,Pediatrics ,RJ1-570 - Abstract
Background: Gestational alloimmune liver disease (GALD) is a rare but critical cause of neonatal liver failure. After discovering the maternal–fetal alloimmune mechanism, intravenous immunoglobulin (IVIG) with or without exchange transfusion (ET) has gradually replaced antioxidant cocktails as the first-line therapy. Whether such therapy changes the outcome of neonates with GALD is yet to be defined.Method: We reported a pair of twins with discordant presentations, mild and self-limited in the older, whereas liver failure in the younger, who was successfully rescued by ET and IVIG. To investigate the outcome after therapeutic alteration, 39 cases between 2005 and 2020 from literature research were collected.Results: Half of the collected cases (47.1%) were preterm. Common presentations were ascites, jaundice, respiratory distress, hepatomegaly, and edema. Leading laboratory abnormalities were coagulopathy, hypoalbuminemia, and elevated serum ferritin. Salivary gland biopsy and magnetic resonance imaging detected extrahepatic siderosis in 70% (14/20) and 56% (14/25), respectively. IVIG, ET, and liver transplantation were performed in 19 (48.7%), 15 (38.5%), and 8 (20.5%) patients, respectively. The overall survival (OS) rate and native liver survival (NLS) rate were 64.1% (25/39) and 43.6% (17/39), respectively. Although the compiled results did not support a significant benefit, the OS and NLS were higher in the IVIG with/without ET group compared with those treated with conventional therapy [OS (70 vs. 57.9%) and NLS (55 vs. 31.6%), respectively].Conclusion: A high index of suspicion for GALD is crucial when facing a neonate with liver failure. Despite no significant influence on the outcome over conventional therapy in such a rare and detrimental disease, IVIG with or without ET can be worth trying before resorting to liver transplantation, which is resource-demanding and technique-challenging in small infants.
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- 2021
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14. Point-of-Care Ultrasound May Reduce Misdiagnosis of Pediatric Intussusception
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Hsiang-Ju Hsiao, Chao-Jan Wang, Chien-Chung Lee, Yi-Chen Hsin, Sze-Yuen Yau, Shih-Yen Chen, Wan-Chak Lo, Patricia-Wanping Wu, Chyi-Liang Chen, and Yi-Jung Chang
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intussusception ,point-of-care system ,ultrasonography ,child ,diagnosis ,Pediatrics ,RJ1-570 - Abstract
Aim: Intussusception, the most common abdominal emergency in early childhood, is frequently misdiagnosed at initial presentation. The effect of using point-of-care ultrasonography (POCUS) by emergency medicine physicians on pediatric intussusception misdiagnosis rate remains unclear. Here, we summarize outcomes and misdiagnoses before and after training junior and senior physicians on using POCUS for diagnosing intussusception and compared their performance levels.Materials and Methods: This observational cohort analysis included patients with suspected intussusception who visited a pediatric emergency department (ED) between January 2017 and December 2019. All enrolled patients were evaluated by junior (
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- 2021
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15. Rare Cases of Pediatric Vasoactive Intestinal Peptide Secreting Tumor With Literature Review: A Challenging Etiology of Chronic Diarrhea
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Pai-Jui Yeh, Shih-Hsiang Chen, Jin-Yao Lai, Ming-Wei Lai, Cheng-Hsun Chiu, Hsun-Chin Chao, Shih-Hsin Chen, Ren-Chin Wu, Chao-Jan Wang, and Chien-Chang Chen
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vasoactive intestinal peptide ,diarrhea ,children ,tumor ,WDHA syndrome ,case report ,Pediatrics ,RJ1-570 - Abstract
Vasoactive intestinal peptide (VIP) secreting tumor (VIPoma) is a rare disease, presenting with profuse diarrhea, electrolyte imbalance, and possibly fatal outcome. The diagnosis and treatment are challenging, and no consensus guideline of management is available. The pediatric incidence remains unclear. This study comprises two pediatric case reports from a tertiary center and a literature-based case series investigating the characteristics among children. The two reported cases both presented with severe diarrhea and laboratory abnormalities, including electrolyte imbalance and elevated plasma VIP level. Case 1 received several imaging investigations, partial pancreatectomy, octreotide, and everolimus, reflecting her complicated and refractory course. Case 2 underwent total excision of suprarenal ganglioneuroblastoma, and the clinical response was significant. In both cases, varied degrees of symptomatic control, reduced plasma VIP level, and correction of electrolyte imbalance were achieved. A literature review-based case series analyzed 45 pediatric cases retrieved from the PubMed database until December 31, 2019. Demographics, clinical features, diagnostic modalities, treatments, and outcomes were presented.
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- 2020
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16. Pathological and Incidental Findings in 403 Taiwanese Girls With Central Precocious Puberty at Initial Diagnosis
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Chiao-Fan Chiu, Chao-Jan Wang, Yi-Pin Chen, and Fu-Sung Lo
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Taiwan ,prevalence ,brain MRI ,girl ,central precocious puberty (CPP) ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Background: Whether girls with central precocious puberty (CPP) should undergo routine brain magnetic resonance imaging (MRI) to identify potential intracranial pathologies is controversial.Aims: To evaluate the brain MRI results of girls with CPP and identify the clinical and endocrine predictors of brain abnormalities.Methods: This retrospective study obtained data from pediatric endocrine clinics at Chang Gung Children's Hospital. From 1997 and 2017, 403 girls were consecutively diagnosed with CPP. After the exclusion of patients with a history of central nervous system (CNS) insults or associated neuropsychiatric symptom or signs, we studied the prevalence of brain abnormalities in 251 girls with CPP who received detailed MRI examinations of the hypothalamus and pituitary area. We also recorded the demographic data of the participants, including the onset of puberty; initial pubertal status; height; weight; uterus and ovary sizes; and basal luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol levels, and the response to GnRH stimulation test.Results: Among the 251 girls with CPP, we observed no brain alterations in 190 (75.70%), abnormalities in the hypothalamic-pituitary (H-P) area in 54 (21.51%), and abnormalities in the non-H-P area in 7 (2.79%). Among the 54 patients that had H-P lesions, we noted pathological findings related to CPP (hypothalamic hamartoma) in only one (0.4%) girl aged below 6 years old. We also identified incidental findings in the other girls with H-P lesions, including non-functioning pituitary microadenomas (12.35%), pituitary pars intermedia cysts (4.38%), Rathke's pouch cysts (1.99%), pituitary hypoplasia (1.59%), and pineal gland cysts (0.8%). The patients that had non-H-P lesions were found to have arachnoid cysts (1.59%), Chiari I malformation (0.4%), prepontine nodule (0.4%), and choroidal fissure cyst (0.4%). Of all the patients with brain lesions, 45 (73.77%) underwent regular MRI follow-up. While none of the H-P and non-H-P lesions showed progression, 19.67% of these regressed during the follow-up. None of the participants exhibited other hormonal abnormalities or underwent surgery.Conclusion: The prevalence of true pathological brain lesions related to CPP in girls without prior symptoms or signs of CNS lesions was low (0.4%). None of the girls with intracranial lesions required further intervention besides the GnRH agonist treatment. These data question the routine use of brain MRI in all girls with CPP, especially in those who are healthy without neurologic symptoms.
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- 2020
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17. Lead point in a colo-colic intussusception identified by combined air and barium enema
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Ho-Chuen Chang, Chao-Jan Wang, and Jin-Yao Lai
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Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
We presented a rare case of colo-colic intussusception in a three-year-old girl . By using combined air and barium enema, we successfully identified a colonic polypoid lesion as a lead point before surgery, which was proved a juvenile polyp through pathological confirmation.
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- 2018
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18. Thymic Langerhans’ cell histiocytosis
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Hung-Hsien Liu, Yu-Jie Wu, Chao-Ping Yang, Patricia WanPing Wu, Chao-Jan Wang, and Chih-Chen Chang
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Pediatrics ,RJ1-570 - Published
- 2020
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19. Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial
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Tsan-Wen Huang, Chao-Jan Wang, Hsin-Nung Shih, Yuhan Chang, Kuo-Chin Huang, Kuo-Ti Peng, and Mel S. Lee
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Cementless total hip arthroplasty ,Bone mineral density ,Bisphosphonate ,Stress shielding ,Zoledronic acid ,Bone turnover markers ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Although the loss of bone mineral density (BMD) after total hip arthroplasty (THA) is a known problem, it remains unresolved. This study prospectively examined the effect of zoledronic acid (ZA) on bone turnover and BMD after cementless THA. Methods Between January 2010 and August 2011, 60 patients who underwent cementless THA were randomly assigned to receive either ZA infusion or placebo (0.9% normal saline only) postoperatively. ZA was administered at 2 day and 1 year postoperatively. Periprosthetic BMD in seven Gruen zones was assessed preoperatively and at given time points for 2 years. Serum markers of bone turnover, functional scales, and adverse events were recorded. Results Each group contained 27 patients for the final analysis. The loss of BMD across all Gruen zones (significantly in zones 1 and 7) up to 2 years postoperatively was noted in the placebo group. BMD was significantly higher in the ZA group than in the placebo group in Gruen zones 1, 2, 6, and 7 at 1 year and in Gruen zones 1, 6, and 7 at 2 years (p
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- 2017
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20. Biodegradable Cable-Tie Rapamycin-eluting Stents
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Cheng-Hung Lee, Ming-Jer Hsieh, Shang-Hung Chang, Chang-Lin Chiang, Ching-Lung Fan, Shih-Jung Liu, Wei-Jan Chen, Chao-Jan Wang, Ming-Yi Hsu, Kuo-Chun Hung, Chung-Chuan Chou, and Po-Cheng Chang
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Medicine ,Science - Abstract
Abstract “Cable-tie” type biodegradable stents with drug-eluting nanofiber were developed to treat rabbit denuded arteries in this study. Biodegradable stents were fabricated using poly-L-lactide film following being cut and rolled into a cable-tie type stent. Additionally, drug-eluting biodegradable nanofiber tubes were electrospun from a solution containing poly (lactic-co-glycolic acid), rapamycin, and hexafluoroisopropanol, and then mounted onto the stents. The fabricated rapamycin-eluting cable-tie stents exhibited excellent mechanical properties on evaluation of compression test and collapse pressure, and less than 8% weight loss following being immersed in phosphate-buffered saline for 16 weeks. Furthermore, the biodegradable stents delivered high rapamycin concentrations for over 4 weeks and achieved substantial reductions in intimal hyperplasia associated with elevated heme oxygenase-1 and calponin level on the denuded rabbit arteries during 6 months of follow-up. The drug-eluting cable-tie type stents developed in this study might have high potential impacts for the local drug delivery to treat various vascular diseases.
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- 2017
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21. Disseminated Cunninghamella bertholletiae Infection During Induction Chemotherapy in a Girl with High-Risk Acute Lymphoblastic Leukemia
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Yung-Yueh Su, Tsung-Yen Chang, Chao-Jan Wang, Tang-Her Jaing, Chuen Hsueh, Cheng-Hsun Chiu, Yhu-Chering Huang, and Shih-Hsiang Chen
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acute lymphoblastic leukemia ,children ,Cunninghamella bertholletiae ,invasive fungal infection ,mucormycosis ,Pediatrics ,RJ1-570 - Abstract
Invasive fungal infections in children with acute lymphoblastic leukemia have been a major cause of mortality. Recent reports have described increasing incidence of invasive non-Aspergillus mold infections in patients with hematological malignancies. It is always challenging to treat invasive fungal infection and underlying hematological malignancies successfully. Here we report a girl with high-risk acute lymphoblastic leukemia who developed disseminated Cunninghamella bertholletiae infection during induction chemotherapy. This case illustrates the difficulties of diagnosis and treatment of invasive C. bertholletiae infection. It also highlights the necessity for physicians to keep high suspicion and awareness for this infrequent fungal infection.
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- 2016
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22. Intermittent catheterization of renal pelvis through nephrocutaneous fistula-a salvage procedure
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Wendy Yang, Min-Hua Tseng, Chao-Jan Wang, Sze-Ya Ting, Mei-Ling Chen, and Pei-Yeh Chang
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Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Published
- 2018
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23. Neurodevelopmental outcome is effectively ameliorated by kidney transplantation in children at 6 years of age: Comparison of two cases
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Mei-Ching Yu, Chao-Jan Wang, and Yang-Jen Chiang
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Surgery ,RD1-811 - Abstract
Chronic kidney failure and end-stage renal disease are known to have detrimental effects on neurodevelopment in pediatric patients, particularly for toddlers and young children (≤6 years old) with developing brain. We present two toddler girls diagnosed of end-stage renal disease and receiving automated peritoneal dialysis at the age of 34 months. Their initial magnetic resonance imaging of brain revealed cerebral atrophy, enlarged ventricles and infarcts in main cerebellar territories. Both of them also had seizures. One girl underwent a kidney transplant 4 years after the initiation of peritoneal dialysis. Her post-transplant neuroimaging demonstrated insignificant structural abnormalities of brain. Besides, she doesn't present notable neurological problems clinically. On the contrary, the other uremic girl has suffered from long-lasting brain atrophy, uncontrolled epilepsy and cognitive function deterioration. Learning from these two contrasting cases, it is augmented that kidney transplantation can be a favorable and effective treatment as prevention of severe neurodevelopmental disabilities in young children with end-stage renal disease. Keywords: Cerebral atrophy, End-stage renal disease, Young children, Kidney transplantation
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- 2019
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24. Nanotechnology and Nanocarrier-Based Drug Delivery as the Potential Therapeutic Strategy for Glioblastoma Multiforme: An Update
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Jen-Fu Hsu, Shih-Ming Chu, Chen-Chu Liao, Chao-Jan Wang, Yi-Shan Wang, Mei-Yin Lai, Hsiao-Chin Wang, Hsuan-Rong Huang, and Ming-Horng Tsai
- Subjects
glioblastoma multiforme ,liposomal doxorubicin ,target therapy ,nanoparticle ,immunotherapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Glioblastoma multiforme (GBM) is the most common and malignant brain tumor with poor prognosis. The heterogeneous and aggressive nature of GBMs increases the difficulty of current standard treatment. The presence of GBM stem cells and the blood brain barrier (BBB) further contribute to the most important compromise of chemotherapy and radiation therapy. Current suggestions to optimize GBM patients’ outcomes favor controlled targeted delivery of chemotherapeutic agents to GBM cells through the BBB using nanoparticles and monoclonal antibodies. Nanotechnology and nanocarrier-based drug delivery have recently gained attention due to the characteristics of biosafety, sustained drug release, increased solubility, and enhanced drug bioactivity and BBB penetrability. In this review, we focused on recently developed nanoparticles and emerging strategies using nanocarriers for the treatment of GBMs. Current studies using nanoparticles or nanocarrier-based drug delivery system for treatment of GBMs in clinical trials, as well as the advantages and limitations, were also reviewed.
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- 2021
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25. Rapid Increase in the Height and Width of the Upper Chest in Adolescents with Primary Spontaneous Pneumothorax
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Pei-Yeh Chang, Kin-Sun Wong, Jin-Yao Lai, Jeng-Chang Chen, Tai-Wai Chin, Ke-Chi Chen, Chao-Jan Wang, Chee-Jen Chang, Wen-Ming Hsu, and Nien-Lu Wang
- Subjects
adolescents ,anthropometry ,primary spontaneous pneumothorax ,radiography ,thoracic wall ,Pediatrics ,RJ1-570 - Abstract
We determined the chest height in a cohort of patients with primary spontaneous pneumothorax (PSP) who had received chest radiographic examinations prior to the attack. The aim of this study was to determine when their chest height began to change and how this was related to the PSP. Methods: From June 2009 to February 2012, the chest posteroanterior radiographs of 156 patients with PSP (Group 1) were reviewed. Among another 3134 patients with PSP, we identified 52 patients who had a chest posteroanterior radiograph prior to the attack (Group 2). We also recruited 196 controls for comparison (Group 3). The chest height and chest width at different levels were measured and analyzed. Results: Before 14 years of age, the chest height of patients in Group 2 was no different from that of patients in Group 3. By the age of 14 years, however, the chest height and upper chest width of patients with PSP was significantly higher than that of the normal controls. The difference from normal chest height did not increase at adulthood. Conclusion: The rapid increase in chest height and upper chest width is a unique finding in patients with PSP. It might be attributable to the occurrence of PSP. This finding may also help to identify patients who are at risk of PSP.
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- 2015
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26. Evaluating Pediatric Intussusception Using 24-hour Ultrasound
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Yi-Jung Chang, Hsun-Chin Chao, Chao-Jan Wang, Wan-Chak Lo, and Dah-Chin Yan
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enema ,intussusception ,ultrasound ,Pediatrics ,RJ1-570 - Abstract
Although ultrasound is often the preferred pediatric imaging modality for the evaluation of intussusception in children, many institutions lack access to ultrasound at night. This study characterized the day- and nighttime use of radiographic imaging for evaluation of intussusception. Methods: The charts of pediatric patients evaluated for intussusception between January 2010 and December 2010 were reviewed retrospectively to evaluate the day- and nighttime use of radiographic imaging. Patients were stratified into day and night groups according to when the imaging studies were performed, and differences in the clinical characteristics, imaging studies, cost, and final diagnosis were compared. Results: Pediatric consultations were performed for 86 suspected intussusceptions: 40 (46.5%) during the day [38 (95%) ultrasounds and 33 (82.5%) plain abdominal X-rays] and 46 at night [3 (6.5%) computed tomography and 39 (84.7%) plain abdominal X-rays]. The rate of positive enemas was significantly higher during the day than at night (97.5% vs. 52.2%, p
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- 2013
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27. Mediastinal and Retropharyngeal Abscesses in a Neonate
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Chien-Han Chen, Chao-Jan Wang, Reyin Lien, Yi-Hung Chou, Chien-Chih Chang, and Ming-Chou Chiang
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mediastinal abscess ,neonate ,retropharyngeal abscess ,sonography ,Pediatrics ,RJ1-570 - Abstract
Mediastinal abscess following retropharyngeal abscess is a rare entity. We report the first neonate presenting with a large mediastinal abscess as a complication of a retropharyngeal abscess. The initial manifestations of this newborn were fever and stridor. The chest sonography revealed a mediastinal mass, and the neck and chest computed tomography showed multiple abscesses in the retropharyngeal space, parapharyngeal space, and superior mediastinum. The mediastinal cystic mass was excised, and antibiotic treatment was completed for 7 weeks. She did well without any sequelae at follow-up clinic. Pediatricians should consider retropharyngeal and mediastinal abscesses among the differential diagnoses when confronting a newborn with fever and stridor.
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- 2011
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28. Elimination of Postoperative Pyloric Stricture by Endoscopic Electrocauterization and Balloon Dilatation in an Infant With Congenital Antral Web
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Hsun-Chin Chao, Chih-Cheng Luo, and Chao-Jan Wang
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anral web ,balloon dilatation ,electrocauterization ,endoscopy ,pyloric stricture ,Pediatrics ,RJ1-570 - Abstract
We, herein, report a male infant who presented with recurrent pyloric stricture after two surgeries (web excision and antropyloroplasty), which were done, respectively, at 5 days of age for congenital antral web and 6 months of age for the subsequent pyloric stricture. The patient suffered from anorexia, progressed vomiting, and weight loss gradually after the first and second surgeries, and then, endoscopy revealed severe pyloric deformity and stricture. Poor inflation was noted during endoscopic balloon dilatation because of tight pylorus; a subsequent electrocauterization and balloon dilatation were done, and the patient’s clinical symptoms improved significantly 2 weeks later. A follow-up endoscopy was performed 1 month and 12 months after endoscopic therapy, showing steady regression of pyloric stricture. The patient had adequate diet intake and growth in the later 12 months.
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- 2011
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29. Chondroblastoma of the Triquetrum
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Chen-Te Wu, Alvin Chao-Yu Chen, Chao-Jan Wang, Chih-Wei Wang, Chen-Ju Fu, and Yon-Cheong Wong
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chondroblastoma ,magnetic resonance imaging ,radiography ,triquetrum ,Pediatrics ,RJ1-570 - Abstract
Chondroblastoma is a relatively uncommon but benign bone tumor that is typically found in a long-bone epiphysis. Reports of this type of tumor in the carpals have been rare, and even fewer cases of such tumors in the triquetrum have been reported. Here, we present classical findings of a chondroblastoma at an unusual location, the triquetrum, in an adolescent. Fat-suppressed T2*-weighted imaging revealed a hyperintense tumor matrix replacing the bony trabecula of the triquetrum, which had not been addressed in previous literature. Radiography-based differential diagnosis of a bubbly lesion in the hand of an adolescent, even in the small carpal bones, should include chondroblastoma.
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- 2013
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30. Intestinal Obstruction Caused by Potato Bezoar in Infancy: A Report of Three Cases
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Hsun-Chin Chao, Kuei-Wen Chang, and Chao-Jan Wang
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bezoar ,endoscopy ,infancy ,intestinal obstruction ,potato ,Pediatrics ,RJ1-570 - Abstract
We present a report of three young infants with unusual intestinal obstruction caused by potato bezoar. They presented with vomiting, irritable crying, and abdominal distention. Barium gastrointestinal series clearly revealed intraluminal filling defect in the duodenum in two cases and ileum in one. Those bezoars in the pylorus and duodenal bulb were all successfully retrieved endoscopically. The patient’s abdominal symptoms subsided after the bezoars were eliminated; no subsequent gastrointestinal events occurred in the following months. The authors believe that the occurrence of these cases suggest that feeding mashed potato to young infants (≤4 months) should be prohibited because it can result in bezoar formation.
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- 2012
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31. High initial bowel resection rate and very-early-onset inflammatory bowel disease – A challenge in a low-prevalence area
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Chien-Chang Chen, Ming-Wei Lai, Jin-Yao Lai, Chao-Jan Wang, Hsun-Chin Chao, Pai-Jui Yeh, and Chuen Hsueh
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medicine.medical_specialty ,Younger age ,Monogenic ,medicine.medical_treatment ,Taiwan ,Disease ,Inflammatory bowel disease ,Gastroenterology ,Diagnostic modalities ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Prevalence ,Humans ,Medicine ,Children ,Retrospective Studies ,lcsh:R5-920 ,Early-onset ,business.industry ,Incidence ,Incidence (epidemiology) ,Proteins ,General Medicine ,Bowel resection ,Resection ,Inflammatory Bowel Diseases ,medicine.disease ,Very early onset ,Ulcerative colitis ,030220 oncology & carcinogenesis ,Colitis, Ulcerative ,030211 gastroenterology & hepatology ,lcsh:Medicine (General) ,business - Abstract
Background Inflammatory bowel diseases (IBD) include ulcerative colitis (UC) and Crohn's disease (CD). The incidence in children and adolescents has risen since the 21st century globally, including Taiwan. The study aimed to disclose the characteristics and outcome of pediatric IBD (pIBD) patients in a tertiary center for the past two decades. Methods We retrospectively reviewed the charts of pIBD children from 2000 to 2018 in a tertiary center in Northern Taiwan. Demographics, presentations, diagnostic modalities, treatment, and outcomes were analyzed. Results A total of 38 cases were enrolled, including 27 CD and 11 UC patients. An almost 3-folds increase in incidence after 2010 was observed. Twelve cases (32%) were early-onset, and six of them (16%) were very-early-onset; four of them were detected with single-gene mutations [XIAP, TTC7A (2 siblings), and ZAP70]. Eleven CD patients (40.7%) received bowel resection at the onset, and another two (7.4%) had bowel resection years after the diagnosis. Initial bowel resection was associated with fibrostenotic/penetrating behavior, early-onset disease, and growth failure. Conclusion This study demonstrated an increased incidence of pIBD in the past two decades in Taiwan, a low-prevalence region. The initial high bowel resection rate in CD was related to the fibrostenotic and/or penetrating behavior, younger age at diagnosis, and growth failure.
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- 2021
32. Pulmonary function evaluation in pediatric patients with primary immunodeficiency complicated by bronchiectasis
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Shen-Hao Lai, Wen-I Lee, Chih-Yung Chiu, Chun-Che Chiu, Chao-Jan Wang, and Kin-Sun Wong
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,Primary Immunodeficiency Diseases ,030106 microbiology ,Taiwan ,lcsh:QR1-502 ,Air trapping ,lcsh:Microbiology ,Pulmonary function testing ,Young Adult ,03 medical and health sciences ,FEV1/FVC ratio ,0302 clinical medicine ,Quality of life ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Child ,Lung ,Children ,Retrospective Studies ,Rank correlation ,Bronchiectasis ,Primary immunodeficiency ,General Immunology and Microbiology ,business.industry ,Pulmonary function test ,Infant ,General Medicine ,respiratory system ,medicine.disease ,Respiratory Function Tests ,respiratory tract diseases ,Infectious Diseases ,Child, Preschool ,Modified reiff scores ,Female ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,Airway ,business - Abstract
Background: Primary immunodeficiency (PID) accompanying with recurrent respiratory infections is thought to have a devastating effect on lung function. However, the associations between the airway structural abnormalities on chest computed tomography (CT), severity of dyspnea, and deterioration of pulmonary function test (PFT) have not been fully addressed. Methods: Children diagnosed with PID in a tertiary referred center in northern Taiwan were enrolled. Demographic and clinical data including age, sex, age at diagnosis of PID, and follow-up period were collected. Chest CT images (modified Reiff scores), parameters of PFT, and life quality questionnaires (mMRC dyspnea scale) were analyzed and correlated using Spearman's rank correlation test. Results: A total of nineteen children with PID were enrolled and thirteen patients were diagnosed as having bronchiectasis based on chest CT scans. Modified Reiff scores of chest CT scan were negatively correlated with FEV1 (% predicted) and FEV1/FVC ratio (P
- Published
- 2020
33. Increase in intrathoracic volume in pectus excavatum patients after the Nuss procedure.
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Pei-Yeh Chang, Zhen-Yu Hsu, Jin-Yao Lai, Chao-Jan Wang, and Yu-Tai Ching
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- 2010
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34. Correlation of Temporal Parameters of Laryngeal Excursion by Using Force-Sensing Resistor Sensors with Hyoid Motion in Videofluoroscopic Swallowing Study
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Wann-Yun Shieh, Yen-Chia Chen, Chao-Jan Wang, Wei-Han Chang, Chin-Man Wang, and Wei-Jen Cheng
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Adult ,Male ,Thumb ,Correlation ,Young Adult ,Speech and Hearing ,Swallowing ,Force-sensing resistor ,medicine ,FSR ,Humans ,VFSS ,business.industry ,Significant difference ,Excursion ,Swallowing temporal parameters ,Hyoid Bone ,Gastroenterology ,Thyroid cartilage ,Deglutition disorders ,Deglutition ,Biomechanical Phenomena ,medicine.anatomical_structure ,Otorhinolaryngology ,Thyroid Cartilage ,Correlation analysis ,Original Article ,Female ,business ,Nuclear medicine - Abstract
Small flexible force-sensing resistor (FSR) sensors can detect laryngeal excursion during swallowing, but the detected laryngeal excursion has not been correlated with videofluoroscopic swallowing study (VFSS) results. Here, we tested the correlation of temporal parameters between the laryngeal excursion recording by FSR sensor and the hyoid motion recording by VFSS under simultaneously swallowing test recordings. Swallowing measurements were recorded in a radiological suite by simultaneously using VFSS and FSR sensors to detect hyoid motion and laryngeal excursion, respectively. Volunteers sat with their head vertical to the Frankfort plane. Two FSR sensors, each for detecting thyroid cartilage excursion and thumb pressing, were placed. VFSS images and FSR sensor signals during single 5-mL barium liquid (30% wt/volume %) bolus swallowing were collected and analyzed for four swallows per participant. In total, 15 men (28.0 ± 4.1 years old); 14 women (28.4 ± 4.2 years old) were recruited. Temporal parameters between VFSS and noninvasive system demonstrated a strong correlation by Pearson’s correlation analysis: in men (R = 0.953–0.999) and in women (R = 0.813–0.982), except for VT1–V1 compared with FT1–F1, which demonstrated a moderate correlation in women (R = 0.648; all p p = 0.001). Therefore, this is the first study to simultaneous record VFSS and noninvasive signals by FSR sensor. The correlation of temporal parameters between these two tests was strong. This finding is valuable for future applications of this noninvasive swallowing study tool.
- Published
- 2020
35. Association between cardiovascular anomalies and karyotypes in Turner syndrome patients in Taiwan: A local cohort study
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Chia-Hung Lin, Hung-Tao Chung, Fu-Sung Lo, Yu-Yu Chou, and Chao-Jan Wang
- Subjects
Adult ,medicine.medical_specialty ,Heart disease ,Adolescent ,Karyotype ,Coarctation of the aorta ,Heart Valve Diseases ,Turner Syndrome ,Aortic Coarctation ,Young Adult ,Bicuspid aortic valve ,Bicuspid Aortic Valve Disease ,Internal medicine ,Turner syndrome ,medicine ,Humans ,Child ,Survival analysis ,Retrospective Studies ,business.industry ,lcsh:RJ1-570 ,Retrospective cohort study ,lcsh:Pediatrics ,Aortic Valve Stenosis ,medicine.disease ,Exact test ,Aortic Valve ,Pediatrics, Perinatology and Child Health ,Cardiology ,business ,Cohort study - Abstract
Background: Turner syndrome (TS) is characterized by growth failure, primary ovarian failure, cardiac anomalies, and other anomalies. Cardiovascular abnormalities such as bicuspid aortic valve (BAV), coarctation of the aorta (CoA), aortic stenosis (AS), and aortic dilatation (AD) account for some cases of TS-related early mortality. In this study, we investigated the correlations between cardiovascular phenotypes and karyotypes in TS. Methods: We conducted a retrospective cohort analysis of 105 local patients with TS aged 6–43 years between January 1994 and December 2018. They were categorized into two groups of complete monosomy X (45,X) and other X chromosome abnormalities. Most of the patients underwent echocardiography (n = 88, 83.8%), cardiac computed tomography (CT) angiography, and/or cardiovascular magnetic resonance imaging (MRI) (n = 58, 55.2%). We used independent the Student's t test, chi-square test or Fisher's exact test, and log-rank test to compare differences in continuous data, proportions, and Kaplan–Meier survival analysis results between the two TS groups. Results: 45,X was the most common karyotype (n = 47, 44.8%). Phenotypically, cardiovascular malformations were found in 29 patients with TS (27.6%). BAV (n = 6), CoA (n = 3), AS (n = 2), ASD (n = 1, 2.5%), and PAPVR (n = 1, 2.5%) were found in only the 45,X group. The mean age at AD onset was 25.55 ± 5.78 years (mean ± SD). Survival analysis of age at onset of AD demonstrated no significant difference between the two groups (p = 0.051). Conclusion: Cardiovascular abnormalities, such as BAV, CoA, AS, and AD, are common and potentially progressive in patients with TS, especially those with the 45,X karyotype. They should receive immediate cardiological assessments upon receiving diagnosis, regular assessments, and treatment to carefully control blood pressure, even with no apparent congenital heart disease. Key Words: aortic dilatation, aortic stenosis, bicuspid aortic valve, coarctation of the aorta, turner syndrome
- Published
- 2020
36. Nanofibrous vildagliptin-eluting stents enhance re-endothelialization and reduce neointimal formation in diabetes: in vitro and in vivo
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Chao-Jan Wang, Shang-Hung Chang, Jyuhn-Huarng Juang, Ming-Yi Hsu, Kuo-Chun Hung, Chen-Hung Lee, I-Chang Hsieh, Ming-Jer Hsieh, Ming-Shien Wen, and Shih-Jung Liu
- Subjects
Biophysics ,Pharmaceutical Science ,Bioengineering ,02 engineering and technology ,Pharmacology ,010402 general chemistry ,01 natural sciences ,Biomaterials ,chemistry.chemical_compound ,In vivo ,Diabetes mellitus ,Drug Discovery ,medicine ,Vildagliptin ,Neointimal hyperplasia ,Vascular disease ,business.industry ,Organic Chemistry ,General Medicine ,Hyperplasia ,021001 nanoscience & nanotechnology ,medicine.disease ,0104 chemical sciences ,PLGA ,chemistry ,0210 nano-technology ,business ,Type I collagen ,medicine.drug - Abstract
Background The high lifetime risk of vascular disease is one of the important issues that plague patients with diabetes mellitus. Systemic oral vildagliptin administration favors endothelial recovery and inhibits smooth muscle cell (SMC) proliferation. However, the localized release of vildagliptin in the diabetic vessel damage has seldom been investigated. Research design and methods In this work, nanofiber-eluting stents that loaded with vildagliptin, a dipeptidyl peptidase-4 enzyme (DPP-4) inhibitor, was fabricated to treat diabetic vascular disease. To prepare nanofibers, the poly (D,L)-lactide-co-glycolide (PLGA) and vildagliptin were mixed using hexafluoroisopropanol and electrospinning process. In vitro and in vivo release rates of the vildagliptin were characterized using high-performance liquid chromatography. Results Effective vildagliptin concentrations were delivered for more than 28 days from the nanofibrous membranes coating on the surface of the stents in vitro and in vivo. The vildagliptin-eluting PLGA membranes greatly accelerated the recovery of diabetic endothelia and reduced SMC hyperplasia. The type I collagen content of the diabetic vascular intimal area that was treated by vildagliptin-eluting stents was lower than that of the non-vildagliptin-eluting group. Conclusion The experimental results revealed that stenting with vildagliptin-eluting PLGA membranes could potentially promote healing for diabetic arterial diseases.
- Published
- 2019
37. Nanotechnology and Nanocarrier-Based Drug Delivery as the Potential Therapeutic Strategy for Glioblastoma Multiforme: An Update
- Author
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Chen-Chu Liao, Ming-Horng Tsai, Jen-Fu Hsu, Yi-Shan Wang, Hsiao-Chin Wang, Shih-Ming Chu, Mei-Yin Lai, Chao-Jan Wang, and Hsuan-Rong Huang
- Subjects
0301 basic medicine ,Drug ,Cancer Research ,medicine.medical_treatment ,media_common.quotation_subject ,Nanotechnology ,Review ,Blood–brain barrier ,Glioblastoma multiforme ,lcsh:RC254-282 ,03 medical and health sciences ,0302 clinical medicine ,medicine ,media_common ,Chemotherapy ,business.industry ,target therapy ,nanoparticle ,Immunotherapy ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,nervous system diseases ,Radiation therapy ,030104 developmental biology ,medicine.anatomical_structure ,liposomal doxorubicin ,Oncology ,030220 oncology & carcinogenesis ,Drug delivery ,immunotherapy ,Stem cell ,Nanocarriers ,business - Abstract
Simple Summary Glioblastoma multiforme (GBM) are among the most lethal tumors. The highly invasive nature and presence of GBM stem cells, as well as the blood brain barrier (BBB) which limits chemotherapeutic drugs from entering the tumor mass, account for the high chance of treatment failure. Recent developments have found that nanoparticles can be conjugated to liposomes, dendrimers, metal irons, or polymeric micelles, which enhance the drug-loaded compounds to efficiently penetrate the BBB, thus offering new possibilities for overcoming GBM stem cell-mediated resistance to chemotherapy and radiation therapy. In addition, there have been new emerging strategies that use nanocarriers for successful GBM treatment in animal models. This review highlights the recent development of nanotechnology and nanocarrier-based drug delivery for treatment of GBMs, which may be a promising therapeutic strategy for this tumor entity. Abstract Glioblastoma multiforme (GBM) is the most common and malignant brain tumor with poor prognosis. The heterogeneous and aggressive nature of GBMs increases the difficulty of current standard treatment. The presence of GBM stem cells and the blood brain barrier (BBB) further contribute to the most important compromise of chemotherapy and radiation therapy. Current suggestions to optimize GBM patients’ outcomes favor controlled targeted delivery of chemotherapeutic agents to GBM cells through the BBB using nanoparticles and monoclonal antibodies. Nanotechnology and nanocarrier-based drug delivery have recently gained attention due to the characteristics of biosafety, sustained drug release, increased solubility, and enhanced drug bioactivity and BBB penetrability. In this review, we focused on recently developed nanoparticles and emerging strategies using nanocarriers for the treatment of GBMs. Current studies using nanoparticles or nanocarrier-based drug delivery system for treatment of GBMs in clinical trials, as well as the advantages and limitations, were also reviewed.
- Published
- 2021
38. Rare Cases of Pediatric Vasoactive Intestinal Peptide Secreting Tumor With Literature Review: A Challenging Etiology of Chronic Diarrhea
- Author
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Shih-Hsin Chen, Ming-Wei Lai, Cheng-Hsun Chiu, Chien-Chang Chen, Hsun-Chin Chao, Pai-Jui Yeh, Ren-Chin Wu, Chao-Jan Wang, Shih-Hsiang Chen, and Jin-Yao Lai
- Subjects
tumor ,medicine.medical_specialty ,WDHA syndrome ,Vasoactive intestinal peptide ,diarrhea ,Octreotide ,030204 cardiovascular system & hematology ,WDHA Syndrome ,Pediatrics ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,children ,030225 pediatrics ,Internal medicine ,medicine ,case report ,VIPoma ,vasoactive intestinal peptide ,Ganglioneuroblastoma ,business.industry ,lcsh:RJ1-570 ,lcsh:Pediatrics ,medicine.disease ,Diarrhea ,Pediatrics, Perinatology and Child Health ,Etiology ,medicine.symptom ,business ,medicine.drug ,Rare disease - Abstract
Vasoactive intestinal peptide (VIP) secreting tumor (VIPoma) is a rare disease, presenting with profuse diarrhea, electrolyte imbalance, and possibly fatal outcome. The diagnosis and treatment are challenging, and no consensus guideline of management is available. The pediatric incidence remains unclear. This study comprises two pediatric case reports from a tertiary center and a literature-based case series investigating the characteristics among children. The two reported cases both presented with severe diarrhea and laboratory abnormalities, including electrolyte imbalance and elevated plasma VIP level. Case 1 received several imaging investigations, partial pancreatectomy, octreotide, and everolimus, reflecting her complicated and refractory course. Case 2 underwent total excision of suprarenal ganglioneuroblastoma, and the clinical response was significant. In both cases, varied degrees of symptomatic control, reduced plasma VIP level, and correction of electrolyte imbalance were achieved. A literature review-based case series analyzed 45 pediatric cases retrieved from the PubMed database until December 31, 2019. Demographics, clinical features, diagnostic modalities, treatments, and outcomes were presented.
- Published
- 2020
39. Thymic Langerhans' cell histiocytosis
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Chao-Jan Wang, Patricia Wanping Wu, Chao-Ping Yang, Yu-Jie Wu, Chih-Chen Chang, and Hung-Hsien Liu
- Subjects
Pathology ,medicine.medical_specialty ,Langerhans cell histiocytosis ,business.industry ,Pediatrics, Perinatology and Child Health ,lcsh:RJ1-570 ,Medicine ,lcsh:Pediatrics ,business ,medicine.disease - Published
- 2020
40. Drug‐Induced Sleep Computed Tomography–Directed Upper Airway Surgery for Obstructive Sleep Apnea: A Pilot Study
- Author
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Wan-Ni Lin, Li-Jen Hsin, Yu-Lun Lo, Chung-Guei Huang, Hsueh-Yu Li, I-Chun Kuo, Li-Ang Lee, Tuan-Jen Fang, and Chao-Jan Wang
- Subjects
Adult ,Male ,Polysomnography ,Pilot Projects ,Computed tomography ,Epiglottis ,Risk Assessment ,Severity of Illness Index ,Cohort Studies ,03 medical and health sciences ,Upper airway surgery ,0302 clinical medicine ,Humans ,Medicine ,Prospective Studies ,030223 otorhinolaryngology ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Sleep in non-human animals ,Obstructive sleep apnea ,Treatment Outcome ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Anesthesia ,Female ,Surgery ,Palate, Soft ,Tomography, X-Ray Computed ,Airway ,business ,Anesthetics, Intravenous - Abstract
A surgical response to upper airway (UA) surgery for obstructive sleep apnea (OSA) depends on adequate correction of collapsible sites in the UA. This pilot study aimed to examine the surgical response to UA surgery directed by drug-induced sleep computed tomography (DI-SCT) for OSA.Prospective case series.Tertiary referral center.This study recruited 29 OSA patients (median age, 41 years; median body mass index, 26.9 kg/mDI-SCT showed that 28 (97%) patients had collapses at multiple sites, all of whom underwent multilevel UA surgery accordingly. The apnea-hypopnea index decreased from 53.6 to 26.8 ( P.001). There were 18 (62%) nonresponders and 11 (38%) responders. Multiple-site collapses could not predict surgical response ( P.99). The nonresponders had significant improvements in velopharyngeal, oropharyngeal lateral wall, and tongue collapses (all P.05), whereas the responders had significant improvements in velopharyngeal and oropharyngeal lateral wall collapses (both P ≤ .05).Despite multilevel OSA surgery, residual UA obstruction in nonresponders likely occurs due to multiple mechanisms. DI-SCT may help to elucidate the reasons for a nonresponse.
- Published
- 2018
41. Propylthiouracil-coated biodegradable polymer inhibited neointimal formation and enhanced re-endothelialization after vascular injury
- Author
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Shang-Hung Chang, Cheng-Hung Lee, Wei-Jan Chen, Chao-Jan Wang, Yung-Hsin Yeh, Shih-Jung Liu, and Ming-Yi Hsu
- Subjects
Male ,0301 basic medicine ,Vascular smooth muscle ,medicine.medical_treatment ,Nanofibers ,Pharmaceutical Science ,030204 cardiovascular system & hematology ,Pharmacology ,propylthiouracil ,0302 clinical medicine ,Polylactic Acid-Polyglycolic Acid Copolymer ,International Journal of Nanomedicine ,Cell Movement ,Absorbable Implants ,Drug Discovery ,Platelet ,Aorta ,Original Research ,platelet ,Chemistry ,Drug-Eluting Stents ,General Medicine ,Endothelial stem cell ,Drug-eluting stent ,endothelial cell ,Rabbits ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug ,Neointima ,endocrine system ,Nitric Oxide Synthase Type III ,Myocytes, Smooth Muscle ,Biophysics ,Bioengineering ,Biomaterials ,03 medical and health sciences ,Platelet Adhesiveness ,Platelet adhesiveness ,medicine.artery ,drug-eluting stent ,medicine ,Animals ,neointimal formation ,Lactic Acid ,Cell Proliferation ,Organic Chemistry ,Endothelial Cells ,Vascular System Injuries ,030104 developmental biology ,Propylthiouracil ,Polyglycolic Acid - Abstract
Shang-Hung Chang,1 Cheng-Hung Lee,1 Yung-Hsin Yeh,1 Shih-Jung Liu,2 Chao-Jan Wang,3 Ming-Yi Hsu,3 Wei-Jan Chen1 1Cardiovascular Department, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Tao-Yuan, Taiwan; 2Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan; 3Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan Background: The drug-eluting stent is a standard approach for the treatment of coronary artery disease. Propylthiouracil (PTU), an antithyroid drug, has been proven to suppress neointimal formation after balloon injury. Materials and methods: This study used a biodegradable polymer coating with PTU to test its effects on platelet function, re-endothelialization, and neointimal formation after vascular injury. Electrospinning was used to fabricate hybrid stents and generate PTU-loaded nanofibers.Results: PTU-eluting stents maintained a stable release of PTU for 3weeks. The PTU-coated stent markedly decreased the neointimal formation induced by vascular injury in the descending aorta of rabbits. Moreover, the PTU coating reduced platelet adhesion on the surface of the biodegradable membrane, which was reflected by the decreased expression of adhesion molecule in PTU-treated endothelial cells. The PTU coating enhanced re-endothelialization in injured aortas. In vitro, PTU exerted less suppressive effect on the proliferation and migration of endothelial cells than on those of vascular smooth muscle cells. Furthermore, treatment of endothelial cells with PTU induced phosphorylation (Ser1177) of endothelial nitric oxide synthase as well as its association with heat shock protein 90, supporting the protective role of PTU in endothelial function. The level of thyroid-stimulating hormone remained unchanged during the experimental period. Conclusion: This study indicates that PTU can be released locally and steadily in injured aortas, with some local effects but without systemic effects. Furthermore, PTU-coated stents may have beneficial effects on neointimal formation, endothelial cell, and platelet functions. Keywords: drug-eluting stent, propylthiouracil, neointimal formation, endothelial cell, platelet
- Published
- 2018
42. Lead point in a colo-colic intussusception identified by combined air and barium enema
- Author
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Jin-Yao Lai, Ho-Chuen Chang, and Chao-Jan Wang
- Subjects
medicine.medical_specialty ,business.industry ,Juvenile Polyp ,lcsh:RJ1-570 ,lcsh:Surgery ,lcsh:Pediatrics ,lcsh:RD1-811 ,medicine.disease ,digestive system ,digestive system diseases ,Polypoid Lesion ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,030225 pediatrics ,Intussusception (medical disorder) ,Pediatrics, Perinatology and Child Health ,Rare case ,otorhinolaryngologic diseases ,Medicine ,Surgery ,030212 general & internal medicine ,Radiology ,business ,Barium enema - Abstract
We presented a rare case of colo-colic intussusception in a three-year-old girl . By using combined air and barium enema, we successfully identified a colonic polypoid lesion as a lead point before surgery, which was proved a juvenile polyp through pathological confirmation.
- Published
- 2018
43. Congenital tuberculosis: case report and review of the literature
- Author
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Patricia Wanping Wu, Kin-Sun Wong, Chih-Chen Chang, Chao-Jan Wang, Chih-Hua Yeh, and Ching-Wen Chang
- Subjects
Miliary tuberculosis ,Pediatrics ,medicine.medical_specialty ,Tuberculosis ,medicine.medical_treatment ,Antitubercular Agents ,Polymerase Chain Reaction ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Ascites ,medicine ,Humans ,030212 general & internal medicine ,Bacteriological Techniques ,Respiratory distress ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Mycobacterium tuberculosis ,medicine.disease ,Gastric lavage ,Treatment Outcome ,Pediatrics, Perinatology and Child Health ,Sputum ,Female ,Radiography, Thoracic ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Chest radiograph ,Congenital tuberculosis - Abstract
Congenital tuberculosis is rare, even where tuberculosis (TB) is endemic. A 14-day-old girl presented with a 3-day history of fever and respiratory distress. Her mother was diagnosed with a disseminated TB infection immediately after the delivery which was confirmed by a positive TB-polymerase chain reaction (TB-PCR) and subsequent culture from ascites and sputum. The infant was separated from her mother at birth. Her chest radiograph showed bilateral miliary nodules. Congenital TB was strongly suspected because of the symptoms, signs and maternal TB history, and was confirmed by TB-PCR and culture from the gastric lavage. Timely administration of standard anti-TB therapy resulted in a good outcome. The case highlights the importance of maternal TB history and typical miliary pattern on chest radiography for early diagnosis of congenital or neonatal TB which in turn facilitates prompt treatment and the prognosis.
- Published
- 2017
44. Disseminated Cunninghamella bertholletiae Infection During Induction Chemotherapy in a Girl with High-Risk Acute Lymphoblastic Leukemia
- Author
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Tsung-Yen Chang, Yhu-Chering Huang, Yung-Yueh Su, Cheng-Hsun Chiu, Chuen Hsueh, Tang-Her Jaing, Shih-Hsiang Chen, and Chao-Jan Wang
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Lymphoblastic Leukemia ,media_common.quotation_subject ,030106 microbiology ,Cunninghamella bertholletiae ,acute lymphoblastic leukemia ,invasive fungal infection ,mucormycosis ,Precursor Cell Lymphoblastic Leukemia Lymphoma ,03 medical and health sciences ,0302 clinical medicine ,Fatal Outcome ,children ,hemic and lymphatic diseases ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Girl ,Pediatrics, Perinatology, and Child Health ,Intensive care medicine ,Cunninghamella ,media_common ,biology ,business.industry ,Incidence (epidemiology) ,Mucormycosis ,lcsh:RJ1-570 ,Induction chemotherapy ,lcsh:Pediatrics ,Induction Chemotherapy ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,biology.organism_classification ,Pediatrics, Perinatology and Child Health ,Female ,business ,Invasive Fungal Infections - Abstract
Invasive fungal infections in children with acute lymphoblastic leukemia have been a major cause of mortality. Recent reports have described increasing incidence of invasive non-Aspergillus mold infections in patients with hematological malignancies. It is always challenging to treat invasive fungal infection and underlying hematological malignancies successfully. Here we report a girl with high-risk acute lymphoblastic leukemia who developed disseminated Cunninghamella bertholletiae infection during induction chemotherapy. This case illustrates the difficulties of diagnosis and treatment of invasive C. bertholletiae infection. It also highlights the necessity for physicians to keep high suspicion and awareness for this infrequent fungal infection.
- Published
- 2016
45. Successful unrelated cord blood transplantation in a girl with malignant infantile osteopetrosis
- Author
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Tang-Her, Jaing, Shao-Hsuan, Hsia, Cheng-Hsun, Chiu, Jia-Woei, Hou, Chao-Jan, Wang, and Robert, Chow
- Published
- 2008
46. Nanofibrous Vildagliptin-Eluting Stents Enhance Re-Endothelialization And Reduce Neointimal Formation In Diabetes: In Vitro And In Vivo [Corrigendum]
- Author
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Chen-Hung Lee, Ming-Jer Hsieh, Shang-Hung Chang, Kuo-Chun Hung, Chao-Jan Wang, Ming-Yi Hsu, Jyuhn-Huarng Juang, I-Chang Hsieh, Ming-Shien Wen, and Shih-Jung Liu
- Subjects
Male ,Vildagliptin ,Organic Chemistry ,Nanofibers ,Biophysics ,Pharmaceutical Science ,Drug-Eluting Stents ,Bioengineering ,General Medicine ,Collagen Type I ,Biomaterials ,International Journal of Nanomedicine ,Neointima ,Drug Discovery ,Diabetes Mellitus ,Human Umbilical Vein Endothelial Cells ,Animals ,Humans ,Endothelium ,Rabbits ,Corrigendum ,Aorta - Abstract
The high lifetime risk of vascular disease is one of the important issues that plague patients with diabetes mellitus. Systemic oral vildagliptin administration favors endothelial recovery and inhibits smooth muscle cell (SMC) proliferation. However, the localized release of vildagliptin in the diabetic vessel damage has seldom been investigated.In this work, nanofiber-eluting stents that loaded with vildagliptin, a dipeptidyl peptidase-4 enzyme (DPP-4) inhibitor, was fabricated to treat diabetic vascular disease. To prepare nanofibers, the poly (D,L)-lactide-co-glycolide (PLGA) and vildagliptin were mixed using hexafluoroisopropanol and electrospinning process. In vitro and in vivo release rates of the vildagliptin were characterized using high-performance liquid chromatography.Effective vildagliptin concentrations were delivered for more than 28 days from the nanofibrous membranes coating on the surface of the stents in vitro and in vivo. The vildagliptin-eluting PLGA membranes greatly accelerated the recovery of diabetic endothelia and reduced SMC hyperplasia. The type I collagen content of the diabetic vascular intimal area that was treated by vildagliptin-eluting stents was lower than that of the non-vildagliptin-eluting group.The experimental results revealed that stenting with vildagliptin-eluting PLGA membranes could potentially promote healing for diabetic arterial diseases.
- Published
- 2019
47. Intermittent catheterization of renal pelvis through nephrocutaneous fistula-a salvage procedure
- Author
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Min-Hua Tseng, Sze-Ya Ting, Mei-Ling Chen, Chao-Jan Wang, Pei-Yeh Chang, and Wendy Yang
- Subjects
medicine.medical_specialty ,Nephrocutaneous fistula ,business.industry ,030232 urology & nephrology ,lcsh:RJ1-570 ,lcsh:Surgery ,lcsh:Pediatrics ,lcsh:RD1-811 ,Salvage procedure ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Pediatrics, Perinatology and Child Health ,medicine ,business ,Renal pelvis - Published
- 2018
48. Distribution of lymphadenopathy in patients with Kikuchi disease
- Author
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Yu Chia Hsieh, Yu Chuan Chang, Yhu Chering Huang, Shian Sen Shie, Chen Yen Kuo, Tzou Yien Lin, Chih-Jung Chen, Lung Chiung Chen, Chao Jan Wang, Cheng-Hsun Chiu, and Kuan-Ying A. Huang
- Subjects
Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Taiwan ,Lymphadenopathy ,Kikuchi disease ,Microbiology ,Young Adult ,Cervical lymphadenopathy ,medicine ,Immunology and Allergy ,Humans ,Child ,Computed tomography ,Histiocytic Necrotizing Lymphadenitis ,Pelvis ,Retrospective Studies ,Leukopenia ,General Immunology and Microbiology ,business.industry ,Mediastinum ,General Medicine ,Middle Aged ,medicine.disease ,QR1-502 ,Axilla ,Infectious Diseases ,medicine.anatomical_structure ,Child, Preschool ,Nuclear medicine ,Abdomen ,Female ,Radiology ,Lymph ,Lymph Nodes ,medicine.symptom ,business ,Tomography, X-Ray Computed ,Neck - Abstract
Background Cervical lymphadenopathy is among the cardinal manifestations of Kikuchi disease (KD). The incidences and locations of extra-cervical lymph nodes (LNs) involvement in KD have not been comprehensively reported. Methods From 2003 to 2016, 60 patients with pathologically confirmed KD and with computed tomography and/or whole-body inflammation scans at diagnosis were retrospectively identified. The locations, sizes and characteristics of all affected LNs were analyzed by extensive review of the image studies. The clinical and laboratory parameters were abstracted from medical records and the associations with extra-cervical LNs involvement were identified. Results Female accounted for 35 (58.3%) patients and the median age of all patients was 21.3 years (ranges, 3–64 years). Of 59 patients with evaluable neck images, 42 (71.2%) and 16 (27.1%) patients presented with unilateral and bilateral nodal involvement, respectively, with the most common locations at level II, III and IV by Som's classification. The largest LNs appeared most commonly in level II. The incidences of extra-cervical lymphadenopathy in abdomen, pelvis, inguina, axilla and mediastinum with available images were respectively 52.9% (9/17), 47.1% (8/17), 41.2% (7/17), 30.6% (11/36) and 14.3% (8/56). When compared to cases with solitary cervical lymphadenopathy, the cases with extra-cervical lymphadenopathy had significantly greater incidences of bilateral cervical lymphadenopathy (P = .0379) and leukopenia (P = .0173). Conclusion Unilateral cervical lymphadenopathy was the most frequent form of LNs involvement of KD. Extra-cervical lymphadenopathy was not uncommon and was associated with the appearance of bilateral distribution of cervical LNs and leukopenia.
- Published
- 2019
49. Promoting vascular healing using nanofibrous ticagrelor-eluting stents
- Author
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Yung-Hsin Yeh, I-Chang Hsieh, Ming-Jer Hsieh, Shang-Hung Chang, Jyuhn-Huarng Juang, Chao-Jan Wang, Ming-Shien Wen, Shih-Jung Liu, Cheng-Hung Lee, Kuo-Chun Hung, Che-Wei Cheng, Wei-Jan Chen, Ming-Yi Hsu, and Kuo-Sheng Liu
- Subjects
Adenosine ,medicine.medical_treatment ,Nanofibers ,Pharmaceutical Science ,02 engineering and technology ,030204 cardiovascular system & hematology ,endothelialization ,Vascular healing ,0302 clinical medicine ,P2Y12 ,Smooth muscle ,International Journal of Nanomedicine ,Drug Discovery ,Basic Helix-Loop-Helix Transcription Factors ,Medicine ,Endothelial dysfunction ,Original Research ,Neointimal hyperplasia ,drug-eluting stents ,General Medicine ,021001 nanoscience & nanotechnology ,surgical procedures, operative ,Rabbits ,0210 nano-technology ,Ticagrelor ,medicine.drug ,medicine.medical_specialty ,Biophysics ,Urology ,Bioengineering ,neointimal hyperplasia ,ticagrelor ,Biomaterials ,03 medical and health sciences ,In vivo ,Animals ,Humans ,cardiovascular diseases ,Cell Shape ,electrospinning ,Wound Healing ,business.industry ,Superoxide Dismutase ,Organic Chemistry ,Stent ,Endothelial Cells ,medicine.disease ,equipment and supplies ,Drug Liberation ,Stress, Mechanical ,business - Abstract
Cheng-Hung Lee,1 Ming-Jer Hsieh,1 Kuo-Sheng Liu,2,3 Che-Wei Cheng,3 Shang-Hung Chang,1 Shih-Jung Liu,3,4 Chao-Jan Wang,5 Ming-Yi Hsu,5 Kuo-Chun Hung,1 Yung-Hsin Yeh,1 Wei-Jan Chen,1 I-Chang Hsieh,1 Jyuhn-Huarng Juang,6 Ming-Shien Wen1 1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University College of Medicine, Tao-Yuan, Taiwan; 2Department of Cardiovascular Surgery, Chang Gung Memorial Hospital-Linkou, Tao-Yuan, Taiwan; 3Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan; 4Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan; 5Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan; 6Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung University and Chang Gung Memorial Hospital, Tao-Yuan, Taiwan Objective: The current treatment of atherosclerotic coronary heart disease with limus-eluting stents can lead to incomplete endothelialization and substantial impairment of arterial healing relative to treatment with bare-metal stents. The sustained and local delivery of ticagrelor, a reversibly binding P2Y12 receptor inhibitor, using hybrid biodegradable nanofibers/stents, was developed to reduce neointimal formation and endothelial dysfunction.Methods: In this investigation, a solution of ticagrelor, poly(D,L)-lactide-co-glycolide, and hexafluoro isopropanol was electrospun to fabricate ticagrelor-eluting nanofibrous drug-eluting stents. The in vitro and in vivo ticagrelor concentrations were measured using a high-performance liquid chromatography assay. The effectiveness of ticagrelor-eluting stents was examined relative to that of sirolimus-eluting stents. Results: Adequate ticagrelor levels were detected for four weeks in vitro. Less HES5-positive labeling was found near the ticagrelor-eluting stented vessels (0.33±0.12) than close to the sirolimus-eluting stented vessels (0.57±0.15) (p
- Published
- 2018
50. Clinical Outcomes of the Dynamic Lumbar Pedicle Screw-rod Stabilization
- Author
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Chao-Jan Wang, Hung-Wen Wei, and Henry Graf
- Subjects
medicine.medical_specialty ,business.industry ,Follow up results ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Lumbar ,medicine ,030212 general & internal medicine ,Neurology (clinical) ,Pedicle screw ,business ,030217 neurology & neurosurgery - Published
- 2016
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