1.Efficacy of Ethanol Ablation for Benign Thyroid Cysts and Predominantly Cystic Nodules: A Systematic Review and Meta-Analysis
Cheng-Chun YANG ; Yung HSU ; Jyun-Yan LIOU
Endocrinology and Metabolism 2021;36(1):81-95
Background:
Ultrasound-guided minimally invasive procedures are widely used to treat thyroid diseases. The objective of this study was to assess the efficacy and safety of ethanol ablation (EA) in comparison with other non-surgical options in the treatment of benign thyroid cystic nodules.
Methods:
We conducted a systematic search of studies on EA for thyroid cystic nodules, mainly in the Ovid-MEDLINE and Embase, Web of Science, and Cochrane databases. The standardized mean difference (SMD) of the volume reduction ratio (VRR) after EA versus other non-surgical treatments comprised the primary outcome, whereas the odds ratio (OR) of therapeutic success rates between the two groups comprised the secondary outcome.
Results:
The meta-analysis included 19 studies (four randomized controlled trials and 15 non-randomized studies) with 1,514 participants. The cumulative VRR of EA was 83.908% (95% confidence interval [CI], 79.358% to 88.457%). EA had a significantly higher pooled VRR (SMD, 0.381; 95% CI, 0.028 to 0.734; P=0.030), but not a significantly higher pooled therapeutic success rate (OR, 0.867; 95% CI, 0.132 to 5.689; P=0.880), than other forms of non-surgical management including radiofrequency ablation (RFA), polidocanol sclerotherapy, and simple aspiration with or without saline flush. However, the VRR and therapeutic success rate were not significantly different between EA and RFA. Major complications were recorded only in six patients (0.53%) with self-limiting dysphonia.
Conclusion
The role of EA as the first-line treatment for benign thyroid cysts and predominantly cystic nodules is supported by its high effectiveness and good safety profile compared to other currently available non-surgical options.
2.Associations between variation of systolic blood pressure and neurological deterioration of ischemic stroke patients
Cheung-Ter Ong ; How-Ran Guo ; Kuo-Chun Sung ; Chi-Shun Wu ; Sheng-Feng Sung ; Yung-Chu Hsu ; Yu-Hsiang Su
Neurology Asia 2010;15(3):217-223
Objectives: To assess the relationship of variation of blood pressure and neurological deterioration
(ND) in ischemic stroke patients. Methods: We recruited patients with the fi rst-ever ischemic stroke
at a teaching hospital. The National Institutes of Health Stoke Score (NIHSS) of each patient was
monitored for 2 months. ND was defi ned as an increase of ≥ 2 points in NIHSS during the fi rst 7
days after stroke. Blood pressure was measured every 6 hours for fi rst 7 days. We analyzed blood
pressure data in the fi rst 36 hours to study the relationship between variation of blood pressure and
ND. Successive variation of systolic (svSBP) and diastolic (svDBP) blood pressure was calculated
as svSBP= |SBPn+1 – SBPn
| and svDBP= |DBPn+1 – DBPn
| respectively. The largest svSBP in the
fi rst 36 hours of hospitalization or before ND was defi ned as maximum variation of systolic blood
pressure (maxvSBP). Then, the mean variation of systolic (mvSBP) and diastolic (mvDBP) blood
pressure was calculated as mvSBP= svSBP/N and mvDBP= svDBP/N respectively. Results: A total
of 121 patients were included in this study, and 38 of them had ND. The mvSBP was higher in the
ND Group (17.9±8.4 mmHg vs. 13.7±4.4 mmHg, p=0.006) but the difference in mvDBP did not
reach statistical signifi cance (9.8±3.5mmHg vs. 8.6±3.0 mmHg p=0.06). The ND Group had a larger
maxvSBP (35.2±17.2 vs. 27.6±11.6 mmHg, p =0.01), which was more frequently over 30mmHg than
that in the stable group (P=0.02).
Conclusions: A large svSBP is associated with an increased risk for ND. The study highlights the
importance of close monitoring of blood pressure in ischemic stroke patients.
3.Uniform deletion junctions of complete azoospermia factor region c deletion in infertile men in Taiwan.
Chao-Chin HSU ; Pao-Lin KUO ; Louise CHUANG ; Ying-Hung LIN ; Yen-Ni TENG ; Yung-Ming LIN
Asian Journal of Andrology 2006;8(2):205-211
AIMTo determine the deletion junctions of infertile men in Taiwan with azoospermia factor region c (AZFc) deletions and to evaluate the genotype/phenotype correlation.
METHODSGenomic DNAs from 460 infertile men were examined. Bacterial artificial chromosome clones were used to verify the accuracy of polymerase chain reaction. Deletion junctions of the AZFc region were determined by analysis of sequence-tagged sites and gene-specific markers.
RESULTSComplete AZFc deletions, including BPY2, CDY1 and DAZ genes, were identified in 24 men. The proximal breakpoints were clustered between sY1197 and sY1192, and the distal breakpoints were clustered between sY1054 and sY1125 in all but one of the 24 men. The testicular phenotypes of men with complete AZFc deletion varied from oligozoospermia, to hypospermatogenesis, to maturation arrest.
CONCLUSIONWe identified a group of infertile men with uniform deletion junctions of AZFc in the Taiwan population. Despite this homogeneous genetic defect in the AZFc region, no clear genotype/phenotype correlation could be demonstrated.
Asian Continental Ancestry Group ; genetics ; Base Sequence ; Chromosomes, Human, Y ; genetics ; DNA Primers ; Deleted in Azoospermia 1 Protein ; Gene Deletion ; Genetic Loci ; Humans ; Infertility, Male ; genetics ; Male ; Nuclear Proteins ; genetics ; Oligospermia ; genetics ; Phenotype ; Polymerase Chain Reaction ; Proteins ; genetics ; RNA-Binding Proteins ; genetics ; Seminal Plasma Proteins ; genetics ; Taiwan ; Testis ; anatomy & histology
4.Using Multidetector-Row CT for the Diagnosis of Afferent Loop Syndrome Following Gastroenterostomy Reconstruction.
Yu Hsiu JUAN ; Chih Yung YU ; Hsian He HSU ; Guo Shu HUANG ; De Chuan CHAN ; Chang Hsien LIU ; Ho Jui TUNG ; Wei Chou CHANG
Yonsei Medical Journal 2011;52(4):574-580
PURPOSE: To assess the clinical manifestations and multidetector-row computed tomography (MDCT) findings of afferent loop syndrome (ALS) and to determine the role of MDCT on treatment decisions. MATERIALS AND METHODS: From January 2004 to December 2008, 1,100 patients had undergone gastroenterostomy reconstruction in our institution. Of these, 22 (2%) patients were diagnosed as ALS after surgery that included Roux-en-Y gastroenterotomy (n=9), Billroth-II gastrojejunostomy (n=7), and Whipple's operation (n=6). Clinical manifestations and MDCT features of these patients were recorded and statistically analyzed. The presumed etiologies of obstruction shown on the MDCT were correlated with clinical information and confirmed by surgery or endoscopic biopsy. RESULTS: The most common clinical symptom was acute abdominal pain, presenting in 18 patients (82%). We found that a fluid-filled C-shaped afferent loop in combination with valvulae conniventes projecting into the lumen was the most common MDCT features of ALS. Malignant causes of ALS, such as local recurrence and carcinomatosis, are the most common etiologies of obstruction. These etiologies and associated complications can be predicted 100% by MDCT. CONCLUSION: Our results suggest that MDCT is a reliable modality for assessing the etiologies of ALS and guiding treatment decisions.
Adult
;
Afferent Loop Syndrome/*radiography
;
Aged
;
Aged, 80 and over
;
Female
;
Gastroenterostomy/*adverse effects
;
Humans
;
Male
;
Middle Aged
;
Retrospective Studies
;
Tomography, X-Ray Computed/*methods
5.The effect of ferulic acid ethyl ester on leptin-induced proliferation and migration of aortic smooth muscle cells.
Yung Chieh TSAI ; Yen Mei LEE ; Chih Hsiung HSU ; Sy Ying LEU ; Hsiao Yen CHIANG ; Mao Hsiung YEN ; Pao Yun CHENG
Experimental & Molecular Medicine 2015;47(8):e180-
Leptin is a peptide hormone, which has a central role in the regulation of body weight; it also exerts many potentially atherogenic effects. Ferulic acid ethyl ester (FAEE) has been approved for antioxidant properties. The aim of this study was to investigate whether FAEE can inhibit the atherogenic effects of leptin and the possible molecular mechanism of its action. Both of cell proliferation and migration were measured when the aortic smooth muscle cell (A10 cell) treated with leptin and/or FAEE. Phosphorylated p44/42MAPK, cell cycle-regulatory protein (for example, cyclin D1, p21, p27), beta-catenin and matrix metalloproteinase-9 (MMP-9) proteins levels were also measured. Results demonstrated that leptin (10, 100 ng ml-1) significantly increased the proliferation of cells and the phosphorylation of p44/42MAPK in A10 cells. The proliferative effect of leptin was significantly reduced by the pretreatment of U0126 (0.5 muM), a MEK inhibitor, in A10 cells. Meanwhile, leptin significantly increased the protein expression of cyclin D1, p21, beta-catenin and decreased the expression of p27 in A10 cells. In addition, leptin (10 ng ml-1) significantly increased the migration of A10 cells and the expression of MMP-9 protein. Above effects of leptin were significantly reduced by the pretreatment of FAEE (1 and 10 muM) in A10 cells. In conclusion, FAEE exerts multiple effects on leptin-induced cell proliferation and migration, including the inhibition of p44/42MAPK phosphorylation, cell cycle-regulatory proteins and MMP-9, thereby suggesting that FAEE may be a possible therapeutic approach to the inhibition of obese vascular disease.
Animals
;
Antioxidants/*pharmacology
;
Aorta/cytology/*drug effects
;
Caffeic Acids/*pharmacology
;
Cell Line
;
Cell Movement/*drug effects
;
Cell Proliferation/*drug effects
;
Leptin/*metabolism
;
Matrix Metalloproteinase 9/metabolism
;
Muscle, Smooth, Vascular/cytology/drug effects
;
Myocytes, Smooth Muscle/cytology/*drug effects
;
Rats
;
beta Catenin/metabolism
6.Grasping the Pseudo-Cleft in the Case of a Small, Severely Tethered Posterior Mitral Leaflet.
Ching Wei LEE ; Shih Hsien SUNG ; Ting Yung CHANG ; I Lin TSAI ; Chih Po HSU ; Chun Che SHIH
Korean Circulation Journal 2017;47(4):536-537
No abstract available.
Hand Strength*
7.Association of USP26 haplotypes in men in Taiwan, China with severe spermatogenic defect.
I-Wen LEE ; Long-Ching KUAN ; Chien-Hung LIN ; Hsien-An PAN ; Chao-Chin HSU ; Yung-Chieh TSAI ; Pao-Lin KUO ; Yen-Ni TENG
Asian Journal of Andrology 2008;10(6):896-904
AIMTo complete comprehensive haplotype analysis of USP26 for both fertile and infertile men.
METHODSTwo hundred infertile men with severe oligospermia or non-obstructive azoospermia were subjected to sequence analysis for the entire coding sequences of the USP26 gene. Two hundred men with proven fertility were genotyped by primer extension methods. Allele/genotype frequencies, linkage disequilibrium (LD) characteristics and haplotypes of fertile men were compared with infertile men.
RESULTSThe allele frequencies of five single nucleotide polymorphisms (370-371insACA, 494T>C, 576G>A, ss6202791C>T, 1737G>A) were significantly higher in infertile patients than control subjects. The major haplotypes in infertile men were TACCGA (28% of the population), TGCCGA (15%), TACCAA (8%), TGCCAA (6%), TATCAA (5%) and CATCAA (5%). The major haplotypes for the control subjects were TACCGA (58% of the population), CACCGA (7%), CATCGA (6%) and TGCCGA (5%). Haplotypes TGCCGA, TATCAA, CATCAA, CATCGC, TACCAA and TGCCAA were over-transmitted in patients with spermatogenic defect, whereas haplotypes TACCGA, CACCGA, and CATCGA were under-transmitted in these patients.
CONCLUSIONSome USP26 alleles and haplotypes are associated with spermatogenic defect in the Han nationality in Taiwan, China.
Adult ; Alleles ; Azoospermia ; epidemiology ; genetics ; Cysteine Endopeptidases ; genetics ; DNA Primers ; Gene Frequency ; Genetic Variation ; Genotype ; Haplotypes ; Humans ; Infertility, Male ; epidemiology ; genetics ; Linkage Disequilibrium ; Male ; Multigene Family ; Oligospermia ; epidemiology ; genetics ; Polymorphism, Genetic ; Spermatogenesis ; genetics ; physiology ; Taiwan ; epidemiology
8.Improved Urothelial Cell Proliferation, Cytoskeleton and Barrier Function Protein Expression in the Patients With Interstitial Cystitis/Bladder Pain Syndrome After Intravesical Platelet-Rich Plasma Injection
Jia-Fong JHANG ; Yuan-Hong JIANG ; Yung-Hsiang HSU ; Han-Chen HO ; Lori A BIRDER ; Teng-Yi LIN ; Hann-Chorng KUO
International Neurourology Journal 2022;26(Suppl 1):S57-67
Purpose:
To investigate urothelial cell proliferation, cytoskeleton, inflammation, and barrier function protein expressions in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical platelet-rich plasma (PRP) injections
Methods:
A total of 19 patients with IC/BPS underwent 4 monthly intravesical PRP injections. Bladder biopsies were taken at the first and fourth PRP treatment. The bladder specimens were analyzed using the Western blot and immunochemical staining for progenitor cell markers for sonic hedgehog (Shh), CD34, and cytoskeleton proteins cytokeratin 5 (CK5), CK14, CK20; barrier function markers for zonula occludens-1 (ZO-1), E-cadherin, and intercellular adhesive molecule-1, tryptase and transforming growth factor-β (TGF-β). Global response assessment (GRA) was used to evaluate treatment outcomes.
Results:
The mean age of patients was 55.6 years. After PRP injections, the functional bladder capacity and maximum flow rate increased, and the visual analogue scale (VAS) of pain, interstitial cystitis (IC) symptom index, IC problem index, O’Leary-Sant symptom score, and GRA improved in all patients. Urothelium Shh, CK5, ZO-1, E-cadherin, and TGF-β expressions increased significantly after repeated PRP injections. By subgrouping, according to PRP treatment outcomes, significant increases in Shh, E-cadherin, and ZO-1 expressions were noted only in patients with GRA ≥1 or improved VAS, but not in patients with GRA=0 and no improvement in VAS.
Conclusions
The level of urothelial barrier function protein and cell proliferation protein expression in the patients with IC/BPS was increased after repeat intravesical PRP injections. Intravesical repeat PRP injections may have potential to improve urothelial health and result in symptoms improvement in the patients with IC/BPS.
9.Corrigendum: Improved Urothelial Cell Proliferation, Cytoskeleton and Barrier Function Protein Expression in the Patients With Interstitial Cystitis/Bladder Pain Syndrome After Intravesical Platelet-Rich Plasma Injection
Jia-Fong JHANG ; Yuan-Hong JIANG ; Yung-Hsiang HSU ; Han-Chen HO ; Lori A BIRDER ; Teng-Yi LIN ; Hann-Chorng KUO
International Neurourology Journal 2022;26(2):169-169
10.Clinical Features and Computed Tomography Characteristics of Non-Klebsiella pneumoniae Liver Abscesses in Elderly (>65 Years) and Nonelderly Patients.
Chih Weim HSIANG ; Chang Hsien LIU ; Hsiu Lung FAN ; Kai Hsiung KO ; Chih Yung YU ; Hong Hau WANG ; Wen I LIAO ; Hsian He HSU ; Wei Chou CHANG
Yonsei Medical Journal 2015;56(2):519-528
PURPOSE: To compare the clinical and computed tomography (CT) appearances of liver abscesses caused by non-Klebsiella pneumoniae bacterial pathogens in elderly and nonelderly patients. MATERIALS AND METHODS: Eighty patients with confirmed non-Klebsiella pneumoniae liver abscesses (non-KPLAs) were enrolled and divided into two age groups: elderly (age > or =65 years, n=42) and nonelderly (age <65 years, n=38). Diagnosis of non-KPLA was established by pus and/or blood culture. We compared clinical presentations, outcomes, and CT characteristics of the two groups, and performed multivariate analysis for significant variables and receiver-operating-characteristic analysis to determine the cutoff value of abscess diameter for predicting non-KPLA. RESULTS: Elderly patients with non-KPLA were associated with a longer hospital stay (p<0.01). Regarding etiology, biliary sources had a strong association in the elderly group (p<0.01), and chronic liver diseases were related to the nonelderly group (p<0.01). Non-KPLAs (52.5%) tended to show a large, multiloculated appearance in the elderly group and were associated with bile duct dilatation (p<0.01), compared with the nonelderly group. The abscess diameter (cutoff value, 5.2 cm; area under the curve, 0.78) between the two groups was predicted. In multivariate analysis, underlying biliary tract disease [odds ratio (OR), 3.58, p<0.05], abscess diameter (OR, 2.40, p<0.05), and multiloculated abscess (OR, 1.19, p<0.01) independently predicted elderly patients with non-KPLA. CONCLUSION: In the elderly patients with non-KPLA, a large, multiloculated abscess with a diameter greater than 5.2 cm was the predominant imaging feature.
Adult
;
Aged
;
Aged, 80 and over
;
Bacterial Infections/*complications/*radiography
;
Female
;
Humans
;
Klebsiella Infections/microbiology
;
Klebsiella pneumoniae
;
Length of Stay
;
Liver Abscess/complications/microbiology/*radiography
;
Logistic Models
;
Male
;
Microscopy
;
Middle Aged
;
Multivariate Analysis
;
ROC Curve
;
Retrospective Studies
;
Tomography, X-Ray Computed/*methods