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Learning Curve Of Natural Orifice Transluminal Endoscopic Surgery (NOTES) hysterectomy
( Yi-chieh Li ),( Wang Chin-jung ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-
Background: Natural orifice transluminal endoscopic surgery (NOTES) hysterectomy is an advanced minimally invasive procedure with less complications and better perioperative outcomes. However, it is more technically challenging, when compared to conventional laparoscopic procedures, and predisposed to require additional training period to ensure technical proficiency. This study aims to analyze the learning curve for NOTES hysterectomy. Methods: From April 2011 to December 2015, 240 NOTES hysterectomies were performed by a single surgeon. Data including preoperative, perioperative and postoperative variables were consecutively collected and analyzed. The learning curve was analyzed with cumulative sum method by taking operative time into account. Results: Mean operative time was 76 minutes (range 35-150) and mean intraoperative blood loss was 167 ml (range 20-900). The learning curve based on operative time for NOTES hysterectomy was categorized into 4 phases: Phase I as the initial learning period (cases 1-20), phase II as the technical competence period (cases 21-100), phase III (101-180) as the trough period and phase IV as the challenging period (cases 180-240). The operative time reached a low trough at phase II after its significant decrease within phase I, while it was observed to rise along with uterine weight in phase III. There were no significant differences in postoperative complications or hospitalization among the four phases. Conclusions: Our study suggested that the learning curve of NOTES hysterectomy consisted of four phases. Experience of 20 cases would be required to achieve technical competence to perform NOTES hysterectomy.
Bactericidal Activity of Soymilk Fermentation Broth by In Vitro and Animal Models
Yi-Ping Chin,Ko-Chung Tsui,Mei-Chieh Chen,Cheng-Yi Wang,Chin-Yuh Yang,Yuh-Ling Lin 한국식품영양과학회 2012 Journal of medicinal food Vol.15 No.6
Soybean fermentation broth (SFB) exhibits potent antibacterial activity against different species of bacteria in in vitro assays and animal models. Four isoflavone compounds—daidzin, genistin, genistein, and daidzein—of SFB were analyzed and quantified by high-performance liquid chromatography. In the in vitro test, daidzin and daidzein had more potent antibacterial activity than genistin. The minimum inhibition concentration values for these bacteria of SFB ranged from 1.25%to 5%, and the minimum bactericidal concentration values of strains ranged from 2.5% to 10%, depending on the species or strain. Vancomycin-resistant Entercoccus faecalis (VRE) strains were also tested for susceptibility to SFB in two species of animal model: the Sprague–Dawley rat and the BALB/c mouse. SFB-fed Sprague–Dawley rats showed excellent elimination efficiency against VRE, close to 99% compared with the phosphate-buffered saline–fed control group. In the BALB/c mouse model, SFB antibacterial activity was 65–80% against VRE compared with the control. In conclusion, SFB contains natural antibacterial substances such as daidzin, genistin, and daidzein that inhibit bacterial growth.
Huang, Peng-Yi,Chen, Liang-Hsiang,Kim, Choongik,Chang, Hsiu-Chieh,Liang, You-jhih,Feng, Chieh-Yuan,Yeh, Chia-Ming,Ho, Jia-Chong,Lee, Cheng-Chung,Chen, Ming-Chou American Chemical Society 2012 ACS APPLIED MATERIALS & INTERFACES Vol.4 No.12
<P>Three benzo[<I>d</I>,<I>d</I>′]thieno[3,2-<I>b</I>;4,5-<I>b</I>′]dithiophene (<B>BTDT</B>) derivatives, end-functionalized with benzothiophenyl (<B>BT-BTDT</B>; <B>2</B>), benzothieno[3,2-b]thiophenyl (<B>BTT-BTDT</B>; 3), and benzo[<I>d</I>,<I>d</I>′]thieno[3,2-<I>b</I>;4,5-<I>b</I>′]dithiophenyl (<B>BBTDT</B>; <B>4</B>), were prepared for bottom-contact/bottom-gate organic thin-film transistors (OTFTs). An improved one-pot [2 + 1 + 1] synthetic method of <B>BTDT</B> with improved synthetic yield was achieved, which enabled the efficient realization of new <B>BTDT</B>-based semiconductors. All of the <B>BTDT</B> compounds exhibited high performance p-channel characteristics with carrier mobilities as high as 0.34 cm<SUP>2</SUP>/(V s) and a current on/off ratio of 1 × 10<SUP>7</SUP>, as well as enhanced ambient stability. The device characteristics have been correlated with the film morphologies and microstructures of the corresponding compounds.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/aamick/2012/aamick.2012.4.issue-12/am3022448/production/images/medium/am-2012-022448_0010.gif'></P><P><A href='http://pubs.acs.org/doi/suppl/10.1021/am3022448'>ACS Electronic Supporting Info</A></P>
Yu-Jia Lin,Hsiao-Ting Chang,Ming-Hwai Lin,Ru-Yih Chen,Ping-Jen Chen,Wen-Yuan Lin,Jyh-Gang Hsieh,Ying-Wei Wang,Chung-Chieh Hu,Yi-Sheng Liou,Tai-Yuan Chiu,Chun-Yi Tu,Yi-Jen Wang,Bo-Ren Cheng,Tzeng-Ji Ch 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.2
Background: Medical staff may have difficulties in using conventional medicine to manage symptoms among terminally ill patients, including adverse effects of the treatment. Traditional Chinese medicine (TCM) is regarded as a complementary or alternative medicine, and has been increasingly used in the field of palliative medicine in recent years. This study aimed to investigate the experiences of and attitudes toward using TCM among palliative care professionals, and to provide preliminary information about its use in palliative care. Methods: This was a cross-sectional survey study conducted in eight inpatient hospice wards in Taiwan between December 2014 and February 2016. The questionnaire was self-administered, and was analyzed with descriptive statistics including Pearson’s Chi-square test and Fisher’s exact test. Results: A total of 251 palliative care professionals responded to the questionnaire, of whom 89.7% and 88.9% believed that the use of TCM could improve the physical symptoms and quality of life in terminally ill patients, respectively. Overall, 59.8%, of respondents suggested that TCM had rare side effects, and 58.2% were worried that TCM could affect the liver and kidney function of patients. In total, 89.7% and 88.0% of professionals agreed there were no suitable clinical practice guidelines and educational programs, respectively, for TCM use in palliative care. Conclusions: Most of the respondents agreed there was insufficient knowledge, skills-training, and continuing education on the use of TCM in terminally ill patients in Taiwan. These results show that to address patient safety considerations, guidelines about use of TCM in palliative care should be established.
Hung-Chun Fu,Jen-Ruei Chen,Min-Yu Chen,Keng-Fu Hsu,Wen-Fang Cheng,An Jen Chiang,Yu-Min Ke,Yu-Chieh Chen,Yin-Yi Chang,Chia-Yen Huang,Chieh-Yi Kang,Yuan-Yee Kan,Sheng-Mou Hsiao,Ming-Shyen Yen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5
Objective: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. Methods: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. Results: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p<0.001), recurrent urinary tract infections (p=0.013), and leg lymphedema (p=0.038). Age over 50-year (HR=9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR=7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR=5.13; 95% CI, 1.38–19.1) and DSS (HR=5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p=0.046), but no impact on survival. Conclusion: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.
Yi‑Ju Ho,Hsiang‑Lung Cheng,Lun‑De Liao,Yu‑Chun Lin,Hong‑Chieh Tsai,Chih‑Kuang Yeh 한국생체재료학회 2023 생체재료학회지 Vol.27 No.00
Background Ischemic stroke-reperfusion (S/R) injury is a crucial issue in the protection of brain function after thrombolysis. The vasodilation induced by ultrasound (US)-stimulated microbubble cavitation has been applied to reduce S/R injury through sonoperfusion. The present study uses oxygen-loaded microbubbles (OMBs) with US stimulation to provide sonoperfusion and local oxygen therapy for the reduction of brain infarct size and neuroprotection after S/R. Methods The murine S/R model was established by photodynamic thrombosis and thrombolysis at the remote branch of the anterior cerebral artery. In vivo blood flow, partial oxygen pressure ( pO2), and brain infarct staining were examined to analyze the validity of the animal model and OMB treatment results. The animal behaviors and measurement of the brain infarct area were used to evaluate long-term recovery of brain function. Results The percentage of blood flow was 45 ± 3%, 70 ± 3%, and 86 ± 2% after 60 min stroke, 20 min reperfusion, and 10 min OMB treatment, respectively, demonstrating sonoperfusion, and the corresponding pO2 level was 60 ± 1%, 76 ± 2%, and 79 ± 4%, showing reoxygenation. After 14 days of treatment, a 87 ± 3% reduction in brain infarction and recovery of limb coordination were observed in S/R mice. The expression of NF-κB, HIF-1α, IL-1β, and MMP-9 was inhibited and that of eNOS, BDNF, Bcl2, and IL-10 was enhanced, indicating activation of anti-inflammatory and anti-apoptosis responses and neuroprotection. Our study demonstrated that OMB treatment combines the beneficial effects of sonoperfusion and local oxygen therapy to reduce brain infarction and activate neuroprotection to prevent S/R injury.