The long-term anatomical and visual effect of intravitreal triamcinolone injection during vitrectomy for the treatment of idiopathic macular epiretinal membrane

Lai, Chi-Chun,Wang, Nan-Kai,Wu, Wei-Chi,Yeung, Ling,Hwang, Yih-Shiou,Chen, Kuan-Jen,Chen, Tun-Lu,Chuang, Lan-Hsin Informa Healthcare 2011 Cutaneous and ocular toxicology Vol.30 No.4

<P><I>Purpose</I>: To compare the long-term anatomical and visual outcomes of patients with idiopathic epiretinal membrane (ERM) removed by vitrectomy and membrane peeling with or without the use of intravitreal injection of triamcinolone acetonide (IVTA).</P><P><I>Methods</I>: A retrospective chart review was performed. Subjects who underwent vitrectomy and who were followed over 12 months were included. The study included two groups of patients. In group 1 (71 eyes), the patients underwent vitrectomy and membrane peeling without the use of IVTA. In group 2 (27 eyes), 2 mg of IVTA was given at the end of the surgery. The main outcome measures were best-corrected visual acuity (BCVA), central foveal thickness (CFT) determined by optical coherence tomography (OCT), the number of cataract surgeries, and the use of anti-glaucomatous drugs during the follow-up period.</P><P><I>Results</I>: This study included 98 eyes with ERM from 98 patients. There was no significant difference between the two groups with respect to age, gender, pre- and postoperative lens status, BCVA, CFT, or length of the follow-up period. The mean age for all of the patients was 62.45 ± 10.01 (mean ± SD) years, and the mean follow-up length was 20.58 ± 9.64 (mean ± SD) months. In all cases, the mean best-corrected logarithm of minimum angle of resolution (logMAR) acuity improved from a preoperative value of 0.91 ± 0.32 [Snellen equivalent (SE), 0.16 ± 0.14] to a postoperative value of 0.46 ± 0.36 (SE, 0.46 ± 0.29) (<I>P</I> < 0.0001). The CFT was reduced from a preoperative value of 473.46 ± 96.91 μm to a postoperative value of 302.44 ± 69.80 μm (<I>P</I> < 0.0001). Six patients (22.2%) in group 2 required anti-glaucomatous drugs to control intraocular pressure (IOP) during the follow-up period, and three patients (4.2%) in group 1 required drugs to control IOP (<I>P</I> == 0.012).</P><P><I>Conclusions</I>: The postoperative visual outcomes for patients with idiopathic ERM were favorable, but CFT did not return to a normal level, even in eyes in which 2 mg IVTA was used. The IVTA use after ERM removal produced no significant benefits during long-term follow-up, but IVTA did increase the risk of increased IOP.</P>

The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy

Chi-Hang Yee,Jeremy Yuen-Chun Teoh,Pui-Tak Lai,Vivian Yee-Fong Leung,Winnie Chiu-Wing Chu,Wai-man Lee,Yuk-Him Tam,Chi-Fai Ng 대한배뇨장애요실금학회 2017 International Neurourology Journal Vol.21 No.2

Purpose: The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods: This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results: From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029), serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006). Conclusions: Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.

An Improved Secure Dynamic ID Based Remote User Authentication Scheme for Multi-Server Environment

Cheng-Chi Lee,Yan-Ming Lai,Chun-Ta Li 보안공학연구지원센터 2012 International Journal of Security and Its Applicat Vol.6 No.2

Lattice Relations and Solidification of the Complex Regular Eutectic (Cr,Fe)-(Cr,Fe)23C6

Hsuan-Han Lai,Chih-Chun Hsieh,Chi-Ming Lin,Weite Wu 대한금속·재료학회 2017 METALS AND MATERIALS International Vol.23 No.3

The eutectic (Cr,Fe)-(Cr,Fe)23C6 showed a triaxial fishbone structure and could be categorized as a “complexregular structure”. In this study, the lattice relations of the fishbone (Cr,Fe)23C6 were examined and the solidificationprocess was observed using a transmission electron microscope and a confocal laser scanning microscope. Forone of the three fish bones in a eutectic cell, parallel (Cr,Fe)23C6 lamellas at one side of the spine had the samelattice direction, as did those in the (Cr,Fe) phase. The lattices of neighboring (Cr,Fe)23C6 and (Cr,Fe) phases werenot coherent. Lamellar (Cr,Fe)23C6 on opposite sides of a spine had different lattice directions, and their latticeboundary was in the spine. By using the confocal laser scanning microscope, the solidification of lamellar eutecticstructure could be observed. At the low cooling rate of 5oC·min-1, parallel lamellas would grow thick blocksinstead of thin plates. To obtain a thin lamellar eutectic structure, the cooling rate should be higher, likethe rate in welding.

Effects of Vanadium Content on the Microstructure and Dry Sand Abrasive Wear of a Eutectic Cr-Fe-C Hardfacing Alloy

Hsuan-Han Lai,Chih-Chun Hsieh,Chi-Ming Lin,Weite Wu 대한금속·재료학회 2016 METALS AND MATERIALS International Vol.22 No.1

In this study, the effects of vanadium on the morphology and wear behavior of a eutectic Cr-Fe-C hardfacing alloy were discussed. The alloys tested contained different amounts of vanadium, ranging from 0 to 2.39 wt%. A fibrous V4C3 was found when the alloy contained 0.93 wt% vanadium. The addition of vanadium was found to decrease the fraction of eutectic M23C6 and increase the width of the interspaces between the eutectic cells. The DTA results revealed that V4C3 formed just before the eutectic α+M23C6 during solidification. The surface hardness was shown to increase with increasing vanadium content, which also caused the hardness deviation and wear loss to decrease; however, the addition of vanadium was not shown to affect the hardness of eutectic α+M23C6. The V4C3 could be scratched off during the wear test due to the increase in the width of the interspaces between the eutectic cells; therefore, the alloys that contained 0.93 and 2.39 wt% vanadium exhibited similar wear loss results.

Using Adaptive Bandwidth Allocation Approach to Defend DDoS Attacks

Wei-Shen Lai,Chu-Hsing Lin,Jung-Chun Liu,Hsun-Chi Huang,Tsung-Che Yang 보안공학연구지원센터 2008 International Journal of Software Engineering and Vol.2 No.4

Denial of service attacks occur when the attacks are from a single host, whereas distributed denial of service attacks occur when multiple affected systems flood the bandwidth or resources of a targeted system. Although it is not possible to exempt entirely from denial of service or distributed denial of service attacks, we can limit the malicious user by controlling the traffic flow. In the paper, we propose to monitor the traffic pattern in order to alleviate distributed denial of service attacks. A bandwidth allocation policy will be adopted to assign normal users to a high priority queue and suspected attackers to a low priority queue. Simulations conducted in network simulator of our proposed priority queue-based scheme shows its effectiveness in blocking attacking traffic while maintaining constant flows for legitimate traffic.

Trends in incidence and survival outcome of epithelial ovarian cancer: 30-year national population-based registry in Taiwan

Ying-Cheng Chiang,Chi-An Chen,Chun-Ju Chiang,Tsui-Hsia Hsu,Ming-Chieh Lin,San-Lin You,Wen-Fang Cheng,Mei-Shu Lai 대한부인종양학회 2013 Journal of Gynecologic Oncology Vol.24 No.4

Objective: To investigate the changes of incidence and prognosis of epithelial ovarian cancer in thirty years in Taiwan. Methods: The databases of women with epithelial ovarian cancer during the period from 1979 to 2008 were retrieved from the National Cancer Registration System of Taiwan. The incidence and prognosis of these patients were analyzed. Results: Totally 9,491 patients were included in the study. The age-adjusted incidences of epithelial ovarian cancer were 1.01, 1.37, 2.37, 3.24, 4.18, and 6.33 per 100,000 person-years, respectively, in every 5-year period from 1979 to 2008. The age-specific incidence rates increased especially in serous, endometrioid and clear cell carcinoma, and the age of diagnosis decreased from sixty to fifty years old in the three decades. Patients with mucinous, endometrioid, or clear cell carcinoma had better long-term survival than patients with serous carcinoma (log rank test, p<0.001). Patients with undifferentiated carcinoma or carcinosarcoma had poorer survival than those with serous carcinoma (log rank test, p<0.001). The mortality risk of age at diagnosis of 30-39 was significantly higher than that of age of 70 years or more (test for trend, p<0.001). The mortality risk decreased from the period of 1996-1999 (hazard ratio [HR], 0.90; p=0.054) to the period after 2000 (HR, 0.74; p<0.001) as compared with that from the period of 1991-1995. Conclusion: An increasing incidence and decreasing age of diagnosis in epithelial ovarian cancer patients were noted. Histological type, age of diagnosis, and treatment period were important prognostic factors for epithelial ovarian carcinoma.

Delay of Surgery for Spinal Metastasis due to the COVID-19 Outbreak Affected Patient Outcomes

Chia-Jung Hsieh,Chun-Yu Wu,Yen-Heng Lin,Yu-Cheng Huang,Wen-Chi Yang,Tom Wei-Wu Chen,Wei-Li Ma,Wei-Hsin Lin,Feng-Ming Hsu,Furen Xiao,Shih-Hung Yang,Dar-Ming Lai,Chang-Mu Chen,Shin-Yi Chao,Fon-Yih Tsuan 대한척추신경외과학회 2023 Neurospine Vol.20 No.4

Objective: The present study is to analyze the effects of the coronavirus disease 2019 (COVID 2019) outbreak and the subsequent lockdown on the outcomes of spinal metastasis patients. Methods: The study was a retrospective analysis of data from a prospective cohort study. All patients underwent surgical intervention for spinal metastases between January 2019 and December 2021 and had at least 3 months of postoperative follow-up. The primary outcome was overall mortality during the 4 different stages (pre-COVID-19 era, COVID-19 pandemic except in Taiwan, national lockdown, lifting of the lockdown). The secondary outcomes were the oncological severity scores, medical/surgical accessibility, and patient functional outcome during the 4 periods as well as survival/mortality. Results: A total of 233 patients were included. The overall mortality rate was 41.20%. During the Taiwan lockdown, more patients received palliative surgery than other surgical methods, and no total en bloc spondylectomy was performed. The time from surgeon visit to operation was approximately doubled after the COVID-19 outbreak in Taiwan (75.97, 86.63, 168.79, and 166.91 hours in the 4 periods, respectively). The estimated survival probability was highest after the national lockdown was lifted and lowest during the lockdown. In the multivariate analysis, increased risk of mortality was observed with delay of surgery, with emergency surgery having a higher risk with delays above 33 hours, urgent surgery (below 59 and above 111 hours), and elective surgery (above 332 hours). Conclusion: The COVID-19 pandemic and related policies have altered daily clinical practice and negatively impacted the survival of patients with spinal metastases.

토마토 육묘방법이 화방의 착생절위에 미치는 영향

김영봉(Yeong Bong Kim),황갑춘(Kap Chun Hwang),노치웅(Chi Woong Ro),박중춘(Joong Choon Park),조정래(Jeoung Lai Cho) 한국원예학회 2000 원예과학기술지 Vol.18 No.2

Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

Tzu-Yi Lin,Eugene Yu-Chuan Kang,Shih-Chieh Shao,Edward Chia-Cheng Lai,Sunir J. Garg,Kuan-Jen Chen,Je-Ho Kang,Wei-Chi Wu,Chi-Chun Lai,Yih-Shiou Hwang 대한당뇨병학회 2023 Diabetes and Metabolism Journal Vol.47 No.3

Background: To compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care.Methods: This retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age <40 years, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR.Results: There were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70).Conclusion: Compared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development.