Targeting Three Brain Regions (Bilateral SMA, Left and Right DLPFC) Sequentially in One Session Using Combined Repetitive Transcranial Magnetic Stimulation and Intermittent Theta-burst Stimulation in Treatment-refractory Obsessive-compulsive Disorder: A

Po-Han Chou(Po-Han Chou),Alexander T. Sack(Alexander T. Sack ),Kuan-Pin Su(Kuan-Pin Su) 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.4

Repetitive transcranial magnetic stimulation (rTMS) has been widely used as a therapy for refractory obsessive-compulsive disorder (OCD). However, it remains unclear which exact target and stimulation sequence of rTMS is most effective for OCD. Here, we report the case of an 18-year-old female with treatment-refractory OCD whose symptoms markedly improved after combined rTMS and intermittent theta-burst stimulation over the bilateral dorsolateral prefrontal cortex and supplementary motor area. Our report indicates that combining treatment sequences that stimulate different brain regions sequentially is feasible and may clinically benefit patients suffering from OCD.

Predicting the surgical reparability of large-to-massive rotator cuff tears by B-mode ultrasonography: a cross-sectional study

Po-Cheng Chen,Kuan-Ting Wu,Yi-Cun Chen,Yu-Chi Huang,Ching-Di Chang,Wei-Che Lin,Wen-Yi Chou 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.1

Purpose: This study aimed to compare the ability of B-mode ultrasonography and magnetic resonance imaging (MRI) to predict the repairability of large-to-massive rotator cuff tears (RCTs). Methods: This cross-sectional study included participants with large-to-massive RCTs who underwent arthroscopic repair. B-mode ultrasonography and MRI were conducted prior to arthroscopic repair. B-mode ultrasonography was used to evaluate the echogenicity of the rotator cuff muscle using the Heckmatt scale. Intra-rater and inter-rater reliabilities were examined for two independent physicians. MRI was used to evaluate the degrees of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, two experienced orthopedic surgeons performed surgery and decided whether the torn stump could be completely repaired intraoperatively. Results: Fifty participants were included, and 32 complete repairs and 18 partial repairs were performed. B-mode ultrasonography showed good intra-rater reliability and inter-rater reliability for assessment of the muscle echogenicity of the supraspinatus and infraspinatus muscles. The correlation coefficients between B-mode ultrasound findings and MRI findings showed medium to large effect sizes (r=0.4-0.8). The Goutallier classification of the infraspinatus muscles was the MRI predictor with the best discriminative power for surgical reparability (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.81 to 0.98), while the Heckmatt scale for infraspinatus muscles was the most accurate ultrasound predictor (AUC, 0.85; 95% CI, 0.74 to 0.96). No significant differences in AUCs among the MRI and ultrasound predictors were found. Conclusion: B-mode ultrasonography was a reliable examination tool and had a similar ability to predict surgical reparability to that of MRI among patients with large-to-massive RCTs. Purpose: This study aimed to compare the ability of B-mode ultrasonography and magnetic resonance imaging (MRI) to predict the repairability of large-to-massive rotator cuff tears (RCTs).Methods: This cross-sectional study included participants with large-to-massive RCTs who underwent arthroscopic repair. B-mode ultrasonography and MRI were conducted prior to arthroscopic repair. B-mode ultrasonography was used to evaluate the echogenicity of the rotator cuff muscle using the Heckmatt scale. Intra-rater and inter-rater reliabilities were examined for two independent physicians. MRI was used to evaluate the degrees of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, two experienced orthopedic surgeons performed surgery and decided whether the torn stump could be completely repaired intraoperatively.Results: Fifty participants were included, and 32 complete repairs and 18 partial repairs were performed. B-mode ultrasonography showed good intra-rater reliability and inter-rater reliability for assessment of the muscle echogenicity of the supraspinatus and infraspinatus muscles. The correlation coefficients between B-mode ultrasound findings and MRI findings showed medium to large effect sizes (r=0.4-0.8). The Goutallier classification of the infraspinatus muscles was the MRI predictor with the best discriminative power for surgical reparability (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.81 to 0.98), while the Heckmatt scale for infraspinatus muscles was the most accurate ultrasound predictor (AUC, 0.85; 95% CI, 0.74 to 0.96). No significant differences in AUCs among the MRI and ultrasound predictors were found.Conclusion: B-mode ultrasonography was a reliable examination tool and had a similar ability to predict surgical reparability to that of MRI among patients with large-to-massive RCTs.

Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder According to the Existing Psychiatric Comorbidity

Po-Han Chou,Yen-Feng Lin,Ming-Kuei Lu,Hsin-An Chang,Che-Sheng Chu,Wei Hung Chang,Taishiro Kishimoto,Alexander T. Sack,Kuan-Pin Su 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.2

Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are evidenced-based treatments for patients with major depressive disorder (MDD) who fail to respond to standard first-line therapies. However, although various TMS protocols have been proven to be clinically effective, the response rate varies across clinical applications due to the heterogeneity of real-world psychiatric comorbidities, such as generalized anxiety dis-order, posttraumatic stress disorder, panic disorder, or substance use disorder, which are often observed in patients with MDD. Therefore, individualized treatment approaches are important to increase treatment response by assigning a given patient to the most optimal TMS treatment protocol based on his or her individual profile. This literature review summarizes different rTMS or TBS protocols that have been applied in researches investigating MDD patients with certain psychiatric comorbidities and discusses biomarkers that may be used to predict rTMS treatment response. Furthermore, we highlight the need for the validation of neuroimaging and electrophysiological biomarkers associated with rTMS treatment responses. Finally, we discuss on which directions future efforts should focus for developing the personalization of the treatment of depression with rTMS or iTBS.

TELLING A GOOD STORY FROM A BAD COMPANY: EXAMINING THE EFFECTS OF NARRATIVE RICHNESS AND MORAL IMAGINATION ON CONSUMER EMOTIONS, ATTITUDE, AND BEHAVIORAL INTENTION

Po-Han Wu,Kuan-Ju Chen 글로벌지식마케팅경영학회 2023 Global Marketing Conference Vol.2023 No.07

Given the conundrum of moral washing in CSR communication, this research examines the effectiveness of narrative richness using storytelling in marketing. In the process, the moderating role of moral imagination is further explored. An online experiment with a 2 (Narrative Richness: High vs. Low) x 2 (Moral Imagination: High vs. Low) between-subjects factorial design was conducted with two well-known companies (Shell vs. Facebook) suffered from a reputation crisis as the target brands. The results (N = 287) showed that the effects of narrative richness on consumer responses, including positive emotion, negative emotion, and behavioral intention, were significant for Facebook whereas its effect on positive emotion was significant for Shell. Most importantly, the two-way interaction between narrative richness and moral imagination on attitude toward the brand was significant for Shell, indicating that the effect of narrative richness on attitude toward the brand was augmented by moral imagination. In other words, consumers with high moral imagination view narrative-rich messages with virtuous thoughts to figure out the conundrum of CSR communication for the company, and vice versa. Theoretical and managerial implications are discussed.

Long-Term Treatment with Shengmai San-Derived Herbal Supplement (Wei Kang Su) Enhances Antioxidant Response in Various Tissues of Rats with Protection Against Carbon Tetrachloride Hepatotoxicity

Pou Kuan Leong,Na Chen,Po Yee Chiu,Hoi Yan Leung,Chung Wah Ma,Qing Tao Tang,Kam Ming Ko 한국식품영양과학회 2010 Journal of medicinal food Vol.13 No.2

Wei Kang Su (WKS) is a commercial herbal product based on a Chinese herbal formula, Shengmai San. Here, we investigated the effects of long-term treatment with WKS on mitochondrial antioxidant status and functional ability, as well as heat shock protein (Hsp) 25/70 production, in various tissues of rats. WKS treatment enhanced mitochondrial antioxidant status and ATP generation capacity, as well as Hsp 25/70 production in various rat tissues. WKS treatment suppressed plasma reactive oxygen metabolite levels and protected against carbon tetrachloride hepatotoxicity in rats. Long-term WKS treatment may prevent diseases by enhancing the resistance of mitochondria to oxidative stress.

The Interaction of Oxytocin and Social Support, Loneliness, and Cortisol Level in Major Depression

Tsung-Yu Tsai,Huai-Hsuan Tseng,Mei Hung Chi,Hui Hua Chang,Cheng-Kuan Wu,Yen Kuang Yang,Po See Chen 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.4

Objective: Loneliness is a specific risk factor for depressive symptoms and suicidal behavior. The present study examined whether the serum oxytocin level would interact with social support and buffers loneliness and hypothalamic-pituitary- adrenal (HPA)-axis activity in drug-naïve patients with major depressive disorder (MDD). Methods: Twenty-six patients with MDD (male:female = 3:23; mean age, 45.54 ± 12.97 years) were recruited. The 17-item Hamilton Depression Rating Scale, UCLA Loneliness Scale and self-reported Measurement of Support Function Questionnaire were administered. Serum oxytocin and cortisol levels were assessed using a commercial immunoassay kits. Results: In MDD patients, a negative association was found between degrees of social support and loneliness ( = −0.39, p = 0.04). The interaction between social support and serum oxytocin level was negatively associated with loneliness ( = −0.50, p = 0.017) and serum cortisol level ( = −0.55, p = 0.020) after adjusting for age. Follow-up analyses showed that the association between higher social support and lower loneliness was observed only in the higher-oxytocin group (r = −0.75, p = 0.003) but not in the lower group (r = −0.19, p = 0.53). The significance remained after further adjusting for sex and depression severity. Conclusion: Low oxytocin level is a vulnerability factor for the buffering effect of social support for loneliness and aberrant HPA-axis activity in MDD patients.