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Type 2 Diabetes Mellitus Increases Peritonsillar Abscess Susceptibility: Real-World Evidence
Ching-Lung Wu,Ming-Shao Tsai,Ta-Jen Lee,Yun-Ting Wang,Chia-Yen Liu,Yao-Hsu Yang,Yao-Te Tsai,Cheng-Ming Hsu,Ching-Yuan Wu,Pey-Jium Chang,Geng-He Chang 대한이비인후과학회 2021 Clinical and Experimental Otorhinolaryngology Vol.14 No.3
Objectives. Type 2 diabetes mellitus (T2DM) is a risk factor for deep neck infection (DNI) and leads to complications and poor outcomes. Our study aimed to investigate the risk, prognosis, and complications of peritonsillar abscess (PTA) in patients with T2DM. Methods. We extracted data of patients newly diagnosed as having T2DM between January 2000 and December 2011 from Taiwan’s National Health Insurance Research Database. These patients were matched with patients without T2DM, and PTA incidence was compared between both cohorts. Results. In total, 67,852 patients with and 135,704 patients without T2DM were enrolled. PTA incidence was significantly higher in patients with T2DM (incidence rate ratio, 1.91; P<0.001); moreover, PTA incidence was higher at 1 to 5 years after T2DM diagnosis than at <1 and >5 years after T2DM diagnosis. Cox regression analysis showed that patients with T2DM had an approximately 2-fold higher PTA risk (adjusted hazard ratio [aHR]: 1.89, P<0.001). Patients with a higher adapted Diabetes Complications Severity Index (aDCSI) had higher PTA risk than those with a lower aDCSI (aHRs: 2.17 for aDCSI ≥1, P=0.006 and 1.81 for aDCSI=0, P=0.002). T2DM patients with a high aDCSI (≥1) had a nonsignificantly longer hospitalization duration and a higher rate of DNI complications than did those with a low aDCSI (=0). Conclusion. In patients with T2DM, PTA incidence was relatively high, and it increased with T2DM severity. Moreover, T2DM patients should be particularly careful about PTA within 1 to 5 years after the diagnosis, and physicians should keep in mind that the prognosis of PTA was correlated with T2DM severity.
A Hybrid Dynamic Stabilization and Fusion System in Multilevel Lumbar Spondylosis
Li-Yu Fay,Chih-Chang Chang,Hsuan-Kan Chang,Tsung-Hsi Tu,Tzu-Yun Tsai,Ching-Lan Wu,Wen-Cheng Huang,Jau-Ching Wu,Henrich Cheng 대한척추신경외과학회 2018 Neurospine Vol.15 No.3
Objective: The Dynesys-Transition-Optima (DTO) hybrid system was designed to achieve arthrodesis and stabilization in patients with lumbar degeneration. Satisfactory outcomes were demonstrated previously. However, no study has evaluated the effects of using the DTO system in patients with lumbar spondylolisthesis or stenosis. Methods: This retrospective study included 35 consecutive patients with multilevel lumbar degeneration with or without spondylolisthesis who underwent surgery using the DTO system. Imaging studies included pre- and postoperative radiography, magnetic resonance imaging, and computed tomography. The clinical outcomes were measured by Japanese Orthopedic Association (JOA) scores, Oswestry Disability Index (ODI) scores, and a visual analogue scale (VAS) for back and leg pain. Results: Thirty patients (85.7%) with a mean age of 61.9 years completed the follow-up, with a mean duration of 35.1 months. There were 21 patients in the spondylolisthesis group and 9 in the stenosis group. The spondylolisthesis group had worse functional scores than the stenosis group preoperatively. After DTO surgery, all patients showed significant improvements in clinical outcomes, including VAS for back and leg pain, ODI, and JOA scores (p<0.05). There were no significant differences in clinical outcomes between the 2 groups. At a 2-year follow-up, lumbar alignment was well maintained in both groups (p=0.116). There were no significant differences in lumbar alignment between the 2 groups. Conclusion: During a follow-up period of over 2 years, both patients with spondylolisthesis and those with stenosis showed improvements and similar disability and pain scores after surgery using the DTO system. Lumbar alignment was also well maintained.
Angel Chao,Yi-Hao Lin,Lan-Yan Yang,Ren-Chin Wu,Wei-Yang Chang,Pi-Yueh Chang,Shih-Cheng Chang,Chiao-Yun Lin,Huei-Jean Huang,Cheng-Tao Lin,Hung-Hsueh Chou,Kuan-Gen Huang,Wen-Ling Kuo,Ting-Chang Chang,Ch 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.3
Objective: The characteristics of patients with metachronous breast and ovarian malignancies and the pathogenic role of BRCA1/2 mutations remain poorly understood. We investigated these issues through a review of hospital records and nationwide Taiwanese registry data, followed by BRCA1/2 mutation analysis in hospital-based cases. Methods: We retrospectively retrieved consecutive clinical records of Taiwanese patients who presented with these malignancies to our hospital between 2001 and 2017. We also collected information from the Data Science Center of the Taiwan Cancer Registry (TCR) between 2007 and 2015. Next-generation sequencing and multiplex ligation-dependent probe amplification were used to identify BRCA1/2 mutations and large genomic rearrangements, respectively. When BRCA1/2 mutations were identified in index cases, pedigrees were reconstructed and genetic testing was offered to family members. Results: A total of 12,769 patients with breast cancer and 1,537 with ovarian cancer were retrieved from our hospital records. Of them, 28 had metachronous breast and ovarian malignancies. We also identified 113 cases from the TCR dataset. Eighteen hospital-based cases underwent BRCA1/2 sequencing and germline pathogenic mutations were detected in 7 patients (38.9%, 5 in BRCA1 and 2 in BRCA2). All BRCA1/2 mutation carriers had ovarian high-grade serous carcinomas. Of the 12 patients who were alive at the time of analysis, 5 were BRCA1/2 mutation carriers. All of them had family members with BRCA1/2-associated malignancies. Conclusions: Our results provide pilot evidence that BRCA1/2 mutations are common in Taiwanese patients with metachronous breast and ovarian malignancies, supporting the clinical utility of genetic counseling.
Chang-Ching Yeh,Hsiao-Yun Tai,Hong Chou,Keh-Gong Wu,Horng-Der Shen 대한천식알레르기학회 2016 Allergy, Asthma & Immunology Research Vol.8 No.5
Purpose: Fusarium species are among prevalent airborne fungi and causative agents of human respiratory atopic disorders. We previously identified a 36.5-kDa F. proliferatum component recognized by IgE antibodies in 9 (53%) of the 17 F. proliferatum-sensitized atopic serum samples. The purpose of this study is to characterize the 36.5-kDa allergen of F. proliferatum. Methods: Characterization of allergens and determination of IgE cross-reactivity were performed by cDNA cloning/expression and immunoblot inhibition studies. Results: Based on the finding that the 36.5-kDa IgE-binding component reacted with the mouse monoclonal antibody FUM20 against fungal vacuolar serine protease allergens, the cDNA of F. proliferatum vacuolar serine protease (Fus p 9.0101) was subsequently cloned. Nine serum samples from respiratory atopic patients with IgE binding to the vacuolar serine protease allergen of Penicillium chrysogenum (Pen ch 18) also showed IgE-immunoblot reactivity to rFus p 9.0101. The purified rFus p 9.0101 can inhibit IgE and FUM20 binding to the 36.5-kDa component of F. proliferatum. Thus, a novel and important Fus p 9.0101 was identified. The rPen ch 18 can inhibit IgE binding to Fus p 9.0101. It indicates that IgE cross-reactivity between Fus p 9.0101 and Pen ch 18 also exists. Furthermore, neither rFus p 9.0101 K88A nor rPen ch 18 K89A mutants inhibited IgE binding to rFus p 9.0101. Lys88 was considered a critical core amino acid in IgE binding to r Fus p 9.0101 and a residue responsible for IgE cross-reactivity between Fus p 9.0101 and Pen ch 18 allergens. Conclusions: Results obtained from this study indicate that vacuolar serine protease may be a major allergen of F. proliferatum and an important IgE cross-reactive pan-fungal allergen, and provide important bases for clinical diagnosis of fungal allergy.
Influence of Residential Environment and Lifestyle on Multiple Primary Malignancies in Taiwan
Chang, Chih-Chun,Chung, Yi-Hua,Liou, Ching-Biau,Lee, Yi-Chen,Weng, Wei-Ling,Yu, Yun-Chieh,Yen, Tzung-Hai,Wu, Jiann-Ming Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8
Background: Multiple primary malignancies (MPM) have become increasingly prevalent worldwide. This investigation was aimed at establishing the clinicopathological characteristics of MPM patients and evaluating the impact of the living environment on MPM in the Taiwanese population. Materials and Methods: From January 2009 to December 2013, a total of 8,268 cancer patients were identified in our institutional center. Of these, 125 were diagnosed as MPM and thus enrolled. Data for clinicopathological features and treatment approaches for these MPM patients living in urban or suburb zone were obtained. Findings for the air pollution status in Taiwan were also collected. Results: The most common cancer match of MPM was esophageal cancer with hypopharyngeal cancer (12.8%), followed by colorectal cancer with gastric cancer (6.4%) and colorectal cancer with breast cancer (5.6%). The air quality was significantly worse in the urban than in the suburban zone and there was a remarkably higher portion of MPM patients in the urban zone suffering from grade III and IV post-chemotherapeutic neutropenia (30.8% vs 15.1%, P=0.036). Conclusions: The tumor frequency and site distribution should be taken into the clinical evaluation because there is a relatively high risk of developing MPM. This study also highlighted the potential influence of environmental factors on post-chemotherapeutic neutropenia for patients with MPM.
Xu, Yun-ping,Zheng, Zhou-lian,Liu, Chang-jiang,Wu, Kui,Song, Wei-ju Techno-Press 2018 Wind and Structures, An International Journal (WAS Vol.26 No.6
This paper studies the aerodynamic stability of a tensioned, geometrically nonlinear orthotropic membrane structure with hyperbolic paraboloid in sag direction. Considering flow separation, the wind field around membrane structure is simulated as the superposition of a uniform flow and a continuous vortex layer. By the potential flow theory in fluid mechanics and the thin airfoil theory in aerodynamics, aerodynamic pressure acting on membrane surface can be determined. And based on the large amplitude theory of membrane and D'Alembert's principle, interaction governing equations of wind-structure are established. Then, under the circumstance of single-mode response, the Bubnov-Galerkin approximate method is applied to transform the complicated interaction governing equations into a system of second-order nonlinear differential equation with constant coefficients. Through judging the frequency characteristic of the system characteristic equation, the critical velocity of divergence instability is determined. Different parameter analysis shows that the orthotropy, geometrical nonlinearity and scantling of structure is significant for preventing destructive aerodynamic instability in membrane structures. Compared to the model without considering flow separation, it's basically consistent about the divergence instability regularities in the flow separation model.
Lee, Yun-Gyoo,Kim, Inho,Lee, Eunyoung,Bang, Soo-Mee,Kang, Chang Hyun,Kim, Young Tae,Kim, Hak Jae,Wu, Hong-Gyun,Kim, Young Whan,Kim, Tae Min,Lee, Keun-Wook,Lee, Se-Hoon,Kim, Dong-Wan,Heo, Dae Seog F. K. Schattauer 2014 Thrombosis and Haemostasis Vol.111 No.6
<P>Although the overall risk of venous thromboembolism (VTE) is high in patients with non-small cell lung cancer (NSCLC), risk identification is limited. The goal of this study was to estimate the incidence, risk factors and prognostic implications of VTE, and to evaluate a genetic link between oncogenes and the risk of VTE in Asian patients with NSCLC. A total of 1,998 consecutive patients with NSCLC were enrolled and analysed retrospectively. Since the effects of therapeutics on VTE development were modified by stage, stratified analyses were performed. When comparing overall survival in terms of VTE development, a propensity score-matching method was adopted to minimise potential confounding. The six-month and two-year cumulative incidences of VTE were 4.2% and 6.4%, respectively. The risk of VTE increased 2.45-fold with each advancing stage in NSCLC (p<0.001). The independent predictors of VTE were advanced age, pneumonectomy and palliative radiotherapy in localised NSCLC and ineligibility for surgery and palliative radiotherapy in locally advanced NSCLC. Adenocarcinoma histology (vs squamous cell) and former/current smoking status were significant predictors of VTE in metastatic NSCLC. A significant association between VTE and decreased survival was observed only among patients with localised NSCLC. EGFR mutations (p=0.170) and ALK rearrangements (p=0.159) were not associated with VTE development in lung adenocarcinoma. In conclusion, the two-year cumulative incidence of VTE is 6.4% in Asian patient with NSCLC. The significant predictors of VTE are different across stages of NSCLC. The prognostic impact of VTE on poor survival was limited to localised NSCLC.</P>