Effects of Transapical Transcatheter Mitral Valve Implantation

Purpose: In this study, transapical transcatheter mitral valve-in-valve implantation (TAMVI) was compared with surgical redo mitral valve replacement (SRMVR) in terms of clinical outcomes.Methods: We retrospectively identified patients with degenerated mitral bioprosthesis or failed annuloplasty rings who underwent redo SRMVR or TAMVI at our medical center. Clinical outcomes were based on echocardiography results.Results: We retrospectively identified patients with symptomatic mitral bioprosthetic valve dysfunction (n = 58) and failed annuloplasty rings (n = 14) who underwent redo SRMVR (n = 36) or TAMVI (n = 36). The Society of Thoracic Surgeons Predicted Risk of Mortality scores were higher in the TAMVI group (median: 9.52) than in the SRMVR group (median: 5.59) (p-value = 0.02). TAMVI patients were more severe in New York Heart Association (p-value = 0.04). The total procedure time (skin to skin) and length of stay after procedures were significantly shorter in the TAMVI group, and no significant difference in mortality was noted after adjustment for confounding factors (p-value = 0.11). The overall mean mitral valve pressure gradient was lower in the TAMVI group than in the SRMVR group at 24 months (p < 0.01). Both groups presented a decrease in the severity of mitral and tricuspid regurgitation at 3–24 months.Conclusions: In conclusion, the statistical analysis is still not robust enough to make a claim that TAMVI is an appropriate alternative. The outcome of the patient appears only to be related to the patient's pre-operative STS score. Additional multi-center, longitudinal studies are warranted to adequately assess the effect of TAMVI

Transitions in smartphone addiction proneness among children: The effect of gender and use patterns.

ObjectivesThis study assessed the incidence of transitions in smartphone addiction proneness (SAP) among children and examined the effects of gender, use patterns (social networking sites (SNSs) use and smartphone gaming) and depression on smartphone addiction transitions.MethodsA representative sample of 2,155 children from Taipei completed longitudinal surveys in both 2015 (5th grade) and 2016 (6th grade). Latent transition analysis (LTA) was used to characterize transitions in SAP and to examine the effects of gender, use patterns and depression on SAP transitions.ResultsLTA identified four latent statuses of SAP: about half of the children were in non-SAP status, one-fifth were in tolerance status, one-sixth were in withdrawal status, and one-seventh were in high-SAP status. Both boys and girls had a higher prevalence of high-SAP and tolerance in 6th grade than in 5th grade, whereas in both grades boys had a higher prevalence of high-SAP and withdrawal, and girls had a higher prevalence of non-SAP and tolerance. Controlling for parents' education, family structure, and household income, higher use of SNSs by children, increasing use of mobile gaming and higher levels of depression were individually associated with increased odds of being in one of the three SAP statuses other than non-SAP. When all three covariates were jointly entered into the model, usage of SNSs and depression remained significant predictors.ConclusionBoth boys and girls tended to transition to tolerance or high-SAP statuses, while children's depression and their usage of SNSs increased the risk of smartphone addiction

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Transitions in smartphone addiction proneness among children: The effect of gender and use pattern

Human Exposure to Ferret Badger Rabies in Taiwan

On 17 July 2013, Taiwan confirmed multiple cases of the rabies virus (RABV) in the wild Taiwan Ferret badger (TFB) (Melogale moschata) member of the family Mustelidae. This study aims at investigating the risk factors for human exposure to rabid TFBs. Statistical inference based on Pearson correlation showed that there was a strong positive correlation between the total number of positive TFB rabies cases and the number of rabid TFBs involved with human activities in 81 enzootic townships (r = 0.91; p < 0.001). A logistic regression analysis indicated that the risk probability of a human being bitten by rabid TFBs was significantly higher when there were no dogs around (35.55% versus 6.17% (indoors, n = 171, p = 0.0001), and 52.00% versus 5.26% (outdoors, n = 44, p = 0.021)), and whether or not there was a dog around was the only crucial covariate that was statistically significantly related to the risk of a human being bitten. In conclusion, this study showed the value of having vaccinated pets as a deterrent to TFB encounters and as a buffer to prevent human exposure to rabid TFBs. The presence of unvaccinated pets could become a significant risk factor in the longer term if rabies isn’t controlled in TFBs because of the spillover between the sylvatic and urban cycles of rabies. Consequently, raising dogs, as well as keeping rabies vaccinations up-to-date for them, can be considered an effective preventive strategy to reduce the risk for human exposure to rabid TFBs

Oral Verruciform Xanthoma: A Clinicopathologic Study of 15 Cases

Oral verruciform xanthoma (VX) is an uncommon oral mucosal lesion. This retrospective study evaluated the clinical and histopathologic features of 15 oral VXs occurring in Taiwanese patients. Methods: Fifteen consecutive cases of oral VX were collected from January 1988 to December 2005. Clinical data and microscopic features of these cases were reviewed and analyzed. Results: The mean age of patients was 45 years (range, 18-79 years). There were eight male and seven female patients. Seven (46.6%) cases occurred on the gingiva, four (26.7%) on the tongue, and four (26.7%) on the buccal or vestibular mucosa. The greatest mean dimension of the lesions was 0.8 cm (range, 0.3-2.0 cm). Three patients had concomitant other oral mucosal lesions such as oral submucous fibrosis, squamous cell carcinoma, and erosive oral lichen planus. Microscopically, all specimens showed varying degrees of surface parakeratosis and the accumulation of numerous foam cells in the connective tissue papillae among uniformly elongated epithelial ridges. Individuals or aggregates of foam cells were also found underneath the epithelial ridges in nine (60%) cases. When the oral VX lesions were further classified into three types according to the microscopic surface architecture, seven (47%) lesions were of the verrucous type, three (20%) the papillary type, and five (33%) the flat type. All patients received surgical excision of the lesions and no recurrence was noted during follow-up of up to 18 years. Conclusion: Oral VXs occur more frequently in the fifth decade of life. The more commonly affected site is the gingiva. The treatment of choice for oral VXs is surgical excision. The prognosis is excellent and recurrence was not seen in this study. [J Formos Med Assoc 2007;106(2):141-147

Excessive Gaming and Online Energy-Drink Marketing Exposure Associated with Energy-Drink Consumption among Adolescents

In this study, we examined excessive online gaming by adolescents and the resultant effects of their exposure to the online marketing of energy drinks and alcohol, and whether marketing literacy could serve as a mitigating factor. This cross-sectional study was conducted in 2020. Data were obtained from a sample of 2613 seventh-grade students from 30 middle schools in Taiwan. A self-administered questionnaire was conducted. The results showed that nearly 18% of the adolescent respondents had used energy drinks, while 75% reported seeing energy-drink advertisements on the internet in the past year. Multiple regression results indicated that factors such as being male, reporting excessive gaming, being exposed to higher levels of online energy-drink marketing, and reporting alcohol use were positively associated with energy-drink consumption. A higher level of online energy-drink marketing-affective literacy, however, was negatively associated with energy-drink consumption. In conclusion, factors that predicted energy-drink consumption among adolescents included excessive gaming and exposure to online energy-drink marketing, but marketing-affective literacy tended to lessen the impact of such advertising

Mirtazapine Inhibits Tumor Growth via Immune Response and Serotonergic System

<div><p>To study the tumor inhibition effect of mirtazapine, a drug for patients with depression, CT26/<em>luc</em> colon carcinoma-bearing animal model was used. BALB/c mice were randomly divided into six groups: two groups without tumors, i.e. <em>wild-type</em> (no drug) and <em>drug</em> (mirtazapine), and four groups with tumors, i.e. <em>never</em> (no drug), <em>always</em> (pre-drug, i.e. drug treatment before tumor inoculation and throughout the experiment), <em>concurrent</em> (simultaneously tumor inoculation and drug treatment throughout the experiment), and <em>after</em> (post-drug, i.e. drug treatment after tumor inoculation and throughout the experiment). The “psychiatric” conditions of mice were observed from the immobility time with tail suspension and spontaneous motor activity post tumor inoculation. Significant increase of serum interlukin-12 (sIL-12) and the inhibition of tumor growth were found in mirtazapine-treated mice (<em>always</em>, <em>concurrent</em>, and <em>after</em>) as compared with that of <em>never</em>. In addition, interferon-γ level and immunocompetent infiltrating CD4+/CD8+ T cells in the tumors of mirtazapine-treated, tumor-bearing mice were significantly higher as compared with that of <em>never.</em> Tumor necrosis factor-α (TNF-α) expressions, on the contrary, are decreased in the mirtazapine-treated, tumor-bearing mice as compared with that of <em>never</em>. Ex vivo autoradiography with [¹²³I]ADAM, a radiopharmaceutical for serotonin transporter, also confirms the similar results. Notably, better survival rates and intervals were also found in mirtazapine-treated mice. These findings, however, were not observed in the immunodeficient mice. Our results suggest that tumor growth inhibition by mirtazapine in CT26/<em>luc</em> colon carcinoma-bearing mice may be due to the alteration of the tumor microenvironment, which involves the activation of the immune response and the recovery of serotonin level.</p> </div

Mirtazapine inhibits tumor growth and prolongs the survival rate and interval in CT-26/<i>luc</i> tumor-bearing model.

<p>On day -14, only “Always” mice were inoculated with tumor cells and treated with mirtazapine throughout the experiment, the other three groups were treated with 0.05 ml of 0.9% NaCl plus 0.5% absolute ethanol up to day 0. On day 0, only “<i>concurrent</i>” mice were inoculated with tumor cells and treated with mirtazapine throughout the rest of the experiment, “<i>after</i>” mice were treated with 0.05 ml of 0.9% NaCl plus 0.5% absolute ethanol but without mirtazapine up to day 14, while “<i>never</i>” mice were treated with 0.05 ml of 0.9% NaCl plus 0.5% absolute ethanol and throughout the experiment. On day 14, “<i>after</i>” mice were inoculated with tumor cells and treated with mirtazapine throughout the rest of the experiment. (A) Tumor growth curves are monitored with digital caliper. (B) Left panel: tumor growth curves are monitored with noninvasive bioluminescence imaging (BLI). The value under each mouse is the tumor volume determined with a caliper. Right panel: quantification of the photon counts in ROIs from the left panel. (C) No antitumor effect of mirtazapine was found on immunodeficient SCID mice with CT26/<i>luc</i> tumors. Left panel: tumor growth curves for <i>always</i> and <i>never</i>. Right panel: quantification of the photon counts in ROIs from the left panel. (D) No significant body-weight change (within 20%) through the whole experiment was found among <i>wild-type</i>, <i>drug</i>, <i>never</i>, <i>always</i>, <i>concurrent</i>, and <i>after</i>. (E) Effects of mirtazapine on the survival rate and interval of CT26/<i>luc</i>-bearing mice. The mean survival times are 67, 64, 57, 43 days for <i>always</i>, <i>concurrent</i>, <i>after</i>, and <i>never</i>, respectively. (n = 10 per group, *<i>p</i><0.05, **<i>p</i><0.01, ***<i>p</i><0.001).</p

The CD4+ and CD8+ T cell subsets with or without mirtazapine treatments in BALB/c mice with or without CT26/<i>luc</i> tumors.

<p>n = 6, ^*<i>p</i><0.05, ^**<i>p</i><0.01, and ^***<i>p</i><0.001 as compared with that of <i>wild type</i>, ^#<i>p</i><0.05, ^##<i>p</i><0.01, and ^###<i>p</i><0.001 as compared with that of <i>never</i>, ⁺<i>p</i><0.05 as compared with that of <i>after</i>.</p

Experimental designs.

<p>(A) Tumor inoculation, mirtazapine treatment, and monitoring of tumor growth and survival. (B) On day 22, mice were assayed for behaviors, then sacrificed for the measurement of lymphocyte subsets and performed with <i>ex vivo</i> autoradiography.</p