Partially hydrolyzed guar gum supplement reduces high-fat diet increased blood lipids and oxidative stress and ameliorates FeCl3-induced acute arterial injury in hamsters

Increased reactive oxygen species (ROS) and hyperlipidemia can promote arterial thrombus. We evaluated the potential of a partially hydrolyzed guar gum (PHGG) as dietary fiber on lipid profiles and FeCl3-induced arterial thrombosis in the high fat-diet fed hamsters. Our in vitro results found that PHGG is efficient to scavenge O2-•, H2O2, and HOCl. High fat-diet increased plasma triglyceride, total cholesterol, LDL, VLDL, methylguanidine and dityrosine level and accelerated FeCl3-induced arterial thrombosis formation (from 463 ± 51 to 303 ± 45 sec). Low dose PHGG supplement significantly decreased the total cholesterol, LDL, methylguanidine and dityrosine level and delayed the time for arterial thrombosis formation (528 ± 75 sec). High dose PHGG supplement decreased the level in triglyceride, total cholesterol, LDL and VLDL and further delayed the time for arterial thrombus (671 ± 36 sec). The increased Bax protein and decreased Bcl-2 and HSP-70 protein expression was found in the carotid and femoral arteries of high fat-diet hamsters. Low and high dose of PHGG supplement decreased Bax expression and increased Bcl-2 and HSP-70 protein expression. We found that FeCl3 significantly enhanced intercellular adhesion molecule-1 and 4-hydroxynonenal expression in the endothelial site of damaged artery after 150-sec FeCl3 stimulation. PHGG supplement decreased the endothelial ICAM-1 and 4-hydroxynonenal expression after 150-sec FeCl3 stimulation. Based on these results, we conclude that PHGG supplement can increase antioxidant protein expression and thus decrease oxidative stress induced arterial injury

Antipsychotic Prescription Trends, Patterns and Associated Factors in Taiwanese Children and Adolescents

This study evaluated the prescription trends, patterns and associated factors of antipsychotic medication in children and adolescents. We conducted a retrospective study by using the database of outpatient health insurance files of a psychiatric center in Northern Taiwan from 2004 to 2013. A total of 173,209 outpatient health insurance files were included. The average age of the study patients was 11.3 (±3.9) years. Of all visits of the patients, 13.4% were prescribed antipsychotics. The prescription rate of all antipsychotic medication types in all the outpatients aged ≤18 years increased yearly by 0.6%. The prescription rate of first-generation antipsychotics decreased with an estimated average annual percent change of 5.6% (p < .001). By contrast, the prescription rate of second-generation antipsychotics increased with an estimated average annual percent change of 3.4% (p <.001). Multiple logistic regression analysis was performed to examine clinical factors (age, sex and diagnosis) associated with antipsychotic prescription. After adjusting for other variables, antipsychotic prescription was found to be increased by 1.31 times every year with age and by 1.06 times in the male patients. The patients with diagnoses other than schizophrenia appeared less likely to be prescribed antipsychotics. Antipsychotic medications are being increasingly prescribed to children and adolescents in recent years. T he efficacy and safety of antipsychotics in children and adolescents warrant clinical attention

Case-Based Reasoning of Man-Made Geohazards Induced by Rainfall on Transportation Systems

Due to global warming and environmental change, disastrous natural events have increased in scale and impact, e.g., Typhoon Morakot, in 2009 and 2011 Tōhoku earthquake and resulting tsunami in Japan. Hazard management is becoming increasingly important, making it a necessity to manage risk and fully understand critical scenarios. For example, the National Infrastructure Protection Plan of the United States emphasizes on lessons learned from past disasters. In this chapter, several selected cases of accidents caused by man-made geohazards in Taiwan are studied

Continuous epidermal growth factor receptor-tyrosine kinase inhibitor administration in primary lung adenocarcinoma patients harboring favorable mutations with controlled target lung tumors dose not hinder survival benefit despite small new lesions

AbstractBackgroundIn this study, we investigated the efficacy of continuous epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) administration in lung adenocarcinoma patients harboring favorable mutations regarding the progressive disease (PD) status with appearance of indolent new lesions.MethodsFrom June 2010 to October 2012, 102 patients with lung adenocarcinoma, harboring favorable EGFR mutations and treated with EGFR-TKI were analyzed. Definite new lesions were detected during EGFR-TKI therapy, even though the primary target tumors were controlled.ResultsOf the 102 patients, 57 continued and 45 discontinued EGFR-TKI therapy. The median overall survival was 529 days for the discontinuation group and 791 days for the continuation group (p = 0.0197). Median survival time after the discontinuation of EGFR-TKI was 181 days and 115 days in the discontinuation and continuation groups, respectively (p = 0.1776), whereas median survival time after the appearance of indolent new lesions was 204 days and 262 days, respectively (p = 0.0237).ConclusionContinuous EGFR-TKI administration in favorable EGFR-mutative lung adenocarcinoma patients with controlled primary tumors did not hinder the survival benefit, despite the appearance of new lesions

Validation of bidimensional measurement in nasopharyngeal carcinoma

<p>Abstract</p> <p>Background</p> <p>Our previous study showed a close relationship between computed tomography (CT)-derived bidimensional measurement of primary tumor and retropharyngeal nodes (BDMprn) and gross tumor volume of primary tumor and retropharyngeal nodes (GTVprn) in nasopharyngeal carcinoma (NPC) and better prognosis for NPC patients with smaller BDMprn. In this study, we report the results on of a study to validate the use of BDM in a separate cohort of NPC patients.</p> <p>Methods</p> <p>We retrospectively reviewed 103 newly diagnosed NPC cases who were treated with radiotherapy/concurrent chemoradiotherapy (CCRT) or CCRT with adjuvant chemotherapy from 2002 to 2009. We used magnetic resonance imaging (MRI) to measure BDMprn. We calculated overall survival, recurrence-free and distant metastasis-free survival curves and set a BDMprn cut off point to categorize patients into a high- or low-risk group. We then used Cox proportional hazard model to evaluate the prognostic influence of BDMprn after correcting age, gender and chemotherapy status.</p> <p>Results</p> <p>After adjusting for age, gender, and chemotherapy status, BDMprn remained an independent prognostic factor for distant metastasis [Hazard ratio (HR) = 1.046; <it>P </it>= 0.042] and overall survival (HR = 1.012; <it>P </it>= 0.012). Patients with BDMprn < 15 cm²had a greater 3-year overall survival rate than those with BDMprn ≧ 15 cm²(92.3% vs. 73.7%; <it>P </it>= 0.009). They also had a greater 3-year distant metastasis-free survival (94% vs.75%; <it>P </it>= 0.034).</p> <p>Conclusion</p> <p>The predictive ability of BDMprn was validated in a separate NPC cohort. A BDMprn of 15 cm²can be used to separate NPC patients into high- and low-risk groups and predict survival rates and metastasis potential. It can, therefore, be used as a reference to design clinical trials, predict prognosis, and make treatment decisions.</p

Predictors of intra-abdominal coagulopathic hemorrhage after living donor liver transplantation

AbstractBackgroundResults of preoperative conventional coagulation assays are a poor predictor of hemorrhage after liver transplantation. In this study, we evaluated the factors that are predictive of intra-abdominal coagulopathic hemorrhage after living donor liver transplantation surgery.MethodsDuring the period from January 2009 to December 2012, 118 adults underwent living donor liver transplantation (LDLT) in our institution. Of those patients, 18 (15.3%) developed intra-abdominal coagulopathic hemorrhage (n = 7) or hemorrhage due to non-coagulopathic causes (n = 11) that required emergency medical, radiological, or surgical intervention within the first month after LDLT. Possible predictors of postoperative coagulopathic hemorrhage included donor-related factors, age, body mass index, MELD score, INR value, intra-operative blood transfusion, graft/recipient weight ratio, anhepatic phase, cold ischemia time, operative time, APACHE II score, onset of re-bleeding, and hemoglobin levels during rebleeding episodes.ResultsThere were no differences in any of the variables between the two groups (coagulopathic and noncoagulopathic hemorrhage) except for cold ischemia time. We found that cold ischemia time was significantly longer in patients with postoperative coagulopathic hemorrhage (160.50 ± 45.02 min) than in patients with hemorrhage due to non-coagulopathic causes (113.55 ± 29.31 min; P = 0.027).ConclusionProlonged cold ischemia time is associated with postoperative intra-abdominal coagulopathic hemorrhage in patients after LDLT. It is, therefore, necessary to shorten the cold ischemia time in order to reduce the risk of postoperative intra-abdominal hemorrhage due to coagulopathic causes