547 research outputs found

    Mutual Help or Social Responsibility of Higher Education—A CJCU Experience

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    In 2009, Typhoon Morakot caused severe damage to the mountains in Kaohsiung, Taiwan. Laulong was one of the villages affected by the typhoon. While all the communities have made all the efforts to restore their infrastructure and livelihood, Laulong village has its unique mission to restore the history and culture of their own. The residents there identify themselves as “Tavorang Tribe”, whose ancestors were from other areas. After merging with other people, they are gradually losing their tribal language. They have come to realize that their traditional rituals and tribal history are at risk of extinction; thus, they have endeavored to preserve and reconstruct their heritage. Chang Jung Christian University (CJCU) has involved in reviving these areas after Morakot. The Department of Applied Philosophy targets at this community as the educational field. The way to flip educational field requires taking students into the society. The purpose of this paper is to share the teaching experience of the past and students’ learning outcomes. It will introduce how a university tried to utilize resource from the government to work with a community while claiming to fulfill its social responsibility, but in fact, both actually received mutual benefits by executing this project

    Effects of phorbol myristate acetate and sivelestat on the lung injury caused by fat embolism in isolated lungs

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    <p>Abstract</p> <p>Background</p> <p>Fat embolism syndrome (FES) associated with acute lung injury (ALI) is a clinical condition following long bone fracture. We have reported 14 victims due to ALI with FES. Our laboratory has developed an animal model that produced fat emboli (FE). The major purpose of this study was to test whether neutrophil activation with phorbol myristate acetate (PMA) and inhibition with sivelestat (SVT) exert protection on the lung.</p> <p>Methods</p> <p>The lungs of Sprague-Dawley rats were isolated and perfused. FE was produced by addition of corn oil micelles into the lung perfusate. PMA and SVT were given simultaneously with FE. Parameters such as lung weight/body weight ratio, LW gain, exhaled nitric oxide (NO), protein concentration in bronchoalveolar lavage relating to ALI were measured. The neutrophil elastase (NE), myeloperoxidase, malondialdehyde and phopholipase A<sub>2 </sub>activity were determined. We also measured the nitrate/nitrite, methyl guanidine (MG), and cytokines. Pulmonary arterial pressure and microvascular permeability were assessed. Lung pathology was examined and scored. The inducible and endothelial NO synthase (iNOS and eNOS) were detected.</p> <p>Results</p> <p>FE caused ALI and increased biochemical factors. The challenge also resulted in pulmonary hypertension and increased microvascular permeability. The NE appeared to be the first to reach its peak at 1 hr, followed by other factors. Coadministration with PMA exacerbated the FE-induced changes, while SVT attenuated the effects of FE.</p> <p>Conclusions</p> <p>The FE-induced lung changes were enhanced by PMA, while SVT had the opposite effect. Sivelestat, a neutrophil inhibitor may be a therapeutic choice for patients with acute respiratory distress syndrome (ARDS) following fat embolism.</p

    Emergency Open Cardiac Massage via Subxyphoid Approach in Ruptured Type A Aortic Dissection

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    Patient sustained cardiac tamponade caused by rupture of type A aortic dissection may result in sudden death. Pericardiocentesis is a lifesaving procedure; nevertheless, blood may occlude the catheter and fail to relieve the pressure. However, open-chest cardiac massage in resuscitation has been studied in animal models by some medical centers and laboratories with inspiring results. We report a 58-year-old woman who was transferred from a local hospital with the diagnosis of cardiac tamponade caused by ruptured type A aortic dissection. Pulseless electrical activity followed by cardiac arrest occurred thereafter. Successful resuscitation in the emergency department was achieved using open cardiac massage through the sub-xyphoid region by opening a pericardial window. Therefore, in unstable patients with cardiac tamponade due to aortic dissection, this resuscitative procedure is feasible, safe and efficient

    Use of sodium bicarbonate for acute dizziness after minor head injury

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    AbstractObjectiveDizziness after minor head injury (mHI) is common. In some eastern countries, it is treated with 7% sodium bicarbonate solution (SB). This prospective study evaluated the clinical efficacy of SB compared with normal saline (NS).Material and methodsFrom April 2009 to April 2010, we performed a prospective observational study on 228 patients (68% female, 32% male) with acute dizziness after mHI. At the emergency physician’s discretion, intravenous SB (1 mL/kg) in NS (250 mL) or NS (250 mL) was administered to 166 patients and 62 patients, respectively, as empiric antidizziness therapy. Outcome measures were severity of dizziness and treatment response, which were measured by a visual analog scale. Various characteristics were compared between treatment groups. Any continued dizziness of the patients during follow-up was also compared with their pre-injury condition, such as prior psychiatric disorders and the presence of vertigo.ResultsThe SB group had their visual analog scale scores reduced by 25.4% compared with 24.6% in the NS group. Both groups showed a statistically significant reduction in dizziness (p < 0.001); however, the dizziness improvement did not differ significantly between the two treatment groups (p = 0.699). Sixty-four patients (28.1%) suffered from continued dizziness during follow-up (mean period, 22.4 ± 28.9 days). The prevalence of continued dizziness was higher in patients with prior psychiatric disorders, although this was not statistically significant (40% vs. 27.2%, p = 0.276), whereas patients with prior vertigo did not experience a higher dizziness relapse rate (27% vs. 28.2%).ConclusionsSB and NS administrations are both effective individually when treating patients with acute dizziness from mHI; however, both results may be attributable to the placebo effect. Therefore more research is necessary to understand the complex conditions that determine the effects of SB on this disorder

    Weakness of shim¡¦s New ID-based tripartite multiple-key agreement protocol

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    In this article we show that Shim¡¦s new ID-based tripartite multiple-key agreement protocol still suffers from the impersonation attack, a malicious user can launch an impersonation attack on their protocol

    (Dithio­benzoato-κ2 S,S′)[hydridotris(pyrazol-1-yl-κN 2)borato](triphenyl­phosphine-κP)ruthenium(II)

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    Reaction of [Ru(Tp)Cl(PPh3)2] (Tp = hydridotrispyrazolyl­borate) with ammonium dithio­benzoate in methanol leads to the formation of the title compound, [Ru(C9H10BN6)(C7H5S2)(C18H15P)]. In the crystal structure, the Ru atom is coordinated by three N atoms of the Tp ligand, one P atom of the triphenyl­phosphine ligand and the two S atoms of the dithio­benzoate ligand within a slightly distorted octa­hedron. The Ru—S bonds are slightly different [2.321 (1) and 2.396 (1) Å] and the average N—Ru—N angle is 86.31°

    Chinese Herbal Medicine Therapy and the Risk of Mortality for Chronic Hepatitis B Patients with Concurrent Liver Cirrhosis: a Nationwide Population-Based Cohort Study

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    Chronic hepatitis B (CHB) is increasingly recognized as a public health problem in Taiwan. After affected patients are diagnosed with contaminant liver cirrhosis (LC), adverse clinical outcomes, especially death, are common. This study aimed to investigate the effect of Chinese herbal medicine (CHM), an essential branch of Traditional Chinese medicine (TCM), on the mortality risk among CHB patients with contaminant LC. This longitudinal cohort study used the Taiwanese National Health Insurance Research Database to identify 1522 patients 20–70 years of age with newly diagnosed CHB with LC during 1998–2007. Among them, 508 (33.37%) had received CHM products after the onset of CHB (CHM users), and the remaining 1014 patients (66.63%) were designated as a control group (non-CHM users). All enrollees were followed until the end of 2012 to determine deaths during the study period. We applied the Cox proportional hazards regression model to compute the hazard ratio for the association of CHM use and the subsequent risk of death. During the follow-up period, 156 CHM users and 493 non-CHM users died. After controlling for potential confounders, CHM users were found to have a significantly reduced risk of death compared with non-CHM users by 56%, and the effect was predominantly observed among those treated with CHM for \u3e 180 days. CHM therapy lowered the risk of death among CHB patients with contaminant LC, which supported CHM might provide further treatment options for those with chronic liver diseases

    Correlation of virulence genes to clinical manifestations and outcome in patients with Streptococcus dysgalactiae subspecies equisimilis bacteremia

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    Background/PurposeStreptococcus dysgalactiae subsp. equisimilis (SDSE) is increasingly recognized as a human pathogen responsible for invasive infection and streptococcal toxic shock syndrome (STSS). The pathogen possesses virulence genes that resemble those found in Streptococcus pyogenes (GAS). We analyzed the association between these specific toxic genes, clinical presentations, and outcome in patients with SDSE infections.MethodsPatients (older than 18 years) with community-acquired invasive bacteremia caused by SDSE bacteremia who were undergoing treatment at China Medical University Hospital from June 2007 to December 2010 were included in this study. Multiplex polymerase chain reaction was performed to identify virulence genes of the SDSE isolates. Demographic data, clinical presentations, and outcome in patients with SDSE infections were reviewed and analyzed.ResultsForty patients with 41 episodes of SDSE bacteremia were reviewed. The median age of the patients with SDSE infection was 69.7 years; 55% were female and 78% had underlying diseases. Malignancy (13, 33%) and diabetes mellitus (13, 33%) were the most common comorbidities. The 30-day mortality rate was 12%. Compared with the survivors, the non-survivors had a higher rate of diabetes mellitus (80% vs. 26%), liver cirrhosis (60% vs.11%), shock (60% vs.17%), STSS (60% vs. 8%), and a high Pittsburgh bacteremia score >4 (40% vs. 6%). Most isolates had scpA, ska, saga, and slo genes, whereas speC, speG, speH, speI, speK, smez, and ssa genes were not detected. speA gene was identified only in one patient with STSS (1/6, 17%). All isolates were susceptible to penicillin, cefotaxime, levofloxacin, moxifloxacin, vancomycin, and linezolid.ConclusionIn invasive SDSE infections, most isolates carry putative virulence genes, such as scpA, ska, saga, and slo. Clinical SDSE isolates in Taiwan remain susceptible to penicillin cefotaxime, and levofloxacin
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