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Search Results: 1 - 10 of 38188 matches for " Horng-Chyuan Lin "
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The Effects of Ciprofloxacin on Chest Radiographic Regression in Patients with Drug Intolerance or Resistant Tuberculosis.
Horng-Chyuan Lin,Kang-Yun Lee,Shu-Min Lin,Chih-Teng Yu
Chang Gung Medical Journal , 2004,
Abstract: Background: The aim of this study was to identify the clinical efficacy of ciprofloxacin asa second-line anti-tuberculosis agent in pulmonary tuberculosis patients withdrug intolerance or resistance.Methods: There were 20 patients with drug related adverse effects or drug resistanceenrolled in the ciprofloxacin treatment group (CG). There were also 32patients enrolled in the non-ciprofloxacin treatment group (NCG) that maintainedconventional drug regimens or the addition of other drugs like streptomycin.The radiographic presentation was evaluated using score grading.The speed and outcome of regression in the chest radiographic presentationswere also evaluated.Results: Data showed the CG had significantly more rapid regression than the NCGin drug-resistant patients ( p < 0.01). For the adversely effected patients in theCG, the mean scores of pre- and post-treatment were 3.1
Pre-Operative Risk Factors Predict Post-Operative Respiratory Failure after Liver Transplantation
Ching-Tzu Huang, Horng-Chyuan Lin, Shi-Chuan Chang, Wei-Chen Lee
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0022689
Abstract: Objective Post-operative pulmonary complications significantly affect patient survival rates, but there is still no conclusive evidence regarding the effect of post-operative respiratory failure after liver transplantation on patient prognosis. This study aimed to predict the risk factors for post-operative respiratory failure (PRF) after liver transplantation and the impact on short-term survival rates. Design The retrospective observational cohort study was conducted in a twelve-bed adult surgical intensive care unit in northern Taiwan. The medical records of 147 liver transplant patients were reviewed from September 2002 to July 2007. Sixty-two experienced post-operative respiratory failure while the remaining 85 patients did not. Measurements and Main Results Gender, age, etiology, disease history, pre-operative ventilator use, molecular adsorbent re-circulating system (MARS) use, source of organ transplantation, model for end-stage liver disease score (MELD) and Child-Turcotte-Pugh score calculated immediately before surgery were assessed for the two groups. The length of the intensive care unit stay, admission duration, and mortality within 30 days, 3 months, and 1 year were also evaluated. Using a logistic regression model, post-operative respiratory failure correlated with diabetes mellitus prior to liver transplantation, pre-operative impaired renal function, pre-operative ventilator use, pre-operative MARS use and deceased donor source of organ transplantation (p<0.05). Once liver transplant patients developed PRF, their length of ICU stay and admission duration were prolonged, significantly increasing their mortality and morbidity (p<0.001). Conclusions The predictive pre-operative risk factors significantly influenced the occurrence of post-operative respiratory failure after liver transplantation.
Efficacy and Tolerability of Salmeterol/Fluticasone Propionate versus Fluticasone Propionate in Asthma Patients: A Randomized, Double-blind Study
Yu-Sung Lee,Horng-Chyuan Lin,Chien-Da Huang,Kang-Yun Lee
Chang Gung Medical Journal , 2011,
Abstract: Background: A combination of salmeterol and fluticasone propionate (SAL/FP) has beenshown to be effective in the treatment of asthma. We compared the efficacyand tolerability of SAL/FP (50/250 μg) with fluticasone propionate (FP)250 μg administrated twice daily for 2 weeks in treating patients with mild tomoderate asthma.Methods: This was a randomized, double-blind study in adult patients with symptomatic asthma that was not controlled by 1000 μg/d inhaled corticosteroids(ICS) alone. 48 asthmatics were randomized to receive 2 inhalations ofSAL/FP 50/250 μg bis in die (BID) or 2 inhalations of FP 250 μg BID, bothdelivered via Accuhaler device, for 2 weeks. The primary objective was themean change from baseline in the mean morning peak expiratory flow (PEF)over the two week period. Other parameters included lung function, dailyasthma symptom scores, evening PEF, percentage of days free of rescuemedication use and daily rescue medication use. Tolerability was assessed byadverse events spontaneously elicited at clinic visits.Results: 46 patients provided evaluable efficacy for analysis. The morning PEFimproved significantly throughout the two weeks of treatment comparedwith baseline in the SAL/FP group. Mean morning PEF was 23.0 L/minhigher in SAL/FP group than in FP group (p = 0.013). The change of forcedexpiratory volume in one second (FEV1) from baseline was greater inSAL/FP group compared to FP group (p = 0.048). There were similar effectson day-time and night-time symptom scores, percentage symptom free daysand nights and usage of salbutamol. 70.8% of the patients receiving SAL/FPwere satisfied with the treatment, while only 26.1% of patients receiving FPalone were (p = 0.020). No death or acute exacerbation occurred.Conclusion: SAL/FP 50/250 μg was safe and effective, and had a high level of patientsatisfaction resulting in significantly greater increases in morning PEF andFEV1 compared to the use of FP 250 μg alone
Complications of airway self-expandable metallic stent in benign airway diseases  [PDF]
Fu-Tsai Chung, Shu-Min Lin, Chun-Liang Chou, Hao-Cheng Chen, Chih-Hsi Kuo, Horng-Chyuan Lin, Chien-Ying Liu, Chun-Hua Wang, Han-Pin Kuo, Chih-Teng Yu
Advances in Bioscience and Biotechnology (ABB) , 2013, DOI: 10.4236/abb.2013.41A016
Abstract:

Objectives: To present the complications of Ultraflex Self-Expandable Metallic Stents (SEMSs) applied in patients with benign tracheobronchial diseases. Methods: Eighty patients received 124 SEMSs were retrospectively reviewed in a tertiary hospital. Results: The baseline characteristics of patients received SEMS implantation including age (mean + standard deviation: 62.5 + 14.8 years), gender (male, 60.5%), smoking (46.8%), forced expiratory volume in first one second (FEV1) (mean + standard deviation, 0.92 +0.41 L/s), follow-up days after SEMS implantation (median (interquartile range); 457 (131 - 897)) and covered SEMS (33.9%) were listed. Symptoms improved after SEMS implantation among 95 patients (76.6%). Time to complications developed was 236 (median; interquartile range, 59 - 672) days. The overall complication rate was 41.9% after SEMS implantation. The complications included SEMS migration (6.5%), granuloma (19.3%) and SEMS fracture (16.1%). Successful management rates of SEMS migration, granuloma and SEMS fracture were up to 100%, 83.3%, and 85% respectively. Conclusions: Patients received SEMS implantation due to benign conditions had poor lung function and were old. The complication rate in patients with benign conditions was high after longer follow-up period, however, successful management achieved in most patients with complications.

Unfractionated heparin and enoxaparin reduce high-stretch ventilation augmented lung injury: a prospective, controlled animal experiment
Li-Fu Li, Chung-Chi Huang, Horng-Chyuan Lin, Ying-Huang Tsai, Deborah A Quinn, Shuen-Kuei Liao
Critical Care , 2009, DOI: 10.1186/cc7949
Abstract: Male C57BL/6 mice, weighing 20 to 25 g, were exposed to either high-tidal-volume (30 ml/kg) or low-tidal-volume (6 ml/kg) mechanical ventilation with room air for 1 to 5 hours after 200 IU/kg or 400 IU/kg unfractionated heparin and 4 mg/kg or 8 mg/kg enoxaparin administration. Nonventilated mice served as a control group. Evan blue dye, lung wet- to dry-weight ratio, histopathologic grading of epithelium, myeloperoxidase, and gene expression of PAI-1 were measured. The expression of PAI-1 was studied by immunohistochemistry.High-tidal-volume ventilation induced increased microvascular permeability, neutrophil influx, PAI-1 mRNA expression, production of PAI-1 protein, and positive staining of PAI-1 in epithelium in a dose-dependent manner. Lung injury induced by high-tidal-volume ventilation was attenuated with PAI-1-deficient mice and pharmacologic inhibition of PAI-1 activity by low-dose unfractionated heparin and enoxaparin.We conclude that high-tidal-volume mechanical ventilation increased microvascular permeability, neutrophil influx, lung PAI-1 mRNA expression, production of active PAI-1. The deleterious effects were attenuated by low-dose unfractionated heparin or enoxaparin treatment. Understanding the protective mechanism of unfractionated heparin and enoxaparin related to the reduction of PAI-1 may afford further knowledge of the effects of mechanical forces in the lung and development of possible therapeutic strategies involved in acute lung injury.Acute respiratory distress syndrome (ARDS) is an inhomogeneous lung disease characterized by neutrophil influx into the lungs, increased expression of inflammatory cytokines or chemokines, loss of epithelial and endothelial integrity, and the development of alveolar and interstitial pulmonary edema [1]. The use of high tidal volume in normal animals mimics this overdistention of the normal lung. Mechanical ventilation with high tidal volumes (VT) causes acute lung injury (VILI, ventilator-induced lung injury) c
Low-molecular-weight heparin reduces hyperoxia-augmented ventilator-induced lung injury via serine/threonine kinase-protein kinase B
Li-Fu Li, Cheng-Ta Yang, Chung-Chi Huang, Yung-Yang Liu, Kuo-Chin Kao, Horng-Chyuan Lin
Respiratory Research , 2011, DOI: 10.1186/1465-9921-12-90
Abstract: Male C57BL/6, either wild type or Akt+/-, aged between 6 and 8 weeks, weighing between 20 and 25 g, were exposed to high-tidal-volume (30 ml/kg) mechanical ventilation with room air or hyperoxia for 2 to 8 hours with or without 4 mg/kg enoxaparin administration. Nonventilated mice served as a control group. Evan blue dye, lung wet-to-dry weight ratio, free radicals, myeloperoxidase, Western blot of Akt, and gene expression of HMGB1 were measured. The expression of HMGB1 was studied by immunohistochemistry.High-tidal-volume ventilation using hyperoxia induced microvascular permeability, Akt activation, HMGB1 mRNA expression, neutrophil infiltration, oxygen radicals, HMGB1 production, and positive staining of Akt in bronchial epithelium. Hyperoxia-induced augmentation of ventilator-induced lung injury was attenuated with Akt deficient mice and pharmacological inhibition of Akt activity by enoxaparin.These data suggest that enoxaparin attenuates hyperoxia-augmented high-tidal-volume ventilation-induced neutrophil influx and HMGB1 production through inhibition of the Akt pathway. Understanding the protective mechanism of enoxaparin related with the reduction of HMGB1 may help further knowledge of the effects of mechanical forces in the lung and development of possible therapeutic strategies involved in acute lung injury.Acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) is characterized by noncardiogenic pulmonary edema, the release of cytokines, and the influx of neutrophils [1]. The management of ARDS often requires the use of mechanical ventilation with high levels of oxygen to maintain adequate blood oxygenation. Concurrent hyperoxia and high tidal volume (VT) mechanical ventilation may interact to promote worsening acute lung injury and lead to the production of inflammatory cytokines, including macrophage inflammatory protein-2 (MIP-2), tumor necrosis factor-α (TNF-α), plasminogen activator inhibitor-1 (PAI-1), and high-mobility group box-1 (HMGB1)
Amplified Mycobacterium Tuberculosis Direct Test for Diagnosing Tuberculous Pleurisy—A Diagnostic Accuracy Study
Chieh-Mo Lin, Shu-Min Lin, Fu-Tsai Chung, Horng-Chyuan Lin, Kang-Yun Lee, Chien-Da Huang, Chih-Hsi Kuo, Chien-Ying Liu, Chun-Hua Wang, Han-Pin Kuo
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044842
Abstract: Background The study was designed to investigate the clinical usefulness of Amplified Mycobacterium Tuberculosis Direct (AMTD) tests for diagnosing TB pleurisy. Methods One hundred and fifty-two patients for whom the exclusion of tuberculous pleural effusion was necessary were retrospectively analyzed. Results The sensitivity of AMTD in diagnosing pleural TB was 36.4% (20 of 55). Combining sputum and pleural effusion AFB smear, pleural biopsy, and AMTD test of pleural effusion increased sensitivity to 82.5% (33/40). There were significantly higher percentages of neutrophils in the pleural effusion in the positive than in the negative AMTD group (38.0±6.7% vs. 11.1±3.7%, p<0.001). Patients with symptom duration <18 days prior to pleural effusion studies had more positive AMTD tests than those with symptom >18 days (70% vs. 31.4%; OR 5.09; 95% CI 1.54–16.79; p = 0.011). Conclusions Combining AMTD tests with conventional diagnostic methods offer good sensitivity for pleural TB diagnosis. Patients in the early course of the disease are better candidates for AMTD tests.
Persistence of lung inflammation and lung cytokines with high-resolution CT abnormalities during recovery from SARS
Chun-Hua Wang, Chien-Ying Liu, Yung-Liang Wan, Chun-Liang Chou, Kuo-Hsiung Huang, Horng-Chyuan Lin, Shu-Min Lin, Tzou-Yien Lin, Kian Chung, Han-Pin Kuo
Respiratory Research , 2005, DOI: 10.1186/1465-9921-6-42
Abstract: To determine further the time course of recovery of lung inflammation, we investigated the HRCT and inflammatory profiles, and coronavirus persistence in bronchoalveolar lavage fluid (BALF) of 12 patients at recovery at 60 and 90 days.At 60 days, compared to normal controls, SARS patients had increased cellularity of BALF with increased alveolar macrophages (AM) and CD8 cells. HRCT scores were increased and correlated with T-cell numbers and their subpopulations, and inversely with CD4/CD8 ratio. TNF-α, IL-6, IL-8, RANTES and MCP-1 levels were increased. Viral particles in AM were detected by electron microscopy in 7 of 12 SARS patients with high HRCT score. On day 90, HRCT scores improved significantly in 10 of 12 patients, with normalization of BALF cell counts in 6 of 12 patients with repeat bronchoscopy. Pulse steroid therapy and prolonged fever were two independent factors associated with delayed resolution of pneumonitis, in this non-randomized, retrospective analysis.Resolution of pneumonitis is delayed in some patients during SARS recovery and may be associated with delayed clearance of coronavirus, Complete resolution may occur by 90 days or later.Severe acute respiratory syndrome (SARS) has affected more than 8 thousand patients in 22 countries causing 774 deaths between July 2002 and September 2003 [1]. SARS-associated Coronavirus (SARS-CoV) has been identified as the causative agent [2]. Typical clinical manifestations include fever, cough, dyspnea and rapid progression of pulmonary infiltration or consolidation [3]. The mean mortality rate is 9.6% [1], mostly attributed to hypoxemic respiratory failure. In the acute phase, typical pathological findings in the lungs include mononuclear cells infiltration, alveolar cell desquamation and hyaline membrane formation [4]. Those mononuclear cells may develop into multinucleated giant cells [4]. Proinflammatory cytokines released by alveolar macrophages may play a prominent role in the pathogenesis in SARS [5].
Endobronchial Mucosa Invasion Predicts Survival in Patients with Small Cell Lung Cancer
Pai-Chien Chou, Shu-Min Lin, Chun-Yu Lo, Hao-Cheng Chen, Chih-Wei Wang, Chun-Liang Chou, Chih-Teng Yu, Horng-Chyuan Lin, Chun-Hua Wang, Han-Pin Kuo
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0047613
Abstract: Background Current staging system for small cell lung cancer (SCLC) categorizes patients into limited- or extensive-stage disease groups according to anatomical localizations. Even so, a wide-range of survival times has been observed among patients in the same staging system. This study aimed to identify whether endobronchial mucosa invasion is an independent predictor for poor survival in patients with SCLC, and to compare the survival time between patients with and without endobronchial mucosa invasion. Methods We studied 432 consecutive patients with SCLC based on histological examination of biopsy specimens or on fine-needle aspiration cytology, and received computed tomography and bone scan for staging. All the enrolled patients were assessed for endobronchial mucosa invasion by bronchoscopic and histological examination. Survival days were compared between patients with or without endobronchial mucosa invasion and the predictors of decreased survival days were investigated. Results 84% (364/432) of SCLC patients had endobronchial mucosal invasion by cancer cells at initial diagnosis. Endobronchial mucosal involvement (Hazard ratio [HR], 2.01; 95% Confidence Interval [CI], 1.30–3.10), age (HR, 1.04; 95% CI, 1.03–1.06), and extensive stage (HR, 1.39; 95% CI, 1.06–1.84) were independent contributing factors for shorter survival time, while received chemotherapy (HR, 0.32; 95% CI, 0.25–0.42) was an independent contributing factor better outcome. The survival days of SCLC patients with endobronchial involvement were markedly decreased compared with patients without (median 145 vs. 290, p<0.0001). Among SCLC patients of either limited (median 180 vs. 460, p<0.0001) or extensive (median 125 vs. 207, p<0.0001) stages, the median survival duration for patients with endobronchial mucosal invasion was shorter than those with intact endobronchial mucosa, respectively. Conclusion Endobronchial mucosal involvement is an independent prognostic factor for SCLC patients and associated with decreased survival days.
Extravascular Lung Water Correlates Multiorgan Dysfunction Syndrome and Mortality in Sepsis
Fu-Tsai Chung,Horng-Chyuan Lin,Chih-Hsi Kuo,Chih-Teng Yu,Chun-Liang Chou,Kang-Yun Lee,Han-Pin Kuo,Shu-Min Lin
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0015265
Abstract: This study was designated to investigate whether increased extravascular lung water index (EVLWI) may correlate multiple organ dysfunction syndrome (MODS) and mortality in sepsis.
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