Biomedical subjects

Ching-Piao Tsai

Publications and source records attributed to Ching-Piao Tsai.

8 recordsLinked to original sources

PubMed2006

Early relapse in multiple sclerosis-associated optic neuritis following the use of interferon beta-1a in Chinese patients.

PURPOSE: The incidence of multiple sclerosis (MS) is relatively rare in Chinese. The beneficial effect of interferon beta-1a in modifying the disease course of MS has been rarely analyzed in Chinese patients. The aim of this study was to investigate the clinical response to interferon beta1-a in Chinese patients with MS-associated optic neuritis (ON). METHODS: A retrospective case control study was conducted in 20 MS patients with optic nerve involvement. The interferon (IF) group comprised ten patients receiving interferon beta-1a. The noninterferon (NIF) group comprised another ten MS patients with optic nerve involvement who did not receive interferon treatment. The clinical characteristics, laboratory data, management, and disease course were retrospectively analyzed. The main outcomes of the study were the annualized relapse rate (ARR) for MS, and final visual outcome data. RESULTS: The ARR did not differ between the pretreatment period and the posttreatment period within the IF group. There was also no significant decrease of ARR in the IF group when compared with the NIF group. However, we observed an early recurrence of ON in 50% of the IF cases following the use of interferon beta-1a. The final visual outcome did not differ between the IF group and the NIF group. CONCLUSIONS: The use of interferon beta-1a should be carefully monitored because early relapse of ON may complicate the treatment course in this patient group.

Adolescent↗

PubMed2006

Efficacy of botulinum toxin type a in the relief of Carpal tunnel syndrome: A preliminary experience.

BACKGROUND AND OBJECTIVES: Botulinum toxin type A has been shown to relieve primary headaches, myofascial pain and various neuropathic pains. Carpal tunnel syndrome (CTS) is a common disorder resulting from median nerve compression at the wrist. As reports of botulinum toxin A in the treatment of CTS were limited, this study set out to evaluate the safety and tolerability of botulinum toxin A and its effects on the relief of nerve entrapment and pain in patients with CTS. METHODS: We conducted an open-label, prospective pilot study using 60 units of botulinum toxin A injected intracarpally in patients with primary CTS. Changes in median nerve conduction velocities, distal latencies, compound muscle action potentials and visual analogue scale (VAS) pain scores were evaluated for 3 months following injection. All adverse experiences, reported spontaneously or observed directly by the investigator, were recorded. RESULTS: Five women aged 52.2 +/- 2.5 years with 1-2 years' history of CTS were enrolled. Botulinum toxin A was well tolerated and safe. No exacerbated hand weakness was observed in any of the patients. At 3 months, pain was lessened in three patients, remained static in one patient, and was aggravated in one patient. The VAS pain score showed a trend to improvement during the 3 months of follow-up, although it did not reach statistical significance (p = 0.2). CONCLUSION: Our data suggest long-lasting antinociceptive effects of botulinum toxin A rather than electrophysiological restoration in patients with CTS. Intracarpal injection of botulinum toxin A was shown to be well tolerated and safe. A double-blind, placebo-controlled trial of botulinum toxin A in CTS is warranted since the current study may have been confounded by the placebo effect of intracarpal injection.

Botulinum Toxins, Type A↗

PubMed2005

Quantitative assessment of efficacy of dysport (botulinum toxin type A) in the treatment of idiopathic blepharospasm and hemifacial spasm.

This study was a Phase IV, prospective, one arm, non-comparative open trial, to investigate the efficacy and safety of Dysport (Botulinum toxin type A) in patients with idiopathic blepharospasm or hemifacial spasm. During the treatment period, patients were evaluated at baseline (week 0), week 6, and week 8, 10, or 12. Thirty two women and 16 men completed the whole course of the study. The therapeutic efficacy of Dysport became evident from 1.5 to 15 days (mean+/- SD, 6.1 +/- 2.9 days). The maximal effect appeared 12.2+/-5.0 days later. Injection of Dysport achieved 72.9 (13.0% amelioration in the spasm symptom. Dysport significantly improved the following functions, such as reading, watching TV, house work, working, driving and outing alone. At the twelfth week after Dysport injection, it was still effective in relieving blepharospasm or hemifacial spasm. The most frequent adverse event was ptosis, which was noted in 9 cases and represented 18.7% of total patients. Other adverse events were very mild, although lagophthalmos and dry eyes occurred in some patients, but none manifested any corneal complications. In conclusion, Dysport injection appears to be a safe, and effective procedure - accompanied only by minor, and transit adverse events.

Adult↗

PubMed2004

Congenital insensitivity to pain with anhidrosis in Taiwan: a morphometric and genetic study.

Congenital insensitivity to pain with anhidrosis (CIPA) is characterized by insensitivity to pain, anhidrosis, recurrent hyperpyrexia, mild mental retardation, and self-mutilating behavior. We report 2 brothers, aged 20 and 18 years, who suffered from phenotypes of CIPA. Both brothers had a branch site mutation in intron 7 (IVS7-33 T-->A) of the neurotrophic tyrosine kinase receptor type 1 gene. The electrophysiological studies showed no significant abnormal findings in sensory evoked potentials, motor evoked potentials to transcranial magnetic stimulation, or heart rate variations; sympathetic skin responses were absent. Morphometric study of their sural nerve histopathology revealed normal myelinated fiber density, 8,082 fibers/mm2 and 5,637 fibers/mm2 (normal 6,141 +/- 421); decreased unmyelinated fiber density, 2,537 fibers/mm2 and 2,211 fibers/mm2 (normal 28,578 +/- 8,669); increased axon size, 4.41 +/- 1.59 microm and 5.33 +/- 1.48 microm (normal 3.73 +/- 1.45), and increased axon diameter (A)/myelin thickness (M) ratio (A/M), 3.47 +/- 1.42 and 2.70 +/- 1.07 (normal 2.49 +/- 0.93). Scatterplot analysis of the G ratio (axon diameter:fiber diameter) did not show consistent results in the relationship between axon size and myelin thickness. In conclusion, the neuropathy of our CIPA patients included a marked reduction of small myelinated and unmyelinated fibers and a relatively increased axon size. This is the first CIPA family encountered in Taiwan.

Adolescent↗

PubMed2004

Multiple sclerosis in Taiwan.

BACKGROUND: There is only 1 report about multiple sclerosis (MS) prevalence in Taiwan, and this was published in 1976 and involved only 25 patients. The clinical features and prevalence of MS in Taiwan still remain to be clarified. The aim of this study was to determine the prevalence and delineate the clinical features of MS in Taiwanese patients. METHODS: We retrospectively identified 43 ethnic Chinese multiple sclerosis (MS) patients over a 14-year period. The MS prevalence in Taiwan was estimated based on Bureau of National Health Insurance (BNHI) data. The clinical data (gender, family history, age at onset, initial symptoms, clinical course, disability and laboratory findings, evoked response and neuroimaging) were recorded, collected and analyzed. RESULTS: The MS prevalence in Taiwan was as low as 1.9 per 100,000. The distribution of most of the clinical features of our patients, like those in other Asian series, was different from Western series except for the percentage of the conventional form and sensory disturbances. Cerebrospinal fluid analysis for IgG index and OCB seemed to be less sensitive in the diagnosis of MS in our series. CONCLUSIONS: The prevalence of MS in Taiwan, as in other Asian countries, was low; the optic-spinal form occurred very often, but predominant spinal cord involvement was not unusual, as well as there being less functional disability. A larger, prospective study is needed to provide more conclusive information.

Adolescent↗

PubMed2003

High frequency of primary Sjögren's syndrome in Taiwanese patients presenting as relapsing-remitting multiple sclerosis.

Primary Sjögren's syndrome (PSS) with central nervous system involvement may mimic the manifestations of multiple sclerosis (MS). The prevalence of PSS in MS patients varies in the published literature (0-16.6%), but has not yet been investigated in Asia, having a much lower MS prevalence than Western countries. Twelve consecutive patients presenting with a relapsing-remitting MS-like syndrome were recruited to assess the presence of PSS according to the American-European consensus group criteria. Six patients (50%) fulfilled the diagnostic criteria of PSS. The preliminary result suggests that PSS is an important differential diagnosis in patients with MS-like syndrome in Taiwan. The prevalence of 'pure MS' in Taiwan might be even lower than expected. A further large-scale study is warranted to confirm this finding in Taiwan as well as other Asian countries.

Adult↗

PubMed2002

Guillain-Barré syndrome: a retrospective, hospital-based study.

BACKGROUND: To obtain more information about Guillain-Barré syndrome (GBS) for Taiwanese patients. METHODS: We retrospectively reviewed the charts for those cases conforming with International Classification of Diseases code (ICD) 357.0, from January 1988 to December 1998. Clinical data such as age, sex, duration of hospitalization, antecedent events, date of onset, initial symptoms, other neurological symptoms and signs, results of lumbar puncture and electrophysiology, respiratory function and mortality, were recorded. RESULTS: We identified 49 cases of typical GBS, with non-specific age distribution. The calibrated male/female ratio was 1.54. The mean age for disease onset was greater for male patients (M: 54.8 years vs. F: 39.5 years), with more cases noted in winter. Upper respiratory tract infection (URI, 53%) was the most common antecedent event, followed, in descending order, by gastrointestinal symptoms (10%), skin lesions (6%) and ear infections (2%). The mean interval between antecedent events and disease onset was 10 +/- 3.1 days. Cranial nerve abnormalities, autonomic dysfunction and respiratory failure were not uncommon. The mortality rate was 6% (3/49). The abnormal findings from motor nerve conduction studies included prolonged distal latencies, reduced conduction velocities, reduced compound muscle action potentials and prolonged F-wave latencies. CONCLUSIONS: GBS occurs at all ages, is more prevalent among males, and is related to the season and antecedent infections. Continuous monitoring of autonomic and respiratory function is recommended. The results of motor nerve conduction studies suggest that the nerves fibers are affected at random, with multifocal distribution of the demyelinating lesions. The precise nature of the ataxia was not determined. Further studies are required to distinguish the etiology and expression of ataxia for GBS patients.

Adolescent↗

PubMedDate not supplied

Encephalitis in Taiwan: a prospective hospital-based study.

To investigate encephalitis in Taiwan, a multicenter study was conducted with patients who had acute severe neurological dysfunction and suspected encephalitis from May 2000 to December 2001. Demographic data such as age, sex, and seasons were analyzed. Polymerase chain reaction analyses were performed to determine the microbiologic diagnosis. The patients included 73 males and 54 females, with a peak age of 10-40 years old. Microbiologic diagnoses in 86 (69%) of 124 cases involved herpes simplex virus (HSV, 45 cases), varicella zoster (16 cases), Mycobacterium tuberculosis (10 cases), cytomegalovirus (8 cases), adenovirus (5 cases), influenza (1 case), and enterovirus (1 case). Pathogens were found in 69% of the cases. Encephalitis was most likely to occur in June and July. Based on the results, HSV is still the major viral cause of encephalitis in Taiwan.

Adolescent↗