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Biomedical subjects

Tai-An Chen

Publications and source records attributed to Tai-An Chen.

9 recordsLinked to original sources
PubMed2005

Single daily amikacin versus cefotaxime in the short-course treatment of spontaneous bacterial peritonitis in cirrhotics.

AIM: To compare the efficacy and safety of single daily amikacin vs. cefotaxime in the 5-d treatment of spontaneous bacterial peritonitis (SBP). METHODS: Thirty-seven cirrhotic patients with SBP, 19 in group A and 18 in group B, were studied. Group A received 1 g of cefotaxime every 6 h, and group B received 500 mg of amikacin qd. Both antibiotics were administered up to 5 d and the responses were compared. RESULTS: Infection was cured in 15 of 19 patients (78.9%) treated with cefotaxime and in 11 of 18 (61.1%) treated with amikacin. Four patients of the Cefotaxime group (21.1%) and five patients of the Amikacin group (27.8%) died. Two in each group (10.5% vs 11.1%) had renal impairment during study period. One in each group (5.3% vs 5.6%) may be considered to suffer from nephrotoxicity due to increased urinary beta(2)-microglobulin concentration. CONCLUSION: In this study, single daily doses of amikacin in the treatment of SBP in cirrhotics were not associated with an increased incidence of renal impairment or nephrotoxicity. However, a 5-d regimen of amikacin is less effective than a 5-d regimen of cefotaxime in the SBP treatment.

Amikacin↗
PubMed2005

Migrating fish bone complicating a deep neck abscess.

Deep neck infections are not uncommon; however, a migrating fish bone is seldom a cause of a deep neck abscess. Fish bones are a sharp foreign body and can penetrate the oropharynx or esophagus. However, this rarely occurs. We report a case of deep neck abscess resulting from the intracorporeal migration of a fish bone. Initial radiography and esophagoscopy of the neck were both negative; migration of the bone was ultimately documented by computed tomography. Surgical exploration was performed via a lateral neck incision, and the fish bone was successfully retrieved. Although fish bones are a rare etiology of deep neck abscesses, should be kept in mind when a patient has the history of fish bone ingestion.

Abscess↗
PubMed2004

Assessment of the ability of Malassezia pachydermatis to stimulate proliferation of canine keratinocytes in vitro.

OBJECTIVE: To investigate the direct interaction between canine keratinocytes and live Malassezia pachydermatis and thereby determine the role of these organisms in the pathogenesis of epidermal hyperplasia associated with Malassezia dermatitis in dogs. SAMPLE POPULATION: Primary canine keratinocyte cultures established from skin samples obtained from clinically normal dogs. PROCEDURE: The proliferative response of keratinocytes co-cultured with Malassezia organisms for 1, 2, or 3 days was assessed by use of direct manual counting (to determine the number of keratinocytes in both the monolayer and the medium) and immunohistochemical staining techniques involving antibodies against proliferating cell nuclear antigen (PCNA) and another cellular proliferation marker, Ki-67. The potential cytotoxic effect of Malassezia organisms was investigated by use of an apoptosis detection kit to label keratinocytes co-cultured with M. pachydermatis that underwent apoptosis. RESULTS: No stimulatory effect of Malassezia organisms on canine keratinocyte proliferation was detected via cell counting and immunohistochemical techniques. However, there was a significant increase in dead keratinocytes in the medium with increasing numbers of Malassezia organisms in the co-culture. More apoptotic cells were observed in keratinocyte monolayers co-cultured with high numbers of M. pachydermatis than there were in monolayers cultured without Malassezia organisms, and the number increased after prolonged incubation. CONCLUSIONS AND CLINICAL RELEVANCE: M. pachydermatis did not stimulate canine keratinocyte proliferation in vitro. The results suggested that the epidermal hyperplasia observed in dogs with Malassezia dermatitis is unlikely to be caused by a direct effect of the organism on the keratinocyte cell cycle, but is likely to involve other mechanisms.

Analysis of Variance↗
PubMed2004

Power microdebrider-assisted modification of endoscopic inferior turbinoplasty: a preliminary report.

BACKGROUND: In this article, microdebrider-assisted modification of endoscopic inferior turbinoplasty is described. It has the advantage of superior visualization during elevation of the mucosal flap and allows precise tailoring of the resection to the needs of patients. METHODS: From November 2001 to December 2002, 29 patients with chronic hypertrophic rhinitis treated with power endoscopic inferior turbinoplasty were available for follow-up examinations. Questionnaires and rhinomanometric studies were performed for subjective and objective evaluations. These patients were followed up for an average of 15.3 months after the operation. RESULTS: The overall improvement in nasal obstruction was 91% in our study. Twenty-two patients received rhinomanometric studies 1 week preoperatively and 2 months postoperatively. The average nasal airflow was increased by 187 ml/min. In addition, complete relief of headaches was achieved. But the remission rates of persistent rhinorrhea and post-nasal dripping were less significant, at about 58% and 54%, respectively. Atrophic change and permanent synechiae had not yet been observed. CONCLUSIONS: Power endoscopic turbintoplasty is a safe, simple, and effective method for the treatment of chronic hypertrophic rhinitis. It is especially handy in adjunct to endoscopic septoplasty or sinosurgery, and appears to provide a surgical choice of a minimally invasive technique. However, further study with a prospective design is needed to strengthen the evidence.

Adolescent↗
PubMed2003

Risk factors for spontaneous bacterial empyema in cirrhotic patients with hydrothorax.

BACKGROUND: Spontaneous bacterial empyema (SBEM) is a rare complication of portal hypertension. The characteristics and risk factors for SBEM are not well known. This study was performed to investigate the risk factors for SBEM in cirrhotic patients with hydrothorax. METHODS: From July 1996 to December 1998, 862 cirrhotic patients were studied. All patients underwent chest radiography, abdominal sonography or computed tomography after admission to detect the existence of pleural effusion. Pleural fluid was obtained after thoracentesis and sent for analysis. The clinical and laboratory data from patients with sterile hydrothorax and from SBEM at the time of first episode were compared. RESULTS: Seventeen patients had 26 episodes of SBEM during the study period, 56% (14 of 26) of these SBEM episodes were associated with spontaneous bacterial peritonitis (SBP) and 31% (8 of 26) were associated with bacteremia. The incidence of SBEM was 2% (17 of 862) in cirrhotic patients and 13% (17 of 132) in cirrhotics with hydrothorax. Patients with SBEM had a higher Child-Pugh score, lower serum albumin, prolonged prothrombin time, lower pleural fluid protein, and higher rate of associated SBP than patients with sterile hydrothorax. Multivariate analysis revealed that pleural fluid protein level (p = 0.0035) and presence of SBP (p = 0.0062) were predictive factors of SBEM. The hospitalization mortality rate of SBEM was 38%. CONCLUSIONS: Patients with advanced liver disease, low pleural fluid protein level, or SBP are predisposed to SBEM. A diagnostic thoracentesis should be performed in cirrhotic patients with pleural effusion when infection is suspected or clinical deterioration occurs.

Bacterial Infections↗
PubMed2002

Identification of major allergens of Malassezia pachydermatis in dogs with atopic dermatitis and Malassezia overgrowth.

We have previously shown that both atopic and normal dogs generate an IgG response to antigens of Malassezia pachydermatis. The aim of this study was to compare IgE responses to separated proteins of M. pachydermatis in 28 atopic dogs with Malassezia dermatitis and 22 clinically normal dogs using Western immunoblotting. Six different detection systems were evaluated in order to assess sensitivity and eliminate nonspecific binding and cross-reactivity. The protocol yielding the best results utilized a monoclonal mouse antidog IgE, an alkaline phosphatase conjugated goat antimouse IgG which had been passed through a canine IgG column 3 times, a chemiluminescent substrate and a digital imaging system. Proteins of 45, 52, 56 and 63 kDa were recognized by more than 50% of the atopic dog sera and thus represented major allergens. Only a minority of normal dogs showed faint IgE binding to these proteins. The results indicate that the majority of atopic dogs with Malassezia dermatitis have a greater IgE response than normal dogs, suggesting an IgE-mediated immune response may be clinically important in the pathogenesis of the disease.

Allergens↗
PubMed2002

Failure of extracts from Malassezia pachydermatis to stimulate canine keratinocyte proliferation in vitro.

Epidermal hyperplasia is one of the major histopathological features seen in dogs with Malassezia dermatitis. The aim of this study was to investigate the effects of extracts and culture supernatants from Malassezia pachydermatis on the proliferation of canine keratinocytes. Keratinocyte cultures were established from normal dog skin, and cell monolayers were co-cultured with Malassezia extracts (prepared either with or without protease inhibitors) and supernatants derived from organisms grown in liquid culture. The proliferation of keratinocytes was measured using a colourimetric assay. Neither the culture supernatants nor the Malassezia extracts had significant effects on the proliferation rate of canine keratinocytes, regardless of whether protease inhibitors were present or not. The results indicate that the epidermal hyperplasia seen in Malassezia dermatitis is unlikely to be caused directly by secretion of products from the organism.

Animals↗
PubMed2002

Prophylactic antibiotics in cirrhotics with upper gastrointestinal hemorrhage: a prospective, controlled trial.

BACKGROUND: Infections are a frequent complication in cirrhotics, and gastrointestinal bleeding may increase the infection rate. Nonabsorbable antibiotics or quinolone have been employed to decrease the incidence of infection. Since most of these studies were performed in western countries, it is still unclear whether this holds true in our Taiwan cirrhotic patients. Thus we conducted this study using a different formula of antibiotics to evaluate the efficacy of reducing infection rates in cirrhotics with upper gastrointestinal bleeding. METHODS: From July 1999 to August 2000, all cirrhotic in-patients presenting with upper gastrointestinal bleeding but without infection were enrolled. The patients should not have received antibiotics within 2 weeks before admission and should have expected life expectance more than 7 days. Eligible patients who had received endoscopy within 12 hours of hospitalization were randomly allocated into 2 groups. Group A received intravenous cefazolin 1 gm every 8 hours started before endoscopy. After 3 days of prophylactic parenteral antibiotics, antibiotics were shifted to oral cephalexin of 500 mg every 6 hours for 4 days. Group B served as control subjects. All patients received chest X-ray, blood and urine cultures, and ascites culture and sputum culture if ascites and sputum were found. Patients were excluded when initial blood, urine or ascites culture was positive for bacterial growth. RESULTS: Ninety-seven patients were included. Group A was comprised of 47 patients and Group B comprised of 50 patients. There was no significant difference in age, sex, Child-Pugh's score or initial hemoglobin between the 2 groups. Proved infection developed in 6 patients of Group B. By contrast, no proved infection was found in Group A. Three organisms belonged to gram-negative bacilli and 3 organisms were gram-positive cocci. The incidence of proved infection during hospitalization was 0% in Group A and 12.0% in Group B (p = 0.027). If possible infection cases (patient's body temperature more than 38 degrees C for more than 2 days) were included, the infection rate was 6.4% in Group A and 26% in Group B (p = 0.013). Infection-related mortality occurred in 2 patients in Group B, but none in Group A. CONCLUSIONS: Our prophylactic antibiotic treatment proved safe and effective in reducing the infection rate in cirrhotics with upper gastrointestinal bleeding.

Adult↗