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Biomedical subjects

Wei-Hung Chen

Publications and source records attributed to Wei-Hung Chen.

25 records · Page 2Linked to original sources
PubMed2003

Pulmonary function study of myasthenia-gravis patients treated with double-filtration plasmapheresis.

The aim of this study was to investigate the changes in pulmonary function tests for patients with myasthenia gravis (MG) after treatment with double filtration plasmapheresis (DFP) and to evaluate whether pulmonary function tests predict the efficacy of DFP treatment. Thirty-five MG patients (20 females and 15 males, age range 21-69 years) underwent DFP for between four and eight consecutive sessions. Vital capacity (VC), maximal inspiratory pressure (Pi(max)), and MG score were measured before and after DFP. Based on the results of pulmonary function tests, the patients were divided into dyspnea (VC < 1.0 L or Pi(max) < -25 cm H(2)O) and control groups (VC > 1.0 L and Pi(max) > -25 cm H(2)O). The dyspnea group had a significantly better response to DFP treatment, reflected in the decrease of the MG-score (P=0.0327), and the increase in VC value (P=0.0561). Higher clearance rates of acetylcholine receptor antibody (AchRAb) had a trend toward higher changes of VC. In conclusion, VC might better serve as a predictor for the effect of DFP in the dyspnea patient group because of better correlation with clinical improvement and AchRAb clearance.

Adult↗
PubMed2003

Low-frequency rTMS over lateral premotor cortex induces lasting changes in regional activation and functional coupling of cortical motor areas.

OBJECTIVE: To study the effect of 0.9 Hz repetitive transcranial magnetic stimulation (rTMS) of the lateral premotor cortex on neuronal activity in cortical motor areas during simple motor tasks. METHODS: In 8 subjects, electroencephalogram (EEG) and electromyogram (EMG) were simultaneously recorded during voluntary contractions of the thumb before and after a 15 min train of 0.9 Hz rTMS over the left lateral premotor cortex at stimulus intensity of 90% of active motor threshold. After-effects on cortical motor activity were assessed by measuring the task-related EEG power and inter-regional coherence changes, and the EEG-EMG coherence (EMGCoh). RESULTS: Low-frequency rTMS over the premotor cortex gave rise to (i) a reduction of the task-related power decrease in the alpha and beta bands, (ii) a selective increase in the task-related coherence change among cortical motor areas in the upper alpha band, and (iii) a decrease in the cortico-muscular coherence. These effects lasted about 15 min after the end of rTMS intervention. CONCLUSIONS: The attenuated task-related power changes and decreased EMGCoh point to a lasting suppression of voluntary activation of cortical motor areas after rTMS. The present data provide an evidence for a transient reorganization of movement-related neuronal activity in the cortical motor areas after 0.9 Hz rTMS over the premotor cortex. SIGNIFICANCE: Low-frequency rTMS changes the regional activation and functional coupling of cortical motor areas as demonstrated by EEG analysis.

Adult↗
PubMed2002

Hemodynamic study of serial double-filtration plasmapheresis.

Although hypotension is a potential complication for all procedures involving extracorporeal circulation, including plasmapheresis, the effects of serial double-filtration plasmapheresis (DFP) on hemodynamic status have rarely been reported. Blood pressure (BP) and pulse rate (PR) were prospectively monitored at 30-minute intervals (baseline, M30, M60, M90, and Ml20) during procedures for 20 myasthenia gravis patients who underwent one course of five consecutive DFP treatments on alternate days, with hemodynamic parameters recorded and analyzed for all sessions. To evaluate the hemodynamic influence of protein loss resulting from serial DFP treatment, additional analysis of serum protein levels including albumin and globulin was conducted before and after the entire course of treatment. Longitudinal analysis on the systolic BP (SBP) changes over five sessions revealed that the SBP at baseline and at M30 dropped significantly during the third and fourth sessions, in comparison to the first (P < 0.05). By contrast, SBP at M120 rose significantly (P < 0.05) after the second session of treatment. A similar trend was revealed for the diastolic BP (DBP) with a significant fall recorded at baseline and at M30 for the fourth session. The PR did not differ significantly during consecutive DFP treatments. Globulin removal rates were correlated significantly with falls in SBP (r(2) = 0.250, P = 0.048) and DBP (r(2) = 0.405, P = 0.008). However, analogous albumin removal rate was not correlated with these hemodynamic parameters. In conclusion, our results confirm that hypoproteinemia is an important factor for contributing to unstable hemodynamics during serial DFP.

Adult↗
PubMed2002

Plasma exchange versus double filtration plasmapheresis in the treatment of Guillain-Barré syndrome.

Previous studies have shown that both plasma exchange (PE) and double filtration plasmapheresis (DFPP) are effective treatments in Guillain-Barré syndrome (GBS). Whether PE and DFPP have similar effects in GBS is not clear. This report compares the therapeutic effectiveness of PE and DFPP in GBS patients treated in 3 major hospitals in northern Taiwan. A total of 102 patients were included in this survey, including 39 with PE (hereafter PE group) and 63 with DFPP (hereafter DFPP group). Both groups showed significant improvement of disability scores after treatment. However, time to onset of effect was shorter (5.6 +/- 3.5 versus 7 +/- 3.4 days, p < 0.05), and changes of disability scores were more prominent (1.3 +/- 0.8 versus 0.8 +/- 0.8, p < 0.05) in the PE group than the DFPP group. Mortality and outcome after 6 months were not different between the 2 groups. In conclusion, both PE and DFPP are effective treatments in GBS. PE was superior to DFPP in short-term effectiveness. The long-term effectiveness was not different.

Female↗
PubMed2002

An acute psychiatric episode following transvaginal oocyte retrieval.

Psychological disorders of infertile patients are traditionally thought to be chronic, to advance gradually, and to be long-term problems. We describe a patient in whom an acute psychiatric episode developed immediately after transvaginal ultrasound-guided oocyte retrieval. A 34 year old women without history of psychiatric disturbance or adverse reaction to drugs suffered an acute psychiatric episode immediately after oocyte retrieval. She exhibited tachycardia, tachypnoea, transient hypertension and limb rigidity, as well as alterations to stupor and posture. Her vital signs stabilized and she opened her eyes 6 h later, but she persistently raised her head to the left and stared blankly without response to external stimuli. Nine hours later, she was able to look around but remained unresponsive to stimuli. Aphasia was noted in the next morning and a wishful thinking of having delivered a baby was noted in the afternoon. Memory loss was noted on the third day. The patient was diagnosed as having dissociative amnesia and was discharged after three courses of supportive psychotherapy. Assisted reproductive technology-related acute psychiatric episodes, which may initially mimic brainstem stroke, are rare; however, attention should be paid to high-risk patients, and they should be offered elective psychological counselling.

Acute Disease↗
PubMedDate not supplied

Colchicine-induced acute myopathy in a patient with concomitant use of simvastatin.

Colchicine and 3-hydroxy-3-methy-glutaryl coenzyme A (HMG-CoA) reductase inhibitors are well known to cause myopathy. Myotoxicity is dose-dependent in both drugs; therefore, the onset of symptoms usually takes months or years. We report the case of a patient with chronic renal failure who had been taking simvastatin for 2 years and developed acute weakness 2 weeks after the start of treatment with colchicines for recurrent gout. The electromyography and elevated muscle enzymes indicated that his symptoms were caused by myopathy. When this patient stopped taking both drugs, his weakness resolved rapidly. Acute myopathy induced by combination therapy with colchicines and simvastatin is rare. In patients with chronic renal failure, co-administration of colchicine with simvastatin may accelerate the onset of myopathy because CYP3A4 (part of cytochrome P450) is crucial in the breakdown of both drugs. When adding colchicine to a medication regimen that includes a HMG-CoA reductase inhibitor for patients with renal insufficiency, drugs that are metabolized outside the CYP3A4 system (e.g., fluvastatin and pravastatin) should be selected instead.

Acute Disease↗