DOCSLIB.ORG

Original Article Long-Term Effect of Extracorporeal Shock Wave Therapy on Attenuating Radiation-Induced Chronic Cystitis in Rat

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Original Article Long-Term Effect of Extracorporeal Shock Wave Therapy on Attenuating Radiation-Induced Chronic Cystitis in Rat Am J Transl Res 2020;12(3):999-1015 www.ajtr.org /ISSN:1943-8141/AJTR0105598 Original Article Long-term effect of extracorporeal shock wave therapy on attenuating radiation-induced chronic cystitis in rat Yen-Ta Chen1,2, Chih-Chao Yang3, Pei-Hsun Sung4,5, Kun-Chen Lin6, John Y Chiang7,8, Chi-Ruei Huang4,5, Kuan-Hui Huang9, Fei-Chi Chuang9, Yi-Ching Chu4,5, Eng-Yen Huang10,11, Hon-Kan Yip4,5,12,13,14 1Division of Urology, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; 2Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; 3Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; 4Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 5Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; 6Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; 7Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan; 8Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan; 9Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; 10Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan; 11School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan; 12Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; 13Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan; 14Department of Nursing, Asia University, Taichung, Taiwan Received November 27, 2019; Accepted March 4, 2020; Epub March 15, 2020; Published March 30, 2020 Abstract: Background: This study tested the long-term effect of extracorporeal shock wave (ECSW) therapy on ame- liorating radiotherapy-induced chronic cystitis (CC) in rat. Methods and results: Adult-female SD rats (n = 24) were equally categorized into group 1 (normal control), group 2 (CC induced by radiotherapy with 450 cGy twice with a four-hour interval to the urinary bladder), group 3 [CC with ECSW treatment (0.1 mJ/mm2/120 impulses once every 3 days after radiotherapy)]. Bladder specimens were harvested by day 60 after radiotherapy. By day 60, the degree of detrusor contraction was significantly reduced in group 2 than groups 1 and 3, and significantly reduced in group 3 than in group 1 (P < 0.0001). Number of WBC, occulted blood and bacteria were significantly higher in group 2 than in groups 1 and 3 (P < 0.01), but they showed no difference between the latter two groups (P > 0.3). The protein expressions of oxidative stress (NOX-1/NOX-2/oxidized protein), apoptosis (cleaved-caspase-3/cleaved- PARP), DNA-damaged marker (γ-H2AX), fibrosis (TGF-β/Smad3) and inflammatory signaling (TLR-4/MYD88/Mal/ TRAF6/p-IκBα/p-NFκB/TNF-α/MMP-9/COX-2) were significantly higher in group 2 than in group 1, and were signifi- cantly reduced in group 3 (all P < 0.001). The cellular expressions of inflammatory (CD14+/CD68+/MIF+/MMP-9), immunoreactive (CD4+/CD8+) and cytokeratin (CK17/CK18) biomarkers, and collagen-deposition/fibrotic areas as well as bladder-damaged score/disruption of the bladder mucosa displayed an identical pattern compared to that of oxidative stress among the three groups (all P < 0.0001). Conclusion: The long-term effect of ECSW treatment was reliable on protecting the urinary bladder from radiation-induced CC. Keywords: Radiation, chronic cystitis, inflammation, urinary bladder contractility Introduction on palliative therapy for advanced stage of some solid cancers such as brain tumor, lung Despite state-of-the-art advances in chemo- cancers and urogenital/gynecologic cancers therapy, hormone therapy and target therapy [1-5]. However, a fly in the ointment is that radio- as well as immunotherapy for advanced can- therapy has been found to commonly induce cers, radiotherapy still plays an essential role hemorrhagic cystitis (HC), gross hematuria and Extracorporeal shock wave therapy on radiation-induced chronic cystis late radiation-induced chronic cystitis (CC), No. 2016012804) and performed in accor- which not merely hinder the patient’s quality dance with the Guide for the Care and Use of of life and social activity but also induce psy- Laboratory Animals. chiatric issues, urinary tract infection/sepsis, obstructive uropathy and renal failure as well Animals were housed in an Association for as increase the risk of mortality [6-10]. Assessment and Accreditation of Laboratory Animal Care International (AAALAC; Frederick, During the last decades, plentiful modalities, MD, USA)-approved animal facility in our hospi- including pharmacological agents, surgical in- tal with controlled temperature and light cycles terventions and even hyperbaric oxygen thera- (24°C and 12/12 light cycle). py, have been extensively applied for the HC [11-18]. However, their efficacies are contradic- Rationale of ECSW energy utilized in the pres- tory, highlighting that treatment of radiothera- ent study py-induced HC/CC and the associated compli- cations remains a formidable challenge. Accor- The purpose of this study was to evaluate the dingly, a safe and efficacious treatment alter- long-term effect of ECSW on protecting the uri- native is still eagerly awaited. nary bladder against the radiotherapy. Thus, the study period was designed as a duration of In view of pathophysiology of radiation cystitis 60 days after radiotherapy. Another evaluation that is mainly caused by activation of an in- was that ECSW application should resemble flammatory cascade leading to tissue swelling, the clinical setting of “regularly intermittent mucosa damage, necrosis, and smooth muscle administration” of the medicine for a chronic destruction and finally fibrosis [19-22], era- disease. Along this line of thinking, regularly dication of the inflammatory reactions may intermittent application of ECSW to the urinary prove as an innovative therapeutic strategies bladder was performed for the animals. Based for those of HC/CC patients refractory to con- on these considerations, the safety of ECSW ventional treatment. had to be considered, especially when regular and consistent application of ECSW was uti- Previous studies have established that extra- lized in the present study. According to our pre- corporeal shock wave (ECSW) therapy is able vious in vitro [31] and in vivo [23, 25-30] stud- to inhibit the inflammatory reaction and oxi- ies, we found that the safest and lowest energy dative stress, and augment the angiogenesis [23, 24]. Besides, our studies have displayed of ECSW with promising efficacy was 0.1 mJ/ mm2/120 impulses. This was the reason why that ECSW therapy is not only safe, but has 2 capacities of pro-angiogenesis, anti-ischemia, we utilized the “0.1 mJ/mm /120 impulses anti-fibrosis, anti-inflammation, and pain-allevi- once every 3 days after radiation” (i.e., a total ating effects [25-29]. Based on these afore- of 20 times in the present study). mentioned issues [19-29], we have recently Rationale of radiotherapy dosage (refer to performed a study with a period of 28 days to Figure 1) and duration of study period address the impact of ECSW on reducing the radiation-induced HC/CC in rodent [30]. Our Practically, for achieving greatest efficacy, the results are attractive and promising. However, dosage of radiotherapy for solid cancers of uro- this study also has limitations, such as the opti- genital/gynecologic origin is always quite high mal dosage of radiation and long-term effect of in order to kill the cancer cells that could explain ECSW therapy with appropriate energy on radi- why a lot of side effects are frequently encoun- ation-induced HC were regrettably left unad- tered in those urogenital/gynecologic patients dressed. Accordingly, this study was designed after receiving this therapy [19-22]. On the to answer the limitations of our recent study other hand, for safety, the dosage of radiother- [30]. apy in our previous animal model study [30] Materials and methods was designed as low dosage (i.e., 300 cGy). This, therefore, raises the question that the Ethics and animal care results of our animal model of study [30] might not truthfully reflect the daily clinical practice. All animal procedures were approved by the Accordingly, in the present study, except the Institute of Animal Care and Use Committee at low dose of our previous study (i.e., 300 cGy Kaohsiung Chang Gung Memorial Hospital twice with a four-hour interval to the urinary (Affidavit of Approval of Animal Use Protocol bladder of one animal), we performed a pilot 1000 Am J Transl Res 2020;12(3):999-1015 Extracorporeal shock wave therapy on radiation-induced chronic cystis 1001 Am J Transl Res 2020;12(3):999-1015 Extracorporeal shock wave therapy on radiation-induced chronic cystis Figure 1. Pilot study, urodynamic study of bladder contraction, urine amount and ratio of urine protein to urine creatinine at day 60 after radiotherapy. (A-F) Escala- tion of dosage of radiation energy (i.e., stepwise increase of the radiotherapy dosage) in the pilot study with consistent ECSW application (i.e., 0.1 mJ/mm2/120 impulses/once every 3 days after radiation). We utilized 300 cGy (A, B), 450 cGy (C, D) and 600 cGy (E, F)/twice with 4-h interval for each animal in CC (A, C, E) and CC + ECSW (B, D, F) groups (n = 2/each group). By day 60 after CC induction, the results showed that no detrusor contractility wave was observed in either CC only or in CC + ECSW animals in 600 cGy, only CC + ECSW animals had notable detrusor contractility wave in 450 cGy and 300 cGy.
Load more

Recommended publications
  • Research on the International Roughness Index Threshold of Road Rehabilitation in Metropolitan Areas: a Case Study in Taipei City
    sustainability Article Research on the International Roughness Index Threshold of Road Rehabilitation in Metropolitan Areas: A Case Study in Taipei City Shong-Loong Chen 1 , Chih-Hsien Lin 1, Chao-Wei Tang 2,3,4,*, Liang-Pin Chu 5 and Chiu-Kuei Cheng 6 1 Department of Civil Engineering, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei 10608, Taiwan; [email protected] (S.-L.C.); [email protected] (C.-H.L.) 2 Department of Civil Engineering and Geomatics, Cheng Shiu University, No. 840, Chengching Rd., Niaosong District, Kaohsiung 83347, Taiwan 3 Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, No. 840, Chengching Rd., Niaosong District, Kaohsiung 83347, Taiwan 4 Super Micro Mass Research and Technology Center, Cheng Shiu University, No. 840, Chengching Rd., Niaosong District, Kaohsiung 83347, Taiwan 5 Taipei City Government, No. 1, City Hall Rd., Xinyi District, Taipei City 110204, Taiwan; [email protected] 6 Department of Agribusiness Management, National Pingtung University of Science and Technology, No. 1, Shuefu Rd., Neipu, Pingtung 91201, Taiwan; [email protected] * Correspondence: [email protected]; Tel.: +886-7-735-8800 Received: 24 October 2020; Accepted: 14 December 2020; Published: 16 December 2020 Abstract: The International Roughness Index (IRI) is the standard scale for evaluating road roughness in many countries in the world. The Taipei City government actively promotes a Road Smoothing Project and plans to complete the rehabilitation of the main and minor roads within its jurisdiction. This study aims to detect the road surface roughness in Taipei City and recommend appropriate IRI thresholds for road rehabilitation.
    [Show full text]
  • The Effect of Pilocarpine on Dental
    Hsu et al. Arthritis Research & Therapy (2019) 21:251 https://doi.org/10.1186/s13075-019-2031-7 RESEARCH ARTICLE Open Access The effect of pilocarpine on dental caries in patients with primary Sjögren’s syndrome: a database prospective cohort study Chung-Yuan Hsu1†, Kuo-Chun Hung2†, Ming-Shyan Lin3, Chi-Hua Ko1, Yu-Sheng Lin4,5, Tien-Hsing Chen6, Chun-Yu Lin7* and Ying-Chou Chen1* Abstract Background: Primary Sjögren’s syndrome (pSS) is associated with dental caries. Pilocarpine, a salivary stimulant, can improve the amount and flow rate of saliva in patients with pSS. This study aimed to assess whether the risk of dental caries decreases with the use of pilocarpine in patients with pSS. Methods: For this prospective cohort study, we identified pSS patients from the catastrophic illnesses registry of the National Health Insurance Research Database of Taiwan between 2009 and 2013. We divided participants into pilocarpine and non-user groups based on the pilocarpine prescriptions available during the first 3-month follow- up. The primary endpoint was dental caries. The secondary endpoints were periodontitis and oral candidiasis. We compared the risk of these oral manifestations using the Cox proportional hazard model. Results: A total of 4973 patients with new-onset pSS were eligible for analysis. After propensity score matching, we included 1014 patients in the pilocarpine group and 2028 patients in the non-user group. During the mean follow-up of 2.6 years, the number of events was 487 in the pilocarpine group (48.0%) and 1047 in the non-user group (51.6%); however, the difference was not significant (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.82 to 1.06).
    [Show full text]
  • Is Alteration of Warfarin Regimen Necessary Before Dental Extractions
    + MODEL Journal of Dental Sciences (2015) xx,1e7 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.e-jds.com ORIGINAL ARTICLE Is alteration of warfarin regime necessary before dental extractions in Taiwanese patients? Results of a retrospective cohort study Shin-Yu Lu a,b*, Chi-Yu Tsai a,b, Sheng-Nan Lu b,c, Liang-Ho Lin a,b a Oral Pathology and Family Dentistry Section, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan b Chang Gung University College of Medicine, Kaohsiung, Taiwan c Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan Received 30 December 2014; Final revision received 4 February 2015 Available online --- KEYWORDS Abstract Background/purpose: Most Western studies do not recommend interrupting extraction; warfarin therapy or replacing it with heparin priortotoothextractioniftheinternational oral anticoagulants; normalized ratio (INR) levels are maintained. However, this issue remains controversial in tranexamic acid; Taiwan. The aim of this study was to investigate whether Taiwanese patients who had an warfarin INR within the therapeutic range required cessation of warfarin prior to dental extractions. Materials and methods: A total of 60 patients on warfarin with INR <4.0 who underwent 207 dental extractions in 70 occasions were divided into two groups. Thirty-two patients were allo- cated to the control group (warfarin stopped and switched to heparin under hospitalization) with average preoperative INR (range) from 2.30 (1.32e3.12) brought down to 1.14 (1.04 e1.32), and 28 patients were allocated to the study group (warfarin continued) with an average preoperative INR of 1.95 (1.06e3.08).
    [Show full text]
  • Protocol Amending the Agreement on Government Procurement
    PROTOCOL AMENDING THE AGREEMENT ON GOVERNMENT PROCUREMENT PROTOCOLE PORTANT AMENDEMENT DE L'ACCORD SUR LES MARCHÉS PUBLICS PROTOCOLO POR EL QUE SE MODIFICA EL ACUERDO SOBRE CONTRATACIÓN PÚBLICA WORLD TRADE ORGANIZATION ORGANISATION MONDIALE DU COMMERCE ORGANIZACIÓN MUNDIAL DEL COMERCIO Geneva 30 March 2012 - 1 - PROTOCOL AMENDING THE AGREEMENT ON GOVERNMENT PROCUREMENT The Parties to the Agreement on Government Procurement, done at Marrakesh on 15 April 1994, (hereinafter referred to as "the 1994 Agreement"), Having undertaken further negotiations pursuant to Article XXIV:7(b) and (c) of the 1994 Agreement; Hereby agree as follows: 1. The Preamble, Articles I through XXIV, and Appendices to the 1994 Agreement shall be deleted and replaced by the provisions as set forth in the Annex hereto. 2. This Protocol shall be open for acceptance by the Parties to the 1994 Agreement. 3. This Protocol shall enter into force for those Parties to the 1994 Agreement that have deposited their respective instruments of acceptance of this Protocol, on the 30th day following such deposit by two thirds of the Parties to the 1994 Agreement. Thereafter this Protocol shall enter into force for each Party to the 1994 Agreement which has deposited its instrument of acceptance of this Protocol, on the 30th day following the date of such deposit. 4. This Protocol shall be deposited with the Director-General of the WTO, who shall promptly furnish to each Party to the 1994 Agreement a certified true copy of this Protocol, and a notification of each acceptance thereof. 5. This Protocol shall be registered in accordance with the provisions of Article 102 of the Charter of the United Nations.
    [Show full text]
  • Bone Turnover and Periprosthetic Bone
    Huang et al. BMC Musculoskeletal Disorders (2017) 18:209 DOI 10.1186/s12891-017-1577-2 RESEARCH ARTICLE Open Access Bone turnover and periprosthetic bone loss after cementless total hip arthroplasty can be restored by zoledronic acid: a prospective, randomized, open-label, controlled trial Tsan-Wen Huang1,2,7, Chao-Jan Wang2,4,6, Hsin-Nung Shih2,3,6, Yuhan Chang2,3,6, Kuo-Chin Huang2,5,8, Kuo-Ti Peng1,2,7 and Mel S. Lee2,5* Abstract Background: Although the loss of bone mineral density (BMD) after total hip arthroplasty (THA) is a known problem, it remains unresolved. This study prospectively examined the effect of zoledronic acid (ZA) on bone turnover and BMD after cementless THA. Methods: Between January 2010 and August 2011, 60 patients who underwent cementless THA were randomly assigned to receive either ZA infusion or placebo (0.9% normal saline only) postoperatively. ZA was administered at 2 day and 1 year postoperatively. Periprosthetic BMD in seven Gruen zones was assessed preoperatively and at given time points for 2 years. Serum markers of bone turnover, functional scales, and adverse events were recorded. Results: Each group contained 27 patients for the final analysis. The loss of BMD across all Gruen zones (significantly in zones 1 and 7) up to 2 years postoperatively was noted in the placebo group. BMD was significantly higher in theZAgroupthanintheplacebogroupinGruenzones1,2,6,and7at1yearandinGruenzones1,6,and7at 2years(p <0.05).ComparedwithbaselinemeasuresofBMD,theZAgrouphadincreasedBMDinzones1,2,4,5, 6, and 7 at 1 year and in zones 1, 4, 6, and 7 at 2 years (p < 0.05).
    [Show full text]
  • Neutrophil-To-Lymphocyte Ratio and Scoring System for Predicting
    Chang et al. BMC Pediatrics (2020) 20:398 https://doi.org/10.1186/s12887-020-02285-5 RESEARCH ARTICLE Open Access Neutrophil-to-lymphocyte ratio and scoring system for predicting coronary artery lesions of Kawasaki disease Ling-Sai Chang1, Yi-Ju Lin1, Jia-Huei Yan2, Mindy Ming-Huey Guo1, Mao-Hung Lo1 and Ho-Chang Kuo1* Abstract Background: Kawasaki disease (KD) causes coronary artery lesions (CAL) and is the leading cause of acquired heart disease in children. The aim of this study is to evaluate the risk factors and set-up a scoring system for predicting CAL of KD. Methods: We retrospectively reviewed a total of 478 patients diagnosed with KD. We compared age, gender, laboratory data, and treatment response in two groups and developed a scoring system for predicting CAL. Results: During the study period, 365 of these patients had complete medical records of coronary surveys by echocardiography. Anemia, hypoalbuminemia, C reactive protein (CRP), alanine aminotransferase, neutrophil count, and neutrophil/lymphocyte ratio (NLR) showed significant differences with CAL formation. We determined the cut-off value using a receiver-operating-characteristic (ROC) curve, and following multivariate logistic regression analysis, four independent risk factors demonstrated a significant difference with CAL formation, including CRP > 103 mg/L, NLR > 3.5, male gender, and intravenous immunoglobulin (IVIG) resistance. We established a score system based on the above evaluation, for which a ROC curve was performed, and a total score of ≥ 2 points showed a sensitivity of 60.8% and a specificity of 70.6%, with an area under the ROC curve of 0.696.
    [Show full text]
  • Using the BODE Index and Comorbidities to Predict Health Utilization Resources in Chronic Obstructive Pulmonary Disease
    International Journal of Chronic Obstructive Pulmonary Disease Dovepress open access to scientific and medical research Open Access Full Text Article ORIGINAL RESEARCH Using the BODE Index and Comorbidities to Predict Health Utilization Resources in Chronic Obstructive Pulmonary Disease This article was published in the following Dove Press journal: International Journal of Chronic Obstructive Pulmonary Disease Chin-Ling Li 1,2 Background and Objective: Chronic Obstructive Pulmonary Disease (COPD) is a com- Mei-Hsin Lin1 mon chronic respiratory disease that in the long term may develop into respiratory failure or Pei-Shiuan Chen1 even cause death and may coexist with other diseases. Over time, it may incur huge medical fl Yuh-Chyn Tsai 1,2 expenses, resulting in a heavy socio-economy burden. The BODE (Body mass index, air ow Lien-Shi Shen1,2 Obstruction, Dyspnea, and Exercise capacity) index is a predictor of the number and severity of acute exacerbations of COPD. This study focused on the correlation between the BODE Ho-Chang Kuo 1,3,4 index, comorbidity, and healthcare resource utilization in COPD. Shih-Feng Liu1,4,5 Patients and Methods: This is a retrospective study of clinical outcomes of COPD 1Department of Respiratory Therapy, patients with complete BODE index data in our hospital from January 2015 to December Kaohsiung Chang Gung Memorial 2016. Based on the patients’ medical records in our hospital’s electronic database from Hospital, Kaohsiung City, Taiwan; 2Department of Healthcare January 1, 2015 to August 31, 2017, we analyzed the correlation between BODE index, Administration and Medical Informatics, Charlson comorbidity index (CCI), and medical resources.
    [Show full text]
  • GPA/W/326 Attachment K K1
    GPA/W/326 Attachment K APPENDIX I CHINESE TAIPEI ANNEX 1 Page 1/2 THE SEPARATE CUSTOMS TERRITORY OF TAIWAN, PENGHU, KINMEN AND MATSU* (Authentic in the English Language only) ANNEX 1 CENTRAL GOVERNMENT ENTITIES Thresholds: Goods SDR 130,000 Services SDR 130,000 Construction Services SDR 5,000,000 List of Entities: 1. Office of the President; 2. Executive Yuan; 3. Ministry of Interior (including its Central Taiwan Division and Second Division); 4. Ministry of Finance (including its Central Taiwan Division); 5. Ministry of Economic Affairs (including its Central Taiwan Division); 6. Ministry of Education (including its Central Taiwan Division); 7. Ministry of Justice (including its Central Taiwan Division); 8. Ministry of Transportation and Communications (including its Central Taiwan Division); 9. Mongolian & Tibetan Affairs Commission; 10. Overseas Compatriot Affairs Commission; 11. Directorate-General of Budget, Accounting and Statistics (including its Central Taiwan Division); 12. Department of Health (including its Central Taiwan Division); 13. Environmental Protection Administration (including its Central Taiwan Division); 14. Government Information Office; 15. Central Personnel Administration; 16. Mainland Affairs Council; 17. Council of Labor Affairs (including its Central Taiwan Division); 18. Research, Development and Evaluation Commission; 19. Council for Economic Planning and Development; 20. Council for Cultural Affairs; 21. Veterans Affairs Commission; 22. Council of Agriculture; 23. Atomic Energy Council; 24. National Youth Commission; 25. National Science Council (Note 3); 26. Fair Trade Commission; 27. Consumer Protection Commission; 28. Public Construction Commission; 29. Ministry of Foreign Affairs (Note 2) (Note 4); 30. Ministry of National Defense; 31. National Palace Museum; 32. Central Election Commission. … 2014 (WT/Let/…) K1 GPA/W/326 Attachment K APPENDIX I CHINESE TAIPEI ANNEX 1 Page 2/2 * In English only.
    [Show full text]
  • Objective Assessment of Impulse Control Disorder in Patients with Parkinson's Disease Using a Low- Cost LEGO-Like EEG Headset
    Objective Assessment of Impulse Control Disorder in Patients with Parkinson’s Disease Using a Low- Cost LEGO-Like EEG Headset Yuan-Pin Lin National Sun Yat-sen University Hsing-Yi Liang National Sun Yat-sen University Yueh-Sheng Chen Kaohsiung Chang Gung Memorial Hospital Cheng-Hsien Lu Kaohsiung Chang Gung Memorial Hospital Yih-Ru Wu Linkou Chang Gung Memorial Hospital Yung-Yee Chang Kaohsiung Chang Gung Memorial Hospital Wei-Che Lin ( [email protected] ) Kaohsiung Chang Gung Memorial Hospital Research Keywords: Parkinson’s disease, Impulse control disorders, Electroencephalogram, Event-related potential, LEGO-like headset Posted Date: December 11th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-125029/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Objective Assessment of Impulse Control Disorder in Patients with Parkinson’s Disease Using a Low- Cost LEGO-like EEG Headset 1,2 Yuan-Pin Lin ([email protected]) 1 Hsing-Yi Liang ([email protected]) 3 Yueh-Sheng Chen ([email protected]) 4 Cheng-Hsien Lu ([email protected]) 5 Yih-Ru Wu ([email protected]) 4 Yung-Yee Chang ([email protected]) 3 Wei-Che Lin ([email protected]) 1 Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan 2 Department of Electrical Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan 3 Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan 4 Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan, Kaohsiung, Taiwan 5 Department of Neurology, Linkou Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Taoyuan, Taiwan Correspondence: Dr.
    [Show full text]
  • Vertical Facility List
    Facility List The Walt Disney Company is committed to fostering safe, inclusive and respectful workplaces wherever Disney-branded products are manufactured. Numerous measures in support of this commitment are in place, including increased transparency. To that end, we have published this list of the roughly 7,600 facilities in over 70 countries that manufacture Disney-branded products sold, distributed or used in our own retail businesses such as The Disney Stores and Theme Parks, as well as those used in our internal operations. Our goal in releasing this information is to foster collaboration with industry peers, governments, non- governmental organizations and others interested in improving working conditions. Under our International Labor Standards (ILS) Program, facilities that manufacture products or components incorporating Disney intellectual properties must be declared to Disney and receive prior authorization to manufacture. The list below includes the names and addresses of facilities disclosed to us by vendors under the requirements of Disney’s ILS Program for our vertical business, which includes our own retail businesses and internal operations. The list does not include the facilities used only by licensees of The Walt Disney Company or its affiliates that source, manufacture and sell consumer products by and through independent entities. Disney’s vertical business comprises a wide range of product categories including apparel, toys, electronics, food, home goods, personal care, books and others. As a result, the number of facilities involved in the production of Disney-branded products may be larger than for companies that operate in only one or a limited number of product categories. In addition, because we require vendors to disclose any facility where Disney intellectual property is present as part of the manufacturing process, the list includes facilities that may extend beyond finished goods manufacturers or final assembly locations.
    [Show full text]
  • Annual Important Performance
    Annual Important Performance Item Unit 1974 1975 1976 1977 1978 1979 1.Capacity of Water Supply System M3/Day … … … … … … 2.Capacity of Water-Purification-Station M3/Day 1,552,559 1,802,000 2,439,390 2,731,112 2,921,834 3,187,036 3.Average Yield Per Day M3 1,176,321 1,265,741 1,332,205 1,513,115 1,791,415 1,996,937 4.Average Water Distributed Per Day M3 1,159,958 1,251,325 1,329,623 1,509,732 1,786,097 1,993,547 5.Average Water Sold Per Day M3 791,814 833,840 906,641 1,053,783 1,294,756 1,493,036 6.Yield M3 429,357,104 461,995,434 487,586,996 552,286,833 653,866,592 728,881,919 7.Distributed Water M3 423,384,502 456,733,547 486,641,970 551,052,131 651,925,230 727,644,563 8.Water Sold M3 289,012,366 304,351,457 331,830,538 384,630,881 472,585,950 544,957,993 9.Actual Meter-Readings M3 … … 325,943,007 366,487,228 447,447,054 508,369,477 10.Percentage of Water Sold ％ 68.26 66.64 68.19 69.80 72.49 74.89 11.Percentage of Actual Meter Readings ％ … … 66.98 66.51 68.63 69.87 12.Administrative Population Person 13,212,945 13,431,137 13,688,930 13,908,275 14,127,946 14,376,247 13.Designed Population Person 6,248,858 6,780,700 7,616,810 8,300,890 8,927,215 9,503,965 14.
    [Show full text]
  • Paliperidone Is Associated with Reduced Risk of Severe Hepatic Outcome in Patients with Schizophrenia and Viral Hepatitis A
    Psychiatry Research 281 (2019) 112597 Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres Paliperidone is associated with reduced risk of severe hepatic outcome in T patients with schizophrenia and viral hepatitis: A nationwide population- based cohort study ⁎ Chun-Hung Changa,b,c, Hsien-Yuan Lanea,b,d,e,1, , Chieh-Yu Liuf, Shaw-Ji Cheng,h, ⁎ Chieh-Hsin Lina,d,i,1, a Department of Psychiatry, Institute of Clinical Medical Science, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung 404, Taiwan b Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan c An Nan Hospital, China Medical University, Tainan, Taiwan d Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan e Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan f Biostatistical Consulting Lab,Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan g Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan h Department of Medicine, Mackay Medical College, New Taipei, Taiwan i Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No 123, Dapi Rd, Niaosong District, Kaohsiung 833, Taiwan ABSTRACT Objective: Paliperidone, a second-generation antipsychotic, has been found to have minimal hepatotoxicity in patients with schizophrenia. However, long-term hepatic outcome in patients with schizophrenia and viral hepatitis remains unclear. Methods: Data obtained from the Taiwan National Health Insurance Research Database was used to enroll newly diagnosed schizophrenic patients between January 2007 and December 2013.
    [Show full text]