Ming-Kai Tsai

Sequence variants of ADIPOQ and association with type 2 diabetes mellitus in Taiwan Chinese Han population.

Diabetes is a serious global health problem. Large-scale genome-wide association studies identified loci for type 2 diabetes mellitus (T2DM), including adiponectin (ADIPOQ) gene and transcription factor 7-like 2 (TCF7L2), but few studies clarified the effect of genetic polymorphisms of ADIPOQ and TCF7L2 on risk of T2DM. We attempted to elucidate association between T2DM and polymorphic variations of both in Taiwans Chinese Han population, with our retrospective case-control study genotyping single nucleotide polymorphisms (SNPs) in ADIPOQ and TCF7L2 genes both in 149 T2DM patients and in 139 healthy controls from Taiwan. Statistical analysis gauged association of these polymorphisms with risk of T2DM to show ADIPOQ rs1501299 polymorphism variations strongly correlated with T2DM risk (P = 0.042), with rs2241766 polymorphism being not associated with T2DM (P = 0.967). However, both polymorphisms rs7903146 and rs12255372 of TCF7L2 were rarely detected in Taiwanese people. This study avers that ADIPOQ rs1501299 polymorphism contributes to risk of T2DM in the Taiwanese population.

Novel Investigations of Flavonoids as Chemopreventive Agents for Hepatocellular Carcinoma

We would like to highlight the application of natural products to hepatocellular carcinoma (HCC). We will focus on the natural products known as flavonoids, which target this disease at different stages of hepatocarcinogenesis. In spite of the use of chemotherapy and radiotherapy in treating HCC, patients with HCC still face poor prognosis because of the nature of multidrug resistance and toxicity derived from chemotherapy and radiotherapy. Flavonoids can be found in many vegetables, fruits, and herbal medicines that exert their different anticancer effects via different intracellular signaling pathways and serve as antioxidants. In this review, we will discuss seven common flavonoids that exert different biological effects against HCC via different pathways.

Prompt plasmapheresis successfully rescue pulmonary-renal syndrome caused by ANCA-negative microscopic polyangiitis

Pulmonary-renal syndrome (PRS) associated with antineutrophil cytoplasmic antibodies (ANCA)-negative microscopic polyangiitis (MPA) is relatively rare, and the effects of plasmapheresis on these patients remain unclear. Here, we report the case of a 66-year-old man who presented with fever, acute renal failure, thrombocytopenia, and sudden onset of diffuse pulmonary hemorrhage. Prompt plasmapheresis and concurrent pulse therapy with methylprednisolone effectively rescued his pulmonary-renal syndrome. The patient was then diagnosed with MPA on the basis of typical histological findings and the absence of surrogate markers of Wegeners granulomatosis and Churg–Strauss syndrome. This case demonstrates the therapeutic effects of plasmapheresis on ANCA-negative MPA and highlights the necessity of prompt plasmapheresis for not only resolving pulmonary hemorrhage but also increasing the likelihood of renal function restoration in patients with PRS.

Rhodobacter sphaeroides Extract Improves Glucose Homeostasis in Streptozotocin-Induced Diabetic Mice

Insulin resistance is one of the most important mechanisms of diabetes mellitus. Anti-oxidants had been proved to improve insulin resistance. However, the direct relation between anti-oxidants and glucose homeostasis is still elusive. Recently, we found that LycogenTM (extracts of Rhodobacter sphaeroides WL-APD911) has lycopene-like activity. Furthermore, LycogenTM showed more potent anti-oxidative effect and less cytotoxicity than lycopene. To evaluate the effect of LycogenTM on blood glucose levels, STZ-induced diabetic mice were randomly divided into four groups: (1) diabetes control group; (2) diabetes+LycogenTM 50 mg/kg; (3) diabetes+LycogenTM 100 mg/kg; and (4) diabetes+LycogenTM 200 mg/kg. After 7 days of treatment, the blood glucose level in the LycogenTM 200 mg/kg group was significantly lower than the disease control group (p<0.01). In the oral glucose tolerance test, the blood glucose level was significantly lower in the LycogenTM 200 mg/kg group than the disease control group (p<0.05). Our results confirmed that LycogenTM, a potent anti-oxidant, can significantly lower blood glucose levels in a diabetic mice model.

Perfect Storm of Life-Threatening Hypocalcemia in a Severe Trauma Patient

The presentations of patients with hypocalcemia varies from an asymptomatic biochemical abnormality to a life-threatening disorder, depending on the severity, duration, and rapidity of development. Hypocalcemia was frequently found in hospitalized patient, but severe low level with life-threatening manifestation in a short period of time rarely occurred. Herein, we reported a trauma patient with ”Perfect Storm” scenario of severe hypocalcemia development. Multiple factors contributed to severe hypocalcaemia, included trauma injury with rhabdomyolysis, hyperphosphatemia, acute renal failure, and blood transfusion. Acute hypocalcemia can result in life-threatening complications such as refractory hypotension and cardiac arrhythmia that need rapid correction. Therefore, carefully observation of the clinical signs and monitoring calcium level is suggested in trauma patients.

Neurological Manifestations in a Patient of Heat Stroke-Case Report and Literature Review

neurological dysfunction. Despite aggressive treatment, including adequate lowering of the body temperature, survivors of heat stroke may sustain neurological sequelae. Cerebellar syndrome is the most common permanent neurological deficit. We present a young soldier who suffered from heat stroke and complicated with multiple organs dysfunction. He survived after intensive treatment but left severe neurological deficit. We demonstrate his clinical course and the accompanying neurological manifestations. New therapeutic strategies for the heat stroke will be reviewed for attempting to reduce the occurrence of permanent neurological complication.