Chang Gung Medical Journal

Vol. 32 No. 3May-June 2009 Chang Gung Medical Journal

CONTENTS IN BRIEF

REVIEW ARTICLES

235The Potential Application of Granulocyte Colony Stimulating Factor Therapy on Neuropathic Pain

Long-Sun Ro, MD, PhD; Shyue-Ru Chen, MS; Po-Kuan Chao, MS; Yun-Lin Lee, MS;

Kwok-Tong Lu, PhD

247Sleep-disordered Breathing in Children

Hsueh-Yu Li, MD; Li-Ang Lee, MD

FORUM

258The Highly Pathogenic Avian Influenza H5N1 – Initial Molecular Signals for the Next Influenza Pandemic

Yasuo Suzuki, PhD

ORIGINAL ARTICLES

264The Efficiency of Percoll and Ficoll Density Gradient Media in the Isolation of Marrow Derived Human Mesenchymal Stem Cells with Osteogenic Potential

Yuhan Chang, MD; Pang-Hsin Hsieh, MD; Chuck C.-K. Chao, PhD

276Biomechanical Testing of Spinal Fusion Segments Enhanced by Extracorporeal Shock Wave Treatment in Rabbits

Tao-Chen Lee, MD; Yu-Lin Yang, PhD; Nyuk-Kong Chang, DVM; Ting-Sheng Lin, PhD;

Wan-Ching Lin, BS; Yi-Shiuan Liu, BS; Ching-Jen Wang, MD

283Using the 100-g Oral Glucose Tolerance Test to Predict Fetal and Maternal Outcomes in Women with Gestational Diabetes Mellitus

Chia-Hung Lin, MD; Shih-Fen Wen, BSc; Ya-Hui Wu, BSc; Miau-Ju Huang, MD

290Etiologic Features in Patients with Unilateral Vocal Fold Paralysis in Taiwan

Hui-Chen Ko, MD; Li-Ang Lee, MD; Hsueh-Yu Li, MD; Tuan-Jen Fang, MD

297Comparison of the Static and Dynamic Balance Performance in Young, Middle-aged, and Elderly Healthy People

Mei-Yun Liaw, MD; Chia-Ling Chen, MD, PhD; Yu-Cheng Pei, MD; Chau-Peng Leong, MD;

Yiu-Chung Lau, MD

305Long-term Video-EEG Monitoring for Paroxysmal Events

Ying-Ying Lee, MD; Mei-Ying Lee; I-an Chen, MD; Yu-Tai Tsai, MD; Chung-Yang Sung, MD;

Hsiang-Yao Hsieh, MD; Siew-Na Lim, MD; Peter Wu Hung; Tony Wu, MD, PhD

Covered in MEDLINE/Index Medicus and EMBASE/Excerpta Medica

313Help-seeking Behavior in Taiwanese Woman with Menopause-related Mood Symptoms Mei-Chun Hsiao, MD; Pi-Hui Chiang, MS; Chia-Yih Liu, MD; Yi-Hsiung Lin, MD

320Vertical Skeletal and Facial Profile Changes after Surgical Correction of Mandibular Prognathism

Yueh-Tse Lee, DDS; Min-Chin Chen, PhD; Huei-Lin Chen, DDS; Chou Bing Wu, DDS, PhD

CASE REPORTS

330De Novo Dedifferentiated Chordoma of the Sacrum: A Case Report and Review of the Literature

Wen-Chi Chou, MD; Yu-Shin Hung, MD; Chang-Hsien Lu, MD; Kun-Yun Yeh, MD;

Swei-Sheu, MD; Chuang-Chi Liaw, MD

336Fibrolamellar Hepatocellular Carcinoma- Report of A Case

Ju-Bei Yen, MD; Kuei-Wen Chang, MD

340INSTRUCTIONS TO AUTHORS

Vol. 32 No. 3May-June 2009

Chang Gung Medical Journal

CONTENTS

REVIEW ARTICLES

235The Potential Application of Granulocyte Colony Stimulating Factor Therapy on Neuropathic Pain

Long-Sun Ro, MD, PhD; Shyue-Ru Chen, MS; Po-Kuan Chao, MS; Yun-Lin Lee, MS;

Kwok-Tong Lu, PhD

Neuropathic pain is a type of pain arising as a direct consequence of a lesion or disease affecting the

somatosensory system. It is relatively common and can not be treated easily. One effective strategy in

neuropathic pain can result from interactions between leukocyte-derived opioid peptides and their receptors on

peripheral sensory neurons. Here, we briefly review granulocyte colony stimulating factor therapy in an animal

model of neuropathic pain that has led to an increased understanding of the opioids and cytokines -modulating

peripheral analgesia effect on neuropathic pain, which opens a new avenue in its treatment.

247Sleep-disordered Breathing in Children

Hsueh-Yu Li, MD; Li-Ang Lee, MD

Children with sleep-disordered breathing (SDB) can manifest a continuum from simple snoring to obstructive

sleep apnea (OSA). Most children who present with SDB are 4 to 8 years old with variable clinical symptoms at

different ages. Adenotonsillar hypertrophy is the leading cause of OSA. As in adults, polysomnography is the

gold standard diagnostic tool for OSA in children. Adenotonsillectomy is the cardinal treatment for pediatric SDB

and is usually followed by resolution of clinical symptoms. However, maxillofacial surgery, orthodontic

procedures, and continuous positive airway pressure are helpful in treating pediatric OSA in patients with

underlying structural or neuromuscular deficiencies.

FORUM

258The Highly Pathogenic Avian Influenza H5N1 – Initial Molecular Signals for the Next Influenza Pandemic

Yasuo Suzuki, PhD

A new pandemic influenza in the human world may originate from avian reservoirs. Influenza is one of the most

widely spread zoonotic infectious diseases. All avian influenza viruses are type A, and they have often caused

pandemics throughout human history. The highly pathogenic H5N1 influenza A viruses have now been spreading

to many countries in Asia, Europe and Africa. They have infected an increasing number of humans in at least 14

countries in the world. This paper describes recent advances in the mechanism of transmission of highly

pathogenic avian influenza to humans and measures for control of a new pandemic.

ORIGINAL ARTICLES

264The Efficiency of Percoll and Ficoll Density Gradient Media in the Isolation of Marrow Derived Human Mesenchymal Stem Cells with Osteogenic Potential

Yuhan Chang, MD; Pang-Hsin Hsieh, MD; Chuck C.-K. Chao, PhD

Percoll and Ficoll density gradient media are widely used in the isolation of human mesenchymal stem cells

(hMSCs) for research. In this study, the ability of the two methods to isolate MSCs from human bone marrow was

compared. We found that the Ficoll methodology was superior to that of Percoll in the preparation of hMSCs.

276Biomechanical Testing of Spinal Fusion Segments Enhanced by Extracorporeal Shock Wave Treatment in Rabbits

Tao-Chen Lee, MD; Yu-Lin Yang, PhD; Nyuk-Kong Chang, DVM; Ting-Sheng Lin, PhD;

Wan-Ching Lin, BS; Yi-Shiuan Liu, BS; Ching-Jen Wang, MD

Twelve rabbits underwent fusion at the bilateral L5 and L6 transverse processes. In the study group (n = 6), the

bilateral L5 and L6 transverse processes were treated with extracorporeal shock wave treatment (ESWT). The

control group rabbits did not undergo ESWT. Radiographic examinations showed that ESWT stimulated new

bone growth. Biomechanical tests showed that ESWT significantly increased the flexion and extension stiffness

of spinal fusion segments.

283Using the 100-g Oral Glucose Tolerance Test to Predict Fetal and Maternal Outcomes in Women with Gestational Diabetes Mellitus

Chia-Hung Lin, MD; Shih-Fen Wen, BSc; Ya-Hui Wu, BSc; Miau-Ju Huang, MD

From March 2001 to February 2006, 8557 pregnant women underwent a 50-g glucose challenge test, followed

by a 100-g oral glucose tolerance test (OGTT) according to the Carpenter and Coustan modification, and the

incidence of gestational diabetes mellitus (GDM) was 7.4%. Older age, lower weight gain during pregnancy,

higher rates of caesarean section, and more macrosomia and neonatal deaths occurred in the 617 women with

GDM compared to the 1250 women with normal glucose tolerance. The fasting glucose in the 100-g OGTT was

positively correlated with birth weight and a value exceeding 90 mg/dl was 80% sensitive and 50% specific for

macrosomia.

290Etiologic Features in Patients with Unilateral Vocal Fold Paralysis in Taiwan

Hui-Chen Ko, MD; Li-Ang Lee, MD; Hsueh-Yu Li, MD; Tuan-Jen Fang, MD

This retrospective, two-center study was conducted to investigate concurrent etiologies in patients with acquired

unilateral vocal fold paralysis (UVFP). The causes were iatrogenic (48%), subclinical tumor (12%), neck trauma

(7%), radiation effect (6%) and other causes (5%). In this study, thyroidectomy was the most common surgical

cause of UVFP. Thyroid tumors and lung tumors could result in UVFP. In patients younger than 30 years, neck

trauma was a major cause of UVFP. Accordingly, a tailored management strategy for UVFP is needed because

vocal fold immobilization is an important sign of various underlying diseases.

297Comparison of the Static and Dynamic Balance Performance in Young, Middle-aged, and Elderly Healthy People

Mei-Yun Liaw, MD; Chia-Ling Chen, MD, PhD; Yu-Cheng Pei, MD; Chau-Peng Leong, MD;

Yiu-Chung Lau, MD

One hundred and seven individuals were divided into young, middle-aged, and elderly groups, and assessed

using computerized dynamic posturography, which comprised sensory organization tests, motor control balance

tests at the 75% limit of stability in 8 movement directions, and left/right rhythmic weight shift tests. The results

showed the elderly had a higher degree of postural imbalance and used hip strategy to a greater extent to

maintain balance, especially when standing on a swaying support surface in the absence of a visual surround or

in the presence of a conflicted visual surround. The elderly required a longer reaction time and demonstrated

lower directional control in balance performance.

305Long-term Video-EEG Monitoring for Paroxysmal Events

Ying-Ying Lee, MD; Mei-Ying Lee; I-an Chen, MD; Yu-Tai Tsai, MD; Chung-Yang Sung, MD;

Hsiang-Yao Hsieh, MD; Siew-Na Lim, MD; Peter Wu Hung; Tony Wu, MD, PhD

To analyze the yield of 2-day video-electroencephalography monitoring (VEM) in managing patients with

paroxysmal events, we established a strict VEM protocol and made a prospective study of 129 consecutive

patients admitted with a diagnosis of paroxysmal events. Seventy patients (54.3%) had events recorded and a

diagnostic yield of 76% was achieved. The two-day VEM led to significant changes in diagnostic categories

(41.1%) and treatment (33.7%). With a well-established VEM protocol and protective measures, no status

epilepticus or trauma ensued from seizure clusters in 11 patients during VEM. Two-day VEM is a safe and

efficient diagnostic tool, guiding treatment appropriate for patients with episodic events.

313Help-seeking Behavior in Taiwanese Woman with Menopause-related Mood Symptoms Mei-Chun Hsiao, MD; Pi-Hui Chiang, MS; Chia-Yih Liu, MD; Yi-Hsiung Lin, MD

Menopausal symptoms sometimes mimic cardiovascular illnesses or other physical problems. We recruited 181

women from one menopause-related mood clinic and collected patient data, help-seeking information and

anxiety/ depression scores on the Hospital Anxiety Depression Scale and Menopause Rating Scale (MRS).

Their first contacts were gynecologists, general practitioners, cardiologists, and psychiatrists. The most common

contacts were gynecologists, general practitioners, and psychiatrists. Women who had visited gynecologists had

higher somatovegetative scores on the MRS. The results suggest that increasing the public’s understanding of

menopause and improving cooperation with the public are very important.

320Vertical Skeletal and Facial Profile Changes after Surgical Correction of Mandibular Prognathism

Yueh-Tse Lee, DDS; Min-Chin Chen, PhD; Huei-Lin Chen, DDS; Chou Bing Wu, DDS, PhD

Patients with mandibular prognathism had surgical correction and we studied the postoperative vertical changes.

Subjects included 18 patients who had surgical correction (S group) and 18 patients with untreated Class I

malocclusion (C group). Cephalograms revealed no differences in the upper facial heights in the two groups.

However, the S group exhibited longer anterior, and shorter posterior lower facial heights. Moreover, surgical

correction maintained the chin position but reduced the posterior ramus heights. Thus, the results indicate that

surgical correction can be planned to maintain lower vertical facial heights without violating physiological

function.

CASE REPORTS

330De Novo Dedifferentiated Chordoma of the Sacrum: A Case Report and Review of the Literature

Wen-Chi Chou, MD; Yu-Shin Hung, MD; Chang-Hsien Lu, MD; Kun-Yun Yeh, MD;

Swei-Sheu, MD; Chuang-Chi Liaw, MD

We report a case of the rare de novo dedifferentiated chordoma (DC) of the sacrum in a patient without prior

surgical or radiation treatments. A complete review of reported cases sourced from reports published in English

literature is discussed and expanded upon and conclusions on the treatment of DC are presented.

336Fibrolamellar Hepatocellular Carcinoma- Report of A Case

Ju-Bei Yen, MD; Kuei-Wen Chang, MD

Fibrolamellar hepatocellular carcinoma (FLH) is a variant of hepatocellular carcinoma (HCC) with distinct clinical,

histologic and prognostic features different from conventional HCC. Herein, we present a 14-year-old girl with a

palpable mass over the right upper -quadrant of the abdomen. A well-defined mass in the left liver with

heterogeneous density and a central linear band was demonstrated by ultrasound and computed tomogram.

FLH was proved by the histopathology study of a liver specimen taken from an echo-guided liver core needle

biopsy before surgery and from a left hepatectomy. No tumor recurrence was detected by ultrasound in the 2-

year follow-up.

340INSTRUCTIONS TO AUTHORS

第三十二卷第三期民國98年5-6月

長庚醫誌

綜　說

235顆粒球生長激素療法對神膱病變痛具有潛力的臨床應用

羅榮昇陳學如趙伯寬李泳鈴呂國棟

247小孩睡眠呼吸障礙

李學禹李立昂

論　壇

258The Highly Pathogenic Avian Influenza H5N1 – Initial Molecular Signals for the Next Influenza Pandemic

Yasuo Suzuki

原　著

264使用比重梯度溶液分離人類骨髓間葉幹細胞效率之研究

張毓翰謝邦鑫趙清貴

276以生物力學檢測體外震波對脊椎融合的功效：兔子的動物實驗

李道真楊堉麟鄭玉光林痽勝林宛青劉逸玄王清貞

283以100 公克葡萄糖耐受試驗來痱估妊娠糖尿病婦女及胎兒之預後

林嘉鴻溫世芬吳雅慧黃妙珠

290台灣單側聲帶麻痺患者之病因特徵

柯卉真李立昂李學禹方端仁

297健康年輕、中年、老年人靜態和動態平衡的比較

廖美雲陳嘉玲裴育晟梁秋痿劉耀宗

305長時間影像腦波監測在陣發症狀之臨床應用

李盈瑩李美瑩陳怡安蔡育泰宋崇元謝向堯林秀娜洪實修吳禹利

313某台灣更年期身心門診婦女之求醫行為探討

蕭美君姜丕慧劉嘉逸林義雄

320下顎骨前突之手術矯正後骨骼與顏面輪廓垂直向的變化

李岳澤陳明岐陳慧玲吳秋彬

病例報告

330薦骨的原生性去分化脊索瘤：病例報告及歷史文獻回顧

周文其洪玉馨呂長賢葉光揚薛綏廖宗琦

336纖維板層肝細胞癌

顏如貝張魁文

340長庚醫學雜誌投稿須知

本迎榮獲83、85-93年度中華民國行政院國家科學委員會優良期刊獎