碩士 / 中臺科技大學 / 醫學影像暨放射科學系暨研究所 / 103 / This study used a newly developed nerve guidance conduit made using genipin-cross-linked chitosan and carbon nanotubes GCC nerve guide conduit). The aim of this study was to analyse the influence of large-area irradiation using an AlGaInP diode laser (660 nm) on the neurorehabilitation of transected sciatic nerves after bridging the GCC nerve guide conduit in rats. 　　The exterior of the GCC nerve guidance conduit was opaque and dark blue in color; the interior of the nerve bridge was hollow to aid in guiding damaged nerve fiber growth. Immediate and deferred treatment models were compared to investigate the impact on impaired sciatic nerve regeneration in rats. The rats were divided into four groups: the Laser/Sham group (no laser therapy), the Laser/Early group (two minutes of laser therapy per day beginning the day after surgery), the Laser/Delay group (two minutes of laser therapy per day beginning seven days after surgery), and the Autograft group. Each group consisted of six rats for a total of 24 rats. 　　Frstly,Twelve weeks after surgery, the groups who had underwent laser therapy showed significantly improved sciatic nerve function compared to the groups who had no laser therapy (P < 0.05) and the Laser/Early group showed more improvement than the Laser/Delay group. Before the rats were sacrificed, there was no observable pathological phenomena or adverse biocompatibility after 12 weeks of GCC nerve guidance conduit implantation. The Laser/Early group also exhibited less gastrocnemius atrophy than the Laser/Delay group and the Autograft group. In addition,the immunohistochemical results of nerve regeneration indicated that low-level laser therapy can stimulate damaged nerve repair and regeneration; also the Laser/Early group showed superior outcomes. This study investigated the effectiveness of different modes of laser therapy on the repair of damaged sciatic nerves. In summary of the experimental results above, laser therapy administered immediately after nerve damage has better treatment efficacy over delayed laser therapy.

In newborns, unconjugated bilirubin (UCB) is not readily excreted, and when bilirubin levels exceed the serum albumin binding capacity, pathological levels of UCB exist. Hyperbilirubinemia may lead to auditory damage and ultimately cause a hearing disorder called auditory neuropathy/dys-synchrony, characterized by absent or abnormal brainstem auditory evoked potentials (BAEPs) with evidence of normal inner ear function assessed by either otoacoustic emissions or cochlear microphonic responses. Phototherapy and double volume exchange transfusion are used as treatment methods for neonatal hyperbilirubinemia. Spontaneously jaundiced Gunn rat pups given sulfadimethoxine to displace bilirubin from serum albumin develop bilirubin encephalopathy and have abnormal BAEPs comparable to human neonates. BAEPs are a noninvasive electrophysiological measure of neural function of the auditory system. High levels of calcineurin activity are believed to be involved in the mechanism of this bilirubin induced auditory neuropathy. FK506, a calcineurin inhibitor, was administered 3 hours prior to sulfa in concentrations of 0.1mg/kg, 1.0mg/kg, and 10.0mg/kg body weight. Due to the observation that all animals had abnormal BAEPs after treatment with FK506 and sulfa, it can be concluded that none of the treatment doses protected against bilirubin induced auditory impairment.

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmacology and Toxicology Candidate: Martin Zápotočný Supervisor: Doc. MUDr. Radomír Hrdina, CSc. Title of diploma thesis: Current possibilities of treatment of psoriasis Psoriasis is an uninfectious disease with a genetic predisposition. There are several types of psoriasis. Therapy is heterogenous with a different efficiency. A topical, physical and systemic treatments are used. Topical treatment is a basic treatment for psoriasis. There are keratolytics, emollients, topical corticosteroids, whose prolonged use may cause adverse effects. A vitamin D3 analogue, retinoids and cignoline are also parts of topical treatment. Physical treatment, mainly phototherapy, has thanks to its unique photobiological effect unsubstituable role in a psoriasis treatment. Recently phototherapy and photochemotherapy have been classified on the same level as systemic treatment. For cases that do not respond on standard local treatment and phototherapy, systemic treatment is reserved. We can differ drugs of the 1st line: acitretin, cyclosporine A, methotrexate and drugs of the 2nd line, that are biologics. Biopharmaceuticals present safer and more accurate interference into the pathophysiological processes of psoriasis. The aim of this...

School: Charles University in Prague Faculty: Faculty of Pharmacy in Hradec Králové Study program: Pharmacy Department: Department of pharmacology and toxicology Academic year: 2010/2011 Author: Markéta Juřičková Supervisor: PharmDr. Ludmila Melicharová Title of diploma thesis: The pharmacotherapy of the depression This diploma thesis deals with the characterization of depression including its pathophysiology, causes, symptoms, progress as well as it classifies the types of depressive disorders. The diploma thesis deals with the treatment of depression, selection of antidepressants, using of antidepressants in children and adolescents, geriatric patients and pregnant women. It further describes individual groups of antidepressants, their mechanism of action, indications, contraindications and adverse effects. The thesis evaluates benefits of pharmacotherapy in depression treatment. It also classifies and describes the most common forms of psychotherapy. It further deals with other options in depression treatment like phototherapy, electroconvulsive therapy, physical activity, repetitive transcranial mechanical stimulation, vagus nerve stimulation and deep brain stimulation. It describes their mechanisms of action, adverse effects, indications and their benefits in depression treatment, especially...

碩士 / 國立臺灣大學 / 護理學研究所 / 103 / Breastfeeding is unquestionably the most natural way for a mother to nourish her baby, not to mention the fact that breast milk is the best source of nutrition for neonates. For more than a decade, the Health Promotion Administration Ministry of Health and Welfare has actively promoted breastfeeding programs, with more and more mothers choosing to breastfeed their babies. Given that the postpartum breastfeeding rate has risen sharply, it is critical not only to teach mothers how to breastfeed efficiently but also to educate them on the dangers of excess weight loss and subsequent complications. Therefore, this study aims to examine in depth the fluctuations in the body weight of neonates who are breastfed and mother-related factors that can lead to a decline in the birth weight, in hope of staving off excess loss in birth weight and reducing the incidence of hyperbilirubinemia and thus detrimental effects on the health of neonates. Ultimately, this will reduce the negative impacts of the use of supplementary infant formula on the success of breastfeeding. We aim to analyze the maternal factors, intravenous fluid administration over the course of the cesarean section, the course of spontaneous delivery, the postpartum lactation and breastfeeding conditions, and the body weight changes of the neonates. This is a quantitative, descriptive, and retrospective cohort study. Cases were randomly collected from a children’s hospital under a leading medical center in Taipei City. The neonates satisfied the following conditions (1) single births, (2) birth after ≧37 weeks of pregnancy, and (3) birth weight of ≧2500g. We excluded neonates who required further treatment for diseases other than hyperbilirubinemia, whose mothers required stay in the intensive care unit, or whose mothers did not breastfeed entirely. From January 1, 2014 to December 31, 2014, 2931 neonates were born in said children’s hospital, and a total of 1838 neonates with body weight equal to or more than 2500 gm were admitted to the baby room. We made adjustments accordingly based on the percentage of neonates per month and the number of neonates per year, and the completeness of the medical records. We numbered the neonates sequentially each month, with the first 10 cases each drawing a number randomly from 1 to 10. The next 10 would draw a number randomly from 11 to 20, and so forth. The study included a total of 406 mother-neonate pairs, with 224 boys and 182 girls and an average neonate birth weight of 3214.50 ± 355.31 grams. The data were canvassed from written or electronic medical records and subsequently numbered and stored in the computer. The data was analyzed with the SPSS for Windows 21.0 software package, using frequency distribution, percentage, mean, median, mode, standard deviation, maximum value, minimum value, t-test, Chi-square test, Pearson correlation coefficient, generalized estimating equation (GEE), and classification tree. The results of the study are as follows: 1.The mean birth body weight was 3214.50 ± 355.31 gm. 2.A mean weight loss of 5.04 ± 2.25％, 8.34 ± 1.50％, 9.06 ± 2.46％, 7 ± 2.81％ of the birth weight was recorded at age 24, 48, 72, and 120 hours, respectively. The babies delivered via cesarean section experienced weight loss of 8.19 ± 2.45％ before gaining after 4 days. However, all babies delivered by either via normal spontaneous delivery or cesarean section typically lost at least 8.27% and 9.44% by 72 hours of age. Out of the 406 babies, 176 babies (44.1%) experienced excess weight loss during hospitalization and often before 72 hours of age (125 babies, 30.79%), while 341 (83.99%) experienced weight loss of >7% at 48 hours of age. During hospitalization, 53 babies (13.1%) were administered the phototherapy treatment for Hyperbilirubinemia, among which 22 babies (41.5%) experienced excess body weight loss. 3.The mean age of the first baby clinic health follow-up was around 35 ± 4.37 days old, with a mean body weight of 4508 ± 522.95 grams, a gain of 1.4 times. 4.The risk factors underpinning excess weight loss in neonates were advanced reproductive age, excess gestational weight gain by the mother, cesarean section, postpartum hemorrhage, and delayed onset of lactation. The risk was especially great if the mother had delayed the onset of lactation. 5.Certain conditions may result in a delayed onset of lactation, e.g. excess gestational weight gain by the mother,the lower pre-pregnancy BMI, BMI before delivery of >30 kg/m2, excess fluctuations in gestational weight, nulliparous women, painless labor, postpartum hemorrhage of >400ml, unanticipated cesarean section, Stage II labor duration of >1 hours, prolonged Stage III labor duration, and prolonged duration of intrapartum prophylaxis. 6.Some conditions may result in a delayed onset of lactation such as the mother’s excess gestational weight gain, pre-pregnancy BMI of ≦20 kg/m2, BMI before delivery of >30 kg/m2, gestational weight changes, nulliparous women, painless labor, postpartum hemorrhage of >400ml, unexpected cesarean section, stage II labor duration of >1 hours, prolonged stage III labor duration, and prolonged duration of intrapartum. 7.Hyperbilirubinemia is significantly related to the delayed onset of lactation. The delayed onset of lactation was a risk factor for excess weight loss in neonates. The greater the body weight loss in neonates, the higher the bilirubin values. In conclusion, it is recommended that expecting mothers undergo adequate education at prenatal clinics to ensure a healthy pregnancy and to assist the mother in managing the discomforts of pregnancy, diet, exercise, and other lifestyle changes during pregnancy such as breastfeeding. These could aid nulliparous women, mothers with prolonged duration of hospitalization, BMI before delivery of >30 kg/m2, exhaustion, etc. Furthermore, healthy pregnancy may prevent delayed lactation or excess body weight loss in neonates.

碩士 / 國立中央大學 / 生物醫學工程研究所 / 103 / The biodegradable indocyanine green (ICG)-loaded poly(lactic-co-glycolic acid) nanoparticles (IPNPs) have been successfully established by using solvent evaporation method. Furthermore we conjugated the functional molecules like Polyethylene glycol (PEG) and human epithelial receptor-2 (HER-2) antibody onto the IPNPs surface by utiliznig the EDC/NHS crosslinking method to fabricate the HER-2 targeted ICG-loaded PLGA nanoparticles (HIPNPs) for phototherapy of breast cancer cells. The ICG encapsulation efficiency was about 70 % determined from the UV-Vis spectrophotometry. The mean size and surface charge of the HIPNPs were 302 ± 1.8 nm and -15 ± 0.15mV through dynamic light scattering and zeta potential analyzer, respectively. Based on the analysis of UV-Vis spectrophotometric absorbances, the encapsulated ICG modestly disintegrated 18% and 63% while ICG freely distributed in water dramatically degraded 60% and 95% at 4 and 37℃ for 48 h, respectively, manifesting the ICG molecules in HIPNPs can be protected by PLGA matrix. In addition, the bulk temperature dramatically increased 45℃ and the singlet oxygen released in the presence of HIPNPs (ICG concentration = 25 μM) under 808 nm-laser exposure with intensity of 6 W/cm2 for 5 min has successfully proved the photothermal and photodynamic function of ICG. Finally through the cellular assay using MCF-7 (HER-2 negative), and MDA-MB-453 (HER-2 positive), we found HIPNPs can specifically target to the HER-2 protein and didn’t have biotoxicity. Even, the nmber of survival MDA-MB-453 was significantly low by treating HIPNPs with identical laser exposure, identifying the effectiveness of phototherapy of HIPNPs. We demonstrated the developed HIPNPs enable to provide the theranostic efficacy for breast cancer cells

博士 / 國立陽明大學 / 護理學系 / 103 / Background: Recent breastfeeding statistics indicate an encouraging increase in breastfeeding rate. However, the rise comes with an increase in the prevalence of neonatal jaundice. Anxiety may occur in mothers who worry that breastfeeding may increase neonatal jaundice and further lengthen the duration of phototherapy. Since their physical reaction promoted by anxiety could cause insufficient breast milk, mothers might consider discontinuing breastfeeding. Few studies explored the affecting factors such as treatment of neonatal jaundice and anxiety on mothers’ decisions of subsequent breastfeeding. Meanwhile, there have been few reports focusing on the effect and impact of a baby-friendly practices on breastfeeding. Objective: The objective of this study was to explore the effect of institutional factors during hospitalization and neonatal jaundice on the decision of breastfeeding. This study also attempted to probe the possible influences of affecting factors such as reception of the baby-friendly practices, treatment for neonatal jaundice and the anxiety level of postpartum women on breastfeeding. Methods: This study combined qualitative and quantitative study design. Qualitative interviews and panel study were conducted to collect data. A convenience sampling and in-depth interviews were conducted to nine mothers who breastfeed their babies during the first year postpartum and whose newborns had neonatal jaundice. The qualitative data was analyzed by content analysis. Quantitative questionnaire survey was conducted toward two groups of women (135 with neonatal jaundice, 160 without neonatal jaundice) at three baby-friendly hospitals in Northern Taiwan. The inclusion criteria were mothers who breastfed during hospitalization, did not have disease diagnosis during pregnancy and labor, and gave birth to healthy term newborns. They were followed by telephone at one month and four months postpartum. Multivariate analysis was performed using logistic regression, generalized estimating equations (GEE), ordinal logistic regression and cox regression model. Results: Retrospective interviews focused on the experience of neonatal jaundice among women on breastfeeding behavior. The theme identified at prenatal stage was –“build belief in breastfeeding,” which included two subthemes —“natural maternal behavior,” and “breastfeeding is best.” Right after neonatal jaundice started to appear, mothers experienced two main themes—“questioning the belief,” and “happiness for being a mother,” eight subthemes—“sufficient breastfeeding milk,” “stone on the chest,” “pressure from family and friends,” “ignorance of the risk of neonatal jaundice,” “doubt in treatment for neonatal jaundice,” “stress from medical environment,” “identifying the benefit of breastfeeding,” and “close link and better comfort.” When newborns were experiencing neonatal jaundice, mothers experienced two main themes —“emotion change,” and “going back to the beginning after swinging.” Seven subthemes were “separating from the newborn,” “anxiety,” “quilt/sadness,” “impact of neonatal jaundice,” “inconsistent interpretation of neonatal jaundice,” “relying on oneself,” “retrieving the initial belief.” After neonatal jaundice faded and mothers continued breastfeeding, one theme emerged— “insist and adapt,” which inclued two subthemes—“breastfeeding is never difficult if I insist on doing it,”and “No need to worries about not having enough milk, the body will produce.” The above data described how mothers coped with neonatal jaundice and the impact of neonatal jaundice on breastfeeding. From the quantitative results, the study found out that during hospitalization, all mothers chose to breastfeed their newborns, with an exclusive breastfeeding rate at 38.6%. The exclusive breastfeeding rate were 40.9% and 39.3% at one month and four month postpartum, respectively. The main reason for discontinuing breastfeeding was mothers having insufficient breast milk (52.1%). The average duration of breastfeeding was 95.52(SD= 37.77) days. Breastfeeding duration was longer in the group of mothers whose infants had neonatal jaundice than in the group whose infants did not have jaundice. The difference of two groups was 12.15 days (SD= 8.1, p=0.008). Most mothers experienced slight anxiety during hospitalization, at one moth and four months (71.2% ~ 81.5%). The prevalence rate of neonatal jaundice was 45.8%, among them 33.3% were given phototherapy. With Cox regression model, sociodemographic and biomedical variables controlled, the risk for discontinuing breastfeeding for mothers whose infants did not experience jaundice was 1.68 times more than those whose infants did experience neonatal jaundice(adjusted hazard ratio [HR], 1.68; 95%CI:1.08- 2.62). Logistic regression predicted factors associated with breastfeeding at four month postpartum. When controlled the sociodemographic and biomedical variables, the result indicated that mothers whose infants developed neonatal jaundice tended to continue breastfeeding than those whose infants did not have jaundice（OR=1.79, 95%CI=1.03– 3.10）. GEE and ordinal logistic regression model which controlled age and delivery methods showed that in the hospital, at one and four months postpartum, mothers whose neonates had jaundice were less likely to feed their newborns with increasing level of formula milk through time (OR=0.64, 95%CI=0.45-0.9). Conclusion: This study combined qualitative and quantitative design and showed that neonatal jaundice was associated with longer duration of breastfeeding, and higher breastfeeding level during postpartum. Effectiveness of Baby-friendly Hospital Initiative policy was supported. All women had anxiety during postpartum, and some women felt stress toward baby-friendly hospital practices during early postpartum, but that had no effect on breastfeeding. Besides further promoting “breastfeeding is the best”, health professionals should provide timely interventions and facilitate family support for women who encountered neonatal jaundice and breastfeeding problems.

Orientador: Carlos Marcelo Pastre / Banca: Luiz Carlos Marques Vanderlei / Banca: Marcelo Papoti / Resumo: Introdução: Estudos recentes têm demonstrado resultados positivos na aplicação da fototerapia para a melhora da performance. Dentre as modalidades utilizadas para avaliar a adaptação ao exercício tem-se a modulação autonômica cardíaca avaliada por meio da variabilidade da frequência cardíaca (VFC), uma ferramenta usada como parâmetro para prescrição individual de treinamento. Objetivo: Analisar e comparar o efeito de um protocolo de fototerapia combinando diferentes fontes de luz (laser de baixa potência e LEDs) e comprimentos de onda (vermelho e infra-vermelho) aplicada durante treinamento de sprint e agachamento na modulação autonômica da frequência cardíaca. Método: o estudo foi composto por 38 participantes do sexo masculino, alocados a partir de uma randomização estratificada em três grupos: controle (n=12), placebo (n=14) e grupo fototerapia (n=12). A fototerapia utilizada combinou diferentes fontes de luz (laser de baixa potência e LEDs) e comprimentos de onda (vermelho e infra-vermelho). Os participantes foram submetidos a um treinamento combinado de sprints e agachamento realizado duas vezes por semana por 12 semanas sendo divididas em duas fases de seis semanas cada. A aplicação da fototerapia e placebo foi administrada na fase 2 do treinamento, após o treino de sprints e imediatamente antes do treino de agachamento. A VFC foi analisada no momento basal; após seis semanas e final (12sem). Os dados foram analisados utilizando a Análise de Variância para Medidas Repet... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Recent studies have shown positive results in the application of phototherapy for the improvement of performance and acceleration of the body homeostasis process. Among the methods used to assess the recovery post-exercise there is cardiac autonomic modulation assessed by heart rate variability (HRV), a widely used tool to evaluate medium global behavior of the autonomic nervous system in sports. Objective: To analyze and compare the effect of a special protocol of phototherapy using different light sources interacting with a combined training by measuring the autonomic modulation of heart rate in different moments (baseline; after six weeks and after 12 weeks). Methods: 38 male participants were allocated from a stratified randomization into three groups: control (n=12), placebo (n=14) and special protocol of phototherapy group (n=12). Participants were asked to perform a combined training of sprints and squats twice a week for twelve weeks divided into two phases. The application of phototherapy and placebo was administered in phase 2, after sprints and just before the squats. The phototherapy used was a combination of different light sources and wavelength (red and infrared). The HRV was analyzed in three moments: baseline; after six weeks and after 12 weeks. It was performed the analysis of variance for repeated measures (Bonferroni post-test), which provides information on the time, group and interaction effects. All statistical analyzes assumed the signifi... (Complete abstract click electronic access below) / Mestre

碩士 / 元培醫事科技大學 / 醫學影像暨放射技術系碩士班 / 107 / Far-infrared ray is usually defined as the electromagnetic radiation with wavelength ranging from 5.6 to 1000 μm, in which the radiation ranging between 4 and 14 μm commonly utilized by far-infrared medical instruments is also named as growth ray. The healing effects and mechanism of far-infrared radiation are still not clear to the public although many far-infrared medical instruments have been marketedpopularly. Therefore, we try to elucidate the physical properties, effects, acting mechanisms on cells and tissues, and clinical applications of far-infrared radiation. Molecules in organism may absorb infrared ray resulting in vibrational and rotational transitions, which cause heat and non-heat effects. These two effects employed in far-infrared ray remedy resulted from resonant far-infrared molecular absorption. Clinical applications include analgesia and skinning over of wounds, hypertension, strain relief,enhancing sleep quality, decreasing blood sugar, reducing fatigue, hyperthermia therapy for tumors, urine retention therapy for lying-in women and intestinal spasm therapy for children. Many emerging studies have explored diverse clinical applications of far-infrared ray, which not only make it prominent in preventive medicine but also provide another treatment for traditional medicine. The purpose of this paper is to develop a medical aesthetic health promotion method and instrument for human skin tissue by efficient use of integration of intense pulsed light and micron light spectrum apparatus. Pulsed light multi-spectrum, wavelength energy design can be fine-tuned, clinically, corresponding to different therapeutic photothermal modes, thermal condensation with green light 515nm, yellow-green light 590nm range as a choice of blood vessel and pigment treatment mode. The red light 695 nm and the infrared 755 nm are selected as the hair removal mode. As a beauty phototherapy mode, pulsed light uses 560 nm red light and 640 nm yellow light. The skin cells are activated by a combination of micron light with a wavelength of 10 µm to 100 µm. Multi-spectrum, controllable mode, safety, high-efficiency therapeutic function, pulsed light and micron-light integration of medical aesthetics technology. Simultaneous 3 to 4 weeks of treatment, its safety and effectiveness, while integrating the green light to far infrared skin tissue phototherapy and activation protection mode and regulation methods. Clinically, hundreds of users of integration of pulsed phototherapy and micron-light instruments on skin activation and protection have obvious functions that promote improvement.

碩士 / 國防醫學院 / 生物化學研究所 / 107 / Skin is one of the largest organs of human body. The primary function of the skin is not only to maintain body temperature and water equilibrium but also to act as a barrier. The skin consists of three layers: the epidermis, the dermis, and the hypodermis or subcutaneous fatty tissue lies beneath the dermis. Matriptase, a member of the type II transmembrane serine protease, and prostasin, a GPI-anchored serine protease, are widely expressed in epidermis of the skin. In addition, HAI-1 and HAI-2, serine protease inhibitors are responsible for the regulation of protease activity. In inflammatory environment, the skin is exposed in acidic condition and the increase of reactive oxygen species and further trigger the activation of matriptase and prostasin in epidermis. Therefore this enviroment may regulate epidermal proliferation and differentiation. The skin diseases often accompany with immune and inflammation reaction, and the results of IHC staining also find the expression of activated matriptase in epidermis with lymphocytic infiltration in dermis. If inflammatory response is triggered continuesly, the environment may induce tumorgenesis and generate a neoplastic skin disease. In this study, the aim is to learn the expression of matriptase, prostasin, HAI-1 and HAI-2 in inflammatory and neoplastic skin diseases. We have discovered the expression and the distribution of matriptase are increase; the expression position of prostasin is also extended downward to form a capping structure. Furthermore, it is found that matriptase is densely stained in some cells of epidermis, and the relative positions are similar with the marker of Langerhans cells. In the dermal lymphocytic infiltration area, matriptase is observed to be co-expressed with moderately glycosylated HAI-2. The lymphocyte marker CD4, CD8 and CD163 were used and confirmed that the co-expressed lymphocytes are mainly CD4 helper T cells. Taking cutaneous T cell lymphoma as an example to further study the pathogenesis of cancer-related pathways, it was also observed that the activated matriptase and the moderately glycosylated modified HAI-2 were co-expressed in the location of lymphoma but the expression disappeared after phototherapy. In this study, the expression of matriptase, prostasin, HAI-1 and HAI-2 were investigated in a variety of inflammatory and neoplastic skin diseases. Increased expression and distribution of epidermal matriptase and prostasin, as well as co-expression of matriptase and HAI-2 in the dermis in inflammatory and neoplastic skin diseases may play important roles in the regulation of the inflammatory mechanism, but the mechanism still needs to be further explored.