Browsing by Author "Wang, Che-Chuan"

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Brain tissue oxygen evaluation by wireless near-infrared spectroscopy
(2016-02-01)
Wang, Che-Chuan
;
Kuo, Jinn-Rung
;
Chen, Yu-Chih
;
Chio, Chung-Ching
;
Wang, Jhi-Joung
Background: Monitoring the partial pressure of oxygen in brain tissue (PbtO(2)) is an important tool for traumatic brain injury (TBI) but is invasive and inconvenient for real time monitoring. Near-infrared spectroscopy (NIRS), which can monitor hemoglobin parameters in the brain tissue, has been used widely as a noninvasive tool for assessing cerebral ischemia and hypoxia. Therefore, it may have the potential as a noninvasive tool for estimating the change of PbtO(2). In this study, a novel wireless NIRS system was designed to monitor hemoglobin parameters of rat brains under different impact strengths and was used to estimate the change of PbtO(2) noninvasively in TBI. Materials and methods: The proposed wireless NIRS system and a PbtO(2) monitoring system were used to monitor the oxygenation of rat brains under different impact strengths. Rats were randomly assigned to four different impact strength groups (sham, 1.6 atm, 2.0 atm, and 2.4 atm; n = 6 per group), and the relationships of concentration changes in oxyhemoglobin (HbO(2)), deoxyhemoglobin (HbR), and total hemoglobin (HbT), and PbtO(2) during and after TBI with different impact strengths were investigated. Triphenyltetrazolium chloride (TTC) staining was also used to evaluate infarction volume. Results: Concentration changes in HbO(2), HbR, and HbT dropped immediately after the impact, increased gradually, and then became stable. Changes in PbtO(2) had a similar tendency with the hemoglobin parameters. There was significant correlation between changes in PbtO(2) and HbO(2) (correlation = 0.76) but not with changes in HbR (correlation = 0.06). In triphenyltetrazolium chloride staining, the infarction volume was highly but negatively associated with oxygen-related parameters like PbtO(2) and HbO(2). Conclusions: Changes in HbO(2) under TBI was highly and positively correlated with changes in PbtO(2). By using the relative changes in HbO(2) as a reference parameter, the proposed
Estimation on the effect of local brain cooling after head injury by wireless near infrared spectroscopy
(2017-02)
Wang, Che-Chuan
;
Wang, Yao-Chin
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Liao, Yi-Chien
;
Wang, Jhi-Joung
;
Chan, Ming-Che
Local brain cooling is a way to treat traumatic brain injury and prevent secondary brain injury. The aim of this study is to explore the change of hemoglobin during local brain cooling after traumatic brain injury, and assess the treatment effect by using the wireless near infrared spectroscopy (NIRS) system. Assign all male Sprague Dawley rats to three groups randomly: sham, fluid percussion injury (FPI), FPI + cooling. After executing fluid percussion injury, a cold water bag (5-6 degrees C) was used locally for 30 min. The wireless NIRS system which we developed was used to monitor the concentration change of HbO(2), HbR and HbT. And other physiological parameters, ICP and CPP, were also monitored during the experiment. According to previous results, local brain cooling could reduce infarction volume while traumatic brain injury occurs. Similarly, our results show that local brain cooling caused oxy-hemoglobin, the tissue oxygen saturation and CPP increase and ICP decreased. From the results, the hemoglobin parameters, ICP and MAP were affected by temperature. And local cooling after FPI might have clinical benefits in the future. In addition, the wireless NIRS system might be an instrument to assess the effect of hypothermia. (C) 2016 Elsevier Ltd. All rights reserved.
Evaluation of traumatic brain injury by optical technique
(2015-10-14)
Lin, Bor-Shyh
;
Wang, Che-Chuan
;
Chang, Ming-Hsien
;
Chio, Chung-Ching
;
光電系統研究所
Background: Traumatic brain injury (TBI), usually due to brain shaking or impact, affects the normal brain function and may lead to severe disability or even death. However, there is paucity of information regarding changes in the physiologic state of humans or animals after brain shaking. Methods: In this study, near-infrared spectroscopy (NIRS) was used to continuously monitor the concentration change of oxy-hemoglobin (HbO2) and deoxy-hemoglobin (HbR) to understand changes in the physiological state during and after brain shaking. Laser Doppler flowmetry was also used to monitor changes in cerebral blood flow under TBI to supplement the investigation. Triphenyltetrazolium chloride (TTC) staining was used to monitor changes of infarction volume corresponding to different impact strengths. Result: The experimental results indicated that concentration changes of HbO2 and total-hemoglobin (HbT) were significantly related to the impact strength. The infarction volume was also significantly related to the impact strength. Conclusion: Therefore, the non-invasive monitoring of concentration changes in HbO2, HbR, and HbT using NIRS may have a clinical application for the evaluation of TBI.
Extracellular signal-regulated kinase 1/2 is involved in a tamoxifen neuroprotective effect in a lateral fluid percussion injury rat model
(2014-06-01)
Tsai, Yin-Tzu
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Wang, Che-Chuan
;
Leung, Pak-On
;
Lin, Kao-Chang
;
Chio, Chung-Ching
Background: The aim of the present study was to determine whether tamoxifen (TMX) causes attenuation of traumatic brain injury (TBI) induced by fluid percussion injury. Materials and methods: Immediately after the onset of fluid percussion TBI, anesthetized male Sprague-Dawley rats were divided into three major groups and intraperitoneally administered the vehicle solution (1 mL/kg), TMX (1 mg/kg), or TMX (1 mg/kg) plus the extracellular signal-regulated kinase 1/2 antagonist SL327 (30 mg/kg). Another group of rats were used as sham-operated controls. The functional outcomes, such as motor outcomes, were evaluated using an incline plane. The cellular infarction volume was evaluated by triphenyltetrazolium chloride staining. Neuronal loss, apoptosis, and p-ERK1/2 and Bcl2 expression in neuronal cortex cells were evaluated by immunofluorescence methods. All the parameters were assessed on day 4 after injury. Results: Compared with the sham-operated controls, the TBI-induced motor deficits and cerebral infarction after TBI were significantly attenuated by TMX therapy. The TBI-induced neuronal loss and apoptosis were also significantly reduced by TMX therapy. The numbers of Bcl2- and phospho-ERK1/2-positive neuronal cells in the ischemic cortex after TBI were significantly increased by TMX therapy. These TMX effects were significantly blocked by SL327 administration. Conclusions: Our results suggest that intravenous injection of TMX may ameliorate TBI in rats by increasing neuronal p-ERK1/2 expression, which might lead to an increase in neuronal Bcl2 expression and a decrease in neuronal apoptosis and cell infarction volume, and it might represent one mechanism by which functional recovery occurred. TMX may be a promising TBI treatment strategy. (C) 2014 Elsevier Inc. All rights reserved.
Optical Technique for Estimating Cerebral Perfusion Pressure
(2015)
Chen, Chang-Ting
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Liao, Yi-Chien
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Lai, Chien-Fu
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Lin, Bor-Shyh
;
Wang, Che-Chuan
It is important to avoid secondary brain injury after Traumatic brain injury (TBI) in clinical. Cerebral perfusion pressure (CPP) is associated with blood flow into the brain, and indirectly reflects the cerebral ischemia and oxygenation. However, it is invasive and is inconvenient for continuous monitoring. Recently, near infrared spectroscopy (NIRS) has been widely applied for monitoring cerebral ischemia and hypoxia. In this study, we developed a wireless NIRS system to monitor rat\'s brain in different impact strengths of trauma. Commercial ICP and MAP devices were also used to compare with NIRS parameters under TBI. The Experimental results show all of Delta CPP, Delta[HbO(2)], Delta[HbT], and Delta[HbR] were inversely proportional to the increased impact strengths, and the correlations between Delta CPP, and Delta[HbO(2)] and Delta[HbT] are high. Hence NIRS system may be useful for estimating the level of cerebral perfusion pressure non-invasively.
Resuscitation from experimental traumatic brain injury by magnolol therapy
(2013-10-01)
Wang, Che-Chuan
;
Lin, Kao-Chang
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Lin, Bor-Shyh
;
Chio, Chung-Ching
;
Kuo, Jinn-Rung
Background: The purpose of the present study was to determine whether magnolol, a free radical scavenger, mitigates the deleterious effects of traumatic brain injury (TBI). Material and methods: Traumatic brain injuries were induced in anesthetized male Sprague-Dawley rats using fluid percussion, and the rats were divided into groups treated with magnolol (2 mg/kg, intravenously) or vehicle. A group of rats that did not undergo TBI induction was also studied as controls. Biomarkers of TBI, including glycerol and 2,3-dihydroxybenzoic acid, were evaluated by microdialysis. Infraction volume, extent of neuronal apoptosis, and antiapoptosis factor transforming growth factor beta 1 (TGF-beta 1) were also measured. Functional outcomes were assessed by motor assays. Results: Compared with the rats without TBI, the animals with TBI exhibited higher hippocampal glycerol and 2,3-dihydroxybenzoic acid. Relative to the vehicle-treated group, the magnolol-treated group showed decreased hippocampal levels of glycerol and hydroxyl radical levels. The magnolol-treated rats also exhibited decreased cerebral infarction volume and neuronal apoptosis and increased antiapoptosis-associated factor TGF-beta 1 expression. These effects were translated into improved motor function post TBI. Conclusions: Our results suggest that intravenous magnolol injection mitigates the deleterious effects of TBI in rats based on its potent free radical scavenging capability, and the mechanism of anti-neuronal apoptosis is partly due to an increase in TGF-beta 1 expression in the ischemic cortex. (C) 2013 Elsevier Inc. All rights reserved.
The impact of comorbidity on survival after hemorrhagic stroke among dialysis patients: a nationwide population-based study
(2014-11-27)
Lin, Chun-Yu
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Chien, Chih-Chiang
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Chen, Hung-An
;
Su, Fu-Mei
;
Wang, Jhi-Joung
Background: This study was aimed at determining the outcome and examining the association between comorbidities and mortality after intracerebral hemorrhage in chronic dialysis patients. Methods: We used the Taiwan National Health Insurance Research Database and enrolled patients who underwent maintenance dialysis between 2000 and 2007. Annual incidence of intracerebral hemorrhage in patients receiving dialysis from 2000 to 2007 was determined. To identify predictors of hemorrhagic stroke, we used logistic regression model to estimate the relative ratio of factors for intracerebral hemorrhage in the most recent cohort (2007). The cumulative survival rate and comorbid conditions associated with mortality after intracerebral hemorrhage among all dialysis patients between 2000 and 2007 was calculated using the Kaplan-Meier method and Cox regression analysis. Results: We identified 57,261 patients on maintenance dialysis in the cohort of 2007, and 340 patients had history of intracerebral hemorrhage among them. Hypertension was the most common comorbidity of dialysis patients. The incidence rate of intracerebral hemorrhage among dialysis patients was about 0.6%. Adjusted logistic regression model showed that male gender, middle age (45-64 years), hypertension, and previous history of stroke were the independent predictors for the occurrence of intracerebral hemorrhage among chronic dialysis patients. 1,939 dialysis patients with development of intracerebral hemorrhage in the analysis period from 2000 to 2007 were identified. In-hospital mortality was high (36.15%) following intracerebral hemorrhage. They were followed up after intracerebral hemorrhage for a mean time of 41.56 months. Adjusted Cox regression analyses demonstrated that the factors independently associated with mortality after intracerebral hemorrhage among dialysis patients included diabetes mellitus, malignancy and a history of prior stroke. Conclusions: Dialysis patients who have history of prior stroke, diabetes and malignancy have worse survival than patients without these comorbidities. Attention must focus on providing optimal medical care after hemorrhagic stroke for these target groups to reduce mortality.
The neuronal protective effects of local brain cooling at the craniectomy site after lateral fluid percussion injury in a rat model
(2013-12-01)
Wang, Che-Chuan
;
Chen, Yuan-Shen
;
Lin, Bor-Shyh
;
Chio, Chung-Ching
;
Hu, Chiao-Ya
Background: The aim of the present study is to investigate whether local brain cooling at the craniectomy site causes attenuation of traumatic brain injury (TBI) induced by fluid percussion injury (FPI). Methods: Anesthetized male SpragueeDawley rats were divided into two major treatment groups. Immediately after the onset of fluid percussion TBI, a craniectomy window of 6 x 8 mm was made at the right parietal, and a cold water bag (0 x C-1 x degrees C or 5 x C-6 degrees C) was applied locally for 30 min. Additional groups of rats were used as craniectomy and craniectomy FPI controls. Physiological parameters, such as brain and colonic temperature, mean arterial pressure, and heart rate, were monitored during FPI. Functional motor outcomes were evaluated using the inclined plane test (maximal grasp angle). Cellular infarction volume was calculated using triphenyltetrazolium chloride staining. Apoptosis and neuronal markerepositive cells in the cortex were measured by immunofluorescence staining. All functional and morphologic parameters were assessed 72 h after injury. Results: Compared with the craniectomy + FPI control groups, the groups treated with 5 degrees C-6 degrees C local cold water therapy showed significant attenuation of the FPI-induced motor deficits, weight loss, and cerebral infarction but no effect on colonic temperature. The FPI-induced apoptosis and neuronal loss were also significantly reduced by local cooling. Conclusions: Our results suggest that local cooling with 5 degrees C-6 degrees C cold water therapy may ameliorate TBI in rats by reducing infarction volume, neuronal cell loss, and apoptosis, resulting in improved functional outcome. We propose that the use of local cooling at the craniectomy site after FPI might have clinical benefits in the future. (C) 2013 Elsevier Inc. All rights reserved.
Wireless near-infrared spectroscopy system for determining brain hemoglobin levels in laboratory animals
(2013-04-15)
Kuo, Jinn-Rung
;
Chang, Ming-Hsien
;
Wang, Che-Chuan
;
Chio, Chung-Ching
;
Wang, Jhi-Joung
Traumatic brain injury (TBI) is usually caused by brain shaking or impact. It can affect normal brain function and may even lead to disability or death. However, there are very few studies on the associated physiologic changes in humans or animals. In this study, a non-invasive, wireless multi-channel near-infrared spectroscopy (NIRS) was developed to continuously monitor the concentration change of oxyhemoglobin (HbO(2)), deoxyhemoglobin (HbR), and total hemoglobin (HbT) to elucidate changes in the physiological state of the brain during and after different strength impaction. The triphenyltetrazolium chloride (TTC) staining was also used to monitor changes of infarction volume after different strength impaction. The results indicated that the concentration changes of HbO(2) and HbT, and the changes of infarction volumes were significantly related to the impact strength. In conclusion, the status of TBI can be clinically evaluated by detecting HbO(2) and HbT changes. The system proposed here is stable, accurate, non-invasive, and mostly important wireless which can easily be used for TBI study. (C) 2013 Elsevier B.V. All rights reserved.