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Chiou SY, Lee RC, Chi KH, Chia-Hsien Cheng J, Chiang JH, Chang CY. The triple-phase CT image appearance of post-irradiated livers. Acta Radiol 2016; 42:526-31. [PMID: 11552892 DOI: 10.1080/028418501127347115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective To evaluate the sequential CT appearance of the liver after hepatic irradiation and to investigate the correlation between CT findings and radiation-induced hepatic injury. Material and Methods: The triple-phase CT images of 18 patients with hepatocellular carcinomas (HCC) after hepatic irradiation were retrospectively reviewed (in total 41 CT studies). The high-dose region within the liver was defined as the area receiving more than 90% of the prescribed irradiation dose. The mean radiation dose was 55.5 Gy. Density changes and patterns of enhancement in the high-dose region were classified as three types: type I, constant low-density change in all phases; type II, low-density change in both pre-contrast and arterial phases, and iso-density change in the portal phase; type III, low- or iso-density change in the pre-contrast phase, low- or high-density change in the arterial phase, and persistent high-density change in the portal phase. The interval between completion of radiotherapy and the CT examinations ranged from 9 to 469 days, with a mean of 147 days. Results: Nine of the 41 CT studies presented with type I, 9 with type II, and 16 with type III CT findings. The mean interval between completion of radiotherapy and the appearance of types I, II, and III CT findings were 74, 183, and 220 days, respectively. The interval was significantly shorter for type I findings than for type II and type III. The difference in interval was not significant between type II and type III. A type I finding with constant low-density change in the high-dose region of the liver was the most common pattern of CT findings within the first 3 months after hepatic irradiation. Either types II or III findings were frequently seen after 3 months. Conclusion: The sequential CT appearance and the density changes may indicate correlation with the pathogenesis of veno-occlusive disease.
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Choi D, Wishon MJ, Barnoud J, Chang CY, Bouazizi Y, Locquet A, Citrin DS. Low-frequency fluctuations in an external-cavity laser leading to extreme events. Phys Rev E 2016; 93:042216. [PMID: 27176302 DOI: 10.1103/physreve.93.042216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Indexed: 06/05/2023]
Abstract
We experimentally investigate the dynamical regimes of a laser diode subject to external optical feedback in light of extreme-event (EE) analysis. We observe EEs in the low-frequency fluctuations (LFFs) regime. This number decreases to negligible values when the laser transitions towards fully developed coherence collapse as the injection current is increased. Moreover, we show that EEs observed in the LFF regime are linked to high-frequency pulsing events observed after a power dropout. Finally, we prove experimentally that the observation of EEs in the LFF regimes is robust to changes in operational parameters.
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Lin HY, Chuang CK, Chen MR, Lin SM, Hung CL, Chang CY, Chiu PC, Tsai WH, Niu DM, Tsai FJ, Lin SJ, Hwu WL, Lin JL, Lin SP. Cardiac structure and function and effects of enzyme replacement therapy in patients with mucopolysaccharidoses I, II, IVA and VI. Mol Genet Metab 2016; 117:431-7. [PMID: 26899310 DOI: 10.1016/j.ymgme.2016.02.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/15/2016] [Accepted: 02/15/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND While enzyme replacement therapy (ERT) has been shown to improve endurance and joint mobility for patients with mucopolysaccharidoses (MPS) I, II, IVA and VI, the impact of ERT on cardiac abnormalities remains uncertain. METHODS Medical records and echocardiograms of 28 Taiwanese MPS patients (9 with MPS I, 7 with MPS II, 7 with MPS IVA, and 5 with MPS VI) treated with ERT for 1-10.8years were retrospectively reviewed. RESULTS At start of ERT, z scores>2 were identified in 46% and 75% for left ventricular mass index (LVMI) and interventricular septum thickness in diastole (IVSd) in these patients, respectively. Twenty-four patients (86%) had valvular heart disease. After ERT, the mean IVSd z score of all patients decreased significantly from 3.87 to 2.57 (p=0.016). For 11 patients starting ERT before 12years of age, z scores for both LVMI and IVSd decreased significantly (p<0.01) after ERT. However, the condition of valve regurgitation or stenosis did not show improvement despite ERT. CONCLUSIONS ERT was shown to be an effective therapy for reducing cardiac hypertrophy, with best results seen when ERT was started at an early age. ERT, however, had little impact on valvular heart disease.
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Venmathi Maran BA, Soh HY, Hwang UW, Chang CY, Myoung JG. First records of parasitic copepods (Crustacea, Siphonostomatoida) from marine fishes in Korea. Trop Biomed 2015; 32:352-364. [PMID: 26691264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The knowledge of the biodiversity of parasitic copepods in South Korea is increasing. Interestingly we report here, some parasitic copepods considered as the first record of findings from Korea. Nine species of parasitic copepods (Siphonostomatoida) including six genera of three different families [Caligidae (7), Lernaeopodidae (1), Lernanthropidae (1)] were recovered from eight species of wild fishes in Korea: 1) Caligus hoplognathi Yamaguti & Yamasu, 1959 (♀, ♂) from the body surface of barred knifejaw Oplegnathus fasciatus (Temminck & Schlegel); 2) Caligus lagocephali Pillai, 1961 (♀) from the gills of panther puffer Takifugu pardalis (Temminck & Schlegel); 3) Euryphorus brachypterus (Gerstaecker, 1853) (♀, ♂) from the opercular cavity of Atlantic bluefin tuna Thunnus thynnus (Linnaeus); 4) Euryphorus nordmanni Milne Edwards, 1840 (♀, ♂) from the opercular cavity of common dolphin fish Coryphaena hippurus Linnaeus; 5) Gloiopotes huttoni (Thomson) (♀, ♂) from the body surface of black marlin Istiompax indica (Cuvier); 6) Lepeophtheirus hapalogenyos Yamaguti & Yamasu, 1959 (♀) from the gill filaments of O. fasciatus; 7) Lepeophtheirus sekii Yamaguti, 1936 (♀, ♂) from the body surface of red seabream Pagrus major (Temminck & Schlegel); 8) Brachiella thynni Cuvier, 1830 (♀) from the body surface of longfin tuna or albacore Thunnus alalunga (Bonnaterre); 9) Lernanthropinus sphyraenae (Yamaguti & Yamasu, 1959) (♀) from the gill filaments of moon fish Mene maculata (Bloch & Schneider). Since the female was already reported in Korea, it is a new record for the male of C. hoplognathi. A checklist for the parasitic copepods of the family Caligidae, Lernaeopodidae and Lernanthropidae of Korea is provided.
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Chang Y, Chang CY, Wang SJ, Huang SK. Myricetin inhibits the release of glutamate in rat cerebrocortical nerve terminals. J Med Food 2014; 18:516-23. [PMID: 25340625 DOI: 10.1089/jmf.2014.3219] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The excessive release of glutamate is a critical element in the neuropathology of acute and chronic brain disorders. The purpose of the present study was to investigate the effect and possible mechanism of myricetin, a naturally occurring flavonoid with a neuroprotective profile, on endogenous glutamate release in the nerve terminals (synaptosomes) of the rat cerebral cortex. The release of glutamate was evoked by the K(+) channel blocker 4-aminopyridine (4-AP) and measured by one-line enzyme-coupled fluorometric assay. We also used a membrane potential-sensitive dye to assay the synaptosomal plasma membrane potential, and a Ca(2+) indicator Fura-2 to monitor cytosolic Ca(2+) concentrations ([Ca(2+)]C). Results show that myricetin inhibited 4-AP-evoked glutamate release, and this effect was prevented by chelating extracellular Ca(2+) ions and the vesicular transporter inhibitor bafilomycin A1. However, the glutamate transporter inhibitor dl-threo-beta-benzyl-oxyaspartate had no effect on myricetin action. Myricetin did not alter the synaptosomal membrane potential, but decreased 4-AP-induced increases in the cytosolic free Ca(2+) concentration. Furthermore, the myricetin effect on 4-AP-evoked glutamate release was prevented by blocking the Cav2.2 (N-type) and Cav2.1 (P/Q-type) channels, but not by blocking intracellular Ca(2+) release. These results suggest that myricetin inhibits glutamate release from cerebrocortical synaptosomes by attenuating voltage-dependent Ca(2+) entry. This implies that the inhibition of glutamate release is an important pharmacological activity of myricetin that may play a critical role in the apparent clinical efficacy of this compound.
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Fang GC, Lin YH, Chang CY, Zheng YC. Concentrations of particulates in ambient air, gaseous elementary mercury (GEM), and particulate-bound mercury (Hg(p)) at a traffic sampling site: a study of dry deposition in daytime and nighttime. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2014; 36:605-612. [PMID: 24263618 DOI: 10.1007/s10653-013-9584-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 11/08/2013] [Indexed: 06/02/2023]
Abstract
In this investigation, the concentrations of particles in ambient air, gaseous elemental mercury (GEM), and particulate-bound mercury (Hg(p)) in total suspended particulates (TSP) as well as dry deposition at a (Traffic) sampling site at Hung-kuang were studied during the day and night in 2012. The results reveal that the mean concentrations of TSP in ambient air, GEM, and Hg(p) were 69.72 μg/m(3), 3.17, and 0.024 ng/m(3), respectively, at the Hung-kuang (Traffic) sampling site during daytime sampling periods. The results also reveal that the mean rates of dry deposition of particles from ambient air and Hg(p) were 145.20 μg/m(2) min and 0.022 ng/m(2) min, respectively, at the Hung-kuang (Traffic) sampling site during the daytime sampling period. The mean concentrations of TSP in ambient air, GEM, and Hg(p) were 60.56 μg/m(3), 2.74, and 0.018 ng/m(3), respectively, at the Hung-kuang (Traffic) sampling site during the nighttime sampling period. The mean rates of dry deposition of particles and Hg(p) from ambient air were 132.58 μg/m(2) min and 0.016 ng/m(2) min, respectively, at the Hung-kuang (Traffic) sampling site during the nighttime sampling period.
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Tseng TM, Chen PY, Tseng H, Lin HC, Chang CY, Hung SH. An unexpected route for otolaryngology bacterial contamination with a Venturi atomizer. Rhinology 2014; 52:156-161. [PMID: 24932628 DOI: 10.4193/rhino13.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Venturi-principle atomizer is a commonly used device in otolaryngology practices. The purpose of this study is to evaluate the possible route of bacterial contamination from the nasal vestibule to the atomizer tip through the jet airflow created during the use of the Venturi atomizer. METHODS Thirty nostrils from 15 enrolled volunteers were tested. The aerosols generated by spraying sterilized saline into the nostrils were collected using a specially made aerosol-collecting nozzle cap. The collected samples were sent for bacterial culture, and nasal vestibular swab cultures were performed for comparison. RESULTS In the aerosol-exposed group, 18 out of 30 samples (60%) were positive for bacterial growth, confirming the bacterial contamination from the nasal vestibule to the atomizer tip through the reverse jet airflow. The bacteria species in 8 of the 18 positive samples were identical to those from the nasal swab culture results from the same nostril. CONCLUSION In ordinary otolaryngology practices, there are significant risks for bacterial contamination from the nasal vestibule to the tip of the Venturi atomizer even without direct contact. Clinicians must be more aware of this pattern of contamination, which has not been reported in the existing literature.
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Yang HS, Chen IC, Lee YT, Lee KC, Chuang YC, Chang CY, Wei J. Cardiac transplantation and concomitant coronary artery bypass grafting: our experiences in 11 cases. Transplant Proc 2014; 46:900-2. [PMID: 24767376 DOI: 10.1016/j.transproceed.2013.11.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/07/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The shortage of donor hearts for transplantation could be alleviated by including the hearts of older donors. Previous literature revealed similar early and medium-term survival outcomes compared with those of younger donors. This study presents our experience with patients who underwent orthotopic heart transplantation and concomitant coronary artery bypass grafting at our institution. METHODS We present our experience with 11 patients with end-stage cardiomyopathy (8 men and 3 women) undergoing orthotopic heart transplantation and concomitant coronary artery bypass grafting from September 2002 to November 2011 at our institute. RESULTS All 11 donor organs would otherwise have been rejected, depriving potential recipients of organ transplantation. Two patients received concurrent 2-coronary-artery bypass, and the other 9 patients received concurrent single-coronary-artery bypass during orthotopic heart transplantation. All patients had an uneventful postoperative course, with follow-up completed 3 to 128 months after cardiac transplantation and concomitant coronary artery bypass grafting surgery. CONCLUSIONS Our experiences suggest that donor hearts requiring coronary artery bypass grafting, which form a small but significant donor subgroup, can be used effectively and safely when matched to the recipients' age and medical condition.
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Cho YT, Lin JW, Chen YC, Chang CY, Hsiao CH, Chung WH, Chu CY. Generalized bullous fixed drug eruption is distinct from Stevens-Johnson syndrome/toxic epidermal necrolysis by immunohistopathological features. J Am Acad Dermatol 2014; 70:539-48. [PMID: 24388722 DOI: 10.1016/j.jaad.2013.11.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 10/11/2013] [Accepted: 11/07/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND Generalized bullous fixed drug eruption (GBFDE), a particular form of fixed drug eruption (FDE), is characterized by widespread blisters and erosions and can be confused with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). OBJECTIVE We sought to analyze specific features of GBFDE and differentiate it from SJS/TEN. METHODS We retrospectively studied patients with GBFDE and SJS/TEN during a period of 10 years. GBFDE was defined as typical FDE lesions with blisters involving at least 10% body surface area on at least 3 of 6 different anatomic sites. Clinical presentations; histopathological features; immunohistochemical patterns of cluster-of-differentiation (CD)3, CD4, CD8, CD56, Fas, Fas ligand, granzyme B, perforin, granulysin, and forkhead box P3 (Foxp3); and serum granulysin levels were compared. RESULTS Twenty-three cases of GBFDE were collected. Patients with GBFDE had shorter latent periods, less mucosal involvement, more eosinophil infiltration, and dermal melanophages. Lesional infiltrates in GBFDE had more dermal CD4(+) cells including Foxp3(+) regulatory T cells, fewer intraepidermal CD56(+) cells, and fewer intraepidermal granulysin(+) cells. The serum level of granulysin in GBFDE was also significantly lower than in SJS/TEN. LIMITATIONS The number of cases in this study is small. CONCLUSION GBFDE is a distinct disease distinguishable from SJS/TEN by particular features such as granulysin, CD56, and Foxp3 expressions.
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Chen CH, Chang CY. Unique glucose-6-phosphatase, catalytic subunit mutation in a child with type Ia glycogen storage disease in Taiwan. JOURNAL OF MEDICAL SCIENCES 2014. [DOI: 10.4103/1011-4564.143651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chang CY, Feng TS, Wang JR, Lin HT, Shih C. Assessing the SCRRI and RIP runback performances of TRACE/PARCS for Lungmen ABWR. ANN NUCL ENERGY 2014. [DOI: 10.1016/j.anucene.2013.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Chen YC, Chang CY, Cho YT, Chiu HC, Chu CY. Reply to: “Using a diagnostic score when reporting the long-term sequelae of the drug reaction with eosinophilia and systemic symptoms”. J Am Acad Dermatol 2013; 69:1060-2. [DOI: 10.1016/j.jaad.2013.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 08/09/2013] [Indexed: 12/17/2022]
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Lin SP, Lin HY, Wang TJ, Chang CY, Lin CH, Huang SF, Tsai CC, Liu HL, Keutzer J, Chuang CK. A pilot newborn screening program for Mucopolysaccharidosis type I in Taiwan. Orphanet J Rare Dis 2013; 8:147. [PMID: 24053568 PMCID: PMC3849552 DOI: 10.1186/1750-1172-8-147] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mucopolysaccharidosis type I (MPS I) is a genetic disease caused by the deficiency of α-L-iduronidase (IDUA) activity. MPS I is classified into three clinical phenotypes called Hurler, Scheie, and Hurler-Scheie syndromes according to their clinical severity. Treatments for MPS I are available. Better outcomes are associated with early treatment, which suggests a need for newborn screening for MPS I. The goal of this study was to determine whether measuring IDUA activity in dried blood on filter paper was effective in newborn screening for MPS I. METHODS We conducted a newborn screening pilot program for MPS I from October 01, 2008 to April 30, 2013. Screening involved measuring IDUA activity in dried blood spots from 35,285 newborns using a fluorometric assay. RESULTS Of the 35,285 newborns screened, 19 did not pass the tests and had been noticed for a recall examination. After completing further recheck process, 3 were recalled again for leukocyte IDUA enzyme activity testing. Two of the three had deficient leukocyte IDUA activity. Molecular DNA analyses confirmed the diagnosis of MPS I in these two newborns. CONCLUSIONS It is feasible to use the IDUA enzyme assay for newborn screening. The incidence of MPS I in Taiwan estimated from this study is about 1/17,643.
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Lin CJ, Wu TH, Lin CH, Hung SC, Chiu CF, Liu MJ, Teng MMH, Chang FC, Guo WY, Chang CY. Can iterative reconstruction improve imaging quality for lower radiation CT perfusion? Initial experience. AJNR Am J Neuroradiol 2013; 34:1516-21. [PMID: 23578678 DOI: 10.3174/ajnr.a3436] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Initial results using IR for CT of the head showed satisfactory subjective and objective imaging quality with a 20-40% radiation dose reduction. The aim of our study was to compare the influence of IR and FBP algorithms on perfusion parameters at standard and lowered doses of CTP. MATERIALS AND METHODS Forty patients with unilateral carotid stenosis post-carotid stent placement referred for follow-up CTP were divided into 2 groups (tube currents were 100 mAs in group A and 80 mAs in group B). Datasets were reconstructed with IR and FBP algorithms; and SNRs of gray matter, white matter, and arterial and venous ROIs were compared. CBF, CBV, and MTT means and SNRs were evaluated by using linear regression, and qualitative imaging scores were compared across the 2 algorithms. RESULTS The mean effective radiation dose of group B (2.06 mSv) was approximately 20% lower than that of group A (2.56 mSv). SNRs for ROIs in the dynamic contrast-enhanced images were significantly higher than those for the FBP images. Correlations of the SNRs for CBF, CBV, and MTT across the 2 algorithms were moderate (R² = 0.46, 0.23, and 0.44, respectively). ROIs in gray matter rather than the IR algorithm predicted increasing SNRs in all CBF, CBV, and MTT maps. Two cases of significant restenosis were confirmed in both algorithms. CBV, CBF, and MTT imaging scores did not differ significantly across algorithms or groups. CONCLUSIONS Lower dose CTP (20% below normal dose) without IR can effectively identify oligemic tissue in poststenting follow-up. IR does not alter the absolute values or increase the SNRs of perfusion parameters. Other methods should be attempted to improve SNRs in settings with low tube currents.
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Chiu HY, Chang CY, Hsiao CH, Wang LF. Concurrent cytomegalovirus and herpes simplex virus infection in pemphigus vulgaris treated with rituximab and prednisolone. Acta Derm Venereol 2013; 93:200-1. [PMID: 22948546 DOI: 10.2340/00015555-1429] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Wang KW, Chueh LL, Wang MH, Huang YT, Fang BH, Chang CY, Fang MC, Chou JY, Hsieh SC, Wan CH. Multiplex polymerase chain reaction assay for the detection of minute virus of mice and mouse parvovirus infections in laboratory mice. Lab Anim 2013; 47:116-21. [PMID: 23492514 DOI: 10.1177/0023677213478298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mouse parvoviruses are among the most prevalent infectious pathogens in contemporary mouse colonies. To improve the efficiency of routine screening for mouse parvovirus infections, a multiplex polymerase chain reaction (PCR) assay targeting the VP gene was developed. The assay detected minute virus of mice (MVM), mouse parvovirus (MPV) and a mouse housekeeping gene (α-actin) and was able to specifically detect MVM and MPV at levels as low as 50 copies. Co-infection with the two viruses with up to 200-fold differences in viral concentrations can easily be detected. The multiplex PCR assay developed here could be a useful tool for monitoring mouse health and the viral contamination of biological materials.
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Chang CC, Chang HC, Wu CH, Chang CY, Liao CC, Chen TL. Adverse postoperative outcomes in surgical patients with immune thrombocytopenia. Br J Surg 2013; 100:684-92; discussion 693. [DOI: 10.1002/bjs.9065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 01/09/2023]
Abstract
Abstract
Background
Patients with immune thrombocytopenia (ITP) are likely to have various medical co-morbidities, yet their global features regarding adverse postoperative outcomes and use of medical resources when undergoing major surgery are unknown. The objective of this study was to validate whether ITP is an independent risk factor for adverse postoperative outcomes, and to explore the potential clinical predictors of outcomes after major surgery among patients with ITP.
Methods
A retrospective population-based cohort study was conducted using Taiwan's National Health Insurance Research Database, controlling for preoperative co-morbidities by means of multiple logistic regression. Major postoperative complication and mortality rates, and in-hospital medical costs were analysed.
Results
The study included 11 085 surgical patients with ITP and 44 340 controls without ITP matched for sex, age, and type of surgery and anaesthesia. Surgical patients with ITP had a higher risk of postoperative death (odds ratio (OR) 1·89, 95 per cent confidence interval 1·57 to 2·27), and overall postoperative complications (OR 1·47, 1·39 to 1·56), and increased hospital stay (OR 1·90, 1·80 to 2·01), admission to the intensive care unit (OR 1·73, 1·63 to 1·83) and medical costs (OR 1·89, 1·79 to 1·99). Amount of preoperative platelet and/or red blood cell transfusion, emergency visits and admission to hospital for ITP care were identified as risk factors for adverse postoperative outcomes.
Conclusion
Patients with ITP undergoing surgery are at increased risk of adverse perioperative events, particularly if blood or blood product transfusion are required preoperatively, or the procedure is done as an emergency.
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Liao EC, Chen JT, Chao ML, Yu SC, Chang CY, Chu WS, Tsai JJ. Nonadverse effects on allergenicity of isopentenyltransferase-transformed broccoli. J Investig Allergol Clin Immunol 2013; 23:112-119. [PMID: 23654078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Genetically modified organisms (GMOs) provide modern agriculture with improvements in efficiency and the benefits of enhanced food production; however, the potential impact of GMOs on human health has not yet been clarified. OBJECTIVE To investigate the allergenicity of isopentenyltransferase (ipt)-transformed broccoli compared with non-GM broccoli. METHODS Sera from allergic individuals were used to identify the allergenicity of GM and non-GM broccoli. Immunoglobulin (Ig) binding of different lines of GM and non-GM broccoli was identified using immunoblotting, enzyme-linked immunosorbent assay, and the histamin release assay. RESULTS Positive reactions to broccoli (Brassica Oleracea) were observed in 7.02% of individuals. Specific IgE to broccoli and total IgE fro allergic individuals were well correlated. The different tests performed showed no significant differences in the allergenicity of conventionally raised and GM broccoli, indicating the absence of unexpected effects on allergenicity in ipt-transformed plants. Using Western blot analysis we detected heterogeneous IgE-reactive allergenic components in broccoli-allergic sera, but no significant differences between GM an non-GM broccoli were observed in serum from the same patients. CONCLUSIONS Our study demonstrates that there are no differences between GM (ipt-transformed) broccoli and non-GM broccoli, as determined by specific IgE in sera from broccoli-allergic patients. This indicates that there were no unexpected effects on allergenicity in this GM broccoli.
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Fang GC, Chang CY. Monitoring ambient air pollutants and apply Woods’ model in the prediction seasonal dry deposition at Chang-Hua (urban) and Kao-Mei (wetland) county, Taiwan. Toxicol Ind Health 2012; 30:728-37. [DOI: 10.1177/0748233712462474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The main purpose for this study was to monitor ambient air particles and metallic elements (Mn, Fe, Zn, Cr, Cu and Pb) in total suspended particulate (TSP) concentration and dry deposition. In addition, the calculated/measured dry deposition flux ratios of ambient air particles and metallic elements (Mn, Fe, Zn, Cr, Cu and Pb) were evaluated using Woods’ model at urban and wetland areas for the 2009–2010 period. The results indicated that the mean highest concentrations of metallic elements Mn, Fe, Zn, Cr, Cu and Pb in TSP were found in Chang-Hua (urban) sampling site. And as for the two characteristic sampling sites, the Woods’ model exhibits better dry deposition of particulates of 18 µm particle size than the rest of the other particle sizes at any sampling site in this study. The average calculated/measured flux ratios for two seasons (summer and fall) by using Woods model at 2.5, 10 and 18 µm particles sizes were also studied. The results indicated that the average calculated/measured flux ratios orders for two seasons of various particles sizes were all displayed as Fe > Mn > Zn > Cu > Cr > Pb > particle. And these calculated/measured flux ratios orders were Fe > Mn > Cu > Zn > Cr > Pb > particle and were Fe > Mn > Zn > Cu > Cr > particle > Pb, during spring and winter seasons, respectively. Finally, in the spring and summer seasons of Gao-Mei (wetland) sampling site, the average calculated/measured flux ratios using Woods’ model was found to be 2.5, 10 and 18 µm, showing the order of the calculated/measured flux ratios to be Fe > Cu > Zn > Mn > Cr > Pb > particle. And the calculated/measured flux ratio orders were Fe > Zn > Mn > Cu > Cr > particle > Pb and were Fe > Cu > Zn > Mn > Cr > particle > Pb for fall and winter season, respectively.
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Wei J, Sue SH, Lee YT, Chang CY. Combined heart transplantation and total replacement of thoracic aorta in Marfan's syndrome with recurrent aortic dissection: a case report. Transplant Proc 2012; 44:1174-5. [PMID: 22564657 DOI: 10.1016/j.transproceed.2012.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
It is extremely rare for a patient to need simultaneous heart transplantation (HTx) and replacement of the thoracic aorta. A 23-year-old woman with Marfan's syndrome underwent Bentall's operation and replacement of the ascending aorta (AsA) due to a type A aortic dissection (AD) in August 2001. In March 2005, she began to experience dyspnea on exertion and was found to have a huge pseudoaneurysm at the aortic root, which had caused dehiscence of the aortic conduit. In July 2009, she suffered acute chest pain followed by hypotension and cold sweating. The computed tomography (CT) scan showed a recurrent dissection with a long intimal tear extending from the arch to the mid-portion of the descending thoracic aorta (DTA). Due to technical difficulties in the repair of the aortic root, she was placed on the HTx waiting list. The next day, she received a donor heart and underwent combined HTx and total replacement of the thoracic aorta. Explantation of the heart improved the exposure of the DTA. With the use of a vascular ring connector (Vasoring), the operation was successfully performed without need for a blood transfusion. The patient was still well at 2 years after the operation. Simultaneous replacement of the heart and the whole segment of the thoracic aorta is technically possible in Marfan patients who are complicated with aortic dissection.
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Johir MAH, Vigneswaran S, Sathasivan A, Kandasamy J, Chang CY. Effect of organic loading rate on organic matter and foulant characteristics in membrane bio-reactor. BIORESOURCE TECHNOLOGY 2012; 113:154-160. [PMID: 22206913 DOI: 10.1016/j.biortech.2011.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 11/30/2011] [Accepted: 12/01/2011] [Indexed: 05/31/2023]
Abstract
In this study, the influence of organic loading rate (OLR) on the performance of a membrane bio-reactor (MBR) was investigated. The MBR was operated with 6 different OLRs between 0.5 and 3.0 kg COD/m(3)d. The hydrodynamic parameters of the MBR were kept constant. The hydraulic retention time and sludge retention time were kept at 8h and 40 d respectively. From the experimental investigation, it was found that the removal efficiency of DOC, COD and NH(4)-N decreased when OLRs were increased from 0.5 to 3.0 kg COD/m(3)d. Higher OLRs of 2.75-3.0 kg COD/m(3)d resulted in a higher transmembrane pressure development. The fractionation of organic matters showed more hydrophilic substances with higher OLRs. A detailed organic matter characterization of membrane foulant, soluble microbial product and extracellular polymeric substances showed that bio-polymers type substances together with humic acid and lower molecular neutral and acids were responsible for membrane fouling.
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Lin CJ, Hung SC, Guo WY, Chang FC, Luo CB, Beilner J, Kowarschik M, Chu WF, Chang CY. Monitoring peri-therapeutic cerebral circulation time: a feasibility study using color-coded quantitative DSA in patients with steno-occlusive arterial disease. AJNR Am J Neuroradiol 2012; 33:1685-90. [PMID: 22499839 DOI: 10.3174/ajnr.a3049] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial hemodynamics are important for management of SOAD. This study aimed to monitor peri-stent placement intracranial CirT of patients with SOAD. MATERIALS AND METHODS Twenty-five patients received stent placement for extracranial ICA stenosis, and 34 patients with normal CirT were recruited as controls. Their color-coded DSAs were used to define the Tmax of selected intravascular ROI. A total of 20 ROIs of the ICA, OphA, ACA, MCA, FV, PV, OV, SSS, SS, IJV, and MCV were selected. rTmax was defined as the Tmax at the selected region of interest minus Tmax at the cervical segment of the ICA (I1 on AP view and IA on lateral view). rTmax of the PV was defined as intracranial CirT. Intergroup and intragroup longitudinal comparisons of rTmax were performed. RESULTS rTmax values of the normal cohorts were as follows: ICA-AP, 0.12; ICA-LAT, 0.10; A1, 0.28; A2, 0.53; A3, 0.81; M1, 0.40; M2, 0.80; M3, 0.95; OphA, 0.35; FV, 4.83; PV, 5.11; OV, 5.17; SSS, 6.16; SS, 6.51; IJV, 6.81; and MCV, 3.86 seconds. Before stent placement, the rTmax values of arterial ROIs, except A3 and M3, were prolonged compared with values from control subjects (P < .05). None of the rTmax of any venous ROIs in the stenotic group was prolonged with significance. After stent placement, the rTmax of all arterial ROIs shortened significantly, except A1and M3. Poststenting rTmax was not different from the control group. CONCLUSIONS Without extra contrast medium and radiation dosages, color-coded quantitative DSA enables real-time monitoring of peri-therapeutic intracranial CirT in patients with SOAD .
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Chang SM, Chang CY, Lin YL, Hwa K. The studies of self‐assembled xylose derivative on gold nanoparticles. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.773.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Lee CH, Chen YC, Cho YT, Chang CY, Chu CY. Fixed-drug eruption: A retrospective study in a single referral center in northern Taiwan. DERMATOL SIN 2012. [DOI: 10.1016/j.dsi.2012.02.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yen CH, Teng MMH, Yuan WH, Sun YC, Chang CY. Preventive vertebroplasty for adjacent vertebral bodies: a good solution to reduce adjacent vertebral fracture after percutaneous vertebroplasty. AJNR Am J Neuroradiol 2012; 33:826-32. [PMID: 22282447 DOI: 10.3174/ajnr.a2898] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Adjacent VCF frequently occurs after percutaneous vertebroplasty. Our aim was to evaluate PrVP in the prevention of PVNO-adjacent VCF. MATERIALS AND METHODS Radiographs of 68 patients who initially presented with a single-level unhealed fracture and underwent vertebroplasty were retrospectively reviewed for the occurrence of PVNO fracture. Patients in the nonpreventive group (n = 33) underwent TVP only for a vertebra with an unhealed fracture. The preventive group (n = 35) underwent PrVP combined with TVP. We injected bone cement into the caudal part of the superior adjacent vertebra and the cephalic part of the inferior adjacent vertebra to perform PrVP. RESULTS The incidences of PVNO fracture in adjacent vertebra next to a vertebra cemented at the patient's first vertebroplasty (within 6 months: 24% versus 3%, P = .012; within 1 year: 30% versus 3%, P = .006; >4 years: 39% versus 3%, P = .006) markedly decreased in the preventive group compared with the nonpreventive group. PVNO fracture was found in 26% of vertebrae adjacent to the first TVP level in the nonpreventive group and in 2% of vertebrae adjacent to a PrVP level in the preventive group after inclusion of all PrVP procedures. Approximately 33% of patients in the nonpreventive group underwent repeat vertebroplasty, mainly due to adjacent fractures. Only 3% of patients in the preventive group underwent repeated procedures. None of the vertebrae cemented for PrVP or TVP developed PVNO refracture. CONCLUSIONS Preventive vertebroplasty for the adjacent vertebra combined with TVP for the fractured vertebra is effective in the prevention of propagation of PVNO adjacent fractures, thus reducing the necessity of multiple repeat vertebroplasty procedures.
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