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Zhao Z, Wu CM, Zhang S, He F, Liu F, Wang B, Huang Y, Shi W, Jian D, Xie H, Yeh CY, Li J. Correction: A Novel Convolutional Neural Network for the Diagnosis and Classification of Rosacea: Usability Study. JMIR Med Inform 2024; 12:e57654. [PMID: 38457810 PMCID: PMC10960214 DOI: 10.2196/57654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/10/2024] Open
Abstract
[This corrects the article DOI: 10.2196/23415.].
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Affiliation(s)
- Zhixiang Zhao
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | | | - Shuping Zhang
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | - Fanping He
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | - Fangfen Liu
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | - Ben Wang
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | - Yingxue Huang
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | - Wei Shi
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | - Dan Jian
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | - Hongfu Xie
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
| | | | - Ji Li
- Department of DermatologyXiangya Hospital of Central South UniversityChangshaChina
- Hunan Key Laboratory of Aging BiologyXiangya Hospital of Central South UniversityChangshaChina
- National Clinical Research Center for Geriatric DisordersXiangya Hospital of Central South UniversityChangshaChina
- Key Laboratory of Organ InjuryAging and Regenerative Medicine of Hunan ProvinceChangshaChina
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Lin YJ, Chen CC, Lee CH, Yeh CY, Jeng YM. Two-tiered deep-learning-based model for histologic diagnosis of Helicobacter gastritis. Histopathology 2023; 83:771-781. [PMID: 37522271 DOI: 10.1111/his.15018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 08/01/2023]
Abstract
AIMS Helicobacter pylori (HP) infection is the most common cause of chronic gastritis worldwide. Due to the small size of HP and limited resolution, diagnosing HP infections is more difficult when using digital slides. METHODS AND RESULTS We developed a two-tier deep-learning-based model for diagnosing HP gastritis. A whole-slide model was trained on 885 whole-slide images (WSIs) with only slide-level labels (positive or negative slides). An auxiliary model was trained on 824 areas with HP in nine positive WSIs and 446 negative WSIs for localizing HP. The whole-slide model performed well, with an area under the receiver operating characteristic curve (AUC) of 0.9739 (95% confidence interval [CI], 0.9545-0.9932). The calculated sensitivity and specificity were 93.3% and 90.1%, respectively, whereas those of pathologists were 93.3% and 84.2%, respectively. Using the auxiliary model, the highlighted areas of the localization maps had an average precision of 0.5796. CONCLUSIONS HP gastritis can be diagnosed on haematoxylin-and-eosin-stained WSIs with human-level accuracy using a deep-learning-based model trained on slide-level labels and an auxiliary model for localizing HP and confirming the diagnosis. This two-tiered model can shorten the diagnostic process and reduce the need for special staining.
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Affiliation(s)
- Yi-Jyun Lin
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Chia-Hsiang Lee
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Yung-Ming Jeng
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan
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Rodríguez JJ, Terzieva S, Yeh CY, Gardenal E, Zallo F, Verkhratsky A, Busquets X. Neuroanatomical and morphometric study of S100β positive astrocytes in the entorhinal cortex during ageing in the 3xTg-Alzehimer's disease mouse model. Neurosci Lett 2023; 802:137167. [PMID: 36894021 DOI: 10.1016/j.neulet.2023.137167] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
Astrocytes contribute to the progression of neurodegenerative diseases, including Alzheimer's disease (AD). Here, we report the neuroanatomical and morphometric analysis of astrocytes in the entorhinal cortex (EC) of the aged wild type (WT) and triple transgenic (3xTg-AD) mouse model of AD. Using 3D confocal microscopy, we determined the surface area and volume of positive astrocytic profiles in male mice (WT and 3xTg-AD) from 1 to 18 months of age. We showed that S100β-positive astrocytes were equally distributed throughout the entire EC in both animal types and showed no changes in Nv (number of cells/mm3) nor in their distribution at the different ages studied. These positive astrocytes, demonstrated an age-dependent gradual increase in their surface area and in their volume starting at 3 months of age, in both WT and 3xTg-AD mice. This last group demonstrated a large increase in both surface area and volume at 18 months of age when the burden of pathological hallmarks of AD is present (69.74% to 76.73% in the surface area and the volume, for WT and 3xTg-AD mice respectively). We observed that these changes were due to the enlargement of the cell processes and to less extend the somata. In fact, the volume of the cell body was increased by 35.82% in 18-month-old 3xTg-AD compared to WT. On the other hand, the increase on the astrocytic processes were detected as soon as 9 months of age where we found an increase of surface area and volume (36.56% and 43.73%, respectively) sustained till 18 month of age (93.6% and 113.78%, respectively) when compared age-matched non-Tg mice. Moreover, we demonstrated that these hypertrophic S100β-positive astrocytes were mainly associated with Aβ plaques. Our results show a severe atrophy in GFAP cytoskeleton in all cognitive areas; whilst within the EC astrocytes independent to this atrophy show no changes in GS and S100β; which can play a key role in the memory impairment.
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Affiliation(s)
- J J Rodríguez
- Biocruces Health Research Institute, Functional Neuroanatomy Group, IKERBASQUE, Basque Foundation for Science, Dept. of Neurosciences, Medical Faculty, University of the Basque Country (UPV/EHU), Barakaldo, Spain.
| | - S Terzieva
- Biocruces Health Research Institute, Functional Neuroanatomy Group, IKERBASQUE, Basque Foundation for Science, Dept. of Neurosciences, Medical Faculty, University of the Basque Country (UPV/EHU), Barakaldo, Spain
| | - C Y Yeh
- Biocruces Health Research Institute, Functional Neuroanatomy Group, IKERBASQUE, Basque Foundation for Science, Dept. of Neurosciences, Medical Faculty, University of the Basque Country (UPV/EHU), Barakaldo, Spain
| | - E Gardenal
- Biocruces Health Research Institute, Functional Neuroanatomy Group, IKERBASQUE, Basque Foundation for Science, Dept. of Neurosciences, Medical Faculty, University of the Basque Country (UPV/EHU), Barakaldo, Spain
| | - F Zallo
- Biocruces Health Research Institute, Functional Neuroanatomy Group, IKERBASQUE, Basque Foundation for Science, Dept. of Neurosciences, Medical Faculty, University of the Basque Country (UPV/EHU), Barakaldo, Spain
| | - A Verkhratsky
- Faculty of Life Sciences, The University of Manchester, Manchester, United Kingdom
| | - X Busquets
- Laboratory of Molecular Cell Biomedicine, Department of Biology, University of the Balearic Islands, 07122 Palma, Spain
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Hsiao MY, Weng CH, Wang YC, Cheng SH, Wei KC, Tung PY, Chen JY, Yeh CY, Wang TG. Deep Learning for Automatic Hyoid Tracking in Videofluoroscopic Swallow Studies. Dysphagia 2023; 38:171-180. [PMID: 35482213 DOI: 10.1007/s00455-022-10438-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/13/2021] [Indexed: 01/27/2023]
Abstract
The hyoid bone excursion is one of the most important gauges of larynx elevation in swallowing, contributing to airway protection and bolus passage into the esophagus. However, the implications of various parameters of hyoid bone excursion, such as the horizontal or vertical displacement and velocity, remain elusive and raise the need for a tool providing automatic kinematics analysis. Several conventional and deep learning-based models have been applied automatically to track the hyoid bone, but previous methods either require partial manual localization or do not transform the trajectory by anatomic axis. This work describes a convolutional neural network-based algorithm featuring fully automatic hyoid bone localization and tracking and spine axis determination. The algorithm automatically estimates the hyoid bone trajectory and calculates several physical quantities, including the average velocity and displacement in horizontal or vertical anatomic axis. The model was trained in a dataset of 365 videos of videofluoroscopic swallowing from 189 patients in a tertiary medical center and tested using 44 videos from 44 patients with different dysphagia etiologies. The algorithm showed high detection rates for the hyoid bone. The results showed excellent inter-rater reliability for hyoid bone detection, good-to-excellent inter-rater reliability for calculating the maximal displacement and the average velocity of the hyoid bone in horizontal or vertical directions, and moderate-to-good reliability in calculating the average velocity in horizontal direction. The proposed algorithm allows for complete automatic kinematic analysis of hyoid bone excursion, providing a versatile tool with high potential for clinical applications.
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Affiliation(s)
- Ming-Yen Hsiao
- Department of Physical Medicine and Rehabilitation, College of Medicine, Zhongzheng Dist., National Taiwan University, No. 7, Zhongshan S. Rd., Taipei, 100, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Yu-Chen Wang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Zhongzheng Dist., National Taiwan University, No. 7, Zhongshan S. Rd., Taipei, 100, Taiwan
| | - Sheng-Hao Cheng
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuo-Chang Wei
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Ya Tung
- The UC Berkeley/ UCSF Master Program in Translational Medicine, University of California, Berkeley, University of California, San Francisco, CA, USA
| | - Jo-Yu Chen
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Zhongzheng Dist., National Taiwan University, No. 7, Zhongshan S. Rd., Taipei, 100, Taiwan.
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
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Chuang WY, Yu WH, Lee YC, Zhang QY, Chang H, Shih LY, Yeh CJ, Lin SMT, Chang SH, Ueng SH, Wang TH, Hsueh C, Kuo CF, Chuang SS, Yeh CY. Deep Learning-Based Nuclear Morphometry Reveals an Independent Prognostic Factor in Mantle Cell Lymphoma. Am J Pathol 2022; 192:1763-1778. [PMID: 36150505 DOI: 10.1016/j.ajpath.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/18/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Blastoid/pleomorphic morphology is associated with short survival in mantle cell lymphoma (MCL), but its prognostic value is overridden by Ki-67 in multivariate analysis. Herein, a nuclear segmentation model was developed using deep learning, and nuclei of tumor cells in 103 MCL cases were automatically delineated. Eight nuclear morphometric attributes were extracted from each nucleus. The mean, variance, skewness, and kurtosis of each attribute were calculated for each case, resulting in 32 morphometric parameters. Compared with those in classic MCL, 17 morphometric parameters were significantly different in blastoid/pleomorphic MCL. Using univariate analysis, 16 morphometric parameters (including 14 significantly different between classic and blastoid/pleomorphic MCL) emerged as significant prognostic factors. Using multivariate analysis, Biologic MCL International Prognostic Index (bMIPI) risk group (P = 0.025), low skewness of nuclear irregularity (P = 0.020), and high mean of nuclear irregularity (P = 0.047) emerged as independent adverse prognostic factors. Additionally, a morphometric score calculated from the skewness and mean of nuclear irregularity (P = 0.0038) was an independent prognostic factor in addition to bMIPI risk group (P = 0.025), and a summed morphometric bMIPI score was useful for risk stratification of patients with MCL (P = 0.000001). These results demonstrate, for the first time, that a nuclear morphometric score is an independent prognostic factor in MCL. It is more robust than blastoid/pleomorphic morphology and can be objectively measured.
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Affiliation(s)
- Wen-Yu Chuang
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan; Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | | | - Yen-Chen Lee
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | | | - Hung Chang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Lee-Yung Shih
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chi-Ju Yeh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Samuel Mu-Tse Lin
- aetherAI, Co, Ltd, Taipei, Taiwan; Taipei American School, Taipei, Taiwan
| | - Shang-Hung Chang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shir-Hwa Ueng
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Tong-Hong Wang
- Tissue Bank, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chuen Hsueh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Chang-Fu Kuo
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan.
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Weng CH, Huang YJ, Fu CJ, Yeh YC, Yeh CY, Tsai TT. Automatic recognition of whole-spine sagittal alignment and curvature analysis through a deep learning technique. Eur Spine J 2022; 31:2092-2103. [PMID: 35366104 DOI: 10.1007/s00586-022-07189-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/21/2022] [Accepted: 03/12/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE Artificial intelligence based on deep learning (DL) approaches enables the automatic recognition of anatomic landmarks and subsequent estimation of various spinopelvic parameters. The locations of inflection points (IPs) and apices (APs) in whole-spine lateral radiographs could be mathematically determined by a fully automatic spinal sagittal curvature analysis system. METHODS We developed a DL model for automatic spinal curvature analysis of whole-spine lateral plain radiographs by using 1800 annotated images of various spinal disease etiologies. The DL model comprised a landmark localizer to detect 25 vertebral landmarks and a numerical algorithm for the generation of an individualized spinal sagittal curvature. The characteristics of the spinal curvature, including the IPs, APs, and curvature angle, could thus be analyzed using mathematical definitions. The localization error of each landmark was calculated from the predictions of 300 test images to evaluate the performance of the landmark localizer. The interrater reliability among a senior orthopedic surgeon, a radiologist, and the DL model was assessed using the intraclass correlation coefficient (ICC). RESULTS The accuracy of the landmark localizer was within an acceptable range (median error: 1.7-4.1 mm), and the interrater reliabilities between the proposed DL model and each expert were good to excellent (all ICCs > 0.85) for the measurement of spinal curvature characteristics. CONCLUSION The interrater reliability between the proposed DL model and human experts was good to excellent in predicting the locations of IPs, APs, and curvature angles. Future applications should be explored to validate this system and improve its clinical efficiency.
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Affiliation(s)
- Chi-Hung Weng
- aetherAI Co., Ltd., 9 F., No. 3-2, Park St., Nangang Dist., Taipei, 115, Taiwan
| | - Yu-Jui Huang
- Spine Division, Department of Orthopaedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan
| | - Chen-Ju Fu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, 333, Taiwan
| | - Yu-Cheng Yeh
- Spine Division, Department of Orthopaedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan.
| | - Chao-Yuan Yeh
- aetherAI Co., Ltd., 9 F., No. 3-2, Park St., Nangang Dist., Taipei, 115, Taiwan
| | - Tsung-Ting Tsai
- Spine Division, Department of Orthopaedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan
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Abstract
The methods of measuring laryngeal elevation during swallowing are time-consuming. We aimed to propose a quick-to-use neural network (NN) model for measuring laryngeal elevation quantitatively using anatomical structures auto-segmented by Mask region-based convolutional NN (R-CNN) in videofluoroscopic swallowing study. Twelve videofluoroscopic swallowing study video clips were collected. One researcher drew the anatomical structure, including the thyroid cartilage and vocal fold complex (TVC) on respective video frames. The dataset was split into 11 videos (4686 frames) for model development and one video (532 frames) for derived model testing. The validity of the trained model was evaluated using the intersection over the union. The mean intersections over union of the C1 spinous process and TVC were 0.73 ± 0.07 [0-0.88] and 0.43 ± 0.19 [0-0.79], respectively. The recall rates for the auto-segmentation of the TVC and C1 spinous process by the Mask R-CNN were 86.8% and 99.8%, respectively. Actual displacement of the larynx was calculated using the midpoint of the auto-segmented TVC and C1 spinous process and diagonal lengths of the C3 and C4 vertebral bodies on magnetic resonance imaging, which measured 35.1 mm. Mask R-CNN segmented the TVC with high accuracy. The proposed method measures laryngeal elevation using the midpoint of the TVC and C1 spinous process, auto-segmented by Mask R-CNN. Mask R-CNN auto-segmented the TVC with considerably high accuracy. Therefore, we can expect that the proposed method will quantitatively and quickly determine laryngeal elevation in clinical settings.
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Affiliation(s)
- Hyun Haeng Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | - Bo Mi Kwon
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
| | | | | | - Jongmin Lee
- Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea
- Center for Neuroscience Research, Institute of Biomedical Science & Technology, Konkuk University, Seoul, Korea
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Hou YT, Chen TC, Yeh CY, Lin CW. Peripapillary Choroid Thickness as a Predisposing Factor for Nonarteritic Anterior Ischemic Optic Neuropathy: A Semiautomated OCT Study. Transl Vis Sci Technol 2021; 10:31. [PMID: 34964834 PMCID: PMC8740530 DOI: 10.1167/tvst.10.14.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the correlations between peripapillary choroidal thickness (PCT) and nonarteritic ischemic optic neuropathy (NAION) by using semiautomated optic coherence tomography (OCT). Methods A total of 35 NAION eyes, 29 unaffected fellow eyes, and 40 eyes from an age-matched control group were recruited. Enhanced-depth imaging OCT was performed after the resolution of disc edema. PCT was measured using a customized semiautomated MATLAB program. Regression models adjusted for multiple variables were used to inspect the correlation between mean PCT and NAION. Results The mean PCT in NAION eyes, unaffected fellow eyes, and the control group was 197.09 ± 38.09, 196.52 ± 38.47, and 153.53 ± 29.92 µm, respectively. The mean PCT was significantly thicker both in NAION-affected eyes and fellow eyes compared with the control group (P < 0.001). No significant difference existed between NAION-affected eyes and unaffected fellow eyes. The PCT of the superior quadrant was significantly thicker than that of the inferior quadrant in all three groups. In the multivariate logistic regression, PCT was the only predisposing factor for NAION. However, the value of the PCT was not correlated with final visual outcomes. Conclusions With a semiautomated program to alleviate the missing measurements, our study demonstrated significantly thicker PCT in both NAION-affected and unaffected eyes of patients, which indicated that peripapillary pachychoroid is a predisposing factor for NAION but may not be a prognostic factor for visual outcomes. Translational Relevance Accurate measurement of PCT by using semiautomated OCT illustrates the correlation between choroidal vasculature and NAION.
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Affiliation(s)
- Yi-Ting Hou
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ta-Ching Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
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Chuang WY, Chen CC, Yu WH, Yeh CJ, Chang SH, Ueng SH, Wang TH, Hsueh C, Kuo CF, Yeh CY. Identification of nodal micrometastasis in colorectal cancer using deep learning on annotation-free whole-slide images. Mod Pathol 2021; 34:1901-1911. [PMID: 34103664 PMCID: PMC8443445 DOI: 10.1038/s41379-021-00838-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 01/17/2023]
Abstract
Detection of nodal micrometastasis (tumor size: 0.2-2.0 mm) is challenging for pathologists due to the small size of metastatic foci. Since lymph nodes with micrometastasis are counted as positive nodes, detecting micrometastasis is crucial for accurate pathologic staging of colorectal cancer. Previously, deep learning algorithms developed with manually annotated images performed well in identifying micrometastasis of breast cancer in sentinel lymph nodes. However, the process of manual annotation is labor intensive and time consuming. Multiple instance learning was later used to identify metastatic breast cancer without manual annotation, but its performance appears worse in detecting micrometastasis. Here, we developed a deep learning model using whole-slide images of regional lymph nodes of colorectal cancer with only a slide-level label (either a positive or negative slide). The training, validation, and testing sets included 1963, 219, and 1000 slides, respectively. A supercomputer TAIWANIA 2 was used to train a deep learning model to identify metastasis. At slide level, our algorithm performed well in identifying both macrometastasis (tumor size > 2.0 mm) and micrometastasis with an area under the receiver operating characteristics curve (AUC) of 0.9993 and 0.9956, respectively. Since most of our slides had more than one lymph node, we then tested the performance of our algorithm on 538 single-lymph node images randomly cropped from the testing set. At single-lymph node level, our algorithm maintained good performance in identifying macrometastasis and micrometastasis with an AUC of 0.9944 and 0.9476, respectively. Visualization using class activation mapping confirmed that our model identified nodal metastasis based on areas of tumor cells. Our results demonstrate for the first time that micrometastasis could be detected by deep learning on whole-slide images without manual annotation.
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Affiliation(s)
- Wen-Yu Chuang
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | | | | | - Chi-Ju Yeh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Shang-Hung Chang
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shir-Hwa Ueng
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
- Chang Gung Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Tong-Hong Wang
- Tissue Bank, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chuen Hsueh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Chang-Fu Kuo
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Yang CK, Lee CY, Wang HS, Huang SC, Liang PI, Chen JS, Kuo CF, Tu KH, Yeh CY, Chen TD. Glomerular Disease Classification and Lesion Identification by Machine Learning. Biomed J 2021; 45:675-685. [PMID: 34506971 PMCID: PMC9486238 DOI: 10.1016/j.bj.2021.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 06/21/2021] [Accepted: 08/31/2021] [Indexed: 12/13/2022] Open
Abstract
Background Classification of glomerular diseases and identification of glomerular lesions require careful morphological examination by experienced nephropathologists, which is labor-intensive, time-consuming, and prone to interobserver variability. In this regard, recent advance in machine learning-based image analysis is promising. Methods We combined Mask Region-based Convolutional Neural Networks (Mask R–CNN) with an additional classification step to build a glomerulus detection model using human kidney biopsy samples. A Long Short-Term Memory (LSTM) recurrent neural network was applied for glomerular disease classification, and another two-stage model using ResNeXt-101 was constructed for glomerular lesion identification in cases of lupus nephritis. Results The detection model showed state-of-the-art performance on variedly stained slides with F1 scores up to 0.944. The disease classification model showed good accuracies up to 0.940 on recognizing different glomerular diseases based on H&E whole slide images. The lesion identification model demonstrated high discriminating power with area under the receiver operating characteristic curve up to 0.947 for various glomerular lesions. Models showed good generalization on external testing datasets. Conclusion This study is the first-of-its-kind showing how each step of kidney biopsy interpretation carried out by nephropathologists can be captured and simulated by machine learning models. The models were integrated into a whole slide image viewing and annotating platform to enable nephropathologists to review, correct, and confirm the inference results. Further improvement on model performances and incorporating inputs from immunofluorescence, electron microscopy, and clinical data might realize actual clinical use.
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Affiliation(s)
- Cheng-Kun Yang
- aetherAI, Co., Ltd., 9F., No.3-2, Park St., Nangang Dist., Taipei City 115, Taiwan.
| | - Ching-Yi Lee
- aetherAI, Co., Ltd., 9F., No.3-2, Park St., Nangang Dist., Taipei City 115, Taiwan.
| | - Hsiang-Sheng Wang
- Department of Anatomic Pathology, Chang Gung Memorial Hospital Linkou Main Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.
| | - Shun-Chen Huang
- Department of Anatomic Pathology, Chang Gung Memorial Hospital Kaohsiung Branch, No. 123, Dapi Rd., Niaosong Dist., Kaohsiung City 833, Taiwan.
| | - Peir-In Liang
- Department of Pathology, Kaohsiung Medical University Hospital, No. 100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City 807, Taiwan.
| | - Jung-Sheng Chen
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital Linkou Main Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.
| | - Chang-Fu Kuo
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital Linkou Main Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.
| | - Kun-Hua Tu
- Department of Nephrology, Chang Gung Memorial Hospital Linkou Main Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.
| | - Chao-Yuan Yeh
- aetherAI, Co., Ltd., 9F., No.3-2, Park St., Nangang Dist., Taipei City 115, Taiwan.
| | - Tai-Di Chen
- Department of Anatomic Pathology, Chang Gung Memorial Hospital Linkou Main Branch, No. 5, Fuxing St., Guishan Dist., Taoyuan City 333, Taiwan.
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11
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Chang YL, Hsieh CY, Yeh CY, Chang CH, Lin FH. Fabrication of Stromal Cell-Derived Factor-1 Contained in Gelatin/Hyaluronate Copo006Cymer Mixed with Hydroxyapatite for Use in Traumatic Bone Defects. Micromachines (Basel) 2021; 12:mi12070822. [PMID: 34357232 PMCID: PMC8306626 DOI: 10.3390/mi12070822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/26/2022]
Abstract
Bone defects of orthopedic trauma remain a challenge in clinical practice. Regarding bone void fillers, besides the well-known osteoconductivity of most bone substitutes, osteoinductivity has also been gaining attention in recent years. It is known that stromal cell-derived factor-1 (SDF-1) can recruit mesenchymal stem cells (MSCs) in certain circumstances, which may also play an important role in bone regeneration. In this study, we fabricated a gelatin/hyaluronate (Gel/HA) copolymer mixed with hydroxyapatite (HAP) and SDF-1 to try and enhance bone regeneration in a bone defect model. After material characterization, these Gel/HA–HAP and Gel/HA–HAP–SDF-1 composites were tested for their biocompatibility and ability to recruit MSCs in vitro. A femoral condyle bone defect model of rats was used for in vivo studies. For the assessment of bone healing, micro-CT analysis, second harmonic generation (SHG) imaging, and histology studies were performed. As a result, the Gel/HA–HAP composites showed no systemic toxicity to rats. Gel/HA–HAP composite groups both showed better bone generation compared with the control group in an animal study, and the composite with the SDF-1 group even showed a trend of faster bone growth compared with the composite without SDF-1 group. In conclusion, in the management of traumatic bone defects, Gel/HA–HAP–SDF-1 composites can be a feasible material for use as bone void fillers.
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Affiliation(s)
- Yun-Liang Chang
- Department of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Jen-Ai Road, Taipei City 10051, Taiwan; (Y.-L.C.); (C.-Y.H.)
- Department of Orthopaedic Surgery, National Taiwan University Hospital, No. 7, Chung Shan South Road, Taipei City 10002, Taiwan
| | - Chia-Ying Hsieh
- Department of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Jen-Ai Road, Taipei City 10051, Taiwan; (Y.-L.C.); (C.-Y.H.)
| | - Chao-Yuan Yeh
- Integrative Stem Cell Center, China Medical University, No. 2, Yude Road, Taichung City 40447, Taiwan;
| | - Chih-Hao Chang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, No. 7, Chung Shan South Road, Taipei City 10002, Taiwan
- Correspondence: (C.-H.C.); (F.-H.L.); Tel.: +886-2-2312-3456 (C.-H.C.); +886-2-2732-0443 (F.-H.L.)
| | - Feng-Huei Lin
- Department of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Jen-Ai Road, Taipei City 10051, Taiwan; (Y.-L.C.); (C.-Y.H.)
- Correspondence: (C.-H.C.); (F.-H.L.); Tel.: +886-2-2312-3456 (C.-H.C.); +886-2-2732-0443 (F.-H.L.)
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12
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Pantanowitz L, Wu U, Seigh L, LoPresti E, Yeh FC, Salgia P, Michelow P, Hazelhurst S, Chen WY, Hartman D, Yeh CY. Artificial Intelligence-Based Screening for Mycobacteria in Whole-Slide Images of Tissue Samples. Am J Clin Pathol 2021; 156:117-128. [PMID: 33527136 DOI: 10.1093/ajcp/aqaa215] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This study aimed to develop and validate a deep learning algorithm to screen digitized acid fast-stained (AFS) slides for mycobacteria within tissue sections. METHODS A total of 441 whole-slide images (WSIs) of AFS tissue material were used to develop a deep learning algorithm. Regions of interest with possible acid-fast bacilli (AFBs) were displayed in a web-based gallery format alongside corresponding WSIs for pathologist review. Artificial intelligence (AI)-assisted analysis of another 138 AFS slides was compared to manual light microscopy and WSI evaluation without AI support. RESULTS Algorithm performance showed an area under the curve of 0.960 at the image patch level. More AI-assisted reviews identified AFBs than manual microscopy or WSI examination (P < .001). Sensitivity, negative predictive value, and accuracy were highest for AI-assisted reviews. AI-assisted reviews also had the highest rate of matching the original sign-out diagnosis, were less time-consuming, and were much easier for pathologists to perform (P < .001). CONCLUSIONS This study reports the successful development and clinical validation of an AI-based digital pathology system to screen for AFBs in anatomic pathology material. AI assistance proved to be more sensitive and accurate, took pathologists less time to screen cases, and was easier to use than either manual microscopy or viewing WSIs.
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Services, Johannesburg, South Africa
| | - Uno Wu
- Department of Electrical Engineering, Molecular Biomedical Informatics Lab, National Cheng Kung University, Tainan City, Taiwan
- aetherAI, Taipei, Taiwan
| | - Lindsey Seigh
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Edmund LoPresti
- Information Services Division, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Payal Salgia
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Pamela Michelow
- Department of Anatomical Pathology, University of the Witwatersrand and National Health Laboratory Services, Johannesburg, South Africa
| | - Scott Hazelhurst
- School of Electrical & Information Engineering and Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Wei-Yu Chen
- Department of Pathology, Wan Fang Hospital
- Department of Pathology, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Douglas Hartman
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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13
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Yeh YC, Weng CH, Huang YJ, Fu CJ, Tsai TT, Yeh CY. Deep learning approach for automatic landmark detection and alignment analysis in whole-spine lateral radiographs. Sci Rep 2021; 11:7618. [PMID: 33828159 PMCID: PMC8027006 DOI: 10.1038/s41598-021-87141-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/18/2021] [Indexed: 12/21/2022] Open
Abstract
Human spinal balance assessment relies considerably on sagittal radiographic parameter measurement. Deep learning could be applied for automatic landmark detection and alignment analysis, with mild to moderate standard errors and favourable correlations with manual measurement. In this study, based on 2210 annotated images of various spinal disease aetiologies, we developed deep learning models capable of automatically locating 45 anatomic landmarks and subsequently generating 18 radiographic parameters on a whole-spine lateral radiograph. In the assessment of model performance, the localisation accuracy and learning speed were the highest for landmarks in the cervical area, followed by those in the lumbosacral, thoracic, and femoral areas. All the predicted radiographic parameters were significantly correlated with ground truth values (all p < 0.001). The human and artificial intelligence comparison revealed that the deep learning model was capable of matching the reliability of doctors for 15/18 of the parameters. The proposed automatic alignment analysis system was able to localise spinal anatomic landmarks with high accuracy and to generate various radiographic parameters with favourable correlations with manual measurements.
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Affiliation(s)
- Yu-Cheng Yeh
- Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
| | - Chi-Hung Weng
- aetherAI Co., Ltd., 9F., No.3-2, Yuanqu St., Nangang Dist., Taipei City, 115, Taiwan, ROC
| | - Yu-Jui Huang
- Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
| | - Chen-Ju Fu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
| | - Tsung-Ting Tsai
- Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC
| | - Chao-Yuan Yeh
- aetherAI Co., Ltd., 9F., No.3-2, Yuanqu St., Nangang Dist., Taipei City, 115, Taiwan, ROC.
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14
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Zhao Z, Wu CM, Zhang S, He F, Liu F, Wang B, Huang Y, Shi W, Jian D, Xie H, Yeh CY, Li J. A Novel Convolutional Neural Network for the Diagnosis and Classification of Rosacea: Usability Study. JMIR Med Inform 2021; 9:e23415. [PMID: 33720027 PMCID: PMC8077711 DOI: 10.2196/23415] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/30/2020] [Accepted: 12/12/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rosacea is a chronic inflammatory disease with variable clinical presentations, including transient flushing, fixed erythema, papules, pustules, and phymatous changes on the central face. Owing to the diversity in the clinical manifestations of rosacea, the lack of objective biochemical examinations, and nonspecificity in histopathological findings, accurate identification of rosacea is a big challenge. Artificial intelligence has emerged as a potential tool in the identification and evaluation of some skin diseases such as melanoma, basal cell carcinoma, and psoriasis. OBJECTIVE The objective of our study was to utilize a convolutional neural network (CNN) to differentiate the clinical photos of patients with rosacea (taken from 3 different angles) from those of patients with other skin diseases such as acne, seborrheic dermatitis, and eczema that could be easily confused with rosacea. METHODS In this study, 24,736 photos comprising of 18,647 photos of patients with rosacea and 6089 photos of patients with other skin diseases such as acne, facial seborrheic dermatitis, and eczema were included and analyzed by our CNN model based on ResNet-50. RESULTS The CNN in our study achieved an overall accuracy and precision of 0.914 and 0.898, with an area under the receiver operating characteristic curve of 0.972 for the detection of rosacea. The accuracy of classifying 3 subtypes of rosacea, that is, erythematotelangiectatic rosacea, papulopustular rosacea, and phymatous rosacea was 83.9%, 74.3%, and 80.0%, respectively. Moreover, the accuracy and precision of our CNN to distinguish rosacea from acne reached 0.931 and 0.893, respectively. For the differentiation between rosacea, seborrheic dermatitis, and eczema, the overall accuracy of our CNN was 0.757 and the precision was 0.667. Finally, by comparing the CNN diagnosis with the diagnoses by dermatologists of different expertise levels, we found that our CNN system is capable of identifying rosacea with a performance superior to that of resident doctors or attending physicians and comparable to that of experienced dermatologists. CONCLUSIONS The findings of our study showed that by assessing clinical images, the CNN system in our study could identify rosacea with accuracy and precision comparable to that of an experienced dermatologist.
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Affiliation(s)
- Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | | | - Shuping Zhang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | - Fanping He
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | - Fangfen Liu
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | - Ben Wang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | - Yingxue Huang
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | - Wei Shi
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | - Dan Jian
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | - Hongfu Xie
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
| | | | - Ji Li
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China
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15
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Chen CL, Chen CC, Yu WH, Chen SH, Chang YC, Hsu TI, Hsiao M, Yeh CY, Chen CY. An annotation-free whole-slide training approach to pathological classification of lung cancer types using deep learning. Nat Commun 2021; 12:1193. [PMID: 33608558 PMCID: PMC7896045 DOI: 10.1038/s41467-021-21467-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/25/2021] [Indexed: 12/18/2022] Open
Abstract
Deep learning for digital pathology is hindered by the extremely high spatial resolution of whole-slide images (WSIs). Most studies have employed patch-based methods, which often require detailed annotation of image patches. This typically involves laborious free-hand contouring on WSIs. To alleviate the burden of such contouring and obtain benefits from scaling up training with numerous WSIs, we develop a method for training neural networks on entire WSIs using only slide-level diagnoses. Our method leverages the unified memory mechanism to overcome the memory constraint of compute accelerators. Experiments conducted on a data set of 9662 lung cancer WSIs reveal that the proposed method achieves areas under the receiver operating characteristic curve of 0.9594 and 0.9414 for adenocarcinoma and squamous cell carcinoma classification on the testing set, respectively. Furthermore, the method demonstrates higher classification performance than multiple-instance learning as well as strong localization results for small lesions through class activation mapping.
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Affiliation(s)
- Chi-Long Chen
- Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Pathology, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
| | | | | | | | - Yu-Chan Chang
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Tai-I Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Michael Hsiao
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | | | - Cheng-Yu Chen
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Radiology, Taipei Medical University Hospital, Taipei, Taiwan.
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16
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Chang JR, Lee CY, Chen CC, Reischl J, Qaiser T, Yeh CY. Hybrid Aggregation Network for Survival Analysis from Whole Slide Histopathological Images. Medical Image Computing and Computer Assisted Intervention – MICCAI 2021 2021:731-740. [DOI: 10.1007/978-3-030-87240-3_70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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17
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Weber EL, Woolley TE, Yeh CY, Ou KL, Maini PK, Chuong CM. Self-organizing hair peg-like structures from dissociated skin progenitor cells: New insights for human hair follicle organoid engineering and Turing patterning in an asymmetric morphogenetic field. Exp Dermatol 2020; 28:355-366. [PMID: 30681746 DOI: 10.1111/exd.13891] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/02/2019] [Accepted: 01/08/2019] [Indexed: 12/11/2022]
Abstract
Human skin progenitor cells will form new hair follicles, although at a low efficiency, when injected into nude mouse skin. To better study and improve upon this regenerative process, we developed an in vitro system to analyse the morphogenetic cell behaviour in detail and modulate physical-chemical parameters to more effectively generate hair primordia. In this three-dimensional culture, dissociated human neonatal foreskin keratinocytes self-assembled into a planar epidermal layer while fetal scalp dermal cells coalesced into stripes, then large clusters, and finally small clusters resembling dermal condensations. At sites of dermal clustering, subjacent epidermal cells protruded to form hair peg-like structures, molecularly resembling hair pegs within the sequence of follicular development. The hair peg-like structures emerged in a coordinated, formative wave, moving from periphery to centre, suggesting that the droplet culture constitutes a microcosm with an asymmetric morphogenetic field. In vivo, hair follicle populations also form in a progressive wave, implying the summation of local periodic patterning events with an asymmetric global influence. To further understand this global patterning process, we developed a mathematical simulation using Turing activator-inhibitor principles in an asymmetric morphogenetic field. Together, our culture system provides a suitable platform to (a) analyse the self-assembly behaviour of hair progenitor cells into periodically arranged hair primordia and (b) identify parameters that impact the formation of hair primordia in an asymmetric morphogenetic field. This understanding will enhance our future ability to successfully engineer human hair follicle organoids.
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Affiliation(s)
- Erin L Weber
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California.,Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | | | - Chao-Yuan Yeh
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Kuang-Ling Ou
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California.,Ostrow School of Dentistry of the University of Southern California, Los Angeles, California.,Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Philip K Maini
- Wolfson Centre for Mathematical Biology, Mathematical Institute, Oxford, UK
| | - Cheng-Ming Chuong
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California.,Integrative Stem Cell Center, China Medical University, Taichung, Taiwan
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18
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Kumar N, Verma R, Anand D, Zhou Y, Onder OF, Tsougenis E, Chen H, Heng PA, Li J, Hu Z, Wang Y, Koohbanani NA, Jahanifar M, Tajeddin NZ, Gooya A, Rajpoot N, Ren X, Zhou S, Wang Q, Shen D, Yang CK, Weng CH, Yu WH, Yeh CY, Yang S, Xu S, Yeung PH, Sun P, Mahbod A, Schaefer G, Ellinger I, Ecker R, Smedby O, Wang C, Chidester B, Ton TV, Tran MT, Ma J, Do MN, Graham S, Vu QD, Kwak JT, Gunda A, Chunduri R, Hu C, Zhou X, Lotfi D, Safdari R, Kascenas A, O'Neil A, Eschweiler D, Stegmaier J, Cui Y, Yin B, Chen K, Tian X, Gruening P, Barth E, Arbel E, Remer I, Ben-Dor A, Sirazitdinova E, Kohl M, Braunewell S, Li Y, Xie X, Shen L, Ma J, Baksi KD, Khan MA, Choo J, Colomer A, Naranjo V, Pei L, Iftekharuddin KM, Roy K, Bhattacharjee D, Pedraza A, Bueno MG, Devanathan S, Radhakrishnan S, Koduganty P, Wu Z, Cai G, Liu X, Wang Y, Sethi A. A Multi-Organ Nucleus Segmentation Challenge. IEEE Trans Med Imaging 2020; 39:1380-1391. [PMID: 31647422 PMCID: PMC10439521 DOI: 10.1109/tmi.2019.2947628] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Generalized nucleus segmentation techniques can contribute greatly to reducing the time to develop and validate visual biomarkers for new digital pathology datasets. We summarize the results of MoNuSeg 2018 Challenge whose objective was to develop generalizable nuclei segmentation techniques in digital pathology. The challenge was an official satellite event of the MICCAI 2018 conference in which 32 teams with more than 80 participants from geographically diverse institutes participated. Contestants were given a training set with 30 images from seven organs with annotations of 21,623 individual nuclei. A test dataset with 14 images taken from seven organs, including two organs that did not appear in the training set was released without annotations. Entries were evaluated based on average aggregated Jaccard index (AJI) on the test set to prioritize accurate instance segmentation as opposed to mere semantic segmentation. More than half the teams that completed the challenge outperformed a previous baseline. Among the trends observed that contributed to increased accuracy were the use of color normalization as well as heavy data augmentation. Additionally, fully convolutional networks inspired by variants of U-Net, FCN, and Mask-RCNN were popularly used, typically based on ResNet or VGG base architectures. Watershed segmentation on predicted semantic segmentation maps was a popular post-processing strategy. Several of the top techniques compared favorably to an individual human annotator and can be used with confidence for nuclear morphometrics.
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19
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Chuang WY, Chang SH, Yu WH, Yang CK, Yeh CJ, Ueng SH, Liu YJ, Chen TD, Chen KH, Hsieh YY, Hsia Y, Wang TH, Hsueh C, Kuo CF, Yeh CY. Successful Identification of Nasopharyngeal Carcinoma in Nasopharyngeal Biopsies Using Deep Learning. Cancers (Basel) 2020; 12:cancers12020507. [PMID: 32098314 PMCID: PMC7072217 DOI: 10.3390/cancers12020507] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/16/2020] [Accepted: 02/19/2020] [Indexed: 12/14/2022] Open
Abstract
Pathologic diagnosis of nasopharyngeal carcinoma (NPC) can be challenging since most cases are nonkeratinizing carcinoma with little differentiation and many admixed lymphocytes. Our aim was to evaluate the possibility to identify NPC in nasopharyngeal biopsies using deep learning. A total of 726 nasopharyngeal biopsies were included. Among them, 100 cases were randomly selected as the testing set, 20 cases as the validation set, and all other 606 cases as the training set. All three datasets had equal numbers of NPC cases and benign cases. Manual annotation was performed. Cropped square image patches of 256 × 256 pixels were used for patch-level training, validation, and testing. The final patch-level algorithm effectively identified NPC patches, with an area under the receiver operator characteristic curve (AUC) of 0.9900. Using gradient-weighted class activation mapping, we demonstrated that the identification of NPC patches was based on morphologic features of tumor cells. At the second stage, whole-slide images were sequentially cropped into patches, inferred with the patch-level algorithm, and reconstructed into images with a smaller size for training, validation, and testing. Finally, the AUC was 0.9848 for slide-level identification of NPC. Our result shows for the first time that deep learning algorithms can identify NPC.
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Affiliation(s)
- Wen-Yu Chuang
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
- Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan
| | - Shang-Hung Chang
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan;
| | - Wei-Hsiang Yu
- aetherAI, Co., Ltd., No. 3-2, Yuan-Qu Street, Nangang District, Taipei City 115, Taiwan; (W.-H.Y.); (C.-K.Y.)
| | - Cheng-Kun Yang
- aetherAI, Co., Ltd., No. 3-2, Yuan-Qu Street, Nangang District, Taipei City 115, Taiwan; (W.-H.Y.); (C.-K.Y.)
| | - Chi-Ju Yeh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
| | - Shir-Hwa Ueng
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
- Chang Gung Molecular Medicine Research Center, Chang Gung University, No. 259, Wenhua First Road, Guishan District, Taoyuan City 333, Taiwan
| | - Yu-Jen Liu
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
| | - Tai-Di Chen
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
| | - Kuang-Hua Chen
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
| | - Yi-Yin Hsieh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
| | - Yi Hsia
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
- Department of Pathology, MacKay Memorial Hospital, No. 92, Section 2, Zhongshan North Road, Zhongshan District, Taipei City 104, Taiwan
| | - Tong-Hong Wang
- Tissue Bank, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan;
| | - Chuen Hsueh
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (W.-Y.C.); (C.-J.Y.); (S.-H.U.); (Y.-J.L.); (T.-D.C.); (K.-H.C.); (Y.-Y.H.); (Y.H.); (C.H.)
- Chang Gung Molecular Medicine Research Center, Chang Gung University, No. 259, Wenhua First Road, Guishan District, Taoyuan City 333, Taiwan
| | - Chang-Fu Kuo
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan;
| | - Chao-Yuan Yeh
- aetherAI, Co., Ltd., No. 3-2, Yuan-Qu Street, Nangang District, Taipei City 115, Taiwan; (W.-H.Y.); (C.-K.Y.)
- Correspondence: ; Tel.: +886-2-27856892
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Weng CH, Wang CL, Huang YJ, Yeh YC, Fu CJ, Yeh CY, Tsai TT. Artificial Intelligence for Automatic Measurement of Sagittal Vertical Axis Using ResUNet Framework. J Clin Med 2019; 8:jcm8111826. [PMID: 31683913 PMCID: PMC6912675 DOI: 10.3390/jcm8111826] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 12/27/2022] Open
Abstract
We present an automated method for measuring the sagittal vertical axis (SVA) from lateral radiography of whole spine using a convolutional neural network for keypoint detection (ResUNet) with our improved localization method. The algorithm is robust to various clinical conditions, such as degenerative changes or deformities. The ResUNet was trained and evaluated on 990 standing lateral radiographs taken at Chang Gung Memorial Hospital, Linkou and performs SVA measurement with median absolute error of 1.183 ± 0.166 mm. The 5-mm detection rate of the C7 body and the sacrum are 91% and 87%, respectively. The SVA calculation takes approximately 0.2 s per image. The intra-class correlation coefficient of the SVA estimates between the algorithm and physicians of different years of experience ranges from 0.946 to 0.993, indicating an excellent consistency. The superior performance of the proposed method and its high consistency with physicians proved its usefulness for automatic measurement of SVA in clinical settings.
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Affiliation(s)
| | - Chih-Li Wang
- Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
| | - Yu-Jui Huang
- Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
| | - Yu-Cheng Yeh
- Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
| | - Chen-Ju Fu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
| | | | - Tsung-Ting Tsai
- Department of Orthopaedic Surgery, Spine Division, Bone and Joint Research Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
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Chang YL, Hsieh CY, Yeh CY, Lin FH. The Development of Gelatin/Hyaluronate Copolymer Mixed with Calcium Sulfate, Hydroxyapatite, and Stromal-Cell-Derived Factor-1 for Bone Regeneration Enhancement. Polymers (Basel) 2019; 11:polym11091454. [PMID: 31491928 PMCID: PMC6780272 DOI: 10.3390/polym11091454] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/24/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022] Open
Abstract
In clinical practice, bone defects still remain a challenge. In recent years, apart from the osteoconductivity that most bone void fillers already provide, osteoinductivity has also been emphasized to promote bone healing. Stromal-cell-derived factor-1 (SDF-1) has been shown to have the ability to recruit mesenchymal stem cells (MSCs), which play an important role in the bone regeneration process. In this study, we developed a gelatin–hyaluronate (Gel-HA) copolymer mixed with calcium sulfate (CS), hydroxyapatite (HAP), and SDF-1 in order to enhance bone regeneration in a bone defect model. The composites were tested in vitro for biocompatibility and their ability to recruit MSCs after material characterization. For the in vivo test, a rat femoral condyle bone defect model was used. Micro computed tomography (Micro-CT), two-photon excitation microscopy, and histology analysis were performed to assess bone regeneration. As expected, enhanced bone regeneration was well observed in the group filled with Gel-HA/CS/HAP/SDF-1 composites compared with the control group in our animal model. Furthermore, detailed blood analysis of rats showed no obvious systemic toxicity or side effects after material implantation. In conclusion, the Gel-HA/CS/HAP/SDF-1 composite may be a safe and applicable material to enhance bone regeneration in bone defects.
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Affiliation(s)
- Yun-Liang Chang
- Department of Biomedical Engineering, National Taiwan University, No. 1, Sec.1, Jen-Ai Road, Taipei City 10051, Taiwan
- Department of Orthopaedic Surgery, National Taiwan University Hospital, No. 7, Chung Shan South Road, Taipei City 10002, Taiwan
| | - Chia-Ying Hsieh
- Department of Biomedical Engineering, National Taiwan University, No. 1, Sec.1, Jen-Ai Road, Taipei City 10051, Taiwan
| | - Chao-Yuan Yeh
- Integrative Stem Cell Center, China Medical University, No. 2, Yude Road, Taichung City 40447, Taiwan
| | - Feng-Huei Lin
- Department of Biomedical Engineering, National Taiwan University, No. 1, Sec.1, Jen-Ai Road, Taipei City 10051, Taiwan.
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22
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Wu XS, Yeh CY, Harn HIC, Jiang TX, Wu P, Widelitz RB, Baker RE, Chuong CM. Self-assembly of biological networks via adaptive patterning revealed by avian intradermal muscle network formation. Proc Natl Acad Sci U S A 2019; 116:10858-10867. [PMID: 31072931 PMCID: PMC6561168 DOI: 10.1073/pnas.1818506116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Networked structures integrate numerous elements into one functional unit, while providing a balance between efficiency, robustness, and flexibility. Understanding how biological networks self-assemble will provide insights into how these features arise. Here, we demonstrate how nature forms exquisite muscle networks that can repair, regenerate, and adapt to external perturbations using the feather muscle network in chicken embryos as a paradigm. The self-assembled muscle networks arise through the implementation of a few simple rules. Muscle fibers extend outward from feather buds in every direction, but only those muscle fibers able to connect to neighboring buds are eventually stabilized. After forming such a nearest-neighbor configuration, the network can be reconfigured, adapting to perturbed bud arrangement or mechanical cues. Our computational model provides a bioinspired algorithm for network self-assembly, with intrinsic or extrinsic cues necessary and sufficient to guide the formation of these regenerative networks. These robust principles may serve as a useful guide for assembling adaptive networks in other contexts.
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Affiliation(s)
- Xiao-Shan Wu
- Department of Pathology, University of Southern California, Los Angeles, CA 90033
- Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, 410008 Changsha, China
- Molecular Laboratory for Gene Therapy and Tooth Regeneration, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Capital Medical University School of Stomatology, 100050 Beijing, China
| | - Chao-Yuan Yeh
- Department of Pathology, University of Southern California, Los Angeles, CA 90033
- Integrative Stem Cell Center, China Medical University, 40402 Taichung, Taiwan
| | - Hans I-Chen Harn
- Department of Pathology, University of Southern California, Los Angeles, CA 90033
- International Research Center of Wound Repair and Regeneration, National Cheng Kung University, 701 Tainan, Taiwan
| | - Ting-Xing Jiang
- Department of Pathology, University of Southern California, Los Angeles, CA 90033
| | - Ping Wu
- Department of Pathology, University of Southern California, Los Angeles, CA 90033
| | - Randall B Widelitz
- Department of Pathology, University of Southern California, Los Angeles, CA 90033
| | - Ruth E Baker
- Mathematical Institute, University of Oxford, OX2 6GG Oxford, United Kingdom
| | - Cheng-Ming Chuong
- Department of Pathology, University of Southern California, Los Angeles, CA 90033;
- Integrative Stem Cell Center, China Medical University, 40402 Taichung, Taiwan
- International Research Center of Wound Repair and Regeneration, National Cheng Kung University, 701 Tainan, Taiwan
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23
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Cessna JT, Fitzgerald R, Zimmerman BE, Laureano-Pérez L, Bergeron DE, van Wyngaardt F, Smith M, Jackson T, Howe B, da Silva CJ, Iwahara A, da Cruz PAL, Zhang M, Liu H, Liang J, Fréchou C, Bobin C, Cassette P, Kossert K, Nähle O, Marganiec-Gałązka J, Joseph L, Ravindra A, Kulkarni DN, Yunoki A, Sato Y, Lee KB, Lee JM, Agung, Dziel T, Listkowska A, Tymiński Z, Sahagia M, Antohe A, Ioan MR, Luca A, Krivosek M, Ometakova J, Javornik A, Zalesakova M, García-Toraño Martinez E, Roteta M, Mejuto M, Nedjadi Y, Juget F, Yuan MC, Yeh CY, Yeltepe E, Dirican A, Keightley J, Pearce A. Results of an international comparison of activity measurements of 68Ge. Appl Radiat Isot 2018; 134:385-390. [PMID: 29248210 PMCID: PMC10996930 DOI: 10.1016/j.apradiso.2017.10.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 11/25/2022]
Abstract
An international key comparison, identifier CCRI(II)-K2.Ge-68, has been performed. The National Institute of Standards and Technology (NIST) served as the pilot laboratory, distributing aliquots of a 68Ge/68Ga solution. Results for the activity concentration, CA, of 68Ge at a reference date of 12h00 UTC 14 November 2014 were submitted by 17 laboratories, encompassing many variants of coincidence methods and liquid-scintillation counting methods. The first use of 4π(Cherenkov)β-γ coincidence and anticoincidence methods in an international comparison is reported. One participant reported results by secondary methods only. Two results, both utilizing pure liquid-scintillation methods, were identified as outliers. Evaluation using the Power-Moderated Mean method results in a proposed Comparison Reference Value (CRV) of 621.7(11)kBqg-1, based on 14 results. The degrees of equivalence and their associated uncertainties are evaluated for each participant. Several participants submitted 3.6mL ampoules to the BIPM to link the comparison to the International Reference System (SIR) which may lead to the evaluation of a Key Comparison Reference Value and associated degrees of equivalence.
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Affiliation(s)
- J T Cessna
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA.
| | - R Fitzgerald
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - B E Zimmerman
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - L Laureano-Pérez
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - D E Bergeron
- Physical Measurements Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - F van Wyngaardt
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - M Smith
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - T Jackson
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - B Howe
- Australian Nuclear Science and Technology Organisation, Lucas Heights, Australia
| | - C J da Silva
- Laboratório Nacional de Metrologia das Radiações Ionizantes, Instituto de Radioproteção e Dosimetria, Rio de Janeiro, Brazil
| | - A Iwahara
- Laboratório Nacional de Metrologia das Radiações Ionizantes, Instituto de Radioproteção e Dosimetria, Rio de Janeiro, Brazil
| | - P A L da Cruz
- Laboratório Nacional de Metrologia das Radiações Ionizantes, Instituto de Radioproteção e Dosimetria, Rio de Janeiro, Brazil
| | - M Zhang
- National Institute of Metrology, Beijing, China
| | - H Liu
- National Institute of Metrology, Beijing, China
| | - J Liang
- National Institute of Metrology, Beijing, China
| | - C Fréchou
- Laboratoire national de métrologie et d'essais - Laboratoire national Henri Becquerel, Gif-sur-Yvette cedex, France
| | - C Bobin
- Laboratoire national de métrologie et d'essais - Laboratoire national Henri Becquerel, Gif-sur-Yvette cedex, France
| | - P Cassette
- Laboratoire national de métrologie et d'essais - Laboratoire national Henri Becquerel, Gif-sur-Yvette cedex, France
| | - K Kossert
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | - O Nähle
- Physikalisch-Technische Bundesanstalt, Braunschweig, Germany
| | | | - L Joseph
- Bhabha Atomic Research Centre, Mumbai, India
| | - A Ravindra
- Bhabha Atomic Research Centre, Mumbai, India
| | | | - A Yunoki
- National Metrology Institute of Japan, AIST, Tsukuba, Japan
| | - Y Sato
- National Metrology Institute of Japan, AIST, Tsukuba, Japan
| | - K B Lee
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - J M Lee
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - Agung
- Korea Research Institute of Standards and Science, Daejeon, Republic of Korea
| | - T Dziel
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - A Listkowska
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - Z Tymiński
- National Centre for Nuclear Research Radioisotope Centre POLATOM, Otwock, Poland
| | - M Sahagia
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - A Antohe
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - M-R Ioan
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - A Luca
- National Institute of Research and Development for Physics and Nuclear Engineering "Horia Hulubei", Bucarest - Magurele, Romania
| | - M Krivosek
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | - J Ometakova
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | - A Javornik
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | - M Zalesakova
- Slovenský Metrologický Ústav, Bratislava, Slovakia
| | | | - M Roteta
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid, Spain
| | - M Mejuto
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, Madrid, Spain
| | - Y Nedjadi
- Institut Universitaire de Radiophysique Appliquée, Lausanne, Switzerland
| | - F Juget
- Institut Universitaire de Radiophysique Appliquée, Lausanne, Switzerland
| | - M-C Yuan
- Institute of Nuclear Energy Research, Taoyuan County, Taiwan
| | - C Y Yeh
- Institute of Nuclear Energy Research, Taoyuan County, Taiwan
| | - E Yeltepe
- Turkish Atomic Energy Authority, Lodumlu - Ankara, Turkey
| | - A Dirican
- Turkish Atomic Energy Authority, Lodumlu - Ankara, Turkey
| | - J Keightley
- National Physical Laboratory, Teddington, United Kingdom
| | - A Pearce
- National Physical Laboratory, Teddington, United Kingdom
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Chen TC, Yeh CY, Lin CW, Yang CM, Yang CH, Lin IH, Chen PY, Cheng JY, Hu FR. Vascular hypoperfusion in acute optic neuritis is a potentially new neurovascular model for demyelinating diseases. PLoS One 2017; 12:e0184927. [PMID: 28926646 PMCID: PMC5605049 DOI: 10.1371/journal.pone.0184927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 09/02/2017] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Optic neuritis is highly correlated with multiple sclerosis and is a major cause of acute visual loss and long-term neuronal degeneration. Primary cerebral hypoperfusion has been reported in brain demyelinating diseases. This study investigated whether peripapillary perfusion is changed in patients with acute optic neuritis (AON). METHODS This three-year cohort study was conducted from September 1 2012, to August 31, 2015. Two hundred and forty-one patients with non-glaucomatous acute optic neuropathy were screened, and 42 non-highly myopic patients who had suffered their first episode of unilaterally idiopathic AON were studied. All cases received spectral-domain optical coherence tomography (OCT) examination, general survey, and standard corticosteroid therapy. OCT images were analyzed using a customized MATLAB program for measuring peripapillary choroidal thickness (PCT). Multivariate regression models were constructed to identify factors that are significantly related to peripapillary perfusion. RESULTS Decreased PCT was found in eyes experiencing AON combined with disc swelling (the ratio of lesion eye PCT/fellow eye PCT was 0.87 ± 0.08; range, from 0.75 to 1.00). In comparison to the healthy fellow eyes, approximately every 26% increase in the thickness of the retinal nerve fiber layer due to axonal swelling was associated with a 10% decreased thickness of PCT. Thinner PCT is also correlated with poorer trough vision, which may lead to poorer final vision. These findings were obvious in patients with optic papillitis but not in patients with retrobulbar neuritis. CONCLUSIONS Peripapillary vascular hypoperfusion was found in patients experiencing AON combined with disc swelling. These findings are unlike those for other ocular inflammatory diseases but are consistent with cerebral hypoperfusion, which is found in brain demyelinating diseases; thus, these findings may represent a new neurovascular model in this field.
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Affiliation(s)
- Ta-Ching Chen
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Yuan Yeh
- Department of Pathology, University of Southern California, Los Angeles, California, United States of America
| | - Chao-Wen Lin
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chang-Hao Yang
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - I-Hung Lin
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pao-Yang Chen
- Institute of Plant and Microbial Biology, Academia Sinica, Taipei, Taiwan
| | - Jung-Yu Cheng
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
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25
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Chiang JM, Chang CJ, Jiang SF, Yeh CY, You JF, Hsieh PS, Huang HY. Pre-operative serum albumin level substantially predicts post-operative morbidity and mortality among patients with colorectal cancer who undergo elective colectomy. Eur J Cancer Care (Engl) 2015; 26. [PMID: 26526411 DOI: 10.1111/ecc.12403] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 11/30/2022]
Abstract
The quantitative relationship between serum albumin level and surgical outcomes has not been clearly established. This study included 3732 patients with colon cancer who underwent a potentially curative colectomy. Post-operative mortality and morbidity were analysed according to the patients' demographic data, pre-operative comorbidities, and tumour-related factors. Age, asthma, renal impairment, and albumin level were significantly associated with post-operative morbidity and mortality in the multivariate analyses. Logistic regression analysis revealed linear relationships of post-operative morbidity and mortality with albumin level. The morbidity and mortality rates decreased by 7.3% and 15.6%, respectively, for each 0.1 g/dL increase in albumin level. This finding remained significant in the hypoalbuminaemia subgroup but not in the normoalbuminaemia subgroup. That is, the morbidity and mortality rates significantly decreased by 8.7% and 17.7%, respectively (both P < 0.001), in the former group and decreased by 2.7% (P = 0.112) and 11.6% (P = 0.092), respectively, in the latter group. This study demonstrated that serum albumin level linearly predicted the post-operative morbidity and mortality among the colorectal cancer patients. Pre-operative serum albumin level may therefore be used as a continuous rather than a categorical marker of disease severity, especially among patients with hypoalbuminaemia.
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Affiliation(s)
- J M Chiang
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - C J Chang
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Tao-Yuan, Taiwan
| | - S F Jiang
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - C Y Yeh
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - J F You
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - P S Hsieh
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - H Y Huang
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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26
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Tsai TY, Chen TC, Wang IJ, Yeh CY, Su MJ, Chen RH, Tsai TH, Hu FR. The effect of resveratrol on protecting corneal epithelial cells from cytotoxicity caused by moxifloxacin and benzalkonium chloride. Invest Ophthalmol Vis Sci 2015; 56:1575-84. [PMID: 25670486 DOI: 10.1167/iovs.14-15708] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Moxifloxacin (MOX), a fourth generation fluoroquinolone (FQ), has a wide antibacterial spectrum, but may show cytotoxicity characterized by high productions of reactive oxygen species (ROS). This study investigated the protective role of a common antioxidant agent, resveratrol (trans-3,5,4'-trihydroxystilbene), against the cytotoxicity caused by MOX. METHODS Experiments were performed with a human corneal epithelial cell line (HCECs; ATCC-CRL-11515). Another commonly used FQ, levofloxacin (LEV), and the most commonly used preservatives, benzalkonium chloride (BAC), were also used for comparison with MOX. Cell viability and morphologic changes after treatment were evaluated with trypan blue exclusion assay, propidium iodine/annexin V-FITC staining, and flow cytometry. Chemiluminescence immunoassay was used for ROS quantification. MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay, wound healing assay, and intracellular detections of oxidative stress were performed to evaluate the effects of resveratrol. RESULTS The MOX group, similar to the BAC group, showed significant cell shrinkage and death compared with the LEV group. High ROS production in HCECs of MOX group was observed both by chemiluminescence immunoassay and intracellular images. Within the observations of MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] assay, live cell images, and wound healing process in vitro, the cytotoxic effects of the MOX and BAC groups were opposed by resveratrol. Human corneal epithelial cells pretreated with resveratrol demonstrated better cell viability and healing rate in the early stage. CONCLUSIONS The protective effects of antioxidant agents indicate that MOX, similar to BAC, causes oxidative stress-related cell damage. The results also inspired us to think about a "supplementary regimen" to increase safety and decrease the adverse effect in the treatment of corneal infections.
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Affiliation(s)
- Tzu-Yun Tsai
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ta-Ching Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Yuan Yeh
- Department of Pathology, University of Southern California, Los Angeles, California, United States
| | - Ming-Jai Su
- Department of Pharmacology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ruey-Hua Chen
- Institute of Biological Chemistry, Academia Sinica, Taipei, Taiwan Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei, Taiwan
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27
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Shen SC, Chang SJ, Yeh CY, Teng PC. Design and testing of a uniformly solar energy TIR-R concentration lenses for HCPV systems. Opt Express 2013; 21 Suppl 6:A942-A952. [PMID: 24514935 DOI: 10.1364/oe.21.00a942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this paper, total internal reflection-refraction (TIR-R) concentration (U-TIR-R-C) lens module were designed for uniformity using the energy configuration method to eliminate hot spots on the surface of solar cell and increase conversion efficiency. The design of most current solar concentrators emphasizes the high-power concentration of solar energy, however neglects the conversion inefficiency resulting from hot spots generated by uneven distributions of solar energy concentrated on solar cells. The energy configuration method proposed in this study employs the concept of ray tracing to uniformly distribute solar energy to solar cells through a U-TIR-R-C lens module. The U-TIR-R-C lens module adopted in this study possessed a 76-mm diameter, a 41-mm thickness, concentration ratio of 1134 Suns, 82.6% optical efficiency, and 94.7% uniformity. The experiments demonstrated that the U-TIR-R-C lens module reduced the core temperature of the solar cell from 108 °C to 69 °C and the overall temperature difference from 45 °C to 10 °C, and effectively relative increased the conversion efficiency by approximately 3.8%. Therefore, the U-TIR-R-C lens module designed can effectively concentrate a large area of sunlight onto a small solar cell, and the concentrated solar energy can be evenly distributed in the solar cell to achieve uniform irradiance and effectively eliminate hot spots.
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Rodríguez JJ, Noristani HN, Hilditch T, Olabarria M, Yeh CY, Witton J, Verkhratsky A. Increased densities of resting and activated microglia in the dentate gyrus follow senile plaque formation in the CA1 subfield of the hippocampus in the triple transgenic model of Alzheimer's disease. Neurosci Lett 2013; 552:129-34. [PMID: 23827221 DOI: 10.1016/j.neulet.2013.06.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/20/2013] [Indexed: 01/01/2023]
Abstract
Alzheimer's disease (AD) is an irreversible neurodegenerative disease that is characterised by the presence of β-amyloid (Aβ) plaques, neurofibrillary tangles (NFTs) and synaptic loss specifically in brain regions involved in learning and memory such as the neocortex and the hippocampus. Aβ depositions in the form of neuritic plaques trigger activation of microglia that is believed to be a common neuropathological feature of AD brains. As an integral part of the hippocampus, the dentate gyrus (DG) plays an important role in cognitive function. Although post-mortem studies suggest later involvement of the DG into the AD progression, changes in microglia have not been studied in this subfield of the hippocampus. In the present study the numerical density (Nv, #/mm(3)) of both resting (identified by tomato lectin staining) and activated (identified by Mac-1 immunoreactivity) microglia was analysed in the molecular layer (ML) of the DG in the triple transgenic (3xTg-AD) mouse model of AD at different ages (9, 12 and 18 months). The 3xTg-AD mouse model of AD showed a significant increase in the Nv of resting (by 75%) and activated (by 67%) at 18 months of age compared to non-Tg controls. These results indicate a complex microglial remodelling during AD progression.
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Affiliation(s)
- J J Rodríguez
- Ikerbasque, Basque Foundation for Science, 48011 Bilbao, Spain; Department of Neurosciences, University of the Basque Country UPV/EHU, 48940 Leioa, Spain.
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Lin SJ, Foley J, Jiang TX, Yeh CY, Wu P, Foley A, Yen CM, Huang YC, Cheng HC, Chen CF, Reeder B, Jee SH, Widelitz RB, Chuong CM. Topology of feather melanocyte progenitor niche allows complex pigment patterns to emerge. Science 2013; 340:1442-5. [PMID: 23618762 DOI: 10.1126/science.1230374] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Color patterns of bird plumage affect animal behavior and speciation. Diverse patterns are present in different species and within the individual. Here, we study the cellular and molecular basis of feather pigment pattern formation. Melanocyte progenitors are distributed as a horizontal ring in the proximal follicle, sending melanocytes vertically up into the epithelial cylinder, which gradually emerges as feathers grow. Different pigment patterns form by modulating the presence, arrangement, or differentiation of melanocytes. A layer of peripheral pulp further regulates pigmentation via patterned agouti expression. Lifetime feather cyclic regeneration resets pigment patterns for physiological needs. Thus, the evolution of stem cell niche topology allows complex pigment patterning through combinatorial co-option of simple regulatory mechanisms.
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Affiliation(s)
- S J Lin
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Chuong CM, Yeh CY, Jiang TX, Widelitz R. Module-based complexity formation: periodic patterning in feathers and hairs. Wiley Interdiscip Rev Dev Biol 2013; 2:97-112. [PMID: 23539312 PMCID: PMC3607644 DOI: 10.1002/wdev.74] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Patterns describe order which emerges from homogeneity. Complex patterns on the integument are striking because of their visibility throughout an organism’s lifespan. Periodic patterning is an effective design because the ensemble of hair or feather follicles (modules) allows the generation of complexity, including regional variations and cyclic regeneration, giving the skin appendages a new lease on life. Spatial patterns include the arrangements of feathers and hairs in specific number, size, and spacing.We explorehowa field of equivalent progenitor cells can generate periodically arranged modules based on genetic information, physical–chemical rules and developmental timing. Reconstitution experiments suggest a competitive equilibrium regulated by activators/inhibitors involving Turing reaction-diffusion. Temporal patterns result from oscillating stem cell activities within each module (microenvironment regulation), reflected as growth (anagen) and resting (telogen) phases during the cycling of feather and hair follicles. Stimulating modules with activators initiates the spread of regenerative hair waves, while global inhibitors outside each module (macroenvironment) prevent this. Different wave patterns can be simulated by cellular automata principles. Hormonal status and seasonal changes can modulate appendage phenotypes, leading to ‘organ metamorphosis’, with multiple ectodermal organ phenotypes generated from the same precursors. We discuss potential novel evolutionary steps using this module-based complexity in several amniote integument organs, exemplified by the spectacular peacock feather pattern. We thus explore the application of the acquired knowledge of patterning in tissue engineering. New hair follicles can be generated after wounding. Hairs and feathers can be reconstituted through self-organization of dissociated progenitor cells.
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Affiliation(s)
- Cheng-Ming Chuong
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA,
| | - Chao-Yuan Yeh
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA,
| | - Ting-Xin Jiang
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA,
| | - Randall Widelitz
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA,
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Abstract
Medical exposure showed a continuous increasing trend. This trend was due to the growth of diagnostic procedures such as computed tomography (CT) and interventional fluoroscopy (IVF). In the present work, results of a recent study on medical exposure in Taiwan are reported. This study analysed data from the National Health Insurance Research Database. Surveyed data on the dose indices, including the entrance surface dose in radiography, dose area product in fluoroscopy, CT dose index in CT and mean glandular dose in mammography, were applied. Using programmes and databases, dose indices were converted to the effective dose. For the year 2008, individual effective doses in Taiwan were estimated as 0.16, 0.37, 0.12 and 0.12 mSv for conventional radiography and fluoroscopy, CT, IVF and nuclear medicine, respectively. The total collective effective dose and the effective dose per individual for medical exposure were 17 788 person-Sv and 0.77 mSv, respectively.
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Affiliation(s)
- C J Tung
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan Kweishan 333, Taiwan
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Tsai KH, Lo HC, Yeh CY, Su FC. Comparison of energy costs leg-cycling with or without functional electrical stimulation and manual wheelchairs for patients after stroke. J Rehabil Med 2010; 42:645-9. [DOI: 10.2340/16501977-0572] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tsai KH, Yeh CY, Lo HC, Lin SY. Controllability and physiological evaluation of three unilaterally-propelled wheelchairs for patients with hemiplegia. Acta Derm Venereol 2007; 39:693-7. [DOI: 10.2340/16501977-0108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abstract
The aim of the study was to evaluate the potential for using natural frequency (NF) as an indicator for assessing the stability of a magnetic keeper device used in prosthodontic treatment. A three-dimensional finite element (FE) model of a root keeper-cement-dentine system was established for NF analysis. The model was first validated against a series of in vitro experiments. Then, NF values of the first vibrational mode of the FE model with various boundary conditions were calculated. The in vitro results showed that the measured NF values of the root keeper-incisor units decreased significantly (p<0.01) from 9.07 +/- 0.37 to 5.73 +/- 0.10 kHz when the units were embedded in simulated bony tissue. Results obtained from FE simulations demonstrated that the root keeper would fully loosen when the constant values of the spring elements were lower than 10(4) N-m(-1). Furthermore, a linear increase in the NF values of the model was observed from 6.16 to 15.52 kHz, when the constant was increased from 10(4) to 10(7) N-m(-1), and the values then reached a plateau. The results indicate that the NF value of a root keeper has the potential to be used for monitoring the stability of such a device.
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Affiliation(s)
- H M Huang
- Graduate Institute of Oral Sciences, Taipei Medical University, Taipei, Taiwan
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Yeh CY, Pikarsky A, Wexner SD, Baig MK, Jain A, Weiss EG, Nogueras JJ, Vernava AM. Electromyographic findings of paradoxical puborectalis contraction correlate poorly with cinedefecography. Tech Coloproctol 2004; 7:77-81. [PMID: 14605924 DOI: 10.1007/s10151-003-0013-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2002] [Accepted: 01/21/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Both intra-anal sponge electromyography (SEMG) and needle electromyography (NEMG) are used to diagnose paradoxical puborectalis contraction (PPC). The aim of this retrospective study was to assess the correlation among SEMG and NEMG and cinedefecography (CD) in the diagnosis of PPC. METHODS Between 1992 and 1999, a total of 261 constipated patients underwent both CD and EMG: 64 had NEMG while 197 had SEMG. PPC was diagnosed by EMG when there was failure to achieve a significant decrease in electrical activity of the puborectalis muscle during attempted evacuation. CD criteria for PPC included lack of straightening of the anorectal angle or persistence of the puborectalis impression during evacuation. CD was considered diagnostic and EMG results were thus compared with those of CD. Agreement was calculated using the kappa statistics (kappa) for concordance. RESULTS Both NEMG and SEMG had low positive predictive rates (33% in NEMG, 28% in SEMG) and high negative predictive rates (91% in NEMG, and 78% in SEMG) when correlated with CD findings. Agreement between NEMG and CD was noted in 46 of 64 patients (72%, kappa=0.274) while there was agreement between SEMG and CD in 120 of 197 patients (61%; kappa=0.067); p>0.05 needle vs. sponge. CONCLUSION Although both NEMG and SEMG have a low positive predictive values, they have high negative predictive value for PPC. Therefore, neither NEMG nor SEMG alone are optimal tests for diagnosing the presence of PPC.
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Affiliation(s)
- C Y Yeh
- Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, USA
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Chen CC, Yeh TL, Yang YK, Chen SJ, Lee IH, Fu LS, Yeh CY, Hsu HC, Tsai WL, Cheng SH, Chen LY, Si YC. Psychiatric morbidity and post-traumatic symptoms among survivors in the early stage following the 1999 earthquake in Taiwan. Psychiatry Res 2001; 105:13-22. [PMID: 11740971 DOI: 10.1016/s0165-1781(01)00334-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This study reports the clinical psychiatric presentations and post-traumatic symptoms among 525 survivors at Yu-Chyr District in Nantou County who sought psychiatric service in the first month following the devastating earthquake that struck the central area of Taiwan. All subjects received psychiatric interviews and assessments using the 12-item Chinese Health Questionnaire (CHQ-12) and a checklist for post-traumatic symptoms. The most common psychiatric symptoms reported were insomnia, palpitations, nervousness, and dizziness with headache. Eleven percent of the subjects reported having thought of death or having suicidal ideation. The mean score on the CHQ-12 was 6.43 (S.D.=2.89). The rate of probable psychiatric morbidity as defined by a CHQ-12 score > or =3 was 89.9%. Post-traumatic symptoms were very prevalent, particularly symptoms of re-experiencing the earthquake and hyper-arousal. Factors significantly associated with high psychiatric morbidity were being female, serious destruction of property and house, and personality characteristics of nervousness and obsessiveness. Findings of this study suggest that early psychiatric intervention, including pharmacological treatment for acute stress disorder, is indicated during the early stages following a disastrous earthquake.
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Affiliation(s)
- C C Chen
- Department of Psychiatry, College of Medicine, National Cheng Kung University and University Hospital, 138 Sheng-Li Road, 70428, Tainan, Taiwan, ROC.
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Abstract
The purpose of this study was to evaluate the possibility of using natural frequency (NF) analysis to detect the attachment loss of periodontal tissue. In this study, 698 anterior teeth were examined by a conventional probing method and also by NF analysis. The teeth were triggered to vibrate with an impulse hammer, and the vibrational response was detected by an acoustic sensor. Our results demonstrate no significant difference in NF values between the upper-lower/left-right quadrants of the tested teeth, although the mean natural frequency value of central incisors with periodontal disease was found to be 1.24 +/- 0.11 kHz which is significantly lower than that of teeth in a healthy condition (1.34 +/- 0.20kHz; p < 0.01). On the other hand, the mean frequency for periodontal disease involving canines (1.28 +/- 0.09 kHz) was also significantly lower than the corresponding value for healthy analogs (1.35 +/- 0.17 kHz; p < 0.05). These results suggest that NF analysis appears to be an effective method for assessing the periodontal condition of anterior teeth. Moreover, since this method is noninvasive, nondestructive, and necessitates minimal tooth contact, it can serve as an effective method for the early quantifiable testing and prevention of periodontal disease.
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Affiliation(s)
- H M Huang
- Graduate Institute of Medical Sciences, Taipei Medical University, Taiwan
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Affiliation(s)
- C Y Yeh
- Department of Chemistry, 6-335, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
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Lyu LC, Yeh CY, Lichtenstein AH, Li Z, Ordovas JM, Schaefer EJ. Association of sex, adiposity, and diet with HDL subclasses in middle-aged Chinese. Am J Clin Nutr 2001; 74:64-71. [PMID: 11451719 DOI: 10.1093/ajcn/74.1.64] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is limited information regarding the associations of lifestyle factors and sex with HDL subclasses containing apolipoprotein (apo) A-I (Lp A-I) and both apo A-I and apo A-II (Lp A-I:A-II). OBJECTIVE We sought to examine the relations between 2 major HDL subclasses and sex, menopausal status, nutrient intakes, and adiposity. DESIGN We conducted interviews and measured blood variables in 409 government employees aged 40-59 y in Taiwan. RESULTS Women (n = 203) had significantly higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did men (n = 206). Postmenopausal women (n = 72) had higher concentrations of HDL cholesterol, Lp A-I, and Lp A-I:A-II than did premenopausal women (n = 131). Body mass index and waist-to-hip ratio were strong predictors of and exerted an independent additive effect on Lp A-I concentrations in both men and women. However, body adiposity was associated with Lp A-I:A-II concentrations only in men. Waist-to-hip ratio was an independent determinant of Lp A-I but not of Lp A-I:A-II in men and postmenopausal women after adjustment for age, body mass index, smoking, and diet. Although there were relatively weak associations between dietary factors and both HDL subclasses (r = 0.01-0.26) in men and women according to bivariate analyses, multiple regression models showed that total fat, saturated fat, and cholesterol intakes were significantly correlated with HDL cholesterol and both Lp A-I and Lp A-I:A-II in men, but not in women. CONCLUSION Our data suggest that body adiposity and dietary fat consumption affect 2 major HDL subclasses differently depending on subject sex and menopausal status.
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Affiliation(s)
- L C Lyu
- Graduate Program of Nutrition, National Taiwan Normal University, Taipei, Taiwan, Republic of China.
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Chen HH, Tsai WS, Yeh CY, Wang JY, Tang R. Prospective study comparing wounds closed with tape with sutured wounds in colorectal surgery. Arch Surg 2001; 136:801-3. [PMID: 11448394 DOI: 10.1001/archsurg.136.7.801] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
HYPOTHESIS To test the efficacy of adhesive paper tape in the closure of clean-contaminated wounds following elective colorectal resection. DESIGN A prospective, nonrandomized controlled study. SETTING A medical center that offers a mixture of primary, secondary, and tertiary care services. PATIENTS The group undergoing skin closure with paper tape (PT group) consisted of 150 patients. The group undergoing skin closure with interrupted suture (IS group) also comprised 150 patients. All 300 patients underwent elective colorectal resection in 1997. MAIN OUTCOME MEASURES The duration of skin closure, wound complication rate, and cosmetic appearance of the scar at 6 months after operation were compared using the chi(2)test or t test. RESULTS The mean +/- SD average duration of skin closure was 116 +/- 23 seconds for the PT group and 457 +/- 64 seconds for the IS group (P<.01). The wound complication rate was 3.3% (3 cases with wound infection; 2 with wound separation) for the PT group and 3.3% (5 cases with wound infection) for the IS group (P = 1.0). No significant differences were found between the narrowest width (mean +/- SD, 2.2 +/- 0.9 mm vs 2.3 +/- 1.0 mm) and widest width (mean +/- SD, 4.7 +/- 2.0 mm vs 4.3 +/- 1.8 mm) of scar formation between the 2 groups at 6 months after the operation. Ninety-eight percent of patients in the PT group reported satisfaction with their scar, compared with 92% in the IS group (P =.03). CONCLUSION Compared with the traditional suture method, paper tape closure in the treatment of clean-contaminated wounds was less time consuming and produced greater patient satisfaction with no increased rate of wound complications.
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Affiliation(s)
- H H Chen
- Colorectal Section, Department of Surgery, Chang Gung Memorial Hospital, 199 TungHwa N Rd, Taipei, Taiwan
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Tsai KH, Yeh CY, Chang HY, Chen JJ. Effects of a single session of prolonged muscle stretch on spastic muscle of stroke patients. Proc Natl Sci Counc Repub China B 2001; 25:76-81. [PMID: 11370763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
The control of spasticity is often a significant problem in the management of patients with spasticity. The aim of this study was to evaluate the effect of a single session of prolonged muscle stretch (PMS) on the spastic muscle. Seventeen patients with spastic hemiplegia were selected to receive treatment. Subjects underwent PMS of the triceps surae (TS) by standing with the feet dorsiflexed on a tilt-table for 30 minutes. Our test battery consisted of four measurements including the modified Ashworth scale of the TS, the passive range of motion (ROM) of ankle dorsiflexion, the H/M ratio of the TS, and the F/M ratio of the tibialis anterior (TA). The results indicated that the passive ROM of ankle dorsiflexion increased significantly (p < 0.05) compared to that before PMS treatment. Additionally, PMS reduced motor neuron excitability of the TS and significantly increased that of the TA (p < 0.05). These results suggest that 30 minutes of PMS is effective in reducing motor neuron excitability of the TS in spastic hemiplegia, thus providing a safe and economical method for treating stroke patients.
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Affiliation(s)
- K H Tsai
- Department of Industrial Management, Southern Taiwan University of Technology, Tainan, ROC
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Abstract
Modal analysis is carried out to test the natural frequencies of certain human teeth, including central incisors (CIs), canines (CAs), first premolars (FPs) and first molars (FMs). A total number of 1007 teeth are tested, taking into account tooth type, oral location, age and gender, to analyse the effects of the above-mentioned factors on the natural frequency of the sample teeth. The results reveal that no significant difference in the natural frequency is noted among teeth in the four different intra-oral quadrants. Nevertheless, tooth type and age elicit an effect upon the value of the natural frequency of teeth. On the other hand, the mean value for the natural frequency of CIs (1.27 +/- 0.15 kHz), CAs (1.30 +/- 0.15 kHz), FPs (1.27 +/- 0.15 kHz) and FMs (1.16 +/- 0.12 kHz) for males are significantly lower (p < 0.01) than the analogous figure for females (1.41 +/- 0.21 kHz for CIs, 1.40 +/- 0.18 kHz for CAs, 1.37 +/- 0.20 kHz for FPs, and 1.25 +/- 0.16 kHz for FMs). Moreover, the natural frequency of teeth in male subjects varies with age (p < 0.05). The highest mean frequency of CIs, CAs and FPs for the male subjects is found for the group aged between 40 and 49 years. On the other hand, the natural frequency for the similar set of teeth for the female subjects is shown to be in no way associated with age.
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Affiliation(s)
- H M Huang
- School of Medical Technology, Tapei Medical University, Taiwan
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Affiliation(s)
- C Y Yeh
- Department of Chemistry, 6-335, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, Massachusetts 02139, USA
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Jeng MS, Jeng WL, Hung TC, Yeh CY, Tseng RJ, Meng PJ, Han BC. Mussel watch: a review of Cu and other metals in various marine organisms in Taiwan, 1991-98. Environ Pollut 2000; 110:207-215. [PMID: 15092835 DOI: 10.1016/s0269-7491(99)00304-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/1998] [Accepted: 11/05/1999] [Indexed: 05/24/2023]
Abstract
This study presents the distribution of Cu, Zn, Pb, Cd, Hg and As in various marine organisms collected along the western coast of Taiwan from 1991 to 1998, and also evaluates the time variation of Cu in oysters before (1980-85) and after (1986-98) the "green oyster" incident. The results show that relatively high geometric mean (GM) concentrations of Cu, Zn, Pb, Cd, As and Hg were generally found in Crassostrea gigas (Cu=229 microg/g, Zn=783 microg/g), Gomphina aeguialtera (Pb=30.3 microg/g), Tegillarca granosa (Cd=2.85 microg/g), Thais clavigera (As=96.9 microg/g) and Parapenaeopsis cornuta (Hg=1.35 microg/g), respectively. Especially, maximum Cu and Zn concentrations (GM=229 and 783 microg/g, respectively) in oysters (C. gigas) from different culture areas were much higher than those of the other organisms by about 1.13-458 and 2.40-63.7 times, respectively. Similarly, rock-shells (Thais clavigera) had a high capacity for accumulating Cu (GM=202 microg/g) and Zn (GM=326 microg/g) under the same physico-chemical conditions. The highest GM Cu and Zn concentrations of 1108 (range from 113 to 2806) and 1567 (range from 303 to 3593) microg/g were obtained in oysters from the Hsiangshan coastal area, one of the most important oyster culture areas in Taiwan. However, the highest GM Cd and As concentrations of 6.82 and 19.3 microg/g were found in oysters from the Machu Islands. Mean Cu concentrations in the oysters from the Erhjin Chi estuary declined from 2194+/-212 microg/g in 1986-90 to 545 microg/g (GM) in 1991-96. In the Hsiganshan area, GM Cu concentrations of 909 microg/g (1991-96) and 1351 microg/g (1997-98) in oysters were significantly higher than those of 201 microg/g (1980-85) and 682 microg/g (1986-90). The gradually increasing levels of Cu and Zn in the oysters from the Hsiangshan area have been observed year by year.
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Affiliation(s)
- M S Jeng
- Institute of Zoology, Academia Sinica, Taipei, Taiwan
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Abstract
PURPOSE The aim of this study is to present the prognosis and possible associated prognostic factors after curative resection of rectal leiomyosarcoma. METHODS From 1979 to 1996 our hospital saw 40 patients with rectal leiomyosarcoma, including 19 females, who did not have metastasis initially and received curative resection and regular postoperative follow-up. RESULTS The mean age of the 40 patients was 58.7 years. Anal bleeding and perianal pain were the two most common symptoms at initial diagnosis. Twenty-nine patients received a radical surgical resection, such as abdominoperineal resection or low anterior resection; the other 11 patients received a wide local excision, such as transrectal excision or Kraske's operation. Sixteen tumors were classified as high-grade leiomyosarcoma, and 23 as low grade. Nineteen patients (48 percent) developed recurrence or metastasis postoperatively (median follow-up, 35 months). The overall and disease-free (1-year, 3-year, and 5-year) survival rates were 97, 90, and 75 percent and 90, 59, and 46 percent, respectively. In univariate analysis, younger group (<50 years, n = 9, P = 0.033) and high-grade leiomyosarcoma (P = 0.043) showed poorer prognosis in the disease-free survival curve. In the multivariate Cox model, gender, tumor size, tumor location, and operation type did not significantly affect disease-free survival, whereas histologic grade (P = 0.037) and age divided by a level of 50 years (P = 0.009) were shown to be independent factors. There was a strong trend toward higher local recurrence rate for the wide local excision group than for the radical resection group (55 vs. 24 percent, P = 0.067) despite the wide local excision group being composed of smaller tumors (5.1 vs. 7.5 cm, P = 0.069). There was no difference in the incidence of distant metastasis between the two groups with different operation types. The metastasis rates of the wide local excision and radical resection groups were 27 and 38 percent, respectively. CONCLUSION A younger age (<50 years) and a high histologic grade of tumor were the two most significant poor prognostic factors for rectal leiomyosarcoma. Radical resection may be superior to wide local excision in the prevention of local recurrence but not distant metastasis.
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Affiliation(s)
- C Y Yeh
- Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
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Abstract
The interaction of viridans streptococci with components of the extracellular matrix (ECM) plays an important role in the pathogenesis of infective endocarditis. We have identified a surface protein of Streptococcus mutans which binds the ECM constituent fibronectin (Fn). Initially, we found that S. mutans could adsorb soluble Fn in plasma, but with lower efficiency than Streptococcus pyogenes. In addition, S. mutans could bind immobilized Fn in a dose-dependent manner when tested using an enzyme-linked immunosorbent assay. Crude extracts of cell wall-associated proteins or extracellular proteins from S. mutans MT8148 specifically bound Fn through a protein with the molecular mass of ca. 130 kDa, as detected by far-Western immunoblotting. The candidate Fn binding protein (FBP-130) was purified to near homogeneity by using Fn coupled Sepharose 4B affinity column chromatography. A rabbit polyclonal antibody against FBP-130 reacted specifically with a protein of molecular mass of ca. 130 kDa in both cell wall and extracellular fractions, and the abundance of FBP was higher in the former than in the latter fractions. The purified FBP bound specifically to immobilized Fn, whereas the binding of soluble Fn to coated FBP could only be detected in the presence of high concentrations of Fn. The purified FBP, as well as anti-FBP immunoglobulin G, inhibited the adherence of S. mutans to immobilized Fn and endothelial cells (ECV304) in a dose-dependent manner. These results demonstrated that FBP-130 mediated the adherence of S. mutans specifically to Fn and endothelial cells in vitro. The characteristics of S. mutans and FBP-130 in binding Fn confirmed that viridans streptococci adopt different strategies in their interaction with ECM.
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Affiliation(s)
- J S Chia
- Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
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47
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Abstract
OBJECTIVES To evaluate the effects of an anterior ankle-foot orthosis (AFO) on static and dynamic postural stability in hemiplegic patients. DESIGN A cross-sectional assessment of hemiplegic subjects with and without an AFO. SETTING Outpatient department of a rehabilitation hospital. PATIENTS A convenience sample of 24 subjects who had been prescribed an anterior AFO. OUTCOME MEASURES Postural sway index and postural symmetry (body weight distribution through the affected leg) when standing were measured as static postural stability. Maximal balance range in anterior-posterior and lateral directions and the affected leg's weight bearing after weight shift to affected side were measured as dynamic postural stability. RESULTS When wearing the anterior AFO, there was no significant difference and small effect size (r<0.3) in postural sway index (p = .35), postural symmetry (p = .21), and maximal balance range in anterior-posterior direction (p = .46). There was a significant improvement and large effect size (r>0.5) in lateral weight shifting (p<.01) and weight bearing through the affected leg after weight shifted to the affected side (p<.01). CONCLUSIONS The significant effects of the anterior AFO in long-term hemiplegic patients were on lateral weight shifting and weight bearing through affected leg after weight shifted to the affected side. Postural sway, postural symmetry, and anterior-posterior weight shifting were not significantly affected.
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Affiliation(s)
- C L Chen
- School of Rehabilitation, Chung Shan Medical and Dental College, Taichung, Taiwan, Republic of China
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48
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Liu MT, Yeh CY. Prognostic value of anti-Epstein-Barr virus antibodies in nasopharyngeal carcinoma (NPC). Radiat Med 1998; 16:113-7. [PMID: 9650898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Epstein-Barr virus (EBV) is a ubiquitous human herpes virus with worldwide infection. It is associated with Burkitt's lymphoma in Africa and nasopharyngeal cancer (NPC) in Asian countries. EBV-coded DNA was found to be present in epithelial elements of NPC, and is usually associated with non-keratinizing (WHO type II) or undifferentiated carcinoma (WHO type III). Transcriptional analyses of EBV genome expression in NPC demonstrate an activated viral state in some of these tumors, leading to elevated levels of serum anti-viral capsid antigen (VCA) antibody in NPC patients. METHODS Eighty patients with histological diagnoses of NPC according to the 1978 WHO classification were referred to the Department of Radiation Oncology at Chang-Hua Christian Hospital for curative radiotherapy from 1985 to 1995. The patients were staged according to the AJCC staging system. A mean dose of 7,020 cGy in 39 fractions was delivered to the primary tumor using a telecobalt-60 unit or 6-10 MV X-ray linear accelerator. Pre- and postradiotherapy serum levels of anti-EBV/VCA IgG and IgA were determined for all patients using the indirect immunoperoxidase assay (IPA). Multivariate analysis was done to determine which factors affected the patients' treatment outcome and survival. RESULTS Five patients were excluded from this study due to incomplete radiotherapy, leaving 75 patients eligible for analysis. Overall local control was 77.3%, with a mean disease-free interval of 19.7 months. Factors affecting local control included radiation dose and pretreatment anti-EBV/VCA IgG titer. The overall 5-year actuarial survival for the 75 patients was 75%, with a median survival of 129.5 months. The 5-year actuarial survival rates for stage I + II, III, and IV patients were 90%, 40%, and 45%, respectively. Prognostic factors for survival included tumor histological type and pretreatment anti-EBV/VCA IgA titer, while prognostic factors for local control included total radiation dose received and pretreatment anti-EBV/VCA IgG titer. CONCLUSION We found that there was a significant difference in the geometric mean titer of anti-EBV/VCA IgA antibodies before and after radiotherapy. Prognostic factors affecting NPC patients' actuarial survival included tumor histology and pretreatment IgA titer, while prognostic factors for local control of NPC included total radiation dose received and pretreatment IgG titer.
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Affiliation(s)
- M T Liu
- Department of Radiation Oncology, Chang-Hua Christian Hospital, Taiwan
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49
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Abstract
PURPOSE Colonic J-pouch reconstruction is designed to improve functional outcome of coloanal anastomosis. Most surgeons use a diverting colostomy to avoid severe pelvic sepsis caused by anastomotic breakdown. METHODS We report the outcome of 30 consecutive patients with colonic J-pouch-anal anastomosis without a diverting colostomy performed between November 1992 and October 1993. All patients had carcinoma of the lower two-thirds of the rectum. Patients were seen every three months. Functional results were compared with those of 21 rectal cancer patients with straight coloanal anastomosis who underwent surgery in the same period and 20 normal patients. RESULTS There were two anastomotic leakages and one postoperative death. After one year, patients with pouch anastomosis had significantly less frequency of defecation and rectal urgency compared with those with straight anastomosis (P < 0.01); 48 percent of patients with straight anastomosis had more than five bowel movements per day, whereas all patients with pouch anastomosis had five or less bowel movements per day. Manometric studies showed maximum tolerable volume was significantly higher in patients with pouch anastomosis (81 vs. 152 ml; P < 0.01). CONCLUSIONS Stapled colonic J-pouch-anal anastomosis without a diverting colostomy is a reliable procedure that provides good, long-term functional results.
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Affiliation(s)
- J Y Wang
- Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China
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50
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Yeh CY, Chiou HY, Chen RY, Yeh KH, Jeng WL, Han BC. Monitoring lead pollution near a storage battery recycling plant in Taiwan, Republic of China. Arch Environ Contam Toxicol 1996; 30:227-234. [PMID: 8593084 DOI: 10.1007/bf00215802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This study presents the distribution of blood lead levels and lead in various environmental samples (water, sediments, soils, and air) near the Shing-Yie storage battery recycling plant in Taiwan before (July 1990 to June 1991) and after (July 1992 to June 1993) amelioration. Before amelioration, the average blood lead levels in the neighborhood of the plant were in the range of 10.55 +/- 5.7 to 12.28 +/- 7.9 micrograms/dl. After amelioration, relatively lower average concentrations of blood lead (range 8.35 +/- 3.0 to 9.13 +/- 2.5 micrograms/dl) were generally found; however, these averages were still higher than that (7.79 +/- 3.5 micrograms/dl) from other lead-unpolluted areas of Taiwan. An exceedingly high geometric mean (GM) lead concentration (128 micrograms/L) was found in the downstream river water of the Tawulum River passing by the plant. The concentrations of lead (GM = 372 and 418 micrograms/g) in the downstream river sediments were higher than those (GM = 123 and 158 micrograms/g) in the upstream river sediments before and after amelioration, respectively. Furthermore, lead species in river sediments were analyzed by a sequential leaching technique. The sum of phases I, II, and III accounted for 83.7% of total lead at station R2 (nearest to the plant). Maximum lead concentration (GM = 2402 micrograms/g) in dust at the soil surface from station S1 (nearest to the plant) was much higher than those from the other stations by about 18 times before amelioration. However, the maximum value dropped to 1,155 micrograms/g after amelioration. On the whole, the geometric mean concentration of lead in dust at the soil surface nearest to the plant was > 1,000 micrograms/g and decreased to < 100 micrograms/g in the 15-30 cm depth soil about 2 km away from the plant. Before amelioration, the geometric mean lead concentration of 4.57 micrograms/m3 (range 0.102-37.6 micrograms/m3) in the air near the plant was higher than that at the background locations, the geometric mean value of which was 0.08 micrograms/m3.
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Affiliation(s)
- C Y Yeh
- School of Public Health, Taipei Medical College, Taiwan, Republic of China
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