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Lee HH, Hsieh CC, Chang CC, Liao WT, Chi HC. YTHDF3 Modulates EGFR/ATK/ERK/p21 Signaling Axis to Promote Cancer Progression and Osimertinib Resistance of Glioblastoma Cells. Anticancer Res 2023; 43:5485-5498. [PMID: 38030188 DOI: 10.21873/anticanres.16751] [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: 09/24/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND/AIM Despite recent advances in EGFR-tyrosine kinase inhibitor (TKI) drugs for glioblastoma multiforme (GBM), intrinsic EGFR alterations in GBM have resulted in drug resistance and unsatisfactory clinical development of EGFR-TKIs. Determining the unknown mechanisms underlying EGFR-TKI drug resistance is an urgent, but unmet, medical need for GBM. Although several m6A RNA methylation regulators, such as reader YTHDF1/2, were recently predicted to be related to GBM recurrence, none was associated with resistance to the 3rd generation EGFR-TKI osimertinib. MATERIALS AND METHODS Osimertinib-resistant GBM cells (U87OSR) were established to ascertain the correlation between m6A expression and osimertinib resistance, prior to systemic analyses on m6A writers, erasers, and readers. YTHDF3-silencing was employed to reveal changes in IC50, cellular migration, cancer stemness, and p21-guided senescence in U87OSR cells. Signaling pathways and an in vivo xenograft model of U87OSR cells were investigated to delineate the influence of osimertinib-resistance and elevated YTHDF3 expression. RESULTS YTHDF3 played a crucial role in inducing cellular proliferation, migration, and stemness in U87OSR GBM cells. Importantly, silencing of YTHDF3 markedly reduced the activation of certain signaling pathways, including EGFR- or ITGA7- AKT, and ERK in U87OSR cells. Our study also revealed the oncogenic function of YTHDF3 in inducing senescence escape via p21 down-regulation. In contrast, silencing of YTHDF3 resulted in increased p21 expression, senescence, and suppressed tumor growth in our osimertinib-resistant preclinical model. CONCLUSION Overall, our research underscores the novel potential of YTHDF3 as a new pharmacological target in GBM treatment, specifically for patients with osimertinib-resistant or refractory tumors.
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Affiliation(s)
- Hsun-Hua Lee
- Department of Neurology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C
- Dizziness and Balance Disorder Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan, R.O.C
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan, R.O.C
- Dizziness and Balance Disorder Center, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan, R.O.C
| | - Ching-Chuan Hsieh
- Department of General Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan, R.O.C
| | - Cheng-Chih Chang
- Department of General Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan, R.O.C
| | - Wan-Ting Liao
- Chinese Medicine Department, Show Chwan Memorial Hospital, Changhua, Taiwan, R.O.C.;
| | - Hsiang-Cheng Chi
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, R.O.C.;
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan, R.O.C
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Hsu YC, Chang CC, Hsieh CC, Huang YT, Shih YH, Chang HC, Chang PJ, Lin CL. Dickkopf-1 Acts as a Profibrotic Mediator in Progressive Chronic Kidney Disease. Int J Mol Sci 2023; 24:ijms24087679. [PMID: 37108841 PMCID: PMC10143456 DOI: 10.3390/ijms24087679] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Chronic kidney disease (CKD) is a serious public health problem. Due to a high variability in the speed of CKD progression to end-stage renal disease (ESRD) and the critical involvement of Wnt/β-catenin signaling in CKD, we investigated the role of the Wnt antagonist Dickkopf-1 (DKK1) in CKD progression. Our data revealed that patients with CKD stages 4-5 had higher DKK1 levels in their serum and renal tissues than the control subjects. In an 8-year follow-up, the serum DKK1-high group in the enrolled CKD patients showed a faster progression to ESRD than the serum DKK1-low group. Using a rat model of 5/6 nephrectomy (Nx)-induced CKD, we consistently detected elevated serum levels and renal production of DKK1 in 5/6 Nx rats compared to sham-operated rats. Importantly, the knockdown of the DKK1 levels in the 5/6 Nx rats markedly attenuated the CKD-associated phenotypes. Mechanistically, we demonstrated that the treatment of mouse mesangial cells with recombinant DKK1 protein induced not only the production of multiple fibrogenic proteins, but also the expression of endogenous DKK1. Collectively, our findings suggest that DKK1 acts as a profibrotic mediator in CKD, and elevated levels of serum DKK1 may be an independent predictor of faster disease progression to ESRD in patients with advanced CKD.
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Affiliation(s)
- Yung-Chien Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Cheng-Chih Chang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Ching-Chuan Hsieh
- Division of General Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Yu-Ting Huang
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Ya-Hsueh Shih
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Hsiu-Ching Chang
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Pey-Jium Chang
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chun-Liang Lin
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Kidney Research Center, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
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Tseng YH, Chang CC, Lin KH. Thyroid hormone upregulates LAMP2 expression and lysosome activity. Biochem Biophys Res Commun 2023; 662:66-75. [PMID: 37099812 DOI: 10.1016/j.bbrc.2023.04.061] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023]
Abstract
Thyroid hormone (T3)-induced autophagy and its biological significance have been extensively investigated in recent years. However, limited studies to date have focused on the important role of lysosomes in autophagy. In this study, we explored the effects of T3 on lysosomal protein expression and trafficking in detail. Our findings showed that T3 activates rapid lysosomal turnover and expression of numerous lysosomal genes, including TFEB, LAMP2, ARSB, GBA, PSAP, ATP6V0B, ATP6V0D1, ATP6V1E1, CTSB, CTSH, CTSL, and CTSS, in a thyroid hormone receptor-dependent manner. In a murine model, LAMP2 protein was specifically induced in mice with hyperthyroidism. T3-promoted microtubule assembly was significantly disrupted by vinblastine, resulting in accumulation of the lipid droplet marker PLIN2. In the presence of the lysosomal autophagy inhibitors bafilomycin A1, chloroquine and ammonium chloride, we observed substantial accumulation of LAMP2 but not LAMP1 protein. T3 further enhanced the protein levels of ectopically expressed LAMP1 and LAMP2. Upon knockdown of LAMP2, cavities of lysosomes and lipid droplets accumulated in the presence of T3, although the changes in LAMP1 and PLIN2 expression were less pronounced. More specifically, the protective effect of T3 against ER stress-induced death was abolished by knockdown of LAMP2. Our collective results indicate that T3 not only promotes lysosomal gene expression but also LAMP protein stability and microtubule assembly, leading to enhancement of lysosomal activity in digesting any additional autophagosomal burden.
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Affiliation(s)
- Yi-Hsin Tseng
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Cheng-Chih Chang
- Department of General Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan.
| | - Kwang-Huei Lin
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang-Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
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Lin DW, Hsu YC, Chang CC, Hsieh CC, Lin CL. Insights into the Molecular Mechanisms of NRF2 in Kidney Injury and Diseases. Int J Mol Sci 2023; 24:ijms24076053. [PMID: 37047024 PMCID: PMC10094034 DOI: 10.3390/ijms24076053] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 04/14/2023] Open
Abstract
Redox is a constant phenomenon in organisms. From the signaling pathway transduction to the oxidative stress during the inflammation and disease process, all are related to reduction-oxidation (redox). Nuclear factor erythroid 2-related factor 2 (NRF2) is a transcription factor targeting many antioxidant genes. In non-stressed conditions, NRF2 maintains the hemostasis of redox with housekeeping work. It expresses constitutively with basal activity, maintained by Kelch-like-ECH-associated protein 1 (KEAP1)-associated ubiquitination and degradation. When encountering stress, it can be up-regulated by several mechanisms to exert its anti-oxidative ability in diseases or inflammatory processes to protect tissues and organs from further damage. From acute kidney injury to chronic kidney diseases, such as diabetic nephropathy or glomerular disease, many results of studies have suggested that, as a master of regulating redox, NRF2 is a therapeutic option. It was not until the early termination of the clinical phase 3 trial of diabetic nephropathy due to heart failure as an unexpected side effect that we renewed our understanding of NRF2. NRF2 is not just a simple antioxidant capacity but has pleiotropic activities, harmful or helpful, depending on the conditions and backgrounds.
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Affiliation(s)
- Da-Wei Lin
- Department of Internal Medicine, St. Martin de Porres Hospital, Chiayi 600, Taiwan
| | - Yung-Chien Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Cheng-Chih Chang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Ching-Chuan Hsieh
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Chun-Liang Lin
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Kidney Research Center, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
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Hsu YC, Chang CC, Hsieh CC, Shih YH, Chang HC, Lin CL. Therapeutic Potential of Extracts from Macaranga tanarius (MTE) in Diabetic Nephropathy. Plants (Basel) 2023; 12:plants12030656. [PMID: 36771740 PMCID: PMC9920382 DOI: 10.3390/plants12030656] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 05/30/2023]
Abstract
Diabetic nephropathy is a complication of diabetes that leads to end-stage kidney disease and is a major health burden worldwide. Prenylflavonoid compounds extracted from Macaranga tanarius (MTE) exhibit anti-inflammation, anti-oxidant, and anti-bacterial properties. However, the effects of these compounds on diabetic nephropathy remain unclear. The effects of MTE on diabetic nephropathy were investigated in vitro by using mouse renal mesangial cells and in vivo by using a db/db knockout mouse model. No overt alteration in proliferation was observed in mouse renal mesangial cells treated with 0-1 μg/mL MTE. Western blot analysis indicated that MTE dose-dependently attenuated the expression of fibronectin, α-smooth muscle actin, and collagen IV. Administration of MTE ameliorated renal albumin loss in db/db mice. Immunohistochemical staining revealed that MTE mitigated diabetes-induced fibronectin and collagen IV expression. Periodic acid-Schiff (PAS) and trichrome staining also showed that administration of MTE reduced the renal fibrosis phenomenon. MTE significantly ameliorated diabetes-induced nephropathy.
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Affiliation(s)
- Yung-Chien Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Cheng-Chih Chang
- Division of General Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Ching-Chuan Hsieh
- Division of General Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Ya-Hsueh Shih
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Hsiu-Ching Chang
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Chun-Liang Lin
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Kidney Research Center, Chang Gung Memorial Hospital, Taipei 105, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
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Hsieh CC, Chang CC, Hsu YC, Lin CL. Immune Modulation by Myeloid-Derived Suppressor Cells in Diabetic Kidney Disease. Int J Mol Sci 2022; 23:13263. [PMID: 36362050 PMCID: PMC9655277 DOI: 10.3390/ijms232113263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/29/2022] [Revised: 10/29/2022] [Accepted: 10/30/2022] [Indexed: 09/22/2023] Open
Abstract
Diabetic kidney disease (DKD) frequently leads to end-stage renal disease and other life-threatening illnesses. The dysregulation of glomerular cell types, including mesangial cells, endothelial cells, and podocytes, appears to play a vital role in the development of DKD. Myeloid-derived suppressor cells (MDSCs) exhibit immunoregulatory and anti-inflammatory properties through the depletion of L-arginine that is required by T cells, through generation of oxidative stress, interference with T-cell recruitment and viability, proliferation of regulatory T cells, and through the promotion of pro-tumorigenic functions. Under hyperglycemic conditions, mouse mesangial cells reportedly produce higher levels of fibronectin and pro-inflammatory cytokines. Moreover, the number of MDSCs is noticeably decreased, weakening inhibitory immune activities, and creating an inflammatory environment. In diabetic mice, immunotherapy with MDSCs that were induced by a combination of granulocyte-macrophage colony-stimulating factor, interleukin (IL)-1β, and IL-6, reduced kidney to body weight ratio, fibronectin expression, and fibronectin accumulation in renal glomeruli, thus ameliorating DKD. In conclusion, MDSCs exhibit anti-inflammatory activities that help improve renal fibrosis in diabetic mice. The therapeutic targeting of the proliferative or immunomodulatory pathways of MDSCs may represent an alternative immunotherapeutic strategy for DKD.
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Affiliation(s)
- Ching-Chuan Hsieh
- Division of General Surgery, Chang Gung Memorial Hospital, Chiayi 261363, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 261363, Taiwan
| | - Cheng-Chih Chang
- Division of General Surgery, Chang Gung Memorial Hospital, Chiayi 261363, Taiwan
| | - Yung-Chien Hsu
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 261363, Taiwan
- Division of Nephrology, Chang Gung Memorial Hospital, Chiayi 261363, Taiwan
| | - Chun-Liang Lin
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 261363, Taiwan
- Division of Nephrology, Chang Gung Memorial Hospital, Chiayi 261363, Taiwan
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Lin YH, Liu YC, Chen CY, Chi HC, Wu MH, Huang PS, Chang CC, Lin TK, Yeh CT, Lin KH. LPAL2 Suppresses Tumor Growth and Metastasis of Hepatocellular Carcinoma by Modulating MMP9 Expression. Cells 2022; 11:cells11162610. [PMID: 36010685 PMCID: PMC9406458 DOI: 10.3390/cells11162610] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/11/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Tumor metastasis is a complex process modulated by both intrinsic and extrinsic factors that ultimately result in poorer patient outcomes, including diminished survival. Pseudogene-derived long non-coding RNAs (lncRNA) play important roles in cancer progression. In the current study, we found that the pseudogene-derived lncRNA LPAL2 is downregulated in hepatocellular carcinoma (HCC) tissues, and further showed that elevated LPAL2 expression is positively correlated with survival outcome. The knockdown of LPAL2 in hepatoma cells induced tumor formation, migration, invasion, sphere formation, and drug resistance. Metalloproteinase 9 (MMP9) was identified as an LPAL2-regulated target gene, consistent with clinical findings that LPAL2 expression is significantly associated with MMP9 expression. Furthermore, patients with a higher expression of LPAL2 and lower expression of MMP9 (LPAL2-high/MMP9-low) had a higher survival rate than those with other combinations. Collectively, our findings establish LPAL2 as a novel tumor suppressor in HCC, and suggest targeting LPAL2 and MMP9 as a therapeutic approach for the treatment of HCC.
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Affiliation(s)
- Yang-Hsiang Lin
- Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Yu-Chin Liu
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 244, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Cheng-Yi Chen
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Hsiang-Cheng Chi
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 40447, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung 406040, Taiwan
| | - Meng-Han Wu
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Po-Shuan Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Cheng-Chih Chang
- Department of General Surgery, Chang Gung Memorial Hospital at Chia-yi, Chia-yi 613, Taiwan
| | - Tzu-Kang Lin
- Neurosurgery, School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- Neurosurgery, Department of Surgery, Fu Jen Catholic University Hospital, New Taipei City 24352, Taiwan
| | - Chau-Ting Yeh
- Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
- Correspondence: (C.-T.Y.); (K.-H.L.); Tel./Fax: +886-3-3281200 (ext. 8102) (C.-T.Y.); +886-3-2118263 (K.-H.L.)
| | - Kwang-Huei Lin
- Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Neurosurgery, Department of Surgery, Fu Jen Catholic University Hospital, New Taipei City 24352, Taiwan
- Correspondence: (C.-T.Y.); (K.-H.L.); Tel./Fax: +886-3-3281200 (ext. 8102) (C.-T.Y.); +886-3-2118263 (K.-H.L.)
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8
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Huang PS, Chang CC, Wang CS, Lin KH. Functional roles of non-coding RNAs regulated by thyroid hormones in liver cancer. Biomed J 2021; 44:272-284. [PMID: 33077406 PMCID: PMC8358202 DOI: 10.1016/j.bj.2020.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 02/06/2023] Open
Abstract
Recent reports have shown the important role of the non-coding part of human genome RNA (ncRNA) in cancer formation and progression. Among several kinds of ncRNAs, microRNAs (miRNA) play a pivotal role in cancer biology. Accumulating researches have been focused on the importance of non-coding genes in various diseases. In addition to miRNAs, long non-coding RNAs (lncRNAs) have also been extensively documented. Recently, the study of human liver cancer has gradually shifted to these non-coding RNAs that were originally considered "junk". Notably, dysregulated ncRNAs maybe influence on cell proliferation, angiogenesis, anti-apoptosis, and metastasis. Thyroid hormones play critical roles in human development and abnormalities in thyroid hormone levels are associated with various diseases, such as liver cancer. Thyroid hormone receptors (TR) act as ligand-activated nuclear transcription factors to affect multiple functions through the gene-level regulation in the cells and several studies have revealed that thyroid hormone associated with ncRNAs expression. TR actions are complex and tissue- and time-specific, aberrant expression of the various TR isoforms have different effects and are associated with different types of tumor or stages of development. In this review, we discuss various aspects of the research on the thyroid hormones modulated ncRNAs to affect the functions of human liver cells.
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Affiliation(s)
- Po-Shuan Huang
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Chih Chang
- Department of General Surgery, Chang Gung Memorial Hospital at Chia yi, Chia yi, Taiwan
| | - Chia-Siu Wang
- Department of General Surgery, Chang Gung Memorial Hospital at Chia yi, Chia yi, Taiwan
| | - Kwang-Huei Lin
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
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9
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Chen YC, Chang CC, Hsu WL, Chuang ST. Dairy cattle with bovine leukaemia virus RNA show significantly increased leukocyte counts. Vet J 2020; 257:105449. [PMID: 32546356 DOI: 10.1016/j.tvjl.2020.105449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/14/2019] [Revised: 03/25/2020] [Accepted: 12/31/2019] [Indexed: 12/26/2022]
Abstract
Infection with bovine leukaemia virus (BLV), a retrovirus, causes dysfunction of the immune system and can have a marked economic impact on dairy industries due to decreased milk production and reduced lifespan in affected dairy cattle. The presence of proviral DNA has been the major diagnostic indicator of BLV infection. However in the course of BLV infection, the viral genome can be dormant, without detectable gene expression, resulting in limited impact on infected animals. At present, there is limited knowledge regarding haematological indices in dairy cattle that could indicate activation of the BLV genome and suggest reactivated BLV infection. In this study, BLV infection and BLV genome reactivation were evaluated based on the presence of BLV DNA and BLV env gene transcripts, respectively. BLV RNA transcription was confirmed. Among 93 whole blood samples obtained from asymptomatic dairy cattle, the prevalence of BLV proviral DNA and transcripts was 93.5% (n = 87/93) and 83.9% (n = 78/93), respectively. Between groups with and without BLV, the mean counts of white blood cells and lymphocytes in whole blood were significantly associated with the presence of BLV RNA (P < 0.05), but not with BLV proviral DNA. These results shed light on the activation status of the BLV genome and should be taken into account when evaluating the possible impact of BLV on cattle.
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Affiliation(s)
- Y C Chen
- Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan
| | - C C Chang
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan
| | - W L Hsu
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan.
| | - S T Chuang
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan.
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Ma SB, Griffin D, Boyd SC, Chang CC, Wong J, Guy SD. Cryptococcus neoformans var grubii meningoencephalitis in a patient on fingolimod for relapsing-remitting multiple sclerosis: Case report and review of published cases. Mult Scler Relat Disord 2020; 39:101923. [PMID: 31986367 DOI: 10.1016/j.msard.2019.101923] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 08/28/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Fingolimod, a sphingosine-1-phosphate modulator used in the treatment of relapsing-remitting multiple sclerosis, has been associated with several cases of cryptococcosis. CASE REPORT We present a case of Cryptococcal meningoencephalitis attributable to Cryptococcus neoformans var. grubii, in a 58-year-old bird-keeper from Australia, after 7 years of fingolimod therapy. We discuss this in the context of previously reported cases, our understanding of fingolimod immune modulation, and known Cryptococcus pathobiology. CONCLUSION We suggest consideration of harm minimisation behaviours in patients requiring fingolimod, particularly in those with profound CD4 lymphopenia. Furthermore, we echo the call for improved post-marketing surveillance systems to determine the epidemiology of atypical infections with novel immunomodulatory treatments.
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Affiliation(s)
- S B Ma
- Western Health, Melbourne, Victoria, Australia.
| | - Dwj Griffin
- Western Health, Melbourne, Victoria, Australia; Alfred Health, Melbourne, Victoria, Australia
| | - S C Boyd
- Western Health, Melbourne, Victoria, Australia
| | - C C Chang
- Alfred Health, Melbourne, Victoria, Australia
| | - Jsj Wong
- Dorevitch Pathology, Heidelberg, Victoria, Australia
| | - S D Guy
- Western Health, Melbourne, Victoria, Australia
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11
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Li WB, Huber GM, Blok HP, Gaskell D, Horn T, Semenov-Tian-Shansky K, Pire B, Szymanowski L, Laget JM, Aniol K, Arrington J, Beise EJ, Boeglin W, Brash EJ, Breuer H, Chang CC, Christy ME, Ent R, Gibson EF, Holt RJ, Jin S, Jones MK, Keppel CE, Kim W, King PM, Kovaltchouk V, Liu J, Lolos GJ, Mack DJ, Margaziotis DJ, Markowitz P, Matsumura A, Meekins D, Miyoshi T, Mkrtchyan H, Niculescu I, Okayasu Y, Pentchev L, Perdrisat C, Potterveld D, Punjabi V, Reimer PE, Reinhold J, Roche J, Roos PG, Sarty A, Smith GR, Tadevosyan V, Tang LG, Tvaskis V, Volmer J, Vulcan W, Warren G, Wood SA, Xu C, Zheng X. Unique Access to u-Channel Physics: Exclusive Backward-Angle Omega Meson Electroproduction. Phys Rev Lett 2019; 123:182501. [PMID: 31763910 DOI: 10.1103/physrevlett.123.182501] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/01/2019] [Indexed: 06/10/2023]
Abstract
Backward-angle meson electroproduction above the resonance region, which was previously ignored, is anticipated to offer unique access to the three quark plus sea component of the nucleon wave function. In this Letter, we present the first complete separation of the four electromagnetic structure functions above the resonance region in exclusive ω electroproduction off the proton, ep→e^{'}pω, at central Q^{2} values of 1.60, 2.45 GeV^{2}, at W=2.21 GeV. The results of our pioneering -u≈-u_{min} study demonstrate the existence of a unanticipated backward-angle cross section peak and the feasibility of full L/T/LT/TT separations in this never explored kinematic territory. At Q^{2}=2.45 GeV^{2}, the observed dominance of σ_{T} over σ_{L}, is qualitatively consistent with the collinear QCD description in the near-backward regime, in which the scattering amplitude factorizes into a hard subprocess amplitude and baryon to meson transition distribution amplitudes: universal nonperturbative objects only accessible through backward-angle kinematics.
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Affiliation(s)
- W B Li
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
- College of William and Mary, Williamsburg, Virginia 23185, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - H P Blok
- VU University, NL-1081 HV Amsterdam, Netherlands
- NIKHEF, Postbus 41882, NL-1009 DB Amsterdam, Netherlands
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Horn
- Catholic University of America, Washington, D.C. 20064, USA
| | - K Semenov-Tian-Shansky
- National Research Centre Kurchatov Institute: Petersburg Nuclear Physics Institute, RU-188300 Gatchina, Russia
- Saint Petersburg National Research Academic University of the Russian Academy of Sciences, RU-194021 St. Petersburg, Russia
| | - B Pire
- CPHT, CNRS, École Polytechnique, IP Paris, 91128-Palaiseau, France
| | - L Szymanowski
- National Centre for Nuclear Research (NCBJ), 02-093 Warsaw, Poland
| | - J-M Laget
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Aniol
- California State University Los Angeles, Los Angeles, California 90032, USA
| | - J Arrington
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - E J Beise
- University of Maryland, College Park, Maryland 20742, USA
| | - W Boeglin
- Florida International University, Miami, Florida 33119, USA
| | - E J Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - H Breuer
- University of Maryland, College Park, Maryland 20742, USA
| | - C C Chang
- University of Maryland, College Park, Maryland 20742, USA
| | - M E Christy
- Hampton University, Hampton, Virginia 23668, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E F Gibson
- California State University, Sacramento, California 95819, USA
| | - R J Holt
- Caltech, Pasadena, California 91125, USA
| | - S Jin
- Kyungpook National University, Daegu, 702-701, Republic of Korea
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C E Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Hampton University, Hampton, Virginia 23668, USA
| | - W Kim
- Kyungpook National University, Daegu, 702-701, Republic of Korea
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - V Kovaltchouk
- Ontario Tech University, Oshawa, Ontario L1G 0C5, Canada
| | - J Liu
- Shanghai Jiao Tong University, Shanghai 200240, China
| | - G J Lolos
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - D J Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D J Margaziotis
- California State University Los Angeles, Los Angeles, California 90032, USA
| | - P Markowitz
- Florida International University, Miami, Florida 33119, USA
| | - A Matsumura
- Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Miyoshi
- Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - H Mkrtchyan
- A.I. Alikhanyan National Science Laboratory, Yerevan 0036, Armenia
| | - I Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - Y Okayasu
- Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - L Pentchev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Perdrisat
- College of William and Mary, Williamsburg, Virginia 23187, USA
| | - D Potterveld
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Punjabi
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - P E Reimer
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Reinhold
- Florida International University, Miami, Florida 33119, USA
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - P G Roos
- University of Maryland, College Park, Maryland 20742, USA
| | - A Sarty
- Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Tadevosyan
- A.I. Alikhanyan National Science Laboratory, Yerevan 0036, Armenia
| | - L G Tang
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Hampton University, Hampton, Virginia 23668, USA
| | - V Tvaskis
- NIKHEF, Postbus 41882, NL-1009 DB Amsterdam, Netherlands
- VU University, NL-1081 HV Amsterdam, Netherlands
| | - J Volmer
- VU University, NL-1081 HV Amsterdam, Netherlands
- DESY, Hamburg 22607, Germany
| | - W Vulcan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G Warren
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Xu
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - X Zheng
- University of Virginia, Charlottesville, Virginia 22904, USA
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12
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Serruys PW, Takahashi K, Kogame N, Chichareon P, Modolo R, Chang CC, Tomaniak M, Komiyama H, Hamm C, Steg PG, Stoll HP, Onuma Y, Valgimigli M, Windecker S, Vranckx P. P2817Efficacy and safety of ticagrelor monotherapy in patients with complex percutaneous coronary intervention: insights from the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1129] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Optimal dual antiplatelet therapy (DAPT) in patients with complex percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has not been fully investigated.
Purpose
To evaluate the efficacy and safety of 1-month DAPT followed by 23-month ticagrelor monotherapy in patients who underwent complex PCI.
Methods
The Global Leaders trial recruited 15,991 patients treated by default with a biolimus A9-eluting stent, and randomised in a 1:1 ratio either to the experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) or to the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy). Complex PCI includes at least one of the following characteristics; left main and/or multivessel PCI, long stenting (defined as total stent length≥46mm), and bifurcation treatment with two stents. The present sub-analysis of the trial evaluated at two years the primary endpoint (composite of all-cause death and new Q-wave myocardial infarction [MI] centrally adjudicated with the Minnesota code). In addition, the patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also evaluated at two years.
Results
Of 15,450 patients included in the present analysis, 5,188 (26.7%) patients underwent complex PCI. The experimental strategy, when compared with the reference one, had a significantly lower risk of the primary endpoint (3.56% vs. 5.33%, HR: 0.66; 95% CI: 0.51–0.86; p-value= 0.002; p-value for interaction= 0.019) in patients with complex PCI. Similarly, the experimental treatment was associated with a significantly reduced risk of POCE (14.41% vs. 16.88%, HR: 0.84; 95% CI: 0.74–0.97; p=0.016, p-value for interaction= 0.099) and NACE (15.77% vs. 18.37%, HR: 0.85; 95% CI: 0.74–0.97; p=0.014; p-value for interaction= 0.096). The reduction in ischemic events was predominantly observed in patients with 2 or more characteristics of complex PCI (Figure). In contrast, there was no significant difference in the risk of BARC type 3 or 5 bleeding between the two regimens (2.40% vs. 2.38%, HR: 1.01; 95% CI: 0.71–1.44; p-value=0.956; p-value for interaction= 0.935).
Central illustration
Conclusion
Together with other well-established clinical risk factors, the extent and complexity of stenting should be taken into account in tailoring antiplatelet regimens for secondary prevention. The 1-month DAPT followed by 23-month ticagrelor monotherapy reduced the ischemic events without increasing the risk of bleeding in patients who underwent complex PCI, when compared with the conventional DAPT.
Acknowledgement/Funding
The Global Leaders trial was supported by the resource from AstraZeneca, Biosensors, and The Medicines Company.
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Affiliation(s)
- P W Serruys
- Imperial College London, London, United Kingdom
| | - K Takahashi
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - N Kogame
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - H Komiyama
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P G Steg
- University Paris Diderot, Paris, France
| | - H P Stoll
- Biosensors Clinical Research, Morges, Switzerland
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
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13
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Van Geuns RJ, Smits PC, Chang CC, Wlodarczyk A, Chevalier B, West N, Gori T, Barbato E, Tarantini G, Kocka V, Achenbach S, Dudek D, Escaned J, Tijssen J, Onuma Y. P2695ABSORB bioresorbable scaffold versus Xience metallic stent in acute coronary syndromes with treated with percutaneous coronary intervention. A subanalysis of the COMPARE-ABSORB trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The safety and efficacy of the ABSORB scaffold in ACS patients remain unclear. The COMPARE-ABSORB trial compares the ABSORB to the Xience stent in lesions and patients at high risk for restenosis Patients with STEMI and urgent PCI for non-STEMI were not excluded.
Methods
Patients included in the COMPARE-ABSORB trial undergoing PCI for ACS were eligible. Predefined implantation techniques for ABSORB was mandatory. Primary endpoint is target lesion failure (TLF) at 1 year, defined as a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularization.
Results
Of 1670 patients, 842 were treated for ACS. At 1-year, TLF occurred in 22 patients (5.0%) of the ABSORB group and in 14 patients (3.5%) of the Xience group (HR 1.44%; 95% CI 0.74%-2.82%, P=0.284). Definite device thrombosis occurred in 9 patients (2.0%) of the ABSORB group and in 2 patients (0.5%) of the Xience group (HR 4.10%; 95% CI 0.89%-18.9%, P=0.071).
Baseline characteristics ABSORB (n=442) XIENCE (n=400) Age, years (SD) 60.7 (9.6) 61.3 (9.1) Male 350/442 (79.2%) 313/400 (78.3%) Current smoker 159/439 (36.2%) 126/397 (31.7%) Diabetes mellitus 152/440 (34.5%) 138/399 (34.6%) Hypertension 298/442 (67.4%) 266/400 (66.5%) Hypercholesterolemia 255/442 (57.7%) 232/400 (58.0%) Family history of coronary artery disease 147/442 (33.3%) 103/400 (25.8%) Previous MI 61/442 (13.8%) 67/400 (16.8%) Established Peripheral Vascular Disease 27/442 (6.1%) 15/400 (3.8%) Previous PCI 83/442 (18.8%) 86/400 (21.5%) Previous CABG 1/442 (0.2%) 4/400 (1.0%) Previous stroke 15/442 (3.4%) 21/400 (5.3%) Renal Insufficiency 9/442 (2.0%) 13/400 (3.3%) Clinical presentation Unstable angina 149/442 (33.7%) 141/400 (35.3%) Non-ST elevation myocardial infarction 183/442 (41.4%) 156/400 (39.0%) ST elevation myocardial infarction 110/442 (24.9%) 103/400 (25.7%)
KM plot for target lesion failure
Conclusion
The COMPARE-ABSORB trial showed no difference in the primary endpoint at one year for the ACS subgroup. The signal for increased thrombosis remained, even with the optimized implantation protocol
Acknowledgement/Funding
Maasstad Hospital, Rotterdam, the Netherlands
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Affiliation(s)
- R J Van Geuns
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - P C Smits
- Maasstad Hospital, Cardiology department, Rotterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - A Wlodarczyk
- Miedziowe Centrum Zdrowia, Department of Cardiology, Lubin, Poland
| | - B Chevalier
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - N West
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - T Gori
- Johannes Gutenberg University Mainz (JGU), Mainz, Germany
| | - E Barbato
- Cardiovascular Center Aalst, Aalst, Belgium
| | | | - V Kocka
- Charles University of Prague, Prague, Czechia
| | - S Achenbach
- Friedrich Alexander University, Erlangen, Germany
| | - D Dudek
- Jagiellonian University Medical College, 2nd Department of Cardiology, Krakow, Poland
| | - J Escaned
- Hospital Clinic San Carlos, Madrid, Spain
| | - J Tijssen
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
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14
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Takahashi K, Chichareon P, Modolo R, Kogame N, Chang CC, Tomaniak M, Hamm C, Steg PG, Stoll HP, Onuma Y, Valgimigli M, Vranckx P, Windecker S, Serruys PW. P2811Impact of ticagrelor monotherapy on two-year clinical outcomes in patients with long stenting: insights from the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1123] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Data on the efficacy and safety of different antiplatelet regimens are limited in patients with increasing total stent length (TSL).
Purpose
To evaluate the impact of the experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) vs. the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with increasing TSL.
Methods
The present post-hoc analysis of the Global Leaders trial evaluated the primary endpoint (the composite of the all-cause death and new Q-wave myocardial infarction [MI]) at two years in patients with increasing TSL. In addition, the patient-oriented composite endpoint (POCE) (the composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (the composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also assessed.
Results
The cohort of 15,450 patients treated with a biolimus-eluting biodegradable polymer stents were included in this analysis. In the longer TSL group (≥46mm), the experimental strategy significantly reduced the risk of the primary endpoint (3.78% vs. 5.68%, hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.49–0.90, p=0.008, P interaction=0.042) as well as POCE (14.57% vs. 18.11%, HR: 0.79, 95% CI: 0.67–0.92, p=0.003, P interaction=0.010) and NACE (16.07% vs. 19.64%, HR: 0.80, 95% CI: 0.69–0.93, p=0.004, P interaction=0.012) at two years. The risk of BARC type 3 or 5 bleeding at two years was similar between the two antiplatelet regimens.
KM in patients with long stenting
Conclusion
Ticagrelor monotherapy significantly reduced the risk of the primary endpoint, POCE and NACE with a similar risk of BARC type 3 or 5 bleeding at two years in patients with the longer TSL.
Acknowledgement/Funding
The Global Leaders trial was supported by unrestricted grants from AstraZeneca, Biosensors, and The Medicines Company. ECRI (European Cardiovascular R
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Affiliation(s)
- K Takahashi
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - N Kogame
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P G Steg
- University Paris Diderot, Paris, France
| | - H P Stoll
- Biosensors Clinical Research, Morges, Switzerland
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P W Serruys
- Imperial College London, London, United Kingdom
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15
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Takahashi K, Chichareon P, Chang CC, Tomaniak M, Modolo R, Kogame N, Stoll HP, Hamm C, Steg PG, Onuma Y, Valgimigli M, Vranckx P, Windecker S, Carrie D, Serruys PW. P2812Ischemic efficacy and bleeding safety of ticagrelor monotherapy in patients with multivessel percutaneous coronary intervention: insights from the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1124] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
The optimal duration of DAPT after coronary stent implantation remains a matter of debate and a novel antiplatelet regimen without an increased risk of bleeding while maintaining an anti-ischemic efficacy is of paramount importance in patients at higher risk of ischemia.
Purpose
The aim of the present sub-study of the Global Leaders trial is to evaluate the efficacy and safety of the experimental antiplatelet strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) vs. the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with multivessel percutaneous coronary intervention (PCI).
Methods
The Global Leaders trial enrolled 15,991 patients treated by default with a biolimus A-9 eluting stent. The present sub-study of the trial sought to evaluate the impact of the long-term ticagrelor monotherapy on the primary endpoint (composite of all-cause death and new Q-wave myocardial infarction [MI] centrally adjudicated with the Minnesota code) at two years. In addition, the patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also evaluated at two years.
Results
A total of 15,845 patients was included in this analysis, of whom 3,576 patients received multivessel PCI. At two years, the experimental strategy significantly reduced a risk of the primary endpoint (the composite of all-cause death and new Q-wave myocardial infarction [MI]) (3.05% vs. 4.85%, HR: 0.62, 95% CI: 0.44–0.88, p=0.006, Pinteraction=0.031) in patients with multivessel PCI. Similarly, the experimental treatment had a significant risk reduction in the patient-oriented composite endpoint (POCE), defined as the composite of all-cause death, any stroke, any MI, and any revascularization (13.37% vs. 16.74%, HR: 0.78, 95% CI: 0.66–0.93, p=0.005, Pinteraction=0.020) and the net adverse clinical events (NACE), defined as the composite of POCE and Bleeding Academic Research Consortium [BARC] defined bleeding type 3 or 5 (14.65% vs. 18.38%, HR: 0.78, 95% CI: 0.66–0.92, p=0.003, Pinteraction=0.014) at two years. There was no significant difference in BARC type 3 or 5 bleeding (2.44% vs. 2.65%, HR: 0.92, 95% CI: 0.61–1.39, p=0.685, Pinteraction=0.754) at two years between the two regimens.
KM in patients with multivessel PCI
Conclusion
The present study has demonstrated the experimental antiplatelet strategy, when compared with the reference regimen, could potentially have a favourable balance between ischemic efficacy and bleeding safety in patients who underwent multivessel PCI.
Acknowledgement/Funding
The Global Leaders trial was supported by unrestricted grants from AstraZeneca, Biosensors, and The Medicines Company. ECRI (European Cardiovascular R
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Affiliation(s)
- K Takahashi
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - R Modolo
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - N Kogame
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - H P Stoll
- Biosensors Clinical Research, Morges, Switzerland
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P G Steg
- University Paris Diderot, Paris, France
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - D Carrie
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - P W Serruys
- Imperial College London, London, United Kingdom
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16
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Chu CY, Cho YT, Jiang JH, Chang CC, Liao SC, Tang CH. Patients with chronic urticaria have a higher risk of psychiatric disorders: a population-based study. Br J Dermatol 2019; 182:335-341. [PMID: 31220338 DOI: 10.1111/bjd.18240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prevalence of psychiatric comorbidities in patients with chronic urticaria (CU) in a national population is largely unknown. OBJECTIVES To investigate the prevalence of psychiatric disorders and psychiatric medication use in patients with CU in Taiwan. METHODS Data were sourced from Taiwan's National Health Insurance Research Database for 2011. Patients who had a primary/secondary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of 708·1, 708·8 or 708·9 during 2011 with at least two outpatient visits and an antihistamine prescription were identified as CU cases. Patients with CU were classified into three disease severity groups according to their medication types. Psychiatric disorders were identified by patients having three outpatient visits with a primary or secondary diagnosis of a given psychiatric disease. Psychiatric medication use was defined by having at least four outpatient visits with prescriptions for anxiolytics, antidepressants or sleeping pills in 2010 or 2011. RESULTS Of the 167 132 patients with CU, 82·5% had mild CU, 17·0% had moderate CU and 0·4% had severe CU. Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication prescription than control groups. The relative risk (RR) of psychiatric disorders was 1·43 for patients with mild, 1·50 for patients with moderate and 2·32 for patients with severe CU vs. the controls (P < 0·001). For psychiatric medication prescription, the RRs were 1·95, 2·70 and 2·09, respectively, vs. controls (P < 0·001). CONCLUSIONS Patients with CU had a higher prevalence and risk of psychiatric disorders and psychiatric medication prescription than control groups. What's already known about this topic? Previous studies have shown a high prevalence of psychiatric comorbidities in patients with chronic urticaria (CU), with rates ranging from 35% to 60%. Anxiety, depression and somatoform disorders have been reported as the most prevalent mental disorders in patients with CU. What does this study add? Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication use than control groups in the general population. The relative risk (RR) of psychiatric disorders was 1·43 for those with mild CU, 1·50 for those with moderate CU and 2·32 for those with severe CU vs. controls. The RR for psychiatric medication use was 1·95 for those with mild CU, 2·70 for those with moderate CU and 2·09 for those with severe CU vs. controls. Mental health evaluations and management are important elements in CU management.
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Affiliation(s)
- C Y Chu
- Departments of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Y T Cho
- Departments of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, 10002, Taiwan
| | - J H Jiang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - C C Chang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - S C Liao
- Departments of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, 10002, Taiwan
| | - C H Tang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
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17
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Huang TH, Hsieh CC, Kuo LM, Chang CC, Chen CH, Chi CC, Liu CH. Malnutrition associated with an increased risk of postoperative complications following hepatectomy in patients with hepatocellular carcinoma. HPB (Oxford) 2019; 21:1150-1155. [PMID: 30765200 DOI: 10.1016/j.hpb.2019.01.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/19/2018] [Accepted: 01/09/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this study was to analyze the nutritional risk factors for postoperative complications following hepatic resection for hepatocellular carcinoma (HCC). METHODS The preoperative nutritional status of patients with HCC who underwent hepatic resection was evaluated using the scored Patient-Generated Subjective Global Assessment (PG-SGA). The perioperative variables were compared between well-nourished and malnourished patients. Regression analysis was employed to identify the risk factors for postoperative complications. RESULTS The overall operative mortality and morbidity of 287 patients who underwent resection for HCC were 1.7% and 44.3%, respectively. Upon admission, 96 (33.4%) study participants were malnourished, which was associated with a significantly higher PG-SGA score (P < 0.001), higher frequency of comorbidity (P < 0.001), more postoperative complications (P < 0.001) and a longer length of hospital stay (P < 0.001). In addition, major complications (Clavien-Dindo classification ≥ IIIa) occurred significantly more frequently in the malnourished group (P < 0.01). Age ≥70 years (risk ratio [RR] = 2.50, P = 0.008) and PG-SGA score ≥ 4 ([RR] = 9.85, P < 0.001) were significant risk factors for postoperative complications. CONCLUSIONS The PG-SGA score is an effective tool for predicting postoperative complications in patients with HCC following hepatic resection.
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Affiliation(s)
- Tzu-Hao Huang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
| | - Ching-Chuan Hsieh
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan; Department of Nutrition, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
| | - Liang-Mou Kuo
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
| | - Cheng-Chih Chang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
| | - Chun-Han Chen
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, 33305, Taiwan
| | - Chin-Hua Liu
- Department of Nutrition, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan
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18
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Goh SW, Adawiyah J, Md Nor N, Yap F, Ch'ng P, Chang CC. Skin eruption induced by dieting - an underdiagnosed skin disease in Malaysia. Malays Fam Physician 2019; 14:42-46. [PMID: 31289632 PMCID: PMC6612274] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prurigo pigmentosa is an inflammatory dermatosis characterized by a pruritic, symmetrically distributed erythematous papular or papulo-vesicular eruption on the trunk arranged in a reticulated pattern that resolves with hyperpigmentation. It is typically non-responsive to topical or systemic steroid therapy. The exact etiology is unknown, but it is more commonly described in the Far East countries. Dietary change is one of the predisposing factors. We report on nine young adult patients with prurigo pigmentosa, among whom five were on ketogenic diets prior to the onset of the eruptions. All cases resolved with oral doxycycline with no recurrence. We hope to improve the awareness of this uncommon skin condition among general practitioners and physicians so that disfiguring hyperpigmentation due to delayed diagnosis and treatment can be avoided.
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Affiliation(s)
- S W Goh
- MB BCh (Soton), MRCP (UK) Medical Department, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur Malaysia.,
| | - J Adawiyah
- MB BCh BAO, MMed (UKM) AdvMDerm (UKM), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur Malaysia.,
| | - N Md Nor
- MBBCH (Cardiff), MRCP (UK), AdvMDerm (UKM), Medical Department, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
| | - Fbb Yap
- MD (UNIMAS), MRCP (UK), AdvMDerm (UKM), Universiti Tunku Abdul Rahman, Selangor, Malaysia,
| | - Pwb Ch'ng
- MD (UKM), MRCP (UK), AdvMDerm (UKM), Gleneagles Kuala Lumpur Kuala Lumpur, Malaysia,
| | - C C Chang
- MBBS (Malaya), MRCP (UK), AdvMDerm (UKM), Gleneagles Kuala Lumpur, Kuala Lumpur, Malaysia
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19
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Chang CC, Yuan CS, Li TC, Su YL, Tong C, Wu SP. Chemical characteristics, source apportionment, and regional transport of marine fine particles toward offshore islands near the coastline of northwestern Taiwan Strait. Environ Sci Pollut Res Int 2018; 25:32332-32345. [PMID: 30229491 PMCID: PMC6208727 DOI: 10.1007/s11356-018-3093-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 08/28/2018] [Indexed: 06/08/2023]
Abstract
This study aims to investigate the spatiotemporal variation, chemical composition, and source apportionment of marine fine particles (PM2.5) as well as their regional transport toward the Matsu Islands located near the coastline of northwestern Taiwan Strait. Four offshore island sites located at the Matsu Islands were selected to conduct both regular and intensive sampling of marine PM2.5. Water-soluble ionic species, metallic elements, and carbonaceous contents were then analyzed to characterize the chemical characteristics of marine PM2.5. In order to identify the potential sources and their contributions to marine PM2.5, chemical mass balance (CMB) receptor model was employed along with the backward trajectory simulation to resolve the source apportionment of marine PM2.5 and to explore their transport routes in different seasons. The results showed that high PM2.5 concentrations were commonly observed during the northeastern monsoon periods. Additionally, marine PM2.5 concentration decreased from the west to the east with the highest PM2.5 at the Nankang Island and the lowest PM2.5 at the Donyin Island in all seasons, indicating an obvious concentration gradient of PM2.5 transported from the continental areas to the offshore islands. In terms of chemical characteristics of PM2.5, the most abundant water-soluble ions of PM2.5 were secondary inorganic aerosols (SO42-, NO3-, and NH4+) which accounted for 55-81% of water-soluble ions and 29-52% of marine PM2.5. The neutralization ratios of PM2.5 were always less than unity, indicating that NH4+ cannot solely neutralize nss-SO42+ and NO3- in marine PM2.5 at the Matsu Islands. Although crustal elements (Al, Ca, Fe, K, and Mg) dominated the metallic content of marine PM2.5, trace anthropogenic metals (Cd, As, Ni, and Cr) increased significantly during the northeastern monsoon periods, particularly in winter. Organic carbons (OCs) were always higher than elemental carbons (ECs), and the mass ratios of OC and EC were generally higher than 2.2 in all seasons, implying that PM2.5 was likely to be aged particles. During the poor air quality periods, major air mass transport routes were the northern transport and the anti-cyclonic circulation routes. Source apportionment results indicated that fugitive soil dusts and secondary aerosols were the major sources of marine PM2.5 at the Matsu Islands, while, in winter, biomass burning contributed up to 15% of marine PM2.5. This study revealed that cross-boundary transport accounted for 66~84% of PM2.5 at the Matsu Islands, suggesting that marine PM2.5 at the Matsu Islands has been highly influenced by anthropogenic emissions from neighboring Fuzhou City as well as long-range transport from Northeast Asia.
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Affiliation(s)
- Cheng-Chih Chang
- Institute of Environmental Engineering, National Sun Yet-sen University, Taiwan, Republic of China
| | - Chung-Shin Yuan
- Institute of Environmental Engineering, National Sun Yet-sen University, Taiwan, Republic of China.
| | - Tsung-Chang Li
- Institute of Environmental Engineering, National Sun Yet-sen University, Taiwan, Republic of China
| | - Yen-Lung Su
- Institute of Environmental Engineering, National Sun Yet-sen University, Taiwan, Republic of China
| | - Chuan Tong
- School of Geographic Science, Fujian Normal University, Fujian, China
| | - Shui-Ping Wu
- Center for Marine Environmental Chemistry and Toxicology, College of Environment and Ecology, Xiamen University, Xiamen, China
- State Key Laboratory of Marine Environmental Science, Xiamen University, Xiamen, China
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20
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Nicholson A, Berkowitz E, Monge-Camacho H, Brantley D, Garron N, Chang CC, Rinaldi E, Clark MA, Joó B, Kurth T, Tiburzi BC, Vranas P, Walker-Loud A. Heavy Physics Contributions to Neutrinoless Double Beta Decay from QCD. Phys Rev Lett 2018; 121:172501. [PMID: 30411940 DOI: 10.1103/physrevlett.121.172501] [Citation(s) in RCA: 2] [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: 05/16/2018] [Indexed: 06/08/2023]
Abstract
Observation of neutrinoless double beta decay, a lepton number violating process that has been proposed to clarify the nature of neutrino masses, has spawned an enormous world-wide experimental effort. Relating nuclear decay rates to high-energy, beyond the standard model (BSM) physics requires detailed knowledge of nonperturbative QCD effects. Using lattice QCD, we compute the necessary matrix elements of short-range operators, which arise due to heavy BSM mediators, that contribute to this decay via the leading order π^{-}→π^{+} exchange diagrams. Utilizing our result and taking advantage of effective field theory methods will allow for model-independent calculations of the relevant two-nucleon decay, which may then be used as input for nuclear many-body calculations of the relevant experimental decays. Contributions from short-range operators may prove to be equally important to, or even more important than, those from long-range Majorana neutrino exchange.
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Affiliation(s)
- A Nicholson
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27516-3255, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - E Berkowitz
- Institut für Kernphysik and Institute for Advanced Simulation, Forschungszentrum Jülich, 54245 Jülich, Germany
| | - H Monge-Camacho
- Department of Physics, The College of William & Mary, Williamsburg, Virginia 23187, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - D Brantley
- Department of Physics, The College of William & Mary, Williamsburg, Virginia 23187, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Physics Division, Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - N Garron
- Theoretical Physics Division, Department of Mathematical Sciences, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - C C Chang
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Interdisciplinary Theoretical and Mathematical Sciences Program (iTHEMS), RIKEN 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - E Rinaldi
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- RIKEN-BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M A Clark
- NVIDIA Corporation, 2701 San Tomas Expressway, Santa Clara, California 95050, USA
| | - B Joó
- Scientific Computing Group, Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Kurth
- NERSC Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B C Tiburzi
- Department of Physics, The City College of New York, New York, New York 10031, USA
- Graduate School and University Center, The City University of New York, New York, New York 10016, USA
| | - P Vranas
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Physics Division, Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A Walker-Loud
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Physics Division, Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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21
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Dixon PC, Stirling L, Xu X, Chang CC, Dennerlein JT, Schiffman JM. Aging may negatively impact movement smoothness during stair negotiation. Hum Mov Sci 2018; 60:78-86. [PMID: 29843055 DOI: 10.1016/j.humov.2018.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 05/09/2017] [Revised: 05/17/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022]
Abstract
Stairs represent a barrier to safe locomotion for some older adults, potentially leading to the adoption of a cautious gait strategy that may lack fluidity. This strategy may be characterized as unsmooth; however, stair negotiation smoothness has yet to be quantified. The aims of this study were to assess age- and task-related differences in head and body center of mass (COM) acceleration patterns and smoothness during stair negotiation and to determine if smoothness was associated with the timed "Up and Go" (TUG) test of functional movement. Motion data from nineteen older and twenty young adults performing stair ascent, stair descent, and overground straight walking trials were analyzed and used to compute smoothness based on the log-normalized dimensionless jerk (LDJ) and the velocity spectral arc length (SPARC) metrics. The associations between TUG and smoothness measures were evaluated using Pearson's correlation coefficient (r). Stair tasks increased head and body COM acceleration pattern differences across groups, compared to walking (p < 0.05). LDJ smoothness for the head and body COM decreased in older adults during stair descent, compared to young adults (p ≤ 0.015) and worsened with increasing TUG for all tasks (-0.60 ≤ r ≤ -0.43). SPARC smoothness of the head and body COM increased in older adults, regardless of task (p < 0.001), while correlations showed improved SPARC smoothness with increasing TUG for some tasks (0.33 ≤ r ≤ 0.40). The LDJ outperforms SPARC in identifying age-related stair negotiation adaptations and is associated with performance on a clinical test of gait.
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Affiliation(s)
- P C Dixon
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA; Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - L Stirling
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, USA; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA
| | - X Xu
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, USA
| | - C C Chang
- Department of Industrial Engineering & Engineering Management, National Tsing Hua University, Taiwan, ROC
| | - J T Dennerlein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA; Bouvé College of Health Sciences, Northeastern University Boston, USA Sciences, Northeastern University, Boston, USA.
| | - J M Schiffman
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
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22
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Naderi A, Koschella A, Heinze T, Shih KC, Nieh MP, Pfeifer A, Chang CC, Erlandsson J. Corrigendum to "Sulfoethylated nanofibrillated cellulose: Production and properties" [Carbohydr. Polym. 169 (2017) 515-523]. Carbohydr Polym 2018; 179:1. [PMID: 29111030 DOI: 10.1016/j.carbpol.2017.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Naderi
- Innventia AB, Box 5604, SE-11486 Stockholm, Sweden.
| | - A Koschella
- Friedrich Schiller University of Jena, Institute for Organic Chemistry and Macromolecular Chemistry, Center of Excellence for Polysaccharide Research, Humboldtstraße 10, D-07743, Jena, Germany.
| | - T Heinze
- Friedrich Schiller University of Jena, Institute for Organic Chemistry and Macromolecular Chemistry, Center of Excellence for Polysaccharide Research, Humboldtstraße 10, D-07743, Jena, Germany.
| | - K C Shih
- Department of Chemical & Biomolecular Engineering, 97 North Eagleville Road, Storrs, CT-06269-3136, United States; Department of Agricultural Chemistry, Taiwan.
| | - M P Nieh
- Department of Chemical & Biomolecular Engineering, 97 North Eagleville Road, Storrs, CT-06269-3136, United States.
| | - A Pfeifer
- Friedrich Schiller University of Jena, Institute for Organic Chemistry and Macromolecular Chemistry, Center of Excellence for Polysaccharide Research, Humboldtstraße 10, D-07743, Jena, Germany.
| | - C C Chang
- ThINC Facility at Advanced Energy Research & Technology Center, 1000 Innovation Road, Stony Brook, NY, 11794-6044, United States.
| | - J Erlandsson
- Department of Fibre and Polymer Technology, KTH - Royal Institute of Technology, Teknikringen 56, SE-100 44 Stockholm, Sweden.
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23
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Abstract
Tracheal bronchus is a congenital anatomical variant of patients with accessory bronchus in the right upper lobe deriving directly from the supracarinal trachea. Pre-operative consultation with the anesthesiologist is important for patient safety and can avoid adverse effects induced by endotracheal intubation. In this report, we described a case of tracheal bronchus in which general anesthesia was performed for video-assisted thoracoscopic surgery. We discussed some of the issues surrounding to complications in tracheal bronchus.
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Affiliation(s)
- K M Lai
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - M H Hsieh
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - F Lam
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - C Y Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - T L Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - C C Chang
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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24
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Faber GS, Koopman AS, Kingma I, Chang CC, Dennerlein JT, van Dieën JH. Continuous ambulatory hand force monitoring during manual materials handling using instrumented force shoes and an inertial motion capture suit. J Biomech 2017; 70:235-241. [PMID: 29157658 DOI: 10.1016/j.jbiomech.2017.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 06/20/2017] [Revised: 09/20/2017] [Accepted: 10/15/2017] [Indexed: 11/17/2022]
Abstract
Hand forces (HFs) are commonly measured during biomechanical assessment of manual materials handling; however, it is often a challenge to directly measure HFs in field studies. Therefore, in a previous study we proposed a HF estimation method based on ground reaction forces (GRFs) and body segment accelerations and tested it with laboratory equipment: GFRs were measured with force plates (FPs) and segment accelerations were measured using optical motion capture (OMC). In the current study, we evaluated the HF estimation method based on an ambulatory measurement system, consisting of inertial motion capture (IMC) and instrumented force shoes (FSs). Sixteen participants lifted and carried a 10-kg crate from ground level while 3D full-body kinematics were measured using OMC and IMC, and 3D GRFs were measured using FPs and FSs. We estimated 3D hand force vectors based on: (1) FP+OMC, (2) FP+IMC and (3) FS+IMC. We calculated the root-mean-square differences (RMSDs) between the estimated HFs to reference HFs calculated based on crate kinematics and the GRFs of a FP that the crate was lifted from. Averaged over subjects and across 3D force directions, the HF RMSD ranged between 10-15N when using the laboratory equipment (FP + OMC), 11-18N when using the IMC instead of OMC data (FP+IMC), and 17-21N when using the FSs in combination with IMC (FS + IMC). This error is regarded acceptable for the assessment of spinal loading during manual lifting, as it would results in less than 5% error in peak moment estimates.
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Affiliation(s)
- G S Faber
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA.
| | - A S Koopman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - I Kingma
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - C C Chang
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA; Department of Industrial Engineering & Engineering Management, National Tsing Hua University, Taiwan, ROC
| | - J T Dennerlein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - J H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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25
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Ko HH, Chang CC, Lin CH, Kuo YH, Chen IS, Chang HS. Bioactive chemical constituents isolated from the root of Neolitsea acuminatissima. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- HH Ko
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Natural Products and Drug Development, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - CC Chang
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - CH Lin
- Research Center for Natural Products and Drug Development, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - YH Kuo
- Department of Chinese Pharmaceutical Science and Chinese Medicine Resources, China Medical University, Taichung, Taiwan
- Department of Biotechnology, Asia University, Taichung, Taiwan
| | - IS Chen
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - HS Chang
- Research Center for Natural Products and Drug Development, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
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26
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Åmellem I, Suresh S, Chang CC, Tok SSL, Tashiro A. A critical period for antidepressant-induced acceleration of neuronal maturation in adult dentate gyrus. Transl Psychiatry 2017; 7:e1235. [PMID: 28925998 PMCID: PMC5639251 DOI: 10.1038/tp.2017.208] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 11/15/2022] Open
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used medications for mood and anxiety disorders, and adult neurogenesis in the dentate gyrus has been shown to be involved in the behavioral effects of SSRIs in mice. Studies have shown the varied effects of chronic treatment with SSRIs on adult neurogenesis. One such effect is the acceleration of neuronal maturation, which affects the functional integration of new neurons into existing neuronal circuitry. In this study, we labeled new neurons by using GFP-expressing retroviral vectors in mice and investigated the effect of an SSRI, fluoxetine, on these neurons at different time points after neuronal birth. Chronic treatment with fluoxetine accelerated the dendritic development of the newborn neurons and shifted the timing of the expression of the maturational marker proteins, doublecortin and calbindin. This accelerated maturation was observed even after sub-chronic treatment, only when fluoxetine was administered during the second week of neuronal birth. These results suggest the existence of a 'critical period' for the fluoxetine-induced maturation of new neurons. We propose that the modified functional integration of new neurons in the critical period may underlie the behavioral effects of fluoxetine by regulating anxiety-related decision-making processes.
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Affiliation(s)
- I Åmellem
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway,St Olavs Hospital, Trondheim, Norway,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, 11 Mandalay Road #12-01B, Singapore 308232. E-mail: or
| | - S Suresh
- Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK
| | - C C Chang
- Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK
| | - S S L Tok
- Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK
| | - A Tashiro
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway,St Olavs Hospital, Trondheim, Norway,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, 11 Mandalay Road #12-01B, Singapore 308232. E-mail: or
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27
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Li HY, Duan Y, Yang BQ, Chang CC, Liu N, Zhang LX, Lin S. [Analysis of the correlation between deep medullary veins and clinical prognosis of middle cerebral artery stroke]. Zhonghua Yi Xue Za Zhi 2017; 97:1956-1959. [PMID: 28693074 DOI: 10.3760/cma.j.issn.0376-2491.2017.25.008] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relativity between the distribution of deep medullary vein (DMV) in patients with middle cerebral artery stroke and clinical prognosis by using susceptibility-weighted imaging (SWI). Methods: A total of 144 cases of middle cerebral artery stroke patients and 55 healthy volunteers were retrospectively analyzed from January 2015 to October 2015 in order to investigate the symmetrical characteristic and the classification of DMV, then 30 cases were followed up. Kappa test was used to consider the consistency of judging DMV symmetry and type data by two radiologists. Results:Kappa value in DMV symmetry and DMV type were 0.875 and 0.852. Chi-square test analysis revealed a statistically significant difference of DMV symmetry between healthy control and stroke group(χ(2)=31.046, P=0.000). There was correlation between DMV type and NIHSS score in stroke group (r(s)=0.208, P=0.025). There was no statistically significant difference of DMV distribution in the different periods of stroke group (P=0.110). But there was statistically significant difference of DMV distribution between acute and chronic stroke (P=0.018). Among 30 follow-up cases, 18 cases with asymmetry DMV changed into symmetry after stroke therapy. In 8 cases with symmetry DMV, the diameter of DMV became smaller after treatment. In 4 cases, DMV had no changes. Conclusions: DMV in patients of MCA stroke are mostly asymmetry distribution. DMV classification can be used as an imaging standard to predict the prognosis of stroke patients.
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Affiliation(s)
- H Y Li
- Department of Radiology, the General Hospital of Shenyang Military Region, Shenyang 110016, China
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Chen CH, Huang TH, Chang CC, Li WF, Lin TL, Wang CC. Central Hepatectomy Still Plays an Important Role in Treatment of Early-Stage Centrally Located Hepatocellular Carcinoma. World J Surg 2017. [DOI: 10.1007/s00268-017-4096-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Duan Y, Yang BQ, Chang CC, Zhou J, Li HY, Xu ZH, Wang ZW, Li DY. [Preliminary study on assessment of lexiscan-induced blood-brain barrier opening and its level by CT perfusion imaging]. Zhonghua Yi Xue Za Zhi 2017; 96:2825-2829. [PMID: 27686551 DOI: 10.3760/cma.j.issn.0376-2491.2016.35.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the level of lexiscan-induced blood-brain barrier opening of healthy rabbits via CT perfusion weighted imaging (PWI) scan. Methods: Between November 2014 and May 2015, thirty New Zealand white rabbits were randomly assigned into three groups: the experimental group A1 which received one injection of lexiscan(1 ml/kg); the experimental group A2 which received three times injection of lexiscan(total dose: 1.5 ml/kg), finished within 15 minutes; the control group B which was injected the same volume normal saline(1 ml/kg), after 30 minutes, CT PWI scan was performed. Then cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and permeability surface(PS) of the region of interest of each group were acquired and compared statistically. Five cases of each group were injected with 2% Evans blue intravenously posterior to imaging. After one hour of infusion, all the animals were killed. Their brains were examined for the determination of Evans blue distribution. Results: Both the values of CBF and CBV and the staining with Evans blue of the group A1(CBF: (89.88±2.21), (81.42±4.28) ml·(100 g)-1·min-1; CBV: (3.97±0.43), (3.66±0.16) ml/g)and group A2 (CBF: (75.16±0.84), (63.66±7.21) ml·(100 g)-1·min-1; CBV: (4.07±0.01), (3.75±0.05) ml/g) were higher than those of the group B(CBF: (20.08±5.08), (14.58±8.62) ml·(100 g)-1·min-1; CBV: (0.85±0.04), (0.65±0.17) ml/g), the differences were all statistically significant (all P<0.01). While there was no statistically difference between group A1 and group A2(P>0.05). The value of PS of the group A2((22.43±8.09), (20.20±7.01)ml·(100 g)-1·min-1 )was higher than that of group A1((13.82±4.44), (10.12±2.44)ml·(100 g)-1·min-1) and group B(0.00, 0.00)(the lowest one), the differences were all statistically significant(all P<0.01). The value of MTT of the group A1((2.50±0.82, 2.47±0.10) s) had no statistical difference with group A2 and group B, while the value of group A2((4.50±0.17), (4.72±0.15) s) was higher than that of group B((1.88±0.09), (1.99±0.00) s), the differences were all statistically significant (P<0.05). Conclusion: Changes in hemodynamics of lexiscan-induced blood-brain barrier opening can be monitored by CT PWI scan. When the total dose of lexiscan increasing, the level of the BBB opening is higher with significantly increased CBF, CBV, PS and MTT.
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Affiliation(s)
- Y Duan
- *Department of Radiology, the General Hospital of Shenyang Military Region, Shenyang 110016, China
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Chang CC, Chen YJ, Huang TH, Chen CH, Kuo FY, Eng HL, Yong CC, Liu YW, Lin TL, Li WF, Lin YH, Lin CC, Wang CC, Chen CL. Living Donor Liver Transplantation for Combined Hepatocellular Carcinoma and Cholangiocarcinoma: Experience of a Single Center. Ann Transplant 2017; 22:115-120. [PMID: 28242867 DOI: 10.12659/aot.900779] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Because the outcome of liver transplantation for cholangiocarcinoma is often poor, cholangiocarcinoma is a contraindication for liver transplantation in most centers. Combined hepatocellular carcinoma and cholangiocarcinoma is a rare type of primary hepatic malignancy containing features of hepatocellular carcinoma and cholangiocarcinoma. Diagnosing combined hepatocellular carcinoma and cholangiocarcinoma pre-operatively is difficult. Because of sparse research presentations worldwide, we report our experience with living donor liver transplantation for combined hepatocellular carcinoma and cholangiocarcinoma. MATERIAL AND METHODS A total of 710 patients underwent living donor liver transplantation at our institution from April 2006 to June 2014; 377 of them received transplantation because of hepatocellular carcinoma with University of California San Francisco (UCSF) staging criteria fulfilled pre-operatively. Eleven patients (2.92%) were diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma confirmed pathologically from explant livers; we reviewed these cases retrospectively. Long-term survival was compared between patients diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma and patients diagnosed with hepatocellular carcinoma. RESULTS The mean age of the patients in our series was 60.2 years, and the median follow-up period was 23.9 months. Four patients were diagnosed with a recurrence during the follow-up period, including one intra-hepatic and three extra-hepatic recurrences. Four patients died due to tumor recurrence. Except for patients with advanced-stage cancer, disease-free survival of patients with combined hepatocellular carcinoma and cholangiocarcinoma compared with that of patients with hepatocellular carcinoma was 80% versus 97.2% in 1 year, and 46.7% versus 92.5% in 3 years (p<0.001), and overall survival was 90% versus 97.2% in 1 year, and 61.7% versus 95.1% in 3 years (p<0.001). CONCLUSIONS Outcomes of liver transplantation for patients with combined hepatocellular carcinoma and cholangiocarcinoma were worse than those for patients with hepatocellular carcinoma in this study. Combined hepatocellular carcinoma and cholangiocarcinoma are presumed to be a relative contraindication for liver transplantation.
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Affiliation(s)
- Cheng-Chih Chang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ying-Ju Chen
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tzu-Hao Huang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chun-Han Chen
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Fang-Ying Kuo
- Department of Pathology, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hock-Liew Eng
- Department of Pathology, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chee-Chien Yong
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Program, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yueh-Wei Liu
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ting-Lung Lin
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Program, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Feng Li
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Program, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Hung Lin
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Program, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Che Lin
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Program, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Chi Wang
- Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Program, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chao-Long Chen
- Department of Surgery, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Liver Transplantation Program, Chang Gung Memorial Hospital-Chiayi, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Chang YS, Chang CC, Chen YH, Chen WS, Chen JH. Risk of infective endocarditis in patients with systemic lupus erythematosus in Taiwan: a nationwide population-based study. Lupus 2017; 26:1149-1156. [PMID: 28420053 DOI: 10.1177/0961203317694260] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives Patients with systemic lupus erythematosus are considered vulnerable to infective endocarditis and prophylactic antibiotics are recommended before an invasive dental procedure. However, the evidence is insufficient. This nationwide population-based study evaluated the risk and related factors of infective endocarditis in systemic lupus erythematosus. Methods We identified 12,102 systemic lupus erythematosus patients from the National Health Insurance research-oriented database, and compared the incidence rate of infective endocarditis with that among 48,408 non-systemic lupus erythematosus controls. A Cox multivariable proportional hazards model was employed to evaluate the risk of infective endocarditis in the systemic lupus erythematosus cohort. Results After a mean follow-up of more than six years, the systemic lupus erythematosus cohort had a significantly higher incidence rate of infective endocarditis (42.58 vs 4.32 per 100,000 person-years, incidence rate ratio = 9.86, p < 0.001) than that of the control cohort. By contrast, the older systemic lupus erythematosus cohort had lower risk (adjusted hazard ratio 11.64) than that of the younger-than-60-years systemic lupus erythematosus cohort (adjusted hazard ratio 15.82). Cox multivariate proportional hazards analysis revealed heart disease (hazard ratio = 5.71, p < 0.001), chronic kidney disease (hazard ratio = 2.98, p = 0.034), receiving a dental procedure within 30 days (hazard ratio = 36.80, p < 0.001), and intravenous steroid therapy within 30 days (hazard ratio = 39.59, p < 0.001) were independent risk factors for infective endocarditis in systemic lupus erythematosus patients. Conclusions A higher risk of infective endocarditis was observed in systemic lupus erythematosus patients. Risk factors for infective endocarditis in the systemic lupus erythematosus cohort included heart disease, chronic kidney disease, steroid pulse therapy within 30 days, and a recent invasive dental procedure within 30 days.
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Affiliation(s)
- Y S Chang
- 1 Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,2 Division of Allergy, Immunology, and Rheumatology, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - C C Chang
- 1 Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,3 Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Y H Chen
- 4 Biostatistics Center, College of Management, Taipei Medical University, Taiwan
| | - W S Chen
- 5 Division of Rheumatology, Immunology, and Allergy, Taipei Veterans General Hospital, Taiwan
| | - J H Chen
- 6 Biostatistics Center and Graduate Institute of Data Science, College of Management, Taipei Medical University, Taiwan
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Tuan PH, Chang CC, Chang FL, Lee CY, Sung CL, Cho CY, Chen YF, Su KW. Modelling end-pumped passively Q-switched Nd-doped crystal lasers: manifestation by a Nd:YVO 4/Cr 4+:YAG system with a concave-convex resonator. Opt Express 2017; 25:1710-1722. [PMID: 29519025 DOI: 10.1364/oe.25.001710] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A theoretical model for the passively Q-switched (PQS) operation which includes the spatial overlapping between the pump and lasing modes under the thermal lensing effect is developed to give a transcendental equation that can directly determine the critical parameters such as pulse energy, pulse repetition rate, and pulse width for the PQS performance. More importantly, an analytical function which gives the approximate solution for the transcendental equation as well as a specific critical criterion for good PQS operation are derived for practical analyses and design. A Nd:YVO4/Cr4+:YAG system with a concave-convex resonator which can achieve fairly stable PQS pulse trains even at a high pump level is further exploited to manifest the proposed spatially dependent model. The good agreement between the experimental results and the theoretical predictions is verified to show the feasibility of the proposed model for designing high-power PQS lasers with high accuracy.
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Sung CL, Lee CY, Chang CC, Liang HC, Chen YF. Generation of terahertz optical beating from a simultaneously self-mode-locked Nd:YAG laser at 1064 and 1123 nm. Opt Lett 2017; 42:302-305. [PMID: 28081098 DOI: 10.1364/ol.42.000302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The reflectivity of the output coupler is designed to achieve the synchronously self-mode-locked operation at 1064 and 1123 nm in a diode-end-pumped Nd:YAG laser. Numerical analyses are performed to confirm that the designed output coupler can lead the emission lines to be predominant at 1064 and 1123 nm. Moreover, the crossover of the threshold pump powers for the 1064 and 1123 nm emission lines can be exploited to obtain the single central wavelength of 1064 nm or the single central wavelength of 1123 nm or, simultaneously, dual-central-wavelength self-mode-locked operation by finely adjusting the cavity alignment. For the dual-central-wavelength mode-locked emissions, the pulse repetition rate and the pulse duration are 4.5 GHz and 50.8 ps, respectively. The maximum output power can be up to 2.47 W at a pump power of 7.5 W. The synchronization of the 1064 and 1123 nm mode-locked pulses generates the optical beating pulse trains with repetition rates up to 14.7 THz.
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Tuan PH, Chang CC, Lee CY, Cho CY, Liang HC, Chen YF. Exploiting concave-convex linear resonators to design end-pumped solid-state lasers with flexible cavity lengths: Application for exploring the self-mode-locked operation. Opt Express 2016; 24:26024-26034. [PMID: 27857341 DOI: 10.1364/oe.24.026024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The characteristics of a convex-concave linear resonator under the thermal lensing effect are theoretically analyzed to find an analytical model for designing end-pumped solid-state lasers with flexible cavity lengths. By exploiting the design model, the power scaling for continuous-wave operation under strong thermal lensing can be easily achieved in the proposed resonator with different cavity lengths. Furthermore, the proposed resonator is applied to explore the exclusive influence of cavity length on the self-mode-locked (SML) operation. It is discovered that the lasing longitudinal modes will split into multiple groups in optical spectrum to lead to a multi-pulse mode-locked temporal state when the cavity length increases. Finally, a theoretical model is derived to reconstruct the experimental results of SML operation to deduce a simple relationship between the group number of lasing modes and the cavity length.
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Li E, Chang CC, Zhang Z, Li Q. Characterization of tissue scaffolds for time-dependent biotransport criteria - a novel computational procedure. Comput Methods Biomech Biomed Engin 2015; 19:1210-24. [PMID: 26718135 DOI: 10.1080/10255842.2015.1124268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 10/22/2022]
Abstract
This study aims to establish a new computational framework that allows modeling transient oxygen diffusion in tissue scaffolds more efficiently. It has been well known that the survival of cells strongly relies on continuous oxygen/nutrient supply and metabolite removal. With optimal design in scaffold architecture, its ability to sustain long distance oxygen supply could be improved considerably. In this study, finite element based homogenization procedure is first used to characterize the initial effective biotransport properties in silico. These initial properties are proper indicators to prediction of the on-going performance of tissue scaffolds over time. The transient model by adopting an edge-based smoothed finite element method with combination of mass-redistributed method is then established to more efficiently simulate the transient oxygen transfer process in tissue scaffolds. The proposed new method allows large time steps to model the oxygen diffusion process without losing numerical accuracy, thereby enhancing the computational efficiency significantly, in particular for the design optimization problems which typically require numerous analysis iterations. A number of different scaffold designs are examined either under net diffusion without cell seeding, or under cellular oxygen/nutrient uptake with or without considering cell viability. The association between the homogenized effective diffusivity of net scaffold microstructures and corresponding transient diffusion and time-dependent cellular activities is divulged. This study provides some insights into scaffold design.
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Affiliation(s)
- Eric Li
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
| | - C C Chang
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
| | - Zhongpu Zhang
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
| | - Qing Li
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
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Faber GS, Chang CC, Kingma I, Dennerlein JT, van Dieën JH. Estimating 3D L5/S1 moments and ground reaction forces during trunk bending using a full-body ambulatory inertial motion capture system. J Biomech 2015; 49:904-912. [PMID: 26795123 DOI: 10.1016/j.jbiomech.2015.11.042] [Citation(s) in RCA: 48] [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: 07/16/2015] [Revised: 10/25/2015] [Accepted: 11/20/2015] [Indexed: 12/22/2022]
Abstract
Inertial motion capture (IMC) systems have become increasingly popular for ambulatory movement analysis. However, few studies have attempted to use these measurement techniques to estimate kinetic variables, such as joint moments and ground reaction forces (GRFs). Therefore, we investigated the performance of a full-body ambulatory IMC system in estimating 3D L5/S1 moments and GRFs during symmetric, asymmetric and fast trunk bending, performed by nine male participants. Using an ambulatory IMC system (Xsens/MVN), L5/S1 moments were estimated based on the upper-body segment kinematics using a top-down inverse dynamics analysis, and GRFs were estimated based on full-body segment accelerations. As a reference, a laboratory measurement system was utilized: GRFs were measured with Kistler force plates (FPs), and L5/S1 moments were calculated using a bottom-up inverse dynamics model based on FP data and lower-body kinematics measured with an optical motion capture system (OMC). Correspondence between the OMC+FP and IMC systems was quantified by calculating root-mean-square errors (RMSerrors) of moment/force time series and the interclass correlation (ICC) of the absolute peak moments/forces. Averaged over subjects, L5/S1 moment RMSerrors remained below 10Nm (about 5% of the peak extension moment) and 3D GRF RMSerrors remained below 20N (about 2% of the peak vertical force). ICCs were high for the peak L5/S1 extension moment (0.971) and vertical GRF (0.998). Due to lower amplitudes, smaller ICCs were found for the peak asymmetric L5/S1 moments (0.690-0.781) and horizontal GRFs (0.559-0.948). In conclusion, close correspondence was found between the ambulatory IMC-based and laboratory-based estimates of back load.
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Affiliation(s)
- G S Faber
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA.
| | - C C Chang
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA; Department of Industrial Engineering & Engineering Management National Tsing Hua University, Taiwan, ROC
| | - I Kingma
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
| | - J T Dennerlein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - J H van Dieën
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
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Abstract
Inhalation of Cryptococcus into the respiratory system is the main route of acquisition of human infection, yet pulmonary cryptococcosis goes mostly unrecognized by many clinicians. This delay in diagnosis, or misdiagnosis, of lung infections is due in part to frequently subtle clinical manifestations such as a subacute or chronic cough, a broad differential of diagnostic possibilities for associated pulmonary masses (cryptococcomas) and, on occasion, negative respiratory tract cultures. Hematogenous dissemination from the lung can result in protean manifestations, the most severe of which is meningoencephalitis. There are few clinical studies of pulmonary cryptococcosis and its pathogenesis is poorly understood. The main purpose of this review is to describe the epidemiology, clinical presentation, diagnosis, and treatment of pulmonary cryptococcosis to increase clinician's awareness of this diagnostic possibility and to enhance clinical management. Useful pointers to the approach and management of pulmonary cryptococcosis and the implications of disseminated disease are included, together with recommendations for future research.
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Affiliation(s)
- C C Chang
- Lewin-Cameron Laboratory, The Doherty Institute, University of Melbourne, Melbourne, Australia
| | - T C Sorrell
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia
| | - S C-A Chen
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia
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Slavin MA, Thursky KA, Worth LJ, Chang CC, Morrissey CO, Blyth CC, Chen SC, Szer J. Introduction to the updated Australian and New Zealand consensus guidelines for the use of antifungal agents in the haematology/oncology setting, 2014. Intern Med J 2015; 44:1267-76. [PMID: 25482739 DOI: 10.1111/imj.12593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 11/29/2022]
Abstract
This article introduces the second revision of the Australian and New Zealand consensus guidelines for the use of antifungal agents in the haematology/oncology setting. The current update occurs within the context of a growing population at risk of invasive fungal disease, improved understanding of risk factors, availability of new diagnostic tests, a much-expanded evidence base and changing clinical paradigms. Here, we provide an overview of the history and purpose of the guidelines, including changes in scope since the last clinical update was published in 2008. The process for development, and for enabling review of draft recommendations by end-users and other relevant stakeholders, is described. The approach to assigning levels of evidence and grades of recommendation is also provided, along with a comparison to international grading systems.
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Affiliation(s)
- M A Slavin
- Department of Infectious Diseases and Infection Control, Peter MacCallum Cancer Centre, East Melbourne, Victoria; Victorian Infectious Diseases Service, The Doherty Institute for Infection and Immunity, Parkville, Victoria; School of Medicine, The University of Melbourne, Melbourne, Victoria
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Chen SC, Sorrell TC, Chang CC, Paige EK, Bryant PA, Slavin MA. Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014. Intern Med J 2015; 44:1315-32. [PMID: 25482743 DOI: 10.1111/imj.12597] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [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: 11/29/2022]
Abstract
Pathogenic yeast forms are commonly associated with invasive fungal disease in the immunocompromised host, including patients with haematological malignancies and patients of haemopoietic stem cell transplants. Yeasts include the Candida spp., Cryptococcus spp., Pneumocystis jirovecii and some lesser-known pathogens. Candida species remain the most common cause of invasive yeast infections (and the most common human pathogenic fungi). These guidelines present evidence-based recommendations for the antifungal management of established, invasive yeast infections in adult and paediatric patients in the haematology/oncology setting. Consideration is also given to the critically ill patient in intensive care units, including the neonatal intensive care unit. Evidence for 'pre-emptive' or 'diagnostic-driven antifungal therapy' is also discussed. For the purposes of this paper, invasive yeast diseases are categorised under the headings of invasive candidiasis, cryptococcosis and uncommon yeast infections. Specific recommendations for the management of Pneumocystis jirovecii are presented in an accompanying article (see consensus guidelines by Cooley et al. appearing elsewhere in this supplement).
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Affiliation(s)
- S C Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, Westmead, New South Wales; Department of Infectious Diseases, Westmead Hospital, Westmead, New South Wales; Sydney Medical School, The University of Sydney, Sydney, New South Wales
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Chang CC, Ananda-Rajah M, Belcastro A, McMullan B, Reid A, Dempsey K, Athan E, Cheng AC, Slavin MA. Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014. Intern Med J 2015; 44:1389-97. [PMID: 25482747 DOI: 10.1111/imj.12601] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted.
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Affiliation(s)
- C C Chang
- Department of Infectious Diseases, Alfred Health and Monash University, Prahran, Victoria; Centre for Biomedical Research, Burnet Institute, Victoria; Lewin-Cameron Laboratory, The Doherty Institute for Infection and Immunity, Parkville, Victoria
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Lee CY, Chang CC, Sung CL, Chen YF. Intracavity continuous-wave multiple stimulated-Raman-scattering emissions in a KTP crystal pumped by a Nd:YVO(4) laser. Opt Express 2015; 23:22765-22770. [PMID: 26368245 DOI: 10.1364/oe.23.022765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Intracavity continuous-wave (CW) multiple stimulated-Raman-scattering emissions have been successfully demonstrated in a KTP crystal pumped by a Nd:YVO(4) 1064-nm laser for the first time. Three different output couplers (OCs) with high-reflection (HR) coating in the range of 1-1.1, 1-1.13, and 1-1.15 μm are employed in the experiment to generate lasing wavelengths at 1095 (the first-Stokes emission of the 266 cm(-1) Raman shift), 1095 + 1128 (the first- and second-Stokes emission of the 266 cm(-1) Raman shift), and 1095 + 1128 + 1149 nm (the first two Stokes emissions of the 266 cm(-1) Raman shift and the first-Stokes emission of the 694 cm(-1) Raman shift), separately. This Raman laser paves a way to produce more-closely spaced set of CW emission in the green-yellow region.
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Lee CY, Chang CC, Tuan PH, Cho CY, Huang KF, Chen YF. Cryogenically monolithic self-Raman lasers: observation of single-longitudinal-mode operation. Opt Lett 2015; 40:1996-1999. [PMID: 25927767 DOI: 10.1364/ol.40.001996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A cryogenically monolithic Nd:YVO4 self-Raman laser is experimentally explored and theoretically analyzed. The variation of the stimulated Raman scattering (SRS) threshold on the temperature is found to be nonlinear because the reduction of thermal lensing enlarges the cavity mode size. In spite of the nonlinear variation of the SRS threshold on the temperature, the overall SRS output power can be efficiently increased from 0.78 to 1.36 W for temperature decreasing from 285 to 80 K at an absorbed power of 17.2 W. More interestingly, the single-longitudinal-mode operation is experimentally achieved when temperature is lower than 125 K.
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Cho CY, Lee CY, Chang CC, Tuan PH, Huang KF, Chen YF. 24-W cryogenically cooled Nd:YAG monolithic 946-nm laser with a slope efficiency >70. Opt Express 2015; 23:10126-10131. [PMID: 25969055 DOI: 10.1364/oe.23.010126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A high-power efficient monolithic Nd:YAG 946-nm laser is demonstrated at the cryogenic temperature. By exploring the absorption and the fluorescence spectra of the Nd:YAG crystal, it reveals the fact that the absorption bandwidth at 808 nm is narrowing and the fluorescence intensity at 1061 nm is significant enhanced when the temperature is decreased. The temperature dependence of the lasing threshold at 946 nm is found to display a minimum value near a temperature of 170 K. At an incident pump power of 34.5 W, the local heating leads the optimum temperature to be approximately 120 K and the maximum output power can reach 24.4 W with the conversion efficiency of 71% as well as the slope efficiency up to 75%.
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Huang TH, Chi CC, Liu CH, Chang CC, Kuo LM, Hsieh CC. Nutritional status assessed by scored patient-generated subjective global assessment associated with length of hospital stay in adult patients receiving an appendectomy. Biomed J 2015; 37:71-7. [PMID: 24732661 DOI: 10.4103/2319-4170.113183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Malnutrition has been associated with poor health outcomes in hospitalized patients. This study assessed the validity of the scored patient-generated subjective global assessment (PG-SGA) in adult patients who had undergone an open appendectomy, and examined the association of this assessment tool with length of hospital stay. METHODS Nutritional status was determined by using the scored PG-SGA in adult patients (n = 86) who had undergone an open appendectomy within 24 hours of admission. Variables were compared between well-nourished and malnourished participants. Regression analysis was used to identify potential predictors for length of hospital stay. Receiver operator characteristic (ROC) analysis was used to examine the validity of the PG-SGA score to predict the nutritional status. RESULTS On admission, 17% of the study subjects were malnourished and associated with a significantly older age (53.0 vs. 39.5), greater PG-SGA score (8 vs. 2), higher comorbidity (67% vs. 27%), and longer length of hospital stay (6.9 d vs. 4.1 d). The PG-SGA score and comorbidity were the determined risk factors for length of hospital stay after performing multiple regression analysis. Furthermore, the PG-SGA score had a significantly positive correlation with length of hospital stay (Spearman's rho = 0.378, p < 0.001). The area under the ROC curve indicating the PG-SGA score, compared with nutritional status, is 0.9751. CONCLUSIONS The scored PG-SGA in adults receiving an appendectomy is significantly associated with length of hospital stay, and is an effective tool for assessing the nutritional status of patients with cancer and chronic illness, as well as of patients with acute surgical abdomen.
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Affiliation(s)
| | | | | | | | | | - Ching-Chuan Hsieh
- Department of Nutrition Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Taoyuan; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
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Chen CH, Chang CC, Shih TH, Aljuffali IA, Yeh TS, Fang JY. Self-nanoemulsifying drug delivery systems ameliorate the oral delivery of silymarin in rats with Roux-en-Y gastric bypass surgery. Int J Nanomedicine 2015; 10:2403-16. [PMID: 25848259 PMCID: PMC4381630 DOI: 10.2147/ijn.s79522] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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] [Indexed: 01/05/2023] Open
Abstract
Roux-en-Y gastric bypass (RYGB) is a popular surgery to reduce the body weight of obese patients. Although food intake is restricted by RYGB, drug absorption is also decreased. The purpose of this study was to develop novel self-nanoemulsifying drug delivery systems (SNEDDS) for enhancing the oral delivery of silymarin, which has poor water solubility. The SNEDDS were characterized by size, zeta potential, droplet number, and morphology. A technique of RYGB was performed in Sprague-Dawley rats. SNEDDS were administered at a silymarin dose of 600 mg/kg in normal and RYGB rats for comparison with silymarin aqueous suspension and polyethylene glycol (PEG) 400 solution. Plasma silibinin, the main active ingredient in silymarin, was chosen for estimating the pharmacokinetic parameters. SNEDDS diluted in simulated gastric fluid exhibited a droplet size of 190 nm with a spherical shape. The nanocarriers promoted silibinin availability via oral ingestion in RYGB rats by 2.5-fold and 1.5-fold compared to the suspension and PEG 400 solution, respectively. A significant double-peak concentration of silibinin was detected for RYGB rats receiving SNEDDS. Fluorescence imaging showed a deeper and broader penetration of Nile red, the fluorescence dye, into the gastrointestinal mucosa from SNEDDS than from PEG 400 solution. Histological examination showed that SNEDDS caused more minor inflammation at the gastrointestinal membrane as compared with that caused by PEG 400 solution, indicating a shielding of direct silymarin contact with the mucosa by the nanodroplets. SNEDDS generally showed low-level or negligible irritation in the gastrointestinal tract. Silymarin-loaded SNEDDS were successfully developed to improve the dissolution, permeability, and oral bioavailability of silymarin. To the best of our knowledge, this is the first investigation reporting the usefulness of SNEDDS for improving drug malabsorption elicited by gastric bypass surgery.
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Affiliation(s)
- Chun-Han Chen
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan ; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan
| | - Cheng-Chih Chang
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tsung-Hsien Shih
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan
| | - Ibrahim A Aljuffali
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ta-Sen Yeh
- Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan, Taiwan ; School of Medicine, College of Medicine, Chang Gung University, Kweishan, Taoyuan, Taiwan
| | - Jia-You Fang
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Kweishan, Taoyuan, Taiwan ; Chinese Herbal Medicine Research Team, Healthy Aging Research Center, Chang Gung University, Kweishan, Taoyuan, Taiwan ; Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan
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Chang CC, Kao SC, Hsiao TC, Hsu HY. Assessment of autonomic nervous system by using empirical mode decomposition-based reflection wave analysis during non-stationary conditions. Physiol Meas 2014; 35:1873-83. [PMID: 25154624 DOI: 10.1088/0967-3334/35/9/1873] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Arterial blood pressure (ABP) is an important indicator of cardiovascular circulation and presents various intrinsic regulations. It has been found that the intrinsic characteristics of blood vessels can be assessed quantitatively by ABP analysis (called reflection wave analysis (RWA)), but conventional RWA is insufficient for assessment during non-stationary conditions, such as the Valsalva maneuver. Recently, a novel adaptive method called empirical mode decomposition (EMD) was proposed for non-stationary data analysis. This study proposed a RWA algorithm based on EMD (EMD-RWA). A total of 51 subjects participated in this study, including 39 healthy subjects and 12 patients with autonomic nervous system (ANS) dysfunction. The results showed that EMD-RWA provided a reliable estimation of reflection time in baseline and head-up tilt (HUT). Moreover, the estimated reflection time is able to assess the ANS function non-invasively, both in normal, healthy subjects and in the patients with ANS dysfunction. EMD-RWA provides a new approach for reflection time estimation in non-stationary conditions, and also helps with non-invasive ANS assessment.
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Affiliation(s)
- C C Chang
- Biomedical Electronics Translational Research Center and Biomimetic Systems Research Center, National Chiao Tung University, Taiwan. Department of Electronics Engineering and Institute of Electronics, National Chiao Tung University, Taiwan
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Huber GM, Blok HP, Butuceanu C, Gaskell D, Horn T, Mack DJ, Abbott D, Aniol K, Anklin H, Armstrong C, Arrington J, Assamagan K, Avery S, Baker OK, Barrett B, Beise EJ, Bochna C, Boeglin W, Brash EJ, Breuer H, Chang CC, Chant N, Christy ME, Dunne J, Eden T, Ent R, Fenker H, Gibson EF, Gilman R, Gustafsson K, Hinton W, Holt RJ, Jackson H, Jin S, Jones MK, Keppel CE, Kim PH, Kim W, King PM, Klein A, Koltenuk D, Kovaltchouk V, Liang M, Liu J, Lolos GJ, Lung A, Margaziotis DJ, Markowitz P, Matsumura A, McKee D, Meekins D, Mitchell J, Miyoshi T, Mkrtchyan H, Mueller B, Niculescu G, Niculescu I, Okayasu Y, Pentchev L, Perdrisat C, Pitz D, Potterveld D, Punjabi V, Qin LM, Reimer PE, Reinhold J, Roche J, Roos PG, Sarty A, Shin IK, Smith GR, Stepanyan S, Tang LG, Tadevosyan V, Tvaskis V, van der Meer RLJ, Vansyoc K, Van Westrum D, Vidakovic S, Volmer J, Vulcan W, Warren G, Wood SA, Xu C, Yan C, Zhao WX, Zheng X, Zihlmann B. Separated response function ratios in exclusive, forward π(±) electroproduction. Phys Rev Lett 2014; 112:182501. [PMID: 24856691 DOI: 10.1103/physrevlett.112.182501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Indexed: 06/03/2023]
Abstract
The study of exclusive π(±) electroproduction on the nucleon, including separation of the various structure functions, is of interest for a number of reasons. The ratio RL=σL(π-)/σL(π+) is sensitive to isoscalar contamination to the dominant isovector pion exchange amplitude, which is the basis for the determination of the charged pion form factor from electroproduction data. A change in the value of RT=σT(π-)/σT(π+) from unity at small -t, to 1/4 at large -t, would suggest a transition from coupling to a (virtual) pion to coupling to individual quarks. Furthermore, the mentioned ratios may show an earlier approach to perturbative QCD than the individual cross sections. We have performed the first complete separation of the four unpolarized electromagnetic structure functions above the dominant resonances in forward, exclusive π(±) electroproduction on the deuteron at central Q(2) values of 0.6, 1.0, 1.6 GeV(2) at W=1.95 GeV, and Q(2)=2.45 GeV(2) at W=2.22 GeV. Here, we present the L and T cross sections, with emphasis on RL and RT, and compare them with theoretical calculations. Results for the separated ratio RL indicate dominance of the pion-pole diagram at low -t, while results for RT are consistent with a transition between pion knockout and quark knockout mechanisms.
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Affiliation(s)
- G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - H P Blok
- VU university, NL-1081 HV Amsterdam, The Netherlands and NIKHEF, Postbus 41882, NL-1009 DB Amsterdam, The Netherlands
| | - C Butuceanu
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Horn
- Catholic University of America, Washington, DC 20064, USA
| | - D J Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Abbott
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Aniol
- California State University Los Angeles, Los Angeles, California 90032, USA
| | - H Anklin
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA and Florida International University, Miami, Florida 33119, USA
| | - C Armstrong
- College of William and Mary, Williamsburg, Virginia 23187, USA
| | - J Arrington
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - K Assamagan
- Hampton University, Hampton, Virginia 23668, USA
| | - S Avery
- Hampton University, Hampton, Virginia 23668, USA
| | - O K Baker
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA and Hampton University, Hampton, Virginia 23668, USA
| | - B Barrett
- Saint Mary's University, Halifax, Nova Scotia B3H 3C3 Canada
| | - E J Beise
- University of Maryland, College Park, Maryland 20742, USA
| | - C Bochna
- University of Illinois, Champaign, Illinois 61801, USA
| | - W Boeglin
- Florida International University, Miami, Florida 33119, USA
| | - E J Brash
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - H Breuer
- University of Maryland, College Park, Maryland 20742, USA
| | - C C Chang
- University of Maryland, College Park, Maryland 20742, USA
| | - N Chant
- University of Maryland, College Park, Maryland 20742, USA
| | - M E Christy
- Hampton University, Hampton, Virginia 23668, USA
| | - J Dunne
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Eden
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA and Norfolk State University, Norfolk, Virginia 23504, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Fenker
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E F Gibson
- California State University, Sacramento, California 95819, USA
| | - R Gilman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA and Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, USA
| | - K Gustafsson
- University of Maryland, College Park, Maryland 20742, USA
| | - W Hinton
- Hampton University, Hampton, Virginia 23668, USA
| | - R J Holt
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - H Jackson
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - S Jin
- Kyungpook National University, Daegu 702-701, Republic of Korea
| | - M K Jones
- College of William and Mary, Williamsburg, Virginia 23187, USA
| | - C E Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA and Hampton University, Hampton, Virginia 23668, USA
| | - P H Kim
- Kyungpook National University, Daegu 702-701, Republic of Korea
| | - W Kim
- Kyungpook National University, Daegu 702-701, Republic of Korea
| | - P M King
- University of Maryland, College Park, Maryland 20742, USA
| | - A Klein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - D Koltenuk
- University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - V Kovaltchouk
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - M Liang
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Liu
- University of Maryland, College Park, Maryland 20742, USA
| | - G J Lolos
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - A Lung
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D J Margaziotis
- California State University Los Angeles, Los Angeles, California 90032, USA
| | - P Markowitz
- Florida International University, Miami, Florida 33119, USA
| | | | - D McKee
- New Mexico State University, Las Cruces, New Mexico 88003-8001, USA
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Mitchell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - H Mkrtchyan
- A.I. Alikhanyan National Science Laboratory, Yerevan 0036, Armenia
| | - B Mueller
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - G Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - I Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | | | - L Pentchev
- College of William and Mary, Williamsburg, Virginia 23187, USA
| | - C Perdrisat
- College of William and Mary, Williamsburg, Virginia 23187, USA
| | - D Pitz
- DAPNIA/SPhN, CEA/Saclay, F-91191 Gif-sur-Yvette, France
| | - D Potterveld
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Punjabi
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - L M Qin
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - P E Reimer
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Reinhold
- Florida International University, Miami, Florida 33119, USA
| | - J Roche
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P G Roos
- University of Maryland, College Park, Maryland 20742, USA
| | - A Sarty
- Saint Mary's University, Halifax, Nova Scotia B3H 3C3 Canada
| | - I K Shin
- Kyungpook National University, Daegu 702-701, Republic of Korea
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Stepanyan
- A.I. Alikhanyan National Science Laboratory, Yerevan 0036, Armenia
| | - L G Tang
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA and Hampton University, Hampton, Virginia 23668, USA
| | - V Tadevosyan
- A.I. Alikhanyan National Science Laboratory, Yerevan 0036, Armenia
| | - V Tvaskis
- VU university, NL-1081 HV Amsterdam, The Netherlands and NIKHEF, Postbus 41882, NL-1009 DB Amsterdam, The Netherlands
| | | | - K Vansyoc
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - D Van Westrum
- University of Colorado, Boulder, Colorado 80309, USA
| | - S Vidakovic
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - J Volmer
- VU university, NL-1081 HV Amsterdam, The Netherlands and DESY, Hamburg, Germany
| | - W Vulcan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G Warren
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Xu
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - C Yan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - W-X Zhao
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - X Zheng
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - B Zihlmann
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA and University of Virginia, Charlottesville, Virginia 22901, USA
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Lin CS, Lin SY, Chang CC, Wang HH, Liao CC, Chen TL. Postoperative adverse outcomes after non-hepatic surgery in patients with liver cirrhosis. Br J Surg 2014; 100:1784-90. [PMID: 24227365 DOI: 10.1002/bjs.9312] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosis and adverse outcomes after non-hepatic surgery. METHODS Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95 per cent confidence intervals (c.i.) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression. RESULTS Thirty-day mortality rates among 24 282 patients with cirrhosis and 97 128 control patients were 1·2 per cent (299 deaths) and 0·7 per cent (635 deaths) respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1·88, 95 per cent c.i. 1·63 to 2·16), acute renal failure (OR 1·52, 1·34 to 1·74), septicaemia (OR 1·42, 1·33 to 1·51) and intensive care unit admission (OR 1·39, 1·33 to 1·45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2·87, 1·55 to 5·30), alcohol dependence syndrome (OR 3·74, 2·64 to 5·31), jaundice (OR 5·47, 3·77 to 7·93), ascites (OR 5·85, 4·62 to 7·41), gastrointestinal haemorrhage (OR 3·01, 2·33 to 3·90) and hepatic coma (OR 5·11, 3·79 to 6·87). CONCLUSION Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators.
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Affiliation(s)
- C S Lin
- Department of Anaesthesiology; Health Policy Research Centre and; Department of Anaesthesiology, Taichung, Taiwan
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Kim S, Kiyosawa N, Burgoon LD, Chang CC, Zacharewski TR. PPARα-mediated responses in human adult liver stem cells: In vivo/in vitro and cross-species comparisons. J Steroid Biochem Mol Biol 2013; 138:236-47. [PMID: 23811191 DOI: 10.1016/j.jsbmb.2013.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 06/13/2013] [Accepted: 06/15/2013] [Indexed: 01/06/2023]
Abstract
The peroxisome proliferator-activated receptor α (PPARα) is a ligand-activated transcription factor that regulates a variety of biological processes including lipid metabolism and energy homeostasis. Peroxisome proliferators (PPs) are carcinogens in rodents, while humans are resistant to peroxisome proliferation and carcinogenesis. In this study, we examined the differential gene expression elicited by clofibrate (CLO) and WY-14,643 (WY) in C57BL/6 mouse liver compared to responses in human HepG2 hepatoma and HL1-1 adult stem cells. Mice were gavaged with sesame oil, 300mg/kg CLO or WY for 2, 4, 8, 12, 18 or 24h, or daily for 4 or 14 days. Although no significant changes in body weight gain were observed, WY induced relative liver weight at 4 and 14 days. Genome-wide hepatic gene expression analysis identified 719 and 1443 differentially expressed unique genes elicited by CLO and WY, respectively (|fold change|>1.5, P1(t)>0.99). Functional analysis associated the gene expression changes with lipid metabolism, transport, cell cycle and immune response. Most differentially expressed genes were in common to both treatments and clustered together only at early time points (2-8h). Complementary QRT-PCR studies in human HL1-1 and HepG2 cells treated with 50μM WY or DMSO for 1, 2, 4, 8, 12, 24 or 48h identified a minimal number of conserved orthologous responses (e.g., Pdk4, Adfp and Angptl4) while some genes (i.e., Bmf, a tumor suppressor) exhibited induction in human cells but repression in mice. These data suggest that PPs elicit species-specific PPARα-mediated gene expression.
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Affiliation(s)
- S Kim
- Department of Biochemistry & Molecular Biology, Michigan State University, East Lansing, MI 48824, United States; Center for Integrative Toxicology, Michigan State University, East Lansing, MI 48824, United States.
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Karuppannan AK, Qiang J, Chang CC, Kwang J. A novel baculovirus vector shows efficient gene delivery of modified porcine reproductive and respiratory syndrome virus antigens and elicits specific immune response. Vaccine 2013; 31:5471-8. [PMID: 24035590 DOI: 10.1016/j.vaccine.2013.08.101] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 04/26/2013] [Revised: 08/23/2013] [Accepted: 08/29/2013] [Indexed: 01/19/2023]
Abstract
Porcine reproductive and respiratory syndrome (PRRS) is an economically devastating epizootic of porcine species. Current vaccines are inadequate to control the disease burden and outbreaks in the field. We report a novel baculovirus vaccine vector with White spot syndrome virus immediate early 1 shuttle promoter, with strong activity in both insect cells and mammalian cells, for immunization against PRRSV. The insect cell cultured baculovirus vector produces PRRSV envelope glycoproteins ORF2a, ORF3, ORF4 and ORF5, which are similar to the antigens in the infectious PRRS virion, and these antigens are stably incorporated on the surface of the baculovirus. Further, the baculovirus vector efficiently transduces these antigens in cells of porcine origin, thereby simulating a live infection. The baculovirus vectored PRRSV antigens, upon inoculation in mice, elicits robust neutralizing antibodies against the infective PRRS virus. Further, the experiments indicate that hitherto under emphasized ORF2a and ORF4 are important target antigens for neutralizing PRRSV infectivity.
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Affiliation(s)
- Anbu K Karuppannan
- Centre for Animal Health Studies, Tamil Nadu Veterinary and Animal Sciences University, Madhavaram, Chennai 600051, India
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