1
|
Wang TH, Tsai YT, Lee PC. Response to "Medical big data value creation: Role of the hospital-based research database". J Formos Med Assoc 2023; 122:812-813. [PMID: 37202238 DOI: 10.1016/j.jfma.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023] Open
Affiliation(s)
- Tsung-Hsi Wang
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan; Department of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
| | - Yuan-Ting Tsai
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Po-Chang Lee
- College of Public Health, Taipei Medical University, Taiwan; College of Medicine, National Cheng Kung University, Taiwan; Research Center of Health and Welfare Policy, Taipei Medical University, Taiwan; Taipei Medical University Shuang-Ho Hospital, Ministry of Health and Welfare, Taiwan.
| |
Collapse
|
2
|
Ali U, Zainal M, Zainol Z, Tai CW, Tang SF, Lee PC, Wong KK. Performance evaluation of two multiplex qualitative RT-PCR assays for detection of respiratory infection in paediatric population. Malays J Pathol 2023; 45:215-227. [PMID: 37658531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
INTRODUCTION Acute respiratory infection (ARI) contributes to significant mortality and morbidity worldwide and is usually caused by a wide range of respiratory pathogens. This study aims to describe the performance of QIAstat-Dx® Respiratory Panel V2 (RP) and RespiFinder® 2SMART assays for respiratory pathogens detection. MATERIALS AND METHODS A total of 110 nasopharyngeal swabs (NPS) were collected from children aged one month to 12 years old who were admitted with ARI in UKMMC during a one-year period. The two qPCR assays were conducted in parallel. RESULTS Ninety-seven samples (88.2%) were positive by QIAstat-Dx RP and 86 (78.2%) by RespiFinder assay. The overall agreement on both assays was substantial (kappa value: 0.769) with excellent concordance rate of 96.95%. Using both assays, hRV/EV, INF A/H1N1 and RSV were the most common pathogens detected. Influenza A/H1N1 infection was significantly seen higher in older children (age group > 60 months old) (53.3%, p-value < 0.05). Meanwhile, RSV and hRV/EV infection were seen among below one-year-old children. Co-infections by two to four pathogens were detected in 17 (17.5%) samples by QIAstat-Dx RP and 12 (14%) samples by RespiFinder, mainly involving hRV/EV. Bacterial detection was observed only in 5 (4.5%) and 6 (5.4%) samples by QIAstat-Dx RP and RespiFinder, respectively, with Mycoplasma pneumoniae the most common detected. CONCLUSION The overall performance of the two qPCR assays was comparable and showed excellent agreement. Both detected various clinically important respiratory pathogens in a single test with simultaneous multiple infection detection. The use of qPCR as a routine diagnostic test can improve diagnosis and management.
Collapse
Affiliation(s)
- U Ali
- Universiti Kebangsaan Malaysia, Department of Medical Microbiology and Immunology, Kuala Lumpur, Malaysia
| | - M Zainal
- Universiti Kebangsaan Malaysia, Department of Medical Microbiology and Immunology, Kuala Lumpur, Malaysia.
| | - Z Zainol
- Universiti Kebangsaan Malaysia, Department of Medical Microbiology and Immunology, Kuala Lumpur, Malaysia
| | - C W Tai
- Universiti Kebangsaan Malaysia, Department of Paediatric, Kuala Lumpur, Malaysia
| | - S F Tang
- Universiti Kebangsaan Malaysia, Department of Paediatric, Kuala Lumpur, Malaysia
| | - P C Lee
- Universiti Kebangsaan Malaysia, Department of Paediatric, Kuala Lumpur, Malaysia
| | - K K Wong
- Universiti Kebangsaan Malaysia, Department of Medical Microbiology and Immunology, Kuala Lumpur, Malaysia
| |
Collapse
|
3
|
Wang TH, Tsai YT, Lee PC. Health big data in Taiwan: A national health insurance research database. J Formos Med Assoc 2023; 122:296-298. [PMID: 36599787 DOI: 10.1016/j.jfma.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/04/2023] Open
Affiliation(s)
- Tsung-Hsi Wang
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Yuan-Ting Tsai
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Po-Chang Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan.
| |
Collapse
|
4
|
Chang D, Chen PT, Wang P, Wu T, Yeh AY, Lee PC, Sung YH, Liu KL, Wu MS, Yang D, Roth H, Liao WC, Wang W. Detection of pancreatic cancer with two- and three-dimensional radiomic analysis in a nationwide population-based real-world dataset. BMC Cancer 2023; 23:58. [PMID: 36650440 PMCID: PMC9843893 DOI: 10.1186/s12885-023-10536-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND CT is the major detection tool for pancreatic cancer (PC). However, approximately 40% of PCs < 2 cm are missed on CT, underscoring a pressing need for tools to supplement radiologist interpretation. METHODS Contrast-enhanced CT studies of 546 patients with pancreatic adenocarcinoma diagnosed by histology/cytology between January 2005 and December 2019 and 733 CT studies of controls with normal pancreas obtained between the same period in a tertiary referral center were retrospectively collected for developing an automatic end-to-end computer-aided detection (CAD) tool for PC using two-dimensional (2D) and three-dimensional (3D) radiomic analysis with machine learning. The CAD tool was tested in a nationwide dataset comprising 1,477 CT studies (671 PCs, 806 controls) obtained from institutions throughout Taiwan. RESULTS The CAD tool achieved 0.918 (95% CI, 0.895-0.938) sensitivity and 0.822 (95% CI, 0.794-0.848) specificity in differentiating between studies with and without PC (area under curve 0.947, 95% CI, 0.936-0.958), with 0.707 (95% CI, 0.602-0.797) sensitivity for tumors < 2 cm. The positive and negative likelihood ratios of PC were 5.17 (95% CI, 4.45-6.01) and 0.10 (95% CI, 0.08-0.13), respectively. Where high specificity is needed, using 2D and 3D analyses in series yielded 0.952 (95% CI, 0.934-0.965) specificity with a sensitivity of 0.742 (95% CI, 0.707-0.775), whereas using 2D and 3D analyses in parallel to maximize sensitivity yielded 0.915 (95% CI, 0.891-0.935) sensitivity at a specificity of 0.791 (95% CI, 0.762-0.819). CONCLUSIONS The high accuracy and robustness of the CAD tool supported its potential for enhancing the detection of PC.
Collapse
Affiliation(s)
- Dawei Chang
- grid.19188.390000 0004 0546 0241Data Science Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Po-Ting Chen
- grid.412094.a0000 0004 0572 7815Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pochuan Wang
- grid.19188.390000 0004 0546 0241Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Tinghui Wu
- grid.19188.390000 0004 0546 0241Institute of Applied Mathematical Sciences, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei, 10617 Taiwan
| | - Andre Yanchen Yeh
- grid.19188.390000 0004 0546 0241School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Chang Lee
- grid.454740.6National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Yi-Hui Sung
- grid.454740.6National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Kao-Lang Liu
- grid.412094.a0000 0004 0572 7815Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan ,grid.19188.390000 0004 0546 0241Department of Medical Imaging, National Taiwan University Cancer Center, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Shiang Wu
- grid.412094.a0000 0004 0572 7815Department of Internal Medicine, Division of Gastroenterology and Hepatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan ,grid.19188.390000 0004 0546 0241Internal Medicine, National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002 Taiwan
| | - Dong Yang
- grid.451133.10000 0004 0458 4453NVIDIA, Bethesda, MD 20814 USA
| | - Holger Roth
- grid.451133.10000 0004 0458 4453NVIDIA, Bethesda, MD 20814 USA
| | - Wei-Chih Liao
- grid.412094.a0000 0004 0572 7815Department of Internal Medicine, Division of Gastroenterology and Hepatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan ,grid.19188.390000 0004 0546 0241Internal Medicine, National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002 Taiwan
| | - Weichung Wang
- grid.19188.390000 0004 0546 0241Institute of Applied Mathematical Sciences, National Taiwan University, No. 1, Section 4, Roosevelt Road, Taipei, 10617 Taiwan
| |
Collapse
|
5
|
Chen PT, Wu T, Wang P, Chang D, Liu KL, Wu MS, Roth HR, Lee PC, Liao WC, Wang W. Pancreatic Cancer Detection on CT Scans with Deep Learning: A Nationwide Population-based Study. Radiology 2023; 306:172-182. [PMID: 36098642 DOI: 10.1148/radiol.220152] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Approximately 40% of pancreatic tumors smaller than 2 cm are missed at abdominal CT. Purpose To develop and to validate a deep learning (DL)-based tool able to detect pancreatic cancer at CT. Materials and Methods Retrospectively collected contrast-enhanced CT studies in patients diagnosed with pancreatic cancer between January 2006 and July 2018 were compared with CT studies of individuals with a normal pancreas (control group) obtained between January 2004 and December 2019. An end-to-end tool comprising a segmentation convolutional neural network (CNN) and a classifier ensembling five CNNs was developed and validated in the internal test set and a nationwide real-world validation set. The sensitivities of the computer-aided detection (CAD) tool and radiologist interpretation were compared using the McNemar test. Results A total of 546 patients with pancreatic cancer (mean age, 65 years ± 12 [SD], 297 men) and 733 control subjects were randomly divided into training, validation, and test sets. In the internal test set, the DL tool achieved 89.9% (98 of 109; 95% CI: 82.7, 94.9) sensitivity and 95.9% (141 of 147; 95% CI: 91.3, 98.5) specificity (area under the receiver operating characteristic curve [AUC], 0.96; 95% CI: 0.94, 0.99), without a significant difference (P = .11) in sensitivity compared with the original radiologist report (96.1% [98 of 102]; 95% CI: 90.3, 98.9). In a test set of 1473 real-world CT studies (669 malignant, 804 control) from institutions throughout Taiwan, the DL tool distinguished between CT malignant and control studies with 89.7% (600 of 669; 95% CI: 87.1, 91.9) sensitivity and 92.8% specificity (746 of 804; 95% CI: 90.8, 94.5) (AUC, 0.95; 95% CI: 0.94, 0.96), with 74.7% (68 of 91; 95% CI: 64.5, 83.3) sensitivity for malignancies smaller than 2 cm. Conclusion The deep learning-based tool enabled accurate detection of pancreatic cancer on CT scans, with reasonable sensitivity for tumors smaller than 2 cm. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Aisen and Rodrigues in this issue.
Collapse
Affiliation(s)
- Po-Ting Chen
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Tinghui Wu
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Pochuan Wang
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Dawei Chang
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Kao-Lang Liu
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Ming-Shiang Wu
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Holger R Roth
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Po-Chang Lee
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Wei-Chih Liao
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| | - Weichung Wang
- From the Department of Medical Imaging (P.T.C., K.L.L.) and Division of Gastroenterology and Hepatology, Department of Internal Medicine (M.S.W., W.C.L.), National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Applied Mathematical Sciences (T.W., D.C., W.W.) and Departments of Computer Science and Information Engineering (P.W.) and Internal Medicine, College of Medicine (M.S.W., W.C.L.), National Taiwan University, No. 1, Section 4, Roosevelt Rd, Taipei 10617, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan (K.L.L.); NVIDIA, Bethesda, Md (H.R.R.); and National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan (P.C.L.)
| |
Collapse
|
6
|
Haron FN, Azazi A, Chua KH, Lim YAL, Lee PC, Chew CH. In silico structural modeling and quality assessment of Plasmodium knowlesi apical membrane antigen 1 using comparative protein models. Trop Biomed 2022; 39:394-401. [PMID: 36214436 DOI: 10.47665/tb.39.3.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Plasmodium knowlesi is the most common zoonotic parasite associated with human malaria infection in Malaysia. Apical membrane antigen 1 (AMA1) protein in the parasite plays a critical role in parasite invasion into host cells. To date, there is no complete three-dimensional ectodomain structure of P. knowlesi AMA1 (PkAMA1) protein. The knowledge of a protein structure is important to understand the protein molecular functions. Three in silico servers with respective structure prediction methods were used in this study, i.e., SWISS-MODEL for homology modeling and Phyre2 for protein threading, which are template-based modeling, while I-TASSER for template-free ab initio modeling. Two query sequences were used in the study, i.e., native ectodomain of PkAMA1 strain H protein designated as PkAMA1-H and a modified PkAMA1 (mPkAMA1) protein sequence in adaptation for Pichia pastoris expression. The quality of each model was assessed by ProSA-web, QMEAN and SAVES v6.0 (ERRAT, Verify3D and Ramachandran plot) servers. Generated models were then superimposed with two models of Plasmodium AMA1 deposited in Protein Data Bank (PDB), i.e., PkAMA1 (4UV6.B) and Plasmodium vivax AMA1 (PvAMA1, 1W81) protein structures for similarity assessment, quantified by root-meansquare deviation (RMSD) value. SWISS-MODEL, Phyre2 and I-TASSER server generated two, one and five models, respectively. All models are of good quality according to ProSA-web assessment. Based on the average values of model quality assessment and superimposition, the models that recorded highest values for most parameters were selected as best predicted models, i.e., model 2 for both PkAMA1-H and mPkAMA1 from SWISS-MODEL as well as model 1 of PkAMA1-H and model 3 of mPkAMA1 from I-TASSER. Template-based method is useful if known template is available, but template-free method is more suitable if there is no known available template. Generated models can be used as guidance in further protein study that requires protein structural data, i.e., protein-protein interaction study.
Collapse
Affiliation(s)
- F N Haron
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
| | - A Azazi
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
| | - K H Chua
- Department of Biomedical Science, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y A L Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - P C Lee
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah, Jalan UMS, 88400 Kota Kinabalu, Sabah, Malaysia
- Biotechnology Research Institute, Universiti Malaysia Sabah, Jalan UMS, 88400 Kota Kinabalu, Sabah, Malaysia
| | - C H Chew
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
| |
Collapse
|
7
|
Wang TH, Chuang HI, Lee PC. How we enhance health literacy of the population through public-private partnership. J Formos Med Assoc 2022; 121:2146-2147. [PMID: 35484002 DOI: 10.1016/j.jfma.2022.04.008] [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] [Received: 03/07/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 10/31/2022]
Affiliation(s)
- Tsung-Hsi Wang
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Hsin-I Chuang
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Po-Chang Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan.
| |
Collapse
|
8
|
Tsai HY, Huang YW, Chang SY, Huang LY, Lin CJ, Lee PC. The reimbursement coverage decisions and pricing rules for medical devices in Taiwan. GMS Health Innov Technol 2022; 16:Doc02. [PMID: 35360087 PMCID: PMC8953662 DOI: 10.3205/hta000134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Medical technology is undergoing rapid transformations, and the classifications of medical devices have also expanded greatly; therefore, it is necessary to develop appropriate reimbursement policies and pricing mechanisms in a timely manner. This paper aims to introduce the reimbursement coverage and pricing rules for medical devices in Taiwan. In addition, this paper identifies and evaluates available health technology assessments (HTA) and literature on published websites concerning medical device decision-making processes and pricing systems in South Korea and Japan, which are near Taiwan and have similar reimbursement coverage processes. Reimbursement policy and pricing mechanisms are constantly being revised in Taiwan, Japan, and South Korea. Recently, all three countries attempted to establish new reimbursement coverage decision-making and pricing rules, adopting a differentiated approach based on the level of evidence required for the appropriated reimbursement in terms of a feasible evaluation mechanism for providing patients with more effective medical devices. This article is expected to contribute to providing references to new reimbursement coverage decision-making and pricing rules.
Collapse
Affiliation(s)
- Hsin-Yi Tsai
- Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan
| | - Yu-Wen Huang
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Shu-Ya Chang
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Li-Ying Huang
- Division of Health Technology Assessment, Center for Drug Evaluation, Taipei, Taiwan,*To whom correspondence should be addressed: Po-Chang Lee, , E-mail:
| | - Chii Jeng Lin
- College of Medicine, National Cheng Kung University, Tainan, Taiwan,Medical Devices Reimbursement Committee of Taiwan, Tainan, Taiwan,*To whom correspondence should be addressed: Po-Chang Lee, , E-mail:
| | - Po-Chang Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan,Departement of Surgery, College of Medicine, National Cheng Kung University, Tainain, Taiwan,*To whom correspondence should be addressed: Po-Chang Lee, , E-mail:
| |
Collapse
|
9
|
Lee PC, Wang TH, Tsai YT. Using IT system to improve public communication in the post-epidemic era. J Formos Med Assoc 2021; 120:1809-1810. [PMID: 34420840 PMCID: PMC8376561 DOI: 10.1016/j.jfma.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Po-Chang Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan.
| | - Tsung-Hsi Wang
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Yuan-Ting Tsai
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| |
Collapse
|
10
|
Azazi A, Haron FN, Chua KH, Lim YAL, Lee PC, Chew CH. Bioinformatics characterization of Plasmodium knowlesi apical membrane antigen 1 (PkAMA1) for multi-epitope vaccine design. Trop Biomed 2021; 38:265-275. [PMID: 34362869 DOI: 10.47665/tb.38.3.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Malaria caused by Plasmodium knowlesi species has become a public health concern, especially in Malaysia. Plasmodium knowlesi parasite which originates from the macaque species, infects human through the bite of the Anopheles mosquitoes. Research on malaria vaccine has been a continuous effort to eradicate the malaria infection, yet there is no vaccine against P. knowlesi malaria to date. Apical membrane antigen 1 (AMA1) is a unique surface protein of all apicomplexan parasites that plays a crucial role in parasite-host cell invasion and thus has been a long-standing malaria vaccine candidate. The selection of protective epitopes in silico has led to significant advances in the design of the vaccine. The present study aimed to employ bioinformatics tools to predict the potential immunogenic B- and T-cell epitopes in designing malaria vaccine targeting P. knowlesi AMA1 (PkAMA1). B-cell epitopes were predicted using four bioinformatics tools, i.e., BepiPred, ABCpred, BcePred, and IEDB servers whereas T-cell epitopes were predicted using two bioinformatics servers, i.e., NetMHCpan4.1 and NetMHCIIpan-4.0 targeting human major histocompatibility complex (MHC) class I and class II molecules, respectively. The antigenicity of the selected epitopes computed by both B- and T-cell predictors were further analyzed using the VaxiJen server. The results demonstrated that PkAMA1 protein encompasses multi antigenic regions that have the potential for the development of multi-epitope vaccine. Two B- and T-cell epitopes consensus regions, i.e., NSGIRIDLGEDAEVGNSKYRIPAGKCP (codons 28-54) and KTHAASFVIAEDQNTSY RHPAVYDEKNKT (codons 122-150) at domain I (DI) of PkAMA1 were reported. Advancement of bioinformatics in characterization of the target protein may facilitate vaccine development especially in vaccine design which is costly and cumbersome process. Thus, comprehensive B-cell and T-cell epitope prediction of PkAMA1 offers a promising pipeline for the development and design of multi-epitope vaccine against P. knowlesi.
Collapse
Affiliation(s)
- A Azazi
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
| | - F N Haron
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
| | - K H Chua
- Department of Biomedical Science, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y A L Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia.,Centre of Excellence for Research in AIDS (CERiA), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - P C Lee
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah, Jalan UMS, 88400 Kota Kinabalu, Sabah, Malaysia
| | - C H Chew
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 21300 Kuala Nerus, Terengganu, Malaysia
| |
Collapse
|
11
|
Chen JY, Liu YC, Lee PC, Lien WC. The specialty-variation effect on the utilization of outpatient service at the COVID-contained hospitals in Taiwan. J Formos Med Assoc 2021; 120:1926-1927. [PMID: 33965259 PMCID: PMC8099732 DOI: 10.1016/j.jfma.2021.04.015] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Jia-Yu Chen
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Chuan Liu
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Po-Chang Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taiwan
| | - Wan-Ching Lien
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
12
|
Liang JA, Lee PC, Ku CP, Chen WTL, Chung CY, Kuo YC, Chou SH, Li CC, Chien CR. Effectiveness of Image-Guided Radiotherapy in Adjuvant Radiotherapy on Survival for Localized Breast Cancer: A Population-Based Analysis. Cancer Manag Res 2021; 13:3465-3472. [PMID: 33907469 PMCID: PMC8069678 DOI: 10.2147/cmar.s299975] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/13/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose Image-guided radiotherapy (IGRT) is an advanced radiotherapy technique to improve the radiotherapy delivery. We aimed to compare the overall survival (OS) for localized breast cancer (LBC) patient treated with adjuvant conventional fractionated radiotherapy (CFRT) using IGRT vs those without IGRT via a population-based analysis. Patients and Methods Eligible LBC patients diagnosed between 2011 and 2013 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratio (HR) of death and other outcomes were compared between IGRT and non-IGRT. We also evaluated OS in various supplementary analyses. Results Our primary analysis included 6490 patients in whom covariates were well balanced after PS weighing. The HR for death when IGRT was compared with non-IGRT was 1.02 (95% confidence interval 0.80–1.31, P = 0.86). There were also no significant differences in the supplementary analyses. Conclusion We found that OS of LBC patients treated with adjuvant CFRT was not statistically different between those treated with IGRT versus without IGRT. This was the first study in this regard to our knowledge but randomized controlled trials were needed to confirm our finding.
Collapse
Affiliation(s)
- Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Po-Chang Lee
- Department of Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Chun-Ping Ku
- Department of Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - William Tzu-Liang Chen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Chih-Yuan Chung
- Department of Medical Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Yu-Cheng Kuo
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Szu-Hsien Chou
- Department of Medical Imaging, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Chun-Ru Chien
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| |
Collapse
|
13
|
Lee PC, Kao FY, Liang FW, Lee YC, Li ST, Lu TH. Existing Data Sources in Clinical Epidemiology: The Taiwan National Health Insurance Laboratory Databases. Clin Epidemiol 2021; 13:175-181. [PMID: 33688263 PMCID: PMC7935352 DOI: 10.2147/clep.s286572] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/30/2021] [Indexed: 01/28/2023] Open
Abstract
This paper provides an introduction to laboratory databases established by Taiwan National Health Insurance Administration (NHIA) since 2015 and released for research since June 2017. The National Health Insurance (NHI) is a government-run single-payer program introduced in 1995 that now covers more than 99% of 23 million Taiwanese citizens. To prevent duplication of medication prescriptions and laboratory test and examination prescriptions, contracted health care providers are required to upload the results of laboratory tests and reports of examinations to the NHIA. The cumulative number of laboratory test results was 5.64 billion from January 2015 to the end of August 2020 for 602 types of test. There are 35 variables for each laboratory test result stored in the databases that can be used for research. However, different hospitals might use different format in reporting the results. The researchers therefore have to develop algorithms to include and exclude incompatible records and to determine whether the results are positive or negative (normal or abnormal). The NHIA suggests that researchers release their source codes of algorithms so that other researchers can modify the codes to improve inter-study comparability. Through the unique personal identification number, the laboratory data can be linked to NHI inpatient and outpatient claims data for further value-added analyses. Non-Taiwanese researchers can collaborate with Taiwan researchers to access the NHI laboratory databases.
Collapse
Affiliation(s)
- Po-Chang Lee
- National Health Insurance Administration, Ministry of Health & Welfare, Taipei, Taiwan
| | - Feng-Yu Kao
- National Health Insurance Administration, Ministry of Health & Welfare, Taipei, Taiwan
| | - Fu-Wen Liang
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chan Lee
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Tun Li
- Department of Industrial and Information Management, College of Management, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Hsueh Lu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
14
|
Mahmud F, Lee PC, Abdul Wahab H, Mustaffa KMF, Leow CH, Azhar R, Lai NS. Plasmodium falciparum protein kinase as a potential therapeutic target for antimalarial drugs development. Trop Biomed 2020; 37:822-841. [PMID: 33612795 DOI: 10.47665/tb.37.3.822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Malaria is one of the most dangerous infectious diseases due to its high infection and mortality rates, especially in the tropical belt. Plasmodium falciparum (P. falciparum), the most virulent malaria parasite in humans, was recently reported to develop resistance against the final efficient antimalarial drug, artemisinin. Little is known about the resistance mechanisms, which further complicates the problem as a proper counteraction is unable to be taken. Hence, the understanding of drug mode of action and its molecular target is valuable knowledge that needs to be considered to develop the next generation of antimalarial drugs. P. falciparum protein kinase (Pf PK) is an attractive target for antimalarial chemotherapy due to its vital roles in all P. falciparum life stages. Moreover, overall structural differences and the presence of unique Pf PKs that are absent in human kinome, suggesting specific inhibition of Pf PK without affecting human cells is achievable. To date, at least 86 eukaryotic protein kinases have been identified in P. falciparum kinome, by which less than 40 were validated as potential targets at the erythrocytes stage. In this review, recent progress of the furthest validated Pf PKs; Pf Nek-1, Pf CDPK1, Pf CDPK4, Pf PKG, and Pf CLK-3 will be briefly discussed.
Collapse
Affiliation(s)
- F Mahmud
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia.,Faculty of Science and Natural Resources, Universiti Malaysia Sabah
| | - P C Lee
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah
| | - H Abdul Wahab
- School of Pharmaceutical Science, Universiti Sains Malaysia
| | - K M F Mustaffa
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia
| | - C H Leow
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia
| | - R Azhar
- Department of Zoology, Government College University Faisalabad, Pakistan
| | - N S Lai
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia
| |
Collapse
|
15
|
Chen CM, Jyan HW, Chien SC, Jen HH, Hsu CY, Lee PC, Lee CF, Yang YT, Chen MY, Chen LS, Chen HH, Chan CC. Containing COVID-19 Among 627,386 Persons in Contact With the Diamond Princess Cruise Ship Passengers Who Disembarked in Taiwan: Big Data Analytics. J Med Internet Res 2020; 22:e19540. [PMID: 32353827 PMCID: PMC7202311 DOI: 10.2196/19540] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/30/2020] [Indexed: 11/13/2022] Open
Abstract
Background Low infection and case-fatality rates have been thus far observed in Taiwan. One of the reasons for this major success is better use of big data analytics in efficient contact tracing and management and surveillance of those who require quarantine and isolation. Objective We present here a unique application of big data analytics among Taiwanese people who had contact with more than 3000 passengers that disembarked at Keelung harbor in Taiwan for a 1-day tour on January 31, 2020, 5 days before the outbreak of coronavirus disease (COVID-19) on the Diamond Princess cruise ship on February 5, 2020, after an index case was identified on January 20, 2020. Methods The smart contact tracing–based mobile sensor data, cross-validated by other big sensor surveillance data, were analyzed by the mobile geopositioning method and rapid analysis to identify 627,386 potential contact-persons. Information on self-monitoring and self-quarantine was provided via SMS, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were offered for symptomatic contacts. National Health Insurance claims big data were linked, to follow-up on the outcome related to COVID-19 among those who were hospitalized due to pneumonia and advised to undergo screening for SARS-CoV-2. Results As of February 29, a total of 67 contacts who were tested by reverse transcription–polymerase chain reaction were all negative and no confirmed COVID-19 cases were found. Less cases of respiratory syndrome and pneumonia were found after the follow-up of the contact population compared with the general population until March 10, 2020. Conclusions Big data analytics with smart contact tracing, automated alert messaging for self-restriction, and follow-up of the outcome related to COVID-19 using health insurance data could curtail the resources required for conventional epidemiological contact tracing.
Collapse
Affiliation(s)
| | - Hong-Wei Jyan
- Department of Cyber Security, Executive Yuan, Taipei, Taiwan
| | | | - Hsiao-Hsuan Jen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chen-Yang Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Po-Chang Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Chun-Fu Lee
- National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Yi-Ting Yang
- Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Meng-Yu Chen
- Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Li-Sheng Chen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Hsi Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chang-Chuan Chan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
16
|
Chen YP, Ho TS, Lee PC, Chang HH, Shieh GS, Lee CI, Hu WL, Hung YC. Effects of Chinese and Western Medicine on Patients with Dengue Fever. Am J Chin Med 2020; 48:329-340. [PMID: 32138530 DOI: 10.1142/s0192415x20500160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Dengue fever is an important epidemic disease with a high prevalence in tropical and subtropical countries. We aimed to investigate the effects of a treatment integrating traditional Chinese (TCM) and Western medicines on dengue inpatients with warning signs (i.e., group B) according to the World Health Organization dengue classification in this retrospective cohort study of medical records. Inpatients who were treated with conventional Western therapies in the absence or presence of TCM were assigned to the control and treatment groups, respectively. Data were compared using an analysis of variance, general linear analysis, and chi-square test. The most common clinical symptoms and signs of dengue fever were fever and muscle ache. The treatment group patients were significantly more likely to present general weakness and poor appetite than the control group patients. Patients in the treatment group were more likely to experience stomachache than those in the control group. Moreover, comparisons of the changes in hemoglobin and alanine aminotransferase levels over time revealed significant differences between the patient groups. Zhu Ye Shi Gao Tang, Gui Pi Tang, Paeonia suffruticosa, and Clerodendrum cyrtophyllum were the most commonly administered TCM formula and single herbs in this study. Patients in the treatment group experienced a resolution of symptoms, signs, and laboratory data and were discharged smoothly, without deterioration to death or critical care. Our findings suggest that the integration of TCM and Western medicine may yield an appropriate treatment for dengue fever.
Collapse
Affiliation(s)
- Yu-Pei Chen
- Department of Chinese Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.,School of Medicine, National Cheng Kung University Tainan, Taiwan.,Department of Pharmacy, Chia Nan University of Pharmacy & Science, Tainan, Taiwan.,School of Chinese Medicine, China Medical University Taichung, Taiwan
| | - Tzong-Shiann Ho
- College of Medicine, National Cheng Kung University Tainan, Taiwan.,Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Po-Chang Lee
- School of Medicine, National Cheng Kung University Tainan, Taiwan.,National Health Insurance Administration, Ministry of Health and Welfare, Taipei, Taiwan
| | - Hen-Hong Chang
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, and Chinese Medicine Research Center, China Medical University, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Gia-Shing Shieh
- Department of Urology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.,Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-I Lee
- Department of Infection, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan.,Fooyin University College of Nursing, Kaohsiung, Taiwan
| | - Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| |
Collapse
|
17
|
Goh XT, Chua KH, Vythilingam I, Lee PC, Tan TC, Yap NJ, Chai HC, Nissapatorn V, Lim YAL. Genetic diversity of Merozoite Surface Protein-1 gene block 2 allelic types in Plasmodium falciparum isolates from Malaysia and Thailand. Trop Biomed 2019; 36:70-80. [PMID: 33597428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Malaria is the most common vector-borne parasitic disease in Malaysia and Thailand, especially in Malayan Borneo and along the Thailand border areas, but little is known about the genetic diversity of the parasite. Present study aims to investigate the genetic diversity of Plasmodium falciparum isolates in these two countries and eventually contributes to more effective malaria control strategies, particularly in vaccine and antimalarial treatment. One hundred and seventy three P. falciparum isolates were collected from Malaysia (n = 67) and Thailand (n = 106) and genotyped using nested PCR targeting the polymorphic region of MSP-1, block 2. Sequence analysis was conducted to investigate the allele diversity of the isolates. Three allelic families were identified in Malaysian and Thailand P. falciparum isolates, MAD20, K1 and RO33. Sequence analysis revealed that there were 5 different MAD20, 1 K1 and 2 different RO33 for Malaysian isolates. Thailand isolates exhibited greater polymorphism because there were 13 different MAD20, 6 different K1 and 2 different RO33 identified in this study. Multiclonal infections were observed for the isolates in both countries, however, low multiplicity of infection (MOI) was observed for Malaysian (1.1) and Thailand (1.2) isolates. Phylogenetic analysis showed that P. falciparum isolates of Malaysia and Thailand were clustered in the same group for all the allelic families. Population structure of P. falciparum isolates in Malaysia and Thailand exhibit extensive genetic polymorphism but showed high similarities as well as comparable MOI.
Collapse
Affiliation(s)
- X T Goh
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K H Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - I Vythilingam
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - P C Lee
- Faculty of Natural Resources, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - T C Tan
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N J Yap
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - H C Chai
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - V Nissapatorn
- Research Excellence Center for Innovation and Health Products (RECIHP) and School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
| | - Y A L Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
18
|
Hung SC, Liao KF, Hung HC, Lin CL, Lee PC, Hung SJ, Lai SW. Tamoxifen use correlates with increased risk of hip fractures in older women with breast cancer: A case-control study in Taiwan. Geriatr Gerontol Int 2018; 19:56-60. [PMID: 30511361 DOI: 10.1111/ggi.13568] [Citation(s) in RCA: 6] [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] [Received: 01/26/2018] [Revised: 09/18/2018] [Accepted: 10/08/2018] [Indexed: 12/18/2022]
Abstract
AIM This study aimed to evaluate the association between tamoxifen use and hip fractures in older women with breast cancer in Taiwan. METHODS We carried out a retrospective nationwide case-control study using the database of the Taiwan National Health Insurance Program. A total of 762 female patients with breast cancer aged ≥65 years newly diagnosed with hip fractures from 2000 to 2011 were identified for inclusion in the study. Additionally, 7620 female patients with breast cancer aged ≥65 years without hip fractures were randomly selected as controls. Patients were defined as having used tamoxifen if they had an existing prescription for tamoxifen before the index date. Patients were defined as having never used tamoxifen if they had never been given a prescription for tamoxifen before the index date. We used an unconditional logistic regression model to calculate the odds ratio and 95% confidence interval for the association between tamoxifen use and risk of hip fractures. RESULTS After adjustment for confounding variables, compared with patients who did not use tamoxifen, the adjusted odds ratio of hip fracture was 2.29 for those who had used tamoxifen (95% confidence interval 1.92, 2.72). Furthermore, adjusted odds ratios were 2.74 (95% confidence interval 2.19, 3.42) among patients with a cumulative duration of tamoxifen use of >3 years. CONCLUSION Tamoxifen use is associated with increased risk of hip fractures among older women with breast cancer in Taiwan. Geriatr Gerontol Int 2019; 19: 56-60.
Collapse
Affiliation(s)
- Shih-Chang Hung
- Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
| | - Hung-Chang Hung
- Department of Internal Medicine, Nantou Hospital, Nantou, Taiwan.,Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Po-Chang Lee
- Department of Surgery, Nantou Hospital, Nantou, Taiwan
| | - Shih-Jung Hung
- Department of Pharmacy, Erlin Christian Hospital, Changhua, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
19
|
Lee PC, Ganguly S, Goh SY. Weight loss associated with sodium-glucose cotransporter-2 inhibition: a review of evidence and underlying mechanisms. Obes Rev 2018; 19:1630-1641. [PMID: 30253050 DOI: 10.1111/obr.12755] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 02/07/2023]
Abstract
With their novel, insulin-independent mechanism, sodium-glucose cotransporter-2 (SGLT2) inhibitors are a major turning point in the management of type 2 diabetes mellitus. At present, there are several SGLT2 inhibitors available or in development, and these oral anti-hyperglycaemic agents lower plasma glucose through the inhibition of SGLT2-mediated reuptake of filtered glucose in the kidney. This unique mechanism of action is also expected to result in other beneficial effects, such as weight loss and blood pressure reduction. In various studies, including randomized controlled trials and real-world studies, patients treated with SGLT2 inhibitors have reported weight loss of around 1 to 3 kg. This review describes the characteristics of weight loss associated with SGLT2 inhibitor therapy, the clinical factors affecting SGLT2 inhibitor-associated weight loss and the possible underlying mechanisms of SGLT2 inhibitor-associated weight loss, including changes in metabolism and body composition, and the role of a reduction in insulin dose and compensatory hyperphagia. Understanding the weight loss effect of SGLT2 inhibitors, its related factors and underlying mechanisms can aid clinicians in optimal treatment decision-making, provide valuable insight on both obesity and diabetes management and reveal areas of future research and new therapeutic options.
Collapse
Affiliation(s)
- P C Lee
- Department of Endocrinology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - S Ganguly
- Department of Endocrinology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - S-Y Goh
- Department of Endocrinology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| |
Collapse
|
20
|
Hung SC, Liao KF, Hung HC, Lin CL, Lai SW, Lee PC, Hung SR. Using proton pump inhibitors correlates with an increased risk of chronic kidney disease: a nationwide database-derived case-controlled study. Fam Pract 2018; 35:166-171. [PMID: 29045621 DOI: 10.1093/fampra/cmx102] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 12/18/2022] Open
Abstract
BACKGROUND Those taking proton pump inhibitors (PPIs) might have a higher risk of acute kidney injury. The long-term safety, especially the PPI-associated chronic kidney disease (CKD) is the subsequent concern. OBJECTIVE This study explores the potential relationship between using PPIs and CKD in Taiwan. METHODS Using a database collated by the Taiwan National Health Insurance programme, we conducted a population-based case-controlled study to identify 16 704 cases of patients aged 20 years or older with newly diagnosed CKD between 2000 and 2013. 16 704 controls were randomly selected and were matched by sex, age and comorbidities. 'Use' of PPIs was defined as when subjects had received at least a prescription for PPIs before the index date. 'Non-use' was defined as subjects who had never received a prescription for PPIs before the index date. The odds ratio (OR) for CKD associated with the use of PPIs was estimated by a logistic regression model. RESULTS The OR for CKD was 1.41 for subjects using PPIs [95% confidence interval (CI) 1.34, 1.48] compared with subjects who had never used PPIs. Almost all major types of PPIs present a weak association with increased odds of CKD in cumulative duration and dosage regression analysis. The OR in relation to cumulative duration (per month) of PPIs use was 1.02 (95% CI 1.01, 1.02) and the OR in relation to cumulative dosage (per microgram) of PPIs use was 1.23 (95% CI 1.18, 1.28). CONCLUSIONS Using PPIs presented 1.4-fold higher odds of CKD in Taiwan health insurance claims data analysis.
Collapse
Affiliation(s)
- Shih-Chang Hung
- Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Hung-Chang Hung
- Department of Internal Medicine, Nantou Hospital, Nantou, Taiwan.,Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Po-Chang Lee
- Department of Surgery, Nantou Hospital, Nantou, Taiwan
| | - Shih-Rong Hung
- Department of Pharmacy, Erlin Christian Hospital, Changhua, Taiwan
| |
Collapse
|
21
|
Lee PC, Ching WM, Kam CW, Yau HH. A Case Series of Candle Wax Burns during the Lantern Festival in Hong Kong. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490790200900408] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Every year there was significant number of burn cases during the Lantern (Mid-Autumn) Festival in Hong Kong because children liked to play with fire on that day. They would either burn the lantern or boil the wax from candles in a pot over a fire. When the wax has melted, they poured cold water into it, causing a small explosion with water vapour and wax droplets. Children and adolescents were more common than adults to be burnt by the hot vapour, fire or hot wax. The majority sustained partial thickness burns involving the face. Such burn injuries should be preventable by education and legislation.
Collapse
|
22
|
Wang TH, Lee PC, Chiang YJ. Taiwan's organ donation and transplantation: Observation from national registry point of view. J Formos Med Assoc 2017; 116:649-651. [DOI: 10.1016/j.jfma.2017.02.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 11/17/2022] Open
|
23
|
Suhaini S, Liew SZ, Norhaniza J, Lee PC, Jualang G, Embi N, Hasidah MS. Anti-malarial and anti-inflammatory effects of Gleichenia truncata mediated through inhibition of GSK3β. Trop Biomed 2015; 32:419-433. [PMID: 26695202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Gleichenia truncata is a highland fern from the Gleicheniaceae family known for its traditional use among indigenous communities in Asia to treat fever. The scientific basis of its effect has yet to be documented. A yeast-based kinase assay conducted in our laboratory revealed that crude methanolic extract (CME) of G. truncata exhibited glycogen synthase kinase-3 (GSK3)-inhibitory activity. GSK3β is now recognized to have a pivotal role in the regulation of inflammatory response during bacterial infections. We have also previously shown that lithium chloride (LiCl), a GSK3 inhibitor suppressed development of Plasmodium berghei in a murine model of malarial infection. The present study is aimed at evaluating G. truncata for its anti-malarial and anti-inflammatory effects using in vivo malarial and melioidosis infection models respectively. In a four-day suppressive test, intraperitoneal injections of up to 250 mg/kg body weight (bw) G. truncata CME into P.berghei-infected mice suppressed parasitaemia development by >60%. Intraperitoneal administration of 150 mg/kg bw G. truncata CME into Burkholderia pseudomallei-infected mice improved survivability by 44%. G. truncata CME lowered levels of pro-inflammatory cytokines (TNF-α, IFN-γ) in serum and organs of B. pseudomallei-infected mice. In both infections, increased phosphorylations (Ser9) of GSK3β were detected in organ samples of animals administered with G. truncata CME compared to controls. Taken together, results from this study strongly suggest that the anti-malarial and anti-inflammatory effects elicited by G. truncata in part were mediated through inhibition of GSK3β. The findings provide scientific basis for the ethnomedicinal use of this fern to treat inflammation-associated symptoms.
Collapse
Affiliation(s)
- S Suhaini
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi, Selangor, Malaysia
| | - S Z Liew
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi, Selangor, Malaysia
| | - J Norhaniza
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia
| | - P C Lee
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia
| | - G Jualang
- Faculty of Science and Natural Resources, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia
| | - N Embi
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi, Selangor, Malaysia
| | - M S Hasidah
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM, Bangi, Selangor, Malaysia
| |
Collapse
|
24
|
Lee PC, Bordelon Y, Bronstein J, Sinsheimer JS, Farrer M, Ritz B. Head injury, α-synuclein genetic variability and Parkinson's disease. Eur J Neurol 2014; 22:874-8. [PMID: 25370538 DOI: 10.1111/ene.12585] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 08/29/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Head injury has been linked to Parkinson's disease (PD) in some but not all studies. Differences in the genetic and environmental susceptibility to PD between populations might be one explanation. The joint effects of head injuries and SNCA genetic variants were investigated. METHODS From 2001 to 2012, 561 incident idiopathic PD cases and 721 population controls from central California were enrolled. Subjects reported on head injuries throughout their lifetime and were assessed for genetic variability in the SNCA 5' region (D4S3481; Rep1) and 3' untranslated region (rs356165). In unconditional logistic regression models adjusted for confounders, interactions between head injuries and genetic risk variants were investigated. RESULTS Parkinson's disease risk in individuals with head injury who are carriers of at least one 263 bp allele in D4S3481 or rs356165 variants was 3-4.5-fold higher compared with non-carriers without head injuries. However, tests for interaction between head injury and SNCA D4S3481or rs356165 were not statistically significant. CONCLUSIONS Our study finds some evidence that head injury and D4S3481 or rs356165 variants jointly increase the risk of PD but little evidence of interaction.
Collapse
Affiliation(s)
- P C Lee
- Department of Health Care Management, College of Healthcare Administration and Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
25
|
Lau TP, Roslani AC, Lian LH, Lee PC, Hilmi I, Goh KL, Chua KH. Association between EGF and VEGF functional polymorphisms and sporadic colorectal cancer in the Malaysian population. Genet Mol Res 2014; 13:5555-61. [PMID: 25117311 DOI: 10.4238/2014.july.25.9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Growth factors are polypeptides that are critical for the initiation, progression, and metastasis of cancer. Most tumor cells are capable of synthesizing particular growth factors leading to constitutive pathway activation in these cells through autocrine signaling. Epidermal growth factor (EGF) is a potent mitogenic peptide that exerts direct effects on the proliferation and differentiation of tumor cells in carcinogenesis. By contrast, vascular endothelial growth factor (VEGF) is vital for the invasion and metastasis of neoplasms through the formation of new blood vessels from mature endothelial cells. In this study, we investigated the association between functional polymorphisms of both the EGF and VEGF genes and colorectal cancer (CRC) susceptibility. A total of 130 CRC patients and 212 healthy controls were recruited for this case-control study. Genotyping of genetic variants was conducted via real-time polymerase chain reaction (PCR) amplification with allele-specific TaqMan probes. None of the genotypes of the EGF +61 A>G and VEGF +936 C>T variants was significantly associated with CRC susceptibility among the Malaysian subjects evaluated (P > 0.05). The observed frequency distributions of the EGF +61 A>G polymorphism genotypes showed ethnic heterogeneity, which was not the case for the VEGF +936 C>T genotypes. In conclusion, no positive correlation between these functional polymorphisms and CRC risk was found in this Malaysian population. Studies of the EGF and VEGF genes and CRC susceptibility are scarce, and the results reported thus far differ from one population to another. Hence, more replication studies are warranted before any firm conclusions can be made.
Collapse
Affiliation(s)
- T P Lau
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A C Roslani
- Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - L H Lian
- Casa Vista, Jalan Penaga, Kuala Lumpur, Malaysia
| | - P C Lee
- School of Science and Technology, Universiti Sabah Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - I Hilmi
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K L Goh
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K H Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
26
|
Pascual J, Srinivas T, Chadban S, Citterio F, Oppenheimer F, Tedesco H, Henry M, Legendre C, Watarai Y, Sommerer C, Lee PC, Hexham JM, Dong G, Bernhardt P, Vincenti F. TRANSFORM: a novel study design to evaluate the effect of everolimus on long-term outcomes after kidney transplantation. OAJCT 2014. [DOI: 10.2147/oajct.s63058] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
27
|
Abstract
Mutations in the PAX6 gene that cause aniridia have been identified in various ethnicities but not in the Malaysian population. Therefore, the objective of this study was to investigate the PAX6 mutation in a Malaysian family with congenital aniridia. In this study, a complete ophthalmic examination was performed on a Dusun ethnic family with aniridia. Genomic DNA was extracted from the peripheral blood of the subjects and screened for the PAX6 gene mutation using polymerase chain reaction amplification high-resolution melting curve analysis (PCR-HRM) followed by confirmation via direct DNA sequencing. A heterozygous G deletion (c.857delG) in exon 7 causing a frame shift in PAX6 was identified in all affected family members. Genotype-phenotype correlation analysis revealed congenital cataract and all affected family members showed a similar spectrum of aniridia with no phenotypic variability but with differences in severity that were age-dependent. In summary, by using a PCR-HRM approach, this study is the first to report a PAX6 mutation in a Malaysian family. This mutation is the cause of the aniridia spectra observed in this family and of congenital cataract.
Collapse
Affiliation(s)
- P C Lee
- School of Science and Technology, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu, Sabah, Malaysia
| | - H H Lam
- Department of Ophthalmology, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - S A Ghani
- Department of Ophthalmology, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - V Subrayan
- Department of Ophthalmology, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - K H Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
28
|
Lau TP, Roslani AC, Lian LH, Lee PC, Hilmi I, Goh KL, Chua KH. NOD2/CARD15 variants in Malaysian patients with sporadic colorectal cancer. Genet Mol Res 2014; 13:7079-85. [PMID: 24682985 DOI: 10.4238/2014.march.19.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Colorectal cancer (CRC) is one of the most common types of cancer in both developed and developing countries. This disease is triggered by and progresses via the sequential accumulation of multiple genetic alterations. In addition, the interaction between low-penetrance genes and environmental factors can also increase the risk of developing CRC. Since inflammatory bowel diseases (IBDs) are one of the predisposing factors for CRC, IBD-related genes might, to a certain extent, be associated with cancer initiation. The nucleotide oligomerization domain 2/caspase activating recruitment domain 15 gene (NOD2/CARD15) is the most well-established gene to be associated with increased susceptibility to Crohn's disease. Thus, various studies have been performed to investigate the potential contribution of this gene to CRC risk. In this study, we aimed to determine the frequency of the Arg702Trp, Gly908Arg, 3020insC, Pro268Ser, and JW1 variants of NOD2/CARD15, and to investigate their association with CRC susceptibility. A total of 130 CRC patients and 212 healthy controls were recruited for this study. Subsequently, real-time polymerase chain reaction with TaqMan was performed for the genotyping of these NOD2/ CARD15 variants. None of the NOD2/CARD15 variants was statistically associated to CRC susceptibility in our Malaysian population. Our findings were remarkably similar to those of other Asian cohorts, which indicated that these NOD2/CARD15 variants exhibit genetic heterogeneity between Caucasian and Asian populations.
Collapse
Affiliation(s)
- T P Lau
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A C Roslani
- Division of General Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - L H Lian
- Casa Vista, Jalan Penaga, Kuala Lumpur, Malaysia
| | - P C Lee
- School of Science and Technology, Universiti Sabah Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - I Hilmi
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K L Goh
- Division of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K H Chua
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
29
|
Lee PC, Chiang YJ, Chen ST. Deceased Donor Kidney Transplantation in Taiwan in 2015. Clin Transpl 2014:55-59. [PMID: 26281127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There were 1997 deceased donor renal transplants reported to the Taiwan Organ Registry and Sharing Center between April 1, 2005, and December 31, 2014. The median age of transplant recipients was 45 years, with most patients between 35 and 64 years old. The number of male patients was comparable to that of female patients. There were more blood type O patients than any other blood type. The 1-, 3-, and 5-year patient survival rates were 96%, 93%, and 89%, respectively. Graft survival rates at 1, 3, and 5 years were 94%, 88%, and 82%, respectively. Overall patient survival was significantly worse in patients with hepatitis B surface antigen (P = 0.0058). However, with respect to overall graft survival, there was no significant difference between patients with or without hepatitis B surface antigen (P = 0.100). Overall patient survival was significantly worse in patients with hepatitis C virus antibody (HCV Ab) compared to patients without HCV Ab (P < 0.0001). Likewise, overall graft survival was significantly worse in patients with HCV Ab compared to patients without HCV Ab (P < 0.0001). In order to promote willingness to be an organ donor, the following law was passed: if any person becomes a deceased organ donor, up to three of his or her blood relatives would have priority to receive a deceased donor organ should they be on the waiting list for transplantation. We do wish this organ allocation priority will be an incentive for deceased organ donors' families to think "to give is to take".
Collapse
|
30
|
Lee PC, Chen YL, Wang WM, Tu WC, Chen HY. Clinical relevance of pre- and post-transplant HLA antibodies, donor-specific, and nondonor-specific HLA antibodies detected by ELISA in renal transplantation. Clin Transpl 2013:385-391. [PMID: 25095533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Human leukocyte antigen (HLA) antibodies reactive to donor antigens (DSA) and non-donor specific antigens (NDSA) were detected by enzyme-linked immunosorbent assay (ELISA) to determine their impact on long-term graft survival. Among 162 patients who had no pre-transplant HLA antibodies, 5-year graft survival was 87%. There was a significant difference compared with 72% for 18 patients who had pre-transplant HLA antibodies (p=0.031). There was a significant difference in graft survival between patients with pre-transplant NDSA and those without HLA antibodies (p=0.0005), but there was not between patients with pre-transplant DSA and those without HLA antibodies (p=0.615). Among 148 patients who had no post-transplant HLA antibodies, 5-year graft survival was 86%. There was no significant difference compared with 85% for 32 patients who had post-transplant HLA antibodies (p=0.118). There was a significant difference in graft survival between patients with post-transplant DSA and those without HLA antibodies (p=0.006), but there was not between patients with post-transplant NDSA and those without HLA antibodies (p=0.599). In conclusion, pre-transplant NDSA and post-transplant DSA were associated with poor long-term graft survival. For patients who had persistent pre- and post-transplant HLA antibodies, the worst long-term survival could be found. We believe HLA antibody analysis by ELISA is still very useful for transplantation.
Collapse
|
31
|
Lee PH, Vathsala A, Han DJ, Chan TM, Wong HS, Woodcock C, Kurstjens N, Sivaraman P, Chu SH, Hsieh HH, Hsu KH, Lee PC, Lian JD, Yang WC, Morad Z, Tan SY, Han DJ, Park KI, Siu YP, Tsang WK. Conversion to enteric-coated mycophenolate sodium from mycophenolate mofetil in stable renal transplant patients: Results of an Asia-Pacific study. Nephrology (Carlton) 2012; 18:57-62. [DOI: 10.1111/nep.12007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Po-Huang Lee
- National Taiwan University Hospital; Taipei; Taiwan
| | | | | | | | | | - Chad Woodcock
- Novartis Pharmaceuticals; Sydney; New South Wales; Australia
| | - Nicol Kurstjens
- Novartis Pharmaceuticals; Sydney; New South Wales; Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Lee PC. Monitoring Cyclosporine Absorption: A Step Beyond Therapeutic Drug Monitoring. Nephrourol Mon 2012; 5:712-3. [PMID: 23577338 PMCID: PMC3614326 DOI: 10.5812/numonthly.7463] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 07/30/2012] [Indexed: 11/25/2022] Open
Affiliation(s)
- Po-Chang Lee
- National Cheng Kung University Hospital, Taipei, Taiwan
- Corresponding author: Po-Chang Lee, National Cheng Kung University Hospital, Taipei, Taiwan. Tel.: +886-914255380, Fax: +886-914255380, E-mail:
| |
Collapse
|
33
|
Taniguchi M, Terasaki P, Hopfield J, Banuelos N, Lee PC. 97-P DSA vs. NDSA reactions against disulfide bond-reduced HLA class II DQ antigens. Hum Immunol 2011. [DOI: 10.1016/j.humimm.2011.07.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
34
|
Lin SY, Fetzer SJ, Lee PC, Chen CH. Predicting adherence to health care recommendations using health promotion behaviours in kidney transplant recipients within 1-5 years post-transplant. J Clin Nurs 2011; 20:3313-21. [DOI: 10.1111/j.1365-2702.2011.03757.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
35
|
Abstract
Allele frequencies of 15 short tandem repeat (STR) loci, namely D5S818, D7S820, D13S317, D16S539, TH01, TPOX, Penta D, Penta E, D3S1358, D8S1179, D18S51, D21S11, CSF1PO, vWA, and FGA, were determined for 154 individuals from the Kadazan-Dusun tribe, an indigenous population of East Malaysia. All loci were amplified by polymerase chain reaction, using the Powerplex 16 system. Alleles were typed using a gene analyzer and the Genemapper ID software. Various statistical parameters were calculated and the combined power of discrimination for the 15 loci in the population was calculated as 0.999999999999999. These loci are thus, informative and can be used effectively in forensic and genetic studies of this indigenous population.
Collapse
Affiliation(s)
- B P Kee
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | | |
Collapse
|
36
|
Rubinstein E, Barriere SL, Genter FC, Corey GR, Lee PC, Lalani T. Late ventilator-associated pneumonia: analysis of baseline characteristics and clinical outcomes in the ATTAIN studies. Crit Care 2010. [PMCID: PMC2934041 DOI: 10.1186/cc8312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
37
|
Hung CJ, Lin YJ, Chang SS, Chou TC, Lee PC. Development of laparoscopic donor nephrectomy: a strategy to increase living kidney donation incentive and maintain equivalent donor/recipient outcome. J Formos Med Assoc 2009; 108:135-45. [PMID: 19251549 DOI: 10.1016/s0929-6646(09)60044-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND/PURPOSE Laparoscopic donor nephrectomy (LDN) has emerged as the preferred technique worldwide, and has contributed to a dramatic increase in living kidney donation during the past decade. We adopted LDN in 2002 with the intention of increasing living kidney donation incentive and maintaining equivalent donor/recipient outcome. METHODS Forty-five LDNs were performed between September 2002 and November 2007. Donor demographics, operative characteristics, perioperative complications and donor/recipient outcome were reviewed retrospectively. The LDN series was divided into earlier and later groups for comparison. To confirm the safety and efficacy of LDN, we compared the results with those of previous series and our open donor nephrectomy (ODN) series. RESULTS All 45 LDN kidneys were procured and transplanted successfully. Mean donor operation time was 327.7+/-10.2 minutes, blood loss was 286.0+/-48.3 mL, and warm ischemia time was 233.9+/-19.6 seconds. Two (4.4%) open conversions happened in the earlier group. There was a significant decrease in warm ischemia time and donor intraoperative complications in the later group. There was no donor mortality and there were no repeat surgical procedures. Delayed graft function occurred in 8.9% of cases and three (6.7%) recipients developed ureteral complications. All but one recipient was discharged with adequate renal function. Graft function continued in 41 of the 43 harvested kidneys (95.3%). Compared with ODN, there was a significant decrease in donor postoperative stay in the LDN series (p=0.00). There was no difference between the series with regard to donor safety, donor outcome, and immediate and long-term recipient outcome. CONCLUSION The number of living kidney donations increased significantly after adopting LDN in our series. The equivalent donor/recipient outcome of the LDN series compared with that of previous and ODN series was achieved with increasing experience.
Collapse
Affiliation(s)
- Chung-Jye Hung
- Division of Transplant Surgery, Department of Surgery, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
| | | | | | | | | |
Collapse
|
38
|
Zhu L, Lee PC, Everly MJ, Terasaki PI. Detailed examination of HLA antibody development on renal allograft failure and function. Clin Transpl 2008:171-187. [PMID: 19711514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This is a long-term retrospective case-control study. Serial sera were collected over 17 years (1991-2008) from two groups comprised of 29 patients with allograft failure (250 sera) and 25 controls with functioning grafts (305 sera), each control matched by transplant date to one failure-group patient, and all patients tested with single antigen beads. The median follow-up for failure-group patients was 7.3 +/- 4.7 years and 11.8 +/- 4.4 years for controls. HLA alloantibodies appeared in 28 of the 29 failure-group patients (97%) and in 12 of the 25 controls (48%) (p < 0.0001). DSA and non-DSA that appeared alone--without any DSA detected-were both associated with graft failure (p = 0.001, p = 0.01). DSA against HLA-DQ antigen was found in 13 of 17 graft-failed patients who had received DQ-incompatible transplants (76%) compared with only one of 11 similarly DQ-mismatched control patients (9%) (p < 0.001). The strength of strong DSA (defined as MFI > 5000) was higher in graft-failed patients than in graft-functioning patients. The time it took for antibodies to develop also differed between groups. HLA antibodies were formed sooner in the failure group compared with the controls (1.7 versus 3.7 years, P < 0.01). Fifteen of the failure group patients developed antibodies within one year while none in the control group did. In conclusion, our study reinforces the observation that circulating de novo HLA alloantibodies predict adverse long-term kidney allograft outcomes. The significant negative impact of all alloantibodies calls for clinicians to monitor patients and implement removal therapy when alloantibody is first detected. This may prove a key step in the ongoing attempt to prevent chronic rejection and prolonging renal allograft survival.
Collapse
Affiliation(s)
- Lan Zhu
- Terasaki Foundation Laboratory, Los Angeles, CA, USA
| | | | | | | |
Collapse
|
39
|
Abstract
We present evidence of agonistic buffering in captive chimpanzees, recorded from 1993 until 2005, mainly from ad libitum sampling in over 2000 hr of observation. A total of 33 agonistic buffering episodes were analyzed for context and effects of this complex social behavior. Agonistic buffering was directed at the whole chimpanzee colony as they supported an individual who initially received aggression from the alpha male, independently of the victim's age, sex or social rank. Chimpanzee agonistic buffering behavior is compared with that in other nonhuman primate species, and we describe some particularities of chimpanzee agonistic buffering: the status of the buffers used-socially important offspring such as those from the alpha female-and the social rank of the adult male responsible for the buffering episode-alpha male. Possible functions for this behavior in chimpanzees are suggested as appeasement of group members in a particularly crowded captive setting, and/or as a "forced reconciliation" mechanism. Chimpanzees exhibit behavioral flexibility by adapting themselves to new social and physical situations and use novel behavior to achieve social benefits.
Collapse
Affiliation(s)
- C Casanova
- Department of Biological Anthropology, University of Cambridge, Cambridge, United Kingdom.
| | | | | |
Collapse
|
40
|
Lee PC, Ozawa M. Reappraisal of HLA antibody analysis and crossmatching in kidney transplantation. Clin Transpl 2007:219-226. [PMID: 18642453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
It has been established that preformed IgG antibodies specific for donor HLA antigens may accelerate graft failure. An increasing number of studies have demonstrated adverse graft survival in patients who have anti-HLA antibodies, whether preformed or developed post-transplant. More recently, ELISA and flow cytometric techniques were introduced to overcome the limited sensitivity and specificity of the CDC assay. These emerging approaches can be reliably used to predict crossmatches in highly sensitized patients and also to monitor the development of clinically relevant anti-HLA antibody after transplantation. This retrospective study used LAT-M screening and Luminex HLA class I and II specificity assay to re-examine: (a), the impact of pre-transplant HLA antibody on long term graft survival; (b), the accuracy with which detection of HLA antibody and specificity by ELISA predicts pretransplant CDC crossmatch; (c), a comparison of Luminex and ELISA methods in detecting HLA antibodies. In this study, pre-transplant sera from 288 renal patients followed up at NCKUH were tested by the ELISA method, LAT-M. The tests showed that 19% had HLA antibodies before transplantation. Among the 234 of the patients who did not have pre-transplant antibodies, 85% enjoyed 5-year functional graft survival, 76% 10-year, and 56% 15-year functional graft survival. The corresponding functional graft survival for the 54 patients who tested HLA antibody-positive was 65%, 53% and 28% (P=0.0021). Sera from 481 patients awaiting kidney transplantation at NCKUH were tested by the ELISA method LAT-M and by CDC to determine how well HLA antibodies detected by ELISA predict the crossmatches shown by CDC. HLA antibodies found by ELISA ranged from 24% weak reactivity (OD "2") to 17% strongly reactive (OD "8"). The positive predictive value (PPV) of ELISA-detected antibodies for positive CDC crossmatch at the time of transplant was found to be 43-54%. The negative predictive value (NPV)-ELISA found no antibodies, CDC no crossmatches- was 88%. The PPV was 55% for sera with HLA class I DSA and 67% with HLA class II sera. On the other hand, NPV was 84% with sera negative for HLA class I DSA and 86% with sera negative for HLA class II DSA. Pretransplant sera from 48 patients with followup data at NCKUH were retested by both ELISA LAT-M and Luminex in order to compare the efficacy of those two methods. ELISA found pre-transplant HLA antibodies in 8 of the 48 (17%). Luminex found HLA antibodies in 27 (56%). Functional graft survival at 5, 10 and 15 years was not significantly different between the 27 patients whom Luminex identified as having pre-transplant HLA antibodies and the 21 patients Luminex found to be free of those antibodies (P=0.7197). For patients shown by Luminex to have pre-transplant class II DSA (N=8), functional graft survival was significantly lower than for those Luminex showed negative for HLA antibodies (P=0.0036). The concept of virtual XM relies on accurate HLA typing and thorough evaluation of HLA antibodies by solid-phase assays. While a negative virtual XM proved to be very reliable to rule out the presence of donor-specific HLA antibodies, it becomes more a concern whether all HLA antibodies detected by flow-beads are in fact clinically relevant. The virtual XM approach-in which antibodies are characterized by solid-phase assays prior to crossmatching-was reported to predict a negative flow XM in greater than 90% of cases. The predictive value for a correct CDC XM, however, was only 75%. A potential disadvantage of the virtual XM approach is that transplants may be excluded based on antibody results with unknown clinical relevance. Based on our results, we believe HLA antibody identification using ELISA still has a role in predicting long term graft survival and negative predictive value for CDC crossmatch before transplantation. Further analysis of HLA antibody, using Luminex, will be done to compare with present data.
Collapse
Affiliation(s)
- Po-Chang Lee
- Department of Surgery, Medical College, National Cheng Kung University, Tainan, Taiwan
| | | |
Collapse
|
41
|
Hsiao CW, Wu CC, Su CY, Fan KF, Tseng IC, Lee PC. Exchange nailing for aseptic tibial shaft nonunion: emphasis on the influence of a concomitant fibulotomy. Chang Gung Med J 2006; 29:283-90. [PMID: 16924890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Exchange nailing is reported to have a high success rate for aseptic tibial nonunions. However, sample sizes in all series in the literature were small, and the influence of a concomitant fibulotomy was not evaluated. METHODS Fifty-four aseptic tibial shaft nonunions for 1.2 approximately 4.3 (mean, 2.4) years were treated with exchange nailing. Indications for this technique included an aseptic nonunion of the tibial shaft with an inserted intramedullary nail and < 2 cm of shortening. A fibulotomy was performed in a nonunion with poor shaft alignment, which concomitantly required manipulation to correct. The success rate of exchange nailing was determined, and whether a concomitant fibulotomy affected the success rate was evaluated. RESULTS Forty-seven nonunions were followed-up for 1.1 approximately 6.9 (mean, 3.8) years, and all nonunions healed. The union rate was 100% (47/47), and the average period required to achieve union was 4.7 (3.0 approximately 7.5) months. The average union periods between the fibulotomy and non-fibulotomy groups did not statistically differ (4.6 vs. 4.8 months, p = 0.61). There were no significant complications in either group. CONCLUSIONS Exchange nailing is an excellent technique to treat aseptic nonunions of the tibia. It can be considered the treatment of choice for all indicated cases. A concomitant fibulotomy has minimal influence on the success rate. It can be performed when the shaft alignment needs correction.
Collapse
Affiliation(s)
- Chih-Wen Hsiao
- Department of Orthopedics, Chang Gung Memorial Hospital, Taipei.
| | | | | | | | | | | |
Collapse
|
42
|
Abstract
The reproductive cycles of 23 captive olive baboons were studied over two successive parturitions. Interbirth intervals of 450 days were reduced by 60% in comparison to wild baboons, and consisted of 145 days of postpartum amenorrhea, 3.5 cycles, and a gestation of 185 days. Dominance rank was found to be one significant factor affecting female fertility. Low-ranking females had longer total intervals between successive births and, in particular, they experienced a longer delay to conception once they had resumed sexual cycles. Mothers of infants who were heavy for age resumed cycling more quickly and had fewer cycles before a subsequent conception. Mothers best able to sustain rapid early infant growth were those of high dominance rank and of high body mass; these females had more rapid reproductive rates. As female energy intake was unrelated to dominance, we suggest that social stresses are important suppressors of the hormonal and lactational competence of subordinate females.
Collapse
Affiliation(s)
- C Garcia
- Laboratoire de Dynamique de l'Evolution Humaine, CNRS UPR 2147, 75014 Paris, France
| | | | | |
Collapse
|
43
|
Abstract
Wild capuchin monkeys inhabiting dry forest were found to customarily use tools as part of their extractive foraging techniques. Tools consisted of twigs and sticks, often modified, which were used to probe for insects and, most frequently, of stones of a variety of sizes and shapes used for cracking and digging. The use of tools for digging has been thought to be restricted to humans. These monkeys, living in a harsh dry habitat, survive food limitation and foraging time constraints through their extensive tool use.
Collapse
Affiliation(s)
- A C de A Moura
- Darwin College, University of Cambridge, Silver Street, Cambridge CB3 9EU, UK.
| | | |
Collapse
|
44
|
Abstract
BACKGROUND Starch digestion is dependent on a combination of pancreatic and salivary amylase and the intestinal brush border enzymes glucoamylase and sucrase-isomaltase. Glucoamylase splits successive glucose molecules from the nonreducing end of starch molecules and is particularly important in infants who are relatively deficient in pancreatic amylase. METHODS The authors measured glucoamylase activity in endoscopic mucosal biopsies submitted for measurement of disaccharidase activity from 214 patients aged 1 month to 20 years. Glucoamylase activity was measured using glucose polymers (polycose) as the substrate. The authors also related enzyme activity to histologic appearance and clinical indication for endoscopy. RESULTS The most common reasons for biopsy were abdominal pain, gastroesophageal reflux, and vomiting. Disaccharidase activity by age was similar to previous reports. Glucoamylase activity did not differ with age, but was 2 to 3 times the activity reported previously. Glucoamylase activity was significantly depressed in children with the most severe histologic abnormalities. Normal glucoamylase activity (+/-2 SD) was 80.6 +/- 54.8 micromoles of glucose produced per minute per gram of protein. CONCLUSIONS Glucoamylase activity is 2 to 3 times higher when glucose polymers are used as substrate than when glycogen is used. Severe mucosal disease is associated with reduced glucoamylase activity. Quantitation of glucoamylase activity with glucose polymers is more appropriate in evaluating children since these polymers are commonly used as carbohydrate source in the diet.
Collapse
Affiliation(s)
- P C Lee
- Department of Pediatrics, Division of Gastroenterology, The Medical College of Wisconsin, Milwaukee 53226, USA
| | | | | | | |
Collapse
|
45
|
Garcia C, Rosetta L, Ancel A, Lee PC, Caloin M. Kinetics of stable isotope and body composition in olive baboons (Papio anubis) estimated by deuterium dilution space: a pilot study. J Med Primatol 2004; 33:146-51. [PMID: 15102071 DOI: 10.1111/j.1600-0684.2004.00064.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Morphometrics and isotope-labelled water were used to determine body composition [total body water, total body fat and fat-free mass (FFM)] of three captive female olive baboons (Papio anubis). Mean mass was 16.5 kg, comparable with other captive settings but heavier than wild olive baboons. Average water content was 66%; FFM averaged 90.5%. Baboon females have less body fat than human counterparts. Compared with captive or wild baboons, these females were adequately nourished for their energy expenditure. A positive association between total mass and FFM existed, but due to the small sample no general relationship was observed for body fat or FFM and condition or size measures. The kinetics of deuterium equilibration in body fluids for baboons was determined as 3-4 hours after injection, similar to that for humans. Deuterium dilution technique appears to be an appropriate method for studying body composition in baboons, although a larger sample is needed for relationships between morphometric indices and body composition.
Collapse
Affiliation(s)
- C Garcia
- Laboratoire de dynamique de l'évolution humaine, Paris, France
| | | | | | | | | |
Collapse
|
46
|
Huo TI, Huang YH, Wu JC, Lee PC, Chang FY, Lee SD. Persistent retention of acetic acid is associated with complete tumour necrosis in patients with hepatocellular carcinoma undergoing percutaneous acetic acid injection. Scand J Gastroenterol 2004; 39:168-73. [PMID: 15000280 DOI: 10.1080/00365520310008269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Ultrasound (US)-guided percutaneous acetic acid injection therapy (PAIT) is effective for patients with hepatocellular carcinoma (HCC). This study aimed to determine the occurrence and predictive value of persistent intra-tumoral retention of acetic acid after PAIT. METHODS We prospectively studied 60 (52 M, mean age 68 +/- 10 years) patients with 72 HCC nodules (45 < or = 3 cm) treated with PAIT. The presence of post-treatment persistent retention of acetic acid, defined as a homogeneous and highly hyperechoid mass in US appearance 3 days after completion of the treatment, was correlated with the treatment response. RESULTS The mean size of the treated tumour was 2.9 +/- 1.0 cm (range 1.5-5 cm). Thirty (42%) HCC nodules showed complete tumour necrosis demonstrated by contrast-enhanced dynamic CT. Complete response was found in 22 (69%) of 32 nodules showing persistent intra-tumoral retention of acetic acid (P < 0.001). Small (< or = 3 cm) tumour size was also significantly associated with complete tumour necrosis (P = 0.001). There were no significant differences of the injection volume and treatment sessions between those with and without complete tumour necrosis in either small or large (> 3 cm) HCC (P > 0.1). Multivariate logistic regression analysis showed that persistent retention of acetic acid (odds ratio (OR) 10.4, 95% confidence interval (CI) 3.1-34.7; P < 0.001) and tumour size < or = 3 cm (OR 6.8, 95%, CI 1.8-25.8; P = 0.002) were independent factors predicting complete tumour necrosis. CONCLUSIONS The presence of persistent retention of acetic acid is associated with a favourable response and may predict complete tumour necrosis after PAIT.
Collapse
Affiliation(s)
- T I Huo
- Division of Gastroenterology, Dept. of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | | | | | | | | | | |
Collapse
|
47
|
Lee PC, Lee SY, Hong SH, Chang HN. Batch and continuous cultures of Mannheimia succiniciproducens MBEL55E for the production of succinic acid from whey and corn steep liquor. Bioprocess Biosyst Eng 2003; 26:63-7. [PMID: 14530958 DOI: 10.1007/s00449-003-0341-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2003] [Accepted: 08/15/2003] [Indexed: 10/26/2022]
Abstract
Mannheimia succiniciproducens MBEL55E isolated from bovine rumen is able to produce a large amount of succinic acid in a medium containing glucose, peptone, and yeast extract. In order to reduce the cost of the medium, whey and corn steep liquor (CSL) were used as substrates for the production of succinic acid by M. succiniciproducens MBEL55E. Anaerobic batch cultures of M. succiniciproducens MBEL55E in a whey-based medium containing CSL resulted in the production of succinic acid with a yield of 71% and productivity of 1.18 g/l/h, which are similar to those obtained in a whey-based medium containing yeast extract (72% and 1.21 g/l/h). Anaerobic continuous culture of M. succiniciproducens MBEL55E in a whey-based medium containing CSL resulted in a succinic acid yield of 69% and a succinic acid productivity as high as 3.90 g/l/h. These results show that succinic acid can be produced efficiently and economically by M. succiniciproducens MBEL55E from whey and CSL.
Collapse
Affiliation(s)
- P C Lee
- Metabolic and Biomolecular Engineering National Research Laboratory, Department of Chemical & Biomolecular Engineering, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong, 305-701 Yuseong-gu, Daejeon, Republic of Korea
| | | | | | | |
Collapse
|
48
|
Huo TI, Huang YH, Wu JC, Lee PC, Chang FY, Lee SD. Comparison of percutaneous acetic acid injection and percutaneous ethanol injection for hepatocellular carcinoma in cirrhotic patients: a prospective study. Scand J Gastroenterol 2003; 38:770-8. [PMID: 12889565 DOI: 10.1080/00365520310003048] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Ultrasound-guided percutaneous ethanol injection (PEI) and percutaneous acetic acid injection (PAI) are effective in the treatment of hepatocellular carcinoma (HCC). We conducted a prospective study to compare the therapeutic efficacy of both these methods. METHODS Sixty-three patients were treated by PAI using 50% acetic acid and 62 by PEI using pure ethanol. There were no significant baseline differences in age, sex, Child-Pugh class, tumour size and number, or other clinico-biochemical parameters between the two groups. RESULTS During a follow-up period of 24 +/- 9 (range 6-38) months, 19 (30%) of the PAI group and 21 (34%) of the PEI group died (P = 0.704). The 1- and 3-year survival rates were 84% and 51% for the PAI group and 81% and 46% for the PEI group (P = 0.651). The corresponding tumour recurrence rates were 51% and 74% for the PAI group, and 54% and 64% for the PEI group (P = 0.787). The treatment sessions were 3.9 +/- 1.6 and 6.2 +/- 2.3 for the PAI and PEI groups, respectively, in each treatment cycle (P = 0.008). A multivariate analysis using the Cox regression model revealed that ascites (relative risk (RR) 3.1, 95% confidence interval (CI) 1.5-6.3, P = 0.002), large (>3 cm) or multinodular HCCs (RR 2.4, 95% CI 1.1-5.4, P = 0.04), and development of tumour recurrence (RR 7.0, 95% CI 3.1-16.0, P < 0.001) were independent, poor prognostic factors in both groups. CONCLUSIONS PAI and PEI are equally effective in the treatment of HCC. PAI has the advantage of fewer treatment sessions in each treatment course. Careful pretreatment patient selection may improve survival.
Collapse
Affiliation(s)
- T I Huo
- Division of Gastroenterology, Dept. of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
| | | | | | | | | | | |
Collapse
|
49
|
Barie PS, Coppa G, Cryer HG, Fry DE, Lee PC, Martens MG, Nichols RL, O'Leary JP, Rapp RP, Sirinek KR, Smith DW, Wilson SE. Roundtable discussion of antibiotic therapy in surgical infections. Surg Infect (Larchmt) 2003; 1:79-89. [PMID: 12594913 DOI: 10.1089/109629600321335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P S Barie
- Cornell University Medical College and Anne and Max A. Cohen Surgical Intensive Care Unit, The New York Presbyterian Hospital-Cornell Medical Center, New York, NY 10021, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
Anaerobiospirillum succiniciproducens grew on a minimal salts medium containing wood hydrolysate (equivalent to 27 g glucose l(-1)) and, when supplemented with 10 g corn steep liquor l(-1) as a complex nitrogen source, succinic acid at 24 g l(-1) was obtained (yield = 88% w/w glucose). This may therefore be an economical method to produce succinic acid.
Collapse
Affiliation(s)
- P C Lee
- Metabolic and Biomolecular Engineering National Research Laboratory, Korea Advanced Institute of Science and Technology, 373-1 Guseong-dong, Yuseong-gu, Daejeon 305-701, Republic of Korea
| | | | | | | | | |
Collapse
|