1
|
Fang N, Chang YR, Fujii S, Yamashita D, Maruyama M, Gao Y, Fong CF, Kozawa D, Otsuka K, Nagashio K, Okada S, Kato YK. Room-temperature quantum emission from interface excitons in mixed-dimensional heterostructures. Nat Commun 2024; 15:2871. [PMID: 38605019 PMCID: PMC11009238 DOI: 10.1038/s41467-024-47099-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
The development of van der Waals heterostructures has introduced unconventional phenomena that emerge at atomically precise interfaces. For example, interlayer excitons in two-dimensional transition metal dichalcogenides show intriguing optical properties at low temperatures. Here we report on room-temperature observation of interface excitons in mixed-dimensional heterostructures consisting of two-dimensional tungsten diselenide and one-dimensional carbon nanotubes. Bright emission peaks originating from the interface are identified, spanning a broad energy range within the telecommunication wavelengths. The effect of band alignment is investigated by systematically varying the nanotube bandgap, and we assign the new peaks to interface excitons as they only appear in type-II heterostructures. Room-temperature localization of low-energy interface excitons is indicated by extended lifetimes as well as small excitation saturation powers, and photon correlation measurements confirm antibunching. With mixed-dimensional van der Waals heterostructures where band alignment can be engineered, new opportunities for quantum photonics are envisioned.
Collapse
Affiliation(s)
- N Fang
- Nanoscale Quantum Photonics Laboratory, RIKEN Cluster for Pioneering Research, Saitama, Japan.
| | - Y R Chang
- Nanoscale Quantum Photonics Laboratory, RIKEN Cluster for Pioneering Research, Saitama, Japan
| | - S Fujii
- Quantum Optoelectronics Research Team, RIKEN Center for Advanced Photonics, Saitama, Japan
- Department of Physics, Keio University, Yokohama, Japan
| | - D Yamashita
- Quantum Optoelectronics Research Team, RIKEN Center for Advanced Photonics, Saitama, Japan
- Platform Photonics Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - M Maruyama
- Department of Physics, University of Tsukuba, Ibaraki, Japan
| | - Y Gao
- Department of Physics, University of Tsukuba, Ibaraki, Japan
| | - C F Fong
- Nanoscale Quantum Photonics Laboratory, RIKEN Cluster for Pioneering Research, Saitama, Japan
| | - D Kozawa
- Nanoscale Quantum Photonics Laboratory, RIKEN Cluster for Pioneering Research, Saitama, Japan
- Quantum Optoelectronics Research Team, RIKEN Center for Advanced Photonics, Saitama, Japan
- Research Center for Materials Nanoarchitectonics, National Institute for Materials Science, Ibaraki, Japan
| | - K Otsuka
- Nanoscale Quantum Photonics Laboratory, RIKEN Cluster for Pioneering Research, Saitama, Japan
- Department of Mechanical Engineering, The University of Tokyo, Tokyo, Japan
| | - K Nagashio
- Department of Materials Engineering, The University of Tokyo, Tokyo, Japan
| | - S Okada
- Department of Physics, University of Tsukuba, Ibaraki, Japan
| | - Y K Kato
- Nanoscale Quantum Photonics Laboratory, RIKEN Cluster for Pioneering Research, Saitama, Japan.
- Quantum Optoelectronics Research Team, RIKEN Center for Advanced Photonics, Saitama, Japan.
| |
Collapse
|
2
|
Chen RJ, Chen MC, Tsai BCK, Roy R, Chang YR, Wang TF, Kuo WW, Kuo CH, Yao CH, Li CC, Huang CY. Ligustrazine improves the compensative effect of Akt survival signaling to protect liver Kupffer cells in trauma-hemorrhagic shock rats. Chem Biol Drug Des 2023; 102:1399-1408. [PMID: 37612133 DOI: 10.1111/cbdd.14327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/16/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023]
Abstract
Trauma-hemorrhagic shock (THS) is a medical emergency that is encountered by physicians in the emergency department. Chuan Xiong is a traditional Chinese medicine and ligustrazine is a natural compound from it. Ligustrazine improves coronary blood flow and reduces cardiac ischemia in animals through Ca2+ and ATP-dependent vascular relaxation. It also decreases the platelets' bioactivity and reduces reactive oxygen species formation. We hypothesized that ligustrazine could protect liver by decreasing the inflammation response, protein production, and apoptosis in THS rats. Ligustrazine at doses of 100 and 1000 μg/mL was administrated in Kupffer cells isolated from THS rats. The protein expressions were detected via western blot. The THS showed increased inflammation response proteins, mitochondria-dependent apoptosis proteins, and had a compensation effect on the Akt pathway. After ligustrazine treatment, the hemorrhagic shock Kupffer cells decreased inflammatory response and mitochondria-dependent apoptosis and promoted a more compensative effect of the Akt pathway. It suggests ligustrazine reduces inflammation response and mitochondria-dependent apoptosis induced by THS in liver Kupffer cells and promotes more survival effects by elevating the Akt pathway. These findings demonstrate the beneficial effects of ligustrazine against THS-induced hepatic injury, and ligustrazine could be a potential medication to treat the liver injury caused by THS.
Collapse
Affiliation(s)
- Ray-Jade Chen
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Cheng Chen
- Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Bruce Chi-Kang Tsai
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Rakesh Roy
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yi-Ru Chang
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tso-Fu Wang
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Medicine, Tzu Chi University, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wei-Wen Kuo
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
- Ph.D. Program for Biotechnology Industry, China Medical University, Taichung, Taiwan
| | - Chia-Hua Kuo
- Department of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Chun-Hsu Yao
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Biomaterials Translational Research Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chi-Cheng Li
- School of Medicine, Tzu Chi University, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Center of Stem Cell & Precision Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chih-Yang Huang
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
- Center of General Education, Buddhist Tzu Chi Medical Foundation, Tzu Chi University of Science and Technology, Hualien, Taiwan
| |
Collapse
|
3
|
Chang YR, Cheng WC, Hsiao YC, Su GW, Lin SJ, Wei YS, Chou HC, Lin HP, Lin GY, Chan HL. Links between oral microbiome and insulin resistance: Involvement of MAP kinase signaling pathway. Biochimie 2023; 214:134-144. [PMID: 37442534 DOI: 10.1016/j.biochi.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
Oral dysbiosis contributes to periodontitis and has implications for systemic diseases. Diabetes mellitus is a common metabolic disorder characterized by impaired glucose regulation. AMP-activated protein kinase (AMPK) plays a vital role in regulating glucose uptake and glycogenesis in the liver. This study aimed to investigate the association between periodontal bacteria and diabetes mellitus. A clinical trial was conducted to explore the association between oral bacteria and hyperglycemia. Additionally, we elucidated the molecular mechanisms by which periodontal bacteria cause insulin resistance. In the clinical trial, we discovered significant alterations in the expression levels of Fusobacterium nucleatum (Fn) and Tannerella forsythia (Tf) in patients with diabetes compared with healthy controls. Furthermore, Fn and Tf levels positively correlated with fasting blood glucose and glycated hemoglobin (HbA1C) levels. Moreover, we explored and elucidated the molecular mechanism by which Fusobacterium nucleatum culture filtrate (FNCF) induces cytokine release via the Toll-like receptor 2 (TLR2) signaling pathway in human gingival epithelial Smulow-Glickman (S-G) cells. This study investigated the effects of cytokines on insulin resistance pathways in liver cells. The use of an extracellular signal-regulated kinase (ERK) inhibitor (U0126) demonstrated that FNCF regulates the insulin receptor substrate 1 and protein kinase B (IRS1/AKT) signaling pathway, which affects key proteins involved in hepatic glycogen synthesis, including glycogen synthase kinase-3 beta (GSK3β) and glycogen synthase (GS), ultimately leading to insulin resistance. These findings suggest that ERK plays a crucial role in hepatocyte insulin resistance.
Collapse
Affiliation(s)
- Yi-Ru Chang
- Institute of Bioinformatics and Structural Biology, National Tsing Hua University, Hsinchu, Taiwan; General Biologicals Corporation, Hsinchu, Taiwan
| | - Wen-Chi Cheng
- SDGs Teaching and Research Headquarters, Tzu Chi University, Hualien, Taiwan
| | - Ya-Chun Hsiao
- Department of Endocrinology and Metabolism, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Guan-Wei Su
- Dental Department of Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Shan-Jen Lin
- Dental Department of Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Yu-Shan Wei
- Institute of Bioinformatics and Structural Biology, National Tsing Hua University, Hsinchu, Taiwan
| | - Hsiu-Chuan Chou
- Institute of Analytical and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | | | - Guan-Yu Lin
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan
| | - Hong-Lin Chan
- Department of Medical Science and Institute of Bioinformatics and Structural Biology, National Tsing Hua University, Hsinchu, Taiwan.
| |
Collapse
|
4
|
Chen UL, Liao CW, Wang SM, Lai TS, Huang KH, Chang CC, Lee BC, Lu CC, Chang YR, Chang YY, Hung CS, Chueh JS, Wu VC, Tsai CH, Lin YH. Diabetes mellitus is associated with more adverse non-hemodynamic left ventricular remodeling and less recovery in patients with primary aldosteronism. J Investig Med 2023; 71:101-112. [PMID: 36647318 DOI: 10.1177/10815589221141840] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The elevated aldosterone in primary aldosteronism (PA) is associated with increased insulin resistance and prevalence of diabetes mellitus (DM). Both aldosterone excess and DM lead to left ventricular (LV) pathological remodeling. In this study, we investigated the impact of DM on LV non-hemodynamic remodeling in patients with PA. We enrolled 665 PA patients, of whom 112 had DM and 553 did not. Clinical, biochemical, and echocardiographic data were analyzed at baseline and 1 year after adrenalectomy. LV non-hemodynamic remodeling was represented by inappropriate excess left ventricular mass index (ieLVMI), which was defined as the difference between left ventricular mass index (LVMI) and predicted left ventricular mass index (pLVMI). Propensity score matching (PSM) was used with age, sex, systolic, and diastolic blood pressure to adjust for baseline variables. After PSM, the patient characteristics were balanced between the DM and non-DM groups, except for fasting glucose, HbA1c, and lipid profile. A total of 111 DM and 419 non-DM patients were selected for further analysis. Compared to the non-DM group, the DM group had significantly higher ieLVMI and LVMI. After multivariable linear regression analysis, the presence of DM remained a significant predictor of increased ieLVMI. After adrenalectomy, ieLVMI decreased significantly in the non-DM group but not in DM group. The presence of DM in PA patients was associated with more prominent non-hemodynamic LV remodeling and less recovery after adrenalectomy.
Collapse
Affiliation(s)
- Uei-Lin Chen
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.,Cardiovascular Center, National Taiwan University Hospital, Taipei
| | - Che-Wei Liao
- Department of Medicine, National Taiwan University Cancer Center, Taipei
| | - Shuo-Meng Wang
- Department of Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Tai-Shuan Lai
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Kuo-How Huang
- Department of Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Chin-Chen Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Bo-Ching Lee
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Ching-Chu Lu
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei
| | - Yi-Ru Chang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.,Cardiovascular Center, National Taiwan University Hospital, Taipei
| | - Yi-Yao Chang
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.,Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City.,Center of General Education, Chihlee University of Technology, New Taipei City
| | - Chi-Sheng Hung
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.,Cardiovascular Center, National Taiwan University Hospital, Taipei
| | - Jeff S Chueh
- Department of Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Vin-Cent Wu
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Cheng-Hsuan Tsai
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.,Cardiovascular Center, National Taiwan University Hospital, Taipei.,National Taiwan University College of Medicine Graduate Institute of Clinical Medicine
| | - Yen-Hung Lin
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.,Cardiovascular Center, National Taiwan University Hospital, Taipei
| | | |
Collapse
|
5
|
Pan CT, Wu XM, Tsai CH, Chang YY, Chen ZW, Chang CC, Lee BC, Liao CW, Chen YL, Lin LC, Chang YR, Hung CS, Lin YH. Hemodynamic and Non-Hemodynamic Components of Cardiac Remodeling in Primary Aldosteronism. Front Endocrinol (Lausanne) 2021; 12:646097. [PMID: 33953695 PMCID: PMC8092478 DOI: 10.3389/fendo.2021.646097] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/24/2021] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Patients with primary aldosteronism (PA) have cardiac remodeling due to hemodynamic and non-hemodynamic causes. However, component analysis of cardiac remodeling and reversal in PA patients is lacking. We investigated components of cardiac remodeling and reversal after adrenalectomy in patients with aldosterone-producing adenoma (APA). METHODS This study prospectively enrolled 304 APA patients who received adrenalectomy and 271 with essential hypertension (EH). Clinical, biochemical and echocardiographic data were collected in both groups and 1 year after surgery in the APA patients. The hemodynamic and non-hemodynamic components of left ventricular (LV) remodeling were represented by predicted left ventricular mass index (LVMI) (pLVMI) and inappropriately excessive LVMI (ieLVMI, defined as LVMI-pLVMI). RESULTS After propensity score matching, 213 APA and 213 EH patients were selected. APA patients had higher hemodynamic (pLVMI) and non-hemodynamic (ieLVMI) components of LV remodeling than EH patients. In multivariate analysis, baseline pLVMI was correlated with systolic blood pressure (SBP) and serum potassium, whereas ieLVMI was correlated with log plasma aldosterone concentration but not blood pressure. Post-operative echocardiography was available in 207 patents and showed significant decreases in both pLVMI and ieLVMI after adrenalectomy. In multivariate analysis, ΔpLVMI was correlated with SBP, ΔSBP, and pre-operative pLVMI, whereas ΔieLVMI was correlated with Δlog aldosterone-to-renin ratio (ARR) and pre-operative ieLVMI. CONCLUSIONS This study concluded that extensive cardiac remodeling in APA patients occurs through hemodynamic and non-hemodynamic causes. Adrenalectomy can improve both hemodynamic and non-hemodynamic components of LV remodeling. Regressions of pLVMI and ieLVMI were correlated with decreases in blood pressure and ARR, respectively.
Collapse
Affiliation(s)
- Chien-Ting Pan
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Xue-Ming Wu
- Department of Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan
| | - Cheng-Hsuan Tsai
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, JinShan Branch, New Taipei, Taiwan
| | - Yi-Yao Chang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
- Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Center of General Education, Chihlee University of Technology, New Taipei City, Taiwan
| | - Zheng-Wei Chen
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Chen Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Bo-Ching Lee
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Che-Wei Liao
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Ya-Li Chen
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Lung-Chun Lin
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ru Chang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Sheng Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hung Lin
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
- *Correspondence: Yen-Hung Lin,
| |
Collapse
|
6
|
Chang YY, Tsai CH, Peng SY, Chen ZW, Chang CC, Lee BC, Liao CW, Pan CT, Chen YL, Lin LC, Chang YR, Peng KY, Chou CH, Wu VC, Hung CS, Lin YH. KCNJ5 Somatic Mutations in Aldosterone-Producing Adenoma Are Associated With a Worse Baseline Status and Better Recovery of Left Ventricular Remodeling and Diastolic Function. Hypertension 2020; 77:114-125. [PMID: 33249859 DOI: 10.1161/hypertensionaha.120.15679] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Primary aldosteronism is the most common secondary endocrine form of hypertension and causes many cardiovascular injuries. KCNJ5 somatic mutations have recently been identified in aldosterone-producing adenoma. However, their impacts on left ventricular remodeling precluding the interference of age, sex, and blood pressure are still uncertain. We enrolled 184 aldosterone-producing adenoma patients who received adrenalectomy. Clinical, biochemical, and echocardiographic data were analyzed preoperatively and 1 year postoperatively. KCNJ5 gene sequencing of aldosterone-producing adenoma was performed. After propensity score matching for age, sex, body mass index, blood pressure, hypertension duration, and number of hypertensive medications, there were 60 patients in each group with and without KCNJ5 mutations. The mutation carriers had higher left ventricular mass index (LVMI) and inappropriately excessive LVMI (ieLVMI) and lower e' than the noncarriers. After adrenalectomy, the mutation carriers had greater decreases in LVMI and ieLVMI than the noncarriers. In addition, only mutation carriers had a significant decrease in E/e' after surgery. In multivariate analysis, baseline LVMI correlated with KCNJ5 mutations, the number of hypertensive medications, and systolic blood pressure. Baseline ieLVMI correlated with KCNJ5 mutations and the number of hypertensive medications. The regression of both LVMI and ieLVMI after surgery was mainly correlated with KCNJ5 mutations and changes in systolic blood pressure. Aldosterone-producing adenoma patients with KCNJ5 mutations had higher LVMI and ieLVMI and a greater regression of LVMI and ieLVMI after adrenalectomy than those without mutations. The patients with KCNJ5 mutations also benefited from adrenalectomy with regard to left ventricular diastolic function, whereas noncarriers did not.
Collapse
Affiliation(s)
- Yi-Yao Chang
- From the National Taiwan University College of Medicine, Graduate Institute of Clinical Medicine, Taipei (Y.-Y.C.).,Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan (Y.-Y.C.).,Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.).,Center of General Education, Chihlee University of Technology, New Taipei City, Taiwan (Y.-Y.C.)
| | - Cheng-Hsuan Tsai
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.).,Department of Obstetrics and Gynecology (C.-H.C.), National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.,Department of Internal Medicine, National Taiwan University Hospital, JinShan Branch (C.-H.T.)
| | - Shih-Yuan Peng
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.)
| | - Zheng-Wei Chen
- Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch (Z.-W.C., C.-T.P.)
| | - Chin-Chen Chang
- Department of Medical Imaging (C.-C.C., B.-C.L.), National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Bo-Ching Lee
- Department of Medical Imaging (C.-C.C., B.-C.L.), National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Che-Wei Liao
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch (C.-W.L.)
| | - Chien-Ting Pan
- Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch (Z.-W.C., C.-T.P.)
| | - Ya-Li Chen
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.)
| | - Lung-Chun Lin
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.).,Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. (L.-C.L., Y.-R.C., C.-S.H., Y.-H.L.)
| | - Yi-Ru Chang
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.).,Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. (L.-C.L., Y.-R.C., C.-S.H., Y.-H.L.)
| | - Kang-Yung Peng
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.)
| | - Chia-Hung Chou
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.)
| | - Vin-Cent Wu
- Division of Nephrology, Department of Internal Medicine (V.-C.W.), National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei
| | - Chi-Sheng Hung
- Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. (L.-C.L., Y.-R.C., C.-S.H., Y.-H.L.)
| | - Yen-Hung Lin
- Division of Cardiology, Department of Internal Medicine (Y.-Y.C., C.-H.T., S.-Y.P., Y.-L.C., L.-C.L., Y.-R.C., K.-Y.P., C.-S.H., Y.-H.L.).,Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan. (L.-C.L., Y.-R.C., C.-S.H., Y.-H.L.)
| | | |
Collapse
|
7
|
Wei YS, Chang YR, Tsai YT, Yang YT, Weng SH, Tseng LF, Chou HC, Hu AT, Liao EC, Chen HY, Lin GY, Cheng WC, Chan HL. The distribution of cultivable oral anaerobic microbiota identified by MALDI-TOF MS in healthy subjects and in patients with periodontal disease. J Pharm Biomed Anal 2020; 192:113647. [PMID: 33010501 DOI: 10.1016/j.jpba.2020.113647] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 09/12/2020] [Accepted: 09/15/2020] [Indexed: 12/22/2022]
Abstract
In this study, we aimed to identify the cultivatable oral anaerobic bacterial distribution in oral cavity by MALDI-TOF Biotyper. The bacterial distribution of three groups, including subjects with/without periodontal disease, two clusters of age (60 years as the cutoff), and before/after treatment, were investigated in this study. There were 38 participants recruited in this study, involving 18 subjects with moderate to severe periodontal-infected patients and 20 healthy controls. Total number of 126 bacterial species were identified by MALDI-TOF MS. The relative abundance of Streptococcus gordonii and Streptococcus intermedius in periodontal patients is higher than healthy controls indicating potential biomarkers for periodontal disease. Participants with periodontal disease were subdivided in to two clusters of age (60 years as the cutoff), 11 and 7 participants were age <60 years and>60 years, respectively. Meanwhile, the incidence of Streptococcus pneumoniae and Streptococcus oralis infection were higher in the subjects above 60 years old than below. Moreover, the bacterial distribution between pre-treatment and post-treatment was similar indicating that basic treatment without the ability to redistribute the microbiota. In summary, the cultivable oral anaerobic bacteria were identified by MALDI-TOF MS and the bacterial distribution shifting was shown to be associated with the progress of periodontal disease to aging and basic treatment. This study provided information for diagnosis and treatment guidelines for oral healthcare.
Collapse
Affiliation(s)
- Yu-Shan Wei
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Yi-Ru Chang
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan; General Biologicals Corporation, Hsinchu, Taiwan
| | - Yi-Ting Tsai
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Yi-Ting Yang
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Shang-Hui Weng
- Department of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Lin-Fang Tseng
- Life Science in Department of Applied Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Hsiu-Chuan Chou
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Taiwan
| | - Alice Tinyu Hu
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan
| | - En-Chi Liao
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Hsin-Yi Chen
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Guan-Yu Lin
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan
| | - Wen-Chi Cheng
- SDGs Teaching and Research Headquarters, Tzu Chi University, Hualien, Taiwan.
| | - Hong-Lin Chan
- Institute of Bioinformatics and Structural Biology and Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan.
| |
Collapse
|
8
|
Wei YS, Hsiao YC, Su GW, Chang YR, Lin HP, Wang YS, Tsai YT, Liao EC, Chen HY, Chou HC, Ko ML, Kuo WH, Chang SJ, Cheng WC, Chan HL. Identification of hyperglycemia-associated microbiota alterations in saliva and gingival sulcus. Arch Biochem Biophys 2020; 682:108278. [DOI: 10.1016/j.abb.2020.108278] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/27/2019] [Accepted: 01/20/2020] [Indexed: 01/15/2023]
|
9
|
Chang YY, Liao CW, Tsai CH, Chen CW, Pan CT, Chen ZW, Chen YL, Lin LC, Chang YR, Wu VC, Wu KD, Hung CS, Lin YH. Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score-Matching Follow-Up Study With Tissue Doppler Imaging. J Am Heart Assoc 2019; 8:e013263. [PMID: 31718437 PMCID: PMC6915298 DOI: 10.1161/jaha.119.013263] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background Primary aldosteronism is the most common cause of secondary hypertension and is associated with left ventricular hypertrophy. However, whether aldosterone excess is responsible for left ventricular (LV) diastolic dysfunction is unknown. Methods and Results We prospectively enrolled 129 patients with aldosterone‐producing adenoma and 120 patients with essential hypertension, and analyzed their clinical, biochemical, and echocardiographic data, including tissue Doppler images. The patients with aldosterone‐producing adenoma were reevaluated 1 year after adrenalectomy. After propensity score matching, there were 105 patients in each group. The patients with aldosterone‐producing adenoma had worse diastolic function than the patients with essential hypertension, as reflected by lower e′ (P<0.001) and higher E/e′ (P=0.003). Multivariate analysis showed that LV diastolic function was significantly correlated with age (P<0.001), sex (P<0.001), body mass index (P=0.002), systolic blood pressure (P=0.004), creatinine (P=0.008), and log‐transformed aldosterone‐renin ratio (P=0.003). After adrenalectomy, the patients with aldosterone‐producing adenoma had significant improvements in LV diastolic function as reflected by an increase in e′ (P=0.003) and decrease in E/e′ (P=0.002). The change in E/e′ was independently correlated with baseline E/e′ (P<0.001) and change in LV mass index (P=0.006). Conclusions The patients with primary aldosteronism had worse LV diastolic function than the patients with essential hypertension after propensity score matching, and this could be reversed after adrenalectomy, suggesting that aldosterone excess may induce LV diastolic dysfunction.
Collapse
Affiliation(s)
- Yi-Yao Chang
- Graduate Institute of Clinical Medicine National Taiwan University College of Medicine Taipei Taiwan.,Cardiology Division of Cardiovascular Medical Center Far Eastern Memorial Hospital New Taipei City Taiwan.,Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan.,Center of General Education Chihlee University of Technology New Taipei City Taiwan
| | - Che-Wei Liao
- Department of Internal Medicine National Taiwan University Hospital Hsin-Chu Branch Hsin-Chu Taiwan
| | - Cheng-Hsuan Tsai
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Ching-Way Chen
- Department of Internal Medicine National Taiwan University Hospital Yun-Lin Branch Yun-Lin Taiwan
| | - Chien-Ting Pan
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Zheng-Wei Chen
- Department of Internal Medicine National Taiwan University Hospital Yun-Lin Branch Yun-Lin Taiwan
| | - Ya-Li Chen
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Lung-Chun Lin
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Yi-Ru Chang
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Vin-Cent Wu
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Kwan-Dun Wu
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Chi-Sheng Hung
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | - Yen-Hung Lin
- Department of Internal Medicine National Taiwan University Hospital and National Taiwan University College of Medicine Taipei Taiwan
| | | | | |
Collapse
|
10
|
Chang YR, Xu FF, Li J, You YH, Liu C, Yin LH. [Surface morphology and surface properties of Ti and TiZr implant materials]. Zhonghua Kou Qiang Yi Xue Za Zhi 2019; 54:118-123. [PMID: 30695914 DOI: 10.3760/cma.j.issn.1002-0098.2019.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effects of hydrophilic treatment on the surface morphology and surface properties of pure titanium and titanium-zirconium alloy implants, and to provide reference for the studies of implant surface modification. Methods: The pure titanium group, the hydrophilic pure titanium group, the titanium zirconium alloy group and the hydrophilic titanium-zirconium alloy group were prepared by sandblasting and acid-etching or hydrophilic sandblasting and acid-etching, (11 specimens in each group). The surface morphology and surface properties of four types of titanium specimens were analyzed by surface contact angle meter, scanning electron microscope (SEM), optical profilometer, atomic force microscope (AFM) and Raman spectrometer. Results: The surface contact angles of hydrophilic pure titanium and hydrophilic titanium-zirconium alloy were 1.6°±0.3° and 1.5°±0.2°, and the surface contact angles of pure titanium and titanium-zirconium alloy were 101.4°±4.6° and 96.2°±3.0°, respectively. SEM showed that the nano-protrusions on the surface of pure titanium and titanium-zirconium alloys were less or even absent, while the nano-protrusions on the surface of hydrophilic pure titanium and hydrophilic titanium-zirconium alloys were relatively more; the nano-protrusions on the surface of hydrophilic pure titanium surface were small and dense relatively, but the nano-protrusions of the hydrophilic titanium-zirconium alloy had large diameters and were dispersed relatively. The optical profiler and AFM showed that the surface roughness of hydrophilic pure titanium and hydrophilic titanium-zirconium alloy was significantly higher than that of pure titanium and titanium-zirconium alloy (P<0.05). Raman spectroscopy showed that only the amorphous TiO(2) was present on the surface of the pure titanium group, while the rutile TiO(2) characteristic peak was observed in the other three groups, but the lateral inhomogeneity was observed. After Raman shift 610 cm(-1), the Raman spectra of four groups were similar. Conclusions: Hydrophilic sandblasting and acid-etching treatment can improve the surface hydrophilicity and surface roughness of pure titanium and titanium zirconium alloy, and improve the surface properties of pure titanium and titanium zirconium alloy implants.
Collapse
Affiliation(s)
- Y R Chang
- Department of Oral Implantology, School of Stomatology, Lanzhou University, Lanzhou 730000, China
| | | | | | | | | | | |
Collapse
|
11
|
Jang JY, Chang YR, Kim SW, Choi SH, Park SJ, Lee SE, Lim CS, Kang MJ, Lee H, Heo JS. Randomized multicentre trial comparing external and internal pancreatic stenting during pancreaticoduodenectomy. Br J Surg 2016; 103:668-675. [PMID: 27040594 DOI: 10.1002/bjs.10160] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/22/2016] [Accepted: 02/12/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is no consensus on the best method of preventing postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). This multicentre, parallel group, randomized equivalence trial investigated the effect of two ways of pancreatic stenting after PD on the rate of POPF. METHODS Patients undergoing elective PD or pylorus-preserving PD with duct-to-mucosa pancreaticojejunostomy were enrolled from four tertiary referral hospitals. Randomization was stratified according to surgeon with a 1 : 1 allocation ratio to avoid any related technical factors. The primary endpoint was clinically relevant POPF rate. Secondary endpoints were nutritional index, remnant pancreatic volume, long-term complications and quality of life 2 years after PD. RESULTS A total of 328 patients were randomized to the external (164 patients) or internal (164) stent group between August 2010 and January 2014. The rates of clinically relevant POPF were 24·4 per cent in the external and 18·9 per cent in the internal stent group (risk difference 5·5 per cent). As the 90 per cent confidence interval (-2·0 to 13·0 per cent) did not fall within the predefined equivalence limits (-10 to 10 per cent), the clinically relevant POPF rates in the two groups were not equivalent. Similar results were observed for patients with soft pancreatic texture and high fistula risk score. Other postoperative outcomes were comparable between the two groups. Five stent-related complications occurred in the external stent group. Multivariable analysis revealed that soft pancreatic texture, non-pancreatic disease and high body mass index (23·3 kg/m2 or above) predicted clinically relevant POPF. CONCLUSION External stenting after PD was associated with a higher rate of clinically relevant POPF than internal stenting. Registration number: NCT01023594 (https://www.clinicaltrials.gov).
Collapse
Affiliation(s)
- J-Y Jang
- Departments of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y R Chang
- Departments of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S-W Kim
- Departments of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S H Choi
- Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S J Park
- Centre for Liver Cancer, National Cancer Centre, Gyeonggido, Republic of Korea
| | - S E Lee
- Chung-Ang University Hospital, Seoul, Republic of Korea
| | - C-S Lim
- Departments of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - M J Kang
- Departments of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H Lee
- Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J S Heo
- Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
12
|
Kang MJ, Jang JY, Chang YR, Jung W, Kim SW. Portal vein patency after pancreatoduodenectomy for periampullary cancer. Br J Surg 2014; 102:77-84. [PMID: 25393075 DOI: 10.1002/bjs.9682] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 09/10/2014] [Accepted: 09/22/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND The fate of the portal vein (PV) after pancreatoduodenectomy, especially its long-term patency and associated complications, has received little attention. The aim of this study was to explore the long-term patency rate of the PV after pancreatoduodenectomy, focusing on risk factors for PV stenosis/occlusion and associated complications. METHODS Serial CT images of patients who underwent pancreatoduodenectomy for periampullary cancer between January 2000 and June 2012 in a single institution were evaluated for PV stenosis or occlusion. RESULTS A total of 826 patients were enrolled. The PV stenosis/occlusion rate after pancreatoduodenectomy was 19.6 per cent and the 5-year patency rate 69.9 per cent. The most frequent cause of PV stenosis/occlusion was local recurrence followed by postoperative change and PV thrombosis. Patients who underwent PV resection had a higher PV stenosis/occlusion rate than those who did not (51 versus 17.4 per cent; P < 0.001). The 3-year patency rate was highest in patients with cancer of the ampulla of Vater and lowest in patients with pancreatic cancer (91.9 versus 55.5 per cent respectively; P < 0.001). Multivariable analysis showed that risk factors for PV stenosis/occlusion included primary tumour location, chemoradiotherapy and PV resection. PV stenosis or occlusion without disease recurrence was observed in 17.3 per cent of the patients. PV resection and grade B or C pancreatic fistula were independent risk factors for PV stenosis/occlusion. Among 162 patients with PV stenosis or occlusion, five (3.1 per cent) had fatal recurrent gastrointestinal bleeding. CONCLUSION PV stenosis or occlusion is common after pancreatoduodenectomy, particularly if the PV has been resected and/or chemoradiotherapy was given after surgery. Although recurrence is the most frequent cause of PV stenosis/occlusion, this complication is found in a significant proportion of patients without disease recurrence.
Collapse
Affiliation(s)
- M J Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | | | | | | | | |
Collapse
|
13
|
Jang JY, Park T, Lee S, Kang MJ, Lee SY, Lee KB, Chang YR, Kim SW. Validation of international consensus guidelines for the resection of branch duct-type intraductal papillary mucinous neoplasms. Br J Surg 2014; 101:686-92. [DOI: 10.1002/bjs.9491] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 12/12/2022]
Abstract
Abstract
Background
Classifications of intraductal papillary mucinous neoplasm (IPMN) remain ambiguous, especially for the mixed type. Factors predicting malignancy remain unclear. The aim of this study was to evaluate the usefulness of factors predicting malignancy in the new international consensus guidelines for resection of branch duct-type (BD)-IPMN and to compare them with those in the previous version.
Methods
A prospectively collected database of patients with biopsy-proven BD-IPMN was analysed to compare factors between the first and second consensus guidelines, particularly as predictors of malignancy.
Results
Of 350 patients with BD-IPMN, sensitivity (0·724) and balanced accuracy (0·751) of the second guidelines were superior to those (0·639 and 0·730) in the first version at the expense of slightly reduced specificity (0·779 versus 0·822 for the first version) by random forest models. Multiple logistic regression analysis showed that main pancreatic duct dilatation greater than 5 mm (hazard ratio (HR) 4·54, 95 per cent confidence interval 2·45 to 8·41; P < 0·001), mural nodules (HR 6·27, 3·27 to 12·01; P < 0·001) and carbohydrate antigen 19–9 level above 37 units/ml (HR 4·03, 1·83 to 8·90; P = 0·001) were independent predictors of BD-IPMN malignancy.
Conclusion
The new consensus guidelines provide better sensitivity, performance of factors predicting malignancy, and balanced accuracy in the diagnosis of BD-IPMN malignancy. Size alone was limited in predicting malignancy. Variability in clinical significance of the individual factors associated with a risk of malignancy indicates the need for a tailored approach in the management of patients with BD-IPMN.
Collapse
Affiliation(s)
- J-Y Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - T Park
- Department of Statistics, Seoul National University College of Natural Sciences, Seoul, Korea
| | - S Lee
- Department of Statistics, Seoul National University College of Natural Sciences, Seoul, Korea
| | - M J Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - S Y Lee
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, Korea
| | - K B Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Y R Chang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - S-W Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
14
|
Park JW, Jang JY, Kim EJ, Kang MJ, Kwon W, Chang YR, Han IW, Kim SW. Effects of pancreatectomy on nutritional state, pancreatic function and quality of life. Br J Surg 2013; 100:1064-70. [DOI: 10.1002/bjs.9146] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2013] [Indexed: 11/08/2022]
Abstract
Abstract
Background
There are concerns about the extent of impaired endocrine and exocrine pancreatic function and poor quality of life (QoL) after pancreatectomy, but there is little information from large prospective follow-up studies.
Methods
Consecutive patients undergoing pancreaticoduodenectomy or distal pancreatectomy between 2007 and 2011 were included. Relative bodyweight (RBW), triceps skinfold thickness (TSFT), serum protein, albumin, transferrin, fasting blood glucose, postprandial 2-h glucose (PP2), glycosylated haemoglobin A1c and stool elastase measurements, and European Organization for Research and Treatment of Cancer QLQ-C30 questionnaires were collected serially for 1 year.
Results
Some 136 patients undergoing pancreatic resection completed the study. RBW and TSFT recovered to over 90 per cent of the preoperative value by 12 months, whereas transferrin, albumin and protein had returned to preoperative levels by 3 months. Diabetes mellitus, impaired fasting glucose or raised PP2 was present in 42 of 76 patients at 6 months and 36 of 76 at 12 months. Although steatorrhoea and diarrhoea had mainly resolved by 3 months, stool elastase level decreased after operation and showed no recovery. Nutritional status, pancreatic endocrine function and QoL returned to preoperative levels in 63 (46·3 per cent), 72 (52·9 per cent) and 77 (56·6 per cent) of 136 patients within 6 months of pancreatectomy. Multivariable analysis revealed that age 60 years or more, operation type, chronic pancreatitis and malignant disease had a significant impact on nutritional index, pancreatic function and QoL.
Conclusion
About half of all patients can expect recovery from pancreatectomy after 6 months, but those with risk factors need more careful follow-up and supportive management.
Collapse
Affiliation(s)
- J W Park
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - J-Y Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - E-J Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - M J Kang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - W Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y R Chang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - I W Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - S-W Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
15
|
Hsu TY, Liu MW, Chang YR, Pai CY, Liu MY, Yang CS, Chen JY. Functional analysis of C-terminal deletion mutants of Epstein-Barr virus thymidine kinase. J Gen Virol 1996; 77 ( Pt 8):1893-9. [PMID: 8760441 DOI: 10.1099/0022-1317-77-8-1893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Thymidine kinase (TK) activity was detected following expression of the TK gene of Epstein-Barr virus (EBV) using the pET expression plasmid and E. coli BL21 (DE3)pLysS. To study the amino acid residues required at the C terminus of the EBV TK protein for enzymatic activity, a series of C-terminal deletion mutants was generated by direct truncation, linker insertion or PCR mutagenesis to create stop codons at particular sites. Deletion of nine residues from the C terminus caused a 35% reduction in TK activity, while a ten-residue deletion completely abolished the activity. A single point mutation at residue Cys570, corresponding to Cys336 of herpes simplex virus TK, did not alter the TK activity. Single amino acid changes within the last seven to ten residues also did not affect activity. The results indicate that maintenance of the conformation of the C terminus is important for enzyme activity.
Collapse
Affiliation(s)
- T Y Hsu
- Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | | | | |
Collapse
|
16
|
Wu CW, Wu TC, Chang YR, Tsay SH, Yin SJ, Lui WY, P'eng FK, Chi CW. Helicobacter Pylori Infection in Patients with Gastric Adenocarcinoma. Tumori 1996; 82:40-4. [PMID: 8623502 DOI: 10.1177/030089169608200108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examined the biologic tumor behavior in Helicobacter pylori-seropositive patients with gastric adenocarcinoma. A total of 214 consecutive patients with pathologically confirmed adenocarcinoma of the stomach who underwent gastric resection were studied. The stored serum samples were tested for serum antibody to H. pylori by using a highly sensitive and specific IgG enzyme-linked immunosorbent assay. The difference in H. pylori-seropositive and seronegative patients with gastric adenocarcinoma was evaluated in terms of various clinicopathologic parameters. A multivariate logistic regression analysis was used to adjust for potential confounding variables. Antibodies to H. pylori were detected in 65.9% of patients with gastric adenocarcinoma. H. pylori-seropositive patients were younger than seronegative patients and had infiltrative tumor according to Ming's criteria. When adjusted for age, infiltrative tumor come out stronger. These findings suggest that H. pylori infection may be related to infiltrative type gastric adenocarcinoma; further study is necessary.
Collapse
Affiliation(s)
- C W Wu
- Department of Surgery, Veterans General Hospital-Taipei, Taiwan Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Abstract
We conducted a study to evaluate the serum theophylline concentrations and dose interval of Theolan preparation in asthmatic children. A series of serum theophylline levels were measured both in 10 asthmatic children taking Theolan once a day and 9 children twice a day. In the once-a-day group, the peak serum theophylline level was greater than 20 micrograms/ml; whereas, in the twice-a-day group, it was mostly between 10 and 20 micrograms/ml. The difference of the peak-to-trough was more fluctuant in the once-a-day group than in the twice-a-day group. These results suggest that Theolan given once a day in the evening can be useful in the management of nocturnal asthma; however, it was difficult for once-a-day administration of Theolan to sustain rigid therapeutic serum theophylline levels. Because of rapid metabolism in children, they may require a more frequent interval than once-a-day dosing to suppress the symptoms of chronic asthma.
Collapse
Affiliation(s)
- R B Tang
- Department of Pediatrics, Veterans General Hospital-Taipei, Taiwan, Republic of China
| | | | | | | | | |
Collapse
|
18
|
Cheng JH, Wang HC, Tang RB, Chang YR, Hwang BT. A rapid cold agglutinin test in Mycoplasma pneumoniae infection. Zhonghua Yi Xue Za Zhi (Taipei) 1990; 46:49-52. [PMID: 2176924] [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: 12/30/2022]
Abstract
A definite diagnosis of Mycoplasma pneumoniae infection is currently based on cultural method or complement fixation test which is usually retrospective. A rapid cold agglutinin test was developed to determine its value on the early diagnosis of M. Pneumoniae infection. One hundred and thirty patients with pneumonia aged between 5 and 14 years were studied. Blood specimens from all the patients were collected for rapid cold agglutinin test, cold hemagglutination test, and complement fixation test. Thirty patients showed positive, rapid cold agglutinin test. All the patients with positive rapid cold agglutinin test had higher (greater than or equal to 1:32) cold agglutinin titers which were simultaneously performed. The rapid cold agglutinin test had 100% sensitivity and 97% specificity when a cut-off criterion was set at cold agglutinin titer greater than or equal to 1:64. Twenty-five of the 130 cases were serologically proven to have M. pneumoniae infection using complement fixation test or/and cold agglutinin titer. M. pneumoniae was a major cause (21/28) in cold agglutinin-positive pneumonic patients. The positive predictive value of the rapid cold agglutinin test is 70% (21/30). Only 28% (7/25) of the patients with M. pneumoniae infection were diagnosed at acute stage with serological method. We conclude that the rapid cold agglutinin test is of much value in the early detection of M. pneumoniae infection in office or hospital practice in children with pneumonia.
Collapse
Affiliation(s)
- J H Cheng
- Department of Pediatrics, Veterans General Hospital-Taipei, R.O.C
| | | | | | | | | |
Collapse
|
19
|
Chang FY, Lai KH, Lu LC, Chang YR, Wu TC, Tsay SH. The relation between Campylobacter pylori and inflammatory cell infiltration of antral mucosa in patients with dyspepsia. Taiwan Yi Xue Hui Za Zhi 1989; 88:8-12. [PMID: 2754423] [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: 01/02/2023]
Abstract
In order to understand the relation between the prevalence of Campylobacter pylori and the severity of gastritis, we conducted a survey of 166 randomly selected dyspeptic patients. The presence of C. pylori on the antral mucosa was aseptically determined by both urease and bacterial culture tests. Specimens of antral mucosa were obtained for pathologic gradings of inflammation: active gastritis, mononuclear cell infiltration C0 (nil) to C3 (lymphoid follicle); presence or absence of intestinal metaplasia. Pathologically, chronic gastritis was invariably present in almost all patients with dyspepsia: three-fourths of them showed evidence of active gastritis, one-third showed intestinal metaplasia. Half of the dyspeptic individuals had C. pylori colonization. The results suggest that the prevalence of C. pylori was closely related to the different grades of active gastritis; neither the different grades of chronic gastritis nor intestinal metaplasia affected the prevalence of C. pylori on gastric mucosa. We conclude from this study that C. pylori is closely related to active chronic gastritis because of the common presence of chronic gastritis in patients with dyspepsia.
Collapse
|
20
|
Wu TC, Lo CH, Ting CW, Chang YR, Tang RB, Wang HC, Hwang B. [Cryptosporidiosis in children]. Taiwan Yi Xue Hui Za Zhi 1987; 86:884-9. [PMID: 3681256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
21
|
Hwang B, Chang YR. Rapid identification of group A streptococcal pharyngitis. Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi 1985; 18:288-92. [PMID: 3910370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|