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Gao SH, Wang GZ, Wang LP, Feng L, Zhou YC, Yu XJ, Liang F, Yang FY, Wang Z, Sun BB, Wang D, Liang LJ, Xie DW, Zhao S, Feng HP, Li X, Li KK, Tang TS, Huang YC, Wang SQ, Zhou GB. Corrigendum to "Mutations and clinical significance of calcium voltage-gated channel subunit alpha 1E (CACNA1E) in non-small cell lung cancer" [Cell Calcium 102 (2022) 102527]. Cell Calcium 2024; 119:102866. [PMID: 38428281 DOI: 10.1016/j.ceca.2024.102866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- S H Gao
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences & University of Chinese Academy of Sciences, Beijing, 100101, China; State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - G Z Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - L P Wang
- State Key Laboratory of Membrane Biology, College of Life Sciences, Peking University, Beijing, 100091, China
| | - L Feng
- Department of Pathology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Y C Zhou
- Department of Thoracic Surgery, the Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, 650106, China
| | - X J Yu
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences & University of Chinese Academy of Sciences, Beijing, 100101, China
| | - F Liang
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences & University of Chinese Academy of Sciences, Beijing, 100101, China; State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - F Y Yang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Z Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - B B Sun
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - D Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - L J Liang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - D W Xie
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - S Zhao
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences & University of Chinese Academy of Sciences, Beijing, 100101, China
| | - H P Feng
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences & University of Chinese Academy of Sciences, Beijing, 100101, China
| | - X Li
- Computer Science Department, University of North Georgia, Dahlonega, GA, 30597, United States
| | - K K Li
- Computer Science Department, University of North Georgia, Dahlonega, GA, 30597, United States
| | - T S Tang
- State Key Laboratory of Membrane Biology, Institute of Zoology, Chinese Academy of Sciences & University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Y C Huang
- Department of Thoracic Surgery, the Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, 650106, China
| | - S Q Wang
- State Key Laboratory of Membrane Biology, College of Life Sciences, Peking University, Beijing, 100091, China
| | - G B Zhou
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Chen HD, Lu B, Zheng Y, Du P, Qi X, Zhang K, Liu YY, Wei JL, Wei DH, Gong JY, Huang YC, Song ZY, Chu X, Dong D, Zheng WJ, Dai M. [Interpretation of specification for service of cancer screening for workers]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:486-489. [PMID: 38678342 DOI: 10.3760/cma.j.cn112338-20240311-00114] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
As the backbone force of China's social and economic construction, the health status of workers is closely related to the nation's productivity and social development. Currently, cancers have become one of the major diseases threatening the health of workers. However, there are still many shortcomings in the cancer screening services for the workers. To standardize cancer screening services for workers, ensure the quality of screening services, and improve the overall screening effectiveness, 19 institutions, including Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences, have jointly formulated the Group Standard "Specification for service of cancer screening for workers (T/CHAA 023-2023)". This standard follows the principles of "legality, scientific rigor, advancement, and feasibility" and combines the frontier scientific advances in cancer screening. It clarifies the relevant requirements for service principles, service design, service delivery, service management, service evaluation, and improving worker cancer screening. Implementing this group standard will help connect the common screening needs of workers, employers, and cancer screening service providers, standardize the screening process, improve screening quality, and ultimately increase the early diagnosis rate and survival rate of cancer patients. Consequently, this group standard will help safeguard workers' health rights and interests, ensure the labor force resources, promote the comprehensive coordinated and sustainable development of society, and contribute to realizing the "Healthy China 2030" strategic policy.
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Affiliation(s)
- H D Chen
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - B Lu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Zheng
- Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - P Du
- Beijing Cancer Hospital, Beijing 100142, China
| | - X Qi
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - K Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y Y Liu
- Cancer Prevention Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - J L Wei
- Henan Cancer Hospital, Zhengzhou 450003, China
| | - D H Wei
- Anhui Cancer Hospital, Hefei 230071, China
| | - J Y Gong
- Department of Preventive Management, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China
| | - Y C Huang
- Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Cancer Center of Yunnan Province, Kunming 650106, China
| | - Z Y Song
- Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, China
| | - X Chu
- Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - D Dong
- Xuzhou Cancer Hospital, Xuzhou 221005, China
| | - W J Zheng
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - M Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Lai KM, Tseng RH, Shih YH, Huang YC. Azacitidine-Hesperetin Combination Induces S-phase Cell Cycle Arrest and Apoptosis in Human Leukemia Cells. Anticancer Res 2024; 44:1033-1044. [PMID: 38423637 DOI: 10.21873/anticanres.16898] [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: 10/19/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND/AIM Chemotherapy drugs for leukemia, such as 5-azacytidine (Aza), have often various adverse effects. Hesperetin (Hes), a naturally occurring compound, is a potential adjuvant agent for anticancer therapy. This study aimed to investigate the effect of an Aza-Hes combination on acute leukemia cell lines, which elucidates the role of combination treatment in leukemia progression. MATERIALS AND METHODS HL-60 and U937 cells were treated with Aza and Hes at various concentrations or their combination. Cell proliferation and apoptosis was evaluated using the Cell Counting Kit-8 assay and annexin V/propidium iodide staining, respectively. Cell cycle analysis was conducted using flow cytometry. The expression of apoptosis-related and cell cycle-related proteins in leukemia cells was analyzed through western blotting. The synergistic effect of the Aza and Hes agents was estimated using the Chou-Talalay method. RESULTS We observed that Aza or Hes monotherapy engendered a dose-dependent reduction in HL-60 and U937 cell viability. However, treatment with the Aza-Hes combination for 24 h synergistically inhibited U937 cell proliferation by inducing both apoptosis and S-phase cell cycle arrest. Furthermore, the Aza-Hes combination down-regulated p-ERK and p-c-Jun N-terminal kinase expression and up-regulated p-p38 expression. CONCLUSION Overall, our findings indicate that the Aza-Hes combination induces apoptosis and S-phase cell-cycle arrest through the mitogen-activated protein kinase pathway. In conclusion, the Aza-Hes combination is a potential antileukemia treatment.
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Affiliation(s)
- Kuan-Ming Lai
- Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, R.O.C
- Hemato-Oncology Division Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, R.O.C
| | - Ruo-Han Tseng
- Hemato-Oncology Division Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, R.O.C
| | - Yu-Hung Shih
- Hemato-Oncology Division Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, R.O.C
| | - Ying-Chih Huang
- Hematology & Oncology Research Laboratory, Changhua Christian Hospital, Changhua, Taiwan, R.O.C.
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Kaderka R, Huang YC, Lo HC, Tu YC, Chang C. AI Beam Angle Prediction in Proton Therapy for Brain Patients. Int J Radiat Oncol Biol Phys 2023; 117:e470. [PMID: 37785497 DOI: 10.1016/j.ijrobp.2023.06.1677] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients receiving brain Intensity-modulated Proton Therapy (IMPT) are treated with 1-3 fields. Typically, beam angles must be selected manually, requiring substantial planner time and experience. The choice of beam angles has a major impact on the treatment plan quality. An AI model was developed to automate this process aiming to improve efficiency and potentially plan quality. AI performance was tested by comparing predicted beam angles to the human ground truth angles and evaluating plans resulting from each set of beam angles. MATERIALS/METHODS Previously treated IMPT brain patients were divided into a training (n = 40) and validation set (n = 10) for the AI. Beam-angle selection in the AI was cast as a multi-label classification problem, training the convolution neural network with a Circular Earth Mover's Distance based regularization and multi-label circular-smooth label technique. An analytical post-processing algorithm is employed to minimize distance to the target and avoid organs-at-risk. Finalized gantry angle predictions are discretized in steps of 5°. For an independent test set of n = 10 patients beam angles were predicted by the AI and compared to those chosen by human planners. Both sets of angles were used to create treatment plans with an automated knowledge-based planning (KBP) tool for brain IMPT utilizing single-field optimization and robust optimization. Plan differences are therefore solely due to the choice of beam angles as automated KBP removes human optimization variability. Resulting plan quality was compared by standard clinical dosimetric parameters to the CTV, brain, brainstem, cochlea, cord, eye, lens, optic chiasm, optic nerves, pituitary, and temporal lobes. RESULTS All Human and AI selected beam angles are shown in the table. For cases 1-6, AI and Human selected beam angles were within ±15° and resulting plans showed minimal dosimetric differences. In cases 7-9 AI beam angles reduced max dose while keeping organ-at-risk dose within ±2 Gy. In case 10 the AI chosen beam angles reduced cord Dmax by 9.1 Gy but increased left eye Dmax by 4.9 Gy, other organs-at-risk showed minimal differences. CONCLUSION Gantry beam angle selection was automated by a newly developed AI model and tested on 10 brain IMPT patients. The comparison showed that the AI often chooses similar beam angles to the human planners. When there are differences, dosimetric analysis demonstrated that plans created from AI beam angles have at least the same quality as the human ones. Results motivate further research into this approach showing the AI being a promising tool to fill a current gap in the strive for automating proton treatment planning, increasing planning efficiency and potentially quality.
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Affiliation(s)
| | | | - H C Lo
- Taiwan AI Labs, Taipei, Taiwan
| | - Y C Tu
- Taiwan AI Labs, Taipei, Taiwan
| | - C Chang
- University of California, San Diego, La Jolla, CA
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Cai HZ, Huang ZH, Huang YC, Zhuge LD, Li ZJ. [Update on diagnosis and treatment of lateral cervical lymph node metastasis in papillary thyroid carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:398-402. [PMID: 37026164 DOI: 10.3760/cma.j.cn115330-20221018-00617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- H Z Cai
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z H Huang
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Y C Huang
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L D Zhuge
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z J Li
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Huang YC, Kao LT, Liao TH, Chiu CC, Wen HC. Risk factors of involuntary referral by police to ER psychiatric services for patients with a severe mental illness: A GEE analysis. Schizophr Res 2023; 254:68-75. [PMID: 36801516 DOI: 10.1016/j.schres.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
This study aimed to identify risk factors for involuntary referral by police to emergency room (ER) psychiatric services for community-based patients with a mental illness via a generalized estimating equation (GEE) analysis. The analysis was based on data from the Management Information System of Psychiatric Care (MISPC) system for patients with a severe mental illness in Taipei, Taiwan and registered referral records of the police. Data on 6378 patients aged ≥20 years were used in this study, including 164 patients who were involuntarily referred to the ER by the police and 6214 patients who were not during the period of January 1, 2018 to December 31, 2020. GEEs were utilized to explore possible risk factors of repeated involuntary referral to ER psychiatric services for patients with a severe mental illness. The logistic regressions indicated that patients defined as "severe" according to the Mental Health Act of Taiwan (crude odds ratio (OR): 3.840, 95 % confidence interval (CI): 2.407-6.126), with a disability (crude OR: 3.567, 95 % CI: 1.339-9.501), with two or more family members with a psychiatric disorder (crude OR: 1.598, 95 % CI: 1.002-2.548), with a history of a suicide attempt (crude OR: 25.582, 95 % CI: 17.608-37.167), and with a history of domestic violence (crude OR: 16.141, 95 % CI: 11.539-22.579) were positively associated with involuntary referral to ER psychiatric services. However, age (crude OR: 0.971, 95 % CI: 0.960-0.983) and the MISPC score (crude OR: 0.834, 95 % CI: 0.800-0.869) were inversely associated with involuntary referral to ER psychiatric services. After adjusting for demographics and potential confounders, we found that patients defined as "severe" (Exp (β): 3.236), with a disability (Exp (β): 3.715), with a history of a suicide attempt (Exp (β): 8.706), and with a history of domestic violence (Exp (β): 8.826), as well as age (Exp (β): 0.986) and the MISPC score (Exp (β): 0.902) remained significantly associated with repeated involuntary referral to ER psychiatric services. In conclusion, community-based mentally ill patients with a history of a suicide attempt, with a history of domestic violence, with a severe illness, and with a profound level of disability were highly associated with involuntary referral to ER psychiatric services. We suggest that community mental health case managers identify significant factors associated with involuntary referral to ER psychiatric services to accordingly arrange case management plans.
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Affiliation(s)
- Y C Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - L T Kao
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan; School of Pharmacy, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - T H Liao
- Department of Health, Taipei City Government, Taiwan
| | - C C Chiu
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - H C Wen
- School of Healthcare Administration, College of Management, Taipei Medical University, Taiwan.
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Shih YH, Huang YC, Lin CY, Lin HY, Kuo SF, Lin JS, Shen MC. A large family of hereditary spherocytosis and a rare case of hereditary elliptocytosis with a novel SPTA1 mutation underdiagnosed in Taiwan: A case report and literature review. Medicine (Baltimore) 2023; 102:e32708. [PMID: 36705355 PMCID: PMC9875991 DOI: 10.1097/md.0000000000032708] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
RATIONALE Hereditary spherocytosis (HS) has a defect in the vertically connected proteins on the cell membrane of red blood cells (RBC). Hereditary elliptocytosis (HE) has a defect in proteins that connect the cell membrane horizontally. We reported two families of RBC membrane disorders in Taiwanese, one was HS and the other was HE. PATIENT CONCERNS Case 1. A 19-year-old male student with chronic jaundice and splenomegaly. His mother, maternal uncle, grandmother, and many members of older generations also had splenomegaly and underwent splenectomy. Case 2. A 40-year-old man has experienced pallor and jaundice since the age of 20 and was found to have splenomegaly, and gall bladder stones in the older age. His younger sister also had pallor and jaundice for a long time. DIAGNOSES In case 1, a peripheral blood smear showed 20% spherocytes. Eosin-5-maleimide labeled RBC by flow cytometry showed a result of 30.6 MCF (cutoff value: 45.5 MCF). He was diagnosed with HS. The gene analysis identified a heterozygous mutation with c.166A > G (p.Lys56Glu) in the SLC4A1 gene in this proband, his mother, and maternal uncle. In case 2, more than 40% of ellipsoid RBC present in the peripheral blood smear. He was diagnosed with HE. Genetic analysis of the SPTA1 gene identified a novel heterozygous exon2, c.86A > C, p.Gln29Prol mutation. INTERVENTIONS The two patients had compensated anemia, clinical follow-up instead of splenectomy was done. OUTCOMES The two patients had normal daily activities and lives. LESSONS We reported two Taiwanese families, one was hereditary spherocytosis affected by a heterozygous mutation with c.166A > G (p.Lys56Glu) in SLC4A1, and the other was hereditary elliptocytosis caused by a novel heterozygous SPTA1 gene mutation, c. 86A > C, p.Gln29Prol. These 2 seemingly common hereditary red blood cell membrane protein defects induced by hemolysis are usually underdiagnosed or misdiagnosed.
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Affiliation(s)
- Yu-Hung Shih
- Division of Hematology-Oncology, Changhua Christian Hospital, Changhua City, Taiwan
| | - Ying-Chih Huang
- Department of Research, Changhua Christian Hospital, Changhua City, Taiwan
| | - Ching-Yeh Lin
- Division of Hematology-Oncology, Changhua Christian Hospital, Changhua City, Taiwan
| | - Hsuan-Yu Lin
- Division of Hematology-Oncology, Changhua Christian Hospital, Changhua City, Taiwan
| | - Su-Feng Kuo
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Jen-Shiou Lin
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Ming-Ching Shen
- Division of Hematology-Oncology, Changhua Christian Hospital, Changhua City, Taiwan
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
- * Correspondence: Ming-Ching Shen, Division of Hematology-Oncology, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua City, Changhua County 500209, Taiwan (e-mail: )
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Yu YL, Zhong HF, Chen C, Gong WT, Huang YC, Lin BC, Huang ZF, Yang CZ. [Management and prognosis of extremely preterm infants with gestational age ≤25 +6 weeks]. Zhonghua Er Ke Za Zhi 2023; 61:36-42. [PMID: 36594119 DOI: 10.3760/cma.j.cn112140-20220809-00717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: To investigate the outcomes including major complications and prognosis of extremely preterm infants with gestational age ≤25+6 weeks. Methods: The cross-sectional study enrolled 233 extremely preterm infants with gestational age ≤25+6 weeks who were admitted to the Department of Neonatology of Shenzhen Maternity and Child Healthcare Hospital from January 2015 to December 2021. The clinical data including perinatal factors, treatments, complications, and prognosis were extracted and analyzed. These extremely preterm infants were also grouped according to gestational age and year of admission to further analyze their survival rate, major complications, causes of death, and long-term outcomes. The comparisons between the groups were performed with Chi-square test and Kruskal-Wallis. Results: Among these 233 extremely preterm infants, 134 (57.5%) were males and 99 (42.5%) females. The gestational age was (24.6±0.9) weeks, the birth weight was 710.0 (605.0,784.5) g, and the overall survival rate was 61.8% (144/233). Among the surviving extremely preterm infants, the earliest gestational age was 22+2 weeks and the lowest birth weight was 390 g. There were 17.6% (41/233) of extremely preterm infants had treatment withdrawn and were discharged in line with the will of guardians. Among the rest 192 extremely preterm infants managed with aggressive treatments, 14 (7.3%) died in hospital and 34 (17.7%) had treatment withdrawn later due to severe complications. Of the 192 extremely preterm infants, 144 (75.0%) survived, and the survival rate increased year by year (χ2=26.28, P<0.001) while the mortality decreased year by year (χ2=14.09, P=0.027). Among the survivors, 20.8%(30/144) had no major complications, and the incidence of complications was also negatively related with the gestational age (χ2=7.24, P=0.044), and the length of invasive ventilation was negatively related to the gestational age (χ2=29.14, P<0.001). In the group of less than 23+6 weeks, all extremely preterm infants had one or more major complications. The follow-up were completed in 122 infants and revealed that delayed motor development, language retardation, and hearing and vision impairment accounted for 17.2% (21/122), 8.2% (10/122) and 17.2% (21/122), respectively. Conclusions: Extremely preterm infants with gestational age ≤25+6 weeks are difficult to treat, but the survival rate of infants undergoing aggressive treatments increases year by year. Although the prevalence of major complications is still high, most extremely preterm infants have acceptable prognosis during follow-up.
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Affiliation(s)
- Y L Yu
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
| | - H F Zhong
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
| | - C Chen
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
| | - W T Gong
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
| | - Y C Huang
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
| | - B C Lin
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
| | - Z F Huang
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
| | - C Z Yang
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen 518000, China
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Lin HY, Lin CY, Kuo SF, Lin JS, Lin PT, Huang YC, Hsieh HN, Shen MC. Congenital factor V deficiency in Taiwan: identification of a novel variant p.Tyr1813 ∗ and two variants specific to East Asians. Blood Coagul Fibrinolysis 2023; 34:8-13. [PMID: 35946468 PMCID: PMC9799032 DOI: 10.1097/mbc.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/24/2022] [Indexed: 01/07/2023]
Abstract
Congenital coagulation factor V deficiency (FVD) is a rare, autosomal recessive bleeding disorder. We characterized the clinical presentations, laboratory features, and genetic alterations of Taiwanese patients with FVD. From 1983 to 2010, five women, one man, and one boy diagnosed with FVD were enrolled in this study. The factor V coagulant activity was determined using a one-stage prothrombin time-based test. The factor V antigen level was measured in an ELISA. Sanger sequencing was performed for genetic analyses of F5 , the gene responsible for the disease. One novel and de novo F5 genetic variant, p.Tyr1813 ∗ , was identified. Based on the presence of a premature termination codon with a resultant truncated factor V-protein lacking an intact light chain fragment, the variant is pathogenic. In addition, we identified seven variants previously found to cause FVD. Among them, p.Gly420Cys and p.Asp96His were repeatedly detected in five and four patients, respectively. Both variants are found to be specific to the East Asian populations. Various FVD-associated bleeding manifestations were observed, predominantly mucocutaneous bleeding and hypermenorrhea. All patients exhibited very low factor V coagulant activity (<1-2.5 IU/dl, reference range: 60-133 IU/dl). The factor V antigen level was less than 2% in six patients (reference range: 75-157%). The novel F5 genetic variant p.Tyr1813 ∗ and two distinct, East Asians-specific, recurrent variants p.Gly420Cys and p.Asp96His were identified among seven index patients with FVD in Taiwan. Our clinical and laboratory findings support the reported features of FVD.
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Affiliation(s)
- Hsuan-Yu Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ching-Yeh Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Su-Feng Kuo
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Jen-Shiou Lin
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Te Lin
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ying-Chih Huang
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Han-Ni Hsieh
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Ching Shen
- Division of Hematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Laboratory Medicine, and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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10
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Huang YC, Huang ZH, Cai HZ, Zhang XW, Yan DG, An CM, Zhang ZM, Niu LJ, Li ZJ. [Active surveillance for thyroid micro-malignant nodules]. Zhonghua Zhong Liu Za Zhi 2022; 44:1214-1220. [PMID: 36380671 DOI: 10.3760/cma.j.cn112152-20210907-00681] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To evaluate the effect of ultrasound diagnosis of thyroid micro-malignant nodules and accumulate practical experience for the management of active surveillance for them, so as to avoid overtreatment. Methods: A total of 949 patients who were diagnosed with thyroid malignant nodules using ultrasonography, with the nodules being less than 1 cm in size and without regional lymph node metastasis or distant metastasis, were included. They were treated by the same surgeon of the Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from February 2014 to December 2020. 112 patients chose immediate surgery. The rest patients were asked to accept ultrasound examination every 6 months to 1 year. Follow-up endpoints: tumor size growth of 3 mm, tumor volume increase greater than 50%, lymph node metastasis or distant metastasis. Results: The median follow-up time was 19 months. 713 patients underwent surveillance for more than 6 months. Of the 713 patients, 570 (79.9%) were women, with mean age at 43.5 years old. Tumor progression was observed in 47 (6.6%) patients with a cumulative incidence of 2.7% (1 year), 7.2% (2 years) and 9.5% (3 years). In multivariate analysis, patient age [HR=0.508, 95%CI: 0.275-0.939, P=0.031], lesion number [HR=2.945, 95%CI: 1.593-5.444, P=0.001] and tumor size [HR=2.245, 95%CI: 1.202-4.192, P=0.011] at the beginning of observation were independent risk factors for tumor progression in patients with minimal thyroid malignant nodules during follow-up. During a median (range) active surveillance of 19 (6-80) months, 74 patients chose surgery during the surveillance. Among the 186 patients who underwent surgery, only 3 patients were diagnosed with fibrotic nodules in pathology, while the rest were papillary thyroid carcinoma. The ultrasound accuracy reached 98.4%(183/186). Conclusions: Ultrasonography is an effective method of diagnosing malignant thyroid nodules. Thyroid micro-malignant nodules progress slowly. As a result, it is safe to observe them instead of taking immediate surgery. Patient age, lesion number and tumor size at the beginning of observation are independent risk factors for the tumor progression of malignant nodules.
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Affiliation(s)
- Y C Huang
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z H Huang
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - H Z Cai
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - X W Zhang
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - D G Yan
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - C M An
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z M Zhang
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - L J Niu
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z J Li
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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11
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Chen M, Shen MC, Chang SP, Ma GC, Huang YC, Lin CY. Origin and timing of de novo variants implicated in type 2 von Willebrand disease. J Cell Mol Med 2022; 26:5403-5413. [PMID: 36226571 PMCID: PMC9639050 DOI: 10.1111/jcmm.17563] [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: 06/23/2022] [Revised: 08/30/2022] [Accepted: 09/11/2022] [Indexed: 12/03/2022] Open
Abstract
Very few studies have shown the real origin and timing of de novo variants (DNV) implicated in von Willebrand disease (VWD). We investigated four families with type 2 VWD. First, we conducted linkage analysis using single nucleotide variant genotyping to recognize the possible provenance of DNV. Second, we performed amplification refractory mutation system‐quantitative polymerase chain reaction to confirm the real origin of variant (~0% mutant cells) or presence of a genetic mosaic variant (0%–50% mutant cells) in three embryonic germ layer‐derived tissues and sperm cells. Then, three possible timings of DNV were categorized based on the relative likelihood of occurrence according to the number of cell divisions during embryogenesis. Two each with type 2B VWD (proband 1 p.Arg1308Cys, proband 4 p.Arg1306Trp) and type 2A VWD (proband 2 p.Leu1276Arg, proband 3 p.Ser1506Leu) were identified. Variant origins were identified for families 1, 2 and 3 and confirmed to originate from the mother, father and father, respectively. However, the father of family 4 was confirmed to have isolated germline mosaicism with 2.2% mutant sperm cells. Further investigation confirmed the paternal grandfather to be the origin of variant. Thus, we proposed that DNV originating from the two fathers most likely occurred at the single sperm cell, the one originating from the mother occurred at the zygote during the first few cellular divisions; alternatively, in family 4, the DNV most likely occurred at the early postzygotic development in the father. Our findings are essential for understanding genetic pathogenesis and providing accurate genetic counselling.
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Affiliation(s)
- Ming Chen
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan.,Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Ching Shen
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.,Department of Laboratory Medicine and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shun-Ping Chang
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Gwo-Chin Ma
- Department of Genomic Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ying-Chih Huang
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ching-Yeh Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
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12
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Lu S, Yan S, Huang TQ, Chen M, Huang YC, Sun Y, Jiang Y. [Vertebral artery rupture and hemorrhage caused by neck trauma: report of two cases]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:732-734. [PMID: 35725317 DOI: 10.3760/cma.j.cn115330-20210506-00255] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- S Lu
- Department of Otorhinolaryngology Head and Neck Surgery, Affilliated Hospital of Qingdao University, Qingdao 266000, China
| | - S Yan
- Department of Otorhinolaryngology Head and Neck Surgery, Affilliated Hospital of Qingdao University, Qingdao 266000, China
| | - T Q Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Affilliated Hospital of Qingdao University, Qingdao 266000, China
| | - M Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Affilliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y C Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Affilliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y Sun
- Department of Otorhinolaryngology Head and Neck Surgery, Affilliated Hospital of Qingdao University, Qingdao 266000, China
| | - Y Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, Affilliated Hospital of Qingdao University, Qingdao 266000, China
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13
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Huang EI, Huang SY, Lin YC, Lin CM, Lin CK, Hsu CY, Huang YC, Su JA. Respiratory Arousals in Patients with Very Severe Obstructive Sleep Apnea and How They Change after a Non-Framework Surgery. Healthcare (Basel) 2022; 10:healthcare10050902. [PMID: 35628039 PMCID: PMC9140339 DOI: 10.3390/healthcare10050902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023] Open
Abstract
Respiratory arousal is the change from a state of sleep to a state of wakefulness following an apnea or hypopnea. In patients with obstructive sleep apnea (OSA), it could have a helpful role to activate upper airway muscles and the resumption of airflow and an opposing role to contribute to greater ventilatory instability, continue cycling, and likely exacerbate OSA. Patients with very severe OSA (apnea-hypopnea index (AHI) ≥ 60 events/h) may have specific chemical (e.g., possible awake hypercapnic hypoxemia) and mechanical (e.g., restricted dilator muscles) stimuli to initiate a respiratory arousal. Little was reported about how respiratory arousal presents in this distinct subgroup, how it relates to AHI, Epworth Sleepiness Scale (ESS), body mass index (BMI), and oxygen saturation, and how a non-framework surgery may change it. Here, in 27 patients with very severe OSA, we show respiratory arousal index was correlated with each of AHI, mean oxyhemoglobin saturation of pulse oximetry (SpO2), mean desaturation, and desaturation index, but not in BMI or ESS. The mean (53.5 events/h) was higher than other reports with less severe OSAs in the literature. The respiratory arousal index can be reduced by about half (45.3%) after a non-framework multilevel surgery in these patients.
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Affiliation(s)
- Ethan I. Huang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
- Sleep Center, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (S.-Y.H.); (Y.-C.L.)
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence:
| | - Shu-Yi Huang
- Sleep Center, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (S.-Y.H.); (Y.-C.L.)
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (C.-M.L.); (C.-K.L.)
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi 61363, Taiwan
| | - Yu-Ching Lin
- Sleep Center, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (S.-Y.H.); (Y.-C.L.)
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (C.-M.L.); (C.-K.L.)
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 61363, Taiwan
| | - Chieh-Mo Lin
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (C.-M.L.); (C.-K.L.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chin-Kuo Lin
- Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (C.-M.L.); (C.-K.L.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chia-Yu Hsu
- Department of Neurology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (C.-Y.H.); (Y.-C.H.)
| | - Ying-Chih Huang
- Department of Neurology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan; (C.-Y.H.); (Y.-C.H.)
| | - Jian-An Su
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
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14
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Liu Y, Ye YX, Wang Y, Wang F, Huang YC, Chen D, Pan XF, Pan A. [Associations between plasma n-3 polyunsaturated fatty acids and gestational diabetes mellitus in the second trimester]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:312-321. [PMID: 35381652 DOI: 10.3760/cma.j.cn112150-20210428-00422] [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: 06/14/2023]
Abstract
Objective: To examine the associations between plasma n-3 polyunsaturated fatty acids (PUFAs) in the second trimester and gestational diabetes mellitus (GDM) among Chinese pregnant women. Methods: Based on data from the Tongji-Shuangliu Birth Cohort enrolled from 2017 to 2019 in the Shuangliu Maternal and Child Health Hospital, it conducted a case-control study among 269 GDM cases who were diagnosed by 75 g oral glucose tolerance test, and 538 non-GDM controls matched at a 1∶2 ratio on maternal age and gestational weeks. The age range of the 807 women was 18-40 years. Fasting plasma n-3 PUFAs were determined by gas chromatography-mass spectrometry in the second trimester (24-28 weeks). Participants were categorized into quartiles (Q1-Q4) of plasma n-3 PUFAs based on distributions in the control group. Conditional logistic regression models were applied to estimate the associations between plasma n-3 PUFAs and GDM. Results: The median (interquartile) relative concentrations of plasma n-3 PUFA C22∶5n-3 was significantly lower in women with GDM 0.87 (0.72, 1.07) compared with women without GDM 0.94 (0.75, 1.19)(P=0.001). Plasma n-3 PUFA C22∶5n-3 was inversely associated with GDM, with an OR (95%CI) of 0.75 (0.62-0.90) for each SD increase of relative concentration. Compared with the Q1 group, the OR values and 95%CIs of Q2, Q3, and Q4 groups were 0.97 (0.62-1.51), 0.72 (0.45-1.15), and 0.54 (0.32-0.90), respectively (Ptrend<0.05). However, there were no significant associations of C18∶3n-3, C20∶5n-3, C22∶6n-3, and total n-3 PUFAs with GDM. Conclusion: Plasma n-3 PUFA C22∶5n-3 was inversely associated with GDM during the second trimester.
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Affiliation(s)
- Y Liu
- Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu 610000, China
| | - Y X Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - F Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Y C Huang
- Department of Health Toxicology, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - D Chen
- College of Environment, Jinan University, Guangzhou 510632, China
| | - X F Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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15
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Huang TQ, Wang L, Lin HZ, Xu Z, Huang YC. [Recurrent Aphthous Stomatitis causes bleeding in the throat: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:57-58. [PMID: 35090212 DOI: 10.3760/cma.j.cn115330-20210221-00076] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- T Q Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - L Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - H Z Lin
- Department of Stomatology, the affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Z Xu
- Department of Otorhinolaryngology Head and Neck Surgery, the affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y C Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the affiliated Hospital of Qingdao University, Qingdao 266003, China
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16
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Lin HY, Lin JS, Tsay W, Lin PT, Huang YC, Shen MC. A distinct common p.Gln317* mutation among causative LMAN1 genetic mutations of combined factor V and factor VIII deficiency in five Taiwanese families. Haemophilia 2021; 28:e28-e31. [PMID: 34766420 DOI: 10.1111/hae.14458] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/16/2021] [Accepted: 10/31/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Hsuan-Yu Lin
- Division of Haematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Jen-Shiou Lin
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Woei Tsay
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Te Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ying-Chih Huang
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Ching Shen
- Division of Haematology/Oncology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
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17
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Shen MC, Wang JD, Tsai W, Lin CY, Lin JS, Kuo SF, Lin PT, Huang YC, Hung MH. Clinical features and genetic defect in six index patients with congenital fibrinogen disorders: Three novel mutations with one common mutation in Taiwan's population. Haemophilia 2021; 27:1022-1027. [PMID: 34460979 DOI: 10.1111/hae.14399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Congenital fibrinogen disorders (CFDs) are caused by mutations in fibrinogen-encoding genes, FGA, FGB, and FGG, which lead to quantitative or qualitative abnormalities of fibrinogen. Although the diagnosis of CFDs is based on antigenic and functional level of fibrinogen, few genotypes are clearly correlated with phenotype. METHODS In this study, we investigated all of the referred patients diagnosed as CFDs in Taiwan's population between 1995 and 2020. Clinical features, laboratory data and genetic defects were analysed. Functional fibrinogen level was determined by the Clauss method. Antigenic fibrinogen was measured by an enzyme-linked immunosorbent assay. Fibrinogen genes were assessed for mutations by polymerase chain reaction and sequencing. RESULTS A total of 18 patients from six unrelated families with CFDs were identified. One patient from a consanguineous family was diagnosed as afibrinogenemia type 1A with a novel homozygous frameshift mutation in FGB exon 4. The other five (83.3 %) index patients were all diagnosed as dysfibrinogenemia type 3A caused by two novel and one known mutation. Six (33.3 %) patients from three families had a novel mutation in FGB exon 8. The clinical features and laboratory data were highly variable among these patients with the same mutation. CONCLUSIONS Three novel mutations of CFDs causing afibrinogenemia and dysfibrinogenemia were identified. The point mutation in FGB exon 8 is also a common mutation in Taiwan's population. Considerable phenotypic variability among the patients with an identical mutation was observed.
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Affiliation(s)
- Ming-Ching Shen
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jiaan-Der Wang
- Center for Rare Disease and Haemophilia, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.,National Chung Hsing University, Taichung, Taiwan
| | - Woei Tsai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Yeh Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Jen-Shiou Lin
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Su-Feng Kuo
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Te Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ying-Chih Huang
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Mei-Hua Hung
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
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18
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Su YR, LI RS, Huang YC, Wang CH, Hsieh JY, Lai HH, Liu M. P–659 Artificial intelligence (AI) as an assisting tool in generating patient-friendly corifollitropin alfa ovarian stimulation protocol during in vitro fertilization. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.658] [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: 11/13/2022] Open
Abstract
Abstract
Study question
How machine learning assisted in generating patient-friendly corifollitropin alfa protocol in normal responders?
Summary answer
In retrospective experiments, our machine learning model integrated physiological measurements of patients and clinical experience to generate a patient-friendly corifollitropin alfa protocol.
What is known already
Long-acting corifollitropin alfa can simplify the regimen, minimizing injections during the whole cycle. The previous study has described the patient-friendly protocol using corifollitropin alfa without routine pituitary suppression in normal responder can result in non-compromised clinical outcomes. Some studies showed machine learning can help with making clinical decisions and have the ability to learn from physiological measurements. Those methods effectuate certain points throughout short-acting menotropin protocols, however, there are still no robust AI tools for long-acting corifollitropin alfa protocols.
Study design, size, duration
1,309 cycles were collected at Stork Fertility Center from November 2016 to October 2019, and 1,221 cycles were available after data cleaning and applying exclusion criteria, which Anti-Mullerian Hormone (AMH) is lower than 2. The data from electronic medical records (EMRs) consisted of age, AMH, body weight, luteinizing hormone (LH), and estradiol (E2) concentrations measured on revisit. Evaluation is performed by one physician who has more than 20 years of experience in IVF. Participants/materials, setting, methods: The protocol generator consisted of 5 parts: doses of Elonva, trigger type, doses of recombinant follicle-stimulating hormone (rFSH), doses of recombinant luteinizing hormone (rLH), and day of oocyte retrieval. The protocol was predicted by age, AMH, and weight firstly, then fine-tuned by LH and E2 after the first revisit. We used the gradient boosting decision tree algorithm to learn the protocol. The dataset was randomly split into 80% for training and 20% for testing.
Main results and the role of chance
In classification, the model predicted the dose of Elonva achieved an accuracy of 0.913 and an AUC of 0.946, and trigger type got an accuracy of 0.901 and AUC of 0.852 only using features on stimulation day (SD) 1 and gained 0.012 and 0.056 in accuracy and AUC correspondingly after adding features on the first revisit day. In regression, the mean absolute error (MAE) of rFSH dose, rLH dose, and oocytes retrieved day was 156.30 IU, 232.75 IU, and 0.80 days respectively, and after refining, the MAE dropped to 92.37 IU, 100.07 IU, and 0.46 days. The error of predictions in rFSH and rLH was almost equal to half increments of rFSH (150 IU) and one increment rLH (75 IU). This indicated that our model could provide a better prediction of these clinical decisions with one revisit only.
Limitations, reasons for caution
The present study was a single-center retrospective, and only analyzed the data from normal responders, whose AMH was equal or greater than 2. Though, the recommendations of our system act as references, the physician will make the final decision.
Wider implications of the findings: Our result showed the potential of machine learning in generating protocols is promising. Recommendations generated by our model can provide the junior clinical teams to optimize the clinical plans and learn from the experience of experts. We look forward to applying our machine learning model to different protocols.
Trial registration number
Not applicable
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Affiliation(s)
- Y R Su
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - R S LI
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan R.O.C
| | - Y C Huang
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan R.O.C
| | - C H Wang
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
| | - J Y Hsieh
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan R.O.C
| | - H H Lai
- Stork Fertility Center, Stork Ladies Clinic, Hsinchu, Taiwan R.O.C
| | - M Liu
- Binflux Inc, R&D Department, Taipei, Taiwan R.O.C
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19
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Chen YH, Huang YC, Yang SF, Yen HH, Tsai HD, Hsieh MC, Hsiao YH. Pitavastatin and metformin synergistically activate apoptosis and autophagy in pancreatic cancer cells. Environ Toxicol 2021; 36:1491-1503. [PMID: 33886150 DOI: 10.1002/tox.23146] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/12/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
Pancreatic cancer is the seventh leading cause of cancer-related deaths globally. Metformin is the standard first-line of treatment for hyperglycemia in Type 2 diabetes, whereas pitavastatin is a cholesterol-lowering drug used to prevent cardiovascular diseases. Both these agents evidently exert anticancer effects on pancreatic cancer; however, it remains unclear whether cotreatment using them has additive or synergistic anticancer effects on pancreatic cancer. Thus, we herein used the ASPC-1 and PANC-1 cells and treated them with metformin and/or pitavastatin. We performed the cell viability assay, transwell migration assay, and cell cycle analysis using flow cytometry. Western blotting was used to determine protein levels. We found that cotreatment with metformin (30 mM) and pitavastatin (10 μM) significantly reduced cell viability; caused G0/G1 cell cycle arrest; upregulated the expression levels of Bax, PCNA, cleaved PARP-1, cleaved caspase-3, LC3 II, and p27 Kip1 /p21Cip1 ; and inhibited cell migration. The combination index value for cell viability indicated a synergistic interaction between metformin and pitavastatin. Moreover, cotreating the cells with metformin (30 mM) and pitavastatin (10 μM) could preserve mitochondrial function, activate AMPK, and inhibit PI3K/mTOR than treatment with metformin or pitavastatin alone. These findings clearly indicated that metformin plus pitavastatin had a synergistic anticancer effect on pancreatic cancer cells, potentially caused due to the activation of AMPK and inhibition of PI3K/mTOR signaling. Altogether, our results provide that use of metformin plus pitavastatin maybe serve as a chemotherapeutic agent for human pancreatic cancer in future.
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Affiliation(s)
- Ya-Hui Chen
- Women's Health Research Laboratory, Changhua Christian Hospital, Changhua, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ying-Chih Huang
- Department of Research, Changhua Christian Hospital, Changhua, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsu-Heng Yen
- Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Horng-Der Tsai
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Chia Hsieh
- Intelligent Diabetes Metabolism and Exercise Center, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Hsuan Hsiao
- Women's Health Research Laboratory, Changhua Christian Hospital, Changhua, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
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20
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Hsu YK, Chen HY, Wu CC, Huang YC, Hsieh CP, Su PF, Huang YF. Butein induces cellular senescence through reactive oxygen species-mediated p53 activation in osteosarcoma U-2 OS cells. Environ Toxicol 2021; 36:773-781. [PMID: 33325610 DOI: 10.1002/tox.23079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
Butein is a flavonoid isolated from various medicinal plants. It is known to have different biological activities including anti-inflammation, anti-adipogenesis, and anti-angiogenesis. In the study, we demonstrated the anti-proliferative effect of butein in human osteosarcoma U-2 OS cells. Our data showed that butein significantly suppressed the viability and colony formation ability of U-2 OS cells. Further experiments revealed butein exposure resulted in a cell cycle arrest at S and G2/M phase in U-2 OS cells. Importantly, we found that butein activated the tumor suppressor p53, and trigged a p53-dependent senescence in U-2 OS cells. Knockdown of p53 suppressed the senescence and rescued the viability in butein-treated U-2 OS cells. Furthermore, we observed that butein exposure significantly enhanced reactive oxygen species (ROS) levels in U-2 OS cells. Co-administration of the ROS inhibitor NAC largely abolished the up-regulated p53 protein level, and rescued the suppressed viability and colony formation ability in butein-exposed U-2 OS cells. Taken together, our data proposed the increased ROS by butein exposure activated p53, and the activated p53 was involved in the anti-proliferative effect of butein via inducing senescence in U-2 OS cells. This report suggests that butein is a promising candidate for cancer therapy against osteosarcoma.
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Affiliation(s)
- Yung-Ken Hsu
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsuan-Ying Chen
- Orthopedics and Sports Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan
| | - Chia-Chieh Wu
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Chih Huang
- Department of Research, Changhua Christian Hospital, Changhua, Taiwan
| | - Cheng-Pu Hsieh
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Orthopedics and Sports Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Feng Su
- Department of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Fu Huang
- Orthopedics and Sports Medicine Laboratory, Changhua Christian Hospital, Changhua, Taiwan
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21
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Zhao BH, Huang ZH, Huang YC, Zhang XW, An CM, Niu LJ, Li ZJ. [Preliminary study of superselective lymph node dissection in regional lateral cervical lymph node metastasis of papillary thyroid carcinoma]. Zhonghua Zhong Liu Za Zhi 2021; 43:484-489. [PMID: 33902212 DOI: 10.3760/cma.j.cn112152-20201015-00901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the applied value of super-selective cervical lymph node dissection in papillary thyroid carcinoma (PTC) patients with clinically suspicious lateral lymph node metastasis (LNM). Methods: We retrospectively analyzed the clinical data of 232 cN1b PTC patients who underwent surgery from September 2013 to May 2018 in the Department of Head and Neck Surgical Oncology, National Cancer Center. Among them, 90 cases received super-selective neck dissection (level Ⅲ and IV) and 142 cases underwent selective neck dissection (level Ⅱ-Ⅳ). The LNM of two groups were analyzed. Results: Postoperative pathological results showed that 173 cases had LNM in the central compartment. The LNM cases of level Ⅱ-Ⅳ were 47, 147 and 130, respectively. Eight patients of super-selective neck dissection and 6 of selective neck dissection had postoperative lymphatic fistulas (P=0.146). No patients in super-selective neck dissection group while 9 patients in the selective lymph node dissection group had postoperatively permanent impairment of shoulder mobility, the difference was statistically significant (P=0.015). In the super-selective neck dissection group, 2 patients had long-term postoperative incision discomfort, and 5 cases had obvious cicatrix after surgery. In the patients with selective neck dissection, 27 cases experienced long-term incision discomfort after surgery, and 26 patients had apparent scar tissue, the differences were statistically significant (P<0.005). There was no recurrence during the follow-up. Conclusions: Super-selective neck dissection is a feasible, safe and effective treatment for cN1b PTC patients. It can improve the quality of postoperative life and avoid the over treatment for patients.
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Affiliation(s)
- B H Zhao
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Z H Huang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Y C Huang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - X W Zhang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - C M An
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - L J Niu
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Z J Li
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
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22
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Chou SC, Lin DT, Lin CY, Huang YC, Hsieh HN, Shen MC. First reported case of congenital thrombotic thrombocytopenic purpura in Taiwan with novel mutation of ADAMTS13 gene. Int J Hematol 2021; 113:760-764. [PMID: 33387295 DOI: 10.1007/s12185-020-03068-5] [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: 10/29/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 11/27/2022]
Abstract
Congenital thrombotic thrombocytopenic purpura (cTTP) is a rare disease that is defined as biallelic mutations of ADAMTS13 causing persistent absence of ADAMTS13 activity. The confirmed diagnosis requires a genetic study, and cTTP has never been previously reported in Taiwan. Our patient was a 29-year-old Taiwanese woman who presented with severe hyperbilirubinemia at birth. She had severe thrombocytopenia and hemolytic anemia at the age of 1, and another acute TTP event at the age of 7 triggered by an upper airway infection. Regular plasma replacement was started at age 12 based on a presumptive diagnosis of cTTP. Clinical diagnosis of cTTP, with undetectable ADAMTS13 activity and absence of ADAMTS13 inhibitor, was confirmed at age 27. A genetic study showed a previously reported mutation c.1921G to A, inherited from her father, and a maternally inherited, novel mutation at exon 12, c.1435+1dupG, which results in a splicing site change and frame shift. Reports of cTTP from East Asia, except Japan, are scarce. Some prevalent ADAMTS13 mutations are also race or region specific. With this report, we hope to raise awareness among physicians in Taiwan, promote early, proper diagnosis of cTTP, and reveal the true prevalence of cTTP in the Taiwanese population.
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Affiliation(s)
- Sheng-Chieh Chou
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Dong-Tasmn Lin
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Yeh Lin
- Division of Hematology and Oncology, Changhua Christian Hospital, Nanhsiao St 135, Changhua City, Changhua County, Taiwan
| | - Ying-Chih Huang
- Division of Hematology and Oncology, Changhua Christian Hospital, Nanhsiao St 135, Changhua City, Changhua County, Taiwan
| | - Han-Ni Hsieh
- Division of Hematology and Oncology, Changhua Christian Hospital, Nanhsiao St 135, Changhua City, Changhua County, Taiwan
| | - Ming-Ching Shen
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Division of Hematology and Oncology, Changhua Christian Hospital, Nanhsiao St 135, Changhua City, Changhua County, Taiwan.
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23
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Huang TQ, Yang BW, He BG, Song RF, Wu J, Yan S, Huang YC, Jiang Y. [Magnifying endoscopy combined with narrow-band imaging for preoperative examination of hypopharyngeal carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:1162-1164. [PMID: 33342132 DOI: 10.3760/cma.j.cn115330-20200627-00531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- T Q Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - B W Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - B G He
- Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - R F Song
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - J Wu
- Department of Pathology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - S Yan
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y C Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
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24
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Huang ZH, Zhang XW, Ning WJ, Zhao BH, Huang YC, Yan DG, An CM, Zhang ZM, Li ZJ. [Comparison of quality of life of hypopharyngeal squamous cell carcinoma patients after laryngeal preservation surgery and total laryngectomy]. Zhonghua Zhong Liu Za Zhi 2020; 42:955-960. [PMID: 33256308 DOI: 10.3760/cma.j.cn112152-20200211-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate and compare the quality of life (QOL) in patients with hypopharyngeal squamous cell carcinoma after laryngeal preservation surgery and total laryngectomy. Methods: We selected parts of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and the Head and Neck Module (EORTC QLQ-C30 and EORTC QLQ-H&N35) and designed the QOL questionnaire. We investigated 42 patients with hypopharyngeal squamous cell carcinoma underwent laryngeal preservation surgery and 38 patients underwent total laryngectomy by QOL questionnaire and followed up their survival. Results: The somatic function dimension, psychological function dimension, and social function dimension of patients underwent laryngeal preservation surgery were (92.46±15.71), (80.56±22.67) and (90.08±19.50), respectively, which were higher than (79.39±32.75), (68.42±25.05) and (61.84±29.55) of the total laryngectomy group (P<0.05), while the economic dimension was not significantly different between the two groups (P>0.05). The social function dimension (including social support and socialization, family relationship) of laryngeal preservation surgery group were (89.04±25.47) for postoperative time < 70 months and (90.94±13.28) for postoperative time ≥70 months, which were higher than (65.48±29.14) and (57.35±30.32) of the total laryngectomy group (P<0.01). Conclusions: The somatic function dimension, psychological function and social function of patients with hypopharyngeal squamous cell carcinoma underwent laryngeal preservation surgery obtain a better QOL than patients underwent total laryngectomy. Therefore, we should improve the laryngeal function and QOL of patients under the premise of ensuring the survival rate.
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Affiliation(s)
- Z H Huang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - X W Zhang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - W J Ning
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - B H Zhao
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Y C Huang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - D G Yan
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - C M An
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Z M Zhang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Z J Li
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
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25
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Zhou YC, Lin YP, Li Q, Ma LY, Liu X, Wang XX, Li HS, Liu JX, Shen ZH, Guo YJ, Du YX, Yang RJ, Huang YC, Dai M, Zhang Q. [Analysis of EGFR mutation and clinical features of lung cancer in Yunnan]. Zhonghua Zhong Liu Za Zhi 2020; 42:729-734. [PMID: 32988154 DOI: 10.3760/cma.j.cn112152-20200313-00201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the EGFR mutation profile of lung cancer patients in Yunnan, and to provide evidence for clinical personalized treatment. Methods: Demographic and clinical data of 2 967 lung cancer patients undergoing EGFR identification were collected and analyzed from January 2014 to August 2019 in Yunnan Cancer Hospital. Results: The proportion of EGFR mutation in 2 967 patients with lung cancer was 46.2%. Univariate analysis showed that the proportion of EGFR mutation in women was higher than that in men (P<0.001) and displayed a downward trend with age (P=0.03). The mutation rate of ethnic minorities was higher than Han (P=0.012). Mutation rate in patients without smoking history was higher than those with smoking history (P<0.001), and patients without drinking history was higher than patients with drinking history (P<0.001). Mutation rate in patients without family history of lung cancer was higher than those with family history (P=0.008). The mutation rate of adenocarcinoma was higher than other pathological types (P<0.001). The mutation rate was different among stages, and it was higher in early patients than that in advanced patients (P<0.001). The mutation rate of tissue specimens was higher than those of cytology and peripheral blood samples (P<0.001). The mutation rate of Xuanwei area was lower than that in non-Xuanwei area (P<0.001). Multivariate analysis showed that gender (P<0.001), age (P=0.036), smoking history (P<0.001), pathological type (P<0.001), specimen type (P<0.001), and whether or not Xuanwei area (P<0.001) were the independent factors of EGFR mutation.The EGFR mutation was more common in female, non-smokers, adenocarcinoma, non-Xuanwei area, tissue specimen and young lung cancer patients.The mutation types of EGFR in 1 370 cases mainly included 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area was L858R, while in non-Xuanwei area was 19-Del.The mutation rates of G719X, G719X+ L861Q, G719X+ S768I, and S768I in Xuanwei were higher while the mutation rates of 19-Del, L858R, and 20-ins were lower than non-Xuanwei area (P<0.05). The 19-Del mutation rate of ethnic minorities is higher than that of Han (P<0.001). The combined mutation rate of G719X, L861Q in Han was higher than that of ethnic minorities (P=0.005). Conclusions: The EGFR mutation rate in lung cancer patients in Yunnan is similar to Asian and Chinese, and higher in female, non-smokers, adenocarcinomas, young and non-Xuanwei area patients. The most common types of EGFR mutation in Yunnan are 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area is L858R, while in non-Xuanwei area is 19-Del. The mutation rates of G719X, G719X+ L861Q, G719X+ S768I and S768I are higher in Xuanwei patients than those in non-Xuanwei patients. The combined mutation rate of G719X and L861Q in Han nationality is higher than that of ethnic minorities.
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Affiliation(s)
- Y C Zhou
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - Y P Lin
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - Q Li
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - L Y Ma
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - X Liu
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - X X Wang
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - H S Li
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - J X Liu
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - Z H Shen
- Office of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - Y J Guo
- Plateau Regional High-Rise Cancer International Cooperation Laboratory of Ministry of Education, Kunming 650118, China
| | - Y X Du
- Plateau Regional High-Rise Cancer International Cooperation Laboratory of Ministry of Education, Kunming 650118, China
| | - R J Yang
- Yunnan Provincial Key Laboratory of Lung Cancer, Kunming 650118, China
| | - Y C Huang
- Molecular Diagnostic Branch Center of Yunnan Cancer Center, Yunnan Cancer Hospital, Kunming 650118, China
| | - M Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Q Zhang
- Medical Center, Yunnan Cancer Hospital, Kunming 650118, China
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26
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Chen XY, Li SL, Huang YC, Ju JB. [Malignant and recurrent solitary fibroma of the neck: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:866-868. [PMID: 32911893 DOI: 10.3760/cma.j.cn115330-20200402-00259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- X Y Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - S L Li
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - Y C Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - J B Ju
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, China
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27
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Huang YC, Shih YH, Lin CY, Chiu PF, Kuo SF, Lin JS, Shen MC. A family with an MYH9-related disorder with different phenotypes masquerading as immune thrombocytopaenia: an underreported disorder in Taiwan. Int J Hematol 2020; 112:878-882. [PMID: 32712863 DOI: 10.1007/s12185-020-02947-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/03/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022]
Abstract
A 66-year-old woman had experienced abnormal bleeding since the age of 7. Thrombocytopenia was not detected until she was 48, and immune thrombocytopenia was diagnosed at age 66. She also reported experiencing hearing disturbance since the age of 30 and acute renal failure since the age of 61 but reported no visual disturbance. Her younger son, who was 40 years old, also experienced abnormal bleeding since the age of 6, but immune thrombocytopenia was diagnosed as late as age 35. He had no other associated disorders. Laboratory examinations of both mother and son revealed a low platelet count (8000 and 29,000 µL, respectively), giant platelets and Döhle body-like granulocyte inclusion bodies. The mother had a high creatinine level (15.4 mg/dL) and normal liver enzyme levels. MYH9 genetic analysis identified a heterozygous mutation, c.101T>A, p.Val34Glu at exon 2 in both patients. These clinical and laboratory findings were consistent with a diagnosis of an MYH9-related disorder with different phenotypes observed in the same family. MYH9-related disorders were recognised in 2003, but were often misdiagnosed as immune thrombocytopenia, and hence, they have rarely been reported in Taiwan.
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Affiliation(s)
- Ying-Chih Huang
- Department of Research, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua City, Taiwan
| | - Yu-Hung Shih
- Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Ching-Yeh Lin
- Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Ping-Fang Chiu
- Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Su-Feng Kuo
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Jen-Shiou Lin
- Department of Laboratory Medicine, Changhua Christian Hospital, Changhua City, Taiwan
| | - Ming-Ching Shen
- Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan. .,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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28
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Lin YP, Long TF, Ma J, Zhou HR, Zhou H, Zhang X, Zhang Q, Huang YC. [Analysis of colorectal cancer screening results in Kunming from 2014 to 2017]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:1162-1165. [PMID: 31683406 DOI: 10.3760/cma.j.issn.0253-9624.2019.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study analyzed the distribution of high-risk population, the compliance and detected lesions of colorectal cancer screening from the Cancer Screening Program in urban areas of Kunming,Yunnan Province from 2014 to 2017. A total of 127 960 residents were included,of which 14 791 (11.70%) cases were diagnosed with high risk of colorectal cancer by the National Cancer Center High Risk Population Assessment System. A total of 3 484 cases completed colonoscopy clinical screening and the rate of participation was 23.55%. The screening results showed that 592 positive cases were detected, and the positive rate was 17.17%. The detection rates of polyps,adenomas,advanced adenomas,precancerous lesions and colorectal cancer were 16.27%,13.12%,7.18%,7.63% and 0.26%, with 567, 457, 250, 266 and 9 cases, respectively.
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Affiliation(s)
- Y P Lin
- Office of Yunnan Cancer Center, Kunming 650118
| | - T F Long
- Department of Internal Medicine, Yunnan Cancer Hospital, Kunming 650118, China
| | - J Ma
- Office of Yunnan Cancer Center, Kunming 650118
| | - H R Zhou
- Medical Center of Yunnan Cancer Hospital, Kunming 650118, China
| | - H Zhou
- Office of Yunnan Cancer Center, Kunming 650118
| | - X Zhang
- Office of Yunnan Cancer Center, Kunming 650118
| | - Q Zhang
- Medical Center of Yunnan Cancer Hospital, Kunming 650118, China
| | - Y C Huang
- Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, 650118, China
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Yeh SC, Wu CH, Huang YC, Lee JY, Jeng RJ. In Search of a Green Process: Polymeric Films with Ordered Arrays via a Water Droplet Technique. Polymers (Basel) 2019; 11:E1473. [PMID: 31505874 PMCID: PMC6780950 DOI: 10.3390/polym11091473] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/02/2019] [Accepted: 09/05/2019] [Indexed: 11/23/2022] Open
Abstract
As an efficient technique for the preparation of polymeric hexagonal orderly arrays, the breath figure (BF) process has opened a modern avenue for a bottom-up fabrication method for more than two decades. Through the use of the water vapor condensation on the solution surface, the water droplets will hexagonally pack into ordered arrays, acting as a template for controlling the regular micro patterns of polymeric films. Comparing to the top-down techniques, such as lithography or chemical etching, the use of water vapor as the template provides a simple fabrication process with sustainability. However, using highly hazardous solvents such as chloroform, carbon disulfide (CS2), benzene, dichloromethane, etc., to dissolve polymers might hinder the development toward green processes based on this technique. In this review, we will touch upon the contemporary techniques of the BF process, including its up-to-date applications first. More importantly, the search of greener processes along with less hazardous solvents for the possibility of a more sustainable BF process is the focal point of this review.
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Affiliation(s)
- Shih-Chieh Yeh
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei 106, Taiwan.
- Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 106, Taiwan.
| | - Chien-Hsin Wu
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei 106, Taiwan.
- Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 106, Taiwan.
| | - Ying-Chih Huang
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei 106, Taiwan.
- Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 106, Taiwan.
| | - Jen-Yu Lee
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei 106, Taiwan.
| | - Ru-Jong Jeng
- Institute of Polymer Science and Engineering, National Taiwan University, Taipei 106, Taiwan.
- Advanced Research Center for Green Materials Science and Technology, National Taiwan University, Taipei 106, Taiwan.
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Chang KC, Chuang IC, Huang YC, Wu CY, Lin WC, Kuo YL, Lee TH, Ryu SJ. Risk factors outperform intracranial large artery stenosis predicting unfavorable outcomes in patients with stroke. BMC Neurol 2019; 19:180. [PMID: 31370812 PMCID: PMC6670158 DOI: 10.1186/s12883-019-1408-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 07/22/2019] [Indexed: 12/24/2022] Open
Abstract
Background This study examined how intracranial large artery stenosis (ILAS), symptomatic and asymptomatic ILAS, and risk factors affect unfavorable outcome events after medical treatment in routine clinical practice. Methods This was a 24-month prospective observational study of consecutively recruited stroke patients. All participants underwent magnetic resonance angiography, and their clinical characteristics were assessed. Outcome events were vascular outcome, recurrent stroke, and death. Cox regression analyses were performed to identify potential factors associated with an unfavorable outcome, which included demographic and clinical characteristics, the risk factors, and stenosis status. Results The analysis included 686 patients; among them, 371 were assessed as ILAS negative, 231 as symptomatic ILAS, and 84 as asymptomatic ILAS. Body mass index (p < .05), hypertension (p = .01), and old infarction (p = .047) were factors relating to vascular outcomes. Hypertension was the only factor for recurrent stroke (p = .035). Poor glomerular filtration rate (< 30 mL/min/1.73 m2) (p = .011) and baseline National Institutes of Health Stroke Scale scores (p < .001) were significant predictors of death. Conclusions This study extended previous results from clinical trials to a community-based cohort study by concurrently looking at the presence/absence of stenosis and a symptomatic/asymptomatic stenotic artery. Substantiated risk factors rather than the stenosis status were predominant determinants of adverse outcome. Although the degree of stenosis is often an indicator for treatment, we suggest risk factors, such as hypertension and renal dysfunction, should be monitored and intensively treated.
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Affiliation(s)
- K C Chang
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Discharge Planning Service Center, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I C Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Y C Huang
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Measurement and Statistics, Education, National University of Tainan, Tainan, Taiwan
| | - C Y Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Department of Physical Medicine and Rehabilitation, Healthy Aging Research Center at Chang Gung University, Chang Gung Memorial Hospital at Linkou, 259 Wen-hwa 1st Road, Taoyuan, Taiwan.
| | - W C Lin
- Department of Radiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Y L Kuo
- Department of Radiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - T H Lee
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - S J Ryu
- Division of Cerebrovascular Diseases, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Huang YC, Li ZJ. [Management and dynamic risk stratification of differentiated thyroid cancer]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:389-393. [PMID: 31137103 DOI: 10.3760/cma.j.issn.1673-0860.2019.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Differentiated thyroid cancer (DTC) is the most frequently diagnosed thyroid cancer. With the development of the imaging technology and fine needle aspiration, early diagnosis rate of DTC is increasing. Most patients have favorable prognosis for DTC's low-invasion. TNM staging is more widely used for predicting mortality than predicting recurrence. In 2008, it was suggested that recurrence risks for DTC should be assessed based on the results of dynamic monitoring treatment response. The validity of dynamic risk stratification (DRS) has been supported by different researches in various countries and DRS is recommended in 2015 American Thyroid Association Management Guidelines. Long-term DRS in patients with DTC make individual management possible.
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Affiliation(s)
- Y C Huang
- Department of Head and Neck Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Z J Li
- Department of Head and Neck Surgery, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Li WJ, Xu Z, Zhu FG, Huang YC. [Reconstruction of scarring pharyngeal stenosis with forearm free flap:a case report]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:1434-1435. [PMID: 30550180 DOI: 10.13201/j.issn.1001-1781.2018.18.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Indexed: 11/12/2022]
Abstract
A 33-year-old man presented with recurrent oral ulcers for more than 10 years,accompanying dyspnea and dysphagia for 1 year and aggravate for 1 month.Physical examination:pharyngeal cavity stenosis,mucous retention, epiglottis was extruded into the infant type. Electronic laryngoscope:Epiglottis curl,bilateral pyriform sinus disappeared.Ulcer and scar changes can be seen in the lateral wall of bilateral hypopharynx, piriform sinus and posterior annular area,and cover the throat inlet.Neck CT showed: soft tissue thickening in the posterior wall of oropharynx and laryngopharynx-prevertebral fascia, thickening in the right aryepiglottic fold and with local niche;slight uneven enhancement in enhanced scanning, and disappearance of bilateral pyriform sinus.Bilateral parapharyngeal space is clear, laryngopharyngeal wall is not thick, bilateral vocal cords are not thick, and laryngopharyngeal space is clear.Diagnosis: pharyngeal stenosis (scar?); Behcet's disease..
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Yang CH, Huang YC, Kuo WT. Spontaneous Rupture of Splenic Varices: A Rare but Lethal Complication of Portal Hypertension from Cirrhosis. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791402100205] [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: 11/17/2022] Open
Abstract
Intra-abdominal varices rupture is a rare but catastrophic complication in cirrhosis. We report our near-miss experience in a woman presenting with acute abdominal pain and shock. This 55-year-old cirrhotic woman presented with sudden onset of epigastric pain. On arrival, her blood pressure was 57/49 mmHg and physical examination revealed epigastric tenderness without rebounding tenderness. Emergency ultrasonography (EUS) showed intra-abdominal haemorrhage. Computed tomography revealed haemoperitoneum but no extravasation of contrast medium. She received conservative treatment first but laparotomy later for ongoing bleeding. Surgeon identified and ligated a ruptured splenic varix and she was discharged home after nine days of hospitalisation. This case report illustrates the use of bedside EUS in cirrhotic patients presenting with acute abdominal pain. (Hong Kong j.emerg.med. 2014;21:120-123)
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Affiliation(s)
| | - YC Huang
- Kaohsiung Medical University, Department of Emergency Medicine, School of Medicine, 100 Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan
| | - WT Kuo
- Chiayi Christian Hospital, Division of General Surgery, Department of Surgery, 539 Chuan-Hsiau Road, Chiayi City, 60002, Taiwan
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Lin CH, Tsai YH, Lee JD, Weng HH, Yang JT, Lin LC, Lin YH, Wu CY, Huang YC, Hsu HL, Lee M, Hsu CY, Pan YT, Huang YC. Magnetic Resonance Perfusion Imaging Provides a Significant Tool for the Identification of Cardioembolic Stroke. Curr Neurovasc Res 2017; 13:271-276. [PMID: 27586679 PMCID: PMC5068491 DOI: 10.2174/1567202613666160901143040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/15/2016] [Accepted: 07/18/2016] [Indexed: 11/24/2022]
Abstract
Despite advances in imaging techniques and detailed examinations to determine the etiology of a stroke, the cause still remains undetermined in about one fourth of all ischemic strokes. The aim of this prospective study was to determine whether perfusion magnetic resonance imaging (MRI) can differentiate cardioembolic stroke from large artery atherosclerosis (LAA). We recruited 17 cardioembolic stroke and 22 LAA stroke patients, who were classified according to the Trial of Org 10172 in Acute Stroke Treatment and underwent perfusion MRI within 24 hours after the onset of stroke. The patients with cardioembolic stroke had more severe initial stroke severity and larger volumes of initial and final infarct compared to those with LAA stroke. Receiver operating characteristic curve analysis showed that the ratio of time to maximum of the residual curve (Tmax) volume for a 2-, 3-, 4- or 5-s lag over Tmax volume for a 8s lag all had excellent area under the curve values (> 0.9) to predict cardioembolic stroke. After adjusting for initial National Institute of Health Stroke Scale scores, a threshold of 3.73 for (Tmax > 4s volume)/(Tmax > 8s volume) had the highest odds ratio to predict cardioembolic stroke (p=0.012; odds ratio: 58.5; 95% confident interval: 2.5-1391.1), with 87.5% sensitivity and 94.4% specificity. In conclusion, perfusion MRI could be a reliable tool to identify cardioembolic stroke with its lower collateral. This is important as it could be used to reveal the exact mechanism and provide supportive evidence to classify a stroke.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Yen-Chu Huang
- Department of Neurology, Chang Gung Memorial Hospital, 6 West Chia-Pu Road, Putz City, Chiayi County, Taiwan.
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Huang YC, Chen X, Wang C, Peng L, Qian Q, Wang SF. Layer-dependent electronic properties of phosphorene-like materials and phosphorene-based van der Waals heterostructures. Nanoscale 2017; 9:8616-8622. [PMID: 28489111 DOI: 10.1039/c7nr01952a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Black phosphorus is a layered semiconducting allotrope of phosphorus with high carrier mobility. Its monolayer form, phosphorene, is an extremely fashionable two-dimensional material which has promising potential in transistors, optoelectronics and electronics. However, phosphorene-like analogues, especially phosphorene-based heterostructures and their layer-controlled electronic properties, are rarely systematically investigated. In this paper, the layer-dependent structural and electronic properties of phosphorene-like materials, i.e., mono- and few-layer MXs (M = Sn, Ge; X = S, Se), are first studied via first-principles calculations, and then the band edge position of these MXs as well as mono- and few-layer phosphorene are aligned. It is revealed that van der Waals heterostructures with a Moiré superstructure formed by mutual coupling among MXs and among MXs and few-layer phosphorene are able to show type-I or type-II characteristics and a I-II or II-I transition can be induced by adjusting the number of layers. Our work is expected to yield a new family of phosphorene-based semiconductor heterostructures with tunable electronic properties through altering the number of layers of the composite.
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Affiliation(s)
- Y C Huang
- Center for Nano Science and Technology, College of Chemistry and Material Science, The Key Laboratory of Functional Molecular Solids, Ministry of Education, Anhui Laboratory of Molecule-Based Materials, Anhui Normal University, Wuhu, 241000, People's Republic of China.
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Wang X, Zhou YC, Huang YC, Zou TN, Lü ZY, Chen Y, Liu X, Duan WS. [Estradiol stimulates the growth and biofilm formation of clinical Staphylococcus epidermidis]. Zhonghua Yi Xue Za Zhi 2016; 96:3083-3089. [PMID: 27784450 DOI: 10.3760/cma.j.issn.0376-2491.2016.38.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of steroid hormones on the growth and biofilm formation of S. epidermidis. Methods: In all experiments, two S. epidermidis standard strains (ATCC12228 and ATCC35984) and two S. epidermidis clinical strains (SE101 and SE40) were incubated on the surface of silica gel in estradiol concentrations of 0, 50, 125, 250 and 500 pmol/L at 4, 6, 12, 24, 48 and 72 hours. Growth curve were drawn by means of the OD value. Formed biofilms were assessed by crystal violet staining methods. In order to observe the processes and structures of biofilm, the confocal laser scanning microscopy (CLSM) and scanning electron microscope (SEM) were used. Results: All of the four strains which were incubated with the concentrations of 125 pmol/L of estradiol had entered the logarithmic growth stage ahead of the blank control (3 h and 4 h). Crystal violet staining indicated that there was no biofilm for ATCC12228. Improved primary attachment abilities were found for ATCC35984 and SE101 in the presence of estradiol, and the OD values were 0 pmol/L (0.081±0.015 and 0.082±0.011), 50 pmol /L (0.087±0.013 and 0.088±0.010), 125 pmol/L (0.175±0.052 and 0.091±0.012), 250 pmol/L (0.153±0.036 and 0.090±0.006), 500 pmol/L (0.157±0.050 and 0.082±0.032), respectively. The thickness of biofilm reached the peak in 125 pmol/L estradiol at 24 h. CLSM and SEM found estradiol promoted the biofilm maturity and the biofilm of 125 pmol/L group was denser and thicker than that of the other concentration groups. Conclusions: Our in vitro experiments indicate that estradiol could promote the growth of S. epidermidis which exit on the surface of silica gel, and improve the ability of biofilm formation of S. epidermidis.
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Affiliation(s)
- X Wang
- Department of Breast Surgery 1 Ward, Third Affiliated Hospital of Kunming Medical University, the Tumor Hospital of Yunnan Province, Kunming 650118, China
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Wu F, Wu LL, Chen GF, Huang YC. [Retrospective study on the efficacy of different chemotherapy regimens concurrently combined with intensity modulated radiation therapyin treatment of Ⅲ-Ⅳa stage nasopharyngeal carcinoma]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1536-1539. [PMID: 29871135 DOI: 10.13201/j.issn.1001-1781.2016.19.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Indexed: 06/08/2023]
Abstract
Objective:To compare the near and long term efficacy and safety of paclitaxel(TAX) plus cisplatin(DDP) (TP regimen) and DDP plus 5-FU(PF regimen) concurrently combined with IMRT in treatment of patients with advanced NPC.Method: A retrospective analysis on 108 advanced NPC cases from January 2010 to December 2012 was conducted. The patients were divided into TP group(57 cases) and PF group(51 cases) according to therapy regimen. TP group received IMRT combined with TP therapy, and PF group received IMRT combined with PF regimen, two groups were both used 4 cycles of chemotherapy, toxicity reactions during concurrent radiochemotherapy were noted. Two months after treatment, near clinical efficacies of the two groups were determined, and then, a three years followingup was conducted, during which recurrence ratio, metastasis ratio, local control ratio and survival rate were analyzed. Result: Two months after treatment, the total effective ratio of TP group(84.2% vs.76.5%) was higher than PF group,however, the difference was not statistically significant(P>0.05). Gastrointestinal reaction(70.2% vs.66.7%), marrow inhibition(75.4% vs.82.4%), liver function damage(12.3% vs.13.7%), radioactive oral and pharyngeal injury(91.2% vs.98.0%), hearing damage(15.8% vs.15.7%) in the two groups during chemoradiotherapy had no significant differences(P>0.05). During followingup, the recurrence and metastasis ratio in TP group(33.3% vs.47.1%) was lower than PF group(χ²=2.116,P=0.146). TP group with The local control rate(73.7% vs.68.5%) and survival rate(84.2% vs.78.4%) after three years treatment in TP group were higher than PF group(χ²=0.336,P=0.562;χ²=0.596,P=0.440). Conclusion: IMRT concurrently combined with TP and PF respectively are both effective methods for treatment of advanced NPC. In this study, IMPT plus TP concurrent chemoradiotherapy has a certain superiority in near and long term clinical treatment efficacy and safety.
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Affiliation(s)
- F Wu
- Department of Otolaryngology,the Second Hospital Affiliated to Hubei University of Science and Technology,Xianning,437100,China
| | - L L Wu
- Department of Otolaryngology,the Second Hospital Affiliated to Hubei University of Science and Technology,Xianning,437100,China
| | - G F Chen
- Department of Medical Institute of Technology, Taizhou Polytechnic College
| | - Y C Huang
- Five senses Medical College,Hubei Science and Technology College
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Lin TC, Lee JD, Lin YH, Yuan RY, Weng HH, Huang YC, Lee M, Wu CY, Hsu HL, Hsu CY, Lee TH, Liu SJ, Chang YJ, Chang CH, Peng TI, Liou CW, Chang KC, Pan YT, Huang YC. Timing of Symptomatic Infarct Swelling Following Intravenous Thrombolysis in Acute Middle Cerebral Artery Infarction: A Case–Control Study. Clin Appl Thromb Hemost 2016; 23:814-820. [DOI: 10.1177/1076029616659693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The risk of symptomatic infarct swelling has been reported to be higher in patients treated with recombinant tissue plasminogen activator (rt-PA). The aim of this study was to evaluate the timing of symptomatic infarct swelling after rt-PA treatment. Methods: We retrospectively analyzed 14 868 patients with acute ischemic stroke from a stroke registry databank. We recruited patients with massive middle cerebral artery (MCA) infarction and symptomatic infarct swelling and excluded those with parenchymal or symptomatic hemorrhage. Multiple linear regression and multivariate logistic regression analyses were used to estimate the impact of rt-PA on the timing of symptomatic infarct swelling. Results: A total of 23 patients with rt-PA treatment and 117 patients without rt-PA treatment were included. The rt-PA treatment group had a lower rate of coronary artery disease (8.7% vs 32.5%; P = .023), lower severity of baseline National Institutes of Health Stroke Scale score (19 vs 23; P = .014), shorter duration of infarct swelling (27.6 vs 45.4 hours; P < .001), and higher rate of hemicraniectomy surgery (65.2% vs 28.2%; P =.001) than those without rt-PA treatment. After adjusting for variables in multiple linear regression analysis, rt-PA treatment and an elevated C-reactive protein level were associated with early symptomatic infarct swelling ( P = .014 and P = .041, respectively). The rt-PA treatment was an independent factor related to early symptomatic infarct swelling within 36 hours ( P = .005; odds ratio [OR]: 5.3; confidence interval [CI]: 1.65-17.0) or 48 hours ( P = .009; OR: 16.4; CI: 2.00-134). Conclusion: Intravenous rt-PA treatment may hasten the onset of cerebral edema and subsequent cerebral herniation in large MCA territory infarction.
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Affiliation(s)
- Ting-Chun Lin
- Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Jiann-Der Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Ya-Hui Lin
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Rey-Yue Yuan
- Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsu-Huei Weng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Taiwan
| | - Ying-Chih Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Meng Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Chih-Ying Wu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Huan-Lin Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Chia-Yu Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Tsong-Hai Lee
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shan-Jin Liu
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yeu-Jhy Chang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chien-Hung Chang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-I Peng
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chia-Wei Liou
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ku-Chou Chang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ting Pan
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Yen-Chu Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
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Yeh SI, Huang YC, Cheng CH, Cheng CM, Yang JT. Development of a millimetrically scaled biodiesel transesterification device that relies on droplet-based co-axial fluidics. Sci Rep 2016; 6:29288. [PMID: 27426677 PMCID: PMC4947928 DOI: 10.1038/srep29288] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 06/17/2016] [Indexed: 11/09/2022] Open
Abstract
In this study, we investigated a fluidic system that adheres to new concepts of energy production. To improve efficiency, cost, and ease of manufacture, a millimetrically scaled device that employs a droplet-based co-axial fluidic system was devised to complete alkali-catalyzed transesterification for biodiesel production. The large surface-to-volume ratio of the droplet-based system, and the internal circulation induced inside the moving droplets, significantly enhanced the reaction rate of immiscible liquids used here – soybean oil and methanol. This device also decreased the molar ratio between methanol and oil to near the stoichiometric coefficients of a balanced chemical equation, which enhanced the total biodiesel volume produced, and decreased the costs of purification and recovery of excess methanol. In this work, the droplet-based co-axial fluidic system performed better than other methods of continuous-flow production. We achieved an efficiency that is much greater than that of reported systems. This study demonstrated the high potential of droplet-based fluidic chips for energy production. The small energy consumption and low cost of the highly purified biodiesel transesterification system described conforms to the requirements of distributed energy (inexpensive production on a moderate scale) in the world.
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Affiliation(s)
- S I Yeh
- Department of Mechanical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan
| | - Y C Huang
- Department of Mechanical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan
| | - C H Cheng
- Department of Mechanical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan
| | - C M Cheng
- Institute of Biomedical Engineering, National Tsing Hua University, No.101, Sec. 2, Guangfu Road, Hsinchu, Taiwan
| | - J T Yang
- Department of Mechanical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, Taiwan
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Cai XH, Peng YH, Wang ZC, Huang T, Xiong XY, Huang YC, Wang B, Xu LW, Wu ZH. Characterization and identification of streptococci from golden pompano in China. Dis Aquat Organ 2016; 119:207-217. [PMID: 27225204 DOI: 10.3354/dao02998] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Streptococcal infections cause significant mortality and high economic losses in the fish farm industry worldwide, including in the culture of golden pompano Trachinotus ovatus L., a species gaining popularity in China. A total of 9 streptococcal strains were isolated from cage-cultured diseased golden pompano in Beihai, Zhanjing, and Shenzhen, China, between 2012 and 2014. Conventional and rapid identification systems were used to determine that the isolates were Streptococcus agalactiae, S. iniae, and S. dysgalactiae subsp. dysgalactiae. All isolates were gram-positive cocci cells in pairs or short-chain, non-motile, catalase negative, α or β hemolytic cocci. The results of multiplex PCR assays and 16S rRNA BLAST analysis also showed that the β hemolytic strains were S. agalactiae and S. iniae and the α hemolytic strain was S. dysgalactiae subsp. dysgalactiae, respectively. Pathogenicity assays revealed that S. agalactiae (lethal dose [LD50]: 6.38 × 10(4) CFU ml(-1)) was more virulent for golden pompano than S. iniae (LD50: 1.47 × 10(7) CFU ml(-1)) and S. dysgalactiae subsp. dysgalactiae (LD50: 2.57 × 10(6) CFU ml(-1)) when they were challenged by intraperiotoneal (i.p.) injection. The results of antibiotic susceptibility showed that all strains were extremely susceptible to cefradine, erythromycin, and cefotaxime but resistant to gentamicin, penicillin G, novobiocin, neomycin, ciprofloxacin, roxithromycin, furazolidone, enrofloxacin, norfloxacin, kanamycin, ampicillin, tetracycline, and vancomycin This is the first report of a phenomenon of golden pompano coinfection with S. agalactiae and S. iniae, which will contribute to the diagnosis and prevention of streptococcicosis.
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Affiliation(s)
- X H Cai
- Guangdong Provincial Key Laboratory of Pathogenic Biology and Epidemiology for Aquatic Economic Animals, Guangdong Key Laboratory of Control for Diseases of Aquatic Economic Animals, Guangdong Ocean University, Zhanjiang 524088, PR China
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Hsu CY, Cheng CY, Tsai YH, Lee JD, Yang JT, Weng HH, Lin LC, Huang YC, Lee M, Lee MH, Wu CY, Lin YH, Hsu HL, Yang HT, Pan YT, Huang YC. Perfusion-diffusion Mismatch Predicts Early Neurological Deterioration in Anterior Circulation Infarction without Thrombolysis. Curr Neurovasc Res 2016; 12:277-82. [PMID: 26044806 PMCID: PMC5403961 DOI: 10.2174/1567202612666150605122536] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/17/2015] [Accepted: 05/20/2015] [Indexed: 12/29/2022]
Abstract
Perfusion-diffusion mismatch in magnetic resonance imaging (MRI) represents the non-core hypoperfused area in acute ischemic stroke. The mismatch has been used to predict clinical response after thrombolysis in acute ischemic stroke, but its role for predicting early neurological deterioration (END) in acute ischemic stroke without thrombolysis has not been clarified yet. In this study, we prospectively recruited 54 patients with acute non-lacunar ischemic stroke in anterior circulation without thrombolysis. All patients received the first perfusion MRI within 24 hours from stroke onset. Target mismatch profile was defined as a perfusion-diffusion mismatch ratio ≥ 1.2. END was defined as an increase of ≥ 4 points in the National Institute of Health Stroke Scale (NIHSS) score within 72 hours. There were 13 (24.1%) patients developing END, which was associated with larger infarct growth (p = 0.002), worse modified Rankin Scale (p = 0.001) and higher mortality rate at 3 months (p = 0.025). Target mismatch profiles measured by Tmax ≥ 4, 5 and 6 seconds were independent predictors for END after correcting initial NIHSS score. Among the 3 Tmax thresholds, target mismatch measured by Tmax ≥ 6 seconds had the highest odd’s ratio in predicting END (p < 0.01, odd’s ratio = 17), with an 80% sensitivity and a 79.5% specificity. In conclusion, perfusion-diffusion mismatch could identify the patients at high risk of early clinical worsening in acute ischemic stroke without thrombolysis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Yen-Chu Huang
- Department of Neurology, Chang Gung Memorial Hospital, 6 West Chia-Pu Road, Putz City, Chiayi County, Taiwan.
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Pan YT, Lee JD, Lin YH, Huang YC, Weng HH, Lee M, Wu CY, Hsu HL, Yang HT, Hsu CY, Lee TH, Liu SJ, Peng TY, Liou CW, Chang KC, Huang YC. Comparisons of outcomes in stroke subtypes after intravenous thrombolysis. Springerplus 2016; 5:47. [PMID: 26835227 PMCID: PMC4718911 DOI: 10.1186/s40064-016-1666-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 01/04/2016] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to analyze the outcomes and complications between stroke subtypes after intravenous thrombolysis. A total of 471 patients with acute ischemic stroke after intravenous thrombolysis from January 2007 to April 2014 were enrolled and classified according to the Trial of Org 10172 in Acute Stroke Treatment. A multivariate logistic regression model was used to evaluate the outcomes and complications among stroke subtypes after adjusting for baseline variables. Of the 471 patients, 117 (25.1 %) had large-artery atherosclerosis (LAA), 148 (31.8 %) had cardioembolism (CE), 82 (17.6 %) had small vessel disease (SVD), 119 (25.5 %) had undetermined etiology, and 5 (1.1 %) had other determined etiology. The patients with SVD had the mildest initial stroke severity and highest ratio of good and favorable outcomes, whereas those with CE had a higher rate of symptomatic intracranial hemorrhage (sICH) than those with SVD. After adjusting for confounding factors, the ratio of favorable outcome in the patients with SVD stroke was higher than in those with LAA. SVD was associated with a significantly lower rate of any hemorrhage compared to other stroke subtypes, whereas there were no differences in sICH or mortality between stroke subtypes. A lower initial National Institutes of Health Stroke Scale score was associated with good and favorable outcomes, and lower rates of sICH and mortality. The patients with SVD after intravenous thrombolysis had better outcomes and a lower rate of hemorrhage even after adjusting for confounding factors. Stroke severity was an independent factor associated with better functional outcomes, sICH and mortality.
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Affiliation(s)
- Yi-Ting Pan
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Jiann-Der Lee
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Ya-Hui Lin
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Ying-Chih Huang
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Hsu-Huei Weng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Putz City, Chiayi County Taiwan
| | - Meng Lee
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Chih-Ying Wu
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Huan-Lin Hsu
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Hsin-Ta Yang
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Chia-Yu Hsu
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
| | - Tsong-Hai Lee
- Department of Neurology, Stroke Center, Chang Gung Memorial Hospital Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan County, Taiwan
| | - Shan-Jin Liu
- Department of Neurology, Stroke Center, Chang Gung Memorial Hospital Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan County, Taiwan
| | - Tsung-Yi Peng
- Department of Neurology, Stroke Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung City, Taiwan
| | - Chia-Wei Liou
- Department of Neurology, Stroke Center, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Ku-Chou Chang
- Department of Neurology, Stroke Center, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Yen-Chu Huang
- Department of Neurology, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, 6 West Chia-Pu Road, Putz City, Chiayi County Taiwan
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Hsu CY, Wu YL, Cheng CY, Lee JD, Huang YC, Lee MH, Wu CY, Hsu HL, Lin YH, Huang YC, Yang HT, Yang JT, Lee M, Ovbiagele B. Low baseline urine creatinine excretion rate predicts poor outcomes among critically ill acute stroke patients. Curr Neurovasc Res 2015; 12:47-52. [PMID: 25557376 PMCID: PMC4460282 DOI: 10.2174/1567202612666150102151455] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 12/14/2014] [Accepted: 12/16/2014] [Indexed: 11/22/2022]
Abstract
Urinary creatinine excretion rate (CER) is an established marker of muscle mass. Low CER has been linked to poor coronary artery disease outcomes, but a link between CER and acute stroke prognosis has not been previously explored. We prospectively collected data from patients with acute stroke (ischemic or hemorrhagic) within 24 hours from symptom onset in a Neurological and Neurosurgery Intensive Care Unit in Taiwan. Baseline CER (mg/d) was calculated by urine creatinine concentration in morning spot urine multiplies 24-hour urine volume on the second day of admission. Patients were divided into 3 tertiles with highest, middle, and lowest CER. Primary endpoint was poor outcome defined as modified Rankin Scale 3-6 at 6 months. Among 156 critically ill acute stroke patients meeting study entry criteria, average age was 67.9 years, and 83 (53.2%) patients had ischemic stroke. Patients with lowest CER (vs. highest CER) had a high risk of poor outcome at 6-month after adjustment (odds ratio 4.96, 95% confidence interval 1.22 to 20.15, p value = 0.025). In conclusion, low baseline CER, a marker of muscle mass, was independently associated with poor 6-month outcome among critically ill acute stroke patients. We speculate that preservation of muscle mass through exercise or protein-energy supplement might be helpful for improving prognosis in severe stroke patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Bruce Ovbiagele
- Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
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Kuo CY, Lin CH, Kuo YW, Huang YC, Hsu HL, Lin YH, Wu CY, Huang YC, Lee M, Yang HT, Hsu CY, Pan YT, Lee JD. Factor VIII levels are associated with ischemic stroke, stroke subtypes and neurological worsening. Curr Neurovasc Res 2015; 12:85-90. [PMID: 25557373 DOI: 10.2174/1567202612666150102153447] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 11/22/2022]
Abstract
The role played by hemostasis in the pathogenesis of ischemic stroke is still controversial. In the present study, we looked for a possible association of ischemic stroke with the high clotting activity of factor VIII (FVIII). The study population consisted of 116 patients with acute ischemic stroke who had been admitted between September 2013 and September 2014 to the Department of Neurology, Chiayi Chang Gung Memorial Hospital, and 76 control subjects with no history of stroke. FVIII levels were higher in stroke patients as compared to controls (127.5 ± 52.5 vs. 108.4 ± 49.0 IU/dL; P = 0.012). In a univariate risk analysis, FVIII at levels above 150 IU/dL was associated with an odds ratio (OR) for ischemic stroke of up to 2.55 (95% CI, 1.20-5.42, P = 0.013). In a multivariate analysis using a logistic regression model including age, hypertension, low density lipoprotein cholesterol level, estimated glomerular filtration rate, and high FVIII (< 150 IU/dL), high FVIII was still found to significantly add to the risk of ischemic stroke (OR = 3.26 with 95% CI, 1.38-7.68, P = 0.007). As for the stroke subtypes, mean FVIII level was significantly higher in patients with cardioembolic stroke than patients with noncardioembolic stroke (156.0 ± 51.5 IU/dL vs. 124.3 ± 51.9 IU/dL). High levels of FVIII were also associated significantly with neurological worsening (OR = 3.66 with 95% CI, 1.24-10.82, P = 0.019). A high plasma level of FVIII is a prevalent and independent risk factor for ischemic stroke and neurological worsening after acute stroke.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Jiann-Der Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, and School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taiwan, No.6, W. Sec., Jiapu Rd., Puzi City, Chiayi County 613, Taiwan (R.O.C.).
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45
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Chen KI, Pan CY, Li KH, Huang YC, Lu CW, Tang CY, Su YW, Tseng LW, Tseng KC, Lin CY, Chen CD, Lin SS, Chen YT. Isolation and Identification of Post-Transcriptional Gene Silencing-Related Micro-RNAs by Functionalized Silicon Nanowire Field-effect Transistor. Sci Rep 2015; 5:17375. [PMID: 26616332 PMCID: PMC4663627 DOI: 10.1038/srep17375] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/29/2015] [Indexed: 02/08/2023] Open
Abstract
Many transcribed RNAs are non-coding RNAs, including microRNAs (miRNAs), which bind to complementary sequences on messenger RNAs to regulate the translation efficacy. Therefore, identifying the miRNAs expressed in cells/organisms aids in understanding genetic control in cells/organisms. In this report, we determined the binding of oligonucleotides to a receptor-modified silicon nanowire field-effect transistor (SiNW-FET) by monitoring the changes in conductance of the SiNW-FET. We first modified a SiNW-FET with a DNA probe to directly and selectively detect the complementary miRNA in cell lysates. This SiNW-FET device has 7-fold higher sensitivity than reverse transcription-quantitative polymerase chain reaction in detecting the corresponding miRNA. Next, we anchored viral p19 proteins, which bind the double-strand small RNAs (ds-sRNAs), on the SiNW-FET. By perfusing the device with synthesized ds-sRNAs of different pairing statuses, the dissociation constants revealed that the nucleotides at the 3′-overhangs and pairings at the terminus are important for the interactions. After perfusing the total RNA mixture extracted from Nicotiana benthamiana across the device, this device could enrich the ds-sRNAs for sequence analysis. Finally, this bionanoelectronic SiNW-FET, which is able to isolate and identify the interacting protein-RNA, adds an additional tool in genomic technology for the future study of direct biomolecular interactions.
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Affiliation(s)
- Kuan-I Chen
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan.,Institute of Atomic and Molecular Sciences, Academia Sinica, P.O. Box 23-166, Taipei 106, Taiwan
| | - Chien-Yuan Pan
- Department of Life Science, National Taiwan University, Taipei 106, Taiwan
| | - Keng-Hui Li
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan
| | - Ying-Chih Huang
- Institute of Biotechnology, National Taiwan University, Taipei 106, Taiwan
| | - Chia-Wei Lu
- Institute of Biotechnology, National Taiwan University, Taipei 106, Taiwan
| | - Chuan-Yi Tang
- Department of Computer Science, National Tsing Hua University, Hsinchu 300, Taiwan
| | - Ya-Wen Su
- National Nano Device Laboratories, Hsinchu 300, Taiwan
| | - Ling-Wei Tseng
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan
| | - Kun-Chang Tseng
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan.,Institute of Atomic and Molecular Sciences, Academia Sinica, P.O. Box 23-166, Taipei 106, Taiwan
| | - Chi-Yun Lin
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan
| | - Chii-Dong Chen
- Institute of Physics, Academia Sinica, Taipei 115, Taiwan
| | - Shih-Shun Lin
- Institute of Biotechnology, National Taiwan University, Taipei 106, Taiwan.,Agricultural Biotechnology Research Center, Academia Sinica, Taipei 115, Taiwan
| | - Yit-Tsong Chen
- Department of Chemistry, National Taiwan University, Taipei 106, Taiwan.,Institute of Atomic and Molecular Sciences, Academia Sinica, P.O. Box 23-166, Taipei 106, Taiwan
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Lin CH, Kuo YW, Kuo CY, Huang YC, Hsu CY, Hsu HL, Lin YH, Wu CY, Huang YC, Lee M, Yang HT, Pan YT, Lee JD. Shortened Activated Partial Thromboplastin Time Is Associated With Acute Ischemic Stroke, Stroke Severity, and Neurological Worsening. J Stroke Cerebrovasc Dis 2015; 24:2270-6. [PMID: 26169548 DOI: 10.1016/j.jstrokecerebrovasdis.2015.06.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 05/23/2015] [Accepted: 06/10/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND The role played by hemostasis in the pathogenesis of ischemic strokes is still controversial. The activated partial thromboplastin time (APTT) measures the time necessary to generate fibrin from initiation of the intrinsic pathway. In the present study, we looked for a possible association of ischemic strokes with the shortened APTT. METHODS The study population consisted of 154 patients with acute ischemic strokes who had been admitted from December 2013 to December 2014 to the Department of Neurology, Chiayi Chang Gung Memorial Hospital, and 71 control subjects with no history of stroke. RESULTS In a univariate risk analysis, shortened APTT was associated with an odds ratio (OR) for acute ischemic strokes of up to 1.86 (95% confidence interval [CI], 1.06-3.29, P = .031). In a multivariate analysis using a logistic regression model including age, sex, hypertension, diabetes mellitus, and shortened APTT, shortened APTT was still found to significantly add to the risk of ischemic stroke (OR = 2.12 with 95% CI, 1.13-3.98, P = .020). Shortened APTT was also associated significantly with neurological worsening (OR = 3.72 with 95% CI 1.03-13.5, P = .046). As for stroke severity, shortened APTT was associated with an OR for moderate/severe stroke of up to 3.42 (95% CI, 1.53-7.61, P = .003). CONCLUSION Shortened APTT is a prevalent and independent risk factor for ischemic stroke, stroke severity, and neurological worsening after acute stroke.
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Affiliation(s)
- Chun-Hsien Lin
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Ya-Wen Kuo
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Chih-Yu Kuo
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Yen-Chu Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yu Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Huan-Lin Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Ya-Hui Lin
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Chih-Ying Wu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Ying-Chih Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Meng Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsin-Ta Yang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Yi-Ting Pan
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan
| | - Jiann-Der Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Life Science, National Chung Cheng University, Chiayi, Taiwan.
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Lee JD, Hsiao KM, Wang TC, Lee TH, Kuo YW, Huang YC, Hsu HL, Lin YH, Wu CY, Huang YC, Lee M, Yang HT, Hsu CY, Pan YT. Mutual Effect of rs688 and rs5925 in Regulating Low-Density Lipoprotein Receptor Splicing. DNA Cell Biol 2014; 33:869-75. [DOI: 10.1089/dna.2014.2577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jiann-Der Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, and School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Chiayi, Taiwan
- Department of Life Science, National Chung Cheng University, Chiayi, Taiwan
| | - Kuang-Ming Hsiao
- Department of Life Science, National Chung Cheng University, Chiayi, Taiwan
| | - Ting-Chung Wang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Tsong-Hai Lee
- Department of Neurology, Chang Gung Memorial Hospital at Taoyuan, and Chang Gung University, Taoyuan, Taiwan
| | - Ya-Wen Kuo
- Department of Nursing, Asia University, Taichung Taiwan
| | - Yen-Chu Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, and School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Chiayi, Taiwan
| | - Huan-Lin Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Ya-Hui Lin
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Chih-Ying Wu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Ying-Chih Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Meng Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, and School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Chiayi, Taiwan
| | - Hsin-Ta Yang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Chia-Yu Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Yi-Ting Pan
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
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Fang CH, Lin KY, Huang YC, Liu L. A Cost-Utility Analysis of Calcium Channel Blockers (Ccbs) Compared with Angiotensin II Receptor Blockers (Arbs) In Preventing Stroke And Myocardial Infarction Among Hypertension Patients In The Taiwan. Value Health 2014; 17:A761-A762. [PMID: 27202782 DOI: 10.1016/j.jval.2014.08.263] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - K Y Lin
- Kantar Health, Taipei, Taiwan
| | - Y C Huang
- Pfizer Limited, New Taipei City, Taiwan
| | - L Liu
- Pfizer, New York, NY, USA
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Huang YC, Tsai YH, Lee JD, Weng HH, Lin LC, Lin YH, Wu CY, Huang YC, Hsu HL, Lee M, Yang HT, Hsu CY, Pan YT, Yang JT. Hemodynamic factors may play a critical role in neurological deterioration occurring within 72 hrs after lacunar stroke. PLoS One 2014; 9:e108395. [PMID: 25340713 PMCID: PMC4207695 DOI: 10.1371/journal.pone.0108395] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 08/21/2014] [Indexed: 11/23/2022] Open
Abstract
Background Whether a perfusion defect exists in lacunar infarct and whether it is related to early neurological deterioration (END) is still under debate. The aim of this study was to evaluate whether END in lacunar infarct is related to a perfusion defect using diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI) and perfusion MR imaging. Methods One hundred and forty-one consecutive patients had an MRI scan within 30 hours after onset of symptoms and 43 patients with acute lacunar infarct and classic lacunar syndrome were recruited. The MRI sequences included DWI, DTI and cerebral blood flow (CBF) maps to respectively represent the topographic locations of acute infarcts, the corticospinal tract and perfusion defects. The END was defined in reference to the National Institute of Health Stroke Scale (NIHSS) as an increase ≧2 within 72 hours. Cohen's Kappa coefficient was used to examine the reliability between the 2 image readers. A multivariate logistic regression model was constructed adjusting for baseline variables. Results Ten out of the 43 patients had END. Patients having END was significantly associated with lower chances of favorable and good outcomes at 3 months (p = 0.01 and p = 0.002, respectively). END was predicted when the non-core hypoperfused area overlapped on the corticospinal tract, which is defined as the expected END profile. Cohen's Kappa coefficient between the 2 image readers to define images of expected END profiles was 0.74. In 15 patients with expected END profile, 9 had END clinically, whereas 28 patients had no expected END profile, and only 1 patient had END (p<0.0001). After adjusting for sex, the expected END profile was still associated with END (odds ratio, 42.2; p = 0.002). Conclusion Our study demonstrated that the END in acute lacunar stroke is likely related to the transformation of non-core hypoperfused area into infarction in the anatomy of corticospinal tracts.
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Affiliation(s)
- Yen-Chu Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi,Taiwan
| | - Jiann-Der Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Hsu-Huei Weng
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi,Taiwan
| | - Leng-Chieh Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Ya-Hui Lin
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Chih-Ying Wu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Ying-Chih Huang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Huan-Lin Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Meng Lee
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Hsin-Ta Yang
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Chia-Yu Hsu
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Yi-Ting Pan
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
| | - Jen-Tsung Yang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Chiayi, Chang-Gung University College of Medicine, Chiayi, Taiwan
- * E-mail:
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Lee JD, Hsiao KM, Lee TH, Kuo YW, Huang YC, Hsu HL, Lin YH, Wu CY, Huang YC, Lee M, Yang HT, Hsu CY, Pan YT. Genetic polymorphism of LDLR (rs688) is associated with primary intracerebral hemorrhage. Curr Neurovasc Res 2014; 11:10-5. [PMID: 24295502 DOI: 10.2174/1567202610666131202115038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 11/07/2013] [Accepted: 11/14/2013] [Indexed: 11/22/2022]
Abstract
Intracranial hemorrhage is the third most common cause of cerebrovascular disease. Some polymorphisms that affect clotting factors increase the risk of thrombosis. However, few reports have analyzed the effect of polymorphisms on the hemostatic state in bleeding disorders. The low-density lipoprotein receptor (LDLR) has been shown to contribute to factor VIII (FVIII) homeostasis, which represents a link between LDLR and hemostasis. FVIII plays a pivotal role in the coagulation cascade. Patients with high levels of FVIII are at an increased risk of arterial and venous thrombosis. On the other hand, patients with insufficient FVIII tend to bleed excessively, such as in hemophilia A. In a previous study, analysis of the genetic LDLR variant rs688 provided evidence suggesting that genetic polymorphisms of rs688 are associated with thrombotic cardiovascular diseases. The current study aimed to investigate the potential role of rs688 in primary intracerebral hemorrhage (PICH). This genetic association study was conducted within an isolated Taiwanese population (447 PICH patients and 430 controls). Genotypes C/C and C/T were used as the reference genotypes, and the genotype T/T was found to be associated with a 73% decreased risk of PICH. The preliminary evidence suggests that genetic polymorphisms of LDLR are associated with PICH.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Yi-Ting Pan
- Department of Neurology, Chang Gung Memorial Hospital at Chiayi, and Chang Gung University, Taiwan, No.6, W. Sec., Jiapu Rd., Puzi City, Chiayi County 613, Taiwan (R.O.C).
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