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Chen JX, Shen YC, Peng SL, Chen YW, Fang HY, Lan JL, Shih CT. Pattern classification of interstitial lung diseases from computed tomography images using a ResNet-based network with a split-transform-merge strategy and split attention. Phys Eng Sci Med 2024:10.1007/s13246-024-01404-1. [PMID: 38436886 DOI: 10.1007/s13246-024-01404-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
In patients with interstitial lung disease (ILD), accurate pattern assessment from their computed tomography (CT) images could help track lung abnormalities and evaluate treatment efficacy. Based on excellent image classification performance, convolutional neural networks (CNNs) have been massively investigated for classifying and labeling pathological patterns in the CT images of ILD patients. However, previous studies rarely considered the three-dimensional (3D) structure of the pathological patterns of ILD and used two-dimensional network input. In addition, ResNet-based networks such as SE-ResNet and ResNeXt with high classification performance have not been used for pattern classification of ILD. This study proposed a SE-ResNeXt-SA-18 for classifying pathological patterns of ILD. The SE-ResNeXt-SA-18 integrated the multipath design of the ResNeXt and the feature weighting of the squeeze-and-excitation network with split attention. The classification performance of the SE-ResNeXt-SA-18 was compared with the ResNet-18 and SE-ResNeXt-18. The influence of the input patch size on classification performance was also evaluated. Results show that the classification accuracy was increased with the increase of the patch size. With a 32 × 32 × 16 input, the SE-ResNeXt-SA-18 presented the highest performance with average accuracy, sensitivity, and specificity of 0.991, 0.979, and 0.994. High-weight regions in the class activation maps of the SE-ResNeXt-SA-18 also matched the specific pattern features. In comparison, the performance of the SE-ResNeXt-SA-18 is superior to the previously reported CNNs in classifying the ILD patterns. We concluded that the SE-ResNeXt-SA-18 could help track or monitor the progress of ILD through accuracy pattern classification.
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Affiliation(s)
- Jian-Xun Chen
- Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Cheng Shen
- Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Yi-Wen Chen
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Hsin-Yuan Fang
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Joung-Liang Lan
- School of Medicine, China Medical University, Taichung, Taiwan
- Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Ting Shih
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan.
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, Taiwan.
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Fang J, Shen YC, Ting YN, Fang HY, Chen YW. Quantitative assessment of pneumothorax by using Shannon entropy of lung ultrasound M-mode image and diaphragmatic excursion based on automated measurement. Quant Imaging Med Surg 2024; 14:123-135. [PMID: 38223084 PMCID: PMC10784102 DOI: 10.21037/qims-23-636] [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: 05/09/2023] [Accepted: 10/12/2023] [Indexed: 01/16/2024]
Abstract
Background Lung ultrasound (LUS) and diaphragm ultrasound (DUS) are the appropriate modalities for conservative observation to those patients who are with stable pneumothorax, as well as for the timely detection of life-threatening pneumothorax at any location, due to they are portable, real-time, relatively cost effective, and most important, without radiation exposure. The absence of lung sliding on LUS M-mode images and the abnormality of diaphragmatic excursion (DE) on DUS M-mode images are the most common and novel diagnostic criteria for pneumothorax, respectively. However, visual inspection of M-mode images remains subjective and quantitative analysis of LUS and DUS M-mode images are required. Methods Shannon entropy of LUS M-mode image (ShanEnLM) and DE based on the automated measurement (DEAM) are adapted to the objective pneumothorax diagnoses and the severity quantifications in this study. Mild, moderate, and severe pneumothoraces were induced in 24 male New Zealand rabbits through insufflation of room air (5, 10 and 15, and 25 and 40 mL/kg, respectively) into their pleural cavities. In vivo intercostal LUS and subcostal DUS M-mode images were acquired using a point-of-care system for estimating ShanEnLM and DEAM. Results ShanEnLM and DEAM as functions of air insufflation volumes exhibited U-shaped curves and were exponentially decreasing, respectively. Either ShanEnLM or DEAM had areas under the receiver operating characteristic curves [95% confidence interval (CI)] of 1.0000 (95% CI: 1.0000-1.0000), 0.9833 (95% CI: 0.9214-1.0000), and 0.9407 (95% CI: 0.8511-1.0000) for differentiating between normal and mild pneumothorax, mild and moderate pneumothoraces, and moderate and severe pneumothoraces, respectively. Conclusions Our findings imply that the combination of ShanEnLM and DEAM give the promising potential for pneumothorax quantitative diagnosis.
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Affiliation(s)
- Jui Fang
- Research & Development Center for x-Dimensional Extracellular Vesicles, China Medical University Hospital, Taichung City
| | - Yu-Cheng Shen
- Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung City
| | - Yen-Nien Ting
- Research & Development Center for x-Dimensional Extracellular Vesicles, China Medical University Hospital, Taichung City
| | - Hsin-Yuan Fang
- Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung City
- School of Medicine, College of Medicine, China Medical University, Taichung City
| | - Yi-Wen Chen
- Research & Development Center for x-Dimensional Extracellular Vesicles, China Medical University Hospital, Taichung City
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City
- High Performance Materials Institute for xD Printing, Asia University, Taichung City
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Huang HS, Fang HY. Effects of Artificial Intelligence on Surgical Patients' Health Education. Healthcare (Basel) 2023; 11:2705. [PMID: 37893779 PMCID: PMC10606014 DOI: 10.3390/healthcare11202705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/27/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Today, the various abilities that nurses require to meet patients' healthcare needs adequately are all affected by AI-enabled systems. This research used an experimental study design in which 60 subjects were randomly assigned to either an experimental (AI image e-book guidance) group or a control (text paper guidance) group after meeting the admission conditions and agreeing to participate in the study. It was proven that providing AI image e-book guidance before surgery significantly changed the behavior of patients and promoted relief of urinary catheter discomfort through self-efficacy to reduce urinary catheter pain after surgery (p < 0.001). It was found that providing AI image e-book guidance can shorten the time for health education and provide patients with repeated medical education and familiarity with health guidance, which can help to address the important clinical service demand issue and the shortage of nursing staff.
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Affiliation(s)
- Hsin-Shu Huang
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan
| | - Hsin-Yuan Fang
- Department of Surgery, China Medical University Hospital, Taichung 40447, Taiwan
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Shie MY, Fang HY, Kan KW, Ho CC, Tu CY, Lee PC, Hsueh PR, Chen CH, Lee AKX, Tien N, Chen JX, Shen YC, Chang JG, Shen YF, Lin TJ, Wang B, Hung MC, Cho DY, Chen YW. Highly Mimetic Ex Vivo Lung-Cancer Spheroid-Based Physiological Model for Clinical Precision Therapeutics. Adv Sci (Weinh) 2023:e2206603. [PMID: 37085943 DOI: 10.1002/advs.202206603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/10/2023] [Indexed: 05/03/2023]
Abstract
Lung cancer remains a major health problem despite the considerable research into prevention and treatment methods. Through a deeper understanding of tumors, patient-specific ex vivo spheroid models with high specificity can be used to accurately investigate the cause, metastasis, and treatment strategies for lung cancer. Biofabricate lung tumors are presented, consisting of patient-derived tumor spheroids, endothelial cells, and lung decellularized extracellular matrix, which maintain a radial oxygen gradient, as well as biophysicochemical behaviors of the native tumors for precision medicine. It is also demonstrated that the developed lung-cancer spheroid model reproduces patient responses to chemotherapeutics and targeted therapy in a co-clinical trial, with 85% accuracy, 86.7% sensitivity, and 80% specificity. RNA sequencing analysis validates that the gene expression in the spheroids replicates that in the patient's primary tumor. This model can be used as an ex vivo predictive model for personalized cancer therapy and to improve the quality of clinical care.
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Affiliation(s)
- Ming-You Shie
- School of Dentistry, China Medical University, Taichung, 406040, Taiwan
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, 404332, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 41354, Taiwan
| | - Hsin-Yuan Fang
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, 404332, Taiwan
- Department of Thoracic Surgery, China Medical University Hospital, Taichung City, 40447, Taiwan
- School of Medicine, China Medical University, Taichung City, 40447, Taiwan
| | - Kai-Wen Kan
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, 404332, Taiwan
| | - Chia-Che Ho
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 41354, Taiwan
- High Performance Materials Institute for x-Dimensional Printing, Asia University, Taichung City, 41354, Taiwan
| | - Chih-Yen Tu
- School of Medicine, China Medical University, Taichung City, 40447, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Pei-Chih Lee
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, 406040, Taiwan
| | - Po-Ren Hsueh
- School of Medicine, China Medical University, Taichung City, 40447, Taiwan
- Department of Laboratory Medicine, China Medical University Hospital, Taichung City, 404332, Taiwan
| | - Chia-Hung Chen
- School of Medicine, China Medical University, Taichung City, 40447, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Alvin Kai-Xing Lee
- School of Medicine, China Medical University, Taichung City, 40447, Taiwan
| | - Ni Tien
- Department of Laboratory Medicine, China Medical University Hospital, Taichung City, 404332, Taiwan
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung City, 406040, Taiwan
| | - Jian-Xun Chen
- Department of Thoracic Surgery, China Medical University Hospital, Taichung City, 40447, Taiwan
- School of Medicine, China Medical University, Taichung City, 40447, Taiwan
| | - Yu-Cheng Shen
- Department of Thoracic Surgery, China Medical University Hospital, Taichung City, 40447, Taiwan
| | - Jan-Gowth Chang
- Center for Precision Medicine, China Medical University Hospital, Taichung City, 404332, Taiwan
- Epigenome Research Center, China Medical University Hospital, Taichung City, 404332, Taiwan
| | - Yu-Fang Shen
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 41354, Taiwan
- High Performance Materials Institute for x-Dimensional Printing, Asia University, Taichung City, 41354, Taiwan
| | - Ting-Ju Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, 406040, Taiwan
| | - Ben Wang
- H. Milton Stewart School of Industrial and System Engineering, Georgia Institute of Technology, 755 Ferst Dr NW, Atlanta, GA, 30332, USA
- School of Materials Science and Engineering, Georgia Institute of Technology, 771 Ferst Dr NW, Atlanta, GA, 30332, USA
| | - Mien-Chie Hung
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, 406040, Taiwan
- Center for Molecular Medicine, China Medical University Hospital, Taichung City, 404332, Taiwan
- Research Center for Cancer Biology, China Medical University, Taichung City, 406040, Taiwan
| | - Der-Yang Cho
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, 406040, Taiwan
- Department of Neurosurgery, China Medical University Hospital, Taichung City, 404332, Taiwan
- Translational Cell Therapy Center, China Medical University Hospital, Taichung City, 404332, Taiwan
| | - Yi-Wen Chen
- x-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, 404332, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 41354, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, 406040, Taiwan
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Lin CY, Lien MY, Chen CC, Fang HY, Lin YS, Chen CK, Chen JX, Lu TY, Huang TM, Hsieh TC, Sun SS, Li CC, Chien CR. Consolidative chemotherapy after definitive concurrent chemoradiotherapy for esophageal squamous cell carcinoma patients: a population based cohort study. BMC Gastroenterol 2022; 22:381. [PMID: 35948871 PMCID: PMC9364621 DOI: 10.1186/s12876-022-02464-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The role of consolidative chemotherapy (CCT) for locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients treated with definitive concurrent chemoradiotherapy (dCCRT) is unclear. We aimed to compare the overall survival (OS) of those treated with vs without CCT via a population based approach. METHODS Eligible LA-ESCC patients diagnosed between 2011 and 2017 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratio (HR) of death and incidence of esophageal cancer mortality (IECM) were compared between those with vs without CCT. We also evaluated the OS in supplementary analyses via alternative approaches. RESULTS Our primary analysis consisted of 368 patients in whom covariates were well balanced after PS weighting. The HR of death when CCT was compared to without was 0.67 (95% confidence interval 0.52-0.86, P = 0.002). The HR of IECM was 0.66 (P = 0.04). The HR of OS remained similarly in favor of CCT in supplementary analyses. CONCLUSIONS We found that CCT was associated with significantly improved OS for LA-ESCC patients treated with dCCRT. Randomized controlled trials were needed to confirm this finding.
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Affiliation(s)
- Chen-Yuan Lin
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Pharmacy, China Medical University, Taichung, Taiwan
| | - Ming-Yu Lien
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, North District, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan
| | - Chi-Ching Chen
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-Yuan Fang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, North District, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan
| | - Yu-Sen Lin
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Kuang Chen
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Jian-Xun Chen
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Ting-Yu Lu
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Min Huang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsieh
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Shung-Shung Sun
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ru Chien
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan. .,School of Medicine, College of Medicine, China Medical University, North District, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
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6
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Liu Y, Zhao X, Liu Y, Guo HX, Fang HY, Jin FY, Yu D. [Metachronous multiple carcinoma of bilateral maxillary sinus and lung: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:746-748. [PMID: 35725322 DOI: 10.3760/cma.j.cn115330-20220209-00053] [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)
- Y Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun 130041, China
| | - X Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun 130041, China
| | - Y Liu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun 130041, China
| | - H X Guo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun 130041, China
| | - H Y Fang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun 130041, China
| | - F Y Jin
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun 130041, China
| | - D Yu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Jilin University, Changchun 130041, China
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Fang HY, Lin YS, Chen CK, Chen JX, Lu TY, Huang TM, Hsieh TC, Kuo YC, Lin CY, Lien MY, Chen CC, Li CC, Chien CR. Effectiveness evaluation of adjuvant concurrent chemoradiotherapy for patients with positron emission tomography-staged esophageal squamous cell carcinoma after complete resection: A population-based cohort study. Thorac Cancer 2022; 13:1986-1993. [PMID: 35661426 PMCID: PMC9250842 DOI: 10.1111/1759-7714.14476] [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: 03/21/2022] [Revised: 04/30/2022] [Accepted: 05/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background The role of adjuvant concurrent chemoradiotherapy (ACCRT) is unclear for patients with esophageal squamous cell carcinoma (ESCC) who receive esophagectomy with clean margins. We compared the survival of the ACCRT versus observation groups for these patients staged with positron emission tomography (PET) via a population‐based approach. Methods Eligible patients with locally advanced ESCC diagnosed between 2011 and 2017 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratios (HR) of death and incidence of esophageal cancer mortality (IECM) were compared between the ACCRT and observation groups. We also evaluated overall survival (OS) in subgroups of either with or without lymph node metastases. Results Our primary analysis consisted of 105 patients in whom the covariates were well balanced after PS weighting. The HR for death when ACCRT was compared with observation was 0.58 (95% confidence interval 0.28–1.21, p = 0.15). The results were also not significantly different for IECM or in the subgroup analyses. Conclusion We found that for patients with PET‐staged ESCC who received esophagectomy with clean margins, the survival was not statistically different between ACCRT and observation. Further studies (randomized or larger sample size) are needed to clarify this issue.
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Affiliation(s)
- Hsin-Yuan Fang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Sen Lin
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Kuang Chen
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Jian-Xun Chen
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Ting-Yu Lu
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Min Huang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsieh
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Yu-Cheng Kuo
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Chen-Yuan Lin
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Yu Lien
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chi-Ching Chen
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ru Chien
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,Department of Medical Research, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
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Tu CY, Chen HJ, Hsia TC, Fang HY, Li CC, Chien CR. Adjuvant Concurrent Chemoradiotherapy Versus Adjuvant Chemotherapy Only in Locally Advanced Non-small-cell Lung Cancer With Involved Microscopic Resection Margin: A Population-based Cohort Study. Anticancer Res 2022; 42:3195-3201. [PMID: 35641272 DOI: 10.21873/anticanres.15809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The role of adjuvant concurrent chemoradiotherapy (aCCRT) for locally advanced non-small cell lung cancer (LA-NSCLC) treated with radical surgery, with microscopically involved resection margin, has been debated without there being any direct evidence. In this study, we aimed to compare the outcomes between aCCRT and adjuvant chemotherapy (aCT). PATIENTS AND METHODS Eligible patients diagnosed within 2011-2018 with LA-NSCLC were identified via the Taiwan Cancer Registry. We used propensity-score weighting to balance observable potential confounders, and then compared the hazard ratios of death between aCCRT-treated vs. aCT-treated groups. We also performed supplementary analyses using propensityscore matching. RESULTS Our main study population consisted of 82 patients. The propensity score weight-adjusted hazard ratio of death for the aCCRT group was 0.74 (95% confidence interval=0.35-1.56, p=0.43). There was also no statistically significant difference in survival between groups in the supplementary analyses. CONCLUSION For patients treated with radical but R1 resection for LA-NSCLC, there was no significant OS benefit from the addition of concurrent radiotherapy.
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Affiliation(s)
- Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Hung-Jen Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Ph.D. Program for Health Science and Industry, College of Health Care, China Medical University, Taichung, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chun-Ru Chien
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.; .,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
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Hsu HC, Fang HY, Kuo CC, Su SF, Liang WM, Ma WF. The effectiveness of acupressure for managing postoperative pain in patients with thoracoscopic surgery: A randomized control trail. J Nurs Scholarsh 2021; 54:411-421. [PMID: 34854214 DOI: 10.1111/jnu.12751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/25/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery. DESIGN A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively). METHODS Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale-Pain (VAS-P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t-test and chi-squared test were used for descriptive statistics, and paired t-test and linear mixed model were used to examine the effect of acupressure in alleviating pain. FINDINGS After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001). CONCLUSIONS This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases. CLINICAL RELEVANCE Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery.
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Affiliation(s)
- Hsing-Chi Hsu
- Department of Nursing, HungKuang University, Taichung, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- School of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chi-Chung Kuo
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C.,School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C
| | - Shu-Fen Su
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan, R.O.C
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan, R.O.C
| | - Wei-Fen Ma
- PhD Program for Health Science and Industry and School of Nursing, China Medical University, Taichung, Taiwan, R.O.C.,Department of Nursing, China Medical University Hospital, Taichung, Taiwan, R.O.C
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10
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Chang YS, Tu SJ, Chen YC, Liu TY, Lee YT, Yen JC, Fang HY, Chang JG. Mutation profile of non-small cell lung cancer revealed by next generation sequencing. Respir Res 2021; 22:3. [PMID: 33407425 PMCID: PMC7789556 DOI: 10.1186/s12931-020-01608-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 04/14/2020] [Accepted: 12/20/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Precision therapy for lung cancer requires comprehensive genomic analyses. Specific effects of targeted therapies have been reported in Asia populations, including Taiwanese, but genomic studies have rarely been performed in these populations. METHOD We enrolled 72 patients with non-small cell lung cancer, of whom 61 had adenocarcinoma, 10 had squamous cell carcinoma, and 1 had combined adenocarcinoma and squamous cell carcinoma. Whole-exome or targeted gene sequencing was performed. To identify trunk mutations, we performed whole-exome sequencing in two tumor regions in four patients. RESULTS Nineteen known driver mutations in EGFR, PIK3CA, KRAS, CTNNB1, and MET were identified in 34 of the 72 tumors evaluated (47.22%). A comparison with the Cancer Genome Atlas dataset showed that EGFR was mutated at a much higher frequency in our cohort than in Caucasians, whereas KRAS and TP53 mutations were found in only 5.56% and 25% of our Taiwanese patients, respectively. We also identified new mutations in ARID1A, ARID2, CDK12, CHEK2, GNAS, H3F3A, KDM6A, KMT2C, NOTCH1, RB1, RBM10, RUNX1, SETD2, SF3B1, SMARCA4, THRAP3, TP53, and ZMYM2. Moreover, all ClinVar pathogenic variants were trunk mutations present in two regions of a tumor. RNA sequencing revealed that the trunk or branch genes were expressed at similar levels among different tumor regions. CONCLUSIONS We identified novel variants potentially associated with lung cancer tumorigenesis. The specific mutation pattern in Taiwanese patients with non-small cell lung cancer may influence targeted therapies.
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Affiliation(s)
- Ya-Sian Chang
- Epigenome Research Center, China Medical University Hospital, 2 Yuh-Der Road, Taichung, 404, Taiwan.,Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan.,Center for Precision Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Siang-Jyun Tu
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Chia Chen
- Center for Precision Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ting-Yuan Liu
- Center for Precision Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Ting Lee
- Epigenome Research Center, China Medical University Hospital, 2 Yuh-Der Road, Taichung, 404, Taiwan
| | - Ju-Chen Yen
- Epigenome Research Center, China Medical University Hospital, 2 Yuh-Der Road, Taichung, 404, Taiwan
| | - Hsin-Yuan Fang
- Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Jan-Gowth Chang
- Epigenome Research Center, China Medical University Hospital, 2 Yuh-Der Road, Taichung, 404, Taiwan. .,Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan. .,Center for Precision Medicine, China Medical University Hospital, Taichung, Taiwan. .,School of Medicine, China Medical University, Taichung, Taiwan. .,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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11
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Huang TM, Chen JX, Lin YC, Fang HY. Chest echocardiography as a tool for finding penetrating atherosclerotic ulcers in a patient with aortic intramural haematoma. Eur J Cardiothorac Surg 2021; 59:279. [PMID: 32840321 DOI: 10.1093/ejcts/ezaa262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tzu-Min Huang
- Department of Surgery, China Medical University Hospital, Taichung City, Taiwan
| | - Jian-Xun Chen
- Department of Surgery, China Medical University Hospital, Taichung City, Taiwan
| | - You-Cian Lin
- Department of Surgery, China Medical University Hospital, Taichung City, Taiwan
| | - Hsin-Yuan Fang
- Department of Surgery, China Medical University Hospital, Taichung City, Taiwan
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12
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Chang YS, Tu SJ, Chiang HS, Yen JC, Lee YT, Fang HY, Chang JG. Genome-Wide Analysis of Prognostic Alternative Splicing Signature and Splicing Factors in Lung Adenocarcinoma. Genes (Basel) 2020; 11:genes11111300. [PMID: 33142748 PMCID: PMC7693837 DOI: 10.3390/genes11111300] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 09/26/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 12/22/2022] Open
Abstract
Analysis of The Cancer Genome Atlas data revealed that alternative splicing (AS) events could serve as prognostic biomarkers in various cancer types. This study examined lung adenocarcinoma (LUAD) tissues for AS and assessed AS events as potential indicators of prognosis in our cohort. RNA sequencing and bioinformatics analysis were performed. We used SUPPA2 to analyze the AS profiles. Using univariate Cox regression analysis, overall survival (OS)-related AS events were identified. Genes relating to the OS-related AS events were imported into Cytoscape, and the CytoHubba application was run. OS-related splicing factors (SFs) were explored using the log-rank test. The relationship between the percent spliced-in value of the OS-related AS events and SF expression was identified by Spearman correlation analysis. We found 1957 OS-related AS events in 1151 genes, and most were protective factors. Alternative first exon splicing was the most frequent type of splicing event. The hub genes in the gene network of the OS-related AS events were FBXW11, FBXL5, KCTD7, UBB and CDC27. The area under the curve of the MIX prediction model was 0.847 for 5-year survival based on seven OS-related AS events. Overexpression of SFs CELF2 and SRSF5 was associated with better OS. We constructed a correlation network between SFs and OS-related AS events. In conclusion, we identified prognostic predictors using AS events that stratified LUAD patients into high- and low-risk groups. The discovery of the splicing networks in this study provides an insight into the underlying mechanisms.
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Affiliation(s)
- Ya-Sian Chang
- Epigenome Research Center, China Medical University Hospital, 404 Taichung, Taiwan; (Y.-S.C.); (J.-C.Y.); (Y.-T.L.)
- Department of Laboratory Medicine, China Medical University Hospital, 404 Taichung, Taiwan; (S.-J.T.); (H.-S.C.)
- Center for Precision Medicine, China Medical University Hospital, 404 Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, China Medical University, 404 Taichung, Taiwan
| | - Siang-Jyun Tu
- Department of Laboratory Medicine, China Medical University Hospital, 404 Taichung, Taiwan; (S.-J.T.); (H.-S.C.)
| | - Hui-Shan Chiang
- Department of Laboratory Medicine, China Medical University Hospital, 404 Taichung, Taiwan; (S.-J.T.); (H.-S.C.)
| | - Ju-Chen Yen
- Epigenome Research Center, China Medical University Hospital, 404 Taichung, Taiwan; (Y.-S.C.); (J.-C.Y.); (Y.-T.L.)
| | - Ya-Ting Lee
- Epigenome Research Center, China Medical University Hospital, 404 Taichung, Taiwan; (Y.-S.C.); (J.-C.Y.); (Y.-T.L.)
| | - Hsin-Yuan Fang
- Department of Thoracic Surgery, China Medical University Hospital, 404 Taichung, Taiwan;
| | - Jan-Gowth Chang
- Epigenome Research Center, China Medical University Hospital, 404 Taichung, Taiwan; (Y.-S.C.); (J.-C.Y.); (Y.-T.L.)
- Department of Laboratory Medicine, China Medical University Hospital, 404 Taichung, Taiwan; (S.-J.T.); (H.-S.C.)
- Center for Precision Medicine, China Medical University Hospital, 404 Taichung, Taiwan
- School of Medicine, China Medical University, 404 Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, 413 Taichung, Taiwan
- Correspondence: ; Tel.: +886-4-22052121 (ext. 2008)
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13
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Chen HJ, Tu CY, Hsia TC, Fang HY, Chen CH, Chen SC, Li CH, Liao YM, Hsieh CY, Lein MY, Liang JA, Chien CR. Prognostic Significance of Oligometastatic Disease Classification by the ESTRO/EORTC of Cancer for Patients With Lung Cancer Treated With Definitive Radical Radiotherapy. Anticancer Res 2020; 40:5895-5899. [PMID: 32988920 DOI: 10.21873/anticanres.14609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Randomized controlled trials had demonstrated local therapy, such as radiotherapy, can improve outcomes of patients with lung cancer with oligometastatic disease (OMD). However, the definition of OMD is not uniform and the European Society for Radiotherapy and Oncology (ESTRO) and European Organisation for Research and Treatment of Cancer (EORTC) proposed a new classification in 2020 comprising nine subtypes. Therefore, we aimed to investigate the prognostic significance of this European classification for patients with lung OMD treated with definitive radical radiotherapy. PATIENTS AND METHODS We identified eligible patients via an in-house database. Patient, disease, and treatment characteristics, as well as outcomes, were obtained via chart review plus peer review. Overall and progression-free survival were estimated via the Kaplan-Meier method. Log-rank test was used in univariate analysis and Cox regression in multivariable analyses to investigate the prognostic significance of the subtypes of OMD. RESULTS We identified 35 eligible patients with six different OMD subtypes treated from 2011 to 2019. After a median follow-up of 23 (range=2-88) months, the median progression-free and overall survival were 11 and 38 months, respectively. The prognosis for patients with the subtype 'induced oligoprogression' was statistically worse than for those without in both univariate (p=0.02) and multivariate (adjusted hazard ratio for death=4.8, 95% confidence interval=1.4-16.2, p=0.01) analyses. CONCLUSION We found the subtype with induced oligoprogression in the European classification to be associated with worse survival. Further studies are needed to confirm our finding.
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Affiliation(s)
- Hung-Jen Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Internal Medicine, Hyperbaric Oxygen Therapy Center, China Medical University, Taichung, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Hung Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Shuo-Chueh Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Hsiang Li
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Yu-Min Liao
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ching-Yun Hsieh
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ming-Yu Lein
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ji-An Liang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chun-Ru Chien
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C. .,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, R.O.C
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14
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Liang JA, Tu CY, Hsia TC, Fang HY, Li CC, Chien CR. Effectiveness of image-guided radiotherapy for locally advanced lung cancer patients treated with definitive concurrent chemoradiotherapy. Thorac Cancer 2020; 11:2639-2649. [PMID: 32725779 PMCID: PMC7471052 DOI: 10.1111/1759-7714.13596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/12/2022] Open
Abstract
Background Image‐guided radiotherapy (IGRT) is an advanced radiotherapy technique to improve the precision and accuracy of treatment delivery. A recent randomized controlled trial (RCT) for prostate cancer patients treated with radiotherapy via either IGRT or routine care reported statistically significantly worse overall survival (OS) for those patients treated with IGRT. This raised the concern regarding the effectiveness of IGRT in definitive concurrent chemoradiotherapy (dCCRT) for locally advanced lung cancer (LALC). Methods Eligible LALC patients diagnosed between 2011 and 2016 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratio (HR) of death and other outcomes were compared between IGRT and non‐IGRT. We also evaluated OS in various subgroups. Results Our primary analysis consisted of 797 patients in whom covariates were well balanced after PS weighing. The HR for death when IGRT was compared with non‐IGRT was 0.96 (95% confidence interval 0.79–1.15, P = 0.65). There were also no significant differences for most of the other outcomes or subgroup analyses. Conclusions In this updated nonrandomized study, we found that OS of LALC patients treated with dCCRT was not statistically different between those treated with IGRT versus non‐IGRT. The results should be interpreted with caution given the nonrandomized design. Studies regarding toxicity, local control, or designed as RCT are needed to clarify the role of IGRT. Key points Significant findings of the study The OS of LALC patients treated with dCCRT was not statistically different between those treated with IGRT versus those without IGRT, although the observed HR for death was less than unity (ie, in favor of IGRT).
What this study adds In this updated nonrandomized study using real world data with additional potential confounders, our study provided a reasonable tentative evidence in the lack of RCT as suggested in the literature.
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Affiliation(s)
- Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chih-Yen Tu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, Taiwan
| | - Hsin-Yuan Fang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ru Chien
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
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15
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Chen CK, Chang YJ, Fang HY. Patients with spontaneous pneumothorax have a higher risk of developing lung cancer: A STROBE-compliant article. Medicine (Baltimore) 2020; 99:e21411. [PMID: 32791756 PMCID: PMC7387064 DOI: 10.1097/md.0000000000021411] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Lung cancer is a common malignancy worldwide, and risk factors include bronchitis, asthma, tuberculosis, smoking, and air pollution. These are also risk factors for spontaneous pneumothorax, a benign disease. We hypothesized that patients who experience a spontaneous pneumothorax have a greater risk to develop lung cancer, and designed a study to determine if this is so.We used the population-based Taiwan Health Insurance Research Database to perform a retrospective cohort study. The database includes more than 99% of the population of Taiwan. We established a 27,405-person pneumothorax cohort and a 109,620 person comparison cohort with data from 2000 to 2009 to evaluate the relationship between spontaneous pneumothorax and lung cancer.Multivariable analysis showed that patients who have had a spontaneous pneumothorax have a greater relative risk to develop lung cancer. The overall hazard ratio was 2.09 (95% confidence interval 1.69-2.58) adjusted by age, gender, hypertension, diabetes mellitus, and chronic lung diseases such as chronic obstructive pulmonary disease, tuberculosis, asthma, bronchitis, and emphysema. A dose effect was present; a high frequency of spontaneous pneumothorax was associated with a greater relative risk to develop lung cancer. If the spontaneous pneumothorax frequency was greater than 2 times per year, the hazard ratio was 34.09 (95% confidence interval 22.74-51.10)Patients with spontaneous pneumothorax have an increased relative risk to develop lung cancer, especially among patients 35 to 49 years of age. The more frequent the occurrence of spontaneous pneumothorax, the greater the relative risk of lung cancer. If the spontaneous pneumothorax frequency was greater than 2 times per year, the increase in risk of lung cancer was more than 30-fold.
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Affiliation(s)
- Chien-Kuang Chen
- Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital
- Graduate Institute of Clinical Medical Science, China Medical University
| | - Yen-Jung Chang
- Management Office for Health Data, China Medical University Hospital
| | - Hsin-Yuan Fang
- Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital
- School of Medicine, China Medical University, Taichung, Taiwan
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16
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Chen JX, Lu TY, Lin YS, Fang HY, Shih PK. Prognostic effect of incongruous lymph node status in early-stage non-small cell lung cancer. Eur J Surg Oncol 2020; 47:450-455. [PMID: 32928610 DOI: 10.1016/j.ejso.2020.06.003] [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: 01/31/2020] [Revised: 05/13/2020] [Accepted: 06/04/2020] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION Tumor recurrence is an important issue for patients with stage I non-small cell lung cancer (NSCLC) and adjuvant therapy is considered of no benefit to a tumor less than 4 cm. The purpose of this study was to evaluate the impact of positron emission tomography/computed tomography (PET/CT) on tumor recurrence in patients with a completely resected pN0 NSCLC less than 4 cm. METHODS Between January 2011 and December 2016, 211 consecutive patients with diagnoses of stage I NSCLC less than 4 cm after complete resection were included. The maximum of standard uptake value (SUVmax) of primary tumor and the presence of positive lymph nodes on PET/CT scans were documented. Disease-free survival was evaluated by the Kaplan-Meier method and recurrence risk factors were identified by univariable and multivariable analyses. RESULTS Patients with positive lymph nodes on PET/CT had a lower 5-year disease-free survival (37.6% vs 72.7%, p < 0.001). Multivariable analysis demonstrated that the tumor SUVmax >2.93, the presence of positive lymph nodes on PET/CT, and poor differentiation were significant factors for tumor recurrence. Patients with the tumor SUVmax >2.93 and positive lymph nodes on PET/CT simultaneously had 5.33-fold increase in the risk of recurrence (p < 0.001). CONCLUSION The presence of positive lymph nodes on PET/CT scans can be a good indicator in predicting patients with high risk of developing recurrence in pN0 NSCLC less than 4 cm. This result helps identify patients likely to benefit from adjuvant therapy.
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Affiliation(s)
- Jian-Xun Chen
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Ting-Yu Lu
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Sen Lin
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-Yuan Fang
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Pin-Keng Shih
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
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17
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Lin CY, Fang HY, Lein MY, Lin CC, Bai LY, Tsai MH, Chen CC, Hsieh TC, Wang YC, Liang JA, Li CC, Chien CR. Clinical Outcomes and Prognostic Factors of Patients With Esophageal Squamous Cell Carcinoma With Oligo-recurrence Treated With Radical Re-irradiation. Anticancer Res 2020; 40:2387-2392. [PMID: 32234942 DOI: 10.21873/anticanres.14208] [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: 02/27/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND For patients with esophageal squamous cell carcinoma (ESCC) with oligo-recurrence (OR) after previous curative radiotherapy and not eligible for radical resection, the role of radical re-irradiation was not clear. Therefore, we aimed to investigate the outcome and prognostic factors of such patients. PATIENTS AND METHODS We identified patients with OR of ESCC after previous curative radiotherapy and were treated with radical re-irradiation within 2012-2018 via an in-house prospectively established database. The characteristics of patients, disease, treatment, and outcome were retrospectively obtained via chart review. The first day of re-irradiation was defined as the index date. Overall survival was calculated via the Kaplan-Meier method. Log-rank test was used for univariate analysis and Cox regression method was used for multivariable analysis. RESULTS We identified thirty patients for analyses. After a median follow-up of 9 (range=2-76) months, the 5-year overall survival rate was 21%. Four patients with possible radiotherapy-related complication in need of inpatient care were identified. Gross tumor volume was the only significant prognostic factor in both univariate and multivariable analyses. CONCLUSION We found that radical definitive re-irradiation may lead to one-fifth long-term survivors of patients with OR after previous curative radiotherapy for ESCC, and the gross tumor volume was the only significant prognostic factor for these patients. Randomized controlled trials should be considered to compare radical re-irradiation with the current standard of care (systemic therapy) for this population.
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Affiliation(s)
- Chen-Yuan Lin
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Pharmacy, China Medical University, Taichung, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Ming-Yu Lein
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ching-Chan Lin
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Li-Yuan Bai
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ming-Hung Tsai
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chi-Ching Chen
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Te-Chun Hsieh
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan, R.O.C
| | - Yao-Ching Wang
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan, R.O.C.,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ji-An Liang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chun-Ru Chien
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C. .,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, R.O.C
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18
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Chen YW, Fang HY, Wang YC, Peng SL, Shih CT. A novel computed tomography image synthesis method for correcting the spectrum dependence of CT numbers. Phys Med Biol 2020; 65:025013. [PMID: 31816614 DOI: 10.1088/1361-6560/ab5fff] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The quantitative evaluation of computed tomography (CT) images is widely investigated and applied in clinical diagnosis. However, the CT number of tissue can vary with scanners or applied tube voltages because of the x-ray spectrum dependence of measured linear attenuation coefficients that degrades evaluation accuracy and limits multicenter or multimodality research. This study proposed a novel CT image synthesis method to correct the spectrum dependence of CT numbers by normalizing them to the same spectrum condition. Stoichiometric calibration was performed to derive the spectrum characteristic parameters (SCPs) of six spectra from two CT scanners with different applied tube voltages. Subsequently, conversion relationships between CT numbers and tissue parameters (TPs) were determined using the SCPs and standard tissue data. The CT number of a tissue measured from a spectrum condition was converted to TPs using these relationships, and the results were used to estimate the CT number of the tissue in another spectrum condition using the corresponding SCPs. Phantom, cadaver, and patient studies were performed to evaluate the proposed method. In the phantom study, image synthesis reduced the mean difference between the CT numbers of tissue-equivalent phantoms measured using different spectra from 57.96 to 33.94 HU. In the cadaveric study, the mean difference between the CT numbers of a temporal bone flap measured using different spectra was lowered by over 57%. In the patient image study, a significant difference of 81.5 HU was observed between the mean CT numbers of femoral shafts obtained from the two scanners; this difference was reduced to less than 17 HU, which was nonsignificant, when the proposed method was used. The proposed image synthesis method could reduce the spectrum dependence of CT numbers measured with different spectra and could be applied clinically to improve the accuracy of multicenter and multimodality evaluation and research.
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Affiliation(s)
- Yi-Wen Chen
- 3D Printing Medical Research Center, China Medical University Hospital, China Medical University, 40402, Taichung, Taiwan. Graduate Institute of Biomedical Sciences, China Medical University, 40402, Taichung, Taiwan
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Kuo YH, Fang HY, Lin YS, Lein MY, Yang CY, Ho SC, Li CC, Chien CR. Effectiveness of image-guided radiotherapy for locally advanced esophageal squamous cell carcinoma patients treated with definitive concurrent chemoradiotherapy. Thorac Cancer 2019; 11:113-119. [PMID: 31742897 PMCID: PMC6938750 DOI: 10.1111/1759-7714.13244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/27/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 12/21/2022] Open
Abstract
Background Image‐guided radiotherapy (IGRT) is an advanced radiotherapy technique to improve the accuracy of treatment delivery. However, a recent randomized controlled trial (RCT) for prostate cancer patients treated with radiotherapy either via IGRT or routine care (no daily IGRT) reported a statistically significant worse overall survival for those treated with IGRT. This raised the concern regarding the effectiveness of IGRT for definitive concurrent chemoradiotherapy (dCCRT) for locally advanced esophageal squamous cell carcinoma (LA‐ESqCC). Methods Eligible LA‐ESqCC patients diagnosed between 2011 and 2015 were identified via the Taiwan Cancer Registry. We estimated propensity scores to construct a 1:1 propensity‐score‐matched groups and balance observable potential confounders. The hazard ratio (HR) of death as well as other outcomes was compared between IGRT and non‐IGRT matched groups during the entire follow‐up period. The impact of additional covariables was considered in the sensitivity analysis. Results Our study population included 590 patients in the primary analysis. The HR for death when IGRT was compared with non‐IGRT was 0.92 (95% confidence interval 0.77–1.10, P = 0.35). There were also no significant differences for other outcomes or sensitivity analyses. Conclusions In this updated nonrandomized study using real world data, we found that the overall survival of LA‐ESqCC patients treated with dCCRT was not statistically different between those treated with IGRT versus those without IGRT, although the hazard ratio was less than unity, ie, in favor of IGRT. The results should be interpreted with caution given the nonrandomized design and RCTs are needed to clarify our findings. Key points Significant findings of the study: The OS of LA‐ESqCC patients treated with dCCRT was not statistically different between those treated with IGRT versus those without IGRT, although the hazard ratio was less than unity, ie, in favor of IGRT. What this study adds: In this updated nonrandomized study using real world data with additional potential confounders, our study provided a reasonable tentative evidence of lack of RCT as suggested in the literature.
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Affiliation(s)
- Yao-Hung Kuo
- Department of Radiation Oncology, E-Da Hospital, Kaohsiung, Taiwan; College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hsin-Yuan Fang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Sen Lin
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Yu Lein
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chi-Ying Yang
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Chi Ho
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ru Chien
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
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Chen YW, Fang HY, Shie MY, Shen YF. The mussel-inspired assisted apatite mineralized on PolyJet material for artificial bone scaffold. Int J Bioprint 2019; 5:197. [PMID: 32596535 PMCID: PMC7294680 DOI: 10.18063/ijb.v5i2.197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 05/27/2019] [Indexed: 02/06/2023] Open
Abstract
With the development of three-dimensional (3D) printing, many commercial 3D printing materials have been applied in the fields of biomedicine and medical. MED610 is a clear, biocompatible PolyJet material that is medically certified for bodily contact. In this study, the polydopamine (PDA)/hydroxyapatite (HA) coating was added to the printed MED610 objects to evaluate its physical properties, cell proliferation, cell morphology, and alkaline phosphatase expression level. The results show that the PDA/HA coating helps printed objects to enhance the hardness, biocompatibility, and osteogenic differentiation potential. We expect that PDA/HA coatings contribute to the applicability of MED610 in biomedical and medical applications.
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Affiliation(s)
- Yi-Wen Chen
- Three-dimensional Printing Medical Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Hsin-Yuan Fang
- Three-dimensional Printing Medical Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.,Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
| | - Ming-You Shie
- Three-dimensional Printing Medical Research Center, China Medical University Hospital, China Medical University, Taichung, Taiwan.,School of Dentistry, China Medical University, Taichung, Taiwan
| | - Yu-Fang Shen
- Three-dimensional Printing Medical Research Institute, Asia University, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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Shie MY, Fang HY, Lin YH, Lee AKX, Yu J, Chen YW. Application of piezoelectric cells printing on three-dimensional porous bioceramic scaffold for bone regeneration. Int J Bioprint 2019; 5:210. [PMID: 32596544 PMCID: PMC7310268 DOI: 10.18063/ijb.v5i2.1.210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/23/2019] [Indexed: 12/12/2022] Open
Abstract
In recent years, the additive manufacture was popularly used in tissue engineering, as the various technologies for this field of research can be used. The most common method is extrusion, which is commonly used in many bioprinting applications, such as skin. In this study, we combined the two printing techniques; first, we use the extrusion technology to form the ceramic scaffold. Then, the stem cells were printed directly on the surface of the ceramic scaffold through a piezoelectric nozzle. We also evaluated the effects of polydopamine (PDA)-coated ceramic scaffolds for cell attachment after printing on the surface of the scaffold. In addition, we used fluorescein isothiocyanate to simulate the cell adhered on the scaffold surface after ejected by a piezoelectric nozzle. Finally, the attachment, growth, and differentiation behaviors of stem cell after printing on calcium silicate/polycaprolactone (CS/PCL) and PDACS/PCL surfaces were also evaluated. The PDACS/PCL scaffold is more hydrophilic than the original CS/PCL scaffold that provided for better cellular adhesion and proliferation. Moreover, the cell printing technology using the piezoelectric nozzle, the different cells can be accurately printed on the surface of the scaffold that provided and analyzed more information of the interaction between different cells on the material. We believe that this method may serve as a useful and effective approach for the regeneration of defective complex hard tissues in deep bone structures.
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Affiliation(s)
- Ming-You Shie
- School of Dentistry, China Medical University, Taichung City, Taiwan
- Three-dimensional Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan
| | - Hsin-Yuan Fang
- School of Medicine, China Medical University, Taichung City, Taiwan
| | - Yen-Hong Lin
- Three-dimensional Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
- The Ph.D. Program for Medical Engineering and Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Alvin Kai-Xing Lee
- Three-dimensional Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung City, Taiwan
| | - Joyce Yu
- Three-dimensional Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung City, Taiwan
| | - Yi-Wen Chen
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung City, Taiwan
- Three-dimensional Printing Medical Research Institute, Asia University, Taichung City, Taiwan
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Shie MY, Fang HY, Lin YH, Lee AKX, Yu J, Chen YW. Application of piezoelectric cells printing on three-dimensional porous bioceramic scaffold for bone regeneration. Int J Bioprint 2019. [DOI: 10.18063/ijb.v5i2.210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In recent years, the additive manufacture was popularly used in tissue engineering, as the various technologies for this field of research can be used. The most common method is extrusion, which is commonly used in many bioprinting applications, such as skin. In this study, we combined the two printing techniques; first, we use the extrusion technology to form the ceramic scaffold. Then, the stem cells were printed directly on the surface of the ceramic scaffold through a piezoelectric nozzle. We also evaluated the effects of polydopamine (PDA)-coated ceramic scaffolds for cell attachment after printing on the surface of the scaffold. In addition, we used fluorescein isothiocyanate to simulate the cell adhered on the scaffold surface after ejected by a piezoelectric nozzle. Finally, the attachment, growth, and differentiation behaviors of stem cell after printing on calcium silicate/polycaprolactone (CS/PCL) and PDACS/PCL surfaces were also evaluated. The PDACS/PCL scaffold is more hydrophilic than the original CS/PCL scaffold that provided for better cellular adhesion and proliferation. Moreover, the cell printing technology using the piezoelectric nozzle, the different cells can be accurately printed on the surface of the scaffold that provided and analyzed more information of the interaction between different cells on the material. We believe that this method may serve as a useful and effective approach for the regeneration of defective complex hard tissues in deep bone structures.
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23
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Tsai CY, Fang HY, Shibu MA, Lin YM, Chou YC, Chen YH, Day CH, Shen CY, Ban B, Huang CY. Taiwanin C elicits apoptosis in arecoline and 4-nitroquinoline-1-oxide-induced oral squamous cell carcinoma cells and hinders proliferation via epidermal growth factor receptor/PI3K suppression. Environ Toxicol 2019; 34:760-767. [PMID: 30884126 DOI: 10.1002/tox.22742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 10/15/2018] [Revised: 02/16/2019] [Accepted: 02/17/2019] [Indexed: 06/09/2023]
Abstract
Oral Squamous Cell Carcinoma (OSSC) is a major life-threatening disease with high incidence in the Southeast Asian countries. Chronic exposure to arecoline causes genetic changes in the epithelial cells of the oral mucosa, induces proliferation through activation of the EGF receptor and promotes downstream COX-2 expression. Taiwanin C, a podophyllotoxin derived from Taiwania cryptomerioides Hayata is known to inhibit COX activity and to hinder PGE2 production in macrophages. In this study a tumor cell line T28 and a non-tumor cell line N28 derived from mice OSCC models were used to study the effect of Taiwanin C on PGE2 associated COX-2 expression and cell cycle regulators. Taiwanin C activated p21 protein expression, down-regulated cell cycle regulatory proteins, elevated apoptosis and down-regulated p-PI3K/p-Akt survival mechanism in T28 oral cancer cells. Our results therefore emphasize the therapeutic potential of Taiwanin C against arecoline-induced oral cancer.
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Affiliation(s)
- Cheng-Yen Tsai
- Department of Pediatrics, China Medical University Beigang Hospital, Yunlin, Taiwan
| | - Hsin-Yuan Fang
- Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Marthandam Asokan Shibu
- Medical Research Center for Exosomes and Mitochondria Related Diseases, China Medical University Hospital, Taichung, Taiwan
| | - Yueh-Min Lin
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
| | - Yung-Chen Chou
- Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan
| | - Yi-Hui Chen
- Department of M-Commerce and Multimedia Applications, Asia University, Taichung, Taiwan
| | | | - Chia-Yao Shen
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, China
| | - Chih-Yang Huang
- Medical Research Center for Exosomes and Mitochondria Related Diseases, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan
- Department of Biotechnology, Asia University, Taichung, Taiwan
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
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Li CC, Fang HY, Lin CY, Shen WC, Chien CR. Outcomes of Localized Esophageal Squamous Cell Carcinoma Patients Treated With Definitive Concurrent Chemoradiotherapy Using Either Standard or High Radiotherapy Dose: A Retrospective Study Controlling for Organ at Risk Dose. Anticancer Res 2019; 39:511-517. [PMID: 30591503 DOI: 10.21873/anticanres.13142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 12/09/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The optimal radiotherapy dose for localized esophageal squamous cell carcinoma (ESqCC) patients treated with definitive concurrent chemo-radiotherapy (CCRT) is debated. The aim of our study was to compare patient outcomes using either standard or high radiotherapy dose. MATERIALS AND METHODS Eligible patients diagnosed between 2011 and 2015 from the cancer registry of our Institute were identified and a propensity score (PS)-matched cohort (1:1 for high vs. standard dose) was constructed to balance observable potential confounders (including organ at risk dose). The hazard ratio (HR) of death between high and standard dose was compared. RESULTS Our study population included 73/36 patients before/after PS matching. The HR of death at the high dose compared to the standard dose was 0.554 (95% confidence interval (CI)=0.308-0.998, p=0.049). CONCLUSION Definitive CCRT using a high radiotherapy dose showed improved survival outcomes for localized ESqCC patients compared to standard dose.
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Affiliation(s)
- Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Chen-Yuan Lin
- Division of Hematology and Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Wei-Chih Shen
- Department of Computer Science and Information Engineering, Asia University, Taichung, Taiwan, R.O.C
| | - Chun-Ru Chien
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan, R.O.C. .,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Department of Radiation Oncology, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, R.O.C
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Fang HY, Liu D, Zhao LY, Yu DM, Zhang Q, Yu WT, Zhai Y, Zhao WH. [Epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 39:715-719. [PMID: 29936734 DOI: 10.3760/cma.j.issn.0254-6450.2018.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years. Methods: Data was from the samples of aged 6-17 years in the China National Nutrition and Health Surveillance program in 2010-2012. P(90) (the same age, the same sex) was used as the diagnostic value for abdominal obesity. Results: The overall waist circumference of children and adolescents in all the age groups appeared higher in males than that in females (P<0.000 1), higher in cities than that in the rural areas (P<0.05), and higher in children with high family income than those with middle or low family incomes (P=0.000 3). The rate of abdominal obesity in children and adolescents aged 6-17 years appeared as 11.2% on average and 10.7% and 11.8% for boys and girls, respectively but with no significant difference (P>0.05). Rates on abdominal obesity appeared as 13.2% and 8.5% for boys while as 12.3% and 11.2% for girls respectively, in urban or rural areas. As for the levels of family income, the abdominal obesity rates appeared as 15.8%, 11.5% and 8.8% respectively for boys while 13.5%, 11.9% and 11.6% respectively for girls, under high, middle and low levels of family income. Conclusion: The rate of abdominal obesity in boys seemed more responsive to the impact of income in urban or rural areas.
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Affiliation(s)
- H Y Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - D Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Y Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - D M Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Q Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - W T Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Zhai
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - W H Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Liu D, Fang HY, Zhao LY, Yu DM, Long JM, Zhao WH. [Study on the relationship between family-related factors and obesity of children and adolescents aged 6-17 years]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 39:720-723. [PMID: 29936735 DOI: 10.3760/cma.j.issn.0254-6450.2018.06.005] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the relationship between family-related factors and the status of overweight and obesity in children and adolescents aged 6-17 years in China. Methods: Data were collected from the China National Nutrition and Health Surveillance in 2010-2012 program. A sample of 6 343 subjects aged 6-17 years was selected, with matched weight, education levels, household income and other family related factors of their parents. Univariate analysis and multivariate logistic regression were used to explore the relationship between family factors and overweight and obesity in school-aged children and adolescents. Results: After adjusted for age, gender and region, results from the multivariate logistic regression showed that both the overweight and obesity of children and adolescents were associated with maternal BMI (OR=1.83, 95%CI: 1.63-2.05), paternal BMI (OR=1.74, 95%CI: 1.57-1.94), mother's educational level (OR=1.24, 95%CI: 1.12-1.37) and household income (OR=1.30, 95%CI: 1.15-1.46). Conclusion: Factors as overweight or obesity status of the parents, mother's educational level and household income were positively correlated with the prevalence of overweight and obesity in Chinese children and adolescents.
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Affiliation(s)
- D Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - H Y Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L Y Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - D M Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - J M Long
- Institute for Medical Humanities, Peking University, Beijing 100191, China
| | - W H Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Yu DM, Ju LH, Zhao LY, Fang HY, Yang ZY, Guo HJ, Yu WT, Jia FM, Zhao WH. [Prevalence and characteristics of overweight and obesity in Chinese children aged 0-5 years]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 39:710-714. [PMID: 29936733 DOI: 10.3760/cma.j.issn.0254-6450.2018.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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 study the prevalence and characteristics of overweight and obesity among Chinese children aged 0-5 years, in 2010-2013. Methods: Data was from the'China Nutrition and Health Surveillance-0-5-Years-Old Children and Lactating Women'project in 2013. Stratified multistage cluster sampling method was used to select 55 districts/counties from 30 provinces (autonomous regions, municipalities) with the sample size of children as 32 862. Definition of overweight and obesity were according to both the WHO 2006 growth standard in children less than 5-year-old and the WHO 2007 growth reference in children of 5-years-old. Results: were calculated by complex weight based on national census from the National Bureau of Statistics in 2010. Results The overall prevalence of overweight was 8.4% among the 0-5-year-old in 2013, with 9.4% in boys and 7.2% in girls. Both of the rates from urban and rural areas were the same, as 8.4%. The prevalence rates of overweight in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups appeared as 13.0%, 11.1%, 8.3%, 6.0%, 4.8%, 3.9% and 15.9%, respectively. The rates of overweight in low, medium and high income families were 8.0%, 8.8% and 8.9%, respectively. The prevalence of obesity was 3.1% among the 0-5-year-old, with 3.6% in boys and 2.5% in girls. There was no significant difference seen in urban (3.3%) and rural areas (2.9%). The prevalence rates for obesity in the 0-, 6-, 12-, 24-, 36-, 48- and 60-71 months age groups were 5.8%, 3.8%, 2.5%, 1.6%, 1.2%, 1.3% and 7.8%, respectively. The rates of obesity in low, medium and high income families were 2.8%, 3.3% and 3.5%, respectively. Conclusion: The prevalence rates of both overweight and obesity were increasing among the 0-5-year-olds in China, suggesting that it is necessary to timely conduct the surveillance and intervention programs on overweight and obesity in this target population.
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Affiliation(s)
- D M Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Fang HY, Zhai Y, Zhao LY, Yu DM, Zhang Q, Ju LH, Yu WT, Zhao WH. [Epidemiological characteristics of overweight and obesity in Chinese children and adolescents aged 6-17 years]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 39:724-727. [PMID: 29936736 DOI: 10.3760/cma.j.issn.0254-6450.2018.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the prevalence rates of overweight and obesity in Chinese children and adolescents aged 6-17 years, and to provide scientific basis for the development of prevention strategies on obesity. Methods: Data was from children and adolescents aged 6-17 years in the China National Nutrition and Health Surveillance 2010-2012 program. In children aged 6 years, criteria of overweight and obesity were followed the WHO growth reference for school-aged children and adolescents. In children and adolescents aged 7-17 years, overweight and obesity were defined by sex and age specific BMI, recommended by Guidelines for prevention and control of overweight and obesity among school-age children and adolescents according to the Chinese guidelines. Results: The overall rates on overweight and obesity were 9.6% and 6.4% among the Chinese children and adolescents aged 6-17 years, with 11.0% (12.8% for boys and 9.0% for girls) in urban and 7.7% (boys 9.7%, girls 5.5%) in rural areas. The rates of overweight and obesity among children and adolescents were 8.4% (boys 9.3%, girls 7.4%) and 5.2% (boys 6.2%, girls 4.1%) in the rural areas. According to the levels of household income, the overweight rates of children in high, middle and low incomes were 12.3%, 10.7% and 8.2%, with obesity as 8.6%, 7.2% and 5.7% respectively. Conclusions: In 2012, the prevalence rates of overweight and obese were 9.6% and 6.4% among children and adolescents aged 6-17 years, respectively, higher in urban than in rural areas and higher boys than in girls. The prevalence rates of overweight and obesity seemed to be related to the levels of household income.
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Affiliation(s)
- H Y Fang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Y Zhai
- Division of Non-communicable Diseases Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L Y Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - D M Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Q Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - L H Ju
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - W T Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - W H Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Lu MC, Yang MD, Li PC, Fang HY, Huang HY, Chan YC, Bau DAT. Effects of Nutritional Intervention on the Survival of Patients with Cardiopulmonary Failure Undergoing Extracorporeal Membrane Oxygenation Therapy. In Vivo 2018; 32:829-834. [PMID: 29936466 DOI: 10.21873/invivo.11315] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to examine the effects of nutritional intervention on the prognosis of patients with cardiopulmonary failure undergoing extracorporeal membrane oxygenation (ECMO) therapy in Taiwan. MATERIALS AND METHODS An institutional review board-approved retrospective study was conducted on patients receiving ECMO therapy in the intensive care unit of the China Medical University Hospital, Taiwan, from January 2013 to December 2013. The study included 102 patients with cardiopulmonary failure receiving ECMO therapy. RESULTS The data indicated that higher survival rates were closely related to lower age and APACHE II scores among the patients. In addition, compared to patients who deceased, those who survived had a higher total calorie intake. Most patients could tolerate bolus feeding and polymeric formulas. Furthermore, patients who underwent nutritional therapy with nutritional goals greater than 80% achieved a better outcome and lower mortality than other patients. CONCLUSION Early nutritional intervention could benefit patients undergoing ECMO, and those who reached the delivery goal of 80% had significantly better outcomes than other patients. Enteral feeding can begin early and was well tolerated by patients receiving ECMO therapy. Following individual nutrition goals is critical for better outcomes, and this analysis might be useful in establishing individualized nutrition goals for oriental population when caring for critically ill patients.
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Affiliation(s)
- Meng-Chun Lu
- Department of Food and Nutrition, Providence University, Taichung, Taiwan, R.O.C.,Department of Clinical Nutrition, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Nutrition, China Medical University, Taichung, Taiwan, R.O.C
| | - Mei-Due Yang
- Department of Clinical Nutrition, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Ping-Chun Li
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Hui-Ying Huang
- Department of Nutrition, China Medical University, Taichung, Taiwan, R.O.C
| | - Yin-Ching Chan
- Department of Food and Nutrition, Providence University, Taichung, Taiwan, R.O.C.
| | - DA-Tian Bau
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan, R.O.C. .,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, R.O.C
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Shen YF, Huang TH, Ng HY, Fang HY, Hsu TT. Mineral Trioxide Aggregate Mixed with 5-Aminolevulinic Acid for the Photodynamic Antimicrobial Strategy in Hard Tissue Regeneration. Materials (Basel) 2018; 11:E1734. [PMID: 30223515 PMCID: PMC6163745 DOI: 10.3390/ma11091734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 09/04/2018] [Accepted: 09/13/2018] [Indexed: 01/08/2023]
Abstract
Aminolevulinic acid (ALA) based photodynamic antimicrobial strategy can provide good antimicrobial effects and be used for medical applications. The aim of this study was to apply this strategy to Mineral Trioxide Aggregate (MTA), which is commonly used as a filling material for root endings and by doing so, to increase the bactericidal capability of MTA, as well as to investigate its characterization, cytocompatibility, and odontogenic differentiation potential. MTA is known to be a derivative of calcium silicate (CS). In this study, MTA specimens with or without ALA and light treatment were prepared. Diametral tensile strength values (DTS), setting durations, X-ray diffraction (XRD) spectra, apatite-mineralization, and antimicrobial abilities of the MTA, were also analyzed. Human dental pulp cells (hDPCs) can proliferate into the newly formed matrix and differentiate into odontoblasts to reinforce and strengthen the root. Levels of hDPCs proliferation and its odontogenic capabilities when cultured on MTA with ALA and light treatment, and the percentages of cells existing in the various cell cycle stages, were further evaluated in this study. The results indicated that MTA added ALA with light treatment had greater antibacterial ability and cytocompatibility, compared to MTA alone. A higher percentage S phase of the cells cultured on MTA added ALA with light treatment was observed. Furthermore, hDPCs cultured on MTA added ALA with light treatment had the highest expression levels of the odontoblastic differentiation markers. ALA has great antimicrobial efficiency and is a potential material for future medical applications. ALA-based photodynamic antibacterial strategy applied in the MTA has great antibacterial ability, cytocompatibility, and odontoblastic differentiation potential, and can facilitate the development of root canal treatment.
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Affiliation(s)
- Yu-Fang Shen
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung City 40447, Taiwan.
- 3D Printing Medical Research Institute, Asia University, Taichung City 40447, Taiwan.
| | - Tsui-Hsien Huang
- School of Dentistry, Chung Shan Medical University, Taichung City 40447, Taiwan.
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung City 40447, Taiwan.
| | - Hooi-Yee Ng
- School of Medicine, China Medical University, Taichung City 40447, Taiwan.
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City 40447, Taiwan.
| | - Hsin-Yuan Fang
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City 40447, Taiwan.
- Department of Thoracic Surgery, China Medical University Hospital, Taichung City 40447, Taiwan.
| | - Tuan-Ti Hsu
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City 40447, Taiwan.
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Li ZW, Li XX, Li JS, Fang HY, Yang GJ. [Exploration of the surgical approach of early glottic cancer with anterior commissure involvement]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:950-952. [PMID: 29921082 DOI: 10.13201/j.issn.1001-1781.2018.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Indexed: 06/08/2023]
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Fang HY, Hung MY, Lin YM, Pandey S, Chang CC, Lin KH, Shen CY, Viswanadha VP, Kuo WW, Huang CY. 17β-Estradiol and/or estrogen receptor alpha signaling blocks protein phosphatase 1 mediated ISO induced cardiac hypertrophy. PLoS One 2018; 13:e0196569. [PMID: 29723269 PMCID: PMC5933784 DOI: 10.1371/journal.pone.0196569] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/16/2018] [Indexed: 11/22/2022] Open
Abstract
Earlier studies have shown that estrogen possess protective function against the development of pathological cardiac hypertrophy. However, the molecular mechanisms of estrogens (E2) protective effect are poorly understood. Additionally, abnormal activation of β-adrenergic signaling have been implicated in the development of pathological cardiac remodeling. However, the role of serine/threonine protein phosphatase 1 (PP1) in pathological cardiac remodeling under the influence of β-adrenergic signaling have been sparsely investigated. In this study, we assessed the downstream effects of abnormal activation of PP1 upon isoproterenol (ISO) induced pathological cardiac changes. We found that pre-treatment of 17β-estradiol (E2), tet-on estrogen receptor-α, or both significantly inhibited ISO-induced increase in cell size, hypertrophy marker gene expression and cytosolic calcium accumulation in H9c2 cells. Additionally, treatment with estrogen receptor inhibitor (ICI) reversed those effects, implicating role of E2 in inhibiting pathological cardiac remodeling. However, specific inhibition of ERα using melatonin, reduced ISO-induced PP1c expression and enhanced the level of ser-16 phosphorylated phospholamban (PLB), responsible for regulation of sarcoplasmic reticulum Ca2+-ATPase (SERCA) activity. Furthermore, hypertrophic effect caused by overexpression of PP1cα was reduced by treatment with specific inhibitor of ERα. Collectively, we found that estrogen and estrogen receptor-α have protective effect against pathological cardiac changes by suppressing PP1 expression and its downstream signaling pathway, which further needs to be elucidated.
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Affiliation(s)
- Hsin-Yuan Fang
- Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Meng-Yu Hung
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Yueh-Min Lin
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan
| | - Sudhir Pandey
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Chia-Chien Chang
- Department of Dermatology, Taipei City Hospital, Renai Branch, Taipei, Taiwan
| | - Kuan-Ho Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Yao Shen
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | | | - Wei-Wen Kuo
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
| | - Chih-Yang Huang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan.,Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan.,Department of Health and Nutrition Biotechnology, Asia University, Taichung, Taiwan
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Tu CY, Hsia TC, Fang HY, Liang JA, Yang ST, Li CC, Chien CR. A Population-based Study of the Effectiveness of Stereotactic Ablative Radiotherapy Versus Conventional Fractionated Radiotherapy for Clinical Stage I Non-small Cell Lung Cancer Patients. Radiol Oncol 2017; 52:181-188. [PMID: 30018522 PMCID: PMC6043889 DOI: 10.1515/raon-2017-0058] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/18/2017] [Indexed: 12/11/2022] Open
Abstract
Background Stereotactic ablative radiotherapy (SABR) is a promising option for non-operated early-stage non-small cell lung cancer (NSCLC) compared to conventional fractionated radiotherapy (CFRT). However, results from conclusive randomized controlled trials are not yet available. The aim of our study was to explore the effectiveness of SABR vs. CFRT for non-operated early-stage NSCLC. Patients and methods We used a comprehensive population-based database to identify clinical stage I non-operated NSCLC patients in Taiwan diagnosed from 2007 to 2013 who were treated with either SABR or CFRT. We used inverse probability weighting and the propensity score as the primary form of analysis to address the nonrandomization of treatment. In the supplementary analyses, we constructed subgroups based on propensity score matching to compare survival between patients treated with SABR vs. CFRT. Results We identified 238 patients in our primary analysis. A good balance of covariates was achieved using the propensity score weighting. Overall survival (OS) was not significantly different between those treated with SABR vs. CFRT (SABR vs. CFRT: probability weighting adjusted hazard ratio [HR] 0.586, 95% confidence interval 0.264-1.101, p = 0.102). However, SABR was significantly favored in supplementary analyses. Conclusions In this population-based propensity-score adjusted analysis, we found that OS was not significantly different between those treated with SABR vs. CFRT in the primary analysis, although significance was observed in the supplementary analyses. Our results should be interpreted with caution given the database (i.e., nonrandomized) approach used in our study. Overall, further studies are required to explore these issues.
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Affiliation(s)
- Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, Taiwan
| | - Hsin-Yuan Fang
- Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Su-Tso Yang
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan.,School of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Chin Li
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ru Chien
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan.,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Zhai Y, Fang HY, Yu WT, Wang JZ, Yu DM, Zhao LY, Liang XF, Zhao WH. [Epidemiological characteristics of waist circumference and abdominal obesity among Chinese adults in 2010-2012]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 51:506-512. [PMID: 28592094 DOI: 10.3760/cma.j.issn.0253-9624.2017.06.010] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the epidemiological characteristics of waist circumference (WC) and abdominal obesity (AO) among Chinese adults aged 18 and above. Methods: Data were collected from China National Nutrition and Health Surveillance in 2010-2012. Multi-stage stratifies proportion to the population cluster random sampling method was conducted to determine 120 265 subjects aged 18 and above at 150 counties in 31 provinces in China mainland. WC was determined for all subjects, and AO was judged according to the "Healthy Adult Weight Determination" (WS/T 428-2013). Using the demographic data published by the National Bureau of Statistics of China in 2009, we performed complex sampling weighted treatment to calculate the WC, AO rate and 95%CI. Results: The mean WC of Chinese men aged 18 and above was 82.8 cm, which of urban men (84.1 cm) was higher than that of rural men (81.4 cm) (P<0.001). The average WC of women was 78.5 cm. There was no statistical difference between urban (78.7 cm) and rural women (78.4 cm) (P=0.965). With the increase of education level, the mean WC of male increased gradually from 81.2 cm to 84.3 cm (P<0.001), and the mean WC of female decreased from 80.3 cm to 74.3 cm (P<0.001). With the family income rose, the mean WC of men increased gradually from 81.9 cm to 84.7 cm (P<0.001), and the mean of WC of women decreased from 78.8 cm to 77.6 cm (P<0.001). The AO rate was 25.7% (95% CI: 23.7%-27.7%) in adults aged 18 years and older. The AO rate in urban males (29.8% (95%CI: 26.5%-33.1%)) was significantly higher than that of rural males (22.3% (95%CI: 19.3%-25.2%)) (P=0.001). There was no significant difference in the female AO rate between urban (25.6% (95%CI: 22.8%-28.4%)) and rural areas (25.1% (95%CI: 22.2%-27.9%)) (P=0.772). With the increase of the educational level, the AO rate of men increased from 20.1% (95%CI: 18.0%-22.1%) to 32.6% (95%CI: 28.6%-36.6%) (P<0.001), the rate of women decreased gradually from 31.3% (95%CI: 28.7%-33.9%) to 13.5% (95%CI: 10.9%-16.1%) (P<0.001). With the increase of family income, the AO rate of male increased gradually from 23.3% (95%CI: 20.7%-25.9%) to 31.8% (95%CI: 27.6%-36.1%) (P<0.001), the rate of female decreased from 26.5% (95% CI: 24.2%-28.7%) to 20.0% (95% CI: 17.2%-22.8%) (P<0.001). Conclusion: The prevalence of AO among Chinese residents aged 18 years and above was high, and there were significant differences in WC and AO rate between men and women under different age, region, educational level and family income level.
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Affiliation(s)
- Y Zhai
- Division of Non-communicable Diseases Control and Community Health; Department of Academic Editorial and Publishing, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Huang KY, Ko PZ, Yao CW, Hsu CN, Fang HY, Tu CY, Chen HJ. Inaccuracy of lung adenocarcinoma subtyping using preoperative biopsy specimens. J Thorac Cardiovasc Surg 2017; 154:332-339.e1. [PMID: 28366548 DOI: 10.1016/j.jtcvs.2017.02.059] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 08/21/2016] [Revised: 01/19/2017] [Accepted: 02/19/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND The prognostic significance of the new classification of lung adenocarcinoma proposed in the 2015 World Health Organization guideline has been validated. This study aimed to compare the preoperative classification of the adenocarcinoma subtype based on computed tomography-guided 18-gauge core needle biopsy (CTNB) or radial probe endobronchial ultrasound (R-EBUS) specimens, with the postoperative classification based on the resected specimens. METHODS We retrospectively analyzed a consecutive series of 128 patients (60 CTNB and 68 R-EBUS) who underwent surgery for preoperatively confirmed lung adenocarcinoma between 2010 and 2014. Comprehensive histological subtyping was performed according to the 2015 World Health Organization classification system. Diagnostic concordance of subtypes between small biopsy and resection specimens was assessed. RESULTS Concordant subtyping of adenocarcinomas between the predominant pattern on resections and biopsy sections was observed in 58.6% of cases (75 of 128; 95% confidence interval [CI], 49.9%-66.8%). Preoperative subtyping was accurate in only 30% of samples (3 of 10) with a predominance of solid patterns. None of the 5 micropapillary predominant cases was detected by CTNB or R-EBUS. For the concordance of the presence or absence of micropapillary/solid component, the sensitivity was as low as 16.5% (95% CI, 9.1%-26.5%). The detection rate by CTNB/R-EBUS increased with the increase in the percentage of micropapillary/solid component; however, even in the ≥40% micropapillary/solid group, only 24% of cases were detected by CTNB/R-EBUS. CONCLUSIONS The accuracy of the estimation of adenocarcinoma histological subtype based on preoperative biopsy sections was unsatisfactory.
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Affiliation(s)
- Kuo-Yang Huang
- Division of Chest Medicine, Department of Internal Medicine, Yuanlin Christian Hospital, Changhua, Taiwan
| | - Pin-Zuo Ko
- Department of Pathology, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Wei Yao
- Division of Chest Medicine, Department of Internal Medicine, Everan Hospital, Taichung, Taiwan
| | - Cheng-Nan Hsu
- Department of Radiology, China Medical University Hospital, Taichung, Taiwan
| | - Hsin-Yuan Fang
- Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yeh Tu
- School of Medicine, College of Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Jen Chen
- Division of Pulmonary and Critical Care, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Respiratory Therapy, China Medical University, Taichung, Taiwan.
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Kao CT, Huang TH, Fang HY, Chen YW, Chien CF, Shie MY, Yeh CH. Tensile force on human macrophage cells promotes osteoclastogenesis through receptor activator of nuclear factor κB ligand induction. J Bone Miner Metab 2016. [PMID: 26204845 DOI: 10.1007/s00774-015-0690-2] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Little is known about the effects of tensile forces on osteoclastogenesis by human monocytes in the absence of mechanosensitive cells, including osteoblasts and fibroblasts. In this study we consider the effects of tensile force on osteoclastogenesis in human monocytes. The cells were treated with receptor activator of nuclear factor κB ligand (RANKL) to promote osteoclastogenesis. Then,expression and secretion of cathepsin K were examined. RANKL and the formation of osteoclasts during the osteoclast differentiation process under continual tensile stress were evaluated by Western blot. It was also found that -100 kPa or lower induces RANKL-enhanced tartrate-resistant acid phosphatase activity in a dose-dependent manner. Furthermore, an increased tensile force raises the expression and secretion of cathepsin K elevated by RANKL, and is concurrent with the increase of TNF-receptor-associated factor 6 induction and nuclear factor κB activation. Overall, the current report demonstrates that tensile force reinforces RANKL-induced osteoclastogenesis by retarding osteoclast differentiation. The tensile force is able to modify every cell through dose-dependent in vitro RANKL-mediated osteoclastogenesis, affecting the fusion of preosteoclasts and function of osteoclasts. However, tensile force increased TNF-receptor-associated factor 6 expression. These results are in vitro findings and were obtained under a condition of tensile force. The current results help us to better understand the cellular roles of human macrophage populations in osteoclastogenesis as well as in alveolar bone remodeling when there is tensile stress.
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Affiliation(s)
- Chia-Tze Kao
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tsui-Hsien Huang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hsin-Yuan Fang
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
- Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, College of Public Health, China Medical University, Taichung, Taiwan
| | - Yi-Wen Chen
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Chien-Fang Chien
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ming-You Shie
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan.
| | - Chia-Hung Yeh
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan.
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Shen YF, Ho CC, Shie MY, Wang K, Fang HY. Hinokitiol-Loaded Mesoporous Calcium Silicate Nanoparticles Induce Apoptotic Cell Death through Regulation of the Function of MDR1 in Lung Adenocarcinoma Cells. Materials (Basel) 2016; 9:E306. [PMID: 28773431 PMCID: PMC5503060 DOI: 10.3390/ma9050306] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 12/21/2022]
Abstract
Hinokitiol is a tropolone-related compound found in heartwood cupressaceous plants. Hinokitiol slows the growth of a variety of cancers through inhibition of cell proliferation. The low water solubility of hinokitiol leads to less bioavailability. This has been highlighted as a major limiting factor. In this study, mesoporous calcium silicate (MCS) nanoparticles, both pure and hinokitiol-loaded, were synthesized and their effects on A549 cells were analyzed. The results indicate that Hino-MCS nanoparticles induce apoptosis in higher concentration loads (>12.5 μg/mL) for A549 cells. Hino-MCS nanoparticles suppress gene and protein expression levels of multiple drug resistance protein 1 (MDR1). In addition, both the activity and the expression levels of caspase-3/-9 were measured in Hino-MCS nanoparticle-treated A549 cells. The Hino-MCS nanoparticles-triggered apoptosis was blocked by inhibitors of pan-caspase, caspase-3/-9, and antioxidant agents (N-acetylcysteine; NAC). The Hino-MCS nanoparticles enhance reactive oxygen species production and the protein expression levels of caspase-3/-9. Our data suggest that Hino-MCS nanoparticles trigger an intrinsic apoptotic pathway through regulating the function of MDR1 and the production of reactive oxygen species in A549 cells. Therefore, we believe that Hino-MCS nanoparticles may be efficacious in the treatment of drug-resistant human lung cancer in the future.
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Affiliation(s)
- Yu-Fang Shen
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City 40447, Taiwan.
| | - Chia-Che Ho
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City 40447, Taiwan.
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, USA.
| | - Ming-You Shie
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City 40447, Taiwan.
| | - Kan Wang
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA.
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, USA.
| | - Hsin-Yuan Fang
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung City 40447, Taiwan.
- Department of Thoracic Surgery, China Medical University Hospital, Taichung City 40447, Taiwan.
- School of Medicine, China Medical University, Taichung City 40447, Taiwan.
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Lin CY, Fang HY, Feng CL, Li CC, Chien CR. Cost-effectiveness of neoadjuvant concurrent chemoradiotherapy versus esophagectomy for locally advanced esophageal squamous cell carcinoma: A population-based matched case-control study. Thorac Cancer 2015; 7:288-95. [PMID: 27148413 PMCID: PMC4846616 DOI: 10.1111/1759-7714.12326] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 09/25/2015] [Indexed: 12/25/2022] Open
Abstract
Background Neoadjuvant concurrent chemoradiotherapy (NCCRT) is often considered for locally‐advanced esophageal squamous cell carcinoma (LA‐ESCC) patients; however, no data regarding the cost‐effectiveness of this treatment is available. Our study aimed to evaluate the cost‐effectiveness of NCCRT versus esophagectomy for LA‐ESCC at population level. Methods We identified LA‐ESCC patients diagnosed within 2008–2009 and treated with either NCCRT or esophagectomy through the Taiwan Cancer Registry. We included potential confounding covariables (age, gender, residency, comorbidity, social‐economic status, disease stage, treating hospital level and surgeon's experience, and the use of endoscopic ultrasound before treatment) and used propensity score (PS) to construct a 1:1 population. The duration of interest was three years within the date of diagnosis. Effectiveness was measured as overall survival. We took the payer's perspective and converted the cost to 2014 United States dollars (USD). In sensitivity analysis, we evaluated the potential impact of an unmeasured confounder on the statistical significance of incremental net benefit at suggested willingness‐to‐pay. Results Our study population constituted 150 PS matched subjects. The mean cost (2014 USD) and survival (year) were higher for NCCRT compared with esophagectomy (US$91,460 vs. $75,836 for cost; 2.2 vs. 1.8 for survival) with an estimated incremental cost‐effectiveness ratio of US$39,060/life‐year. Conclusions When compared to esophagectomy, NCCRT is likely to improve survival and is probably more cost‐effective. Cost‐effectiveness results should be interpreted with caution given our results were sensitive to potential unmeasured confounder(s) in sensitivity analysis.
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Affiliation(s)
- Chen-Yuan Lin
- Division of Hematology and Oncology China Medical University Hospital Taichung Taiwan
| | - Hsin-Yuan Fang
- Department of Chest Surgery China Medical University Hospital Taichung Taiwan; School of Medicine College of Medicine China Medical University Taichung Taiwan
| | - Chun-Lung Feng
- Division of Gastroenterology and Hepatology China Medical University Hospital Taichung Taiwan
| | - Chia-Chin Li
- Cancer Center China Medical University Hospital Taichung Taiwan
| | - Chun-Ru Chien
- School of Medicine College of Medicine China Medical University Taichung Taiwan; Department of Radiation Oncology China Medical University Hospital Taichung Taiwan
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Hsia TC, Tu CY, Fang HY, Liang JA, Li CC, Chien CR. Cost and effectiveness of image-guided radiotherapy for non-operated localized lung cancer: a population-based propensity score-matched analysis. J Thorac Dis 2015; 7:1643-9. [PMID: 26543613 DOI: 10.3978/j.issn.2072-1439.2015.09.36] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Image-guided radiotherapy (IGRT) is a novel technology to enhance RT delivery accuracy. However, the clinical effectiveness and cost-effectiveness are less clear. The aim of our study is to compare the cost and effectiveness of conventional fractionated RT for non-operated localized lung cancer delivered with vs. without IGRT via this population-based propensity score (PS) matched analysis. METHODS We identified eligible patients diagnosed within 2007-2010 through a comprehensive population-based database containing cancer, death registries, and reimbursement data in Taiwan. The primary duration of interest (DOI) was 2 years within diagnosis. Effectiveness was measured as survival whereas direct medical cost was measured from the payers' perspective. In supplementary analysis (SA), we estimated the cost-effectiveness in consider of out-of-pocket (OOP) payment and 4 years as DOI. RESULTS Our study population constituted 124 patients. Within 2 years, both the mean cost (2014 USD) and survival (life-year, LY) were higher for IGRT ($60,774 vs. $60,554; 1.43 vs. 1.37). The incremental cost-effectiveness ratio (ICER) when IGRT was compared to non-IGRT was 3,667 (USD/LY). The chance for IGRT to be cost-effective was around 68% & 70% at willingness-to-pay threshold 50,000 USD/LY and 150,000 USD/LY respectively. IGRT remained cost-effective in SA. CONCLUSIONS We provide the first empirical evidence that when compared to non-IGRT, IGRT was potentially cost-effective.
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Affiliation(s)
- Te-Chun Hsia
- 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan ; 2 Department of Respiratory Therapy, College of Health Care, 3 School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan ; 4 Department of Chest Surgery, 5 Department of Radiation Oncology, 6 Cancer Center, China Medical University Hospital, Taichung 40402, Taiwan
| | - Chih-Yen Tu
- 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan ; 2 Department of Respiratory Therapy, College of Health Care, 3 School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan ; 4 Department of Chest Surgery, 5 Department of Radiation Oncology, 6 Cancer Center, China Medical University Hospital, Taichung 40402, Taiwan
| | - Hsin-Yuan Fang
- 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan ; 2 Department of Respiratory Therapy, College of Health Care, 3 School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan ; 4 Department of Chest Surgery, 5 Department of Radiation Oncology, 6 Cancer Center, China Medical University Hospital, Taichung 40402, Taiwan
| | - Ji-An Liang
- 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan ; 2 Department of Respiratory Therapy, College of Health Care, 3 School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan ; 4 Department of Chest Surgery, 5 Department of Radiation Oncology, 6 Cancer Center, China Medical University Hospital, Taichung 40402, Taiwan
| | - Chia-Chin Li
- 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan ; 2 Department of Respiratory Therapy, College of Health Care, 3 School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan ; 4 Department of Chest Surgery, 5 Department of Radiation Oncology, 6 Cancer Center, China Medical University Hospital, Taichung 40402, Taiwan
| | - Chun-Ru Chien
- 1 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 40402, Taiwan ; 2 Department of Respiratory Therapy, College of Health Care, 3 School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan ; 4 Department of Chest Surgery, 5 Department of Radiation Oncology, 6 Cancer Center, China Medical University Hospital, Taichung 40402, Taiwan
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Chang NJ, Chen YW, Shieh DE, Fang HY, Shie MY. The effects of injectable calcium silicate-based composites with the Chinese herb on an osteogenic accelerator
in vitro. Biomed Mater 2015; 10:055004. [DOI: 10.1088/1748-6041/10/5/055004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Chen JX, Jeng LB, Lin YS, Lu TY, Kao PY, Fang HY. A Mimicking Esophageal Cancer After Liver Transplant for Hepatocellular Carcinoma: A Rare Posttransplant Metastasis. EXP CLIN TRANSPLANT 2015; 14:571-574. [PMID: 26325233 DOI: 10.6002/ect.2014.0179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Liver transplant is now considered to be a successful treatment modality for early hepatocellular carcinoma. In addition, advances in immunosuppressive therapy have greatly prolonged posttransplant survival of patients with hepatocellular carcinoma. However, both the posttransplant physiologic condition and immunosuppressive therapy affect the patient's natural immunity, resulting in accumulating and more problematic complications. Three years after a male patient with hepatocellular carcinoma underwent living-donor liver transplant, he presented with esophageal metastasis from recurrence of hepatocellular carcinoma. This is an extremely rare complication, perhaps with an ominous prognosis, and, to the best of our knowledge, the first such case to be published in the English literature.
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Affiliation(s)
- Jian-Xun Chen
- From the Department of Thoracic Surgery, China Medical University Hospital, Taichung, Taiwan and the School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Gong B, Yao XH, Zhang YQ, Fang HY, Pang TC, Dong QL. A cultured endophyte community is associated with the plant Clerodendrum inerme and antifungal activity. Genet Mol Res 2015; 14:6084-93. [PMID: 26125809 DOI: 10.4238/2015.june.8.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Fungal endophytes live in the inner tissues of Clerodendrum inerme and may be significant resources for new chemicals in drug discovery. A total of 242 endophytic fungi were recovered from 602 sample segments of C. inerme; 66 were purified. The 66 fungi belonging to 16 taxa and 11 genera (Alternaria, Nigrospora, Bartalinia, Pestalotiopsis, Fusarium, Mycoleptodiscus, Trichoderma, Phomopsis, Diaporthe, Lasiodiplodia, and Curvularia) were identified by morphological characteristics and fungal internal transcribed spacer sequences. The most abundant genera were Alternaria and Lasiodiplodia. Some of the endophytes exhibited tissue specificity. The colonization frequencies of endophytes in the stems were evidently higher than those in the roots and leaves. The crude ethyl acetate extracts were tested against 6 endophytes isolated from C. inerme. Three of 10 (33.3%) endophytes, which were identified as Phomopsis sp, Curvularia sp, and Mycoleptodiscus sp, displayed distinct antifungal activity against ≥3 tested fungi. To our knowledge, this is the first report of an endophytic community associated with C. inerme in China and its antifungal activity in vitro.
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Affiliation(s)
- B Gong
- Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Qinzhou University, Guangxi, China
| | - X H Yao
- Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Qinzhou University, Guangxi, China
| | - Y Q Zhang
- Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Qinzhou University, Guangxi, China
| | - H Y Fang
- Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Qinzhou University, Guangxi, China
| | - T C Pang
- Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Qinzhou University, Guangxi, China
| | - Q L Dong
- Guangxi Key Laboratory of Beibu Gulf Marine Biodiversity Conservation, Qinzhou University, Guangxi, China
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Chen YY, Su WP, Fang HY. Unusual chest pain. Gastroenterology 2015; 148:e7-9. [PMID: 25824358 DOI: 10.1053/j.gastro.2014.10.048] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 10/31/2014] [Indexed: 12/02/2022]
Affiliation(s)
- Yang-Yuan Chen
- Division of Gastroenterology, Chest Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Pang Su
- Division of Gastroenterology, Chest Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Hsin-Yuan Fang
- Division of Gastroenterology, Chest Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan
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Chang WS, Liao CH, Hsu CM, Huang CY, Fang HY, Kao PY, Tsai CW, Wu HC, Hu PS, Wang TC, Syu YR, Shui HA, Bau DT. Significant Association of Cyclo-oxygenase 2 Genotypes with Upper Tract Urothelial Cancer. Anticancer Res 2015; 35:2725-2730. [PMID: 25964551] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Reliable biomarkers are in urgent need for diagnosis, outcome prediction and treatment-effect monitoring for upper tract urothelial carcinomas (UTUC). Although up-regulation of cyclo-oxygenase 2 (COX2) is found in stroma and tumor cells in more than half of the patients with UTUC investigated, the genomic contribution of COX2 to UTUC has not been studied. The study aimed to evaluate the association of six polymorphic genotypes of COX2 with UTUC within a Taiwanese population. MATERIALS AND METHODS A total of 218 patients with UTUC and 580 healthy controls were genotyped for six COX2 polymorphisms, namely A-1195G, G-765C, T+8473C, intron 1, intron 5 and intron 6, and examined for their association with UTUC risk. RESULTS The distribution of genotypes of COX2 G-765C and intron 5 were significantly different between patient and control groups (p=0.0001 and 0.0016, respectively), while others were not (p>0.05). The haplotype analysis showed that compared to the GG/TT haplotype of COX2 G-765C/intron 5, those carrying GG/AT variants have a significantly increased risk of UTUC (odds ratio=4.83, 95% confidence interval=1.79-13.06), while those carrying CG/TT variants have a decreased risk (odds ratio=0.26, 95% confidence interval=0.14-0.49). CONCLUSION Our results suggest that individual and combined COX2 G-765C/intron 5 genotypes play a role in controlling COX2 expression and UTUC development.
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Affiliation(s)
- Wen-Shin Chang
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C. Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Cheng-Hsi Liao
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C. Department of Urology, Taichung Armed Forces General Hospital, Taichung, Taiwan, R.O.C
| | - Chin-Mu Hsu
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chung-Yu Huang
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Pei-Yu Kao
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chia-Wen Tsai
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Hsi-Chin Wu
- Department of Urology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Pei-Shin Hu
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan, R.O.C
| | - Tzu-Chia Wang
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Yun-Ru Syu
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Hao-Ai Shui
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Da-Tian Bau
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C. Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan, R.O.C.
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Fang HY, Hsiao FY, Huang HC, Lin YS, Chen CY, Shieh SH, Chen PR, Chen CK, Chien CR. Cost and effectiveness of video-assisted thoracoscopic surgery for clinical stage I non-small cell lung cancer: a population-based analysis. J Thorac Dis 2015; 6:1690-6. [PMID: 25589961 DOI: 10.3978/j.issn.2072-1439.2014.10.27] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/25/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND Video-assisted thoracoscopic surgery (VATS) is a minimally invasive alternative to conventional surgery (CS). We aimed to estimate the short-term cost-effectiveness of VATS vs. CS for clinical stage I non-small cell lung cancer (NSCLC-c-stage-I) patients from the payer's perspective (National Health Insurance). METHODS We identified NSCLC-c-stage-I patients diagnosed and received surgery within 2007-2009 through a comprehensive population-based database containing cancer and death registries, and reimbursement data. The duration of interest was 1 year. We included potential confounding covariables through literature searching and our own experience, and used a propensity score to construct a 1:1 population for adjustment. RESULTS Our study population constituted 966 patients. The mean hospital stay [days, standard deviation (SD)] were 14.4 [7] and 16.1 (7.7) for VATS and CS respectively (P=0.002). The mean cost (2013 USD) and survival (year) was $22,316 vs. $21,976 and 0.98 vs. 0.974 for VATS vs. CS. The probability for VATS to be cost-effective (i.e., positive net benefit) was 0.49 & 0.56 at willingness-to-pay (WTP) 50,000 & 100,000 USD/life-year, respectively. CONCLUSIONS We provide the first empirical evidence that when compared to CS, VATS was potentially cost-effective in the short term (1 year) within the common WTP levels in Taiwan.
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Affiliation(s)
- Hsin-Yuan Fang
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Fei-Yuan Hsiao
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Hsu-Chih Huang
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Sen Lin
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yi Chen
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Shwn-Huey Shieh
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Pin-Ru Chen
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chein-Kuang Chen
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ru Chien
- 1 Department of Chest Surgery, China Medical University Hospital, Taichung, Taiwan ; 2 School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ; 3 Graduate Institute of Clinical Pharmacy, College of Medicine, 4 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan ; 5 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan ; 6 Division of Trauma, Emergency Surgery, and Critical Care, China Medical University Hospital, Taichung, Taiwan ; 7 Department of Health Services Administration, College of Health Care, China Medical University, Taichung, Taiwan ; 8 Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
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Hsu YJ, Chen PR, Lin YS, Fang HY, Chen CK. Chylothorax following endovascular aortic repair with subclavian revascularization--a case report. J Cardiothorac Surg 2014; 9:165. [PMID: 25361705 PMCID: PMC4234843 DOI: 10.1186/s13019-014-0165-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 09/26/2014] [Indexed: 01/30/2023] Open
Abstract
Background Thoracic endovascular aortic repair (TEVAR) is becoming increasingly popular due to reduced perioperative morbidity and mortality compared with open surgical repair. However, complications can occur when the left subclavian artery is involved. When performing TEVAR with left carotid-subclavian artery bypass the stent graft will extend to the left common carotid artery. We herein present the case of a patient with a type B aortic dissection with an acute intramural hematoma. Chylothorax was noted after TEVAR with left carotid-subclavian artery bypass. Case report A 66-year-old female with descending aortic dissection that was treated conservatively developed the sudden onset of back pain. Aortic computed tomography (CT) showed a type B intramural aortic dissection. TEVAR with left carotid-subclavian artery bypass was performed. Left chylothorax was noted after surgery with drainage of up to 1000 mL per day. Conservative management was ineffective. Thoracoscopic ligation of the thoracic duct was performed with resolution of the chyle leakage. Conclusion Chylothorax can occur after TEVAR with carotid-subclavian artery bypass and likely results from thoracic duct injury. When conservative treatments fail, ligation of the thoracic duct cephalad to aortic hiatus can resolve the chyle leakage. Electronic supplementary material The online version of this article (doi:10.1186/s13019-014-0165-x) contains supplementary material, which is available to authorized users.
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Chen CK, Chen PR, Huang HC, Lin YS, Fang HY. Overexpression of matrix metalloproteinases in lung tissue of patients with primary spontaneous pneumothorax. Respiration 2014; 88:418-25. [PMID: 25300296 DOI: 10.1159/000366065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/22/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although blebs and bullae are frequently found in the apexes of lungs of patients with primary spontaneous pneumothorax (PSP), its pathogens remain unclear. OBJECTIVES To examine the role of proteases [matrix metalloproteinase (MMP)-2, MMP-7 and MMP-9] and antiproteases [tissue inhibitors of metalloproteinase (TIMP)-1, TIMP-2, TIMP-3 and TIMP-4] in the pathogenesis of PSP. METHOD Fifty consecutive PSP patients who received standard surgical care were enrolled in the study. Lung tissues from 20 patients with stage I non-small cell lung cancer were used as a control. Immunohistochemistry (IHC), reverse transcription-polymerase chain reaction (RT-PCR) and gelatin zymography were used to evaluate the expression of MMP and TIMP in the lung tissue of patients with PSP. RESULTS Overexpression of MMP-2, MMP-7 and MMP-9 was found in the afflicted lung by IHC, zymography and RT-PCR. By IHC, higher expression of MMP-2 and MMP-9 in PSP patients was identified in alveolar macrophages and type II pneumocytes (88 and 92% of patients in macrophages, and 72 and 70% of patients in type II pneumocytes, respectively). MMP-2, MMP-7 and MMP-9 expression in patients was higher in mesothelial cells (66, 76 and 76%). Overexpression of TIMP-2 was detected in the extracellular matrix around bullae and blebs. Expression levels of TIMP-1, TIMP-3 and TIMP-4 were negligible (<10% of cells) in both PSP patients and controls. CONCLUSIONS MMP-2, MMP-9, MMP-7 and TIMP-2 were upregulated in PSP lesions. These results suggest that an imbalance between the expression of proteases and antiproteases may be involved in the pathogeneses of PSP.
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Affiliation(s)
- Chien-Kuang Chen
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, ROC
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He ZQ, Wang D, Fang HY, Chen JM, Song S. Highly efficient and stable Ag/AgIO₃ particles for photocatalytic reduction of CO₂ under visible light. Nanoscale 2014; 6:10540-10544. [PMID: 25109882 DOI: 10.1039/c4nr02450h] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ag supported on AgIO₃ (Ag/AgIO₃ particles), a plasmonic photocatalyst, was synthesized through a facile solid-state ion-exchange procedure followed by reduction with hydrazine hydrate. The particles displayed high activity and stability in the photocatalytic conversion of CO₂ to CH₄ and CO using water vapor under visible-light irradiation (>400 nm wavelength).
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Affiliation(s)
- Z Q He
- College of Biological and Environmental Engineering, Zhejiang University of Technology, Hangzhou 310032, People's Republic of China.
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Kao P, Fang HY, Lu TY, Hsu SC, Chen CK, Chen PR. Strangulation of Chronic Transdiaphragmatic Intercostal Hernia. Ann Thorac Surg 2014; 97:e155-7. [DOI: 10.1016/j.athoracsur.2014.01.085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/30/2013] [Accepted: 01/29/2014] [Indexed: 10/25/2022]
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Chiang YY, Wang SL, Yang CL, Yang HY, Yang HC, Sudhakar JN, Lee CK, Huang HW, Chen CM, Chiou SH, Chiang SF, Fang HY, Chen CY, Shieh SH, Chow KC. Extracts of Koelreuteria henryi Dummer induce apoptosis and autophagy by inhibiting dihydrodiol dehydrogenase, thus enhancing anticancer effects. Int J Mol Med 2013; 32:577-84. [PMID: 23857115 DOI: 10.3892/ijmm.2013.1441] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 06/07/2013] [Indexed: 11/06/2022] Open
Abstract
Dihydrodiol dehydrogenase (DDH) is frequently detected in cancer cells, and its overexpression correlates with drug resistance, the downregulation of DNA repair mechanisms, increased frequency of tumor recurrence, cancer cell metastasis and poor prognosis. The silencing of DDH expression using siRNA, on the other hand, reduces drug resistance and cancer cell mobility. These data suggest that DDH may be an oncogene-related protein. However, no specific DDH inhibitor has been identified to date. Thus, in this study, we used DDH as a target enzyme in a live-cell enzyme-linked immunosorbent assay to screen Chinese medicinal herb extracts (CMHEs) with the aim of identifying a DDH inhibitor. Using this method, we found 49 among 796 CMHEs that inhibited DDH expression. We selected three potential extracts, which had the highest activity against DDH, for further fractionation using high-performance liquid chromatography. The active ingredient was identified by immunoblot analysis. The function of the active ingredient was characterized by cell function analysis. Our results revealed that the CMHE-purified compounds targeted DDH, inducing autophagy and reducing DNA repair, which in turn enhanced the cytotoxic effects of the anticancer drugs and irradiation.
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Affiliation(s)
- Yung-Yen Chiang
- Department of Dental Laboratory Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan, R.O.C
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