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Chang CY, Lee YL, Huang YT, Ko WC, Ho MW, Hsueh PR. In vitro activity of imipenem/relebactam, meropenem/vaborbactam and comparators against Enterobacterales causing urinary tract infection in Taiwan: Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2020. Int J Antimicrob Agents 2023; 61:106815. [PMID: 37059343 DOI: 10.1016/j.ijantimicag.2023.106815] [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: 01/31/2023] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 04/16/2023]
Abstract
Antimicrobial resistance due to β-lactamase production is a worldwide problem, and β-lactamase inhibitors have been developed to overcome the growing resistance to β-lactamase. The in vitro activities of two recently introduced carbapenem/β-lactamase inhibitor combinations, imipenem/relebactam and meropenem/vaborbactam, and their comparators against Enterobacterales from patients with urinary tract infection (UTI) were evaluated. Enterobacterales isolates from patients with UTIs in Taiwan participating in the Study for Monitoring Antimicrobial Resistance Trends (SMART) in 2020 were included. Minimum inhibitory concentrations (MICs) for various antibiotics were determined using the broth microdilution method. Susceptibility was interpreted based on the MIC breakpoints of Clinical and Laboratory Standards Institute (CLSI) 2022. Genes encoding common β-lactamases, including extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases (AmpC) and carbapenemases, were detected using multiplex polymerase chain reaction. A total of 309 Enterobacterales isolates were included, against which both imipenem/relebactam and meropenem/vaborbactam exerted excellent efficacy (95% [275/309] and 99.3% [288/309], respectively). Among imipenem-non-susceptible isolates, 39.5% [17/43] and 90.7% [39/43] were susceptible to imipenem/relebactam and meropenem/vaborbactam, respectively. In conclusion, imipenem/relebactam and meropenem/vaborbactam may be appropriate choices for treating UTIs due to Enterobacterales resistant to commonly used antibiotics. Continuous monitoring of antimicrobial resistance is crucial.
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Affiliation(s)
- Chih-Yen Chang
- Department of Internal Medicine, Yuanlin Christian Hospital, Changhua, Taiwan
| | - Yu-Lin Lee
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan, Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan
| | - Yu-Tsung Huang
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chien Ko
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mao-Wang Ho
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; Center of Laboratory Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan; Ph.D Program for Aging, School of Medicine, China Medical University, Taichung, Taiwan.
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2
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Chen YH, Chang CY, Huang SK. Strike or ball? Batters know it better: an fMRI study of action anticipation in baseball players. Cereb Cortex 2023; 33:3221-3238. [PMID: 35788641 DOI: 10.1093/cercor/bhac271] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/23/2022] [Accepted: 06/16/2022] [Indexed: 11/12/2022] Open
Abstract
To assess whether the brain processes of action anticipation are modulated differently by perceptual and motor experiences, baseball batters, pitchers, and non-players were asked to predict the fate of pitching actions (strike or ball) while undergoing functional magnetic resonance imaging. Results showed both batters (perceptual experts of pitching action) and pitchers (motor experts) were more accurate than non-players. Furthermore, batters demonstrated higher perceptual sensitivity in discriminating strikes than non-players. All groups engaged the action observation network, putamen, and cerebellum during anticipation, while pitchers showed higher activity than non-players in the left premotor cortex, which has been implicated in the internal simulation of observed action. Only batters exhibited differences in strike versus ball pitches in their left ventral extrastriate cortex, which might be associated with the processing of relevant visual information conveyed by the observed pitcher's movement kinematics and pitch trajectory. Moreover, all groups showed higher activity selectively in the striatum, thalamus, sensorimotor cortices, and cerebellum during correct predictions than during incorrect ones, with most widespread activation in batters, reinforcing the greater involvement of the sensorimotor system in perceptual experience. Our findings demonstrate that perceptual experience might enhance action anticipation ability to a greater extent than motor experience, with overlapping but specific neural underpinnings.
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Affiliation(s)
- Yin-Hua Chen
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, No. 250, Wenhua 1st Road, Guishan, Taoyuan 33301, Taiwan
| | - Chih-Yen Chang
- Department of Physical Education, National Taiwan Normal University, No. 162, Sec. 1, Heping E. Road, Taipei 10610, Taiwan
| | - Shih-Kuei Huang
- Department of Physical Education, Chinese Culture University, No. 55, Hwa-Kang Road, Yang-Ming-Shan, Taipei 11114, Taiwan
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3
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Chen YH, Chang CY, Yen NS, Tsai SY. Brain plasticity of structural connectivity networks and topological properties in baseball players with different levels of expertise. Brain Cogn 2023; 166:105943. [PMID: 36621186 DOI: 10.1016/j.bandc.2022.105943] [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: 06/29/2022] [Revised: 12/06/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
Brain plasticity in structural connectivity networks along the development of expertise has remained largely unknown. To address this, we recruited individuals with three different levels of baseball-playing experience: skilled batters (SB), intermediate batters (IB), and healthy controls (HC). We constructed their structural connectivity networks using diffusion tractography and compared their region-to-region structural connections and the topological characteristics of the constructed networks using graph-theoretical analysis. The group differences were detected in 35 connections predominantly involving sensorimotor and visual systems; the intergroup changes could be depicted either in a stepwise (HC < / = IB < / = SB) or a U-/inverted U-shaped manner as experience increased (IB < SB and/or HC, or opposite). All groups showed small-world topology in their constructed networks, but SB had increased global and local network efficiency than IB and/or HC. Furthermore, although the number and cortical regions identified as hubs of the networks in the three groups were highly similar, SB exhibited higher nodal global efficiency in both the dorsolateral and medial parts of the bilateral superior frontal gyri than IB. Our findings add new evidence of topological reorganization in brain networks associated with sensorimotor experience in sports. Interestingly, these changes do not necessarily increase as a function of experience as previously suggested in literature.
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Affiliation(s)
- Yin-Hua Chen
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, No. 250, Wenhua 1st Rd, Guishan, Taoyuan 33301, Taiwan
| | - Chih-Yen Chang
- Department of Physical Education, National Taiwan Normal University, 162, Sec. 1, Heping E. Rd, Taipei 10610, Taiwan
| | - Nai-Shing Yen
- Research Center for Mind, Brain, and Learning, National Chengchi University, No. 64, Sec. 2, Zhi-Nan Rd, Wen-Shan District, Taipei 11605, Taiwan; Department of Psychology, National Chengchi University, No. 64, Sec. 2, Zhi-Nan Rd, Wen-Shan District, Taipei 11605, Taiwan.
| | - Shang-Yueh Tsai
- Research Center for Mind, Brain, and Learning, National Chengchi University, No. 64, Sec. 2, Zhi-Nan Rd, Wen-Shan District, Taipei 11605, Taiwan; Graduate Institute of Applied Physics, National Chengchi University, No. 64, Sec. 2, Zhi-Nan Rd, Wen-Shan District, Taipei 11605, Taiwan.
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4
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Tan KT, Benedict SLH, Chang CY, Chidambaram SK, Abd Jamil I, Bahrudin MS, Kandasamy SS, Khor CS. Clinical severity of COVID-19 with omicron variant predominance in relation to vaccination status, age, comorbidities- a single center in Selangor, Malaysia. Med J Malaysia 2022; 77:558-563. [PMID: 36169066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Recently, the rapid surge of reported COVID-19 cases attributed to the Omicron variant of severe acute respiratory syndrome coronavirus (SARS-CoV-2) created an immediate concern across nations. Local information pertaining to the new variant of concern (VOC) is lacking. We aimed to determine the clinical characteristics of COVID-19 during a period of Omicron prevalence among patients hospitalised from February 1 to 21, 2022 at Sungai Buloh Hospital and to estimate the risks of disease progression presumably caused by this variant in association with gender, age, comorbidity, and vaccination status. MATERIALS AND METHODS In this retrospective, singlecentered, retrospective cohort study, all hospitalised adults with laboratory-confirmed COVID-19, aged 18 and above, were recruited from February 1 to 21, 2022. Clinical characteristics, investigations, and outcomes were assessed. RESULTS A total of 2279 patients aged 18 years and above with laboratory-proven COVID-19 were recruited and analysed, excluding 32 patients owing to incomplete data. Majority of the study population had a mean age of 41.8 ± 17.7, was female-predominant (1329/2279, 58.6%), had completed a primary series of vaccination with a booster (1103/2279, 48.4%), and had no underlying medical conditions (1529/2279, 67.4%). The risk of COVID-19-related disease progression was significantly lower in hospitalised patients under the age of 50 who were female, had no comorbidity, and had completed two doses of the primary series with or without a booster. [respectively, OR 7.94 (95% CI 6.16, 10.23); 1.68 (1.34, 2,12); 2.44 (1.85, 3.22); 2.56 (1.65, 3.97), p< 0.001]. CONCLUSION During the period of Omicron prevalence, a favourable outcome of COVID-19 was strongly associated with female gender, age below 50, a comorbidity-free condition, and having completed immunization. With this new observation, it could help improve public health planning and clinical management in response to the emergence of the latest VOC.
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Affiliation(s)
- K T Tan
- Sungai Buloh Hospital, Department of Internal Medicine, Selangor, Malaysia.
| | - S L H Benedict
- Sungai Buloh Hospital, Department of Internal Medicine, Selangor, Malaysia
| | - C Y Chang
- Sungai Buloh Hospital, Department of Internal Medicine, Selangor, Malaysia
| | - S K Chidambaram
- Sungai Buloh Hospital, Department of Internal Medicine, Selangor, Malaysia
| | - I Abd Jamil
- Sungai Buloh Hospital, Department of Crisis Preparedness and Response Centre, Selangor, Malaysia
| | - M S Bahrudin
- Sungai Buloh Hospital, Department of Crisis Preparedness and Response Centre, Selangor, Malaysia
| | - S S Kandasamy
- Sungai Buloh Hospital, Department of Internal Medicine, Selangor, Malaysia
| | - C S Khor
- Sungai Buloh Hospital, Department of Internal Medicine, Selangor, Malaysia
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Chang CY, Chin HH, Chin PW, Zaid M. Cold agglutinin-mediated autoimmune haemolytic anaemia associated with COVID-19 infection: a case report. Hong Kong Med J 2022; 28:257-259. [PMID: 35485209 DOI: 10.12809/hkmj219828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- C Y Chang
- Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - H H Chin
- Department of Medicine, Hospital Enche' Besar Hajjah Kalsom, Kluang, Johor, Malaysia
| | - P W Chin
- Department of Medicine, Hospital Enche' Besar Hajjah Kalsom, Kluang, Johor, Malaysia
| | - M Zaid
- Department of Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
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Chang CY, Gan YL, Lio JY, Radhakrishnan AP. Invasive salmonella enteritidis infection complicated by colonic perforations and pancytopenia: A case report. Med J Malaysia 2022; 77:264-266. [PMID: 35338642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Salmonellosis caused by bacterial genus Salmonella is associated with a high morbidity and mortality rate. Salmonellae can be divided into typhoidal serotypes (S. enterica ser. Typhi and S. enterica ser. Paratyphi A) and nontyphoidal Salmonella (NTS) serotypes. The two most common NTS serotypes isolated from human sources were S. enterica ser. Typhimurium and S. enterica ser. Enteritidis. NTS infection can present with diverse clinical manifestations, including gastroenteritis, bacteraemia, septic arthritis, osteomyelitis, and endovascular infection. Intestinal perforation is an extremely rare and potentially fatal complication of severe salmonella infection. Herein, we report a case of invasive S. Enteritidis infection complicated by colonic perforation and pancytopenia. Following a colonic resection, the patient received a prolonged course of antimicrobial therapy and eventually recovered.
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Affiliation(s)
- C Y Chang
- Hospital Selayang, Medical Department, Batu Caves, Selangor, Malaysia.
| | - Y L Gan
- Hospital Selayang, Medical Department, Batu Caves, Selangor, Malaysia
| | - J Y Lio
- Hospital Selayang, Medical Department, Batu Caves, Selangor, Malaysia
| | - A P Radhakrishnan
- Hospital Selayang, Medical Department, Batu Caves, Selangor, Malaysia
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Affiliation(s)
- C Y Chang
- Medical Department, Hospital Selayang, Selayang-Kepong Highway, 68100 Batu Caves, Selangor, Malaysia
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Wang KC, Yang DH, Chang KI, Hsu WT, Chang CY, Wang CY, Yang YP, Chien CS, Yang MY, Shen CC. Using percutaneous parapedicle screw vertebroplasty to treat transpedicle screw loosening. J Chin Med Assoc 2021; 84:517-522. [PMID: 33496511 DOI: 10.1097/jcma.0000000000000490] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pedicle screw loosening (PSL) is a postsurgical complication of spinal fusion surgery that can result in morbidity. The aim of this study was to evaluate the efficacy and safety of percutaneous parapedicle screw vertebroplasty (PPSV) for pain reduction and motility improvement in patients with PSL. METHODS The postsurgical solid inter-body fusion with inter-body bone mass formation of 32 patients who underwent lumbar-sacrum spinal fusion surgery was confirmed with plain films and CT scans. Each patient had one or two screws with symptomatic PSL and was treated with PPSV. All the patients were then followed up for 12 to 24 months. The visual analog scale (VAS) and Roland-Morris Disability Questionnaire (RMDQ) were used to evaluate each patient before the operation, after the operation, and during the follow-up period. RESULTS A total of 32 patients with a total of 47 screws with PSL were treated with PPSV and experienced different results in terms of pain reduction (with the mean VAS score dropping from 7.97 ± 0.74 to 2.34 ± 1.59, p < 0.001) and motility improvement (with the mean RMDQ score dropping from 16.75 ± 1.84 to 7.21 ± 4.08, p < 0.001). The motility improvement was significantly correlated with pain reduction (r = 0.42, p = 0.018), with the mean follow-up period being 19.3 ± 6.2 months (range: 8-36 months). However, five patients who experienced moderate improvements had eventually received a revision operation after undergoing PPSV. CONCLUSION The PPSV procedure is effective and safe for the reduction of pain and improvement of life quality in patients with PSL. It can thus be considered as a possible option for the revision of spinal fusion surgery.
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Affiliation(s)
- Kai-Chun Wang
- Department of Orthopaedic and Spinal Surgery, Taichung Veterans General Hospital, Puli Branch, Taichung, Taiwan, ROC
| | - Deng-Ho Yang
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Taichung Armed-Forces General Hospital, Taichung, Taiwan, ROC
- Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC
- Division of Rheumatology/Immunology/Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Ku-I Chang
- Department of Orthopaedic and Spinal Surgery, Da-Li Jan-Ai Hospital, Taichung, Taiwan, ROC
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC
| | - Wei-Tzu Hsu
- Department of Orthopaedic and Spinal Surgery, Taichung Veterans General Hospital, Puli Branch, Taichung, Taiwan, ROC
| | - Chih-Yen Chang
- Department of Medical Education and Research, Jen-Ai Hospital, Taichung, Taiwan, ROC
- Department of Elderly Care, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC
| | - Chien-Ying Wang
- Institute of Pharmacology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Trauma, Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yi-Ping Yang
- Institute of Pharmacology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chian-Shiu Chien
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Meng-Yin Yang
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Department of Neurosurgery, Da-Li Jan-Ai Hospital, Taichung, Taiwan, ROC
- Department of Surgery/Neurosurgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- College of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC
| | - Chiung-Chyi Shen
- Department of Neurosurgery, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Department of Physical Therapy, Hung Kuang University, Taichung, Taiwan, ROC
- Basic Medical Education Center, Central Taiwan University of Science and Technology, Taichung, Taiwan, ROC
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Chang CY. Peripheral T-cell lymphoma presenting with pleural effusion. QJM 2021; 114:55. [PMID: 32330273 DOI: 10.1093/qjmed/hcaa140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Y Chang
- Department of General Medicine, Kapit Hospital, Jalan Mamora, Kapit, Sarawak 96800, Malaysia
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10
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Chang CY, Lu YCA, Ting WC, Shen TWD, Peng WC. An artificial immune system with bootstrap sampling for the diagnosis of recurrent endometrial cancers. Open Med (Wars) 2021; 16:237-245. [PMID: 33585700 PMCID: PMC7863001 DOI: 10.1515/med-2021-0226] [Citation(s) in RCA: 2] [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: 11/10/2020] [Revised: 12/11/2020] [Accepted: 12/29/2020] [Indexed: 12/24/2022] Open
Abstract
Endometrial cancer is one of the most common gynecological malignancies in developed countries. The prevention of the recurrence of endometrial cancer has always been a clinical challenge. Endometrial cancer is asymptomatic in the early stage, and there remains a lack of time-series correlation patterns of clinical pathway transfer, recurrence, and treatment. In this study, the artificial immune system (AIS) combined with bootstrap sampling was compared with other machine learning techniques, which included both supervised and unsupervised learning categories. The back propagation neural network, support vector machine (SVM) with a radial basis function kernel, fuzzy c-means, and ant k-means were compared with the proposed method to verify the sensitivity and specificity of the datasets, and the important factors of recurrent endometrial cancer were predicted. In the unsupervised learning algorithms, the AIS algorithm had the highest accuracy (83.35%), sensitivity (77.35%), and specificity (92.31%); in supervised learning algorithms, the SVM algorithm had the highest accuracy (97.51%), sensitivity (95.02%), and specificity (99.29%). The results of our study showed that histology and chemotherapy are important factors affecting the prediction of recurrence. Finally, behavior code and radiotherapy for recurrent endometrial cancer are important factors for future adjuvant treatment.
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Affiliation(s)
- Chih-Yen Chang
- Department of Medical Education and Research, Jen-Ai Hospital, Taichung, Taiwan.,Department of Elderly Care, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Yen-Chiao Angel Lu
- School of Nursing, College of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Wen-Chien Ting
- Division of Colorectal Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tsu-Wang David Shen
- Department of Automatic Control Engineering, Feng Chia University, No. 100, Wenhwa Road, Seatwen, Taichung, 40724, Taiwan.,Master's Program in Biomedical Informatics and Biomedical Engineering, Feng Chia University, No. 100, Wenhwa Road, Seatwen, Taichung, 40724, Taiwan
| | - Wen-Chen Peng
- Department of Long-Term Care, Jen-Ai hospital, Taichung, Taiwan
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Chen YH, Chang CY, Huang SK, Yen NS. Nonlinear engagement of action observation network underlying action anticipation in players with different levels of expertise. Hum Brain Mapp 2020; 41:5199-5214. [PMID: 32845066 PMCID: PMC7670634 DOI: 10.1002/hbm.25186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/27/2020] [Revised: 08/04/2020] [Accepted: 08/10/2020] [Indexed: 12/26/2022] Open
Abstract
The goal of this study was to reconcile inconsistency of neural engagement underlying action anticipation between experts and nonexperts, as well as between correct and incorrect anticipations. Therefore, we asked novice, intermediate, and skilled baseball batters (N, IB, and SB) to anticipate their swing decisions in response to pitching videos of a strike or ball, using functional magnetic resonance imaging. Behavioral results confirmed the effect of expertise that is generally shown in a linear fashion. Imaging results instead revealed a nonlinear relationship between expertise level and the evoked response amplitude of nodes within the action observation network. The relationship was best captured by an inverted U‐shaped quadratic response profile across the three groups such that IB exhibited higher activation than did both SB and N. These empirical findings extend the framework of predictive coding as well as of neural efficiency in anticipating the action of others, and they might be associated with the underlying process to interpret the goal of the observed action and prepare one's own response. Furthermore, the right anterior cerebellum showed different levels of activation for correct and incorrect anticipations in all groups, adding novel evidence of its subtle involvement in anticipation processes irrespective of expertise status.
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Affiliation(s)
- Yin-Hua Chen
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan
| | - Chih-Yen Chang
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan.,Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan
| | - Shih-Kuei Huang
- Department of Physical Education, Chinese Culture University, Taipei, Taiwan
| | - Nai-Shing Yen
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
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Chang CY, Husseini JS, Moreira A, Simeone FJ, Yee AJ, Bredella MA, Hasserjian R. CT-guided bone marrow aspirations and biopsies: retrospective study and comparison with blind procedures. Skeletal Radiol 2020; 49:1285-1294. [PMID: 32232499 DOI: 10.1007/s00256-020-03423-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/14/2020] [Accepted: 03/16/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the pathology results of CT-guided and blind bone marrow aspirations and biopsies. METHODS Ninety-eight consecutive CT-guided biopsies and 98 age- and gender-matched blind (non-CT-guided) posterior iliac crest bone marrow aspirations and biopsies performed in 2017 were reviewed for adequacy of core biopsies and aspirate smears. CT procedure images and CT abdomen/pelvis images were reviewed to evaluate anatomic features of the posterior ilium and soft tissues. Statistical analysis was performed using a T test, Fisher exact test, and Kruskal-Wallis test. RESULTS There was no significant difference in the age and gender of the two groups (p > 0.05). However, the CT-guided group had a higher BMI (p = 0.0049) and posterior soft tissue thickness (p = 0.0016). More CT-guided biopsy samples (CT 93 (95%); blind 77 (79%); p = 0.0006) and aspirate smears (CT 90 (92%); blind 78 (80%); p = 0.042) were categorized as adequate. The CT-guided group had longer core lengths (CT 1.4 ± 0.6 (range 0.3-3.5) cm; blind 1.0 ± 0.60 (range 0-2.6) cm; p = 0.0001). Overall, 131/164 (80%) of the cases had at least one of the described features (slanted posterior ilium (angle > 30°), 30%; rounded posterior ilium, 20%; thick posterior ilium cortex, 13%; focal lesion in posterior ilium, 12%; prior procedure in posterior ilium, 5%; posterior soft tissue thickness > 3 cm, 40%). CONCLUSION CT-guided bone marrow procedures were more likely to result in both adequate aspirate smears and biopsy samples and longer core lengths when compared with blind procedures.
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Affiliation(s)
- C Y Chang
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Cambridge, MA, USA.
| | - J S Husseini
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Cambridge, MA, USA
| | - A Moreira
- Department of Radiology, Centro Hospitalar São João, Porto, Portugal
| | - F J Simeone
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - A J Yee
- Harvard Medical School, Cambridge, MA, USA.,Division of Hematology and Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - M A Bredella
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Cambridge, MA, USA
| | - R Hasserjian
- Harvard Medical School, Cambridge, MA, USA.,Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
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Thacker M, Tseng CL, Chang CY, Jakfar S, Chen HY, Lin FH. Mucoadhesive Bletilla striata Polysaccharide-Based Artificial Tears to Relieve Symptoms and Inflammation in Rabbit with Dry Eyes Syndrome. Polymers (Basel) 2020; 12:polym12071465. [PMID: 32629860 PMCID: PMC7407882 DOI: 10.3390/polym12071465] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/13/2020] [Accepted: 06/27/2020] [Indexed: 12/13/2022] Open
Abstract
Dry eye syndrome (DES) is a multifactorial disorder of the ocular surface affecting many people all over the world. However, there have been many therapeutic advancements for the treatment of DES, substantial long-term treatment remains a challenge. Natural plant-based polysaccharides have gained much importance in the field of tissue engineering for their excellent biocompatibility and unique physical properties. In this study, polysaccharides from a Chinese ground orchid, Bletilla striata, were successfully extracted and incorporated into the artificial tears for DES treatment due to its anti-inflammatory and mucoadhesive properties. The examination for physical properties such as refractive index, pH, viscosity and osmolality of the Bletilla striata polysaccharide (BSP) artificial tears fabricated in this study showed that it was in close association with that of the natural human tears. The reactive oxygen species (ROS) level and inflammatory gene expression tested in human corneal epithelium cells (HCECs) indicated that the low BSP concentrations (0.01–0.1% v/v) could effectively reduce inflammatory cytokines (TNF, IL8) and ROS levels in HCECs, respectively. Longer retention of the BSP-formulated artificial tears on the ocular surface is due to the mucoadhesive nature of BSP allowing lasting lubrication. Additionally, a rabbit’s DES model was created to evaluate the effect of BSP for treating dry eye. Schirmer test results exhibited the effectiveness of 0.1% (v/v) BSP-containing artificial tears in enhancing the tear volume in DES rabbits. This work combines the effectiveness of artificial tears and anti-inflammatory herb extract (BSP) to moisturize ocular surface and to relieve the inflammatory condition in DES rabbit, which further shows great potential of BSP in treating ocular surface diseases like DES in clinics in the future.
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Affiliation(s)
- Minal Thacker
- Graduate Institute of Biomedical Engineering, National Taiwan University, No.49, Fanglan Road, Daan District, Taipei 10051, Taiwan; (M.T.); (C.-Y.C.); (S.J.); (H.Y.C.)
| | - Ching-Li Tseng
- Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, No. 250 Wu-Xing Street, Taipei 11031, Taiwan;
| | - Chih-Yen Chang
- Graduate Institute of Biomedical Engineering, National Taiwan University, No.49, Fanglan Road, Daan District, Taipei 10051, Taiwan; (M.T.); (C.-Y.C.); (S.J.); (H.Y.C.)
| | - Subhaini Jakfar
- Graduate Institute of Biomedical Engineering, National Taiwan University, No.49, Fanglan Road, Daan District, Taipei 10051, Taiwan; (M.T.); (C.-Y.C.); (S.J.); (H.Y.C.)
| | - Hsuan Yu Chen
- Graduate Institute of Biomedical Engineering, National Taiwan University, No.49, Fanglan Road, Daan District, Taipei 10051, Taiwan; (M.T.); (C.-Y.C.); (S.J.); (H.Y.C.)
| | - Feng-Huei Lin
- Graduate Institute of Biomedical Engineering, National Taiwan University, No.49, Fanglan Road, Daan District, Taipei 10051, Taiwan; (M.T.); (C.-Y.C.); (S.J.); (H.Y.C.)
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli County 35053, Taiwan
- Correspondence: ; Tel.: +886-928260400
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14
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Kuo JH, Chang CC, Chen CW, Liang HH, Chang CY, Chu YW. Sequence-based Structural B-cell Epitope Prediction by Using Two Layer SVM Model and Association Rule Features. Curr Bioinform 2020. [DOI: 10.2174/1574893614666181123155831] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Immune reaction is the most important defense mechanism for destroying
invading pathogens in our body, and the epitope is the position of the antigen–antibody interaction
on pathogenic proteins.
Objective:
The majority of epitopes are structural; however, the existing sequence-based predicting
websites still have several methods to improve the predicting performance. Therefore, in this
study, we used SVM as a machine learning tool to predict the epitope-based on protein sequences.
Methods:
Firstly, we built five SVM models in the first layer according to five features, including
binary composition, position-specific scoring matrix, secondary structure, accessible surface area,
and association rule, and then chose the patterns that exhibited the best performance in each
model. Secondly, using the confidence score of the first-layer models as the input value for the
SVM model in the second layer, that SVM model was integrated into the first-layer SVM models
for improving the predicting accuracy.
Results:
The final prediction model was able to achieve up to 63% accuracy in predicting epitope
results, and the predicting performance was better than that achieved by the existing predicting
websites.
Conclusion:
Finally, a case study using a two-subunit cytochrome c oxidase of Paracoccus
denitrificans was tested, achieving an accuracy of up to 66%.
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Affiliation(s)
- Jehn-Hwa Kuo
- Department of Urology, Jen-Ai Hospital, Taichung, Taiwan, China
| | - Chi-Chang Chang
- School of Medical Informatics, Chung Shan Medical University, Taiwan, China
| | - Chi-Wei Chen
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung, Taiwan, China
| | - Heng-Hao Liang
- Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan, China
| | - Chih-Yen Chang
- Department of Medical Education and Research, Jen-Ai Hospital, Taichung, Taiwan, China
| | - Yen-Wei Chu
- Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan, China
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15
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Chang CY, Hsieh YP, Lan SJ, Ho CS. SHS exposure among high school students in Taiwan. Journal of Substance Use 2019. [DOI: 10.1080/14659891.2019.1652363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Chih-Yen Chang
- Department of Medical Education and Research, Jen-Ai Hospital, Taichung, Taiwan R.O.C
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan R.O.C
| | - Yen-Ping Hsieh
- Department of Long-term Care, National Quemoy University, Kinmen, Taiwan R.O.C
| | - Shou-Jen Lan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, R.O.C
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, R.O.C
| | - Ching-Sung Ho
- Department of Long-term Care, National Quemoy University, Kinmen, Taiwan R.O.C
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16
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Chen CH, Chen YM, Chang YJ, Wang SH, Chang CY, Yen HC. Continuous versus intermittent infusions of antibiotics for the treatment of infectious diseases: Meta-analysis and systematic review. Medicine (Baltimore) 2019; 98:e14632. [PMID: 30855448 PMCID: PMC6417613 DOI: 10.1097/md.0000000000014632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 11/26/2022] Open
Abstract
BACKGROUND Severe sepsis and pneumonia are common problems in the intensive care units (ICUs) and cause high morbidity and mortality. Optimal doses and appropriate routes of antibiotics are critical to improve their efficacy, but their appropriate routes remain controversial. OBJECTIVE The efficacy of antibiotic administration among critically ill patient populations remains controversial. Therefore, the present meta-analysis aimed to investigate the effectiveness of antibiotic administration in patients with infection and to assess whether the effect differs between the two antibiotic administration types. METHODS A systematic search of studies on continuous infusions of intravenous antibiotics and traditional intermittent infusions of antibiotics for patients with infection was performed mainly in PubMed. The odds ratios (ORs) of the microbiological results as primary outcome and mortality rate, length of stay, and duration of antibiotic treatment as secondary outcomes were evaluated. RESULTS The meta-analysis comprised 9 randomized controlled trials (RCTs) and 4 retrospective studies comprising 1957 participants. Current analysis showed that the overall OR of clinical success between the continuous and intermittent groups was 0.675 (95% confidence interval [CI]: 0.523-0.870). Comparing continuous and intermittent groups, the subgroup analysis showed a lower ICU stay (OR 0.834, 95% CI: 0.542-1.282), a higher mortality (OR 1.433, 95% CI: 1.139-1.801), and a longer antibiotic duration (OR 1.055, 95% CI: 0.659-1.689), but the results of present meta-analysis were not significant because of the limited number of enrolled trials. LIMITATIONS Heterogeneity of included trials and studies. CONCLUSIONS The results of present meta-analysis were insufficient to recommend continuous infusion of intravenous antibiotics better than traditional intermittent infusions of antibiotics at routine clinical care. Hope large-scale RCT to provide more rebuts evidence for making recommendations to warrant continuous infusions of intravenous antibiotics at clinical practice.
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Affiliation(s)
- Chang-Hua Chen
- Division of Infectious Disease, Department of Internal Medicine
- Center for Infection Prevention and and Control
- PhD Program in Translational Medicine
- Rong Hsing Research Center For Translational Medicine, National Chung Hsing University, Taichung County, Taiwan
| | | | | | | | - Chih-Yen Chang
- Division of Infectious Disease, Department of Internal Medicine
| | - Hua-Cheng Yen
- Department of Neurosurgery, Changhua Christian Hospital, Changhua
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17
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Chang CY, Abujaber S, Pany MJ, Obermeyer Z. Are vital sign abnormalities associated with poor outcomes after emergency department discharge? Acute Med 2019; 18:88-95. [PMID: 31127797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To examine association between vital sign abnormalities in the emergency department (ED) and early death after ED discharge, we performed a matched case-control study. Conditional logistic regression showed that presence of any vital sign abnormality at ED discharge was significantly associated with over three-fold increase in likelihood of death within 15 days of ED discharge (OR: 3.06, 95%CI: 2.81-4.48). Even small changes were associated with increased risk: every additional beat increase in heart rate conferred additional risk (OR: 1.04, 95%CI: 1.02-1.06), while every additional oxygen saturation percentage point was protective (0.89, 0.80-0.98). However, none of these vital sign abnormalities was a good predictor of early death; there was poor discrimination and substantial overlap in values between cases and controls.
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Affiliation(s)
- C Y Chang
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - S Abujaber
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - M J Pany
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Z Obermeyer
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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18
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Chang CY, Ho CS. E-cigarette exposure among high schools students in Taiwan. Journal of Substance Use 2018. [DOI: 10.1080/14659891.2018.1537383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Chih-Yen Chang
- Department of Medical Education and Research, Jen-Ai Hospital, Taichung, Taiwan
- Department of Golden-Ager Industry Management, Chaoyang University of Technology, Taichung, Taiwan
| | - Ching-Sung Ho
- Department of Long Term Care, National Quemoy University, Kinmen, Taiwan
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19
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Chang CY, Yuan FG. Extraction of guided wave dispersion curve in isotropic and anisotropic materials by Matrix Pencil method. Ultrasonics 2018; 89:143-154. [PMID: 29803979 DOI: 10.1016/j.ultras.2018.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 06/08/2023]
Abstract
Guided wave dispersion curves in isotropic and anisotropic materials are extracted automatically from measured data by Matrix Pencil (MP) method investigating through k-t or x-ω domain with a broadband signal. A piezoelectric wafer emits a broadband excitation, linear chirp signal to generate guided waves in the plate. The propagating waves are measured at discrete locations along the lines for one-dimensional laser Doppler vibrometer (1-D LDV). Measurements are first Fourier transformed into either wavenumber-time k-t domain or space-frequency x-ω domain. MP method is then employed to extract the dispersion curves explicitly associated with different wave modes. In addition, the phase and group velocity are deduced by the relations between wavenumbers and frequencies. In this research, the inspections for dispersion relations on an aluminum plate by MP method from k-t or x-ω domain are demonstrated and compared with two-dimensional Fourier transform (2-D FFT). Other experiments on a thicker aluminum plate for higher modes and a composite plate are analyzed by MP method. Extracted relations of composite plate are confirmed by three-dimensional (3-D) theoretical curves computed numerically. The results explain that the MP method not only shows more accuracy for distinguishing the dispersion curves on isotropic material, but also obtains good agreements with theoretical curves on anisotropic and laminated materials.
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Affiliation(s)
- C Y Chang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, United States; Integrated System Health Management Laboratory ISHM, National Institute of Aerospace, 100 Exploration Way, Hampton, VA 23666, United States
| | - F G Yuan
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, United States; Integrated System Health Management Laboratory ISHM, National Institute of Aerospace, 100 Exploration Way, Hampton, VA 23666, United States.
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20
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Chang CY, Chen YH, Yen NS. Nonlinear neuroplasticity corresponding to sports experience: A voxel-based morphometry and resting-state functional connectivity study. Hum Brain Mapp 2018; 39:4393-4403. [PMID: 29956410 DOI: 10.1002/hbm.24280] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 03/17/2018] [Revised: 05/15/2018] [Accepted: 06/03/2018] [Indexed: 12/11/2022] Open
Abstract
We aimed to investigate the structural neuroplasticity associated with different levels of sports experience and its effect on the corresponding resting-state functional circuitry. We recruited 18 skilled baseball batters (SB), 19 intermediate baseball batters (IB), and 17 healthy controls (HC), and used magnetic resonance imaging methods to compare their regional gray-matter volume (GMV) and seed-based resting-state functional connectivity (rsFC). Our results revealed that a quadratic function could better depict intergroup differences in regional GMV than a linear function. In particular, the IB showed lower or higher regional GMV than the other two groups. The difference in GMV in the supplementary motor area and areas belonging to the ventral stream, including the middle temporal gyrus and middle temporal pole, might be possibly related to baseball-specific motor and perceptual experience, such as inhibitory action control and pitch identification. On the other hand, the stronger rsFC seeded from the right middle temporal pole to the default mode network, particularly in the precuneus, in the SB and IB relative to that in the HC might be possibly associated with the theory of mind, such as deciding whether to swing or not against the pitcher by detecting the spatial information of pitches. In conclusion, our three-group design enabled the capture of the unique and transient changes that occur during the intermediate phase of expertise development. Our findings indicated that structural and functional brain changes do not necessarily linearly increase as a function of experience as previously suggested by the literature.
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Affiliation(s)
- Chih-Yen Chang
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan
| | - Yin-Hua Chen
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan
| | - Nai-Shing Yen
- Research Center for Mind, Brain, and Learning, National Chengchi University, Taipei, Taiwan.,Department of Psychology, National Chengchi University, Taipei, Taiwan
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21
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Fan CC, Chiu YC, Liu C, Lai WW, Cheng CH, Lin DL, Li GR, Lo YH, Chang CW, Tsai CC, Chang CY. The Impact of the Shallow-Trench Isolation Effect on Flicker Noise of Source Follower MOSFETs in a CMOS Image Sensor. J Nanosci Nanotechnol 2018; 18:4217-4221. [PMID: 29442765 DOI: 10.1166/jnn.2018.15239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The flicker noise of source follower transistors is the dominant noise source in image sensors. This paper reports a systematic study of the shallow trench isolation effect in transistors with different sizes under high temperature conditions that correspond to the quantity of empty defect sites. The effects of shallow trench isolation sidewall defects on flicker noise characteristics are investigated. In addition, the low-frequency noise and subthreshold swing degrade simultaneously in accordance to the device gate width scaling. Both serious subthreshold leakage and considerable noise can be attributed to the high trap density near the STI edge. Consequently, we propose a coincidental relationship between the noise level and the subthreshold characteristic; its trend is identical to the experiments and simulation results.
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Affiliation(s)
- C C Fan
- Department of Electronics Engineering, National Chiao Tung University, Hsinchu City 30010, Taiwan
| | - Y C Chiu
- Department of Electronics Engineering, National Chiao Tung University, Hsinchu City 30010, Taiwan
| | - C Liu
- Department of Electro-Physics, National Chiao Tung University, Hsinchu City 30010, Taiwan
| | - W W Lai
- Department of Electronics Engineering, National Chiao Tung University, Hsinchu City 30010, Taiwan
| | - C H Cheng
- Department of Mechatronic Engineering, National Taiwan Normal University, Taipei, 106, Taiwan
| | - D L Lin
- Himax Technologies, Inc., Tainan City 74148, Taiwan
| | - G R Li
- Himax Technologies, Inc., Tainan City 74148, Taiwan
| | - Y H Lo
- Himax Technologies, Inc., Tainan City 74148, Taiwan
| | - C W Chang
- Himax Technologies, Inc., Tainan City 74148, Taiwan
| | - C C Tsai
- Himax Technologies, Inc., Tainan City 74148, Taiwan
| | - C Y Chang
- Department of Electronics Engineering, National Chiao Tung University, Hsinchu City 30010, Taiwan
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22
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Chen CH, Kuo CY, Chen SH, Mao SH, Chang CY, Shalumon KT, Chen JP. Thermosensitive Injectable Hydrogel for Simultaneous Intraperitoneal Delivery of Doxorubicin and Prevention of Peritoneal Adhesion. Int J Mol Sci 2018; 19:E1373. [PMID: 29734717 PMCID: PMC5983626 DOI: 10.3390/ijms19051373] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/26/2018] [Accepted: 05/02/2018] [Indexed: 01/04/2023] Open
Abstract
To improve intraperitoneal chemotherapy and to prevent postsurgical peritoneal adhesion, we aimed to develop a drug delivery strategy for controlled release of a chemotherapeutic drug from the intraperitoneally injected thermosensitive poly(N-isopropylacrylamide)-based hydrogel (HACPN), which is also endowed with peritoneal anti-adhesion properties. Anticancer drug doxorubicin (DOX) was loaded into the hydrogel (HACPN-DOX) to investigate the chemotherapeutic and adhesion barrier effects in vivo. A burst release followed by sustained release of DOX from HACPN-DOX was found due to gradual degradation of the hydrogel. Cell culture studies demonstrated the cytotoxicity of released DOX toward CT-26 mouse colon carcinoma cells in vitro. Using peritoneal carcinomatosis animal model in BALB/c mice with intraperitoneally injected CT-26 cells, animals treated with HACPN-DOX revealed the best antitumor efficacy judging from tumor weight and volume, survival rate, and bioluminescence signal intensity when compared with treatment with free DOX at the same drug dosage. HACPN (or HACPN-DOX) also significantly reduced the risk of postoperative peritoneal adhesion, which was generated by sidewall defect-cecum abrasion in tumor-bearing BALB/c mice, from gross and histology analyses. This study could create a paradigm to combine controlled drug release with barrier function in a single drug-loaded injectable hydrogel to enhance the intraperitoneal chemotherapeutic efficacy while simultaneously preventing postsurgical adhesion.
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Affiliation(s)
- Chih-Hao Chen
- Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 33302, Taiwan.
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Chang Gung University School of Medicine, Kwei-San, Taoyuan 33305, Taiwan.
| | - Chang-Yi Kuo
- Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 33302, Taiwan.
| | - Shih-Hsien Chen
- Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 33302, Taiwan.
| | - Shih-Hsuan Mao
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Chang Gung University School of Medicine, Kwei-San, Taoyuan 33305, Taiwan.
| | - Chih-Yen Chang
- Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 33302, Taiwan.
| | - K T Shalumon
- Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 33302, Taiwan.
| | - Jyh-Ping Chen
- Department of Chemical and Materials Engineering, Chang Gung University, Kwei-San, Taoyuan 33302, Taiwan.
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Chang Gung University School of Medicine, Kwei-San, Taoyuan 33305, Taiwan.
- Research Center for Food and Cosmetic Safety, Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 33302, Taiwan.
- Department of Materials Engineering, Ming Chi University of Technology, Tai-Shan, New Taipei City 24301, Taiwan.
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23
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Ohshio G, Yamaki K, Imamura T, Suwa H, Chang CY, Wada H, Sueno Y, Imamura M. Distribution of the Carbohydrate Antigens, Du-Pan-2 and Ca19-9, in Tumors of the Lung. Tumori 2018; 81:67-73. [PMID: 7754546 DOI: 10.1177/030089169508100116] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background The carbohydrate chains of malignant cells appear to be related to oncofetal differentiation. The serum levels of CA19-9 have been reported to be evaluated in some patients with lung carcinomas, however, the distribution of carbohydrate antigens were not precisely described. We have investigated in this study the distribution of DU-PAN-2 and CA19-9 antigens in lung tumors. Methods Ninety five specimens of lung tumors were selected from surgical specimens. The expression of DU-PAN-2 and CA19-9 were studied by immunohystochemical techniques. The relationship between the expression of these antigens and the classification or the differentiation degree of the tumors were examined. Results DU-PAN-2 or CA19-9 antigens were detected in 41 (54%) and 45 (59%) cases of the 76 malignant epithelial tumors investigated. These antigens were detected in all types of malignant epithelial tumors, including squamous cell carcinomas, where they were mainly localized to the entire cell surface of malignant cells. In adenocarcinomas, large cell carcinomas and small cell carcinomas, however, these antigens were commonly detected both on the cell membrane and in the cytoplasm. There was positive correlation between the degree of differentiation and DU-PAN-2, but not CA19-9 expression. Among the non-epithelial tumors investigated, those antigens were detected in pulmonary blastomas but not in mesotheliomas. Conclusions Immunohistochemical studies for DU-PAN-2 and CA19-9 are useful for defining characteristics of the lung tumors. DU-PAN-2 could be a marker for differentiating between malignant epithelial tumors and mesotheliomas.
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Affiliation(s)
- G Ohshio
- Department of Surgery and Thoracic Surgery, Kyoto University, Japan
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24
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Choi D, Wishon MJ, Chang CY, Citrin DS, Locquet A. Multistate intermittency on the route to chaos of a semiconductor laser subjected to optical feedback from a long external cavity. Chaos 2018; 28:011102. [PMID: 29390638 DOI: 10.1063/1.5013332] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We observe experimentally two regimes of intermittency on the route to chaos of a semiconductor laser subjected to optical feedback from a long external cavity as the feedback level is increased. The first regime encountered corresponds to multistate intermittency involving two or three states composed of several combinations of periodic, quasiperiodic, and subharmonic dynamics. The second regime is observed for larger feedback levels and involves intermittency between period-doubled and chaotic regimes. This latter type of intermittency displays statistical properties similar to those of on-off intermittency.
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Affiliation(s)
- Daeyoung Choi
- Georgia Tech-CNRS UMI 2958, Georgia Tech Lorraine, 2 Rue Marconi, F-57070 Metz, France
| | - Michael J Wishon
- Georgia Tech-CNRS UMI 2958, Georgia Tech Lorraine, 2 Rue Marconi, F-57070 Metz, France
| | - C Y Chang
- Georgia Tech-CNRS UMI 2958, Georgia Tech Lorraine, 2 Rue Marconi, F-57070 Metz, France
| | - D S Citrin
- Georgia Tech-CNRS UMI 2958, Georgia Tech Lorraine, 2 Rue Marconi, F-57070 Metz, France
| | - A Locquet
- Georgia Tech-CNRS UMI 2958, Georgia Tech Lorraine, 2 Rue Marconi, F-57070 Metz, France
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Abstract
Bloodstream infections (BSIs) due to vancomycin-resistant Enterococcus faecium (VREfae) remain a therapeutic challenge. This study aimed to evaluate mortality from BSIs due to VREfae in Central Taiwan.We retrospectively analyzed patients with significant VREfae BSIs in the Changhua Christian Hospital System between January 1, 2010 and December 31, 2014.Of the 152 patients with Enterococcal BSI, 56 patients (36.8%) were admitted to intensive care units (ICUs) at the onset of BSI and 20 (13.2%) patients were associated with polymicrobial bacteremia. VREfae BSI was observed in 36 (23.7%) patients. Van A (100%) is the prevalence genotype, and ST 17 (41.7%) is the predominant ST type among 36 VREfae isolates during the study period. The 30-day mortality rate was 13.2% (20/152). The multivariate logistic regression analysis showed that the onset of VREfae BSI in the ICU (odds ratio [OR] = 4.2, 95% confidence interval [CI] = 1.7-10.0, P = .002) was a significant risk factor for 30-day mortality, whereas an appropriate antimicrobial therapy was a protective factor for 30-day mortality (OR = 0.33, 95% CI = 0.14-0.79, P = .013).Our results underscore the need to assist patients who are admitted to ICUs with VREfae BSIs. We emphasize the use of an appropriate antimicrobial therapy for VREfae BSI with the aim to treat more patients with these infections.
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Affiliation(s)
- Chang-Hua Chen
- Center of Infection Prevention and Control
- Division of Infectious Diseases, Department of Internal Medicine, Yuanlin Christian Hospital, Changhua
- Department of Nursing, College of Medicine & Nursing, Hung Kuang University, Sha-lu District, Taichung
| | | | - Yu-Jun Chang
- Epidemiology and Biostatics Center, Changhua Christian Hospital
| | - Chih-Yen Chang
- Department of Internal Medicine,Yuanlin Christian Hospital, Changhua, Taiwan
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26
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Le AK, Zhao C, Hoang JK, Tran SA, Chang CY, Jin M, Nguyen NH, Yasukawa LA, Zhang JQ, Weber SC, Garcia G, Nguyen MH. Ethnic disparities in progression to advanced liver disease and overall survival in patients with chronic hepatitis C: impact of a sustained virological response. Aliment Pharmacol Ther 2017; 46:605-616. [PMID: 28766727 DOI: 10.1111/apt.14241] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 06/04/2017] [Accepted: 07/08/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic hepatitis C (CHC) can lead to cirrhosis and hepatocellular carcinoma (HCC). A sustained virological response (SVR) is associated with improved outcomes, however, its impact on different ethnic groups is unknown. AIM To evaluate ethnic differences in the natural history of CHC and the impact of SVR. METHODS We conducted a cohort study of 8039 consecutive adult CHC patients seen at two medical centres in California between January 1997 and June 2016. Individual chart review confirmed CHC diagnosis. RESULTS Asian and Hispanic but not African American patients had significantly higher cirrhosis and HCC incidence than Caucasians. On multivariate analysis, Hispanic ethnicity was independently associated with increased cirrhosis (adjusted HR 1.37, CI, confidence interval 1.10-1.71, P=.006) and HCC risk (adjusted HR 1.47, CI 1.13-1.92, P=.004) compared to Caucasian. Asian ethnicity had a significant association with cirrhosis (adjusted HR 1.28, CI 1.02-1.61, P=.034) and HCC risk (adjusted HR 1.29, CI 0.94-1.77, P=.025). In patients who achieved SVR, Hispanic ethnicity was no longer independently associated with cirrhosis (adjusted HR 1.76, CI 0.66-4.71, P=.26) or HCC (adjusted HR 1.05, CI 0.27-4.08, P=.94); nor was Asian ethnicity (adjusted HR 0.62, CI 0.21-1.82, P=.38 for cirrhosis; 2.01, CI 0.63-6.36, P=.24 for HCC). Similar findings were observed with overall survival among the ethnicities by SVR status. CONCLUSION Hispanic and Asian ethnicity was independently associated with increased cirrhosis and HCC risk. Achieving an SVR eliminates the ethnic disparity in liver disease progression and overall survival between Hispanic and Asian vs Caucasian CHC patients.
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Affiliation(s)
- A K Le
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - C Zhao
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.,Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital, Shanghai, China
| | - J K Hoang
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - S A Tran
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.,Stanford University, Palo Alto, CA, USA
| | - C Y Chang
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.,David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - M Jin
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.,Department of Epidemiology and Biostatistics, Zhejiang University, Hangzhou, China
| | - N H Nguyen
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA.,Department of Medicine, University of California, San Diego, San Diego, CA, USA
| | - L A Yasukawa
- Center for Clinical Informatics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - J Q Zhang
- Chinese Hospital, San Francisco, CA, USA
| | - S C Weber
- Center for Clinical Informatics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - G Garcia
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
| | - M H Nguyen
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
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Abstract
For dental orthodontic applications, NiTi wires are used under bending conditions in the oral environment for a long period. The purpose of this study was to investigate the effect of bending stress on the corrosion of NiTi wires using potentiodynamic and potentiostatic tests in artificial saliva. The results indicated that bending stress induces a higher corrosion rate of NiTi wires in passive regions. It is suggested that the passive oxide film of specimens would be damaged under bending conditions. Auger electron spectroscopic analysis showed a lower thickness of passive films on stressed NiTi wires compared with unstressed specimens in the passive region. By scanning electron microscopy, localized corrosion was observed on stressed Sentalloy specimens after a potentiodynamic test at pH 2. In conclusion, this study indicated that bending stress changed the corrosion properties and surface characteristics of NiTi wires in a simulated intra-oral environment.
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Affiliation(s)
- I H Liu
- Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
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Lutchman G, Nguyen NH, Chang CY, Ahmed A, Daugherty T, Garcia G, Kumari R, Gupta S, Doshi D, Nguyen MH. Effectiveness and tolerability of simeprevir and sofosbuvir in nontransplant and post-liver transplant patients with hepatitis C genotype 1. Aliment Pharmacol Ther 2016; 44:738-46. [PMID: 27506182 DOI: 10.1111/apt.13761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 06/16/2016] [Accepted: 07/21/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hepatitis C virus genotype 1a (HCV-1a), prior treatment, cirrhosis and post-transplant status are historically associated with poor treatment responses. The new oral direct-acting agents appear to be effective and safe in these patients. AIMS To evaluate the effectiveness and tolerability of simeprevir and sofosbuvir in a diverse real-life cohort of patients, including difficult-to-treat patients. METHODS We conducted a retrospective cohort study in 198 consecutive patients with hepatitis C genotype 1 (148 nontransplant, 50 post transplant), who were treated with simeprevir and sofosbuvir for 12 weeks between December 2013 and December 2014. Primary outcome was sustained virological response with undetectable HCV RNA 12 weeks after completion of therapy (SVR12). Risk factors evaluated for lack of SVR12 included HCV 1a (vs. 1b), prior treatment (vs. none), and cirrhosis (vs. no cirrhosis). RESULTS SVR12 rates were similar in non- and post-transplant settings, 82% and 88%, respectively. There were no significant differences in adverse events in patients regardless of cirrhosis or transplant status. On multivariate analysis also inclusive of gender and liver transplant status, negative predictors of SVR12 were having at least 2 or 3 risk factors (OR 0.30, 95% CI 0.10-0.87, P = 0.027 or 0.29, 95% CI 0.09-0.85, P = 0.025, respectively). CONCLUSION Simeprevir and sofosbuvir combination is a safe and effective regimen for the treatment of non- and post-transplant patients with traditional risk factors for poor treatment response, unless more than 2 difficult-to-treat risk factors are present.
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Affiliation(s)
- G Lutchman
- Gastroenterology and Hepatology, Liver Transplant Program, Stanford University Medical Center, Palo Alto, CA, USA
| | - N H Nguyen
- School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - C Y Chang
- Gastroenterology and Hepatology, Liver Transplant Program, Stanford University Medical Center, Palo Alto, CA, USA
| | - A Ahmed
- Gastroenterology and Hepatology, Liver Transplant Program, Stanford University Medical Center, Palo Alto, CA, USA
| | - T Daugherty
- Gastroenterology and Hepatology, Liver Transplant Program, Stanford University Medical Center, Palo Alto, CA, USA
| | - G Garcia
- Gastroenterology and Hepatology, Liver Transplant Program, Stanford University Medical Center, Palo Alto, CA, USA
| | - R Kumari
- Gastroenterology and Hepatology, Liver Transplant Program, Stanford University Medical Center, Palo Alto, CA, USA
| | - S Gupta
- Medical Affairs, Janssen Scientific Affairs, Titusville, NJ, USA
| | - D Doshi
- Health Economics & Outcomes Research, Janssen Scientific Affairs, Titusville, NJ, USA
| | - M H Nguyen
- Gastroenterology and Hepatology, Liver Transplant Program, Stanford University Medical Center, Palo Alto, CA, USA
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Chiou SY, Lee RC, Chi KH, Chia-Hsien Cheng J, Chiang JH, Chang CY. The triple-phase CT image appearance of post-irradiated livers. Acta Radiol 2016; 42:526-31. [PMID: 11552892 DOI: 10.1080/028418501127347115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective To evaluate the sequential CT appearance of the liver after hepatic irradiation and to investigate the correlation between CT findings and radiation-induced hepatic injury. Material and Methods: The triple-phase CT images of 18 patients with hepatocellular carcinomas (HCC) after hepatic irradiation were retrospectively reviewed (in total 41 CT studies). The high-dose region within the liver was defined as the area receiving more than 90% of the prescribed irradiation dose. The mean radiation dose was 55.5 Gy. Density changes and patterns of enhancement in the high-dose region were classified as three types: type I, constant low-density change in all phases; type II, low-density change in both pre-contrast and arterial phases, and iso-density change in the portal phase; type III, low- or iso-density change in the pre-contrast phase, low- or high-density change in the arterial phase, and persistent high-density change in the portal phase. The interval between completion of radiotherapy and the CT examinations ranged from 9 to 469 days, with a mean of 147 days. Results: Nine of the 41 CT studies presented with type I, 9 with type II, and 16 with type III CT findings. The mean interval between completion of radiotherapy and the appearance of types I, II, and III CT findings were 74, 183, and 220 days, respectively. The interval was significantly shorter for type I findings than for type II and type III. The difference in interval was not significant between type II and type III. A type I finding with constant low-density change in the high-dose region of the liver was the most common pattern of CT findings within the first 3 months after hepatic irradiation. Either types II or III findings were frequently seen after 3 months. Conclusion: The sequential CT appearance and the density changes may indicate correlation with the pathogenesis of veno-occlusive disease.
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Affiliation(s)
- S Y Chiou
- Department of Radiology, Veterans General Hospital-Taipei, Taipei, Taiwan
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Abstract
Postcraniotomy meningitis (PCM) is a major challenge in neurosurgery, and changing patterns of infectious agents in PCM have been noted. The limited epidemiological data and urgent clinical needs motivated this research. We conducted this study to determine a risk assessment for PCM and the current pattern of infectious agents.We performed a retrospective case-control study of significant cases of postcraniotomy meningitis in the Changhua Christian Hospital System between January 1, 2008, and December 31, 2012. Postcraniotomy meningitis was diagnosed in 22 out of 4392 surgical patients; this data was reviewed for risk assessment.This study assessed the risk factors for postcraniotomy meningitis and found that it was more frequently seen in patients who were elderly (OR = 1.57, 95% CI = 1.32-2.98, P = 0.013), underwent emergency procedures (OR = 4.82, 95% CI = 1.50-14.53, P = 0.008), had leak of cerebrospinal fluid (OR = 4.62, 95% CI = 2.03-10.50, P = 0.012), had external ventricular drainage (OR = 4.68, 95% CI = 2.46-8.87, P = 0.006), were admitted to the intensive care unit (OR = 2.41, 95% CI = 1.53-8.08, P = 0.012), had used drain placement >72 hours (OR = 2.66, 95% CI = 1.04-4.29, P = 0.007), had surgery >4.5 hours (OR = 2.38, 95% CI = 1.39-4.05, P = 0.005), had repeat operations (OR = 2.74, 95% CI = 1.31-5.73, P = 0.018), endured trauma (OR = 5.97, 95% CI = 1.57-17.61, P = 0.007), or had 30-days mortality (OR = 5.07, 95% CI = 2.20-11.48, P = 0.001). The predominant pathogens isolated from cerebrospinal fluid were Staphylococcus aureus in 8 patients (36.7%) and Acinetobacter baumannii in 7 patients (31.8%). In our study, the mortality rate was 5.1% among all postcraniotomy patients.Accurate risk assessment, early diagnosis, and choice of appropriate antibiotics in accordance with epidemiologic information are the cornerstones of reducing mortality and morbidity in PCM. The changing pattern of infectious agents in PCM over time suggests the necessity of further studies to provide the most up-to-date insight to physicians.
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Affiliation(s)
- Chang-Hua Chen
- Division of Infectious Disease, Department of Internal Medicine
- Infection Control Committee
- Department of Nursing, College of Medicine and Nursing, Hung Kuang University, Taichung County, Taiwan
| | - Chih-Yen Chang
- Division of Infectious Disease, Department of Internal Medicine
| | | | | | | | - Shu-Hui Wang
- Division of Critical Care Medicine Changhua Christian Hospital, Changhua
| | | | - Hua-Cheng Yen
- Department of Neurosurgery
- Correspondence: Hua-Cheng Yen, Department of Neurosurgery, Changhua Christian Hospital, Changhua, Taiwan (e-mail: )
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Chi CY, Lin CH, Ho MW, Ding JY, Huang WC, Shih HP, Yeh CF, Fung CP, Sun HY, Huang CT, Wu TS, Chang CY, Liu YM, Feng JY, Wu WK, Wang LS, Tsai CH, Ho CM, Lin HS, Chen HJ, Lin PC, Liao WC, Chen WT, Lo CC, Wang SY, Kuo CY, Lee CH, Ku CL. Clinical manifestations, course, and outcome of patients with neutralizing anti-interferon-γ autoantibodies and disseminated nontuberculous mycobacterial infections. Medicine (Baltimore) 2016; 95:e3927. [PMID: 27336882 PMCID: PMC4998320 DOI: 10.1097/md.0000000000003927] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Neutralizing anti-interferon-γ autoantibody (nAIGA)-associated immunodeficiency is an emerging medical issue worldwide. In the present study, we describe and discuss the clinical features and outcomes of patients with nAIGAs and disseminated infections by nontuberculous mycobacteria (dNTM).We thoroughly reviewed the medical records of all patients. Microorganisms and nAIGAs were identified using previously described methods with modifications. All data were calculated and analyzed using SPSS software.Among 46 adult patients with dNTM infections, we identified 45 cases (97.8%) with nAIGAs. The average patient age was 58.6 years, and there was no sex predominance. Cervical lymphadenitis (81.8%) was the most common clinical manifestation. Endocrine disorder was the leading comorbidity (7 cases). Malignancies were found in 4 patients, and all of the malignancies originated from the T-cell/macrophage lineage. More than half of the identifiable isolates were slow-growing NTMs. Twenty-eight (62.2%) and 18 (40.0%) patients had a history of zoster and salmonellosis, respectively. A high proportion of patients with recurrent episodes of NTM infection or a history of zoster and dNTM infection had initial nAIGA titers ≥10 dilution (P < 0.05). Twenty-seven patients (60.0%) required long-term antimycobacterial therapy and had at least 1 episode of recurrent NTM disease. No mortality was related to dNTM infection.In Taiwan, nAIGAs are a recently recognized mechanism of dNTM infection. Long term of antibiotic treatment and adherence to medical advice are necessary to improve the clinical outcome of patients with nAIGAs.
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Affiliation(s)
- Chih-Yu Chi
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hao Lin
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Biomedical Science, Chang Gung University, Taoyuan, Taiwan
| | - Mao-Wang Ho
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Jing-Ya Ding
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Chi Huang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Han-Po Shih
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Fu Yeh
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chang-Phone Fung
- Division of Infectious Diseases, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsin-Yun Sun
- Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Tai Huang
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ting-Shu Wu
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chih-Yen Chang
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yuag-Meng Liu
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Jia-Yih Feng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Kai Wu
- Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Lih-Shinn Wang
- Department of Infectious Diseases, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Chung-Hao Tsai
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Mao Ho
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Huang-Shen Lin
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Hung-Jen Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Po-Chang Lin
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wei-Chin Liao
- Division of Infectious Disease, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taichung, Taiwan
| | - Wei-Ting Chen
- Division of Infectious Diseases, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
| | - Chia-Chi Lo
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Shang-Yu Wang
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chen-Yen Kuo
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chen-Hsiang Lee
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheng-Lung Ku
- Laboratory of Human Immunology and Infectious Diseases, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
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Choi D, Wishon MJ, Barnoud J, Chang CY, Bouazizi Y, Locquet A, Citrin DS. Low-frequency fluctuations in an external-cavity laser leading to extreme events. Phys Rev E 2016; 93:042216. [PMID: 27176302 DOI: 10.1103/physreve.93.042216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Indexed: 06/05/2023]
Abstract
We experimentally investigate the dynamical regimes of a laser diode subject to external optical feedback in light of extreme-event (EE) analysis. We observe EEs in the low-frequency fluctuations (LFFs) regime. This number decreases to negligible values when the laser transitions towards fully developed coherence collapse as the injection current is increased. Moreover, we show that EEs observed in the LFF regime are linked to high-frequency pulsing events observed after a power dropout. Finally, we prove experimentally that the observation of EEs in the LFF regimes is robust to changes in operational parameters.
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Affiliation(s)
- Daeyoung Choi
- UMI 2958 Georgia Tech-CNRS, Georgia Tech Lorraine, 2 Rue Marconi F-57070, Metz, France
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332-0250, USA
| | - Michael J Wishon
- UMI 2958 Georgia Tech-CNRS, Georgia Tech Lorraine, 2 Rue Marconi F-57070, Metz, France
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332-0250, USA
| | - J Barnoud
- UMI 2958 Georgia Tech-CNRS, Georgia Tech Lorraine, 2 Rue Marconi F-57070, Metz, France
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332-0250, USA
| | - C Y Chang
- UMI 2958 Georgia Tech-CNRS, Georgia Tech Lorraine, 2 Rue Marconi F-57070, Metz, France
- School of Physics, Georgia Institute of Technology, Atlanta, Georgia 30332-0430, USA
| | - Y Bouazizi
- UMI 2958 Georgia Tech-CNRS, Georgia Tech Lorraine, 2 Rue Marconi F-57070, Metz, France
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332-0250, USA
| | - A Locquet
- UMI 2958 Georgia Tech-CNRS, Georgia Tech Lorraine, 2 Rue Marconi F-57070, Metz, France
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332-0250, USA
| | - D S Citrin
- UMI 2958 Georgia Tech-CNRS, Georgia Tech Lorraine, 2 Rue Marconi F-57070, Metz, France
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332-0250, USA
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Li YL, Chang CY, Liu CE, Cheng YR, Chong CH, Lai HW, Hou IL. Factors Associated With Delayed Management of Smear-Positive Pulmonary Tuberculosis in Hospitalized Patients. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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34
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Chen HM, Li YL, Liu YM, Liu CE, Cheng YR, Chen CH, Hii IM, Chang CY. The experience of intramuscular benzathine penicillin for prophylaxis of recurrent cellulitis: A cohort study. J Microbiol Immunol Infect 2015; 50:613-618. [PMID: 26475200 DOI: 10.1016/j.jmii.2015.08.008] [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] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 08/11/2015] [Accepted: 08/28/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND/PURPOSE Recurrent cellulitis is an important clinical issue but the optimal strategy for prophylaxis is not determined. Intramuscular benzathine penicillin at a 4-week interval had been adopted in our hospital and the study was conducted to evaluate the efficacy. METHODS From January 1, 2009 to May 31, 2013, all patients aged ≥ 18 year, with a history of recurrent cellulitis and having received at least three shots of intramuscular benzathine penicillin for prophylaxis were retrospectively recruited for analysis. Two treatment periods (prophylaxis period and nonprophylaxis period) were defined. The effects of benzathine penicillin prophylaxis and patient characteristics on the incidence rate of recurrent cellulitis were analyzed using Poisson regression model. RESULTS A total of 72 patients were enrolled, including 26 (36.1%) men. The most common underlying conditions were past surgery at the proximal side of the affected limb (38, 52.8%), malignancy (31, 43.1%), and diabetes mellitus (24, 33.3%). The incidence rate of recurrent cellulitis in the prophylaxis period was 0.73 episode/patient-year, significantly lower than that of 1.25 episodes/patient-year in the nonprophylaxis period (p < 0.001). Tinea pedis was a significant factor associated with increasing incidence of recurrent cellulitis in our cohort. CONCLUSION Intramuscular benzathine penicillin at a 4-week interval may be an effective prophylactic strategy to reduce the incidence of cellulitis. Further studies are necessary to determine the factors associated with failure of prophylaxis as well as optimal individualized dosage and dosing interval of the prophylactic agent.
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Affiliation(s)
- Hsien-Meng Chen
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-Lin Li
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yuag-Meng Liu
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chun-Eng Liu
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-Ren Cheng
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chang-Hua Chen
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ing-Moi Hii
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Yen Chang
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
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Venmathi Maran BA, Soh HY, Hwang UW, Chang CY, Myoung JG. First records of parasitic copepods (Crustacea, Siphonostomatoida) from marine fishes in Korea. Trop Biomed 2015; 32:352-364. [PMID: 26691264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The knowledge of the biodiversity of parasitic copepods in South Korea is increasing. Interestingly we report here, some parasitic copepods considered as the first record of findings from Korea. Nine species of parasitic copepods (Siphonostomatoida) including six genera of three different families [Caligidae (7), Lernaeopodidae (1), Lernanthropidae (1)] were recovered from eight species of wild fishes in Korea: 1) Caligus hoplognathi Yamaguti & Yamasu, 1959 (♀, ♂) from the body surface of barred knifejaw Oplegnathus fasciatus (Temminck & Schlegel); 2) Caligus lagocephali Pillai, 1961 (♀) from the gills of panther puffer Takifugu pardalis (Temminck & Schlegel); 3) Euryphorus brachypterus (Gerstaecker, 1853) (♀, ♂) from the opercular cavity of Atlantic bluefin tuna Thunnus thynnus (Linnaeus); 4) Euryphorus nordmanni Milne Edwards, 1840 (♀, ♂) from the opercular cavity of common dolphin fish Coryphaena hippurus Linnaeus; 5) Gloiopotes huttoni (Thomson) (♀, ♂) from the body surface of black marlin Istiompax indica (Cuvier); 6) Lepeophtheirus hapalogenyos Yamaguti & Yamasu, 1959 (♀) from the gill filaments of O. fasciatus; 7) Lepeophtheirus sekii Yamaguti, 1936 (♀, ♂) from the body surface of red seabream Pagrus major (Temminck & Schlegel); 8) Brachiella thynni Cuvier, 1830 (♀) from the body surface of longfin tuna or albacore Thunnus alalunga (Bonnaterre); 9) Lernanthropinus sphyraenae (Yamaguti & Yamasu, 1959) (♀) from the gill filaments of moon fish Mene maculata (Bloch & Schneider). Since the female was already reported in Korea, it is a new record for the male of C. hoplognathi. A checklist for the parasitic copepods of the family Caligidae, Lernaeopodidae and Lernanthropidae of Korea is provided.
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Affiliation(s)
- B A Venmathi Maran
- Biological Oceanography & Marine Biology Division, Korea Institute of Ocean Science & Technology, 787 Haean-ro, Ansan 426-744, Republic of Korea
| | - H Y Soh
- Faculty of Marine Technology, Chonnam National University, 50 Daehak-ro, Yeosu, Jeollanam-do 550-749, Republic of Korea
| | - U W Hwang
- Department of Biology, Teachers College and Institute for Phylogenomics and Evolution, Kyungpook National University, Buk-gu, Deagu 702-701, Republic of Korea
| | - C Y Chang
- Department of Biology, College of Natural Science, Daegu University, Gyeongsan, Gyeongsangbuk-do 712-714, Republic of Korea
| | - J G Myoung
- Biological Oceanography & Marine Biology Division, Korea Institute of Ocean Science & Technology, 787 Haean-ro, Ansan 426-744, Republic of Korea
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Li YL, Liu CE, Lai HW, Chang CY, Liu YM. 940Universal Antibody Screening and Vaccination for Controlling Varicella among Health Care Workers: A 5-year Experience in A tertiary Hospital. Open Forum Infect Dis 2014. [PMCID: PMC5781819 DOI: 10.1093/ofid/ofu052.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Yu-Lin Li
- Infectious Diseases, Changhua Christian Hospital, Changhua, Taiwan
| | | | - Hui-Wen Lai
- Changhua Christian Hospital, Changhua, Taiwan
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Tseng TM, Chen PY, Tseng H, Lin HC, Chang CY, Hung SH. An unexpected route for otolaryngology bacterial contamination with a Venturi atomizer. Rhinology 2014; 52:156-161. [PMID: 24932628 DOI: 10.4193/rhino13.124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Venturi-principle atomizer is a commonly used device in otolaryngology practices. The purpose of this study is to evaluate the possible route of bacterial contamination from the nasal vestibule to the atomizer tip through the jet airflow created during the use of the Venturi atomizer. METHODS Thirty nostrils from 15 enrolled volunteers were tested. The aerosols generated by spraying sterilized saline into the nostrils were collected using a specially made aerosol-collecting nozzle cap. The collected samples were sent for bacterial culture, and nasal vestibular swab cultures were performed for comparison. RESULTS In the aerosol-exposed group, 18 out of 30 samples (60%) were positive for bacterial growth, confirming the bacterial contamination from the nasal vestibule to the atomizer tip through the reverse jet airflow. The bacteria species in 8 of the 18 positive samples were identical to those from the nasal swab culture results from the same nostril. CONCLUSION In ordinary otolaryngology practices, there are significant risks for bacterial contamination from the nasal vestibule to the tip of the Venturi atomizer even without direct contact. Clinicians must be more aware of this pattern of contamination, which has not been reported in the existing literature.
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Yang HS, Chen IC, Lee YT, Lee KC, Chuang YC, Chang CY, Wei J. Cardiac transplantation and concomitant coronary artery bypass grafting: our experiences in 11 cases. Transplant Proc 2014; 46:900-2. [PMID: 24767376 DOI: 10.1016/j.transproceed.2013.11.127] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/07/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The shortage of donor hearts for transplantation could be alleviated by including the hearts of older donors. Previous literature revealed similar early and medium-term survival outcomes compared with those of younger donors. This study presents our experience with patients who underwent orthotopic heart transplantation and concomitant coronary artery bypass grafting at our institution. METHODS We present our experience with 11 patients with end-stage cardiomyopathy (8 men and 3 women) undergoing orthotopic heart transplantation and concomitant coronary artery bypass grafting from September 2002 to November 2011 at our institute. RESULTS All 11 donor organs would otherwise have been rejected, depriving potential recipients of organ transplantation. Two patients received concurrent 2-coronary-artery bypass, and the other 9 patients received concurrent single-coronary-artery bypass during orthotopic heart transplantation. All patients had an uneventful postoperative course, with follow-up completed 3 to 128 months after cardiac transplantation and concomitant coronary artery bypass grafting surgery. CONCLUSIONS Our experiences suggest that donor hearts requiring coronary artery bypass grafting, which form a small but significant donor subgroup, can be used effectively and safely when matched to the recipients' age and medical condition.
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Affiliation(s)
- H S Yang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - I C Chen
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - Y T Lee
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - K C Lee
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - Y C Chuang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - C Y Chang
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C
| | - J Wei
- Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C.
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Liu PY, Shi ZY, Shyu CL, Wu ZY, Lai KL, Chang CY, Chen YJ, Huang JA, Mao YC, Tung KC. Cobra bite wound infection caused by Shewanella algae. Int J Infect Dis 2014; 20:11-2. [DOI: 10.1016/j.ijid.2013.08.014] [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] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 08/25/2013] [Indexed: 11/24/2022] Open
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Hii IM, Chang HL, Lin LC, Lee YL, Liu YM, Liu CE, Chen CH, Cheng YR, Chang CY. Changing epidemiology of candidemia in a medical center in middle Taiwan. J Microbiol Immunol Infect 2013; 48:306-15. [PMID: 24113067 DOI: 10.1016/j.jmii.2013.08.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/20/2013] [Accepted: 08/29/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Candidemia remains a major cause of morbidity and mortality in the health care setting, and the epidemiology of Candida infection is changing. METHODS Clinical and laboratory data from patients with candidemia were collected retrospectively at a tertiary medical center in Taiwan from July 1, 2009 to June 30, 2012 (a 36-month period). Demographics, clinical characteristics, and drug susceptibility of the invading Candida species of patients at the onset of candidemia were analyzed and compared with previous study from January 1, 2001 to June 30, 2003 (a 30-month period). RESULTS A total of 209 episodes of candidemia in 205 patients were identified in this study period. When compared with the previous study period, more patients were admitted for medical conditions at percentages ranging from 49.5% to 69.8%; the incidence rate of health care-associated candidemia increased from 0.76 to 1.14 per 1000 discharges; the proportion of Candida albicans in patients with candidemia decreased from 64.8% to 43.6% whereas the proportion of Candida glabrata increased greatly from 1.1% to 21.6% and the proportions of Candida tropicalis and Candida parapsilosis were slightly elevated (19.8-22.0% and 2.2-7.3%, respectively). All of the C. albicans isolates remained susceptible to fluconazole, whereas 66.7% of C. glabrata isolates were dose-dependent susceptible, and 4.4% of C. glabrata isolates and 11.6% C. tropicalis isolates were resistant. There was one C. glabrata and one Candida guilliermondii resistant to echinocandin. The predictors for 30-day mortality included the high Acute Physiology and Chronic Health Evaluation II (APACHE II) score, use of parenteral nutrition, underlying malignancy, liver cirrhosis, and neutropenia whereas candidemia by C. parapsilosis or C. glabrata is a favorable predictor when compared with C. albicans. CONCLUSION The distribution of Candida species in candidemia was changed. Although C. albicans remained the major species, the isolation of non-C. albicans spp., especially C. glabrata, increased. Patients with candidemia still had high mortalities due to severity of illness and underlying conditions.
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Affiliation(s)
- Ing-Moi Hii
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Hui-Lan Chang
- Infection Control Committee, Changhua Christian Hospital, Changhua, Taiwan
| | - Li-Chen Lin
- Infection Control Committee, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-Lin Lee
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yuag-Meng Liu
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chun-Eng Liu
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chang-Hua Chen
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-Ren Cheng
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Yen Chang
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
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Lin CJ, Wu TH, Lin CH, Hung SC, Chiu CF, Liu MJ, Teng MMH, Chang FC, Guo WY, Chang CY. Can iterative reconstruction improve imaging quality for lower radiation CT perfusion? Initial experience. AJNR Am J Neuroradiol 2013; 34:1516-21. [PMID: 23578678 DOI: 10.3174/ajnr.a3436] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Initial results using IR for CT of the head showed satisfactory subjective and objective imaging quality with a 20-40% radiation dose reduction. The aim of our study was to compare the influence of IR and FBP algorithms on perfusion parameters at standard and lowered doses of CTP. MATERIALS AND METHODS Forty patients with unilateral carotid stenosis post-carotid stent placement referred for follow-up CTP were divided into 2 groups (tube currents were 100 mAs in group A and 80 mAs in group B). Datasets were reconstructed with IR and FBP algorithms; and SNRs of gray matter, white matter, and arterial and venous ROIs were compared. CBF, CBV, and MTT means and SNRs were evaluated by using linear regression, and qualitative imaging scores were compared across the 2 algorithms. RESULTS The mean effective radiation dose of group B (2.06 mSv) was approximately 20% lower than that of group A (2.56 mSv). SNRs for ROIs in the dynamic contrast-enhanced images were significantly higher than those for the FBP images. Correlations of the SNRs for CBF, CBV, and MTT across the 2 algorithms were moderate (R² = 0.46, 0.23, and 0.44, respectively). ROIs in gray matter rather than the IR algorithm predicted increasing SNRs in all CBF, CBV, and MTT maps. Two cases of significant restenosis were confirmed in both algorithms. CBV, CBF, and MTT imaging scores did not differ significantly across algorithms or groups. CONCLUSIONS Lower dose CTP (20% below normal dose) without IR can effectively identify oligemic tissue in poststenting follow-up. IR does not alter the absolute values or increase the SNRs of perfusion parameters. Other methods should be attempted to improve SNRs in settings with low tube currents.
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Affiliation(s)
- C J Lin
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
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Wang KW, Chueh LL, Wang MH, Huang YT, Fang BH, Chang CY, Fang MC, Chou JY, Hsieh SC, Wan CH. Multiplex polymerase chain reaction assay for the detection of minute virus of mice and mouse parvovirus infections in laboratory mice. Lab Anim 2013; 47:116-21. [PMID: 23492514 DOI: 10.1177/0023677213478298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mouse parvoviruses are among the most prevalent infectious pathogens in contemporary mouse colonies. To improve the efficiency of routine screening for mouse parvovirus infections, a multiplex polymerase chain reaction (PCR) assay targeting the VP gene was developed. The assay detected minute virus of mice (MVM), mouse parvovirus (MPV) and a mouse housekeeping gene (α-actin) and was able to specifically detect MVM and MPV at levels as low as 50 copies. Co-infection with the two viruses with up to 200-fold differences in viral concentrations can easily be detected. The multiplex PCR assay developed here could be a useful tool for monitoring mouse health and the viral contamination of biological materials.
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Affiliation(s)
- K W Wang
- Graduate Institute of Veterinary Medicine, National Taiwan University, Taipei, Taiwan, ROC
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Chang CC, Chang HC, Wu CH, Chang CY, Liao CC, Chen TL. Adverse postoperative outcomes in surgical patients with immune thrombocytopenia. Br J Surg 2013; 100:684-92; discussion 693. [DOI: 10.1002/bjs.9065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 01/09/2023]
Abstract
Abstract
Background
Patients with immune thrombocytopenia (ITP) are likely to have various medical co-morbidities, yet their global features regarding adverse postoperative outcomes and use of medical resources when undergoing major surgery are unknown. The objective of this study was to validate whether ITP is an independent risk factor for adverse postoperative outcomes, and to explore the potential clinical predictors of outcomes after major surgery among patients with ITP.
Methods
A retrospective population-based cohort study was conducted using Taiwan's National Health Insurance Research Database, controlling for preoperative co-morbidities by means of multiple logistic regression. Major postoperative complication and mortality rates, and in-hospital medical costs were analysed.
Results
The study included 11 085 surgical patients with ITP and 44 340 controls without ITP matched for sex, age, and type of surgery and anaesthesia. Surgical patients with ITP had a higher risk of postoperative death (odds ratio (OR) 1·89, 95 per cent confidence interval 1·57 to 2·27), and overall postoperative complications (OR 1·47, 1·39 to 1·56), and increased hospital stay (OR 1·90, 1·80 to 2·01), admission to the intensive care unit (OR 1·73, 1·63 to 1·83) and medical costs (OR 1·89, 1·79 to 1·99). Amount of preoperative platelet and/or red blood cell transfusion, emergency visits and admission to hospital for ITP care were identified as risk factors for adverse postoperative outcomes.
Conclusion
Patients with ITP undergoing surgery are at increased risk of adverse perioperative events, particularly if blood or blood product transfusion are required preoperatively, or the procedure is done as an emergency.
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Affiliation(s)
- C C Chang
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anaesthesiology, Taipei Medical University, Taipei, Taiwan
| | - H C Chang
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anaesthesiology, Taipei Medical University, Taipei, Taiwan
| | - C H Wu
- Department of Surgery, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - C Y Chang
- Department of Paediatrics, Division of Paediatric Haematology/Oncology, Taipei Medical University Hospital, and Graduate Institute of Clinical Medicine, College of Medicine, Taipei, Taiwan
| | - C C Liao
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anaesthesiology, Taipei Medical University, Taipei, Taiwan
| | - T L Chen
- Department of Anaesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Anaesthesiology, Taipei Medical University, Taipei, Taiwan
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Liao EC, Chen JT, Chao ML, Yu SC, Chang CY, Chu WS, Tsai JJ. Nonadverse effects on allergenicity of isopentenyltransferase-transformed broccoli. J Investig Allergol Clin Immunol 2013; 23:112-119. [PMID: 23654078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Genetically modified organisms (GMOs) provide modern agriculture with improvements in efficiency and the benefits of enhanced food production; however, the potential impact of GMOs on human health has not yet been clarified. OBJECTIVE To investigate the allergenicity of isopentenyltransferase (ipt)-transformed broccoli compared with non-GM broccoli. METHODS Sera from allergic individuals were used to identify the allergenicity of GM and non-GM broccoli. Immunoglobulin (Ig) binding of different lines of GM and non-GM broccoli was identified using immunoblotting, enzyme-linked immunosorbent assay, and the histamin release assay. RESULTS Positive reactions to broccoli (Brassica Oleracea) were observed in 7.02% of individuals. Specific IgE to broccoli and total IgE fro allergic individuals were well correlated. The different tests performed showed no significant differences in the allergenicity of conventionally raised and GM broccoli, indicating the absence of unexpected effects on allergenicity in ipt-transformed plants. Using Western blot analysis we detected heterogeneous IgE-reactive allergenic components in broccoli-allergic sera, but no significant differences between GM an non-GM broccoli were observed in serum from the same patients. CONCLUSIONS Our study demonstrates that there are no differences between GM (ipt-transformed) broccoli and non-GM broccoli, as determined by specific IgE in sera from broccoli-allergic patients. This indicates that there were no unexpected effects on allergenicity in this GM broccoli.
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Affiliation(s)
- E C Liao
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
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Wei J, Sue SH, Lee YT, Chang CY. Combined heart transplantation and total replacement of thoracic aorta in Marfan's syndrome with recurrent aortic dissection: a case report. Transplant Proc 2012; 44:1174-5. [PMID: 22564657 DOI: 10.1016/j.transproceed.2012.02.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
It is extremely rare for a patient to need simultaneous heart transplantation (HTx) and replacement of the thoracic aorta. A 23-year-old woman with Marfan's syndrome underwent Bentall's operation and replacement of the ascending aorta (AsA) due to a type A aortic dissection (AD) in August 2001. In March 2005, she began to experience dyspnea on exertion and was found to have a huge pseudoaneurysm at the aortic root, which had caused dehiscence of the aortic conduit. In July 2009, she suffered acute chest pain followed by hypotension and cold sweating. The computed tomography (CT) scan showed a recurrent dissection with a long intimal tear extending from the arch to the mid-portion of the descending thoracic aorta (DTA). Due to technical difficulties in the repair of the aortic root, she was placed on the HTx waiting list. The next day, she received a donor heart and underwent combined HTx and total replacement of the thoracic aorta. Explantation of the heart improved the exposure of the DTA. With the use of a vascular ring connector (Vasoring), the operation was successfully performed without need for a blood transfusion. The patient was still well at 2 years after the operation. Simultaneous replacement of the heart and the whole segment of the thoracic aorta is technically possible in Marfan patients who are complicated with aortic dissection.
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Affiliation(s)
- J Wei
- Heart Centre, Cheng-Hsin General Hospital, Taipei, Taiwan, R.O.C.
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Johir MAH, Vigneswaran S, Sathasivan A, Kandasamy J, Chang CY. Effect of organic loading rate on organic matter and foulant characteristics in membrane bio-reactor. Bioresour Technol 2012; 113:154-160. [PMID: 22206913 DOI: 10.1016/j.biortech.2011.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 11/30/2011] [Accepted: 12/01/2011] [Indexed: 05/31/2023]
Abstract
In this study, the influence of organic loading rate (OLR) on the performance of a membrane bio-reactor (MBR) was investigated. The MBR was operated with 6 different OLRs between 0.5 and 3.0 kg COD/m(3)d. The hydrodynamic parameters of the MBR were kept constant. The hydraulic retention time and sludge retention time were kept at 8h and 40 d respectively. From the experimental investigation, it was found that the removal efficiency of DOC, COD and NH(4)-N decreased when OLRs were increased from 0.5 to 3.0 kg COD/m(3)d. Higher OLRs of 2.75-3.0 kg COD/m(3)d resulted in a higher transmembrane pressure development. The fractionation of organic matters showed more hydrophilic substances with higher OLRs. A detailed organic matter characterization of membrane foulant, soluble microbial product and extracellular polymeric substances showed that bio-polymers type substances together with humic acid and lower molecular neutral and acids were responsible for membrane fouling.
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Affiliation(s)
- M A H Johir
- Faculty of Engineering and Information Technology, University of Technology, Sydney, Broadway, NSW 2007, Australia
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Lin CJ, Hung SC, Guo WY, Chang FC, Luo CB, Beilner J, Kowarschik M, Chu WF, Chang CY. Monitoring peri-therapeutic cerebral circulation time: a feasibility study using color-coded quantitative DSA in patients with steno-occlusive arterial disease. AJNR Am J Neuroradiol 2012; 33:1685-90. [PMID: 22499839 DOI: 10.3174/ajnr.a3049] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial hemodynamics are important for management of SOAD. This study aimed to monitor peri-stent placement intracranial CirT of patients with SOAD. MATERIALS AND METHODS Twenty-five patients received stent placement for extracranial ICA stenosis, and 34 patients with normal CirT were recruited as controls. Their color-coded DSAs were used to define the Tmax of selected intravascular ROI. A total of 20 ROIs of the ICA, OphA, ACA, MCA, FV, PV, OV, SSS, SS, IJV, and MCV were selected. rTmax was defined as the Tmax at the selected region of interest minus Tmax at the cervical segment of the ICA (I1 on AP view and IA on lateral view). rTmax of the PV was defined as intracranial CirT. Intergroup and intragroup longitudinal comparisons of rTmax were performed. RESULTS rTmax values of the normal cohorts were as follows: ICA-AP, 0.12; ICA-LAT, 0.10; A1, 0.28; A2, 0.53; A3, 0.81; M1, 0.40; M2, 0.80; M3, 0.95; OphA, 0.35; FV, 4.83; PV, 5.11; OV, 5.17; SSS, 6.16; SS, 6.51; IJV, 6.81; and MCV, 3.86 seconds. Before stent placement, the rTmax values of arterial ROIs, except A3 and M3, were prolonged compared with values from control subjects (P < .05). None of the rTmax of any venous ROIs in the stenotic group was prolonged with significance. After stent placement, the rTmax of all arterial ROIs shortened significantly, except A1and M3. Poststenting rTmax was not different from the control group. CONCLUSIONS Without extra contrast medium and radiation dosages, color-coded quantitative DSA enables real-time monitoring of peri-therapeutic intracranial CirT in patients with SOAD .
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Affiliation(s)
- C J Lin
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
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Yen CH, Teng MMH, Yuan WH, Sun YC, Chang CY. Preventive vertebroplasty for adjacent vertebral bodies: a good solution to reduce adjacent vertebral fracture after percutaneous vertebroplasty. AJNR Am J Neuroradiol 2012; 33:826-32. [PMID: 22282447 DOI: 10.3174/ajnr.a2898] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Adjacent VCF frequently occurs after percutaneous vertebroplasty. Our aim was to evaluate PrVP in the prevention of PVNO-adjacent VCF. MATERIALS AND METHODS Radiographs of 68 patients who initially presented with a single-level unhealed fracture and underwent vertebroplasty were retrospectively reviewed for the occurrence of PVNO fracture. Patients in the nonpreventive group (n = 33) underwent TVP only for a vertebra with an unhealed fracture. The preventive group (n = 35) underwent PrVP combined with TVP. We injected bone cement into the caudal part of the superior adjacent vertebra and the cephalic part of the inferior adjacent vertebra to perform PrVP. RESULTS The incidences of PVNO fracture in adjacent vertebra next to a vertebra cemented at the patient's first vertebroplasty (within 6 months: 24% versus 3%, P = .012; within 1 year: 30% versus 3%, P = .006; >4 years: 39% versus 3%, P = .006) markedly decreased in the preventive group compared with the nonpreventive group. PVNO fracture was found in 26% of vertebrae adjacent to the first TVP level in the nonpreventive group and in 2% of vertebrae adjacent to a PrVP level in the preventive group after inclusion of all PrVP procedures. Approximately 33% of patients in the nonpreventive group underwent repeat vertebroplasty, mainly due to adjacent fractures. Only 3% of patients in the preventive group underwent repeated procedures. None of the vertebrae cemented for PrVP or TVP developed PVNO refracture. CONCLUSIONS Preventive vertebroplasty for the adjacent vertebra combined with TVP for the fractured vertebra is effective in the prevention of propagation of PVNO adjacent fractures, thus reducing the necessity of multiple repeat vertebroplasty procedures.
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Affiliation(s)
- C H Yen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
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Lo HM, Chiang CF, Tsao HC, Pai TY, Liu MH, Kurniawan TA, Chao KP, Liou CT, Lin KC, Chang CY, Wang SC, Banks CJ, Lin CY, Liu WF, Chen PH, Chen CK, Chiu HY, Wu HY, Chao TW, Chen YR, Liou DW, Lo FC. Effects of spiked metals on the MSW anaerobic digestion. Waste Manag Res 2012; 30:32-48. [PMID: 20880938 DOI: 10.1177/0734242x10383079] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study aimed to investigate the effects of eight metals on the anaerobic digestion of the organic fraction of municipal solid waste (OFMSW) in bioreactors. Anaerobic bioreactors containing 200 mL MSW mixed completely with 200 m L sludge seeding. Ca and K (0, 1000, 2000 and 6,000 mg L(-1)) and Cr, Ni, Zn, Co, Mo and W (0, 5, 50 and 100 mg L(-1)) of various dose were added to anaerobic bioreactors to examine their anaerobic digestion performance. Results showed that except K and Zn, Ca (~728 to ~1,461 mg L(-1)), Cr (~0.0022 to ~0.0212 mg L(-1)), Ni (~0.801 to ~5.362 mg L(-1)), Co (~0.148 to ~0.580 mg L(-1)), Mo (~0.044 to ~52.94 mg L(-1)) and W (~0.658 to ~40.39 mg L(-1)) had the potential to enhance the biogas production. On the other hand, except Mo and W, inhibitory concentrations IC(50) of Ca, K, Cr, Ni, Zn and Co were found to be ~3252, ~2097, ~0.124, ~7.239, ~0.482, ~8.625 mg L(-1), respectively. Eight spiked metals showed that they were adsorbed by MSW to a different extent resulting in different liquid metals levels and potential stimulation and inhibition on MSW anaerobic digestion. These results were discussed and compared to results from literature.
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Affiliation(s)
- H M Lo
- Department of Environmental Engineering and anagement, Chaoyang University of Technology, Wufong Township, Taichung County, Taiwan, ROC.
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Bi SPL, Lin CC, Chang TT, Huang SW, Chang CY, Lin JC. Repetitive Ischemic Preconditioning before GXT can Transiently Induce Oxidative stress but Promote Maximal Oxygen Consumption. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000402482.55386.cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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