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Sargent KS, Martinez EL, Reed AC, Guha A, Bartholomew ME, Diehl CK, Chang CS, Salama S, Popov T, Thayer JF, Miller GA, Yee CM. Oscillatory Coupling Between Neural and Cardiac Rhythms. Psychol Sci 2024:9567976241235932. [PMID: 38568870 DOI: 10.1177/09567976241235932] [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] [Indexed: 04/05/2024] Open
Abstract
Oscillations serve a critical role in organizing biological systems. In the brain, oscillatory coupling is a fundamental mechanism of communication. The possibility that neural oscillations interact directly with slower physiological rhythms (e.g., heart rate, respiration) is largely unexplored and may have important implications for psychological functioning. Oscillations in heart rate, an aspect of heart rate variability (HRV), show remarkably robust associations with psychological health. Mather and Thayer proposed coupling between high-frequency HRV (HF-HRV) and neural oscillations as a mechanism that partially accounts for such relationships. We tested this hypothesis by measuring phase-amplitude coupling between HF-HRV and neural oscillations in 37 healthy adults at rest. Robust coupling was detected in all frequency bands. Granger causality analyses indicated stronger heart-to-brain than brain-to-heart effects in all frequency bands except gamma. These findings suggest that cardiac rhythms play a causal role in modulating neural oscillations, which may have important implications for mental health.
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Affiliation(s)
- Kaia S Sargent
- Department of Psychology, University of California, Los Angeles
| | | | | | - Anika Guha
- Department of Psychology, University of California, Los Angeles
| | | | | | | | - Sarah Salama
- Department of Psychology, University of California, Los Angeles
| | - Tzvetan Popov
- Department of Psychology, University of Konstanz
- Department of Psychology, University of Zurich
| | - Julian F Thayer
- Department of Psychological Science, University of California, Irvine
| | - Gregory A Miller
- Department of Psychology, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Cindy M Yee
- Department of Psychology, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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2
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Jain A, Brooks JR, Alford CC, Chang CS, Mueller NM, Umscheid CA, Bierman AS. Awareness of Racial and Ethnic Bias and Potential Solutions to Address Bias With Use of Health Care Algorithms. JAMA Health Forum 2023; 4:e231197. [PMID: 37266959 DOI: 10.1001/jamahealthforum.2023.1197] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Importance Algorithms are commonly incorporated into health care decision tools used by health systems and payers and thus affect quality of care, access, and health outcomes. Some algorithms include a patient's race or ethnicity among their inputs and can lead clinicians and decision-makers to make choices that vary by race and potentially affect inequities. Objective To inform an evidence review on the use of race- and ethnicity-based algorithms in health care by gathering public and stakeholder perspectives about the repercussions of and efforts to address algorithm-related bias. Design, Setting, and Participants Qualitative methods were used to analyze responses. Responses were initially open coded and then consolidated to create a codebook, with themes and subthemes identified and finalized by consensus. This qualitative study was conducted from May 4, 2021, through December 7, 2022. Forty-two organization representatives (eg, clinical professional societies, universities, government agencies, payers, and health technology organizations) and individuals responded to the request for information. Main Outcomes and Measures Identification of algorithms with the potential for race- and ethnicity-based biases and qualitative themes. Results Forty-two respondents identified 18 algorithms currently in use with the potential for bias, including, for example, the Simple Calculated Osteoporosis Risk Estimation risk prediction tool and the risk calculator for vaginal birth after cesarean section. The 7 qualitative themes, with 31 subthemes, included the following: (1) algorithms are in widespread use and have significant repercussions, (2) bias can result from algorithms whether or not they explicitly include race, (3) clinicians and patients are often unaware of the use of algorithms and potential for bias, (4) race is a social construct used as a proxy for clinical variables, (5) there is a lack of standardization in how race and social determinants of health are collected and defined, (6) bias can be introduced at all stages of algorithm development, and (7) algorithms should be discussed as part of shared decision-making between the patient and clinician. Conclusions and Relevance This qualitative study found that participants perceived widespread and increasing use of algorithms in health care and lack of oversight, potentially exacerbating racial and ethnic inequities. Increasing awareness for clinicians and patients and standardized, transparent approaches for algorithm development and implementation may be needed to address racial and ethnic biases related to algorithms.
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Affiliation(s)
- Anjali Jain
- Evidence-based Practice Center Division, Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland
| | - Jasmin R Brooks
- Department of Psychology, University of Houston, Houston, Texas
| | - Cleothia C Alford
- Evidence-based Practice Center Division, Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland
| | - Christine S Chang
- Evidence-based Practice Center Division, Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland
| | - Nora M Mueller
- Evidence-based Practice Center Division, Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland
- Division of Practice Improvement, Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland
| | - Craig A Umscheid
- Evidence-based Practice Center Division, Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland
| | - Arlene S Bierman
- Office of the Director, Agency for Healthcare Research and Quality, Rockville, Maryland
- Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, Rockville, Maryland
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3
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Chang CS, Yang CY, Hsiao HY, Chen L, Chu IM, Cheng MH, Tsao CH. Cultivation of auricular chondrocytes in poly(ethylene glycol)/poly(ε-caprolactone) hydrogel for tracheal cartilage tissue engineering in a rabbit model. Eur Cell Mater 2018; 35:350-364. [PMID: 29926464 DOI: 10.22203/ecm.v035a24] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Tissue engineering has the potential to overcome the limitations of tracheal reconstruction. To tissue-engineer a tracheal cartilage, auricular chondrocytes were encapsulated in a photocurable poly(ethylene glycol)/poly(ε-caprolactone) (PEG/PCL) hydrogel. Chondrogenic genes, including Sox9, Acan and Col2a1, were up-regulated in auricular chondrocytes after 2 weeks of in vitro cultivation in the PEG/PCL hydrogel. Co-cultivation of 70 % auricular chondrocytes and 30 % bone marrow mesenchymal stem cells (BMSCs) accelerated the chondrogenic genes' expression in the PEG/PCL hydrogel. Cartilaginous matrix markers, including proteoglycans and collagen type II, were detected in the chondrocytes-encapsulated PEG/PCL hydrogel after 4 weeks of in vitro cultivation. The higher expression level of cartilaginous matrix markers was observed in the PEG/PCL hydrogel with co-cultivation of 70 % chondrocytes and 30 % BMSCs. After 4 weeks of ectopic cultivation in rabbits, the cylindrical PEG/PCL structure was sustained with the use of a luminal silicon stent. However, without the stent, the construct collapsed under a compression force. No fibrosis or vessel ingrowth were found in the PEG/PCL hydrogel after 4 weeks of ectopic cultivation, whereas the auricular chondrocytes showed proteoglycans' accumulation and collagen type II production. Rabbit auricular chondrocytes could survive and retain chondrogenic ability in the PEG/PCL hydrogel under both in vitro and in vivo conditions. While the PEG/PCL hydrogel did not show sufficient mechanical properties for supporting the cylindrical shape of the construct, the high chondrogenesis level of chondrocytes in the PEG/PCL hydrogel displayed the potential of this material for tracheal tissue engineering.
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Affiliation(s)
| | | | | | | | | | | | - C H Tsao
- Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, 5 Fu-Hsing Street, Kweishan, Taoyuan 33305,
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4
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Chang CS, Tsai IT, Liang CY, Hsu CW. Traumatic Dissections of Bilateral Internal carotid Artery with Aneurysms Formation. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Carotid artery dissection is an unusual complication of blunt neck trauma with high mortality and severe neurological deficits. Traumatic bilateral dissections and dissecting aneurysms are extremely rare. A 17-year-old male presented to our emergency department with sudden onset of right hemiparesis and aphasia. Initial computed tomography scan of head and neck showed no remarkable finding. On the second day, a magnetic resonance angiography of head and neck demonstrated bilateral extracranial internal carotid artery dissections. The diagnosis of traumatic carotid artery dissection for emergency physicians is difficult because of the absence or delayed onset in symptomatology. Magnetic resonance angiography is currently considered as an appropriate initial diagnostic tool for carotid artery injury. In clinical practice, early diagnosis by keeping a high index of suspicions is required by emergency physicians.
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Lin WT, Chen YM, Chen DY, Lan JL, Chang CS, Yeh HZ, Yang SS. Increased risk of hepatitis B virus reactivation in systemic lupus erythematosus patients receiving immunosuppressants: a retrospective cohort study. Lupus 2017; 27:66-75. [PMID: 28534427 DOI: 10.1177/0961203317711009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective We aimed to investigate risk of hepatitis B virus reactivation in systemic lupus erythematosus patients with different hepatitis B virus infection statuses receiving immunosuppressive therapy. Methods We retrospectively analyzed systemic lupus erythematosus patients with positive hepatitis B surface antigen or anti-hepatitis B core IgG antibody who underwent immunosuppressive therapies from January 2001 to December 2012 at a medical center in Taiwan for evidence of hepatitis B virus reactivation. Results During this period, 906 out of 3125 patients who were diagnosed with systemic lupus erythematosus received screening tests for hepatitis B virus. Thirty-eight patients were identified as hepatitis B surface antigen-positive. Fifteen of 38 (39.5%) hepatitis B surface antigen-positive patients developed hepatitis B virus reactivation, and 53.3% of these patients experienced severe hepatitis flare. Three of 157 hepatitis B surface antigen-negative/anti-hepatitis B core IgG antibody-positive patients (1.9%) experienced hepatitis B surface antigen seroreversion after immunosuppressive therapy. Five patients received prophylactic or preemptive antiviral therapy and none of them developed hepatitis B virus flares. A daily dose of prednisolone greater than 5 mg was a risk factor for hepatitis B reactivation by multivariate logistic analysis. Conclusions The risk of hepatitis B virus reactivation is high in lupus patients receiving immunosuppressive therapy. Antiviral prophylaxis or preemption can effectively reduce the incidence of hepatitis B virus reactivation in lupus patients.
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Affiliation(s)
- W T Lin
- 1 Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Y M Chen
- 2 Division of Allergy, Immunology & Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan.,3 Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - D Y Chen
- 2 Division of Allergy, Immunology & Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan.,3 Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - J L Lan
- 4 Division of Immunology and Rheumatology, China Medical University Hospital, Taichung, Taiwan
| | - C S Chang
- 1 Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - H Z Yeh
- 1 Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.,3 Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - S S Yang
- 1 Division of Gastroenterology & Hepatology, Taichung Veterans General Hospital, Taichung, Taiwan.,3 Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,5 Department of Nursing, Central Taiwan University of Science & Technology, Taichung, Taiwan
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6
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Hager R, Lang J, Chang CS, Ku S, Chen Y, Parker SE, Adams MF. Verification of long wavelength electromagnetic modes with a gyrokinetic-fluid hybrid model in the XGC code. Phys Plasmas 2017; 24:054508. [PMID: 29104419 PMCID: PMC5648567 DOI: 10.1063/1.4983320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 04/25/2017] [Indexed: 06/07/2023]
Abstract
As an alternative option to kinetic electrons, the gyrokinetic total-f particle-in-cell (PIC) code XGC1 has been extended to the MHD/fluid type electromagnetic regime by combining gyrokinetic PIC ions with massless drift-fluid electrons analogous to Chen and Parker [Phys. Plasmas 8, 441 (2001)]. Two representative long wavelength modes, shear Alfvén waves and resistive tearing modes, are verified in cylindrical and toroidal magnetic field geometries.
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Affiliation(s)
- Robert Hager
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543, USA
| | - Jianying Lang
- Intel Corporation, 2200 Mission College Blvd., Santa Clara, California 95054, USA
| | - C S Chang
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543, USA
| | - S Ku
- Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543, USA
| | - Y Chen
- University of Colorado, 2000 Colorado Avenue, Boulder, Colorado 80309, USA
| | - S E Parker
- University of Colorado, 2000 Colorado Avenue, Boulder, Colorado 80309, USA
| | - M F Adams
- Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720, USA
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7
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Chang CS, Ku S, Tynan GR, Hager R, Churchill RM, Cziegler I, Greenwald M, Hubbard AE, Hughes JW. Fast Low-to-High Confinement Mode Bifurcation Dynamics in a Tokamak Edge Plasma Gyrokinetic Simulation. Phys Rev Lett 2017; 118:175001. [PMID: 28498701 DOI: 10.1103/physrevlett.118.175001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Indexed: 06/07/2023]
Abstract
Transport barrier formation and its relation to sheared flows in fluids and plasmas are of fundamental interest in various natural and laboratory observations and of critical importance in achieving an economical energy production in a magnetic fusion device. Here we report the first observation of an edge transport barrier formation event in an electrostatic gyrokinetic simulation carried out in a realistic diverted tokamak edge geometry under strong forcing by a high rate of heat deposition. The results show that turbulent Reynolds-stress-driven sheared E×B flows act in concert with neoclassical orbit loss to quench turbulent transport and form a transport barrier just inside the last closed magnetic flux surface.
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Affiliation(s)
- C S Chang
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - S Ku
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - G R Tynan
- University of California San Diego, La Jolla, California 92093, USA
| | - R Hager
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - R M Churchill
- Princeton Plasma Physics Laboratory, Princeton, New Jersey 08540, USA
| | - I Cziegler
- University of California San Diego, La Jolla, California 92093, USA
| | - M Greenwald
- MIT Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - A E Hubbard
- MIT Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
| | - J W Hughes
- MIT Plasma Science and Fusion Center, Cambridge, Massachusetts 02139, USA
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8
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Hsiao HH, Liu YC, Wang HC, Tsai YF, Wu CH, Cho SF, Hsu JF, Huang CT, Hsiao SY, Lee CP, Chang CS, Lin SF, Liu TC. Additional chromosomal abnormalities in core-binding factor acute myeloid leukemia. Genet Mol Res 2015; 14:17028-33. [PMID: 26681050 DOI: 10.4238/2015.december.16.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Despite sharing a similar genetic abnormality, patients with core binding factor acute myeloid leukemia (CBF-AML), which is characterized by the presence of t(8;21) or inv(16)/t(16;16), show heterogeneous survival. Other molecular or cytogenetic factors are supposed to have an impact on the prognosis. We enrolled 24 CBF-AML patients to determine the impact of cytogenetic abnormality, and c-KIT, FLT3, NPM1, and CEBPA mutations on the prognosis. Only three patients had the c-KIT mutation (3/24, 12.5%) and one had the FLT3 mutation. However, over half of the patients (14/24) harbored additional cytogenetic changes, including ten with loss of sexual chromosomes (LOS) [all in the t(8;21) group], and six had additional abnormalities (two cases had both LOS and additional abnormalities). From this small-number study, no association was found between c-KIT mutation and survival and relapse rate. However, additional chromosome abnormalities had a significant association with relapse of the disease (P = 0.027). Stem cell transplant had a trend of benefitting patients after relapse (P = 0.065). This implies that chromosome abnormalities occur in CBF-AML and might take part in the heterogeneous nature of CBF-AML.
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Affiliation(s)
- H H Hsiao
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Y C Liu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - H C Wang
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - Y F Tsai
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - C H Wu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - S F Cho
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - J F Hsu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - C T Huang
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - S Y Hsiao
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - C P Lee
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan
| | - C S Chang
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - S F Lin
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - T C Liu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung, Taiwan.,Department of Laboratory Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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9
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Camp KM, Parisi MA, Acosta PB, Berry GT, Bilder DA, Blau N, Bodamer OA, Brosco JP, Brown CS, Burlina AB, Burton BK, Chang CS, Coates PM, Cunningham AC, Dobrowolski SF, Ferguson JH, Franklin TD, Frazier DM, Grange DK, Greene CL, Groft SC, Harding CO, Howell RR, Huntington KL, Hyatt-Knorr HD, Jevaji IP, Levy HL, Lichter-Konecki U, Lindegren ML, Lloyd-Puryear MA, Matalon K, MacDonald A, McPheeters ML, Mitchell JJ, Mofidi S, Moseley KD, Mueller CM, Mulberg AE, Nerurkar LS, Ogata BN, Pariser AR, Prasad S, Pridjian G, Rasmussen SA, Reddy UM, Rohr FJ, Singh RH, Sirrs SM, Stremer SE, Tagle DA, Thompson SM, Urv TK, Utz JR, van Spronsen F, Vockley J, Waisbren SE, Weglicki LS, White DA, Whitley CB, Wilfond BS, Yannicelli S, Young JM. Phenylketonuria Scientific Review Conference: state of the science and future research needs. Mol Genet Metab 2014; 112:87-122. [PMID: 24667081 DOI: 10.1016/j.ymgme.2014.02.013] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 02/25/2014] [Accepted: 02/26/2014] [Indexed: 01/17/2023]
Abstract
New developments in the treatment and management of phenylketonuria (PKU) as well as advances in molecular testing have emerged since the National Institutes of Health 2000 PKU Consensus Statement was released. An NIH State-of-the-Science Conference was convened in 2012 to address new findings, particularly the use of the medication sapropterin to treat some individuals with PKU, and to develop a research agenda. Prior to the 2012 conference, five working groups of experts and public members met over a 1-year period. The working groups addressed the following: long-term outcomes and management across the lifespan; PKU and pregnancy; diet control and management; pharmacologic interventions; and molecular testing, new technologies, and epidemiologic considerations. In a parallel and independent activity, an Evidence-based Practice Center supported by the Agency for Healthcare Research and Quality conducted a systematic review of adjuvant treatments for PKU; its conclusions were presented at the conference. The conference included the findings of the working groups, panel discussions from industry and international perspectives, and presentations on topics such as emerging treatments for PKU, transitioning to adult care, and the U.S. Food and Drug Administration regulatory perspective. Over 85 experts participated in the conference through information gathering and/or as presenters during the conference, and they reached several important conclusions. The most serious neurological impairments in PKU are preventable with current dietary treatment approaches. However, a variety of more subtle physical, cognitive, and behavioral consequences of even well-controlled PKU are now recognized. The best outcomes in maternal PKU occur when blood phenylalanine (Phe) concentrations are maintained between 120 and 360 μmol/L before and during pregnancy. The dietary management treatment goal for individuals with PKU is a blood Phe concentration between 120 and 360 μmol/L. The use of genotype information in the newborn period may yield valuable insights about the severity of the condition for infants diagnosed before maximal Phe levels are achieved. While emerging and established genotype-phenotype correlations may transform our understanding of PKU, establishing correlations with intellectual outcomes is more challenging. Regarding the use of sapropterin in PKU, there are significant gaps in predicting response to treatment; at least half of those with PKU will have either minimal or no response. A coordinated approach to PKU treatment improves long-term outcomes for those with PKU and facilitates the conduct of research to improve diagnosis and treatment. New drugs that are safe, efficacious, and impact a larger proportion of individuals with PKU are needed. However, it is imperative that treatment guidelines and the decision processes for determining access to treatments be tied to a solid evidence base with rigorous standards for robust and consistent data collection. The process that preceded the PKU State-of-the-Science Conference, the conference itself, and the identification of a research agenda have facilitated the development of clinical practice guidelines by professional organizations and serve as a model for other inborn errors of metabolism.
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Affiliation(s)
- Kathryn M Camp
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD 20982, USA.
| | - Melissa A Parisi
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | - Gerard T Berry
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Deborah A Bilder
- Department of Psychiatry, University of Utah, Salt Lake City, UT 84108, USA.
| | - Nenad Blau
- University Children's Hospital, Heidelberg, Germany; University Children's Hospital, Zürich, Switzerland.
| | - Olaf A Bodamer
- University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - Jeffrey P Brosco
- University of Miami Mailman Center for Child Development, Miami, FL 33101, USA.
| | | | | | - Barbara K Burton
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.
| | - Christine S Chang
- Agency for Healthcare Research and Quality, Rockville, MD 20850, USA.
| | - Paul M Coates
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD 20982, USA.
| | - Amy C Cunningham
- Tulane University Medical School, Hayward Genetics Center, New Orleans, LA 70112, USA.
| | | | - John H Ferguson
- Office of Rare Diseases Research, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD 20982, USA.
| | | | | | - Dorothy K Grange
- Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO 63110, USA.
| | - Carol L Greene
- University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Stephen C Groft
- Office of Rare Diseases Research, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD 20982, USA.
| | - Cary O Harding
- Oregon Health & Science University, Portland, OR 97239, USA.
| | - R Rodney Howell
- University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | | | - Henrietta D Hyatt-Knorr
- Office of Rare Diseases Research, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD 20982, USA.
| | - Indira P Jevaji
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD 20817, USA.
| | - Harvey L Levy
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Uta Lichter-Konecki
- George Washington University, Children's National Medical Center, Washington, DC 20010, USA.
| | | | | | | | | | - Melissa L McPheeters
- Vanderbilt Evidence-based Practice Center, Institute for Medicine and Public Health, Nashville, TN 37203, USA.
| | - John J Mitchell
- McGill University Health Center, Montreal, Quebec H3H 1P3, Canada.
| | - Shideh Mofidi
- Maria Fareri Children's Hospital of Westchester Medical Center, Valhalla, NY 10595, USA.
| | - Kathryn D Moseley
- University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
| | - Christine M Mueller
- Office of Orphan Products Development, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Andrew E Mulberg
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Lata S Nerurkar
- Office of Rare Diseases Research, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD 20982, USA.
| | - Beth N Ogata
- University of Washington, Seattle, WA 98195, USA.
| | - Anne R Pariser
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD 20993, USA.
| | - Suyash Prasad
- BioMarin Pharmaceutical Inc., San Rafael, CA 94901, USA.
| | - Gabriella Pridjian
- Tulane University Medical School, Hayward Genetics Center, New Orleans, LA 70112, USA.
| | | | - Uma M Reddy
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | | | - Sandra M Sirrs
- Vancouver General Hospital, University of British Columbia, Vancouver V5Z 1M9, Canada.
| | | | - Danilo A Tagle
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Susan M Thompson
- The Children's Hospital at Westmead, Sydney, NSW 2145, Australia.
| | - Tiina K Urv
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Jeanine R Utz
- University of Minnesota, Minneapolis, MN 55455, USA.
| | - Francjan van Spronsen
- University of Groningen, University Medical Center of Groningen, Beatrix Children's Hospital, Netherlands.
| | - Jerry Vockley
- University of Pittsburgh, Pittsburgh, PA 15224, USA.
| | - Susan E Waisbren
- Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Linda S Weglicki
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Desirée A White
- Department of Psychology, Washington University, St. Louis, MO 63130, USA.
| | | | - Benjamin S Wilfond
- Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, WA 98101, USA.
| | | | - Justin M Young
- The Young Face, Facial Plastic and Reconstructive Surgery, Cumming, GA 30041, USA.
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Buckley DI, Ansari MT, Butler M, Soh C, Chang CS. The refinement of topics for systematic reviews: lessons and recommendations from the Effective Health Care Program. J Clin Epidemiol 2014; 67:425-32. [PMID: 24581296 DOI: 10.1016/j.jclinepi.2013.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 08/31/2013] [Accepted: 10/07/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program conducts systematic reviews of health-care topics nominated by stakeholders. Topics undergo refinement to ensure relevant questions of appropriate scope and useful reviews. Input from key informants, experts, and a literature scan informs changes in the nominated topic. AHRQ convened a work group to assess approaches and develop recommendations for topic refinement. STUDY DESIGN AND SETTING Work group members experienced in topic refinement generated a list of questions and guiding principles relevant to the refinement process. They discussed each issue and reached agreement on recommendations. RESULTS Topics should address important health-care questions or dilemmas, consider stakeholder priorities and values, reflect the state of the science, and be consistent with systematic review research methods. Guiding principles of topic refinement are fidelity to the nomination, relevance, research feasibility, responsiveness to stakeholder inputs, reduced investigator bias, transparency, and suitable scope. Suggestions for stakeholder engagement, synthesis of input, and reporting are discussed. Refinement decisions require judgment and balancing guiding principles. Variability in topics precludes a prescriptive approach. CONCLUSION Accurate, rigorous, and useful systematic reviews require well-refined topics. These guiding principles and methodological recommendations may help investigators refine topics for reviews.
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Affiliation(s)
- David I Buckley
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code: FM, Portland, OR 97239, USA
| | - Mohammed T Ansari
- Clinical Epidemiology Program, Methods Centre, Box 201B, General Campus, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
| | - Mary Butler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Clara Soh
- Kaiser Permanente Center for Health Research, Evidence-based Practice Center, 3800 N Interstate Ave, Portland, OR 97227, USA
| | - Christine S Chang
- Center for Outcomes and Evidence, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850, USA
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11
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Liu YC, Hsiao HH, Lin PM, Yang WC, Chang CS, Liu TC, Hsu JF, Yang MY, Lin SF. Prognostic implication of molecular aberrations in cytogenetically normal acute myeloid leukemia patients receiving allogeneic hematopoietic stem cell transplantation. Genet Mol Res 2013; 12:5414-23. [PMID: 24301914 DOI: 10.4238/2013.november.11.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Different molecular aberrations can be discriminated into certain prognostic subgroups in cytogenetically normal acute myeloid leukemia (CN-AML) patients but their impact on allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains controversial and studies from Asian populations are lacking. Forty-two adult non-M3 AML patients receiving allo-HSCT from 2002 to 2009 in southern Taiwan were retrospectively reviewed for survey, 23 (54.7%) of whom were CN-AML. NPM1, FLT3-ITD, and CEBPA were analyzed. After a median follow-up of 104 weeks (range, 8 to 384), patients in the good risk group (harboring either NPM1 or CEBPA mutation without concurrent FLT3-ITD) showed a borderline worse overall survival (OS) compared with the intermediate/poor risk group (P = 0.08). Interestingly, a poorer OS was found in patients with the CEBPA mutation (P = 0.003) but not the NPM1 mutation (P = 0.96). No OS difference was found between patients with or without FLT3-ITD (P = 0.15). In patients receiving allo-HSCT at first remission, there was no significant OS benefit in the good risk group (P = 0.33). In patients receiving allo-HSCT beyond first remission, disease status played a major role (P = 0.006), irrespective of molecular aberrations. Allo-HSCT in good risk patients should be carefully evaluated in Taiwanese, especially in patients with the CEBPA mutation. Conversely, allo-HSCT should be considered in first remission in patients with an intermediate/poor risk, where it may overcome the adverse impact of FLT3-ITD. Disease status remained a main issue in patients receiving allo-HSCT beyond first remission.
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Affiliation(s)
- Y C Liu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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12
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Lin BH, Liu WR, Lin CY, Hsu ST, Yang S, Kuo CC, Hsu CH, Hsieh WF, Chien FSS, Chang CS. Single domain m-plane ZnO grown on m-plane sapphire by radio frequency magnetron sputtering. ACS Appl Mater Interfaces 2012; 4:5333-5337. [PMID: 22989018 DOI: 10.1021/am301271k] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
High-quality m-plane orientated ZnO films have been successfully grown on m-plane sapphire by using radio frequency magnetron sputtering deposition. The introduction of a nanometer-thick, low-temperature-grown ZnO buffer layer effectively eliminates inclusions of other undesirable orientations. The structure characteristics of the ZnO epi-layers were thoroughly studied by synchrotron X-ray scattering and transmission electron microscopy (TEM). The in-plane epitaxial relationship between ZnO and sapphire follows (0002)(ZnO) [parallel] (112[overline]0)(sapphire) and (112[overline]0)(ZnO) [parallel] (0006)(sapphire) and the ZnO/sapphire interface structure can be described by the domain matching epitaxy along the [112[overline]0](ZnO) direction. The vibrational properties of the films were investigated by polarization dependent micro-Raman spectroscopy. Both XRD and micro-Raman results reveal that the obtained m-ZnO layers are under an anisotropic biaxial strain but still retains a hexagonal lattice.
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Affiliation(s)
- B H Lin
- Department of Photonics and Institute of Electro-Optical Engineering, National Chiao Tung University, Hsinchu 30010, Taiwan
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13
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Chan WY, Huang HS, Su WB, Lin WH, Jeng HT, Wu MK, Chang CS. Field-induced expansion deformation in Pb islands on Cu(111): evidence from energy shift of empty quantum-well states. Phys Rev Lett 2012; 108:146102. [PMID: 22540808 DOI: 10.1103/physrevlett.108.146102] [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] [Received: 12/23/2011] [Indexed: 05/31/2023]
Abstract
We use scanning tunneling microscopy and spectroscopy to measure the energy shift of empty quantum-well (QW) states in Pb islands on the Cu(111) surface. It is found that, with an increase of the electric field, the behavior of the energy shift can be grouped into two different modes for most QW states. In the first mode, the state energy moves toward high energy monotonically. In the second mode, the state energy shifts to a lower energy initially and then turns around to a higher energy. Moreover, we have observed that the QW states of higher energy behave in preference to the first mode, but they gradually change to the second mode as the Pb island becomes thicker. This thickness-dependent behavior reflects the existence of local expansion in the Pb islands, due to the electric field, and that the expansion is larger for a thicker island. QW states can thus be used for studying the localized lattice deformation in the nanometer scale.
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Affiliation(s)
- W Y Chan
- Institute of Physics, Academia Sinica, Nankang, Taipei 115, Taiwan
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14
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Cha SI, Chang CS, Kim EK, Lee JW, Matthay MA, Golden JA, Elicker BM, Jones K, Collard HR, Wolters PJ. Lung mast cell density defines a subpopulation of patients with idiopathic pulmonary fibrosis. Histopathology 2012; 61:98-106. [PMID: 22394225 DOI: 10.1111/j.1365-2559.2012.04197.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The relationship of mast cells to the pathogenesis of lung fibrosis remains undefined despite recognition of their presence in the lungs of patients with pulmonary fibrosis. This study was performed to characterize the relationship of mast cells to fibrotic lung diseases. METHODS AND RESULTS Lung tissues from patients with idiopathic pulmonary fibrosis (IPF), chronic hypersensitivity pneumonitis (HP), systemic sclerosis (SSc)-related interstitial lung disease (ILD) and normal individuals were subjected to chymase immunostaining and the mast cell density quantified. Eosinophils were quantified by immunostaining for eosinophil peroxidase. Changes in lung function were correlated with mast cell density. Lung tissue obtained from IPF patients had a higher density of chymase-immunoreactive mast cells than that from patients with HP, SSc-related ILD or normal lungs. IPF lung tissue had a higher density of eosinophils than normal lung. There was no correlation between mast cell density and eosinophil density in IPF lung. IPF patients with high mast cell density had a slower rate of decline in forced vital capacity (FVC) than IPF patients with low mast cell density. CONCLUSIONS Mast cell density in IPF lungs is higher than in other fibrotic lung diseases and normal lungs. Increased mast cell density in IPF may predict slower disease progression.
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Affiliation(s)
- Seung-Ick Cha
- Department of Medicine, University of California, San Francisco School of Medicine, CA 94143-0111, USA
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15
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Chang CS, Bergeron L, Yu CC, Chen PKT, Chen YR. Mandible changes evaluated by computed tomography following Botulinum Toxin A injections in square-faced patients. Aesthetic Plast Surg 2011; 35:452-5. [PMID: 21103871 DOI: 10.1007/s00266-010-9624-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [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: 06/10/2010] [Accepted: 10/18/2010] [Indexed: 11/29/2022]
Abstract
BACKGROUND A facial contour that is oval is more pleasing in Asian women. Patients with a square face often seek facial contouring procedures to improve their appearance. Treatment often involves various combinations of Botulinum NeuroToxin A (BoNTA) injections into the masseters and/or mandibular angle resection. Many physicians claim that muscle paralysis with injections alone will decrease pulling on the underlying bone and also treat underlying bony flaring when present. Muscular changes after BoNTA injections have been well documented. However, the effect of BoNTA injections on the underlying mandibular bone morphology has not been studied to the best of the authors' knowledge. The goal of this study was to determine whether there are mandibular changes after masseter injection with botulinum toxin. METHODS In this retrospective study of ten female patients seeking treatment for a square face, three-dimensional CT scans were taken before and 3 months after standardized BoNTA injections in bilateral masseters. Mandibular cortex thickness, mandibular bone thickness, and mandibular volume were measured. RESULTS Soft-tissue changes were observed but no bony changes were observed 3 months after injections. CONCLUSIONS In this study of adult patients, there were no statistically significant mandibular changes 3 months after BoNTA injection. The current theory of mandibular flaring resolution after partial muscle paralysis is not supported by our findings. Therefore, a patient presenting both masseteric hypertrophy and bony flaring will most likely require a combined muscular and bony procedure.
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Affiliation(s)
- C S Chang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital at Linkou, 5, Fu-Hsin St., Guei-Shan 333, Taoyuan, Taiwan
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16
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Chang CS, Chen CF, Berthouly-Salazar C, Chazara O, Lee YP, Chang CM, Chang KH, Bed'Hom B, Tixier-Boichard M. A global analysis of molecular markers and phenotypic traits in local chicken breeds in Taiwan. Anim Genet 2011; 43:172-82. [PMID: 22404353 DOI: 10.1111/j.1365-2052.2011.02226.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Molecular and phenotypic data have been combined to characterize the genetic diversity of six local chicken breeds maintained with a long-term conservation programme. Hua-Tung, Hsin-Yi, Ju-Chi and Quemoy originated from Taiwan, Shek-Ki is from South China, and Nagoya is from Japan. Molecular tools included 24 microsatellite markers, melanocortin 1 receptor (alpha melanocyte stimulating hormone receptor) (MC1R), the LEI0258 marker located within the major histocompatibility complex (MHC), and mitochondrial DNA. Performance was recorded on the same individuals for body weight, panting rate in summer and antibody response (antigens: Newcastle disease virus and sheep red blood cells). A multivariate method previously proposed for taxonomy was used to combine the different data sets. Melanocortin 1 receptor (alpha melanocyte stimulating hormone receptor) and the MCW330 marker contributed the most to the first axis of the multiple coinertia analysis of molecular markers. Melanocortin 1 receptor (alpha melanocyte stimulating hormone receptor) showed evidence of selection, probably related to its effect on feather colour. The MHC exhibited a large diversity, with 16 alleles of the LEI0258 marker. Immune response traits contributed the most to the principal component analysis of phenotypic data. Eight mitochondrial DNA haplotypes related to clades A, B, C and E were distributed across breeds and revealed an important contribution of Indian and European breeds to Ju-Chi, Quemoy and Hsin-Yi. Phenotypic data contributed less than molecular data to the combined analysis, and two markers, LEI0258 and LEI0228, contributed the most. The combined analysis could clearly discriminate all breeds, except Ju-Chi, which was similar to Quemoy for many criteria, except immune response.
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Affiliation(s)
- C S Chang
- Department of Animal Science, National Chung-Hsing University, Taichung 402, Taiwan.
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17
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Chang HW, Tsay JS, Hung YC, Chan WY, Su WB, Chang CS, Yao YD. Investigation of magnetic properties and microstructure of ultrathin Co films grown on Si(111)- 7 x 7 surface. J Nanosci Nanotechnol 2011; 11:2696-2699. [PMID: 21449457 DOI: 10.1166/jnn.2011.2728] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Magnetic properties and growth mechanism of ultrathin Co films on Si(111)-7 x 7 surface have been studied by using both surface magneto-optic Kerr effect (SMOKE) and scanning tunneling microscopy (STM), respectively. STM results show that the growth mechanism of ultrathin Co films on Si(111)-7 x 7 surface at room temperature belongs to Stranski-Krastanov (SK) growth mode. Due to formation of CoSi2 layer, no magnetic signal could be detected by SMOKE for 1-4 ML Co deposited on Si(111) surface. Because of rougher surface, both longitudinal and perpendicular magnetic anisotropy configuration appear for 4.2-10 ML Co/Si(111) films. When the Co thickness is increased to 10 ML, only longitudinal anisotropy configuration is found, resulting from the contribution to the volume anisotropy. Furthermore, in-plane coercivity increases with Co coverage because of enhancement of ferromagnetic coupling with Co thickness, out-of-plane coercivity increases with Co coverage due to the increment of demagnetized field, induced by the rougher Co surface and pinhole structures.
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Affiliation(s)
- H W Chang
- Department of Physics, Tunghai University, Taichung, 407 Taiwan, ROC
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18
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Lien HC, Wang CC, Hsu JY, Sung FC, Cheng KF, Liang WM, Kuo HW, Lin PH, Chang CS. Classical reflux symptoms, hiatus hernia and overweight independently predict pharyngeal acid exposure in patients with suspected reflux laryngitis. Aliment Pharmacol Ther 2011; 33:89-98. [PMID: 21083591 DOI: 10.1111/j.1365-2036.2010.04502.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Gastro-oesophageal reflux disease (GERD) has been associated with reflux laryngitis. AIMS To investigate the risk factors and the predictors of pharyngeal acid reflux (PAR) in Taiwanese patients with suspected reflux laryngitis. METHODS With referral from ENT physicians, 104 patients with symptoms and signs suggestive of reflux laryngitis completed a validated symptom questionnaire, an upper endoscopy exam and ambulatory 24-h pH tests with three sensors located at the hypopharynx, proximal and distal oesophagus. Patients with one or more episodes of PAR were considered abnormal. RESULTS Pharyngeal acid reflux was identified in 17% (18/104) of patients. In multivariate logistic regression analysis, PAR was independently associated with classical reflux symptoms [adjusted odds ratio (aOR) = 3.5, 95% confidence interval (CI): 1.0-12.8], hiatus hernia (aOR = 6.7, 95% CI: 1.5-30.2) and overweight (aOR = 3.4, 95% CI: 1.0-11.0). In predicting PAR, classical reflux symptoms had a sensitivity of 78% and hiatus hernia had a specificity of 95%. With all three factors, the positive predictive value for PAR was 80%. Classical reflux symptoms included heartburn, chest pain, dyspepsia and acid regurgitation. CONCLUSIONS Classical reflux symptoms, hiatus hernia and overweight are independent risk factors that may predict pharyngeal acid reflux in patients with suspected reflux laryngitis.
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Affiliation(s)
- H C Lien
- Taichung Veterans General Hospital, Taiwan
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19
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Dif-Pradalier G, Diamond PH, Grandgirard V, Sarazin Y, Abiteboul J, Garbet X, Ghendrih P, Strugarek A, Ku S, Chang CS. On the validity of the local diffusive paradigm in turbulent plasma transport. Phys Rev E Stat Nonlin Soft Matter Phys 2010; 82:025401. [PMID: 20866867 DOI: 10.1103/physreve.82.025401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Indexed: 05/29/2023]
Abstract
A systematic, constructive and self-consistent procedure to quantify nonlocal, nondiffusive action at a distance in plasma turbulence is exposed and applied to turbulent heat fluxes computed from the state-of-the-art full- f, flux-driven gyrokinetic GYSELA and XGC1 codes. A striking commonality is found: heat transport below a dynamically selected mesoscale has the structure of a Lévy distribution, is strongly nonlocal, nondiffusive, scale-free, and avalanche mediated; at larger scales, we report the observation of a self-organized flow structure which we call the " E × B staircase" after its planetary analog.
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Affiliation(s)
- G Dif-Pradalier
- Center for Astrophysics and Space Sciences, UCSD, La Jolla, CA 92093, USA.
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20
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Chang HW, Wu BF, Yao YD, Su WB, Chang CS. Co nanoislands on Au(111) and Cu(111) surfaces studied by scanning tunneling microscopy and spectroscopy. J Nanosci Nanotechnol 2010; 10:4663-4666. [PMID: 21128475 DOI: 10.1166/jnn.2010.1686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Co nanoislands on the Au(111) and Cu(111) surfaces have been studied by scanning tunneling microscopy and spectroscopy. The experimental results showed that Co nanoislands prefer to aggregate at the step edge and dislocation sites on the reconstructed Au(111) surface and at the step edge on the Cu(111) surface, respectively. In addition, based on dZ/dV-V spectra, in both the Co/Au(111) and the Co/Cu(111) systems, Gundlach oscillation was observed. From the peak shift of dZ/dV-V spectra between Co nanoisland and substrate surface, we can quantitatively obtain that the constant energy separation is -0.13 +/- 0.01 eV for the Co/Au(111) system, and 0.41 +/- 0.02 eV for the Co/Cu(111) system, respectively. These values indicate the work function difference between Co nanoisland and these surfaces.
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Affiliation(s)
- H W Chang
- Department of Physics, Tunghai University, Taichung, 407 Taiwan
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21
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Abstract
BACKGROUND Several studies have supported the hypothesis of different presentations in the autonomic nervous system (ANS) between cardiac and gastric vagal activity. Due to the regionality of the ANS, different responses among different organ systems to the same stimulation (such as a meal) are quite possible. METHODS In this study we monitored the postprandial changes of heart rate variability (HRV) and gastrointestinal (GI) hormones to determine whether both responded in a similar pattern. Twenty-two healthy volunteers (6 males and 16 females) were enrolled. After recording a baseline ECG rhythm, further recordings were made at 20 min intervals for 120 min after a test meal. Serum human pancreatic polypeptide (PP), leptin, and total and active ghrelin levels were measured. KEY RESULTS After the meal, HR increased significantly from baseline at each time point, except for 20 min after the meal. The high frequency (HF) power decreased significantly from 40 min to 120 min after the meal. In addition, the low frequency (LF) power also decreased significantly from 60 min to 120 min. However, the LF:HF ratio increased significantly from 20 min to 120 min. There was a marked increase (>2 fold) of PP at 20 min after the meal, and the increase was sustained throughout the test period. CONCLUSIONS & INFERENCES These findings suggest that HRV reflects cardiac, but not equivalently, abdominovagal activity. Therefore, HRV as an abdominovagal activity measurement in patients with GI functional problems should be used with caution, and other markers such as PP should be included.
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Affiliation(s)
- C S Chang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Affiliation(s)
- P F Liu
- Division of Gastroenterology, General Surgery and Pathology, Taichung Veterans General Hospital, Taichung, Taiwan
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Wang LH, Chang CS, Hsieh LL, Er TK, Chang JG, Liu TC. Hb Owari associated with alpha-thalassaemia-1 in a Taiwanese subject. Br J Biomed Sci 2010; 66:205-7. [PMID: 20095131 DOI: 10.1080/09674845.2009.11978170] [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: 10/18/2022]
Affiliation(s)
- L H Wang
- Division of Molecular Diagnostics, Department of Laboratory Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Chuang JY, Yang SS, Lu YT, Hsieh YY, Chen CY, Chang SC, Chang CS, Yeh HZ, Kao JH. IL-10 promoter gene polymorphisms and sustained response to combination therapy in Taiwanese chronic hepatitis C patients. Dig Liver Dis 2009; 41:424-30. [PMID: 19004675 DOI: 10.1016/j.dld.2008.09.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [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: 06/24/2008] [Revised: 08/14/2008] [Accepted: 09/09/2008] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Host genetic factors may affect clinical outcomes of hepatitis C virus (HCV) infection; however, the possible mechanisms remain largely unknown. The role of immunopathogenesis in chronic hepatitis C leads to extensive exploration of host immunity including inflammatory cytokines. METHODS We examined interleukin 10 (IL-10) promoter gene polymorphisms at positions -1082, -819, and -592 relative to transcription start site and studied their association with response to 24 weeks of pegylated interferon plus ribavirin treatment in 143 chronic hepatitis C patients, of whom 97 (67.8%) achieved a sustained virologic response (SVR). In addition, 134 healthy adults were used as controls. RESULTS Of chronic hepatitis C patients, 111 (77.6%) were genotype 1 infection, 32 (22.4%) were genotype 2 infection. Patients with sustained virologic response were younger and had higher pretreatment ALT levels than those without. No statistical difference was found between chronic hepatitis C patients who achieved SVR or not in terms of gender, HCV genotype, pretreatment HCV RNA levels, and severity of liver disease. The serum IL-10 levels were comparable between healthy controls and chronic hepatitis C patients as well as between HCV patients with and without SVR. The distribution of IL-10 promoter gene polymorphisms at positions -1082, -819, and -592 relative to transcription start site was comparable between HCV patients and healthy controls as well as HCV patients with and without SVR. A high frequency of ATA haplotype of common IL-10 promoter gene SNPs was found in both chronic hepatitis C patients (70.3%) and healthy controls (69.8%). However, ATA haplotype was not associated with SVR in chronic hepatitis C patients. CONCLUSIONS Our data fail to demonstrate the influence of IL-10 promoter gene polymorphisms on the response to combination therapy in Taiwanese chronic hepatitis C patients. The impact of genetic variations in IL-10 haplotype on the response to anti-HCV treatment among different ethnic populations deserves further examination.
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Affiliation(s)
- J Y Chuang
- Graduate Institute and Department of Medical Laboratory Science and Biotechnology, College of Health Care, China Medical University, Taichung, Taiwan
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Yang MC, Lin CL, Su WB, Lin SP, Lu SM, Lin HY, Chang CS, Hsu WK, Tsong TT. Phase contribution of image potential on empty quantum well States in pb islands on the cu(111) surface. Phys Rev Lett 2009; 102:196102. [PMID: 19518977 DOI: 10.1103/physrevlett.102.196102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Indexed: 05/27/2023]
Abstract
We use scanning tunneling spectroscopy to explore the quantum well states in the Pb islands grown on a Cu(111) surface. Our observation demonstrates that the empty quantum well states, whose energy levels lie beyond 1.2 eV above the Fermi level, are significantly affected by the image potential. As the quantum number increases, the energy separation between adjacent states is shrinking rather than widening, contrary to the prediction for a square potential well. By simply introducing a phase factor to reckon the effect of the image potential, the shrinking behavior of the energy separation can be reasonably explained with the phase accumulation model. The model also reveals that there exists a quantum regime above the Pb surface in which the image potential is vanished. Moreover, the quasi-image-potential state in the tunneling gap is quenched because of the existence of the quantum well states.
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Affiliation(s)
- M C Yang
- Institute of Physics, Academia Sinica, Nankang, Taipei 115, Taiwan, ROC
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Lin CL, Lu SM, Su WB, Shih HT, Wu BF, Yao YD, Chang CS, Tsong TT. Manifestation of work function difference in high order Gundlach oscillation. Phys Rev Lett 2007; 99:216103. [PMID: 18233232 DOI: 10.1103/physrevlett.99.216103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Indexed: 05/25/2023]
Abstract
Gundlach oscillation (or the standing-wave state) is a general phenomenon manifesting in the tunneling spectrum acquired from a metal surface using scanning tunneling spectroscopy. Previous studies relate the energy shift between peaks of the lowest-order Gundlach oscillation observed on the thin film and the metal substrate to the difference in their work functions. By observing Gundlach oscillations on Ag/Au(111), Ag/Cu(111), and Co/Cu(111) systems, we demonstrate that the work function difference is not the energy shift of the lowest order but the ones of higher order where a constant energy shift exhibits. Higher order Gundlach oscillations can thus be applied to determine the work function of thin metal films precisely.
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Affiliation(s)
- C L Lin
- Institute of Physics, Academia Sinica, Nankang, Taipei, Taiwan, Republic of China
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Abstract
The MYST family of histone acetyltransferases (HATs) was initially defined by human genes with disease connections and by yeast genes identified for their role in epigenetic transcriptional silencing. Since then, many new MYST genes have been discovered through genetic and genomic approaches. Characterization of the complexes through which MYST proteins act, regions of the genome to which they are targeted and biological consequences when they are disrupted, all deepen the connections of MYST proteins to development, growth control and human cancers. Many of the insights into MYST family function have come from studies in model organisms. Herein, we review functions of two of the founding MYST genes, yeast SAS2 and SAS3, and the essential yeast MYST ESA1. Analysis of these genes in yeast has defined roles for MYST proteins in transcriptional activation and silencing, and chromatin-mediated boundary formation. They have further roles in DNA damage repair and nuclear integrity. The observation that MYST protein complexes share subunits with other HATs, histone deacetylases and other key nuclear proteins, many with connections to human cancers, strengthens the idea that coordinating distinct chromatin modifications is critical for regulation.
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Affiliation(s)
- A Lafon
- Section of Molecular Biology, Division of Biological Sciences, UCSD Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA
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Jho YS, Park G, Chang CS, Pincus PA, Kim MW. Effects of dielectric discontinuities on two charged plates. Phys Rev E Stat Nonlin Soft Matter Phys 2007; 76:011920. [PMID: 17677507 DOI: 10.1103/physreve.76.011920] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2006] [Revised: 05/10/2007] [Indexed: 05/16/2023]
Abstract
Counterions in a biological system are charged in water and interact with charged macroions, which are generally made up of hydrocarbons. The dielectric difference between water and the hydrocarbon substrates occurs naturally, and may greatly affect the electrostatic properties of biological systems. Particularly for a slab geometry, bulk counterions that are dissolved in water are driven to the midplane of the slab because of their repulsive interaction with their image charges. The pressure between two charged plates becomes less repulsive since the low dielectric constant of the hydrocarbon substrate creates stronger association between counterions and surface charges as compared to the case of no dielectric discontinuity.
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Affiliation(s)
- Y S Jho
- Department of Physics, Korea Advanced Institute of Science and Technology, Yuseong-Gu, Daejeon, Korea.
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29
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Liao SC, Ko CW, Yeh HZ, Chang CS, Yang SS, Chen GH. Successful treatment of persistent bacteremia after endoscopic injection of N-butyl-2-cyanoacrylate for gastric varices bleeding. Endoscopy 2007; 39 Suppl 1:E176-7. [PMID: 17614066 DOI: 10.1055/s-2007-966556] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [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: 12/10/2022]
Affiliation(s)
- S C Liao
- Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan
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30
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Jho YS, Park G, Chang CS, Pincus P, Kim MW. Interaction between two inhomogeneously charged parallel surfaces in the strong coupling regime. Phys Rev E Stat Nonlin Soft Matter Phys 2006; 73:021502. [PMID: 16605337 DOI: 10.1103/physreve.73.021502] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Revised: 11/14/2005] [Indexed: 05/08/2023]
Abstract
The counterion density profile and pressure between two inhomogenously charged parallel plates are analyzed analytically and numerically in the strong-coupling regime. Point charges are used and the surface charges are immobile. It is found that when the surface charge distribution is inhomogeneous, the charge coupling effect becomes stronger, the counterion spatial distribution is more localized toward the plate surfaces, and, thus, the pressure between two plates becomes lower than in the case when the surface charge distribution is homogeneous.
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Affiliation(s)
- Y S Jho
- Department of Physics, Korea Advanced Institute of Science and Technology, Yuseong-Gu, Daejeon, Korea 305-701.
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31
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Abstract
The duration of diabetes mellitus and presence of hyperglycemia appear to be important in the development of diabetic nephropathy. Here, we present three patients with edema, heavy proteinuria, chronic renal failure, in whom no past or present symptomatic glucose intolerance or diabetic retinopathy were found. The kidney biopsy of these patients showed diffuse glomerular basement membrane thickening and nodular glomerulosclerosis, which resembled diabetic nephropathy. The renal function of these patients deteriorated rapidly and renal replacement therapy started later in the average of 11 months since the first visiting. These cases were diagnosed as diabetic nodular glomerulosclerosis, although there was no obvious evidence for diabetes. The absence of overt diabetes and diabetic retinopathy at presentation of nodular glomerulosclerosis in these cases does not refute the hypothesis that metabolic consequence of hyperglycemia is a prerequisite for the pathogenesis of diabetic microangiopathy, but some factors other than hyperglycemia may be responsible for renal damage in our patients. The modifiable risk factors in such a condition are postulated and discussed.
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Affiliation(s)
- C S Chang
- Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
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32
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Yeh KH, Lu YS, Hsu CH, Lin JF, Chao HJ, Huang TC, Chung CY, Chang CS, Yang CH, Cheng AL. Phase II study of weekly vinorelbine and 24-h infusion of high-dose 5-fluorouracil plus leucovorin as first-line treatment of advanced breast cancer. Br J Cancer 2005; 92:1013-8. [PMID: 15770209 PMCID: PMC2361932 DOI: 10.1038/sj.bjc.6602469] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We prospectively investigated the efficacy and safety of combining weekly vinorelbine (VNB) with weekly 24-h infusion of high-dose 5-fluorouracil (5-FU) and leucovorin (LV) in the treatment of patients with advanced breast cancer (ABC). Vinorelbine 25 mg m−2 30-min intravenous infusion, and high-dose 5-FU 2600 mg m−2 plus LV 300 mg m−2 24-h intravenous infusion (HDFL regimen) were given on days 1 and 8 every 3 weeks. Between June 1999 and April 2003, 40 patients with histologically confirmed recurrent or metastatic breast cancer were enrolled with a median age of 49 years (range: 36–68). A total of 25 patients had recurrent ABC, and 15 patients had primary metastatic diseases. The overall response rate for the intent-to-treat group was 70.0% (95% CI: 54–84%) with eight complete responses and 20 partial responses. All 40 patients were evaluated for survival and toxicities. Among a total of 316 cycles of VNB–HDFL given (average: 7.9: range: 4–14 cycles per patient), the main toxicity was Gr3/4 leucopenia and Gr3/4 neutropenia in 57 (18.0%) and 120 (38.0%) cycles, respectively. Gr1/2 infection and Gr1/2 stomatitis were noted in five (1.6%) and 59 (18.7%) cycles, respectively. None of the patients developed Gr3/4 stomatitis or Gr3/4 infection. Gr2/3 and Gr1 hand–foot syndrome was noted in two (5.0%) and 23 (57.5%) patients, respectively. Gr1 sensory neuropathy developed in three patients. The median time to progression was 8.0 months (range: 3–25.5 months), and the median overall survival was 25.0 months with a follow-up of 5.5 to 45+ months. This VNB–HDFL regimen is a highly active yet well-tolerated first-line treatment for ABC.
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Affiliation(s)
- K H Yeh
- National Taiwan University Hospital, Taiwan
- National Taiwan University College of Medicine, Taiwan
- Far Eastern Memorial Hospital, Taiwan
| | - Y S Lu
- National Taiwan University Hospital, Taiwan
- National Taiwan University College of Medicine, Taiwan
| | - C H Hsu
- National Taiwan University Hospital, Taiwan
- National Taiwan University College of Medicine, Taiwan
| | - J F Lin
- National Taiwan University College of Medicine, Taiwan
| | - H J Chao
- National Taiwan University College of Medicine, Taiwan
| | - T C Huang
- National Taiwan University College of Medicine, Taiwan
| | | | | | - C H Yang
- National Taiwan University Hospital, Taiwan
- National Taiwan University College of Medicine, Taiwan
| | - A L Cheng
- National Taiwan University Hospital, Taiwan
- National Taiwan University College of Medicine, Taiwan
- National Health Research Institutes, Taiwan
- Department of Internal Medicine and Department of Oncology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. E-mail:
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Lin HY, Chiu YP, Huang LW, Chen YW, Fu TY, Chang CS, Tsong TT. Self-organized growth of nanopucks on Pb quantum islands. Phys Rev Lett 2005; 94:136101. [PMID: 15904006 DOI: 10.1103/physrevlett.94.136101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2004] [Indexed: 05/02/2023]
Abstract
Electronic Moirè patterns found on lead (Pb) quantum islands can serve as a template to grow self-organized cluster (nanopucks) arrays of various materials. These patterns can be divided into fcc- and hcp-stacked areas, which exhibit different binding strengths to the deposited adatoms. For Ag adatoms, the binding energy can differ substantially and the confined nucleation thus occurs in the fcc sites. Both the size distribution and spatial arrangement of the Ag nanopucks are analyzed and found to be commensurate with the characteristics of the template island, which exhibits a bilayer oscillatory behavior.
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Affiliation(s)
- H Y Lin
- Institute of Physics, Academia Sinica, Taipei, Taiwan, Republic of China
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Chen SH, Su AC, Chang CS, Chen HL, Ho DL, Tsao CS, Peng KY, Chen SA. Aging of poly(2-methoxy-5-(2'-ethylhexyloxy)-1,4-phenylenevinylene)/toluene solutions and subsequent effects on luminescence behavior of cast films. Langmuir 2004; 20:8909-8915. [PMID: 15379526 DOI: 10.1021/la049083d] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Morphological effects in luminescence properties of a representative semiconducting polymer, poly(2-methoxy-5-(2'-ethylhexyloxy)-1,4-phenylenevinylene) (MEH-PPV), has recently attracted much attention. Previous studies indicated that short-term heat treatment of solution-cast MEH-PPV films may result in the formation of mesomorphic order that is responsible for the "red" emission around 640 nm, in contrast to the single-chromophore "yellow" emission near 590 nm from the disordered matrix. On the basis of microscopic and spectroscopic evidence for films cast from freshly prepared and aged solutions, here we show that prolonged storage of MEHyellowPPV solutions at room temperature or lower may result in retardation of the thermally induced mesophase formation in the subsequently cast films. According to small-angle neutron scattering and differential scanning calorimetric observations over aged MEH-PPV/toluene solutions, we propose that the suppressed transformation into mesomorphic order is due to further development of nanocrystalline aggregates that serve as physical cross-links among MEH-PPV chains in the solution state upon long-term storage. These solvent-induced nanocrystalline aggregates, however, do not exhibit new spectroscopic features beyond the suppression of "red" emission at 640 nm from the mesomorphic phase.
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Affiliation(s)
- S H Chen
- Institute of Materials Science and Engineering, National Sun Yat-Sen University, Kaohsiung 804, Taiwan
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35
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Chao Y, Yeh KH, Chang CJ, Chen LT, Chao TY, Wu MF, Chang CS, Chang JY, Chung CY, Kao WY, Hsieh RK, Cheng AL. Phase II study of weekly oxaliplatin and 24-h infusion of high-dose 5-fluorouracil and folinic acid in the treatment of advanced gastric cancer. Br J Cancer 2004; 91:453-8. [PMID: 15226770 PMCID: PMC2409850 DOI: 10.1038/sj.bjc.6601985] [Citation(s) in RCA: 65] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
To investigate the efficacy and safety of combining weekly oxaliplatin with weekly 24-h infusion of high-dose 5-fluorouracil (5-FU) and folinic acid (FA) in treatment of patients with advanced gastric cancer. Patients with histologically confirmed, locally advanced or recurrent/metastatic gastric cancer were studied. Oxaliplatin 65 mg m−2 2-h intravenous infusion, and 5-FU 2600 mg m−2 plus FA 300 mg m−2 24-h intravenous infusion, were given on days 1 and 8, repeated every 3 weeks. Between January 2001 through January 2002, 55 patients were enrolled. The median age was 64 years (range: 22–75). In all, 52 patients (94.5%) had recurrent or metastatic disease and three patients had locally advanced disease. Among 50 patients evaluable for tumour response, 28 patients achieved partial response, with an overall response rate of 56% (95% confidence interval (CI): 41.8–70.3%). All 55 patients were evaluated for survival and toxicities. Median time to progression and overall survival were 5.2 and 10.0 months, respectively, during median follow-up time of 24.0 months. Major grades 3–4 toxicities were neutropenia in 23 cycles (7.1%) and thrombocytopenia in 16 cycles (5.0%). Treatment was discontinued for treatment-related toxicities in nine patients (16.4%), of whom eight were due to oxaliplatin-related neurotoxicity. One patient (1.8%) died of neutropenic sepsis. This oxaliplatin-containing regimen is effective in the treatment of advanced gastric cancer. Except for neurotoxicity that often develops after prolonged use of oxaliplatin, the regimen is well tolerated.
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Affiliation(s)
- Y Chao
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - K H Yeh
- National Taiwan University Hospital, Taipei, Taiwan
- Far Eastern Memorial Hospital, Taipei, Taiwan
| | - C J Chang
- National Taiwan University Hospital, Taipei, Taiwan
| | - L T Chen
- Taipei Veterans General Hospital, Taipei, Taiwan
- National Health Research Institutes, Taipei, Taiwan
| | - T Y Chao
- Tri-Service General Hospital, Taipei, Taiwan
| | - M F Wu
- Chung Shan Medical and Dental College Hospital, Taipei, Taiwan
| | - C S Chang
- Changhua Christian Hospital, Taipei, Taiwan
| | - J Y Chang
- National Taiwan University Hospital, Taipei, Taiwan
- National Health Research Institutes, Taipei, Taiwan
| | - C Y Chung
- Changhua Christian Hospital, Taipei, Taiwan
| | - W Y Kao
- Tri-Service General Hospital, Taipei, Taiwan
| | - R K Hsieh
- Mackay Memorial Hospital, Taipei, Taiwan
| | - A L Cheng
- National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine and Department of Oncology, National Taiwan University Hospital, No 7, Chung-Shan South Road, Taipei, Taiwan. E-mail:
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36
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Hahn S, Park G, Chang CS, Choi CK. Diffusion in a two-dimensional anisotropic web map by extrinsic noise applied to the intrinsically perturbed quantity. Phys Rev E Stat Nonlin Soft Matter Phys 2004; 69:017202. [PMID: 14995757 DOI: 10.1103/physreve.69.017202] [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] [Received: 07/09/2003] [Indexed: 05/24/2023]
Abstract
Diffusion by an extrinsic noise in a two-dimensional anisotropic web mapping is studied in the case where an extrinsic noise is applied to the intrinsically perturbed (intrinsically active) physical quantity and the intrinsic web diffusion is negligible. Contrary to the case where the extrinsic noise is applied to the other (intrinsically passive) physical quantity to yield a highly anisotropic diffusion scaling [Gunyoung Park and C. S. Chang, Phys. Rev. E 64, 026211 (2001)], the diffusion scaling in this case is found to be isotropic.
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Affiliation(s)
- Sanghee Hahn
- Department of Physics, Korea Advanced Institute of Science and Technology, 373-1 Kuseong-dong, Yuseong-ku, Daejon 305-701, Korea
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Chang CS, Yang SS, Ko CW, Lien HC, Yeh HZ, Chen GH. Predictive factors of the long-term outcome in reflux esophagitis in a low-prevalence gastroesophageal reflux disease region. Scand J Gastroenterol 2003; 38:1131-5. [PMID: 14686715 DOI: 10.1080/00365520310006171] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND There are no data concerning the long-term outcome of patients with reflux esophagitis in Taiwan. In this study the outcome and the specific prognostic indicators associated with outcome in patients were assessed retrospectively, 7 years after diagnosis of esophagitis. METHODS The study comprised a total of 128 patients with endoscopic esophagitis, diagnosed between January and June 1995, at Taichung Veterans' General Hospital. The outcome at 7 years after diagnosis was assessed by outpatient or telephone interview. Factors associated with requiring long-term acid suppression therapy were analyzed. RESULTS In all, 105 patients were eligible for analysis: 61 patients (58.1%) with LA (Los Angeles classification) grade A, 29 patients (27.6%) with grade B, 11 patients (10.5%) with grade C and 4 patients (3.5%) with grade D esophagitis. Seven years after diagnosis, there were 52 patients (49.5%) with no or occasional reflux symptoms, 8 patients (7.6%) with occasional symptoms requiring treatment with histamine-2 receptor antagonists (H2RAs), 12 patients (11.4%) with occasional symptoms requiring treatment with proton pump inhibitors (PPIs), as needed, and 33 patients (31.3%) with sustained symptoms needing daily maintenance with PPIs. CONCLUSION Nearly 50% of patients in Taiwan with endoscopic esophagitis still required treatment 7 years after diagnosis. Approximately 31% of patients still required daily acid suppression therapy. Presence of hiatal hernia and the severity of esophagitis at initial endoscopy independently were predictive of those who would require long-term acid suppression therapy.
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Affiliation(s)
- C S Chang
- Division of Gastroenterology, Taichung Veterans' General Hospital, Taichung, Taiwan, ROC.
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Chang CS, Liu FY, Hsu WH, Lin CC, Lee CC, Kao A. Usefulness of quantitative Tc-99m HMPAO and Ga-67 citrate lung scans in detecting pulmonary vascular endothelium damage and lung inflammation in patients with systemic lupus erythematosus: a preliminary report. Rheumatol Int 2003; 23:178-81. [PMID: 12856143 DOI: 10.1007/s00296-002-0273-0] [Citation(s) in RCA: 3] [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: 09/06/2002] [Accepted: 11/13/2002] [Indexed: 11/30/2022]
Abstract
Pulmonary vascular endothelium damage in 34 patients with systemic lupus erythematosus (SLE) was measured by technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan. The degree of damage was represented as lung/liver uptake (L/L) ratio. The patients were divided into two subgroups according to the following criteria: (a) clinical features, separated as stable or flare stage and (b) chest X-ray findings separated as positive or negative results. Meanwhile, quantitative gallium-67 citrate (Ga-67) lung scan was performed as Ga-67 uptake index (GUI) to evaluate the severity of inflammation in the SLE lungs. The results show (a) no significant statistical differences in the degree of pulmonary vascular endothelium damage (the L/L ratio on Tc-99m HMPAO lung scan) between the two subgroups according to clinical features or chest X-ray findings and (b) no good correlation between the degree of pulmonary vascular endothelium damage and lung inflammation (GUI on Ga-67 lung scan). In conclusion, the change in pulmonary vascular endothelium damage in SLE may be unrelated to the clinical presentation or chest X-ray findings, and its degree is not related to the severity of pulmonary inflammation.
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Affiliation(s)
- C S Chang
- Department of Anesthesia, Pain Service and Critical Care Medicine, China Medical College Hospital, Taichung, Taiwan
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Ding HJ, Huang WT, Tsai CS, Chang CS, Kao A. Usefulness of technetium-99m tetrofosmin liver imaging to detect hepatocellular carcinoma and related to expression of P-glycoprotein or multidrug resistance associated protein-a preliminary report. Nucl Med Biol 2003; 30:471-5. [PMID: 12831984 DOI: 10.1016/s0969-8051(03)00029-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Technetium-99m Tetrofsomin (Tc-TF) has been shown to be useful in identifying several types of tumors, such as breast, lung, and thyroid cancers. There was no report in the literature for Tc-TF uptake in hepatocellular carcinoma (HCC). The aim of this study was to evaluate the usefulness of Tc-TF liver imaging to detect HCC and investigate the relationship between Tc-TF liver imaging findings and P-glycoprotein (Pgp) and multidrug resistance associated protein (MRP) expression. Before any therapy, 22 patients with HCC were enrolled in this study. Tc-TF liver images were performed l0 minutes after intravenous injection of 20mCi Tc-TF. All patients had liver biopsy or surgery within l week after Tc-TF liver imaging. Immunohistochemical study of the biopsy or resected HCC specimens was performed using anti-human Pgp and MRP antibodies. Twenty of the 22 (90.9%) patients showed negative Tc-TF liver imaging results without significant Tc-TF uptake in HCC, whereas only the remaining 2 (9.1%) patients showed positive Tc-TF liver imaging results with significant Tc-TF uptake in HCC. Positive Pgp expression was observed in 13 of 20 patients with negative Tc-TF liver imaging results, whereas positive MRP expression was observed in 6 of the remaining 7 patients with negative both Tc-TF liver imaging results and Pgp expression. However, negative Pgp expression but positive MRP expression was observed in all of the remaining 2 patients with positive Tc-TF liver imaging results. The correlation between Tc-TF liver imaging findings and Pgp expression was significant and better than between Tc-TF liver imaging findings and MRP expression. Pgp or MRP expression in HCC may induce no significant Tc-TF uptake in HCC resulting in negative Tc-TF liver imaging findings. Therefore, Tc-TF liver imaging is potential to be a non-invasive method to predict Pgp or MRP expression in HCC. However, further studies with a larger series of patients and longer follow-up time are necessary to confirm our findings.
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Affiliation(s)
- H J Ding
- Department of Medical Research, School of Technology for Medical Sciences, Kaohsiung Medical University, Republic of China, Kaohsiung, Taiwan
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Jian WB, Su WB, Chang CS, Tsong TT. Vertical friedel oscillations in interface-induced surface charge modulations of ultrathin quantum islands. Phys Rev Lett 2003; 90:196603. [PMID: 12785967 DOI: 10.1103/physrevlett.90.196603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2002] [Indexed: 05/24/2023]
Abstract
Two-dimensional Pb islands of a few atomic layers are grown on the incommensurate Si(111)-Pb surface at low temperatures. Among them, two types of islands having different stacking with the substrate are observed. These islands, respectively, display an alternating image contrast with their thickness. Besides, the contrasts of the islands of different types are complementary to each other layer by layer. These intriguing behaviors do not show significant bias dependence throughout the range from -3 to +3 V and can be explained by the vertical charge oscillation with the growth of a new layer. The charge oscillation in the out-of-plane direction originates from electron scattering by the in-plane potential variation at the Pb/Si interface.
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Affiliation(s)
- W B Jian
- Institute of Physics, Academia Sinica, Nankang, Taipei, Taiwan, Republic of China
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Abstract
This study evaluated the suitability of fimY gene amplification by PCR as an effective means of detecting Salmonella species. Although fimY gene of Salmonella typhimurium is involved in regulating type 1 fimbrial expression, the amino acid sequence of FimY shares very little homology with other known prokaryotic proteins in the GenBank database. Therefore, fimY is a promising target gene to detect the presence of Salmonella species. Herein, two primers internal to the fimY gene of S. typhimurium are used to investigate the distribution of the fimY homologous sequence among 45 Salmonella serovars and 20 non-Salmonella species by using PCR. Experimental results indicated that only Salmonella species possessed the fimY homologous sequence, subsequently generating the specific 526-bp DNA fragments. The sensitivity of the fmY-specific primer set was demonstrated on a Salmonella-free swab sample from a pork carcass surface, which was then artificially contaminated with different concentrations of S. typhimurium. A combining of pre-enrichment step in buffered peptone water and PCR amplification of fimY allowed the detection of S. typhimurium at the concentration of 3.4 x 10(0) CFU/ml from the swab sample. With an additional enrichment step in Rappaport-Vassiliadis (RV) broth, this procedure can also detect pork carcass surface naturally contaminated with Salmonella species in a slaughterhouse. Results in this study demonstrate that fimY is unique to Salmonella species and is an appropriate PCR target for detecting these microorganisms.
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Affiliation(s)
- K S Yeh
- Department of Pathobiology, Pig Research Institute Taiwan, Chunan, Miaoli.
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Abstract
BACKGROUND/AIMS Abnormal gastric slow-wave frequencies have been observed in diabetic gastroparesis and are associated with impaired antral motor activity. In this study, we aimed at evaluating the effect of acupuncture on gastric slow waves in diabetic patients with symptoms suggesting gastric motor dysfunction. METHODS Fifteen patients with type II diabetes who had had dyspeptic symptoms for more than 3 months were enrolled. Two acupuncture needles were inserted into the subjects' legs at the Zusanli points, and electrical stimulation (2-Hz pulses) was delivered for 30 min. Cutaneous electrogastrography was performed for 30 min at baseline, for 30 min during acupuncture, and for an additional 30 min after acupuncture. Serum gastrin, motilin, and human pancreatic polypeptide levels were also measured. RESULTS There was a significant increase in the percentages of normal frequency during and after acupuncture (baseline vs. acupuncture and after acupuncture 21.99 +/- 19.38% vs. 45.93 +/- 19.72 and 48.92 +/- 19.56%; p < 0.01). In addition, the percentage of tachygastric frequency was decreased significantly during and after acupuncture. The dominant frequency was also changed significantly. There was an increase of serum human pancreatic polypeptide during acupuncture (baseline vs. acupuncture 56.96 +/- 27.64 vs. 73.11 +/- 22.37 pmol/l; p < 0.05). CONCLUSIONS The results of this study revealed that electrical stimulation at the Zusanli points could increase the percentage of normal electrogastrography frequency and decrease the percentage of tachygastric frequency in diabetic patients. The data indicate that acupuncture may enhance the regularity of gastric myoelectrical activity in diabetic patients.
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Affiliation(s)
- C S Chang
- Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, 160, Sec. 3, Chung-Kang Road, Taichung 407, Taiwan.
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Poon SK, Chang CS, Su J, Lai CH, Yang CC, Chen GH, Wang WC. Primary resistance to antibiotics and its clinical impact on the efficacy of Helicobacter pylori lansoprazole-based triple therapies. Aliment Pharmacol Ther 2002; 16:291-6. [PMID: 11860412 DOI: 10.1046/j.1365-2036.2002.01184.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM To evaluate Helicobacter pylori primary resistance and its clinical impact on the efficacy of two lansoprazole-based eradication triple therapies. METHODS H. pylori-positive patients (n=228) were randomized to receive one of the 1-week regimens: lansoprazole 30 mg, clarithromycin 500 mg and amoxicillin 1 g (LAC), or lansoprazole 30 mg, clarithromycin 500 mg and metronidazole 500 mg (LMC), each given twice daily. H. pylori status was assessed by 13C-urea breath test and culture at diagnosis and by 13C-urea breath test 6 weeks after therapy. Antibiotic susceptibility was determined by E-test (n=98). RESULTS The eradication rates with per protocol/ intention-to-treat analyses were: LAC (n=95/114) 83%/69% and LMC (n=96/114) 85%/72%. Primary resistance was 11% for clarithromycin, 41% for metronidazole and 0% for amoxicillin. Eradication in metronidazole-susceptible/-resistant strains was 85%/82% in LAC and 83%/63% in LMC. Significantly lower cure rates were observed in clarithromycin-resistant patients treated with LAC (95% vs. 0%, P < 0.001) and LMC (86% vs. 0%, P < 0.001). CONCLUSIONS One-week LAC and LMC are similarly effective therapies. Clarithromycin resistance significantly affected H. pylori eradication in both regimens.
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Affiliation(s)
- S K Poon
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
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Chang CS, Liu TC, Yeh CJ, Lin SF, Chen TP. Autologous peripheral blood stem cells harvesting in Kaohsiung Medical University Hospital. Kaohsiung J Med Sci 2001; 17:594-601. [PMID: 12168492] [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: 02/26/2023] Open
Abstract
We report our clinical experience in autologous peripheral blood stem cells harvesting. A total of 40 patients with 112 apheresis procedures were analyzed, 88 with Cobe system and 24 with MCS3P system. Our results revealed that there was no significant difference in efficiency of CD34(+) cell harvesting between both apheresis systems, but the Cobe system had more nucleated cells collected and less red cell contaminated in the final PBSCs collections. The percentage of CD34(+) cells collected decreased significantly following the first day's harvesting (p = 0.026). There was a good correlation between the percentage of CD34(+) cells in PBSCs and colony forming units-granulocyte macrophage (CFU-GM) or burst forming unit-erythrocyte (BFU-E)(r = 0.909, p < 0.0001; r = 0.788, p < 0.0001, respectively). However, it was negatively correlated with the patient's age. The CD34(+) cells collected in patients with acute leukemias were also higher than those patients with other solid tumors. Ten cases (13%) with 15 apheresis procedures experienced side effects like numbness, nausea, fever, or headache etc. The Cobe system seemed to have higher frequency of side effects than that of MCS3P system (16% vs 4%). From our results, we concluded that both COBE and MCS3P system have similar efficiency and all patients could tolerate the apheresis procedures in peripheral blood stem cells harvesting. The CD34(+) cell can be used as a good parameter to estimate the amount of stem cells collected. The patient's age and disease pattern were significant factors influencing the CD34(+) stem cells collection in autologous peripheral blood stem cells harvesting.
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Affiliation(s)
- C S Chang
- Division of Hemato-oncology, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Rd., Kaohsiung, Taiwan.
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Chen GS, Chang CS, Kan WM, Chang CL, Wang KC, Chern JW. Novel lead generation through hypothetical pharmacophore three-dimensional database searching: discovery of isoflavonoids as nonsteroidal inhibitors of rat 5 alpha-reductase. J Med Chem 2001; 44:3759-63. [PMID: 11689062 DOI: 10.1021/jm010433s] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A hypothetical pharmacophore of 5 alpha-reductase inhibitors was generated and served as a template in virtual screening. When the pharmacophore was used, eight isoflavone derivatives were characterized as novel potential nonsteroidal inhibitors of rat 5 alpha-reductase. This investigation has demonstrated a practical approach toward the development of lead compounds through a hypothetic pharmacophore via three-dimensional database searching.
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Liu TC, Lin SF, Chang CS, Chen TP, Chang JG. A molecular genetic analysis of the Kidd blood group polymorphism in Taiwanese, Thais, and Filipinos. Kaohsiung J Med Sci 2001; 17:552-5. [PMID: 11852461] [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: 02/23/2023] Open
Abstract
In this study, we molecularly detect the Jka/Jkb polymorphism in Taiwanese, Thais, and Filipinos with PCR-restriction enzyme digestion. We designed the primers with mutagenic bases to create two restriction enzyme cutting sites (EcoN I and Xba I) simultaneously to confirm the genetic polymorphism of Jka/Jkb. One hundred and seven unrelated Taiwanese, 107 Thais foreign laborers, and 102 Filipino foreign laborers in Taiwan were analyzed. The frequency of Jka and Jkb is 0.51 and 0.49 in Taiwanese, 0.44 and 0.56 in Thais, and 0.45 and 0.55 in Filipinos, respectively. The molecular analysis of Jka/Jkb polymorphism is simple, accurate and could confirm the uncertain results obtained by serological typing. The method could be used for predicting fetal Kidd genotype from amniocyte DNA, and to avoid the hemolytic disease of newborns caused by Jk antibody.
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Affiliation(s)
- T C Liu
- Division of Haematology-Oncology, Department of Internal Medicine, Kaohsing Medical University Hospital, Kaohsiung, Taiwan
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47
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Chang CS, Lin SF, Liu TC, Chen TP, Yeh CJ. CD34+ stem cell transplantation in malignancies: report of three cases. J Formos Med Assoc 2001; 100:692-5. [PMID: 11760375] [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: 02/23/2023] Open
Abstract
Purging tumor cells from peripheral blood stem cells (PBSCs) used to treat patients with malignancy is important in the prevention of relapse. Positive selection of CD34+ stem cells using either immunomagnetic methods or an avidin-biotin conjugated CD34 monoclonal antibody binding column can reduce the number of contaminating tumor cells. We describe the management of three patients with malignancy treated using high-dose chemotherapy and enriched CD34+ cell transplantation. PBSCs were mobilized with cyclophosphamide plus recombinant granulocyte-colony stimulating factor (rG-CSF), and then leukophoresis was performed to harvest the PBSCs. The collected cells were positively selected for CD34+ cells using the Cellpro system. The CD34(+)-enriched PBSCs were then cryopreserved in the vapor phase of liquid nitrogen for future reinfusion. All three patients recovered smoothly after transplantation. The mean time to full hematologic recovery was 12 days for white blood cells (> or = 1 x 10(9)/L) and 14 days for platelets (> or = 20 x 10(9)/L), respectively. Partial remission occurred in two patients who were disease free for more than 4 years, and in one patient who died of hepatic failure with liver cirrhosis 5.5 months posttransplantation.
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Affiliation(s)
- C S Chang
- Kaohsiung Hsiaokang Municipal Hospital, Kaohsiung, Taiwan
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Park G, Chang CS. Diffusion by extrinsic noise in a two-dimensional anisotropic web mapping. Phys Rev E Stat Nonlin Soft Matter Phys 2001; 64:026211. [PMID: 11497681 DOI: 10.1103/physreve.64.026211] [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] [Received: 02/07/2001] [Indexed: 05/23/2023]
Abstract
Diffusion by an extrinsic noise is studied in a two-dimensional anisotropic web mapping where the intrinsic web diffusion is negligible, diffusion in one direction is dominant over the other, and the extrinsic noise enters in the dominant dimension only. It is found that the diffusion scaling is governed by the competition between the extrinsic noise and the intrinsic rotation. If the extrinsic noise is weaker than the intrinsic rotation, diffusion scales as lK(1/2) in the dominant direction and as lK(3/2) in the nondominant direction, where l is the extrinsic noise strength and K is the intrinsic perturbation parameter. If the extrinsic noise is stronger, diffusion behaves as l(2)/2 in the dominant direction and as K(2)/4 in the nondominant direction. Diffusion in the nondominant direction can be important if the equilibrium system is translationally invariant in the dominant direction.
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Affiliation(s)
- G Park
- Physics Department, Korea Advanced Institute of Science and Technology, 373-1 Kusong-dong, Yuseong-ku, Taejon 305-701, Korea
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Abstract
Psychologic factors in functional dyspepsia have been discussed in many previous articles. However, the relationship between depression and functional dyspepsia is still obscure. We investigated the impact of depression on clinical symptoms and gastric dysrhythmia in functional dyspepsia. Thirty-nine patients with functional dyspepsia and 18 healthy subjects were included. Patients were investigated with clinical symptoms assessment, Zung's self-rating depression scale, and electrogastrography. Patients with functional dyspepsia were divided into two groups: 21 patients with depression and 18 patients without depression. The depressed patients had similar total gastrointestinal symptom severity scores compared with the nondepressed patients, but with higher total symptom frequency scores (p < 0.05). With regards to symptoms, the depressed patients had higher abdominal fullness severity and frequency scores and nausea frequency scores. The patients with functional dyspepsia had a lower percentage of normal slow wave in both the fasting and fed states and a higher percentage of bradygastria in the fasting state and tachygastria in the postprandial state (p < 0.05). There was no significant difference in the percentage of bradygastria or tachygastria between the depressed and nondepressed patients. There was no correlation between the specific type of electrogastrographic abnormality and the presence or absence of depression in functional dyspepsia patients.
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Affiliation(s)
- L T Chou
- Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
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Abstract
A significantly improved analytic understanding of the extrinsically driven diffusion process is presented in a nonlinear dynamical system in which the phase space is divided into periodic two-dimensional tiles of regular motion, separated by a connected separatrix network (web) [previously studied by A. J. Lichtenberg and Blake P. Wood, Phys. Rev. Lett. 62, 2213 (1989)]. The system is represented by the usual "kicked Harper map" with added extrinsic noise terms. Three different diffusion regimes are found depending upon the strength of the extrinsic perturbation l relative to the web and regular motions. When the extrinsic noise is dominant over the intrinsic stochasticity and the regular rotation motions in the tile, diffusion obeys the random phase scaling l(2). When the extrinsic noise is dominant over the intrinsic stochasticity, but weaker than the regular rotation motion, the diffusion scales as lK(1/2), where K is the strength of the intrinsic kick. These findings agree well with numerical simulation results. When the extrinsic noise process is weaker than the stochastic web process, we analytically reproduce the well-known numerical result: The web diffusion is reduced by the ratio of phase-space areas of intrinsic to extrinsic stochasticity.
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Affiliation(s)
- G Park
- Department of Physics, Korea Advanced Institute of Science and Technology, 373-1 Kusong-dong, Yuseong-ku, Taejon 305-701, Korea
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