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Chen TH, Wang HC, Chang CJ, Lee SY. Mitochondrial Glutathione in Cellular Redox Homeostasis and Disease Manifestation. Int J Mol Sci 2024; 25:1314. [PMID: 38279310 PMCID: PMC10816320 DOI: 10.3390/ijms25021314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/15/2024] [Accepted: 01/19/2024] [Indexed: 01/28/2024] Open
Abstract
Mitochondria are critical for providing energy to maintain cell viability. Oxidative phosphorylation involves the transfer of electrons from energy substrates to oxygen to produce adenosine triphosphate. Mitochondria also regulate cell proliferation, metastasis, and deterioration. The flow of electrons in the mitochondrial respiratory chain generates reactive oxygen species (ROS), which are harmful to cells at high levels. Oxidative stress caused by ROS accumulation has been associated with an increased risk of cancer, and cardiovascular and liver diseases. Glutathione (GSH) is an abundant cellular antioxidant that is primarily synthesized in the cytoplasm and delivered to the mitochondria. Mitochondrial glutathione (mGSH) metabolizes hydrogen peroxide within the mitochondria. A long-term imbalance in the ratio of mitochondrial ROS to mGSH can cause cell dysfunction, apoptosis, necroptosis, and ferroptosis, which may lead to disease. This study aimed to review the physiological functions, anabolism, variations in organ tissue accumulation, and delivery of GSH to the mitochondria and the relationships between mGSH levels, the GSH/GSH disulfide (GSSG) ratio, programmed cell death, and ferroptosis. We also discuss diseases caused by mGSH deficiency and related therapeutics.
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Affiliation(s)
- Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan;
| | - Hsiang-Chen Wang
- Department of Mechanical Engineering, National Chung Cheng University, Chiayi 62102, Taiwan;
| | - Chia-Jung Chang
- Division of Critical Care Medicine, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Shih-Yu Lee
- Division of Critical Care Medicine, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
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Chen HY, Lee CY, Hsu CW, Yeh JH, Chen TH, Tsai KF, Chou CK. Double-endoscope endoscopic submucosal dissection with snare traction and loop stabilization for adenoma involving appendiceal orifice. Endoscopy 2023; 55:E1203-E1204. [PMID: 37989238 PMCID: PMC10762688 DOI: 10.1055/a-2197-8828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Affiliation(s)
- Hsin-Yu Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Cathay General Hospital, Taipei, Taiwan
| | - Chung-Ying Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chao-Wen Hsu
- Division of Colorectal Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Hao Yeh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA DaChang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan
| | - Kun-Feng Tsai
- Department of Internal Medicine, Gastroenterology and Hepatology Section, An Nan Hospital, China Medical University, Tainan, Taiwan
- Department of Medical Sciences Industry, Chang Jung Christian University, Tainan, Taiwan
| | - Chu-Kuang Chou
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
- Obesity center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
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Shen YR, Chen TH, Liang SL, Cheng XY, Lv JW, Jiang YX, Cheng L, Yu YB, Jin GR, Chen AX. The generation of genuine quadripartite Einstein-Podolsky-Rosen steering in an optical superlattice. Sci Rep 2023; 13:21196. [PMID: 38040917 PMCID: PMC10692164 DOI: 10.1038/s41598-023-48626-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/28/2023] [Indexed: 12/03/2023] Open
Abstract
Einstein-Podolsky-Rosen (EPR) steering is a quantum effect based on quantum entanglement and it is the key resource for building quantum networks because of its useful properties. Based on the criterion for genuine multipartite EPR steering, the genuine quadripartite EPR steering is confirmed and it can be generated by a spontaneous parametric down-conversion cascaded process with two sum-frequency generations in an optical superlattice. This occurs either below the oscillation threshold and without oscillation threshold. The influence of the parameters of cascaded nonlinear process on the quadripartite EPR steering among signal, idler, and two sum-frequency beams are also discussed. Choosing appropriate nonlinear parameters can achieve good quadripartite quantum steering. This scheme of the generation of genuine quadripartite EPR steering has potential applications in quantum communication and computing.
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Affiliation(s)
- Y R Shen
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - T H Chen
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - S L Liang
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - X Y Cheng
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - J W Lv
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - Y X Jiang
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - L Cheng
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China.
| | - Y B Yu
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China.
| | - G R Jin
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
| | - A X Chen
- Key Laboratory of Optical Field Manipulation of Zhejiang Province, Department of Physics, Zhejiang Sci-Tech University, Hangzhou, 310018, China
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Liu CS, Chen TH, Wang RY, Lee HL, Chiou JF, Lu LS. Cardiopulmonary Protection for Bilateral Breast Irradiation: A Dosimetric Comparison between Proton and Photon Plans. Int J Radiat Oncol Biol Phys 2023; 117:e688-e689. [PMID: 37786021 DOI: 10.1016/j.ijrobp.2023.06.2159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Recent advances in cancer treatment improve cancer survivorship. Cardiovascular disease has become the leading cause of non-cancer death in breast cancer survivors. Therefore, risk of cardiopulmonary toxicities during multimodality treatment should be assessed carefully. It remains to be defined the best scenario for proton therapy to confer meaningful cardiovascular protection in the setting of breast irradiation. We hypothesized proton therapy plan provides optimal cardiopulmonary protection during bilateral breast irradiation. The study aimed to compare cardiopulmonary dosimetric parameters of proton and photon radiotherapy plans. MATERIALS/METHODS We conducted a retrospective study and patients with bilateral breast cancer indicated for radiotherapy between January 01, 2010 and December 31, 2020 were included. All patients received whole breast or chest wall irradiation with or without regional nodal irradiation. The dose scheme was 50-50.4 Gy in 25-28 fractions. Boost was allowed if patients receiving breast conserving surgery or known risk factors. The dosimetric parameters included planning target volume, mean dose to the heart, the volume of whole lung receiving 5 Gy, 10 Gy, and 20 Gy. For photon therapy, volumetric modulated arc therapy using double partial arc plans was generated with Pinnacle 9.8, Elekta Synergy and tomotherapy helical plan was generated with Tomo Hi-Art planning system. For proton therapy, treatment planning was generated with Ray station 9A. All data was managed using SAS v.9.4 software. Analysis of variance (α = 0.05) was used to compute the dosimetry of different treatment modalities. The statistical significance was considered with a p-value <0.05. RESULTS Thirty-one patients with bilateral breast cancer were included, including 12 bilateral breast irradiation patients and 6 bilateral chest wall irradiation patients. The mean dose of heart was 53.0±43.3 cGy in proton therapy while 736.6±225.1 cGy and 869.67±241.0 cGy in Tomotherapy and volumetric modulated arc therapy respectively. The volume of whole lung receiving 5 Gy was 15.4±7.91% in proton therapy while 46.1±10.8% and 46.3±2.5% in Tomotherapy and volumetric modulated arc therapy respectively. The volume of whole lung receiving 20 Gy was 7.7±4.3% in proton therapy while 15.4±5.6% and 19±3.5% in Tomotherapy and volumetric modulated arc therapy respectively. The effects of cardiopulmonary protection were more significant for chest wall irradiation over breast irradiation. CONCLUSION Proton radiotherapy provided significant dose reduction for bilateral breast irradiation. The benefit is more significant is patients receiving bilateral chest wall irradiation. Further clinical validations will be warranted to confirm the clinical relevance of the finding.
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Affiliation(s)
- C S Liu
- Taipei Medical University Hospital, Taipei 10449, Taiwan
| | - T H Chen
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - R Y Wang
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - H L Lee
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - J F Chiou
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - L S Lu
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
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Chen TH, Lin SC, Chiou JF, Chen CP, Hsu SM, Tseng KH, Lu LS. Analysis of Skin Dose and Position Stability for a New Personalized Device for Breast Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e169. [PMID: 37784774 DOI: 10.1016/j.ijrobp.2023.06.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Whole breast irradiation is the standard treatment for patients with early-stage breast cancer. We previously developed a personalized breast support device (PERSBRA) that reduced heart and lung radiation exposure. However, the skin dose was concerned for the device due to its thickness. In this study, we designed the new honeycomb structures to reduce the dose to the skin and maintain stable breast position with this device. MATERIALS/METHODS Three different structures of PERSBRA were designed. They were solid structure, honeycomb structures with 3.5 mm wall thickness and honeycomb structures with 4.5 mm wall thickness respectively. Those patients who scheduled to receive whole breast irradiation were enrolled for anthropometric breast position analysis. Stability of breast position in supine with PERSBRA were analyzed by scanning with a 3D infrared scanner. The distances between the nipples, between the nipple and the xiphoid process, and between the nipple and the inframammary fold were used to be the index. 32 patients were enrolled for anthropometric breast position analysis. The skin dose was simulated using the thermoluminescent dosimeter (TLD) positioned on the phantom with PERSBRA in the treatment scenario. RESULTS The displacements between two nipples, the nipple and the infra mammary point, and the nipple and the xiphoid process were 1.4%, 1.2%, and 0.4% for 3.5 mm honeycomb structure. Meanwhile, these displacements were 0.8%, 0.7% and 0.2% for solid 10% structure. Compared to these results, there were no significant difference for the two designations. The surface dose simulating the treatment scenario were 78.27%, 89.39% and 91.9% of prescribed dose for the 3.5mm, 4.5 mm honeycomb structure and the solid 10% filled structure, respectively. The 3.5 mm honeycomb structure reduce the surface dose significantly compared to another two designations. CONCLUSION The honeycomb structures do not jeopardize mechanical properties of PERSBRA or the breast positional stability support. Moreover, honeycomb structure with 3.5 mm thickness effectively reduces skin surface dose on a breast phantom. These data encourage further clinical studies to investigate the effects of such design on radiation dermatitis during whole breast irradiation.
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Affiliation(s)
- T H Chen
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - S C Lin
- Department of Graduate Institution of Biomedical Material and Tissue Engineering, Taipei Medical University, Taipei, Taiwan
| | - J F Chiou
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - C P Chen
- Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - S M Hsu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - K H Tseng
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - L S Lu
- Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
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Chou CK, Nguyen HT, Wang YK, Chen TH, Wu IC, Huang CW, Wang HC. Preparing Well for Esophageal Endoscopic Detection Using a Hybrid Model and Transfer Learning. Cancers (Basel) 2023; 15:3783. [PMID: 37568599 PMCID: PMC10417640 DOI: 10.3390/cancers15153783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Early detection of esophageal cancer through endoscopic imaging is pivotal for effective treatment. However, the intricacies of endoscopic diagnosis, contingent on the physician's expertise, pose challenges. Esophageal cancer features often manifest ambiguously, leading to potential confusions with other inflammatory esophageal conditions, thereby complicating diagnostic accuracy. In recent times, computer-aided diagnosis has emerged as a promising solution in medical imaging, particularly within the domain of endoscopy. Nonetheless, contemporary AI-based diagnostic models heavily rely on voluminous data sources, limiting their applicability, especially in scenarios with scarce datasets. To address this limitation, our study introduces novel data training strategies based on transfer learning, tailored to optimize performance with limited data. Additionally, we propose a hybrid model integrating EfficientNet and Vision Transformer networks to enhance prediction accuracy. Conducting rigorous evaluations on a carefully curated dataset comprising 1002 endoscopic images (comprising 650 white-light images and 352 narrow-band images), our model achieved exceptional outcomes. Our combined model achieved an accuracy of 96.32%, precision of 96.44%, recall of 95.70%, and f1-score of 96.04%, surpassing state-of-the-art models and individual components, substantiating its potential for precise medical image classification. The AI-based medical image prediction platform presents several advantageous characteristics, encompassing superior prediction accuracy, a compact model size, and adaptability to low-data scenarios. This research heralds a significant stride in the advancement of computer-aided endoscopic imaging for improved esophageal cancer diagnosis.
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Affiliation(s)
- Chu-Kuang Chou
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan;
- Obesity Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Hong-Thai Nguyen
- Department of Mechanical Engineering, National Chung Cheng University, Chiayi 62102, Taiwan;
| | - Yao-Kuang Wang
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 80756, Taiwan;
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80756, Taiwan;
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80756, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan;
| | - I-Chen Wu
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80756, Taiwan;
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80756, Taiwan
| | - Chien-Wei Huang
- Department of Gastroenterology, Kaohsiung Armed Forces General Hospital, Kaohsiung City 80284, Taiwan
- Department of Nursing, Tajen University, 20, Weixin Rd., Yanpu Township, Pingtung 90741, Taiwan
| | - Hsiang-Chen Wang
- Department of Mechanical Engineering, National Chung Cheng University, Chiayi 62102, Taiwan;
- Hitspectra Intelligent Technology Co., Ltd., Kaohsiung City 80661, Taiwan
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Dewi AK, Sharma RK, Das K, Sukul U, Lin PY, Huang YH, Lu CM, Lu CK, Chen TH, Chen CY. Biologically-induced synthetic manganese carbonate precipitate (BISMCP) for potential applications in heavy metal removal. Heliyon 2023; 9:e15919. [PMID: 37223715 PMCID: PMC10200859 DOI: 10.1016/j.heliyon.2023.e15919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/14/2023] [Accepted: 04/26/2023] [Indexed: 05/25/2023] Open
Abstract
Heavy metal pollution of water is a burning issue of today's world. Among several strategies involved for heavy metal remediation purpose, biomineralization has shown great potential. Of late, research has been focused on developing effective mineral adsorbents with reduced time and cost consumption. In this present paper, the Biologically-Induced Synthetic Manganese Carbonate Precipitate (BISMCP) was produced based on the biologically-induced mineralization method, employing Sporosarcina pasteurii in aqueous solutions containing urea and MnCl2. The prepared adsorbent was characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), SEM-energy dispersive X-ray spectroscopy (SEM-EDX), X-ray diffraction (XRD) and BET surface area analyzer. EDX analysis showed the elements in the crystal BISMCP were Mn, C, and O. XRD result of BISMCP determined the crystal structure, which is close to rhodochrosite (MnCO3). Spectral peaks of FTIR at 1641.79 cm-1 confirmed the appearance of C[bond, double bond]O binding, with strong stretching of CO32- in Amide I. From the six kinds of BISMCP produced, sample MCP-6 has the higher specific surface area by BET analysis at 109.01 m2/g, with pore size at 8.76 nm and higher pore volume at 0.178 cm3/g. These specifications will be suitable as an adsorbent for heavy metal removal by adsorption process. This study presents a preliminary analysis of the possibility of BISMCP for heavy metals adsorption using ICP multi-element standard solution XIII (As, Cr, Cd, Cu, Ni, and Zn). BISMCP formed from 0.1 MnCl2 and 30 ml of bacteria volume (MCP-6) produced a better adsorbent material than others concentrations, with the adsorption efficiency of total As at 98.9%, Cr at 97.0%, Cu at 94.7%, Cd at 88.3%, Zn at 48.6%, and Ni at 29.5%. Future work could be examined its efficiency adsorbing individual heavy metals.
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Affiliation(s)
- Anggraeni Kumala Dewi
- Department of Physics, National Chung Cheng University, University Road, Minhsiung, Chiayi County, 62102, Taiwan
- Doctoral Program in Science, Technology, Environment, and Mathematics, Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
| | - Raju Kumar Sharma
- Doctoral Program in Science, Technology, Environment, and Mathematics, Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
- Department of Chemistry and Biochemistry, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
| | - Koyeli Das
- Doctoral Program in Science, Technology, Environment, and Mathematics, Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
- Department of Biomedical Sciences, Graduate Institute of Molecular Biology, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
| | - Uttara Sukul
- Doctoral Program in Science, Technology, Environment, and Mathematics, Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
- Department of Biomedical Sciences, Graduate Institute of Molecular Biology, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
| | - Pin-Yun Lin
- Department of Chemistry and Biochemistry, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
| | - Yi-Hsun Huang
- Doctoral Program in Science, Technology, Environment, and Mathematics, Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
| | - Chung Ming Lu
- Doctoral Program in Science, Technology, Environment, and Mathematics, Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
- Department of Chemical Engineering, National Chung Cheng University, University Road, Minhsiung, Chiayi County, 62102, Taiwan
| | - Cheng-Kang Lu
- Department of Chest Division, Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital 600566, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital 600566, Taiwan
| | - Chien-Yen Chen
- Doctoral Program in Science, Technology, Environment, and Mathematics, Department of Earth and Environmental Sciences, National Chung Cheng University, 168 University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
- Center for Nano Bio-Detection, Center for Innovative Research on Aging Society, AIM-HI, National Chung Cheng University, 168, University Road, Min-Hsiung, Chiayi County, 62102, Taiwan
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Chen TH, Chang CJ, Hung PH. Possible Pathogenesis and Prevention of Long COVID: SARS-CoV-2-Induced Mitochondrial Disorder. Int J Mol Sci 2023; 24:8034. [PMID: 37175745 PMCID: PMC10179190 DOI: 10.3390/ijms24098034] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
Patients who have recovered from coronavirus disease 2019 (COVID-19) infection may experience chronic fatigue when exercising, despite no obvious heart or lung abnormalities. The present lack of effective treatments makes managing long COVID a major challenge. One of the underlying mechanisms of long COVID may be mitochondrial dysfunction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can alter the mitochondria responsible for energy production in cells. This alteration leads to mitochondrial dysfunction which, in turn, increases oxidative stress. Ultimately, this results in a loss of mitochondrial integrity and cell death. Moreover, viral proteins can bind to mitochondrial complexes, disrupting mitochondrial function and causing the immune cells to over-react. This over-reaction leads to inflammation and potentially long COVID symptoms. It is important to note that the roles of mitochondrial damage and inflammatory responses caused by SARS-CoV-2 in the development of long COVID are still being elucidated. Targeting mitochondrial function may provide promising new clinical approaches for long-COVID patients; however, further studies are needed to evaluate the safety and efficacy of such approaches.
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Affiliation(s)
- Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan;
| | - Chia-Jung Chang
- Division of Critical Care Medicine, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Peir-Haur Hung
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan;
- Department of Life and Health Science, Chia-Nan University of Pharmacy and Science, Tainan 717301, Taiwan
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Zhao F, Zhang YL, Liu X, Chen TH, Li J. [A case of malignant peritoneal mesothelioma]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:307-309. [PMID: 37248188 DOI: 10.3760/cma.j.cn121094-20220328-00158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Malignant mesothelioma is a highly malignant disease that most often occurs in the pleural cavity, followed by the peritoneum and pericardium. Malignant peritoneal mesothelioma (MPM) accounts for 10%-15% of all mesothelioma. The most important risk factor for MPM is exposure to asbestos. MPM has no specific clinical symptoms, imaging and histopathology are critical for the diagnosis. There are currently no generally accepted guidelines for curative treatment of MPM. The patient mainly presented with abdominal pain, abdominal distension and discomfort. Due to extensive omentum metastasis, no further surgical treatment was performed. Pemetrexed combined with cisplatin chemotherapy was given for 2 cycles, and the patient is still alive.
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Affiliation(s)
- F Zhao
- General Surgery of Ziyang First People's Hospital, Ziyang 641300, China
| | - Y L Zhang
- General Surgery of Ziyang First People's Hospital, Ziyang 641300, China
| | - X Liu
- General Surgery of Ziyang First People's Hospital, Ziyang 641300, China
| | - T H Chen
- General Surgery of Ziyang First People's Hospital, Ziyang 641300, China
| | - J Li
- General Surgery of Ziyang First People's Hospital, Ziyang 641300, China
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Chang RY, Chen TH, Kuo CJ, Tsai HL. Intravascular Ultrasound and Multidetector Computed Tomography Imaging of Polymethylmethacrylate Cement Leakage Inducing Inferior Vena Cava Thrombosis. Circ Cardiovasc Imaging 2023; 16:e014527. [PMID: 36325903 DOI: 10.1161/circimaging.122.014527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rei-Yeuh Chang
- Division of Cardiology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan (R.-Y.C., H.-L.T.).,Min-Hwei Junior College of Health Care Management, Tainan, Taiwan (R.-Y.C.)
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan (T.-H.C.)
| | - Chu-Jen Kuo
- Department of Radiology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan (C.-J.K.)
| | - Han-Lin Tsai
- Division of Cardiology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan (R.-Y.C., H.-L.T.)
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Chen TH, Koh KY, Lin KMC, Chou CK. Mitochondrial Dysfunction as an Underlying Cause of Skeletal Muscle Disorders. Int J Mol Sci 2022; 23:12926. [PMID: 36361713 PMCID: PMC9653750 DOI: 10.3390/ijms232112926] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 09/19/2023] Open
Abstract
Mitochondria are an important energy source in skeletal muscle. A main function of mitochondria is the generation of ATP for energy through oxidative phosphorylation (OXPHOS). Mitochondrial defects or abnormalities can lead to muscle disease or multisystem disease. Mitochondrial dysfunction can be caused by defective mitochondrial OXPHOS, mtDNA mutations, Ca2+ imbalances, mitochondrial-related proteins, mitochondrial chaperone proteins, and ultrastructural defects. In addition, an imbalance between mitochondrial fusion and fission, lysosomal dysfunction due to insufficient biosynthesis, and/or defects in mitophagy can result in mitochondrial damage. In this review, we explore the association between impaired mitochondrial function and skeletal muscle disorders. Furthermore, we emphasize the need for more research to determine the specific clinical benefits of mitochondrial therapy in the treatment of skeletal muscle disorders.
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Affiliation(s)
- Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Kok-Yean Koh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Kurt Ming-Chao Lin
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan 35053, Taiwan
| | - Chu-Kuang Chou
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
- Obesity Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
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12
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Tsai TJ, Mukundan A, Chi YS, Tsao YM, Wang YK, Chen TH, Wu IC, Huang CW, Wang HC. Intelligent Identification of Early Esophageal Cancer by Band-Selective Hyperspectral Imaging. Cancers (Basel) 2022; 14:cancers14174292. [PMID: 36077827 PMCID: PMC9454598 DOI: 10.3390/cancers14174292] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 12/18/2022] Open
Abstract
In this study, the combination of hyperspectral imaging (HSI) technology and band selection was coupled with color reproduction. The white-light images (WLIs) were simulated as narrow-band endoscopic images (NBIs). As a result, the blood vessel features in the endoscopic image became more noticeable, and the prediction performance was improved. In addition, a single-shot multi-box detector model for predicting the stage and location of esophageal cancer was developed to evaluate the results. A total of 1780 esophageal cancer images, including 845 WLIs and 935 NBIs, were used in this study. The images were divided into three stages based on the pathological features of esophageal cancer: normal, dysplasia, and squamous cell carcinoma. The results showed that the mean average precision (mAP) reached 80% in WLIs, 85% in NBIs, and 84% in HSI images. This study′s results showed that HSI has more spectral features than white-light imagery, and it improves accuracy by about 5% and matches the results of NBI predictions.
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Affiliation(s)
- Tsung-Jung Tsai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi City 60002, Taiwan
| | - Arvind Mukundan
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI) and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi City 62102, Taiwan
| | - Yu-Sheng Chi
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI) and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi City 62102, Taiwan
| | - Yu-Ming Tsao
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI) and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi City 62102, Taiwan
| | - Yao-Kuang Wang
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
| | - Tsung-Hsien Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi City 60002, Taiwan
| | - I-Chen Wu
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No. 100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
| | - Chien-Wei Huang
- Department of Gastroenterology, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st Rd., Lingya District, Kaohsiung City 80284, Taiwan
- Department of Nursing, Tajen University, 20, Weixin Rd., Yanpu Township, Pingtung County 90741, Taiwan
- Correspondence: (C.-W.H.); (H.-C.W.)
| | - Hsiang-Chen Wang
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High Tech Innovations (AIM-HI) and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi City 62102, Taiwan
- Director of Technology Development, Hitspectra Intelligent Technology Co., Ltd., 4F., No. 2, Fuxing 4th Rd., Qianzhen Dist., Kaohsiung City 80661, Taiwan
- Correspondence: (C.-W.H.); (H.-C.W.)
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13
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Hung PH, Hsu YC, Chen TH, Ho C, Lin CL. The Histone Demethylase Inhibitor GSK-J4 Is a Therapeutic Target for the Kidney Fibrosis of Diabetic Kidney Disease via DKK1 Modulation. Int J Mol Sci 2022; 23:ijms23169407. [PMID: 36012674 PMCID: PMC9409090 DOI: 10.3390/ijms23169407] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Diabetic kidney disease (DKD) can cause inflammation and fibrosis, in addition to being the main complication of diabetes. Among many factors, epigenetic alterations in aberrant histone modifications play a key role in causing DKD. In this study, the mechanism of GSK-J4, a histone demethylase KDM6A inhibitor, was evaluated in streptozotocin-induced diabetic mice. It was confirmed that GSK-J4, via dickkopf-1 (DKK1) modulation, could significantly reduce proteinuria and glomerulosclerosis in diabetic mice. The mRNA accumulation levels of DKK1, TGF-β1, fibronectin, and collagen IV were significantly elevated in diabetic mice. In contrast, the mRNA accumulations of those genes were significantly reduced in diabetic mice treated with GSK-J4 compared to those in diabetic mice, relatively speaking. The protein accumulation levels of fibronectin and collagen IV were significantly elevated in diabetic mice. Furthermore, GSK-J4 attenuated the high glucose-induced expression of profibrotic factors in mesangial cells via DKK1. In conclusion, our study provides a novel strategy to eliminate fibrosis in the kidneys of DKD mice. Using GSK-J4 reduces DKK1 expression, thereby ameliorating renal insufficiency, glomerulosclerosis morphological abnormalities, inflammation, and fibrosis in diabetic mice.
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Affiliation(s)
- Peir-Haur Hung
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan
- Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan 717301, Taiwan
| | - Yung-Chien Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan
| | - Cheng Ho
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
- Correspondence: (C.H.); (C.-L.L.)
| | - Chun-Liang Lin
- Department of Nephrology, Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
- Kidney and Diabetic Complications Research Team (KDCRT), Chang Gung Memorial Hospital, Chiayi 613016, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333423, Taiwan
- Kidney Research Center, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
- Center for Shockwave Medicine and Tissue Engineering, Chang Gung Memorial Hospital, Kaohsiung 833253, Taiwan
- Correspondence: (C.H.); (C.-L.L.)
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14
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Wu TC, Liao CY, Lu WC, Chang CR, Tsai FY, Jiang SS, Chen TH, Lin KMC, Chen LT, Chang WSW. Identification of distinct slow mode of reversible adaptation of pancreatic ductal adenocarcinoma to the prolonged acidic pH microenvironment. J Exp Clin Cancer Res 2022; 41:137. [PMID: 35410237 PMCID: PMC8996570 DOI: 10.1186/s13046-022-02329-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/13/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic neoplasm with high metastatic potential and poor clinical outcome. Like other solid tumors, PDAC in the early stages is often asymptomatic, and grows very slowly under a distinct acidic pHe (extracellular pH) microenvironment. However, most previous studies have only reported the fate of cancerous cells upon cursory exposure to acidic pHe conditions. Little is known about how solid tumors-such as the lethal PDAC originating within the pancreatic duct-acinar system that secretes alkaline fluids-evolve to withstand and adapt to the prolonged acidotic microenvironmental stress. METHODS Representative PDAC cells were exposed to various biologically relevant periods of extracellular acidity. The time effects of acidic pHe stress were determined with respect to tumor cell proliferation, phenotypic regulation, autophagic control, metabolic plasticity, mitochondrial network dynamics, and metastatic potentials. RESULTS Unlike previous short-term analyses, we found that the acidosis-mediated autophagy occurred mainly as an early stress response but not for later adaptation to microenvironmental acidification. Rather, PDAC cells use a distinct and lengthy process of reversible adaptive plasticity centered on the early fast and later slow mitochondrial network dynamics and metabolic adjustment. This regulates their acute responses and chronic adaptations to the acidic pHe microenvironment. A more malignant state with increased migratory and invasive potentials in long-term acidosis-adapted PDAC cells was obtained with key regulatory molecules being closely related to overall patient survival. Finally, the identification of 34 acidic pHe-related genes could be potential targets for the development of diagnosis and treatment against PDAC. CONCLUSIONS Our study offers a novel mechanism of early rapid response and late reversible adaptation of PDAC cells to the stress of extracellular acidosis. The presence of this distinctive yet slow mode of machinery fills an important knowledge gap in how solid tumor cells sense, respond, reprogram, and ultimately adapt to the persistent microenvironmental acidification.
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Affiliation(s)
- Tzu-Chin Wu
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, 350401 Taiwan
| | - Chien-Yu Liao
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, 350401 Taiwan
| | - Wei-Chien Lu
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, 350401 Taiwan
| | - Chuang-Rung Chang
- Institute of Molecular and Cellular Biology, College of Life Science, National Tsing Hua University, Hsinchu, 300044 Taiwan
| | - Fang-Yu Tsai
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, 350401 Taiwan
| | - Shih-Sheng Jiang
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, 350401 Taiwan
| | - Tsung-Hsien Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, 350401 Taiwan
- Current address: Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi, 60002 Taiwan
| | - Kurt Ming-Chao Lin
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, 350401 Taiwan
| | - Li-Tzong Chen
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, 350401 Taiwan
| | - Wun-Shaing Wayne Chang
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, 350401 Taiwan
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15
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Hsiao CY, Chen TH, Lee YC, Wang MC. Ureteral stone with hydronephrosis and urolithiasis alone are risk factors for acute kidney injury in patients with urinary tract infection. Sci Rep 2021; 11:23333. [PMID: 34857804 PMCID: PMC8639828 DOI: 10.1038/s41598-021-02647-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 11/09/2021] [Indexed: 12/18/2022] Open
Abstract
To identify whether urolithiasis with or without hydronephrosis has an impact on acute kidney injury (AKI) in patients with urinary tract infection (UTI). This study aimed to identify whether urolithiasis with or without hydronephrosis has an impact on AKI in patients with UTI. This retrospective study enrolled hospitalized UTI patients who underwent imaging in an acute care setting from January 2006 to April 2019. Of the 1113 participants enrolled, 191 (17.2%) had urolithiasis and 76 (6.8%) had ureteral stone complicated with hydronephrosis. Multivariate logistic regression analysis showed that in UTI patients with urolithiasis, the presence of ureteral stone with concomitant hydronephrosis was an independent risk factor for AKI (odds ratio [OR] 2.299, 95% confidence interval [CI] 1.112–4.755, P = 0.025). In addition, urolithiasis was associated with an increased risk for AKI (OR 2.451, 95% CI 1.369–4.389, P = 0.003) in UTI patients without hydronephrosis. The presence of ureteral stone with hydronephrosis increases the risk for AKI of UTI patients with urolithiasis, and urolithiasis remains a risk factor of AKI in UTI patients without hydronephrosis.
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Affiliation(s)
- Chih-Yen Hsiao
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.,Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Yi-Chien Lee
- Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Ming-Cheng Wang
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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16
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Feng YM, Chen TH, Berman D, Chou CK, Liao KS, Hsieh MC, Chen CY. Efficacy of Cyproheptadine Monotherapy in Hepatocellular Carcinoma With Bone Metastasis: A Case Report. Front Oncol 2021; 11:620212. [PMID: 34745929 PMCID: PMC8563693 DOI: 10.3389/fonc.2021.620212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have poorer prognoses. Case Presentation A 62-year-old woman with suspected advanced HCC accompanied by bone metastasis with severe back pain and sciatica showed disease remission after cyproheptadine monotherapy. Initially, her serum alpha fetal protein (AFP) level was high, reaching up to 17697.62 ng/ml. A dose of 4 mg cyproheptadine, 3 times a day for 17 months was prescribed as the only treatment. Within 3 months, the serum AFP level gradually normalized down to 4.3 ng/ml. Both liver biopsy and bone biopsies were subsequently performed after 2 weeks of cyproheptadine. The results showed no malignancy. During the 34 months of follow-ups, the serum AFP remained normal in the range of 1.05 to 2.86 ng/ml. The patient has survived for 5 years without back pain and sciatica thus far. Conclusions This is the first report to investigate a successful clinical approach in cyproheptadine monotherapy for an advanced HCC patient with bone metastasis. We recommend cyproheptadine as a potential anti-HCC agent for the treatment of HCC with bone metastasis, but more related studies such as prospectively clinical trials, and ideally randomized trials are still needed.
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Affiliation(s)
- Yu-Min Feng
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.,Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Dara Berman
- Charles H. Dyson School of Applied Economics and Management, SC Johnson College of Business, Cornell University, Ithaca, NY, United States
| | - Chu-Kuang Chou
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.,Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.,Clinical Trial Center, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Kai-Sheng Liao
- Department of Nursing, Chung-Jen Junior College of Nursing, Health Sciences and Management, Chiayi, Taiwan.,Department of Pathology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Ming-Chih Hsieh
- Department of Radiology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Chi-Yi Chen
- Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.,Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
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17
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Chen TY, Liu CH, Chen TH, Chen MR, Liu SW, Lin P, Lin KMC. Conditioned Media of Adipose-Derived Stem Cells Suppresses Sidestream Cigarette Smoke Extract Induced Cell Death and Epithelial-Mesenchymal Transition in Lung Epithelial Cells. Int J Mol Sci 2021; 22:ijms222112069. [PMID: 34769496 PMCID: PMC8584490 DOI: 10.3390/ijms222112069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/18/2022] Open
Abstract
The role of the epithelial-mesenchymal transition (EMT) in lung epithelial cells is increasingly being recognized as a key stage in the development of COPD, fibrosis, and lung cancers, which are all highly associated with cigarette smoking and with exposure to second-hand smoke. Using the exposure of human lung cancer epithelial A549 cells and non-cancerous Beas-2B cells to sidestream cigarette smoke extract (CSE) as a model, we studied the protective effects of adipose-derived stem cell-conditioned medium (ADSC-CM) against CSE-induced cell death and EMT. CSE dose-dependently induced cell death, decreased epithelial markers, and increased the expression of mesenchymal markers. Upstream regulator analysis of differentially expressed genes after CSE exposure revealed similar pathways as those observed in typical EMT induced by TGF-β1. CSE-induced cell death was clearly attenuated by ADSC-CM but not by other control media, such as a pass-through fraction of ADSC-CM or A549-CM. ADSC-CM effectively inhibited CSE-induced EMT and was able to reverse the gradual loss of epithelial marker expression associated with TGF-β1 treatment. CSE or TGF-β1 enhanced the speed of A549 migration by 2- to 3-fold, and ADSC-CM was effective in blocking the cell migration induced by either agent. Future work will build on the results of this in vitro study by defining the molecular mechanisms through which ADSC-CM protects lung epithelial cells from EMT induced by toxicants in second-hand smoke.
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Affiliation(s)
- Tzu-Yin Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan 35053, Taiwan; (T.-Y.C.); (C.-H.L.); (T.-H.C.); (M.-R.C.); (S.-W.L.)
| | - Chia-Hao Liu
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan 35053, Taiwan; (T.-Y.C.); (C.-H.L.); (T.-H.C.); (M.-R.C.); (S.-W.L.)
| | - Tsung-Hsien Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan 35053, Taiwan; (T.-Y.C.); (C.-H.L.); (T.-H.C.); (M.-R.C.); (S.-W.L.)
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 600566, Taiwan
| | - Mei-Ru Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan 35053, Taiwan; (T.-Y.C.); (C.-H.L.); (T.-H.C.); (M.-R.C.); (S.-W.L.)
| | - Shan-Wen Liu
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan 35053, Taiwan; (T.-Y.C.); (C.-H.L.); (T.-H.C.); (M.-R.C.); (S.-W.L.)
- Institute of Population Health, National Health Research Institutes, Zhunan 35053, Taiwan
| | - Pinpin Lin
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan 35053, Taiwan;
| | - Kurt Ming-Chao Lin
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan 35053, Taiwan; (T.-Y.C.); (C.-H.L.); (T.-H.C.); (M.-R.C.); (S.-W.L.)
- Correspondence: ; Tel.: +886-37206166 (ext. 37118)
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18
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Chen PY, Tsai TJ, Yang HY, Chou CK, Chang LJ, Chen TH, Hsu MT, Fang CC, Su CC, Lin YL, Feng YM, Chen CY. The Incidence of Bacteremia and Risk Factors of Post-Radiofrequency Ablation Fever for Patients with Hepato-Cellular Carcinoma. Cancers (Basel) 2021; 13:cancers13215303. [PMID: 34771466 PMCID: PMC8582517 DOI: 10.3390/cancers13215303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022] Open
Abstract
Post-radiofrequency ablation (RFA) fever is a self-limited complication of RFA. The correlation between post-RFA fever and bacteremia and the risk factors associated with post-RFA fever have not been evaluated. Patients with newly diagnosed or recurrent hepatocellular carcinoma who underwent ultrasonography-guided RFA between April 2014 and February 2019 were retrospectively enrolled. Post-RFA fever was defined as any episode of body temperature >38.0 °C after RFA during hospitalization. A total of 272 patients were enrolled, and there were 452 applications of RFA. The frequency of post-RFA fever was 18.4% (83/452), and 65.1% (54/83) of post-RFA fevers occurred on the first day after ablation. Patients with post-RFA fever had a longer hospital stay than those without (9.06 days vs. 5.50 days, p < 0.001). Only four (4.8%) patients with post-RFA fever had bacteremia. The independent factors associated with post-RFA fever were younger age (adjusted odds ratio (OR) = 0.96, 95% CI, 0.94-0.99, p = 0.019), low serum albumin level (adjusted OR = 0.49, 95% CI, 0.25-0.95, p = 0.036), general anesthesia (adjusted OR = 2.06, 95% CI, 1.15-3.69, p = 0.015), tumor size (adjusted OR = 1.52, 95% CI, 1.04-2.02, p = 0.032), and tumor number (adjusted OR = 1.71, 95% CI, 1.20-2.45, p = 0.003).
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Affiliation(s)
- Po-Yueh Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Tsung-Jung Tsai
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Hsin-Yi Yang
- Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan;
| | - Chu-Kuang Chou
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Li-Jen Chang
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
- Min-Hwei Junior College of Health Care Management, Tainan 73658, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Ming-Tse Hsu
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Chien-Chung Fang
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Chang-Chao Su
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Yu-Ling Lin
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Yu-Min Feng
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
| | - Chi-Yi Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan; (P.-Y.C.); (T.-J.T.); (C.-K.C.); (L.-J.C.); (T.-H.C.); (M.-T.H.); (C.-C.F.); (C.-C.S.); (Y.-L.L.); (Y.-M.F.)
- Correspondence: ; Tel.: +886-5-2765041 (ext. 62535)
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19
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Sharma RK, Wang SC, Maity JP, Banerjee P, Dey G, Huang YH, Bundschuh J, Hsiao PG, Chen TH, Chen CY. A novel BMSN (biologically synthesized mesoporous silica nanoparticles) material: synthesis using a bacteria-mediated biosurfactant and characterization. RSC Adv 2021; 11:32906-32916. [PMID: 35493595 PMCID: PMC9042205 DOI: 10.1039/d1ra05852e] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/02/2021] [Indexed: 11/21/2022] Open
Abstract
Mesoporous materials (MMs) have recently been applied as advanced nanomaterials in different fields (separation, catalysis, adsorption etc.). Synthesis of MMs by chemical surfactants is not ecofriendly. This study focused on the biological synthesis of a MM by sol–gel method, using a Bacillus subtilis BBK006-mediated surfactant (template) and a precursor (TEOS). The biologically synthesized mesoporous silica nanoparticles (BMSN) were formed at calcination temperatures of 450–600 °C. The BMSN comprise Si and O elements with specific weights of 56.09% and 42.13% respectively, where the atomic% was detected to be 41.79% and 55.10%, respectively. The phase identity of the synthesized particles (61–300 nm uniform spherical shape; surface area: 8.2616 m2 g−1; pore diameter at 550 °C: 14.8516 nm) was confirmed with wide-angle XRD (10°–81°). A typical type IV isotherm was exhibited (BET curves) following IUPAC nomenclature and confirmed the mesoporous nature. The green-synthesized biosurfactant-mediated BMSN is an environmentally promising material to apply in biomedical science (e.g., antimicrobial activity, drug delivery, CMC, anticancer activity) and oil spill management. Synthesis of a novel BMSN material using bacteria-mediated biosurfactant and their characterization.![]()
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Affiliation(s)
- Raju Kumar Sharma
- Department of Chemistry and Biochemistry, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan.,Department of Earth and Environmental Sciences, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan
| | - Shau-Chun Wang
- Department of Chemistry and Biochemistry, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan
| | - Jyoti Prakash Maity
- Department of Earth and Environmental Sciences, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan .,Department of Chemistry, School of Applied Sciences, KIIT Deemed to be University Bhubaneswar Odisha 751024 India
| | - Pritam Banerjee
- Department of Earth and Environmental Sciences, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan .,Department of Biomedical Science, Graduate Institute of Molecular Biology, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan
| | - Gobinda Dey
- Department of Earth and Environmental Sciences, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan .,Department of Biomedical Science, Graduate Institute of Molecular Biology, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan
| | - Yi-Hsun Huang
- Department of Earth and Environmental Sciences, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan
| | - Jochen Bundschuh
- Department of Earth and Environmental Sciences, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan .,UNESCO Chair on Groundwater Arsenic within the 2030 Agenda for Sustainable Development, University of Southern Queensland (USQ) West Street Toowoomba QLD 4350 Australia
| | - Ping-Gune Hsiao
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital Chiayi City Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital Chiayi City Taiwan
| | - Chien-Yen Chen
- Department of Earth and Environmental Sciences, National Chung Cheng University 168 University Road, Min-Hsiung Chiayi County 62102 Taiwan
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20
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Tsai CL, Mukundan A, Chung CS, Chen YH, Wang YK, Chen TH, Tseng YS, Huang CW, Wu IC, Wang HC. Hyperspectral Imaging Combined with Artificial Intelligence in the Early Detection of Esophageal Cancer. Cancers (Basel) 2021; 13:cancers13184593. [PMID: 34572819 PMCID: PMC8469506 DOI: 10.3390/cancers13184593] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 02/08/2023] Open
Abstract
Simple Summary Detection of early esophageal cancer is important to improve patient survival, however, early diagnosis of the cancer cells is difficult, even for experienced endoscopists. This article provides a new method by using hyperspectral imaging and a deep learning diagnosis model to classify and diagnose esophageal cancer using a single-shot multibox detector. The accuracy of the results when using an RGB image in WLI was 83% and while using the spectrum data the accuracy was increased to 88%. There was an increase of 5% in WLI. The accuracy of the results when using an RGB image in NBI was 86% and while using the spectrum data the accuracy was increased to 91%. There was an increase of 5% in NBI. This study proves that the accuracy of prediction when using the spectrum data has been significantly improved and the diagnosis of narrow-band endoscopy data is more sensitive than that of white-light endoscopy. Abstract This study uses hyperspectral imaging (HSI) and a deep learning diagnosis model that can identify the stage of esophageal cancer and mark the locations. This model simulates the spectrum data from the image using an algorithm developed in this study which is combined with deep learning for the classification and diagnosis of esophageal cancer using a single-shot multibox detector (SSD)-based identification system. Some 155 white-light endoscopic images and 153 narrow-band endoscopic images of esophageal cancer were used to evaluate the prediction model. The algorithm took 19 s to predict the results of 308 test images and the accuracy of the test results of the WLI and NBI esophageal cancer was 88 and 91%, respectively, when using the spectral data. Compared with RGB images, the accuracy of the WLI was 83% and the NBI was 86%. In this study, the accuracy of the WLI and NBI was increased by 5%, confirming that the prediction accuracy of the HSI detection method is significantly improved.
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Affiliation(s)
- Cho-Lun Tsai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi City 60002, Taiwan; (C.-L.T.); (Y.-H.C.); (T.-H.C.)
| | - Arvind Mukundan
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High tech Innovations (AIM-HI) and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi County 62102, Taiwan; (A.M.); (Y.-S.T.)
| | - Chen-Shuan Chung
- Department of Internal Medicine, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City 22060, Taiwan;
| | - Yi-Hsun Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi City 60002, Taiwan; (C.-L.T.); (Y.-H.C.); (T.-H.C.)
| | - Yao-Kuang Wang
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan; (Y.-K.W.); (I.-C.W.)
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
| | - Tsung-Hsien Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia Yi City 60002, Taiwan; (C.-L.T.); (Y.-H.C.); (T.-H.C.)
| | - Yu-Sheng Tseng
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High tech Innovations (AIM-HI) and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi County 62102, Taiwan; (A.M.); (Y.-S.T.)
| | - Chien-Wei Huang
- Department of Gastroenterology, Kaohsiung Armed Forces General Hospital, 2, Zhongzheng 1st. Rd., Lingya District, Kaohsiung City 80284, Taiwan
- Department of Nursing, Tajen University, 20, Weixin Rd., Yanpu Township, Pingtung City 90741, Taiwan
- Correspondence: (C.-W.H.); (H.-C.W.)
| | - I-Chen Wu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan; (Y.-K.W.); (I.-C.W.)
- Department of Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung City 80756, Taiwan
| | - Hsiang-Chen Wang
- Department of Mechanical Engineering, Advanced Institute of Manufacturing with High tech Innovations (AIM-HI) and Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, 168, University Rd., Min Hsiung, Chia Yi County 62102, Taiwan; (A.M.); (Y.-S.T.)
- Correspondence: (C.-W.H.); (H.-C.W.)
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21
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Koner S, Chen JS, Hsu BM, Tan CW, Fan CW, Chen TH, Hussain B, Nagarajan V. Assessment of Carbon Substrate Catabolism Pattern and Functional Metabolic Pathway for Microbiota of Limestone Caves. Microorganisms 2021; 9:microorganisms9081789. [PMID: 34442868 PMCID: PMC8398112 DOI: 10.3390/microorganisms9081789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022] Open
Abstract
Carbon utilization of bacterial communities is a key factor of the biomineralization process in limestone-rich curst areas. An efficient carbon catabolism of the microbial community is associated with the availability of carbon sources in such an ecological niche. As cave environments promote oligotrophic (carbon source stress) situations, the present study investigated the variations of different carbon substrate utilization patterns of soil and rock microbial communities between outside and inside cave environments in limestone-rich crust topography by Biolog EcoPlate™ assay and categorized their taxonomical structure and predicted functional metabolic pathways based on 16S rRNA amplicon sequencing. Community level physiological profiling (CLPP) analysis by Biolog EcoPlate™ assay revealed that microbes from outside of the cave were metabolically active and had higher carbon source utilization rate than the microbial community inside the cave. 16S rRNA amplicon sequence analysis demonstrated, among eight predominant bacterial phylum Planctomycetes, Proteobacteria, Cyanobacteria, and Nitrospirae were predominantly associated with outside-cave samples, whereas Acidobacteria, Actinobacteria, Chloroflexi, and Gemmatimonadetes were associated with inside-cave samples. Functional prediction showed bacterial communities both inside and outside of the cave were functionally involved in the metabolism of carbohydrates, amino acids, lipids, xenobiotic compounds, energy metabolism, and environmental information processing. However, the amino acid and carbohydrate metabolic pathways were predominantly linked to the outside-cave samples, while xenobiotic compounds, lipids, other amino acids, and energy metabolism were associated with inside-cave samples. Overall, a positive correlation was observed between Biolog EcoPlate™ assay carbon utilization and the abundance of functional metabolic pathways in this study.
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Affiliation(s)
- Suprokash Koner
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi City 621, Taiwan; (S.K.); (B.H.)
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi City 621, Taiwan; (C.-W.F.); (V.N.)
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung 824, Taiwan;
| | - Bing-Mu Hsu
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi City 621, Taiwan; (C.-W.F.); (V.N.)
- Center for Innovative on Aging Society (CIRAS), National Chung Cheng University, Chiayi City 621, Taiwan
- Correspondence: ; Tel.: +886-5272-0411 (ext. 66218)
| | - Chao-Wen Tan
- Division of Cardiology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City 600, Taiwan;
| | - Cheng-Wei Fan
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi City 621, Taiwan; (C.-W.F.); (V.N.)
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City 600, Taiwan;
| | - Bashir Hussain
- Department of Biomedical Sciences, National Chung Cheng University, Chiayi City 621, Taiwan; (S.K.); (B.H.)
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi City 621, Taiwan; (C.-W.F.); (V.N.)
| | - Viji Nagarajan
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi City 621, Taiwan; (C.-W.F.); (V.N.)
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22
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Shih YJ, Chen JS, Chen YJ, Yang PY, Kuo YJ, Chen TH, Hsu BM. Impact of heavy precipitation events on pathogen occurrence in estuarine areas of the Puzi River in Taiwan. PLoS One 2021; 16:e0256266. [PMID: 34398929 PMCID: PMC8366992 DOI: 10.1371/journal.pone.0256266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 08/03/2021] [Indexed: 12/03/2022] Open
Abstract
Pathogen populations in estuarine areas are dynamic, as they are subject to multiple natural and anthropogenic challenges. Heavy rainfall events bring instability to the aquatic environment in estuaries, causing changes in pathogen populations and increased environmental sanitation and public health concerns. In this study, we investigated the effects of heavy precipitation on the occurrence of pathogens in the Puzi River estuary, which is adjacent to the largest inshore oyster farming area in Taiwan. Our results indicated that Vibrio parahaemolyticus and adenovirus were the most frequently detected pathogens in the area. There was a significant difference (Mann-Whitney U test, p < 0.01) in water quality parameters, including total coliform, Escherichia coli, water temperature, turbidity, salinity, and dissolved oxygen, between groups with and without V. parahaemolyticus. In addition, the detection rate was negatively correlated with the average daily rainfall (r2 > 0.8). There was no significant difference between water quality parameters and the presence/absence of adenovirus, but a positive correlation was observed between the average daily rainfall and the detection rate of adenovirus (r2 ≥ 0.75). We conclude that heavy precipitation changes estuarine water quality, causing variations in microbial composition, including pathogens. As extreme weather events become more frequent due to climate change, the potential impacts of severe weather events on estuarine environments require further investigation.
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Affiliation(s)
- Yi-Jia Shih
- Fujian Provincial Key Laboratory of Marine Fishery Resources and Eco-environment, Fisheries College, Jimei University, Xiamen, China
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan
| | - Jung-Sheng Chen
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan
| | - Yi-Jen Chen
- Department of Chest Division, Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Pei-Yu Yang
- Department of Laboratory, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Kinesiology, Health and Leisure, Chienkuo Technology University, Changhua City, Taiwan
| | - Yi-Jie Kuo
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
| | - Bing-Mu Hsu
- Department of Earth and Environmental Sciences, National Chung Cheng University, Chiayi, Taiwan
- Center for Innovative on Aging Society (CIRAS), National Chung Cheng University, Chiayi, Taiwan
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23
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Chang LJ, Chen TH. NSP16 2'-O-MTase in Coronavirus Pathogenesis: Possible Prevention and Treatments Strategies. Viruses 2021; 13:v13040538. [PMID: 33804957 PMCID: PMC8063928 DOI: 10.3390/v13040538] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 12/11/2022] Open
Abstract
Several life-threatening viruses have recently appeared, including the coronavirus, infecting a variety of human and animal hosts and causing a range of diseases like human upper respiratory tract infections. They not only cause serious human and animal deaths, but also cause serious public health problems worldwide. Currently, seven species are known to infect humans, namely SARS-CoV-2, MERS-CoV, SARS-CoV, HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1. The coronavirus nonstructural protein 16 (NSP16) structure is similar to the 5′-end capping system of mRNA used by eukaryotic hosts and plays a vital role in evading host immunity response and protects the nascent viral mRNA from degradation. NSP16 is also well-conserved among related coronaviruses and requires its binding partner NSP10 to activate its enzymatic activity. With the continued threat of viral emergence highlighted by human coronaviruses and SARS-CoV-2, mutant strains continue to appear, affecting the highly conserved NSP16: this provides a possible therapeutic approach applicable to any novel coronavirus. To this end, current information on the 2′-O-MTase activity mechanism, the differences between NSP16 and NSP10 in human coronaviruses, and the current potential prevention and treatment strategies related to NSP16 are summarized in this review.
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Affiliation(s)
- Li-Jen Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan;
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
- Correspondence: ; Tel.: +886-5276-5041
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24
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Chen CC, Chiang PC, Chen TH. The Biosafety and Risk Management in Preparation and Processing of Cerebrospinal Fluid and Other Neurological Specimens With Potential Coronavirus Infection. Front Neurol 2021; 11:613552. [PMID: 33551970 PMCID: PMC7855587 DOI: 10.3389/fneur.2020.613552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/24/2020] [Indexed: 11/17/2022] Open
Abstract
The recent outbreak of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2, has become a global threat. Due to neurological manifestations presented throughout the coronavirus disease process, the potential involvement of COVID-19 in central nervous system has attracted considerable attention. Notably, the neurologic system could be widely affected, with various complications such as acute cerebrovascular events, encephalitis, Guillain-Barré syndrome, and acute necrotizing hemorrhagic encephalopathy. However, the risk assessment of exposure to potential biohazards in the context of the COVID-19 pandemic has not been clearly clarified regarding the sampling, preparation, and processing neurological specimens. Further risk managements and implantations are seldom discussed either. This article aims to provide current recommendations and evidence-based reviews on biosafety issues of preparation and processing of cerebrospinal fluid and neurological specimens with potential coronavirus infection from the bedside to the laboratory.
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Affiliation(s)
- Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Pei-Chun Chiang
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
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25
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Lee YC, Chen TH, Hsiao MC, Hung PH, Tung SH, Hsiao CY. Glycated Hemoglobin < 6.5% Is Associated With Uroseptic Shock in Diabetic Patients With Urinary Tract Infection. Front Med (Lausanne) 2020; 7:515506. [PMID: 33344465 PMCID: PMC7748060 DOI: 10.3389/fmed.2020.515506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 11/02/2020] [Indexed: 11/18/2022] Open
Abstract
This study aimed to compare the clinical characteristics and treatment outcomes of diabetic and non-diabetic individuals with urinary tract infection (UTI) and determine whether glycated hemoglobin (HbA1c) levels <6. 5% leads to uroseptic shock in diabetic individuals. We retrospectively collected and analyzed the clinical data of 1,363 individuals with UTIs in Taiwan from January 2006 to January 2018. Of the 345 diabetic individuals, 61 (17.7%) developed uroseptic shock. Diabetic patients who developed uroseptic shock tended to be older and males and, had a history of congestive heart failure, urolithiasis, higher serum creatinine level during hospitalization, lower serum HbA1c level, bacteremia, and acute kidney injury. Backward stepwise multivariate logistic regression analysis showed that male gender [odds ratio (OR), 1.861; 95% confidence interval (CI), 1.009–3.433; P = 0.047], congestive heart failure (OR, 4.036; 95% CI, 1.542–10.565; P = 0.004), bacteremia (OR, 2.875; 95% CI, 1.539–5.370; P = 0.001), and HbA1c level <6.5% (OR, 2.923; 95% CI, 1.580–5.406; P = 0.001) were associated with an increased risk of developing uroseptic shock among diabetic patients during hospitalization due to UTI. HbA1c level <6.5% is independently associated with uroseptic shock in diabetic patients with UTI.
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Affiliation(s)
- Yi-Chien Lee
- Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan
| | - Tsung-Hsien Chen
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | | | - Peir-Haur Hung
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shao-Hsien Tung
- Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei, Taiwan
| | - Chih-Yen Hsiao
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
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26
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Fang X, Zhong WL, Yu L, Yang Z, Lin XQ, Chen TH. [Blood pressure control and influencing factors in hypertension patients with metabolic syndrome]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1514-1517. [PMID: 33076609 DOI: 10.3760/cma.j.cn112338-20190926-00704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the blood pressure control and its influencing factors in hypertension patients with MS. Methods: Between January 2017 and December 2018, more than 78 000 residents aged 35-75 years selected through convenient sampling were invited to participant in China Patient-Centered Evaluative Assessment of Cardiac Event Million Persons Project in Fujian province, physical and laboratory tests were conducted for them, and their basic information were recorded. A total of 5 281 hypertension patients with MS were included in the study. Results: The treatment rate of hypertension patients with MS was 55.5%, and the control rate was 7.2%. The control rate was higher in patients who were older, women, had advanced education level, had history or family history of cardiovascular disease. The results of multivariate analysis indicated that living area (urban or rural), cardiovascular history, diabetes, urine protein, BMI had impacts on both treatment and control of hypertension. Family history of cardiovascular disease, age, self-management of hypertension, dyslipidemia, waist circumference and drinking had impacts on the treatments, and gender had effects on the control. Conclusions: The treatment rate of hypertension patients with MS was unsatisfactory and the control rate was low. Intervention should be strengthened in rural area, males and young age groups, and activity of self-management group of hypertension should be conducted regularly.
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Affiliation(s)
- X Fang
- Department of Chronic and Non-communicable Disease Prevention and Control, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - W L Zhong
- Department of Chronic and Non-communicable Disease Prevention and Control, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - L Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350001, China
| | - Z Yang
- Department of Chronic and Non-communicable Disease Prevention and Control, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - X Q Lin
- Department of Chronic and Non-communicable Disease Prevention and Control, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - T H Chen
- Department of Chronic and Non-communicable Disease Prevention and Control, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
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27
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Hsiao CY, Chen TH, Lee YC, Hsiao MC, Hung PH, Wang MC. Risk factors for uroseptic shock in hospitalized patients aged over 80 years with urinary tract infection. Ann Transl Med 2020; 8:477. [PMID: 32395521 PMCID: PMC7210120 DOI: 10.21037/atm.2020.03.95] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background The purpose of this study was to compare clinical characteristics and outcomes in individuals of different age groups with urinary tract infection (UTI), and to identify the relationships among advanced age and uroseptic shock. Methods This retrospective study compared clinical characteristics and outcomes in patients in different age groups with UTI and identified relationships between advanced age and uroseptic shock among hospitalized patients with UTI in an acute hospital care setting from January 2006 to October 2018. Patients were divided into young (age below 65 years), old (65–80 years), and very old (above 80 years) groups. Results Of 1,043 participants, 269 (25.8%) were very old and 200 (19.2%) developed uroseptic shock. Very old age [odds ratio (OR) 1.99, 95% confidence interval (CI): 1.25–3.19, P=0.004], male (OR 1.54, 95% CI: 1.07–2.24, P=0.022), presented flank pain (OR 1.54, 95% CI: 1.05–2.24, P=0.025), congestive heart failure (CHF) (OR 2.54, 95% CI: 1.27–5.06, P=0.008), acute kidney injury (AKI) (OR 4.19, 95% CI: 2.78–6.30, P<0.001), bacteremia (OR 1.78, 95% CI: 1.25–2.53, P=0.001), and multiple drug-resistant (MDR) bacteria (OR 1.43, 95% CI: 1.02–2.00, P=0.039) were associated with an increased risk of uroseptic shock in patients with UTI. In very old patients with UTI, bacteremia (OR 2.54, 95% CI: 1.38–4.69, P=0.003) and AKI (OR 4.37, 95% CI: 2.15–8.90, P<0.001) were independently associated with uroseptic shock. Conclusions Very old patients with UTI had a higher risk of developing uroseptic shock than younger patients. Bacteremia was an independent risk factor for uroseptic shock in very old patients with UTI.
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Affiliation(s)
- Chih-Yen Hsiao
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi.,Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan
| | - Tsung-Hsien Chen
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi
| | - Yi-Chien Lee
- Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei
| | - Meng-Chang Hsiao
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Peir-Haur Hung
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi.,Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science, Tainan
| | - Ming-Cheng Wang
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
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Lin CH, Hung PH, Liu WS, Hu HY, Chung CJ, Chen TH. Infections and risk of end-stage renal disease in patients with nephrotic syndrome: a nationwide population-based case-control study. Ann Transl Med 2020; 8:228. [PMID: 32309375 PMCID: PMC7154467 DOI: 10.21037/atm.2020.01.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Infections are a major cause of morbidity in patients with nephrotic syndrome (NS); however, the risk of infections in NS and its subsequent effect on adverse renal outcomes are not well established. Methods From 2000–2013 claims data, 4,856 patients with NS were identified from the Taiwanese National Health Insurance Research Database (NHIRD). In the study group, 554 patients progressing to end-stage renal disease (ESRD), as identified during follow-up, were enrolled. In the control group, two patients with NS without progression to ESRD, during the same period, matched with one patient from the study group were included. The correlation between rates of infections and risk of ESRD in patients with NS was estimated using conditional logistic regression analysis. Results The proportion of outpatient visits for infections in patients with NS with and without progression to ESRD was 61.2% and 32.8%, respectively, and the proportion of hospitalization due to infections was 28.9% and 1.7%, respectively. The risk of ESRD was higher in patients with frequent outpatient visits for infections (>10 outpatient visits), with a relative risk of 3.20 [95% confidence interval (CI), 1.84–5.57]. Additionally, a significant association was found between severe infections requiring hospitalization and ESRD, with a relative risk of 7.01 (95% CI, 3.65–13.44). Subgroup analysis stratified by sex or age indicated that the risk associated with ESRD was significantly higher in female and elderly patients with NS. Conclusions The risk of ESRD in patients with NS was linked to the incidence of infection, especially those requiring hospitalization due to more severe bacterial infections. Implications of study results are important for clinicians who should be aware of the possibility of ESRD development in patients with NS with infectious complications.
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Affiliation(s)
- Chien-Hung Lin
- Department of Pediatrics, Zhongxing Branch, Taipei City Hospital, Taipei.,Institute of Clinical Medicine, National Yang-Ming University, Taipei.,Division of Pediatric Immunology and Nephrology, Department of Pediatrics, Taipei Veterans General Hospital, Taipei.,College of Science and Engineering, Fu Jen Catholic University, New Taipei
| | - Peir-Haur Hung
- Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan.,Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chiayi
| | - Wen-Sheng Liu
- College of Science and Engineering, Fu Jen Catholic University, New Taipei.,Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhong-Xing Branch, Taipei.,School of Medicine, National Yang-Ming University, Taipei.,Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei
| | - Hsiao-Yun Hu
- Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei.,Department of Education and Research, Taipei City Hospital, Taipei
| | - Chi-Jung Chung
- Department of Public Health, China Medical University, Taichung.,Department of Medical Research, China Medical University Hospital, Taichung
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chiayi
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Hsiao CY, Chen TH, Lee YC, Hsiao MC, Hung PH, Chen YY, Wang MC. Urolithiasis Is a Risk Factor for Uroseptic Shock and Acute Kidney Injury in Patients With Urinary Tract Infection. Front Med (Lausanne) 2019; 6:288. [PMID: 31867338 PMCID: PMC6906152 DOI: 10.3389/fmed.2019.00288] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/22/2019] [Indexed: 12/15/2022] Open
Abstract
Urinary tract infection (UTI) is a common complication in patients with urolithiasis. This study aimed to compare clinical manifestations and treatment outcomes among UTI patients with or without urolithiasis. It also focused on identifying relationships among urolithiasis, uroseptic shock, and acute kidney injury (AKI). This retrospective study enrolled hospitalized UTI patients who underwent imaging in an acute care setting from January 2006 to March 2015. Of 662 participants enrolled, 113 (17.1%) had urolithiasis, 107 (16.2%) developed uroseptic shock, and 184 (27.8%) developed AKI. A multivariate logistic regression analysis showed that in UTI patients, urolithiasis is associated with an increased risk of uroseptic shock (OR 1.80, 95% CI: 1.08-3.02, P = 0.025), AKI (OR 1.95, 95% CI: 1.22-3.12, P = 0.005), and bacteremia (OR 1.68, 95% CI: 1.08-2.64, P = 0.022). Urolithiasis is common in UTI patients and is associated with an increased risk of uroseptic shock and AKI.
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Affiliation(s)
- Chih-Yen Hsiao
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Tsung-Hsien Chen
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Yi-Chien Lee
- Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.,School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Meng-Chang Hsiao
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
| | - Peir-Haur Hung
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Applied Life Science and Health, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Yih-Yuan Chen
- Department of Biochemical Science and Technology, National Chiayi University, Chiayi, Taiwan
| | - Ming-Cheng Wang
- Division of Nephrology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Lin CH, Hung PH, Hu HY, Chung CJ, Chen TH, Hung KY. Clinically diagnosed urticaria and risk of systemic lupus erythematosus in children: A nationwide population-based case-control study. Pediatr Allergy Immunol 2018; 29:732-739. [PMID: 30054929 DOI: 10.1111/pai.12962] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/10/2018] [Accepted: 07/12/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Urticaria is one of the most common diseases seen in clinical practice, whereas several reports have proposed that urticaria may have a link with autoimmune disorders. Few studies have examined the clinical association between urticaria with systemic lupus erythematosus (SLE). By conducting a nationwide population-based case-control study in Taiwan, we evaluated the risk of SLE in children with a prior clinical diagnosis of urticaria. METHODS Using 2000-2011 claims data from the Taiwanese National Health Insurance Research Database, we identified 2105 SLE children during 2004-2011 as the study group, along with randomly selected 8420 non-SLE patients matched (1:4) for age, sex, and first diagnosis date as the control group. The correlation between urticaria and SLE risk was estimated using conditional logistic regression analysis. RESULTS The prevalence rates of clinically diagnosed acute and chronic urticaria in SLE patients were 22.09% and 18.24%, respectively. A significant association was found between clinically diagnosed urticaria and childhood SLE, with a stronger risk associated with more episodes of urticaria (≥3 visits, OR: 2.33, 95% CI 1.91-2.84). The risk was higher with chronic urticaria (OR: 2.21, 95% CI 1.85-2.64) than with acute urticaria (OR: 1.54, 95% CI 1.34-1.76). Subgroup analysis stratified by sex or age indicated that the risk associated with SLE was significantly greater among female children and adolescents with urticaria. CONCLUSIONS Our results suggest that children with urticaria have a significantly higher risk of SLE, with the risk increasing further among those with more episodes of urticaria or chronic urticaria.
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Affiliation(s)
- Chien-Hung Lin
- Department of Pediatrics, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Peir-Haur Hung
- Department of Applied Life Science and Health, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.,Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi City, Taiwan
| | - Hsiao-Yun Hu
- Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei, Taiwan.,Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Chi-Jung Chung
- Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Tsung-Hsien Chen
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-yi Christian Hospital, Chia-yi City, Taiwan
| | - Kuan-Yu Hung
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu City, Taiwan
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Yu JJ, Shen F, Chen TH, Liang L, Han J, Xing H, Zhou YH, Wang H, Gu WM, Lau WY, Yang T. Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma. Br J Surg 2018; 106:276-285. [PMID: 30199100 DOI: 10.1002/bjs.10981] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/09/2018] [Accepted: 07/20/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Whether preoperative bodyweight is associated with long-term prognosis in patients after liver resection for hepatocellular carcinoma (HCC) is controversial. This study aimed to investigate the relationship of patient weight with long-term recurrence and overall survival (OS) after curative liver resection for HCC. METHODS Data for patients with HCC who underwent curative liver resection between 2000 and 2015 in five centres in China were analysed retrospectively in three groups according to their preoperative BMI: underweight (BMI 18·4 kg/m2 or less), normal weight (BMI 18·5-24·9 kg/m2 ) and overweight (BMI 25·0 kg/m2 or above). Patients' baseline characteristics, operative variables and long-term survival outcomes were compared. Univariable and multivariable Cox regression analyses were performed to identify risk factors for OS and recurrence-free survival (RFS) after resection. RESULTS Of 1524 patients, 107 (7·0 per cent) were underweight, 891 (58·5 per cent) were of normal weight and 526 (34·5 per cent) were overweight. Univariable analyses showed that underweight and overweight patients had poorer OS (both P < 0·001) and RFS (both P < 0·001) than patients of normal weight. Multivariable Cox regression analysis also identified both underweight and overweight to be independent risk factors for OS (hazard ratio (HR) 1·22, 95 per cent c.i. 1·19 to 1·56, P = 0·019; and HR 1·57, 1·36 to 1·81, P < 0·001, respectively) and RFS (HR 1·28, 1·16 to 1·53, P = 0·028; and HR 1·34, 1·17 to 1·54, P < 0·001). CONCLUSION Underweight and overweight patients appear to have a worse prognosis than those of normal weight following liver resection for HCC.
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Affiliation(s)
- J J Yu
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.,Department of Clinical Medicine, Second Military Medical University, Shanghai, China
| | - F Shen
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - T H Chen
- Department of General Surgery, Ziyang First People's Hospital, Sichuan, China
| | - L Liang
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - J Han
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - H Xing
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Y H Zhou
- Department of Hepatobiliary Surgery, Pu'er People's Hospital, Yunnan, China
| | - H Wang
- Department of General Surgery, Liuyang People's Hospital, Hunan, China
| | - W M Gu
- The First Department of General Surgery, Fourth Hospital of Harbin, Heilongjiang, China
| | - W Y Lau
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.,Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - T Yang
- Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
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Chen TH, Chen MR, Chen TY, Wu TC, Liu SW, Hsu CH, Liou GG, Kao YY, Dong GC, Chu PH, Liao JW, Lin KMC. Cardiac fibrosis in mouse expressing DsRed tetramers involves chronic autophagy and proteasome degradation insufficiency. Oncotarget 2018; 7:54274-54289. [PMID: 27494843 PMCID: PMC5342341 DOI: 10.18632/oncotarget.11026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/22/2016] [Indexed: 11/25/2022] Open
Abstract
Proteinopathy in the heart which often manifests excessive misfolded/aggregated proteins in cardiac myocytes can result in severe fibrosis and heart failure. Here we developed a mouse model, which transgenically express tetrameric DsRed, a red fluorescent protein (RFP), in an attempt to mimic the pathological mechanisms ofcardiac fibrosis. Whilst DsRed is expressed and forms aggregation in most mouse organs, certain pathological defects are specifically recapitulated in cardiac muscle cells including mitochondria damages, aggresome-like residual bodies, excessive ubiquitinated proteins, and the induction of autophagy. The proteinopathy and cellular injuries caused by DsRed aggregates may be due to impaired or overburdened ubiquitin-proteasome system and autophagy-lysosome systems. We further identified that DsRed can be ubiquitinated and associated with MuRF1, a muscle-specific E3 ligase. Concomitantly, an activation of NF-κB signaling and a strong TIMP1 induction were noted, suggesting that RFP-induced fibrosis was augmented by a skewed balance between TIMP1 and MMPs. Taken together, our study highlights the molecular consequences of uncontrolled protein aggregation leading to congestive heart failure, and provides novel insights into fibrosis formation that can be exploited for improved therapy.
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Affiliation(s)
- Tsung-Hsien Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan
| | - Mei-Ru Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan
| | - Tzu-Yin Chen
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan
| | - Tzu-Chin Wu
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan
| | - Shan-Wen Liu
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan.,Institute of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Ching-Han Hsu
- Institute of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Gan-Guang Liou
- Institute of Molecular and Genomic Medicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan
| | - Yu-Ying Kao
- Department of Biotechnology, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Guo-Chung Dong
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan
| | - Pao-Hsien Chu
- Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jiunn-Wang Liao
- Graduate Institute of Veterinary Pathobiology, National Chung Hsing University, Taichung, Taiwan
| | - Kurt Ming-Chao Lin
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Zhunan, Miaoli, Taiwan
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Li SW, Liu C, Chen TH, Ning JH, Zhang T, Lyu FJ, Xu M. [Clinical effects of pediatric penetrating keratoplasty for congenital corneal opacity]. Zhonghua Yan Ke Za Zhi 2017; 53:941-946. [PMID: 29325387 DOI: 10.3760/cma.j.issn.0412-4081.2017.12.011] [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] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To report the clinical results of pediatric penetrating keratoplasty (PKP) in patients under 3 years old with congenital corneal opacity. Methods: Retrospective study. Sixteen eyes of 12 patients who were treated with PKP in Aier Eye Hospital Group from June 2009 to December 2016 were enrolled in this study. All the patients were diagnosed as congenital corneal opacities: 8 cases (11 eyes) with Peter's anomaly I, 2 cases (3 eyes) with sclerocornea, and 2 cases (2 eyes) with corneal dermoid tumor combined with iris synechia. Seven cases (7 eyes) were under 1 year old. Eight cases (10 eyes) could not follow the light. Only 1 case (2 eyes) received PKP with extracapsular cataract extraction, and the others only had PKP. Postoperative examinations were performed more frequently than in adults, and sometimes general anesthesia was needed. Results: The follow-up period was from 8 months to 6 years (33.17±22.60 months). The postoperative visual acuity improvement was found in all eyes from 1 week to 1 month after surgery except a 3-year-old patient with corneal dermoid tumor with serious esotropia. All the surgeries were successful without intraoperative complications. Graft rejection occurred in 4 cases (4 eyes). The graft of a 33-month-old patient became semitransparent. The grafts of 2 cases under 1 year old were clear after drug therapy. And the vision of a 3-year-old patient with Peter anomaly improved obviously, but immune rejection occurred 2 years after surgery. The second PKP was performed, but rejection occurred again. Secondary glaucoma was found in the other eye early after operation; anti-glaucoma surgery failed, and the graft became cloudy. Graft infection associated with loosened sutures was observed in one case (2 eyes) of sclerocornea, and the second PKP failed. Conclusions: For the patients with congenital corneal opacities, there is often a noticeable visual improvement after PKP. Good postoperative care, appropriate amblyopia treatment and timely examination are the keys to success. (Chin J Ophthalmol, 2017, 53: 941-946).
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Affiliation(s)
- S W Li
- Beijing Aier-Intech Eye Hospital, Beijing 100021, China
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Chen TH, Hu CC, Liao JT, Lee YL, Huang YW, Lin NS, Lin YL, Hsu YH. Production of Japanese Encephalitis Virus Antigens in Plants Using Bamboo Mosaic Virus-Based Vector. Front Microbiol 2017; 8:788. [PMID: 28515719 PMCID: PMC5413549 DOI: 10.3389/fmicb.2017.00788] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/18/2017] [Indexed: 12/27/2022] Open
Abstract
Japanese encephalitis virus (JEV) is among the major threats to public health in Asia. For disease control and prevention, the efficient production of safe and effective vaccines against JEV is in urgent need. In this study, we produced a plant-made JEV vaccine candidate using a chimeric virus particle (CVP) strategy based on bamboo mosaic virus (BaMV) for epitope presentation. The chimeric virus, designated BJ2A, was constructed by fusing JEV envelope protein domain III (EDIII) at the N-terminus of BaMV coat protein, with an insertion of the foot-and-mouth disease virus 2A peptide to facilitate the production of both unfused and epitope-presenting for efficient assembly of the CVP vaccine candidate. The strategy allowed stable maintenance of the fusion construct over long-term serial passages in plants. Immuno-electron microscopy examination and immunization assays revealed that BJ2A is able to present the EDIII epitope on the surface of the CVPs, which stimulated effective neutralizing antibodies against JEV infection in mice. This study demonstrates the efficient production of an effective CVP vaccine candidate against JEV in plants by the BaMV-based epitope presentation system.
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Affiliation(s)
- Tsung-Hsien Chen
- Graduate Institute of Biotechnology, National Chung Hsing UniversityTaichung, Taiwan
| | - Chung-Chi Hu
- Graduate Institute of Biotechnology, National Chung Hsing UniversityTaichung, Taiwan
| | - Jia-Teh Liao
- Graduate Institute of Biotechnology, National Chung Hsing UniversityTaichung, Taiwan
| | - Yi-Ling Lee
- Institute of Biomedical Sciences, Academia SinicaTaipei, Taiwan
| | - Ying-Wen Huang
- Graduate Institute of Biotechnology, National Chung Hsing UniversityTaichung, Taiwan
| | - Na-Sheng Lin
- Graduate Institute of Biotechnology, National Chung Hsing UniversityTaichung, Taiwan.,Institute of Plant and Microbial Biology, Academia SinicaTaipei, Taiwan
| | - Yi-Ling Lin
- Institute of Biomedical Sciences, Academia SinicaTaipei, Taiwan
| | - Yau-Heiu Hsu
- Graduate Institute of Biotechnology, National Chung Hsing UniversityTaichung, Taiwan
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Huang SF, Zhu Y, Lin XQ, Chen TH, Ye Y, Zhong WL, Lin SG, Yin P. [Estimation of underreporting rate of death cases in disease surveillance system of Fujian province using propensity score weighting method, 2012-2014]. Zhonghua Liu Xing Bing Xue Za Zhi 2016; 37:1476-1479. [PMID: 28057138 DOI: 10.3760/cma.j.issn.0254-6450.2016.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: To understand the underreporting of death cases and related factors in disease surveillance system of Fujian province. Methods: We carried out a field underreporting survey in 20 disease surveillance sites selected through stratified cluster random sampling during 2012-2014. The related factors of underreporting were analyzed by using logistic regression method. Propensity score weighting method was used to calculate the underreporting rate in different groups classified by year, urban/rural areas, gender, age and death cause variables. Results: The overall underreporting rate was 9.21%(95%CI: 9.06%-9.39%) after adjusting by propensity score weighting method. The underreporting rate was higher in rural area (11.55%, 95%CI: 11.30%-11.81%) than in urban area (6.64%, 95%CI: 6.50%-6.78%). The underreporting rate was highest in age group 0-14 years (36.29%, 95% CI: 34.23%-38.67%) and lowest in age group ≥65 years (7.91%, 95% CI: 7.78%-8.03%). The underreporting rate was higher in people died of perinatal disease, congenital anomalies and injury. Conclusion: The underreporting rates were different between different groups classified by urban/rural areas, age and death cause variables. Propensity score weighting method can be used to adjust underreporting rate of death cases in mortality surveillance in Fujian.
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Affiliation(s)
- S F Huang
- Department of Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - Y Zhu
- Department of Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - X Q Lin
- Department of Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - T H Chen
- Department of Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - Y Ye
- Department of Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - W L Zhong
- Department of Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - S G Lin
- Department of Chronic and Non-communicable Disease Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
| | - P Yin
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Abstract
BACKGROUND Workplace noise exposure gains growing attention in high tech industry. OBJECTIVE This study investigated the noise effect on physiological and subjective responses in semiconductor manufacturing clean room environment. METHODS Twenty subjects including 10 males and 10 females completed all phases of the experiment. Each subject was asked to participate in four treatment combinations of two noise intensities [65 dB(A) and 80 dB(A)] × two frequency levels [high and low]. For each treatment condition, the subject was exposed to the specified noise condition in a sound proof cabin for one hour. The physiological measures included blood pressure and heart rate. The subjective measures included noise sensitivity, fatigue and annoyance. RESULTS The ANOVA results indicate that long-time noise exposure caused significant increase in blood pressure (p< 0.001). Furthermore, the noise intensity by time interaction effect was found to be significant on annoyance and fatigue. CONCLUSIONS The findings suggest that prolonged exposure to noise intensity at 80 dB(A) would result in a significant increase in physiological cost and subjective discomfort feeling. Thus, some countermeasures should be taken to reduce noise exposure and to promote health, and quality of working life.
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Chen TH, Chen MR, Chen TY, Liu SW, Hsu CH, Lin KM. Abstract 626: Vascular Endothelial HSP60 and Von Willebrand Factor Induction Are Both Involved in Promoting Fatty-Streak Formation in ApoE Null Mice. Arterioscler Thromb Vasc Biol 2015. [DOI: 10.1161/atvb.35.suppl_1.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives:
This study was designed to determine the murine atherosclerosis in ApoE null mice with inducible expression of human heat shock protein 60 (hHSP60) in vascular endothelium.
Background:
Autoimmunity to HSP60 may be involved in eliciting early atherosclerotic lesions. Most classical risk factors of atherosclerosis were previously shown in cell culture models to induce HSP60 expression in vascular ECs and in vivo particularly at regions predilected to lesions. However, it has not been demonstrated directly in an animal model whether HSP60 induction in ECs are capable of influencing lesion formation.
Methods:
We developed ApoE
-/-
::Cdh5-CreER
T2
::G-Lox-HSP60 triple Tg mouse model with tamoxifen-induced hHSP60 expression in ECs. Eight week-old triple TG mice were fed by tamoxifen citrate-contained chow for 2 weeks, followed by high fat chow (HF) for additional 4 and 8 weeks before sacrificed for oil red staining for fatty streaks and IHC staining.
Results:
In tamoxifen-fed triple Tg mouse, vascular EC expression of hHSP60 increased fatty-streak formation and increased the severity of lesions in comparison with uninduced triple Tg or wildtype ApoE mouse. In triple Tg mouse, we found tamoxifen strongly induced HSP60 expression in ECs of the lesions and to a lesser degree in ECs of veins and other arterial regions not predilected to lesions. Concomitant VWF induction at ECs and subendothelial regions was observed at areas with increased HSP60 expression.
Conclusions:
hHSP60 induction at vascular ECs accelerates fatty-steak formation in ApoE null mice that may involve increasing local VWF expression.
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Affiliation(s)
- Tsung-Hsien Chen
- Biomedical Engineering and Nanomedicine, National Health Rsch Institutes, Zhunan Miaoli, Taiwan
| | - Mei-Ru Chen
- Biomedical Engineering and Nanomedicine, National Health Rsch Institutes, Zhunan Miaoli, Taiwan
| | - Tzu-Ying Chen
- Biomedical Engineering and Nanomedicine, National Health Rsch Institutes, Zhunan Miaoli, Taiwan
| | - Shan-Wen Liu
- Biomedical Engineering and Nanomedicine, National Health Rsch Institutes, Zhunan Miaoli, Taiwan
| | - Ching-Han Hsu
- Biomedical Engineering and Nanomedicine, National Tsin Hua Univ, Hsin Chu City, Taiwan
| | - Kurt M Lin
- Biomedical Engineering and Nanomedicine, National Health Rsch Institutes, Zhunan Town, Miaoli, Taiwan
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Chang YC, Lee KH, Chen TH, Tsai PJ, Chen PY, Guo MC, Lin SA, Chen JY, Yang WC, Ng YY. A case of intraperitoneal fracture of a double-cuff Tenckhoff catheter. Perit Dial Int 2014; 34:132-4. [PMID: 24525604 DOI: 10.3747/pdi.2012.00239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Y C Chang
- Division of Nephrology1 Department of Medicine2 Department of Surgery3 Taipei Veterans General Hospital National Yang-Ming University School of Medicine Taipei, Taiwan
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Chen DY, Schneider PF, Zhang XS, Luo XY, He ZM, Chen TH. Changes in graves' ophthalmopathy after radioiodine and anti-thyroid drug treatment of Graves' disease from 2 prospective, randomized, open-label, blinded end point studies. Exp Clin Endocrinol Diabetes 2013; 122:1-6. [PMID: 24203649 DOI: 10.1055/s-0033-1358484] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIMS A significant association between radioiodine therapy (RIT) and the development or the worsening of pre-existing Graves' ophthalmopathy (GO) has been reported. This post-hoc analysis of 2 studies attempted to describe the changes observed in pre-existing or new-onset GO following RIT with the goal of euthyroidism rather than hypothyroidism and to describe the relationship GO changes and the final outcome. PATIENTS AND METHODS In 2 prospective, randomized open-label blinded endpoint trials, patients received radioiodine alone; or, patients received radioiodine or antithyroid drug therapy (ATD). The severity and activity of GO were assessed during a 9-12-year follow-up. The study end points in study 1 were euthyroidism, hyperthyroidism, hypothyroidism, and changes in GO. In study 2, the end points were euthyroidism, hyperthyroidism, hypothyroidism, relapse, and changes in GO. RESULTS Both RIT and ATD were associated with worsening GO and new-onset GO. Both RIT and ATD led to similar aggravation of pre-existing GO or the development to new-onset GO. After RIT or ATD, the euthyroid patients (without levothyroxine substitution) demonstrated an improvement in GO, with 78-89% patients with preexisting GO exhibiting improvement, whereas hyperthyroid, hypothyroid and relapsed patients had worsening or new-onset GO. CONCLUSIONS Thyroid function is a dominant risk factor. Thyroid function may be the most important determinant in worsening or new-onset GO in both the natural disease course and in treated patients, independent of the kind of treatment. Therefore, we recommend euthyroidism as a goal of treatment.
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Affiliation(s)
- D Y Chen
- Department of Nuclear Medicine of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - P F Schneider
- Clinic for Nuclear Medicine, University Hospital, Würzburg, Germany
| | - X S Zhang
- Department of Nuclear Medicine of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - X Y Luo
- Ophthalmology Division, Guangdong General Hospital, Guangzhou, China
| | - Z M He
- Department of Internal Medicine of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - T H Chen
- Department of Nuclear Medicine of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Liu SW, Chen TH, Chen YL, Chen MR, Hsu CH, Lin KM. Abstract 092: Transgenic Expression of Heat Shock Protein 60 Results in Neonatal Death and Adult Heart Failure. Circ Res 2013. [DOI: 10.1161/res.113.suppl_1.a092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Heat shock proteins (HSPs) are known for their enhanced expression and pro-survival role in cells under noxious stress. Only recently was it discovered that aberrant expression of HSPs was linked to the onset of cardiovascular diseases. HSP60, originally identified as one of the mitochondrial chaperonins, was shown involved in autoimmune, metabolic, and cardiovascular diseases, but the roles of HSP60 remain unclear in part due to the lack of HSP60 transgenic mouse models. This study aims to investigate the outcome of expressing HSP60 in cardiac tissues to elucidate the role of HSP60 in initiating apoptotic cardiomyopathy.
By using a conditional HSP60 transgenic mouse line (G-Lox-HSP60) and a Cre mouse line, human HSP60 expression in most mouse tissues, driven by the ubiquitous CAG promoter, was achieved. The ubiquitous expression of HSP60 was found to cause neonatal death during postnatal day one. In HSP60 expressing newborn mice, hemorrhagic cardiac myopathy was found, and some of these mice exhibited atrium septal defects. A greatly increased rate of apoptosis was found in cardiac tissues with HSP60 overexpression, suggesting a pro-apoptotic role for HSP60. A tamoxifen-inducible Cre mouse (Myh6-Cre/ESR) was used to induce HSP60 expression in the adult mouse heart, and the results showed that dilated heart failure developed within 8 weeks after the induction of HSP60 expression. By employing an isolated perfusion model, the basal contractility was found to be significantly enhanced by HSP60, and a cardiac protection against simulated ischemia and reperfusion injury was found in mice with the HSP60 induction for 4 weeks. Both increased contractility and cardiac protection were lost in mice 6 to 8 weeks after HSP60 induction.
Our results showed that HSP60 expression led to heart failure in neonatal mice and likely involved developmental defects and induced apoptosis. While expressing HSP60 in adult cardiac tissues only temporally improved cardiac function and exerted cardiac stress protection, hypertrophy and heart failure eventually occured in these mice. The G-Lox-HSP60 model that achieves expression of HSP60 in an inducible and tissue-specific manner will be useful in studies to investigate the roles and molecular details of HSP60 in various diseases.
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Affiliation(s)
| | | | - Yen-Ling Chen
- National Health Rsch Institutes, Zhunan Town, Miaoli, Taiwan
| | - Mei-Ru Chen
- National Health Rsch Institutes, Zhunan Town, Miaoli, Taiwan
| | | | - Kurt M Lin
- National Health Rsch Institutes, Zhunan Town, Miaoli, Taiwan
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Chen TH, Liu SW, Chen MR, Lin KM. Abstract 065: Cardiac Fibrosis and Heart Failure Caused by DsRed Tetramers Involves the Induction of Tissue Inhibitor of Metalloproteinase-1. Circ Res 2013. [DOI: 10.1161/res.113.suppl_1.a065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Whereas aggregation of intracellular proteins was linked to the initiation of cardiac myopathy, the sequence of participating events, including myocyte apoptosis, autophagy, necrosis and fibrosis as the underlying mechanisms leading to heart failure, was not clear. Green fluorescent protein (GFP) and its derivatives induced cardiac dysfunction in mice when expressed in high quantity; however, the mechanism underlying the aggregation of fluorescent protein leading to heart failure remains unexplored.We created a transgenic mouse with switchable expression of the GFP monomer or the expression of DsRed, a red fluorescent protein (RFP) tetramer that tends to aggregate into a large protein complex. GFP mice were free of cardiac symptoms; in contrast, RFP mice with homozygous DsRed alleles developed myocyte necrosis, carditis, ventricular hypertrophy and fibrosis, left atrium thrombosis, dilated heart failure and death at the age of approximately five months. The hemizygote mice displayed similar symptoms at a later age. The expression of the microtubule-associated protein 1 light chain 3 cleaved isoform II (LC3 II) and transglutaminase 2, and the expression of many myopathy- and fibrosis-related genes were significantly induced in the hearts of two-month-old RFP mice. Together with the findings of increased autophagosomes, lysosomes and dysfunctional mitochondria, these results suggest a marked induction of myocyte autophagy and fibrosis as the main underlying mechanism of heart failure in RFP mice. Interestingly, apoptosis was not elevated in RFP hearts. One of the most up-regulated genes in the early stage RFP heart was the tissue inhibitor of matrix metalloproteinases type 1 (TIMP-1), corroborating the role of TIMP-1 in cardiac remodeling and anti-apoptotic activity. The heart-origin of the morbidity in RFP mice was confirmed by expressing DsRed tetramers specifically in cardiac tissues, and the same phenotypes as in RFP mice were observed.
In summary, in cardiac myocytes under the stress of protein aggregation, strong induction of TIMP-1 and down-regulation of MMP activity may play a significant role in enhancing the synthesis of extracellular matrix, resulting in fibrosis and heart failure.
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Affiliation(s)
| | - Shan-Wen Liu
- National Health Rsch Institutes, Zhunan Town, Miaoli, Taiwan
| | - Mei-Ru Chen
- National Health Rsch Institutes, Zhunan Town, Miaoli, Taiwan
| | - Kurt M Lin
- National Health Rsch Institutes, Zhunan Town, Miaoli, Taiwan
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Chen DY, Schneider PF, Zhang XS, He ZM, Jing J, Chen TH. Mental health status and factors that influence the course of Graves' disease and antithyroid treatments. Exp Clin Endocrinol Diabetes 2012; 120:524-8. [PMID: 23070829 DOI: 10.1055/s-0032-1323807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS Biological, psychological and social factors may interact with the mental health status of Graves' disease (GD) patients before and after antithyroid drug (ATD) treatment. Our aim was to quantify the impact of supportive and risk factors after recovery from GD which may enhance cure rates. PATIENTS AND METHODS 300 patients were recruited for a 6-year prospective cohort study. Before and after treatment, we assessed the impact of biopsychosocial factors on the success of ATD treatment and mental health using the Symptom Checklist 90, the Eysenck Personality Questionnaire, the Life Event Scale, Simplified Coping Styles and the Perceived Social Support Scale. The patients routinely received ATD at least over 18 months. End-point was defined as cured (at least 2 years without a relapse after the withdrawal of ATD), otherwise as not cured. RESULTS Regression analysis explained 80.5% of the influences affecting mental health. The odds ratios (OR) revealed positive coping styles (OR: 2.90, 95% CI, 1.09-7.68), negative events (OR: 1.04, 95% CI, 1.01-1.07) and social support (OR: 5.10, 95% CI, 2.77-9.40) as protective factors, predicting a cure for GD patients. These variables explained 61.7% of the influences leading to a cure or no cure. Large thyroid volume was a risk factor, predicting failure (OR: 0.865, 95% CI, 0.83-0.90, P<0.000). CONCLUSIONS Enhancing positive coping strategies and social support is important to improve mental health in GD patients, to avoid compromising work-related performance and endangering a patient's social status.
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Affiliation(s)
- D Y Chen
- Department of Nuclear Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Hayes PM, Blake T, Chen TH, Tragoonrung S, Chen F, Pan A, Liu B. Quantitative trait loci on barley (Hordeum vulgare L.) chromosome 7 associated with components of winterhardiness. Genome 2012; 36:66-71. [PMID: 18469970 DOI: 10.1139/g93-009] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Quantitative trait loci (QTL) controlling traits associated with winterhardiness in barley (field survival, LT50, growth habit, and crown fructan content) were mapped to chromosome 7 in a population of 100 F1-derived doubled haploid lines. The largest QTL effects for all traits were detected in a 21% recombination interval on the long arm of chromosome 7. QTL in this region accounted for 37-68% of the variation for three measures of cold tolerance, 47% of the variation for growth habit, and 28% of the variation in crown fructan content. Trait association may be due to linkage rather than pleiotropy.
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Wu YL, Chen LC, Sheu MH, Chen TH, Wu SC, Wu CL, Li SY, Yang WC, Ng YY. Peritoneal-uterine communication: a complication of prolonged embedding of a peritoneal catheter. ARCH ESP UROL 2012; 32:481-3. [PMID: 22859846 DOI: 10.3747/pdi.2011.00016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Chen TH, Chen TH, Hu CC, Liao JT, Lee CW, Liao JW, Lin MY, Liu HJ, Wang MY, Lin NS, Hsu YH. Induction of protective immunity in chickens immunized with plant-made chimeric Bamboo mosaic virus particles expressing very virulent Infectious bursal disease virus antigen. Virus Res 2012; 166:109-15. [PMID: 22406128 DOI: 10.1016/j.virusres.2012.02.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 02/20/2012] [Accepted: 02/22/2012] [Indexed: 11/18/2022]
Abstract
Very virulent Infectious bursal disease virus (vvIBDV) causes a highly contagious disease in young chickens and leads to significant economic loss in the poultry industry. Effective new vaccines are urgently needed. Autonomously replicating plant virus-based vector provides attractive means for producing chimeric virus particles (CVPs) in plants that can be developed into vaccines. In this study, we demonstrate the potential for vaccine development of Bamboo mosaic virus (BaMV) epitope-presentation system, where the antigen from vvIBDV VP2 was fused to the N-terminus of BaMV coat protein. Accordingly, an infections plasmid, pBIBD2, was constructed. Inoculation of the recombinant BaMV clone pBIBD2 enabled the generation of chimeric virus, BIBD2, and stable expression of IBDV VP2 antigen on its coat protein. After intramuscular immunization with BIBD2 CVPs, chickens produced antibodies against IBDV and were protected from vvIBDV (V263/TW strain) challenges. These results corroborate the feasibility of BaMV-based CVP platform in plants for the development and production of vaccines against IBDV.
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Affiliation(s)
- Tsung-Hsien Chen
- Graduate Institute of Biotechnology, National Chung Hsing University, Taichung 402, Taiwan, ROC
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Chen TH, Lin MS, Kung WM, Hung KS, Chiang YH, Chen CH. Combined ventriculoperitoneal shunt blockage, viscus perforation and migration into urethra, presenting with repeated urinary tract infection. Ann R Coll Surg Engl 2011; 93:e151-3. [PMID: 22004629 PMCID: PMC5827002 DOI: 10.1308/147870811x602212] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We present an extremely rare case of delayed and combined ventriculoperitoneal shunt blockage, viscus perforation and migration into the urethra manifested by a repeated urinary tract infection. This was discovered six months after the shunt was inserted. Although there were various other transient symptoms, the patient did not show obvious peritoneal signs. This complication could have been lethal if the discovery had been delayed. One of the best ways of preventing such migration is possibly the use of a softer catheter. However, making sure of appropriate redundancy for the abdominal part of the catheter may be of equal importance.
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Affiliation(s)
- T H Chen
- Taipei Medical University, Taipei, Taiwan
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Chang HC, Chen TH, Lin DL. Forensic Science in Support of Wildlife Conservation Efforts - Developments in Morphological and Chemical Approaches in Taiwan. Forensic Sci Rev 2011; 23:37-54. [PMID: 26231168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Parts from animals that are now endangered species (such as bear bile, rhino horn, and tiger bone) have long been important ingredients of traditional Chinese medicine (TCM). Deeply believing in the potency of these ingredients and coupled with substantial gains in wealth of the population in Taiwan in the 1980s, ugly scenarios came to light. Taiwan quickly became the target of investigation pursued by international wildlife conservationists. To provide scientific bases for the government's investigation efforts, morphological, chemical/physical, and genetic methods were developed to characterize TCM products. This review focuses on Taiwanese scientists' efforts on the following topic matters: (a) morphological approach to identify CITES-listed species from the turtle shells traded in the TCM market; (b) chromatographic and spectrophotometric methods for the identification and differentiation of bile products of different animal origins; and (c) gas chromatography-mass spectrometry method for the analysis of deer musk components and alleged musk products.
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Affiliation(s)
- H C Chang
- School of Chinese Medicine, China Medical University, Taichung City, Taiwan
| | - T H Chen
- Institute of Wildlife Conservation, National Pinging University of Science and Technology, Neipu Hsiang, Pinging Hsien, Taiwan
| | - D L Lin
- Institute of Forensic Medicine, Ministry of Justice, New Taipei City, Taiwan
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Tsai MC, Chen TH, Chang MH, Chen TY, Lin CC. Gallbladder perforation with formation of hepatic subcapsular biloma, treated with endoscopic nasobiliary drainage. Endoscopy 2010; 42 Suppl 2:E206-7. [PMID: 20845274 DOI: 10.1055/s-0030-1255709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- M C Tsai
- Department of Internal Medicine, Chung Shan Medical University Hospital and Institute of Medicine of Chung Shan Medical University, Taichung, Taiwan
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Duffy SW, Tabar L, Olsen AH, Vitak B, Allgood PC, Chen TH, Yen AM, Smith R. Cancer mortality in the 50-69 year age group before and after screening. J Med Screen 2010. [DOI: 10.1258/jms.2010.010083] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- S W Duffy
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - L Tabar
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - A H Olsen
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - B Vitak
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - P C Allgood
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - T H Chen
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - A M Yen
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Ra Smith
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
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