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Tsai CY, Cheong HI, Houghton R, Hsu WH, Lee KY, Kang JH, Kuan YC, Lee HC, Wu CJ, Li LYJ, Lin YT, Lin SY, Manole I, Majumdar A, Liu WT. Predicting Fatigue-Associated Aberrant Driving Behaviors Using a Dynamic Weighted Moving Average Model With a Long Short-Term Memory Network Based on Heart Rate Variability. Hum Factors 2024; 66:1681-1702. [PMID: 37387305 DOI: 10.1177/00187208231183874] [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] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
OBJECTIVE This study proposed a moving average (MA) approach to dynamically process heart rate variability (HRV) and developed aberrant driving behavior (ADB) prediction models by using long short-term memory (LSTM) networks. BACKGROUND Fatigue-associated ADBs have traffic safety implications. Numerous models to predict such acts based on physiological responses have been developed but are still in embryonic stages. METHOD This study recorded the data of 20 commercial bus drivers during their routine tasks on four consecutive days and subsequently asked them to complete questionnaires, including subjective sleep quality, driver behavior questionnaire and the Karolinska Sleepiness Scale. Driving behaviors and corresponding HRV were determined using a navigational mobile application and a wristwatch. The dynamic-weighted MA (DWMA) and exponential-weighted MA were used to process HRV in 5-min intervals. The data were independently separated for training and testing. Models were trained with 10-fold cross-validation strategy, their accuracies were evaluated, and Shapley additive explanation (SHAP) values were used to determine feature importance. RESULTS Significant increases in the standard deviation of NN intervals (SDNN), root mean square of successive heartbeat interval differences (RMSSD), and normalized spectrum of high frequency (nHF) were observed in the pre-event stage. The DWMA-based model exhibited the highest accuracy for both driver types (urban: 84.41%; highway: 80.56%). The SDNN, RMSSD, and nHF demonstrated relatively high SHAP values. CONCLUSION HRV metrics can serve as indicators of mental fatigue. DWMA-based LSTM could predict the occurrence of the level of fatigue associated with ADBs. APPLICATION The established models can be used in realistic driving scenarios.
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Affiliation(s)
- Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - He-In Cheong
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Robert Houghton
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jiunn-Horng Kang
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Dementia Center, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Lok-Yee Joyce Li
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospitall, Taipei, Taiwan
| | - Yin-Tzu Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shang-Yang Lin
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Iulia Manole
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
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Tsai CY, Majumdar A, Wang Y, Hsu WH, Kang JH, Lee KY, Tseng CH, Kuan YC, Lee HC, Wu CJ, Houghton R, Cheong HI, Manole I, Lin YT, Li LYJ, Liu WT. Machine learning model for aberrant driving behaviour prediction using heart rate variability: a pilot study involving highway bus drivers. Int J Occup Saf Ergon 2023; 29:1429-1439. [PMID: 36281493 DOI: 10.1080/10803548.2022.2135281] [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] [Indexed: 10/31/2022]
Abstract
Objectives. Current approaches via physiological features detecting aberrant driving behaviour (ADB), including speeding, abrupt steering, hard braking and aggressive acceleration, are developing. This study proposes using machine learning approaches incorporating heart rate variability (HRV) parameters to predict ADB occurrence. Methods. Naturalistic driving data of 10 highway bus drivers in Taiwan from their daily routes were collected for 4 consecutive days. Their driving behaviours and physiological data during a driving task were determined using a navigation mobile application and heart rate watch. Participants' self-reported data on sleep, driving-related experience, open-source data on weather and the traffic congestion level were obtained. Five machine learning models - logistic regression, random forest, naive Bayes, support vector machine and gated recurrent unit (GRU) - were employed to predict ADBs. Results. Most drivers with ADB had low sleep efficiency (≤80%), with significantly higher scores in driver behaviour questionnaire subcategories of lapses and errors and in the Karolinska sleepiness scale than those without ADBs. Moreover, HRV parameters were significantly different between baseline and pre-ADB event measurements. GRU had the highest accuracy (81.16-84.22%). Conclusions. Sleep deficit may be related to the increased fatigue level and ADB occurrence predicted from HRV-based models among bus drivers.
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Affiliation(s)
- Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, UK
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, UK
| | - Yija Wang
- Department of Civil and Environmental Engineering, Imperial College London, UK
| | - Wen-Hua Hsu
- College of Medicine, Taipei Medical University, Taiwan
| | - Jiunn-Horng Kang
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taiwan
- Research Centre of Artificial Intelligence in Medicine, Taipei Medical University, Taiwan
- College of Biomedical Engineering, Taipei Medical University, Taiwan
| | - Kang-Yun Lee
- Shuang Ho Hospital, Taipei Medical University, Taiwan
| | | | - Yi-Chun Kuan
- College of Medicine, Taipei Medical University, Taiwan
- Shuang Ho Hospital, Taipei Medical University, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taiwan
- Dementia Centre, Taipei Medical University-Shuang Ho Hospital, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taiwan
| | - Cheng-Jung Wu
- Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Robert Houghton
- Department of Civil and Environmental Engineering, Imperial College London, UK
| | - He-In Cheong
- Department of Civil and Environmental Engineering, Imperial College London, UK
| | - Iulia Manole
- Department of Civil and Environmental Engineering, Imperial College London, UK
| | - Yin-Tzu Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taiwan
| | - Lok-Yee Joyce Li
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taiwan
| | - Wen-Te Liu
- College of Medicine, Taipei Medical University, Taiwan
- Research Centre of Artificial Intelligence in Medicine, Taipei Medical University, Taiwan
- Shuang Ho Hospital, Taipei Medical University, Taiwan
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Liu WT, Huang HT, Hung HY, Lin SY, Hsu WH, Lee FY, Kuan YC, Lin YT, Hsu CR, Stettler M, Yang CM, Wang J, Duh PJ, Lee KY, Wu D, Lee HC, Kang JH, Lee SS, Wong HJ, Tsai CY, Majumdar A. Continuous Positive Airway Pressure Reduces Plasma Neurochemical Levels in Patients with OSA: A Pilot Study. Life (Basel) 2023; 13:life13030613. [PMID: 36983769 PMCID: PMC10059911 DOI: 10.3390/life13030613] [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] [Received: 12/16/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Obstructive sleep apnea (OSA) is a risk factor for neurodegenerative diseases. This study determined whether continuous positive airway pressure (CPAP), which can alleviate OSA symptoms, can reduce neurochemical biomarker levels. Thirty patients with OSA and normal cognitive function were recruited and divided into the control (n = 10) and CPAP (n = 20) groups. Next, we examined their in-lab sleep data (polysomnography and CPAP titration), sleep-related questionnaire outcomes, and neurochemical biomarker levels at baseline and the 3-month follow-up. The paired t-test and Wilcoxon signed-rank test were used to examine changes. Analysis of covariance (ANCOVA) was performed to increase the robustness of outcomes. The Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index scores were significantly decreased in the CPAP group. The mean levels of total tau (T−Tau), amyloid-beta-42 (Aβ42), and the product of the two (Aβ42 × T−Tau) increased considerably in the control group (ΔT−Tau: 2.31 pg/mL; ΔAβ42: 0.58 pg/mL; ΔAβ42 × T−Tau: 48.73 pg2/mL2), whereas the mean levels of T−Tau and the product of T−Tau and Aβ42 decreased considerably in the CPAP group (ΔT−Tau: −2.22 pg/mL; ΔAβ42 × T−Tau: −44.35 pg2/mL2). The results of ANCOVA with adjustment for age, sex, body mass index, baseline measurements, and apnea–hypopnea index demonstrated significant differences in neurochemical biomarker levels between the CPAP and control groups. The findings indicate that CPAP may reduce neurochemical biomarker levels by alleviating OSA symptoms.
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Affiliation(s)
- Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Huei-Tyng Huang
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Hsin-Yi Hung
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Shang-Yang Lin
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Fang-Yu Lee
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 110301, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Yin-Tzu Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 333423, Taiwan
| | - Chia-Rung Hsu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Marc Stettler
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
| | - Chien-Ming Yang
- Department of Psychology, National Chengchi University, Taipei 11605, Taiwan
| | - Jieni Wang
- Chemical Engineering and Biotechnology, University of Cambridge, Cambridge CB2 1TN, UK
| | - Ping-Jung Duh
- Cognitive Neuroscience, Division of Psychology and Language Science, University College London, London WC1E 6BT, UK
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Dean Wu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 110301, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Jiunn-Horng Kang
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, New Taipei City 235041, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110301, Taiwan
| | - Szu-Szu Lee
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Hsiu-Jui Wong
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Cheng-Yu Tsai
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
- Correspondence: (C.-Y.T.); (A.M.)
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
- Correspondence: (C.-Y.T.); (A.M.)
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Tsai CY, Wu SM, Kuan YC, Lin YT, Hsu CR, Hsu WH, Liu YS, Majumdar A, Stettler M, Yang CM, Lee KY, Wu D, Lee HC, Wu CJ, Kang JH, Liu WT. Associations between risk of Alzheimer's disease and obstructive sleep apnea, intermittent hypoxia, and arousal responses: A pilot study. Front Neurol 2022; 13:1038735. [PMID: 36530623 PMCID: PMC9747943 DOI: 10.3389/fneur.2022.1038735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/04/2022] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) may increase the risk of Alzheimer's disease (AD). However, potential associations among sleep-disordered breathing, hypoxia, and OSA-induced arousal responses should be investigated. This study determined differences in sleep parameters and investigated the relationship between such parameters and the risk of AD. METHODS Patients with suspected OSA were recruited and underwent in-lab polysomnography (PSG). Subsequently, blood samples were collected from participants. Patients' plasma levels of total tau (T-Tau) and amyloid beta-peptide 42 (Aβ42) were measured using an ultrasensitive immunomagnetic reduction assay. Next, the participants were categorized into low- and high-risk groups on the basis of the computed product (Aβ42 × T-Tau, the cutoff for AD risk). PSG parameters were analyzed and compared. RESULTS We included 36 patients in this study, of whom 18 and 18 were assigned to the low- and high-risk groups, respectively. The average apnea-hypopnea index (AHI), apnea, hypopnea index [during rapid eye movement (REM) and non-REM (NREM) sleep], and oxygen desaturation index (≥3%, ODI-3%) values of the high-risk group were significantly higher than those of the low-risk group. Similarly, the mean arousal index and respiratory arousal index (R-ArI) of the high-risk group were significantly higher than those of the low-risk group. Sleep-disordered breathing indices, oxygen desaturation, and arousal responses were significantly associated with an increased risk of AD. Positive associations were observed among the AHI, ODI-3%, R-ArI, and computed product. CONCLUSIONS Recurrent sleep-disordered breathing, intermittent hypoxia, and arousal responses, including those occurring during the NREM stage, were associated with AD risk. However, a longitudinal study should be conducted to investigate the causal relationships among these factors.
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Affiliation(s)
- Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Sheng-Ming Wu
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yin-Tzu Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chia-Rung Hsu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Shin Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Marc Stettler
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Chien-Ming Yang
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Dean Wu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jiunn-Horng Kang
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Wen-Te Liu
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei, Taiwan
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Tsai CY, Huang HT, Cheng HC, Wang J, Duh PJ, Hsu WH, Stettler M, Kuan YC, Lin YT, Hsu CR, Lee KY, Kang JH, Wu D, Lee HC, Wu CJ, Majumdar A, Liu WT. Screening for Obstructive Sleep Apnea Risk by Using Machine Learning Approaches and Anthropometric Features. Sensors (Basel) 2022; 22:s22228630. [PMID: 36433227 PMCID: PMC9694257 DOI: 10.3390/s22228630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/26/2022] [Accepted: 11/05/2022] [Indexed: 05/14/2023]
Abstract
Obstructive sleep apnea (OSA) is a global health concern and is typically diagnosed using in-laboratory polysomnography (PSG). However, PSG is highly time-consuming and labor-intensive. We, therefore, developed machine learning models based on easily accessed anthropometric features to screen for the risk of moderate to severe and severe OSA. We enrolled 3503 patients from Taiwan and determined their PSG parameters and anthropometric features. Subsequently, we compared the mean values among patients with different OSA severity and considered correlations among all participants. We developed models based on the following machine learning approaches: logistic regression, k-nearest neighbors, naïve Bayes, random forest (RF), support vector machine, and XGBoost. Collected data were first independently split into two data sets (training and validation: 80%; testing: 20%). Thereafter, we adopted the model with the highest accuracy in the training and validation stage to predict the testing set. We explored the importance of each feature in the OSA risk screening by calculating the Shapley values of each input variable. The RF model achieved the highest accuracy for moderate to severe (84.74%) and severe (72.61%) OSA. The level of visceral fat was found to be a predominant feature in the risk screening models of OSA with the aforementioned levels of severity. Our machine learning models can be employed to screen for OSA risk in the populations in Taiwan and in those with similar craniofacial structures.
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Affiliation(s)
- Cheng-Yu Tsai
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
| | - Huei-Tyng Huang
- Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK
| | - Hsueh-Chien Cheng
- Parasites and Microbes Programme, Wellcome Sanger Institute, Hinxton CB10 1RQ, UK
| | - Jieni Wang
- Chemical Engineering and Biotechnology, University of Cambridge, Cambridge CB3 0AS, UK
| | - Ping-Jung Duh
- Cognitive Neuroscience, Division of Psychology and Language Science, University College London, London WC1H 0AP, UK
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Marc Stettler
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
| | - Yi-Chun Kuan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 110301, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Yin-Tzu Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
| | - Chia-Rung Hsu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Jiunn-Horng Kang
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Graduate Institute of Nanomedicine and Medical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 110301, Taiwan
| | - Dean Wu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, Taipei 110301, Taiwan
- Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Arnab Majumdar
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London SW7 2AZ, UK
- Correspondence: (A.M.); (W.-T.L.)
| | - Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Research Center of Artificial Intelligence in Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Correspondence: (A.M.); (W.-T.L.)
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Knobles DP, Neilsen TB, Wilson PS, Hodgkiss WS, Bonnel J, Lin YT. Maximum entropy inference of seabed properties using waveguide invariant features from surface ships. J Acoust Soc Am 2022; 151:2885. [PMID: 35649902 DOI: 10.1121/10.0010372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
Acoustic data were recorded on two vertical line arrays (VLAs) deployed in the New England Mud Patch during the Seabed Characterization Experiment 2017 in about 75 m of water. The sound recorded during the passage of merchant ships permits identification of singular points for the waveguide invariant β for mode pairs (1,n):β1,n,for n=2,3,4,5, in the 15-80 Hz band. Using prior geophysical information and an acoustic data sample from the merchant ship KALAMATA, a geoacoustic model M of the seabed was developed. Then, using data samples from other merchant ships, a feature-ensemble maximum entropy method is employed to infer the statistical properties of geoacoustic parameter values for the sound speeds in a surface mud layer and a deep sand layer. Technical challenges include a sparsity of observed singular points, the unique identification of mode pairs for an observed singular point, and the deviation of the waveguide from horizontal stratification. A geoacoustic model M is developed that reproduced the observed β≈-1 for f < 20 Hz and mode cutoff features at about 15 Hz. The statistical low-frequency inference of the singular point structure from multiple ships provides evidence of an angle of intromission at the water sediment interface with an average sound speed ratio of about 0.986 and an average sound speed for the deeper sand layer of about 1775 m/s.
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Affiliation(s)
- D P Knobles
- Knobles Scientific and Analysis, Austin, Texas 78755, USA
| | - T B Neilsen
- Department of Physics, Brigham Young University, Provo, Utah 84604, USA
| | - P S Wilson
- Mechanical Engineering Department and Applied Research Laboratories, University of Texas, Austin, Texas 78713, USA
| | - W S Hodgkiss
- Marine Physical Laboratory, Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California 92093, USA
| | - J Bonnel
- Woods Hole Oceanographic Institute, Falmouth, Massachusetts 02543, USA
| | - Y T Lin
- Woods Hole Oceanographic Institute, Falmouth, Massachusetts 02543, USA
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7
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Lu ZK, Cheng J, Li SM, Lin YT, Zhang W, Li XZ, Sheng HY, Mao XJ, Mei HF, Zheng RD, Liang CL, Jiang MY, Huang YL, Liu L, Zeng CH. [Phenotypes and ATP7B gene variants in 316 children with Wilson disease]. Zhonghua Er Ke Za Zhi 2022; 60:317-322. [PMID: 35385937 DOI: 10.3760/cma.j.cn112140-20210827-00708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: To summarize the clinical phenotypes and the variation spectrum of ATP7B gene in Chinese children with Wilson's disease (WD) and to investigate their significance for early diagnosis. Methods: Retrospective analysis was performed on the clinical data of 316 children diagnosed as WD in Guangzhou Women and Children's Medical Center during the period from January 2010 to June 2021. The general situations, clinical manifestations, lab test results, imaging examinations, and ATP7B gene variant characteristics were collected. The patients were divided into asymptomatic WD group and symptomatic WD group based on the presence or absence of clinical symptoms at the time that WD diagnosis was made. The χ2 test, t test or Mann-Whitney U test were used to compare the differences between groups. Results: Among the 316 children with WD, 199 were males and 117 were females, with the age of 5.4 (4.0, 7.6) years at diagnosis; 261 cases (82.6%) were asymptomatic with the age of 4.9 (3.9, 6.4) years; whereas 55 cases (17.4%) were symptomatic with the age of 9.6 (7.3, 12.0) years. The main symptoms invloved liver, kidney, nervous system, or skin damage. Of all the patients, 95.9% (303/316) had abnormal liver function at diagnosis; 98.1% (310/316) had the serum ceruloplasmin lever lower than 200 mg/L; 97.7% (302/309) had 24-hour urine copper content exceeding 40 μg; only 7.4% (23/310) had positive corneal K-F rings, 8.2% (23/281) had abnormal MRI signals in the lenticular nucleus, and all of them had symptoms of damage in liver, kidney or nervous system. Compared with the group of symptomatic WD, asymptomatic group had higher levels of serum alanine aminotransferase and lower levels ceruloplasmin and 24-hour urine copper [(208±137) vs. (72±78) U/L, (55±47) vs. (69±48) mg/L, 103 (72, 153) vs. 492 (230, 1 432) μg; t=9.98, -1.98, Z=-4.89, all P<0.001]. Among the 314 patients completing genetic sequencing, a total of 107 mutations in ATP7B gene were detected, of which 10 are novel variants, and 3 cases (1.0%) had large heterozygous deletion (exons 10 to exon 11) in ATP7B gene. The percentage of missense mutation in asymptomatic WD children was significantly higher than that in symptomatic WD (81.5% (422/518) vs. 69.1% (76/110), χ²=8.47, P<0.05). WD patients carrying homozygous variant of c.2 333G>T had significantly low levels of ceruloplasmin than those not carrying this variant ((23±5) vs. (61±48) mg/L, t=-2.34, P<0.001). Conclusions: The elevation of serum ALT is an important clue for early diagnosis of WD in children, while serum ceruloplasmin and 24-hour urine copper content are specific markers for early diagnosis of WD. In order to confirm the diagnosis of WD, it is necessary to combine the Sanger sequencing with multiplex ligation-dependent probe amplification or other testing technologies.
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Affiliation(s)
- Z K Lu
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - J Cheng
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - S M Li
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Y T Lin
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - W Zhang
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - X Z Li
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - H Y Sheng
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - X J Mao
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - H F Mei
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - R D Zheng
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - C L Liang
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - M Y Jiang
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - Y L Huang
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - L Liu
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
| | - C H Zeng
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, China
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8
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Tsai CY, Liu WT, Lin YT, Lin SY, Houghton R, Hsu WH, Wu D, Lee HC, Wu CJ, Li LYJ, Hsu SM, Lo CC, Lo K, Chen YR, Lin FC, Majumdar A. Machine learning approaches for screening the risk of obstructive sleep apnea in the Taiwan population based on body profile. Inform Health Soc Care 2021; 47:373-388. [PMID: 34886766 DOI: 10.1080/17538157.2021.2007930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
(a) Objective: Obstructive sleep apnea syndrome (OSAS) is typically diagnosed through polysomnography (PSG). However, PSG incurs high medical costs. This study developed new models for screening the risk of moderate-to-severe OSAS (apnea-hypopnea index, AHI ≥15) and severe OSAS (AHI ≥30) in various age groups and sexes by using anthropometric features in the Taiwan population.(b) Participants: Data were derived from 10,391 northern Taiwan patients who underwent PSG.(c) Methods: Patients' characteristics - namely age, sex, body mass index (BMI), neck circumference, and waist circumference - was obtained. To develop an age- and sex-independent model, various approaches - namely logistic regression, k-nearest neighbor, naive Bayes, random forest (RF), and support vector machine - were trained for four groups based on sex and age (men or women; aged <50 or ≥50 years). Dataset was separated independently (training:70%; validation: 10%; testing: 20%) and Cross-validated grid search was applied for model optimization. Models demonstrating the highest overall accuracy in validation outcomes for the four groups were used to predict the testing dataset.(d) Results: The RF models showed the highest overall accuracy. BMI was the most influential parameter in both types of OSAS severity screening models.(e) Conclusion: The established models can be applied to screen OSAS risk in the Taiwan population and those with similar craniofacial features.
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Affiliation(s)
- Cheng-Yu Tsai
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Wen-Te Liu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Engineering Science, National Cheng Kung University, Tainan, Taiwan
| | - Yin-Tzu Lin
- Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shang-Yang Lin
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Robert Houghton
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Dean Wu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Dizziness and Balance Disorder Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Biomedical Science and Engineering, National Chiao Tung University, Hsinchu, Taiwan
| | - Lok Yee Joyce Li
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Shin-Mei Hsu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chen-Chen Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Kang Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - You-Rong Chen
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Feng-Ching Lin
- Division of Integrated Diagnostic and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.,Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, Taipei, Taiwan
| | - Arnab Majumdar
- Centre for Transport Studies, Department of Civil and Environmental Engineering, Imperial College London, London, UK
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9
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Zhang YY, Lin YT, Wang L, Sun XW, Dang EL, Xue K, Zhang WG, Zhang KM, Wang G, Li B. CD8αα +T cells exert a pro-inflammatory role in patients with psoriasis. Skin Health Dis 2021; 1:e64. [PMID: 35663772 PMCID: PMC9060015 DOI: 10.1002/ski2.64] [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] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
Background Psoriasis is a common chronic inflammatory disease caused by excessive activation of CD4+T cells, including Th17, Th1 and Th22. The role of CD8+T cells in psoriasis pathogenesis remains poorly understood. Aim To identify the phenotype of CD8+T cells in patients with psoriasis and to investigate its role in the formation of lesions. Methods The phenotype of CD8+T cells in psoriatic lesions was detected by immunofluorescence staining. Flow cytometry was performed to detect their phenotype in peripheral blood. Thereafter, coculture of CD8αα+T cells with autogenous CD4+T cells was performed to investigate the function of CD8αα+T cells in patients with psoriasis. Finally, pro‐inflammatory factors produced by CD8αα+T cells were examined by immunofluorescence staining and flow cytometry. Results Compared to the CD8αβ+T cells, CD8αα+T cell infiltration in psoriatic lesions markedly increased. Moreover, epidermal CD8αα+T cells exhibited tissue‐resident memory T cells (TRM) phenotypes and dermal CD8αα+T cells exhibited effector memory (TEM) phenotypes in psoriatic lesions. Additionally, we found that CD8αα+T cells from patients with psoriasis did not express the markers of regulatory T cells and could promote the proliferation of CD4+T effector cells and produce interleukin‐17 and interferon‐γ. Conclusions Our findings demonstrate that CD8αα+T cells contribute to the pathogenesis of psoriasis by producing pro‐inflammatory factors.
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Affiliation(s)
- Y Y Zhang
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - Y T Lin
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - L Wang
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - X W Sun
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - E L Dang
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - K Xue
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - W G Zhang
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - K M Zhang
- Institute of Dermatology Taiyuan City Central Hospital Shanxi Key Laboratory for Immunological Dermatosis Taiyuan China
| | - G Wang
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
| | - B Li
- Department of Dermatology Xijing Hospital Fourth Military Medical University Xi'an China
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10
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Tsai CY, Hsu WH, Lin YT, Liu YS, Lo K, Lin SY, Majumdar A, Cheng WH, Lee KY, Wu D, Lee HC, Hsu SM, Ho SC, Lin FC, Liu WT, Kuan YC. Associations among sleep-disordered breathing, arousal response, and risk of mild cognitive impairment in a northern Taiwan population. J Clin Sleep Med 2021; 18:1003-1012. [PMID: 34782066 DOI: 10.5664/jcsm.9786] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Dementia is associated with sleep disorders. However, the relationship between dementia and sleep arousal remains unclear. This study explored the associations among sleep parameters, arousal responses, and risk of mild cognitive impairment (MCI). METHODS Participants with the chief complaints of memory problems and sleep disorders were screened from the sleep center database of Taipei Medical University Shuang-Ho Hospital, and the parameters related to the Cognitive Abilities Screening Instrument (CASI), Clinical Dementia Rating (CDR), and polysomnography (PSG) were determined. All the examinations were conducted within 6 months and without a particular order. The participants were divided into those without cognitive impairment (CDR = 0) and those with MCI (CDR = 0.5). Mean comparison, linear regression models, and logistic regression models were employed to investigate the associations among obtained variables. RESULTS This study included 31 participants without MCI and 37 with MCI (17 with amnestic MCI; 20 with multidomain MCI). Patients with MCI had significantly higher mean values of the spontaneous arousal index (SpArI) and SpArI in the nonrapid eye movement (NREM) stage (SpArINREM) than those without MCI. An increased risk of MCI was significantly associated with an increase SpArI and SpArINREM with various adjustments. Significant associations between the CASI scores and the oximetry parameters and sleep disorder indexes were observed. CONCLUSIONS Repetitive respiratory events with hypoxia were associated with cognitive dysfunction. Spontaneous arousal, especially in NREM sleep, was related to the risk of MCI. However, additional longitudinal studies are required to confirm their causality.
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Affiliation(s)
- Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Wen-Hua Hsu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yin-Tzu Lin
- Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yi-Shin Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shang-Yang Lin
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Wun-Hao Cheng
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine,School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Dean Wu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.,Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Hsin-Chien Lee
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shin-Mei Hsu
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Feng-Ching Lin
- Division of Integrated Diagnostic and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yi-Chun Kuan
- Sleep Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan.,Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
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11
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Liu YS, Tsai CY, Majumdar A, Lin SY, Lin YT, Ho SC, Cheng WH, Liu WT, Wu D, Lee HC, Kuan YC, Wu CJ, Lo CC. 389 The Association between Arousals and Neurochemical Biomarkers Accumulation in Obstructive Sleep Apnea with Low Arousal Threshold. Sleep 2021. [DOI: 10.1093/sleep/zsab072.388] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Previous studies indicated the accumulation of neurodegenerative protein may be caused by higher Obstructive sleep apnea syndrome (OSAS) severity. However, the association between arousal-related parameters induced by OSAS and the amyloid burden remains unclear. The aim of this study is to investigate the association between arousal threshold (ArTH) and neurochemical protein accumulation in OSAS patients.
Methods
Suspected OSAS participants were performed Mini-mental status examination (MMSE) and full-night polysomnography (PSG) in the sleep center of Taipei Medical University Shuang Ho Hospital, Taiwan. On the same morning, the blood samples were obtained from the participants. The concentrations of total Tau (T-Tau) and amyloid beta peptide 42 (Aβ42) were quantified by ultra-sensitive immunomagnetic reduction assays. An overall of 23 participants were enrolled and classified into Low ArTH group (n=12) and High ArTH group (n=11) based on low ArTH criteria. Regarding the statistical methods, for categorical variables and continuous variables, Fisher’s exact test and Mann-Whitney U test were performed to investigate the differences between groups, respectively. The associations between biomarkers concentrations and PSG parameters were assessed by Spearman’s correlation.
Results
Regarding the demographic characteristics in two subgroups, significantly lower body-mass index and OSAS severity were noted in Low ArTH group (p<0.05). The MMSE was in normal range in both groups and had no significant differences in subgroups. For PSG parameters, there were significantly lower desaturation index, AHI and higher spontaneous arousals index in each sleep stage in Low ArTH group (p<0.01). Nevertheless, in the plasma neurochemical biomarkers, Aβ42 and Aβ42 X T-Tau were significantly higher in Low ArTH group (p<0.05). Moreover, in Low ArTH group, T-Tau was positively correlated with respiratory arousals index (r=0.61, p<0.05) and all arousals index (r=0.76, p<0.01), respectively. The positive correlations between Aβ42 X T-Tau and respiratory arousals index (r=0.62, p<0.05), all arousals index (r=0.75, p<0.01) could also be observed. There were no significant correlations noted in High ArTH group.
Conclusion
OSAS patients with low ArTH have higher neurochemical biomarker levels. Also, the significantly positive correlations between arousals and biomarkers were observed in that group.
Support (if any):
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Affiliation(s)
- Yi-Shin Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London
| | - Arnab Majumdar
- Department of Civil and Environmental Engineering, Imperial College London
| | - Shang-Yang Lin
- School of Respiratory Therapy, College of Medicine, Taipei Medical University
| | - Yin-Tzu Lin
- Department of General Medicine, Shuang Ho Hospital, Taipei Medical University
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University
| | - Wun-Hao Cheng
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University
| | - Wen-Te Liu
- School of Respiratory Therapy, College of Medicine, Taipei Medical University
| | - Dean Wu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University
| | - Hsin-Chien Lee
- Department of Psychiatry, Shuang-Ho Hospital, Taipei Medical University
| | - Yi-Chun Kuan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University
| | - Cheng-Jung Wu
- Department of Otolaryngology, Shuang-Ho Hospital, Taipei Medical University
| | - Chen-Chen Lo
- Sleep Center, Shuang Ho Hospital, Taipei Medical University
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12
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Ma JY, Zhou Y, Lin YT, Xiang ZS, Zheng RS, Zhang SW, Wang SM, Chen R, Wei WW, He J. [Incidence and mortality of corpus uteri cancer in China, 2015]. Zhonghua Zhong Liu Za Zhi 2021; 43:108-112. [PMID: 33472322 DOI: 10.3760/cma.j.cn112152-20200423-00373] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To estimate the incidence and mortality of corpus uteri cancer in China, 2015. Methods: Quality audit and evaluation of the data from 2015 cancer registration reported by 501 cancer registries were conducted, and 368 cancer registries were included in the analysis. The incidence rate and mortality rate of corpus uteri cancer were calculated according to the factors of the region (urban, rural, east, central, western), sex and age groups. The incidence and mortality of corpus uteri cancer with the 2015 population were estimated. Chinese standard population in 2000 and world Segi's population were used for the calculation of age-standardized rates (ASR) of incidence and mortality. Results: In 2015, 368 cancer registries included in the analysis covered a total of 309 553 499 populations in China, accounting for 22.52% of the national population. It is estimated that there were about 68 900 new cases of corpus uteri cancer in 2015, the incidence rate was 10.28/10(5), age-standardized incidence rates by Chinese standard population (ASR China) and world standard population (ASR world) were 6.86/10(5) and 6.66/10(5), respectively. The incidence rate of urban area (11.35/10(5)) was higher than that of rural area (8.90/10(5)), and the incidence of eastern region (12.12/10(5)) was higher than the central region (9.94/10(5)) and the western region (8.25/10(5)). It is estimated that in 2015, there were about 16 000 deaths of corpus uteri cancer, the mortality rate was 2.39/10(5), ASR China was 1.49/10(5), ASR world was 1.47/10(5). The mortality in urban areas (2.40/10(5)) is close to rural areas (2.39/10(5)); the mortality in central areas (2.55/10(5)) was higher than the eastern areas (2.32/10(5)) and the western areas (2.31/10(5)). Conclusions: In China, the incidence of corpus uteri cancer is on the rise and has a trend of youth, the burden of disease is gradually increasing, which threatens the health of women. Targeted prevention and control measures should be carried out in the different regions.
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Affiliation(s)
- J Y Ma
- Fujian Provincial Office for Tumor Prevention and Control, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - Y Zhou
- Fujian Provincial Office for Tumor Prevention and Control, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - Y T Lin
- Fujian Provincial Office for Tumor Prevention and Control, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - Z S Xiang
- Fujian Provincial Office for Tumor Prevention and Control, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, China
| | - R S Zheng
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S W Zhang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - S M Wang
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - R Chen
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - W W Wei
- Office for Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - J He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021,China
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13
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Luo YJ, Lo CC, Tsai CY, Lin YT, Hsu HM, Kuan YC, Liu WT. 2 The association between obstructive sleep apnea severity and cognition in older people. J Neurol Neurosurg Psychiatry 2020. [DOI: 10.1136/jnnp-2020-bnpa.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Relationship between obstructive sleep apnea syndrome (OSAS) and dementia has been investigated in recent years. However, the effects of hypoxia during sleep timeon dementia remain unclear. The objective of this study is to associate the score of mini-mental state examination (MMSE) with OSAS. In this study, 67 patients whom were more than 50 years old and have been done for MMSE test and diagnosed with OSAS in sleep center in Taipei from 2015 to 2018. Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI), according to the American Academy of Sleep Medicine (AASM) guideline. Subjects with MMSE scores above 25 and below 25 were served respectively as case group and control group. Logistic regression analyses were used to examine the associations. The average AHI were 28.48 times per hour for case group and 17.93 times per hour for control group. The AHI had a 1.03 fold higher odds ratio (95% CI=0.99 ~ 1.07, p=0.06) for lower score group compared with higher score group. The mean sleep efficiency were 57.8% in lower score group, while higher score group had an average sleep efficiency of 70.3%. Furthermore, sleep efficiency, total sleep time, the ratio of wake to total time in bed as well as the ratio of wake to sleep period time in case group were significant lower than the control group. We observe the associations between MMSE score and some parameters of polysomnography. The subjects with high severity OSAS, insufficient sleep efficacy, longer awake duration and shorter sleep duration could lead to cognitive impairment.
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14
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Chin YPH, Hou ZY, Lee MY, Chu HM, Wang HH, Lin YT, Gittin A, Chien SC, Nguyen PA, Li LC, Chang TH, Li YCJ. A patient-oriented, general-practitioner-level, deep-learning-based cutaneous pigmented lesion risk classifier on a smartphone. Br J Dermatol 2020; 182:1498-1500. [PMID: 31907926 DOI: 10.1111/bjd.18859] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Y P H Chin
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Department of Biomedical Informatics, Harvard Medical School, Boston, MA, U.S.A
| | - Z Y Hou
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Centre for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - M Y Lee
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Centre for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - H M Chu
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - H H Wang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Taipei Municipal Wan Fang Hospital, Taipei, Taiwan
| | - Y T Lin
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Taipei Municipal Wan Fang Hospital, Taipei, Taiwan
| | - A Gittin
- Department of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - S C Chien
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Centre for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - P A Nguyen
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Centre for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - L C Li
- International Centre for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - T H Chang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Clinical Big Data Research Centre, Taipei Medical University Hospital, Taipei, Taiwan
| | - Y C J Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Centre for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,Department of Dermatology, Taipei Municipal Wan Fang Hospital, Taipei, Taiwan
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15
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Feng PH, Chen TT, Lin YT, Chiang SY, Lo CM. Corrigendum to "Classification of lung cancer subtypes based on autofluorescence bronchoscopic pattern recognition: A preliminary study" [Comput Methods Programs Biomed. 163 (2018) 33-38]. Comput Methods Programs Biomed 2019; 182:105095. [PMID: 31622831 DOI: 10.1016/j.cmpb.2019.105095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Po-Hao Feng
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yin-Tzu Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Shang-Yu Chiang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chung-Ming Lo
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Library, Information and Archival Studies, National ChengchiUniversity, Taipei, Taiwan.
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16
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Hong X, Min SN, Zhang YY, Lin YT, Wang F, Huang Y, Yu GY, Wu LL, Yang HY. TNF-α Suppresses Autophagic Flux in Acinar Cells in IgG4-Related Sialadenitis. J Dent Res 2019; 98:1386-1396. [PMID: 31461632 DOI: 10.1177/0022034519871890] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IgG4-related sialadenitis (IgG4-RS) is a newly recognized immune-mediated systemic fibroinflammatory disease that affects salivary glands and leads to hyposalivation. Tumor necrosis factor-α (TNF-α) is a critical proinflammatory cytokine involved in several salivary gland disorders, but its role and mechanism regarding acinar cell injury in IgG4-RS are unknown. Here, we found that TNF-α level was significantly increased in serum and submandibular gland (SMG) of patients and that serum TNF-α level was negatively correlated with saliva flow rate. Ultrastructural observations of IgG4-RS SMGs revealed accumulation of large autophagic vacuoles, as well as dense fibrous bundles, decreased secretory granules, widened intercellular spaces, swollen mitochondria, and expanded endoplasmic reticulum. Expression levels of LC3 and p62 were both increased in patients' SMGs. TNF-α treatment led to elevated levels of LC3II and p62 in both SMG-C6 cells and cultured human SMG tissues but did not further increase their levels when combined with bafilomycin A1 treatment. Moreover, transfection of Ad-mCherry-GFP-LC3B in SMG-C6 cells confirmed the suppression of autophagic flux after TNF-α treatment. Immunofluorescence imaging revealed that costaining of LC3 and the lysosomal marker LAMP2 was significantly decreased in patients, TNF-α-treated SMG-C6 cells, and cultured human SMGs, indicating a reduction in autophagosome-lysosome fusion. Furthermore, the ratio of pro/mature cathepsin D was elevated in vivo, ex vivo, and in vitro. TNF-α also appeared to induce abnormal acidification of lysosomes in acinar cells, as assessed by lysosomal pH and LysoTracker DND-26 fluorescence intensity. In addition, TNF-α treatment induced transcription factor EB (TFEB) redistribution in SMG-C6 cells, which was consistent with the changes observed in IgG4-RS patients. TNF-α increased the phosphorylation of extracellular signal-regulated kinase (ERK) 1/2, and inhibition of ERK1/2 by U0126 reversed TNF-α-induced TFEB redistribution, lysosomal dysfunction, and autophagic flux suppression. These findings suggest that TNF-α is a key cytokine related to acinar cell injury in IgG4-RS through ERK1/2-mediated autophagic flux suppression.
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Affiliation(s)
- X Hong
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University, the Hong Kong University of Science and Technology Medical Center, Shenzhen, P.R. China
| | - S N Min
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Y Y Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - Y T Lin
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University, the Hong Kong University of Science and Technology Medical Center, Shenzhen, P.R. China
| | - F Wang
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University, the Hong Kong University of Science and Technology Medical Center, Shenzhen, P.R. China
| | - Y Huang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - G Y Yu
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University, the Hong Kong University of Science and Technology Medical Center, Shenzhen, P.R. China.,Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P.R. China
| | - L L Wu
- Department of Physiology and Pathophysiology, Peking University School of Basic Medical Sciences, Beijing, P.R. China
| | - H Y Yang
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen Peking University, the Hong Kong University of Science and Technology Medical Center, Shenzhen, P.R. China
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17
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Zhou ZZ, Li XZ, Cheng J, Zhang W, Zeng CH, Lin YT, Shao YX, Huang YL, Liu L. [Clinical features and genetics studies of Finnish variant late infantile neuronal ceroid lipofuscinosis in two families]. Zhonghua Er Ke Za Zhi 2019; 56:601-604. [PMID: 30078242 DOI: 10.3760/cma.j.issn.0578-1310.2018.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To report clinical feature and results of genetic analysis of 3 patients from 2 families with Finnish variant late infantile neuronal ceroid lipofuscinosis. Methods: The clinical and ultrastructural features of 3 patients with progressive neurodegenerative diseases were retrospectively analyzed from October 2014 to December 2016 in Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center. The whole exon sequencing and Sanger sequencing were used to analyze the molecular genetics of the patients and their parents. Results: The probands were 11 years and 3 moths, 9 years and 1 month,10 years and 1 month old. All were normal at birth, and from 5-6 years old they began to develop "regression of cognition and motion, impaired vision". Physical examination at the first consultation: clear minded butignorant, unable to speak and understand instructions, unable to stand up and sit alone, unable to maintain postureupright. The brain magnetic resonance imaging(MRI) indicated diffuse cerebral and cerebellar atrophy, white matter damage. Blood biochemistry, lactic acid, acid-base balancewere normal. Electron microscopic examination of peripheral blood lymphocytes showed swelling of the nucleus, autophagy, intracellular massive deposits and abnormal vacuoles. Two compound heterozygous c.334C> T (p.Arg112Cys) and c.595C> T (p.Arg199Ter) mutations of CLN5 gene were identified in the two siblings, and the proband 3 was c.335G> A (p.Arg199His) homozyousmutation, which were inherited from their unaffected parents. Conclusions: The 3 cases with Finnish variant late infantileneuronal ceroid lipofuscinosises were normal at birth, cognitive and motor function was regressed at preschool age.Brain MRI showed whole brain atrophy, white matter lesions, there were no bovious difference from other neurodegenerative diseases. Blood biochemistry and pathological examination of lymphocytes had no specific changes. The pathogenic genes were CLN5,most are inherited in autosomal recessive way.
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Affiliation(s)
- Z Z Zhou
- Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou 510623, China
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18
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Zhang TY, Shang XL, Xie YX, Lin YT, Zhang QJ, Li D, Xin YC. [The effects of postauricular injection of methylprednisolone on medium-high frequency sudden hearing loss]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:537-540. [PMID: 29798087 DOI: 10.13201/j.issn.1001-1781.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Indexed: 11/12/2022]
Abstract
Objective:To study the effects of postauricular injection of methylprednisolone on medium-high frequency sudden hearing loss.Method:The data of 45 patients with invalid treatment who were diagnosed as medium-high frequency sudden hearing loss were retrospectively studied. They were divided into postauricular injection group and non-postauricular injection group. The treatment efficiency and hearing improvement at each frequency were compared between the two groups.Result:The improvements of hearing threshold in the non-postauricular injection group were(6.30±5.00)dB HL,(3.80±5.52)dB HL,(5.35±5.50)dB HL,(15.60±11.84)dB HL,(19.60±13.46)dB HL,(15.40±12.90)dB HL at 250, 500, 1000, 2000, 4000 and 8000Hz, respectively. The hearing improvements of the postauricular injection group were (5.35±6.22)dB HL,(2.50±3.00)dB HL,(4.65±6.60)dB HL,(23.75±10.75)dB HL,(25.75±11.73)dB HL,(30.50±14.50)dB HL at 250, 500,1000,2000,4000 and 8000Hz, respectively. There were significant differences between the two groups in hearing improvements at 2000-8000Hz. The treatment effective rates were 44% and 80% for the non-postauricular injection group and postauricular injection group respectively, which showed a significant difference(χ²=8.385P<0.05).Conclusion:Postauricular injection of methylprednisolone as a remedy treatment is safe and effective for sudden hearing loss in middle and high frequency.
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Affiliation(s)
- T Y Zhang
- Hebei North University,Zhangjiakou,075000,China
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19
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Feng PH, Lin YT, Lo CM. A machine learning texture model for classifying lung cancer subtypes using preliminary bronchoscopic findings. Med Phys 2018; 45:5509-5514. [PMID: 30325517 DOI: 10.1002/mp.13241] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 10/07/2018] [Accepted: 10/08/2018] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Bronchoscopy is useful in lung cancer detection, but cannot be used to differentiate cancer types. A computer-aided diagnosis (CAD) system was proposed to distinguish malignant cancer types to achieve objective diagnoses. METHODS Bronchoscopic images of 12 adenocarcinoma and 10 squamous cell carcinoma patients were collected. The images were transformed from a red-blue-green (RGB) to a hue-saturation-value (HSV) color space to obtain more meaningful color textures. By combining significant textural features (P < 0.05) in a machine learning classifier, a prediction model of malignant types was established. RESULTS The performance of the CAD system achieved an accuracy of 86% (19/22), a sensitivity of 90% (9/10), a specificity of 83% (10/12), a positive predictive value of 82% (9/11), and a negative predictive value of 91% (10/11) in distinguishing lung cancer types. The area under the receiver operating characteristic curve was 0.82. CONCLUSIONS On the basis of extracted HSV textures of bronchoscopic images, the CAD system can provide recommendations for clinical diagnoses of lung cancer types.
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Affiliation(s)
- Po-Hao Feng
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan
| | - Yin-Tzu Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.,Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, 10675, Taiwan
| | - Chung-Ming Lo
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, 10675, Taiwan.,Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, 11031, Taiwan
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20
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Feng PH, Chen TT, Lin YT, Chiang SY, Lo CM. Classification of lung cancer subtypes based on autofluorescence bronchoscopic pattern recognition: A preliminary study. Comput Methods Programs Biomed 2018; 163:33-38. [PMID: 30119855 DOI: 10.1016/j.cmpb.2018.05.016] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/05/2018] [Accepted: 05/14/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVES Lung cancer is the leading cause of cancer deaths worldwide. With current use of autofluorescent bronchoscopic imaging to detect early lung cancer and limitations of pathologic examinations, a computer-aided diagnosis (CAD) system based on autofluorescent bronchoscopy was proposed to distinguish different pathological cancer types to achieve objective and consistent diagnoses. METHODS The collected database consisted of 12 adenocarcinomas and 11 squamous cell carcinomas. The corresponding autofluorescent bronchoscopic images were first transformed to a hue (H), saturation (S), and value (V) color space to obtain better interpretation of the color information. Color textural features were respectively extracted from the H, S, and V channels and combined in a logistic regression classifier to classify malignant types by machine learning. RESULTS After feature selection, the proposed CAD system achieved an accuracy of 83% (19/23), a sensitivity of 73% (8/11), a specificity of 92% (11/12), a positive predictive value of 89% (8/9), a negative predictive value of 79% (11/14), and an area under the receiver operating characteristic curve of 0.81 for distinguishing lung cancer types. CONCLUSIONS The proposed CAD system based on color textures of autofluorescent bronchoscopic images provides a diagnostic method of malignant types in clinical use.
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Affiliation(s)
- Po-Hao Feng
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Tzu-Tao Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yin-Tzu Lin
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Shang-Yu Chiang
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Chung-Ming Lo
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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Ho CB, Hsieh K, Chen WY, Lin YT, Chiou JF, Lee HL, Shiah HS. Effective sirolimus treatment for refractory spindle cell haemangioma. Br J Dermatol 2018; 179:976-977. [PMID: 29750334 DOI: 10.1111/bjd.16739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C B Ho
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - K Hsieh
- Department of Medical Imaging, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - W Y Chen
- Department of Pathology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Y T Lin
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - J F Chiou
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei Medical University, Taipei, Taiwan
| | - H L Lee
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University and Academia Sinica, Taipei Medical University, Taipei, Taiwan
| | - H S Shiah
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan.,Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Cancer Molecular Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
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22
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Abstract
UNLABELLED The use of local anaesthesia and adrenaline for hand surgery is gaining popularity; however, where vascularity is impaired, wide-awake surgery is considered a contraindication. We present our case series of five digital devascularizations and eight amputations that underwent surgery using the 'wide-awake' anaesthetic technique. A temporary digital tourniquet (< 20 min) was used in three cases to identify structures quickly. The anastomoses were performed under local anaesthesia without a tourniquet. All cases had successful re-establishment of blood flow with good perfusion to the digital tips; no cases were re-explored because of vascular crisis. Four cases had minor superficial soft tissue necrosis that healed secondarily. We conclude that digital revascularization and replantation can be performed under local anaesthesia with use of adrenaline and without detriment to the traumatized digit provided careful patient selection and adequate operator experience are available. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Jkf Wong
- 1 Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.,2 Blond McIndoe Laboratories, Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - C H Lin
- 1 Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan
| | - N J Chang
- 1 Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan
| | - H C Chen
- 1 Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan
| | - Y T Lin
- 1 Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan
| | - C C Hsu
- 1 Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College and Chang Gung University, Taipei, Taiwan
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Song XY, Shang XL, Zhang YT, Lin YT, Xu GG, Xue G, Zhang QJ, Zou F. [Investigation of CXCR4 mediated chemoresistance in nasopharyngeal carcinoma cell line CNE2]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:887-891;896. [PMID: 29797935 DOI: 10.13201/j.issn.1001-1781.2016.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Indexed: 11/12/2022]
Abstract
Objective:Since nasopharyngeal carcinoma is easy to develop resistance during cisplatin-based chemotherapy,CXCR4 expression levels were elevated in mang tumors,and the factor to do with tumor metastasis and chemotherapy drug resistance,and so on has a very important link.We established cisplatin-resistant nasopharyngeal carcinoma cell line, named as CNE2/DDP, and investigated the function of CXCR4 in molecular mechanism behind this resistance.Method:CNE2/DDP was firstly build up by increasing concentration of cisplatin. And then afterwards,MTT assay, RNA interference techniques, microRNA overexpresion techniques, quantative PCR and western blotting were applied to analyze the function of CXCR4 and its downstream effectors.Result:①the expression of CXCR4 was increased in CNE2/DDP and downregulation of CXCR4 with CXCR4 siRNA was able to decrease the resistance of CNE/DDP to cisplatin; ②the expression of let-7a was decrease in CNE2/DDP, while the expression of bcl-2 was increased. Upregulation of let-7a via transfection of let-7a mimics could downregulate the expression of bcl-2 and damage the resistance of CNE2/DDP to cisplation;③downregulation of CXCR4 through CXCR4 siRNA transfection was capable of improving the expression of let-7a. Conclusion:We were the first to found that CXCR4 was related to chemoresistance of CNE2/DPP to cisplatin. Meanwhile, we confirmed that CXCR4 affected the expression of bcl-2 through regulating the expression of let-7a to modulate the chemoresistance of CNE2/DPP to cisplatin.
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Affiliation(s)
- X Y Song
- Institute of Pathogen Biology and Immunology of Hebei North University, Zhangjiakou,075000,China
| | - X L Shang
- Department of Otolaryngology Head and Neck Surgery,the First Attached Hospital of Hebei North University
| | - Y T Zhang
- Institute of Pathogen Biology and Immunology of Hebei North University, Zhangjiakou,075000,China
| | - Y T Lin
- Department of Otolaryngology Head and Neck Surgery,the First Attached Hospital of Hebei North University
| | - G G Xu
- Department of Otolaryngology Head and Neck Surgery,the First Attached Hospital of Hebei North University
| | - G Xue
- Department of Otolaryngology Head and Neck Surgery,the First Attached Hospital of Hebei North University
| | - Q J Zhang
- Department of Otolaryngology Head and Neck Surgery,the First Attached Hospital of Hebei North University
| | - F Zou
- Institute of Pathogen Biology and Immunology of Hebei North University, Zhangjiakou,075000,China
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Liu YC, Wei J, Li YP, Li D, Liu YB, Xu GG, Xue G, Lin YT, Shang XL. [Study on anti-oxidase in smoking-related laryngeal squamous cell carcinoma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:733-736. [PMID: 29771025 DOI: 10.13201/j.issn.1001-1781.2016.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the role of oxidative stress in smoking-related laryngeal squamous carcinoma through detecting the expression of antioxidant enzymes in smoking patients. Method:A total of 138 cases with laryngeal squamous cell carcinoma enrolled in the first hospital affiliated the northern he bei college from 2012 to 2015 and forty five volunteers were conducted. All participants were divided into three groups according to smoking index: group A(heavy smoking, 88 cases of laryngeal cancer patients) and group B(no smoking 50 cases of laryngeal cancer patients) and C group(45 heavy smoking volunteers).Catalase(CAT), glutathione peroxidase(GSH-px) and malondialdehyde(MDA) and the expression of NRF2 in serum, tissue adjacent to carcinoma, and carcinoma tissues from each groups were measured, respectively. Result:①the expression of the CAT and GSH-px in group A were significantly lower than that of group B(P <0.05), but higher than that of group C(P <0.05); ②the MDA level of group A is significantly higher than group B(P <0.05) and C group(P <0.01);③NRF2 was highly expressed in carcinoma tissues, and the expression level was negatively correlated with degree of carcinoma differentiation (P <0.05). Conclusion:Compared with nonsmoking patients, heavy smoking patients with laryngeal cancer were under more severe oxidative stress. NRF2 expression level in patients with laryngeal squamous cell carcinomas was associated with pathological stage.
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Affiliation(s)
- Y C Liu
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - J Wei
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - Y P Li
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - D Li
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - Y B Liu
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - G G Xu
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - G Xue
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - Y T Lin
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
| | - X L Shang
- Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China
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He H, Xu F, Huang W, Luo SY, Lin YT, Zhang GH, Du Q, Duan RH. miR-125a-5p expression is associated with the age of breast cancer patients. Genet Mol Res 2015; 14:17927-33. [PMID: 26782438 DOI: 10.4238/2015.december.22.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Dysregulated miR-125 observed in multiple cancer types has suggested that it is involved in malignant proliferation and invasion. However, the clinical significance of miR-125 in human breast cancer (BC) has not yet been fully elucidated. In the present study, the expression of miR-125a-5p/3p and miR-125b in 143 pairs of BC and normal adjacent tissues (NATs) was measured by real-time quantitative PCR, and the correlation between expression and clinicopathological features was explored. miR-125a-5p and miR-125b were significantly down-regulated in BC tissue samples compared with their matched NAT samples, while the difference in miR-125a-3p expression between BC tissues and NATs was not statistically significant. The expression level of miR-125a-5p was found to be significantly higher in younger patients (<35 years) than in older patients (≥35, P = 0.005). When the patients were divided into three groups according to age (<35, 36-48, and ≥48 years), a gradual reduction in miR-125a-5p expression was observed in BC tissue samples that correlated to increases in age (P = 0.009). There were no significant correlations between miR-125 expression and other clinicopathological features including tumor size, histological grade, hormone receptor status, Her-2 status, and lymph node metastasis. Taken together, these findings suggest that miR-125a-5p may play an important role in BC progression in an age-dependent manner, and that the down-regulation of miR-125a-5p and miR-125b may serve as independent predictors for breast cancer.
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Affiliation(s)
- H He
- The State Key Laboratory of Medical Genetics & School of Life Sciences, Central South University, Changsha, China
| | - F Xu
- Department of Breast and Thyroid Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - W Huang
- The State Key Laboratory of Medical Genetics & School of Life Sciences, Central South University, Changsha, China
| | - S Y Luo
- The State Key Laboratory of Medical Genetics & School of Life Sciences, Central South University, Changsha, China
| | - Y T Lin
- The State Key Laboratory of Medical Genetics & School of Life Sciences, Central South University, Changsha, China
| | - G H Zhang
- The State Key Laboratory of Medical Genetics & School of Life Sciences, Central South University, Changsha, China
| | - Q Du
- The State Key Laboratory of Medical Genetics & School of Life Sciences, Central South University, Changsha, China
| | - R H Duan
- The State Key Laboratory of Medical Genetics & School of Life Sciences, Central South University, Changsha, China
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Shi ZH, Lin YT, Hou YM. Mother-derived trans-generational immune priming in the red palm weevil, Rhynchophorus ferrugineus Olivier (Coleoptera, Dryophthoridae). Bull Entomol Res 2014; 104:742-750. [PMID: 25208627 DOI: 10.1017/s0007485314000583] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Rhynchophorus ferrugineus (Coleoptera, Curculionidae) is the most destructive pest of palm trees worldwide containing it invasive areas, such as the southern part of China. It is always emphasized to develop integrated pest management based on biological agents, but their success is not very exciting. Presently, the immune defenses of this pest against biological agents attract scarce attention. It is still unclear whether immune priming also generally occurs in insect pests and in response to different pathogens. Our results indicated that previous challenge of bacteria pathogen enhanced the magnitude of phenoloxidase activity and antibacterial activity in R. ferrugineus larvae against the secondary infection. Furthermore, trans-generational immune priming was also determined in this pest, and only challenged R. ferrugineus mothers transferred the immune protection to their offspring which suggested males and females of this pest might have evolved different strategies on the investment of delivering immune protection to their offspring. Importantly, our data provide the evidence to suggest that different kinds of biological control agents might be used alternatively or in combination to fight against R. ferrugineus because of the existence of immune priming with low species-specific level. On the other hand, for this invasive pest, the immune priming may also facilitate its adaptation and dispersal in the new regions.
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Affiliation(s)
- Z H Shi
- Key Laboratory of Integrated Pest Management of Fujian-Taiwan Crops,Ministry of Agriculture,China
| | - Y T Lin
- Key Laboratory of Integrated Pest Management of Fujian-Taiwan Crops,Ministry of Agriculture,China
| | - Y M Hou
- Key Laboratory of Integrated Pest Management of Fujian-Taiwan Crops,Ministry of Agriculture,China
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Lin GJ, Chen TJ, Tsai YW, Lin YT, Wu JJ, Yang YJ. Performance enhancement using a non-uniform vertical electric field and polymer networks for in-plane switching of multi-pretilt, vertically aligned liquid crystal devices. Opt Lett 2014; 39:6225-6228. [PMID: 25361320 DOI: 10.1364/ol.39.006225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A simple and reproducible alignment method for fabricating vertically aligned (VA) liquid crystal (LC) cells with a multi-pretilt structure is developed. A non-uniform vertical electric field is employed in the LC/monomer mixed cells during the photocuring process, and two pretilt domains with a functional small pretilt angle (∼1.6°) in the stabilized VA LC/polymer cells are achieved. The enhanced electro-optical performance of the cell driven by an in-plane switching field is demonstrated. Compared to the pure cell, the 2 wt.% pretilt angle cell shows 36%, 64%, and 76% improvement in the optical switch, the gray-level rise time, and the gray-level fall time responses, respectively, which are obtained at a low driving voltage (≤12 V). When applied to LC devices, the proposed method not only effectively benefits the LC molecular alignment, but it also significantly boosts the electro-optical performance.
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Lam WL, Lin WN, Bell D, Higgins JP, Lin YT, Wei FC. The physiology, microcirculation and clinical application of the shunt-restricted arterialized venous flaps for the reconstruction of digital defects. J Hand Surg Eur Vol 2013. [PMID: 23186864 DOI: 10.1177/1753193412468632] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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: 02/03/2023]
Abstract
Reconstruction of digital defects using the venous flap offer several advantages but remained unpopular owing to levels of venous congestion rates. We performed animal studies to test the hypothesis that an arterio-venous shunt increases pressure for peripheral flap perfusion and decreases venous congestion. Using an abdominal adipofascial flap model in six male Sprague-Dawley rats, microcirculation was modified as follows: type I - arterial flap; type II - flow-through arterio-venous flap (AVF); and type III - shunt-restricted AVF. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type I flaps, blood flow was observed to be unidirectional in both arterioles and venules. In type II flaps, blood flow oscillated without a dominant direction and came to a standstill. In type III flaps, blood flowed proximally in a reverse direction whereas distally, flow was similar to type I flaps. In a clinical series, 21 patients received a total of 22 shunt-restricted AVFs. All 22 clinical flaps survived; four flaps suffered epidermolysis but recovered without full thickness loss.
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Affiliation(s)
- W L Lam
- Department of Plastic and Hand Surgery, Royal Hospital for Sick Children, Edinburgh, UK
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Han YX, Lin YT, Xu JJ, Cao LL, Liu XW, Jiang H, Chi ZF. Status epilepticus stimulates peroxisome proliferator-activated receptor γ coactivator 1-α/mitochondrial antioxidant system pathway by a nitric oxide-dependent mechanism. Neuroscience 2011; 186:128-34. [PMID: 21536107 DOI: 10.1016/j.neuroscience.2011.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 04/07/2011] [Accepted: 04/08/2011] [Indexed: 12/26/2022]
Abstract
Peroxisome proliferator-activated receptor (PPAR) γ coactivator 1-α (PGC-1α) is a transcriptional coactivator identified as an upstream regulator of lipid catabolism, mitochondrial number and function. PGC-1α protects neurons against oxidative damage by inducing several members of the mitochondrial antioxidant system such as superoxide dismutase 2 (SOD2) and uncoupling protein 2 (UCP2). Its role in seizure-induced oxidative stress has not been studied. Here we showed that pilocarpine-induced status epilepticus (SE) stimulates the PGC-1α/mitochondrial antioxidant system signaling pathway in the rat hippocampus. Because nitric oxide (NO) is the key factor of mitochondrial biogenesis through the transcriptional induction of PGC-1α, we investigated whether NO is involved in activation of the PGC-1α/mitochondrial antioxidant system after SE. Treatment with the NO synthase (NOS) inhibitor N(G)-nitro-l-argininemethyl ester (l-NAME) attenuated the increased expression of the PGC-1α/mitochondrial antioxidant system after SE and enhanced oxidative stress. These results suggest that SE can induce the PGC-1α/mitochondrial antioxidant system signaling pathway, which may represent a protective mechanism against SE-induced oxidative stress. Furthermore, NO may positively regulate the mitochondrial antioxidant system by inducing PGC-1α in pilocarpine-induced SE.
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Affiliation(s)
- Y X Han
- Department of Neurology, Qilu Hospital, Shandong University, Jinan, China
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Uman MA, Beasley WH, Tiller JA, Lin YT, Krider EP, Weidmann CD, Krehbiel PR, Brook M, Few AA, Bohannon JL, Lennon CL, Poehler HA, Jafferis W, Gulick JR, Nicholson JR. An unusual lightning flash at kennedy space center. Science 2010; 201:9-16. [PMID: 17777737 DOI: 10.1126/science.201.4350.9] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A lightning flash that struck the 150-meter weather tower at Kennedy Space Center was studied by several research groups using varioul techniques. The flash had unusually large peak currents and a stepped leader of relatively short duration. The charged regions neutralized by the three return strokes were located within a horizontal layer between heights of about 6 and 8 kilometers, where environmental temperatures were about -10 degrees to -20 degrees C. The charge source for the first return stroke coincided with a vertical shaft of precipitation inferred to have been graupel or hail. Charge sources for subsequent strokes were near the edge of the detectable precipitation echo. The overall channel length was about 10 kilometers. A Vertically oriented intracloud discharge occurred after the three return strokes.
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Wang CH, Lin YT, Shiao JC, You CF, Tzeng WN. Spatio-temporal variation in the elemental compositions of otoliths of southern bluefin tuna Thunnus maccoyii in the Indian Ocean and its ecological implication. J Fish Biol 2009; 75:1173-1193. [PMID: 20738607 DOI: 10.1111/j.1095-8649.2009.02336.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The elements Na, Mg, Mn, Ca, Sr and Ba in otoliths of southern bluefin tuna Thunnus maccoyii, collected from their feeding ground in the central Indian Ocean and spawning ground between southern Java and north-western Australia were measured by laser-ablation inductively coupled plasma mass spectrometry (LA-ICPMS) and compared among sampling locations and developmental stages. The Na, Mg and Mn to Ca concentration ratios were significantly higher at the larval stage than at the adult stage, and the ratio reached a peak at the first inflection point of the otolith, mean +/-s.d. 43.3 +/- 4.9 days after hatching and decreased sharply to a low level thereafter. The temporal change of the elements:Ca ratios in the first inflection point corresponded to the life stage transition from larva to juvenile, indicating that the uptake rate of elements from ambient waters was significantly influenced by the ontogenetic change in the fish. The elemental composition at the otolith edge differed significantly in sub-adults on the feeding grounds and adults on the spawning grounds. Thus, the otolith elemental composition can be used as a biological tracer to study the time of the ontogenetic shift and to reconstruct the past migratory environmental history of T. maccoyii. In addition, the elemental composition of the otolith core of the adult was similar between feeding and spawning grounds, indicating that the fish in the Indian Ocean had the same larval origin, which is consistent with the single spawning population hypothesis.
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Affiliation(s)
- C H Wang
- Earth Dynamic System Research Center, National Cheng Kung University, Tainan, Taiwan, ROC.
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Lin YT, Wang CT, Lee JH, Chu CY, Tsao WC, Yang YH, Chiang BL. Higher Bcl-2 levels decrease staphylococcal superantigen-induced apoptosis of CD4+ T cells in atopic dermatitis. Allergy 2007; 62:520-6. [PMID: 17313401 DOI: 10.1111/j.1398-9995.2006.01297.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Staphylococcal superantigens (SsAgs) contribute to the persistence of allergic skin inflammation in atopic dermatitis (AD). The aims of this study were to (1) determine whether there are differences between AD patients and healthy subjects in SsAg-induced caspase-3 activation and SsAg-induced changes of anti-apoptotic protein Bcl-2 and Bcl-2 mRNA levels of CD4+ T cells; (2) investigate the effect of interleukin (IL)-4 on SsAg-induced caspase-3 activation and SsAg-induced changes of Bcl-2 and Bcl-2 mRNA levels of CD4+ T cells. METHODS Using immunofluorescence staining followed by flow cytometric analysis and real-time PCR, we analyzed peripheral blood mononuclear cells with or without staphylococcal enterotoxin B (SEB) stimulation in the presence or absence of recombinant IL-4 or anti-IL-4 neutralizing antibodies in 16 AD patients and 14 healthy subjects. RESULTS SEB-reactive (TCRVbeta3+, Vbeta12+, and Vbeta17+) CD4+ T cells from AD patients were more resistant to SEB-induced caspase-3 activation and SEB-induced decrease of Bcl-2 and Bcl-2 mRNA than those from healthy subjects. Exogenously added IL-4 inhibited SEB-induced caspase-3 activation and SEB-induced decrease of Bcl-2 and Bcl-2 mRNA in SEB-reactive CD4+ T cells from healthy subjects. Inhibition of endogenous IL-4 by using anti-IL-4 neutralizing antibodies up-regulated SEB-induced caspase-3 activation and SEB-induced decrease of Bcl-2 and Bcl-2 mRNA in SEB-reactive CD4+ T cells from AD patients. CONCLUSIONS Following SsAg stimulation, IL-4 produced by T cells in AD patients down-regulates SsAg-induced caspase-3 activation and apoptosis of CD4+ T cells through inhibiting the decrease of Bcl-2. This may impair deletion of SsAg-activated T cells and resolution of allergic skin inflammation.
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Affiliation(s)
- Y T Lin
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
The use of goethite and hydrogen peroxide was recently found to effectively oxidise organic compounds. This research was to investigate the effect of adsorption, pH, Fe2+ and Fe3+ on 2-CP oxidation. Results indicated that 2-CP can be decomposed with hydrogen peroxide catalysed by goethite and the oxidation rate increased with decreasing goethite particle size. The optimum oxidation rate was observed at the pH below 3.0. Addition of Fe2+ and Fe3+ can enhance the catalytic oxidation rate of 2-CP very efficiently. The main mechanism of goethite catalysing hydrogen peroxide to oxidise 2-CP may be due to the catalysis of ferrous ions and goethite surface.
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Affiliation(s)
- Y T Lin
- National Chung-Hsing University, 250 Kuo Juang Rd. Taichung 402, Chinese Taiwan.
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Lin YT, Kwon YI, Labbe RG, Shetty K. Inhibition of Helicobacter pylori and associated urease by oregano and cranberry phytochemical synergies. Appl Environ Microbiol 2006; 71:8558-64. [PMID: 16332847 PMCID: PMC1317381 DOI: 10.1128/aem.71.12.8558-8564.2005] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Ulcer-associated dyspepsia is caused by infection with Helicobacter pylori. H. pylori is linked to a majority of peptic ulcers. Antibiotic treatment does not always inhibit or kill H. pylori with potential for antibiotic resistance. The objective of this study was to determine the potential for using phenolic phytochemical extracts to inhibit H. pylori in a laboratory medium. Our approach involved the development of a specific phenolic profile with optimization of different ratios of extract mixtures from oregano and cranberry. Subsequently, antimicrobial activity and antimicrobial-linked urease inhibition ability were evaluated. The results indicated that the antimicrobial activity was greater in extract mixtures than in individual extracts of each species. The results also indicate that the synergistic contribution of oregano and cranberry phenolics may be more important for inhibition than any species-specific phenolic concentration. Further, based on plate assay, the likely mode of action may be through urease inhibition and disruption of energy production by inhibition of proline dehydrogenase at the plasma membrane.
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Affiliation(s)
- Y T Lin
- Department of Food Science, Chenoweth Laboratory, University of Massachusetts, Amherst, MA 01003, USA
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Yang YH, Lai HJ, Huang CM, Wang LC, Lin YT, Chiang BL. Sera from children with active Henoch-Schönlein purpura can enhance the production of interleukin 8 by human umbilical venous endothelial cells. Ann Rheum Dis 2004; 63:1511-3. [PMID: 15479906 PMCID: PMC1754792 DOI: 10.1136/ard.2003.016196] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the ability of sera from children with active Henoch-Schonlein purpura (HSP) to enhance endothelial interleukin (IL) 8 production and intercellular adhesion molecule (ICAM)-1 expression. METHODS Nine children with active HSP and nine normal healthy children were enrolled. IL8 serum levels of patients and controls at different stages were analysed. Production of IL8 and expression of ICAM-1 by human umbilical venous endothelial cells were detected (ELISA for IL8, flow cytometry for ICAM-1) and compared under various stimuli, including sera of patients at different stages, sera of controls, and medium alone. RESULTS Serum levels of IL8 were increased at the acute stage. Levels of IL8 in supernatants from human umbilical venous endothelial cells (HUVEC) co-cultured with sera from children with active HSP were significantly higher than those from HUVEC without any treatment (p = 0.001), HUVEC treated with inactive sera (p = 0.004), and HUVEC treated with sera from healthy controls (p = 0.004). Sera from patients and from controls did not enhance the expression of ICAM-1 on HUVEC. CONCLUSIONS Some factors may be present in sera from children with active HSP that could activate endothelial cells to produce IL8. This process may account, in part, for the mechanisms of perivascular neutrophil infiltration and leucocytosis in HSP.
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Affiliation(s)
- Y H Yang
- Department of Paediatrics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
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Lin YT, Labbe RG, Shetty K. Inhibition of Listeria monocytogenes in fish and meat systems by use of oregano and cranberry phytochemical synergies. Appl Environ Microbiol 2004; 70:5672-8. [PMID: 15345457 PMCID: PMC520903 DOI: 10.1128/aem.70.9.5672-5678.2004] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [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: 10/22/2003] [Accepted: 04/28/2004] [Indexed: 11/20/2022] Open
Abstract
Optimized phenolics from oregano and cranberry extracts were evaluated for antimicrobial activity against Listeria monocytogenes in laboratory media and in beef and fish. The antimicrobial activity increased when oregano and cranberry extracts were mixed at a ratio of 75% oregano and 25% cranberry (wt/wt) with 0.1 mg of phenolic per disk or ml, and the efficacy was further enhanced by lactic acid. The inhibition by phytochemical and lactic acid synergies was most effective when beef and fish slices were stored at 4 degrees C.
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Affiliation(s)
- Y T Lin
- Chenoweth Laboratory, Department of Food Science, University of Massachusetts, 100 Holdsworth Way, Amherst, MA 01003, USA
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Chen YF, Lee CS, Lin CC, Su SF, Chen ML, Hsieh CC, Chen HM, Chiu CC, Lu YH, Liang HY, Yen HW, Hwang YS, Lin YT. Twenty-year follow-up of the Carpentier-Edwards standard porcine bioprosthesis in the Oriental population. J Cardiovasc Surg (Torino) 2003; 44:691-9. [PMID: 14735029] [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: 04/28/2023]
Abstract
AIM The 20-year period long-term results of porcine bioprosthetic valve use are limited. In addition, the majority of these reports come from Western countries. Given the scanty information reported in Oriental countries, this study was therefore designed to examine 20-year long-term results in patients who received a Carpentier-Edwards porcine bioprosthetic valve in an effort to contribute further information on the long-term clinical performance of porcine prosthetic valves from a viewpoint of results in the Oriental population. METHODS From July 1979 to April 2001, 82 patients received valve replacement with a standard Carpentier-Edwards porcine valve. There were 40 men and 42 women with a mean age of 42.3+/-15.1 years (range 16 to 73 years). Follow-up time extended more than 20 years (mean 10.9+/-3.2 years, range 0.5 to 21.5 years ) for a total of 719.5 patient-years. RESULTS The overall operative mortality was 16.9% (14 of 83 procedures). At 5, 10, 15, and 20 years, the actuarial survival rate of patients was 71.7%, 66.9%, 55.5%, and 44.4%, respectively. Actuarial estimates of freedom from structural valvular deterioration (SVD) at 5, 10, 15, and 17 years were 96.3%, 64.0%, 24.3%, and 24.3%, respectively; from reoperation 96.3%, 64.5%, 24.5%, and 24.5%; from operated valvular endocarditis 96.8%, 92.6%, 92.6%, and 92.6%; and from overall thromboembolism 96.3%, 88.5%, 67.2%, and 52.2%. In normal sinus rhythm, actuarial estimates of freedom from thromboembolism at 5, 10, 15, and 17 years were 100.0%, 100.0%, 81.8%, and 81.8%, respectively. Whereas for those in patients with atrial fibrillation, the estimates of freedom from thromboembolism were 94.5%, 82.4%, 57.7%, and 38.5%. CONCLUSION This study demonstrates the very satisfactory 20-year period long-term performance of freedom from bleeding events, thromboembolism (except in patients with atrial fibrillation), and valvular endocarditis in Oriental patients undergoing replacement with a porcine valve. However, the remarkable rate of SVD and reoperation ensued at 6 years after bioprosthesis implanted which does not differ from the series reported from Western countries.
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Affiliation(s)
- Y F Chen
- Division of Cardiovascular Surgery and Cardiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Abstract
A 40-year-old male motorcyclist suffered a near-total amputation of his right foot. His limb was successfully salvaged with the aid of a cross-leg vascular shunt. Temporary arterial flow from the contralateral limb was transmitted via a pressure monitor tube to perfuse the avulsed part. This allowed the surgeon to carry out unhurried wound debridement, dissection of vital structures and skeletal fixation. The cannulation port was placed well distal to the proposed definitive anas<$>tomosis, to reduce damage to the endothelium. This procedure could be a valuable adjunct in major limb replantation, particularly in cases of prolonged ischaemia.
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Affiliation(s)
- J W Lee
- Division of Plastic Surgery, Department of Surgery, National Cheng-Kung University Hospital, Tainan, Taiwan
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Abstract
In this study, we attempted to identify the interactions and mechanisms between veratrine and paeoniflorin on isolated mouse vas deferens. Paeoniflorin had no effect on isolated mouse vas deferens. Veratrine (1 x 10(-5) approximately 1 x 10(-3) g/ml) could directly induce contraction of isolated rat and mouse vas deferens. The concentration induced by veratrine (1 x 10(-5) g/ml) was completely inhibited by Ca2+-free solution and verapamil (1 x 10(-5) M), in both the epididymal and the prostatic portions of isolated mouse vas deferens. Naloxone (1 x 10(-5) M) did not alter the contraction induced by veratrine (1 x 10(-5) g/ml) in either the epididymal or the prostatic portions of isolated mouse vas deferens. Paeoniflorin (4.8 x 10(-5) g/ml) inhibited the contraction induced by veratrine (1 x 10(-5) g/ml) in both the epididymal and the prostatic portions of isolated mouse vas deferens. Paeoniflorin (4.8 x 10(-5) g/ml) potentiated norepinephrine (1 x 10(-5) M)-induced phasic contraction in the epididymal portion, but decreased contractions in the prostatic portion. Paeoniflorin (4.8 x 10(-5) g/ml) increased KCI (56 mM)-induced phasic contraction in the epididymal portion, but decreased the tonic contraction in either the epididymal or the prostatic portion. Veratrine (1 x 10(-5) g/ml)-induced contractions could be decreased by pretreatment with ryanodine (1 x 10(-5) M) in both the epididymal and the prostatic portions. Pretreatment with the combination of paeoniflorin (4.8 x 10(-5) g/ml) and ryanodine (1 x 10(-5) M) did not potentiate the inhibition of paeoniflorin in the veratrine-induced contraction in both the epididymal and the prostatic portions of isolated mouse vas deferens.
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Affiliation(s)
- Y F Chen
- Department of Pharmacology and Institute of Pharmaceutical Sciences, China Medical College, Taichung, Taiwan, ROC
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Liu J, Yang YH, Lin YT, Chiang BL. Clinical characteristics of neonatal lupus erythematosus. J Microbiol Immunol Infect 2001; 34:265-8. [PMID: 11825006] [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: 02/23/2023]
Abstract
Neonatal lupus erythematosus is a rare disorder caused by transplacental autoantibodies from the mother to the fetus. This syndrome is characterized by congenital heart block and/or cutaneous lesion. A total of 10 cases of neonatal lupus erythematosus were diagnosed at the National Taiwan University Hospital from 1988 through 1998. The incidence of cardiac anomaly and other clinical features in patients with neonatal lupus erythemayosus in this study was compared with those in previous studies. Results showed that 50% of patients had congenital heart block and/or cutaneous lesion, which is compatible to previous statistics. However, the findings showed that 80% of the patients were female and 90% of the mothers had acquired an autoimmune disorder, which were much higher compared with that of other studies. To date, no definite treatment is suggested prenatally to prevent the occurrence of congenital heart block, but careful maternal screening and serial fetal echocardiogram are warranted.
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Affiliation(s)
- J Liu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, ROC
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Lin HC, Hwang KC, Yang YH, Lin YT, Chiang BL. Risk factors of wheeze and allergy after lower respiratory tract infections during early childhood. J Microbiol Immunol Infect 2001; 34:259-64. [PMID: 11825005] [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: 02/23/2023]
Abstract
Lower respiratory tract infections (LRIs) during early childhood can lead to bronchial hyperreactivity or recurrent obstructive bronchitis. The role of LRIs in the pathogenesis of allergic diseases such as allergic rhinoconjunctivitis, atopic eczema, and bronchial asthma is less clear. The aim of this retrospective study was to determine the incidence of subsequent wheezing and atopy, and the known risk factors for allergic sensitization in 74 children hospitalized for acute LRIs of various etiologies from January 1994 through December 1994. Results showed that there are no differences in outcomes between patients with respiratory syncytial virus LRI, Chlamydia pneumoniae LRI, and LRIs caused by other agents. Although lower respiratory tract illnesses, especially those caused by respiratory syncytial virus during infancy, were associated with an increased risk of subsequent wheezing during early childhood, wheezing tended to disappear with increasing age in many children. This study also found recurrent episodes of wheezing during the first 5 years of life, and symptoms suggestive of allergic rhinoconjunctivitis were the only factors predictive of subsequent diagnosis of asthma for children who had LRIs during early childhood. In conclusion, this study suggests that prevention of recurrent wheezing LRIs and good control of allergic rhinoconjunctivitis is critical for preventing subsequent development of bronchial asthma.
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Affiliation(s)
- H C Lin
- Department of Pediatrics, Provincial Keelung Hospital, Taiwan, ROC
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Wei FC, Demirkan F, Chen HC, Chuang DC, Chen SH, Lin CH, Cheng SL, Cheng MH, Lin YT. The outcome of failed free flaps in head and neck and extremity reconstruction: what is next in the reconstructive ladder? Plast Reconstr Surg 2001; 108:1154-60; discussion 1161-2. [PMID: 11604611 DOI: 10.1097/00006534-200110000-00007] [Citation(s) in RCA: 112] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The indications for free flaps have been more or less clarified; however, the course of reconstruction after the failure of a free flap remains undetermined. Is it better to insist on one's initial choice, or should surgeons downgrade their reconstructive goals? To establish a preliminary guideline, this study was designed to retrospectively analyze the outcome of failed free-tissue transfers performed in the authors hospital. Over the past 8 years (1990 through 1997), 3361 head and neck and extremity reconstructions were performed by free-tissue transfers, excluding toe transplantations. Among these reconstructions, 1235 flaps (36.7 percent) were transferred to the head and neck region, and 2126 flaps (63.3 percent) to the extremities. A total of 101 failures (3.0 percent total plus the partial failure rate) were encountered. Forty-two failures occurred in the head and neck region, and 59 in the extremities. Evaluation of the cases revealed that one of three following approaches to handling the failure was taken: (1) a second free-tissue transfer; (2) a regional flap transfer; or (3) conservative management with debridement, wound care, and subsequent closure by secondary intention, whether by local flaps or skin grafting. In the head and neck region, 17 second free flaps (40 percent) and 15 regional flaps (36 percent) were transferred to salvage the reconstruction, whereas conservative management was undertaken in the remaining 10 cases (24 percent). In the extremities, 37 failures were treated conservatively (63 percent) in addition to 17 second free flaps (29 percent) and three regional flaps (5 percent) used to salvage the failed reconstruction. Two cases underwent amputation (3 percent). The average time elapsed between the failure and second free-tissue transfer was 12 days (range, 2 to 60 days) in the head and neck region and 18 days (range, 2 to 56 days) in the extremities. In a total of 34 second free-tissue transfers at both localizations, there were only three failures (9 percent). However, in the head and neck region, seven of the regional flaps transferred (47 percent) and four cases that were conservatively treated (40 percent) either failed or developed complications that lengthened the reconstruction period because of additional procedures. Six other free-tissue transfers had to be performed to manage these complicated cases. Conservative management was quite successful in the extremities; most patients' wounds healed, although more than one skin-graft procedure was required in 10 patients (27 percent). In conclusion, a second free-tissue transfer is, in general, a relatively more reliable and more effective procedure for the treatment of flap failure in the head and neck region, as well as failed vascularized bone flaps in the reconstruction of the extremities. Conservative treatment may be a simple and valid alternative to second (free) flaps for soft-tissue coverage in extremities with partial and even total losses.
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Affiliation(s)
- F C Wei
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taipei, Taiwan, ROC.
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Abstract
An elderly man with ocular type myasthenia gravis (MG) was found to have monoclonal gammopathy (IgM). Waldenström's macroglobulinemia (WM) was proven later. This is the second case report of MG associated with WM. However, this case is unique due to the presence of anti-acetylcholine receptor (anti-AChR) antibody (IgG). MG is considered to be an autoimmune disease and WM an immunoproliferative disorder. The association of MG and WM is not clear.
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Affiliation(s)
- Y T Lin
- Section of Neurology, Kaohsiung Veterans' General Hospital, Taiwan
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Abstract
Sometimes patients with a psychoneurological impairment present with a traumatic injury that requires either microsurgical replantation or free-tissue transfer. We reviewed 38 patients undergoing 40 microvascular operations; the patients included 26 patients with psychological impairment (group 1), 3 with mental disability (group 2), and 9 with an acquired head injury and consciousness disturbance (Glasgow Coma Scale score < or =14) (group 3). Patients with a psychological impairment, especially those with a self-inflicted injury, are often uncooperative and do not recognize the necessity of restorative procedures. A multidisciplinary approach by the trauma surgeon, plastic surgeon, psychiatrist, and neurosurgeon, with coordinated assistance from the physician, nurse, therapist, and family, is required for treatment. In our study the success rate of replantation was 77.8 percent (14 of 18); for free tissue transfer the success rate was 95.5 percent (21 of 22). The overall success rate of microsurgical procedures (87.5 percent, 35 of 40) was similar to that in the population at large. Patients with psychological impairment tend to be lost during follow-up; therefore, their functional results may be poorer than expected. Nonetheless, patients with psychological impairment should not be deprived of the benefits of restorative surgery.
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Affiliation(s)
- C H Lin
- Trauma Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.
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Lin JH, Hsiao SF, Liu CK, Lin YT. Rehabilitation fees, length of stay and efficiency for hospitalized stroke patients: a preliminary study based on function-related groups. Kaohsiung J Med Sci 2001; 17:475-83. [PMID: 11842651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
The purpose of this study was to examine the relationships between severity of disability and factors such as rehabilitation fees, length of stay and efficiency for hospitalized stroke patients. One hundred and seven first-time stroke patients were studied consecutively for this study. They were recruited from a rehabilitation ward in a university medical center during 1997. Functional ability was evaluated using the Functional Independence Measure (FIM) instrument on admission and discharge. Stroke patients who presented with similar degrees of disability were put together using the admission FIM score (FIM Function-Related Groups, FIM-FRGs) for further analysis. Twenty-eight (26.2%) patients examined were categorized as severely disabled (scored 18-36), 48 (44.8%) moderately disabled (scored 37-72) and 31 (29.0%) mildly disabled (scored 73-126). The average expense on rehabilitation fees, for the average rehabilitation length of stay (LOSR) of 34.7 +/- 16.7 days, was NT$ 27,645 +/- 13,812. The FIM score improved from 56.8 +/- 24.2 on admission to 76.6 +/- 26.2 at discharge, with a rehabilitation efficiency index (EIR) of 0.7 +/- 0.7. Further analysis indicated that there were significant differences among the three disability groups on rehabilitation fees and LOSR while EIR was unaffected. The findings of this study suggest that FIM-FRGs can differentiate different rehabilitation needs in terms of rehabilitation fees and LOSR; therefore, a prospective case payment system based on FIM-FRGs is suggested for stroke rehabilitation reimbursement scheme in the future.
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Affiliation(s)
- J H Lin
- School of Rehabilitation Medicine, Kaohsiung Medical University, Taiwan
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Yang YH, Lin YT, Lu MY, Tsai MJ, Chiang BL. A double-blind, placebo-controlled, and randomized study of loratadine (Clarityne) syrup for the treatment of allergic rhinitis in children aged 3 to 12 years. Asian Pac J Allergy Immunol 2001; 19:171-5. [PMID: 11826911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Allergic rhinitis is a common disease in children, and antihistamines are the key medication. However, traditional tablets are not convenient and lead to low compliance in young children. The aim of this double-blind, placebo-controlled, parallel, randomized study was to evaluate the effectiveness and safety of loratadine syrup for the treatment of children aged 3 to 12 years with allergic rhinitis. Sixty children with allergic rhinitis due to dust mites were enrolled. They were randomized into 2 parallel groups: one group received loratadine syrup 5 mg or 10 mg daily for 3 weeks, and the other group received placebo. The patients returned to special clinics for symptoms evaluation at day 7 and day 21, and the parents were requested to record disease severity daily. Both evaluations, physician's and parents', were recorded with a 4-point scale for 5 symptoms: sneezing, rhinorrhea, nasal congestion, nasal itching and ocular symptoms. Forty-six patients completed the study, 22 in the loratadine group and 24 in the placebo group. At the initial visit, the total symptom score (TSS) in both groups was not significantly different (p = 0.39). The TSS of the loratadine syrup group at day 7 and day 21 was lower than those of the placebo group (p = 0.003, p = 0.06). The daily card scores in the experimental group were also significantly lower than those of the placebo group (week 1, p = 0.014; week 2, p = 0.029; week 3, p = 0.014). No adverse reactions were recorded in both groups. This study revealed that loratadine syrup 5 mg or 10 mg once a day improved symptom scores of children with allergic rhinitis effectively and safely.
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Affiliation(s)
- Y H Yang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei
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Affiliation(s)
- C H Lin
- Trauma Center, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital College of Medicine, Chang Gung University, Taipei, Taiwan.
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Lin YT, Tsai CL. Comparative anti-caries effects of tablet and liquid fluorides in cleft children. J Clin Dent 2001; 11:104-6. [PMID: 11460274] [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: 02/20/2023]
Abstract
Children with cleft lip and/or palate are at a higher risk for developing caries of the primary incisors compared with non-cleft children. To determine whether fluoride in tablet or liquid form would be more efficacious with children with cleft lip and/or palate, a two-year clinical investigation was conducted to test the anti-caries effects. One-hundred and fifteen cleft children (59 boys and 56 girls) between 22 and 26 months old were randomly selected into control, tablet and liquid fluoride groups. The amount of administered fluoride was 0.25 mg F daily in non-fluoridated Taiwan. Dental examinations were conducted using mirrors and #23 explorers. Caries were assessed using the DMF index in the baseline, first year and second year. The results showed that children in the tablet and liquid groups had a significantly lower DMFT increment than in the control group (p < 0.05). In the DMFS index, children in the liquid group showed a significantly lower caries increment than in the control group (p < 0.01), and children in the tablet group presented a borderline, but non-significant statistical difference when compared with the control group (p = 0.065). No significant statistical difference was found in either DMFT or DMFS between tablet and liquid fluoride administrations (p = 0.521 and p = 0.383, respectively). It is concluded that dietary fluoride supplements in liquid form show efficacy in reducing early childhood caries in the cleft children. Liquid fluoride showed slightly better numerical anti-caries effect than tablet fluoride, which is possibly due to its ease of administration with small children.
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Affiliation(s)
- Y T Lin
- Department of Orthodontics and Pediatric Dentistry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan.
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Hwu CM, Kwok CF, Ku BI, Lin YT, Lee YS, Hsiao LC, Lee SH, Ho LT. Undiagnosed glucose intolerance encountered in clinical practice: reappraisal of the use of the oral glucose tolerance test. Zhonghua Yi Xue Za Zhi (Taipei) 2001; 64:435-42. [PMID: 11720141] [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: 02/22/2023]
Abstract
BACKGROUND In 1997, the Expert Committee of the American Diabetes Association (ADA) revised the diabetes mellitus (DM) diagnostic criteria to facilitate the diagnosis of DM on the basis of fasting plasma glucose (PG). The major purpose of the study is to evaluate if oral glucose tolerance test (OGTT) is still needed after the revision of criteria. METHODS From September 1994 to March 1995, 247 ambulatory subjects referred by clinicians for 75-g OGTT were recruited for the study. Fasting and 2-h PG and serum insulin concentrations were determined. Additional fasting blood samples were collected for the measurement of HbA1c. We used the receiver operating characteristic (ROC) curve to locate a cut-point of fasting PG corresponding to 2-h PG of 200 mg/dl. RESULTS The optimal fasting PG level depicted by ROC curve was more than 105 mg/dl, giving 80.6% sensitivity and 85.6% specificity for the diagnosis of DM in clinical setting. If fasting PG > or = 126 mg/dl was employed, the specificity was 98.3% but the sensitivity went down to 42.6%. High rates of glucose intolerance would remain undiagnosed in subjects with fasting PG less than 126 mg/dl (41.6% of them being IGT and 38.6% DM), if the OGTT was exempted from clinical practice. HbA1c more than 6.2% could be a clue to recognize undiagnosed DM, but was unable to separate impaired glucose tolerance (IGT) from non-DM. CONCLUSIONS In the population studied, undiagnosed glucose intolerance can still be encountered in a large number of subjects with fasting PG less than 126 mg/dl. OGTT is still indispensable in clinical setting for the diagnosis of DM and IGT after the revision of diagnostic criteria.
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Affiliation(s)
- C M Hwu
- Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC
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Huang YC, Lin YT, Yang YH, Wang SJ, Yang CM, Chiang BL. Acute lupus pneumonitis mimicking pulmonary tuberculosis: a case report. J Microbiol Immunol Infect 2001; 34:143-6. [PMID: 11456361] [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: 02/20/2023]
Abstract
We report a case of systemic lupus erythematosus in a 15-year-old girl with initial presentation as acute lupus pneumonitis. A fulminant course with pancytopenia and respiratory distress were developed 3 weeks after symptom onset. Chest radiographs revealed an interstitial pattern with miliary nodules over bilateral lower lung fields that mimics miliary tuberculosis. The patient was treated with intravenous immunoglobulin and antituberculosis drugs because the infection-associated hemophagocytic syndrome and pulmonary tuberculosis could not be excluded from the clinical course. The response to antituberculosis treatment, however, was poor and her respiratory condition deteriorated rapidly to impending respiratory failure 1 week after admission. Systemic lupus erythematosus with acute lupus pneumonitis was then diagnosed based on the fulminant clinical course and accordant laboratory results. Corticosteroid (methylprednisolone) and cytotoxic agent (cyclophosphamide) pulse therapies were applied twice and once, respectively. She recovered gradually after receiving the immunotherapy.
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Affiliation(s)
- Y C Huang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, ROC
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