47 results on '"Yu, Chong"'
Search Results
2. New evidence: Metformin unsuitable as routine adjuvant for breast cancer: a drug-target mendelian randomization analysis
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Xu, Jing-Xuan, Zhu, Qi-Long, Bi, Yu-Miao, and Peng, Yu-Chong
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- 2024
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3. Cross-site validation of lung cancer diagnosis by electronic nose with deep learning: a multicenter prospective study
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Lee, Meng-Rui, Kao, Mu-Hsiang, Hsieh, Ya-Chu, Sun, Min, Tang, Kea-Tiong, Wang, Jann-Yuan, Ho, Chao-Chi, Shih, Jin-Yuan, and Yu, Chong-Jen
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- 2024
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4. Integrative metagenomic analysis reveals distinct gut microbial signatures related to obesity
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Hu, Xinliang, Yu, Chong, He, Yuting, Zhu, Songling, Wang, Shuang, Xu, Ziqiong, You, Shaohui, Jiao, Yanlei, Liu, Shu-Lin, and Bao, Hongxia
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- 2024
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5. Clinical outcomes and risk factors of progressive pulmonary fibrosis in primary Sjögren’s syndrome-associated interstitial lung disease
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Chen, Yu-Hsuan, Lee, Tai-Ju, Hsieh, Hsin-Jung, Hsieh, Song-Chou, Wang, Hao-Chien, Chang, Yeun-Chung, Yu, Chong-Jen, and Chien, Jung-Yien
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- 2023
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6. Prognostic value of the post-exercise heart rate recovery and BHDE-index in chronic obstructive pulmonary disease
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Chen, Shih-Yu, Huang, Chun-Kai, Wu, Chia-Ling, Peng, Hui-Chuan, Yu, Chong-Jen, and Chien, Jung-Yien
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- 2023
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7. Monitoring of T790M in plasma ctDNA of advanced EGFR-mutant NSCLC patients on first- or second-generation tyrosine kinase inhibitors
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Huang, Chun-Ta, Lin, Chih-An, Su, Te-Jen, Yang, Ching-Yao, Tsai, Tzu-Hsiu, Hsu, Chia-Lin, Liao, Wei-Yu, Chen, Kuan-Yu, Ho, Chao-Chi, and Yu, Chong-Jen
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- 2023
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8. The effects of an integrated mindfulness-based tai chi chuan programme on sleep disturbance among community-dwelling elderly people: protocol for a randomized controlled trial
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Chan, Sunny Ho-Wan, Ng, Siu-Man, Yu, Chong-Ho, Chan, Ching-Man, Wang, Shu-Mei, and Chan, Wai-Chi
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- 2022
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9. Targeting microglial autophagic degradation of the NLRP3 inflammasome for identification of thonningianin A in Alzheimer’s disease
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Zhou, Xiao-Gang, Qiu, Wen-Qiao, Yu, Lu, Pan, Rong, Teng, Jin-Feng, Sang, Zhi-Pei, Law, Betty Yuen-Kwan, Zhao, Ya, Zhang, Li, Yan, Lu, Tang, Yong, Sun, Xiao-Lei, Wong, Vincent Kam Wai, Yu, Chong-Lin, Wu, Jian-Ming, Qin, Da-Lian, and Wu, An-Guo
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- 2022
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10. Prognostic value of computed tomographic findings in acute respiratory distress syndrome and the response to prone positioning
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Chen, You-Yi, Kuo, Jerry Shu-Hung, Ruan, Sheng-Yuan, Chien, Ying-Chun, Ku, Shih-Chi, Yu, Chong-Jen, and Chien, Jung-Yien
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- 2022
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11. Development of computational models for microtesla-level magnetic brain scanning: a novel avenue for device development
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Shahrestani, Shane, Zada, Gabriel, and Tai, Yu-Chong
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- 2022
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12. Gastrointestinal complications are associated with a poor outcome in non-critically ill pneumonia patients
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Huang, Chun-Ta, Hong, Chun-Ming, Tsai, Yi-Ju, Sheng, Wang-Huei, and Yu, Chong-Jen
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- 2020
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13. The impact on incident tuberculosis by kidney function impairment status: analysis of severity relationship
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Shu, Chin-Chung, Wei, Yu-Feng, Yeh, Yi-Chun, Lin, Hsien-Ho, Chen, Chung-Yu, Wang, Ping-Huai, Cheng, Shih-Lung, Wang, Jann-Yuan, and Yu, Chong-Jen
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- 2020
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14. Major comorbidities lead to the risk of adverse cardiovascular events in chronic obstructive pulmonary disease patients using inhaled long-acting bronchodilators: a case-control study
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Chen, Yen-Fu, Cheng, Yi-Ching, Chou, Chien-Hong, Chen, Chung-Yu, and Yu, Chong-Jen
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- 2019
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15. Radial endobronchial ultrasound-guided transbronchial biopsy for peripheral pulmonary malignancy: biopsy- or brushing-first?
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Huang, Chun-Ta, Tsai, Yi-Ju, Ho, Chao-Chi, and Yu, Chong-Jen
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- 2019
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16. Clinical factors associated with treatment outcomes in EGFR mutant non-small cell lung cancer patients with brain metastases: a case-control observational study
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Chen, Yung-Hsuan, Chen, Yen-Fu, Chen, Chung-Yu, Shih, Jin-Yuan, and Yu, Chong-Jen
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- 2019
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17. Metformin use mitigates the adverse prognostic effect of diabetes mellitus in chronic obstructive pulmonary disease
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Ho, Te-Wei, Huang, Chun-Ta, Tsai, Yi-Ju, Lien, Angela Shin-Yu, Lai, Feipei, and Yu, Chong-Jen
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- 2019
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18. Inhaled nitric oxide therapy and risk of renal dysfunction: a systematic review and meta-analysis of randomized trials
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Ruan, Sheng-Yuan, Huang, Tao-Min, Wu, Hon-Yen, Wu, Huey-Dong, Yu, Chong-Jen, and Lai, Mei-Shu
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- 2015
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19. Can psychological flexibility and prosociality mitigate illness perceptions toward COVID-19 on mental health? A cross-sectional study among Hong Kong adults
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Maria Karekla, Angelos P. Kassianos, Yuen Yu Chong, Wai Tong Chien, Ho Yu Cheng, and Andrew T. Gloster
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Adult ,Male ,050103 clinical psychology ,medicine.medical_specialty ,Coping (psychology) ,Adolescent ,Explanatory model ,Social Sciences ,Structural equation modeling ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Adaptation, Psychological ,medicine ,Humans ,Psychology ,Prosociality ,0501 psychology and cognitive sciences ,Psychological flexibility ,Social Behavior ,SARS-CoV-2 ,Health Policy ,Public health ,lcsh:Public aspects of medicine ,Research ,05 social sciences ,Public Health, Environmental and Occupational Health ,Health services research ,Flexibility (personality) ,COVID-19 ,lcsh:RA1-1270 ,Mental health ,Coronavirus ,Cross-Sectional Studies ,Prosocial behavior ,Hong Kong ,Female ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
Background The negative impact of COVID-19 pandemic on public mental health can be persistent and substantial over a long period of time, but little is known regarding what psychological factors or processes can buffer such impact. The present study aimed to examine the mediating roles of coping, psychological flexibility and prosociality in the impacts of perceived illness threats toward COVID-19 on mental health. Method Five-hundred and fourteen Hong Kong citizens (18 years or above) completed an online survey to measure illness perceptions toward COVID-19, coping, psychological flexibility, prosociality, and mental health, together with their socio-demographic variables. Structural equation modelling was used to explore the explanatory model that was the best-fit to illustrate the relationships between these constructs. Results Serial mediation structural equation model showed that only psychological flexibility (unstandardised beta coefficient, β = − 0.12, 95% CI [− 0.20, − 0.02], p = 0.031) and prosociality (unstandardised β = 0.04, 95% CI [0.01, 0.08], p = 0.001) fully mediated the relationship between illness perceptions toward COVID-19 and mental health. In addition, psychological flexibility exerted a direct effect on prosociality (standardised β = 0.22, 95% CI [0.12, 0.32], p Conclusions Fostering psychological flexibility and prosocial behaviour may play significant roles in mitigating the adverse effects of COVID-19 and its perceived threats on public mental health.
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- 2021
20. Risk factors for latent tuberculosis infection in RA patients treated with anti-tumor necrosis factor
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Huang, Shiang-Fen, Su, Wei-Juin, Ruan, Sheng-Yuan, Yu, Chong-Jen, Hsieh, Song-Chou, Liu, Yu-Chih, Wu, Yeong-Jian Jan, and Lin, Hsiao-Yi
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- 2012
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21. Incomplete cellular reprogramming of colorectal cancer cells elicits an epithelial/mesenchymal hybrid phenotype
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Soon Keng Cheong, Michele Sook Yuin Hiew, Kong-Bung Choo, Tunku Kamarul, Kowit-Yu Chong, Han Ping Cheng, and Chiu-Jung Huang
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0301 basic medicine ,Epithelial-Mesenchymal Transition ,Endocrinology, Diabetes and Metabolism ,Cellular differentiation ,Clinical Biochemistry ,Induced Pluripotent Stem Cells ,lcsh:Medicine ,MET and EMT genes ,Biology ,Induced pluripotent cancer cells ,03 medical and health sciences ,Phosphatidylinositol 3-Kinases ,Cell Movement ,Cell Line, Tumor ,Cancer reprogramming ,Humans ,Pharmacology (medical) ,Cell Lineage ,Epithelial–mesenchymal transition ,Induced pluripotent stem cell ,Molecular Biology ,Research ,Biochemistry (medical) ,lcsh:R ,Cell Differentiation ,Cell Biology ,General Medicine ,Cellular Reprogramming ,Embryonic stem cell ,Cell biology ,Colon cancer ,Neoplasm Proteins ,Gene Expression Regulation, Neoplastic ,Epithelial-mesenchymal hybrid phenotype ,MicroRNAs ,030104 developmental biology ,Cancer cell ,SNAI1 ,Neoplastic Stem Cells ,Ectopic expression ,Colorectal Neoplasms ,Reprogramming - Abstract
Background Induced pluripotency in cancer cells by ectopic expression of pluripotency-regulating factors may be used for disease modeling of cancers. MicroRNAs (miRNAs) are negative regulators of gene expression that play important role in reprogramming somatic cells. However, studies on the miRNA expression profile and the expression patterns of the mesenchymal-epithelial transition (MET)/epithelial-mesenchymal transition (EMT) genes in induced pluripotent cancer (iPC) cells are lacking. Methods iPC clones were generated from two colorectal cancer (CRC) cell lines by retroviral transduction of the Yamanaka factors. The iPC clones obtained were characterized by morphology, expression of pluripotency markers and the ability to undergo in vitro tri-lineage differentiation. Genome-wide miRNA profiles of the iPC cells were obtained by microarray analysis and bioinformatics interrogation. Gene expression was done by real-time RT-PCR and immuno-staining; MET/EMT protein levels were determined by western blot analysis. Results The CRC-iPC cells showed embryonic stem cell-like features and tri-lineage differentiation abilities. The spontaneously-differentiated post-iPC cells obtained were highly similar to the parental CRC cells. However, down-regulated pluripotency gene expression and failure to form teratoma indicated that the CRC-iPC cells had only attained partial pluripotency. The CRC-iPC cells shared similarities in the genome-wide miRNA expression profiles of both cancer and pluripotent embryonic stem cells. One hundred and two differentially-expressed miRNAs were identified in the CRC-iPC cells, which were predicted by bioinformatics analysis be closely involved in regulating cellular pluripotency and the expression of the MET/EMT genes, possibly via the phosphatidylinositol-3 kinases-protein kinase B (PI3K-Akt) and transforming growth factor beta (TGF-β) signaling pathways. Irregular and inconsistent expression patterns of the EMT vimentin and Snai1 and MET E-cadherin and occludin proteins were observed in the four CRC-iPC clones analyzed, which suggested an epithelial/mesenchymal hybrid phenotype in the partially reprogrammed CRC cells. MET/EMT gene expression was also generally reversed on re-differentiation, also suggesting epigenetic regulation. Conclusions Our data support the elite model for cancer cell-reprogramming in which only a selected subset of cancer may be fully reprogrammed; partial cancer cell reprogramming may also elicit an epithelial-mesenchymal mixed phenotype, and highlight opportunities and challenges in cancer cell-reprogramming. Electronic supplementary material The online version of this article (10.1186/s12929-018-0461-1) contains supplementary material, which is available to authorized users.
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- 2018
22. Timing of tracheostomy as a determinant of weaning success in critically ill patients: a retrospective study
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Hsu, Chia-Lin, Chen, Kuan-Yu, Chang, Chia-Hsuin, Jerng, Jih-Shuin, Yu, Chong-Jen, and Yang, Pan-Chyr
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Male ,Time Factors ,Research ,weaning ,Critical Illness ,tracheostomy ,mechanical ventilation ,Length of Stay ,Respiration, Artificial ,Intensive Care Units ,Humans ,Female ,Hospital Mortality ,Ventilator Weaning ,APACHE ,Aged ,Retrospective Studies - Abstract
Introduction Tracheostomy is frequently performed in critically ill patients for prolonged intubation. However, the optimal timing of tracheostomy, and its impact on weaning from mechanical ventilation and outcomes in critically ill patients who require mechanical ventilation remain controversial. Methods The medical records of patients who underwent tracheostomy in the medical intensive care unit (ICU) of a tertiary medical centre from July 1998 to June 2001 were reviewed. Clinical characteristics, length of stay in the ICU, rates of post-tracheostomy pneumonia, weaning from mechanical ventilation and mortality rates were analyzed. Results A total of 163 patients (93 men and 70 women) were included; their mean age was 70 years. Patients were classified into two groups: successful weaning (n = 78) and failure to wean (n = 85). Shorter intubation periods (P = 0.02), length of ICU stay (P = 0.001) and post-tracheostomy ICU stay (P = 0.005) were noted in patients in the successful weaning group. Patients who underwent tracheostomy more than 3 weeks after intubation had higher ICU mortality rates and rates of weaning failure. The length of intubation correlated with the length of ICU stay in the successful weaning group (r = 0.70; P < 0.001). Multivariate analysis revealed that tracheostomy after 3 weeks of intubation, poor oxygenation before tracheostomy (arterial oxygen tension/fractional inspired oxygen ratio
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- 2004
23. Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis.
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Jun-hua Zhao, Peng Gao, Yong-xi Song, Jing-xu Sun, Xiao-wan Chen, Bin Ma, Yu-chong Yang, Zhen-ning Wang, Zhao, Jun-Hua, Gao, Peng, Song, Yong-Xi, Sun, Jing-Xu, Chen, Xiao-Wan, Ma, Bin, Yang, Yu-Chong, and Wang, Zhen-Ning
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STOMACH cancer treatment ,META-analysis ,CANCER chemotherapy ,STOMACH cancer patients ,PERIOPERATIVE care ,FLUOROPYRIMIDINES ,THERAPEUTICS ,ANTINEOPLASTIC agents ,COMBINED modality therapy ,STOMACH tumors ,SYSTEMATIC reviews - Abstract
Background: The preferred chemotherapy method for gastric cancer continues to be matter of debate. We performed a meta-analysis to comparing prognosis and safety between perioperative chemotherapy and adjuvant chemotherapy to identify the better chemotherapy option for gastric cancer.Methods: We searched the PubMed, EMBASE, Cochrane Library, and Ovid databases for eligible studies until February 2016. The main endpoints were prognostic value (hazard ratio [HR] for overall survival [OS] and 1-, 2-, 3-, and 5-year survival rate), response rate of chemotherapy, radical resection rate, post-operative complication rate, and adverse effects of chemotherapy.Results: Five randomized controlled trials and six clinical controlled trials involving 1,240 patients were eligible for analysis. Compared with the adjuvant chemotherapy group, the perioperative chemotherapy group had significantly better prognosis (HR, 0.74; 95 % CI, 0.61 to 0.89; P < 0.01). The difference between the two groups remained significant in the studies that used combination chemotherapy as the neoadjuvant chemotherapy regimen (HR, 0.59; 95 % CI, 0.46 to 0.76; P < 0.01) but were not significant in the studies that used fluoropyrimidine monotherapy (HR, 0.93; 95 % CI, 0.56 to 1.55; P = 0.84). Furthermore, the two groups showed no significant differences in the post-operative complication rates (relative risk, 0.98; 95 % CI, 0.63 to 1.51; P = 0.91) or adverse effects of chemotherapy (P > 0.05 for all adverse effects).Conclusion: Perioperative chemotherapy showed improved survival compared to adjuvant chemotherapy for gastric cancer. In addition, combination chemotherapy resulted in better survival compared to monotherapy in the neoadjuvant chemotherapy regimens. [ABSTRACT FROM AUTHOR]- Published
- 2016
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24. Development of a multi-electrode array for spinal cord epidural stimulation to facilitate stepping and standing after a complete spinal cord injury in adult rats
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V. Reggie Edgerton, Jaehoon Choe, Parag Gad, Hui Zhong, Yu-Chong Tai, Roland R. Roy, and Mandheerej S. Nandra
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Cord ,Spinal cord electrode array ,Health Informatics ,Stimulation ,Context (language use) ,Spinal cord injury ,Epidural stimulation ,03 medical and health sciences ,0302 clinical medicine ,Electrode array ,Medicine ,030304 developmental biology ,0303 health sciences ,business.industry ,Research ,Rehabilitation ,Motor recovery ,Spinal cord ,medicine.disease ,Epidural space ,Electrophysiology ,medicine.anatomical_structure ,business ,Neuroscience ,030217 neurology & neurosurgery ,Biomedical engineering - Abstract
Background Stimulation of the spinal cord has been shown to have great potential for improving function after motor deficits caused by injury or pathological conditions. Using a wide range of animal models, many studies have shown that stimulation applied to the neural networks intrinsic to the spinal cord can result in a dramatic improvement of motor ability, even allowing an animal to step and stand after a complete spinal cord transection. Clinical use of this technology, however, has been slow to develop due to the invasive nature of the implantation procedures, the lack of versatility in conventional stimulation technology, and the difficulty of ascertaining specific sites of stimulation that would provide optimal amelioration of the motor deficits. Moreover, the development of tools available to control precise stimulation chronically via biocompatible electrodes has been limited. In this paper, we outline the development of this technology and its use in the spinal rat model, demonstrating the ability to identify and stimulate specific sites of the spinal cord to produce discrete motor behaviors in spinal rats using this array. Methods We have designed a chronically implantable, rapidly switchable, high-density platinum based multi-electrode array that can be used to stimulate at 1–100 Hz and 1–10 V in both monopolar and bipolar configurations to examine the electrophysiological and behavioral effects of spinal cord epidural stimulation in complete spinal cord transected rats. Results In this paper, we have demonstrated the effectiveness of using high-resolution stimulation parameters in the context of improving motor recovery after a spinal cord injury. We observed that rats whose hindlimbs were paralyzed can stand and step when specific sets of electrodes of the array are stimulated tonically (40 Hz). Distinct patterns of stepping and standing were produced by stimulation of different combinations of electrodes on the array located at specific spinal cord levels and by specific stimulation parameters, i.e., stimulation frequency and intensity, and cathode/anode orientation. The array also was used to assess functional connectivity between the cord dorsum to interneuronal circuits and specific motor pools via evoked potentials induced at 1 Hz stimulation in the absence of any anesthesia. Conclusions Therefore the high density electrode array allows high spatial resolution and the ability to selectively activate different neural pathways within the lumbosacral region of the spinal cord to facilitate standing and stepping in adult spinal rats and provides the capability to evoke motor potentials and thus a means for assessing connectivity between sensory circuits and specific motor pools and muscles.
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- 2013
25. The value of repeat radial-probe endobronchial ultrasound-guided transbronchial biopsy after initial non-diagnostic results in patients with peripheral pulmonary lesions.
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Chun-Ta Huang, Yi-Ju Tsai, Chao-Chi Ho, Chong-Jen Yu, Huang, Chun-Ta, Tsai, Yi-Ju, Ho, Chao-Chi, and Yu, Chong-Jen
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LUNG disease diagnosis ,ULTRASONIC imaging ,BIOPSY ,ADVERSE health care events ,PUBLIC health ,BRONCHOSCOPY ,COMPUTED tomography ,LUNGS ,LUNG diseases ,SPECIALTY hospitals ,RETROSPECTIVE studies - Abstract
Background: Radial-probe endobronchial ultrasound (rEBUS)-guided transbronchial biopsy (TBB) is invaluable in the diagnosis of peripheral pulmonary lesions (PPLs); however, in certain instances, the procedure has to be repeated because of initial non-diagnostic procedure(s). Little if any literature has been published on this issue. Therefore, the aim of this study was to investigate the utility of repeat rEBUS-guided TBB in achieving a definitive diagnosis of PPLs.Methods: All patients who underwent rEBUS-guided TBB of PPLs at National Taiwan University Hospital between 2011 and 2015 and had a repeat procedure after non-diagnostic initial procedures were identified as the study subjects. The primary outcome of interest was the diagnostic yield of repeat rEBUS-guided TBB for PPLs. Also, we sought to discover features associated with the yield of repeat procedures.Results: Forty-three (11%) out of 384 patients with initial non-diagnostic TBB were included for analysis. A diagnosis of PPLs was able to be confirmed with repeat TBB in 23(53%) patients. The pathology of the first TBB was significantly associated with the yield of repeat procedures (P = 0.011). Further, patients with normal lung tissue in initial pathology rarely (2/12, 17%) had a definite diagnosis on repeat TBB. Yet, patients with pathology showing atypical cells and other non-specific findings were more likely (21/31, 68%) to obtain a confirmed diagnosis. The diagnostic yield of repeat procedures was not affected by the size, location or CT appearance of the lesions, or position of the rEBUS probe. No death or other serious adverse events occurred with the repeat rEBUS-guided procedures.Conclusions: If clinically indicated, it is reasonable to repeat rEBUS-guided TBB after an initial non-diagnostic procedure as the diagnostic yield will be at least 50% and the side effect profile is favorable. [ABSTRACT FROM AUTHOR]- Published
- 2017
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26. Decreased T helper 17 cells in tuberculosis is associated with increased percentages of programmed death ligand 1, T helper 2 and regulatory T cells.
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Chin-Chung Shu, Ming-Fang Wu, Jann-Yuan Wang, Hsin-Chih Lai, Li-Na Lee, Bor-Luen Chiang, Chong-Jen Yu, Shu, Chin-Chung, Wu, Ming-Fang, Wang, Jann-Yuan, Lai, Hsin-Chih, Lee, Li-Na, Chiang, Bor-Luen, and Yu, Chong-Jen
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TUBERCULOSIS ,CELL death ,PHORBOLS ,RADIOGRAPHY ,FLOW cytometry - Abstract
Background: Tuberculosis (TB) is one of the most common infectious diseases worldwide. During active tuberculosis, T helper (Th) 17 cells are decreased, however the association with inhibitory immune regulation is unclear.Methods: We enrolled 27 patients with TB and 20 age- and sex-matched controls and studies their lymphocyte status. Peripheral blood lymphocytes were isolated and programmed death-1 (PD-1) and programmed death ligand 1 (PD-L1) were measured on Th17 cells by using flow cytometry after the cells were stimulated with phorbol 12-myristate 13-acetate and ionomycin for 6 h. In addition, Th2 and regulatory T cells were measured and analyzed.Results: The TB group had lower levels of Th17 cells but higher levels of Th2 and Treg cells than the controls. In Th17 cells, the percentage of PD-L1 was higher in the TB group than that in the controls. In Th2 and Treg cells, the percentage of cytotoxic T-lymphocyte associated protein 4 (CTLA-4) was lower in the TB group and PD-1 was higher in Treg cells in the TB group. In the patients with extra-pulmonary TB, levels of Th1, Th2 and T17 cells were lower than those with pulmonary TB. The percentage of PD-1 on Th1 lymphocytes positively correlated with radiographic score.Conclusions: Lower level of Th17 in TB patients may be associated with increased percentage of PD-L1 and increasing levels of Th2 and Treg cells which influenced by CTLA-4. [ABSTRACT FROM AUTHOR]- Published
- 2017
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27. Hypoxia-preconditioned mesenchymal stem cells attenuate bleomycin-induced pulmonary fibrosis.
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Ying-Wei Lan, Kong-Bung Choo, Chuan-Mu Chen, Tsai-Hsien Hung, Young-Bin Chen, Chung-Hsing Hsieh, Han-Pin Kuo, and Kowit-Yu Chong
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PULMONARY fibrosis ,BLEOMYCIN ,HYPOXEMIA ,MESENCHYMAL stem cells ,DRUG side effects ,DISEASE risk factors - Abstract
Introduction: Idiopathic pulmonary fibrosis is a progressive diffuse parenchymal lung disorder of unknown etiology. Mesenchymal stem cell (MSC)-based therapy is a novel approach with great therapeutic potential for the treatment of lung diseases. Despite demonstration of MSC grafting, the populations of engrafted MSCs have been shown to decrease dramatically 24 hours post-transplantation due to exposure to harsh microenvironments. Hypoxia is known to induce expression of cytoprotective genes and also secretion of anti-inflammatory, anti-apoptotic and anti-fibrotic factors. Hypoxic preconditioning is thought to enhance the therapeutic potency and duration of survival of engrafted MSCs. In this work, we aimed to prolong the duration of survival of engrafted MSCs and to enhance the effectiveness of idiopathic pulmonary fibrosis transplantation therapy by the use of hypoxia-preconditioned MSCs. Methods: Hypoxic preconditioning was achieved in MSCs under an optimal hypoxic environment. The expression levels of cytoprotective factors and their biological effects on damaged alveolar epithelial cells or transforming growth factor-beta 1-treated fibroblast cells were studied in co-culture experiments in vitro. Furthermore, hypoxia-preconditioned MSCs (HP-MSCs) were intratracheally instilled into bleomycin-induced pulmonary fibrosis mice at day 3, and lung functions, cellular, molecular and pathological changes were assessed at 7 and 21 days after bleomycin administration. Results: The expression of genes for pro-survival, anti-apoptotic, anti-oxidant and growth factors was upregulated in MSCs under hypoxic conditions. In transforming growth factor-beta 1-treated MRC-5 fibroblast cells, hypoxia-preconditioned MSCs attenuated extracellular matrix production through paracrine effects. The pulmonary respiratory functions significantly improved for up to 18 days of hypoxia-preconditioned MSC treatment. Expression of inflammatory factors and fibrotic factor were all downregulated in the lung tissues of the hypoxia-preconditioned MSC-treated mice. Histopathologic examination observed a significant amelioration of the lung fibrosis. Several LacZ-labeled MSCs were observed within the lungs in the hypoxia-preconditioned MSC treatment groups at day 21, but no signals were detected in the normoxic MSC group. Our data further demonstrated that upregulation of hepatocyte growth factor possibly played an important role in mediating the therapeutic effects of transplanted hypoxia-preconditioned MSCs. Conclusion: Transplantation of hypoxia-preconditioned MSCs exerted better therapeutic effects in bleomycin-induced pulmonary fibrotic mice and enhanced the survival rate of engrafted MSCs, partially due to the upregulation of hepatocyte growth factor. [ABSTRACT FROM AUTHOR]
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- 2015
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28. Immunogenicity, reactogenicity and safety of an inactivated quadrivalent influenza vaccine candidate versus inactivated trivalent influenza vaccine: a phase III, randomized trial in adults aged ≥18 years.
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Kieninger, Dorothee, Sheldon, Eric, Wen-Yuan Lin, Chong-Jen Yu, Bayas, Jose M., Gabor, Julian J., Esen, Meral, Fernandez Roure, Jose Luis, Narejos Perez, Silvia, Alvarez Sanchez, Carmen, Yang Feng, Claeys, Carine, Peeters, Mathieu, Innis, Bruce L., Jain, Varsha, Lin, Wen-Yuan, Yu, Chong-Jen, and Feng, Yang
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INFLUENZA B virus ,H1N1 influenza ,INFLUENZA A virus ,INFLUENZA vaccines ,INFLUENZA prevention ,CLINICAL trials ,COMPARATIVE studies ,HEMAGGLUTINATION tests ,RESEARCH methodology ,INFLUENZA A virus, H3N2 subtype ,MEDICAL cooperation ,RESEARCH ,VACCINES ,VIRAL antibodies ,EVALUATION research ,RANDOMIZED controlled trials ,INFLUENZA A virus, H1N1 subtype - Abstract
Background: Two antigenically distinct influenza B lineages have co-circulated since the 1980s, yet inactivated trivalent influenza vaccines (TIVs) include strains of influenza A/H1N1, A/H3N2, and only one influenza B from either the Victoria or Yamagata lineage. This means that exposure to B-lineage viruses mismatched to the TIV is frequent, reducing vaccine protection. Formulations including both influenza B lineages could improve protection against circulating influenza B viruses. We assessed a candidate inactivated quadrivalent influenza vaccine (QIV) containing both B lineages versus TIV in adults in stable health.Methods: A total of 4659 adults were randomized 5:5:5:5:3 to receive one dose of QIV (one of three lots) or a TIV containing either a B/Victoria or B/Yamagata strain. Hemagglutination-inhibition assays were performed pre-vaccination and 21-days after vaccination. Lot-to-lot consistency of QIV was assessed based on geometric mean titers (GMT). For QIV versus TIV, non-inferiority against the three shared strains was demonstrated if the 95% confidence interval (CI) upper limit for the GMT ratio was ≤1.5 and for the seroconversion difference was ≤10.0%; superiority of QIV versus TIV for the alternate B lineage was demonstrated if the 95% CI lower limit for the GMT ratio was > 1.0 and for the seroconversion difference was > 0%. Reactogenicity and safety profile of each vaccine were assessed. Clinicaltrials.gov: NCT01204671.Results: Consistent immunogenicity was demonstrated for the three QIV lots. QIV was non-inferior to TIV for the shared vaccine strains, and was superior for the added alternate-lineage B strains. QIV elicited robust immune responses against all four vaccine strains; the seroconversion rates were 77.5% (A/H1N1), 71.5% (A/H3N2), 58.1% (B/Victoria), and 61.7% (B/Yamagata). The reactogenicity and safety profile of QIV was consistent with TIV.Conclusions: QIV provided superior immunogenicity for the additional B strain compared with TIV, without interfering with antibody responses to the three shared antigens. The additional antigen did not appear to alter the safety profile of QIV compared with TIV. This suggests that the candidate QIV is a viable alternative to TIV for use in adults, and could potentially improve protection against influenza B.Trial Registration: Clinical Trials.gov: NCT01204671/114269. [ABSTRACT FROM AUTHOR]- Published
- 2013
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29. Development of a multi-electrode array for spinal cord epidural stimulation to facilitate stepping and standing after a complete spinal cord injury in adult rats.
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Gad, Parag, Choe, Jaehoon, Nandra, Mandheerej Singh, Hui Zhong, Roy, Roland R., Tai, Yu-Chong, and Edgerton, V. Reggie
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SPINAL cord diseases ,ELECTROPHYSIOLOGY ,DEVELOPMENTAL biology ,ETIOLOGY of diseases ,BIOLOGICAL neural networks ,MOTOR ability ,LABORATORY rats - Abstract
Background: Stimulation of the spinal cord has been shown to have great potential for improving function after motor deficits caused by injury or pathological conditions. Using a wide range of animal models, many studies have shown that stimulation applied to the neural networks intrinsic to the spinal cord can result in a dramatic improvement of motor ability, even allowing an animal to step and stand after a complete spinal cord transection. Clinical use of this technology, however, has been slow to develop due to the invasive nature of the implantation procedures, the lack of versatility in conventional stimulation technology, and the difficulty of ascertaining specific sites of stimulation that would provide optimal amelioration of the motor deficits. Moreover, the development of tools available to control precise stimulation chronically via biocompatible electrodes has been limited. In this paper, we outline the development of this technology and its use in the spinal rat model, demonstrating the ability to identify and stimulate specific sites of the spinal cord to produce discrete motor behaviors in spinal rats using this array. Methods: We have designed a chronically implantable, rapidly switchable, high-density platinum based multi-electrode array that can be used to stimulate at 1-100 Hz and 1-10 V in both monopolar and bipolar configurations to examine the electrophysiological and behavioral effects of spinal cord epidural stimulation in complete spinal cord transected rats. Results: In this paper, we have demonstrated the effectiveness of using high-resolution stimulation parameters in the context of improving motor recovery after a spinal cord injury. We observed that rats whose hindlimbs were paralyzed can stand and step when specific sets of electrodes of the array are stimulated tonically (40 Hz). Distinct patterns of stepping and standing were produced by stimulation of different combinations of electrodes on the array located at specific spinal cord levels and by specific stimulation parameters, i.e., stimulation frequency and intensity, and cathode/anode orientation. The array also was used to assess functional connectivity between the cord dorsum to interneuronal circuits and specific motor pools via evoked potentials induced at 1 Hz stimulation in the absence of any anesthesia. Conclusions: Therefore the high density electrode array allows high spatial resolution and the ability to selectively activate different neural pathways within the lumbosacral region of the spinal cord to facilitate standing and stepping in adult spinal rats and provides the capability to evoke motor potentials and thus a means for assessing connectivity between sensory circuits and specific motor pools and muscles. [ABSTRACT FROM AUTHOR]
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- 2013
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30. Granzyme G is expressed in the two-cell stage mouse embryo and is required for the maternal-zygotic transition.
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Tung-Chou Tsai, William Lin, Shang-Hsun Yang, Cheng, Winston T. K., En-Hui Cheng, Maw-Sheng Lee, Kowit-Yu Chong, and Chuan-Mu Chen
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MICE ,EMBRYOS ,GENE expression ,CELL differentiation ,EMBRYOLOGY ,POLYMERASE chain reaction ,T cells - Abstract
Background: Detailed knowledge of the molecular and cellular mechanisms that direct spatial and temporal gene expression in pre-implantation embryos is critical for understanding the control of the maternal-zygotic transition and cell differentiation in early embryonic development. In this study, twenty-three clones, expressed at different stages of early mouse development, were identified using differential display reverse transcription polymerase chain reaction (DDRT-PCR). One of these clones, which is expressed in 2-cell stage embryos at 48 hr post-hCG injection, shows a perfect sequence homology to the gene encoding the granzyme G protein. The granzyme family members are serine proteases that are present in the secretory granules of cytolytic T lymphocytes. However, the pattern of granzyme G expression and its function in early mouse embryos are entirely unknown. Results: Upon the introduction of an antisense morpholino (2 mM) against granzyme G to knock-down endogenous gene function, all embryos were arrested at the 2- to 4-cell stages of egg cleavage, and the de novo synthesis of zygotic RNAs was decreased. The embryonic survival rate was dramatically decreased at the late 2-cell stage when serine protease-specific inhibitors, 0.1 mM 3,4-dichloroisocoumarin (3,4-DCI), and 2 mM phenyl methanesulphonyl fluoride (PMSF), were added to the in vitro embryonic culture medium. Survival was not affected by the addition of 0.5 mM EDTA, a metalloproteinase inhibitor. Conclusion: We characterized for the first time the expression and function of granzyme G during early stage embryogenesis. Our data suggest that granzyme G is an important factor in early mouse embryonic development and may play a novel role in the elimination of maternal proteins and the triggering of zygotic gene expression during the maternal-zygotic transition. [ABSTRACT FROM AUTHOR]
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- 2010
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31. Chronic Hypoxia Attenuates Nitric Oxide-Dependent Hemodynamic Responses to Acute Hypoxia.
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Kun-Lun Huang, Chin-Pyng Wu, Bor-Hwang Kang, and Yu-Chong Lin
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VASODILATION ,VASOCONSTRICTORS ,VASODILATORS ,HYPOXEMIA ,NITRIC oxide ,HEMODYNAMICS - Abstract
Alterations in the nitric oxide (NO) pathway have been implicated in the pathogenesis of chronic hypoxia-induced pulmonary hypertension. Chronic hypoxia can either suppress the NO pathway, causing pulmonary hypertension, or increase NO release in order to counteract elevated pulmonary arterial pressure. We determined the effect of NO synthase inhibitor on hemodynamic responses to acute hypoxia (10% O[sub 2] ) in anesthetized rats following chronic exposure to hypobaric hypoxia (0.5 atm, air). In rats raised under normoxic conditions, acute hypoxia caused profound systemic hypotension and slight pulmonary hypertension without altering cardiac output. The total systemic vascular resistance (SVR) decreased by 41 ± 5%, whereas the pulmonary vascular resistance (PVR) increased by 25 ± 6% during acute hypoxia. Pretreatment with N[sup ω] -nitro-L-arginine methyl ester (L-NAME; 25 mg/kg) attenuated systemic vasodilatation and enhanced pulmonary vasoconstriction. In rats with prior exposure to chronic hypobaric hypoxia, the baseline values of mean pulmonary and systemic arterial pressure were significantly higher than those in the normoxic group. Chronic hypoxia caused right ventricular hypertrophy, as evidenced by a greater weight ratio of the right ventricle to the left ventricle and the interventricular septum compared to the normoxic group (46 ± 4 vs. 28 ± 3%). In rats which were previously exposed to chronic hypoxia (half room air for 15 days), acute hypoxia reduced SVR by 14 ± 6% and increased PVR by 17 ± 4%. Pretreatment with L-NAME further inhibited the systemic vasodilatation effect of acute hypoxia, but did not enhance pulmonary vasoconstriction. Our results suggest that the release of NO counteracts pulmonary vasoconstriction but lowers systemic vasodilatation on exposure to acute hypoxia, and these responses are attenuated following adaptation to chronic hypoxia.Copyright © 2002 National Science Council, ROC and S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
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- 2002
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32. Risk of active tuberculosis among COPD patients treated with fixed combinations of long-acting beta2 agonists and inhaled corticosteroids.
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Huang, Tsan-Ming, Kuo, Kuan-Chih, Wang, Ya-Hui, Wang, Cheng-Yi, Lai, Chih-Cheng, Wang, Hao-Chien, Chen, Likwang, Yu, Chong-Jen, On the behalf of Taiwan Clinical Trial Consortium for Respiratory Diseases (TCORE), Perng, Diahn-Warng, Cheng, Shih-Lung, Hsu, Jeng-Yuan, Hsu, Wu-Huei, Tsai, Ying-Huang, Hsiue, Tzuen-Ren, Lin, Meng-Chih, Lin, Hen-I, Chang, Yeun-Chung, Yang, Ueng-Cheng, and Lin, Cing-Syong
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OBSTRUCTIVE lung diseases ,TUBERCULOSIS ,SALMETEROL ,PROPENSITY score matching ,FLUTICASONE ,TUBERCULOSIS epidemiology ,ADRENERGIC beta agonists ,ADRENOCORTICAL hormones ,DISEASE incidence ,MYCOBACTERIUM tuberculosis ,INHALATION administration ,LONGITUDINAL method ,PROBABILITY theory - Abstract
Objectives: To investigate the incidence of active tuberculosis (TB) among COPD patients using fluticasone/salmeterol or budesonide/formoterol, and to identify any differences between these two groups of patients.Methods: The study enrolled COPD patients from Taiwan NHIRD who received treatment with fluticasone/salmeterol or budesonide/formoterol for > 90 days between 2004 and 2011. The incidence of active TB was the primary outcome.Results: Among the intention-to-treat population prior to matching, the incidence rates of active TB were 0.94 and 0.61% in the fluticasone/salmeterol and budesonide/formoterol groups, respectively. After matching, the fluticasone/salmeterol group had significantly higher rates of active TB (adjusted HR, 1.41, 95% CI, 1.17-1.70) compared with the budesonide/formoterol group. The significant difference between these two groups remained after a competing risk analysis (HR, 1.45, 95% CI, 1.21-1.74). Following propensity score matching, the fluticasone/salmeterol group had significantly higher rates of active TB compared with the budesonide/formoterol group (adjusted HR, 1.45, 95% CI, 1.14-1.85). A similar trend was observed after a competing risk analysis (HR, 1.44, 95% CI, 1.19-1.75). A higher risk of active TB was observed in the fluticasone/salmeterol group compared with the budesonide/formoterol group across all subgroups, but some differences did not reach statistical significance.Conclusion: Fluticasone/salmeterol carried a higher risk of active TB compared with budesonide/formoterol among COPD patients. [ABSTRACT FROM AUTHOR]- Published
- 2020
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33. Efficacy and adverse events of high-frequency oscillatory ventilation in adult patients with acute respiratory distress syndrome: a meta-analysis.
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Huang, Chun-Ta, Lin, Hsien-Ho, Ruan, Sheng-Yuan, Lee, Meng-Sui, Tsai, Yi-Ju, and Yu, Chong-Jen
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- 2014
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34. Exploring the heterogeneity of effects of corticosteroids on acute respiratory distress syndrome: a systematic review and meta-analysis.
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Ruan, Sheng-Yuan, Lin, Hsien-Ho, Huang, Chun-Ta, Kuo, Ping-Hung, Wu, Huey-Dong, and Yu, Chong-Jen
- Abstract
Introduction: The effectiveness of corticosteroid therapy on the mortality of acute respiratory distress syndrome (ARDS) remains under debate. We aimed to explore the grounds for the inconsistent results in previous studies and update the evidence.Methods: We searched MEDLINE, Cochrane Central Register of Controlled Trials and Web of Science up to December 2013. Eligible studies included randomized clinical trials (RCTs) and cohort studies that reported mortality and that had corticosteroid nonusers for comparison. The effect of corticosteroids on ARDS mortality was assessed by relative risk (RR) and risk difference (RD) for ICU, hospital, and 60-day mortality using a random-effects model.Results: Eight RCTs and 10 cohort studies were included for analysis. In RCTs, corticosteroids had a possible but statistically insignificant effect on ICU mortality (RD, -0.28; 95% confidence interval (CI), -0.53 to -0.03 and RR, 0.55; 95% CI, 0.24 to 1.25) but no effect on 60-day mortality (RD, -0.01; 95% CI, -0.12 to 0.10 and RR, 0.97; 95% CI, 0.75 to 1.26). In cohort studies, corticosteroids had no effect on ICU mortality (RR, 1.05; 95% CI, 0.74 to 1.49) but non-significantly increased 60-day mortality (RR, 1.30; 95% CI, 0.96 to 1.78). In the subgroup analysis by ARDS etiology, corticosteroids significantly increased mortality in influenza-related ARDS (three cohort studies, RR, 2.45, 95% CI, 1.40 to 4.27).Conclusions: The effects of corticosteroids on the mortality of ARDS differed by duration of outcome measures and etiologies. Corticosteroids did not improve longer-term outcomes and may cause harm in certain subgroups. Current data do not support routine use of corticosteroids in ARDS. More clinical trials are needed to specify the favorable and unfavorable subgroups for corticosteroid therapy. [ABSTRACT FROM AUTHOR]- Published
- 2014
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35. Apoptosis-associated biomarkers in tuberculosis: promising for diagnosis and prognosis prediction.
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Shu, Chin-Chung, Wu, Ming-Fang, Hsu, Chia-Lin, Huang, Chun-Ta, Wang, Jann-Yuan, Hsieh, Shie-Liang, Yu, Chong-Jen, Lee, Li-Na, and Yang, Pan-Chyr
- Abstract
Background: Apoptosis-associated biomarkers are rarely studied, especially their role in predicting the development of tuberculosis (TB) from latent TB infection and in prognostication.Methods: Patients with TB and interferon-gamma release assay (IGRA)-positive and IGRA-negative family contacts were evaluated to analyze changes in apoptosis-associated serum biomarkers, which included decoy receptor 3 (DcR3), prostaglandin 2 (PGE2), and lipoxin. The prognostic implications of these serum biomarkers were also analyzed.Results: One hundred TB patients and 92 IGRA-negative and 91 IGRA-positive family contacts were recruited. The DcR3 and PGE2 levels decreased from the IGRA-negative group to the IGRA-positive group, and peaked in the TB group. Lipoxin decreased to trough in the TB group. The three apoptosis serum markers and age were independent factors discriminating active TB from latent TB infection. In active TB, older age, co-morbidity, and higher serum DcR3 and monocyte chemotactic protein (MCP)-1 were independently associated with poorer six-month survival.Conclusion: Apoptosis-associated serum biomarkers change along with the status of Mycobacterium tuberculosis infection. In close contacts with positive IGRA, high DcR3 and PGE2 and low lipoxin may increase the probability of active TB. Older age, co-morbidity, and high DcR3 and MCP-1 levels might be important prognostic factors that warrant further investigation. [ABSTRACT FROM AUTHOR]- Published
- 2013
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36. Life expectancies and incidence rates of patients under prolonged mechanical ventilation: a population-based study during 1998 to 2007 in Taiwan.
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Hung, Mei-Chuan, Lu, Hsin-Ming, Chen, Likwang, Hu, Fu-Chang, Chan, Soa-Yu, Yan, Yuan-Horng, Fan, Po-Sheng, Lin, Ming-Shian, Chen, Cheng-Ren, Kuo, Lu-Cheng, Yu, Chong-Jen, and Wang, Jung-Der
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ARTIFICIAL respiration ,DATABASES ,LIFE expectancy ,SURVIVAL analysis (Biometry) ,TIME ,TREATMENT effectiveness ,DISEASE incidence - Abstract
Introduction: The present study examined the median survival, life expectancies, and cumulative incidence rate (CIR) of patients undergoing prolonged mechanical ventilation (PMV) stratified by different underlying diseases.Methods: According to the National Health Insurance Research Database of Taiwan, there were 8,906,406 individuals who obtained respiratory care during the period from 1997 to 2007. A random sample of this population was performed, and subjects who had continuously undergone mechanical ventilation for longer than 21 days were enrolled in the current study. Annual incidence rates and the CIR were calculated. After stratifying the patients according to their specific diagnoses, latent class analysis was performed to categorise PMV patients with multiple co-morbidities into several groups. The life expectancies of different groups were estimated using a semiparametric method with a hazard function based on the vital statistics of Taiwan.Results: The analysis of 50,481 PMV patients revealed that incidence rates increased as patients grew older and that the CIR (17 to 85 years old) increased from 0.103 in 1998 to 0.183 in 2004 before stabilising thereafter. The life expectancies of PMV patients suffering from degenerative neurological diseases, stroke, or injuries tended to be longer than those with chronic renal failure or cancer. Patients with chronic obstructive pulmonary disease survived longer than did those co-morbid with other underlying diseases, especially septicaemia/shock.Conclusions: PMV provides a direct means to treat respiratory tract diseases and to sustain respiration in individuals suffering from degenerative neurological diseases, and individuals with either of these types of conditions respond better to PMV than do those with other co-morbidities. Future research is required to determine the cost-effectiveness of this treatment paradigm. [ABSTRACT FROM AUTHOR]- Published
- 2011
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37. Development of a new tissue injector for subretinal transplantation of human embryonic stem cell derived retinal pigmented epithelium.
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Fernandes RAB, Stefanini FR, Falabella P, Koss MJ, Wells T, Diniz B, Ribeiro R, Schor P, Maia M, Penha FM, Hinton DR, Tai YC, and Humayun M
- Abstract
Background: Subretinal cell transplantation is a challenging surgical maneuver. This paper describes the preliminary findings of a new tissue injector for subretinal implantation of an ultrathin non-absorbable substrate seeded with human embryonic stem cell-derived retinal pigment epithelium (hESC-RPE)., Methods: Ultrathin Parylene-C substrates measuring 3.5 mm × 6.0 mm seeded with hESC-RPE (implant referred to as CPCB-RPE1) were implanted into the subretinal space of 12 Yucatan minipigs. Animals were euthanized immediately after the procedure and underwent spectral domain optical coherence tomography (SD-OCT) and histological analysis to assess the subretinal placement of the implant. Evaluation of the hESC-RPE cells seeded on the substrate was carried out before and after implantation using standard cell counting techniques., Results: The tissue injector delivered the CPCB-RPE1 implant through a 1.5 mm sclerotomy and a 1.0-1.5 mm retinectomy. SD-OCT scans and histological examination revealed that substrates were precisely placed in the subretinal space, and that the hESC-RPE cell monolayer continued to cover the surface of the substrate after the surgical procedure., Conclusion: This innovative tissue injector was able to efficiently deliver the implant in the subretinal space of Yucatan minipigs, preventing significant hESC-RPE cell loss, minimizing tissue trauma, surgical complications and postoperative inflammation.
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- 2017
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38. The value of repeat radial-probe endobronchial ultrasound-guided transbronchial biopsy after initial non-diagnostic results in patients with peripheral pulmonary lesions.
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Huang CT, Tsai YJ, Ho CC, and Yu CJ
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- Aged, Female, Humans, Lung diagnostic imaging, Lung pathology, Lung Diseases pathology, Male, Middle Aged, Retrospective Studies, Taiwan, Tertiary Care Centers, Tomography, X-Ray Computed, Ultrasonography, Bronchoscopy, Image-Guided Biopsy adverse effects, Lung Diseases diagnostic imaging
- Abstract
Background: Radial-probe endobronchial ultrasound (rEBUS)-guided transbronchial biopsy (TBB) is invaluable in the diagnosis of peripheral pulmonary lesions (PPLs); however, in certain instances, the procedure has to be repeated because of initial non-diagnostic procedure(s). Little if any literature has been published on this issue. Therefore, the aim of this study was to investigate the utility of repeat rEBUS-guided TBB in achieving a definitive diagnosis of PPLs., Methods: All patients who underwent rEBUS-guided TBB of PPLs at National Taiwan University Hospital between 2011 and 2015 and had a repeat procedure after non-diagnostic initial procedures were identified as the study subjects. The primary outcome of interest was the diagnostic yield of repeat rEBUS-guided TBB for PPLs. Also, we sought to discover features associated with the yield of repeat procedures., Results: Forty-three (11%) out of 384 patients with initial non-diagnostic TBB were included for analysis. A diagnosis of PPLs was able to be confirmed with repeat TBB in 23(53%) patients. The pathology of the first TBB was significantly associated with the yield of repeat procedures (P = 0.011). Further, patients with normal lung tissue in initial pathology rarely (2/12, 17%) had a definite diagnosis on repeat TBB. Yet, patients with pathology showing atypical cells and other non-specific findings were more likely (21/31, 68%) to obtain a confirmed diagnosis. The diagnostic yield of repeat procedures was not affected by the size, location or CT appearance of the lesions, or position of the rEBUS probe. No death or other serious adverse events occurred with the repeat rEBUS-guided procedures., Conclusions: If clinically indicated, it is reasonable to repeat rEBUS-guided TBB after an initial non-diagnostic procedure as the diagnostic yield will be at least 50% and the side effect profile is favorable.
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- 2017
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39. Which is better for gastric cancer patients, perioperative or adjuvant chemotherapy: a meta-analysis.
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Zhao JH, Gao P, Song YX, Sun JX, Chen XW, Ma B, Yang YC, and Wang ZN
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- Adult, Aged, Female, Humans, Male, Middle Aged, Prognosis, Randomized Controlled Trials as Topic, Survival Analysis, Treatment Outcome, Young Adult, Antineoplastic Agents therapeutic use, Neoadjuvant Therapy methods, Perioperative Care methods, Stomach Neoplasms drug therapy
- Abstract
Background: The preferred chemotherapy method for gastric cancer continues to be matter of debate. We performed a meta-analysis to comparing prognosis and safety between perioperative chemotherapy and adjuvant chemotherapy to identify the better chemotherapy option for gastric cancer., Methods: We searched the PubMed, EMBASE, Cochrane Library, and Ovid databases for eligible studies until February 2016. The main endpoints were prognostic value (hazard ratio [HR] for overall survival [OS] and 1-, 2-, 3-, and 5-year survival rate), response rate of chemotherapy, radical resection rate, post-operative complication rate, and adverse effects of chemotherapy., Results: Five randomized controlled trials and six clinical controlled trials involving 1,240 patients were eligible for analysis. Compared with the adjuvant chemotherapy group, the perioperative chemotherapy group had significantly better prognosis (HR, 0.74; 95 % CI, 0.61 to 0.89; P < 0.01). The difference between the two groups remained significant in the studies that used combination chemotherapy as the neoadjuvant chemotherapy regimen (HR, 0.59; 95 % CI, 0.46 to 0.76; P < 0.01) but were not significant in the studies that used fluoropyrimidine monotherapy (HR, 0.93; 95 % CI, 0.56 to 1.55; P = 0.84). Furthermore, the two groups showed no significant differences in the post-operative complication rates (relative risk, 0.98; 95 % CI, 0.63 to 1.51; P = 0.91) or adverse effects of chemotherapy (P > 0.05 for all adverse effects)., Conclusion: Perioperative chemotherapy showed improved survival compared to adjuvant chemotherapy for gastric cancer. In addition, combination chemotherapy resulted in better survival compared to monotherapy in the neoadjuvant chemotherapy regimens.
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- 2016
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40. Factors responsible for poor sleep quality in patients with chronic obstructive pulmonary disease.
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Chang CH, Chuang LP, Lin SW, Lee CS, Tsai YH, Wei YF, Cheng SL, Hsu JY, Kuo PH, Yu CJ, and Chen NH
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- Aged, Aged, 80 and over, Comorbidity, Dyspnea physiopathology, Female, Forced Expiratory Volume, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Retrospective Studies, Risk Factors, Severity of Illness Index, Spirometry, Surveys and Questionnaires, Taiwan, Lung physiopathology, Pulmonary Disease, Chronic Obstructive complications, Sleep Wake Disorders epidemiology, Smoking epidemiology
- Abstract
Background: Sleep disturbance is a common complaint in patients with chronic obstructive lung disease (COPD). However, the factors resulting in sleep disturbance remain unclear. This retrospective, observational, multicenter study aimed to identify the factors associated with sleep disturbance in patients with COPD., Methods: The study was a retrospective, observational, and multicenter research. Data including age, sex, body mass index, smoking status, COPD inhaler prescribed, clinical symptoms, pulmonary function tests, medical history of comorbidities, and questionnaires were collected. Parameters including demographics, symptoms, medication, severity, functional classification, and comorbidities were correlated with sleep quality scores., Results: Among 377 patients with COPD, 200 (53 %) patients experienced poor sleep quality (Pittsburg Sleep Quality Index scores > 5). A significant difference in sleep quality, as measured by PSQI scores, was noted between groups based on the 2011 Global Initiatives for Chronic Obstructive Lung Disease (GOLD) classification system. The most common sleep disturbances included "getting up to use the bathroom" (70.3 %), "wake up at night or early morning" (40.3 %), and "cough and snore loudly at night" (15.9 %). The use of inhaled corticosteroids, the presence of wheezing, COPD Assessment Test (CAT) scores, and Modified Medical Research Council (mMRC) dyspnea scale scores positively correlated with poor sleep quality (odds ratio: 1.51, 1.66, 1.09, and 1.30, respectively). Upon multivariate analysis, the CAT score was an independent factor for poor sleep quality in these patients. With the exception of sleep problem items, based on the CAT questionnaire, phlegm was significantly higher in COPD patients with poor sleep quality., Conclusions: Poor sleep quality is common among patients with COPD and symptoms including wheeze, phlegm, and inhaled corticosteroid use may contribute to poor sleep quality. The CAT score is a good indicator of poor sleep quality in patients with COPD.
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- 2016
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41. Erratum: development of a multi-electrode array for spinal cord epidural stimulation to facilitate stepping and standing after a complete spinal cord injury in adult rats.
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Gad P, Choe J, Nandra MS, Zhong H, Roy RR, Tai YC, and Edgerton VR
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- 2015
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42. Acute kidney injury due to anti-tuberculosis drugs: a five-year experience in an aging population.
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Chang CH, Chen YF, Wu VC, Shu CC, Lee CH, Wang JY, Lee LN, and Yu CJ
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- Acute Kidney Injury epidemiology, Acute Kidney Injury therapy, Aged, Aged, 80 and over, Comorbidity, Female, Humans, Incidence, Kidney Failure, Chronic complications, Kidney Failure, Chronic epidemiology, Kidney Function Tests, Male, Middle Aged, Retrospective Studies, Time Factors, Acute Kidney Injury chemically induced, Antitubercular Agents adverse effects, Tuberculosis drug therapy
- Abstract
Background: Patients on anti-tuberculosis treatment may develop acute kidney injury (AKI), but little is known about the renal outcome and prognostic factors, especially in an aging population. This study aimed to calculate the incidence of AKI due to anti-TB drugs and analyze the outcomes and predictors of renal recovery., Methods: From 2006 to 2010, patients on anti-TB treatment were identified and their medical records reviewed. Acute kidney injury was defined according to the criteria established by the AKI Network, while renal recovery was defined as a return of serum creatinine to baseline. Predictors of renal recovery were identified by Cox regression analysis., Results: Ninety-nine out of 1394 (7.1%) patients on anti-TB treatment had AKI. Their median age was 68 years and there was male predominance. Sixty (61%) developed AKI within two months of anti-TB treatment, including 11 (11%) with a prior history of rifampin exposure. Thirty (30%) had co-morbid chronic kidney disease or end-stage renal disease. The median time of renal recovery was 39.6 days (range, 1-180 days). Factors predicting renal recovery were the presence of fever, rash, and gastro-intestinal disturbance at the onset of AKI. Sixty-two of the 71 (87%) patients who recovered from AKI had successful re-introduction or continuation of rifampin., Conclusions: Renal function impairment is not a rare complication during anti-TB treatment in an elderly population. The presence of fever and rash may be associated with renal recovery. Rifampin can still be used in most patients who recover from AKI.
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- 2014
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43. Advanced non-small cell lung cancer in patients aged 45 years or younger: outcomes and prognostic factors.
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Hsu CL, Chen KY, Shih JY, Ho CC, Yang CH, Yu CJ, and Yang PC
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- Adult, Age Factors, Carcinoma, Non-Small-Cell Lung epidemiology, Carcinoma, Non-Small-Cell Lung therapy, ErbB Receptors genetics, Female, Humans, Incidence, Lung Neoplasms epidemiology, Lung Neoplasms therapy, Male, Middle Aged, Mutation, Neoplasm Staging, Prognosis, Treatment Outcome, Young Adult, Carcinoma, Non-Small-Cell Lung pathology, Lung Neoplasms pathology
- Abstract
Background: Lung cancer in young patients (less or equal to 45 years) is uncommon and has clinical characteristics different from that in older patients. We investigated the outcomes and prognostic factors of young patients with advanced non-small cell lung cancer (NSCLC)., Methods: From January 2000 to December 2009, we enrolled patients aged ≤45 years and diagnosed with stage IIIB or IV NSCLC. Their clinical data, including age, gender, performance status, histologic types, disease stages, laboratory data at diagnosis, treatment modalities, and survival were reviewed and analyzed. A Cox proportional hazard model was used to calculate the hazard ratio (HR) and its 95% confidence interval (CI)., Results: A total of 144 patients with advanced NSCLC were included. Female patients were more prevalent (n = 74, 51.4%). Adenocarcinoma was the most common histologic type (n = 119, 82.6%) in both genders (male, n = 54, 77.1%; female, n = 65, 87.8%). Epidermal growth factor receptor (EGFR) sequences were determined using tumor specimens from 58 patients, and 29 showed an EGFR mutation. No significant difference in median survival was found between patient groups with and without the EGFR mutation (798 vs. 708 days, p = 0.65). In multivariate analysis, male gender (HR, 1.70; 95% CI: 1.08-2.68), body mass index (BMI) less than 25 kg/m(2) (HR, 2.72; 95% CI: 1.39-5.30), stage IV disease (HR, 2.62; 95% CI: 1.50-4.57), and anemia (HR, 2.08; 95% CI: 1.15-3.77) were associated with a short survival time., Conclusions: Low BMI, stage IV disease, anemia at diagnosis, and male gender were the negative prognostic factors for young patients with advanced NSCLC.
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- 2012
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44. Elevated placenta growth factor predicts pneumonia in patients with chronic obstructive pulmonary disease under inhaled corticosteroids therapy.
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Cheng SL, Wang HC, Cheng SJ, and Yu CJ
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- Administration, Inhalation, Biomarkers blood, C-Reactive Protein analysis, Female, Glucocorticoids adverse effects, Humans, Male, Middle Aged, Placenta Growth Factor, Pneumonia diagnosis, Pulmonary Disease, Chronic Obstructive physiopathology, Risk Factors, Glucocorticoids administration & dosage, Pneumonia chemically induced, Pregnancy Proteins blood, Pulmonary Disease, Chronic Obstructive blood, Pulmonary Disease, Chronic Obstructive complications
- Abstract
Background: An increased incidence of pneumonia in patients with chronic obstructive pulmonary disease (COPD) under inhaled corticosteroid (ICS) therapy was noticed in previous studies. We performed a prospective study to elucidate the risk factors for the development of pneumonia in this group of patients., Methods: A prospective, non-randomized study with patients diagnosed as having COPD from 2007 to 2008 identified in the Far Eastern Memorial Hospital were recruited. We recorded data for all patients, including clinical features and signs, demographic data, lung function status, and medications. Bio-markers such as C-reactive protein (CRP) and placenta growth factor (PlGF) were checked at first diagnosis. Every acute exacerbation was also recorded, especially pneumonia events, which were confirmed by chest radiography. Multivariate analysis was performed with stepwise logistic regression for pneumonia risk factors., Results: 274 patients were diagnosed as having COPD during the study period and 29 patients suffered from pneumonia with a prevalence of 10.6%. The rate was significantly higher in patients with ICS therapy (20/125, 16%) compared with those without ICS (9/149, 6%) (p = 0.02). We stratified ICS therapy into medium dose (500-999 ug/day fluticasone equivalent, 71 patients) and high dose (1000 ug/day and higher fluticasone equivalent, 54 patients) group. There was no statistical difference in the incidence of pneumonia between these two group (medium dose: 13/71, 18.3% vs. high dose: 7/54, 12.9%, p = 0.47). Multivariate analysis was performed to identify the risk factors for developing pneumonia and included forced expiratory volume in one second (FEV1) less than 40% of predicted (odds ratio (OR) 2.2, 95% confidence interval (CI): 1.1-6.9), ICS prescription ((OR) 2.4, 95% (CI): 1.3-8.7), the presence of diabetes mellitus (DM) (OR 2.6, 95% CI: 1.2-9.4) and PlGF level over 40 pg/L (OR 4.1, 95% CI: 1.5-9.9)., Conclusion: ICS therapy in patients with COPD increased the risk of pneumonia. However, there was no relationship between the incidence of pneumonia and dosage of ICS. Additionally, advanced COPD status, DM and elevated PlGF level were independent risk factors for the development of pneumonia. PlGF would be a good novel biomarker for predicting pneumonia.
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- 2011
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45. In-hospital outcome of patients with culture-confirmed tuberculous pleurisy: clinical impact of pulmonary involvement.
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Shu CC, Wang JT, Wang JY, Lee LN, and Yu CJ
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- Adult, Aged, Aged, 80 and over, Biopsy, Female, Hospitals, Humans, Lung pathology, Male, Middle Aged, Pleura pathology, Treatment Outcome, Tuberculosis, Pleural diagnosis, Tuberculosis, Pleural mortality, Tuberculosis, Pulmonary diagnosis, Tuberculosis, Pulmonary mortality, Mycobacterium tuberculosis isolation & purification, Tuberculosis, Pleural complications, Tuberculosis, Pleural drug therapy, Tuberculosis, Pulmonary complications, Tuberculosis, Pulmonary drug therapy
- Abstract
Background: Outcomes for hospitalized patients with tuberculous pleurisy (TP) have rarely been reported, and whether or not pulmonary involvement affects outcomes is uncertain. This study aimed to analyze the in-hospital mortality rate of culture-confirmed TP with an emphasis on the clinical impact of pulmonary involvement., Methods: Patients who were hospitalized for pleural effusion (PE) of unconfirmed diagnosis and finally diagnosed as TP were identified. We classified them according to the disease extent: isolated pleurisy (isolated pleurisy group) and pleurisy with pulmonary involvement (pleuro-pulmonary group)., Results: Among the 205 patients hospitalized before the diagnosis was established, 51 (24.9%) belonged to the isolated pleurisy group. Compared to the pleuro-pulmonary group, patients in the isolated pleurisy group were younger, had fewer underlying co-morbidities, and presented more frequently with fever and chest pain. Fewer patients in the isolated pleurisy group had hypoalbuminemia (< 3.5 g/dL) and anemia. The two groups were similar with regards to PE analysis, resistance pattern, and timing of anti-tuberculous treatment. Patients who had a typical pathology of TP on pleural biopsy received anti-tuberculous treatment earlier than those who did not, and were all alive at discharge. The isolated pleurisy group had a lower in-hospital mortality rate, a shorter length of hospital stay and better short-term survival. In addition, the presence of underlying comorbidities and not receiving anti-tuberculous treatment were associated with a higher in-hospital mortality rate., Conclusion: In culture-confirmed tuberculous pleurisy, those with pulmonary involvement were associated with a higher in-hospital mortality rate. A typical pathology for TP on pleura biopsy was associated with a better outcome.
- Published
- 2011
- Full Text
- View/download PDF
46. Predicting results of mycobacterial culture on sputum smear reversion after anti-tuberculous treatment: a case control study.
- Author
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Shu CC, Wang JT, Lee CH, Wang JY, Lee LN, and Yu CJ
- Subjects
- Aged, Aged, 80 and over, Case-Control Studies, Drug Resistance, Bacterial, Female, Hospitals, Teaching, Humans, Male, Microscopy, Mycobacterium tuberculosis cytology, Radiography, Thoracic, Recurrence, Retrospective Studies, Taiwan, Tuberculosis microbiology, Tuberculosis pathology, Antitubercular Agents therapeutic use, Mycobacterium tuberculosis isolation & purification, Sputum microbiology, Tuberculosis drug therapy
- Abstract
Background: Little is currently known regarding sputum smear reversion (acid-fast smear becomes positive again after negative conversion) during anti-tuberculous treatment. This study aimed to evaluate its occurrence in patients with pulmonary tuberculosis (TB) and identify factors predicting results of mycobacterial culture for smear-reversion of sputum samples., Methods: The retrospective review was performed in a tertiary referral center and a local teaching hospital in Taiwan. From 2000 to 2007, patients with smear-positive culture-confirmed pulmonary TB experiencing smear reversion after 14 days of anti-tuberculous treatment were identified., Results: The 739 patients with smear-positive pulmonary TB had 74 (10%) episodes of sputum smear reversion that grew Mycobacterium tuberculosis in 22 (30%) (Mtb group). The remaining 52 episodes of culture-negative sputum samples were classified as the non-Mtb group. The anti-tuberculous regimen was modified after confirming smear reversion in 15 (20%). Fourteen episodes in the Mtb group and 15 in the non-Mtb group occurred during hospitalization. All were admitted to the negative-pressure rooms at the time of smear reversion. Statistical analysis showed that any TB drug resistance, smear reversion within the first two months of treatment or before culture conversion, and the absence of radiographic improvement before smear reversion were associated with the Mtb group. None of the smear reversion was due to viable M. tuberculosis if none of the four factors were present., Conclusions: Sputum smear reversion develops in 10% of patients with smear-positive pulmonary TB, with 30% due to viable M. tuberculosis bacilli. Isolation and regimen modification may not be necessary for all drug-susceptible patients who already have radiographic improvement and develop smear reversion after two months of treatment or after sputum culture conversion.
- Published
- 2010
- Full Text
- View/download PDF
47. Chronic hypoxia attenuates nitric oxide-dependent hemodynamic responses to acute hypoxia.
- Author
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Huang KL, Wu CP, Kang BH, and Lin YC
- Subjects
- Animals, Blood Pressure physiology, Enzyme Inhibitors metabolism, Hemodynamics, Hypotension metabolism, Male, NG-Nitroarginine Methyl Ester metabolism, Rats, Rats, Sprague-Dawley, Hypertension, Pulmonary metabolism, Hypoxia metabolism, Nitric Oxide metabolism, Vasodilator Agents metabolism
- Abstract
Alterations in the nitric oxide (NO) pathway have been implicated in the pathogenesis of chronic hypoxia-induced pulmonary hypertension. Chronic hypoxia can either suppress the NO pathway, causing pulmonary hypertension, or increase NO release in order to counteract elevated pulmonary arterial pressure. We determined the effect of NO synthase inhibitor on hemodynamic responses to acute hypoxia (10% O(2)) in anesthetized rats following chronic exposure to hypobaric hypoxia (0.5 atm, air). In rats raised under normoxic conditions, acute hypoxia caused profound systemic hypotension and slight pulmonary hypertension without altering cardiac output. The total systemic vascular resistance (SVR) decreased by 41 +/- 5%, whereas the pulmonary vascular resistance (PVR) increased by 25 +/- 6% during acute hypoxia. Pretreatment with N(omega)-nitro-L-arginine methyl ester (L-NAME; 25 mg/kg) attenuated systemic vasodilatation and enhanced pulmonary vasoconstriction. In rats with prior exposure to chronic hypobaric hypoxia, the baseline values of mean pulmonary and systemic arterial pressure were significantly higher than those in the normoxic group. Chronic hypoxia caused right ventricular hypertrophy, as evidenced by a greater weight ratio of the right ventricle to the left ventricle and the interventricular septum compared to the normoxic group (46 +/- 4 vs. 28 +/- 3%). In rats which were previously exposed to chronic hypoxia (half room air for 15 days), acute hypoxia reduced SVR by 14 +/- 6% and increased PVR by 17 +/- 4%. Pretreatment with L-NAME further inhibited the systemic vasodilatation effect of acute hypoxia, but did not enhance pulmonary vasoconstriction. Our results suggest that the release of NO counteracts pulmonary vasoconstriction but lowers systemic vasodilatation on exposure to acute hypoxia, and these responses are attenuated following adaptation to chronic hypoxia., (Copyright 2002 National Science Council, ROC and S. Karger AG, Basel)
- Published
- 2002
- Full Text
- View/download PDF
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