Buddhist Tzu Chi General Hospital Taipei Branch

Taipei, Taiwan

Buddhist Tzu Chi General Hospital Taipei Branch

Taipei, Taiwan
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Yan F.-X.,Chang Gung University | Wu C.W.,National Central University | Cheng S.-Y.,Chang Gung Memorial Hospital Kaohsiung Medical Center | Lim K.-E.,Buddhist Tzu Chi General Hospital Taipei Branch | And 3 more authors.
Brain Connectivity | Year: 2013

Researchers have recently focused their attention on the intrinsic functional connectivity (FC) in the brain using resting-state functional magnetic resonance imaging. Seed-based correlation analysis (SCAC), which correlates a predefined seed region with other voxels in the brain, is a common index for FC. However, definition of seed sizes and locations was ambiguous in previous studies and this may lead to spurious results for people with a unique functional anatomy. To address this issue, this study proposes a novel method (SCAReHo) that provides a data-driven seed selection (including sizes and locations) method by incorporating regional homogeneity (ReHo) in the SCAC method. The disparities between SCAC and SCAReHo methods among 12 healthy participants were evaluated in the FC of default mode network (DMN), task-positive network (TPN), and amygdala network. The SCAReHo method bypasses the seed-selection ambiguity and enhances the sensitivity in detecting FC of the DMN, TPN, and amygdala network. This study suggests that the SCAReHo method improves the sensitivity of FC analysis and reduces the uncertainty of seed selection. Thus, this method may be particularly useful for psychiatric and neurological investigations. © Mary Ann Liebert, Inc.


Peng Y.-J.,Buddhist Tzu Chi General Hospital Taipei Branch | Wen C.-W.,Chang Gung University | Chiou S.-H.,Taipei Veterans General Hospital | Chiou S.-H.,National Yang Ming University | Liu S.-J.,Chang Gung University
Biomaterials | Year: 2010

The purpose of this report was to develop solvent-free biodegradable scleral plugs for simultaneous ganciclovir and foscarnet delivery for cytomegalovirus retinitis treatment. To fabricate a biodegradable plug, polylactide-polyglycolide copolymers were pre-mixed with the drugs. The mixture was then compression molded and sintered to form a compact scleral plug. The drug release features were monitored with HPLC assay both in vitro and in vivo. Both drugs showed a biphasic release curvature with an initial burst and followed by a second sustained release phase and maintained at therapeutic level for 3-4 weeks. As compared to ganciclovir, foscarnet was released faster in initial phase, but later, showed extended retention in vitreous humor. For biocompatibility analysis, dark-adapted flash electroretinography was performed, and the a-wave and b-wave amplitudes were statistically equal before and after the scleral plug implantation. Finally, serial microstructure changes of releasing scleral plugs were evaluated with scanning electron microscope. The scleral plug surface showed progressive transformation from granular solid surface to smoothen and cavitated appearance. © 2009 Elsevier Ltd. All rights reserved.


Cheng H.-R.,National Taiwan University | Liu C.-J.,National Taiwan University | Liu C.-J.,National Taiwan University Hospital | Tseng T.-C.,Buddhist Tzu Chi General Hospital Taipei Branch | And 6 more authors.
PLoS ONE | Year: 2013

Spontaneous clearance of hepatitis B surface antigen (HBsAg) in chronic hepatitis B (CHB) patients usually indicates a remission of hepatitis activity and a favorable outcome. Two single nucleotide polymorphisms (SNP), rs3077 near HLA-DPA1 region and rs9277535 near HLA-DPB1 region, have been shown to be associated with HBV persistence after acute HBV infection. However, little is known about the impact of these 2 SNPs on spontaneous HBsAg clearance in CHB patients. In this case-control study, a total of 100 male HBeAg-negative chronic HBV carriers who cleared HBsAg spontaneously (case group) and 100 age-matched HBeAg-negative male patients with persistent HBsAg positivity (control group) were enrolled. We investigated the relationship between these 2 SNPs and HBsAg clearance. There was a higher frequency of rs9277535 non-GG genotype in the case group (57% vs. 42%). Patients with rs9277535 non-GG genotype had a higher chance to clear HBsAg [Odds ratio (OR): 1.83, 95% confidence interval (CI): 1.04~3.21, P = 0.034]. Compared to GG haplotype of rs3077 and rs9277535, GA haplotype had a higher chance of achieving spontaneous HBsAg loss (OR: 2.17, 95% CI: 1.14~4.16, P = 0.030). In conclusion, rs9277535 non-GG genotype is associated with a higher likelihood of spontaneous HBsAg seroclearance in CHB patients. © 2013 Cheng et al.


Tseng T.-C.,Buddhist Tzu Chi General Hospital Taipei Branch | Liu C.-J.,National Taiwan University Hospital | Kao J.-H.,National Taiwan University Hospital
Current Pharmacogenomics and Personalized Medicine | Year: 2010

Infection due to hepatitis B virus (HBV) is a global public health issue. With effective treatment, it is possible to prevent disease progression to cirrhosis and hepatocellular carcinoma in chronic hepatitis B patients. Several viral factors have been documented to be associated with disease progression and treatment response, including HBV genotype and several naturally occurring HBV mutants, such as precore stop codon mutation (G1896A) and basal core promoter mutation (A1762T/G1764A). Recent studies suggested that responses to standard interferon or peginterferon are more favourable in patients infected with the HBV virus of genotype A or B than the genotype C or D infection. In contrast, therapeutic responses to nucleos(t)ide analogues are generally comparable between HBV genotypes. In addition to the viral genotype, BCP mutation (A1762T/G1764A) is likely to be associated with a higher sustained viral response in HBeAg-positive patients receiving interferon or peginterferon treatment. In conclusion, therapeutic differences seem to exist among HBV genotypes and genetic variations. However, the definite contribution of each viral factor still remains unclear. Since the majority of current studies included small numbers of patients and were not powered to answer such critical questions, the role of viral genetic variation for treatment outcomes awaits further studies before personalized treatment strategies can be planned. © 2010 Bentham Science Publishers Ltd.


Tseng T.-C.,Buddhist Tzu Chi General Hospital Taipei Branch | Tseng T.-C.,National Taiwan University Hospital | Tseng T.-C.,Tzu Chi University | Liu C.-J.,National Taiwan University Hospital | And 10 more authors.
Hepatology | Year: 2012

Loss of hepatitis B surface antigen (HBsAg) usually indicates the cure of hepatitis B virus (HBV) infection. In spontaneous hepatitis B e antigen (HBeAg) seroconverters, lower serum HBsAg and HBV DNA levels have been shown to be associated with HBsAg loss over time. However, little is known about their impacts on HBsAg loss in HBeAg-negative patients with limited viral replication. A total of 688 HBeAg-negative patients with baseline serum HBV DNA levels <2000 IU/mL were enrolled in Taiwan. The relationships of HBsAg and HBV DNA levels with subsequent HBsAg loss were investigated. In a mean follow-up of 11.6 years, the average annual rate of HBsAg loss was 1.6%. Baseline HBsAg and HBV DNA levels were inversely associated with subsequent HBsAg loss. When compared to patients who had HBsAg levels >1000 IU/mL, the rates of HBsAg loss were significantly higher in patients with HBsAg levels of 100-999, 10-99, and <10 IU/mL, with hazard ratios of 2.5 (95% confidence interval [CI], 1.6-4.0), 2.8 (95% CI, 1.6-5.0), and 13.2 (95% CI, 8.1-21.5), respectively. Multivariate analysis showed that HBsAg level, but not HBV DNA, remained as an independent factor. The adjusted hazard ratio of HBsAg loss was 13.2 (95% CI, 7.8-22.1) for HBsAg level <10 versus ≥1000 IU/mL. When compared to HBV DNA level by receiver operating characteristic curve analysis, HBsAg level served as a better predictor of both 5-year and 10-year HBsAg loss. Conclusion: In HBeAg-negative patients with HBV genotype B or C infection who have HBV DNA level <2000 IU/mL, HBsAg level <10 IU/mL is the strongest predictor of HBsAg loss. © 2011 American Association for the Study of Liver Diseases.


Tseng T.,Buddhist Tzu Chi General Hospital Taipei Branch | Tseng T.,National Taiwan University Hospital | Liu C.,National Taiwan University Hospital | Su T.,National Taiwan University Hospital | And 5 more authors.
Gastroenterology | Year: 2011

Background & Aims: Loss of hepatitis B surface antigen (HBsAg) usually indicates that hepatitis B virus (HBV) infection has been cured. However, little is known about factors predicting HBsAg loss in patients who spontaneously clear hepatitis B e antigen (HBeAg). Methods: We studied 390 Taiwanese HBeAg-positive patients with chronic hepatitis who had spontaneously cleared HBeAg (seroconversion) during follow-up. Serum levels of HBV DNA and HBsAg were determined 1 year after HBeAg seroconversion, and their relationships with subsequent HBsAg loss were investigated. Results: In a mean follow-up of 7.4 years, the average annual rate of HBsAg loss was 0.62%. Serum levels of HBsAg and HBV DNA were inversely associated with HBsAg loss in a dose-response manner. Compared with patients with HBsAg levels <1000 IU/mL, the HBsAg loss rate was higher for those with HBsAg levels of 100 to 999 and <100 IU/mL, with hazard ratios of 4.4 (95% confidence interval, 1.117.0) and 24.3 (8.767.5), respectively. Among those who underwent HBsAg loss within 6 years of follow-up, serum HBsAg levels were a better predictor than HBV DNA levels by receiver operating characteristic curve analysis (area under the receiver operating characteristic curve, 0.90 vs 0.69; P =.012); an HBsAg level <100 IU/mL predicted HBsAg loss within 6 years with a diagnostic accuracy of 91.5%, sensitivity of 83.3%, specificity of 92.1%, positive predictive value of 45.5%, and negative predictive value of 98.6% in patients with an HBV DNA level <200 IU/mL. Conclusions: Low serum levels of HBsAg, alone or in combination with HBV DNA levels, 1 year after HBeAg seroconversion can predict HBsAg loss in patients with HBV genotype B or C infection. © 2011 AGA Institute.


Teng M.-S.,Taipei Medical University | Teng M.-S.,Buddhist Tzu Chi General Hospital Taipei Branch | Hsu L.-A.,Chang Gung University | Wu S.,Buddhist Tzu Chi General Hospital Taipei Branch | And 7 more authors.
Atherosclerosis | Year: 2013

Objective: Previous investigations have revealed an association between the ABO locus/blood group and total cholesterol and inflammatory biomarker levels. We aimed to test the statistical association of ABO locus variants with lipid profiles and levels of thirteen inflammatory markers in a Taiwanese population. Methods and results: A sample population of 617 Taiwanese subjects was enrolled. Five ABO gene region polymorphisms were selected and genotyped. After adjusting for clinical covariates and inflammatory marker levels, the genetic-inferred ABO blood group genotypes were associated with sE-selectin level (P=3.5×10-36). Significantly higher total and low-density lipoprotein cholesterol (LDL-C) levels were noted in individuals with blood group A (P=7.2×10-4 and P=7.3×10-4, respectively). Interestingly, after adjusting for sE-selectin level, significantly lower high-density lipoprotein cholesterol (HDL-C) level as well as higher triglyceride (TG) level and ratio of triglyceride to HDL-C (TG/HDL-C ratio) were noted in individuals with blood group A comparing to non-A individuals (P=0.009, P=0.004 and P=0.001, respectively); these associations were also observed in the group A male subjects (P=0.027, P=0.001, and P=0.002, respectively). Mediation analysis further revealed a suppression effect of sE-selectin level on the association between genetic-inferred ABO blood group genotypes and TG/HDL-C ratio in total participants (P=1.18×10-6) and in males (P=5.99×10-5). Conclusion: Genetic variants at the ABO locus independently affect sE-selectin level in Taiwanese subjects, while the association of ABO locus variants with TG/HDL-C ratio is suppressed by sE-selectin level in Taiwanese males. These results provided further evidence for the mechanism in the association of ABO blood groups with atherosclerotic cardiovascular diseases. © 2013 Elsevier Ireland Ltd.


Tseng T.-C.,Buddhist Tzu Chi General Hospital Taipei Branch | Tseng T.-C.,National Taiwan University Hospital | Tseng T.-C.,Tzu Chi University | Liu C.-J.,National Taiwan University Hospital | And 10 more authors.
Gastroenterology | Year: 2012

Background & Aims: Patients with chronic hepatitis B virus (HBV) infection have a high risk for developing hepatocellular carcinoma (HCC). Patients with lower levels of hepatitis B surface antigen (HBsAg) have higher chances of losing HBsAg than those with high levels. However, little is known about whether higher levels of HBsAg increase risk for HCC. Methods: We followed 2688 Taiwanese HBsAg-positive patients without evidence of cirrhosis for a mean time period of 14.7 years. In addition to the known risk factors of HCC, we investigated the association between levels of HBsAg and development of HCC. Results: Of the patients followed, 191 developed HCC, with an average annual incidence rate of 0.5%. Baseline levels of HBsAg and HBV were associated with development of HCC, and risk increased with level. Compared to HBsAg level, by receiver operating characteristic curve analysis, HBV DNA level better predicted the development of HCC during 10-year and 15-year periods (both, P <.001). However, when we evaluated hepatitis B e antigen-negative patients with levels of HBV DNA <2000 IU/mL, factors that determined HCC risk included sex, age, and levels of alanine aminotransferase and HBsAg (<1000 IU/mL), but not level of HBV DNA. Multivariate analysis showed that the adjusted hazard ratio for HCC in patients with levels of HBsAg <1000 IU/mL versus <1000 IU/mL was 13.7 (95% confidence interval: 4.8-39.3). Conclusions: Among patients infected with HBV genotype B or C, determinants of HCC risk include their sex, age, hepatitis B e antigen status, HBV genotype, and levels of alanine aminotransferase and HBV DNA, but not level of HBsAg. Among hepatitis B e antigen-negative patients with low viral loads, HCC risk is determined by levels of HBsAg and alanine aminotransferase and age, but not HBV DNA. © 2012 AGA Institute.


Yu C.-W.,Chang Gung University | Juan L.-I.,Buddhist Tzu Chi General Hospital Taipei Branch | Hsu S.-C.,Chang Gung University | Chen C.-K.,Chang Gung University | And 4 more authors.
American Journal of Emergency Medicine | Year: 2013

Background Infective endocarditis (IE) is a diagnostic challenge. We aimed to systemically summarize the current evidence on the diagnostic value of procalcitonin (PCT) in identifying IE. Methods We searched EMBASE, MEDLINE, Cochrane database, and reference lists of relevant articles with no language restrictions through September 2012 and selected studies that reported the diagnostic performance of PCT alone or compare with other biomarkers to diagnose IE. We summarized test performance characteristics with the use of forest plots, hierarchical summary receiver operating characteristic curves, and bivariate random effects models. Results We found 6 qualifying studies that included 1006 episodes of suspected infection with 216 (21.5%) confirmed IE episodes from 5 countries. Bivariate pooled sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios were 64% (95% confidence interval [CI], 52%-74%), 73% (95% CI 58%-84%), 2.35 (95% CI 1.40-3.95), and 0.50 (95% CI 0.35-0.70), respectively. Of the 5 studies examining C-reactive protein (CRP), the pooled sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios were 75% (95% CI 62%-85%), 73% (95% CI 61%-82%), 2.81 (95% CI 1.70-4.65), and 0.34 (95% CI 0.19-0.60), respectively. The global measures of accuracy, area under the receiver operating characteristic curve (AUC) and diagnostic odds ratio (dOR), showed CRP (AUC 0.80, dOR 8.55) may have higher accuracy than PCT (AUC 0.71, dOR 4.67) in diagnosing IE. Conclusions Current evidence does not support the routine use of serum PCT or CRP to rule in or rule out IE in patients suspected to have IE. © 2013 Elsevier Inc.


Wu C.-C.,Tri Service General Hospital | Shyu R.-Y.,Buddhist Tzu Chi General Hospital Taipei Branch | Wang C.-H.,Buddhist Tzu Chi General Hospital Taipei Branch | Tsai T.-C.,National Chiayi University | And 4 more authors.
Biochimica et Biophysica Acta - Molecular Cell Research | Year: 2012

Retinoid-inducible gene 1 (RIG1), also called tazarotene-induced gene 3, belongs to the HREV107 gene family, which contains five members in humans. RIG1 is expressed in high levels in well-differentiated tissues, but its expression is decreased in cancer tissues and cancer cell lines. We found RIG1 to be highly expressed in testicular cells. When RIG1 was expressed in NT2/D1 testicular cancer cells, neither cell death nor cell viability was affected. However, RIG1 significantly inhibited cell migration and invasion in NT2/D1 cells. We found that prostaglandin D2 synthase (PTGDS) interacted with RIG1 using yeast two-hybrid screens. Further, we found PTGDS to be co-localized with RIG1 in NT2/D1 testis cells. In RIG1-expressing cells, elevated levels of prostaglandin D2 (PGD2), cAMP, and SRY-related high-mobility group box 9 (SOX9) were observed. This indicated that RIG1 can enhance PTGDS activity. Silencing of PTGDS expression significantly decreased RIG1-mediated cAMP and PGD2 production. Furthermore, silencing of PTGDS or SOX9 alleviated RIG1-mediated suppression of migration and invasion. These results suggest that RIG1 will suppress cell migration/invasion through the PGD2 signaling pathway. In conclusion, RIG1 can interact with PTGDS to enhance its function and to further suppress NT2/D1 cell migration and invasion. Our study suggests that RIG1-PGD2 signaling might play an important role in cancer cell suppression in the testis. © 2012 Elsevier B.V.

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