Cheng Ching General Hospital

Taichung, Taiwan

Cheng Ching General Hospital

Taichung, Taiwan
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Hwang-Verslues W.W.,Academia Sinica, Taiwan | Chang P.-H.,Academia Sinica, Taiwan | Wei P.-C.,Academia Sinica, Taiwan | Yang C.-Y.,Academia Sinica, Taiwan | And 9 more authors.
Oncogene | Year: 2011

MicroRNAs (miRNAs) are involved in tumorigenecity by regulating specific oncogenes and tumor suppressor genes, and their roles in breast cancer stem cells (BCSCs) are becoming apparent. Distinct from the CD44 /CD24 /low sub-population, we have isolated a novel PROCR /ESA BCSC sub-population. To explore miRNA-regulatory mechanisms in this sub-population, we performed miRNA expression profiling and found miR-495 as the most highly upegulated miRNA in PROCR /ESA cells. Coincidently, high upregulation of miR-495 was also found in CD44+ /CD24 /low BCSCs, reflecting its potential importance in maintaining common BCSC properties. Ectopic expression of miR-495 in breast cancer cells promoted their colony formation in vitro and tumorigenesis in mice. miR-495 directly suppressed E-cadherin expression to promote cell invasion and inhibited REDD1 expression to enhance cell proliferation in hypoxia through post-transcriptional mechanism. miR-495 expression was directly modulated by transcription factor E12/E47, which itself is highly expressed in BCSCs. These findings reveal a novel regulatory pathway centered on miR-495 that contributes to BCSC properties and hypoxia resistance. © 2011 Macmillan Publishers Limited All rights reserved.

Juang D.F.,Meiho University | Yang P.C.,Cheng Ching General Hospital | Kuo T.H.,New Taipei City Hospital Banciao Branch
International Journal of Environmental Science and Technology | Year: 2012

Two microbial fuel cells with different oxygen supplies in the cathodic chamber were constructed. Electrogenic capabilities of both cells were compared under the same operational conditions. Results showed that binary quadratic equations can express the relationships between chemical oxygen demand degradation rate and chemical oxygen demand loading and between chemical oxygen demand removal rate and chemical oxygen demand loading in both cells. Good linear relationships between power output (voltage or power density) and flow rate and between power output and chemical oxygen demand degradation rate were only found on the cell with mechanical aeration in the cathodic chamber, but not on the cell with algal photosynthesis in the cathodic chamber. The relationships between power output and chemical oxygen demand removal rate and between power output and effluent chemical oxygen demand concentration on both cells can be expressed as binary quadratic equations. The optimum flow rates to obtain higher power density and higher Coulombic efficiency in the cell with mechanical aeration in the cathodic chamber (=0.85 mW/m 2 and 0.063%) and in the cell with algal photosynthesis in the cathodic chamber (=0.65 mW/m 2 and 0.05%) are about 1000 and 1460 μL/min, respectively. The optimum chemical oxygen demand removal rates to obtain higher power density and higher Coulombic efficiency in the cell with mechanical aeration in the cathodic chamber (=1.2 mW/m 2 and 0.064%) and in the cell with algal photosynthesis in the cathodic chamber (=0.81 mW/m 2 and 0.051%) are about 40.5 and 36.5%, respectively. © 2012 CEERS, IAU.

Hsu H.-T.,Kaohsiung Medical University | Chou S.-H.,Kaohsiung Medical University | Chen C.-L.,Cheng Ching General Hospital | Tseng K.-Y.,Kaohsiung Medical University | And 3 more authors.
Anaesthesia | Year: 2013

We compared direct laryngoscopy with a Macintosh blade vs indirect bronchoscopy with a Trachway® stylet, for endobronchial intubation with a left-sided double-lumen tube. We allocated participants scheduled for thoracic surgery and who had normal predicted laryngoscopy, 30 to each group. The mean (SD) intubation times with laryngoscope and Trachway were 48 (11) s vs 28 (4) s, respectively, p < 0.001. The rates of hoarseness on the first postoperative day, categorised as none/mild/moderate/severe, were 10/12/7/1 and 22/6/2/0, respectively, p = 0.008, without differences on subsequent days. Left endobronchial intubation with a double-lumen tube is slower using direct laryngoscopy and causes more hoarseness than indirect bronchoscopy with a Trachway stylet. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Tsai J.C.-H.,Cheng Ching General Hospital | Tsai J.C.-H.,National Yang Ming University | Liang Y.-W.,National Taichung Nursing College | Pearson W.S.,Centers for Disease Control and Prevention
Journal of the Formosan Medical Association | Year: 2010

Background/Purpose: We investigated the factors associated with emergency department (ED) use among patients with non-urgent medical problems, with a focus on convenience and preference to use the ED instead of primary care clinics. Methods: A five-level triage system was adopted by research nurses to decide each patient's triage level and the maximum time to physician interview. Patients who had a maximum time to physician interview of more than 60 minutes were assumed to be non-urgent in this study. Results: More than half of ED visits were considered to be non-urgent. Non-urgent patients were more likely to be unmarried, government employees, visit the ED due to trauma, have a history of chronic illness, and present in the day time or at the weekend. ED visits were also more likely to occur in patients who took less than 15 minutes to reach the ED, chose the ED for its convenience, agreed that they could have chosen another facility for their visit, did not agree that the ED was convenient for receiving medical care. Multivariate logistic regression showed that marital status, time of presentation, time needed to get to the ED, and occupation were associated with non-urgent ED visits. Conclusion: Preference for using EDs for medical care and their convenience might contribute to non-urgent ED visits. A five-level triage system reliably stratified patients with different admission rates and utilization of medical resources, and could be helpful for reserving limited medical resources for more urgent patients. © 2010 Formosan Medical Association & Elsevier.

Tsai J.C.H.,Cheng Ching General Hospital | Tsai J.C.H.,National Yang Ming University | Chen W.-Y.,Nan Kai University of Technology | Liang Y.-W.,National Taichung Nursing College
Health Policy | Year: 2011

Objectives: To explore the magnitude of nonemergent emergency department visits under the Taiwan National Health Insurance program and to identify significant factors associated with these visits. Methods: A cross-sectional analysis of the 2002 Taiwan National Health Insurance Research Database was used to identify nonemergent emergency department conditions according to the New York University algorithm. The data contained 43,384 visits, of which 83.89% could be classified. Multivariate logistic regression identified individual and contextual factors associated with nonemergent emergency department visits. Results: Nearly 15% of all emergency department visits were nonemergent; an additional 20% were emergent-preventable with primary care. Patients likely to make nonemergent emergency department visits were older, female, categorized as a Taiwan National Health Insurance Category IV beneficiary, and without major illness. Hospital accreditation level, teaching status, and location were associated with an increased likelihood of nonemergent emergency department visits. Conclusion: Understanding the factors leading to nonemergent emergency department visits can assist in evaluating the overall quality of a health care system and help reduce the use of the emergency department for nonemergent conditions. Policy makers desiring cost-effective care should assess emergency department visit rates in light of available resources for specific populations. © 2010 Elsevier Ireland Ltd.

Juang D.-F.,Meiho University | Yang P.-C.,Cheng Ching General Hospital | Chou H.-Y.,Meiho University | Chiu L.-J.,Meiho University
Biotechnology Letters | Year: 2011

Four microbial fuel cells (MFCs) inoculated with different bacterial species were constructed. The species were Pseudomonas putida, Comamonas testosteroni, Corynebacterium gultamicum, and Arthrobacter polychromogenes. The MFCs were operated under identical continuous flow conditions. The factors affecting the capabilities of the MFCs for treating organic matter and generating power were evaluated and compared. The factors include microbial species type, organic loading, and substrate degradation rate. For all four MFCs, power output increased with the organic loading rate. Power density also increased with the substrate degradation rate. These findings implied that more organic matter was utilized for power generation at higher organic loading and substrate degradation rates. However, coulombic efficiency increased with decreased organic loading and substrate degradation rates. Apparently, all four MFCs had low efficiencies in generating power from organic matter. These low efficiencies are attributed to the long distance between the anode and the cathode, as well as to the small ratio of the proton exchange membrane surface area to the anode chamber surface area. These features may have caused most of the protons produced in the anode chamber to leave the chamber with the effluent, which led to the low power generation performance of the MFCs. © 2011 Springer Science+Business Media B.V.

Liau B.-Y.,Hungkuang University | Yeh S.-J.,Cheng Ching General Hospital | Chiu C.-C.,Feng Chia University
Computing in Cardiology | Year: 2010

In this study, time-domain cross-correlation function was applied to evaluate the relationship between blood pressure and cerebral blood flow velocity signals acquiring from healthy subjects and stroke patients both in supine and head-up tilt positions to evaluate the effect of posture change. 10 stroke patients and 11 healthy subjects were included in this study. Results revealed that the mean arterial blood pressure (MABP) values of stroke patients in response to posture changes were reduced. However, MABP values in healthy subjects were become higher in head-up tilt position. Both of MABP values of healthy subjects in supine and head-up tilt were significantly lower than those in stroke patients (p<0.05). On the other hand, mean cerebral blood flow velocity (MCBFV) in healthy subjects remain constant. However, the values in stroke patients reduced in response to headup tilt. In the results of cross-correlation function (CCF) analysis, max CCF values in healthy subjects were significantly higher than those in stroke patients (p<0.05) in both supine and head-up tile positions. It might indicate correlation of MABP and MCBFV was higher in healthy subjects. The max CCF index in stroke patients were close to 0 second in both positions (supine: - 0.35±3.36 sec; head-up tilt:-0.29±3.20 sec). In healthy subjects, max CCF values should be around 2 seconds. Hence, it indicated the phase difference almost did not exist between MABP and MCBFV. This reveals the buffer function of CA were lower in stroke patients. Therefore, CA in stroke patients might be impaired by the results in response to posture changes.

Wu R.-G.,Cheng Ching General Hospital
Journal of Internal Medicine of Taiwan | Year: 2015

Negative pressure pulmonary edema (NPPE) or postobstructive pulmonary edema (POPE) is a form of noncardiogenic pulmonary edema that results from the generation of high negative intrathoracic pressure needed to overcome upper airway obstruction 1. It typically develops rapidly and can be life-threatening if not diagnosed promptly. Following an episode of acute airway obstruction or the relief of chronic upper airway obstruction, patients with NPPE develop sudden, unexpected and often severe pulmonary edema. Awareness of this uncommon condition is crucial if the physician is to make an early diagnosis and initiate successful treatment. NPPV may develop in several clinical situations follows a sudden, severe episode of upper airway obstruction, such as postanesthetic laryngospasm, postextubation laryngospasm, epiglottitis, croup, choking and strangulation. It also develops after surgical relief of chronic upper airway obstruction.

Hsu C.-H.,Cheng Ching General Hospital | Hsieh L.-P.,Cheng Ching General Hospital
Journal of Internal Medicine of Taiwan | Year: 2014

Neurologic complications of murine typhus were uncommon but included aseptic meningitis, meningoencephalitis and rarely if ever, cranial nerve deficit. We report a rare case of murine typhus complicated with increased intracranial pressure and isolated abducens nerve palsy in a 31-year-old returned traveler. The patient developed right abducens nerve palsy In the absence of other neurologic symptoms or signs within 12 hours following receipt of a lumbar puncture. Murine typhus was diagnosed by serology using indirect immunofluorescence assay. The patient received 8-day antibiotic therapy with favorable response. His abducens palsy resolved completely without adjuvant therapy in 3 months. Literature was reviewed focusing on pathogenesis and management.

Wu R.-G.,Cheng Ching General Hospital
Journal of Internal Medicine of Taiwan | Year: 2013

Molecular diagnostic tests have greatly increased our understanding of the role of viruses in pneumonia, and findings indicate that the incidence of viral pneumonia has been underestimated. The most commonly identified viruses in community-acquired pneumonia (CAP) are influenza, rhinovirus, respiratory syncytial virus (RSV), and human metapneumovirus (hMPV). Viral infections are common in adults with CAP, ranging from 10-30% of diagnosed cases. Polymicrobial infections involving bacterial and viral pathogens are frequent and may be associated with severe pneumonia. Besides, cytomegalovirus, herpes simplex and herpes zoster virus may cause severe respiratory illness and life-threatening pneumonia in immunocomromised adults (neoplasm, organ-transplantation, acquired immunodeficiency syndrome, AIDS).

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