Ditmanson Medical Foundation Chia Yi Christian Hospital

Jiayi Shi, Taiwan

Ditmanson Medical Foundation Chia Yi Christian Hospital

Jiayi Shi, Taiwan
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Yang C.-H.,National Kaohsiung University of Applied Sciences | Weng Z.-J.,National Kaohsiung University of Applied Sciences | Chuang L.-Y.,I - Shou University | Yang C.-S.,Ditmanson Medical Foundation Chia Yi Christian Hospital
Computers in Biology and Medicine | Year: 2017

Analyses of interactions between single nucleotide polymorphisms (SNPs) have reported significant associations between mitochondrial displacement loops (D-loops) and chronic dialysis diseases. However, the method used to detect potential SNP-SNP interaction still requires improvement. This study proposes an effective algorithm named dynamic center particle swarm optimization k-nearest neighbors (DCPSO-KNN) to detect the SNP-SNP interaction. DCPSO-KNN uses dynamic center particle swarm optimization (DCPSO) to generate SNP combinations with a fitness function designed using the KNN method and statistical verification. A total of 77 SNPs in the mitochondrial D-loop were used to detect the SNP-SNP interactions and the search ability was compared against that of other methods. The detected SNP-SNP interactions were statistically evaluated. Experimental results showed that DCPSO-KNN successfully detects SNP-SNP interactions in two-to-seven-order combinations (positive predictive value (PPV)+negative predictive value (NPV)=1.154 to 1.310; odds ratio (OR)=1.859 to 4.015; 95% confidence interval (95% CI)=1.151 to 4.265; p-value <0.001). DCPSO-KNN can improve the detection ability of SNP-SNP associations between mitochondrial D-loops and chronic dialysis diseases, thus facilitating the development of biomedical applications. © 2017 Elsevier Ltd

Chen S.C.-C.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Lin H.-J.,Chi Mei Medical Center | Lin H.-J.,Chia Nan University of Pharmacy and Science | Chen Y.-W.,Landseed Hospital | And 3 more authors.
Stroke | Year: 2013

Background and Purpose-Various risk score models have been developed to predict symptomatic intracerebral hemorrhage (SICH) after intravenous thrombolysis for acute ischemic stroke. In this study, we aimed to determine the prediction performance of these risk scores in a Taiwanese population Methods-Prospectively collected data from 4 hospitals were used to calculate probability of SICH with the scores developed by Cucchiara et al, the Hemorrhage After Thrombolysis (HAT) score, the Safe Implementation of Thrombolysis in Stroke-SICH risk score, the Glucose Race Age Sex Pressure Stroke Severity score, and the Stroke Prognostication using Age and National Institutes of Health Stroke Scale-100 index. We used logistic regression to evaluate the effectiveness of each risk model in predicting SICH and the c statistic to assess performance. Results-A total of 548 patients were included. The rates of SICH were 7.3% by the National Institute of Neurological Diseases and Stroke definition, 5.3% by the European-Australasian Cooperative Acute Stroke Study II definition, and 3.5% by the Safe Implementation of Thrombolysis in Stroke-Monitoring Study definition. The Cucchiara score, the HAT score, and the Safe Implementation of Thrombolysis in Stroke-SICH risk score were significant predictors of SICH for all 3 definitions, whereas the Glucose Race Age Sex Pressure Stroke Severity score and the Stroke Prognostication using Age and National Institutes of Health Stroke Scale-100 index predicted well only for 1 or 2 definitions of SICH. The c statistic was highest for the HAT score (range, 0.69-0.73) across the definitions of SICH. Conclusions-The Cucchiara score, the HAT score, and the Safe Implementation of Thrombolysis in Stroke-SICH risk score predicted SICH reasonably well regardless of which SICH definition was used. However, only the HAT score had an acceptable discriminatory ability. © 2013 American Heart Association, Inc.

Lin C.-H.,National Yang Ming University | Lin C.-H.,Taipei City Hospital | Chao L.-K.,National Yang Ming University | Chao L.-K.,Tzu Chi Medical Center | And 3 more authors.
International Journal of Clinical and Experimental Pathology | Year: 2014

A subset of cancer cells, termed cancer stem cells (CSCs) or tumor-initiating cells (TICs) could initiate tumors and are responsible for tumor recurrence and chemotherapeutic resistance. In this study, we enriched TICs in nasopharyngeal carcinoma (NPC) by the spheres formation and characterized the stem-like signatures such as self-renewal, proliferation, chemoresistance and tumorigenicity. By this method, we investigated that epigallocathechin gallate (EGCG), the major polyphenol in green tea could target TICs and potently inhibit sphere formation, eliminate the stem-like properties and enhance chemosensitivity in NPC through attenuation of STAT3 activation, which could be important in regulating the stemness expression in NPC. Our results demonstrated that STAT3 pathway plays an important role in mediating tumor-initiating capacities in NPC and suggest that inactivation of STAT3 with EGCG may represent a potential preventive and therapeutic approach for NPC.

Chuang H.-C.,Taipei Medical University | Juan H.-T.,National Taiwan University | Chang C.-N.,National Taiwan University | Yan Y.-H.,National Taiwan University | And 7 more authors.
Nanotoxicology | Year: 2014

Exposure to zinc oxide (ZnO) metal fumes is linked to adverse human health effects; however, the hazards of ZnO nanoparticles (ZnONPs) remain unclear. To determine pulmonary exposure to occupationally relevant ZnONPs cause cardiopulmonary injury, Sprague-Dawley rats were exposed to ZnONPs via intratracheal (IT) instillation and inhalation. The relationship between intrapulmonary zinc levels and pulmonary oxidative-inflammatory responses 72 h after ZnONP instillation was determined in bronchoalveolar lavage fluid (BALF). Instilled ZnONPs altered zinc balance and increased the levels of total cells, neutrophils, lactate dehydrogenase (LDH) and total protein in BALF and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in blood after 72 h. The ZnONPs accumulated predominantly in the lungs over 24 h, and trivial amounts of zinc were determined in the heart, liver, kidneys and blood. Furthermore, the inflammatory-oxidative responses induced by occupationally relevant levels of 1.1 and 4.9 mg/m3 of ZnONP inhalation for 2 weeks were determined in BALF and blood at 1, 7 and 30 days post-exposure. Histopathological examinations of the rat lungs and hearts were performed. Inhalation of ZnONP caused an inflammatory cytological profile. The total cell, neutrophil, LDH and total protein levels were acutely increased in the BALF, and there was an inflammatory pathology in the lungs. There were subchronic levels of white blood cells, granulocytes and 8-OHdG in the blood. Cardiac inflammation and the development of fibrosis were detected 7 days after exposure. Degeneration and necrosis of the myocardium were detected 30 days after exposure. The results demonstrate that ZnONPs cause cardiopulmonary impairments. These findings highlight the occupational health effects for ZnONP-exposed workers. © 2014 Informa UK, Ltd.

Feng Y.-M.,Foundation Medicine | Feng C.-W.,National Sun Yat - sen University | Chen S.-Y.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Hsieh H.-Y.,Ditmanson Medical Foundation Chia Yi Christian Hospital | And 2 more authors.
BMC Cancer | Year: 2015

Background: Hepatocellular carcinoma (HCC) is a major cause of cancer deaths worldwide. However, current chemotherapeutic drugs for HCC are either poorly effective or expensive, and treatment with these drugs has not led to satisfactory outcomes. In a 2012 case report, we described our breakthrough finding in two advanced HCC patients, of whom one achieved complete remission of liver tumors and the other a normalized α-fetoprotein level, along with complete remission of their lung metastases, after the concomitant use of thalidomide and cyproheptadine. We assumed the key factor in our effective therapy to be cyproheptadine. In this study, we investigated the antiproliferative effects and molecular mechanisms of cyproheptadine. Methods: The effect of cyproheptadine on cell proliferation was examined in human HCC cell lines HepG2 and Huh-7. Cell viability was assayed with Cell Counting Kit-8; cell cycle distribution was analyzed by flow cytometry. Mechanisms underlying cyproheptadine-induced cell cycle arrest were probed by western blot analysis. Results: Cyproheptadine had a potent inhibitory effect on the proliferation of HepG2 and Huh-7 cells but minimal toxicity in normal hepatocytes. Cyproheptadine induced cell cycle arrest in HepG2 cells in the G1 phase and in Huh-7 cells at the G1/S transition. The cyproheptadine-induced G1 arrest in HepG2 cells was associated with an increased expression of HBP1 and p16, whereas the G1/S arrest in Huh-7 cells was associated with an increase in p21 and p27 expression and a dramatic decrease in the phosphorylation of the retinoblastoma protein. Additionally, cyproheptadine elevated the percentage of Huh-7 cells in the sub-G1 population, increased annexin V staining for cell death, and raised the levels of PARP and its cleaved form, indicating induction of apoptosis. Finally, cyproheptadine-mediated cell cycle arrest was dependent upon the activation of p38 MAP kinase in HepG2 cells and the activation of both p38 MAP kinase and CHK2 in Huh-7 cells. Conclusions: Our results demonstrate that a non-classical p38 MAP kinase function, regulation of cell cycle checkpoints, is one of the underlying mechanisms promoted by cyproheptadine to suppress the proliferation of HCC cells. These results provide evidence for the drug's potential as a treatment option for liver cancer. © 2015 Feng et al.

Shen H.-N.,Chi Mei Medical Center | Shen H.-N.,National Cheng Kung University | Lu C.-L.,National Cheng Kung University | Lu C.-L.,Ditmanson Medical Foundation Chia Yi Christian Hospital | And 2 more authors.
Critical Care Medicine | Year: 2014

Objectives: Physicians generally have higher disease awareness and easier access to medical care, which may help them reduce risk of developing severe sepsis and associated mortality when they suffer from acute infection. However, the opposite situation may occur due to the presence of potential barriers to healthcare in physicians. We aim to examine the risk of severe sepsis and associated mortality in physicians. Design: A matched cohort study. Setting: Registry of medical professionals and inpatient and outpatient claims data from Taiwan's National Health Insurance Research Database. SUBJECTS: Physicians (n = 29,697) in Taiwan and a group of persons who were demographically and socioeconomically matched (1:1 ratio) and without any medical education and background. All subjects were followed from the index date (January 1, 2000) to the occurrence of endpoint, withdrawal, or December 31, 2008, whichever date came first. Interventions: None. Measurements and Main Results: Primary outcome was development of severe sepsis. Secondary outcome was 90-day mortality following severe sepsis. The overall incidence density of severe sepsis was lower in physicians than in controls (3.25 vs 3.90 per 1,000 person-years, p < 0.001). According to the Cox regression model, severe sepsis develops in physicians 24% less likely than controls after baseline covariates were adjusted (adjusted hazard ratio, 0.76; 95% CI, 0.68-0.85). The 90-day mortality rates were similar between physicians and controls with severe sepsis (46.5% vs 45.7%, p = 0.72). However, after controlling for the baseline and additional covariates, the risk of death was significantly lower in physicians than in controls (adjusted hazard ratio, 0.82; 95% CI, 0.71-0.95). Conclusions: These findings support the hypothesis that physicians are less likely than controls to develop or die of severe sepsis, implying that medical knowledge, higher disease awareness, and easier healthcare access in physicians may help reduce their risk of severe sepsis and associated mortality. © 2013 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins.

Hung H.-W.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Yang P.-Y.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Yan Y.-H.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Jou H.-J.,Taiwan Adventist Hospital | And 2 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2016

Objective: To compare the short-term maternal postpartum complications associated with cesarean section (CS), vaginal delivery (VD), repeated CS and vaginal birth after cesarean section (VBAC) in a large national sample.Methods: This was a population-based study of the Taiwan National Health Insurance Research Database (NHIRD). Outcomes include post-discharge (2 weeks) urinary tract infection (p-UTI), complications of obstetrical surgical wounds (p-wound) and postpartum hemorrhage (p-hemorrhage). A logistic regression model with generalized estimating equations were utilized, and adjustments were made for maternal and hospital characteristics.Results: The incidence of p-UTI was 0.79%. CS was associated with a significantly higher risk of p-UTI compared with VD (odds ratio [OR] 1.14; 95% confidence interval [CI], 1.003-1.29). The incidence of p-wound was 4.07%. CS and repeated CS were associated with a higher risk of p-wound compared with VD (OR 1.68; 95% CI, 1.28-2.21 and OR 1.64; 95% CI, 1.22-2.20, respectively). Age, maternal diseases and hospital and obstetrician volumes were associated with patient outcomes.Conclusions: Women with a delivery mode of CS have a higher risk of p-UTI and p-wound than women with VD. Maternal characteristics and hospital and obstetrician volumes may also influence postpartum outcomes. © 2015 Taylor & Francis.

Chen J.-J.,Taipei Medical University | Hsu Y.-C.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Chen D.-L.,G Home Clinic
Journal of Headache and Pain | Year: 2012

Hormonal changes related to the menstrual cycle have a great impact on migraines in women. Menstrual migraine attacks are almost invariably without aura. Categorizing migraines into menstrual or non-menstrual types is one way to stratify migraines without aura according to the appendix criteria of the International Classification of Headache Disorders. We report a peri-menopausal woman whose sensory aura exclusively heralded menstrual migraine. A 51-year-old woman had suffered from monthly episodic headaches since the age of 46. Before a headache, and within 1 h on the first day of her menstruation, she always experienced numbness in her entire left upper limb. After the sensory aura, migrainous headaches occurred with nausea and photophobia. In the postmenopausal period, she no longer had sensory aura, and her headache pattern changed and became less severe. Her physical and neurologic exams as well as electroencephalography, brain magnetic resonance imaging, and conventional angiography were all normal. She fulfilled the diagnosis of pure menstrual migraine with typical sensory aura. To our knowledge, this is the first formal case report of pure menstrual migraine with aura. © The Author(s) 2012.

Ditmanson Medical Foundation Chia Yi Christian Hospital and Kun Shan University | Date: 2013-10-03

An administration method for a medical spray inhaler and the medical spray inhaler, which utilizes an inhaling sensing unit to sense an air flow change for generating an inhaling signal after a user inhales by an inhaler body. A control unit is then used to receive the inhaling signal and calculate a delay time. After the delay time, the control unit outputs a control instruction to control a medicine container disposed on the inhaler body to spray a medical spray and concurrently records the ventilation volume per inhalation of the user.

Chiu C.-Y.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Chiu C.-Y.,Central Taiwan University of Science and Technology | Tsang Y.-W.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Hsieh B.-T.,Central Taiwan University of Science and Technology
Applied Radiation and Isotopes | Year: 2014

The introduction of beam intensity control concept in current radiotherapy techniques has increased treatment planning complexity. Thus, small-field dose measurement has become increasingly vital. Polymer gel dosimetry method is widely studied. It is the only dose measurement tool that provides 3D dose distribution. This study aims to use an N-isopropylacrylamide (NIPAM) gel dosimeter to conduct beam performance measurements of percentage depth dose (PDD), beam flatness, and symmetry for photon beams with field sizes of 3×3 and 4×4cm2. Computed tomography scans were used to readout the gel dosimeters. In the PDD measurement, the NIPAM gel dosimeter and GafchromicTM EBT3 radiochromic film displayed high consistency in the region deeper than the build-up region. The gel dosimeter dose profile had 3% lower flatness and symmetry measurement at 5cm depth for different fields compared with that of the GafchromicTM EBT3 film. During gamma evaluation under 3%/3mm dose difference/distance-to-agreement standard, the pass rates of the polymer gel dosimeter to the TPS and EBT3 film were both higher than 96%. Given that the gel is tissue equivalent, it did not exhibit the energy dependence problems of radiochromic films. Therefore, the practical use of NIPAM polymer gel dosimeters is enhanced in clinical dose verification. © 2014 Elsevier Ltd.

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