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Tang W.-H.,Kaohsiung Medical University | Wang C.-P.,I - Shou University | Chung F.-M.,I - Shou University | Huang L.L.H.,National Cheng Kung University | And 8 more authors.
PLoS ONE | Year: 2015

Total mortality and sudden cardiac death is highly prevalent in patients with chronic kidney disease (CKD). In CKD patients, the protein-bound uremic retention solute indoxyl sulfate (IS) is independently associated with cardiovascular disease. However, the underlying mechanisms of this association have yet to be elucidated. The relationship between IS and cardiac electrocardiographic parameters was investigated in a prospective observational study among early CKD patients. IS arrhythmogenic effect was evaluated by in vitro cardiomyocyte electrophysiological study and mathematical computer simulation. In a cohort of 100 early CKD patients, patients with corrected QT (QTc) prolongation had higher IS levels. Furthermore, serum IS level was independently associated with prolonged QTc interval. In vitro, the delay rectifier potassium current (IK) was found to be significantly decreased after the treatment of IS in a dose-dependent manner. The modulation of IS to the IK was through the regulation of the major potassium ion channel protein Kv 2.1 phosphorylation. In a computer simulation, the decrease of IK by IS could prolong the action potential duration (APD) and induce early afterdepolarization, which is known to be a trigger mechanism of lethal ventricular arrhythmias. In conclusion, serum IS level is independently associated with the prolonged QTc interval in early CKD patients. IS down-regulated IK channel protein phosphorylation and the IK current activity that in turn increased the cardiomyocyte APD and QTc interval in vitro and in the computer ORd model. These findings suggest that IS may play a role in the development of arrhythmogenesis in CKD patients. © 2015 Tang et al.


Hung W.-C.,hou University | Tang W.-H.,Kaohsiung Medical University | Wang C.-P.,hou University | Lu L.-F.,hou University | And 8 more authors.
Clinical and Investigative Medicine | Year: 2015

Purpose: Epicardial fat is visceral adipose tissue that possesses inflammatory properties. Inflammation and obesity are associated with cardiovascular disease and arrhythmogenesis, but little is known about the relationship between epicardial fat and PR-Interval prolongation. The purpose of this study was to investigate the association between epicardial adipose tissue (EAT) volume and PR-interval prolongation as assessed by computed tomography (CT) and Twelve-lead ECGs. Methods: Patients (n=287) were referred for 64-slice CT for exclusion of coronary artery disease and EAT volumes were determined. Twelve-lead ECGs were obtained from each subject and were evaluated by two independent readers. Results: Patients with significant PR interval prolongation had higher median EAT volume than patients with normal PR interval. Statistically significant correlations were observed between the EAT volume and the PR interval (p = 0.183, p = 0.003), and QRS duration (p = 0.144, p = 0.018). Multivariate and trend analyses confirmed that EAT volume was independently associated with the presence of PR interval prolongation. The receiver operator characteristics curve of EAT volume showed that an EAT volume >144.4 cm3 was associated with PR interval prolongation. Conclusion: This study indicates that EAT volume is highly associated with PR interval prolongation. Whether epicardial fat plays a role in the pathogenesis of PR interval prolongation requires future investigation. © 2015 CIM.


PubMed | Kaohsiung Medical University, National Kaohsiung University of Applied Sciences and hou University
Type: Journal Article | Journal: Oncology reports | Year: 2016

In association studies, the combined effects of single nucleotide polymorphism(SNP)-SNP interactions and the problem of imbalanced data between cases and controls are frequently ignored. In the present study, we used an improved multifactor dimensionality reduction(MDR) approach namely MDR-ER to detect the high order SNPSNP interaction in an imbalanced breast cancer data set containing seven SNPs of chemokine CXCL12/CXCR4 pathway genes. Most individual SNPs were not significantly associated with breast cancer. After MDRER analysis, six significant SNPSNP interaction models with seven genes (highest crossvalidation consistency, 10; classification error rates, 41.321.0; and prediction error rates, 47.455.3) were identified. CD4 and VEGFA genes were associated in a 2loci interaction model (classification error rate, 41.3; prediction error rate, 47.5; odds ratio(OR), 2.069; 95% bootstrap CI, 1.402.90; P=1.71E04) and it also appeared in all the best 27loci models. When the loci number increased, the classification error rates and Pvalues decreased. The powers in 27loci in all models were >0.9. The minimum classification error rate of the MDRERgenerated model was shown with the 7loci interaction model (classification error rate, 21.0; OR=15.282; 95% bootstrap CI, 9.5423.87; P=4.03E31). In the epistasis network analysis, the overall effect with breast cancer susceptibility was identified and the SNP order of impact on breast cancer was identified as follows: CD4= VEGFA> KITLG> CXCL12> CCR7= MMP2> CXCR4. In conclusion, the MDRER can effectively and correctly identify the best SNPSNP interaction models in an imbalanced data set for breast cancer cases.


Tseng C.H.,China Medical University at Taichung | Muo C.H.,China Medical University at Taichung | Lin M.C.,hou University | Kao C.H.,China Medical University at Taichung
Medicine (United States) | Year: 2016

This study examines whether pelvic inflammatory disease (PID) facilitates the development of intracerebral hemorrhage (ICH). By using outpatient claims data from the National Health Insurance Research Database (NHIRD) of Taiwan, we included the data of 25,508 patients who were newly diagnosed with PID between 1999 and 2004, and also from the Taiwan NHIRD, we randomly selected 102,032 women without PID, who were frequency-matched by age and entryyear and with 4 times the number of the PID patients, as the control cohort. We measured ICH risks associated with PID and comorbidities, including hyperlipidemia, diabetes, hypertension, ischemic heart disease, and atrial fibrillation, by the end of 2011. In comparison with the controls, the ICH hazard was less in the PID group with an adjusted hazard ratio (aHR) of 0.67 (95% confidence interval [CI]:0.50-0.90), which was noted by calculation with the Cox proportional regression model. The ICH risk in the PID patients reduced progressively with the advance of age, with aHRs of 0.75 (95% CI:0.41-1.39) and 0.50 (95% CI:0.29-0.88), respectively, in the age<35-year and age 50-year groups. ICH risk lowered gradually with the progress of PID severity, from mild PID with an aHR of 0.72 (95% CI:0.53-0.98) to severe PID with that of 0.30 (95% CI:0.10-0.92). PID patients without any comorbidites had lower ICH risk (aHR1/40.63, 95% CI:0.42-0.94) than the controls without any comorbidites did. Our findings revealed that PID is associated with reduced ICH development, especially for older patients. © 2016 Wolters Kluwer Health, Inc.


Yang C.-H.,National Kaohsiung University of Applied Sciences | Lin Y.-D.,National Kaohsiung University of Applied Sciences | Chiang Y.-C.,National Kaohsiung University of Applied Sciences | Chuang L.-Y.,hou University
PLoS ONE | Year: 2016

Background: CpG islands have been demonstrated to influence local chromatin structures and simplify the regulation of gene activity. However, the accurate and rapid determination of CpG islands for whole DNA sequences remains experimentally and computationally challenging. Methodology/Principal Findings: A novel procedure is proposed to detect CpG islands by combining clustering technology with the sliding-window method (PSO-based). Clustering technology is used to detect the locations of all possible CpG islands and process the data, thus effectively obviating the need for the extensive and unnecessary processing of DNA fragments, and thus improving the efficiency of sliding-window based particle swarm optimization (PSO) search. This proposed approach, named ClusterPSO, provides versatile and highly-sensitive detection of CpG islands in the human genome. In addition, the detection efficiency of ClusterPSO is compared with eight CpG island detection methods in the human genome. Comparison of the detection efficiency for the CpG islands in human genome, including sensitivity, specificity, accuracy, performance coefficient (PC), and correlation coefficient (CC), ClusterPSO revealed superior detection ability among all of the test methods. Moreover, the combination of clustering technology and PSO method can successfully overcome their respective drawbacks while maintaining their advantages. Thus, clustering technology could be hybridized with the optimization algorithm method to optimize CpG island detection. Conclusion/Significance: The prediction accuracy of ClusterPSO was quite high, indicating the combination of CpGcluster and PSO has several advantages over CpGcluster and PSO alone. In addition, ClusterPSO significantly reduced implementation time. © 2016 Yang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Yang S.-Y.,Chi Mei Medical Center | Wu T.-H.,Chi Mei Medical Center | Wang M.-C.,Cancer Center | Chen F.-T.,Chi Mei Medical Center | Pan Y.-J.,hou University
Journal of Nursing and Healthcare Research | Year: 2015

Background: Poor quality of sleep is a common problem among female nurses due to the nature of nursing work. This situation may impact negatively on their physical and mental health and on their overall work performance. Purpose: This study was designed to explore the effect on the sleep quality of female nurses of sniffing essential lavender oil (lavender aromatherapy). Methods: This quasi‐experimental study was conducted at a regional hospital in southern Taiwan. A total of 100 qualified participants were randomly assigned to either the experimental group or the control group. The experimental group received lavender‐based aromatherapy for eight weeks (n = 48) and the control group received no intervention (n = 47). The main outcome indexes used the Pittsburgh Sleep Quality Index (PSQI) and heart rate variability (HRV). Results: After eight weeks of the Lavender‐Based Aromatherapy intervention, the differences between the PSQI pretest and posttest scores were statistically significant (p = .005) for the experimental group and not statistically significant (p = .052) for the control group. Furthermore, the control group registered significant pretest/posttest differences in terms of blood pressure, hear rate, heart rate variability (HRV), high frequency (HF), low frequency (LF), and LF/HF (p < .001). The lavender‐based aromatherapy intervention effectively improved the sleep quality of experimental‐group participants. The present study demonstrated that lavender inhalation may have a persistent and short‐term effect on HRV with an increase in parasympathetic modulation that results in improved sleep quality in female nurses. Conclusions / Implications for Practice: The present study supports the efficacy of lavender‐based aromatherapy, a safe and convenient intervention, in improving the sleep quality of nurses. Improving the sleep quality of professional nurses is a priority issue due to their variable shift‐work schedules and critical role in ensuring the delivery of effective, high‐quality public healthcare. © 2015, (publisher). All rights reserved.


Huang A.,Kaohsiung Chang Gung Memorial Hospital | Lin Y.-H.,hou University | Chang K.-C.,Kaohsiung Chang Gung Memorial Hospital | Huang S.,Kaohsiung Chang Gung Memorial Hospital | And 2 more authors.
Journal of Nursing and Healthcare Research | Year: 2015

Background: Discharge planning services have been shown to increase the quality of patient care and to help patients better handle care‐related issues. However, the literature related to patient readiness for discharge and its related factors is scarce. Purpose: This study was designed to explore the discharge readiness of patients with cerebrovascular disease (CVD) and the factors related to this readiness. Methods: Using a cross‐sectional study design, 304 CVD patients were recruited from a medical center in southern Taiwan. The structural questionnaire of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS‐C) was used to collect data. Results: A total of 91.4% participants reported at two‐weeks post‐discharge that they perceived at least a middle level of pre‐discharge preparation for discharge. The top three subscales scores for discharge readiness were: expected support, personal status, and coping ability. The regression model indicated that six predictors, including living alone, living with families after discharge, limb hemiplegia, Modified Rankin Scale score, Karn of sky level 0 to 2, and with tube in dwelling, contributed significantly to discharge readiness, accounting for 63.0% of the total variance. Conclusions / Implications for Practice: The results of the present study assist healthcare professionals to understand the predictors of discharge readiness. Healthcare providers should provide professional education and information to CVD patients and promote discharge readiness among their patients during admission and discharge assessment periods. The present study suggests that the self‐perceived discharge readiness of patients may be used to evaluate patient discharge readiness prior to discharge in order to ensure that patients are well prepared when they are eventually discharged. © 2015, (publisher). All rights reserved.


Li X.,hou University
ICCET 2010 - 2010 International Conference on Computer Engineering and Technology, Proceedings | Year: 2010

For avoiding the dependence of the validity of cl ustering on the space distribution of high dimensional sa mples of Fuzzy C2Means, a dynamic fuzzy clustering me thod based on artificial fish swarm algorithm was propo sed By introducing a fuzzy equivalence matrix to the sim ilar degree among samples, the high dimensional sample s were mapped to two dimensional planes. Then the Euc lidean distance of the samples was approximated to the f uzzy equivalence matrix gradually by using artificial fish warm algorithm to optimize the coordinate values. Final ly, the fuzzy clustering was obtained. The proposed meth od, not only avoided the dependence of the validity of clu stering on the space distribution of high dimensional sa mples, but also raised the clustering efficiency. Experime nt results show that it is an efficient clustering algorithm © 2010 IEEE.


Cheng C.-A.,hou University | Cheng H.-L.,hou University | Ku C.-W.,hou University | Chung T.-Y.,hou University
IEEE Transactions on Power Electronics | Year: 2014

High-intensity-discharge (HID) lamps are widely utilized in a variety of lighting circumstances that need high luminance. This paper proposes a single-stage electronic ballast for HID lamps; the ballast offers power factor correction and is acoustic resonance free. The presented HID lamp ballast integrates a discontinuous-conduction-mode (DCM)-operated bridgeless power factor correction (PFC) converter for shaping the input utility-line current with a high-frequency (36 kHz)/low-frequency (60 Hz) square-wave-driven half-bridge inverter for supplying low-frequency (60 Hz) square-wave sources to the HID lamp. The features of the proposed ballast are high power factor, low total harmonic distortion (THD) of the input current, cost effectiveness, and that it avoids acoustic resonance. The operational modes, key design guidelines, and a design example are included. A 70 W prototype HID lamp ballast circuit operating with 110 V-rms input utility-line voltage has been implemented and testified. The functionalities of the presented ballast are demonstrated by satisfactorily experimental results with a maximum efficiency of 90.8%, a maximum power factor of 0.998, and a minimum current THD of 11.13%. © 2013 IEEE.


Li C.-S.,hou University | Su S.-H.,hou University | Lin T.-M.,hou University | Chi H.-Y.,hou University | Yokoyama M.,hou University
INEC 2010 - 2010 3rd International Nanoelectronics Conference, Proceedings | Year: 2010

The external electron source is used to enhance the luminous efficiency of organic light-emitting diodes (OLEDs). Based on the electrons emission characteristics of carbon nanotubes (CNTs), an OLED combined with a CNTs template is proposed. Electrons emitted from the CNTs template impact the Al cathode layer of an OLED device and transport arriving at the emission layer. Balanced recombination of electrons and holes occurs in the OLED and the luminous efficiency can be enhanced by 50%. ©2010 IEEE.

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