Sinlau Christian Hospital

Tainan, Taiwan

Sinlau Christian Hospital

Tainan, Taiwan

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Chiu H.-W.,National Cheng Kung University | Fang W.-H.,National Cheng Kung University | Chen Y.-L.,Food Industry Research and Development Institute | Wu M.-D.,Food Industry Research and Development Institute | And 3 more authors.
PLoS ONE | Year: 2012

Prostate cancer is a very common cancer among males. Traditional treatments for prostate cancer have limited efficacy; therefore, new therapeutic strategies and/or new adjuvant drugs must be explored. Red yeast rice (RYR) is a traditional food spice made in Asia by fermenting white rice with Monascus purpureus Went yeast. Accumulating evidence indicates that RYR has antitumor activity. In this study, PC-3 cells (human prostate cancer cells) were used to investigate the anti-cancer effects of ionizing radiation (IR) combined with monascuspiloin (MP, a yellow pigment isolated from Monascus pilosus M93-fermented rice) and to determine the underlying mechanisms of these effects in vitro and in vivo. We found that IR combined with MP showed increased therapeutic efficacy when compared with either treatment alone in PC-3 cells. In addition, the combined treatment enhanced DNA damage and endoplasmic reticulum (ER) stress. The combined treatment induced primarily autophagy in PC-3 cells, and the cell death that was induced by the combined treatment was chiefly the result of inhibition of the Akt/mTOR signaling pathways. In an in vivo study, the combination treatment showed greater anti-tumor growth effects. These novel findings suggest that the combined treatment could be a potential therapeutic strategy for prostate cancer. © 2012 Chiu et al.


Chang L.,I - Shou University | Chui C.-S.,Koo Foundation Sun Yat Sen Cancer Center | Ding H.-J.,I - Shou University | Hwang I.-M.,Kaohsiung Medical University | Ho S.-Y.,Sinlau Christian Hospital
Physics in Medicine and Biology | Year: 2012

The EBT2 film together with a flatbed scanner is a convenient dosimetry QA tool for verification of clinical radiotherapy treatments. However, it suffers from a relatively high degree of uncertainty and a tedious film calibration process for every new lot of films, including cutting the films into several small pieces, exposing with different doses, restoring them back and selecting theproper region of interest (ROI) for each piece for curve fitting. In this work, we present a percentage depth dose (PDD) method that can accurately calibrate the EBT2 film together with the scanner non-uniformity correction and provide an easy way to perform film dosimetry. All films were scanned before and after the irradiation in one of the two homemade 2mm thick acrylic frames (one portrait and the other landscape), which was located at a fixed position on the scan bed of an Epson 10000XL scanner. After the pre-irradiated scan, the film was placed parallel to the beam central axis and sandwiched between six polystyrene plates (5cm thick each), followed by irradiation of a 20×20cm 26 MV photon beam. Two different beams on times were used on two different films to deliver a dose to the film ranging from 32 to 320 cGy. After the post-irradiated scan, the net optical densities for a total of 235 points on the beam central axis on the films were auto-extracted and compared with the corresponding depth doses that were calculated through the measurement of a 0.6 cc farmer chamber and the related PDD table to perform the curve fitting. The portrait film location was selected for routine calibration, since the central beam axis on the film is parallel to the scanning direction, where non-uniformity correction is not needed (Ferreira et al 2009 Phys. Med. Biol. 54 1073-85). To perform the scanner non-uniformity calibration, the cross-beam profiles of the film were analysed by referencing the measured profiles from a Profiler™. Finally, to verify our method, the films were exposed to 60° physical wedge fields and the compositive fields, and their relative dose profiles were compared with those from the water phantom measurement. The fitting uncertainty was less than 0.5% due to the many calibration points, and the overall calibration uncertainty was within 3% for doses above 50 cGy, when the average of four films were used for the calibration. According to our study, the non-uniformity calibration factor was found to be independent of the given dose for the EBT2 film and the relative dose differences between the profiles measured by the film and the Profiler were within 1.5% after applying the non-uniformity correction. For the verification tests, the relative dose differences between the measurements by films and in the water phantom, when the average of three films were used, were generally within 3% for the 60° wedge fields and compositive fields, respectively. In conclusion, our method is convenient, time-saving and cost-effective, since no film cutting is needed and only two films with two exposures are needed. © 2012 Institute of Physics and Engineering in Medicine.


Chiu H.-W.,National Cheng Kung University | Lin J.-H.,National Cheng Kung University | Chen Y.-A.,National Cheng Kung University | Ho S.-Y.,Sinlau Christian Hospital | Wang Y.-J.,National Cheng Kung University
Autophagy | Year: 2010

The traditional treatments for fibrosarcoma have limited efficacy. Therefore, new therapeutic strategies and/or new adjuvant drugs still need to be explored. Accumulating evidence indicates that programmed cell death (PCD) is closely related to anticancer therapy. Many studies have shown that tumor cells treated with anticancer drugs experience the induction of type I PCD, apoptosis, and type II PCD, autophagy. In the present study, we investigated the anticancer effects of ionizing radiation (IR) combined with arsenic trioxide (ATO) in human fibrosarcoma cells in vitro and in xenograft tumors in SCID mice in vivo. We found that IR increased the population of HT1080 cells in the G 2/M phase in a time-dependent manner within 9 h. IR treatment combined with ATO at this time point induced a significantly prolonged G 2/M arrest and consequently enhanced cell death. Furthermore, damage of mitochondria membrane potential could be involved in the underlying mechanisms. The enhanced cytotoxic effect of combined treatment occurred due to the increased induction of more autophagy and apoptosis through the inhibition of Akt and the activation of ERK1/2 signaling pathways in HT1080 cells. The combined treatment of HT1080 cells pretreated with Z-VAD or 3-MA resulted in a significant reduction in AO-positive cells, apoptotic cells and cytotoxicity. In in vivo studies, the combination of IR and ATO significantly reduced the tumor volume in SCID mice that had received a subcutaneous injection of HT1080 cells. The data suggest that a combination of IR and ATO could be a new potential therapeutic strategy for the treatment of fibrosarcoma. © 2010 Landes Bioscience.


Chiu H.-W.,National Cheng Kung University | Lin W.,National Cheng Kung University | Ho S.-Y.,Sinlau Christian Hospital | Wang Y.-J.,National Cheng Kung University
Radiation Research | Year: 2011

Osteosarcoma is the most common primary malignant bone tumor, occurring mainly in children and adolescents, and survival largely depends on their response to chemotherapy. However, the risk of relapse and adverse outcomes is still high. We investigated the synergistic anti-cancer effects of ionizing radiation combined with arsenic trioxide (ATO) and the mechanisms underlying apoptosis or autophagy induced by combined radiation and ATO treatment in human osteosarcoma cells. We found that exposure to radiation increased the population of HOS cells in the G2/M phase within 12 h in a time-dependent manner. Radiation combined with ATO induced a significantly prolonged G2/M arrest, consequently enhancing cell death. Furthermore, combined treatment resulted in enhanced ROS generation compared to treatment with ATO or radiation alone. The enhanced cytotoxic effect of combined treatment occurred from the increased induction of autophagy and apoptosis through inhibition of the PI3K/Akt signaling pathway in HOS cells. The combined treatment of HOS cells pretreated with Z-VAD, 3-MA or PEG-catalase resulted in a significant reduction of cytotoxicity. In addition, G2/M arrest and ROS generation could be involved in the underlying mechanisms. The data suggest that a combination of radiation and ATO could be a new potential therapeutic strategy for the treatment of osteosarcoma. © 2011 by Radiation Research Society.


Chiu H.-W.,National Cheng Kung University | Chen Y.-A.,National Cheng Kung University | Ho S.-Y.,Sinlau Christian Hospital | Wang Y.-J.,National Cheng Kung University
PLoS ONE | Year: 2012

Prostate cancer is the most common malignancy in men. In the present study, LNCaP (androgen-sensitive human prostate cancer cells) and PC-3 cells (androgen-independent human prostate cancer cells) were used to investigate the anti-cancer effects of ionizing radiation (IR) combined with arsenic trioxide (ATO) and to determine the underlying mechanisms in vitro and in vivo. We found that IR combined with ATO increases the therapeutic efficacy compared to individual treatments in LNCaP and PC-3 human prostate cancer cells. In addition, combined treatment showed enhanced reactive oxygen species (ROS) generation compared to treatment with ATO or IR alone in PC-3 cells. Combined treatment induced autophagy and apoptosis in LNCaP cells, and mainly induced autophagy in PC-3 cells. The cell death that was induced by the combined treatment was primarily the result of inhibition of the Akt/mTOR signaling pathways. Furthermore, we found that the combined treatment of cells pre-treated with 3-MA resulted in a significant change in AO-positive cells and cytotoxicity. In an in vivo study, the combination treatment had anti-tumor growth effects. These novel findings suggest that combined treatment is a potential therapeutic strategy not only for androgen-dependent prostate cancer but also for androgen-independent prostate cancer. © 2012 Chiu et al.


Chen P.-Y.,Sinlau Christian Hospital | Chen P.-Y.,National Cheng Kung University | Chen H.H.W.,National Cheng Kung University | Hsiao J.-R.,National Cheng Kung University | And 5 more authors.
Oral Oncology | Year: 2012

Objectives: We compared the outcomes and survival rates of patients with oral cavity squamous cell carcinoma receiving postoperative conventional radiotherapy (RT) or intensity-modulated radiotherapy (IMRT). Materials and methods: From January 2005 to September 2008, medical records of 131 consecutive patients with oral cancer receiving postoperative radiotherapy in the Department of Radiation Oncology of National Cheng Kung University Hospital were reviewed. Patients were divided into two groups according to the administration of postoperative conventional RT or IMRT. The loco-regional control, survival, and other prognostic factors were compared. Results: The 3-year Kaplan-Meier estimates of overall survival for patients receiving conventional RT and IMRT groups were 51.2% vs. 69.4% (p = 0.079), respectively. The 3-year local-regional control (53.5% vs. 76.3%; p = 0.020) and disease-free survival rates (47.8% vs. 70.0%; p = 0.027) were significantly increased in the IMRT group. This retrospective study also identified that extracapsular spreading, margin positive/close (≤2 mm), more advanced T stage (T3-4 vs. T1-2), and conventional RT method were associated with worse prognosis. Conclusions: The addition of chemotherapy to adjuvant radiotherapy is recommended in patients with above risk factors. Our result underscores that IMRT should be considered to apply to OSCC patients referred for postoperative treatment. © 2012 Elsevier Ltd. All rights reserved.


Chang L.,I - Shou University | Ho S.-Y.,Chi Mei Medical Center | Lee T.-F.,National Kaohsiung University of Applied Sciences | Yeh S.-A.,I - Shou University | And 3 more authors.
Nuclear Instruments and Methods in Physics Research, Section A: Accelerators, Spectrometers, Detectors and Associated Equipment | Year: 2015

EBT2 film is a convenient dosimetry quality-assurance (QA) tool with high 2D dosimetry resolution and a self-development property for use in verifications of radiation therapy treatment planning and special projects; however, the user will suffer from a relatively higher degree of uncertainty (more than ±6% by Hartmann et al. [29]), and the trouble of cutting one piece of film into small pieces and then reintegrating them each time. To prevent this tedious cutting work, and save calibration time and budget, a dose range analysis is presented in this study for EBT2 film calibration using the Percentage-Depth-Dose (PDD) method. Different combinations of the three dose ranges, 9-26 cGy, 33-97 cGy and 109-320 cGy, with two types of curve fitting algorithms, film pixel values and net optical densities converting into doses, were tested and compared. With the lowest error and acceptable inaccuracy of less than 3 cGy for the clinical dose range (9-320 cGy), a single film calibrated by the net optical density algorithm with the dose range 109-320 cGy was suggested for routine calibration. © 2014 Elsevier B.V. All rights reserved.


Chang L.,I - Shou University | Ho S.-Y.,Chi Mei Medical Center | Ding H.-J.,I - Shou University | Lee T.-F.,National Kaohsiung University of Applied Sciences | Chen P.-Y.,Sinlau Christian Hospital
Medical Physics | Year: 2014

Purpose: The Ashland Inc. product EBT2 film model is a widely used quality assurance tool, especially for verification of 2-dimensional dose distributions. In general, the calibration film and the dose measurement film are irradiated, scanned, and calibrated at the same postirradiation time (PIT), 1-2 days after the films are irradiated. However, for a busy clinic or in some special situations, the PIT for the dose measurement film may be different from that of the calibration film. In this case, the measured dose will be incorrect. This paper proposed a film calibration method that includes the effect of PIT. Methods: The dose versus film optical density was fitted to a power function with three parameters. One of these parameters was PIT dependent, while the other two were found to be almost constant with a standard deviation of the mean less than 4%. The PIT-dependent parameter was fitted to another power function of PIT. The EBT2 film model was calibrated using the PDD method with 14 different PITs ranging from 1 h to 2 months. Ten of the fourteen PITs were used for finding the fitting parameters, and the other four were used for testing the model. Results: The verification test shows that the differences between the delivered doses and the film doses calculated with this modeling were mainly within 2% for delivered doses above 60 cGy, and the total uncertainties were generally under 5%. The errors and total uncertainties of film dose calculation were independent of the PIT using the proposed calibration procedure. However, the fitting uncertainty increased with decreasing dose or PIT, but stayed below 1.3% for this study. Conclusions: The EBT2 film dose can be modeled as a function of PIT. For the ease of routine calibration, five PITs were suggested to be used. It is recommended that two PITs be located in the fast developing period (1∼6 h), one in 1 ∼ 2 days, one around a week, and one around a month. © 2014 American Association of Physicists in Medicine.


Chen M.-Y.,Sinlau Christian Hospital | Chen M.-J.,Fooyin University | Lee P.-F.,Fooyin University | Cheng L.-H.,Fooyin University | And 3 more authors.
Biochemical Engineering Journal | Year: 2010

A real-time quartz crystal microbalance (QCM) technique was employed to monitor early formation of Pseudomonas fluorescens biofilms. To better understand the dynamic process of conditioning film and early biofilm formation, all experiments were conducted in a laminar flow-through chamber under various environmental conditions. Prior to early biofilm formation, a conditioning film comprising organic, inorganic and macromolecular substances was detected over the sensor chip surface within an extremely short duration due to their instantaneous adsorption. Based on atomic force microscopy (AFM) observations, we identified different surface features associated with various conditioning films, demonstrating that the sensor chip surface displayed complex properties in terms of surface topography, roughness, water contact angle, and conditioning film chemistry. There appeared to be a lag time before early biofilm formation. The rate of early biofilm formation was found to differ considerably, depending upon the characteristics of conditioning films and environmental conditions. However, subsequent biofilm formation could be mediated by environmental conditions, reflecting the complex and dynamic process of biofilm development. Of particular interest was the direct in situ real-time observation of the overall sequence of biofilm development processes using a QCM, starting with conditioning film formation, followed by initial bacterial adhesion and subsequently by biofilm formation. © 2010 Elsevier B.V.


Chang L.,I - Shou University | Ding H.-J.,I - Shou University | Ho S.-Y.,Sinlau Christian Hospital
Nuclear Instruments and Methods in Physics Research, Section A: Accelerators, Spectrometers, Detectors and Associated Equipment | Year: 2011

A simple, practical and economical technique was proposed to calibrate an 192Ir HDR brachytherapy source in terms of air kerma strength. This technique makes use of the 0.6 cm3 Farmer type ion chamber, radiographic film and polystyrene phantom. These tools are commonly used for dosimetry quality assurance of the clinical linear accelerator. In this study, the Exradin A19, PTW N30004 and TM30001 Farmer type ion chambers were used for the calibration of the 192Ir HDR source. To perform the calibration, a 25.4×30.5 cm2 radiographic film was taped on a piece of polystyrene plate, and a straight applicator probe of a HDR brachytherapy unit and the Farmer type ion chamber were affixed to the film envelope. The film was irradiated by the 192Ir source, followed by an exposure in the simulator X-ray beam. The film set with the film removed was then placed on a 5 cm thick polystyrene phantom for calibration measurement. Based on the electrometer reading from the Farmer type ion chamber irradiated by 192Ir and the measured source-to-chamber distance by means of the images on the developed film, we can calculate the air kerma strength of the 192Ir using the new technique. Our calibration results were compared to the data provided by the manufacturer and that of five different well type ion chambers, namely, Sun Nuclear cooperation (SNC) 1008, Nucletron SDS 077.091, SDS 077.094, PTW TN33004 and Standard Imaging (SI) HDR-1000 Plus. The differences were all within 1.6%. Relative to the 7-distance measurement technique by Stump et al., 2002, our method is more efficient if our empirical formula was used. In summary, our method is simpler and cost-effective to calibrate an 192Ir HDR brachytherapy source for those hospitals without a calibration jig or a well type ion chamber. © 2011 Elsevier B.V. All rights reserved.

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