Chang C.-C.,National Chiao Tung University |
Hsiao T.-C.,National Chiao Tung University |
Hsu H.-Y.,Chung Shan Medical University |
Hsu H.-Y.,Tungs Taichung Metro Harbor Hospital
Medical and Biological Engineering and Computing | Year: 2014
Heart rate variability (HRV) is a well-accepted indicator for neural regulatory mechanisms in cardiovascular circulation. Its spectrum analysis provides the powerful means of observing the modulation between sympathetic and parasympathetic nervous system. The timescale of HRV is limited by discrete beat-to-beat time intervals; therefore, the exploration region of frequency band of HRV spectrum is relatively narrow. It had been proved that pulse rate variability (PRV) is a surrogate measurement of HRV in most of the circumstances. Moreover, arterial pulse wave contains small oscillations resulting from complex regulation of cardiac pumping function and vascular tone at higher frequency range. This study proposed a novel instantaneous PRV (iPRV) measurement based on Hilbert-Huang transform. Fifteen healthy subjects participated in this study and received continuous blood pressure wave recording in supine and passive head-up tilt. The result showed that the very-high-frequency band (0.4-0.9 Hz) varied during head-up tilt and had strong correlation (r = 0.77) with high-frequency band and medium correlation (r = 0.643) with baroreflex sensitivity. The very-high-frequency band of iPRV helps for the exploration of non-stationary autoregulation and provides the non-stationary spectral evaluation of HRV without distortion or information loss. © 2014 International Federation for Medical and Biological Engineering.
Tung M.-C.,Tungs Taichung Metro Harbor Hospital |
Hsieh S.-C.,Chung Shan Medical University |
Yang S.-F.,Chung Shan Medical University |
Cheng C.-W.,Chung Shan Medical University |
And 3 more authors.
Prostate | Year: 2013
BACKGROUND Lipocalin-2 (LCN2) is a member of the lipocalin superfamily, and it has an important role in the regulation of cellular oncogenesis and apoptosis. However, the role for LCN2 in prostate cancer remains unclear. METHOD LCN2 expression has been determined by Western blotting, qRT-PCR, and immunohistochemistry in the human prostate cell lines PC3, DU145, LNCaP, and 22Rv, and in human prostate tissue array. In this study, we identified shRNA-LCN2 to determine the role of LCN2 in prostate-cancer cell proliferation, migration, and invasion. Cell proliferative ability was measured by MTT, colony-formation, and cell-cycle analysis. The role of LCN2 in prostate-cancer cell migration and invasion was analyzed by cell-migration assay and Matrigel invasion assay. The effect of LCN2 knockdown on prostate tumor growth was assessed in a subcutaneous xenograft model. RESULTS LCN2 protein and mRNA expression are higher in PC3 and DU145 cells than in LNCaP and 22Rv cells, and prostate cancer tissue correlated significantly with tumor differentiation (P < 0.017) and Gleason's grade (P < 0.02). LCN2 knockdown in PC3 and DU145 cells decreased cell proliferation, colony formation, cell cycle arrest, migration, and invasion. Conversely, LCN2 overexpression in 22Rv cells produced the opposite effect. Subcutaneous xenografts in mice models showed decreased tumor growth in the LCN2-knockdown mice. CONCLUSIONS Our results suggest that LCN2 might play an important role in regulation of proliferation and invasion of human prostate cancer, and that it can be a valuable marker of prostate cancer progression. Copyright © 2013 Wiley Periodicals, Inc.
Chao A.-C.,Kaohsiung Medical University |
Hsu H.-Y.,Tungs Taichung Metro Harbor Hospital |
Hsu H.-Y.,Chung Shan Medical University |
Chung C.-P.,Taipei Veterans General Hospital |
And 6 more authors.
Stroke | Year: 2010
BACKGROUND AND PURPOSE-: The safety and efficacy of alteplase for ischemic stroke has not been examined in Chinese patients. We assessed the safety and efficacy of alteplase for acute ischemic stroke in daily clinical practice in Taiwan. METHODS-: A prospective, multicenter, observational study was conducted in Taiwan from December 2004 to July 2008. Eligible patients (241) receiving alteplase were recruited and divided into 2 groups: standard dose (0.90±0.02 mg/kg, n=125) and lower dose (0.72±0.07 mg/kg, n=116). Primary outcome measures were safety: symptomatic intracerebral hemorrhage and death within 3 months. The secondary outcome measure was efficacy a modified Rankin scale of 0 to 2 after 3 months. RESULTS-: The standard-dose group had higher rates of symptomatic intracerebral hemorrhage using National Institute of Neurological Diseases and Stroke, European Cooperative Acute Stroke Study, and Safe Implementation of Thrombolysis in Stroke-Monitoring Study definitions (10.4% versus 5.2%, 8.0% versus 2.6%, and 5.6% versus 1.7%, respectively) and mortality within 3 months (12.8% versus 6.9%), twice that of the lower-dose group. This pattern was more prominent in older patients. Significantly higher rates of symptomatic intracerebral hemorrhage per European Cooperative Acute Stroke Study (15.4% versus 3.3%, P=0.0257) and mortality (21.1% versus 5.0%, P=0.0099) and significantly lower independence rate (32.6% versus 53.6%, P=0.0311) were observed among patients â‰170 years old receiving the standard dose than those receiving the lower dose. CONCLUSIONS-: This study suggests that the standard dose of 0.9 mg/kg alteplase may not be optimal for treating aged Chinese patients. However, the dose of recombinant tissue plasminogen activator for ischemic stroke in Chinese patients should be based on more broad and convincing evidences and randomized trials of lower versus higher doses are needed. © 2010 American Heart Association, Inc.
Yu H.-C.,Asia University, Taiwan |
Yu H.-C.,Tungs Taichung Metro Harbor Hospital |
Tsai W.-C.,China Medical University at Taichung |
Kung P.-T.,Asia University, Taiwan
Health Policy and Planning | Year: 2013
Objective The pay-for-performance (P4P) programme for diabetes care was implemented in Taiwan to promote holistic care for diabetic patients. This study investigated the effect of P4P on the need for emergency care for diabetic hypoglycaemia.Research design and methods The Taiwan National Health Insurance Research Database was used to gather nationwide data on patients with new-onset type 2 diabetes in 2001-09. Using the propensity score matching method, diabetes patients in the P4P programme and those not in P4P were matched, resulting in 199 626 people in each group. A Cox proportional hazards model was applied to analyse the risk of requiring emergency care for diabetic hypoglycaemia in P4P patients.Results A total of 5519 patients sought emergency care for diabetic hypoglycaemia. Of them, 2097 (1.97%) were enrolled in regular P4P treatment, 1671 (1.79%) were enrolled in P4P and irregular treatment, whereas 1751 (0.88%) were not. The Cox proportional hazards model revealed that the risk of seeking emergency care for diabetic hypoglycaemia was higher in P4P patients, with an hazard ratio of 1.90 (95% CI: 1.73-2.08) for regular treatment and 1.32 (95% CI: 1.20-1.45) for irregular treatment. Others with a higher risk of diabetic hypoglycaemia included those older than 25 years, those with lower salaries, those living in less urban areas, those with catastrophic illness and those with a higher comorbidity or higher diabetes complication. Those treated in a non-public hospital were at a higher risk of diabetic hypoglycaemia than those in a public hospital. Patients treated in the higher service volume hospital were at a higher risk as well. Emergency visits due to diabetic hypoglycaemia after P4P were significantly higher than those before P4P.Conclusion When treating P4P patients, special care should be taken to help them avoid diabetic hypoglycaemia severe enough to require emergency care. © The Author 2013; all rights reserved.
Chen L.-H.,National Cheng Kung University |
Ning C.-C.,Tungs Taichung Metro Harbor Hospital |
Chao S.-C.,National Cheng Kung University
British Journal of Dermatology | Year: 2010
The trichorhinophalangeal syndromes (TRPSs) are rare hereditary diseases with mainly autosomal dominant inheritance. Three different forms sharing similar clinical features with heterogeneous mutations have been identified: type I (TRPS I), type II (TRPS II) and type III (TRPS III). These syndromes have characteristic facial abnormalities such as sparse and slow-growing scalp hair, laterally sparse eyebrows, bulbous pear-shaped nose, elongated and flat philtrum, thin upper lip, and protruding ears. Various skeletal abnormalities are also frequently noted: short stature, shortening of the phalanges and metacarpals, cone-shaped epiphyses and Perthes-like change of the hips. 1-4 The TRPS1 gene was first identified in 2000 and mapped to 8q24.1.1 More than 50 mutations have been found in the gene to date. We here report mutation analysis of eight patients with the typical phenotype of TRPS I, revealing five novel mutations. © 2010 British Association of Dermatologists.
Chen C.-M.,Tungs Taichung Metro Harbor Hospital |
Huang M.,Show Chwan Memorial Hospital |
Chen H.-F.,China Medical University at Taichung |
Ke S.-C.,Tungs Taichung Metro Harbor Hospital |
And 3 more authors.
BMC Microbiology | Year: 2011
Abstract. Background: The prevalence of resistance to fusidic acid of methicillin-resistant Staphylococcus aureus (MRSA) was increased each year in a Taiwan hospital. Thirty-four MRSA clinical isolates collected in 2007 and 2008 with reduced susceptibility to FA were selected for further evaluation the presence of resistance determinants. Results: The most common resistance determinant was fusC, found in 25 of the 34 MRSA isolates. One of the 25 fusidic acid-resistant MRSA harboured both fusB and fusC, which is the first time this has been identified. Mutations in fusA were found in 10 strains, a total of 3 amino-acid substitutions in EF-G (fusA gene) were detected. Two substitutions with G556S and R659L were identified for the first time. Low-level resistance to fusidic acid (MICs, 32 g/ml) was found in most our collection. All collected isolates carried type III SCCmec elements. MLST showed the isolates were MRSA ST239. PFGE revealed nine different pulsotypes in one cluster. Conclusions: Our results indicate that the increase in the number of fusidic acid resistant among the MRSA isolates in this hospital is due mainly to the distribution of fusC determinants. Moreover, more than one fusidic acid-resistance mechanism was first detected in a same stain in our collection. © 2011 Chen et al; licensee BioMed Central Ltd.
Hu L.-W.,Tungs Taichung Metro Harbor Hospital |
Ho Y.-F.,Wei Gong Memorial Hospital |
Lin P.-C.,Taipei Medical University
Journal of Nursing and Healthcare Research | Year: 2012
Background: Nursing is a highly stressful job. Following a health-promoting lifestyle can assist nurses to reduce work stress and promote personal health. Purpose: The purpose of this study was to explore the health-promoting lifestyles of clinical nurses and related factors. Methods: We conducted a cross-sectional questionnaire survey on 297 nurses at a regional teaching hospital in central Taiwan. Results: Nurses gave themselves the highest scores on interpersonal support followed by self-actualization, stress management, nutrition, health responsibility, and exercise. Nurses who received more social support, had stronger self-efficacy, were happier, had more positive health conceptualization, and were more likely to have internal locus of control and authority outside control tended to follow a more health-promoting lifestyle. Self-efficacy, work shift, and age were significant predictors, explaining 48% of total health-promoting lifestyle variance. Conclusions/Implications for practice: Findings may provide a valuable reference for nurse administrators to create a health promotion culture in hospitals targeted to improve nurses' health.
Yue C.H.,Tungs Taichung Metro Harbor Hospital
The Chinese journal of physiology | Year: 2012
Recently, our research into hepatocellular carcinoma (HCC) has shown that the transcription factors Myeloid Zinc Finger-1 (MZF-1) and Ets-like-protein 1 are related to protein kinase C alpha (PKCα) expression. The purpose of this study was to determine the correlation of the expression of PKCαwith the expressions of Elk-1 and MZF-1 in various differentiated breast cancer cell lines: MDA- MB-231, Hs57BT, SKBR3, MDA-MB-468 and MCF-7. The malignant potential in the five lines of breast cancer cells was examined by using a cell proliferation/migration/invasion assay and the protein and mRNA levels of PKCα, ElK-1 and MZF-1 were examined by Western blot and RT-PCR analysis, re- spectively. The results showed that there were obvious signs of migration and invasion of cells in MDA- MB-231 and Hs57BT cells, little signs of cell migration and invasion in MDA-MB-468 cells, and no sign in SKBR3 and MCF-7 cells. Moreover, the highest expression levels of PKCα, Elk-1 and MZF-1 were also observed in MDA-MB-231 and Hs57BT cells when compared to the other breast cancer cell lines. These findings confirm that elevated expression of PKCαin breast cancer cells may be correlated with the potential of cell migration and invasion, and suggest an association between the expression of PKCα and the expression of the transcription factors Elk-1 and MZF-1.
Wang S.-A.,Tungs Taichung Metro Harbor Hospital
Journal of the Pakistan Medical Association | Year: 2015
Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma. © 2015, Pakistan Medical Association. All rights reserved.
Kuang-Ling O.U.,Tri Service General Hospital |
Tzeng Y.-S.,Tri Service General Hospital |
Chien-Chih Y.U.,Tungs Taichung Metro Harbor Hospital |
Chen T.-M.,Tri Service General Hospital
Microsurgery | Year: 2010
We report the case of a 46-year-old patient who suffered from huge tophus masses involving the metatarsal joints of the big toes of both feet, with infection and skin necrosis secondary to chronic tophaceous gout. After conventional curettage and debridement of each lesion, a free anterolateral thigh flap (ALTF) was used to resurface the circumferential wound, protect the underlying structures, and provide a gliding surface for the exposed tendons. The flap was safely raised and debulked during revision surgery, and excellent functional and cosmetic results were apparent at the 2-year follow-up. We consider ALTF to be a valuable option for the coverage of necrotic skin over tophi after adequate debridement. © 2009 Wiley-Liss, Inc.