Taipei, Taiwan
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Kao T.M.,National Taiwan University Hospital | Hsieh S.M.,National Taiwan University Hospital | Kung H.C.,National Taiwan University Hospital | Lee Y.C.,National Taiwan University Hospital | And 9 more authors.
Vaccine | Year: 2010

We conducted a multi-center, randomized and laboratory-blinded clinical trial with subgroup analyses, involving adults aged greater than 60 years old (range 61-86 years old), to investigate the immunogenicity and the potential factors affecting the immune response of a monovalent, unadjuvanted, inactivated, split-virus vaccine. A total of 107 subjects were randomized to receive 15 and 30μg of hemagglutinin antigen in a 1:1 ratio. The immunogenicity was detected through hemagglutination inhibition (HAI) test of serum obtained before and 3 weeks after vaccination. By 3 weeks after vaccination, HAI titer ≥1:40 was observed in 75.5% and 81.1% of participants receiving 15 and 30μg of hemagglutinin antigen, respectively. Positive seroconversion was observed in 71.7% and 81.1% of recipients of the 15 and the 30μg, respectively. The GMTs increased by a factor of 10.7 and 17.4 in the groups of 15 and 30μg, respectively. This study indicated that one dose of 15μg hemagglutinin antigen without adjuvant induced protective immune response in the majority of elderly. Multivariate logistic regression analyses showed that gender, age and diabetes were statistically significant factors affecting the seroprotection rate (p=0.04, 0.01 and 0.01, respectively) and seroconversion rate (p=0.01, 0.01 and 0.01, respectively). © 2010 Elsevier Ltd.

Ko W.-C.,Taipei Medical University | Ko W.-C.,Cathay General Hospital | Hong C.-Y.,Taipei Medical University | Hong C.-Y.,Wang Fang Hospital | And 7 more authors.
Circulation Journal | Year: 2011

Background: Atrial fibrosis is a feature of structural remodeling in atrial fibrillation (AF). Connective tissue growth factor (CTGF) is a potent profibrotic factor, but its role of CTGF in AF is not yet fully understood. Methods and Results: Right atrial appendages were obtained from 20 patients who underwent cardiac surgery (10 with sinus rhythm, 10 with AF). The mRNA level, protein level and immunohistochemical staining of CTGF were significantly increased in AF patients. In a porcine AF model, tissue angiotensin II (Ang II) and CTGF levels were significantly upregulated in both atria. In perfused rat hearts, Ang II stimulation increased CTGF expression, which could be inhibited by Ang II type I receptor antagonist. In a cell culture system, both atrial fibroblasts and myocytes were responsible for the increased CTGF expression under Ang II treatment. Ang II type I receptor antagonist could inhibit the Ang II-induced CTGF expression. Treating with recombinant CTGF, atrial fibroblasts expressed an increased level of collagen I. Furthermore, the CTGF level was highly correlated with tissue Ang II content in AF pigs. Conclusions: AF patients and animals exhibited a significantly increased expression of CTGF. Ang II stimulation upregulated CTGF expression in both atrial fibroblasts and myocytes. Ang II-induced CTGF expression might be involved in atrial substrate remodeling.

Kung H.-C.,National Taiwan University Hospital | Huang K.-C.,National Taiwan University Hospital | Kao T.-M.,National Taiwan University Hospital | Lee Y.-C.,National Taiwan University Hospital | And 9 more authors.
Vaccine | Year: 2010

We conducted a multi-center, randomized, laboratory-blinded clinical trial in 185 healthy adults (<60 years) and 107 elders (>60 years) to examine the immunogenicity and safety of different doses of an inactivated, monovalent, non-adjuvanted, split vaccine against the 2009 pandemic influenza A (H1N1) virus. The 186 adults were assigned to three treatment groups, i.e., one 15μg hemagglutination (HA) antigen dose, two 15μg or 30μg HA doses in 3 weeks apart, and the 107 elders were treated with two 15μg or 30μg doses in 3 weeks apart. Prior to the vaccination, 4.8% subjects had hemagglutination-inhibition (HAI) antibody titers of 1:40 or more. By day 21 post-vaccination of one dose of 15μg HA, the seroprotective rate was 95.1% and 75.5% in subjects <60 and >65 years of age, respectively; by day 21 post the second 15μg HA dose, the seroprotective rates were 93.2% and 73.1%, respectively. The seroprotective rates for recipients of 30μg HA antigen by day 21 were 95.2% for subjects <60 years and 81.1% for subjects >65 years of age, that was boosted to 98.3% and 80.4%, respectively with a second dose of 30μg HA antigen. No vaccine-related serious adverse events occurred. The data indicated a single 15μg HA dose of the vaccine induced a protective immune response in most adults, including the elders >60 years of age, and a booster dose at the third week did not render a higher level of antibody response. © 2010 Elsevier Ltd.

Huang Y.-F.,Taichung Veterans General Hospital | Yen C.-M.,Taichung Veterans General Hospital | Shen C.-C.,Taichung Veterans General Hospital | Shen C.-C.,National Yang Ming University | And 4 more authors.
Journal of Medical Sciences (Taiwan) | Year: 2014

This paper describes the use of CyberKnife radiosurgery in the treatment of accidentally found cervical spinal arteriovenous malformation (AVM). We present the case of a patient with cervical spinal AVM, who developed progressive neck pain, gait disturbance, urine and stool incontinence 2 weeks after the fell down accident. The patient underwent CyberKnife radiosurgery. After CyberKnife radiosurgery for 2 years, the patient’s neck pain diminished and was able to keep the walk without any assistance. The management of cervical spinal AVM varies. This patient demonstrated a successful treatment of cervical spinal AVM with CyberKnife radiosurgery. © 2014 JMS.

Wang W.-T.,National Chengchi University | Tu P.-C.,National Chengchi University | Liu T.-J.,Wang Fang Hospital | Yeh D.-C.,Taichung Veterans General Hospital | Hsu W.-Y.,National Chengchi University
Psycho-Oncology | Year: 2013

Objective The aim of this study is twofold. First, it aims to determine the factor structure of the Mini-Mental Adjustment to Cancer (Mini-MAC) Scale by using confirmatory factor analysis (CFA) to compare the three-factor, four-factor, and five-factor structures among 340 Taiwanese breast cancer patients. Second, it aims to test the difference in the correlations of coping strategies and the outcome measures between two populations: one-month newly diagnosed and five-year long-term survival patients. Methods Two samples, composed of 142 newly diagnosed and 198 long-term survival breast cancer patients, were recruited. Cancer-specific coping and distress were assessed via the Mini-MAC Scale and the Hospital Anxiety and Depression Scale (HADS), respectively. Results The CFA confirmed Watson's original five-factor structure fit the data best. The correlation difference between the two samples lies in the fighting spirit (FS), which correlated negatively with distress among the newly diagnosed sample but had no correlation among the long-term survivors. Moreover, fatalism (FA) was found to correlate positively with distress. Conclusions The five-factor structure represents a more psychometrically sound measure of psychological adjustment in the current data set. The findings also support the argument that the relationships between coping and distress vary, to some degree, at different phases in the cancer trajectory. FS is only a positive predictor of psychological adjustment among newly diagnosed patients. Because of the exclusion of two items, FA showed a positive correlation with distress, a result that contradicts previous findings. Further theoretical and practical implications for FS and FA are discussed.Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.

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