Risks of cervical intraepithelial neoplasia grade 3 or invasive cancers in ASCUS women with different management: a population-based cohort study

Yi-Jou Tai,Yun-Yuan Chen,Huang-Cheng Hsu,Chun-Ju Chiang,San-Lin You,Chi-An Chen,Wen-Fang Cheng,Taiwan Cervical Cancer Control Task Force 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.4

OBJECTIVE: To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. METHODS: Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). RESULTS: There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). CONCLUSION: In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.

Pathophysiological Mechanisms Underlying Unilateral Vocal Fold Paralysis in Female Patients: An Ultrasonographic Study

Yi-An Lu,Tuan-Jen Fang,Yu-Cheng Pei,Yun-Chen Tsai,Wan-Ni Lin 대한이비인후과학회 2023 Clinical and Experimental Otorhinolaryngology Vol.16 No.4

Objectives. Laryngeal ultrasonography (LUS) has been suggested as an alternative diagnostic tool for unilateral vocal foldparalysis (UVFP). The present study applied LUS and quantitative laryngeal electromyography (LEMG) in female UVFPpatients to investigate the pathophysiologic mechanisms of UVFP. Methods. In this cross-sectional study, vocal fold (VF) length parameters included resting and phonating VF length measuredusing B-mode LUS, and color Doppler vibrating length (CDVL) measured using the color Doppler mode. Results. Forty female patients with UVFP were enrolled, among whom 11 and 29 were assigned to the thyroarytenoid (TA)muscle+cricothyroid (CT) muscle group (with CT involvement) and the TA (without CT involvement) group, respec-tively. In the TA group, the turn frequency in thyroarytenoid-lateral cricoarytenoid (TA-LCA) on the paralyzed side,as observed through LEMG, correlated with the VF length during the resting phase (R =0.368, P =0.050) and CDVLvalues (R =0.627, P =0.000) on the paralyzed side. In the TA+CT group, the turn ratio in the CT muscle correlatedwith the normalized phonatory vocal length change (nPLC; R =0.621, P =0.041) on the paralyzed side. Conclusion. CDVL and nPLC are two parameters that can be utilized to predict the turn frequencies of TA-LCA in UVFPcases without CT involvement, and the turn ratio of CT in cases of UVFP with CT involvement, respectively. The find-ings suggest that LUS, as a noninvasive tool, can serve as an alternative method for assessing the severity of laryngealnerve injury and offer valuable insights into the pathophysiology of UVFP.

Acute Hepatitis Due to Agomelatine Use in Elderly Women with Depression: Case Series

Cheng-Chen Chang,Yen-Jen Chen,Yu-An Chen,Yi-Cheng Liao 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.4

Although agomelatine may be associated with an increased risk of hepatotoxicity, the incidence rate of acute hepatitis seemed divergent between clinical trials and daily practice. Whether aging or gender is a risk factor in developing hepatotoxicity due to agomelatine is not clear. We present 3 older female cases with acute hepatitis occurring due to highly probable idiosyncratic drug-induced liver injury caused by agomelatine. From these cases, regular surveillance on liver function in the older women taking antidepressants would be of benefits.

Reinforcing Techniques and Property Evaluations of Electromagnetic Shielding Effective Fabrics Based on Polypropylene-coated Carbon Fibers

Jan-Yi Lin,Mei-Chen Lin,Yan-Yu Lin,Ting An Lin,Chen-Hung Huang,Ching-Wen Lou,Jia-Horng Lin 한국섬유공학회 2021 Fibers and polymers Vol.22 No.3

In this study, the coating process is employed on metal wire to help improve the friction resistant property ofcarbon fibers, thereby provides more application feasibility. The yarn coating technique for reinforcement and woven fabricprocess are used to produce carbon/stainless steel/polyester/polypropylene/acrylic (CSPPA) woven fabrics that arecharacterized with softness and a light weight. The constituent coated yarns exhibit good conductivity after being coated witha PP layer, and likewise strengthen the woven fabrics in terms of mechanical behavior of tensile strength, elongation, bendingtorsion, creep resistance, and wear-resistant properties. The test results indicate that in the woven process, samples retaingood morphology. Due to PP sheath, the tensile strength of woven fabrics increases from 23 MPa to 42 MPa. Although thelamination layer numbers does not improve the EMI SE of woven fabrics, the EMI SE still reaches over 40 dB. Themanufacturing design proposed in this study provides an innovative finishing for carbon fibers without affecting the intrinsicproperties, and provides a greater range of application for carbon fibers.

Association between Higher Blood Pressure and Risk of Diabetes Mellitus in Middle-Aged and Elderly Chinese Adults

Xue Yang,Jian Chen,An Pan,Jason H.Y. Wu,Fei Zhao,Yue Xie,Yi Wang,Yi Ye,Xiong-Fei Pan,Chun-Xia Yang 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.3

Background: To examine the prospective association between higher blood pressure (BP) and risk of type 2 diabetes mellitus (T2DM) in middle-aged and elderly Chinese adults. Methods: A total of 9,642 middle-aged and elderly Chinese adults (≥45 years old; 47.30% men) without diabetes from the China Health and Retirement Longitudinal Study were included for analyses. Participants were categorized into three groups: normal BP, prehypertension, and hypertension, according to the 2010 Chinese Guidelines for the Management of Hypertension. The incidence of T2DM was determined by self-reported physician diagnosis during two follow-up surveys conducted in 2013 to 2014 and 2015 to 2016. Results: During the 4-year follow-up, 429 participants (4.45%) developed T2DM, including 3.51% of the men and 5.29% of the women. The incidence rates of T2DM were 2.57%, 3.75%, and 6.71% in the normal BP, prehypertension, and hypertension groups, respectively. After adjustment for age, sex, education level, residence, smoking status, alcohol consumption, body mass index, waist circumference, and dyslipidemia, both prehypertension (odds ratio [OR], 1.32; 95% confidence interval [CI], 0.98 to 1.77) and hypertension (OR, 2.02; 95% CI, 1.54 to 2.64) were associated with increased risk of T2DM, compared to those with a normal BP. The ORs associated with T2DM were 1.08 (95% CI, 1.03 to 1.13) for an increase of 10 mm Hg in systolic BP and 1.06 (95% CI, 1.01 to 1.10) for an increase of 5 mm Hg in diastolic BP. Conclusion: Higher BP is a risk factor for T2DM in middle-aged and elderly Chines. It may be a potential target for diabetes prevention.

Large displacement analysis of inelastic frame structures by convected material frame approach

Chiou, Yaw-Jeng,Wang, Yeon-Kang,Hsiao, Pang-An,Chen, Yi-Lung Techno-Press 2002 Structural Engineering and Mechanics, An Int'l Jou Vol.13 No.2

This paper presents the convected material frame approach to study the nonlinear behavior of inelastic frame structures. The convected material frame approach is a modification of the co-rotational approximation by incorporating an adaptive convected material frame in the basic definition of the displacement vector and strain tensor. In the formulation, each discrete element is associated with a local coordinate system that rotates and translates with the element. For each load increment, the corresponding strain-displacement and nodal force-stress relationships are defined in the updated local coordinates, and based on the updated element geometry. The rigid body motion and deformation displacements are decoupled for each increment. This modified approach incorporates the geometrical nonlinearities through the continuous updating of the material frame geometry. A generalized nonlinear function is used to derive the inelastic constitutive relation and the kinematic hardening is considered. The equation of motion is integrated by an explicit procedure and it involves only vector assemblage and vector storage in the analysis by assuming a lumped mass matrix of diagonal form. Several numerical examples are demonstrated in close agreement with the solutions obtained by the ANSYS code. Numerical studies show that the proposed approach is capable of investigating large deflection of inelastic planar structures and providing an excellent numerical performance.

Vertical equipment isolation using piezoelectric inertial-type isolation system

Lyan-Ywan Lu,Ging-Long Lin,Yi-Siang Chen,Kun-An Hsiao 국제구조공학회 2020 Smart Structures and Systems, An International Jou Vol.26 No.2

Among anti-seismic technologies, base isolation is a very effective means of mitigating damage to structural and nonstructural components, such as equipment. However, most seismic isolation systems are designed for mitigating only horizontal seismic responses because the realization of a vertical isolation system (VIS) is difficult. The difficulty is primarily due to conflicting isolation stiffness demands in the static and dynamic states for a VIS, which requires sufficient rigidity to support the self-weight of the isolated object in the static state, but sufficient flexibility to lengthen the isolation period and uncouple the ground motion in the dynamic state. To overcome this problem, a semi-active VIS, called the piezoelectric inertia-type vertical isolation system (PIVIS), is proposed in this study. PIVIS is composed of a piezoelectric friction damper (PFD) and a leverage mechanism with a counterweight. The counterweight provides an uplifting force in the static state and an extra inertial force in the dynamic state; therefore, the effective vertical stiffness of PIVIS is higher in the static state and lower in the dynamic state. The PFD provides a controllable friction force for PIVIS to further prevent its excessive displacement. For experimental verification, a shaking table test was conducted on a prototype PIVIS controlled by a simple controller. The experimental results well agree with the theoretical results. To further investigate the isolation performance of PIVIS, the seismic responses of PIVIS were simulated numerically by considering 14 vertical ground motions with different characteristics. The responses of PIVIS were compared with those of a traditional VIS and a passive system (PIVIS without control). The numerical results demonstrate that compared with the traditional and passive systems, PIVIS can effectively suppress isolation displacement in all kinds of earthquake with various peak ground accelerations and frequency content while maintaining its isolation efficiency. The proposed system is particularly effective for nearfault earthquakes with long-period components, for which it prevents resonant-like motion.

Treatment outcomes of patients with stage II pure endometrioid-type endometrial cancer: a Taiwanese Gynecologic Oncology Group (TGOG-2006) retrospective cohort study

Hung-Chun Fu,Jen-Ruei Chen,Min-Yu Chen,Keng-Fu Hsu,Wen-Fang Cheng,An Jen Chiang,Yu-Min Ke,Yu-Chieh Chen,Yin-Yi Chang,Chia-Yen Huang,Chieh-Yi Kang,Yuan-Yee Kan,Sheng-Mou Hsiao,Ming-Shyen Yen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5

Objective: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. Methods: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. Results: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p<0.001), recurrent urinary tract infections (p=0.013), and leg lymphedema (p=0.038). Age over 50-year (HR=9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR=7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR=5.13; 95% CI, 1.38–19.1) and DSS (HR=5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p=0.046), but no impact on survival. Conclusion: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.

Resveratrol enhances the functionality and improves the regeneration of mesenchymal stem cell aggregates

Yi-Jing Wang,Pan Zhao,Bing-Dong Sui,Nu Liu,Cheng-Hu Hu,Ji Chen,Chen-Xi Zheng,An-Qi Liu,Kun Xuan,Ya-Ping Pan,Yan Jin 생화학분자생물학회 2018 Experimental and molecular medicine Vol.50 No.-

Mesenchymal stem cell (MSC)-based regeneration, specifically cell aggregate or cell sheet engineering, is a promising approach for tissue reconstruction. Considering the advantages of ease of harvest and lack of immune rejection, the application of autologous MSCs (i.e., patients’ own MSCs) in regenerative medicine has developed considerable interest. However, the impaired cell viability and regenerative potential following MSCs impacted by disease remain a major challenge. Resveratrol (RSV) exhibits reliable and extensive rejuvenative activities that have received increasing clinical attention. Here, we uncovered that resveratrol enhances the functionality and improves the regeneration of mesenchymal stem cell aggregates. Periodontal ligament MSCs (PDLSCs) from normal control subjects (N-PDLSCs) and periodontitis patients (P-PDLSCs) were investigated. Compared to N-PDLSCs, P-PDLSCs were less capable of forming cell aggregates, and P-PDLSC aggregates showed impaired osteogenesis and regeneration. These functional declines could be mimicked in N-PDLSCs by tumor necrosis factor alpha (TNF-α) treatment. Notably, a TNF-α-induced functional decline in N-PDLSC aggregates was rescued by RSV application. More importantly, in both N-PDLSCs and P-PDLSCs, RSV promoted cell aggregate formation and improved their osteogenic potential. Furthermore, as proven ectopically in vivo, the tissue regenerative capability of P-PDLSC aggregates was also enhanced after RSV treatment during aggregate formation in vitro. Finally, in a rat in situ regeneration model, we successfully applied both N-PDLSC aggregates and P-PDLSC aggregates to repair periodontal defects upon long-term functional improvements by RSV preconditioning. Together, our data unravel a novel methodology for using pharmacology (i.e., RSV)-based cell aggregate engineering to improve the functionality and facilitate the regeneration of MSCs from both healthy and inflammatory microenvironments, shedding light on improving the application of autologous MSC-mediated regenerative medicine.

Cadmium stress inhibits the growth of primary roots by interfering auxin homeostasis in Sorghum bicolor seedlings

Yi-hua Zhan,Cheng-hao Zhang,Qiu-xun Zheng,Zong-an Huang,Chen-liang Yu 한국식물학회 2017 Journal of Plant Biology Vol.60 No.6

Phytotoxic effects of cadmium (Cd), a heavy metalpollutant, on plants have been extensively examined. Auxinplays vital roles in many aspects of plant development. Theassociation between root growth and auxin signaling in CdstressedSorghum bicolor was analyzed in our study. Rootelongation, shoot length and the maximal photochemicalefficiency (Fv/Fm) in S. bicolor seedlings were dramaticallyreduced after Cd stress treatment. Cd was found to bepredominantly confined in the meristematic zone using a Cdstainingmethod. Cd stress remarkably influenced the cellcycle progression at the root tip as shown by EdU (ethynyldeoxyuridine) assay. The content of IAA was markedlydiminished in the roots of Cd-stressed S. bicolor, which wasalong with the increase of IAA oxidase activity. Auxintransport inhibitors, 1-naphthoxyacetic acid (1-NOA) or 1-naphthylphthalamic acid (NPA), greatly reduced plant toleranceto Cd stress, whereas exogenous application of 1-naphthaleneacetic acid (NAA) improved Cd tolerance in S. bicolor seedlings. Cd stress altered the transcript level ofsome putative auxin biosynthetic genes. In addition, NAAinterfered with the homeostasis of Cd-induced reactiveoxygen species (ROS). These results revealed that Cd stressdisturbed the growth of S. bicolor seedlings by affecting thehomeostasis of auxin and ROS.