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The Risk of Upper Urinary Tract Involvement in Patients With Ketamine-Associated Uropathy
Chi-Hang Yee,Jeremy Yuen-Chun Teoh,Pui-Tak Lai,Vivian Yee-Fong Leung,Winnie Chiu-Wing Chu,Wai-man Lee,Yuk-Him Tam,Chi-Fai Ng 대한배뇨장애요실금학회 2017 International Neurourology Journal Vol.21 No.2
Purpose: The aims of this study were to investigate the prevalence of upper tract involvement in ketamine-associated uropathy, and to determine the predictors of hydronephrosis in patients with a history of ketamine abuse. Methods: This was a cross-sectional study of a prospective cohort of patients with ketamine-associated uropathy. Data including demographics, pattern of ketamine abuse, pelvic pain and urgency or frequency (PUF) symptom score, uroflowmetry (UFM) parameters, serum renal function, and liver function tests were collected. Upon consultation, ultrasonography was performed to assess the function of the urinary system. Results: From December 2011 to October 2015, we treated 572 patients with ketamine-associated uropathy. Of these patients, 207 (36.2%) had managed to achieve abstinence at the time of their first consultation. Ninety-six patients (16.8%) in the cohort were found to have hydronephrosis on ultrasonography. Univariate analysis identified age, duration of ketamine abuse, PUF symptom score, voided volume on UFM, serum creatinine levels >100 μmol/L, and an abnormal serum liver enzyme profile as factors associated with hydronephrosis. Logistic regression revealed the following parameters to be statistically related to hydronephrosis: age (adjusted odds ratio [OR], 1.090; 95% confidence interval [CI], 1.020–1.166; P=0.012), functional bladder capacity (adjusted OR, 0.997; 95% CI, 0.995–0.999; P=0.029), serum creatinine >100 μmol/L (adjusted OR, 3.107; 95% CI, 1.238–7.794; P=0.016, and an abnormal serum liver enzyme profile (adjusted OR, 1.967; 95% CI, 1.213–3.187; P=0.006). Conclusions: Ketamine-associated uropathy can involve the upper urinary tract. Patient demographics as well as investigations of UFM, renal function tests, and liver function tests may allow us to identify at-risk patients.
Turbid Density Current Venting through Reservoir Outlets
Fong-Zuo Lee,Jihn-Sung Lai,Yih-Chi Tan,Chia-Chi Sung 대한토목학회 2014 KSCE JOURNAL OF CIVIL ENGINEERING Vol.18 No.2
The planning and design of an outlet operation by releasing a turbid density current from a reservoir requires accurate prediction ofoutflow concentration for sluicing sediment through outlet structures. This study investigates outflow concentration and ventingefficiency through reservoir outlets in a reservoir sluicing operation related to turbid density current. A 3D numerical model isemployed to simulate a venting operation for a turbid density current in typhoon-induced flood events. A simple and efficientformula derived from theoretical analysis with experimental data is proposed for estimating outflow concentration and ventingefficiency. By adopting the proposed formula to avoid time-consuming calculation using the 3D numerical model, the estimatedoutflow concentration and venting efficiency through reservoir outlets have shown good agreement with the measured and simulatedresults in typhoon flood events. This demonstrates that the formula provides an efficient approach for engineering practice in realtimereservoir venting operations.
Chi-Ho Lee,Mei-Zhen Wu,David Tak-Wai Lui,Darren Shing-Hei Chan,Carol Ho-Yi Fong,Sammy Wing-Ming Shiu,Ying Wong,Alan Chun-Hong Lee,Joanne King-Yan Lam,Yu-Cho Woo,Karen Siu-Ling Lam,Kelvin Kai-Hang Yiu 대한당뇨병학회 2022 Diabetes and Metabolism Journal Vol.46 No.6
Background: Insulin-treated patients with long duration of type 2 diabetes mellitus (T2DM) are at increased risk of ketoacidosis related to sodium-glucose co-transporter 2 inhibitor (SGLT2i). The extent of circulating ketone elevation in these patients remains unknown. We conducted this study to compare the serum ketone response between dapagliflozin, an SGLT2i, and sitagliptin, a dipeptidyl peptidase-4 inhibitor, among insulin-treated T2DM patients.Methods: This was a randomized, open-label, active comparator-controlled study involving 60 insulin-treated T2DM patients. Participants were randomized 1:1 for 24-week of dapagliflozin 10 mg daily or sitagliptin 100 mg daily. Serum β-hydroxybutyrate (BHB) levels were measured at baseline, 12 and 24 weeks after intervention. Comprehensive cardiometabolic assessments were performed with measurements of high-density lipoprotein cholesterol (HDL-C) cholesterol efflux capacity (CEC), vibration-controlled transient elastography and echocardiography.Results: Among these 60 insulin-treated participants (mean age 58.8 years, diabetes duration 18.2 years, glycosylated hemoglobin 8.87%), as compared with sitagliptin, serum BHB levels increased significantly after 24 weeks of dapagliflozin (P=0.045), with a median of 27% increase from baseline. Change in serum BHB levels correlated significantly with change in free fatty acid levels. Despite similar glucose lowering, dapagliflozin led to significant improvements in body weight (P=0.006), waist circumference (P=0.028), HDL-C (P=0.041), CEC (P=0.045), controlled attenuation parameter (P=0.007), and liver stiffness (P=0.022). Average E/e’, an echocardiographic index of left ventricular diastolic dysfunction, was also significantly lower at 24 weeks in participants treated with dapagliflozin (P=0.037).Conclusion: Among insulin-treated T2DM patients with long diabetes duration, compared to sitagliptin, dapagliflozin modestly increased ketone levels and was associated with cardiometabolic benefits.
Chi-Ho Lee,Wai-Kay Seto,Kelly Ieong,David T.W. Lui,Carol H.Y. Fong,Helen Y. Wan,Wing-Sun Chow,Yu-Cho Woo,Man-Fung Yuen,Karen SL Lam 대한내분비학회 2021 Endocrinology and metabolism Vol.36 No.1
Background: In non-alcoholic fatty liver disease (NAFLD), transient elastography (TE) is an accurate non-invasive method to identify patients at risk of advanced fibrosis (AF). We developed a diabetes-specific, non-invasive liver fibrosis score based on TE to facilitate AF risk stratification, especially for use in diabetes clinics where TE is not readily available. Methods: Seven hundred sixty-six adults with type 2 diabetes and NAFLD were recruited and randomly divided into a training set (n=534) for the development of diabetes fibrosis score (DFS), and a testing set (n=232) for internal validation. DFS identified patients with AF on TE, defined as liver stiffness (LS) ≥9.6 kPa, based on a clinical model comprising significant determinants of LS with the lowest Akaike information criteria. The performance of DFS was compared with conventional liver fibrosis scores (NFS, FIB-4, and APRI), using area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive and negative predictive values (NPV). Results: DFS comprised body mass index, platelet, aspartate aminotransferase, high-density lipoprotein cholesterol, and albuminuria, five routine measurements in standard diabetes care. Derived low and high DFS cut-offs were 0.1 and 0.3, with 90% sensitivity and 90% specificity, respectively. Both cut-offs provided better NPVs of >90% than conventional fibrosis scores. The AUROC of DFS for AF on TE was also higher (P<0.01) than the conventional fibrosis scores, being 0.85 and 0.81 in the training and testing sets, respectively. Conclusion: Compared to conventional fibrosis scores, DFS, with a high NPV, more accurately identified diabetes patients at-risk of AF, who need further evaluation by hepatologists.
Chi-I Tuan,Ting-Chien Chen,Yi-Lung Yeh,Lang-Fong Hsu 한국화학공학회 2012 Korean Journal of Chemical Engineering Vol.29 No.3
This research investigated optimal energy utilization with pinch technology based on an actual gelatin production factory using a three-effect evaporator (TEE). A TEE is a well-known device used extensively when concentrating process fluid with large amounts of boiler steam. Under ideal energy use conditions, the exhaust heat can be recovered with the addition of a heat pump system. The study results showed that the original energy demand and discharge of the TEE were 1,736.2 and 1,733.2 kWh, respectively. Simulating the pinch technology use, the energy demand and discharge decreased to 1,531.5 and 1,527.7 kWh, respectively. When the heat pump was used to recover the exhaust heat, 324 kL per annum of fuel oil was saved, while electricity use increased 131 kWh. The total investment cost was 86,550 US$, but the total annual operation cost could save up to 166,421 US$. The net present value was estimated to be 544,316 US$ with a 5-year equipment operation. The investment expense could be completely recovered within a seven-month remuneration period.
Cardiac Angiosarcoma Heralded by Recurrent Hemorrhagic Pericardial Effusions–Utility of MRI and CT
Fiona Fong-ying Wan,Jonan Chun-yin Lee,Jeanie Betsy Chiang,Kim-hung Tsang,Cheuk-bong Ho,Eric Chi-yuen Wong 아시아심장혈관영상의학회 2020 Cardiovascular Imaging Asia Vol.4 No.1
Cardiac angiosarcoma is a rare primary cardiac malignancy that should be considered in patients with recurrent pericardial effusions, especially those with spontaneous hemorrhagic pericardial effusion. A 34-year-old man presented for evaluation of pericardial effusion. Initial imaging and pericardial histopathological workup failed to provide a definitive diagnosis. Serum parvovirus B19 PCR test was positive and he was treated for viral pericarditis. In view of his recurrent hemorrhagic pericardial effusions and persistent right atrial thrombus, MRI was performed and revealed findings suggestive of cardiac angiosarcoma with lung metastases. The diagnosis was confirmed histologically. The patient’s condition progressed rapidly with massive hemothorax, and although he received systemic therapy for disease control, he succumbed to the disease five months after diagnosis confirmation.
Synthesis and Evaluation of Homoazasugars as Glycosidase Inhibitors
Wong, Chi-Huey,Louis, Provencher,John A. Porco, Jr.,Jung, Sang-Hun,Wang, Yi-Fong,Chen, Lihren,Wang, Ruo,Darryl H. Steensma 충남대학교 약학대학 의약품개발연구소 1995 藥學論文集 Vol.11 No.-
In an effort to develop transition-state mimetics of the glycosidase-catalyzed reaction, five- and six-membered azasugars and their homo-analogs were prepared and tested as inhibitors of glycosidases. Inhibition studies indicate that the fucosyl cationlike, five-membered imine 1 and its reduced form 2 are potent inhibitors of α-fucosidase from bovine kideney with respective K_i values of 160 nM and 2μM. The five-membered homoaminoazasugar 3 is also a potent inhibitor of the enzyme (K_i=1.9×10^-6M), while the glucose and mannose-like six-membered homoaminoazasugars 4 and 5 are less potent than the corresponding 1-deoxyazasugars as inhibitors of α-glucosidase and α-mannosidase, respectively. The primary amino group was placed in an attempt to introduce additional electrostatic interactions in the active site. The inhibitory activities are, however, in the high μM range. Synthesis of homoazasugars structurally related to a disaccharide and a nucleoside is also described.
Cheong, Chi Po,Fong, Simon,Lei, Pouwan,Chatwin, Chris,Young, Rupert Korea Information Processing Society 2012 Journal of information processing systems Vol.8 No.3
A secure Electronic Payment System (EPS) is essential for the booming online shopping market. A successful EPS supports the transfer of electronic money and sensitive information with security, accuracy, and integrity between the seller and buyer over the Internet. SET, CyberCash, Paypal, and iKP are the most popular Credit Card-Based EPSs (CCBEPSs). Some CCBEPSs only use SSL to provide a secure communication channel. Hence, they only prevent "Man in the Middle" fraud but do not protect the sensitive cardholder information such as the credit card number from being passed onto the merchant, who may be unscrupulous. Other CCBEPSs use complex mechanisms such as cryptography, certificate authorities, etc. to fulfill the security schemes. However, factors such as ease of use for the cardholder and the implementation costs for each party are frequently overlooked. In this paper, we propose a Web service based new payment system, based on ANSI X9.59-2006 with extra features added on top of this standard. X9.59 is an Account Based Digital Signature (ABDS) and consumer-oriented payment system. It utilizes the existing financial network and financial messages to complete the payment process. However, there are a number of limitations in this standard. This research provides a solution to solve the limitations of X9.59 by adding a merchant authentication feature during the payment cycle without any addenda records to be added in the existing financial messages. We have conducted performance testing on the proposed system via a comparison with SET and X9.59 using simulation to analyze their levels of performance and security.