Sofosbuvir/velpatasvir plus ribavirin for Child-Pugh B and Child-Pugh C hepatitis C virus-related cirrhosis

( Chen-hua Liu ),( Chi-yi Chen ),( Wei-wen Su ),( Chun-jen Liu ),( Ching-chu Lo ),( Ke-jhang Huang ),( Jyh-jou Chen ),( Kuo-chih Tseng ),( Chi-yang Chang ),( Cheng-yuan Peng ),( Yu-lueng Shih ),( Chia 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.4

Background/Aims: Real-world studies assessing the effectiveness and safety of sofosbuvir/velpatasvir (SOF/VEL) plus ribavirin (RBV) for Child-Pugh B/C hepatitis C virus (HCV)-related cirrhosis are limited. Methods: We included 107 patients with Child-Pugh B/C HCV-related cirrhosis receiving SOF/VEL plus RBV for 12 weeks in Taiwan. The sustained virologic response rates at off-treatment week 12 (SVR₁₂) for the evaluable population (EP), modified EP, and per-protocol population (PP) were assessed. The safety profiles were reported. Results: The SVR₁₂ rates in the EP, modified EP and PP were 89.7% (95% confidence interval [CI], 82.5-94.2%), 94.1% (95% CI, 87.8-97.3%), and 100% (95% CI, 96.2-100%). Number of patients who failed to achieve SVR₁₂ were attributed to virologic failures. The SVR₁₂ rates were comparable regardless of patient characteristics. One patient discontinued treatment because of adverse events (AEs). Twenty-four patients had serious AEs and six died, but none were related to SOF/VEL or RBV. Among the 96 patients achieving SVR₁₂, 84.4% and 64.6% had improved Child-Pugh and model for endstage liver disease (MELD) scores. Multivariate analysis revealed that a baseline MELD score ≥15 was associated with an improved MELD score of ≥3 (odds ratio, 4.13; 95% CI, 1.16-14.71; P=0.02). Patients with chronic kidney disease (CKD) stage 1 had more significant estimated glomerular filtration rate declines than patients with CKD stage 2 (-0.42 mL/min/1.73 ㎡/month; P=0.01) or stage 3 (-0.56 mL/min/1.73 ㎡/month; P<0.001). Conclusions: SOF/VEL plus RBV for 12 weeks is efficacious and well-tolerated for Child-Pugh B/C HCV-related cirrhosis. (Clin Mol Hepatol 2021;27:575-588)

A case study of reinforced concrete short column under earthquake using experimental and theoretical investigations

Chen-Yuan Chen,Kuo-Chiang Liu,Yuh-Wehn Liu,Wehn-Jiunn Huang 국제구조공학회 2010 Structural Engineering and Mechanics, An Int'l Jou Vol.36 No.2

The purpose of this paper is to carry out both experimental and theoretical investigations of R.C. short column subjected to horizontal forces under constant compressive loading. Eight specimens with section of 40 cm × 40 cm, height 40 cm and 50 cm and different type hoop were used of the steel cage to detect the seismic behavior of reinforced concrete short columns. Hoop spacing of column, strength of concrete, and the axial load of experiments were the three main parameters in this test. A series of equations were derived to reveal the theory could be used on analysis short column, too. Through test failure model of R.C short column being established, the type of hoop affects the behavior R.C short column in ductility rather than in strength. And the effect of analysis by Truss Model is evident and reliable in shear failure model of short column.

Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

Kuo-Tai Chen,김진성,Abel Po-Hao Huang,Martin Hsiu-Chu Lin,Chien-Min Chen 대한척추신경외과학회 2023 Neurospine Vol.20 No.1

Endoscopic spine surgery (ESS) has evolved as a safe, effective, and efficient alternative for minimally invasive spine surgery (MISS). The innovation of full-endoscopic systems makes definitive decompression surgery through different approaches feasible. The approach can be determined according to the location of the target lesion or the surgeon's preference. During the past 2 decades, ESS has expanded its indications from lumbar to cervical spines. Except for decompression, endoscopy-assisted fusion surgery is also developing. However, ESS is still evolving and has a steep learning curve. The revolution of technologies and ESS techniques will enable surgeons to treat various spinal diseases more practically. In recent years, the application of the computer-assisted navigation system and augmented reality have reformed imaging quality and interpretation. The endoscopic rhizotomy techniques have opened a new way for MISS of chronic low back pain. This review introduces the current indications of ESS and its potential future expansion.

A case study of reinforced concrete short column under earthquake using experimental and theoretical investigations

Chen, Chen-Yuan,Liu, Kuo-Chiang,Liu, Yuh-Wehn,Huang, Wehn-Jiunn Techno-Press 2010 Structural Engineering and Mechanics, An Int'l Jou Vol.36 No.2

The purpose of this paper is to carry out both experimental and theoretical investigations of R.C. short column subjected to horizontal forces under constant compressive loading. Eight specimens with section of 40 cm ${\times}$ 40 cm, height 40 cm and 50 cm and different type hoop were used of the steel cage to detect the seismic behavior of reinforced concrete short columns. Hoop spacing of column, strength of concrete, and the axial load of experiments were the three main parameters in this test. A series of equations were derived to reveal the theory could be used on analysis short column, too. Through test failure model of R.C short column being established, the type of hoop affects the behavior R.C short column in ductility rather than in strength. And the effect of analysis by Truss Model is evident and reliable in shear failure model of short column.

Clinical Practice of Blood Transfusion in Orthotopic Organ Transplantation: A Single Institution Experience

Tsai, Huang-Wen,Hsieh, Fu-Chien,Chang, Chih-Chun,Su, Ming-Jang,Chu, Fang-Yeh,Chen, Kuo-Hsin,Jeng, Kuo-Shyang,Chen, Yun Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Background: Orthotopic organ transplantation, a treatment option for irreversible organ dysfunction according to organ failure, severe damaged organ or malignancy in situ, was usually accompanied with massive blood loss thus transfusion was required. We aimed to evaluate the adverse impact of blood transfusion on solid organ transplantation. Materials and Methods: From January, 2009 to December, 2014, patients who received orthotopic organ transplantation at Far Eastern Memorial Hospital medical center were enrolled. Clinical data regarding anemia status and red blood cell (RBC) transfusion before, during and after operation, as well as patient outcomes were collected for further univariate analysis. Results: A total of 105 patients who underwent orthotopic transplantation, including liver, kidney and small intestine were registered. The mean hemoglobin (Hb) level upon admission and before operation were $11.6{\pm}1.8g/dL$ and $11.7{\pm}1.7g/dL$, respectively; and the nadir Hb level post operation and the final Hb level before discharge were $8.3{\pm}1.6g/dL$ and $10.2{\pm}1.6g/dL$, respectively. The median units (interquartile range) of RBC transfusion in pre-operative, peri-operative and post-operative periods were 0 (0-0), 2 (0-12), and 2 (0-6) units, respectively. Furthermore, the median (interquartile range) length of hospital stay (LHS) from admission to discharge and from operation to discharge were 28 (17-44) and 24 (16-37) days, respectively. Both peri-operative and post-operative RBC transfusion were associated with longer LHS from admission to discharge and from operation to discharge. Furthermore, it increased the risk of post-operative septicemia. While peri-operative RBC transfusion elevated the risk of acute graft rejection in patients who received orthotopic transplantation. Conclusions: Worse outcome could be anticipated in those who had received massive RBC transfusion in transplantation operation. Hence, peri-operative RBC transfusion should be avoided as much as possible.

The Association of Acquired T790M Mutation with Clinical Characteristics after Resistance to First-Line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor in Lung Adenocarcinoma

Yen-Hsiang Huang,Kuo-Hsuan Hsu,Jeng-Sen Tseng,Kun-Chieh Chen,Chia-Hung Hsu,Kang-Yi Su,Jeremy J. W. Chen,Huei-Wen Chen,Sung-Liang Yu,Tsung-Ying Yang,Gee-Chen Chang 대한암학회 2018 Cancer Research and Treatment Vol.50 No.4

Purpose The main objective of this study was to investigate the relationship among the clinical characteristics and the frequency of T790M mutation in advanced epidermal growth factor receptor (EGFR)mutant lung adenocarcinoma patients with acquired resistance after firstline EGFRtyrosine kinase inhibitor (TKI) treatment. Materials and Methods We enrolled EGFR-mutant stage IIIB-IV lung adenocarcinoma patients, who had progressed to prior EGFR-TKI therapy, and evaluated their rebiopsy EGFRmutation status. Results A total of 205 patients were enrolled for analysis. The overall T790M mutation rate of rebiopsy was 46.3%. The T790M mutation rates among patients with exon 19 deletion mutation, exon 21 L858R point mutation, and other mutations were 55.0%, 37.3%, and 27.3%, respectively. Baseline exon 19 deletion was associated with a significantly higher frequency of T790M mutation (adjusted odds ratio, 2.14; 95% confidence interval [CI], 1.20 to 3.83; p=0.010). In the exon 19 deletion subgroup, there was a greater prevalence of T790M mutation than other exon 19 deletion subtypes in patients with the Del E746-A750 mutation (61.6% vs. 40.6%; odds ratio, 2.35; 95% CI, 1.01 to 5.49; p=0.049). The progression- free survival (PFS) of first-line TKI treatment > 11 months was also associated with a higher T790M mutation rate (54.1% vs. 39.3%; adjusted odds ratio, 1.82; 95% CI, 1.02 to 3.25; p=0.044). Patients who underwent rebiopsy at metastatic sites had more chance to harbor T790M mutation (52.6% vs. 33.8%; adjusted odds ratio, 1.97; 95% CI, 1.06 to 3.67; p=0.032). Conclusion PFS of first-line EGFR-TKI, rebiopsy site, EGFR exon 19 deletion and its subtype Del E746- A750 mutation are associated with the frequency of T790M mutation.

The Clinical Outcomes of Different First-Line EGFR-TKIs Plus Bevacizumab in Advanced EGFR-Mutant Lung Adenocarcinoma

Yen-Hsiang Huang,Kuo-Hsuan Hsu,Chun-Shih Chin,Jeng-Sen Tseng,Tsung-Ying Yang,Kun-Chieh Chen,Kang-Yi Su,Sung-Liang Yu,Jeremy J.W. Chen,Gee-Chen Chang 대한암학회 2022 Cancer Research and Treatment Vol.54 No.2

Purpose The aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced EGFR-mutant lung adenocarcinoma patients. Materials and Methods From August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis. Results A total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481). Conclusion Our research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced EGFR-mutant lung adenocarcinoma patients. PurposeThe aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced <i>EGFR</i>-mutant lung adenocarcinoma patients.Materials and MethodsFrom August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis.ResultsA total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481).ConclusionOur research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced <i>EGFR</i>-mutant lung adenocarcinoma patients.

Computer-aided diagnosis using morphological features for classifying breast lesions on ultrasound

Huang, Y.-L.,Chen, D.-R.,Jiang, Y.-R.,Kuo, S.-J.,Wu, H.-K.,Moon, W. K. John Wiley Sons, Ltd. 2008 Ultrasound in obstetrics & gynecology Vol.32 No.4

<B>Objectives</B><P>To develop and evaluate a computer-aided diagnosis (CAD) system with automatic contouring and morphological analysis to aid in the classification of breast tumors using ultrasound.</P><B>Methods</B><P>We evaluated 118 breast lesions (34 malignant and 84 benign tumors). Each tumor contour was automatically extracted from the digitized ultrasound image. Nineteen practical morphological features from the extracted contour were calculated and principal component analysis (PCA) was applied to find independent features. A support vector machine (SVM) classifier utilized the selected principal vectors to identify the breast tumor as benign or malignant. In this study, all the cases were sampled with k-fold cross-validation (k = 10) to evaluate the performance by receiver–operating characteristics (ROC) curve analysis.</P><B>Results</B><P>The areas under the ROC curves for the proposed CAD systems using all morphological features and the lower-dimensional principal vector were 0.91 and 0.90, respectively. The classification ability for breast tumors using morphological information was good.</P><B>Conclusions</B><P>This system differentiates benign from malignant breast tumors well and therefore provides a clinically useful second opinion. Moreover, the morphological features are nearly setting-independent and thus available to various ultrasound machines. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.</P>

Using Kano Model to Explore the Charm of Painting Art Works in the Meaning of Life and Death

Kuo, Chin-Chin,Chen, Chun-Chih,Chia-Hui Huang 한국일러스트레이션학회 2022 일러스트레이션 포럼 Vol.23 No.70

The study of life and death is a learning topic. When we face to the life and death issue, it relates to our own lives. Most people are happy with life, but are full of fear of death. This research uses life and death as an example to explore "the creation of the meaning of life and death in composite media." It is hoped that through the extension of the meaning and images of life and death, the themes and elements of painting creation can be integrated to provide the exploration and thinking direction of the meaning of life. This research hopes to extend the meaning and imagery of life and death and incorporate the creative themes and elements of mixed media, so as to provide a direction for the exploration and thinking of the meaning of life. Applying the Miryoku Engineering Evaluation Grid Method to clarify the relationship between the meaning of life and death, style and perceptual imagery, and through the artistic creation of mixed media, summarize the preferences of mixed media creation works that affect the expression of birth and death images. Using the Evaluation Grid Method, 7 people with high involvement in the creation of mixed media and the imagery of life and death were conducted in-depth interviews on the charm and feelings of the meaning of life and death. By summarizing the attractiveness factors of choosing between life and death, the conclusion can be used as a basis for the development of future painting creation after subsequent verification and research on the purpose of life, the meaning of life, the value of survival, and the true meaning of death.

Mechanism and Application of NMOS Leakage with Intra-Well Isolation Breakdown by Voltage Contrast Detection

Chen, Hunglin,Fan, Rongwei,Lou, Hsiaochi,Kuo, Mingsheng,Huang, Yiping The Institute of Electronics and Information Engin 2013 Journal of semiconductor technology and science Vol.13 No.4

An innovative application of voltage-contrast (VC) inspection allowed inline detection of NMOS leakage in dense SRAM cells is presented. Cell sizes of SRAM are continual to do the shrinkage with bit density promotion as semiconductor technology advanced, but the resulting challenges include not only development of smaller-scale devices, but also intra-devices isolation. The NMOS leakage caused by the underneath n+/P-well shorted to the adjacent PMOS/N-well was inspected by the proposed electron-beam (e-beam) scan in which VC images were compared during the in-line process step of post contact tungsten (W) CMP (Chemical Mechanical Planarization) instead of end-of-line electrical test, which has a long response time. A series of experiments based on the mechanism for improving the intra-well isolation was performed and verified by the inline VC inspection. An optimal process-integration condition involved to the tradeoff between the implant dosage and photo CD was carried out.