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I Chun Ma,Kao Chin Chen,Wei Tseng Chen,Hsin Chun Tsai,Chien-Chou Su,Ru-Band Lu,Po See Chen,Wei Hung Chang,Yen Kuang Yang 대한정신약물학회 2018 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.16 No.4
Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson’s comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities (CCI≥3) or older patients (≥65 years). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.
Dermal Lipogenesis Inhibits Adiponectin Production in Hs68 Fibroblasts
( Kai-chen Hu ),( Tsung-yan Tsai ),( Chu-wen Shao ),( Hsin-i Chang ) 한국농업기계학회 2018 한국농업기계학회 학술발표논문집 Vol.23 No.1
Adiponectin is one of the most abundant adipokines from the subcutaneous fat, and regulates multiple activities through endocrine, paracrine, or autocrine mechanisms. However, its expression in adipogenic induced fibroblasts, and the potential role in photoaging has not been determined. Here, human dermal fibroblasts, Hs68, were presented as a cell model of dermal lipogenesis through stimulation of adipogenic differentiation medium (ADM). Similar to other studies in murine pre-adipocyte models (i.e., 3T3-L1), Hs68 fibroblasts showed a tendency to lipogenesis based on lipid accumulation, triglyceride formation, and the expressions of PPAR-γ, lipoprotein lipase (LPL), and FABP4 mRNA. As expected, ADM-treated fibroblasts displayed a reduction on adiponectin expression. Overall, these results suggest that dermal lipogenesis may inhibit the expression of adiponectin.
Chang, Chih-Chun,Su, Ming-Jang,Lee, Shu-Jene,Tsai, Yu-Hui,Kuo, Lin-Yin,Lin, I-Hsin,Huang, Hui-Ling,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.1
Background: Whether ambient exposure to environmental pollutants leads to hematopoietic malignancies such as multiple myeloma (MM) remains to be ascertained. Therefore, we aimed to investigate the immunotyping distribution of serum monoclonal paraprotein and the environmental influence on MM and monoclonal gammopathy of uncertain significance (MGUS) in the Taiwanese population. Materials and Methods: Serum protein electrophoresis with immunosubtraction by the capillary zone electrophoresis method was performed as primary screening for MM and MGUS. Clinical, pathological, and residence data of patients were also obtained. Results: From August, 2013 to June, 2015, a total of 327 patients underwent serum protein electrophoresis with immunosubtraction. Among these, 281 demonstrated no remarkable findings or non-malignant oligoclonal gammopathy, 23 were detected to have MGUS, 18 were identified as MM, and a further 5 were found as other malignancies. The most frequent immunotyping distribution of serum monoclonal paraprotein was IgG kappa (54.3%, n=25), followed by IgA lambda (15.2%, n=7) and IgG lambda (10.9%, n=5) in subjects with gammopathy. Additionally, it was shown that the elderly (OR: 4.61, 95% CI: 1.88-11.30, P<0.01) and males (OR: 2.04, 95% CI: 1.04-4.02, P=0.04) had significantly higher risk of developing MM and MGUS. There was no obvious impact of environmental factors on the health risk of MM and MGUS evolution (OR: 0.77, 95% CI: 0.40-1.50, P=0.49). Conclusions: The most frequent immunotyping distribution of serum monoclonal paraprotein included IgG kappa, IgA lambda and IgG lambda in MM and MGUS in the Taiwanese population. The elderly and male subjects are at significantly higher risk of MM and MGUS development, but there was no obvious impact of environmental factors on risk.
Investigate the Mechanical and Biological Activities of PVA Membranes
( Chih-chang Yeh ),( Kai-chen Hu ),( Tsung-yan Tsai ),( Chu-wen Shao ),( Ruey-shyang Chen ),( Hsin-i Chang ) 한국농업기계학회 2018 한국농업기계학회 학술발표논문집 Vol.23 No.1
Polyvinyl alcohol (PVA) is a water-soluble synthetic polymer and which has high tensile strength and flexibility, low toxicity and good biocompatibility for the application of soft tissue engineering. Generally, PVA can be crosslinked to form 3-D structure by a variety of methods, such as chemical crosslinking, irradiation or the freeze-thaw techniques. In contrast, chemical-crosslinked PVA structure has good elasticity, high water content, and stability at room temperature but most of crosslinking reagents such as glutaradehyde have high cytotoxicity. In here, we used low toxic genipin as crosslinking reagent for the formulation of PVA membrane. Thermal behavior and mechanical properties of genipin-crosslinked PVA membrane have been measured by thermo gravimetric analyzer and universal testing machine. Genipin-crosslinked PVA membrane had a smooth surface and the contact angel was about 67°. The swelling test displayed that genipin-crosslinked PVA membrane had high water content (130%) and the increase of PVA molecular weight can slightly improve water content. Moreover, dried genipin-crosslinked PVA membrane presented higher tensile strength (7.21MPa) but lower ductility (3.4%) than hydrated membrane (3.9MPa and 302.4%). Interestingly, rehydration of dried PVA membrane can maintain similar ductility to original hydrated membrane but the tensile strength was reduced by 40%. Therefore, drying process may break some hydrogen bonding between the polymer structure of PVA membrane. In MTT assay, there was some toxicity remained in genipin-PVA membrane but cell survivability was 1.5-1.9 fold higher than glutaradehyde-crosslinked PVA membrane. Overall, genipin-crosslinked PVA membrane showed low toxicity, good cell attachment and growth of human foreskin fibroblasts. After the cell culture study, the degradation of genipin-crosslinked PVA membrane was investigated by scanning electron microscope. Therefore, genipin-crosslinked PVA membrane is a biodegradable material and which can apply in soft tissue engineering due to its good elastic behavior.
Clinical Features of Patients with Esophageal and Second Primary Cancers
Tsai, Huang-Wen,Chang, Chih-Chun,Sun, Jen-Tang,Liou, Ching-Biau,Lin, Hsiu-Chen,Lin, I-Hsin,Yu, Yun-Chieh,Weng, Wei-Ling,Leong, Ka-I,Yen, Tzung-Hai,Wu, Jiann-Ming Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.22
Background: The prevalence of esophageal cancer (EC) with second primary cancers (SPC) is increasing worldwide. This study was aimed to understand the clinical features of EC patients with SPC in the Taiwanese population. Materials and Methods: Clinical and laboratory data for 180 EC patients with or without SPC were collected between January 2009 and December 2013. Information on treatment approaches, location of SPCs and ABO blood type were also collected and stratified. Results: The most common SPC in EC patients was hypopharyngeal cancer, followed by laryngeal cancer and hepatocellular carcinoma in our study. Malignancies of colon, prostate and lung were also found. There was a significant higher portion of blood type A in the EC patients with SPC compared with those without (42.4% vs 19.5%, P=0.006). Conclusions: The frequency and SPC site distribution and blood type A should be considered in clinical evaluation of EC patients with a high risk of developing SPC in the Taiwanese population.
( Shih Rong Kuo ),( Hsin-i Chang ),( Cheng-nan Chen ) 한국농업기계학회 2018 한국농업기계학회 학술발표논문집 Vol.23 No.1
Black garlic has been reported to show multiple bioactivities against the development of different diseases. In this study, we investigated the hepatoprotective effect of black garlic on injured liver cells. Rat clone-9 hepatocytes were used for all the experiments. We used tert-Butyl hydroperoxide (tBHP) to induce injury of rat clone-9 hepatocytes. The contents of malondialdehyde (MDA) and glutathione (GSH), antioxidative enzyme activities of catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), and mRNA expressions of IL-6 and IL-8 in rat clone-9 hepatocytes were determined to evaluate the level of cell damage. We found that black garlic extracts significantly recovered tBHP-induced cell death of rat clone-9 hepatocytes. Pretreatment with black garlic extracts antagonized GSH depletion, tBHP-increased MDA accumulation, IL-6/IL-8 mRNA expressions, and tBHP-decreased antioxidative enzyme activities. Moreover, we further found that JNK signaling regulated black-garlic-inhibited tBHP effects in rat clone-9 hepatocytes. Our findings demonstrate that black garlic has great hepatoprotective potential to block tBHP-damaged effects on cell death, lipid peroxidation, oxidative stress, and inflammation in rat clone-9 hepatocytes. Thus, this study suggests that black garlic may be an excellent natural candidate in the development of adjuvant therapy and healthy foods for liver protection.
Pin-Chan Lee,Junhao Wei,Hsin-I Ting,Tzu-Ping Lo,Danbing Long,Luh-Maan Chang 대한토목학회 2019 KSCE JOURNAL OF CIVIL ENGINEERING Vol.23 No.10
Construction has long been seen as a high-risk industry. Many studies conduct risk management by controlling construction risk indicators, but few studies associate risk indicators with time and space to propose long-term risk management methods. Therefore, this study proposes a dynamic analysis and visual tracking method based on behavior-based safety (BBS). This study establishes a BBS observation checklist and records workers’ unsafe behavior. The risk level of unsafe behavior is then determined by grey clustering model. When a high risk occurs, an improved grey correlation model is used to track key indicators that affect risk. In order to achieve visual risk management, this study develops semantic logic to predefine the relationship between components and space. In schedule simulation of BIM, the key indicators of BBS are transformed into an executable visual inspection between work items, components, and space through ARC. This method makes it easier for construction managers to combine time and space to manage safety risk and to adopt appropriate strategies in a timely manner to improve the efficiency of safety management.
Chih-Jung Yao,Jyh-Ming Chow,Shuang-En Chuang,Chia-Lun Chang,Ming-De Yan,Hsin-Lun Lee,I-Chun Lai,Pei-Chun Lin,Gi-Ming Lai 고려인삼학회 2017 Journal of Ginseng Research Vol.41 No.3
Background: KG-135, a standardized formulation enriched with Rk1, Rg3, and Rg5 ginsenosides, has been shown to inhibit various types of cancer cells; however, the underlying mechanisms are not fully understood. In this study, we explored its effects in A549 human lung cancer cells to investigate the induction of Forkhead Class box O3a (FOXO3a) and autophagy. Methods: Cell viability was determined by sulforhodamine B staining. Apoptosis and cell cycle distribution were analyzed using flow cytometry. The changes of protein levels were determined using Western blot analysis. Autophagy induction was monitored by the formation of acidic vesicular organelles stained with acridine orange. Results: KG-135 effectively arrested the cells in G1 phase with limited apoptosis. Accordingly, a decrease of cyclin-dependent kinase-4, cyclin-dependent kinase-6, cyclin D1, and phospho-retinoblastoma protein, and an increase of p27 and p18 proteins were observed. Intriguingly, KG-135 increased the tumor suppressor FOXO3a and induced the accumulation of autophagy hallmark LC3-II and acidic vesicular organelles without an increase of the upstream marker Beclin-1. Unconventionally, the autophagy adaptor protein p62 (sequestosome 1) was increased rather than decreased. Blockade of autophagy by hydroxychloroquine dramatically potentiated KG-135-induced FOXO3a and its downstream (FasL) ligand accompanied by the cleavage of caspase-8. Meanwhile, the decrease of Bcl-2 and survivin, as well as the cleavage of caspase-9, were also drastically enhanced, resulting in massive apoptosis. Conclusion: Besides arresting the cells in G1 phase, KG-135 increased FOXO3a and induced an unconventional autophagy in A549 cells. Both the KG-135-activated extrinsic FOXO3a/FasL/caspase-8 and intrinsic caspase-9 apoptotic pathways were potentiated by blockade of autophagy. Combination of KG- 135 and autophagy inhibitor may be a novel strategy as an integrative treatment for cancers.