SECONDARY ELECTRONS IN CLUSTERS OF GALAXIES AND GALAXIES

HWANG CHORNG- YUAN The Korean Astronomical Society 2004 Journal of The Korean Astronomical Society Vol.37 No.5

We investigate the role of secondary electrons in galaxy clusters and in ultra-luminous infrared galaxies (ULIGs). The radio emission in galaxy clusters and ULIGs is believed to be produced by the synchrotron radiation of relativistic electrons. Nonetheless, the sources of these relativistic electrons are still unclear. Relativistic secondary electrons can be produced from the hadronic interactions of cosmic-ray nuclei with the intra-cluster media (ICM) of galaxy clusters and the dense molecular clouds of ULIGs. We estimate the contribution of the secondary electrons in galaxy clusters and ULIGs by comparing observational results with theoretical calculations for the radio emission in these sources. We find that the radio halos of galaxy clusters can not be produced from the secondary electrons; on the other hand, at least for some ULIGs, the radio emission can be dominated by the synchrotron emission of the secondary electrons.

Therapeutic Efficacy of Urethral Sphincter Injections of Platelet- Rich Plasma for the Treatment of Stress Urinary Incontinence due to Intrinsic Sphincter Deficiency: A Proof-of-Concept Clinical Trial

Yuan-Hong Jiang,Ping-Jui Lee,Hann-Chorng Kuo 대한배뇨장애요실금학회 2021 International Neurourology Journal Vol.25 No.1

Purpose: The aim of this study was to investigate the efficacy of autologous platelet-rich plasma (PRP) in the treatment of stress urinary incontinence (SUI) due to intrinsic sphincter deficiency (ISD) refractory to medical treatment. Methods: Thirty-five patients with SUI due to urodynamically proven ISD were prospectively enrolled. Five milliliters of PRP (2.5–5 times the platelet concentration in peripheral blood) was injected into the external sphincter at 5 sites; all patients received 4 injections at monthly intervals. The primary end-point was the change in SUI severity as assessed by a visual analogue scale (VAS of SUI). The secondary-endpoints were the Global Response Assessment score and changes in urodynamic parameters from baseline to 3 months after treatment. Results: The mean age of patients was 68.7±12 years; the median duration of SUI was 4 years. Five patients had neurogenic SUI, while 30 had nonneurogenic SUI (21 with postprostatectomy incontinence, 6 with previous radical cystectomy, and 3 with other etiologies). Complete dryness was achieved in 7 patients (20.0%) while moderate improvement was observed in 14 (40.0%). The mean VAS of SUI score decreased significantly from 6.57±1.89 to 3.77±2.41 after treatment. The abdominal leak point pressure (ALPP) increased significantly from 98.3±55.8 to 157.3±79.3 cm H2O. There was no increase of ALPP in neurogenic SUI and less increase of ALPP in patients with failed treatment outcomes. No perioperative adverse events or severe complications occurred. Conclusions: Urethral PRP injection is safe and effective in increasing urethral resistance and improving SUI. PRP could be an alternative treatment modality for male and female patients with moderate SUI due to nonneurogenic causes.

Frontiers in the Clinical Applications of Botulinum Toxin A as Treatment for Neurogenic Lower Urinary Tract Dysfunction

Yuan-Hong Jiang,Sheng-Fu Chen,Hann-Chorng Kuo 대한배뇨장애요실금학회 2020 International Neurourology Journal Vol.24 No.4

Patients with neurogenic lower urinary tract dysfunction (NLUTD) experience urinary incontinence with or without difficult urination, which might promote recurrent urinary tract infection (UTI) and exacerbate upper urinary tract function. Nonetheless, appropriate bladder management has been shown to reduce urological complications and improve quality of life. In addition to pharmacological therapy and surgical intervention, botulinum toxin A (BoNT-A) has been widely utilized in NLUTD. The therapeutic efficacy of detrusor BoNT-A injections for neurogenic detrusor overactivity due to spinal cord injury (SCI), multiple sclerosis, or other central nervous system lesions, such as cerebrovascular accident, Parkinson disease, early dementia, and pediatric NLUTD due to myelomeningocele, has been well established, with repeated BoNT-A injections every 6 to 9 months being necessary to maintain its therapeutic effects. Urethral BoNT-A injection can decrease urethral sphincter resistance and facilitate efficient voiding in patients with NLUTD who wish to preserve self-voiding. Detrusor BoNT-A injection can also decrease the occurrence of autonomic dysreflexia in patients with SCI, even after failed augmentation enterocystoplasty, with additional benefits including reduced UTI episodes and preserved renal function with repeated injections. However, this treatment does have some side effects. Complete informed consent for BoNT-A injection therapy with full disclosure of its potential complications should therefore be obtained before this procedure is undertaken.

Improved Urothelial Cell Proliferation, Cytoskeleton and Barrier Function Protein Expression in the Patients With Interstitial Cystitis/Bladder Pain Syndrome After Intravesical Platelet-Rich Plasma Injection

Jia-Fong Jhang,Yuan-Hong Jiang,Yung-Hsiang Hsu,Han-Chen Ho,Lori A Birder,Teng-Yi Lin,Hann-Chorng Kuo 대한배뇨장애요실금학회 2022 International Neurourology Journal Vol.26 No.S1

Purpose: To investigate urothelial cell proliferation, cytoskeleton, inflammation, and barrier function protein expressions in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) after intravesical platelet-rich plasma (PRP) injections Methods: A total of 19 patients with IC/BPS underwent 4 monthly intravesical PRP injections. Bladder biopsies were taken at the first and fourth PRP treatment. The bladder specimens were analyzed using the Western blot and immunochemical staining for progenitor cell markers for sonic hedgehog (Shh), CD34, and cytoskeleton proteins cytokeratin 5 (CK5), CK14, CK20; barrier function markers for zonula occludens-1 (ZO-1), E-cadherin, and intercellular adhesive molecule-1, tryptase and transforming growth factor-β (TGF-β). Global response assessment (GRA) was used to evaluate treatment outcomes. Results: The mean age of patients was 55.6 years. After PRP injections, the functional bladder capacity and maximum flow rate increased, and the visual analogue scale (VAS) of pain, interstitial cystitis (IC) symptom index, IC problem index, O’Leary-Sant symptom score, and GRA improved in all patients. Urothelium Shh, CK5, ZO-1, E-cadherin, and TGF-β expressions increased significantly after repeated PRP injections. By subgrouping, according to PRP treatment outcomes, significant increases in Shh, E-cadherin, and ZO-1 expressions were noted only in patients with GRA ≥1 or improved VAS, but not in patients with GRA=0 and no improvement in VAS. Conclusions: The level of urothelial barrier function protein and cell proliferation protein expression in the patients with IC/ BPS was increased after repeat intravesical PRP injections. Intravesical repeat PRP injections may have potential to improve urothelial health and result in symptoms improvement in the patients with IC/BPS.

STUDYING THE MORPHOLOGY AND STAR FORMATION OF GALAXIES AS A PROBE OF GALAXY EVOLUTION

CHEN, HSUAN-JU,HWANG, CHORNG-YUAN The Korean Astronomical Society 2015 天文學論叢 Vol.30 No.2

Star formation activities dominate the evolution of galaxies. Elliptical galaxies are believed to be old galaxies in the Hubble sequence, and elliptical galaxies at different evolution epochs might have different star formation activities and/or morphologies. We investigate the connection between star formation rates and the morphology of elliptical galaxies. With the Sloan Digital Sky Survey (SDSS) and the Galaxy Zoo, we select a sample of elliptical galaxies by morphology and consider their infrared emission as an index of star formation rate to study the relation between the star formation rates and their morphological properties, such as ellipticities. In addition, we select some nearby spiral galaxies with very low MIR emission to probe the mechanisms of these red spiral galaxies. We display our preliminary results and discuss their implication on the evolution of galaxies in this poster.

Long-term Outcomes of Augmentation Enterocystoplasty in Patients With End-Stage Bladder Diseases: A Single-Institute Experience Involving 102 Patients

Shu-Yu Wu,Yuan-Hong Jiang,Hann-Chorng Kuo 대한배뇨장애요실금학회 2017 International Neurourology Journal Vol.21 No.2

Purpose: Augmentation enterocystoplasty (AE) has been shown to improve clinical symptoms in patients with end-stage bladder disease (ESBD). Herein, we report the long-term outcomes of a series of patients with different etiologies of ESBD who received AE. Methods: We retrospectively reviewed 102 patients with ESBD who received AE at the Hualien Tzu Chi General Hospital from 1992 to 2014. ESBD in this study was defined as including neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI) or myelomeningocele, inflammatory bladder disease (IBD), ESBD occurring after pelvic cancer surgery, and other etiologies. Complications including active lower urinary tract problems and urinary tract infection (UTI), as well as patients’ self-reported satisfaction with the procedure, were evaluated. Results: A total of 102 patients were included in the study. A majority of patients received AE for NLUTD (n=43), followed by IBD (n=38), ESBD after pelvic cancer surgery (n=15), and the other etiologies (n=6). Patients had a mean age of 39.4±18.7 years and were followed for a mean of 78 months. All patients had significantly increased cystometric bladder capacity and compliance at the time of follow-up. Fifty-four patients (52.9%) reported moderate to excellent satisfaction with the outcome, and there were no significant differences among the groups (P=0.430). The most common reason for dissatisfaction was the need for clean intermittent catheterization (CIC; 41.7%), followed by urinary incontinence (25.0%) and recurrent UTI (16.7%). Conclusions: AE is a safe and effective procedure for patients with ESBD. Postoperative urinary incontinence and UTI as well as the need for CIC may affect quality of life and decrease patient satisfaction.

Urothelial Dysfunction and Chronic Inflammation are Associated With Increased Bladder Sensation in Patients With Chronic Renal Insufficiency

Sheng-Fu Cheng,Yuan-Hong Jiang,Hann-Chorng Kuo 대한배뇨장애요실금학회 2018 International Neurourology Journal Vol.22 No.S2

Purpose: Chronic kidney disease (CKD) or end-stage renal disease (ESRD) patients usually have lower urinary tract symptoms, such as frequency and urgency. Additionally, they frequently suffer from urinary tract infections. This study investigated dysfunction and chronic inflammation of the bladder urothelium in ESRD/CKD patients. Methods: This study enrolled 27 patients with CKD (n=13) or ESRD (n=14) for urodynamic studies and bladder biopsies. Patients presented with detrusor underactivity (DU; n=8) or bladder oversensitivity (BO; n=19). Bladder biopsies were performed in these patients and in 20 controls. The bladder mucosa was examined for E-cadherin and zonula occludens-1 (ZO-1) expression, activated mast cell count (through tryptase staining), and urothelial apoptosis (through terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling [TUNEL]). The urodynamic parameters were also compared with variables regarding urothelial dysfunction. Results: The bladder mucosa samples of ESRD and CKD patients revealed significantly higher mast cell counts, more urothelial apoptosis, and lower levels of ZO-1 expression than the control samples. E-cadherin expression was significantly reduced in ESRD/CKD patients with DU, but not in ESRD/CKD patients with BO. Increased mast cell and apoptotic cell counts were also associated with ESRD/CKD with BO. Less expression of ZO-1 and E-cadherin was significantly associated with increased bladder sensation and a small bladder capacity. Conclusions: Bladder urothelial dysfunction and chronic inflammation were present to a noteworthy extent in patients with ESRD or CKD. Increased inflammation and defective barrier function were more notable in ESRD/CKD bladders with BO than in those with DU. The clinical characteristics of these patients may involve urothelial pathophysiology.

Therapeutic Efficacy of a New Procedure for Male Urinary Incontinence Combining a Suburethral Polypropylene Mesh and Cardiovascular Patch

Shu-Yu Wu,Yuan-Hong Jiang,Hann-Chorng Kuo 대한배뇨장애요실금학회 2017 International Neurourology Journal Vol.21 No.1

Purpose: Stress urinary incontinence (SUI) in men is a complication secondary to prostatectomy or resulting from neurological lesions. This study presents our experiences with male suburethral slings over the past decade. Methods: In this study, we considered patients who presented with SUI and were diagnosed with an intrinsic sphincteric deficiency due to postprostatectomy incontinence (PPI) or other causes (non-PPI). Patients who underwent the suburethral sling procedure using a polypropylene mesh and a cardiovascular patch were retrospectively included. An urodynamic study was performed before and after the operation. Global response assessment (GRA) and SUI grading were used for surgical outcome. The revision rate and the infection rate were also evaluated. Results: A total 31 patients were enrolled in this study; the mean patient age was 59.5±18.9 years, and the mean follow-up period was 36.9±29.4 months. Fourteen patients comprised the non-PPI group and 17 were in the PPI group. The preoperative SUI of all patients were categorized as a moderate to severe problem according to the SUI grade, with a mean score of 2.32±0.48 before the operation and 0.48±0.57 after the operation. With a mean score of 2.35±0.71, GRA showed that the patients were satisfied with the treatment. After the sling procedure, 4 patients (13%) reported a mild improvement, 12 (38.7%) a moderate improvement, while 15 (48.4%) reported an excellent improvement. Six patients (19.4%), including 5 from the non-PPI group (35.7%) and 1 (5.9%) from the PPI group (P=0.037), underwent sling removal because of infection. Conclusions: The male suburethral sling procedure using a polypropylene mesh and a cardiovascular patch is a safe, efficacious, and inexpensive surgical procedure for PPI. In cases of neurological incontinence, however, the higher infection rate in non-PPI patients means that they should be carefully managed.

THE CONTRIBUTION TO THE EXTRAGALACTIC γ-RAY BACKGROUND BY HADRONIC INTERACTIONS OF COSMIC RAYS PRODUCING EUV EMISSION IN CLUSTERS OF GALAXIES

KUO PING-HUNG,BOWYER STUART,HWANG CHORNG- YUAN The Korean Astronomical Society 2004 Journal of The Korean Astronomical Society Vol.37 No.5

A substantial number of processes have been suggested as possible contributors to the extragalactic $\gamma$-ray background (EGRB). Yet another contribution to this background will be emission produced in hadronic interactions of cosmic-ray protons with the cluster thermal gas; this class of cosmic rays (CRs) has been shown to be responsible for the EUV emission in the Coma Cluster of galaxies. In this paper we assume the CRs in the Coma Cluster is prototypic of all clusters and derive the contribution to the EGRB from all clusters over time. We examine two different possibilities for the scaling of the CR flux with cluster size: the number density of the CRs scale with the number density of the thermal plasma, and alternatively, the energy density of the CRs scale with the energy density of the plasma. We find that in all scenarios the EGRB produced by this process is sufficiently low that it will not be observable in comparison with other mechanisms that are likely to produce an EGRB.

Molecular Gas Feeding the Circumnuclear Disk of the Galactic Center

Hsieh, Pei-Ying,Koch, Patrick M.,Ho, Paul T. P.,Kim, Woong-Tae,Tang, Ya-Wen,Wang, Hsiang-Hsu,Yen, Hsi-Wei,Hwang, Chorng-Yuan American Astronomical Society 2017 The Astrophysical journal Vol.847 No.1

<P>The interaction between a supermassive black hole (SMBH) and the surrounding material is of primary importance in modern astrophysics. The detection of the molecular 2 pc circumnuclear disk (CND) immediately around the Milky Way SMBH, SgrA*, provides a unique opportunity to study SMBH accretion at subparsec scales. Our new wide-field CS(J = 2 - 1) map toward the Galactic center (GC) reveals multiple dense molecular streamers that originated from the ambient clouds 20 pc further out, and that are connected to the central 2 pc of the CND. These dense gas streamers appear to carry gas directly toward the nuclear region and might be captured by the central potential. Our phase-plot analysis indicates that these streamers show a signature of rotation and inward radial motion with progressively higher velocities as the gas approaches the CND and finally ends up corotating with the CND. Our results might suggest a possible mechanism of gas feeding the CND from 20 pc around 2 pc in the GC. In this paper, we discuss the morphology and the kinematics of these streamers. As the nearest observable Galactic nucleus, this feeding process may have implications for understanding the processes in extragalactic nuclei.</P>