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      • KCI등재

        Recent Research and A, pp.ication of Earthquake Protection System in Taiwan

        Chang Kuo Chun,Tsai Meng Hao 한국지진공학회 1998 한국지진공학회논문집 Vol.2 No.3

        Research and a, pp.ication of earthquake protection system in Taiwan have become very active since about ten years ago. Many passive isolators, etc., have been studied extensively. These studies have resulted in a few practical a, pp.ications and proposals of two draft design provisions for seismic isolation design of bridges and buildings. In addition to the pass control, analytical studies on active semi-active control have also been very active and the experimental studies have scheduled in the near future. This paper summarise the progress on recent research and a, pp.ication of earthquake protection systems in Taiwan. The emphases are given to the control systems that have been a, pp.ied in practical a, pp.ications.

      • Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

        Wang, Chun-Hsiang,Wey, Keh-Cherng,Mo, Lein-Ray,Chang, Kuo-Kwan,Lin, Ruey-Chang,Kuo, Jen-Juan Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9

        Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

      • KCI등재

        Traditional Chinese medicine attenuates hospitalization and mortality risks in diabetic patients with carcinoma in situ in Taiwan

        Tsai Li-Jen,Chung Chi-Hsiang,Lin Chien-Jung,Su Sheng-Chiang,Kuo Feng-Chih,Liu Jhih-Syuan,Chen Kuan-Chan,Ho Li-Ju,Kuo Chih-Chun,Chang Chun-Yung,Lin Ming-Hsun,Chu Nain-Feng,Lee Chien-Hsing,Hsieh Chang-H 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.2

        Background: Diabetic patients are at high risk of developing cancer. Traditional Chinese medicine (TCM) has become increasingly popular as an adjuvant treatment for patients with chronic diseases, and some studies have identified its beneficial effect in diabetic patients with cancer. The purpoes of this study was to outline the potential of TCM to attenuate hospitalization and mortality rates in diabetic patients with carcinoma in situ (CIS). Methods: A total of 6,987 diabetic subjects with CIS under TCM therapy were selected from the National Health Insurance Research Database of Taiwan, along with 38,800 of 1:1 sex-, age-, and index year-matched controls without TCM therapy. Cox proportional hazard analysis was conducted to compare hospitalization and mortality rates during an average of 15 years of follow-up. Results: A total of 3,999/1,393 enrolled-subjects (28.62%/9.97%) had hospitalization/mortality, including 1,777/661 in the TCM group (25.43%/9.46%) and 2,222/732 in the control group (31.80%/10.48%). Cox proportional hazard regression analysis showed a lower rate of hospitalization and mortality for subjects in the TCM group (adjusted HR=0.536; 95% CI=0.367–0.780, P<0.001; adjusted HR=0.783; 95% CI=0.574– 0.974, P = 0.022). Kaplan-Meier analysis showed that the cumulative risk of hospitalization and mortality in the case and control groups was significantly different (log rank, P<0.001 and P = 0.011, respectively). Conclusions: Diabetic patients with CIS under TCM therapy were associated with lower hospitalization and mortality rates compared to those without TCM therapy. Thus, TCM application may reduce the burden of national medical resources.

      • Clinical Significance of Smudge Cells in Peripheral Blood Smears in Hematological Malignancies and Other Diseases

        Chang, Chih-Chun,Sun, Jen-Tang,Liou, Tse-Hsuan,Kuo, Chin-Fu,Bei, Chia-Hao,Lin, Sheng-Jun,Tsai, Wei-Ting,Tan, N-Chi,Liou, Ching-Biau,Su, Ming-Jang,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

        Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.

      • KCI등재

        Distributed Control for Uncertain Nonlinear Multiagent Systems Subject to Hybrid Faults

        Chang-chun Hua,Zhijie Li,Kuo Li,Shuzong Chen,Jie Sun 제어·로봇·시스템학회 2020 International Journal of Control, Automation, and Vol.18 No.10

        This paper investigates a distributed consensus control problem for a class of uncertain nonlinear multiagent systems with hybrid faults. Most of the existing works about consensus control for multi-agent systems solely consider either actuator faults or process faults. Different from the works, the more comprehensive hybrid faults are proposed which mainly focusing on both process and actuator faults occur simultaneously. For the nonlinear multiagent systems with uncertainties, we propose a less conservative consensus strategy which relaxes the conservative condition on nonlinear terms. Subsequently, the novel distributed consensus strategy is proposed with the help of a backstepping design method. Based on the Lyapunov stability theory, it is proved strictly that the proposed controllers make the followers reach an agreement on a certain quantity of common interest. Finally, a simulation example is given to verify the effectiveness of the theoretical result.

      • KCI등재

        A Single-Stage LED Tube Lamp Driver with Input-Current Shaping for Energy-Efficient Indoor Lighting Applications

        Chun-An Cheng,Chien-Hsuan Chang,Hung-Liang Cheng,Tsung-Yuan Chung,Ching-Hsien Tseng,Kuo-Ching Tseng 전력전자학회 2016 JOURNAL OF POWER ELECTRONICS Vol.16 No.4

        This study proposes a single-stage light-emitting diode (LED) tube lamp driver with input-current shaping for T8/T10-type fluorescent lamp replacements. The proposed AC–DC LED driver integrates a dual-boost converter with coupled inductors and a half-bridge series-resonant converter with a bridge rectifier into a single-stage power conversion topology. This paper presents the operational principles and design considerations for one T8-type 18 W-rated LED tube lamp with line input voltages ranging from 100 V rms to 120 V rms. Experimental results for the prototype driver show that the highest power factor (PF = 0.988), lowest input current total harmonic distortion (THD = 7.22%), and highest circuit efficiency (η = 92.42%) are obtained at an input voltage of 120 V. Hence, the proposed driver is feasible for use in energy-efficient indoor lighting applications.

      • The Immunotyping Distribution of Serum Monoclonal Paraprotein and Environmental Impact on Multiple Myeloma (MM) and Monoclonal Gammopathy of Uncertain Significance (MGUS) in Taiwan: A Medical Center-Based Experience

        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.

      • Ledipasvir/Sofosbuvir for 12 Weeks Is Safe and Effective in CHC and CHB Coinfection Patients: A Phase 3 Study in Taiwan

        ( Chun-Jen Liu ),( Wan-Long Chuang ),( I-Shyan Sheen ),( Horng-Yuan Wang ),( Chi-Yi Chen ),( Kuo-Chih Tseng ),( Ting-Tsung Chang ),( Benede tta Massetto ),( Jenny Yang ),( Gregory Camus ),( Fangqiu Zh 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

        Aims: Patients co-infected with HCV and HBV have more rapid progression and worse outcomes than mono-infected patients. Taiwan has among the highest prevalence of chronic HCV/HBV coinfection in Southeast Asia. This study evaluated the safety and efficacy of an all-oral treatment with ledipasvir(LDV)/sofosbuvir(SOF) for 12 weeks in chronic HCV and HBV coinfection. Methods: Patients with or without compensated cirrhosis chronic HCV GT1/GT2 and HBV (HBsAg+) treatment naïve were enrolled into open-label, receiving LDV 90 mg/SOF 400 mg(QD) for 12 weeks. The primary efficacy endpoint is SVR12. HBV DNA was monitored at all study visits and it will be monitored for 2 years post-treatment. Results: A total of 111 patients (68[61%] with GT1 and 43[39%] with GT2) were enrolled and treated. The majority were female(62%), treatment naive(67%), and non-cirrhotic(85%), with a mean age of 55 years and mean BMI of 24.5kg/m2. All but one was HBeAg negative. Mean baseline HBV DNA was 2.1 log10IU/mL. SVR4 was 100%(111/111). The mean change in HBV DNA ranged from -0.06 log10IU/mL at week 1 to +0.49 log10IU/mL at follow-up visit 4; HBV DNA kinetics are shown in Fig 1. 60(54%) patients had an increase in HBV DNA> 10 x BL or became HBV DNA > LLOQ. No patients had ALT ≥ 2 X baseline. No patients discontinued treatment due to adverse events (AEs). Three patients had serious AEs(optic neuritis, post procedural bleeding and duodenal ulcer bleeding; none was considered drug related). Conclusions: In chronic HCV/HBV infection patients, LDV/SOF for 12 weeks resulted in an SVR4 rate of 100%. Although most patients had an increase in HBV DNA during treatment, this was not associated with ALT elevations ≥2 X baseline, and no patients started HBV therapy to date. This all-oral, interferon-free regimen was well tolerated, supporting its potential as a treatment option for HCV/HBV co-infected patients.

      • SCIESCOPUSKCI등재

        A Single-Stage LED Tube Lamp Driver with Input-Current Shaping for Energy-Efficient Indoor Lighting Applications

        Cheng, Chun-An,Chang, Chien-Hsuan,Cheng, Hung-Liang,Chung, Tsung-Yuan,Tseng, Ching-Hsien,Tseng, Kuo-Ching The Korean Institute of Power Electronics 2016 JOURNAL OF POWER ELECTRONICS Vol.16 No.4

        This study proposes a single-stage light-emitting diode (LED) tube lamp driver with input-current shaping for T8/T10-type fluorescent lamp replacements. The proposed AC-DC LED driver integrates a dual-boost converter with coupled inductors and a half-bridge series-resonant converter with a bridge rectifier into a single-stage power conversion topology. This paper presents the operational principles and design considerations for one T8-type 18 W-rated LED tube lamp with line input voltages ranging from 100 V rms to 120 V rms. Experimental results for the prototype driver show that the highest power factor (PF = 0.988), lowest input current total harmonic distortion (THD = 7.22%), and highest circuit efficiency (η = 92.42%) are obtained at an input voltage of 120 V. Hence, the proposed driver is feasible for use in energy-efficient indoor lighting applications.

      • KCI등재후보

        Influence of prestressing on the behavior of uncracked concrete beams with a parabolic bonded tendon

        Marco Bonopera,Kuo-Chun Chang,Tzu-Kang Lin,Nerio Tullini 국제구조공학회 2021 Structural Engineering and Mechanics, An Int'l Jou Vol.77 No.1

        The influence of prestress force on the fundamental frequency and static deflection shape of uncracked Prestressed Concrete (PC) beams with a parabolic bonded tendon was examined in this paper. Due to the conflicts among existing theories, the analytical solutions for properly considering the dynamic and static behavior of these members is not straightforward. A series of experiments were conducted for a total period of approximately 2.5 months on a PC beam made with high strength concrete, subsequently and closely to the 28 days of age of concrete. Specifically, the simply supported PC member was short term subjected to free transverse vibration and three-point bending tests during its early-age. Subsequently, the experimental data were compared with a model that describes the dynamic behavior of PC girders as a combination of two substructures interconnected, i.e., a compressed Euler–Bernoulli beam and a tensioned parabolic cable. It was established that the fundamental frequency of uncracked PC beams with a parabolic bonded tendon is sensitive to the variation of the initial elastic modulus of concrete in the early-age curing. Furthermore, the small variation in experimental frequency with time makes doubtful its use in inverse problem identifications. Conversely, the relationship between prestress force and static deflection shape is well described by the magnification factor formula of the “compression-softening” theory by assuming the variation of the chord elastic modulus of concrete with time.

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