Slide Session : OS-CAD-06 ; Cardiology : Erythrocytosis Increased One-Year Mortality in Patients with St-Segment Elevation Myocardial Infarction Un-dergoing Primary Percutaneous Coronary Intervention

( Cheng Wei Liu ),( Yi Ching Lin ),( Chung Ming Tu ),( Pen Chih Liao ),( Kuan Change Chen ),( Yen Wen Wu ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Anemia is associated with poor prognosis in patients with ST-segment elevation myocardial infarction(STEMI). However, it is unclear that erythrocytosis has protective effect in these populations. Hence, we conducted a retrospective cohort study to examine the relationship between erythrocytosis and mortality in patients with STEMI undergoing primary percutaneous coronary intervention (PCI ). Materials and Methods: We screened 1,156 consecutive patients with STEMI undergoing primary PCI in a single center during Feb 2007 and January 2012. There were 201 missing data for door-to-balloon time and 4 missing data for hemoglobin. Of 951 analyzable patients, they were divided into anemia (Hemoglobin<13.0mg/dl in men or <12.0mg/dl in women), normal hemoglobin, and erythrocytosis (hemoglobin =16.0mg/dl in men or =15.0mg/dl in women) groups. The study end point was one-year mortality. Results: There were 148, 535, and 268 patients in anemia, normal hemoglobin, and erythrocytosis groups, respectively. Patients in the anemia group were older and had lower body mass index than other two groups. There was more female, smokers, hypertension, and diabetes in the anemia group. One-year mortality rates were 16.2%, 6.5%, 2.6% (P<0.001) respectively. In univariate proportional hazards regression analysis, age, hemoglobin, total cholesterol, statin use, glycoprotein llb/llla inhibitor use, and TIMI risk score were associated with 1-year mortality in three groups. After adjustment for potential confounders, hemoglobin levels remained an independent predictor of one-year mortality in both anemia (hazard ratio 0.697, 95% CI 0.528-0.960) and erythrocytosis group (hazard ratio 3.129, 95% CI 1.1.474-6.642). Conclusions: Patients with STEMI and anemia had the worst outcomes than normal hemoglobin and erythrocytosis groups. Expectedly, hemoglobin had the protective effect on prognosis in anemia group. However, a hemoglobin level was an independent risk factor of one-year mortality in those with erythrocytosis.

Predicting the surgical reparability of large-to-massive rotator cuff tears by B-mode ultrasonography: a cross-sectional study

Po-Cheng Chen,Kuan-Ting Wu,Yi-Cun Chen,Yu-Chi Huang,Ching-Di Chang,Wei-Che Lin,Wen-Yi Chou 대한초음파의학회 2022 ULTRASONOGRAPHY Vol.41 No.1

Purpose: This study aimed to compare the ability of B-mode ultrasonography and magnetic resonance imaging (MRI) to predict the repairability of large-to-massive rotator cuff tears (RCTs). Methods: This cross-sectional study included participants with large-to-massive RCTs who underwent arthroscopic repair. B-mode ultrasonography and MRI were conducted prior to arthroscopic repair. B-mode ultrasonography was used to evaluate the echogenicity of the rotator cuff muscle using the Heckmatt scale. Intra-rater and inter-rater reliabilities were examined for two independent physicians. MRI was used to evaluate the degrees of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, two experienced orthopedic surgeons performed surgery and decided whether the torn stump could be completely repaired intraoperatively. Results: Fifty participants were included, and 32 complete repairs and 18 partial repairs were performed. B-mode ultrasonography showed good intra-rater reliability and inter-rater reliability for assessment of the muscle echogenicity of the supraspinatus and infraspinatus muscles. The correlation coefficients between B-mode ultrasound findings and MRI findings showed medium to large effect sizes (r=0.4-0.8). The Goutallier classification of the infraspinatus muscles was the MRI predictor with the best discriminative power for surgical reparability (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.81 to 0.98), while the Heckmatt scale for infraspinatus muscles was the most accurate ultrasound predictor (AUC, 0.85; 95% CI, 0.74 to 0.96). No significant differences in AUCs among the MRI and ultrasound predictors were found. Conclusion: B-mode ultrasonography was a reliable examination tool and had a similar ability to predict surgical reparability to that of MRI among patients with large-to-massive RCTs. Purpose: This study aimed to compare the ability of B-mode ultrasonography and magnetic resonance imaging (MRI) to predict the repairability of large-to-massive rotator cuff tears (RCTs).Methods: This cross-sectional study included participants with large-to-massive RCTs who underwent arthroscopic repair. B-mode ultrasonography and MRI were conducted prior to arthroscopic repair. B-mode ultrasonography was used to evaluate the echogenicity of the rotator cuff muscle using the Heckmatt scale. Intra-rater and inter-rater reliabilities were examined for two independent physicians. MRI was used to evaluate the degrees of tendon retraction, fatty infiltration of rotator cuff muscles, and muscle atrophy. Finally, two experienced orthopedic surgeons performed surgery and decided whether the torn stump could be completely repaired intraoperatively.Results: Fifty participants were included, and 32 complete repairs and 18 partial repairs were performed. B-mode ultrasonography showed good intra-rater reliability and inter-rater reliability for assessment of the muscle echogenicity of the supraspinatus and infraspinatus muscles. The correlation coefficients between B-mode ultrasound findings and MRI findings showed medium to large effect sizes (r=0.4-0.8). The Goutallier classification of the infraspinatus muscles was the MRI predictor with the best discriminative power for surgical reparability (area under the curve [AUC], 0.89; 95% confidence interval [CI], 0.81 to 0.98), while the Heckmatt scale for infraspinatus muscles was the most accurate ultrasound predictor (AUC, 0.85; 95% CI, 0.74 to 0.96). No significant differences in AUCs among the MRI and ultrasound predictors were found.Conclusion: B-mode ultrasonography was a reliable examination tool and had a similar ability to predict surgical reparability to that of MRI among patients with large-to-massive RCTs.

Effects of UV Assistance on the Properties of Al-Doped ZnO Thin Films Deposited by Sol-Gel Method

Yung-Kuan Tseng,Feng-Ming Pai,Yan-Cheng Chen,Chao-Hsien Wu 대한금속·재료학회 2013 ELECTRONIC MATERIALS LETTERS Vol.9 No.6

We report here the preparation of aluminum doped zinc oxide transparent conductive thin films by a UV-assisted sol-gel method. It was found that UV irradiation creates ozone, which promotes the conductivity and transparency of the films. Boro-silicate glasses are used as substrates; an PGME is used as a solvent; after spin-coating,the films are dried and radiated with UV and then heated to 400°C for decarburization and 500°C for annealing under air. The surface morphologies of the prepared films are observed by FE-SEM and AFM. It was found that the films irradiated with UV-C are smoother and denser. An XRD analysis shows that the films have a typical wurtzite crystalline structure with a c-axis orientation normal to the surface. The electric resistance values measured with a four-point probe show that the films irradiated with UV have better conductivity (at approximately 3.4 × 10−3Ω-cm) than the films that did not undergo UV irradiation. An analysis by visible light spectrometry indicates that the AZO films irradiated with UV are more transparent than the films without UV-irradiation.

DEN1 deneddylates non-cullin proteins in vivo.

Chan, Yaru,Yoon, Jeongsook,Wu, June-Tai,Kim, Hyung-Jun,Pan, Kuan-Ting,Yim, Jeongbin,Chien, Cheng-Ting Cambridge University Press 2008 Journal of cell science Vol.121 No.19

<P>The ubiquitin-like protein Nedd8/Rub1 covalently modifies and activates cullin ubiquitin ligases. However, the repertoire of Nedd8-modified proteins and the regulation of protein neddylation status are not clear. The cysteine protease DEN1/NEDP1 specifically processes the Nedd8 precursor and has been suggested to deconjugate Nedd8 from cullin proteins. By characterizing the Drosophila DEN1 protein and DEN1 null (DEN1(null)) mutants, we provide in vitro and in vivo evidence that DEN1, in addition to processing Nedd8, deneddylates many cellular proteins. Although purified DEN1 protein efficiently deneddylates the Nedd8-conjugated cullin proteins Cul1 and Cul3, neddylated Cul1 and Cul3 protein levels are not enhanced in DEN1(null). Strikingly, many cellular proteins are highly neddylated in DEN1 mutants and are deneddylated by purified DEN1 protein. DEN1 deneddylation activity is distinct from that of the cullin-deneddylating CSN. Genetic analyses indicate that a balance between neddylation and deneddylation maintained by DEN1 is crucial for animal viability.</P>

Construction of the Operating Limits Diagram for a Ship-Based Helicopter Using the Design of Experiments with Computational Intelligence Techniques

Lin Hsin-Hung,Wu Sheng-Ju,Liu Tsung-Lung,Pan Kuan-Cheng 한국항공우주학회 2021 International Journal of Aeronautical and Space Sc Vol.22 No.1

Compared with land-based helicopters, ship-based helicopters are required to land in a more challenging working environment as the airwakes generated by the wind field flowing through the superstructure of the ship changes the wind field structure. This complicates the wind field structure and affects the safety of flight control. The flight safety of the helicopter pilot can be significantly improved with prior understanding of the relevant information in the ship-based helicopter operating limits (SHOL) diagram. In previous studies, the SHOL diagram of ship-based helicopters has been obtained using numerical simulations in conjunction with a flight simulator. However, the flight simulator equipment is expensive and difficult to maintain. This study references the aforementioned studies by initially employing a numerical simulation method to obtain the flow field information of the interaction between the airwakes of the ship’s superstructure and the downwash flow of the helicopter. Then, the flight simulator is replaced by computational intelligence methods involving artificial intelligence. This significantly reduces the research cost for envelope construction. This study integrates design of experiments (DOE) and computational intelligence techniques (soft computing) to establish a recommended range for the SHOL diagram of ship-based helicopters. This study utilizes the DOE and computational intelligence techniques to construct the SHOL diagram of ship-based helicopters, provide suggestions, and serve as a reference for helicopter pilots and engineering designers to improve the safety during flight.

Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

Tzu-Yi Lin,Eugene Yu-Chuan Kang,Shih-Chieh Shao,Edward Chia-Cheng Lai,Sunir J. Garg,Kuan-Jen Chen,Je-Ho Kang,Wei-Chi Wu,Chi-Chun Lai,Yih-Shiou Hwang 대한당뇨병학회 2023 Diabetes and Metabolism Journal Vol.47 No.3

Background: To compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care.Methods: This retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age <40 years, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR.Results: There were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70).Conclusion: Compared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development.

The Interaction of Oxytocin and Social Support, Loneliness, and Cortisol Level in Major Depression

Tsung-Yu Tsai,Huai-Hsuan Tseng,Mei Hung Chi,Hui Hua Chang,Cheng-Kuan Wu,Yen Kuang Yang,Po See Chen 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.4

Objective: Loneliness is a specific risk factor for depressive symptoms and suicidal behavior. The present study examined whether the serum oxytocin level would interact with social support and buffers loneliness and hypothalamic-pituitary- adrenal (HPA)-axis activity in drug-naïve patients with major depressive disorder (MDD). Methods: Twenty-six patients with MDD (male:female = 3:23; mean age, 45.54 ± 12.97 years) were recruited. The 17-item Hamilton Depression Rating Scale, UCLA Loneliness Scale and self-reported Measurement of Support Function Questionnaire were administered. Serum oxytocin and cortisol levels were assessed using a commercial immunoassay kits. Results: In MDD patients, a negative association was found between degrees of social support and loneliness ( = −0.39, p = 0.04). The interaction between social support and serum oxytocin level was negatively associated with loneliness ( = −0.50, p = 0.017) and serum cortisol level ( = −0.55, p = 0.020) after adjusting for age. Follow-up analyses showed that the association between higher social support and lower loneliness was observed only in the higher-oxytocin group (r = −0.75, p = 0.003) but not in the lower group (r = −0.19, p = 0.53). The significance remained after further adjusting for sex and depression severity. Conclusion: Low oxytocin level is a vulnerability factor for the buffering effect of social support for loneliness and aberrant HPA-axis activity in MDD patients.

Impact of Clinical Characteristics of Individual Metabolic Syndrome on the Severity of Insulin Resistance in Chinese Adults

Chang-Hsun Hsieh,Yi-Jen Hung,Du-An Wu,Shi-Wen Kuo,Chien-Hsing Lee,Wayne Huey-Herng Sheu,Jer-Chuan Li,Kuan-Hung Yeh,Cheng-Yu Chen,Dee Pei 대한의학회 2007 Journal of Korean medical science Vol.22 No.1

BRCA1/2 mutation status in patients with metachronous breast and ovarian malignancies: clues towards the implementation of genetic counseling

Angel Chao,Yi-Hao Lin,Lan-Yan Yang,Ren-Chin Wu,Wei-Yang Chang,Pi-Yueh Chang,Shih-Cheng Chang,Chiao-Yun Lin,Huei-Jean Huang,Cheng-Tao Lin,Hung-Hsueh Chou,Kuan-Gen Huang,Wen-Ling Kuo,Ting-Chang Chang,Ch 대한부인종양학회 2020 Journal of Gynecologic Oncology Vol.31 No.3

Objective: The characteristics of patients with metachronous breast and ovarian malignancies and the pathogenic role of BRCA1/2 mutations remain poorly understood. We investigated these issues through a review of hospital records and nationwide Taiwanese registry data, followed by BRCA1/2 mutation analysis in hospital-based cases. Methods: We retrospectively retrieved consecutive clinical records of Taiwanese patients who presented with these malignancies to our hospital between 2001 and 2017. We also collected information from the Data Science Center of the Taiwan Cancer Registry (TCR) between 2007 and 2015. Next-generation sequencing and multiplex ligation-dependent probe amplification were used to identify BRCA1/2 mutations and large genomic rearrangements, respectively. When BRCA1/2 mutations were identified in index cases, pedigrees were reconstructed and genetic testing was offered to family members. Results: A total of 12,769 patients with breast cancer and 1,537 with ovarian cancer were retrieved from our hospital records. Of them, 28 had metachronous breast and ovarian malignancies. We also identified 113 cases from the TCR dataset. Eighteen hospital-based cases underwent BRCA1/2 sequencing and germline pathogenic mutations were detected in 7 patients (38.9%, 5 in BRCA1 and 2 in BRCA2). All BRCA1/2 mutation carriers had ovarian high-grade serous carcinomas. Of the 12 patients who were alive at the time of analysis, 5 were BRCA1/2 mutation carriers. All of them had family members with BRCA1/2-associated malignancies. Conclusions: Our results provide pilot evidence that BRCA1/2 mutations are common in Taiwanese patients with metachronous breast and ovarian malignancies, supporting the clinical utility of genetic counseling.

Surgical Outcomes and Predictive Factors in Patients With Detrusor Underactivity Undergoing Bladder Outlet Obstruction Surgery

Ming-Syun Chuang,Yin-Chien Ou,Yu-Sheng Cheng,Kuan-Yu Wu,Chang-Te Wang,Yuan-Chi Huang,Yao-Lin Kao 대한배뇨장애요실금학회 2024 International Neurourology Journal Vol.28 No.1

Purpose: This study was conducted to evaluate the efficacy of bladder outlet surgery in patients with detrusor underactivity (DU) and to identify factors associated with successful outcomes.Methods: We conducted a retrospective review of men diagnosed with DU in urodynamic studies who underwent bladder outlet surgery for lower urinary tract symptoms between May 2018 and April 2023. The International Prostate Symptom Score (IPSS) questionnaire, uroflowmetry (UFM), and multichannel urodynamic studies were administered. Successful treatment outcomes were defined as either an IPSS improvement of at least 50% or the regaining of spontaneous voiding in patients urethral catheterization prior to surgery.Results: The study included 93 male patients. Men diagnosed with significant or equivocal bladder outlet obstruction (BOO) experienced significant postoperative improvements in IPSS (from 20.6 to 6.0 and from 17.4 to 6.5, respectively), maximum urine flow rate (from 5.0 mL/sec to 14.4 mL/sec and from 8.8 mL/sec to 12.2 mL/sec, respectively) and voiding efficiency (from 48.8% to 86.0% and from 61.2% to 85.1%, respectively). However, in the group without obstruction, the improvements in IPSS and UFM results were not significant. The presence of detrusor overactivity (odds ratio [OR], 3.152; P=0.025) and preoperative urinary catheterization (OR, 2.756; P=0.040) were associated with favorable treatment outcomes. Conversely, an unobstructed bladder outlet was identified as a negative prognostic factor.Conclusions: In men with DU accompanied by equivocal or significant BOO, surgical intervention to alleviate the obstruction may enhance the IPSS, quality of life, and UFM results. However, those with DU and an unobstructed bladder outlet face a comparatively high risk of treatment failure. Preoperative detrusor overactivity and urinary catheterization are associated with more favorable surgical outcomes. Consequently, active deobstructive surgery should be considered for patients with DU who are experiencing urinary retention. Purpose: This study was conducted to evaluate the efficacy of bladder outlet surgery in patients with detrusor underactivity (DU) and to identify factors associated with successful outcomes. Methods: We conducted a retrospective review of men diagnosed with DU in urodynamic studies who underwent bladder outlet surgery for lower urinary tract symptoms between May 2018 and April 2023. The International Prostate Symptom Score (IPSS) questionnaire, uroflowmetry (UFM), and multichannel urodynamic studies were administered. Successful treatment outcomes were defined as either an IPSS improvement of at least 50% or the regaining of spontaneous voiding in patients urethral catheterization prior to surgery. Results: The study included 93 male patients. Men diagnosed with significant or equivocal bladder outlet obstruction (BOO) experienced significant postoperative improvements in IPSS (from 20.6 to 6.0 and from 17.4 to 6.5, respectively), maximum urine flow rate (from 5.0 mL/sec to 14.4 mL/sec and from 8.8 mL/sec to 12.2 mL/sec, respectively) and voiding efficiency (from 48.8% to 86.0% and from 61.2% to 85.1%, respectively). However, in the group without obstruction, the improvements in IPSS and UFM results were not significant. The presence of detrusor overactivity (odds ratio [OR], 3.152; P=0.025) and preoperative urinary catheterization (OR, 2.756; P=0.040) were associated with favorable treatment outcomes. Conversely, an unobstructed bladder outlet was identified as a negative prognostic factor. Conclusions: In men with DU accompanied by equivocal or significant BOO, surgical intervention to alleviate the obstruction may enhance the IPSS, quality of life, and UFM results. However, those with DU and an unobstructed bladder outlet face a comparatively high risk of treatment failure. Preoperative detrusor overactivity and urinary catheterization are associated with more favorable surgical outcomes. Consequently, active deobstructive surgery should be considered for patients with DU who are experiencing urinary retention.