JNM : Original Article ; Relevance of Ultrastructural Alterations of Intercellular Junction Morphology in Inflamed Human Esophagus

( Chia Chin Liu ),( Jeng Woei Lee ),( Tso Tsai Liu ),( Chih Hsun Yi ),( Chien Lin Chen ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2013 Journal of Neurogastroenterology and Motility (JNM Vol.19 No.3

Background/Aims Detailed characterization of the ultrastructural morphology of intercellular space in gastroesophageal reflux disease has not been fully studied. We aimed to investigate whether subtle alteration in intercellular space structure and tight junction proteins might differ among patients with gastroesophageal reflux disease. Methods Esophageal biopsies at 5 cm above the gastroesophageal junction were obtained from 6 asymptomatic controls, 10 patients with reflux symptoms but without erosions, and 18 patients with erosions. The biopsies were morphologically evaluated by transmission electron microscopy, and by using immunohistochemistry for tight junction proteins (claudin-1 and claudin-2 proteins). Results The expressions of tight junction proteins did not differ between asymptomatic controls and gastroesophageal reflux disease patients. In patients with gastroesophageal reflux disease, altered desmosomal junction morphology was only found in upper stratified squamous epithelium. Dilated intercellular space occurred only in upper stratified squamous epithelium and in patients with erosive esophagitis.Conclusions This study suggests that dilated intercellular space may not be uniformly present inside the esophageal mucosa and predom - inantly it is located in upper squamous epithelium. Presence of desmosomal junction alterations is associated with increased severity of gastroesophageal reflux disease. Besides dilated intercellular space, subtle changes in ultrastructural morphology of intercellular space allow better identification of inflamed esophageal mucosa relevant to acid reflux. (J Neurogastroenterol Motil 2013; 19:324-331)

Thyroid fine-needle aspiration cytology in Taiwan: a nationwide survey and literature update

Chien-Chin Chen,Jen-Fan Hang,Chih-Yi Liu,Yeh-Han Wang,Chiung-Ru Lai 대한병리학회 2020 Journal of Pathology and Translational Medicine Vol.54 No.5

In Taiwan, thyroid fine-needle aspiration cytology is easily accessible and reliable for evaluating thyroid nodules. The sonographic pattern plays a major role and is the deciding factor for aspiration. We conducted a nationwide survey in 2017 and it revealed that 31% of laboratories had adopted The Bethesda System for Reporting Thyroid Cytopathology. There was a relatively high unsatisfactory rate (24.04%) and low rates of indeterminate diagnoses, including atypia of undetermined significance/follicular lesions of undetermined significance: 4.87%, and follicular neoplasm/suspicious for a follicular neoplasm: 0.35%. Moreover, the risks of malignancy in benign, atypia of undetermined significance, and suspicious for a follicular neoplasm were relatively high. These may reflect strict diagnostic criteria for indeterminate categories and better patient selection for surgery. Improvements in specimen sampling and continuing education programs are crucial. Newly-developed thyroid cytology technologies, such as immunocytochemistry, molecular testing, and computerized cytomorphometry, may further facilitate cytology diagnoses.

Multislice CT Scans in Patients on Extracorporeal Membrane Oxygenation: Emphasis on Hemodynamic Changes and Imaging Pitfalls

Kao-Lang Liu,Yu-Feng Wang,Yeun-Chung Chang,Shu-Chien Huang,Shyh-Jye Chen,Yuk-Ming Tsang,Chin-Chen Chang 대한영상의학회 2014 Korean Journal of Radiology Vol.15 No.3

This pictorial review provides the principles of extracorporeal membrane oxygenation (ECMO) support and associated CT imaging features with emphasis on the hemodynamic changes and possible imaging pitfalls encountered. It is important that radiologists in ECMO centers apply well-designed imaging protocols and familiarize themselves with post-contrast CT imaging findings in patients on ECMO.

Comparison of Equivalent Oxide Thickness and Electrical Properties of Atomic Layer Deposited Hafnium Zirconate Dielectrics with Thermal or Decoupled Plasma Nitridation Process

Chen-Kuo Chiang,Chien-Hung Wu,Chin-Chien Liu,Jin-Fu Lin,Chien-Lun Yang,Jiun-Yuan Wu,Shui-Jinn Wang 대한금속·재료학회 2012 ELECTRONIC MATERIALS LETTERS Vol.8 No.5

The NH3 thermal annealing and decoupled plasma nitridation (DPN) processes are compared for the equivalent oxide thickness (EOT) scaling of atomic-layer-deposited hafnium zirconate (HfZrO2) gate dielectric. Detailed physical, optical, and electrical characteristics of nitrided HfZrO2 (HfZrON) film are reported. It is found that DPN can yield a thinner SiOx interfacial layer (IL) (about 0.12 nm more in terms of EOT scaling)and a more densified HfZrO2 layer compared to those obtained using NH3 thermal annealing at a 16% nitrogen dose. NH3 thermal nitridation causes a large nitrogen distribution tail at the SiOx IL/Si substrate interface and increases leakage current, which suppresses EOT scalability.

Improved Electron Injection of Organic Light-emitting Diodes by Using an Ultrathin Lithium-hydroxide Buffer Layer

Po-Ching Kao,Shu-I Lin,Chin-Chih Chang,Ching-Wen Huang,Chien-Chi Liu 한국물리학회 2012 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.60 No.10

A cathode buffer layer of lithium hydroxide (LiOH) was used to improve the electro-optical properties of organic light-emitting diodes (OLEDs). LiOH layers with various thicknesses were prepared by thermally evaporating LiOH powders. When a 1-nm-thick LiOH layer was inserted between the aluminum (Al) cathodes and the tris(8-hydroxyquinolinato)aluminum (Alq3) electrontransporting layers, device properties such as the turn-on voltage, the maximum luminance, and the device efficiency were improved, becoming better than those of the device with a LiF buffer layer. The surface of the Alq3 film became smoother after the LiOH layer had been deposited. Ultraviolet photoelectron spectroscopy results show that the reaction between LiOH and Alq3 results in an n-type doping effect, which moves the Fermi level close to the lowest unoccupied molecular orbital (LUMO) of Alq3. Thus, the electron-injection efficiency was enhanced due to a lower electron injection barrier, which improved the charge carrier balance in the OLEDs and led to a better device efficiency.

Learning Curve of ROSA ONE Spine System for Transpedicular Screw Placement

Bing-Hung Hsu,Heng-Wei Liu,Kha-Liang Lee,Ming-Chin Lin,Gao Chen,Jang Yu,Chiao-Ling Chen,I-Chang Su,Chien-Min Lin 대한척추신경외과학회 2022 Neurospine Vol.19 No.2

Objective: The study investigated our institutional learning curve for the ROSA ONE spine system (ROSA) based on ROSA usage time. Methods: ROSA was designed to provide high accuracy for spinal pedicle screw placement through a built-in tracking technique. This study was conducted from November 2018 to January 2021. The time taken to complete each step of the robotic workflow was recorded. Patient demographics, comorbidities, surgical indications, and number of screw placements were examined in subgroup analysis. The Curve Fitting-General package (a part of NCSS 2021 software) was used to fit a mathematical model to the learning curve. Patient demographics, imaging data, and surgical time were reviewed retrospectively. Results: A total of 167 patients who had undergone surgery were included. The mean total ROSA usage time was 107.1 ± 27.3 minutes. The estimated learning rate was 90.4%, and the largest slope change occurred close to the time of the 20th surgery. The observed overall learning trend in the 4-screw group could be attributed to screw planning. The presence of scoliosis (p = 0.73) or spondylolisthesis (p = 0.70) did not significantly influence the mean total time (TT) for all patients; however, the mean TT differed significantly (p < 0.01) among subgroups stratified by body mass index, screw number placement, and thoracic spine involvement. Conclusion: To the best of our knowledge, this is the first study to examine the learning curve for the various crucial steps of ROSA-guided pedicle screw placement. The indicative learning curve involved 20 patients who had undergone surgery.

Decellularized Human Umbilical Artery Exhibits Adequate Endothelialization in Xenogenic Transplantation

Kai Hsia,Tien-Shiang Wang,Chin-Su Liu,Chih-Kuan Su,Chien-Chin Chen,Chang-Ching Yeh,Hsinyu Lee,Chao-Ling Yao,Tsung-Yu Tseng,Shih-Hwa Chiou,Hsu Ma,Chih-Hsun Lin,Jen-Her Lu 한국생물공학회 2023 Biotechnology and Bioprocess Engineering Vol.28 No.3

Decellularized human umbilical arteries (dHUA) is an off-the-shelf graft that can potentially serve as vascular scaffolds in tissue engineering of small-diameter vascular grafts. This research aimed to investigate that dHUA could exhibit adequate endothelialization for a long term in xenogenic transplantation. 13 dHUAs were implanted in rat abdominal aortas up to 90 days. Rats were divided into three groups in terms of survival period: Group 1, one to seven days (n = 6); Group 2, 14 to 30 days (n = 4) and Group 3, 90 days (n = 3). The explants were analyzed by histological, immunohistochemistry and magnetic resonance angiography (MRA) examination. Allograft implantation of 12 decellularized rat abdominal aortas` were processed the same way as the rat in order to make a comparison for survival rates (Group 1, n = 5; Group 2, n = 4; Group 3, n = 3). The results demonstrated that the survival rates of xenograft and allograft implantation were estimated to be 59.2% vs. 58.3% in Group 1, 50.7% vs. 58.3% in Group 2 and 3. Grafts harvested from Group 2 were showed CD31, endothelial nitric oxide synthase expression at intima, and α-smooth muscle actin, CD45, CD68 and CD168 expression at the tunica externa. A layer structure with obvious endothelialization and fiber regeneration/orientation could be inspected from the explants of Group 3. MRA demonstrated the patency of dHUA on day 30 and 90. In conclusion, more than 50% dHUA maintained patency in the xenogenic model till 90 days after surgery. A mature vessel-like functional structure with intact endothelial layer was observed then. This warrants further study in the reinforcement of decellularized vascular scaffolds.

Noni (Morinda citrifolia L.) Fruit Extracts Improve Colon Microflora and Exert Anti-Inflammatory Activities in Caco-2 Cells

Hsin-Lun Huang,Cheng-Tzu Liu,Ming-Chih Chou,Chien-Hui Ko,Chin-Kun Wang 한국식품영양과학회 2015 Journal of medicinal food Vol.18 No.6

Intestinal microflora and inflammation are associated with the risk of inflammatory bowel diseases. Noni (Morinda citrifolia L.) has various bioactivities, but its effect on colon health remains unknown. This study focused on the effects of fermented noni fruit extracts on colon microflora and inflammation of colon epithelial cells. The anti-inflammatory activities of ethanol and ethyl acetate extracts on Caco-2 cells were evaluated including interleukin-8 (IL-8) and cyclooxygenase-2 (COX-2). The growth of Lactobacillus and Bifidobacterium species was promoted by ethanol extract. Ethyl acetate extract decreased intracellular reactive oxygen species and significantly suppressed COX-2, IL-8, and prostaglandin E2 production and neutrophil chemotaxis by suppressing the translocation of the p65 subunit. Quercetin was the main contributor to the anti-inflammatory activity. The fermented noni fruit promoted probiotic growths and downregulated the intracellular oxidation and inflammation in Caco-2 cells. These results suggest that fermented noni fruit might protect against inflammatory diseases of the colon.

A Systemic Review and Experts’ Consensus for Long-acting Injectable Antipsychotics in Bipolar Disorder

Yuan-Hwa Chou,Po-Chung Chu,Szu-Wei Wu,Jen-Chin Lee,Yi-Hsuan Lee,I-Wen Sun,Chen-Lin Chang,Chien-Liang Huang,I-Chao Liu,Chia-Fen Tsai,Yung-Chieh Yen 대한정신약물학회 2015 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.13 No.2

Bipolar disorder (BD) is a major psychiatric disorder that is easily misdiagnosed. Patient adherence to a treatment regimen is of utmost importance for successful outcomes in BD. Several trials of antipsychotics suggested that depot antipsychotics, including long-acting first- and second-generation agents, are effective in preventing non-adherence, partial adherence, and in reducing relapse in BD. Various long-acting injectable (LAI) antipsychotics are available, including fluphenazine decanoate, haloperidol decanoate, olanzapine pamoate, risperidone microspheres, paliperidone palmitate, and aripiprazole monohydrate. Due to the increasing number of BD patients receiving LAI antipsychotics, treatment guidelines have been developed. However, the clinical applicability of LAI antipsychotics remains a global cause for concern, particularly in Asian countries. Expert physicians from Taiwan participated in a consensus meeting, which was held to review key areas based on both current literature and clinical practice. The purpose of this meeting was to generate a practical and implementable set of recommendations for LAI antipsychotic use to treat BD; target patient groups, dosage, administration, and adverse effects were considered. Experts recommended using LAI antipsychotics in patients with schizophrenia, rapid cycling BD, BD I, and bipolar-type schizoaffective disorder. LAI antipsychotic use was recommended in BD patients with the following characteristics: multiple episodes and low adherence; seldom yet serious episodes; low adherence potential per a physician’s clinical judgment; preference for injectable agents over oral agents; and multiple oral agent users still experiencing residual symptoms.

The development of Taiwan Fracture Liaison Service network

Lo-Yu Chang,Keh-Sung Tsai,Jen-Kuei Peng,Chung-Hwan Chen,Gau-Tyan Lin,Chin-Hsueh Lin,Shih-Te Tu,I-Chieh Mao,Yih-Lan Gau,Hsusan-Chih Liu,Chi-Chien Niu,Min-Hong Hsieh,Jui-Teng Chien,Wei-Chieh Hung,Rong-S 대한골다공증학회 2018 Osteoporosis and Sarcopenia Vol.4 No.2

Osteoporosis and its associated fragility fractures are becoming a severe burden in the healthcare system globally. In the Asian-Pacific (AP) region, the rapidly increasing in aging population is the main reason accounting for the burden. Moreover, the paucity of quality care for osteoporosis continues to be an ongoing challenge. The Fracture Liaison Service (FLS) is a program promoted by International Osteoporosis Foundation (IOF) with a goal to improve quality of postfracture care and prevention of secondary fractures. In this review article, we would like to introduce the Taiwan FLS network. The first 2 programs were initiated in 2014 at the National Taiwan University Hospital and its affiliated Bei-Hu branch. Since then, the Taiwan FLS program has continued to grow exponentially. Through FLS workshops promoted by the Taiwanese Osteoporosis Association (TOA), program mentors have been able to share their valuable knowledge and clinical experience in order to promote establishments of additional programs. With 22 FLS sites including 11 successfully accredited on the best practice map, Taiwan remains as one of the highest FLS coverage countries in the AP region, and was also granted the IOF Best Secondary Fracture Prevention Promotion award in 2017. Despite challenges faced by the TOA, we strive to promote more FLS sites in Taiwan with a main goal of ameliorating further health burden in managing osteoporotic patients.