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      • KCI등재

        The effects of loading dose administration rate of dexmedetomidine on sedation and dexmedetomidine requirement in elderly patients undergoing spinal anesthesia

        Hsi Chiang Kung,Chia Chi Cheng,강동희,정형주,신혜영,김두식,류시정,김경한,김주덕 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.3

        Background: This study evaluated the effect of decrease in loading dose administration rate of dexmedetomidine (DMT) on sedation and DMT requirement in elderly patients. Methods: Fifty-eight patients over 65 years old with ASA I–II who were planned to receive DMT sedation during spinal anesthesia were randomly assigned to two groups. Group S (n = 29) received a 0.5 μg/kg DMT loading dose over 20 minutes, while group C (n = 29) received the DMT loading dose over 10 minutes. Then, both groups received a continuous infusion of 0.4 μg/kg/h. The sedative status was recorded before and at 5, 10, 15, 20, 25, and 30 minutes after administration of DMT and at the end of the anesthesia according to the Ramsay sedation scale (RSS). Also, the time to reach RSS- 3 (patients asleep, responsive to commands) and the dose of DMT until reaching RSS-3 were recorded. Results: The time to reach RSS-3 was similar between the two groups (group S = 16.0 ± 4.3 minutes vs. group C = 15.5 ± 4.2 minutes, P = 0.673). However, the DMT required to reach RSS-3 in group S was significantly lower than that in group C (23.3 ± 7.1 vs. 32.5 ± 6.0 μg, P < 0.001). There was no difference in RSS between the two groups from the administration of DMT to the end of the anesthesia (P = 0.927). Conclusions: Decreasing the administration rate of the DMT loading dose did not delay the onset of RSS-3 sedation and reduced the DMT requirement in elderly patients.

      • C-33 : QC strategy for US FDA approval of biopharmaceutics

        ( Hsi Meng* ) 한국화학공학회 2007 화학공학의이론과응용 Vol.10 No.2

        Biopharmaceutics as an industry is now in transit. By 2006, more than $10 billion in annual sales of biotech product will lose their patent protection. Unlike the small molecules, these biogeneric recombinant proteins have to face a different situation. These so called “follow on biologics” or bio-similar product, does not have a clear path for registration. There are triple hurdles: legal, technical, and clinical hurdles to overcome and in comparison to original product. U.S. FDA is facing pressures from the Congress and had pushed the original time line to “some time next year” for publishing a guideline for registration path for “follow on biologics”. The hesitancy comes from Novatis` problem in registration of human growth hormone in Europe. The hurdle is mostly from showing equivalence in clinics, and the use of “originator`s” proprietory information. The characterization of protein product are both time and resource intensive. The proper application and knowledge of analytical methods will ensure a smooth and less traumatic (or heavily criticized) registration process. The “Trio-Equivalence”: analytical equivalence, bioequivalence, and clinical equivalence are the best assurance to a successful registration.

      • KCI등재

        The role of organizational learning in transformational leadership and organizational innovation

        Hsi-Chi Hsiao,Jen-Chia Chang 서울대학교 교육연구소 2011 Asia Pacific Education Review Vol.12 No.4

        Leadership is an important factor affecting organizational innovation. Many studies show that transformational leadership has positive and significant influence on organizational innovation. Based on a literature review and previous work, this study aims to investigate the influence of transformational leadership on organizational innovation and to examine whether organizational learning is a mediator between their relationships. Structural equation modeling was used to test the model. The research sample consisted of 330 teachers in charge of administration in postsecondary schools. The findings of this study provide evidence that transformational leadership and organizational learning have significant positive relationship influence on organizational innovation. The research also demonstrates that there is significant effect on the role of mediation in organizational learning on the relationship between transformational leadership and organizational innovation. The study suggests that if school principals use the strategies of transformational leadership and organizational learning at the same time, organizational learning was highly effectiveness to achieve organizational innovation in the postsecondary schools.

      • KCI등재

        Capsaicin-Sensitive Sensory Nerves Indirectly Modulate Motor Function of the Urinary Bladder

        Hsi-Hsien Chang,Shang-Jen Chang,Cheng-Hsing Hsieh,Chun-Kai Hsu,Stephen Shei-Dei Yang 대한배뇨장애요실금학회 2018 International Neurourology Journal Vol.22 No.2

        Purpose: The urinary bladder (UB) is innervated by both sensory and autonomic nerves. Recent studies have shown that sensory neuropeptides induced contractions in the detrusor muscle. Therefore, in a mouse model, we investigated the presence of interactions between the submucosal sensory nerves and the autonomic nerves that regulate the motor function of the detrusor muscle. Methods: UB samples from male C57BL/6 mice were isolated, cut into strips, and mounted in an organ bath. Dose-response curves to norepinephrine and phenylephrine were studied in UB strips with and without mucosa, and the effects of preincubation with a receptor antagonist and various drugs on relaxation were also studied using tissue bath myography. Results: Phenylephrine-induced relaxation of the UB strips showed concentration-related effects. This relaxation appeared in both mucosa-intact and mucosa-denuded UB strips, and was significantly inhibited by lidocaine, silodosin, and guanethidine (an adrenergic neuronal blocker). Meanwhile, phenylephrine-induced relaxation was inhibited by pretreatment with propranolol and calcitonin gene-related peptide (CGRP)–depletory capsaicin in UB strips with and without mucosa. Conclusions: The present study suggests that phenylephrine activates the α-1A adrenergic receptor (AR) of the sensory nerve, and then activates capsaicin-sensitive sensory nerves to release an unknown substance that facilitates the release of norepinephrine from adrenergic nerves. Subsequently, norepinephrine stimulates β-ARs in the detrusor muscle in mice, leading to neurogenic relaxation of the UB. Further animal and human studies are required to prove this concept and to validate its clinical usefulness.

      • KCI등재

        Cerebral Venous Reflux and Dilated Basal Ganglia Perivascular Space in Hypertensive Intracerebral Hemorrhage

        Hsin-Hsi Tsai,Bo-Ching Lee,Ya-Fang Chen,Jiann-Shing Jeng,Li-Kai Tsai 대한뇌졸중학회 2022 Journal of stroke Vol.24 No.3

        Background and Purpose Cerebral venous flow alterations potentially contribute to age-related white matter changes, but their role in small vessel disease has not been investigated. Methods This study included 297 patients with hypertensive intracerebral hemorrhages (ICH) who underwent magnetic resonance imaging. Cerebral venous reflux (CVR) was defined as the presence of abnormal signal intensity in the dural venous sinuses or internal jugular vein on time-of-flight angiography. We investigated the association between CVR, dilated perivascular spaces (PVS), and recurrent stroke risk. Results CVR was observed in 38 (12.8%) patients. Compared to patients without CVR those with CVR were more likely to have high grade (>20 in the number) dilated PVS in the basal ganglia (60.5% vs. 35.1%; adjusted odds ratio [aOR], 2.64; 95% confidence interval [CI], 1.25 to 5.60; P=0.011) and large PVS (>3 mm in diameter) (50.0% vs. 18.5%; aOR, 3.87; 95% CI, 1.85 to 8.09; P<0.001). During a median follow-up of 18 months, patients with CVR had a higher recurrent stroke rate (13.6%/year vs. 6.2%/year; aOR, 2.53; 95% CI, 1.09 to 5.84; P=0.03) than those without CVR. Conclusions CVR may contribute to the formation of enlarged PVS and increase the risk of recurrent stroke in patients with hypertensive ICH.

      • Individual and Social Network Predictors of Physical Bullying: A Longitudinal Study of Taiwanese Early Adolescents

        Wei, Hsi-Sheng,Lee, Wonjae Springer Publications 2014 Violence and victims Vol.29 No.4

        <P>This study followed 125 7th-grade students in Taiwan for the entire school year and analyzed the individual and social network factors predicting their involvement in physical bullying over 5 waves of data. Using self-reports of bullying experiences, 20 classroom-level networks of bullying and friendship were constructed for 4 classrooms and 5 temporal points, from which 4 individual-level network measures were calculated. They included bully and victim centrality, popularity, and embeddedness in friendship networks. A series of mixed models for repeated measures were constructed to predict students’ bully and victim centrality in bullying network at time <I>t</I> + 1. Compared to girls, boys were more likely to be both the bullies and victims. Lower self-esteem and higher family economic status contributed to victim centrality. Having parents married and living together predicted lower bully centrality. Higher educational level of parents predicted lower victim and bully centrality. Regarding the social network factors, students’ bully centrality at <I>t</I> positively predicted their bully centrality at <I>t</I> + 1, whereas victim centrality predicted their subsequent victim centrality. Interaction effects between friendship network and bullying network were observed. Embeddedness in friendship network reduced victim centrality at <I>t</I> + 1 except for those students with low victim centrality at <I>t</I>. For those with high victim centrality at <I>t</I>, popularity increased their risk of physical victimization over time. Implications for research and practice are discussed.</P>

      • SCISCIESCOPUS
      • Four Strategies of Heuristic Thinking to Solve "Sudoku"

        ( Che Hsi Kuo ),( Peng Jen Lai ) 한국수학교육학회 2012 수학교육 학술지 Vol.2012 No.2

        Sudoku is an interesting mathematical game. It could be used to cultivate students` logical thinking without complicated mathematical knowledge. When someone plays Sudoku, the player needs to follow up the basic rule-to fill the numbers 1~9 in all squares , and to ensure that the number 1 to 9 does not repeat in any 3 by 3 grid and any column and row of the 9 by 9 grid. Four strategies of heuristic thinking to solve Sudoku are proposed in this paper. The first is “finding the checker for a candidate number" or " looking for the candidate numbers for a fixed checker ". The second is “using the candidate number derived from the first strategy as the new condition, and applying strategy one again ". The third is “filling the candidate numbers derived from the second step in some fixed checkers, and then running the first strategy again to find a better solution”. The final one is “using exhausted method based on the results by strategy 3.

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