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Stroke and Bleeding Risk Assessment in Atrial Fibrillation: Where Are We Now?
Ling Kuo,Yi-Hsin Chan,Jo-Nan Liao,Shih-Ann Chen,Tze-Fan Chao 대한심장학회 2021 Korean Circulation Journal Vol.51 No.8
Most important international guidelines recommend the use of CHA2DS2-VASc and HAS-BLED scores for stroke and bleeding risk assessments in atrial fibrillation (AF) patients, respectively. The 2020 AF guidelines of European Society of Cardiology have revised the definition of “C: congestive heart failure (HF)” component, and now patients with either HF with reduced ejection fraction or preserved ejection fraction should be assigned 1 point. Hypertrophic cardiomyopathy was also included. Besides, the revised “V: vascular diseases” component included both prior myocardial infarction and “angiographically significant coronary artery disease”. It is important to understand that the stroke and bleeding risks of AF patients were not static and should be re-assessed regularly. A high HAS-BLED score itself should not be the only reason to withhold or discontinue oral anticoagulants, but remind physicians for the corrections of modifiable bleeding risk factors and more regular follow up. In the future, the AF duration and left atrial function may play an important role for personalized evaluation of individual stroke risk while more studies are necessary.
Isolation, Physicochemical Properties and Toxicities of Territrem A' and B'
Kuo Huang Ling,Fu Chuo Peng,Bai Jiun Chen 한국생약학회 1986 생약학회지 Vol.17 No.2
We have isolated two new metabolites of territrem, designated as territrem A`^* (TRA`; C_(28)H_(30)O_(10) and B`(TRB`; C<sub>29</sub>H<sub>34</sub>O_(10)) from chloroform extract of rice culture of Aspergillus terreus 23-1, using the same isolation procedure as that for territrem A, B and C(TRA, TRB, TRC). The present isolation procedure gave about 5 ㎎ of TRA` and 10 ㎎ of TRB` from 4 ㎏ of rice culture per batch. Analysis of the high resolution mass spectrum showed that the molecular composition of TRA` and TRB` are C_(28)H_(30)O_(10) and C<sub>29</sub>H<sub>34</sub>O_(10) respectively, Some results of physicochemical properties were presented in this paper. Single crystal X-ray diffractometry of TRB` showed that the three dimensional structure of TRB` has not changed significantly from that of TRB (C<sub>29</sub>H<sub>34</sub>O<sub>9</sub>), except for the insertion of one oxygen atom into TRB to make additional pyran in the E-ring. It is also suggested that the aromatic moiety of TRA` is similar to that of TRA (C_(28)H_(30)O<sub>9</sub>) and the rest non-aromatic portions resemble to those of TRB`. The tremorgenic activity, lethality and inhibitory effect on acetylcholine esterase of TRA` and TRB` are greatly reduced comparing to that of TRA and TRB.
COILにおける協働的な課題解決学習の試み -学習内省シ-トと期末レポ-トの事例分析から-
郭淑齡(Kuo, Shu-Ling) 대한일어일문학회 2020 일어일문학 Vol.88 No.-
The author brings awareness to the problem arising from international learning, and proposes online intercultural collaborative learning (hereinafter abbreviated as COIL). It involves Collaborative Problem-Solving through multi-layered dialogues with new knowledge between learners and others. This study examines the learning process and results focusing on the problem-solving aspect, and explores the potential and significance of collaborative problem-based learning in COIL. A qualitative analysis using the introspection sheets and the final report finds the following: 1 The program has improved cognitive and emotional aspects of the students, and can help make more thoughtful and feasible proposals compared with individual problem-solving. 2 Proposals for problem-solving can be classified into the most ideal "integrated type", "alternative type", and the most undesirable "dismissing type". 3 In order to prevent "dismissing" proposals, it is important to improve learners" dialogue skills and provide opportunities to speak while emphasizing personal relationship.
Kuo-Feng Hua,Chia-Yang Li,Feng-Ling Yang,Shih-Hsiung Wu 한국당과학회 2012 한국당과학회 학술대회 Vol.2012 No.1
The capsular polysaccharide (CPS) of pyogenic liver abscessKlebsiella pneumoniaeconsists of repeating units of the trisaccharide (→3)-□-D-Glc-(1→4)-[2,3-(S)-pyruvate]-□-D-GlcA-(1→4)-□-L-Fuc-(1→) and has the unusual feature of extensive pyruvation of glucuronic acid and acetylation of C2-OH or C3-OH of fucose. The present study investigates how CPS activates human monocyte-derived dendritic cells (DCs). Our experimental results show that CPS activates DCs by (1) increasing the expression of CD11c, CD40, CD80, CD83, CD86, and MHC-II (2) increasing the production of TNF-□, IL-1, IL-6, and IL-12p70 (3) increasing DC-elicited allogeneic T-cell proliferation, and (4) increasing the DC-driven Th1 response. In addition, CPS activates DCs through TLR4 and the pyruvation and the acetylation of CPS are important for its cytokine induction activity. Further, our results show that CPS activates TNF-□ and IL-6 secretion through JNK1/2, p38, NF-B,- PKC and ROS pathways in DCs.
Bullying in Middle Schools: An Asian-Pacific Regional Study
Shu-Ling Lai,Renmin Ye,Kuo-Pao Chang 서울대학교 교육연구소 2008 Asia Pacific Education Review Vol.9 No.4
This study discusses and compares five types of bullying in middle schools among tell Asia-Pacific countries. The study does this in the following ways. It explores the impact of students' genders and family backgrounds oil the bullying. finds interactions of the victimization of bullying and relevant attitudes toward schools, teachers and schoolmates. and reveals the relationships between the experiences of bullying and the difficulties, pressures and achievements of academic study in each country. The findings provide meaningful reference points for understanding students' ethics and behavior education, schools' counseling and support systems (as well as the general improvement of the situation in the Asia-Pacific region), and for cross-cultural education comparisons.
Hueih Ling Ong,Chun-Hou Liao,Hann-Chorng Kuo 대한배뇨장애요실금학회 2016 International Neurourology Journal Vol.20 No.4
Purpose: To investigate long-term therapeutic effects and patient adherence to a combination therapy of a 5α-reductase inhibitor and an α-blocker and to identify causes of withdrawal from medication in patients with clinical benign prostatic hyperplasia (BPH). Methods: BPH patients with lower urinary tract symptoms (LUTS) receiving combination therapy with follow-ups for 1–12 years were retrospectively analyzed. Therapeutic effects were assessed at baseline and annually by measuring International Prostatic Symptoms Score, quality of life index, total prostate volume (TPV), maximal flow rate, voided volume, postvoid residual volume and prostate-specific antigen level. Causes of discontinued combination therapy were also investigated. Results: A total of 625 patients, aged 40–97 years (mean, 73 years) were retrospectively analyzed. All measured parameters showed significant improvements after combination therapy. Three hundred sixty-nine patients (59%) discontinued combination therapy with a mean treatment duration of 2.2 years. The most common reasons for discontinued treatment were changing medication to monotherapy with α-blockers or antimuscarinics (124 patients, 19.8%), receiving surgical intervention (39 patients, 6.2%), and LUTS improvement (53 patients, 8.5%). Only 64 patients (10.2%) were loss to follow-up and 6 (1.0%) discontinued combined treatment due to adverse effects. Smaller TPV after short-term combination treatment caused withdrawal from combination therapy. Conclusions: BPH patients receiving long-term combination therapy showed significant improvement in all measured parameters. Changing medication, improved LUTS and choosing surgery are common reasons for discontinuing combination herapy. A smaller TPV after short-term combination treatment was among the factors that caused withdrawal from combination therapy.