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      • KCI등재

        Treatment outcomes of patients with stage II pure endometrioid-type endometrial cancer: a Taiwanese Gynecologic Oncology Group (TGOG-2006) retrospective cohort study

        Hung-Chun Fu,Jen-Ruei Chen,Min-Yu Chen,Keng-Fu Hsu,Wen-Fang Cheng,An Jen Chiang,Yu-Min Ke,Yu-Chieh Chen,Yin-Yi Chang,Chia-Yen Huang,Chieh-Yi Kang,Yuan-Yee Kan,Sheng-Mou Hsiao,Ming-Shyen Yen 대한부인종양학회 2018 Journal of Gynecologic Oncology Vol.29 No.5

        Objective: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. Methods: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. Results: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p<0.001), recurrent urinary tract infections (p=0.013), and leg lymphedema (p=0.038). Age over 50-year (HR=9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR=7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR=5.13; 95% CI, 1.38–19.1) and DSS (HR=5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p=0.046), but no impact on survival. Conclusion: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.

      • SCIESCOPUSKCI등재

        Platelet-Derived Growth Factor Receptor-α Subunit Targeting Suppresses Metastasis in Advanced Thyroid Cancer In Vitro and In Vivo

        ( Ching-ling Lin ),( Ming-lin Tsai ),( Yu-hsin Chen ),( Wei-ni Liu ),( Chun-yu Lin ),( Kai-wen Hsu ),( Chien-yu Huang ),( Yu-jia Chang ),( Po-li Wei ),( Shu-huey Chen ),( Li-chi Huang ),( Chia-hwa Lee 한국응용약물학회 2021 Biomolecules & Therapeutics(구 응용약물학회지) Vol.29 No.5

        Thyroid cancer is the most common endocrine malignancy. Patients with well-differentiated thyroid cancers, such as papillary and follicular cancers, have a favorable prognosis. However, poorly differentiated thyroid cancers, such as medullary, squamous and anaplastic advanced thyroid cancers, are very aggressive and insensitive to radioiodine treatment. Thus, novel therapies that attenuate metastasis are urgently needed. We found that both PDGFC and PDGFRA are predominantly expressed in thyroid cancers and that the survival rate is significantly lower in patients with high PDGFRA expression. This finding indicates the important role of PDGF/PDGFR signaling in thyroid cancer development. Next, we established a SW579 squamous thyroid cancer cell line with 95.6% PDGFRA gene insertion and deletions (indels) through CRISPR/Cas9. Protein and invasion analysis showed a dramatic loss in EMT marker expression and metastatic ability. Furthermore, xenograft tumors derived from PDGFRA geneedited SW579 cells exhibited a minor decrease in tumor growth. However, distant lung metastasis was completely abolished upon PDGFRA gene editing, implying that PDGFRA could be an effective target to inhibit distant metastasis in advanced thyroid cancers. To translate this finding to the clinic, we used the most relevant multikinase inhibitor, imatinib, to inhibit PDGFRA signaling. The results showed that imatinib significantly suppressed cell growth, induced cell cycle arrest and cell death in SW579 cells. Our developed noninvasive apoptosis detection sensor (NIADS) indicated that imatinib induced cell apoptosis through caspase-3 activation. In conclusion, we believe that developing a specific and selective targeted therapy for PDGFRA would effectively suppress PDGFRA-mediated cancer aggressiveness in advanced thyroid cancers.

      • KCI등재

        A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease

        ( Chun-chi Lin ),( Shu-chen Wei ),( Been-ren Lin ),( Wen-sy-tsai ),( Jinn-shiun Chen ),( Tzu-chi Hsu ),( Wei-chen Lin ),( Tien-yu Huang ),( Te-hsin Chao ),( Hung-hsin Lin ),( Jau-min Wong ),( Jen-kou 대한장연구학회 2016 Intestinal Research Vol.14 No.3

        Background/Aims: With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD. Methods: A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients’ demographic data, indications for surgery, and outcome details were recorded and analyzed. Results: The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P =0.013 and 0.034, respectively). Conclusions: In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount.

      • SCIESCOPUSKCI등재

        Early Intervention with High-Dose Steroid Pulse Therapy Prolongs Disease-Free Interval of Severe Alopecia Areata: A Retrospective Study

        ( Chao Chun Yang ),( Chun Te Lee ),( Chao Kai Hsu ),( Yi Pei Lee ),( Tak Wah Wong ),( Sheau Chiou Chao ),( Julia Yu Yun Lee ),( Hamm Ming Sheu ),( Wenchieh Chen ) 대한피부과학회 2013 Annals of Dermatology Vol.25 No.4

        Background: Spontaneous recovery of severe alopecia areata is rare and the condition is difficult to treat. Objective: The aim of this study is to investigate and compare the effects and safety of steroid pulse therapy between oral and intravenous administrations between 1999 and 2010 at the Department of Dermatology, National Cheng Kung University Hospital. Methods: Data were retrospectively retrieved. A satisfactory response was defined as more than 75% hair regrowth in the balding area. Results: A total of 85 patients with more than 50% hair loss were identified and treated, with an overall satisfactory response rate of 51.8%. The mean follow-up time was 37.6 months, with a relapse rate of 22.7%. Patients with alopecia areata (hereafter, AA) of recent onset within one year showed higher response rates (p< 0.001) and lower relapse rates compared to patients with AA persisting for more than 1 year. Further, even in patients with alopecia totalis, alopecia universalis or ophiasis type, early treatment resulted in a satisfactory response rate of 47% among the treated patients. In general, oral therapy was as effective and well-tolerated as intravenous therapy. Conclusion: The response rate is determined by disease severity and time of intervention, not by the administration form of steroid pulse therapy. Oral steroid pulse therapy can be considered as the first-line treatment for patients with severe AA of recent onset within one year. (Ann Dermatol 25(4) 471∼474, 2013)

      • KCI등재

        Application of Auriculotherapy for Post-Burn Scar Syndrome in Young Adults with Major Burns

        Cha-Chun Chen,San-Pei Chen,Shu-Yu Lyu,Chung-Hua Hsu 사단법인약침학회 2021 Journal of Acupuncture & Meridian Studies Vol.14 No.4

        Background: A burn scar is a type of hypertrophic scar that can cause significant clinical symptoms, discomfort, and post-burn scar (PBS) syndrome in up to 77% of patients with burn injuries. Medication and rehabilitation are rarely effective at managing patient discomfort, and both laser and surgical interventions are postponed until the scar stabilizes and discomfort is tolerable. Objectives: The present study was conducted to investigate the effectiveness of auricular acupuncture among burn victims from the Formosa Color Dust Explosion in Taiwan. Methods: We enrolled 31 victims of the 2016 Formosa Color Dust Explosion who met the study inclusion criteria. The intervention involved placement of magnetic beads over the auricular Shenmen and Subcortex acupoints on one ear. Patients performed selfmassage five times per day, and both magnet beads were removed between the fifth and seventh days during the sessions. Several evaluation tools were used to assess clinical symptoms: the visual analogue scale for pain assessment, Burn Man Itch Scale for perceived patient itchiness, 5-D Pruritus Scale for sleep quality, and heart rate variability (HRV) for effects on the autonomic nervous system. Results: The clinical symptoms were significantly decreased following the intervention, but the effect did not endure. The normal-to-normal heart rate interval, heart rate analysis abnormalities, and very low frequency heart rate were significantly decreased among patients with abnormal HRV (SD < 40) following treatment. Conclusion: Stimulation of the auricular Shenmen and Subcortex acupoints may effectively reduce pain, itchiness, and sleep disturbances among patients with PBS syndrome.

      • KCI등재

        Unrecognized History of Transient Atrial Fibrillation at the Time of Discharge from an Index Stroke Hospitalization Is Associated with Increased Recurrent Stroke Risk

        Chia-Yu Hsu,Daniel E. Singer,Hooman Kamel,Yi-Ling Wu,Pei-Chun Chen,Jiann-Der Lee,Meng Lee,Bruce Ovbiagele 대한뇌졸중학회 2019 Journal of stroke Vol.21 No.2

        Background and Purpose Preceding episodes of paroxysmal atrial fibrillation (AF) among stroke patients can be easily overlooked in routine clinical practice. We aim to determine whether an unrecognized history of paroxysmal AF is associated with an increased risk of recurrent stroke. Methods We retrospectively identified all adult patients hospitalized with a primary diagnosis of ischemic stroke who had no AF diagnosis on their discharge records, using the Taiwan National Health Insurance Research Database between January 2001 and December 2012. Patients were categorized into two groups: unrecognized AF history and no AF. Patients with unrecognized AF history were defined as having documented AF preceding the index ischemic stroke hospitalization, but not recording at the index ischemic stroke. Primary endpoint was recurrent stroke within 1 year after the index stroke. Results Among 203,489 hospitalized ischemic stroke patients without AF diagnosed at discharge, 6,731 patients (3.3%) had an unrecognized history of prior transient AF. Patients with an unrecognized AF history, comparing to those without AF, had higher adjusted risk of all recurrent stroke ([original cohort: hazard ratio (HR), 1.41; 95% confidence interval [CI], 1.30 to 1.53], [matched cohort: HR, 1.51; 95% CI, 1.37 to 1.68]) and recurrent ischemic stroke ([original cohort: HR, 1.42; 95% CI, 1.30 to 1.55], [matched cohort: HR, 1.56; 95% CI, 1.40 to 1.74]) during the 1-year follow-up period. Conclusions Unrecognized history of AF among patients discharged after an index ischemic stroke hospitalization is associated with higher recurrent stroke risk. Careful history review to uncover a paroxysmal AF history is important for ischemic stroke patients.

      • KCI등재

        Analysis of the Interdecadal and Interannual Variability of Autumn Extreme Rainfall in Taiwan Using a Deep-Learning-Based Weather Typing Approach

        Li‑Huan Hsu,Yi‑chao Wu,Chou‑Chun Chiang,Jung‑Lien Chu,Yi‑Chiang Yu,An‑Hsiang Wang,Ben Jong‑Dao Jou 한국기상학회 2023 Asia-Pacific Journal of Atmospheric Sciences Vol.59 No.2

        This study sought to assess the interdecadal and interannual variability of autumn extreme rainfall (ER) in Taiwan from 1979to 2019. Three types of ER events were identified based on a clustering analysis augmented by a deep autoencoder-basedneural network model. This method outperforms other methods in obtaining the optimal number of clusters by extractingthe synoptic features in advance. The patterns associated with these three types include a tropical cyclone covering Taiwan(TC), a TC-like circulation in the South China Sea (SCS) accompanied by northeasterly near northern Taiwan (TC-NE), andnortheasterly near northern Taiwan (NE). The differences in the rainfall pattern caused by the three types were discernableover Taiwan. How the PDO or ENSO modulates the regional large-scale environment to favor the occurrence of these ERevents was investigated. The occurrence of TC-NE events was simultaneously correlated with the negative phases of PDO/ENSO in the interdecadal/interannual scale. In the negative phases of PDO/ENSO, a low-level anomalous cyclone overSCS accompanied by background northeasterly favored the regional TC activities and may cause more TC-NE events. Theoccurrence of NE events is simultaneously correlated with the cold phase of ENSO. An anomalous low-level anticyclone inNortheast Asia strengthened the northeasterly toward northern Taiwan, and with the seasonal background moisture, providedfavorable conditions for the occurrence of the NE events. Overall, the occurrence of the TC events did not correlate with thePDO or ENSO signals; the reasons for the lack of correlation were discussed herein.

      • KCI등재

        Genotype­specific methylation of HPV in cervical intraepithelial neoplasia

        Yaw-Wen Hsu,Rui-Lan Huang,Po-Hsuan Su,Yu-Chih Chen,Hui-Chen Wang,Chi-Chun Liao,Hung-Cheng Lai 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4

        Objective: Hypermethylation of human papillomavirus (HPV) and host genes has beenreported in cervical cancer. However, the degree of methylation of different HPV typesrelative to the severity of the cervical lesions remains controversial. Studies of the degree ofmethylation associated with the host gene and the HPV genome to the severity of cervicallesions are rare. We examined the association of methylation status between host genes andlate gene 1 (L1) regions of HPV16, 18, 52, and 58 in cervical brushings. Methods: Cervical brushings from 147 HPV-infected patients were obtained. The samplescomprised normal (n=28), cervical intraepithelial neoplasia (CIN) 1 (n=45), CIN2 (n=13), andCIN3/carcinoma in situ (n=61). The methylation status of HPV and host genes was measuredusing bisulfite pyrosequencing and quantitative methylation-specific polymerase chainreaction (PCR). Results: The degree of methylation of L1 in HPV16, 18, and 52 was associated with theseverity of the cervical lesion. In HPV52, C-phosphate-G (CpG) sites 6368m, 6405m, and6443m showed significantly higher methylation in lesions ≥CIN3 (p=0.005, 0.003, and0.026, respectively). Methylation of most HPV types except HPV52 (r<−0.1) was positivelycorrelated with the degree of methylation of host genes including PAX1 and SOX1 (0.4≤r≤0.7). Combining HPV methylation with PAX1 methylation improved the clustering for ≥CIN2. Conclusion: Our study showed that the degree of L1 methylation of HPV16, 18, and 52but not 58 is associated with the severity of cervical lesions. The association betweenHPV methylation and host gene methylation suggests different responses of host cellularepigenetic machinery to different HPV genotypes.

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