Comedications and potential drug-drug interactions with direct-acting antivirals in hepatitis C patients on hemodialysis

( Po-yao Hsu ),( Yu-ju Wei ),( Jia-jung Lee ),( Sheng-wen Niu ),( Jiun-chi Huang ),( Cheng-ting Hsu ),( Tyng-yuan Jang ),( Ming-lun Yeh ),( Ching-i Huang ),( Po-cheng Liang ),( Yi-hung Lin ),( Ming-ye 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1

Background/Aims: Direct-acting antivirals (DAAs) have been approved for hepatitis C virus (HCV) treatment in patients with end-stage renal disease (ESRD) on hemodialysis. Nevertheless, the complicated comedications and their potential drug-drug interactions (DDIs) with DAAs might limit clinical practice in this special population. Methods: The number, class, and characteristics of comedications and their potential DDIs with five DAA regimens were analyzed among HCV-viremic patients from 23 hemodialysis centers in Taiwan. Results: Of 2,015 hemodialysis patients screened in 2019, 169 patients seropositive for HCV RNA were enrolled (mean age, 65.6 years; median duration of hemodialysis, 5.8 years). All patients received at least one comedication (median number, 6; mean class number, 3.4). The most common comedication classes were ESRD-associated medications (94.1%), cardiovascular drugs (69.8%) and antidiabetic drugs (43.2%). ESRD-associated medications were excluded from DDI analysis. Sofosbuvir/velpatasvir/voxilaprevir had the highest frequency of potential contraindicated DDIs (red, 5.6%), followed by glecaprevir/pibrentasvir (4.0%), sofosbuvir/ledipasvir (1.3%), sofosbuvir/velpatasvir (1.3%), and elbasvir/grazoprevir (0.3%). For potentially significant DDIs (orange, requiring close monitoring or dose adjustments), sofosbuvir/velpatasvir/voxilaprevir had the highest frequency (19.9%), followed by sofosbuvir/ledipasvir (18.2%), glecaprevir/pibrentasvir (12.6%), sofosbuvir/velpatasvir (12.6%), and elbasvir/grazoprevir (7.3%). Overall, lipid-lowering agents were the most common comedication class with red-category DDIs to all DAA regimens (n=62), followed by cardiovascular agents (n=15), and central nervous system agents (n=10). Conclusions: HCV-viremic patients on hemodialysis had a very high prevalence of comedications with a broad spectrum, which had varied DDIs with currently available DAA regimens. Elbasvir/grazoprevir had the fewest potential DDIs, and sofosbuvir/velpatasvir/voxilaprevir had the most potential DDIs. (Clin Mol Hepatol 2021;27:186-196)

Performance Improvement of Offline Phase for Indoor Positioning Systems Using Asus Xtion and Smartphone Sensors

Sheng-Cheng Yeh,Yih-Shyh Chiou,Huan Chang,Wang-Hsin Hsu,Shiau-Huang Liu,Fuan Tsai 한국통신학회 2016 Journal of communications and networks Vol.18 No.5

Providing a customer with tailored location-based ser-vices (LBSs) is a fundamental problem. For location-estimationtechniques with radio-based measurements, LBS applications arewidely available for mobile devices (MDs), such as smartphones,enabling users to run multi-task applications. LBS information notonly enables obtaining the current location of an MD but also pro-vides real-time push-pull communication service. For indoor envi-ronments, localization technologies based on radio frequency (RF)pattern-matching approaches are accurate and commonly used. However, to survey radio information for pattern-matching ap-proaches, a considerable amount of time and work is spent in in-door environments. Consequently, in order to reduce the system-deployment cost and computing complexity, this article proposesan indoor positioning approach, which involves using Asus Xtionto facilitate capturing RF signals during an offline site survey. Thedepth information obtained using Asus Xtion is utilized to estimatethe locations and predict the received signal strength (RF informa-tion) at uncertain locations. The proposed approach effectively re-duces not only the time and work costs but also the computing com-plexity involved in determining the orientation and RF during theonline positioning phase by estimating the user’s location by usinga smartphone. The experimental results demonstrated that morethan 78% of time was saved, and the number of samples acquiredusing the proposed method during the offline phase was twice asmuch as that acquired using the conventional method. For the on-line phase, the location estimates have error distances of less than2.67 m. Therefore, the proposed approach is beneficial for use invarious LBS applications.

Performance Improvement of Offline Phase for Indoor Positioning Systems Using Asus Xtion and Smartphone Sensors

Yeh, Sheng-Cheng,Chiou, Yih-Shyh,Chang, Huan,Hsu, Wang-Hsin,Liu, Shiau-Huang,Tsai, Fuan The Korea Institute of Information and Commucation 2016 Journal of communications and networks Vol.18 No.5

Providing a customer with tailored location-based services (LBSs) is a fundamental problem. For location-estimation techniques with radio-based measurements, LBS applications are widely available for mobile devices (MDs), such as smartphones, enabling users to run multi-task applications. LBS information not only enables obtaining the current location of an MD but also provides real-time push-pull communication service. For indoor environments, localization technologies based on radio frequency (RF) pattern-matching approaches are accurate and commonly used. However, to survey radio information for pattern-matching approaches, a considerable amount of time and work is spent in indoor environments. Consequently, in order to reduce the system-deployment cost and computing complexity, this article proposes an indoor positioning approach, which involves using Asus Xtion to facilitate capturing RF signals during an offline site survey. The depth information obtained using Asus Xtion is utilized to estimate the locations and predict the received signal strength (RF information) at uncertain locations. The proposed approach effectively reduces not only the time and work costs but also the computing complexity involved in determining the orientation and RF during the online positioning phase by estimating the user's location by using a smartphone. The experimental results demonstrated that more than 78% of time was saved, and the number of samples acquired using the proposed method during the offline phase was twice as much as that acquired using the conventional method. For the online phase, the location estimates have error distances of less than 2.67 m. Therefore, the proposed approach is beneficial for use in various LBS applications.

Antiproliferative and Antitumorigenic Activity of Toona sinensis Leaf Extracts in Lung Adenocarcinoma

Chih-Jen Yang,Yu-Jung Huang,Cheng-Yuan Wang,Chuan-Sheng Wang,Pei-Hui Wang,Jen-Yu Hung,Tung-Heng Wang,Hseng-Kuang Hsu,Hurng-Wern Huang,S.P. Anand Kumar,Ming-Shyan Huang,Ching-Feng Weng 한국식품영양과학회 2010 Journal of medicinal food Vol.13 No.1

Toona sinensis is a traditional Chinese herb, and the extracts of T. sinensis leaf possess a variety of biological functions. This study attempted to test the antiproliferative effect of TSL-1 (a bioactive fraction of T. sinensis) in H441 cells (lung adenocarcinoma). The data showed that the antiproliferative effect of TSL-1 on H441 cells is prominent using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. TSL-1-induced apoptosis was confirmed by cell morphology, sub-G1 peak accumulation, cleavage of poly(ADP)-ribose polymerase, and propidium iodide-annexin V double staining. Furthermore, decreased Bcl-2 accompanied by increased Bax (in western blotting) was found with TSL-1 treatment of H441 cells. TSL-1 treatment-induced G1 arrest was concurrent with the down-regulation of protein levels of cyclin D1 and cyclin-dependent kinase 4 in H441 cells. Peroral and intraperitoneal administrations of TSL-1 were performed to evaluate the therapeutic efficacy, and peroral administration of TSL-1 was also used to elucidate the therapeutic efficacy in the H441 cell xenograft model in vivo. The data revealed that TSL-1 treatment inhibited H441 tumor growth in both therapeutic and preventive experiments. Taken together, these results demonstrate that TSL-1 possesses the capability of preventing and alleviating lung cancer proliferation in vitro and in vivo with proven nephrological and hepatic safety and has the potential to be developed as an anti–lung cancer drug.

Poster Session : PS 0589 ; Psychiatry ; Holistic Care Unit Improves Access Block in Emergency Department in Taiwan

( Meng Chieh Wu ),( Hsin Kai Huang ),( Chun Cheng Zhang ),( Li Sheng Chang ),( Yung Ze Cheng ),( Chien Chin Hsu ),( Kao Chang Lin ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1

Background: Emergency department (ED) overcrowding is a problem in many countries including Taiwan. Access block refers to a situation where patients in the emergency department requiring inpatient care are unable to gain access to appropriate hospital beds within a reasonable time frame (more than 8 hours total time in the emergency department). Access block is one major reason of ED overcrowding. Methods: A new holistic care unit was established in our medical center in Taiwan in July 2012, with the attending physicians including internal medicine physicians and a neurologist. The patients who required hospitalized treatment were referred to internal medicine physicians in the emergency department. The new department was comprised of seven experienced medical attending physician to take care of the patients directly, with 8-hour duty work shifts within 24 hours, in collaboration with emergency physicians, radiologists, nurses, social workers and case managers to form a team. This team had similar three-shift work duty, education and training programs, and they shared medical devices and resources. If beds in the intensive care unit or ward are not available immediately, procedures and treatment can be performed in the holistic care unit. The pediatric patients were excluded from this study. Results: In total, 26,623 patients were admitting to ward from our emergency department from August 2011 to July 2012, and 23,790 patients from August 2012 to July 2013. The rate of access block decreased from 55.29% to 50.01% ( p < 0.01) after holistic care unit was established. The mean time of ED length of stay was also improved from 18.04 hours to 15.43 hours ( p < 0.01). Conclusions: The newly established holistic care unit in our hospital improved the quality of medical care, not only physiologically but also psychologically.

Advanced Imaging of Nanometer-Scale Recorded Bits on Super-Resolution Near-Field Optical Disk

Pei Lin Yang,Din Ping Tsai,Cheng Wei Lin,Chih Ching Hsu,Pei Hsin Chang,Tsung Sheng Kao,Wei Chih Lin 한국물리학회 2005 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.47 No.1

An advanced imaging technique is demonstrated for fast, non-destructive and high resolution characterizations for nanometer-scale recorded bits on a super-resolution near-field optical disk (super-RENS). For the first time, an array of individual 100 nm recorded marks is imaged and studied by using the conductive-atomic force microscopy (C-AFM) method. Discussions also include comparisons of 300 nm, 200 nm and 100 nm recorded marks on both a super-RENS disk and a commercial DVD disk, and the image results are evidence of the high carrier-to-noise ratio (CNR) value on the super-RENS disk, even though the mark size has been shrunk to less than the diffraction limit.

ORiginal Article : Association between IPTA Gene Polymorphisms and Hematological Abnormalities in Hepatitis C Virus-Infected Patients Receiving Combination Therapy

( Jow Jyh Hwang ),( Ching Chu Lo ),( Chien Hung Lin ),( Hsu Sheng Cheng ),( I Wen Hung ),( Wan Ju Tsai ),( Chien Hui Hung ) The Editorial Office of Gut and Liver 2015 Gut and Liver Vol.9 No.2

Background/Aims: Hematological abnormalities during hepatitis C virus (HCV) combination therapy with pegylated interferon α and ribavirin often necessitate dose reduction. Variants of the ITPA gene have been reported to protect against anemia during the early stages of HCV combination treatments but have also been associated with larger decreases in platelet counts. We aimed to identify the association between specific ITPA gene polymorphisms and hematological abnormalities in patients undergoing HCV combination therapy. Methods: In this retrospective study, 175 patients treated with HCV combination therapy were enrolled at St. Martin De Porres Hospital in Taiwan between 2006 and 2012. Two single nucleotide polymorphisms (SNP) within or adjacent to the ITPA gene (rs1127354, rs6051702) were genotyped. We investigated the effect of ITPA gene variants on hematological abnormalities during the therapy. Results: The ITPA rs1127354 minor variants were significantly associated with protection against anemia at week 4 (p=1.86×10-6) and with more severe decreases in platelet counts during HCV combination therapy. SNP rs6051702 was not associated with the hemoglobin decline to >3 g/dL at week 4 in our study (p=0.055). Conclusions: The ITPA SNP rs1127354 is a useful predictor of ribavirin-induced anemia in Taiwanese patients and may be related to more severe decreases in platelet counts during the early stage of HCV combination therapy. (Gut Liver, 2015;9:214-223)

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.

Hypoglycemia Revisited in the Acute Care Setting

Shih-Hung Tsai,Der-Ming Chu,Yen-Yue Lin,Chin-Wang Hsu,Chien-Sheng Cheng 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.6

Hypoglycemia is a common finding in both daily clinical practice and acute care settings. The causes of severe hypoglycemia (SH) are multi-factorial and the major etiologies are iatrogenic, infectious diseases with sepsis and tumor or autoimmune diseases. With the advent of aggressive lowering of HbA1c values to achieve optimal glycemic control, patients are at increased risk of hypoglycemic episodes. Iatrogenic hypoglycemia can cause recurrent morbidity, sometime irreversible neurologic complications and even death, and further preclude maintenance of euglycemia over a lifetime of diabetes. Recent studies have shown that hypoglycemia is associated with adverse outcomes in many acute illnesses. In addition, hypoglycemia is associated with increased mortality among elderly and non-diabetic hospitalized patients. Clinicians should have high clinical suspicion of subtle symptoms of hypoglycemia and provide prompt treatment. Clinicians should know that hypoglycemia is associated with considerable adverse outcomes in many acute critical illnesses. In order to reduce hypoglycemia-associated morbidity and mortality, timely health education programs and close monitoring should be applied to those diabetic patients presenting to the Emergency Department with SH. ED disposition strategies should be further validated and justified to achieve balance between the benefits of euglycemia and the risks of SH. We discuss relevant issues regarding hypoglycemia in emergency and critical care settings.

Development and Characterization of a Specific Anti-Caveolin-1 Antibody for Caveolin-1 Functional Study in Human, Goat and Mouse

Ke, Meng-Wei,Jiang, Yan-Nian,Li, Yi-Hung,Tseng, Ting-Yu,Kung, Ming-Shung,Huang, Chiun-Sheng,Cheng, Winston Teng-Kuei,Hsu, Jih-Tay,Ju, Yu-Ten Asian Australasian Association of Animal Productio 2007 Animal Bioscience Vol.20 No.6

Caveolin-1 of the caveolin family of proteins regulates mammary gland development and has been shown to play a contradictory role in breast tumor progression. A specific anti-Caveolin-1 antibody will be useful for functional study of Caveolin-1 in different tissues. In this study, we generated a rabbit polyclonal antibody that specifically recognizes the N-terminal amino acids 50-65 of Caveolin-1. This polyclonal antibody specifically reacted with Caveolin-1 extracted from cells of different species, including human epithelial A431 cells, goat primary mammary epithelial cells and mice fibroblast NIH 3T3 cells, by Western blotting. Endogenous Caveolin-1 protein expressing in cells and normal human tissues was detected by this polyclonal antibody using immunocytofluorescent and immunohistochemical staining, respectively. Furthermore, an apparent decrease in Caveolin-1 expression in tumorous breast and colon tissues was detected by this polyclonal antibody. In conclusion, we have identified amino acids 50-65 of Caveolin-1, which contains an epitope that is specific to Caveolin-1 and is conserved in the human, goat and mouse. In future, this anti-Caveolin-1 antibody can be used to examine the progression of breast and colon cancers and to study functions of Caveolin-1 in human, goat and mouse cells.