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- 검색키워드
- 저자 : Chien-Liang Chen (검색결과 32 건)
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Chien-Liang Liu,Ming-Jen Chen,Jiunn-Chang Lin,Chi-Hsin Lin,Wen-Chien Huang,Shih-Ping Cheng,Shan-Na Chen,Yuan-Ching Chang 한국유방암학회 2019 Journal of breast cancer Vol.22 No.2
Purpose: Cancer cells develop acquired resistance induced by chemotherapeutic drugs. In this study, we investigated the effects of brief treatment with cytotoxic drugs on the phenotype of breast cancer cells. Methods: Breast cancer cells MCF7 and BT-474 were briefly treated with paclitaxel or doxorubicin. Clonogenic, migration, and invasion assays were performed on the treated cells. Western blot analysis and RhoA activity assay were also performed. Results: Breast cancer cells when briefly treated with paclitaxel or doxorubicin showed reduced clonogenic ability. Doxorubicin, but not paclitaxel, augmented cell migration and invasion. The invasion-promoting effects of doxorubicin were lost when the two drugs were sequentially used in combination. Myosin light chain (MLC) 2 phosphorylation and RhoA activity were upregulated by doxorubicin and downregulated by paclitaxel. Pretreatment with RhoA inhibitors abolished the migration- and invasion-promoting effects of doxorubicin. Conclusion: Doxorubicin activates the RhoA/MLC pathway and enhances breast cancer cell migration and invasion. Therefore, this pathway might be explored as a therapeutic target to suppress anthracycline-enhanced tumor progression.
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On eBay's Fee Structure from a Channel Coordination Perspective
Chen, Jen-Ming,Cheng, Hung-Liang,Chien, Mei-Chen Korean Institute of Industrial Engineers 2010 Industrial Engineeering & Management Systems Vol.9 No.2
Can eBay.com's fee structure coordinate the channel? It's a critical strategic problem in e-commerce operations and an interesting research hypothesis as well. eBay's fees include three parts: monthly subscription fee, insertion fee, and final value fee (i.e., a revenue sharing portion), which represent a generic form of revenue sharing fee structure between the retailer and the vendor in a supply chain. This research deals with such a channel consisting of a price-setting vendor who sells products through eBay's marketplace exclusively to the end customers. The up- and down-stream channel relationship is consignment-based revenue sharing. We use a game-theoretic approach with assumption of the retailer (i.e., eBay.com) being a Stackelberg-leader and the vendor being a follower. The Stackelberg-leader decides on the terms of revenue sharing contract (i.e., fee structure), and the follower (vendor) decides on how many units to sell and the items' selling price. This study formulates several profit-maximization models by considering the effects of the retail price on the demand function. Under such settings, we show that eBay's fee structure can improve the channel efficiency; yet it cannot coordinate the channel optimally.
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( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: The association between epilepsy and stroke was not completely understood. The purpose of this study is to investigate whether patients with epilepsy have an increased risk of stroke or post-stroke mortality. Methods: Using Taiwan`s National Health Insurance Research Database, we conducted a retrospective cohort study of 3,284 patients with new-diagnozed epilepsy and 13,136 persons without epilepsy between 2000 and 2004. The risk of stroke was compared between 2 cohorts through December 31, 2008. To investigate the association between in-hospital mortality after stroke and history of epilepsy, we conducted a case-control study of 135,220 hospitalized patients with newly diagnosed stroke between January 1, 2005, and December 31, 2008. The post-stroke in-hospital mortality and complications were compared between stroke patients with and without previous epilepsy. Results: The epilpesy cohort had an increased stroke risk (hazard ratio [HR] 2.18; 95% CI 1.87-2.54). Among patients with stroke, those with a history of epilepsy had a higher risk of post-stroke mortality compared withthose without epilepsy (odds ratio 1.26; 95% CI 1.17-1.36). Epilepsy was also associated with post-stroke pneumonia (odds ratio 1.52; 95% CI 1.44-1.62) and urinary tract infection (odds ratio 1.48; 95% CI 1.39- 1.56). The association between epilepsy and stroke risk remains signifi cant in every age group (20-39, 40-49, 50-59, 60-69, >=70) and both sexes. Conclusions: Epilepsy was associated with risk of stroke and post-stroke pneumonia, urinary tract infection and mortality. This research shows the importance of prevention, early recognition, and treatment of stroke in epileptic population.
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( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: The relationship between Parkinson`s disease (PD) and fracture is not completely understood. This study evaluated fracture risk and post-fracture mortality in patients with diabetes. Methods: We identifi ed 1624 adults aged 40 years and older newly diagnosed with PD in 2000-2003 using the Taiwan National Health Insurance Research Database. Comparison cohort consisted of 6496 adults without PD randomly selected from the same dataset, frequency matched by age and sex. Events of fracture in 2000-2008 were ascertained from medical claims. Adjusted hazard ratios (HR) and 95% confidence interval (CI) of fracture associated with PD was calculated. Another nested cohort study consisting of 397,766 patients with fracture admission between 2004 and 2010 calculated the adjusted odds ratios (ORs) and 95% CIs of adverse events after fracture in patients with and without PD. Results: During 51,287 person-years of follow-up, there were 1402 newly diagnosed fracture cases. The incidences of fracture for people with diabetes and without diabetes were 40.4 and 24.1 per 1000 person-years, respectively (P < 0.0001). Compared with people without PD, the adjusted HR of fracture was 1.96 (95% CI 1.74-2.21) for people with PD. The ORs of post-fracture urinary tract infection, pneumonia, septicemia, stroke, and mortality associated with PD were 1.61 (95% CI 1.54-1.69), 1.48 (95% CI 1.40-1.56), 1.45 (95% CI 1.37-1.54), 1.50 (95% CI 1.41-1.60), and 1.27 (95% CI 1.18-1.38), respectively. Conclusions: PD was associated with fracture. Patients with PD had more adverse events and subsequent mortality after fracture. Prevention of fracture and post-fracture adverse events is needed in this susceptible population.
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( Chien Chang Liao ),( Ta Liang Chen ),( Chun Chuan Shih ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: Limited information was available on the outcomes after stroke in patients with immune thrombocytopenia (ITP). This study evaluated the adverse events after stroke in patients with ITP. Methods: From the claims data of National Health Insurance Database, we conducted a nationwide retrospective cohort study consisted of 2183 stroke patients with ITP between 2002 and 2009. Using matching procedure by propensity score with age, sex, low income, urbanization, teaching hospital, diabetes, hypertension, hyperlipidemia, myocardial infarction, mental disorders, liver cirrhosis, dementia, renal dialysis, anticoagulants, anti-platelet agents, lipid-lowering agents, and types of stroke, we selected 21830 non-ITP patients with stroke during the index date for comparison. Results: After adjustment for sociodemographics, coexisting medical conditions, medications, and types of stroke in the multivariate logistic regressions, patients with ITP had higher 30-day mortality after stroke compared with stroke patients without ITP (odds ratio=1. 41, 95% confi dence interval=1. 15-1. 74). ITP was also associated withincreased medical expenditure after stroke (odds ratio=1. 13, 95% confi dence interval= 1. 01-1. 27). Conclusions: Our nationwide retrospective cohort study investigated the increased risk of mortality after stroke in patients with ITP.
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( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: This study evaluated the risk of acute myocardial infarction (AMI) and mortality among patients with systemic lupus erythematosus (SLE) in two nationwide retrospective cohort studies. Methods: Using Taiwan`s National Health Insurance Research Database, we conducted a retrospective cohort study and identifi ed 1207 adults newly diagnosed with SLE in 2000-2004. Non-SLE cohort consisted of 9656 adults without SLE, frequency- matched for age and sex and randomly selected from the same data set. Events of AMI were considered as outcome during the follow-up period between 2000 and 2008. Another nested cohort study of 6900 patients with AMI receiving cardiac surgeries was conducted to analyze the impact of SLE on post-AMI mortality. Results: During the follow-up period, there were 52 newly diagnosed AMI cases. The incidences of AMI for SLE cohort and non-SLE cohort were 2.10 and 0.49 per 1000 person-years, respectively, with an adjusted hazard ratio (HR) of 5.11 (95% confi dence interval [CI] 2.63-9.92). For females, the adjusted HR of AMI associated with SLE was as high as 6.28 (95% CI 2.67-14.7). Further analyses in the nested cohort showed SLE was signifi cantly associated with post-AMI mortality (odds ratio, 2.83; 95% CI 1.21- 6.64). Conclusions: Patients with SLE had higher risk of AMI compared with non-SLE control, and this risk was more signifi cant in females. In addition, SLE is an independent risk factor for post-AMI mortality.
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( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: To identify and assess the preoperative risk factors for postoperative mortality in patients with diabetes. Methods: Using reimbursement claims, we performed a nationwide retrospective cohort study of 339,053 patients with diabetes undergoing major surgery. Sociodemographic factors, preoperative coexisting medical conditions, and types of surgery were evaluated for the 30-day postoperative mortality rates. Using conditional logistic regression, adjusted odds ratios (ORs) with 95% confi dence intervals (CIs) and risk scores were analyzed. Results: Among surgical patients with diabetes, 30-day postoperative in-hospital mortality was 1.31%. Gastrectomy (OR 8.02 [95% CI 6.42-10.0]), cardiovascular surgery (OR 6.57 [5.51-7.83]), and neurosurgery (OR 6.01 [5.06-7.14]) were associated with the highest postoperative mortality. Renal dialysis (OR 2.60 [2.38-2.85]) and low income (OR 2.19 [1.90-2.54]) were also important predictors for postoperative mortality in diabetic patients. Diabetic patients with risk scores higher than 15 had the highest postoperative mortality compared with those with baseline scores (OR 27.6 [18.0-42.6]). Thirty-day postoperative mortality correlates closely with increased risk scores (P for trend <0.0001). Conclusions: This study provides preoperative risk scores to predict 30-day postoperative mortality rates in diabetic patients. Type of surgery, renal dialysis and low income were the most infl uential factors for postoperative mortality in diabetic patients.
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( Chien Chang Liao ),( Ta Liang Chen ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: Postoperative adverse outcomes in patients with liver cirrhosis are not completely understood. This study evaluated the association between liver cirrhosisand adverse outcomes after non-hepatic surgery. Methods: Reimbursement claims were used to identify patients with preoperative liver cirrhosis who underwent non-hepatic surgery from 2004 to 2007. Control patients without cirrhosis were matched by age, sex, type of surgery and anaesthesia. The adjusted odds ratios (ORs) and 95% confi dence intervals (CI) of postoperative adverse events associated with liver cirrhosis were analysed by multivariable logistic regression. Results: Thirty-day mortality rates among 24282 patients with cirrhosis and 97128 control patients were 1.2% (299 deaths) and 0.7% (635 deaths), respectively. Liver cirrhosis was associated with postoperative 30-day mortality (OR 1.88, 95% CI 1.63- 2.16), acute renal failure (OR 1.52, 95% CI 1.34-1.74), septicaemia (OR 1.42, 95% CI 1.33-1.51) and intensive care unit admission (OR 1.39, 95% CI 1.33-1.45). Postoperative mortality increased in patients who had liver cirrhosis with viral hepatitis (OR 2.87, 95% CI 1.55-5.30), alcohol dependence syndrome (OR 3.74, 95% CI 2.64-5.31), jaundice (OR 5.47, 95% CI 3.77-7.93), ascites (OR 5.85, 95% CI 4.62-7.41), gastrointestinal haemorrhage (OR 3.01, 95% CI 2.33-3.90) and hepatic coma (OR 5.11, 95% CI 3.79-6.87). Conclusions: Patients with liver cirrhosis had increased mortality and complications after non-hepatic surgery, particularly those with cirrhosis-related clinical indicators.
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Outcomes after Non-Hepatic Surgery in Patients with Alcoholic Liver Disease: A Nationwide Study
( Chien-chang Liao ),( Ta-liang Chen ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: The outcomes after surgery for patients with alcoholic liver diseases (ALD) remains incompletely understood. Our purpose is to evaluate the adverse outcomes after non-hepatic surgeries in patients with ALD. Methods: We conducted a retrospective cohort study of 32548 adults aged 20 years and older who underwent non-hepatic surgical procedures using Taiwan’s National Health Insurance Research Database 2008-2013 claims data. Using a propensity score matching procedure, 32548 non-ALD adults were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of postoperative complications and in-hospital mortality associated with ALD. Results: Patients with ALD had higher risks of postoperative acute renal failure (OR 2.75, 95% CI 2.37-3.19), septicemia (OR 1.88, 95% CI 1.75-2.00), pneumonia (OR 1.63, 95% CI 1.49-1.77), and in-hospital mortality (OR 3.28, 95% CI 2.81-3.83) compared with non-ALD people. Patients with ALD also had longer hospital stays (10.2±14.1 vs. 8.5±13.6 days, p<0.0001) and higher medical expenditures after non-hepatic surgical procedures than controls. Jaundice (OR 5.80, 95% CI 4.58-7.33), ascites (OR 5.72, 95% CI 4.71-6.96), gastrointestinal hemorrhage (OR 5.39, 95% CI 4.49-6.46), and hepatic coma (OR 6.54, 95% CI 5.36-7.97) were significant determinants for postoperative mortality in patients with ALD compared with those without ALD. Conclusions: Surgical patients with ALD showed more adverse events, with a risk of in-hospital mortality approximately 3-fold higher after non-hepatic surgeries compared with non-ALD people. These findings suggest the urgent need to revise the protocols for postoperative care for this population.
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( Chien-chang Liao ),( Ta-liang Chen ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Limited information is available on the outcomes af ter surgery in patients with liver cirrhosis receiving general or neuraxial anaesthesia. The purpose of this study is to compare the postoperative complications and mortality between cirrhot ic patients with general and neuraxial anaesthesia. Methods: From the claims data from the National Health Insur ance program in Taiwan, we identified cirrhotic patients aged ≥ 20 years who underwent non-hepatic surgery in 2008-2013. Using propensity-score matching procedure, we selected 8194 cirrhotic patients with neuraxial anaesthesia and 8194 cirrhotic patients with general anesthesia during the same period for comparison. The adjusted odds ratios (ORs) and 95% confi dence intervals (CIs) of postoperative complications and mor tality were calculated between cirrhotic patients with general anesthesia and neuraxial anaesthesia. Results: Compared with patients received neuraxial anaesthe sia, patients received general anesthesia had increased risk of postoperative pneumonia (OR, 2.08; 95% CI, 1.48-2.90), septi caemia (OR, 1.24; 95% CI, 1.04-1.48), acute renal failure (OR, 2.31; 95% CI, 1.57-3.42), intensive care (OR, 4.63; 95% CI, 3.73-5.75), and 30-day mortality (OR, 2.09; 95% CI, 1.15-3.82). Longer length of hospital stay (P<0.0001) and higher medical expenditure (P<0.0001) were also noted in patients with gener al anesthesia than patients with neuraxial anaesthesia. Conclusions: Cirrhotic patients received general anesthesia had more complications and higher mortality after non-hepatic surgeries than those received neuraxial anaesthesia. Physicians in gastroenterology and perioperative care team need to pay attention to the anesthesia type for this susceptible population.
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