Tenofovir Alafenamide for Chronic Hepatitis B Patients with Advanced Fibrosis and Partial Virologic Responses to Oral Nucleos(T)Ide Analogues- Interim Report

( Ming-lung Yu ),( Ming-lun Yeh ),( Chi-yi Chen ),( Pin-nan Cheng ),( Ming-jong Bair ),( Jyh-jou Chen ),( Ching-chu Lo ),( Chi-ming Tai ),( Ching-yang Tsai ),( Kuo-chih Tseng ),( Chien-hung Chen ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Insufficient data regarding the treatment strategy for partial response to nucleot(s)ide analogue (NUC) raised the aim of investigating tenofovir alafenamide (TAF) switching for chronic hepatitis B (CHB) patients with advanced fibrosis and partial response to other NUCs. Methods: CHB patients with advanced fibrosis (stage 3 or 4) and under NUC (except TAF) therapy with detectable hepatitis B virus (HBV) DNA for >52 weeks are enrolled to TAF 25 mg/day for 96 weeks. The objectives are viral suppression, alanine aminotransferase (ALT) normalization and safety. Results: From Feb. 2019, 34 patients, including 21 (61.8%) with entecavir, 10 (29.4%) TDF and 3 (8.8%) lamivudine or adefovir, were enrolled (15 [44.1%] male, median 53 years). The fibroscan demonstrated a mean of 10.5 kPa (7 [20.6%] cirrhotic). Sixteen (47.1%) patients were HBV e antigen positive, seven (20.6%) had YMDD mutation. The median HBV DNA level declined from 68.5 IU/mL at enrollment to 27.0 IU/mL at 4^th week, and undetectable at 12^th, 24^th, 36^th week, respectively, after TAF switching, with undetectable HBV DNA in 14/34 (41.2%), 17/33 (51.5%), 15/25 (60.0%), and 9/15 (60.0%) patients and rate of ALT normalization (≤40 U/L) of 85.3%, 85.3%, 84.8%, 92.0%, and 80.0%, respectively, after TAF switching. (figure 1) Two patients experienced transient virological breakthrough and another one developed at the final time follow up. Serum creatinine and eGFR levels were stable after TAF switching (figure 1). Two patients early terminated including one at 12^th week due to personal reason, and another one accidently died at 20^th week due to acute heart attack. Others suffered only mild degrees of adverse events which were considered unrelated to treatment. Conclusions: The preliminary results demonstrated the TAF switching is effective and safe in viral suppression for CHB patients with advanced fibrosis and partial virologic responses to other NUCs.

Efficacy and Safety of 12 Weeks of Daclatasvir, Asunaprevir Plus Ribavirin for the Treatment of HCV Genotype 1b Infection without Baseline NS5A Resistance-Associated Variants (DARING)-Interim Report

( Ming-lung Yu ),( Chao-hung Hung ),( Yi-hsiang Huang ),( Cheng-yuan Peng ),( Chun-yen Lin ),( Pin-nan Cheng ),( Rong-nan Chien ),( Shih-jer Hsu ),( Chen-hua Liu ),( Jee-fu Huang ),( Chung-feng Huang 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The current study aims to elucidate the treatment efficacy (defined as undetectable HCV RNA throughout 12 weeks of post-treatment follow-up, SVR12) and safety DCV/ASV plus ribavirin for 12 weeks in HCV-1b patients without NS5A RAS. Methods: This is a single-arm, open-label phase 2 study. Seventy directly acting antivirals (DAA)-naïve HCV-1b patients without L31/Y93 RAS are planned to receive daclatasvir (60 mg/ day) and asunaprevir (100 mg twice daily) plus weight-based ribavirin (1000-1200 mg/day) for 12 weeks. After treatment they were followed up for 12 weeks. Results: As of 31 Oct 2017, 58 eligible patients are allocated to treatment, with a mean age of 59.3 years and female predominance (67.2%, 39/58). The mean HCV RNA was 5.87+0.77 log10 IU/mL; 23 patients (39.7 %) had significant hepatic fibrosis (>F2). In the modified intention-to-treat analysis, the rate of undetectable HCV at week 1, week 2, week 4, week 8 and endof- treatment was 25 % (14/56), 84.8 % (39/46), 100 % (46/46), 100 % (38/38) and 100 % (27/27), respectively. Undetectable HCV RNA were observed in all of the patients with HCV RNA assessable 4 weeks (SVR4, 18/18) and 12 weeks (SVR12, 12/12) post treatment. None of the 18 patients who completed the 12-week treatment experienced relapse during post-treatment follow-up. The most common adverse event was fatigue (78.3 %), followed by pruritus (65.2 %) and dizziness (52.2 %), of which were considered as ribavirin related. None of the participating subjects withdrew treatment or follow-up throughout the trial peroid. Three serious adverse events were reported which included urosepsis, appendicitis and left ureteral stone. All were unrelated to the investigating drugs. Conclusions: 12 weeks of DCV/ASV plus ribavirin was highly effective and safe in HCV-1b patients without NS5A RAS in the interim analysis. The satisfactory results would be anticipated in the full patient set.

Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation

Huei-Lung Liang,Huay-Ben Pan,Yih-Huie Lin,Chiung-Yu Chen,Hsiao-Min Chung,Tung-Ho Wu,Kang-Ju Chou,Pin-Hong Lai,Chien-Fang Yang 대한영상의학회 2006 Korean Journal of Radiology Vol.7 No.2

Objective: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. Materials and Methods: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patients (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8 10mm in diameter and 40 80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. Results: No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates ( standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69% 9 and 88% 6, 41% 10 and 88% 6, 30% 10 and 77% 10, and 12% 8 and 61% 13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51% 16 and 86% 13 vs 45% 15 and 73% 13 at 6 months, and 25% 15 and 71% 17 vs 23% 17 and 73% 13 at 12 months (p = .346 and .224), respectively. Conclusion: Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.

POLARIZATION PROPERTIES OF LARGE-AREA GaN-BASED LIGHT-EMITTING DIODES WITH AN OMNIDIRECTIONAL NANOSTRUCTURE

WAN-WEI WANG,LUNG-CHIEN CHEN,YA-HSIN WANG 성균관대학교(자연과학캠퍼스) 성균나노과학기술원 2012 NANO Vol.7 No.5

Large-area GaN-based blue light-emitting diodes (LEDs) on sapphire substrates with an omnidirectional nanostructure consisted of Ag nanoparticles and TiO2/SiO2 Bragg re°ector were fabricated. For the LEDs without the omnidirectional nanostructure, the spectra of the P- and S-polarization light are lightly di®erent and the peak wavelength of P- and S-polarization light was estimated to be 464 nm and 463 nm, respectively at forward current of 20 mA. In contrast, for the LEDs with the omnidirectional nanostructure, the spectra of the P- and S-polarization light are nearly the same at forward current of 20mA and 100 mA.

The pinch technology combined with a heat pump applied in a three-effect evaporator and energy-saving performance assessment

Chi-I Tuan,Ting-Chien Chen,Yi-Lung Yeh,Lang-Fong Hsu 한국화학공학회 2012 Korean Journal of Chemical Engineering Vol.29 No.3

This research investigated optimal energy utilization with pinch technology based on an actual gelatin production factory using a three-effect evaporator (TEE). A TEE is a well-known device used extensively when concentrating process fluid with large amounts of boiler steam. Under ideal energy use conditions, the exhaust heat can be recovered with the addition of a heat pump system. The study results showed that the original energy demand and discharge of the TEE were 1,736.2 and 1,733.2 kWh, respectively. Simulating the pinch technology use, the energy demand and discharge decreased to 1,531.5 and 1,527.7 kWh, respectively. When the heat pump was used to recover the exhaust heat, 324 kL per annum of fuel oil was saved, while electricity use increased 131 kWh. The total investment cost was 86,550 US$, but the total annual operation cost could save up to 166,421 US$. The net present value was estimated to be 544,316 US$ with a 5-year equipment operation. The investment expense could be completely recovered within a seven-month remuneration period.

Photocatalytic study of Zinc Oxide with bismuth doping prepared by spray pyrolysis

Lin, Tzu-Yang,Hsu, Yu-Ting,Lan, Wen-How,Huang, Chien-Jung,Chen, Lung-Chien,Huang, Yu-Hsuan,Lin, Jia-Ching,Chang, Kuo-Jen,Lin, Wen-Jen,Huang, Kai-Feng Techno-Press 2015 Advances in nano research Vol.3 No.3

The unintentionally doped and bismuth (Bi) doped zinc oxide (ZnO) films were prepared by spray pyrolysis at $450^{\circ}C$ with zinc acetate and bismuth nitrate precursor. The n-type conduction with concentration $6.13{\times}10^{16}cm^{-3}$ can be observed for the unintentionally doped ZnO. With the increasing of bismuth nitrate concentration in precursor, the p-type conduction can be observed. The p-type concentration $4.44{\times}10^{17}cm^{-3}$ can be achieved for the film with the Bi/Zn atomic ratio 5% in the precursor. The photoluminescence spectroscopy with HeCd laser light source was studied for films with different Bi doping. The photocatalytic activity for the unintentionally doped and Bi-doped ZnO films was studied through the photodegradation of Congo red under UV light illumination. The effects of different Bi contents on photocatalytic activity are studied and discussed. Results show that appropriate Bi doping in ZnO can increase photocatalytic activity.

Comparison of Models for the Prediction of Medical Costs of Spinal Fusion in Taiwan Diagnosis-Related Groups by Machine Learning Algorithms

Ching-Yen Kuo,Liang-Chin Yu,Hou-Chaung Chen,Chien-Lung Chan 대한의료정보학회 2018 Healthcare Informatics Research Vol.24 No.1

Objectives: The aims of this study were to compare the performance of machine learning methods for the prediction of themedical costs associated with spinal fusion in terms of profit or loss in Taiwan Diagnosis-Related Groups (Tw-DRGs) andto apply these methods to explore the important factors associated with the medical costs of spinal fusion. Methods: A dataset was obtained from a regional hospital in Taoyuan city in Taiwan, which contained data from 2010 to 2013 on patients ofTw-DRG49702 (posterior and other spinal fusion without complications or comorbidities). Naïve-Bayesian, support vectormachines, logistic regression, C4.5 decision tree, and random forest methods were employed for prediction using WEKA3.8.1. Results: Five hundred thirty-two cases were categorized as belonging to the Tw-DRG49702 group. The mean medicalcost was US $4,549.7, and the mean age of the patients was 62.4 years. The mean length of stay was 9.3 days. The lengthof stay was an important variable in terms of determining medical costs for patients undergoing spinal fusion. The randomforest method had the best predictive performance in comparison to the other methods, achieving an accuracy of 84.30%,a sensitivity of 71.4%, a specificity of 92.2%, and an AUC of 0.904. Conclusions: Our study demonstrated that the randomforest model can be employed to predict the medical costs of Tw-DRG49702, and could inform hospital strategy in terms ofincreasing the financial management efficiency of this operation.

Use of glecaprevir/pibrentasvir in patients with chronic hepatitis C virus infection and severe renal impairment

Desmond Y. H. Yap,Kevin S. H. Liu,Yu-Chun Hsu,Grace L. H. Wong,Ming-Chang Tsai,Chien-Hung Chen,Ching-Sheng Hsu,Yee Tak Hui,Michael K. K. Li,Chen-Hua Liu,Yee-Man Kan,Ming-Lung Yu,Man-Fung Yuen 대한간학회 2020 Clinical and Molecular Hepatology(대한간학회지) Vol.26 No.4

Background/Aims: Data on treatment efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) for chronic hepatitis C virus (HCV) infection in Asian patients with severe renal impairment are limited. This study aimed to study the treatment and side effects of GLE/PIB in these patients infected with non-1 genotype (GT) HCV. Methods: We prospectively recruited patients with Child’s A cirrhosis and eGFR <30 mL/min/1.73 m2 in Hong Kong and Taiwan during 2017–2018 to receive GLE/PIB treatment. Results: Twenty-one patients (GT2, n=7; GT3, n=6; and GT6, n=8) received GLE/PIB for 11.2±1.8 weeks. All except one were treatment-naïve. GLE/PIB was initiated in 16 patients while on dialysis (seven on peritoneal dialysis [PD] and nine on hemodialysis) and in five patients before dialysis. One patient died of PD-related peritonitis during treatment and two were lost to follow up. The SVR12 rate in the remaining 18 patients was 100%. All patients achieved undetectable levels at 4-, 12-, 24- and 48-week after treatment. Patients with deranged alanine aminotransferase showed normalization after 4 weeks and the response was sustained for 48 weeks. No significant adverse event was observed. Conclusions: GLE/PIB treatment was associated with high efficacy and tolerability in HCV-infected patients with severe renal impairment.

Effects of post anneal for the INZO films prepared by ultrasonic spray pyrolysis

Lan, Wen-How,Li, Yue-Lin,Chung, Yu-Chieh,Yu, Cheng-Chang,Chou, Yi-Chun,Wu, Yi-Da,Huang, Kai-Feng,Chen, Lung-Chien Techno-Press 2014 Advances in nano research Vol.2 No.4

Indium-nitrogen co-doped zinc oxide thin films (INZO) were prepared on glass substrates in the atmosphere by ultrasonic spray pyrolysis. The aqueous solution of zinc acetate, ammonium acetate and different indium sources: indium (III) chloride and indium (III) nitrate were used as the precursors. After film deposition, different anneal temperature treatment as 350, 450, $550^{\circ}C$ were applied. Electrical properties as concentration and mobility were characterized by Hall measurement. The surface morphology and crystalline quality were characterized by SEM and XRD. With the activation energy analysis for both films, the concentration variation of the films at different heat treatment temperature was realized. Donors correspond to zinc related states dominate the conduction mechanism for these INZO films after $550^{\circ}C$ high temperature heat treatment process.