Exploring the immunological factors of preeclampsia

( Chang-ching Yeh ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Preeclampsia, manifested primarily by hypertension and proteinuria, complicates 3% to 8% of pregnancies and is a leading cause of fetal-maternal morbidity and mortality worldwide. It may lead to intrauterine growth restriction, preterm delivery, and long-term sequelae in women and fetuses, and consequently cause socioeconomic burden to the affected families and society. However, the pathophysiology of preeclampsia, a major threat during pregnancy characterized by excessive inflammatory status, remains unclear. Decoy receptor 3 (DcR3), a soluble member of the tumor necrosis factor receptor (TNFR) superfamily, is capable of inducing anti-apoptosis via binding with TL1A and anti-inflammation by driving Th2 immune reactions, which may play a role in immune modulation during pregnancy. The plasma levels of DcR3 gradually decreased as the gestational days increased during pregnancy. In the third trimester, pregnant women with preeclampsia had significantly lower plasma DcR3 levels compared to non-preeclamptic women. DcR3 may serve a protective role in normal pregnancy and decreased levels of DcR3 may be related to preeclampsia.

Vacuolar Serine Protease Is a Major Allergen of Fusarium proliferatum and an IgE-Cross Reactive Pan-Fungal Allergen

Chang-Ching Yeh,Hsiao-Yun Tai,Hong Chou,Keh-Gong Wu,Horng-Der Shen 대한천식알레르기학회 2016 Allergy, Asthma & Immunology Research Vol.8 No.5

Purpose: Fusarium species are among prevalent airborne fungi and causative agents of human respiratory atopic disorders. We previously identified a 36.5-kDa F. proliferatum component recognized by IgE antibodies in 9 (53%) of the 17 F. proliferatum-sensitized atopic serum samples. The purpose of this study is to characterize the 36.5-kDa allergen of F. proliferatum. Methods: Characterization of allergens and determination of IgE cross-reactivity were performed by cDNA cloning/expression and immunoblot inhibition studies. Results: Based on the finding that the 36.5-kDa IgE-binding component reacted with the mouse monoclonal antibody FUM20 against fungal vacuolar serine protease allergens, the cDNA of F. proliferatum vacuolar serine protease (Fus p 9.0101) was subsequently cloned. Nine serum samples from respiratory atopic patients with IgE binding to the vacuolar serine protease allergen of Penicillium chrysogenum (Pen ch 18) also showed IgE-immunoblot reactivity to rFus p 9.0101. The purified rFus p 9.0101 can inhibit IgE and FUM20 binding to the 36.5-kDa component of F. proliferatum. Thus, a novel and important Fus p 9.0101 was identified. The rPen ch 18 can inhibit IgE binding to Fus p 9.0101. It indicates that IgE cross-reactivity between Fus p 9.0101 and Pen ch 18 also exists. Furthermore, neither rFus p 9.0101 K88A nor rPen ch 18 K89A mutants inhibited IgE binding to rFus p 9.0101. Lys88 was considered a critical core amino acid in IgE binding to r Fus p 9.0101 and a residue responsible for IgE cross-reactivity between Fus p 9.0101 and Pen ch 18 allergens. Conclusions: Results obtained from this study indicate that vacuolar serine protease may be a major allergen of F. proliferatum and an important IgE cross-reactive pan-fungal allergen, and provide important bases for clinical diagnosis of fungal allergy.

Clinical Significance of Smudge Cells in Peripheral Blood Smears in Hematological Malignancies and Other Diseases

Chang, Chih-Chun,Sun, Jen-Tang,Liou, Tse-Hsuan,Kuo, Chin-Fu,Bei, Chia-Hao,Lin, Sheng-Jun,Tsai, Wei-Ting,Tan, N-Chi,Liou, Ching-Biau,Su, Ming-Jang,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

Background: It is reported that the percentage of smudge cells in the blood smear could be a prognostic indicator in chronic lymphocytic leukemia. However, the clinical significance of smudge cells in other hematological malignancies, solid tumors or non-malignant diseases is less clear. Hence, this study was conducted to survey the clinical significance of smudge cells in hematological cancers and other disorders. Materials and Methods: From January to November, 2015, the clinical data of patients who received blood examination with differential counts for clinical purpose and were found to have smudge cells in the peripheral blood film in Far Eastern Memorial Hospital were selected. The percentage of smudge cells and patient outcomes were evaluated for further univariate and survival analyses. Results: A total of 102 patients with smudge cells in their blood smears were included. Smudge cells were frequently presented in out-of-hospital cardiac arrest (OHCA; n=30), infections (n=23), hematological cancers (n=23) and solid cancers (n=10). There was no relationship between the percentage of smudge cells and the patient mortality in all diseases (OR: 1.08, 95% CI: 0.47-2.48, P=1.000) as well as the OHCA group (OR: 1.91, 95% CI: 0.38-9.60, P=0.694). It was observed that in patients with all cancers with the percentage of smudge cells less than 50% had a lower mortality rate in comparison with those who had the percentage of smudge cells of 50% or more (OR: 22.29, 95% CI: 2.38-208.80, P<0.001). Additionally, it was seemingly that patients with smudge cells of 50% or more had a lower survival rate than those with smudge cells less than 50% in all cancers with follow-up at 2-month intervals, but without statistical significance (P=0.064). Conclusions: Our survey indicated that in all cancers, those who had higher percentage of smudge cells were prone to have poor outcomes when compared with the subjects with lower percentage of smudge cells. This finding was quite different from the results of previous studies in which the race-ethnicity of most study populations was non-Asian; hence, further investigations are required. Besides, there was no apparent association of the percentage of smudge cells with patient outcomes in all diseases, including OHCA.

Creatine Kinase (CK)-MB-to-Total-CK Ratio: a Laboratory Indicator for Primary Cancer Screening

Chang, Chih-Chun,Liou, Ching-Biau,Su, Ming-Jang,Lee, Yi-Chen,Liang, Chai-Ting,Ho, Jung-Li,Tsai, Huang-Wen,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15

Background: For the determination of creatine kinase (CK)-MB, the immunoinhibition method is utilized most commonly. However, the estimated CK-MB activity may be influenced by the presence of CK isoenzymes in some conditions like cancer. Thus, a CK-MB-to-total-CK ratio more than 1.0 could be found in such a situation. The study aimed to explore the relationship of cancer to high CK-MB-to-total-CK ratio. Materials and Methods: From January 2011 to December 2014, laboratory data on all CK-MB and total CK test requests were extracted at Far Eastern Memorial Hospital (88,415 requests). Patients with a CK-MB-to-total-CK ratio more than 1.0 were registered in this study. Clinical data including tumor location, tumor TNM stage and metastatic status were also collected. Results: A total of 846 patients were identified with a CK-MB-to-total-CK ratio more than 1.0. Of these, 339 (40.1%) were diagnosed with malignancies. The mean CK-MB-to-total-CK ratio was significantly higher in malignancy than in non-malignancy ($1.35{\pm}0.28$ vs $1.25{\pm}0.23$, p<0.001) groups. The most frequent malignancy with a CK-MB-to-total-CK ratio more than 1.0 was colorectal cancer ($1.42{\pm}0.28$, 16.5%, n=56), followed by lung cancer ($1.38{\pm}0.24$, 15.9%, n=54) and hepatocellular carcinoma (14.5%, n=49). Higher CK-MB-to-total-CK ratios in hematological malignancies ($1.44{\pm}0.41$)were also noted. Additionally, the CK-MB-to-total-CK ratio was markedly higher in advanced stage malignancy than in early stage ($1.37{\pm}0.26$ vs. $1.29{\pm}0.31$, p=0.014) and significantly higher in liver metastasis than in non-liver metastasis ($1.48{\pm}0.30$ vs. $1.30{\pm}0.21$, p<0.001). Conclusions: The CK-MB-to-total-CK ratio is an easily available indicator and could be clinically utilized as a primary screening tool for cancer. Higher ratio of CK-MB-to-total-CK was specifically associated with certain malignancies, like colorectal cancer, lung cancer and hepatocellular carcinoma, as well as some cancer-associated status factors such as advanced stage and liver metastasis.

A study on behavior of steel joints that combine high-strength bolts and fillet welds

Heui-Yung Chang,Ching-Yu Yeh 국제구조공학회 2019 Steel and Composite Structures, An International J Vol.31 No.4

In recent years, considerable attention has been paid to the research and development of high-strength steel plates, with particular emphasis on the enhancement of the seismic resistance of buildings and bridges. Many efforts have also been undertaken to improve the properties of high-strength bolts and weld materials. However, there are still different opinions on steel joints that combine high-strength bolts and fillet welds. Therefore, it is necessary to verify the design specifications and guidelines, especially for newly developed 1,400-MPa high-strength bolts, 570-MPa steel plates, and weld materials. This paper presents the results of literature reviews and experimental investigations. Test parameters include bolt strengths, weld orientations, and their combinations. The results show that advances in steel materials have increased the plastic deformation capacities of steel welds. That allows combination joints to gain their maximum strength before the welds have fracture failures. When in combination with longitudinal welds, high-strength bolts slip, come in contact with cover plates, and develop greater bearing strength before the joints reach their maximum strength. However, in the case of combinations with transverse welds, changes in crack angles cause the welds to provide additional strength. The combination joints can therefore develop strength greater than estimated by adding the strength of bolted joints in proportion to those of welded joints. Consequently, using the slip resistance as the available strength of high-strength bolts is recommended. That ensures a margin of safety in the strength design of combination joints.

Suture Repair in Endoscopic Surgery for Craniovertebral Junction

Mei-Yin Yeh,Wen-Cheng Huang,Jau-Ching Wu,Chao-Hung Kuo,Hsuan-Kan Chang,Tsung-Hsi Tu,Peng-Yuan Chang,Yu-Shu Yen,Henrich Cheng 대한척추신경외과학회 2019 Neurospine Vol.16 No.2

Objective: Endoscopic approaches to the craniovertebral junction (CVJ) have been established as viable and effective surgical treatments in the past decade. One of the major complications is leakage of the cerebrospinal fluid (CSF). This study aimed to investigate the efficacy and feasibility of suture closure at the nasopharyngeal mucosa upon durotomy. Methods: A series of consecutive patients who underwent different endoscopic approaches to the CVJ were retrospectively reviewed. The pathologies, surgical corridors, neurological and functional outcomes, radiological evaluations, and complications were analyzed. Different strategies of repair for the intraoperative CSF leakage were described and compared. Results: A total of 22 patients covering 13 years were analyzed. There were 12, 2, and 8 patients who underwent transnasal, transoral, and combined approaches, respectively. There were 8 patients (36.4%) who experienced intraoperative CSF leakage, and were grouped into 2: 4 in the nonsuture (NS) group and 4 in the suture-repaired (SR) group. The NS group had 3 (75%) persistent CSF leakages postoperation that caused 1 mortality, whereas patients of the SR group had only 1 minor CSF rhinorrhea that healed spontaneously within days. Conclusion: In this series of 22 patients who required anterior endoscopic resection of pathologies at the CVJ, there was 1 (4.5%) serious complication related to CSF leakage. For patients who had no durotomy, the mucosal incision at the nasopharynx usually healed rapidly and there were few procedure-related complications. For patients with intraoperative CSF leakage, suture closure was technically challenging but could significantly lower the risks of postoperative complications.

Eosinophilia in Pleural Effusions: a Speculative Negative Predictor for Malignancy

Chu, Fang-Yeh,Liou, Ching-Biau,Sun, Jen-Tang,Bei, Chia-Hao,Liou, Tse-Hsuan,Tan, N-Chi,Yu, Yun-Chieh,Chang, Chih-Chun,Yen, Tzung-Hai,Su, Ming-Jang Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Background: Eosinophilic pleural effusion (EPE) is an eosinophil count more than 10% on cytology of pleural samples. Recently, it was reported that malignancy had been the most prevalent cause inducing EPE. Therefore, we conducted an analysis on the prevalence and etiology of EPE and investigated the relationship between EPE and malignancy. Materials and Methods: Data for pleural cell differential count from patients receiving thoracentesis during the period from January 2008 to December 2013 were compared with clinical data and established diagnosis of patients obtained via electronic chart review. Results: A total of 6,801 requests of pleural cytology from 3,942 patients with pleural effusion who had received thoracentesis were available at Far Eastern Memorial Hospital from 2008 to 2013, and of these subjects, 115 (2.9%) were found to have EPE. The most frequent cause of EPE was malignancy (33.0%, n=38), followed by parapneumonic effusions (27.8%, n=32), tuberculosis pleuritis (13.9%, n=16), transudate effusions (12.2%, n=14) and the presence of blood or air in pleural space (10.4%, n=12). Additionally, an inverse relationship of eosinophilia in pleural fluid was identified in patients with malignancy and EPE. The cut-off eosinophil count in pleural fluid was 15% for the most accurate discrimination between malignancy and benign disorders in patients with EPE. At the cut-off level, the sensitivity and specificity were 65.8% and 67.5%, respectively. Conclusions: Pleural fluid eosinophilia was a speculative negative predictor for malignancy, despite the fact that cancers, including lung cancers and metastatic cancers to lung, were the most leading cause of pleural fluid eosinophilia. An inverse correlation was observed between the pleural eosinophil percentage and the likelihood of malignancy in patients with EPE.

Explore the Relationship Between Living Environment, Lifestyleand Eating Habits to Urinary Tract Stones Formation in Taiwan

Hui-Min Lo,Shu-Chuan chang,Li-Hua Lee,Ching Yi Yeh,Hsia Lingy Wu 한국간호과학회 2009 한국간호과학회 학술대회 Vol.2009 No.10

Decellularized Human Umbilical Artery Exhibits Adequate Endothelialization in Xenogenic Transplantation

Kai Hsia,Tien-Shiang Wang,Chin-Su Liu,Chih-Kuan Su,Chien-Chin Chen,Chang-Ching Yeh,Hsinyu Lee,Chao-Ling Yao,Tsung-Yu Tseng,Shih-Hwa Chiou,Hsu Ma,Chih-Hsun Lin,Jen-Her Lu 한국생물공학회 2023 Biotechnology and Bioprocess Engineering Vol.28 No.3

Decellularized human umbilical arteries (dHUA) is an off-the-shelf graft that can potentially serve as vascular scaffolds in tissue engineering of small-diameter vascular grafts. This research aimed to investigate that dHUA could exhibit adequate endothelialization for a long term in xenogenic transplantation. 13 dHUAs were implanted in rat abdominal aortas up to 90 days. Rats were divided into three groups in terms of survival period: Group 1, one to seven days (n = 6); Group 2, 14 to 30 days (n = 4) and Group 3, 90 days (n = 3). The explants were analyzed by histological, immunohistochemistry and magnetic resonance angiography (MRA) examination. Allograft implantation of 12 decellularized rat abdominal aortas` were processed the same way as the rat in order to make a comparison for survival rates (Group 1, n = 5; Group 2, n = 4; Group 3, n = 3). The results demonstrated that the survival rates of xenograft and allograft implantation were estimated to be 59.2% vs. 58.3% in Group 1, 50.7% vs. 58.3% in Group 2 and 3. Grafts harvested from Group 2 were showed CD31, endothelial nitric oxide synthase expression at intima, and α-smooth muscle actin, CD45, CD68 and CD168 expression at the tunica externa. A layer structure with obvious endothelialization and fiber regeneration/orientation could be inspected from the explants of Group 3. MRA demonstrated the patency of dHUA on day 30 and 90. In conclusion, more than 50% dHUA maintained patency in the xenogenic model till 90 days after surgery. A mature vessel-like functional structure with intact endothelial layer was observed then. This warrants further study in the reinforcement of decellularized vascular scaffolds.