Current Indications for Spinal Endoscopic Surgery and Potential for Future Expansion

Kuo-Tai Chen,김진성,Abel Po-Hao Huang,Martin Hsiu-Chu Lin,Chien-Min Chen 대한척추신경외과학회 2023 Neurospine Vol.20 No.1

Endoscopic spine surgery (ESS) has evolved as a safe, effective, and efficient alternative for minimally invasive spine surgery (MISS). The innovation of full-endoscopic systems makes definitive decompression surgery through different approaches feasible. The approach can be determined according to the location of the target lesion or the surgeon's preference. During the past 2 decades, ESS has expanded its indications from lumbar to cervical spines. Except for decompression, endoscopy-assisted fusion surgery is also developing. However, ESS is still evolving and has a steep learning curve. The revolution of technologies and ESS techniques will enable surgeons to treat various spinal diseases more practically. In recent years, the application of the computer-assisted navigation system and augmented reality have reformed imaging quality and interpretation. The endoscopic rhizotomy techniques have opened a new way for MISS of chronic low back pain. This review introduces the current indications of ESS and its potential future expansion.

Transforaminal Endoscopic Lumbar Discectomy for L5–S1 Disc Herniation With High Iliac Crest: Technical Note and Preliminary Series

Kuo-Tai Chen,Sung-Tai Wei,Chun Tseng,Su-Wei Ou,Li-Wei Sun,Chien-Min Chen 대한척추신경외과학회 2020 Neurospine Vol.17 No.sup.

With the trend of minimally invasive spine surgery, full-endoscopic lumbar discectomy (FELD) has evolved with the advancement of the optics and instruments. Regarding the techniques, the transforaminal and interlaminar approach remain the major accesses in FELD. Transforaminal endoscopic lumbar discectomy (TELD) is an effective and safe treatment for herniation of the lumbar disc. More and more evidence supports the TELD in enhancing recovery and decreasing surgical complications. However, the learning curve of TELD remains steep, especially at the L5–S1 level. The iliac crest height is an essential factor in the operability of TELD at the L5–S1 level. In the situation of the high iliac crest, TELD is technically challenging even for an experienced surgeon. Therefore, the authors report their techniques of TELD with foraminoplasty step-by-step and the preliminary results in this report.

The energy band alignment at the interface between mechanically exfoliated few-layer NiPS3 nanosheets and ZnO

Cheng-Tai Kuo,Karuppannan Balamurugan,Hung Wei Shiu,Hyun Ju Park,Soobin Sinn,Michael Neumann,한문섭,장영준,Chia-Hao Chen,Hyeong-Do Kim,박제근,Tae Won Noh 한국물리학회 2016 Current Applied Physics Vol.16 No.3

We have studied the electronic structure and interfacial properties of mechanically exfoliated few-layer NiPS3 van der Waals crystals on ZnO/Nb:SrTiO3 substrates using scanning photoelectron microscopy and spectroscopy. The conducting ZnO layer enhances the visibility of few-layer NiPS3 on Nb:SrTiO3 and prevents charging effects in photoemission. We experimentally determined a type-II band alignment at the NiPS3/ZnO interface. The valence band offset (VBO) of few-layer NiPS3/ZnO is 2.8 ± 0.09 eV, and the conduction band offset is 1.0 ± 0.09 eV. Moreover, we found an increase of ~0.3 eV in VBO as decreasing NiPS3 thickness, suggesting electronic coupling or charge transfer at the NiPS3/ZnO interface.

Hints from a Female Patient with Breast Cancer Who Later Presented with Cowden Syndrome

Wen-Chung Wang,Tai-Cheng Hou,Chen-Yun Kuo,Yen-Chein Lai 한국유방암학회 2020 Journal of breast cancer Vol.23 No.4

A 51-year-old woman presented with metachronous tumor development in bilateral breasts, thyroid, and endometrium. Additional signs and symptoms fulfilled the National Comprehensive Cancer Network criteria for Cowden syndrome. Immunohistochemistry showed loss of PTEN expression in all tumors. Single nucleotide variants, 647 germline variants (including one each in PTEN and MSH3), and 21 somatic mutations within exons were detected in all tumors after whole-exome sequencing. There were 0, 11, and 46 specific somatic mutations in bilateral breasts, thyroid, and endometrial cancers, respectively. Although PTEN mutation is key to the development of Cowden syndrome, DNA repair dysfunction might be the initial driver of mutations. Fewer mutations were required to induce initial bilateral breast carcinomas, with subsequent thyroid and endometrial carcinomas requiring more mutations for induction. When genetic screening is unavailable, breast cancer patients with clinical manifestations of Cowden syndrome must be carefully assessed for secondary malignancies, such as thyroid and endometrial carcinomas.

The Natural Flavonoid Apigenin Suppresses Th1- and Th2-Related Chemokine Production by Human Monocyte THP-1 Cells Through Mitogen-Activated Protein Kinase Pathways

Ching-Hua Huang,Po-Lin Kuo,Ya-Ling Hsu,Tai-Tsung Chang,Hsing-I Tseng,Yu-Te Chu,Chang-Hung Kuo,Huan-Nan Chen,Chih-Hsing Hung 한국식품영양과학회 2010 Journal of medicinal food Vol.13 No.2

Dietary flavonoids have various biological functions, and there is increasing evidence that reduced prevalence and severity of allergic reactions are associated with the intake of flavonoids. Among natural flavonoids, apigenin is a potent anti-inflammatory agent. However, the mechanisms of apigenin's effect remain uncertain. Monocyte-derived chemokine (MDC) plays a pivotal role in recruiting T-helper (Th) 2 cells in the allergic inflammation process. In the late phase of allergic inflammation, the Th1 chemokine interferon-inducible protein 10 (IP-10) has also been found in elevated levels in the bronchial alveolar fluid of asthmatic children. We used human THP-1 monocyte cells, pretreated with or without apigenin, prior to lipopolysaccharide stimulation. By means of enzyme-linked immunosorbent assay, we found that apigenin inhibited production of both MDC and IP-10 by THP-1 cells and that the suppressive effect of apigenin was not reversed by the estrogen receptor antagonist ICI182780. The p65 phosphorylation of nuclear factor κB remained unaffected, but the phosphorylation of p38, c-Jun N-terminal kinase, and extracellular signal-regulated kinase mitogen-activated protein kinase pathways were all blocked. We found that inhibition of c-raf phosphorylation might be the target of apigenin's anti-inflammation property.

Sofosbuvir/Ledipasvir in the Treatment of Chronic Hepatitis C - A Subgroup Analysis from A Nationwide Real-World HCV Registry Program (TACR) in Taiwan

( Ming-Lung Yu ),( Chi-Yi Chen ),( Kuo-Chih Tseng ),( Ching-Chu Lo ),( Pin-Nan Cheng ),( Cheng-Yuan Peng ),( Ming-Jong Bair ),( Chih-Lang Lin ),( Chi-Ming Tai ),( Chi-Chieh Yang ),( Chih-Wen Lin ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: TASL HCV Registry (TACR) is a nationwide registry program organized and supervised by Taiwan Association for the Study of the Liver (TASL), which aims to setup the database and biobank of patients with chronic hepatitis C (CHC) in Taiwan. The present study aimed to evaluate the treatment outcome of sofosbuvir (SOF)/ledipasvir (LDV) in Taiwanese CHC patients in TACR. Methods: By May 2020, 19 tertiary hospitals, 23 community hospitals and one primary care clinic join the TACR program. The baseline characteristics, prior liver and non-liver related medical history, DAA regimens, laboratory results, treatment course and outcome were recorded. The primary objective was sustained virological response, defined as undetectable HCV RNA 3 months after end-of-treatment (SVR12). Results: A total of 4742 SOF/LDV+ ribavirin treated CHC patients with available SVR12 data from 39 sites were enrolled in the current analysis. The mean age was 61.3 years, and female accounted for 54.8% of the population. The dominant viral genotypes were GT1b (52.6%) and GT2 (35.6%). 1354 (28.6%) patients had liver cirrhosis, including 156 (3.3%) with liver decompensation, 552 (11.6%) had preexisting hepatocellular carcinoma (HCC) before DAAs treatment and 413 (8.7%) had hepatitis B virus dual infections. The overall SVR12 rate was 98.5%, with 98.5%, 98.2%, 99.7% and 98.6% in treatment- naïve non-cirrhotics, treatment-naïve cirrhotics, treatment- experienced non-cirrhotics and treatment-experienced cirrhotics patients, respectively. While patients were stratified by HCV genotype, the SVR12 was 98.5%, 98.4% and 98.5% among those with GT1, GT2 and GT6 infection, respectively. The strongest factor independent associated with treatment failure was DAA adherence < 60% (odds ratio [OR]/95% confidence intervals [CI]: 125.4/25.7-612.4, P<0.0001), followed by active HCC (OR/CI: 6.20/2.57-14.97, P<0.0001), HIV co-infection (OR/CI: 3.01/1.14-7.92, P=0.026), and male gender (OR/ CI: 1.85/1.09-3.13, P=0.023). The eGFR decreased significantly at the end of treatment (EOT) (89.3 ml/min/1.73㎡ vs. 93.2 ml/min/1.73㎡, P< 0.001) and remained stable 3 months after EOT (89.3 ml/min/1.73㎡). However, the decreased eGFR was observed only in patients whose baseline eGFR > 90 ml/ min/1.73㎡. Instead, patients with chronic kidney diseases whose pretreatment eGFR < 60 ml/min/1.73㎡ had improved eGFR after SOF/LDV. Conclusions: SOF/LDV is highly effective in treating CHC patients in real-world setting of Taiwan. The satisfactory result could be explicitly generalized to patients with different viral genotypes and liver disease severities.

A Convergent and Stereoselective Synthesis of homogenous alternating α(2→8)/α(2→9) Neu5Ac oligosialic acids

Jeng-Liang Han,Bikash Pal,Kuo-Ching Chu,Chien-Tai Ren,Chung-Yi Wu 한국당과학회 2012 한국당과학회 학술대회 Vol.2012 No.1

Polysialic acids, linearly fused N-acetylneuraminic acid (Neu5Ac), play a central role in numerous biological recognition processes such as lymphocyte homing, tumor metathesis, meningitis, urinary tract infections and pathogenic bacteria infections. Three types of polysialic acids, which are different by the internal linkages, have been isolated and identified from the microorganisms. The α (2→8) polysialic acid is a component of neuroinvasive E. coli K1and N. meningitida serogroup B, while the α (2→9) polysialic acid is a component of N. meningitida serogroup C. The alternating α (2→8)/α (2→9) polysialic acid is isolated from E. coli K92 and Bos-12 strains and not found in mammalian systems, making it a potentially carbohydrate vaccine for medicinal treatment. The glycoconjugates of isolated α (2→9) polysialic acid and a carrier protein (ex: diphtheria or tentanus toxoid) are the current vaccines against Meningococcal group C diseases; however, these vaccines are often heterogeneous or contaminated with other antigenic components due to the difficulty in purifying polysialic acids from natural sources. Recently, our lab has successfully and efficiently synthesized α (2→9) polysialic acids up to dodecamers with high yield using 5 -N,4-O-carbonyl protected phosphate-based donors via the convergent block synthesis strategy.

The Effects of Executive Stock Options and Stock Bonuses on Payout Policies in Taiwan

Chia-Ying Chan,Vivian W. Tai,Chi-Hung Chan,Kuo-An Li 한국증권학회 2012 Asia-Pacific Journal of Financial Studies Vol.41 No.2

This study investigates how executive stock-based compensation affects the payout policies of a company. Stock bonuses, which are dividend-protected, induce executives to pay out cash dividends. Conversely, stock options, which are not dividend-protected, discourage the payment of dividends. We posit that the structure of executive stock-based compensation plays a crucial role in determining the payout policies of a firm, particularly for those firms with higher percentages of institutional investors and shareholders with ultimate controlling power. We further examine the effects of the 2008 stock option expensing policy reform in Taiwan as well as the repercussions, if any, that this policy had on payout choices in 2009. The empirical results not only indicate that executive stock-based compensation has a conspicuous influence on the payout policies of a firm, but also that there is a positive relation between stock bonuses and cash dividends. Furthermore, in the case of Taiwan, which has a relatively low corporate income tax rate, firms with higher percentages of shareholders with ultimate controlling power have less preference to pay cash dividends and greater preference to retain profits within the company.

Effects of nitrogen and carbon doping on properties and photocatalytic activity of TiO2-In2O3 composite

Chung-Hsin Wu,Chao-Yin Kuo,Jui-Tai Wu,Pui-Kwan Andy Hong,Chih-Hao Lai,Wei-Yang Chung 한국화학공학회 2015 Korean Journal of Chemical Engineering Vol.32 No.5

TiO2-In2O3 (Ti-In) was synthesized by the sol-gel method and the composite was further doped with nitrogen and carbon to create Ti-In-N and Ti-In-C, respectively. The dye C.I. Reactive Red 2 (RR2) was used a model compound to be subjected to various composites and measured for removal by photocatalytic degradation and adsorption. Ti-In-N possessed a larger mean diameter than Ti-In-C, while the latter possessed a greater anatase content and surface area than the former. After N or C doping, the spectra of corresponding Ti-In-N and Ti-In-C showed absorption edges at longer wavelengths than the parent Ti-In. Ti-N-O and Ti-O-C bonds were found in Ti-In-N and Ti-In-C composites, respectively. Ti-In-N was more effective for RR2 photodegradation than Ti-In-C, and the Ti-In-C removed more RR2 by adsorption than Ti-In-N.

Effect of patient decision aids on choice between sugammadex and neostigmine in surgeries under general anesthesia: a multicenter randomized controlled trial

Wang Li-Kai,Lin Yao-Tsung,Chen Jui-Tai,Lan Winnie,Hung Kuo-Chuan,Chen Jen-Yin,Liu Kuei-Jung,Yen Yu-Chun,Chou Yun-Yun,Cherng Yih-Giun,Tam Ka-Wai 대한마취통증의학회 2023 Korean Journal of Anesthesiology Vol.76 No.4

Background: Shared decision making using patient decision aids (PtDAs) was established over a decade ago, but few studies have evaluated its efficacy in Asian countries. We therefore evaluated the application of PtDAs in a decision conflict between two muscle relaxant reversal agents, neostigmine and sugammadex, and sequentially analyzed the regional differences and operating room turnover rates.Methods: This multicenter, outcome-assessor-blind, randomized controlled trial included 3,132 surgical patients from two medical centers admitted between March 2020 and August 2020. The patients were randomly divided into the classical and PtDA groups for pre-anesthesia consultations. Their clinicodemographic characteristics were analyzed to identify variables influencing the choice of reversal agent. On the day of the pre-anesthesia consultation, the patients completed the four SURE scale (sure of myself, understand information, risk-benefit ratio, encouragement) screening items. The operating turnover rates were also evaluated using anesthesia records. Results: Compared with the classical group, the PtDA group felt more confident about receiving sufficient medical information (P < 0.001), felt better informed about the advantages and disadvantages of the medications (P < 0.001), exhibited a superior understanding of the benefits and risks of their options (P < 0.001), and felt surer about their choice (P < 0.001). Moreover, the PtDA group had a significantly greater tendency to choose sugammadex over neostigmine (P < 0.001). Conclusions: PtDA interventions in pre-anesthesia consultations provided surgical patients with clear knowledge and better support. PtDAs should be made available in other medical fields to enhance shared clinical decision-making.