The Effect of the First Spontaneous Bacterial Peritonitis Event on the Mortality of Cirrhotic Patients with Ascites: A Nationwide Population-Based Study in Taiwan

( Tsung-hsing Hung ),( Chen-chi Tsai ),( Yu-hsi Hsieh ),( Chih-chun Tsai ),( Chih-wei Tseng ),( Kuo-chih Tseng ) 대한간학회 2016 Gut and Liver Vol.10 No.5

Background/Aims: Spontaneous bacterial peritonitis (SBP) contributes to poorer short-term mortality in cirrhotic patients with ascites. However, it is unknown how long the effect of the first SBP event persists in these patients. Methods: The National Health Insurance Database, derived from the Taiwan National Health Insurance Program, was used to identify and enroll 7,892 cirrhotic patients with ascites who were hospitalized between January 1 and December 31, 2007. All patients were free from episodes of SBP from 1996 to 2006. Results: The study included 1,176 patients with SBP. The overall 30-day, 90-day, 1-year, and 3-year mortality rates in this group were 21.8%, 38.9%, 57.5%, and 73.4%, respectively. The overall 30-day, 90-day, 1-year, and 3-year mortality rates in the non-SBP group were 15.7%, 32.5%, 53.3%, and 72.5%, respectively. After adjusting for gender, age, and other medical comorbidities, the adjusted hazard ratios of SBP for 30-day, 30- to 90-day, 90-day to 1-year, and 1- to 3-year mortality were 1.49 (95% confidence interval [CI], 1.30 to 1.71), 1.19 (95% CI, 1.02 to 1.38), 1.04 (95% CI, 0.90 to 1.20), and 0.90 (95% CI, 0.77 to 1.05), respectively, compared with the non-SBP group. Conclusions: The effect of SBP on the mortality of cirrhotic patients with ascites disappeared in those surviving more than 90 days after the first SBP event. (Gut Liver 2016;10:803-807)

Synthesis of ginsenoside Rb₁-imprinted magnetic polymer nanoparticles for the extraction and cellular delivery of therapeutic ginsenosides

Liu, Kai-Hsi,Lin, Hung-Yin,Thomas, James L.,Shih, Yuan-Pin,Yang, Zhuan-Yi,Chen, Jen-Tsung,Lee, Mei-Hwa The Korean Society of Ginseng 2022 Journal of Ginseng Research Vol.46 No.5

Background: Panax ginseng (ginseng) is a traditional medicine that is reported to have cardioprotective effects; ginsenosides are the major bioactive compounds in the ginseng root. Methods: Magnetic molecularly imprinted polymer (MMIP) nanoparticles might be useful for both the extraction of the targeted (imprinted) molecules, and for the delivery of those molecules to cells. In this work, plant growth regulators were used to enhance the adventitious rooting of ginseng root callus; imprinted polymeric particles were synthesized for the extraction of ginsenoside Rb₁ from root extracts, and then employed for subsequent particle-mediated delivery to cardiomyocytes to mitigate hypoxia/reoxygenation injury. Results: These synthesized composite nanoparticles were first characterized by their specific surface area, adsorption capacity, and magnetization, and then used for the extraction of ginsenoside Rb₁ from a crude extract of ginseng roots. The ginsenoside-loaded MMIPs were then shown to have protective effects on mitochondrial membrane potential and cellular viability for H9c2 cells treated with CoCl₂ to mimic hypoxia injury. The protective effect of the ginsenosides was assessed by staining with JC-1 dye to monitor the mitochondrial membrane potential. Conclusion: MMIPs can play a dual role in both the extraction and cellular delivery of therapeutic ginsenosides.

REVIEW : Mass Eradication of Helicobacter pylori to Prevent Gastric Cancer: Theoretical and Practical Considerations

( Yi Chia Lee ),( Tsung Hsien Chiang ),( Jyh Ming Liou ),( Hsiu Hsi Chen ),( Ming Shiang Wu ),( David Y Graham ) 대한간학회 2016 Gut and Liver Vol.10 No.1

Although the age-adjusted incidence of gastric cancer is declining, the absolute number of new cases of gastric cancer is increasing due to population growth and aging. An effective strategy is needed to prevent this deadly cancer. Among the available strategies, screen-and-treat for Helicobacter pylori infection appears to be the best approach to decrease cancer risk; however, implementation of this strategy on the population level requires a systematic approach. The program also must be integrated into national healthcare priorities to allow the limited resources to be most effectively allocated. Implementation will require adoption of an appropriate screening strategy, an efficient delivery system with a timely referral for a positive test, and standardized treatment regimens based on clinical efficacy, side effects, simplicity, duration, and cost. Within the population, there are subpopulations that vary in risk such that a "one size fits all" approach is unlikely to be ideal. Sensitivity analyses will be required to identify whether the programs can be utilized by heterogeneous populations and will likely require adjustments to accommodate the needs of subpopulations. (Gut Liver 2016;10:12-26)

Commentary on “Simultaneous Single-Position Oblique Lateral Interbody Fusion Combined With Unilateral Percutaneous Pedicle Screw Fixation for Single-Level Lumbar Tuberculosis: A 3-Year Retrospective Comparative Study”

Chao-Hung Kuo,Tsung-Hsi Tu 대한척추신경외과학회 2023 Neurospine Vol.20 No.4

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Policies and Transformation of Long-Term Care System in Taiwan

Cheng-fen Chen,Tsung-hsi Fu 대한노인병학회 2020 Annals of geriatric medicine and research Vol.24 No.3

The Taiwanese government has been facing severe challenges pressed by population ageing. The government started taking the issue of long-term care seriously since the first rotation of the political parties in 2000. However, early plans for long-term care were limited in terms of coverage. The Long-Term Care 2.0 Plan—a tax-funded, universal plan—was implemented in 2016. Soon after its implementation, the number of service organizations and the coverage of service increased sharply. This paper takes Taiwan as an example to discuss the designs of long-term care, and strategies to expand service. Many countries nowadays are under pressure to expand long-term care services. Taiwan’s experience could serve as a good example on how to achieve such policy goal within a short period of time. In addition, policy challenges for expanding long-term care are discussed.

Simplified Design Equation of Minimum Interior Joint Depth for Special Moment Frames with High-Strength Reinforcement

Hung-Jen Lee,Hsi-Ching Chen,Tsung-Chieh Tsai 한국콘크리트학회 2018 International Journal of Concrete Structures and M Vol.12 No.7

To avoid excessive slip of beam longitudinal bars at the joints of an earthquake-resisting moment frame, ACI 318 Building Code set a minimum joint depth of 20 times the diameter of the largest longitudinal beam bars passing through the joint, which is based on prior experimental verification of beam-column joints with Grade 420 ㎫ reinforcement. In view of that the 20-bar-diameter criterion cannot be simply extended for concrete frame joints with higher grade reinforcement, this paper summarizes international existing design criteria and proposes a simplified equation for the minimum joint depth. The equation applicability is assessed by evaluating the cyclic testing results of beam-column joints conducted in East Asian and Pacific Countries, where Grade 490, 590, and 690 ㎫ reinforcement have been used for earthquake-resistant concrete structures. Beam-column joints that satisfy the proposed equation can demonstrate satisfactory hysteresis behavior at an interstory drift of 4%.

Acidic Fibroblast Growth Factor in Spinal Cord Injury

Chin-Chu Ko,Tsung-Hsi Tu,Jau-Ching Wu,Wen-Cheng Huang,Henrich Cheng 대한척추신경외과학회 2019 Neurospine Vol.16 No.4

Spinal cord injury (SCI), with an incidence rate of 246 per million person-years among adults in Taiwan, remains a devastating disease in the modern day. Elderly men with lower socioeconomic status have an even higher risk for SCI. Despite advances made in medicine and technology to date, there are few effective treatments for SCI due to limitations in the regenerative capacity of the adult central nervous system. Experiments and clinical trials have explored neuro-regeneration in human SCI, encompassing cell- and molecule-based therapies. Furthermore, strategies have aimed at restoring connections, including autologous peripheral nerve grafts and biomaterial scaffolds that theoretically promote axonal growth. Most molecule-based therapies target the modulation of inhibitory molecules to promote axonal growth, degrade glial scarring obstacles, and stimulate intrinsic regenerative capacity. Among them, acidic fibroblast growth factor (aFGF) has been investigated for nerve repair; it is mitogenic and pluripotent in nature and could enhance axonal growth and mitigate glial scarring. For more than 2 decades, the authors have conducted multiple trials, including human and animal experiments, using aFGF to repair nerve injuries, including central and peripheral nerves. In these trials, aFGF has shown promise for neural regeneration, and in the future, more trials and applications should investigate aFGF as a neurotrophic factor. Focusing on aFGF, the current review aimed to summarize the historical evolution of the utilization of aFGF in SCI and nerve injuries, to present applications and trials, to summarize briefly its possible mechanisms, and to provide future perspectives.

A Hybrid Dynamic Stabilization and Fusion System in Multilevel Lumbar Spondylosis

Li-Yu Fay,Chih-Chang Chang,Hsuan-Kan Chang,Tsung-Hsi Tu,Tzu-Yun Tsai,Ching-Lan Wu,Wen-Cheng Huang,Jau-Ching Wu,Henrich Cheng 대한척추신경외과학회 2018 Neurospine Vol.15 No.3

Objective: The Dynesys-Transition-Optima (DTO) hybrid system was designed to achieve arthrodesis and stabilization in patients with lumbar degeneration. Satisfactory outcomes were demonstrated previously. However, no study has evaluated the effects of using the DTO system in patients with lumbar spondylolisthesis or stenosis. Methods: This retrospective study included 35 consecutive patients with multilevel lumbar degeneration with or without spondylolisthesis who underwent surgery using the DTO system. Imaging studies included pre- and postoperative radiography, magnetic resonance imaging, and computed tomography. The clinical outcomes were measured by Japanese Orthopedic Association (JOA) scores, Oswestry Disability Index (ODI) scores, and a visual analogue scale (VAS) for back and leg pain. Results: Thirty patients (85.7%) with a mean age of 61.9 years completed the follow-up, with a mean duration of 35.1 months. There were 21 patients in the spondylolisthesis group and 9 in the stenosis group. The spondylolisthesis group had worse functional scores than the stenosis group preoperatively. After DTO surgery, all patients showed significant improvements in clinical outcomes, including VAS for back and leg pain, ODI, and JOA scores (p<0.05). There were no significant differences in clinical outcomes between the 2 groups. At a 2-year follow-up, lumbar alignment was well maintained in both groups (p=0.116). There were no significant differences in lumbar alignment between the 2 groups. Conclusion: During a follow-up period of over 2 years, both patients with spondylolisthesis and those with stenosis showed improvements and similar disability and pain scores after surgery using the DTO system. Lumbar alignment was also well maintained.

Development and characterization of a potential diagnostic monoclonal antibody against capsid protein VP1 of the chicken anemia virus

Yi-Yang Lien,Chi-Hung Huang,Fang-Chun Sun,Shyang-Chwen Sheu,Tsung-Chi Lu,Meng-Shiunn Lee,Shu-Chin Hsueh,Hsi-Jien Chen,Meng-Shiou Lee 대한수의학회 2012 JOURNAL OF VETERINARY SCIENCE Vol.13 No.1

Chicken anemia virus (CAV) is an important viral pathogen that causes anemia and severe immunodeficiency syndrome in chickens worldwide. In this study, a potential diagnostic monoclonal antibody against the CAV VP1 protein was developed which can precisely recognize the CAV antigen for diagnostic and virus recovery purposes. The VP1 gene of CAV encoding the N-terminus-deleted VP1 protein, VP1Nd129, was cloned into an Escherichia (E.) coli expression vector. After isopropyl-b-D-thiogalactopyronoside induction, VP1Nd129 protein was shown to be successfully expressed in the E. coli. By performing an enzyme-linked immunoabsorbent assay using two coating antigens, purified VP1Nd129 and CAV-infected liver tissue lysate, E3 monoclonal antibody (mAb) was found to have higher reactivity against VP1 protein than the other positive clones according to the result of limiting dilution method from 64 clones. Using immunohistochemistry, the presence of the VP1-specific mAb, E3, was confirmed using CAV- infected liver and thymus tissues as positive-infected samples. Additionally, CAV particle purification was also performed using an immunoaffinity column containing E3 mAb. The monoclonal E3 mAb developed in this study will not only be very useful for detecting CAV infection and performing histopathology studies of infected chickens, but may also be used to purify CAV particles in the future.

Nationwide “Hospital Emergent Capability Accreditation by Level-Stroke” Improves Stroke Treatment in Taiwan

Tain-Junn Cheng,Giia-Sheun Peng,Wei-Siang Jhao,Jiunn-Tay Lee,Tsung-Hsi Wang 대한뇌졸중학회 2017 Journal of stroke Vol.19 No.2

Background and Purpose Recombinant tissue plasminogen activator (rtPA) is one of the proventherapies that improve the outcome of patients with acute ischemic stroke (AIS). In 2009, theMinistry of Health and Welfare, Executive Yuan, Republic of China, launched the project “HospitalEmergent Capability Accreditation by Level-Stroke (HECAL-Stroke)” to improve AIS treatment inTaiwan. The current study was performed to determine whether the project launched by thegovernment was effective in promoting rtPA therapy among AIS patients. Methods All participating hospitals were verified and designated as “heavy duty (HD),” “moderateduty (MoD),” or “medium duty (MeD)” according to the stroke center criteria. Four annual indices(rates of treatment, protocol adherence, in-time treatment, and complications) were recorded from2009 to 2014 as outcome measures. The data were analyzed using the χ2 test for significance. Results The number of certified hospitals progressively increased from 74 to 112 during the 6-yearperiod and finally consisted of 33 HD, 9 MoD and 70 MeD hospitals in 2014. The annualintravenous rtPA treatment rate increased significantly from 3.0% in 2009 to 4.5% in 2014. Theprotocol adherence rates were 95.7% in the HD group, 92.4% in the MoD group and 72.8% in theMeD group. The annual in-time treatment rate significantly improved from 26.0% in 2009 to60.1% in 2014. The overall symptomatic intracranial hemorrhagic rate after rtPA treatment was8.6%. Conclusions Initiation of the HECAL-Stroke project by the government significantly improved rtPAtreatment in Taiwan.