1.A Systematic Classification of the Congenital Bronchopulmonary Vascular Malformations: Dysmorphogeneses of the Primitive Foregut System and the Primitive Aortic Arch System.
Meng Luen LEE ; Hung Chi LUE ; Ing Sh CHIU ; Han Yao CHIU ; Lon Yen TSAO ; Ching Yuan CHENG ; Albert D YANG
Yonsei Medical Journal 2008;49(1):90-102
PURPOSE: We reviewed the cases of 33 patients from our clinic and 142 patients from the literature with congenital bronchopulmonary vascular malformations (BPVM), systematically analyzed the bronchopulmonary airways, pulmonary arterial supplies, and pulmonary venous drainages, and classified these patients by pulmonary malinosculation (PM). MATERIALS AND METHODS: From January 1990 to January 2007, a total of 33 patients (17 men or boys and 16 women or girls), aged 1 day to 24 years (median, 2.5 months), with congenital BPVM were included in this study. Profiles of clinical manifestations, chest radiographs, echocardiographs, esophagographs, computer tomography (CT), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), cardiac catheterizations with angiography, contrast bronchographs, bronchoscopies, chromosomal studies, surgeries, and autopsies of these patients were analyzed to confirm the diagnosis of congenital BPVM. A total of 142 cases from the literature were also reviewed and classified similarly. RESULTS: The malformations of our 33 patients can be classified as type A isolated bronchial PM in 13 patients, type B isolated arterial PM in three, type C isolated venous PM in two, type D mixed bronchoarterial PM in five, type F mixed arteriovenous PM in one, and type G mixed bronchoarteriovenous PM in nine. CONCLUSION: Dysmorphogeneses of the primitive foregut system and the primitive aortic arch system may lead to haphazard malinosculations of the airways, arteries, and veins of the lung. A systematic classification of patients with congenital BPVM is clinically feasible by assessing the three basic bronchovascular systems of the lung independently.
Adolescent
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Adult
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Aorta, Thoracic/*abnormalities
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Child
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Child, Preschool
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Female
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Humans
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Infant
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Infant, Newborn
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Intestines/*abnormalities/*blood supply
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Lung/*abnormalities/*blood supply
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Male
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Vascular Malformations/*classification
2.Safety and efficacy of extending intravenous thrombolysis treatment for acute ischemic stroke in Taiwan
Neurology Asia 2019;24(3):209-214
Recombinant tissue plasminogen activator (rt-PA) is the most effective treatment for acute ischemic
stroke and the exclusion criteria of rt-PA has been revised to extend its application. However, in
Taiwan, National Health Insurance (NHI) did not follow the latest international consensus due to
safety concerns. The present study investigated whether extending the application of rt-PA in Taiwan
was safe and effective. The medical records from the Shuang Ho hospital stroke registry between
August 2009 and December 2016 were retrospectively reviewed. Post rt-PA intracranial hemorrhage
(ICH) and modified Rankin Scale (mRS) score at 3-month after stroke were the primary and secondary
outcomes, respectively. Differences were analyzed through Fisher’s exact test and Student’s t test. A
p-value of <0.05 was considered statistically significant. Overall, there were 243 patients categorized
into two groups: NHI exclusion criteria adherence (n = 160) and non-adherence (n = 83). There
was no significant difference in the risk of post rt-PA ICH (12.50% in adherence group, 4.82% in
non-adherence group, p=0.07). Among the non-adherence group, 10 patients breached the latest
international exclusion criteria and none of them experienced post rt-PA ICH. However, among
patients with moderately severe stroke, the odds of mRS < 2 at 3-month were significantly lower in
non-adherence group. This study demonstrated that extending administration of rt-PA in Taiwan was
safe but the functional outcome after moderate stroke was not as favorable as adherence group. Old
age, long onset-to-treatment time and less efficacy of lower dose of rt-PA were the possible factors
for the difference in outcome.
3.Combined Assessment of Serum Alpha-Synuclein and Rab35 is a Better Biomarker for Parkinson's Disease
Hung Li WANG ; Chin Song LU ; Tu Hsueh YEH ; Yu Ming SHEN ; Yi Hsin WENG ; Ying Zu HUANG ; Rou Shayn CHEN ; Yu Chuan LIU ; Yi Chuan CHENG ; Hsiu Chen CHANG ; Ying Ling CHEN ; Yu Jie CHEN ; Yan Wei LIN ; Chia Chen HSU ; Huang Li LIN ; Chi Han CHIU ; Ching Chi CHIU
Journal of Clinical Neurology 2019;15(4):488-495
BACKGROUND AND PURPOSE: It is essential to develop a reliable predictive serum biomarker for Parkinson's disease (PD). The accumulation of alpha-synuclein (αSyn) and up-regulated expression of Rab35 participate in the etiology of PD. The purpose of this investigation was to determine whether the combined assessment of serum αSyn and Rab35 is a useful predictive biomarker for PD. METHODS: Serum levels of αSyn or Rab35 were determined in serum samples from 59 sporadic PD patients, 19 progressive supranuclear palsy (PSP) patients, 20 multiple system atrophy (MSA) patients, and 60 normal controls (NC). Receiver operating characteristics (ROC) curves were calculated to determine the diagnostic accuracy of αSyn or/and Rab35 in discriminating PD patients from NC or atypical parkinsonian patients. RESULTS: The levels of αSyn and Rab35 were increased in PD patients. The serum level of Rab35 was positively correlated with that of αSyn in PD patients. Compared to analyzing αSyn or Rab35 alone, the combined analysis of αSyn and Rab35 produced a larger area under the ROC curve and performed better in discriminating PD patients from NC, MSA patients, or PSP patients. When age was dichotomized at 55, 60, 65, or 70 years, the combined assessment of αSyn and Rab35 for classifying PD was better in the group below the cutoff age than in the group above the cutoff age. CONCLUSIONS: Combined assessment of serum αSyn and Rab35 is a better biomarker for discriminating PD patients from NC or atypical parkinsonian patients, and is a useful predictive biomarker for younger sporadic PD patients.
alpha-Synuclein
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Humans
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Multiple System Atrophy
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Parkinson Disease
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ROC Curve
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Supranuclear Palsy, Progressive
4.Mutations of t-complex testis expressed gene 5 transcripts in the testis of sterile t-haplotype mutant mouse.
Yibing HAN ; Xue-Xiong SONG ; Huai-Liang FENG ; Che-Kwok CHEUNG ; Po-Mui LAM ; Chi-Chiu WANG ; Christophe John HAINES
Asian Journal of Andrology 2008;10(2):219-226
AIMTo determine the possible roles of the t-complex testis expressed gene 5 (Tctex5) on sperm functions, the full-length sequence of mRNA was studied and compared in the testis between the normal wild-type and the sterile t-haplotype mutant mice.
METHODSWe applied rapid amplification of cDNA ends, Northern blot and reverse transcription polymerase chain reaction to analyze the full length of Tctex5 mRNAs isolated from testes of the wild-type and the t-haplotype mice. Reverse transcription polymerase chain reaction was used to semi-quantitatively compare expression of Tctex5 transcripts in the 16 tissues and 9.5 day stage embryos in the wild-type mice. E-translation was applied to estimate the amino acid sequences.
RESULTSOne long and one short transcript of Tctex5 mRNA were discovered in mouse testis of wild-type (Tctex5(long-+) and Tctex5(short-+)) and t-haplotype (Tctex5(long-t) and Tctex5(short-t)) mice, respectively. Being enhanced only in the testis, Tctex5(long-t) had 17 point mutations and one 15-bp-deletion in the exon 1 region, comparing with the Tctex5(long-+), whereas the Tctex5(short-t) was similar to the Tctex5(short-+). The short isoforms of Tctex5 mRNAs in the two models encoded exactly the same peptides, but the long isoforms did not. The estimated peptide encoded by Tctex5(long-t) had significant mutations on putative sites of phosphorylation and PP1 binding.
CONCLUSIONWe established that mutations that occur in the Tctex5 long transcript of the t-haplotype mice are important for normal sperm function, whereas the short transcript of Tctex5 might have a conserved function among different tissues.
Animals ; Gene Expression ; Haplotypes ; Infertility, Male ; Male ; Mice ; Microtubule-Associated Proteins ; chemistry ; genetics ; Mutation ; Nuclear Proteins ; chemistry ; genetics ; Protein Phosphatase 1 ; Sequence Analysis, Protein ; Spermatozoa ; metabolism ; Testis ; metabolism ; t-Complex Genome Region
5.Metformin and statins reduce hepatocellular carcinoma risk in chronic hepatitis C patients with failed antiviral therapy
Pei-Chien TSAI ; Chung-Feng HUANG ; Ming-Lun YEH ; Meng-Hsuan HSIEH ; Hsing-Tao KUO ; Chao-Hung HUNG ; Kuo-Chih TSENG ; Hsueh-Chou LAI ; Cheng-Yuan PENG ; Jing-Houng WANG ; Jyh-Jou CHEN ; Pei-Lun LEE ; Rong-Nan CHIEN ; Chi-Chieh YANG ; Gin-Ho LO ; Jia-Horng KAO ; Chun-Jen LIU ; Chen-Hua LIU ; Sheng-Lei YAN ; Chun-Yen LIN ; Wei-Wen SU ; Cheng-Hsin CHU ; Chih-Jen CHEN ; Shui-Yi TUNG ; Chi‐Ming TAI ; Chih-Wen LIN ; Ching-Chu LO ; Pin-Nan CHENG ; Yen-Cheng CHIU ; Chia-Chi WANG ; Jin-Shiung CHENG ; Wei-Lun TSAI ; Han-Chieh LIN ; Yi-Hsiang HUANG ; Chi-Yi CHEN ; Jee-Fu HUANG ; Chia-Yen DAI ; Wan-Long CHUNG ; Ming-Jong BAIR ; Ming-Lung YU ;
Clinical and Molecular Hepatology 2024;30(3):468-486
Background/Aims:
Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients.
Methods:
We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development.
Results:
Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients.
Conclusions
Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.
6.Artificial neural network-based analysis of the safety and efficacy of thrombolysis for ischemic stroke in older adults in Taiwan
Chen-Chih Chung ; You-Chia Chen ; Chien-Tai Hong ; Nai-Fang Chi ; Chaur-Jong Hu ; Han-Hwa Hu ; Lung Chan ; Hung-Wen Chiu
Neurology Asia 2020;25(2):109-117
Background: The risk and benefit of tissue plasminogen activator (tPA) for aged>80 years with acute
ischemic stroke (AIS) are controversial. In this study, we investigated the safety and efficacy of tPA
in this population and utilized the artificial neural network (ANN) to established outcome predictive
models. Methods: We retrospectively reviewed the stroke registry data of patients with AIS, aged >80
years who arrived at the hospital within 3 hours from the onset of symptoms. The characteristics and
the outcomes, presented as modified Rankin Scale (mRS), and mortality rate at 3 months between the
tPA-treated and non-tPA groups were analyzed. An ANN algorithm was applied to establish predictive
models. Results: A total of 80 patients aged>80 years with AIS were identified, and 49 of them received
tPA. After adequate training, our ANN models accurately predicted the outcomes with the area under
the receiver operating characteristic curves of 0.974, and a low error to predict the mRS score at 3
months. After applying our prediction model to those in the non-tPA group, we demonstrated the
potential benefits in those patients if they had undergone tPA therapy.
Conclusions: Our results show that ANN can be a potentially useful tool for predicting the treatment
outcomes of tPA. Such novel machine learning-based models may help with therapeutic decision
making in clinical settings.