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Assessment of Postmenopausal Bleeding

Chin-Yuan Hsu, Chih-Ping Chen, Kung-Liahng Wang
2008 International Journal of Gerontology  
Postmenopausal bleeding is bleeding that occurs 12 or more months after the last menstrual period and accounts for 5% of all gynecologic office visits. While it is not always a symptom of cancer, the exclusion of endometrial hyperplasia and carcinoma is the key issue in the evaluation of patients with postmenopausal bleeding. The primary evaluation of postmenopausal women who present with abnormal uterine bleeding includes a medical history and a pelvic examination. Investigative studies, such
more » ... s a uterine biopsy, ultrasound, hysteroscopy or dilation and curettage, may be required. Treatment will depend on the cause determined. The most important point is that irregular perimenopausal or postmenopausal bleeding should not be ignored or assumed to be a normal phenomenon.
doi:10.1016/s1873-9598(08)70011-5 fatcat:hcwkwhfzm5dntmyy3m5evdlw4q

Metabolic Risk Factors of Alzheimer's Disease, Dementia with Lewy Bodies, and Normal Elderly: A Population-Based Study

Chih-Kuang Cheng, Yu-Chien Tsao, Yuan-Chih Su, Fung-Chang Sung, Hsu-Chih Tai, Woon-Man Kung
2018 Behavioural Neurology  
Background. Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) share many risk factors. Evidence suggests that metabolic risk factors are important to AD; however, their association with DLB is unclear. The risk of cardiovascular diseases (CVD) associated with AD and DLB is also uncertain. Thus, this nationwide, population-based study was designed to evaluate the metabolic and CVD risks in AD and DLB. Materials and Methods. Data were obtained from the Taiwan National Health Insurance
more » ... esearch Database. AD patients, DLB patients, and normal control (NC) individuals from 1996 to 2013 were enrolled for risk assessment. Results. In total, 7544 NC individuals, 1324 AD patients, and 562 DLB patients were enrolled. Participants with one or more metabolic risk factors had significantly higher odds of AD or DLB. No significant differences in metabolic risk factors were observed between DLB and AD patients. AD patients had a lower risk of CVD (aHR = 0.67, 95% CI = 0.59–0.76, p value < 0.001) and coronary artery disease (CAD) (aHR = 0.59, 95% CI = 0.51–0.69, p value < 0.001) than NC. DLB patients had a higher risk of ischemic stroke (aHR = 2.27, 95% CI = 1.68–3.06, p value < 0.001) than NC. Conclusion. Metabolic risk factors are important in AD and DLB. Patients with AD might have a lower risk of CAD and ischemic strokes. Patients with DLB might have a higher risk of ischemic stroke.
doi:10.1155/2018/8312346 pmid:29971140 pmcid:PMC6008802 fatcat:kp2y5k7nlzh63daldsocstvuwe

Determination of Binding Constant and Stoichiometry for Antibody-Antigen Interaction with Surface Plasmon Resonance

Shiming Lin, Adam Shih-Yuan Lee, Chih-Chen Lin, Chih-Kung Lee
2006 Current Protoemics  
A surface plasmon resonance (SPR) biosensor technology has recently been applied biochemically and clinically to the study of immunologic recognition and the evaluation of binding parameters for various interactions between antibodies (Abs) and antigens (Ags) at liquid-solid interface. The simple interaction between hapten and Ab fragment, e.g., variable single-chain fragment and antigenbinding fragment, can be described sufficiently by a 1:1 stoichiometry in SPR. However, the determination of
more » ... he binding constant of an anti-protein Ab is usually complicated by the multivalence of the protein Ag. The SPR-based method enables direct determination of binding constants for a variety of specific Ab-Ag interactions in real-time. It also allows estimation of the binding stoichiometry and binding ratio for low-, intermediate-, and high-affinity Ab-Ag interaction systems. The present review is designed to indicate the theoretical background of SPR-based biosensor technology as well as to present the great variety of measurement modes of interaction kinetics that can be performed with these techniques. Quantitative aspects of the Ab-Ag interaction kinetics are reviewed, focusing especially on mono-and multi-valent Ab-Ag interaction modes using a SPR biosensor. Four model binding systems developed recently for use with SPR biosenser are described with principles and examples: (i) one to one interaction mode, (ii) nonequivalent two-site interaction mode, (iii) multiple equivalent-site interaction mode and (iv) multisite interaction mode. This article closes with two descriptions of the determinations of the binding stoichiometry and maximum binding ratio of Ab-Ag interactions.
doi:10.2174/157016406780655586 fatcat:5x2nytrpp5dvthgvwixso3skse

The Prognostic Value of Serum Soluble TREM-1 on Outcome in Adult Patients with Sepsis

Chia-Te Kung, Chih-Min Su, Sheng-Yuan Hsiao, Fu-Cheng Chen, Yun-Ru Lai, Chih-Cheng Huang, Cheng-Hsien Lu
2021 Diagnostics  
Increased soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) levels have been reported in patients with sepsis. We tested the hypotheses that serum sTREM-1 levels increase in the early phase of sepsis and decrease after sepsis under appropriate treatment and that sTREM-1 levels can predict therapeutic outcomes. One hundred and fifty-five patients prospectively underwent blood samples including biochemical data, sTREM-1, and biomarkers on endothelial dysfunction as well as
more » ... l severity index examinations. Blood samples from Days 1, 4, and 7 after admission were checked. For comparison, 50 healthy subjects were selected as healthy control. Those patients who had sepsis had significantly higher sTREM-1 levels than those of healthy control. sTREM-1 levels positively correlated with biomarkers for endothelial dysfunction (ICAM-1, VCAM-1, and E-selectin) and lactate level as well as clinical severity index (maximum 24 h APACHE score and Sequential Organ Failure Assessment (SOFA) score) upon admission. sTREM-1 concentrations were significantly higher from Day 1 to Day 7 in the non-survivors than in the survivors. A stepwise logistic regression analysis showed only sTREM-1 level and maximum 24 h SOFA score upon admission were significantly associated with fatality. Area under the receiver operating characteristic curve analysis for the diagnostic accuracy of sTREM-1 in sepsis-related fatality gave a value of 0.726, with a cutoff value of 384.6 pg/mL (sensitivity = 80.8% and specificity = 61.5%). sTREM-1 level may be valuable in auxiliary diagnosis, and it can serve as a useful biomarker as a screening service and follow-up therapeutic outcomes in sepsis.
doi:10.3390/diagnostics11111979 pmid:34829326 pmcid:PMC8625818 fatcat:czi6jcq2szd3hcuubq2av5zlq4

Investigation of 3.3 kV 4H-SiC DC-FSJ MOSFET Structures

Chia-Yuan Chen, Yun-Kai Lai, Kung-Yen Lee, Chih-Fang Huang, Shin-Yi Huang
2021 Micromachines  
This research proposes a novel 4H-SiC power device structure—different concentration floating superjunction MOSFET (DC-FSJ MOSFET). Through simulation via Synopsys Technology Computer Aided Design (TCAD) software, compared with the structural and static characteristics of the traditional vertical MOSFET, DC-FSJ MOSFET has a higher breakdown voltage (BV) and lower forward specific on-resistance (Ron,sp). The DC-FSJ MOSFET is formed by multiple epitaxial technology to create a floating P-type
more » ... cture in the epitaxial layer. Then, a current spreading layer (CSL) is added to reduce the Ron,sp. The floating P-type structure depth, epitaxial layer concentration and thickness are optimized in this research. This structure can not only achieve a breakdown voltage over 3300 V, but also reduce Ron,sp. Under the same conditions, the Baliga Figure of Merit (BFOM) of DC-FSJ MOSFET increases by 27% compared with the traditional vertical MOSFET. Ron,sp is 25% less than that of the traditional vertical MOSFET.
doi:10.3390/mi12070756 fatcat:4hlphbmvbza7rnmnhr4c6sp2g4

Analysis of Surgically Treated Intraspinal Tumors in Southern Taiwan

Yu-Feng Su, Ann-Shung Lieu, Chih-Lung Lin, Kung-Shing Lee, Yen-Fen Hwang, Chun-Po Yen, Chih-Zen Chang, Joon-Khim Loh, Tzuu-Yuan Huang, Shiuh-Lin Hwang, Aij-Lie Kwan, Sheng-Long Howng (+1 others)
2007 Kaohsiung Journal of Medical Sciences  
In 1997, we presented an analysis of intraspinal tumors in south Taiwan [1] . In total, 120 cases of intraspinal tumors diagnosed and surgically treated at Kaohsiung Medical College Hospital between 1988 and 1995 were assessed, and the results were compared with those from other series. This previous study showed that the four most common histologic types of spinal tumors were nerve sheath tumors (40%), metastatic tumors (23.3%), meningiomas (11.7%) and neuroepithelial tumors (8.3%). The next
more » ... cade was marked by improved availability and quality of noninvasive imaging modalities, especially magnetic resonance imaging (MRI), which has facilitated diagnosis and management [2] . Because the age of the patient population in Taiwan is increasing rapidly [3], the epidemiology of spinal tumors may change. The purpose of this survey was to assess spinal tumor occurrence in Taiwan during a recent 5-year period and compare this assessment with the one we reported in 1997, and with those of other reported series. MATERIALS AND METHODS The medical histories of 117 consecutive patients who were surgically The medical records of 117 patients with spinal tumors who underwent surgery with pathologic confirmation from January 1999 to April 2004 at Kaohsiung Medical University Hospital were reviewed. Data from this review were compared with those obtained from the same institution 10 years earlier (covering the period 1988-1995) and from other reported series. There were 69 male and 48 female patients aged from 13 to 87 years old (mean age, 51.9). The most common pathologic findings were metastasis in 45.3% (53/117), nerve sheath tumors in 28.2% (33/117), meningiomas in 12% (14/117) and neuroepithelial tumors in 6% (7/117). The peak ages at diagnosis were 41-50 years and 61-70 years. A slight male predominance was noted for all tumors, except meningiomas. Motor weakness, even paralysis, was the major clinical presentation (64-86%), followed by sensory deficits (50%) and pain (42%). The location of tumors was most often in the thoracic (50.4%; 59/117), lumbosacral (27.4%; 32/117) and cervical spine (22.2%; 26/117) segments. Among the metastatic tumors, the lung (22.6%) and breast (15.1%) were the most common primary sites of origin, followed by unknown origin, the liver (hepatocellular carcinoma), the gastrointestinal tract and the nasopharynx (nasopharyngeal cancer).
doi:10.1016/s1607-551x(08)70005-6 pmid:18055306 fatcat:ymtuycuq5rb7hn6ewaykg5xcb4

CHADS2Scores in the Prediction of Major Adverse Cardiovascular Events in Patients with Cushing's Syndrome

Yuh-Feng Wang, Mei-Hua Chuang, Tzyy-Ling Chuang, Kung-Yung Huang, Shaw-Ruey Lyu, Chih-Yuan Huang, Ching-Chih Lee
2014 International Journal of Endocrinology  
Vascular events are one of the major causes of death in case of Cushing's syndrome (CS). However, due to the relative low frequency of CS, it is hard to perform a risk assessment for these events. As represented congestive heart failure (C), hypertension (H), age (A), diabetes (D), and stroke (S), the CHADS2score is now accepted to classify the risk of major adverse cardiovascular events (MACEs) in patients with atrial fibrillation. In this study, participants were enrolled from the National
more » ... lth Research Institute Database (NHIRD) of Taiwan, and we reviewed 551 patients with their sequential clinically diagnosed CS data between 2002 and 2009 in relation to MACEs risk using CHADS2score. Good correlation could be identified between the CS and CHADS2score(AUC=0.795). Our results show that patients with CS show significantly higher risk of vascular events and the CHADS2score could be applied for MACEs evaluation. Adequate lifestyle modifications and aggressive cardiovascular risks treatment are suggested for CS patients with higher CHADS2score.
doi:10.1155/2014/138653 pmid:25101124 pmcid:PMC4102001 fatcat:lzxhrd7pazgqdmvlhpofbgrdk4

Melatonin exerts anti-oral cancer effect via suppressing LSD1 in patient-derived tumor xenograft models

Cheng-Yu Yang, Chih-Kung Lin, Chang-Huei Tsao, Cheng-Chih Hsieh, Gu-Jiun Lin, Kuo-Hsing Ma, Yi-Shing Shieh, Huey-Kang Sytwu, Yuan-Wu Chen
2017 OncoTarget  
Chih-Kung Lin and Chang-Huei Tsao contributed to acquisition of data. Gu-Jiun Lin analyzed the data. Kuo-Hsing Ma, Cheng-Chih Hsieh and Huey-Kang Sytwu provided technical and material supports.  ...  Yuan-Wu Chen designed the experiments, and revised the manuscript. , 3e) revealed poorly differentiated OSCC, which was consistent with the original clinical cancer tissues(Figure 3b, 3d).  ... 
doi:10.18632/oncotarget.16808 pmid:28422711 pmcid:PMC5464909 fatcat:5xr2kucjpfgqnkpwk6chv3yhbm

Potentially high-risk medication categories and unplanned hospitalizations: a case–time–control study

Chih-Wan Lin, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
2017 Scientific Reports  
doi:10.1038/srep41035 pmid:28112193 pmcid:PMC5253626 fatcat:ljv3j4o3zbgxlj2bitp2tfwek4

Janus monolayers of transition metal dichalcogenides

Ang-Yu Lu, Hanyu Zhu, Jun Xiao, Chih-Piao Chuu, Yimo Han, Ming-Hui Chiu, Chia-Chin Cheng, Chih-Wen Yang, Kung-Hwa Wei, Yiming Yang, Yuan Wang, Dimosthenis Sokaras (+6 others)
2017 Nature Nanotechnology  
Structural symmetry-breaking plays a crucial role in determining the electronic band structures of two-dimensional materials. Tremendous efforts have been devoted to breaking the in-plane symmetry of graphene with electric fields on AB-stacked bilayers 1,2 or stacked van der Waals heterostructures 3,4 . In contrast, transition metal dichalcogenide monolayers are semiconductors with intrinsic in-plane asymmetry, leading to direct electronic bandgaps, distinctive optical properties and great
more » ... tial in optoelectronics 5,6 . Apart from their in-plane inversion asymmetry, an additional degree of freedom allowing spin manipulation can be induced by breaking the out-of-plane mirror symmetry with external electric fields 7,8 or, as theoretically proposed, with an asymmetric out-of-plane structural configuration 9 . Here, we report a synthetic strategy to grow Janus monolayers of transition metal dichalcogenides breaking the out-of-plane structural symmetry. In particular, based on a MoS 2 monolayer, we fully replace the top-layer S with Se atoms. We confirm the Janus structure of MoSSe directly by means of scanning transmission electron microscopy and energy-dependent X-ray photoelectron spectroscopy, and prove the existence of vertical dipoles by second harmonic generation and piezoresponse force microscopy measurements. We first prepare single-crystalline triangular molybdenum disulfide (MoS 2 ) monolayers on c-plane sapphire substrates using chemical vapour deposition 10,11 , then strip off the top-layer sulfur atoms and replace them with hydrogen atoms using a remote hydrogen plasma (Fig. 1a) . Without breaking the vacuum, the subsequent thermal selenization allows Se to replace the H atoms, forming a structurally stable Janus MoSSe monolayer in which the Mo atoms are covalently bonded to underlying S and top-layer Se atoms. Optical microscope images for the monolayer at each stage are presented in Fig. 1a , where the stripped MoS 2 (MoSH) is shown to retain its triangular shape. Atomic force microscope images reveal an apparent change in the cross-sectional height from 1.0 nm for pristine MoS 2 to 0.7-0.8 nm for MoSH and 1.1 nm for Janus MoSSe. The reduced thickness after H 2 -plasma indicates the successful S-stripping. Our first-principles calculations further predict that the H 2 -plasma-treated MoS 2 should generate hydrogenated MoS with nearly full H-coverage (MoSH), due to the large absorption energy of H atoms at the vacancy sites (∼1 eV per H atom) (see Supplementary Section 'Theoretical calculation'). The plasma power needs to be at an optimum value to break the surface Mo-S bonds but still preserve the underlying two-dimensional Mo-S structure. In this respect, the remote plasma produced from light molecules (hydrogen) works better than that from heavy molecules such as argon plasma 12 , which easily destroys the entire two-dimensional structure (as shown in Supplementary Fig. 1a) . The selenization temperature also plays a critical role. The substrate temperature needs to be higher than 350°C for Mo-Se bond formation but not higher than 450°C, where the two-dimensional structure becomes unstable and holes appears in the monolayer (Supplementary Fig. 1b) . When the temperature is higher than 600°C, randomized MoSSe alloy structures are obtained, and the Se and S are mixed in a disordered arrangement at both the top and bottom surfaces, reaching a state of maximum entropy with a thermodynamically favoured structure in an Ar/H 2 environment, consistent with previous reports 13,14 . Hence, the key to the synthetic strategy for Janus MoSSe is to control the reaction by kinetics rather than thermodynamics. Figure 1b shows that the intensities of Raman out-of-plane A 1 (406 cm −1 ) and in-plane E′ (387 cm −1 ) modes for a MoS 2 monolayer decrease (curve for 5 min stripping) and eventually vanish (curve for 20 min stripping) with increasing stripping time, agreeing well with the calculated phonon dispersion of the expected MoSH structure ( Supplementary Fig. 3a ). Note that we perform the subsequent thermal sulfurization or selenization only for the samples not showing any Raman A 1 and E′ peaks. Interestingly, the A 1 and E′ peaks appear again after sulfurization, indicating the recovery of MoS 2 monolayers from MoSH and the reversibility of this process. When we perform the selenization for MoSH, the A 1 peak shifts to 288 cm −1 from the original 406 cm −1 , and the E′ peak shifts to 355 cm −1 from 387 cm −1 in MoS 2 . These peaks match well with the two major phonon energies predicted in Supplementary Fig. 3b ,c. The shift of the A 1 frequency is caused by the out-of-plane symmetry change upon selenization, while the shift of the E′ mode is related to a change in the lattice constant. Figure 1c shows that the optical gap of a pristine MoS 2 monolayer
doi:10.1038/nnano.2017.100 pmid:28507333 fatcat:llkbv3comnct7gxxskk54tzymu

Specular Scattering Probability of Acoustic Phonons in Atomically Flat Interfaces

Yu-Chieh Wen, Chia-Lung Hsieh, Kung-Hsuan Lin, Hung-Pin Chen, Shu-Cheng Chin, Ching-Lien Hsiao, Yuan-Ting Lin, Chia-Seng Chang, Yuan-Chih Chang, Li-Wei Tu, Chi-Kuang Sun
2009 Physical Review Letters  
We report a direct determination of the specular scattering probability of acoustic phonons at a crystal boundary by observing the escape of incident coherent phonons from the coherent state during reflection. In the sub-THz frequency range where the phonon wavelength is much longer than the lattice constant, the acoustic phonon-interface interaction is found to agree well with the macroscopic theory on wave scattering from rough surfaces. This examination thus quantitatively verifies the
more » ... nt role of atomic-scale corrugations in the Kapitza anomaly observed at 1-10 K and further opens a new path to nondestructively estimate subnanoscale roughness of buried interfaces.
doi:10.1103/physrevlett.103.264301 pmid:20366314 fatcat:2qn3xril2vbbva6afahdkj7vgy

Diagnosis of Parapneumonia Pleural Effusion with Serum and Pleural Fluid Cell-Free DNA

Chih-Min Su, Chia-Te Kung, Sheng-Yuan Hsiao, Nai-Wen Tsai, Yun-Ru Lai, Chih-Cheng Huang, Hung-Chen Wang, Wei-Che Lin, Ben-Chung Cheng, Yu-Jih Su, Cheng-Hsien Lu
2019 BioMed Research International  
Chia-Te Kung, Sheng-Yuan Hsiao, Yun-Ru Lai, Nai-Wen Tsai, Chih-Cheng Huang, and Hung-Chen Wang participated in sequence alignment and clinical evaluation of patients.  ...  Authors' Contributions Chih-Min Su participated in the design of this study and drafted the manuscript.  ... 
doi:10.1155/2019/5028512 pmid:30949501 pmcid:PMC6425321 fatcat:42lpt5sdbbdhbpyosnse3rsxze

The Role of Monocyte Percentage in Osteoporosis in Male Rheumatic Diseases

Yu-Jih Su, Chao Tung Chen, Nai-Wen Tsai, Chih-Cheng Huang, Hung-Chen Wang, Chia-Te Kung, Wei-Che Lin, Ben-Chung Cheng, Chih-Min Su, Sheng-Yuan Hsiao, Cheng-Hsien Lu
2017 American Journal of Men's Health  
doi:10.1177/1557988317721642 pmid:28901203 pmcid:PMC5675259 fatcat:du7ndzxk2fgfji4lufogvtojiq

Danshen extract circumvents drug resistance and represses cell growth in human oral cancer cells

Cheng-Yu Yang, Cheng-Chih Hsieh, Chih-Kung Lin, Chun-Shu Lin, Bo Peng, Gu-Jiun Lin, Huey-Kang Sytwu, Wen-Liang Chang, Yuan-Wu Chen
2017 BMC Complementary and Alternative Medicine  
Danshen roots were obtained from Chien Yuan Herbal Medicinal Co., Taipei, Taiwan, and identified to be Salviae miltiorrhizae Radix.  ... 
doi:10.1186/s12906-017-2063-y pmid:29284481 pmcid:PMC5747158 fatcat:wfyp7lsbdzbw3iuil4krz6hcwe

Triptolide represses oral cancer cell proliferation, invasion, migration, and angiogenesis in co-inoculation with U937 cells

Cheng-Yu Yang, Chih-Kung Lin, Gu-Jiun Lin, Cheng-Chih Hsieh, Shing-Hwa Huang, Kuo-Hsing Ma, Yi-Shing Shieh, Huey-Kang Sytwu, Yuan-Wu Chen
2016 Clinical Oral Investigations  
Objectives Advanced oral cancer is a major public health concern because of a lack of effective prevention and treatment. Triptolide (TPL), a diterpenoid triepoxide derived from the Chinese herb Tripterygium wilfordii, has been demonstrated to possess strong anticancer properties. In this study, we investigated whether TPL exerts anticancer effects on the tumor microenvironment of head and neck squamous cell carcinoma (HNSCC). Materials and methods Human macrophage-like U937 cells were
more » ... ated with oral cancer SAS cells in a noncontact transwell coculture system. Cytokine expression was detected using ELISA, and cell proliferation was detected using methylene blue. RNA levels were detected using qPCR. Protein levels were detected using Western blot analysis. In vivo experiments involved using xenografted NOD/SCID mice. Results Our results demonstrated that TPL inhibited the growth of SAS cells co-inoculated with U937 cells in vitro and in vivo. TPL inhibited the invasion, migration ability, and angiogenesis of SAS cells co-inoculated with U937 cells. Expression of cytokines IL-6, IL-8, and TNF-α was induced by co-inoculation, but TPL repressed their expression. Conclusion TPL suppressed the expression of cytokines IL-6, IL-8, and TNF-α, as well as tumor growth, invasion, migration, and angiogenesis in the co-inoculation of human tongue cancer cells with macrophage-like U937 cells. Clinical relevance TPL is a potential candidate among novel chemotherapeutic agents or adjuvants for modulating tumorassociated macrophages in a tumor microenvironment of HNSCC.
doi:10.1007/s00784-016-1808-1 pmid:27073100 pmcid:PMC5203829 fatcat:cn4tlw6qpnbtlkeys5c52zdi64
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