Elizabethkingia bruuniana is a novel species of the Elizabethkingia genus. There is scant informa... more Elizabethkingia bruuniana is a novel species of the Elizabethkingia genus. There is scant information on this microorganism. Here, we report the whole-genome features and antimicrobial susceptibility patterns of E. bruuniana strain EM798-26. Elizabethkingia strain EM798-26 was initially identified as E. miricola. This isolate contained a circular genome of 4,393,011 bp. The whole-genome sequence-based phylogeny revealed that Elizabethkingia strain EM798-26 was in the same group of the type strain E. bruuniana G0146T. Both in silico DNA-DNA hybridization and average nucleotide identity analysis clearly demonstrated that Elizabethkingia strain EM798-26 was a species of E. bruuniana. The pan-genome analysis identified 2,875 gene families in the core genome and 5,199 gene families in the pan genome of eight publicly available E. bruuniana genome sequences. The unique genes accounted for 0.2–12.1% of the pan genome in each E. bruuniana. A total of 59 potential virulence factor homologs w...
Background: Q fever is a zoonosis distributed worldwide that is caused by Coxiella burnetii infec... more Background: Q fever is a zoonosis distributed worldwide that is caused by Coxiella burnetii infection and the defervescence usually occurs within few days of appropriate antibiotic therapy. Whether the changes of cytokine levels are associated with acute Q fever with persistent fever despite antibiotic therapy had not been investigated before. Case Presentation: We report a rare case of acute Q fever granulomatous hepatitis remained pyrexia despite several antibiotic therapy and 6-day course of oral prednisolone. During the 18-month follow-up, the investigation of the serum cytokines profile and procalcitonin (PCT) revealed that initially elevated levels of interleukin-2 (IL-2), IL-8, IL-10, and PCT decreased gradually, but the IL-6 remained in low titer. No evidence of chronic Q fever was identified by examinations of serum antibodies against C. burnetii and echocardiography. Conclusions: The changes of cytokine levels may be associated with acute Q fever with poor response to trea...
Journal of Microbiology, Immunology and Infection, 2015
Results: Four samples were taken to culture from inner tube and outer tube of a endoscope. Two sa... more Results: Four samples were taken to culture from inner tube and outer tube of a endoscope. Two samples did not meet the standards of high-level disinfection procedures. After the infection control team involving in investigation and analyzing these results, we improved the clean procedure and added a drying equipment in endoscopic cabinet. The incident was terminated. Conclusions: The incident unveiled the clean and disinfection procedure should be implemented for the safety and quality of endoscopy. The concentration of detergents should be detected. We also considered the training for new staff. It should include endoscopic clean and disinfection, storage location, and space clean level maintenance.
In this study, we collected 44 hepatitis B virus surface antigen positivity HBsAg (+) tumor and n... more In this study, we collected 44 hepatitis B virus surface antigen positivity HBsAg (+) tumor and nontumor hepatocellular tissues from hepatocellular carcinoma (HCC) patients during hepatectomy, and quantified the APOBEC3G (A3G) mRNA by using a real-time PCR. Our results showed higher expression of A3G mRNA in the nontumor tissues than in the tumor tissues of the HBsAg (+) HCC patients. To further investigate this phenomenon, we constructed a pLV-A3G vector and transfected it into the human HCC cell line, Hep 3B. The results of an immunofluorescence analysis showed the overexpression of A3G in the cytoplasm. We then evaluated A3G cytotoxicity by using a cell viability assay (MTS assay), the results of which showed that Hep 3B cell viability was 88 and 58% after the transfection of pLV and pLV-A3G, respectively, indicating the growth inhibitory effects of A3G on Hep 3B cells. To further evaluate the tumor suppressive effects of A3G, we used a plastic pipette tip to scratch Hep 3B cells grown on a culture dish (to 70-80% confluence) after transfection with pLV-A3G. Our data indicated a ratio of wound closure of 100% in the control cells and in the pLV-expressing cells, compared with 43% in the pLV-A3G-overexpressing cells, 72 h after the wound scratch, as observed using phase-contrast microscopy. These results indicated that A3G inhibits wound healing in Hep 3B cells. Overall, our results suggest that A3G inhibits the growth of human hepatoma cells.
Two commercial primer kits and detection systems, the Roche AMPLICOR MYCOBACTERIUM test and the D... more Two commercial primer kits and detection systems, the Roche AMPLICOR MYCOBACTERIUM test and the Digene primer-probe kit with the SHARP Signal System, were compared to in-house PCR as well as standard culture techniques. For the 27 culture-positive specimens, the Roche AMPLICOR MYCOBACTERIUM test detected 20 specimens, the Digene system detected 19, and in-house PCR detected 21. Of the 86 culture-negative specimens, 13 were positive by the Roche AMPLICOR MYCOBACTERIUM test, 16 were positive by the Digene system, and 21 were positive by in-house PCR. When clinical situations were evaluated, 11 of 13 culture-negative Roche AMPLICOR MYCOBACTERIUM test-positive specimens, 10 of 16 culture-negative Digene system-positive specimens, and 13 of 21 culture-negative-in-house PCR-positive specimens were diagnosed as true-positive specimens. The sensitivities of Roche AMPLICOR MYCOBACTERIUM test, the Digene system, and in-house PCR were 73.81, 69.05, and 80.95%, and the specificities were 97.18,...
Backgrounds As an infectious agent, Burkholderia pseudomallei is capable of persisting in CD11b p... more Backgrounds As an infectious agent, Burkholderia pseudomallei is capable of persisting in CD11b phagocytes and escapes from innate immunity during subacute or chronic melioidosis. We hypothesized that those infected cells were used as a vehicle that facilitate the bacterial invading to CNS (central nerve system). Materials and methods The BALB/c and C57BL/6 respectively as subacute and chronic infectious models were used to evaluate the murine melioidosis with CNS syndromes via an intravenous injection of B. pseudomallei GFP or through an adoptively transferred by CD11b cells harboring B. pseudomallei GFP. Observation on occurrence of CNS melioidosis was performed by histological examination, cytokine analysis and bacterial loads in brain. Results We found that, during an initial 14 d-infection, by injecting B. pseudomallei GFP, the sL-selectin, sP-selectin, sICAM-1, MCP-1 and IFN-gamma were increased in blood and CSF specimens for the mice with melioidosis. After a 14 d-infection, ...
Journal of developmental and behavioral pediatrics : JDBP, 2017
Both tics and enterovirus (EV) infections are common in children. The association between EV infe... more Both tics and enterovirus (EV) infections are common in children. The association between EV infections and tics has been seldom evaluated. The aim of this study was to evaluate the risk of diagnosed tics after EV infections in children. A nationwide retrospective cohort study was conducted to determine the risk of tics after EV infections by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged < 18 years with EV infection during 2000 to 2007 were enrolled. For comparison, non-EV-infected children were randomly selected and matched with EV-infected children at a 1:1 ratio according to sex, age, urbanization level, parental occupation, and the year of EV infection. All patients were followed up until the diagnosis of tics, death, loss to follow-up, withdrawal from the insurance system, or December 31, 2008. A total of 282,321 EV-infected and 282,317 non-EV-infected children were included in this study. The mean age was 2.39 years in both coh...
Journal of the Formosan Medical Association = Taiwan yi zhi, 1996
Meningitis due to group A Streptococcus is uncommon. Only a few cases have been reported in the l... more Meningitis due to group A Streptococcus is uncommon. Only a few cases have been reported in the literature. In this paper, we report a case of a 19-year-old man who presented with fever, headache, nausea, vomiting and a decrease in level of consciousness. Five days prior to admission, he had an episode of acute pharyngitis. Group A Streptococcus was isolated from both the cerebrospinal fluid and blood. He recovered without sequelae after therapy with penicillin G for 2 weeks. Physicians should be aware that group A streptococcal infection may cause meningitis.
Using flow cytometry analysis, the flagellin of Burkholderia pseudomallei acts as a signalling in... more Using flow cytometry analysis, the flagellin of Burkholderia pseudomallei acts as a signalling inducer, and evokes an increase in the intracellular calcium ion concentration ([Ca(2+)]i) in human peripheral blood mononuclear cells (PBMC). The cells with increased [Ca(2+)]i segregate into the live monocyte gate and not into the live lymphocyte gates. The stimulated [Ca(2+)]i increase can be neutralized with anti-flagellin antibodies. In the absence of [Ca(2+)], [Ca(2+)]i was increased rapidly in flagellin-treated cells compared to non-flagellin-treated cells only after the addition of 1 mM CaCl(2). Selective calcium antagonists were used to effectively block the [Ca(2+)]i signal, revealing that this signal was decreased by the addition of L-type calcium channel blockers (diltiazem, nifedipine and verapamil) and La(2+) but was not changed by the addition of a T-type calcium channel blocker (flunarizine). It seemed that flagellin facilitates [Ca(2+)]i influx via a La(2+) sensitive L-type cellular membrane channel. Furthermore, flagellin also acts as a TNF-alpha inducer in a time- and concentration-dependent manner when adhered mononuclear cells are treated with flagellin. This ability to induce TNF-alpha production was affected by the presence of [Ca(2+)] in the culture medium. It suggested that B. pseudomallei flagellin is an immuno-stimulatory molecule, causing an increase in [Ca(2+)]i and an up-regulation of TNF-alpha, which may play an important role in the inflammation process.
Organophosphate (OP) and carbamate (CM) are the most commonly used pesticides against insects. Li... more Organophosphate (OP) and carbamate (CM) are the most commonly used pesticides against insects. Little is known regarding the relationship between dementia and acute OP and CM poisoning.A nationwide population-based cohort study was conducted from the National Health Insurance Research Database in Taiwan. The incidence and relative risk of dementia were assessed in patients hospitalized for acute OP and CM poisoning from 2000 to 2011. The comparison cohort was matched with the poisoned cohort at a 4:1 ratio based on age, sex, and the year of hospitalization.During the follow-up period, the incidence of dementia was 29.4 per 10,000 person-years in the poisoned group, and represented a 1.98-fold increased risk of dementia compared with the control cohort (95% confidence interval, 1.59-2.47).This study provides evidence on the association between dementia and acute OP and CM poisoning. Regular follow-up of poisoned patients for dementia is suggested.
Diverticular disease and acute coronary syndrome (ACS) are common disorders that share several ri... more Diverticular disease and acute coronary syndrome (ACS) are common disorders that share several risk factors. Few researchers have evaluated the association between diverticular disease and ACS. We aimed to assess the risk of ACS in patients with diverticular disease.A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. All patients aged ≥20 years with a diagnosis of diverticular disease from January 1, 2000, to December 31, 2011, were included in this study. For comparison, patients without diverticular disease were randomly selected and matched with the study cohort at a 4:1 ratio according to age, sex, and the year of the diagnosis of diverticular disease. Patients with incomplete age or sex information and a history of cardiovascular diseases were excluded from the study. All patients were followed until an ACS event, withdrawal from the insurance program, or December 31, 2011.In this study, 52,681 ...
Using 16S rRNA and rpoB gene sequencing, we identified 6 patients infected with Elizabethkingia b... more Using 16S rRNA and rpoB gene sequencing, we identified 6 patients infected with Elizabethkingia bruuniana treated at E-Da Hospital (Kaohsiung, Taiwan) during 2005-2017. We describe patient characteristics and the molecular characteristics of the E. bruuniana isolates, including their MICs. Larger-scale studies are needed for more robust characterization of this pathogen.
Long-term data on post-hematopoietic stem cell transplantation (HSCT) osteoporosis and fracture a... more Long-term data on post-hematopoietic stem cell transplantation (HSCT) osteoporosis and fracture are limited. This study evaluated the long-term risk of osteoporosis and fracture in cancer patients who underwent HSCT. The incidence density rate of osteoporosis was 12.5 per 1000 person-years in the HSCT group, which was significantly higher than that in the non-HSCT group (5.65 per 1000 person-years) after adjustment for associated factors and consideration of competing risk factors (adjusted subhazard ratio, 1.48; 95% confidence interval, 1.06-2.07). The incidence density rate of fracture was 4.89 per 1000 person-years in the HSCT group, and the risk of fracture was 1.40 times higher in the HSCT group than in the non-HSCT group (95% confidence interval, 0.83-2.40). The vertebra was the most common site of fracture after HSCT (68.4%). The risk of osteoporosis and fracture significantly increased in post-HSCT patients with both hematological malignancies and solid tumors. Both autologo...
Elizabethkingia bruuniana is a novel species of the Elizabethkingia genus. There is scant informa... more Elizabethkingia bruuniana is a novel species of the Elizabethkingia genus. There is scant information on this microorganism. Here, we report the whole-genome features and antimicrobial susceptibility patterns of E. bruuniana strain EM798-26. Elizabethkingia strain EM798-26 was initially identified as E. miricola. This isolate contained a circular genome of 4,393,011 bp. The whole-genome sequence-based phylogeny revealed that Elizabethkingia strain EM798-26 was in the same group of the type strain E. bruuniana G0146T. Both in silico DNA-DNA hybridization and average nucleotide identity analysis clearly demonstrated that Elizabethkingia strain EM798-26 was a species of E. bruuniana. The pan-genome analysis identified 2,875 gene families in the core genome and 5,199 gene families in the pan genome of eight publicly available E. bruuniana genome sequences. The unique genes accounted for 0.2–12.1% of the pan genome in each E. bruuniana. A total of 59 potential virulence factor homologs w...
Background: Q fever is a zoonosis distributed worldwide that is caused by Coxiella burnetii infec... more Background: Q fever is a zoonosis distributed worldwide that is caused by Coxiella burnetii infection and the defervescence usually occurs within few days of appropriate antibiotic therapy. Whether the changes of cytokine levels are associated with acute Q fever with persistent fever despite antibiotic therapy had not been investigated before. Case Presentation: We report a rare case of acute Q fever granulomatous hepatitis remained pyrexia despite several antibiotic therapy and 6-day course of oral prednisolone. During the 18-month follow-up, the investigation of the serum cytokines profile and procalcitonin (PCT) revealed that initially elevated levels of interleukin-2 (IL-2), IL-8, IL-10, and PCT decreased gradually, but the IL-6 remained in low titer. No evidence of chronic Q fever was identified by examinations of serum antibodies against C. burnetii and echocardiography. Conclusions: The changes of cytokine levels may be associated with acute Q fever with poor response to trea...
Journal of Microbiology, Immunology and Infection, 2015
Results: Four samples were taken to culture from inner tube and outer tube of a endoscope. Two sa... more Results: Four samples were taken to culture from inner tube and outer tube of a endoscope. Two samples did not meet the standards of high-level disinfection procedures. After the infection control team involving in investigation and analyzing these results, we improved the clean procedure and added a drying equipment in endoscopic cabinet. The incident was terminated. Conclusions: The incident unveiled the clean and disinfection procedure should be implemented for the safety and quality of endoscopy. The concentration of detergents should be detected. We also considered the training for new staff. It should include endoscopic clean and disinfection, storage location, and space clean level maintenance.
In this study, we collected 44 hepatitis B virus surface antigen positivity HBsAg (+) tumor and n... more In this study, we collected 44 hepatitis B virus surface antigen positivity HBsAg (+) tumor and nontumor hepatocellular tissues from hepatocellular carcinoma (HCC) patients during hepatectomy, and quantified the APOBEC3G (A3G) mRNA by using a real-time PCR. Our results showed higher expression of A3G mRNA in the nontumor tissues than in the tumor tissues of the HBsAg (+) HCC patients. To further investigate this phenomenon, we constructed a pLV-A3G vector and transfected it into the human HCC cell line, Hep 3B. The results of an immunofluorescence analysis showed the overexpression of A3G in the cytoplasm. We then evaluated A3G cytotoxicity by using a cell viability assay (MTS assay), the results of which showed that Hep 3B cell viability was 88 and 58% after the transfection of pLV and pLV-A3G, respectively, indicating the growth inhibitory effects of A3G on Hep 3B cells. To further evaluate the tumor suppressive effects of A3G, we used a plastic pipette tip to scratch Hep 3B cells grown on a culture dish (to 70-80% confluence) after transfection with pLV-A3G. Our data indicated a ratio of wound closure of 100% in the control cells and in the pLV-expressing cells, compared with 43% in the pLV-A3G-overexpressing cells, 72 h after the wound scratch, as observed using phase-contrast microscopy. These results indicated that A3G inhibits wound healing in Hep 3B cells. Overall, our results suggest that A3G inhibits the growth of human hepatoma cells.
Two commercial primer kits and detection systems, the Roche AMPLICOR MYCOBACTERIUM test and the D... more Two commercial primer kits and detection systems, the Roche AMPLICOR MYCOBACTERIUM test and the Digene primer-probe kit with the SHARP Signal System, were compared to in-house PCR as well as standard culture techniques. For the 27 culture-positive specimens, the Roche AMPLICOR MYCOBACTERIUM test detected 20 specimens, the Digene system detected 19, and in-house PCR detected 21. Of the 86 culture-negative specimens, 13 were positive by the Roche AMPLICOR MYCOBACTERIUM test, 16 were positive by the Digene system, and 21 were positive by in-house PCR. When clinical situations were evaluated, 11 of 13 culture-negative Roche AMPLICOR MYCOBACTERIUM test-positive specimens, 10 of 16 culture-negative Digene system-positive specimens, and 13 of 21 culture-negative-in-house PCR-positive specimens were diagnosed as true-positive specimens. The sensitivities of Roche AMPLICOR MYCOBACTERIUM test, the Digene system, and in-house PCR were 73.81, 69.05, and 80.95%, and the specificities were 97.18,...
Backgrounds As an infectious agent, Burkholderia pseudomallei is capable of persisting in CD11b p... more Backgrounds As an infectious agent, Burkholderia pseudomallei is capable of persisting in CD11b phagocytes and escapes from innate immunity during subacute or chronic melioidosis. We hypothesized that those infected cells were used as a vehicle that facilitate the bacterial invading to CNS (central nerve system). Materials and methods The BALB/c and C57BL/6 respectively as subacute and chronic infectious models were used to evaluate the murine melioidosis with CNS syndromes via an intravenous injection of B. pseudomallei GFP or through an adoptively transferred by CD11b cells harboring B. pseudomallei GFP. Observation on occurrence of CNS melioidosis was performed by histological examination, cytokine analysis and bacterial loads in brain. Results We found that, during an initial 14 d-infection, by injecting B. pseudomallei GFP, the sL-selectin, sP-selectin, sICAM-1, MCP-1 and IFN-gamma were increased in blood and CSF specimens for the mice with melioidosis. After a 14 d-infection, ...
Journal of developmental and behavioral pediatrics : JDBP, 2017
Both tics and enterovirus (EV) infections are common in children. The association between EV infe... more Both tics and enterovirus (EV) infections are common in children. The association between EV infections and tics has been seldom evaluated. The aim of this study was to evaluate the risk of diagnosed tics after EV infections in children. A nationwide retrospective cohort study was conducted to determine the risk of tics after EV infections by analyzing data from the National Health Insurance Research Database in Taiwan. Children aged < 18 years with EV infection during 2000 to 2007 were enrolled. For comparison, non-EV-infected children were randomly selected and matched with EV-infected children at a 1:1 ratio according to sex, age, urbanization level, parental occupation, and the year of EV infection. All patients were followed up until the diagnosis of tics, death, loss to follow-up, withdrawal from the insurance system, or December 31, 2008. A total of 282,321 EV-infected and 282,317 non-EV-infected children were included in this study. The mean age was 2.39 years in both coh...
Journal of the Formosan Medical Association = Taiwan yi zhi, 1996
Meningitis due to group A Streptococcus is uncommon. Only a few cases have been reported in the l... more Meningitis due to group A Streptococcus is uncommon. Only a few cases have been reported in the literature. In this paper, we report a case of a 19-year-old man who presented with fever, headache, nausea, vomiting and a decrease in level of consciousness. Five days prior to admission, he had an episode of acute pharyngitis. Group A Streptococcus was isolated from both the cerebrospinal fluid and blood. He recovered without sequelae after therapy with penicillin G for 2 weeks. Physicians should be aware that group A streptococcal infection may cause meningitis.
Using flow cytometry analysis, the flagellin of Burkholderia pseudomallei acts as a signalling in... more Using flow cytometry analysis, the flagellin of Burkholderia pseudomallei acts as a signalling inducer, and evokes an increase in the intracellular calcium ion concentration ([Ca(2+)]i) in human peripheral blood mononuclear cells (PBMC). The cells with increased [Ca(2+)]i segregate into the live monocyte gate and not into the live lymphocyte gates. The stimulated [Ca(2+)]i increase can be neutralized with anti-flagellin antibodies. In the absence of [Ca(2+)], [Ca(2+)]i was increased rapidly in flagellin-treated cells compared to non-flagellin-treated cells only after the addition of 1 mM CaCl(2). Selective calcium antagonists were used to effectively block the [Ca(2+)]i signal, revealing that this signal was decreased by the addition of L-type calcium channel blockers (diltiazem, nifedipine and verapamil) and La(2+) but was not changed by the addition of a T-type calcium channel blocker (flunarizine). It seemed that flagellin facilitates [Ca(2+)]i influx via a La(2+) sensitive L-type cellular membrane channel. Furthermore, flagellin also acts as a TNF-alpha inducer in a time- and concentration-dependent manner when adhered mononuclear cells are treated with flagellin. This ability to induce TNF-alpha production was affected by the presence of [Ca(2+)] in the culture medium. It suggested that B. pseudomallei flagellin is an immuno-stimulatory molecule, causing an increase in [Ca(2+)]i and an up-regulation of TNF-alpha, which may play an important role in the inflammation process.
Organophosphate (OP) and carbamate (CM) are the most commonly used pesticides against insects. Li... more Organophosphate (OP) and carbamate (CM) are the most commonly used pesticides against insects. Little is known regarding the relationship between dementia and acute OP and CM poisoning.A nationwide population-based cohort study was conducted from the National Health Insurance Research Database in Taiwan. The incidence and relative risk of dementia were assessed in patients hospitalized for acute OP and CM poisoning from 2000 to 2011. The comparison cohort was matched with the poisoned cohort at a 4:1 ratio based on age, sex, and the year of hospitalization.During the follow-up period, the incidence of dementia was 29.4 per 10,000 person-years in the poisoned group, and represented a 1.98-fold increased risk of dementia compared with the control cohort (95% confidence interval, 1.59-2.47).This study provides evidence on the association between dementia and acute OP and CM poisoning. Regular follow-up of poisoned patients for dementia is suggested.
Diverticular disease and acute coronary syndrome (ACS) are common disorders that share several ri... more Diverticular disease and acute coronary syndrome (ACS) are common disorders that share several risk factors. Few researchers have evaluated the association between diverticular disease and ACS. We aimed to assess the risk of ACS in patients with diverticular disease.A nationwide retrospective cohort study was conducted by analyzing data from the National Health Insurance Research Database in Taiwan. All patients aged ≥20 years with a diagnosis of diverticular disease from January 1, 2000, to December 31, 2011, were included in this study. For comparison, patients without diverticular disease were randomly selected and matched with the study cohort at a 4:1 ratio according to age, sex, and the year of the diagnosis of diverticular disease. Patients with incomplete age or sex information and a history of cardiovascular diseases were excluded from the study. All patients were followed until an ACS event, withdrawal from the insurance program, or December 31, 2011.In this study, 52,681 ...
Using 16S rRNA and rpoB gene sequencing, we identified 6 patients infected with Elizabethkingia b... more Using 16S rRNA and rpoB gene sequencing, we identified 6 patients infected with Elizabethkingia bruuniana treated at E-Da Hospital (Kaohsiung, Taiwan) during 2005-2017. We describe patient characteristics and the molecular characteristics of the E. bruuniana isolates, including their MICs. Larger-scale studies are needed for more robust characterization of this pathogen.
Long-term data on post-hematopoietic stem cell transplantation (HSCT) osteoporosis and fracture a... more Long-term data on post-hematopoietic stem cell transplantation (HSCT) osteoporosis and fracture are limited. This study evaluated the long-term risk of osteoporosis and fracture in cancer patients who underwent HSCT. The incidence density rate of osteoporosis was 12.5 per 1000 person-years in the HSCT group, which was significantly higher than that in the non-HSCT group (5.65 per 1000 person-years) after adjustment for associated factors and consideration of competing risk factors (adjusted subhazard ratio, 1.48; 95% confidence interval, 1.06-2.07). The incidence density rate of fracture was 4.89 per 1000 person-years in the HSCT group, and the risk of fracture was 1.40 times higher in the HSCT group than in the non-HSCT group (95% confidence interval, 0.83-2.40). The vertebra was the most common site of fracture after HSCT (68.4%). The risk of osteoporosis and fracture significantly increased in post-HSCT patients with both hematological malignancies and solid tumors. Both autologo...
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Papers by Hsi-hsun Lin