Objectives: Tumor angiogenesis is the consequence of an imbalance between positive and negative a... more Objectives: Tumor angiogenesis is the consequence of an imbalance between positive and negative angiogenic regulatory factors. We sought to determine the role of pretreated serum angiogenic factors, including vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and soluble vascular endothelial growth factor receptor 1 (sVEGFR-1), in predicting clinical outcome in patients with pancreatic cancer. Methods: We assessed pretreated serum VEGF, PlGF, and sVEGFR-1 levels in 92 patients with pancreatic adenocarcinoma and 60 healthy control subjects using an enzyme-linked immunosorbent assay. The correlation between these angiogenesis-related factors and clinicopathologic factors, including staging and overall survival, was analyzed.
Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder that... more Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder that is characterized by intestinal hamartomatous polyps and mucocutaneous pigmentation. Recently, germline mutations in the LKB1 gene have been reported to underlie PJS. The gene that encodes this serine/threonine kinase is located at chromosome 19p13.3. The aim of this study was to investigate the clinical and genetic characteristics of PJS patients in Taiwan. Methods: We searched the patient database of the National Taiwan University Hospital, a tertiary medical center in Taiwan, between January 1990 and November 2005. Patients' clinical information, demographic data, endoscopic pictures, and outcome were reviewed and analyzed. After obtaining informed consent, DNA and RNA were extracted from peripheral blood mononuclear cells and the LKB1 gene was sequenced. Results: A total of 14 unrelated patients who fulfilled the diagnostic criteria of PJS were included, and seven of them had genetic analysis performed. Mucocutaneous pigmentation was the most frequent presentation. Hamartomas occur most commonly in the small intestine (86%). Frequent abdominal complications include intussusception and gastrointestinal bleeding. Four germline mutations were found (57.1%). Three resulted in stop codons at codon 60, 162 (novel mutation), and 308. The fourth mutation was a missense mutation at codon 239 (novel mutation). Conclusion: Compared with other countries, PJS patients in Taiwan tended to have more extensive polyps in the gastrointestinal tract, with intussusception being the most common abdominal symptom. Mutations in the LKB1 gene were identified in 57% of the probands in Taiwan.
Chronic pancreatitis (CP) may be associated with genetic susceptibility. We read with interest th... more Chronic pancreatitis (CP) may be associated with genetic susceptibility. We read with interest the article by Mahurkar et al ( Gut 2006; 55 :1270–5) which described the role of pancreatic secretory trypsin inhibitor (SPINK1) gene mutation and cathepsin B gene polymorphisms in tropical calcific pancreatitis. Mutations in the cationic trypsinogen gene (PRSS1) and SPINK1 gene have been reported to be associated with different types of pancreatitis.1 However, controversial data also exist.2 The discordant observations demonstrate that the role of the PRSS1/SPINK1 mutation might differ in distinct types of CP or different ethnic populations.3 4 The genetic basis of pancreatitis of PRSS1 and SPINK1 genes in Chinese patients has rarely been explored. We undertook a study with idiopathic chronic pancreatitis (ICP) to determine whether PRSS1 and SPINK1 mutations are associated with ICP in Chinese patients and to analyse the genotype–phenotype correlation in the ICP subgroups …
Increased angiogenesis at the site of the primary tumor in colorectal cancer has been associated ... more Increased angiogenesis at the site of the primary tumor in colorectal cancer has been associated with poor prognosis and relapse of disease. We previously demonstrated that the tissue level of placenta growth factor expression was upregulated in colorectal cancer and correlated with disease progression and patient survival. The aims of this study are to examine the prognostic value of serum placenta growth factor, vascular endothelial growth factor, and sFlt-1 and to compare them with the carcinoembryonic antigen levels in patients with colorectal cancer. METHODS: Preoperative serum from 86 patients and serum from 30 healthy controls was included. The levels of sFlt-1, placenta growth factor, vascular endothelial growth factor in the serum were assayed and correlated with the clinical stage results. RESULTS: Serum placenta growth factor, but not vascular endothelial growth factor, increased; sFlt-1 decreased in patients with preoperative colorectal cancer, compared with healthy controls. Higher preoperation serum placenta growth factor levels were associated with higher risk of recurrence. Preoperation serum placenta growth factor, but not carcinoembryonic antigen, was a prognostic indicator in patients with Stage III colorectal cancer. When we use the median level (20.6 pg/ml) of preoperative serum placenta growth factor as a cutoff point, the sensitivity, specificity, and positive predictive value for tumor recurrence and survival was 80, 54, 80% and 70, 56, 70%, respectively. CONCLUSIONS: Preoperative serum placenta growth factor levels were higher in patients with colorectal cancer, were negatively correlated with the serum sFlt-1, and could be used as a prognostic indicator for recurrence and survival for colorectal cancer.
Goblet cell metaplasia and mucus overproduction contribute to the pathogenesis of chronic lung di... more Goblet cell metaplasia and mucus overproduction contribute to the pathogenesis of chronic lung diseases, including asthma and chronic obstructive pulmonary disease (COPD). Notch signaling regulates cell fate decisions and is crucial in controlling goblet cell differentiation in the gut epithelium. Little is known, however, about how endogenous Notch signaling influences the goblet cell differentiation program that takes place in the postnatal lung. Using a combination of genetic and in vitro approaches here we provide evidence of a novel role for Notch in restricting goblet cell differentiation in the airway epithelium during the postnatal period. Conditional inactivation of the essential Notch pathway component Pofut1 (protein O-fucosyltransferase1) in Tgfb3-Cre-expressing mice resulted in an aberrant postnatal airway phenotype characterized by marked goblet cell metaplasia, decreased Clara cell number and increase in ciliated cells. The presence of the same phenotype in mice in wh...
Background Toll-like receptor (TLR)3 gene variants may correlate with clinical significance of ch... more Background Toll-like receptor (TLR)3 gene variants may correlate with clinical significance of chronic viral infections including HBV. We aimed to investigate the expression of TLR3 in peripheral blood mononuclear cells (PBMCs) and liver cells of chronic hepatitis B (CHB) patients and its response to pegylated interferon or nucleoside analogue therapy. Methods We consecutively enrolled 127 CHB patients and 64 hepatitis B surface antigen-negative, anti-HCV-negative healthy individuals as controls. We compared the TLR3 expressions on fresh PBMCs and liver cells from patients and controls, before and during pegylated interferon or nucleoside analogue therapy. Results Compared to controls, patients had a lower TLR3 mean fluorescence intensity (MFI) on PBMCs (mean ±sd 14.61 ±13.49 versus 9.70 ±4.61; P<0.001), independent of age, gender and alanine aminotransferase (ALT; -13.466, 95% CI -17.202, -9.730; P<0.001). Patients had limited TLR3 stains on Kupffer cells, whereas controls ha...
Two thirds of patients with acquired immunodeficiency syndrome (AIDS) develop diarrhea at some ti... more Two thirds of patients with acquired immunodeficiency syndrome (AIDS) develop diarrhea at some time during the course of their illness. 1-3 Diarrhea itself is a cause of major morbidity and may contribute to the death of these patients. Infectious etiologies account for 30% to 80% of the diarrhea in patients with AIDS and the chance of finding an infectious agent depends on patient characteristics and extent of evaluation. 4-9 As with other clinical syndromes in AIDS, the approach to the patient with diarrhea is oriented toward diagnosing treatable causes and avoiding unnecessary invasive procedures. In clinical practice a stepwise diagnostic approach is often recommended in which less invasive investigations are used first (stool analysis), and more invasive tests (endoscopy with biopsy) are reserved for patients in whom a pathogen is not identified by stool examinations or those who fail to respond to treatment of symptoms. 10-15 However, it is not clear whether endoscopy with other associated studies will influence the survival of these patients. Therefore, this study was designed to determine how often an identifiable pathogen can be recognized by endoscopy in AIDS patients in whom stool analysis has been negative, and the impact that specific therapy might have on the outcome for these patients. 11,15 PATIENTS AND METHODS A 9-bed AIDS unit was established on June 24, 1994, at our university hospital. It has since become the largest referral center for the management of complications associated with human immunodeficiency virus (HIV) infection in Taiwan. As of December 31, 1997, there were 390 admissions for 210 HIV-infected patients, the great majority being patients with advanced HIV infection, for the management of HIV-related complications. Before mid-April 1997, patients were treated with two non-nucleotide reverse transcriptase inhibitors (zidovudine, dideoxycytidine, or didanosine). Protease inhibitors (indinavir, ritonavir, hard-gel saquinavir) were not available until mid-April 1997. Since then, protease inhibitors were freely provided to all HIV-infected patients at any stage of infection. For those patients with CD4 lymphocyte counts less than 200/mm 3 or previous episodes of pneumocystosis,
American Journal of Obstetrics and Gynecology, 1960
Abstract 1. The incidence of abruptio placentae at Provincial Taipei Hospital is 2.09 per cent of... more Abstract 1. The incidence of abruptio placentae at Provincial Taipei Hospital is 2.09 per cent of the total deliveries and that in Taipei City is 0.16 per cent. 2. In our small series a high incidence of afibrinogenemia was seen (62.5 per cent). 3. Elderly grand multiparas with toxemia or chronic hypertensive vascular disease are predisposed to abruptio placentae and should be placed under special prenatal supervision. 4. Coagulation defects in our series were characterized by thrombocytopenia, deficiency of Ac-globulin, prolonged prothrombin time, prolonged bleeding and coagulation times, hypo-, or afibrinogenemia, and the rarity of appearance of fibrinolysin and fibrinogenolysin. 5. Transfusions of fresh blood effected a rise in the fibrinogen level, without the use of supplementary fibrinogen. 6. It is important to terminate the labor as quickly as possible when the fibrinogen level is elevated above the critical level. 7. Paper electrophoresis of the plasma in cases of suspected afibrinogenemia is a rapid and simple tool for the diagnosis of this condition.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1997
This retrospective study was designed to assess the roles of stool culture for Clostridium diffic... more This retrospective study was designed to assess the roles of stool culture for Clostridium difficile, detection of the presence of toxin A, and endoscopic examination in the diagnosis of Clostridium difficile-associated disease (CDAD). From January 1994 through September 1996, there were 213 patients with stool cultures positive for C. difficile in National Taiwan University Hospital. Of these, 126 had CDAD. There were 87 asymptomatic carriers of C. difficile in our study, 12 of whom were positive for toxin A. In addition, seven patients with pseudomembranous colitis (PMC), who were either culture-negative or not tested, were included in the study. The positive predictive values of stool cultures for CDAD and PMC were 59% and 32%, respectively. The positive predictive values of toxin A for CDAD and PMC were 41% and 43%, respectively. Seventy-eight patients (59%) improved with supportive treatment after discontinuing antibiotics. We concluded that stool culture for C. difficile and d...
Journal of the Formosan Medical Association = Taiwan yi zhi, 1997
Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or absc... more Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or abscess formation, and extrapancreatic manifestations such as pulmonary renal, hepatic, endocrine, and coagulation abnormalities. Coagulation abnormalities associated with acute pancreatitis usually present as thrombophlebitis or widespread microthrombi; most occur in the venous or capillary circulation. We report a rare case of acute pancreatitis complicated by pseudocyst formation, splenic vein thrombosis, splenic infarction, and spinal cord infarction, which resulted in paraplegia. An association between acute pancreatitis and spinal cord infarction has not been reported before.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1997
Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or absc... more Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or abscess formation, and extrapancreatic manifestations such as pulmonary renal, hepatic, endocrine, and coagulation abnormalities. Coagulation abnormalities associated with acute pancreatitis usually present as thrombophlebitis or widespread microthrombi; most occur in the venous or capillary circulation. We report a rare case of acute pancreatitis complicated by pseudocyst formation, splenic vein thrombosis, splenic infarction, and spinal cord infarction, which resulted in paraplegia. An association between acute pancreatitis and spinal cord infarction has not been reported before.
Background: Distinguishing between pancreatic cancer and chronic pancreatitis (CP) is sometimes d... more Background: Distinguishing between pancreatic cancer and chronic pancreatitis (CP) is sometimes difficult. It is well known that some (5-6%) CP is autoimmune in nature, and these patients respond to corticosteroid treatment, making surgery avoidable.
Respiratory distress syndrome (RDS) secondary to surfactant deficiency is a common cause of morbi... more Respiratory distress syndrome (RDS) secondary to surfactant deficiency is a common cause of morbidity and mortality in premature infants. Increasing evidence suggests that vascular endothelial growth factor (VEGF) may contribute to surfactant secretion and pulmonary maturation. However, differences in cord blood VEGF concentrations in infants with and without respiratory distress syndrome have not been reported. We hypothesized that premature infants with higher VEGF levels in cord blood had a lower risk of developing RDS. Cord blood samples were obtained from preterm infants born at 32 weeks of gestation or earlier. Infants were excluded if there was evidence of prenatal maternal infection or any infection within the first 3 days of life. Cord blood VEGF levels were measured using an enzyme-linked immunosorbent assay (ELISA). We found that neonates with clinically diagnosed RDS had a lower gestational age (GA), lower birth weight (BW), higher incidence of mechanical ventilation requirements, longer duration of mechanical ventilation, and lower Apgar scores at 1 and 5 min. Infants with RDS had significantly lower cord blood VEGF levels. GA, BW, premature rupture of membranes (PROM), and antenatal steroid treatment were not associated with changes in cord blood VEGF levels. The specificity of cord blood VEGF above 34 pg/ml for predicting the absence of RDS was 86%, the sensitivity was 53%, the positive predictive value was 84%, and the negative predictive value was 56%. Our data demonstrated that cord blood VEGF elevation was significantly correlated with an absence of RDS.
Background/Purpose: The aim of this study was to gain a better understanding of the current incid... more Background/Purpose: The aim of this study was to gain a better understanding of the current incidence of Crohn's disease (CD) in Taiwan and examine its clinical/genetic characteristics because there has been a trend toward increased diagnosis in the Asia-Pacific area. The genetic background seen in CD cases in Taiwan seems to be different from that in Western countries. Methods: By reviewing the database in the National Taiwan University Hospital, CD patients were identified by clinical, endoscopic, and imaging findings. The clinical characteristics were recorded and analyzed. DNA was extracted from the peripheral blood of patients after obtaining informed consent. Polymerase chain reaction was performed with specific primers followed by direct sequencing to determine the single-nucleotide polymorphisms ATG16L1, CCR6, IL12B, IL23R, LRRK2, TNFSF2, and TNFSF15 CD-associated genes. Results: Clinical data from 110 CD patients were examined from 1988 to 2008, with a mean followup period of 4.5 years. There was a marked increase in new CD diagnosis, especially after 2004. Among the 110 patients, 71 men and 39 women, the age at diagnosis was 30.5 AE 17.8 years (mean AE standard deviation). Stenosis occurred in 33.6% (37 of 110) and 40.9% (45 of 110) of patients who underwent surgery. The mortality rate was 2.7%, all because of sepsis. Genetic analysis of 39 patients showed that ATG16L1 and TNFSF15 were associated with susceptibility to CD in Taiwan. Conclusion: Recently, the incidence of CD diagnosis in Taiwan has markedly increased. ATG16L1 and TNFSF15 are associated with CD in Taiwan.
Nitride-based GaN/In 0.12 Ga 0.88 N heterostructure field effect transistors (HFETs) with semi-in... more Nitride-based GaN/In 0.12 Ga 0.88 N heterostructure field effect transistors (HFETs) with semi-insulating Mg-doped GaN current blocking layers were successfully fabricated. The as-grown layers exhibited a very smooth surface. The DC characteristics of these HFETs were substantially improved over those previously reported. Devices with a 0.75 mm gate length showed a maximum drain current (I DS) of 421 mA/mm, and a maximum g m of about 85.6 mS/mm at V GS between À0.5 and À3 V. The device which had a very good pinch-off with source-drain (S-D) leakage current was negligibly small, in the range of 10 À1-10 À2 mA/mm. The RF characteristic of devices showed the current gain cutoff frequency, f T , was 7.45 GHz and the maximum oscillation frequency, f MAX , was 12.36 GHz.
The low-frequency noise of AlGaN=GaN heterojunction field-effect transistors (HFETs) with differe... more The low-frequency noise of AlGaN=GaN heterojunction field-effect transistors (HFETs) with different Al fraction of the AlGaN layer was measured and characterised. The DC characteristics of AlGaN=GaN HFETs with higher Al fraction is better. However, the noise performance is poorer owing to the large lattice mismatch with higher Al fraction in the AlGaN layer. The pure flicker noise and lower noise power density can be obtained by the smaller Al fraction in the AlGaN layer of AlGaN=GaN HFETs.
Background: Autoimmune pancreatitis (AIP) is a distinct disease entity of chronic pancreatitis. C... more Background: Autoimmune pancreatitis (AIP) is a distinct disease entity of chronic pancreatitis. Cytotoxic T lymphocyte–associated antigen 4 (CTLA-4) is a key negative regulator of the T-cell immune response, and its gene is highly polymorphic. Many positive associations between cytotoxic T-lymphocyte–associated protein 4 (CTLA4) single-nucleotide polymorphisms and various autoimmune diseases have been identified. We investigated possible genetic associations of CTLA4 in a Chinese population with AIP. Methods: We performed genotyping for CTLA4 (49 A/G, −318 C/T, and CT60 A/G) and tumor necrosis factor (TNF)-α promoter (−857 C/T, −863 C/A, and −1031 C/T) by use of PCR sequence-specific primers and direct sequencing, respectively, in 46 patients with AIP, 78 patients with chronic calcifying pancreatitis (CCP), and 200 healthy individuals. Results: We found a significant increase in CTLA4 49A carriers in patients with AIP compared with healthy individuals (78.3% vs 48%; P <0.0001). T...
Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder char... more Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder characterized by intestinal hamartomatous polyps and mucocutaneous pigmentation. Recently, germline mutations in the LKB1 gene have been reported to underlie PJS. The gene encoding this serine/threonine kinase is located at 19p 13.3. The aim of this study was to investigate the clinical and genetic characteristics of PJS patients in Taiwan. Methods: We searched the database in the National Taiwan University Hospital, a tertiary medical center in Taiwan, between January 1990 and November 2005. Patients’ clinical information, demographic data, endoscopic pictures, and outcome details for these cases were reviewed and analyzed. After obtaining informed consent, DNA and RNA were extracted from peripheral blood mononuclear cells and the LKB1 gene was sequenced. Results: A total of 14 non-related patients fulfilling the diagnostic criteria of PJS were included, and seven of them had genetic analys...
Objectives: Tumor angiogenesis is the consequence of an imbalance between positive and negative a... more Objectives: Tumor angiogenesis is the consequence of an imbalance between positive and negative angiogenic regulatory factors. We sought to determine the role of pretreated serum angiogenic factors, including vascular endothelial growth factor (VEGF), placental growth factor (PlGF), and soluble vascular endothelial growth factor receptor 1 (sVEGFR-1), in predicting clinical outcome in patients with pancreatic cancer. Methods: We assessed pretreated serum VEGF, PlGF, and sVEGFR-1 levels in 92 patients with pancreatic adenocarcinoma and 60 healthy control subjects using an enzyme-linked immunosorbent assay. The correlation between these angiogenesis-related factors and clinicopathologic factors, including staging and overall survival, was analyzed.
Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder that... more Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder that is characterized by intestinal hamartomatous polyps and mucocutaneous pigmentation. Recently, germline mutations in the LKB1 gene have been reported to underlie PJS. The gene that encodes this serine/threonine kinase is located at chromosome 19p13.3. The aim of this study was to investigate the clinical and genetic characteristics of PJS patients in Taiwan. Methods: We searched the patient database of the National Taiwan University Hospital, a tertiary medical center in Taiwan, between January 1990 and November 2005. Patients' clinical information, demographic data, endoscopic pictures, and outcome were reviewed and analyzed. After obtaining informed consent, DNA and RNA were extracted from peripheral blood mononuclear cells and the LKB1 gene was sequenced. Results: A total of 14 unrelated patients who fulfilled the diagnostic criteria of PJS were included, and seven of them had genetic analysis performed. Mucocutaneous pigmentation was the most frequent presentation. Hamartomas occur most commonly in the small intestine (86%). Frequent abdominal complications include intussusception and gastrointestinal bleeding. Four germline mutations were found (57.1%). Three resulted in stop codons at codon 60, 162 (novel mutation), and 308. The fourth mutation was a missense mutation at codon 239 (novel mutation). Conclusion: Compared with other countries, PJS patients in Taiwan tended to have more extensive polyps in the gastrointestinal tract, with intussusception being the most common abdominal symptom. Mutations in the LKB1 gene were identified in 57% of the probands in Taiwan.
Chronic pancreatitis (CP) may be associated with genetic susceptibility. We read with interest th... more Chronic pancreatitis (CP) may be associated with genetic susceptibility. We read with interest the article by Mahurkar et al ( Gut 2006; 55 :1270–5) which described the role of pancreatic secretory trypsin inhibitor (SPINK1) gene mutation and cathepsin B gene polymorphisms in tropical calcific pancreatitis. Mutations in the cationic trypsinogen gene (PRSS1) and SPINK1 gene have been reported to be associated with different types of pancreatitis.1 However, controversial data also exist.2 The discordant observations demonstrate that the role of the PRSS1/SPINK1 mutation might differ in distinct types of CP or different ethnic populations.3 4 The genetic basis of pancreatitis of PRSS1 and SPINK1 genes in Chinese patients has rarely been explored. We undertook a study with idiopathic chronic pancreatitis (ICP) to determine whether PRSS1 and SPINK1 mutations are associated with ICP in Chinese patients and to analyse the genotype–phenotype correlation in the ICP subgroups …
Increased angiogenesis at the site of the primary tumor in colorectal cancer has been associated ... more Increased angiogenesis at the site of the primary tumor in colorectal cancer has been associated with poor prognosis and relapse of disease. We previously demonstrated that the tissue level of placenta growth factor expression was upregulated in colorectal cancer and correlated with disease progression and patient survival. The aims of this study are to examine the prognostic value of serum placenta growth factor, vascular endothelial growth factor, and sFlt-1 and to compare them with the carcinoembryonic antigen levels in patients with colorectal cancer. METHODS: Preoperative serum from 86 patients and serum from 30 healthy controls was included. The levels of sFlt-1, placenta growth factor, vascular endothelial growth factor in the serum were assayed and correlated with the clinical stage results. RESULTS: Serum placenta growth factor, but not vascular endothelial growth factor, increased; sFlt-1 decreased in patients with preoperative colorectal cancer, compared with healthy controls. Higher preoperation serum placenta growth factor levels were associated with higher risk of recurrence. Preoperation serum placenta growth factor, but not carcinoembryonic antigen, was a prognostic indicator in patients with Stage III colorectal cancer. When we use the median level (20.6 pg/ml) of preoperative serum placenta growth factor as a cutoff point, the sensitivity, specificity, and positive predictive value for tumor recurrence and survival was 80, 54, 80% and 70, 56, 70%, respectively. CONCLUSIONS: Preoperative serum placenta growth factor levels were higher in patients with colorectal cancer, were negatively correlated with the serum sFlt-1, and could be used as a prognostic indicator for recurrence and survival for colorectal cancer.
Goblet cell metaplasia and mucus overproduction contribute to the pathogenesis of chronic lung di... more Goblet cell metaplasia and mucus overproduction contribute to the pathogenesis of chronic lung diseases, including asthma and chronic obstructive pulmonary disease (COPD). Notch signaling regulates cell fate decisions and is crucial in controlling goblet cell differentiation in the gut epithelium. Little is known, however, about how endogenous Notch signaling influences the goblet cell differentiation program that takes place in the postnatal lung. Using a combination of genetic and in vitro approaches here we provide evidence of a novel role for Notch in restricting goblet cell differentiation in the airway epithelium during the postnatal period. Conditional inactivation of the essential Notch pathway component Pofut1 (protein O-fucosyltransferase1) in Tgfb3-Cre-expressing mice resulted in an aberrant postnatal airway phenotype characterized by marked goblet cell metaplasia, decreased Clara cell number and increase in ciliated cells. The presence of the same phenotype in mice in wh...
Background Toll-like receptor (TLR)3 gene variants may correlate with clinical significance of ch... more Background Toll-like receptor (TLR)3 gene variants may correlate with clinical significance of chronic viral infections including HBV. We aimed to investigate the expression of TLR3 in peripheral blood mononuclear cells (PBMCs) and liver cells of chronic hepatitis B (CHB) patients and its response to pegylated interferon or nucleoside analogue therapy. Methods We consecutively enrolled 127 CHB patients and 64 hepatitis B surface antigen-negative, anti-HCV-negative healthy individuals as controls. We compared the TLR3 expressions on fresh PBMCs and liver cells from patients and controls, before and during pegylated interferon or nucleoside analogue therapy. Results Compared to controls, patients had a lower TLR3 mean fluorescence intensity (MFI) on PBMCs (mean ±sd 14.61 ±13.49 versus 9.70 ±4.61; P<0.001), independent of age, gender and alanine aminotransferase (ALT; -13.466, 95% CI -17.202, -9.730; P<0.001). Patients had limited TLR3 stains on Kupffer cells, whereas controls ha...
Two thirds of patients with acquired immunodeficiency syndrome (AIDS) develop diarrhea at some ti... more Two thirds of patients with acquired immunodeficiency syndrome (AIDS) develop diarrhea at some time during the course of their illness. 1-3 Diarrhea itself is a cause of major morbidity and may contribute to the death of these patients. Infectious etiologies account for 30% to 80% of the diarrhea in patients with AIDS and the chance of finding an infectious agent depends on patient characteristics and extent of evaluation. 4-9 As with other clinical syndromes in AIDS, the approach to the patient with diarrhea is oriented toward diagnosing treatable causes and avoiding unnecessary invasive procedures. In clinical practice a stepwise diagnostic approach is often recommended in which less invasive investigations are used first (stool analysis), and more invasive tests (endoscopy with biopsy) are reserved for patients in whom a pathogen is not identified by stool examinations or those who fail to respond to treatment of symptoms. 10-15 However, it is not clear whether endoscopy with other associated studies will influence the survival of these patients. Therefore, this study was designed to determine how often an identifiable pathogen can be recognized by endoscopy in AIDS patients in whom stool analysis has been negative, and the impact that specific therapy might have on the outcome for these patients. 11,15 PATIENTS AND METHODS A 9-bed AIDS unit was established on June 24, 1994, at our university hospital. It has since become the largest referral center for the management of complications associated with human immunodeficiency virus (HIV) infection in Taiwan. As of December 31, 1997, there were 390 admissions for 210 HIV-infected patients, the great majority being patients with advanced HIV infection, for the management of HIV-related complications. Before mid-April 1997, patients were treated with two non-nucleotide reverse transcriptase inhibitors (zidovudine, dideoxycytidine, or didanosine). Protease inhibitors (indinavir, ritonavir, hard-gel saquinavir) were not available until mid-April 1997. Since then, protease inhibitors were freely provided to all HIV-infected patients at any stage of infection. For those patients with CD4 lymphocyte counts less than 200/mm 3 or previous episodes of pneumocystosis,
American Journal of Obstetrics and Gynecology, 1960
Abstract 1. The incidence of abruptio placentae at Provincial Taipei Hospital is 2.09 per cent of... more Abstract 1. The incidence of abruptio placentae at Provincial Taipei Hospital is 2.09 per cent of the total deliveries and that in Taipei City is 0.16 per cent. 2. In our small series a high incidence of afibrinogenemia was seen (62.5 per cent). 3. Elderly grand multiparas with toxemia or chronic hypertensive vascular disease are predisposed to abruptio placentae and should be placed under special prenatal supervision. 4. Coagulation defects in our series were characterized by thrombocytopenia, deficiency of Ac-globulin, prolonged prothrombin time, prolonged bleeding and coagulation times, hypo-, or afibrinogenemia, and the rarity of appearance of fibrinolysin and fibrinogenolysin. 5. Transfusions of fresh blood effected a rise in the fibrinogen level, without the use of supplementary fibrinogen. 6. It is important to terminate the labor as quickly as possible when the fibrinogen level is elevated above the critical level. 7. Paper electrophoresis of the plasma in cases of suspected afibrinogenemia is a rapid and simple tool for the diagnosis of this condition.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1997
This retrospective study was designed to assess the roles of stool culture for Clostridium diffic... more This retrospective study was designed to assess the roles of stool culture for Clostridium difficile, detection of the presence of toxin A, and endoscopic examination in the diagnosis of Clostridium difficile-associated disease (CDAD). From January 1994 through September 1996, there were 213 patients with stool cultures positive for C. difficile in National Taiwan University Hospital. Of these, 126 had CDAD. There were 87 asymptomatic carriers of C. difficile in our study, 12 of whom were positive for toxin A. In addition, seven patients with pseudomembranous colitis (PMC), who were either culture-negative or not tested, were included in the study. The positive predictive values of stool cultures for CDAD and PMC were 59% and 32%, respectively. The positive predictive values of toxin A for CDAD and PMC were 41% and 43%, respectively. Seventy-eight patients (59%) improved with supportive treatment after discontinuing antibiotics. We concluded that stool culture for C. difficile and d...
Journal of the Formosan Medical Association = Taiwan yi zhi, 1997
Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or absc... more Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or abscess formation, and extrapancreatic manifestations such as pulmonary renal, hepatic, endocrine, and coagulation abnormalities. Coagulation abnormalities associated with acute pancreatitis usually present as thrombophlebitis or widespread microthrombi; most occur in the venous or capillary circulation. We report a rare case of acute pancreatitis complicated by pseudocyst formation, splenic vein thrombosis, splenic infarction, and spinal cord infarction, which resulted in paraplegia. An association between acute pancreatitis and spinal cord infarction has not been reported before.
Journal of the Formosan Medical Association = Taiwan yi zhi, 1997
Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or absc... more Complications of acute pancreatitis may include local pancreatic necrosis with pseudocyst or abscess formation, and extrapancreatic manifestations such as pulmonary renal, hepatic, endocrine, and coagulation abnormalities. Coagulation abnormalities associated with acute pancreatitis usually present as thrombophlebitis or widespread microthrombi; most occur in the venous or capillary circulation. We report a rare case of acute pancreatitis complicated by pseudocyst formation, splenic vein thrombosis, splenic infarction, and spinal cord infarction, which resulted in paraplegia. An association between acute pancreatitis and spinal cord infarction has not been reported before.
Background: Distinguishing between pancreatic cancer and chronic pancreatitis (CP) is sometimes d... more Background: Distinguishing between pancreatic cancer and chronic pancreatitis (CP) is sometimes difficult. It is well known that some (5-6%) CP is autoimmune in nature, and these patients respond to corticosteroid treatment, making surgery avoidable.
Respiratory distress syndrome (RDS) secondary to surfactant deficiency is a common cause of morbi... more Respiratory distress syndrome (RDS) secondary to surfactant deficiency is a common cause of morbidity and mortality in premature infants. Increasing evidence suggests that vascular endothelial growth factor (VEGF) may contribute to surfactant secretion and pulmonary maturation. However, differences in cord blood VEGF concentrations in infants with and without respiratory distress syndrome have not been reported. We hypothesized that premature infants with higher VEGF levels in cord blood had a lower risk of developing RDS. Cord blood samples were obtained from preterm infants born at 32 weeks of gestation or earlier. Infants were excluded if there was evidence of prenatal maternal infection or any infection within the first 3 days of life. Cord blood VEGF levels were measured using an enzyme-linked immunosorbent assay (ELISA). We found that neonates with clinically diagnosed RDS had a lower gestational age (GA), lower birth weight (BW), higher incidence of mechanical ventilation requirements, longer duration of mechanical ventilation, and lower Apgar scores at 1 and 5 min. Infants with RDS had significantly lower cord blood VEGF levels. GA, BW, premature rupture of membranes (PROM), and antenatal steroid treatment were not associated with changes in cord blood VEGF levels. The specificity of cord blood VEGF above 34 pg/ml for predicting the absence of RDS was 86%, the sensitivity was 53%, the positive predictive value was 84%, and the negative predictive value was 56%. Our data demonstrated that cord blood VEGF elevation was significantly correlated with an absence of RDS.
Background/Purpose: The aim of this study was to gain a better understanding of the current incid... more Background/Purpose: The aim of this study was to gain a better understanding of the current incidence of Crohn's disease (CD) in Taiwan and examine its clinical/genetic characteristics because there has been a trend toward increased diagnosis in the Asia-Pacific area. The genetic background seen in CD cases in Taiwan seems to be different from that in Western countries. Methods: By reviewing the database in the National Taiwan University Hospital, CD patients were identified by clinical, endoscopic, and imaging findings. The clinical characteristics were recorded and analyzed. DNA was extracted from the peripheral blood of patients after obtaining informed consent. Polymerase chain reaction was performed with specific primers followed by direct sequencing to determine the single-nucleotide polymorphisms ATG16L1, CCR6, IL12B, IL23R, LRRK2, TNFSF2, and TNFSF15 CD-associated genes. Results: Clinical data from 110 CD patients were examined from 1988 to 2008, with a mean followup period of 4.5 years. There was a marked increase in new CD diagnosis, especially after 2004. Among the 110 patients, 71 men and 39 women, the age at diagnosis was 30.5 AE 17.8 years (mean AE standard deviation). Stenosis occurred in 33.6% (37 of 110) and 40.9% (45 of 110) of patients who underwent surgery. The mortality rate was 2.7%, all because of sepsis. Genetic analysis of 39 patients showed that ATG16L1 and TNFSF15 were associated with susceptibility to CD in Taiwan. Conclusion: Recently, the incidence of CD diagnosis in Taiwan has markedly increased. ATG16L1 and TNFSF15 are associated with CD in Taiwan.
Nitride-based GaN/In 0.12 Ga 0.88 N heterostructure field effect transistors (HFETs) with semi-in... more Nitride-based GaN/In 0.12 Ga 0.88 N heterostructure field effect transistors (HFETs) with semi-insulating Mg-doped GaN current blocking layers were successfully fabricated. The as-grown layers exhibited a very smooth surface. The DC characteristics of these HFETs were substantially improved over those previously reported. Devices with a 0.75 mm gate length showed a maximum drain current (I DS) of 421 mA/mm, and a maximum g m of about 85.6 mS/mm at V GS between À0.5 and À3 V. The device which had a very good pinch-off with source-drain (S-D) leakage current was negligibly small, in the range of 10 À1-10 À2 mA/mm. The RF characteristic of devices showed the current gain cutoff frequency, f T , was 7.45 GHz and the maximum oscillation frequency, f MAX , was 12.36 GHz.
The low-frequency noise of AlGaN=GaN heterojunction field-effect transistors (HFETs) with differe... more The low-frequency noise of AlGaN=GaN heterojunction field-effect transistors (HFETs) with different Al fraction of the AlGaN layer was measured and characterised. The DC characteristics of AlGaN=GaN HFETs with higher Al fraction is better. However, the noise performance is poorer owing to the large lattice mismatch with higher Al fraction in the AlGaN layer. The pure flicker noise and lower noise power density can be obtained by the smaller Al fraction in the AlGaN layer of AlGaN=GaN HFETs.
Background: Autoimmune pancreatitis (AIP) is a distinct disease entity of chronic pancreatitis. C... more Background: Autoimmune pancreatitis (AIP) is a distinct disease entity of chronic pancreatitis. Cytotoxic T lymphocyte–associated antigen 4 (CTLA-4) is a key negative regulator of the T-cell immune response, and its gene is highly polymorphic. Many positive associations between cytotoxic T-lymphocyte–associated protein 4 (CTLA4) single-nucleotide polymorphisms and various autoimmune diseases have been identified. We investigated possible genetic associations of CTLA4 in a Chinese population with AIP. Methods: We performed genotyping for CTLA4 (49 A/G, −318 C/T, and CT60 A/G) and tumor necrosis factor (TNF)-α promoter (−857 C/T, −863 C/A, and −1031 C/T) by use of PCR sequence-specific primers and direct sequencing, respectively, in 46 patients with AIP, 78 patients with chronic calcifying pancreatitis (CCP), and 200 healthy individuals. Results: We found a significant increase in CTLA4 49A carriers in patients with AIP compared with healthy individuals (78.3% vs 48%; P <0.0001). T...
Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder char... more Background/Purpose: Peutz-Jeghers syndrome (PJS) is an autosomal dominant inherited disorder characterized by intestinal hamartomatous polyps and mucocutaneous pigmentation. Recently, germline mutations in the LKB1 gene have been reported to underlie PJS. The gene encoding this serine/threonine kinase is located at 19p 13.3. The aim of this study was to investigate the clinical and genetic characteristics of PJS patients in Taiwan. Methods: We searched the database in the National Taiwan University Hospital, a tertiary medical center in Taiwan, between January 1990 and November 2005. Patients’ clinical information, demographic data, endoscopic pictures, and outcome details for these cases were reviewed and analyzed. After obtaining informed consent, DNA and RNA were extracted from peripheral blood mononuclear cells and the LKB1 gene was sequenced. Results: A total of 14 non-related patients fulfilling the diagnostic criteria of PJS were included, and seven of them had genetic analys...
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