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Background/Purpose The clinical analyses and prognoses of mitochondrial diseases with A3243G mutation are rarely documented in Taiwan. Our study investigated the clinical phenotypes and the outcomes of patients with mitochondrial disease and the A3243G mutation of mtDNA in a Taiwanese population, and compared these with previous reports. Methods We retrospectively studied 22 consecutive patients with mitochondrial disease and the A3243G mutation of mtDNA in Chang Gung Memorial Hospital between 1988 and 2009. All patients underwent a detailed demographic registration, neurological examinations, a muscle biopsy, and mitochondrial DNA analysis. Modified Rankin scale, the presence of recurrent strokes or seizures, critical medical complications, and death were monitored during the follow-up period. Results Of the 22 patients, seizures and stroke-like episodes were found in 12 (55%). Visceral involvement, including cardiomyopathy, nephropathy, and pulmonary hypertension, were noted in five patients (23%). Patients with seizures had a high frequency of status epilepticus (92%) and a younger age of onset (21.3 ± 7.2 years). Both the Kaplan–Meier survival analysis and the Cox-regression model showed a marked deterioration in patients with seizures after 7 years of follow-up. Conclusion Our study found that seizures and status epilepticus are the most important predictive values for a poor outcome in patients with the mtA3243G mutation of mtDNA. Age of onset and visceral organ involvement had no prominent influence on the prognosis. Some medical complications could be well controlled or even reversed after management.

Objectives To investigate the long-term neurotoxic effects in a patient with acute dimethylamine borane (DMAB) intoxication. Patients A 38-year-old man, working in a semiconductor factory, with acute DMAB intoxication presented with confusion, and drowsiness, followed by cognitive impairments and motor-predominant axonal polyneuropathy. Investigations We performed serial neurobehavioral assessments and functional neuroimaging studies, including brain 99m Tc-TRODAT single photon emission computed tomography (SPECT) and brain positron emission tomography (PET) scan to monitor the long-term central nervous system (CNS) effects of DMAB intoxication. Results Neurobehavioral tests revealed a persistent impairment in episodic memory of visual retention semantic category retrieval and working memory of digit span (backward). Brain 99m Tc-TRODAT SPECT scan showed a lower radioactivity uptake in the left striatum and F-18 FDG PET scan revealed a relatively decreased cerebral metabolism at the anterior cingulate gyrus and both frontal regions. Follow-up neurobehavioral tests showed that the cognitive improvements were mainly documented in intelligence, attention function, conceptual shift, perceptual motor speed, verbal learning and working memory but were limited in visual memory and executive functions. Conclusion Patients with acute DMAB intoxication may have a long-lasting CNS toxicity on the cognitive dysfunction, parkinsonism, and an impaired metabolic activity of the brain. Clinical improvements may sustain during the long-term follow-up period.

An atmosphere pressure plasma (APP) deposition system with dielectric barrier discharge (DBD) is proposed for deposition selenium thin films. Several advantages of the APP deposition system are low cost, high processing speed and its potential to be applied in roll-to-roll process. Morphologies and thicknesses of selenium thin films deposited on In/CuGa/Mo/SLG can be affected by plasma power which also has impact on crystallinity of CIGS absorber. With the increase in plasma power, CIGS grains tend to distribute non-uniformly. Plasma power of 100W has the smallest FWHM of the main peak (112). Insufficient selenium incorporation into precursors result in undesired phases such as Cu3Se2, Cu2Se and separation phase, CuGaSe2 ¬compound. Compositions of optimal selenized CIGS thin film deposited by scanning 180 times are Cu/(In+Ga) = 1.03 and Ga/(In+Ga) = 0.24.

This cohort study uses Taiwan National Health Insurance database data to evaluate the incidence of ischemic stroke, hospitalization for heart failure, and all-cause mortality among patients with atrial fibrillation and atrial flutter stratified by CHA2DS2-VASc score., Key Points Question Do clinical outcomes differ between atrial fibrillation and atrial flutter by CHA2DS2-VASc scores? Findings This nationwide cohort study of 219 416 age- and sex-matched individuals in Taiwan found that the incidence of ischemic stroke among patients with atrial flutter was significantly lower than that among patients with atrial fibrillation at a CHA2DS2-VASc score less than 5, whereas the incidences of heart failure hospitalization and all-cause mortality were different across different CHA2DS2-VASc scores. Meaning The current recommended level of CHA2DS2-VASc score (≥2) used to prevent ischemic stroke in patients with atrial flutter should be reevaluated and prospectively studied., Importance Current guidelines support treating atrial fibrillation (AF) and atrial flutter (AFL) as equivalent risk factors for ischemic stroke stratified by CHA2DS2-VASc scores, recommending anticoagulation therapy for patients with a CHA2DS2-VASc score of 2 or higher, but some studies found differences in clinical outcomes. Objective To investigate differences in clinical outcomes among AF, AFL, and matched control cohorts. Design, Setting, and Participants This nationwide cohort study analyzed data from the Taiwan National Health Insurance Research Database from January 1, 2001, through December 31, 2012. Follow-up and data analysis ended December 31, 2012. A total of 219 416 age- and sex-matched individuals participated in the study. Clinical outcomes were compared after stratification by CHA2DS2-VASc score (possible score range, 0-9; higher scores indicate greater risk of ischemic stroke). Main Outcomes and Measures Ischemic stroke, heart failure hospitalization, and all-cause mortality among the AF, AFL, and matched control cohorts were analyzed using Cox proportional hazards regression. Results This study comprised 188 811 patients in the AF cohort (mean [SD] age, 73.8 [13.4] years; 104 703 [55.5%] male), 6121 patients in the AFL cohort (mean [SD] age, 67.7 [15.8] years; 3735 [61.0%] male), and 24 484 patients in the matched control cohort (mean [SD] age, 67.3 [15.6] years; 14 940 [61.0%] male). The patients with AF were older, were more predominantly female, and had higher CHA2DS2-VASc scores than the patients with AFL and the control participants. After stratification by CHA2DS2-VASc score, the incidence densities (IDs; events per 100 person-years) of ischemic stroke (AF cohort: ID, 3.08; 95% CI, 3.03-3.13; AFL cohort: ID, 1.45; 95% CI, 1.28-1.62; controls: ID, 0.97; 95% CI, 0.92-1.03), heart failure hospitalization (AF cohort: ID, 3.39; 95% CI, 3.34-3.44; AFL cohort: ID, 1.57; 95% CI, 1.39-1.74; controls: ID, 0.32; 95% CI, 0.29-0.35), and all-cause mortality (AF cohort: ID, 17.8; 95% CI, 17.7-17.9; AFL cohort: ID, 13.9; 95% CI, 13.4-14.4; controls: ID, 4.2; 95% CI, 4.1-4.4) were significantly higher in the AF cohort than in the matched control cohort. For the AFL cohort vs the matched control cohort, the incidences of heart failure hospitalization and all-cause mortality were significantly higher across all levels, but the incidence of ischemic stroke was only significantly higher at CHA2DS2-VASc scores of 5 to 9. For the AF cohort vs the AFL cohort, the incidences of ischemic stroke and heart failure hospitalization were significantly higher at a CHA2DS2-VASc score of 1 or higher, but the incidence of all-cause mortality was significantly higher only at CHA2DS2-VASc scores of 1 to 3. Conclusions and Relevance This study found different clinical outcomes between patients with AFL and AF and those without AF and AFL. The current recommended level of the CHA2DS2-VASc score in preventing ischemic stroke in patients with AFL should be reevaluated.

Fluorocarbon thin films were prepared and investigated using atmospheric pressure plasma jet. This atmospheric pressure plasma jet deposited fluorocarbon films without unfavorable contamination in plasma source. The atmospheric pressure plasma, generated with RF frequency power at 13.56 MHz, was fed with hexafluorobenzene (C6F6) as the deposition precursor and helium as the carrier gas. After deposition, the fluorocarbon films were analyzed for chemical characteristic, elemental composition, and surface morphology. The chemical structures and surface properties of the films were evaluated by Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM) analyses. By reason of the XPS and FTIR data, atmospheric pressure plasma deposited fluorocarbon films are similar to original aromatic ring in chemical structure. This investigation demonstrates that atmospheric pressure plasma jet affords good control over fluorocarbon film properties.

In an attempt to perform hydrophobic nano-coating, this investigation examined various operational parameters including in RF plasma power, system gas pressure, and CH2F2:Ar ratio of low-pressure plasma processing. The low-pressure plasma, generated with radio frequency power at 13.56 MHz, was fed difluoromethane (CH2F2)/Ar gas mixture. The surface characteristics of the plasma polymerized films were studied by static contact angle measurement (CA) and atomic force microscopy (AFM). As a result, increasing deposition of CH2F2 plasma polymerized films was achieved in enhanced RF plasma power input. The CH2F2 plasma polymerized films also were conducted in a varying system gas pressure with enhanced hydrophobic surface property. The effects of CH2F2/Ar plasma on the surface characteristics of the plasma polymerized films were investigated as a function of the Ar content. The super hydrophobic coating under optimized operational parameters prepared in this study obtained water contact angles greater than 150°. It was found that the maximum water contact angles (161°) was obtained at 1.5:1 (CH2F2: Ar) ratio. In addition, AFM analysis shows that possible ion bombardment from CH2F2/Ar plasma can increase surface roughness, and effectively form a hydrophobic coating on the surface of heat sensitive materials.

Background: To compare the long-term clinical outcomes of different antihypertensive drugs in stable patients after acute hemorrhagic stroke (HS). Methods: From January 2001 to December 2013, patients with first-ever primary HS were identified in the National Health Insurance Research Database, Taiwan. Patients with traumatic intracerebral hemorrhage and secondary HS were excluded. Those with first-ever HS were recruited and classified into three groups: (1) angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB); (2) calcium channel blocker (CCB); and (3) other antihypertensive drugs (comparison) groups. Propensity score matching was used to balance the distribution of baseline characteristics, stroke severity, and medications between any two of the three groups. A validation study was performed using the databank of the Stroke Registry in Chang-Gung Healthcare System to reduce the bias. Primary outcomes were recurrent HS, ischemic stroke, any stroke, and all-cause mortality. Results: Compared to the comparison group, the ACEI/ARB group [35.4% versus 39.3%; hazard ratio (HR), 0.84; 95% confidence interval (CI), 0.74–0.95] and CCB group (33.0% versus 41.9%; HR, 0.72; 95% CI, 0.64–0.81) had a lower risk of all-cause mortality during long-term follow up. The CCB group had a similar risk of all-cause mortality to the ACEI/ARB group. Risks of recurrent HS, ischemic stroke, or any stroke were not different between the study groups. Conclusions: Antihypertensive drug class could be important to long-term outcomes in HS patients in addition to the target control of blood pressure. Both ACEIs/ARBs and CCBs are associated with lower risks of all-cause mortality. Our results may be applied to inform future research on hypertensive control in HS patients.

Atmospheric-pressure spin plasma jets (APSPJs) have been developed to induce surface modifications on polymethylmethacrylate (PMMA). In this study, an experimental design methodology was used to investigate the influence of process parameters [such as radio frequency (RF) power, processing gap, and number of treatment cycles] on the characteristics of PMMA surface treated by APSPJs. It was observed from the atomic force microscope (AFM) and scanning electron microscope (SEM) results that the surface morphology of PMMA treated by direct plasma is much rougher than that treated by remote plasma. The direct plasma used in APSPJs processing created a substantial amount of nanostructure grains. Moreover, the measured XPS results showed that the O/C ratios of the PMMA surface were substantially increased and subsequently water contact angle decreased on direct plasma treatment. This decrease is due to an increase of oxygen-containing functional groups on the PMMA surface by the APSPJs processing. From the statistical analysis, the RF power and the processing gap were found to play a major role in enhancing the hydrophilic properties of PMMA surface. In contrast, the number of treatment cycles played only a secondary role in this case. Finally, in this study the APSPJs processing was demonstrated to be an effective method for surface modification of PMMA by controlling processing parameters during the treatment process. Copyright © 2009 John Wiley & Sons, Ltd.

The novel technique of plasma chemical vapor deposition without using vacuum chamber was investigated to deposit SiOx films on polymeric substrates through tetraethoxysilane (TEOS)/Air atmospheric-pressure plasma (APP) glow discharge. Depending on the proper deposition parameters, thin and smooth SiOx films on polycarbonate substrates were prepared. The atmospheric-pressure plasma deposited SiOx films obtained the desirable transparency in the visible and increased absorption in UV region. The surface characteristics of APP deposited SiOx films were examined by various surface analysis methods including FTIR, XPS, and SEM. It is shown that SiOx films exhibited low porosity and admirable hardness for optical applications.

In this study, we investigate the chemical properties and surface morphology of super-hydrophobic (SH) films deposited by self-assembled RF atmospheric-pressure plasma (APP) deposition system. The O2/HMDSN (hexamethyldisilazane) and Ar serve as the deposition precursor and ionization gas, respectively. The effects of process parameters, including the oxygen flow rate and the nozzle-to-sample distance on the characteristics of SiOx films measured by FTIR, XPS, SEM and AFM are also discussed. It was found that the higher deposition rate was obtained at higher oxygen flow rate conditions. Consequently, the smooth surface was transformed into a rough surface with many particles when the nozzle-to-sample distance was decreased from 20 mm to 10 mm. The SH films (contact angle over 150° and sliding angle below 5°) were obtained when the nozzle-to-sample distance was 10 mm. A simplified deposition mechanism is proposed to explain the effect of process parameters on the films that are formed.

In this study, super-hydrophobic films were deposited in a one-step simple process by pulsed RF C6F6 plasma, and the influence of the duty-cycle (DC) on the surface structure and chemical characteristics of depositing fluorocarbon films was examined. The deposited coatings were analyzed by X-ray Photoelectron Spectroscopy (XPS), Fourier Transform Infrared Spectrometry (FTIR), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), and Contact Angle Analyzer. It was found that by decreasing the DC from 1 to 0.1, the rough structure of the film with a lot of particles was obtained. In addition, the super-hydrophobic property was obtained on this composite fluorocarbon film. Finally, the adhesion of fluorocarbon films could be increased by deposited on the cotton fiber substrates instead of Si wafer.

The deposition rate and surface properties of SiOx films were prepared and investigated using remote atmospheric pressure plasma (APP) jet. The APP, generated with low frequency power at 16 kHz, was fed with tetraethoxysilane (TEOS)/air gas mixture. After deposition, the SiOx films were analyzed for chemical characteristics, elemental composition, surface morphology, and hardness. It was found that the deposition substrate temperature is the key factor to affect the deposition rate of remote APP chemical vapor deposition process. Fourier transform infrared (FTIR) spectra indicated that APP deposited SiOx films are an inorganic feature. XPS examination revealed that the SiOx films contained approximately 30% silicon, 58% oxygen and 12% carbon. Atomic forced microscopy (AFM) analysis results indicated a smooth surface of SiOx films in deposition under higher substrate temperature. Also, pencil hardness tests indicated that the hardness of APP deposited SiOx films was greatly improved with increasing substrate temperatures. Copyright © 2008 John Wiley & Sons, Ltd.

The liquid crystal alignment of fluorinated amorphous carbon (a-C:F) films which were deposited on the indium tin oxide (ITO) glass have shown to be improved by plasma beam processing. The experimental results indicated that excellent alignment characteristics regarding the range of pretilt angles and the alignment uniformity in a-C:F alignment films were improved by using the H2/Ar plasma beam processing. In this study, measurements of a-C:F film properties and liquid crystal (LC) cell characteristics were performed to investigate the relationship between the ratio of H2/Ar gaseous mixture and the LC alignment characteristics. The use of different gases allows enhanced control of the final surface chemical and physical properties. It was observed from the atomic force microscopy (AFM) results that the ion bombardment of films has a minimal impact on the alignment properties. Moreover, the X-ray photoemission spectroscopy (XPS) results showed that the H2/Ar plasma beam processing induces bond-breaking and chain scission. The results also indicated that the C–F bonds are broken by Ar+ and H radicals, while the benzene rings have carbon dangling bonds for the formation of C–O bonds in a-C:F films. Finally, the F/C ratio of a-C:F films was observed to be controlled by the H2/Ar ratio and the pretilt angles could be obtained from measurements of LC cells shown on a-C:F films.

Morning blood sampling, conducted around 4am to 5am, is routinely ordered due to nothing-by-mouth (NPO) requirements and clinical practice norms. However, this routine may interrupt the normal sleep of patients and decrease the satisfaction of patients with the care received. However, our night-shift staff is not able to take all blood samples during this time, resulting in a high rate of overdue reporting.To reduce the overdue rate of laboratory result from 62.3% to less than 19.3%.In 2013, we performed interventions including the process reengineering of blood sampling to meet the needs of laboratory result flows and the upgrading of equipment in our neurology ward. The reengineering strategies used included the redistribution of blood sampling times in order to decrease testing for unnecessary items. The equipment upgrades improved the ability of the carrier in the pneumatic tube systems to carry the chilled blood samples. An independent two-sample t-test was used to compare the overdue rate before and after the interventions.The overall overdue rate for the blood sampling to laboratory flow improved from 62.3% before the intervention to 18.0% (t = 7.07, p.001) after the intervention. Furthermore, the overdue rate for the testing done at the stat laboratory improved from 66.9% to 21.3% (t = 7.36, p.001), while the overdue rate for the testing done at the non-stat laboratory improved from 52.4% to 17.8% (t = 5.37, p.001). Besides, the satisfaction of both inpatients and nurses with regard to blood-sampling flow improved from 51% and 54.2%, respectively to 93% (t = 51.10, p.001) and 94% (t = 12.26, p.001).Our process reengineering strategies and the upgrading of the pneumatic tube system successfully reduced the overdue rate for the blood sampling and increased the satisfaction of inpatients.降低住診病人晨間採血檢驗報告逾時率.臨床配合醫師開立醫囑習慣及需禁食之檢驗項目，醫囑皆為隔日清晨採檢，護理人員皆於早上4點至5點執行檢體採集，此時段採檢，容易中斷病人睡眠及降低住院滿意度，也因過度集中送檢，在大夜班人力不足下，使得檢驗報告逾時率偏高。.檢驗報告逾時率由62.3%下降至19.3%以下。.2013年於神內科病房，調查造成檢驗報告逾時率之原因及針對所確立的問題及考量專科特性，進行相關作業流程改善，首創晨間分流機制，檢驗單增列需禁食時間提示、創新冰浴檢體運送管使用，以達縮短檢驗報告等候時間，進而提昇照護品質。.以independent t-test、two tailed test進行改善前後逾時率與滿意度的統計檢定分析，結果發現：整體逾時率由62.3%下降至18.0%（t = 7.07, p.001），急件逾時率由66.9%下降至21.3%（t = 7.36, p.001），普通件逾時率由52.4%下降至17.8%（t = 5.37, p.001）；病人對採檢滿意度由51.0%提升至93.0%（t = 51.10, p.001）；護理人員對採檢滿意度由54.2%提升至94.0%（t = 12.26, p.001）。.在專案的進行下，團隊成員運用創新概念，以病人為中心思考解決方案，打破陳舊的觀念，以創新的採檢分流機制，達到降低檢驗報告逾時率之目標，病人夜間睡眠也不中斷，更提升採檢的滿意度，達到護病雙贏局面。.

Background To investigate if initial blood pressure (BP) on admission is associated with stroke severity and predictive of admission costs and one-year-outcome in acute ischemic (IS) and hemorrhagic stroke (HS). Methods This is a single-center retrospective cohort study. Stroke patients admitted within 3 days after onset between January 1st and December 31st in 2009 were recruited. The initial BP on admission was subdivided into high (systolic BP ≥ 211 mmHg or diastolic BP ≥ 111 mmHg), medium (systolic BP 111–210 mmHg or diastolic BP 71–110 mmHg), and low (systolic BP ≤ 110 mmHg or diastolic BP ≤ 70 mmHg) groups and further subgrouped with 25 mmHg difference in systole and 10 mmHg difference in diastole for the correlation analysis with demographics, admission cost and one-year modified Rankin scale (mRS). Results In 1173 IS patients (mean age: 67.8 ± 12.8 years old, 61.4 % male), low diastolic BP group had higher frequency of heart disease (p =0.001), dehydration (p =0.03) and lower hemoglobin level (p

Recent experimental studies revealed that dopamine neuron dysfunction in chronic manganism may be due to a reduced capacity of dopamine release in the striatum. The findings imposed further difficulty in the differential diagnosis between manganism and IPD. We conducted a long-term clinical follow-up study of 4 manganism patients, applying a new tracer 18 F-9-fluoropropyl-(+)-dihydrotetrabenazine ( 18 F-AV-133) with positron emission tomography (PET). Twenty age-matched subjects including 4 manganism patients, 8 idiopathic Parkinson's disease (IPD) patients, and 8 healthy controls were enrolled for comparison. Volumes of interest of the bilateral putamen, caudate nuclei and occipital cortex as the reference region were delineated from individual magnetic resonance images. The clinical features of the manganism patients still progressed, with increased scores on the Unified Parkinson Disease Rating Scale. The 18 F-AV-133 uptake in the IPD patients decreased at the bilateral striatum, compared with the healthy controls. In the manganism patients, there was no decreased uptake of radioactivity involving the bilateral striatum, except Patient 4, who had a stroke with decreased uptake in the right posterior putamen. The 18 F-AV-133 PET finding reveals that nigrostriatum neurons are not degenerated in chronic manganism and can provide a useful neuroimage biomarker in the differential diagnosis.

Plasma technology is attractive for thin film deposition because films with various characteristics can be obtained by adjusting the process parameters. In this study, the experimental design methodology was used to investigate the influence of process parameters on the characteristics of fluorocarbon films deposited in CH2F2/CF4 plasma. It was found that the CF4 flow rate and substrate temperature were the most significant factors that affect the deposition rate and refractive index of the deposited film. A higher deposition rate was obtained in films deposited under moderate CF4 feed; lower substrate temperature and higher RF power conditions. The lower refractive index was obtained under higher CF4 feed; lower substrate temperature and moderate RF power conditions. It was also found that the fluorocarbon film with a higher F / C ratio was less cross-linked with a lower refractive index and less thermal stability. Potential reactions were proposed to explain the effect of process parameters on the film characteristics.

This work presents a method to separate polar naphthalenesulfonate (NS) isomers by capillary zone electrophoresis (CZE) with ultraviolet detection in industrial effluents and river water samples. The method involves extraction of samples by a polystyrene-divinylbenzene copolymer (PS-DVB) solid-phase extraction (SPE) cartridge. The most effective CZE separation conditions were obtained in 20 mM borate buffer with 30% acetonitrile at pH 9.0 and 30 °C. The method proposed herein provides a high precision and sensitivity for NS isomers, to quantitation at ≤ 1.0 μg/L in 200 mL of the water samples. Recovery of the NS isomers in spiked water samples ranged from 73% to 87% while RSD ranging from 5.6 to 9.7%. The analysis of industrial effluents and river water samples was performed and naphthalene-2-sulfonate was found as a major pollutant. The difficulties in quantitating and identifying analytes in complex environmental samples can be resolved by using an internal standard response factor to calculate concentrations and relative migration times for peak confirmation.

A systematic investigation of optimal conditions for determining the homologues of linear alkylbenzenesulfonates (LAS) by capillary zone electrophoresis (CZE) using the large-volume sample stacking technique was presented. The most effective sample stacking and separation conditions was 20 mM borate buffer with 30% acetonitrile at pH 9.0, and the sample hydrodynamic injection of up to 90 s at 4 p.s.i. (1 p.s.i. = 6,892.86 Pa) (around 711 nl). Under such conditions, approximately a 100-fold enrichment factor was achieved based on peak heights. The reproducibility of migration time and quantitative results of stacking CZE can be improved by using internal standards. Quantitation limits of the homologues of LAS were 0.002-0.01 mg/l under these enrichment conditions. The analysis of real samples of laundry and dishwashing detergents was performed. The established high-performance liquid chromatography method was applied to evaluate the stacking CZE method, and compatible results were obtained.

Cyclonic atmospheric pressure plasma with low-temperature nature has been investigated. High-speed rotating nonthermal atmospheric plasma jets were utilized as RF plasma sources to provide the gas velocities required to generate the cyclonic gas flow patterns. It was shown that the plasma temperature could be controlled by operational parameters. The experimentally measured gas phase temperature was around 30degC-85degC, indicating that this cyclonic atmospheric pressure plasma can treat polymers without unfavorable thermal effects. This type of low-temperature atmospheric plasma can provide a novel technique for large-scale surface modification of heat-sensitive materials.

Complexity C can characterize the order or disorder of a time series and was used to discriminate between normal and abnormal electroencephalograms (EEG) in this study. Two classified groups of 20 ...

Cerebral hypoperfusion is responsible for cognitive impairment in patients with severe carotid artery stenosis (CAS). The manifestation of reversed ophthalmic artery flow (ROAF) is not uncommon in patients with CAS, suggesting a state of intensified cerebral hypoperfusion. This study aimed to examine whether the presence of ROAF can exacerbate cognitive impairment in patients with severe unilateral CAS.One-hundred-and-two patients with CAS and 37 age-matched volunteers participated in this case-control study. Depending on the side of CAS and occurrences of ROAF, the patients were allocated to four groups: left CAS groups with ROAF (n=28) or without ROAF (n=22), and right CAS groups with ROAF (n=26) or without ROAF (n=26). All subjects underwent a battery of neuropsychological tests.All patients performed worse than the control group on most tests. No significant differences were observed between patient groups (ps0.05), except for inferior performance on psychomotor speed and visuospatial tests in the right ROAF group (ps0.03). Hierarchical regression analyses indicated strong contributions of estimated premorbid intelligence to performance on most tests (ps0.05). The severity of left and right CAS was distinctively associated with different functions. To a lesser extent, the severity of infarcts was also associated with impairment of psychomotor speed and some executive functions (ps0.05). The contributions of ROAF to performance on most tests were negligible.Patients with unilateral CAS may present with specific cognitive impairment relevant to the ipsilateral hemispheric functions. However, the manifestation of ROAF does not necessarily imply more extensive or severe cognitive impairment.

Purpose: One complication of thrombolysis is intracranial hemorrhage (ICH). We investigated whether treatment with tissue plasminogen activator (t-PA) for ischemic infarction results in a higher risk of ICH in patients with kidney dysfunction, who are predisposed to treatment complications due to their bleeding tendency. Methods: A total of 297 patients given thrombolytic therapy for ischemic stroke were classified into 2 groups on the basis of their estimated renal glomerular filtration rate (eGFR). The outcome measures included the incidence of ICH and modified Rankin scale scores at 1 month and 1 year. Results: ICH was more common in the renal dysfunction group (23 vs. 12.5%). Nevertheless, multivariate logistic regression showed that the odds of ICH were not high in the group with low eGFR. Also, eGFR values 2 did not predict the odds for functional dependence or death at 1 month and 1 year. Conclusion: After adjusting for confounding factors, the odds ratio for ICH was not higher in intravenous t-PA-treated stroke patients with renal dysfunction. A trend to the occurrence of ICH among these patients, however, was noted. Renal dysfunction does not predict the odds for functional dependence or death at 1 month and 1 year.

A new type of interaction between optical waves occurs in chirally-coupled-core (CCC) fibers. Instead of linear-translational symmetry of conventional cylindrical fibers, CCC fibers are helical-translation symmetric, and, consequently, interaction between CCC fiber modes involves both spin and orbital angular momentum of the waves. Experimentally this has been verified by observing a multitude of new phase-matching resonances in the transmitted super-continuum spectrum, and theoretically explained through modal theory developed in helical reference frame. This enables new degrees of freedom in controlling fiber modal properties.

We present an amplifier similariton laser based on chirally-coupled core fiber. Chirped pulse energies up to 60 nJ are obtained with compressed durations below 90 fs. We demonstrate an integrated pump-signal combiner for chirally-coupled fibers.

We experimentally demonstrate suppression of Stimulated Raman Scattering using a spectrally tailored transmission of a large-core effectively-single-mode Chirally-Coupled-Core fiber with a large loss at Stokes wavelengths.

Introduction: Clinical research of cervicocranial fibromuscular dysplasia (FMD) is rare in Asian populations. Our study reviewed Taiwanese ischemic stroke patients with cervicocranial FMD and compared them with previous reports. Methods: Between 2000 and 2011, we collected 19 consecutive cervicocranial FMD patients who received demographic registration, a blood test for excluding vasculitis, and comprehensive angiography. Cerebral ultrasound, vascular images and clinical outcomes (Barthel index, modified Rankin scale, recurrent stroke, or death) were monitored during follow-up. Results: Of the 19 patients, 16 (84%) had carotid FMD, while 7 (37%) had vertebral FMD. Only 2 investigated patients (13%) had renal FMD and 1 (5%) had cerebral aneurysm. 14 (74%) presented acute arterial dissection. All patients received medical treatment and had neither recurrent stroke nor dissection during follow-up. In the literature review of 225 FMD patients, 3.6% had recurrent stroke during follow-up, and some reported surgical procedure or angioplasty could give a good clinical outcome in progressing ischemia irrelevant to the cause of stenosis. Conclusion: In Taiwanese cervicocranial FMD patients, arterial dissection was one of the most common clinical presentations. Most of our patients had isolated involvement of the cervicocranial artery and carried a favorable outcome under medical treatment.

We report the energy scaling of mode-locked fiber lasers using a large-mode area chirally-coupled core fiber. This is a demonstration of the scaling of ultrafast fiber oscillators to large cores in an all-solid glass package that holds the lowest order fiber mode while maintaining compatibility with fiber fusion technology. An all-normal dispersion cavity design yields pulse energies above 40 nJ that dechirp to durations below 200 fs. Using lower net dispersion, pulses dechirping close to 100 fs are obtained with pump limited energies. Effectively single-mode operation is confirmed by beam quality as well as spectral interference measurements.

3C (Chirally-Coupled Core) optical fiber establishes a technological platform for high brightness, power scalable lasers with an engineerable fiber geometry that enables robustly single-mode performance of large core diameter fibers. Here we report the demonstration of robust polarization preserving performance of 35 μm core 3C fiber for short pulse systems. A polarization extinction ratio (PER) of ~ 20 dB is stably maintained with ambient temperatures varying over a 50°C range from a Yb-doped double clad 3C fiber amplifier. We also demonstrate that this high-PER polarization output is insensitive to temperature gradients and mechanical perturbations in the 3C fiber amplifier. The ability to deliver high peak power pulses at high average powers while maintaining exceptional beam quality and a stable polarization state in an easily integrated format makes 3C fiber laser systems extremely attractive for harmonic generation to visible and UV wavelengths.

Mitochondrial T9957C mutations have been reported in patients with nonarteritic ischemic optic neuropathy and seizures and in patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes. However, thus far, this mutation has not been reported in patients with chronic progressive external ophthalmoplegia (CPEO).Here we report a female patient with CPEO and agenesis of the corpus callosum. Although no ragged-red fibers were found upon muscle biopsy, sequencing of the entire mitochondrial DNA genome was done.The molecular genetic study revealed a nonsynonymous mitochondrial T9957C mutation. a new genotype of CPEO was identified with varied clinical presentations. Although the effect of the nuclear genome remains unknown, we believe that the nonsynonymous mitochondrial DNA (mtDNA) T9957C mutation may have a role in the clinical manifestations of this patient.This study extends the phenotype of T9957C mtDNA mutation.

We report energy scaling of mode-locked fiber lasers using chirally-coupled core fiber. Pulse energies above 40 nJ dechirping below 200 fs are demonstrated, as well as dechirped durations around 100 fs at pump-limited energies.

We demonstrate a high-energy femtosecond laser system with two rapidly advancing technologies: 3C LMA fiber to ensure single-mode operation and high-dispersion mirror to enable loss-free pulse compression with the diffraction-limited beam quality.

We demonstrate a high-energy femtosecond laser system that incorporates two rapidly advancing technologies: chirally-coupled-core large-mode-area Yb-fiber to ensure fundamental-mode operation and high-dispersion mirrors to enable loss-free pulse compression while preserving the diffraction-limited beam quality. Mode-locking is initiated by a saturable absorber mirror and further pulse shortening is achieved by nonlinear polarization evolution. Centered at 1045 nm with 39-MHz repetition rate, the laser emits 25-nJ, positively chirped pulses with 970-mW average power. 6 bounces from double-chirped-mirrors compress these pulses down to 80 fs, close to their transform-limited duration. The loss-free compression gives rise to a diffraction-limited optical beam (M2 = 1.05).

We demonstrate a high-energy femtosecond laser system that incorporates two rapidly advancing technologies: chirally-coupled-core large-mode-area Yb-fiber to ensure fundamental-mode operation and high-dispersion mirrors to enable loss-free pulse compression while preserving the diffraction-limited beam quality.

A power-scalable approach for THz generation is demonstrated using optical rectification in GaP pumped by a high power ultrafast Yb-doped fiber amplifier operating at 1.055 mum. A 120-MHz-repetition-rate pulse train of single-cycle THz radiation with 6.5 muW average power is generated using 10 W from a parabolic fiber amplifier. Analysis of the THz power scalability indicates that due to the unique advantages offered by ultrafast optical rectification in GaP and due to the power scalability of fiber lasers, this approach has the potential to generate single-cycle THz pulse trains with average powers up to several mW.

In the study, an atmospheric-pressure plasma-induced grafting (APPG) has been developed to induce surface modification change on adhesion of polyethylene terephthalate (PET) surface and silicone. The Argon plasma was generated by a RF power under atmospheric-pressure. The most significant feature (APPG) of the process developed in this study was to induce chemical grafting using organosilane vapor (with argon as the precursor carrier gas) simultaneously with the plasma treatment of the surface undergone modification.

The black matrix (BM) rework using traditional wet process in the LCD industries is time consuming, costly and pollution. However, the plasma process provides a fast, less expensive and clean alternative. Especially, it is noticed that atmospheric pressure plasma attracts many attentions due to their lower equipment cost, operating without chambers and most suitable for large area substrate processing.

We demonstrate robustly single-mode power scaling in fiber laser systems built using 35-µm core Yb-doped double-clad Chirally-Coupled-Core (CCC) fibers. Up to 250W have been demonstrated up to date and further power scaling is in progress.

Pulsed amplifier using chirally-coupled-core Yb-doped double-clad fiber is demonstrated at average powers above 100W and 10-ns pulse energies exceeding 1mJ, with pure single-mode output at all powers and energies independently from coiling and excitation conditions.

Chirally-coupled-core fibers with core sizes well exceeding those of conventional LMA provide robust single-mode output irrespective of mode excitation and fiber coiling, are spliceable, and can preserve mode-area in tight bends and reduce nonlinear effects.

The first fiber laser is demonstrated at 1064-nm using a novel index-guiding-core single- mode fiber (chirally-coupled-core) with V ≫2.405. Robust single-mode operation achieved at all power levels (up-to ~40W) independently of beam excitation and fiber coiling conditions.

Polypropylene (PP) films have been widely used in many industrial areas, such as for protective overcoats and food packaging. However, PP film’s hydrophobic surface properties induce poor wettability and adhesion; these properties have restrained the application of these films. Many surface modification techniques like wet-chemical treatment, UV irradiation, and plasma (including the atmospheric-pressure plasma, APP) treatment have been applied to films to enhance their hydrophilic properties. Among these technologies, APP treatment has attracted much attention due to its dry process, low vacuum equipment cost, and high productivity.

50-W average power fiber-CPA at 1055-nm is demonstrated using chirped- volume-Bragg-gratings for pulse stretching and compression. This compact pulse compression technology is efficient (83% compression efficiency in the current demonstration) and suitable for further power scaling.

Novel index-guiding-core single-mode fibers with V >> 2.405 are demonstrated at 1550-nm and 1064-nm wavelengths. This fiber design is based on chirally-coupled core concept, which enables a new type of index-guiding and photonic-crystal fiber structures.

We demonstrate the generation of radially polarized terahertz pulses via optical rectification in a Cherenkov geometry exploiting velocity mismatch, contrary to the traditional approach for generating linearly polarized terahertz beams. A compact system is implemented using ‹001›-cut ZnTe pumped by an ultrafast Yb-doped fiber amplifier.

By exploiting velocity mismatch, we show that optical rectification can generate radially polarized THz pulses. A compact system is implemented using cut ZnTe pumped by an ultrafast Yb-doped parabolic fiber amplifier.

We demonstrate Chirally-Coupled-Core (CCC) fiber with 35-µm diameter and 0.07 NA core which is effectively single-mode. This is a new type of fibers whose modal properties are defined both by their longitudinal and transverse structure.