119 results on '"Chun-Hung Su"'
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2. CHA2DS2-VASc score as an independent outcome predictor in patients hospitalized with acute ischemic stroke.
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Chun-Hung Su, Chien-Hsien Lo, Hsin-Hung Chen, Chin-Feng Tsai, Hei-Tung Yip, Kai-Cheng Hsu, Chung Y Hsu, Chia-Hung Kao, and Taiwan Stroke Registry Investigators
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Medicine ,Science - Abstract
PurposeAtrial fibrillation (AF) is a significant independent risk factor for 1-year mortality in patients with first acute ischemic stroke (AIS). The CHA2DS2-VASc score was initially developed to assess the risk of stroke in patients with AF. Recently, this scoring system has been demonstrated to have clinical value for predicting long-term clinical outcomes in AIS but the evidence is insufficient. This large-scale prospective cohort study investigated the independent predictive value of the score in such patients.MethodsWe included patients with AIS from the Taiwan Stroke Registry (TSR) during 2006-2016 as the present study population. Patients were divided into those with high (≥2) and low (ResultsA total of 62,227 patients with AIS were enrolled. The median age was 70.3 years, and 59% of the patients were women. After confounding factors were controlled, patients with high CHA2DS2-VASc scores had significantly higher incidence of 1-year MACCEs (adjusted hazard ratio [HR] = 1.63; 95% confidence interval [CI] = 1.52, 1.76), re-stroke (adjusted HR = 1.28; 95% CI = 1.16, 1.42), and all-cause mortality (adjusted HR = 2.03; 95% CI = 1.83, 2.24) than those with low CHA2DS2-VASc scores did. In the comparison between AF and non-AF groups, the AF group had increased MACCEs (adjusted HR = 1.74; 95% CI = 1.60, 1.89), myocardial infarction (adjusted HR = 4.86; 95% CI = 2.07, 11.4), re-stroke (adjusted HR = 1.47; 95% CI = 1.26, 1.71), and all-cause mortality (adjusted HR = 1.90; 95% CI = 1.72, 2.10). The Kaplan-Meier curve revealed that both CHA2DS2-VASc scores and AF were independent risk predictors for 1-year MACCEs and mortality.ConclusionsThe CHA2DS2-VASc score and AF appeared to consistently predict 1-year MACCEs of AIS patients and provide more accurate risk stratification. Therefore, increased use of the CHA2DS2-VASc score may help improve the holistic clinical assessment of AIS patients with or without AF.
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- 2022
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3. Using Ballistocardiogram and Impedance Plethysmogram for Minimal Contact Measurement of Blood Pressure Based on a Body Weight-Fat Scale
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Shing-Hong Liu, Yan-Rong Wu, Wenxi Chen, Chun-Hung Su, and Chiun-Li Chin
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ballistocardiogram ,impedance plethysmogram ,pulse transit time (PTT) ,weight-fat scale ,blood pressure ,Chemical technology ,TP1-1185 - Abstract
Electronic health (eHealth) is a strategy to improve the physical and mental condition of a human, collecting daily physiological data and information from digital apparatuses. Body weight and blood pressure (BP) are the most popular and important physiological data. The goal of this study is to develop a minimal contact BP measurement method based on a commercial body weight-fat scale, capturing biometrics when users stand on it. The pulse transit time (PTT) is extracted from the ballistocardiogram (BCG) and impedance plethysmogram (IPG), measured by four strain gauges and four footpads of a commercial body weight-fat scale. Cuffless BP measurement using the electrocardiogram (ECG) and photoplethysmogram (PPG) serves as the reference method. The BP measured by a commercial BP monitor is considered the ground truth. Twenty subjects participated in this study. By the proposed model, the root-mean-square errors and correlation coefficients (r2s) of estimated systolic blood pressure and diastolic blood pressure are 7.3 ± 2.1 mmHg and 4.5 ± 1.8 mmHg, and 0.570 ± 0.205 and 0.284 ± 0.166, respectively. This accuracy level achieves the C grade of the corresponding IEEE standard. Thus, the proposed method has the potential benefit for eHealth monitoring in daily application.
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- 2023
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4. Association between haemorrhoids and Graves’ disease: a retrospective cohort study using data from Taiwan’s Longitudinal Health Insurance Database
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Chia-Hung Kao, Hsin-Hung Chen, Shang-Rong Zhong, Chun-Cheng Liao, Chun-Hung Su, and Hei-Tung Yip
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Medicine - Abstract
Objective To evaluate the relationship between haemorrhoids and Graves’ disease (GD).Setting Using the nationwide data from Taiwan’s Longitudinal Health Insurance Database.Participants We conducted a retrospective study, stratified patients by International Classification of Diseases, Ninth Revision, Clinical Modification disease code and compared the incidence rate of GD between patients with and without haemorrhoids. The study period was from 2000 to 2010, with exclusion of patients with diagnosed haemorrhoids before 2000 or after 2009, and we analysed the HR of GD in the univariable and multivariable models as well as the cumulative incidence curves of GD by using Kaplan-Meier curves.Result This study included 13 165 and 52 660 patients with and without haemorrhoids, respectively. The mean follow-up duration was approximately 6 years. The incidence rate of GD was 1.57 and 1.13 per 1000 person-years in patients with and without haemorrhoids, respectively. The area under the cumulative incidence curve of GD in patients with haemorrhoids was higher than that of patients without haemorrhoids. The risk of GD increased by 1.39 times (95% CI 1.13 to 1.71) in patients with haemorrhoids compared with patients without haemorrhoids. In the subgroup analysis, women with haemorrhoids had a higher risk of GD (adjusted HR 1.44; 95% CI 1.13 to 1.83). Patients with haemorrhoids aged 30–39 years were more likely to develop GD (adjusted HR 1.73; 95% CI 1.18 to 2.55).Conclusion The findings of this study indicate that patients with haemorrhoids may have an increased risk of GD compared with other potential confounding factors.
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- 2021
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5. 3-Bromofluoranthene-induced cardiotoxicity of zebrafish and apoptosis in the vascular endothelial cells via intrinsic and extrinsic caspase-dependent pathways
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Chun-Hung Su, Shih-Pin Chen, Li-You Chen, Jiann-Jou Yang, Yi-Chia Lee, Shiuan-Shinn Lee, Hsin-Hung Chen, Yan-Yan Ng, and Yu-Hsiang Kuan
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3-Bromofluoranthene ,Zebrafish ,Vascular endothelial cells ,Caspase-dependent apoptosis ,Environmental pollution ,TD172-193.5 ,Environmental sciences ,GE1-350 - Abstract
Fluoranthene, a high-molecular-weight polycyclic aromatic hydrocarbon (PAH), is widely present in air pollutants, including fine inhalable particulate matter. 3-Bromofluoranthene (3-BrFlu), which is a brominated fluoranthene and halogenated PAH, is generated from waste combustion, metallurgical processes, cement production, e-waste dismantling, and photoreaction. Vascular endothelial cells have key functions in the homeostasis and the development of the cardiovascular system. The zebrafish model has been widely employed to study cardiotoxicity and embryotoxicity. However, no evidence has indicated that 3-BrFlu induces cytotoxicity in vascular endothelial cells, or cardiotoxicity and embryotoxicity in zebrafish. In this study, 3-BrFlu induced concentration-dependent changes in embryo- and cardiotoxicity. Cytotoxicity was also induced by 3-BrFlu in a concentration-dependent manner through apoptosis and necrosis in vascular endothelial cells, SVEC4-10 cells. The activities of caspase-3, -8, and -9 were induced by 3-BrFlu via an intrinsic pathway constituting Bcl-2 downregulation, Bad upregulation, and mitochondrial dysfunction; the extrinsic pathway included the expression of death receptors, including tumour necrosis factor α and Fas receptors. These results indicated that 3-BrFlu caused cardio- and embryotoxicity in zebrafish through vascular endothelial cells cytotoxicity resulting from caspase-dependent apoptosis through intrinsic and extrinsic pathways.
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- 2021
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6. Hydroxychloroquine Does Not Increase the Risk of Cardiac Arrhythmia in Common Rheumatic Diseases: A Nationwide Population-Based Cohort Study
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Chien-Hsien Lo, James Cheng-Chung Wei, Yu-Hsun Wang, Chin-Feng Tsai, Kuei-Chuan Chan, Li-Ching Li, Tse-Hsien Lo, and Chun-Hung Su
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Hydroxychloroquine ,arrhythmia ,rheumatoid arthritis ,systemic lupus erythematosus ,Sjögren's syndrome ,Immunologic diseases. Allergy ,RC581-607 - Abstract
ObjectivesHydroxychloroquine (HCQ) is widely used to treat rheumatic diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SS). Cardiac arrhythmia has been concerned as important safety issue for HCQ. The aim of this study was to investigate whether hydroxychloroquine increases new-onset arrhythmia among patients with RA, SLE or SS.MethodsThis was a retrospective cohort study that conducted from the longitudinal health insurance database of Taiwan. Patients with newly diagnosed RA, SLE or SS with age ≥20 years old were selected from 2000 to 2012. Patients who received HCQ and without HCQ treatment groups were matched by propensity score to minimize the effect of selection bias and confounders. The Cox proportional hazard model was used to analyze the risk of arrhythmia between the two groups after controlling for related variables.ResultsA total of 15892 patients were selected to participate and finally 3575 patients were enrolled in each group after matching. There was no different risk of all arrhythmia in patients using HCQ than without HCQ (adjusted hazards ratio 0.81, 95% CI 0.61–1.07) and ventricular arrhythmia as well. The incidence of arrhythmia did not increase when HCQ co-administrated with macrolides. The arrhythmia risk was also not different regardless of daily HCQ dose 4 months.ConclusionThe administration of HCQ did not increase the risk of all cardiac arrhythmia and ventricular arrhythmia regardless of different duration of treatment (≦4 months or >4 months) or cumulative dose (
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- 2021
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7. Bilateral Vertebral Artery Hypoplasia and Fetal-Type Variants of the Posterior Cerebral Artery in Acute Ischemic Stroke
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Chung-Fu Hsu, Kuan-Wen Chen, Chun-Hung Su, Chao-Yu Shen, and Hsin-Yi Chi
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posterior circulation infarction ,vertebral artery hypoplasia ,posterior cerebral artery ,vertebrobasilar insufficiency ,ultrasonagraphy ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Aim: Unilateral vertebral artery hypoplasia is considered a risk factor for posterior circulation infarction. Despite the increasing attention on unilateral vertebral artery hypoplasia, few studies have discussed bilateral vertebral artery hypoplasia, its influence on stroke, or its collateral supply from the circle of Willis. We aimed to identify its characteristics, stroke pattern, and unique ultrasonographic and brain imaging findings.Materials and Methods: Of the 1,301 consecutive in-patients diagnosed with acute ischemic stroke from January 2013 to December 2015, medical and laboratory data and stroke or transient ischemic attack history were recorded. We enrolled patients who underwent both brain magnetic resonance imaging and sonography examinations. Vertebral artery and posterior cerebral artery analyses were conducted in accordance with clinical criteria.Results: Adequate imaging data were available for 467 patients. Of these, eight patients met the criteria for bilateral vertebral artery hypoplasia. The mean age was 62.9 ± 12.1 years. There were six male (75.0%) and two female patients (25.0%). A high prevalence of hypertension (7/8, 87.5%) was noted.Sonograms displayed a very low net flow volume in the vertebral arteries, with the average net flow volume being 28.9 ± 9.7 mL/min. A high frequency (6/8; 75.0%) of the fetal variant posterior cerebral artery from the carotids was found. The infarction patterns in these patients were all bilateral, scattered, and in multiple vascular territories.Conclusion: Patients with bilateral vertebral hypoplasia displayed a unique collateral supply, special stroke pattern, and younger stroke onset. Early recognition and stroke prevention should be considered critical in clinical practice.
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- 2021
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8. Genotoxic effects of 1-nitropyrene in macrophages are mediated through a p53-dependent pathway involving cytochrome c release, caspase activation, and PARP-1 cleavage
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Sheng-Wen Wu, Chun-Hung Su, Yung-Chuan Ho, Rosa Huang-Liu, Ching-Chi Tseng, Yun-Wei Chiang, Kun-Lin Yeh, Shiuan-Shinn Lee, Wen-Ying Chen, Chun-Jung Chen, Yi-Ching Li, Chien-Ying Lee, and Yu-Hsiang Kuan
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1-Nitropyrene ,Genotoxicity ,p53-dependent pathway ,Macrophage ,Environmental pollution ,TD172-193.5 ,Environmental sciences ,GE1-350 - Abstract
Genotoxic stress from environmental pollutants plays a critical role in cytotoxicity. The most abundant nitro-polycyclic aromatic hydrocarbon in environmental pollutants, 1-nitropyrene (1-NP), is generated during fossil fuel, diesel, and biomass combustion under sunlight. Macrophages, the key regulators of the innate immune system, provide the first line of defense against pathogens. The toxic effects of 1-NP on macrophages remain unclear. Through a lactate dehydrogenase assay, we measured the cytotoxicity induced by 1-NP. Our results revealed that 1-NP induced genotoxicity also named DNA damage, including micronucleus formation and DNA strand breaks, in a concentration-dependent manner. Furthermore, 1-NP induced p53 phosphorylation and nuclear accumulation; mitochondrial cytochrome c release; caspase-3 and -9 activation and cleavage; and poly (ADP-ribose) polymerase-1 (PARP-1) cleavage in a concentration-dependent manner. Pretreatment with the PARP inhibitor, 3-aminobenzamide, significantly reduced cytotoxicity, genotoxicity, and PARP-1 cleavage induced by 1-NP. Pretreatment with the caspase-3 inhibitor, z-DEVD-fmk, significantly reduced cytotoxicity, genotoxicity, PARP-1 cleavage, and caspase 3 activation induced by 1-NP. Pretreatment with the p53 inhibitor, pifithrin-α, significantly reduced cytotoxicity, genotoxicity, PARP-1 cleavage, caspase 3 activation, and p53 phosphorylation induced by 1-NP. We propose that cytotoxicity and genotoxicity induced by 1-NP by PARP-1 cleavage via caspase-3 and -9 activation through cytochrome c release from mitochondria and its upstream p53-dependent pathway in macrophages.
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- 2021
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9. The Association Between Pleural Empyema and Peripheral Arterial Disease in Younger Patients: A Retrospective National Population-Based Cohort Study
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Tzu-Yuan Wang, Hsin-Hung Chen, Chun-Hung Su, Sheng-Pang Hsu, Chun-Wei Ho, Ming-Chia Hsieh, Cheng-Li Lin, and Chia-Hung Kao
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pleural empyema ,peripheral arterial disease ,retrospective cohort study ,NHIRD ,National Health Insurance Research Database ,Cox regression hazard model ,Medicine (General) ,R5-920 - Abstract
Background: To investigate the relationship between pleural empyema (PE) and peripheral arterial disease (PAD).Methods: We conducted a retrospective cohort study using data from the National Health Institute Research Database. Univariable and multivariable Cox's proportional hazard regressions were performed to investigate the association between PE and the risk of PAD. Kaplan–Meier method and the differences were assessed using a log-rank test.Results: The overall incidence of PAD was higher in the PE cohort than in the non-PE cohort (2.76 vs. 1.72 per 1,000 person-years) with a crude hazard ratio (HR) of 1.61 [95% confidence interval (CI) = 1.41–1.83]. After adjustment for age, gender, and comorbidities, patients with PE were noted to be associated with an increased risk of PAD compared with those without PE [adjusted HR (aHR) = 1.18, 95% CI = 1.03–1.35]. Regarding the age-specific comparison between the PE and non-PE cohorts, PAD was noted to be significantly high in the ≤ 49 years age group (aHR = 5.34, 95% CI = 2.34–10.1). The incidence of PAD was higher in the first 2 years, with an aHR of 1.35 (95% CI = 1.09–1.68) for patients with PE compared with those without PE.Conclusion: The risk of PAD was higher if patients with PE were younger than 49 years and within the 2-year diagnosis of PE.
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- 2021
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10. Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy.
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Ming-Yun Ho, Po-Wei Chen, Wen-Han Feng, Chun-Hung Su, Sheng-Wei Huang, Chung-Wei Cheng, Hung-I Yeh, Ching-Pei Chen, Wei-Chun Huang, Ching-Chang Fang, Hui-Wen Lin, Sheng-Hsiang Lin, I-Chang Hsieh, and Yi-Heng Li
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Medicine ,Science - Abstract
Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. From January 1, 2014 to December 31, 2018, we included 498 ACS patients (age 70.18 ± 12.84 years, 71.3% men) with aspirin stopped for various reasons before 6 months after PCI and received P2Y12 inhibitor monotherapy. The clinical outcomes between those with aspirin treatment ≤ 1 month and > 1 month were compared in 12-month follow up after PCI. Inverse probability of treatment weighting was used to balance the covariates between groups. The mean duration of aspirin treatment was 7.52 ± 8.10 days vs. 98.05 ± 56.70 days in the 2 groups (p 1 month. Our results indicated that ≤ 1-month aspirin may be enough in P2Y12 inhibitor monotherapy strategy for ACS patients undergoing PCI.
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- 2021
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11. Association of hydroxychloroquine and cardiac arrhythmia in patients with systemic lupus erythematosus: A population-based case control study.
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Chien-Hsien Lo, Yu-Hsun Wang, Chin-Feng Tsai, Kuei-Chuan Chan, Li-Ching Li, Tse-Hsien Lo, James Cheng-Chung Wei, and Chun-Hung Su
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Medicine ,Science - Abstract
ObjectivesHydroxychloroquine is widely used to treat certain viral and rheumatic diseases including systemic lupus erythematosus. Cardiac arrhythmia is an important safety issue with hydroxychloroquine. The aim of this study was to investigate whether hydroxychloroquine increases new-onset arrhythmia among patients with systemic lupus erythematosus.MethodsThis was a nested case-control study using data from the Longitudinal Health Insurance Database of Taiwan. A conditional logistic regression model was used to analyse differences in the risk of arrhythmia between systemic lupus erythematosus patients with and without hydroxychloroquine treatment after controlling for related variables.ResultsA total of 2499 patients with newly diagnosed systemic lupus erythematosus were identified (81% females), of whom 251 were enrolled in the new-onset arrhythmia group (mean age 50.4 years) and 251 in the non-arrhythmia group (mean age 49.1 years). There was no significantly increased risk of cardiac arrhythmia (adjusted odds ratio = 1.49, 95% confidence interval: 0.98-2.25) or ventricular arrhythmia (adjusted odds ratio = 1.02, 95% confidence interval: 0.19-5.41) between the patients with and without hydroxychloroquine treatment. In addition, there were no significant differences in the risk of arrhythmia between those receiving hydroxychloroquine treatment for ConclusionIn patients with systemic lupus erythematosus, hydroxychloroquine treatment did not significantly increase the risk of cardiac arrhythmia or life-threatening ventricular arrhythmia regardless of the different hydroxychloroquine treatment duration, drug adherence rate, or daily dose.
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- 2021
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12. Protective effect of nerolidol on lipopolysaccharide-induced acute lung injury through the inhibition of NF-κB activation by the reduction of p38 MAPK and JNK phosphorylation
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Shih-Pin Chen, Chun-Hung Su, Rosa Huang-Liu, Min-Wei Lee, Chen-Yu Chiang, Wen-Ying Chen, Chun-Jung Chen, Sheng-Wen Wu, and Yu-Hsiang Kuan
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Nerolidol ,LPS ,Acute lung injury ,NF-κB ,p38 MAPK ,JNK ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Acute lung injury (ALI) is a severe syndrome, and there are no effective therapeutic appropriate medicines. Nerolidol, which exists in the essential oils of aromatic plants and flowers, exhibits antioxidative and anti-inflammatory activities. The present study evaluated the potential protective effect of nerolidol in ALI and the related mechanism in lipopolysaccharide (LPS)-treated mice. Here, nerolidol inhibited the LPS-induced neutrophil and other leukocyte infiltration of the alveolar space. LPS increased cytokines, chemokines, and adhesion molecules, and proinflammatory protein production was inhibited by nerolidol. LPS-induced phosphorylation of NF-κB p65, p38 MAPK, JNK, ERK were inhibited by nerolidol. The inhibitory concentration of nerolidol for the phosphorylation of NF-κB p65 and its upstream factors, p38 MAPK and JNK, was similar to the inflammatory responses of ALI. In conclusion, nerolidol is a potential protective agent in ALI via the inhibition of NF-κB activation and its upstream factors phosphorylation of p38 MAPK and JNK.
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- 2020
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13. An Examination System to Detect Deep Vein Thrombosis of a Lower Limb Using Light Reflection Rheography
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Shing-Hong Liu, Jia-Jung Wang, Wenxi Chen, Kuo-Li Pan, and Chun-Hung Su
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deep vein thrombosis ,light reflection rheography ,wearable device ,photoplethysmography ,Chemical technology ,TP1-1185 - Abstract
Deep vein thrombosis (DVT) of lower limbs can easily arise from prolonged sitting or standing. Elders and pregnant women are most likely to have this disease. When the embolus of DVT comes to pass the lung, it will become a life-threatening disease. Thus, for DVT disease, early detection and the early treatment are needed. The goal of this study was to develop an examination system to be used at non-medical places to detect the DVT of lower limbs with light reflection rheography (LRR). Consisting of a wearable device and a mobile application (APP), the system is operated in a wireless manner to control the actions of sensors and display and store the LRR signals on the APP. Then, the recorded LRR signals are processed to find the parameters of DVT examination. Twenty subjects were recruited to perform experiments. The veins of lower limbs were occluded by pressuring the cuff up to 100 mmHg and 150 mmHg to simulate the slight and serious DVT scenarios, respectively. Six characteristic parameters were defined to classify whether there was positive or negative DVT using the receiver operating characteristic curves, including the slopes of emptying and refilling curves in the LRR signal, and the changes of venous pump volume. Under the slight DVT scenario (0 mmHg vs. 100 mmHg), the first three parameters, m10, m40, and m50, had accuracies of 72%, 69%, and 69%, respectively. Under the serious DVT scenario (0 mmHg vs. 150 mmHg), m10, m40, and m50 achieved accuracies of 73%, 76%, and 73%, respectively. The experimental results show that this proposed examination system may be practical as an auxiliary tool to screen DVT in homecare settings.
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- 2021
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14. Classification of Photoplethysmographic Signal Quality with Deep Convolution Neural Networks for Accurate Measurement of Cardiac Stroke Volume
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Shing-Hong Liu, Ren-Xuan Li, Jia-Jung Wang, Wenxi Chen, and Chun-Hung Su
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photoplethysmography (PPG) ,deep convolution neural network (DCNN) ,signal quality index (SQI) ,impedance cardiography (ICG) ,stroke volume (SV) ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
As photoplethysmographic (PPG) signals are comprised of numerous pieces of important physiological information, they have been widely employed to measure many physiological parameters. However, only a high-quality PPG signal can provide a reliable physiological assessment. Unfortunately, PPG signals are easily corrupted by motion artifacts and baseline drift during recording. Although several rule-based algorithms have been developed for evaluating the quality of PPG signals, few artificial intelligence-based algorithms have been presented. Thus, this study aims to classify the quality of PPG signals by using two two-dimensional deep convolution neural networks (DCNN) when the PPG pulse is used to measure cardiac stroke volume (SV) by impedance cardiography. An image derived from a PPG pulse and its differential pulse is used as the input to the two DCNN models. To quantify the quality of individual PPG pulses, the error percentage of the beat-to-beat SV measured by our device and medis® CS 2000 synchronously is used to determine whether the pulse quality is high, middle, or low. Fourteen subjects were recruited, and a total of 3135 PPG pulses (1342 high quality, 73 middle quality, and 1720 low quality) were obtained. We used a traditional DCNN, VGG-19, and a residual DCNN, ResNet-50, to determine the quality levels of the PPG pulses. Their results were all better than the previous rule-based methods. The accuracies of VGG-19 and ResNet-50 were 0.895 and 0.925, respectively. Thus, the proposed DCNN may be applied for the classification of PPG quality and be helpful for improving the SV measurement in impedance cardiography.
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- 2020
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15. Classification of Photoplethysmographic Signal Quality with Fuzzy Neural Network for Improvement of Stroke Volume Measurement
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Shing-Hong Liu, Jia-Jung Wang, Wenxi Chen, Kuo-Li Pan, and Chun-Hung Su
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photoplethysmography ,signal quality index (sqi) ,impedance cardiography (icg) ,stroke volume (sv) ,self-constructing neural fuzzy inference network (sonfin) ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
Photoplethysmography (PPG) has been extensively employed to acquire some physiological parameters such as heart rate, oxygen saturation, and blood pressure. However, PPG signals are frequently corrupted by motion artifacts and baseline wandering, especially for the reflective PPG sensor. Several different algorithms have been studied for determining the signal quality of PPG by the characteristic parameters of its waveform and the rule-based methods. The levels of signal quality usually were defined by the manual operations. Thus, whether the good PPG waveforms are enough to increase the accuracy of the measurement is still a subjective issue. The aim of this study is to use a fuzzy neural network to determine the signal quality indexes (SQI) of PPG pulses measured by the impedance cardiography. To test the algorithm performance, the beat-to-beat stroke volumes (SV) were measured with our device and the medis® CS 2000, synchronously. A total of 1466 pulses from 10 subjects were used to validate our algorithm in which the SQIs of 1007 pulses were high, those of 71 pulses were in the middle, and those of 388 pulses were low. The total error of SV measurement was −18 ± 22.0 mL. The performances of the classification were that the sensitivity and specificity for the 1007 pulses with the high SQIs were 0.81 and 0.90, and the error of SV measurement was 6.4 ± 12.8 mL. The sensitivity and specificity for the 388 pulses with the low SQIs were 0.84 and 0.93, while the error of SV measurement was 30.4 ± 3.6 mL. The results show that the proposed algorithm could be helpful in choosing good-quality PPG pulses to increase the accuracy of SV measurement in the impedance plethysmography.
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- 2020
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16. A Comprehensive Review of US FDA-Approved Immune Checkpoint Inhibitors in Urothelial Carcinoma
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Fu-Shun Hsu, Chun-Hung Su, and Kou-How Huang
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Few effective treatment options are available for patients with advanced or metastatic urothelial carcinoma (UC) after unsuccessful first-line platinum-based chemotherapy. To date, immune checkpoint inhibitors are novel therapeutic agents for UC treatment. From May 2016 to May 2017, five anti-PD-1/PD-L1 monoclonal antibodies received accelerated or regular approval from the US Food and Drug Administration (FDA) for the treatment of patients with locally advanced or metastatic UC. The present comprehensive review presents the background information of these five US FDA-approved anticancer agents to provide a basic but concise understanding of these agents for advanced studies. We summarize their immune checkpoint mechanisms, clinical efficacy, recommended usage protocols, adverse events, and the limitations of the PD-L1 biomarker assays.
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- 2017
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17. Using the Pulse Contour Method to Measure the Changes in Stroke Volume during a Passive Leg Raising Test
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Chun-Hung Su, Shing-Hong Liu, Tan-Hsu Tan, and Chien-Hsien Lo
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pulse contour method ,stroke volume ,flow sensor ,blood pressure monitor ,Chemical technology ,TP1-1185 - Abstract
The pulse contour method is often used with the Windkessel model to measure stroke volume. We used a digital pressure and flow sensors to detect the parameters of the Windkessel model from the pulse waveform. The objective of this study was to assess the stability and accuracy of this method by making use of the passive leg raising test. We studied 24 healthy subjects (40 ± 9.3 years), and used the Medis® CS 1000, an impedance cardiography, as the comparing reference. The pulse contour method measured the waveform of the brachial artery by using a cuff. The compliance and resistance of the peripheral artery was detected from the cuff characteristics and the blood pressure waveform. Then, according to the method proposed by Romano et al., the stroke volume could be measured. This method was implemented in our designed blood pressure monitor. A passive leg raising test, which could immediately change the preloading of the heart, was done to certify the performance of our method. The pulse contour method and impedance cardiography simultaneously measured the stroke volume. The measurement of the changes in stroke volume using the pulse contour method had a very high correlation with the Medis® CS 1000 measurement, the correlation coefficient of the changed ratio and changed differences in stroke volume were r2 = 0.712 and r2 = 0.709, respectively. It was shown that the stroke volume measured by using the pulse contour method was not accurate enough. But, the changes in the stroke volume could be accurately measured with this pulse contour method. Changes in stroke volume are often used to understand the conditions of cardiac preloading in the clinical field. Moreover, the operation of the pulse contour method is easier than using impedance cardiography and echocardiography. Thus, this method is suitable to use in different healthcare fields.
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- 2018
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18. Improvement of Left Ventricular Ejection Time Measurement in the Impedance Cardiography Combined with the Reflection Photoplethysmography
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Shing-Hong Liu, Jia-Jung Wang, Chun-Hung Su, and Da-Chuan Cheng
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stroke volume ,left ventricular ejection time ,impedance cardiography ,photoplethysmography ,Chemical technology ,TP1-1185 - Abstract
Cardiac stroke volume (SV) is an essential hemodynamic indicator that can be used to assess whether the pump function of the heart is normal. Non-invasive SV measurement is currently performed using the impedance cardiography (ICG). In this technology, left ventricular ejection time (LVET) is an important parameter which can be determined from the ICG signals. However, the ICG signals are inherently susceptible to artificial noise interference, which leads to an inaccurate LVET measurement and then yields an error in the calculation of SV. Therefore, the goal of the study was to measure LVETs using both the transmission and reflection photoplethysmography (PPG), and to assess whether the measured LVET was more accurate by the PPG signal than the ICG signal. The LVET measured by the phonocardiography (PCG) was used as the standard for comparing with those by the ICG and PPG. The study recruited ten subjects whose LVETs were simultaneously measured by the ICG using four electrodes, the reflection PPG using neck sensors (PPGneck) and the transmission PPG using finger sensors (PPGfinger). In each subject, ten LVETs were obtained from ten heartbeats selected properly from one-minute recording. The differences of the measured LVETs between the PCG and one of the ICG, PPGneck and PPGfinger were −68.2 ± 148.6 ms, 4.8 ± 86.5 ms and −7.0 ± 107.5 ms, respectively. As compared with the PCG, both the ICG and PPGfinger underestimated but the PPGneck overestimated the LVETs. Furthermore, the measured LVET by the PPGneck was the closest to that by the PCG. Therefore, the PPGneck may be employed to improve the LVET measurement in applying the ICG for continuous monitoring of SV in clinical settings.
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- 2018
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19. A Cuffless Blood Pressure Measurement Based on the Impedance Plethysmography Technique
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Shing-Hong Liu, Da-Chuan Cheng, and Chun-Hung Su
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cuffless blood pressure measurement ,impedance plethysmography ,pulse transit time ,Chemical technology ,TP1-1185 - Abstract
In the last decade, cuffless blood pressure measurement technology has been widely studied because it could be applied to a wearable apparatus. Electrocardiography (ECG), photo-plethysmography (PPG), and phonocardiography are always used to detect the pulse transit time (PTT) because the changed tendencies of the PTT and blood pressure have a negative relationship. In this study, the PPG signal was replaced by the impedance plethysmography (IPG) signal and was used to detect the PTT. The placement and direction of the electrode array for the IPG measurement were discussed. Then, we designed an IPG ring that could measure an accurate IPG signal. Twenty healthy subjects participated in this study. The changes in blood pressure after exercise were evaluated through the changes of the PTT. The results showed that the change of the systolic pressure had a better relationship with the change of the PTTIPG than that of the PTTPPG (r = 0.700 vs. r = 0.450). Moreover, the IPG ring with spot electrodes would be more suitable to develop with the wearable cuffless blood pressure monitor than the PPG sensor.
- Published
- 2017
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20. Identification of amino acid propensities that are strong determinants of linear B-cell epitope using neural networks.
- Author
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Chun-Hung Su, Nikhil R Pal, Ken-Li Lin, and I-Fang Chung
- Subjects
Medicine ,Science - Abstract
BACKGROUND: Identification of amino acid propensities that are strong determinants of linear B-cell epitope is very important to enrich our knowledge about epitopes. This can also help to obtain better epitope prediction. Typical linear B-cell epitope prediction methods combine various propensities in different ways to improve prediction accuracies. However, fewer but better features may yield better prediction. Moreover, for a propensity, when the sequence length is k, there will be k values, which should be treated as a single unit for feature selection and hence usual feature selection method will not work. Here we use a novel Group Feature Selecting Multilayered Perceptron, GFSMLP, which treats a group of related information as a single entity and selects useful propensities related to linear B-cell epitopes, and uses them to predict epitopes. METHODOLOGY/ PRINCIPAL FINDINGS: We use eight widely known propensities and four data sets. We use GFSMLP to rank propensities by the frequency with which they are selected. We find that Chou's beta-turn and Ponnuswamy's polarity are better features for prediction of linear B-cell epitope. We examine the individual and combined discriminating power of the selected propensities and analyze the correlation between paired propensities. Our results show that the selected propensities are indeed good features, which also cooperate with other propensities to enhance the discriminating power for predicting epitopes. We find that individually polarity is not the best predictor, but it collaborates with others to yield good prediction. Usual feature selection methods cannot provide such information. CONCLUSIONS/ SIGNIFICANCE: Our results confirm the effectiveness of active (group) feature selection by GFSMLP over the traditional passive approaches of evaluating various combinations of propensities. The GFSMLP-based feature selection can be extended to more than 500 remaining propensities to enhance our biological knowledge about epitopes and to obtain better prediction. A graphical-user-interface version of GFSMLP is available at: http://bio.classcloud.org/GFSMLP/.
- Published
- 2012
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21. Correction: Identification of Amino Acid Propensities That Are Strong Determinants of Linear B-cell Epitope Using Neural Networks.
- Author
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Chun-Hung Su, Nikhil R. Pal, Ken-Li Lin, and I-Fang Chung
- Subjects
Medicine ,Science - Published
- 2012
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22. Accurate Measurement of Cross-Sectional Area of Femoral Artery on MRI Sequences of Transcontinental Ultramarathon Runners Using Optimal Parameters Selection.
- Author
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Da-Chuan Cheng, Jhu-Fong Wu, Yi-Hsuan Kao, Chun-Hung Su, and Shing-Hong Liu
- Published
- 2016
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- View/download PDF
23. A modified fuzzy co-clustering (MFCC) approach for microarray data analysis.
- Author
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Sheng-Yao Huang, Hsing-Jen Sun, Chuen-Der Huang, I-Fang Chung, and Chun-Hung Su
- Published
- 2014
- Full Text
- View/download PDF
24. Risk of peripheral artery disease and stroke in migraineurs with or without aura: a nationwide population-based cohort study
- Author
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Wun-Zhih, Siao, Chun-Hung, Su, Yu-Hsiang, Kuan, Tung-Han, Tsai, Kuang-Hua, Huan, and Chien-Ying, Lee
- Subjects
Cohort Studies ,Migraine without Aura ,Stroke ,Peripheral Arterial Disease ,Epilepsy ,Risk Factors ,Migraine with Aura ,Myocardial Infarction ,Humans ,General Medicine - Published
- 2022
- Full Text
- View/download PDF
25. Safety and efficacy of early varenicline prescription in hospitalized patients with acute myocardial infarction: East Asian population
- Author
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Chien-Hsien Lo, Li-Ching Li, Kai-Wei Chang, Chin-Feng Tsai, Chun-Hung Su, Tse-Hsien Lo, Chi-Hua Yen, and Kuei-Chuan Chan
- Subjects
General Medicine - Published
- 2023
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26. Finding marker genes from high dimensional expression profiles: Divide-and-conquer exploiting a fuzzy rule based framework.
- Author
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Sheng-Yao Huang, Yi-Cheng Chen, I-Fang Chung, Feng-Yi Yang, and Chun-Hung Su
- Published
- 2013
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27. Bisphenol <scp>A</scp> induced apoptosis via oxidative stress generation involved <scp>Nrf2</scp> / <scp>HO</scp> ‐1 pathway and mitochondrial dependent pathways in human retinal pigment epithelium ( <scp>ARPE</scp> ‐19) cells
- Author
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Yu-Hsiang Kuan, Yun-Wei Chiang, Chia-Che Chang, Wen-Ying Chen, Chun-Hung Su, Han-Yin Sun, Chun-Jung Chen, Chuan-Mu Chen, and Shih-Pin Chen
- Subjects
endocrine system ,biology ,urogenital system ,Chemistry ,Health, Toxicology and Mutagenesis ,Cytochrome c ,AMPK ,General Medicine ,Management, Monitoring, Policy and Law ,Mitochondrion ,Toxicology ,medicine.disease_cause ,Cell biology ,Heme oxygenase ,Superoxide dismutase ,Apoptosis ,biology.protein ,medicine ,Apoptotic signaling pathway ,hormones, hormone substitutes, and hormone antagonists ,Oxidative stress - Abstract
Bisphenol A (BPA) is an estrogen-like compound, and an environmental hormone, that is commonly used in daily life. Therefore, it may enter the human body through food or direct contact, causing BPA residues in blood and urine. Because most studies focused on the analysis of BPA in reproductive cells or tissues, regarding evidence the effect of BPA on human retinal pigment epithelium (ARPE-19) cells unavailable. Accordingly, the present study explored the cytotoxicity of BPA on ARPE-19 cells. After BPA treatment, the expression of Bcl-XL an antiapoptotic protein, in the mitochondria decreased, and the expression of Bax, a proapoptotic protein increased. Then the mitochondrial membrane potential was affected. BPA changed in mitochondrial membrane potential led to the release of cytochrome C, which activated caspase-9 to promote downstream caspase-3 leading to cytotoxicity. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and heme oxygenase 1 (HO-1) pathway play a major role in age-related macular degeneration. Our results showed that expression of HO-1 and Nrf2 suppressed by BPA. Superoxide dismutase and catalase, which Nrf2 downstream antioxidants, were degraded by BPA. AMP-activated kinase (AMPK), which can regulate the phosphorylation of Nrf2, and the phosphorylation of AMPK expression was reduced by BPA. Finally, BPA-induced ROS generation and cytotoxicity were reduced by N-acetyl-l-cysteine. Taken together, these results suggest that BPA induced ARPE-19 cells via oxidative stress, which was associated with down regulated Nrf2/HO-1 pathway, and the mitochondria dependent apoptotic signaling pathway.
- Published
- 2021
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- View/download PDF
28. Based on Fuzzy Color Detection and Field Calibration for Robot Soccer.
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Shun-Hung Tsai, Chun-Hung Su, Chih-Hsiang Chang, Chorng-Tyan Lin, Chih-Chin Wen, and Jeng-Han Li
- Published
- 2011
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29. 1-Nitropyrene Induced Reactive Oxygen Species–Mediated Apoptosis in Macrophages through AIF Nuclear Translocation and AMPK/Nrf-2/HO-1 Pathway Activation
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Ming Kun Hsieh, Chien-Ying Lee, Chun-Hung Su, Shiuan-Shinn Lee, Ching-Chi Tseng, Yu-Hsiang Kuan, Min-Wei Lee, Yung-Chuan Ho, Sheng-Wen Wu, and Hsin-Hung Chen
- Subjects
Aging ,Article Subject ,Apoptosis ,AMP-Activated Protein Kinases ,010501 environmental sciences ,01 natural sciences ,Biochemistry ,Superoxide dismutase ,03 medical and health sciences ,Humans ,Viability assay ,030304 developmental biology ,0105 earth and related environmental sciences ,chemistry.chemical_classification ,0303 health sciences ,Reactive oxygen species ,Pyrenes ,QH573-671 ,biology ,Chemistry ,Macrophages ,Glutathione peroxidase ,Apoptosis Inducing Factor ,AMPK ,Cell Biology ,General Medicine ,Cell biology ,Catalase ,biology.protein ,Cytology ,Reactive Oxygen Species ,Intracellular ,Research Article - Abstract
1-Nitropyrene (1-NP), one of the most abundant nitropolycyclic aromatic hydrocarbons (nitro-PAHs), is generated from the incomplete combustion of carbonaceous organic compounds. 1-NP is a specific marker of diesel exhaust and is an environmental pollutant and a probable carcinogen. Macrophages participate in immune defense against the invasive pathogens in heart, lung, and kidney infection diseases. However, no evidence has indicated that 1-NP induces apoptosis in macrophages. In the present study, 1-NP was found to induce concentration-dependent changes in various cellular functions of RAW264.7 macrophages including cell viability reduction; apoptosis generation; mitochondrial dysfunction; apoptosis-inducing factor (AIF) nuclear translocation; intracellular ROS generation; activation of the AMPK/Nrf-2/HO-1 pathway; changes in the expression of BCL-2 family proteins; and depletion of antioxidative enzymes (AOE), such as glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) These results indicate that 1-NP induced apoptosis in macrophages through AIF nuclear translocation and ROS generation due to mitochondrial dysfunction and to the depletion of AOE from the activation of the AMPK/Nrf-2/HO-1 pathway.
- Published
- 2021
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30. Rutin‐protected <scp>BisGMA</scp> ‐induced cytotoxicity, genotoxicity, and apoptosis in macrophages through the reduction of the mitochondrial apoptotic pathway and induction of antioxidant enzymes
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Yu-Chao Chang, Min-Wei Lee, Chun-Hung Su, Yu-Hsiang Kuan, Yin-Che Lu, Fu-Mei Huang, Shiuan-Shinn Lee, Dom-Gene Tu, Kun-Lin Yeh, Sheng-Wen Wu, and Chen-Yu Chiang
- Subjects
Health, Toxicology and Mutagenesis ,010501 environmental sciences ,Management, Monitoring, Policy and Law ,Mitochondrion ,Toxicology ,medicine.disease_cause ,01 natural sciences ,03 medical and health sciences ,chemistry.chemical_compound ,Rutin ,0302 clinical medicine ,medicine ,Cytotoxicity ,0105 earth and related environmental sciences ,chemistry.chemical_classification ,Reactive oxygen species ,biology ,Chemistry ,Cytochrome c ,General Medicine ,Phosphatidylserine ,Molecular biology ,Apoptosis ,030220 oncology & carcinogenesis ,biology.protein ,Genotoxicity - Abstract
Bisphenol-A-glycidyldimethacrylate (BisGMA) is a resin monomer frequently used in dentin restorative treatments. The leakage of BisGMA monomer from BisGMA-based polymeric resins can lead to cytotoxicity in macrophages. Rutin has various beneficial bioeffects, including antioxidation and antiinflammation. In this study, we found that pretreatment of RAW264.7 macrophages with rutin-inhibited cytotoxicity induced by BisGMA in a concentration-dependent manner. BisGMA-induced apoptosis, which was detected by levels of phosphatidylserine from the internal to the external membrane and formation of sub-G1, and genotoxicity, which was detected by cytokinesis-blocked micronucleus and single-cell gel electrophoresis assays, were inhibited by rutin in a concentration-dependent manner. Rutin suppressed the BisGMA-induced activation of caspase-3 and -9 rather than caspase-8. Rutin inhibited the activation of the mitochondrial apoptotic pathway, including cytochrome C release and mitochondria disruption, after macrophages were treated with BisGMA. Finally, BisGMA-induced reactive oxygen species (ROS) generation and antioxidant enzyme (AOE) deactivation could be reversed by rutin. Parallel trends were observed in the elevation of AOE activation and inhibition of ROS generation, caspase-3 activity, mitochondrial apoptotic pathway activation, and genotoxicity. These results suggested that rutin suppressed BisGMA-induced cytotoxicity through genotoxicity, the mitochondrial apoptotic pathway, and relatively upstream factors, including reduction of ROS generation and induction of AOE.
- Published
- 2020
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31. CHA2DS2-VASc score as independent outcome predictor in patients with acute ischemic stroke with and without atrial fibrillation
- Author
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Chin-Feng Tsai, Chun-Hung Su, and Chien-Hsien Lo
- Subjects
medicine.medical_specialty ,business.industry ,Atrial fibrillation ,medicine.disease ,Outcome predictor ,Internal medicine ,CHA2DS2–VASc score ,Cardiology ,medicine ,In patient ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,Acute ischemic stroke - Abstract
Introduction Atrial fibrillation (AF) was a significant independent risk factor for 1-year mortality of first acute ischemic stroke. The CHA2DS2-VASc scores were initially developed to assess the risk of stroke or systemic embolism in patients with AF. Recently, this scoring system have been demonstrated to have clinical value for predicting the severity of infarction and long-term clinical outcomes in acute ischemic stroke but the evidence is not strong enough due to limited numbers and single center data. Purpose This large-scale prospective cohort study aimed to investigate the independent predictive value of CHA2DS2-VASc scores and AF in such patients. Materials and methods We included patients from Taiwan Stroke Registry (TSR) with ischemic stroke within 2006 to 2016 as the present study population. Patients were mainly divided in atrial fibrillation (AF) group and non-AF group. We future classified patient by CHA2DS2-VASc (congestive heart failure, hypertension, age≥75 years, diabetes, previous stroke, vascular disease, age 65–74 years, sex category) score 0–1 and ≥2. The primary outcome was major adverse cardiovascular events (MACE), which include re-stroke, myocardial infarction and cardiovascular death, occurred within 1 year after the onset of stroke. The secondary outcome was the all-cause mortality. Results We defined 2972 patients with MACE and 61,937 patients without MACE. With adjusting with the confounding of CHA2DS2-VASc scores, The AF group was associated with increased MACE (OR=1.15; 95% CI=1.00, 1.33), myocardial infarction (adjusted OR=3.89; 95% CI=1.81, 8.34), CV death (OR=5.73; 95% CI=3.77, 8.69) and all-cause mortality (OR=1.50; 95% CI=1.37, 1.65) but not in re-stroke (adjusted OR=1.02; 95% CI=0.88, 1.18). After controlling for AF, patients with CHA2DS2-VASc scores ≥2 had significantly higher odds of MACE (OR=1.28; 95% CI=1.16, 1.41), re-stroke (OR=1.27; 95% CI=1.16, 1.40) and all-cause mortality (OR=2.26; 95% CI=2.06, 2.48) than that of patients with CHA2DS2-VASc scores 0–1. The survival curve revealed both AF and CHA2DS2-VASc scores are independent risk factors of 1 year MACE and mortality. By investigating the individual risk factor of CHA2DS2-VASc score, diabetes, hypertension and age over 65 years old increase the risk of MACE significantly. Conclusions CHA2DS2-VASc scores appear to have potent independent value as AF for predicting 1 year MACE and all-cause mortality in patients of acute ischemic stroke. Funding Acknowledgement Type of funding sources: None. Figure 1Figure 2
- Published
- 2021
- Full Text
- View/download PDF
32. Bisphenol A induced apoptosis via oxidative stress generation involved Nrf2/HO-1 pathway and mitochondrial dependent pathways in human retinal pigment epithelium (ARPE-19) cells
- Author
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Yun-Wei, Chiang, Chun-Hung, Su, Han-Yin, Sun, Shih-Pin, Chen, Chun-Jung, Chen, Wen-Ying, Chen, Chia-Che, Chang, Chuan-Mu, Chen, and Yu-Hsiang, Kuan
- Subjects
Oxidative Stress ,Phenols ,Cell Survival ,NF-E2-Related Factor 2 ,Humans ,Apoptosis ,Retinal Pigment Epithelium ,Benzhydryl Compounds ,Antioxidants ,Heme Oxygenase-1 ,Mitochondria - Abstract
Bisphenol A (BPA) is an estrogen-like compound, and an environmental hormone, that is commonly used in daily life. Therefore, it may enter the human body through food or direct contact, causing BPA residues in blood and urine. Because most studies focused on the analysis of BPA in reproductive cells or tissues, regarding evidence the effect of BPA on human retinal pigment epithelium (ARPE-19) cells unavailable. Accordingly, the present study explored the cytotoxicity of BPA on ARPE-19 cells. After BPA treatment, the expression of Bcl-XL an antiapoptotic protein, in the mitochondria decreased, and the expression of Bax, a proapoptotic protein increased. Then the mitochondrial membrane potential was affected. BPA changed in mitochondrial membrane potential led to the release of cytochrome C, which activated caspase-9 to promote downstream caspase-3 leading to cytotoxicity. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) and heme oxygenase 1 (HO-1) pathway play a major role in age-related macular degeneration. Our results showed that expression of HO-1 and Nrf2 suppressed by BPA. Superoxide dismutase and catalase, which Nrf2 downstream antioxidants, were degraded by BPA. AMP-activated kinase (AMPK), which can regulate the phosphorylation of Nrf2, and the phosphorylation of AMPK expression was reduced by BPA. Finally, BPA-induced ROS generation and cytotoxicity were reduced by N-acetyl-l-cysteine. Taken together, these results suggest that BPA induced ARPE-19 cells via oxidative stress, which was associated with down regulated Nrf2/HO-1 pathway, and the mitochondria dependent apoptotic signaling pathway.
- Published
- 2021
33. Nerolidol Suppresses the Inflammatory Response during Lipopolysaccharide-Induced Acute Lung Injury via the Modulation of Antioxidant Enzymes and the AMPK/Nrf-2/HO-1 Pathway
- Author
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Yung-Lun Ni, Yu-Hsiang Kuan, Huan-Ting Shen, Chun-Hung Su, Shih-Pin Chen, Chun-Jung Chen, Rosa Huang-Liu, and Wen-Ying Chen
- Subjects
Lipopolysaccharides ,Male ,Aging ,Antioxidant ,Article Subject ,Lipopolysaccharide ,NF-E2-Related Factor 2 ,medicine.medical_treatment ,Acute Lung Injury ,Anti-Inflammatory Agents ,AMP-Activated Protein Kinases ,Lung injury ,Pharmacology ,Biochemistry ,Antioxidants ,Superoxide dismutase ,Lipid peroxidation ,Mice ,chemistry.chemical_compound ,medicine ,Animals ,lcsh:QH573-671 ,Nerolidol ,chemistry.chemical_classification ,Mice, Inbred BALB C ,biology ,lcsh:Cytology ,Glutathione peroxidase ,AMPK ,Pneumonia ,Cell Biology ,General Medicine ,respiratory system ,respiratory tract diseases ,Oxidative Stress ,Gene Expression Regulation ,chemistry ,Heme Oxygenase (Decyclizing) ,biology.protein ,Sesquiterpenes ,Research Article ,Signal Transduction - Abstract
Acute lung injury (ALI) is a life-threatening disease that is characterised by the rapid onset of inflammatory responses. Lipopolysaccharide (LPS) is an endotoxin that plays an important role in triggering ALI via pneumonia and sepsis. However, no effective therapeutic strategies are currently available to treat ALI. Nerolidol is an aliphatic sesquiterpene alcohol that is found in the essential oils of many flowers as well as floral plants. It has been shown to exhibit anti-inflammatory, antioxidant, and anticancer properties. Herein, we show that nerolidol pretreatment counteracted the histopathological hallmarks in LPS-induced ALI mice. Indeed, nerolidol pretreatment inhibited LPS-induced alveolar-capillary barrier disruption, lung edema, and lipid peroxidation. Moreover, nerolidol pretreatment prevented the LPS from decreasing the enzymatic activities of superoxide dismutase, catalase, and glutathione peroxidase. Importantly, nerolidol treatment enhanced phosphorylation of AMP-activated protein kinase (AMPK) and expression of nuclear factor erythroid-derived 2-related factor 2 (Nrf-2) and heme oxygenase-1 (HO-1). Taken together, our study reveals the novel protective effects of nerolidol in LPS-induced ALI via the induction of antioxidant responses and activation of the AMPK/Nrf-2/HO-1 signalling pathway.
- Published
- 2019
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34. An Examination System to Detect Deep Vein Thrombosis of a Lower Limb Using Light Reflection Rheography
- Author
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Kuo-Li Pan, Wenxi Chen, Chun-Hung Su, Shing-Hong Liu, and Jia-Jung Wang
- Subjects
medicine.medical_specialty ,Deep vein ,0206 medical engineering ,wearable device ,02 engineering and technology ,030204 cardiovascular system & hematology ,lcsh:Chemical technology ,Biochemistry ,Article ,Lower limb ,deep vein thrombosis ,Veins ,Analytical Chemistry ,03 medical and health sciences ,0302 clinical medicine ,Embolus ,Pregnancy ,Internal medicine ,Photoplethysmogram ,medicine ,Humans ,lcsh:TP1-1185 ,cardiovascular diseases ,Electrical and Electronic Engineering ,Instrumentation ,Aged ,Light reflection rheography ,Venous Thrombosis ,light reflection rheography ,Receiver operating characteristic ,business.industry ,medicine.disease ,020601 biomedical engineering ,Thrombosis ,Atomic and Molecular Physics, and Optics ,medicine.anatomical_structure ,Lower Extremity ,ROC Curve ,Cuff ,Cardiology ,Female ,photoplethysmography ,business - Abstract
Deep vein thrombosis (DVT) of lower limbs can easily arise from prolonged sitting or standing. Elders and pregnant women are most likely to have this disease. When the embolus of DVT comes to pass the lung, it will become a life-threatening disease. Thus, for DVT disease, early detection and the early treatment are needed. The goal of this study was to develop an examination system to be used at non-medical places to detect the DVT of lower limbs with light reflection rheography (LRR). Consisting of a wearable device and a mobile application (APP), the system is operated in a wireless manner to control the actions of sensors and display and store the LRR signals on the APP. Then, the recorded LRR signals are processed to find the parameters of DVT examination. Twenty subjects were recruited to perform experiments. The veins of lower limbs were occluded by pressuring the cuff up to 100 mmHg and 150 mmHg to simulate the slight and serious DVT scenarios, respectively. Six characteristic parameters were defined to classify whether there was positive or negative DVT using the receiver operating characteristic curves, including the slopes of emptying and refilling curves in the LRR signal, and the changes of venous pump volume. Under the slight DVT scenario (0 mmHg vs. 100 mmHg), the first three parameters, m10, m40, and m50, had accuracies of 72%, 69%, and 69%, respectively. Under the serious DVT scenario (0 mmHg vs. 150 mmHg), m10, m40, and m50 achieved accuracies of 73%, 76%, and 73%, respectively. The experimental results show that this proposed examination system may be practical as an auxiliary tool to screen DVT in homecare settings.
- Published
- 2021
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35. Protective effect of microorganism biotransformation-produced resveratrol on the high fat diet-induced hyperlipidemia, hepatic steatosis and synaptic impairment in hamsters
- Author
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Chun-Hung Su, Ho-Lin Wang, Min-Ling Tsai, Yi-Chun Lin, Jiuan-Miaw Liao, Cheng-Chieh Yen, Hung-Chih Ting, and Ching-Han Yu
- Subjects
Blood Glucose ,Cholesterol, HDL ,Synaptophysin ,Polyphenols ,Hyperlipidemias ,General Medicine ,Cholesterol, LDL ,Diet, High-Fat ,Antioxidants ,Fatty Liver ,Liver ,Resveratrol ,Cricetinae ,Animals ,Calcium-Calmodulin-Dependent Protein Kinase Type 2 ,Biotransformation ,Triglycerides - Published
- 2021
36. Observation of the Expression of Vascular Endothelial Growth Factor and the Potential Effect of Promoting Hair Growth Treated with Chinese Herbal BeauTop
- Author
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Chun-Hung Su, Chun-Nan Wu, Chien-Ying Lee, Yu-Hsiang Kuan, and Chien-Ying Chiang
- Subjects
Angelica sinensis ,Article Subject ,03 medical and health sciences ,chemistry.chemical_compound ,Other systems of medicine ,0302 clinical medicine ,medicine ,Eclipta prostrata ,030304 developmental biology ,0303 health sciences ,biology ,Traditional medicine ,Rehmannia glutinosa ,biology.organism_classification ,Hair follicle ,medicine.disease ,Vascular endothelial growth factor ,Astragalus ,medicine.anatomical_structure ,Hair loss ,Complementary and alternative medicine ,chemistry ,Minoxidil ,030220 oncology & carcinogenesis ,RZ201-999 ,medicine.drug ,Research Article - Abstract
Despite minoxidil and finasteride already being approved by the Food and Drug Administration (FDA) for the treatment of hair loss, it is important to identify new and innovative treatments for hair loss, such as looking for a solution in Chinese herbal medicine. One such treatment to consider is BeauTop (BT), whose primary ingredients include Panax japonicus (T.Nees), C.A. Mey. (Araliaceae), Astragalus membranaceus (Fisch) Bunge (Fabaceae), Angelica sinensis (Oliv.) Diels (Apiaceae), Ligustrum lucidum W.T. Aiton (Oleaceae), Rehmannia glutinosa (Gaertn.) DC. (Plantaginaceae), and Eclipta prostrata (L.) L. (Compositae). The aim of this study was to evaluate whether BT can promote hair growth in C57BL/6 mice and to investigate hair coverage, the expression of vascular endothelial growth factor (VEFG), and the numbers of hair follicles in growth phase after oral administration. A total of 12 C57BL/6 mice were divided into two groups: control group and treatment group BT. BT was administered orally as an extract at a volume of 0.6 g/kg. The control group was treated with distilled water. Each group was treated once a day for 12 consecutive days. To observe the expression of VEGF distribution, the number of hair follicles and the hair coverage were examined on days 4, 8, and 12. By comparing the treatment group and control group, we found that VEGF in the BT group on day 8 presented with a higher area percentage than the control group (pvalue = 0.003). Hair follicle counting results showed that the BT group was significantly higher than the control group on day 8 (pvalue = 0.031). Furthermore, hair coverage was shown to be significantly increased in the treatment group BT on day 8 (pvalue = 0.013). Taken together, these results suggest that Chinese medicine (BT) possesses the potential effect of promoting hair growth through VEGF expression. VEGF is considered the most important mediator for the process of angiogenesis involved in hair growth development.
- Published
- 2021
37. Effect of aspirin treatment duration on clinical outcomes in acute coronary syndrome patients with early aspirin discontinuation and received P2Y12 inhibitor monotherapy
- Author
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Hung-I Yeh, Sheng-Wei Huang, Chung-Wei Cheng, Hui-Wen Lin, Ching-Pei Chen, Yi-Heng Li, Ming-Yun Ho, I-Chang Hsieh, Wei-Chun Huang, Chun-Hung Su, Sheng Hsiang Lin, Po Wei Chen, Wen-Han Feng, and Ching-Chang Fang
- Subjects
Male ,Cardiovascular Procedures ,Epidemiology ,medicine.medical_treatment ,Cardiovascular Medicine ,Antiplatelet Therapy ,Vascular Medicine ,Medical Conditions ,P2Y12 ,Chronic Kidney Disease ,Medicine and Health Sciences ,Aged, 80 and over ,Aspirin ,Coronary Artery Bypass Grafting ,Multidisciplinary ,Pharmaceutics ,Dual Anti-Platelet Therapy ,Receptors, Purinergic P2Y12 ,Cardiovascular Diseases ,Nephrology ,Cohort ,Medicine ,Drug Therapy, Combination ,Female ,Research Article ,medicine.drug ,Acute coronary syndrome ,medicine.medical_specialty ,Coronary Stenting ,Science ,Taiwan ,Cardiology ,Hemorrhage ,Surgical and Invasive Medical Procedures ,Percutaneous Coronary Intervention ,Signs and Symptoms ,Drug Therapy ,Internal medicine ,Renal Diseases ,medicine ,Humans ,Acute Coronary Syndrome ,Aged ,Duration of Therapy ,business.industry ,Angioplasty ,Percutaneous coronary intervention ,Cardiovascular Disease Risk ,medicine.disease ,Discontinuation ,Clinical trial ,Medical Risk Factors ,Stent Implantation ,Conventional PCI ,Purinergic P2Y Receptor Antagonists ,Clinical Medicine ,business ,Coronary Angioplasty ,Platelet Aggregation Inhibitors - Abstract
Recent clinical trials showed that short aspirin duration (1 or 3 months) in dual antiplatelet therapy (DAPT) followed by P2Y12 inhibitor monotherapy reduced the risk of bleeding and did not increase the ischemic risk compared to 12-month DAPT in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). However, it is unclear about the optimal duration of aspirin in P2Y12 inhibitor monotherapy. The purpose of this study was to evaluate the influence of aspirin treatment duration on clinical outcomes in a cohort of ACS patients with early aspirin interruption and received P2Y12 inhibitor monotherapy. From January 1, 2014 to December 31, 2018, we included 498 ACS patients (age 70.18 ± 12.84 years, 71.3% men) with aspirin stopped for various reasons before 6 months after PCI and received P2Y12 inhibitor monotherapy. The clinical outcomes between those with aspirin treatment ≤ 1 month and > 1 month were compared in 12-month follow up after PCI. Inverse probability of treatment weighting was used to balance the covariates between groups. The mean duration of aspirin treatment was 7.52 ± 8.10 days vs. 98.05 ± 56.70 days in the 2 groups (p 1 month. Our results indicated that ≤ 1-month aspirin may be enough in P2Y12 inhibitor monotherapy strategy for ACS patients undergoing PCI.
- Published
- 2021
38. Cuffless and Touchless Measurement of Blood Pressure from Ballistocardiogram Based on a Body Weight Scale
- Author
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Shing-Hong Liu, Bing-Hao Zhang, Wenxi Chen, Chun-Hung Su, and Chiun-Li Chin
- Subjects
Nutrition and Dietetics ,ballistocardiogram ,photoplethysmogram ,pulse transit time (PTT) ,weight scale ,blood pressure ,Body Weight ,BCG Vaccine ,COVID-19 ,Humans ,Blood Pressure ,Pulse Wave Analysis ,Photoplethysmography ,Food Science - Abstract
Currently, in terms of reducing the infection risk of the COVID-19 virus spreading all over the world, the development of touchless blood pressure (BP) measurement has potential benefits. The pulse transit time (PTT) has a high relation with BP, which can be measured by electrocardiogram (ECG) and photoplethysmogram (PPG). The ballistocardiogram (BCG) reflects the mechanical vibration (or displacement) caused by the heart contraction/relaxation (or heart beating), which can be measured from multiple degrees of the body. The goal of this study is to develop a cuffless and touchless BP-measurement method based on a commercial weight scale combined with a PPG sensor when measuring body weight. The proposed method was that the PTTBCG-PPGT was extracted from the BCG signal measured by a weight scale, and the PPG signal was measured from the PPG probe placed at the toe. Four PTT models were used to estimate BP. The reference method was the PTTECG-PPGF extracted from the ECG signal and PPG signal measured from the PPG probe placed at the finger. The standard BP was measured by an electronic blood pressure monitor. Twenty subjects were recruited in this study. By the proposed method, the root-mean-square error (ERMS) of estimated systolic blood pressure (SBP) and diastolic blood pressure (DBP) are 6.7 ± 1.60 mmHg and 4.8 ± 1.47 mmHg, respectively. The correlation coefficients, r2, of the proposed model for the SBP and DBP are 0.606 ± 0.142 and 0.284 ± 0.166, respectively. The results show that the proposed method can serve for cuffless and touchless BP measurement.
- Published
- 2022
- Full Text
- View/download PDF
39. Protective effect of microorganism biotransformation-produced resveratrol on the high fat diet-induced hyperlipidemia, hepatic steatosis and synaptic impairment in hamsters.
- Author
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Chun-Hung Su, Ho-Lin Wang, Min-Ling Tsai, Yi-Chun Lin, Jiuan-Miaw Liao, Cheng-Chieh Yen, Hung-Chih Ting, and Ching-Han Yu
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- 2022
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40. Oral treatment for diabetes using α-glucosidase inhibitors was a risk factor for chronic obstructive pulmonary disease: a cohort study
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Yung-Chyuan Ho, Chun-Hung Su, Hung-Yi Chen, Ci-Wen Luo, Sheng-Wen Wu, and Yu-Hsiang Kuan
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Adult ,Male ,medicine.medical_specialty ,Population ,Taiwan ,α-glucosidase inhibitor ,Administration, Oral ,Comorbidity ,Risk Assessment ,chronic obstructive pulmonary disease ,Pulmonary Disease, Chronic Obstructive ,Risk Factors ,Internal medicine ,Diabetes mellitus ,cohort study ,Medicine ,Humans ,Glycoside Hydrolase Inhibitors ,Risk factor ,education ,Aged ,COPD ,education.field_of_study ,business.industry ,Proportional hazards model ,cox regression ,Incidence ,Hazard ratio ,General Medicine ,Middle Aged ,medicine.disease ,Confidence interval ,Case-Control Studies ,diabetes mellitus ,Female ,business ,Cohort study ,Follow-Up Studies ,Research Paper - Abstract
Objectives: Currently, diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) have proven to be risk factors for each other. This study aimed to determine the risk relationship between COPD and five common oral medications for DM among patients with DM. Methods: This population-based cohort study was conducted from 2008 to 2013. Patient data were retrieved from the Longitudinal Health Insurance Database (LHID) of the National Health Insurance Research Database (NHIRD). After pairing by gender, age, and index date, time-to-event analysis and multiple regression analysis were performed to determine the factors associated with COPD in patients taking oral medication for DM, including age, gender, income, and comorbidities. We identified 1,028 patients who took oral medication for DM and 1,028 controls who did not take oral medication for DM. Results: We observed that the use of α-glucosidase inhibitors was associated with a higher risk of COPD (hazard ratio [HR]: 1.964, 95% confidence interval [CI]: 1.207-2.380). Furthermore, compared with the control group, α-glucosidase inhibitor users had a higher risk of COPD (HR: 2.295, 95% CI: 1.304-4.038), and no significant difference was observed in other oral medications for DM. Conclusions: Based on present results, we could suggest that patients with DM who used α-glucosidase inhibitors are probably a higher risk of COPD. We recommend that in the future, treatment with α-glucosidase inhibitors upregulate the occurrence of COPD might through gastrointestinal side effects and malnutrition.
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- 2020
41. Ticagrelor monotherapy vs clopidogrel monotherapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention
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I-Chang Hsieh, S.W Huang, M.Y Ho, Hui-Wen Lin, Chun-Hung Su, C.W Cheng, C.P Chen, Sheng Hsiang Lin, Po Wei Chen, C.C Fang, W.C Huang, Wen-Han Feng, Hung I. Yeh, and Yi-Heng Li
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Gastrointestinal bleeding ,medicine.medical_specialty ,Acute coronary syndrome ,Aspirin ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,Revascularization ,medicine.disease ,Clopidogrel ,Pharmacotherapy ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Ticagrelor ,medicine.drug - Abstract
Background P2Y12 inhibitor monotherapy with either clopidogrel or ticagrelor becomes an alternative antiplatelet strategy in patients (pts) undergoing percutaneous coronary intervention (PCI). The purpose of this study was to compare the efficacy and safety of clopidogrel vs. ticagrelor monotherapy in pts with acute coronary syndrome (ACS) undergoing PCI who cannot tolerate aspirin. Methods and results From January 1, 2014 to December 31, 2018, a total of 610 ACS pts (mean age 70.4±13.1 years, 72.1% men, 28.5% STEMI) that aspirin was stopped prematurely for various reasons and received either clopidogrel (n=369) or ticagrelor (n=241) monotherapy were included from 8 major hospitals in Taiwan. The duration (median and the 25th and 75th percentile) of aspirin treatment was 9 (1.39–37.00) days in the clopidogrel group and 10 (1.00–55.00) days in the ticagrelor group (p=0.514). Gastrointestinal bleeding (36.9%) was the most common reason to stop aspirin in both groups. The primary endpoint is the composite of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months after discharge. The safety endpoint was the major bleeding defined as BARC 3 or 5 bleedings. The covariates were balanced between groups after using inverse probability of treatment weighting. Overall, 84 patients developed events of primary endpoint, with 57 (15.4%) in the clopidogrel group and 27 (11.2%) in the ticagrelor group. After multivariate adjustment in the Cox proportional-hazards models, ticagrelor was associated with a lower risk of primary endpoint compared with clopidogrel (adjusted hazard ratio [aHR] 0.67, 95% CI 0.49–0.93). Among the primary endpoint, ticagrelor significantly reduced the risk of recurrent ACS or unplanned revascularization (aHR 0.46, 95% CI 0.28–0.75). There was no significant difference of all-cause mortality between the 2 groups (aHR 0.92, 95% CI 0.52–1.61). The risk of BARC 3 or 5 bleeding was also similar (aHR 0.71, 95% CI 0.35–1.45). Conclusions Among ACS patients undergoing PCI who cannot tolerate aspirin, ticagrelor monotherapy was associated with a significantly lower risk of a composite of cardiovascular events compared to clopidogrel monotherapy. The major bleeding risk was similar between groups. Funding Acknowledgement Type of funding source: None
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- 2020
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42. Genotoxic effects of 1-nitropyrene in macrophages are mediated through a p53-dependent pathway involving cytochrome c release, caspase activation, and PARP-1 cleavage
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Sheng-Wen Wu, Ching-Chi Tseng, Yung-Chuan Ho, Chun-Hung Su, Chun-Jung Chen, Chien-Ying Lee, Shiuan-Shinn Lee, Yu-Hsiang Kuan, Yun-Wei Chiang, Yi-Ching Li, Wen-Ying Chen, Kun-Lin Yeh, and Rosa Huang-Liu
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Macrophage ,DNA damage ,Health, Toxicology and Mutagenesis ,Poly ADP ribose polymerase ,0211 other engineering and technologies ,Poly (ADP-Ribose) Polymerase-1 ,Caspase 3 ,Apoptosis ,02 engineering and technology ,Genotoxic Stress ,010501 environmental sciences ,Poly(ADP-ribose) Polymerase Inhibitors ,medicine.disease_cause ,Cleavage (embryo) ,01 natural sciences ,Environmental pollution ,1-Nitropyrene ,medicine ,Humans ,GE1-350 ,Phosphorylation ,Cytotoxicity ,0105 earth and related environmental sciences ,021110 strategic, defence & security studies ,Pyrenes ,biology ,p53-dependent pathway ,Chemistry ,Cytochrome c ,Macrophages ,Public Health, Environmental and Occupational Health ,Cytochromes c ,General Medicine ,Pollution ,Molecular biology ,Caspase 9 ,Mitochondria ,Environmental sciences ,TD172-193.5 ,Caspases ,biology.protein ,Genotoxicity ,Tumor Suppressor Protein p53 ,DNA Damage - Abstract
Genotoxic stress from environmental pollutants plays a critical role in cytotoxicity. The most abundant nitro-polycyclic aromatic hydrocarbon in environmental pollutants, 1-nitropyrene (1-NP), is generated during fossil fuel, diesel, and biomass combustion under sunlight. Macrophages, the key regulators of the innate immune system, provide the first line of defense against pathogens. The toxic effects of 1-NP on macrophages remain unclear. Through a lactate dehydrogenase assay, we measured the cytotoxicity induced by 1-NP. Our results revealed that 1-NP induced genotoxicity also named DNA damage, including micronucleus formation and DNA strand breaks, in a concentration-dependent manner. Furthermore, 1-NP induced p53 phosphorylation and nuclear accumulation; mitochondrial cytochrome c release; caspase-3 and -9 activation and cleavage; and poly (ADP-ribose) polymerase-1 (PARP-1) cleavage in a concentration-dependent manner. Pretreatment with the PARP inhibitor, 3-aminobenzamide, significantly reduced cytotoxicity, genotoxicity, and PARP-1 cleavage induced by 1-NP. Pretreatment with the caspase-3 inhibitor, z-DEVD-fmk, significantly reduced cytotoxicity, genotoxicity, PARP-1 cleavage, and caspase 3 activation induced by 1-NP. Pretreatment with the p53 inhibitor, pifithrin-α, significantly reduced cytotoxicity, genotoxicity, PARP-1 cleavage, caspase 3 activation, and p53 phosphorylation induced by 1-NP. We propose that cytotoxicity and genotoxicity induced by 1-NP by PARP-1 cleavage via caspase-3 and -9 activation through cytochrome c release from mitochondria and its upstream p53-dependent pathway in macrophages.
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- 2020
43. 2020 Focused Update of the 2012 Guidelines of the Taiwan Society of Cardiology for the Management of ST-Segment Elevation Myocardial Infarction
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Yi-Heng, Li, Cheng-Han, Lee, Wei-Chun, Huang, Yu-Chen, Wang, Chun-Hung, Su, Pei-Hsun, Sung, Shih-Chieh, Chien, and Juey-Jen, Hwang
- Subjects
cardiovascular diseases ,Review Article - Abstract
One of the major missions of the Taiwan Society of Cardiology is to publish practice guidelines that are suitable for local use in Taiwan. The ultimate purpose is to continuously improve cardiovascular health care from the implementation of the recommendations in the guidelines. Despite recent improvement of medical care, patients with ST-segment elevation myocardial infarction (STEMI) still carry a high morbidity and mortality. There have been many changes in the concepts of STEMI diagnosis and treatment in recent years. The 2020 focused update of the 2012 guidelines of the Taiwan Society of Cardiology for the management of STEMI is an amendment of the 2012 guidelines based on the newest published scientific data. The recommendations in this focused update provide the diagnosis and treatment strategy for STEMI that should be generally implemented in Taiwan. Nevertheless, guidelines never completely replace clinical judgment and medical decision still should be determined individually.
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- 2020
44. Correspondence on '
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Chien Hsien, Lo, Yu-Hsun, Wang, Chin Feng, Tsai, Kuei Chuan, Chan, Li Ching, Li, Tse Hsien, Lo, Chun Hung, Su, and James Cheng-Chung, Wei
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- 2020
45. P2Y12 Inhibitor Monotherapy with Clopidogrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
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Po-Wei Chen, Wen-Han Feng, Ming-Yun Ho, Chun-Hung Su, Sheng-Wei Huang, Chung-Wei Cheng, Hung-I Yeh, Ching-Pei Chen, Wei-Chun Huang, Ching-Chang Fang, Hui-Wen Lin, Sheng-Hsiang Lin, I-Chang Hsieh, and Yi-Heng Li
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Article ,ticagrelor ,acute coronary syndrome ,03 medical and health sciences ,0302 clinical medicine ,P2Y12 ,P2Y12 inhibitor monotherapy ,Internal medicine ,medicine ,Clinical endpoint ,030212 general & internal medicine ,cardiovascular diseases ,Aspirin ,clopidogrel ,business.industry ,lcsh:R ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Clopidogrel ,Conventional PCI ,Cardiology ,business ,Ticagrelor ,medicine.drug - Abstract
Background: P2Y12 inhibitor monotherapy is an alternative antiplatelet strategy in patients undergoing percutaneous coronary intervention (PCI). However, the ideal P2Y12 inhibitor for monotherapy is unclear. Methods and Results: We performed a multicenter, retrospective, observational study to compare the efficacy and safety of monotherapy with clopidogrel versus ticagrelor in patients with acute coronary syndrome (ACS) undergoing PCI. From 1 January 2014 to 31 December 2018, 610 patients with ACS who received P2Y12 monotherapy with either clopidogrel (n = 369) or ticagrelor (n = 241) after aspirin was discontinued prematurely were included. Inverse probability of treatment weighting was used to balance covariates between the groups. The primary endpoint was the composite of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months after discharge. Overall, 84 patients reached the primary endpoint, with 57 (15.5%) in the clopidogrel group and 27 (11.2%) in the ticagrelor group. Multivariate adjustment in Cox proportional-hazards models revealed a lower risk of the primary endpoint with ticagrelor than with clopidogrel (adjusted hazard ratio (aHR): 0.67, 95% confidence interval (CI): 0.49&ndash, 0.93). Ticagrelor significantly reduced the risk of recurrent ACS or unplanned revascularization (aHR: 0.46, 95% CI: 0.28&ndash, 0.75). No significant difference in all-cause mortality and major bleeding events was observed between the 2 groups. Conclusions: Among patients with ACS undergoing PCI who cannot complete course of dual antiplatelet therapy, a significantly lower risk of cardiovascular events was associated with ticagrelor monotherapy than with clopidogrel monotherapy. The major bleeding risk was similar in both the groups.
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- 2020
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46. Classification of Photoplethysmographic Signal Quality with Fuzzy Neural Network for Improvement of Stroke Volume Measurement
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Wenxi Chen, Jia-Jung Wang, Shing-Hong Liu, Chun-Hung Su, and Kuo-Li Pan
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impedance cardiography (icg) ,Computer science ,0206 medical engineering ,02 engineering and technology ,stroke volume (sv) ,lcsh:Technology ,signal quality index (sqi) ,lcsh:Chemistry ,Photoplethysmogram ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Waveform ,Plethysmograph ,General Materials Science ,Instrumentation ,Electrical impedance ,lcsh:QH301-705.5 ,Fluid Flow and Transfer Processes ,Artificial neural network ,medicine.diagnostic_test ,business.industry ,lcsh:T ,Process Chemistry and Technology ,020208 electrical & electronic engineering ,General Engineering ,Pattern recognition ,Stroke volume ,020601 biomedical engineering ,lcsh:QC1-999 ,Computer Science Applications ,Impedance cardiography ,lcsh:Biology (General) ,lcsh:QD1-999 ,lcsh:TA1-2040 ,self-constructing neural fuzzy inference network (sonfin) ,photoplethysmography ,Artificial intelligence ,business ,lcsh:Engineering (General). Civil engineering (General) ,Sensitivity (electronics) ,lcsh:Physics - Abstract
Photoplethysmography (PPG) has been extensively employed to acquire some physiological parameters such as heart rate, oxygen saturation, and blood pressure. However, PPG signals are frequently corrupted by motion artifacts and baseline wandering, especially for the reflective PPG sensor. Several different algorithms have been studied for determining the signal quality of PPG by the characteristic parameters of its waveform and the rule-based methods. The levels of signal quality usually were defined by the manual operations. Thus, whether the good PPG waveforms are enough to increase the accuracy of the measurement is still a subjective issue. The aim of this study is to use a fuzzy neural network to determine the signal quality indexes (SQI) of PPG pulses measured by the impedance cardiography. To test the algorithm performance, the beat-to-beat stroke volumes (SV) were measured with our device and the medis®, CS 2000, synchronously. A total of 1466 pulses from 10 subjects were used to validate our algorithm in which the SQIs of 1007 pulses were high, those of 71 pulses were in the middle, and those of 388 pulses were low. The total error of SV measurement was &minus, 18 ±, 22.0 mL. The performances of the classification were that the sensitivity and specificity for the 1007 pulses with the high SQIs were 0.81 and 0.90, and the error of SV measurement was 6.4 ±, 12.8 mL. The sensitivity and specificity for the 388 pulses with the low SQIs were 0.84 and 0.93, while the error of SV measurement was 30.4 ±, 3.6 mL. The results show that the proposed algorithm could be helpful in choosing good-quality PPG pulses to increase the accuracy of SV measurement in the impedance plethysmography.
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- 2020
47. Convolutional neural Network-based detection of deep vein thrombosis in a low limb with light reflection rheography
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Chun-Hung Su, Wenxi Chen, Kuo-Li Pan, and Shing-Hong Liu
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medicine.medical_specialty ,business.industry ,Applied Mathematics ,Deep vein ,Condensed Matter Physics ,medicine.disease ,Thrombosis ,Convolutional neural network ,medicine.anatomical_structure ,Embolus ,Cuff ,medicine ,cardiovascular diseases ,Radiology ,Electrical and Electronic Engineering ,Medical diagnosis ,business ,Vein ,Instrumentation ,Light reflection rheography - Abstract
Artificial intelligence has been widely used in the biomedical engineering field, which can assist the clinicians in disease diagnoses, help the engineers in physiological signal processing, or serve the people with chronic diseases in the homecare management. Blood clots in the deep veins of human body is called the deep vein thromboses (DVT). If the embolus passes through the lung, patient will have a life-threatening risk. Therefore, how to use the artificial intelligence to serve daily monitoring of the DVT condition is a valuable exploration. The light reflection rheography (LRR) has been used to detect the DVT of low limbs. In the previous study, the wearable device using LRR technique has been developed. But, this examination system could not be used by non-physician because the signal-quality evaluation of LRR and the classification of positive or negative DVT using the LRR signal all need the manual process. The goal of this study is to use a two-dimension convolutional neural network (2D CNN) to evaluate the qualities of LRR signals and classify the positive or negative DVT from the LRR signal with high reliability. The LRR signal and the smoothed signal were combined together to form a 450x450 image as the input pattern. In this study, twenty subjects were recruited to perform four-time experiments. A cuff pressured to 100 mmHg and 150 mmHg occluded the veins of low limbs to simulate the slight and serious DVT scenarios, and which was placed at the top and bottom of the knee of left leg to simulate the distal and proximal embolization. In the signal-quality evaluation, there were 700 samples including 476 high qualities and 224 low qualities, which were marked by the experts according to the vein emptying phenomenon. In the DVT classification, there were 476 samples including 167 negative samples, 158 slight positive samples, and 151 serious positive samples. A 19-layer CNN model proposed by Visual Geometry Group (VGG-19) was used in the two experiments. We performed the inter-group and intra-group analysis. Both results were better than the previous study. The accuracies of signal-quality evaluation and DVT classification were 0.92 and 0.75, respectively. Thus, the proposed method could support people with the high risk for DVT examination at non-medical settings.
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- 2022
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48. Cadmium nitrate-induced neuronal apoptosis is protected by N-acetyl-l-cysteine via reducing reactive oxygen species generation and mitochondria dysfunction
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Chen-Yu Chian, Ya-Lan Chang, Chien-Ying Lee, Meng-Liang Lin, Yu-Hsiang Kuan, Ming-Ling Yang, Shiuan-Shinn Lee, Rosa Huang-Liu, Chun-Jung Chen, Ping-Kun Tsai, Chia-Hui Chen, Chun-Hung Su, Wen-Ying Chen, and Yung-Chyuan Ho
- Subjects
inorganic chemicals ,0301 basic medicine ,Programmed cell death ,Necrosis ,Cell Survival ,Apoptosis ,Mitochondrion ,Rats, Sprague-Dawley ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Annexin ,Cell Line, Tumor ,Cadmium Compounds ,medicine ,Animals ,Caspase ,Membrane Potential, Mitochondrial ,Neurons ,Pharmacology ,chemistry.chemical_classification ,Reactive oxygen species ,Nitrates ,Cell Death ,biology ,Neurodegeneration ,General Medicine ,medicine.disease ,Molecular biology ,Acetylcysteine ,Mitochondria ,Rats ,030104 developmental biology ,chemistry ,Caspases ,biology.protein ,medicine.symptom ,Reactive Oxygen Species ,030217 neurology & neurosurgery ,Signal Transduction - Abstract
Cigarette smoking is a well-established risk factor for various diseases, such as cardiovascular diseases, neurodegeneration, and cancer. Cadmium nitrate (Cd(NO3)2) is one of the major products from the cigarette smoke. Up to now, no supporting evidence on Cd(NO3)2-induced apoptosis and its related working mechanism in neurons has been found. In present study, the mode of cell death, caspase activities, reactive oxygen species (ROS) generation, and mitochondrial dysfunction in N2a cells, which are neuron-like cells, were assessed by Annexin V-FITC and PI assays, caspase fluorometric assay, DCFH-DA fluorescence assay, and JC-1 fluorescence assay respectively. The results showed that not only Cd(NO3)2 induced apoptosis and necrosis but also the activities of caspase-3 and -9 expressed in a concentration-dependent manner. In addition, Cd(NO3)2 also induced both mitochondrial dysfunction and ROS generation in a concentration-dependent manner. All these indicated that in N2a cells parallel trends could be observed in apoptosis, caspase-3 and -9 activities, mitochondrial dysfunction, and ROS generation when induced by Cd(NO3)2. Furthermore, Cd(NO3)2-induced apoptosis, caspases activities, mitochondrial dysfunction, and ROS generation were reduced by N-acetyl-l-cysteine (NAC). These results indicated that Cd(NO3)2-induced neuronal apoptosis was reduced by NAC via intrinsic apoptotic caspase cascade activities and their up-stream factors, including mitochondrial dysfunction and ROS generation.
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- 2018
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49. Safrole induced cytotoxicity, DNA damage, and apoptosis in macrophages via reactive oxygen species generation and Akt phosphorylation
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Chi-Ting Horng, Wen-Ying Chen, Yu-Hsiang Kuan, Kuang-Jen Chien, Chung-Hsin Yeh, Chen-Yu Chian, Meng-Liang Lin, Chun-Jung Chen, Ming-Ling Yang, Chun-Hung Su, Ping-Kun Tsai, and Chia-Hui Chen
- Subjects
0301 basic medicine ,Cell Survival ,DNA damage ,Health, Toxicology and Mutagenesis ,Apoptosis ,Toxicology ,Superoxide dismutase ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Safrole ,Animals ,Phosphorylation ,Protein kinase B ,Pharmacology ,chemistry.chemical_classification ,Reactive oxygen species ,biology ,Macrophages ,Glutathione peroxidase ,General Medicine ,Molecular biology ,Mitochondria ,RAW 264.7 Cells ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,Myeloperoxidase ,biology.protein ,Reactive Oxygen Species ,Proto-Oncogene Proteins c-akt ,DNA Damage - Abstract
Safrole is a natural compound categorized as a group 2B carcinogen extracted from betel quid chewing, which is a common practice of psychoactive habits integrated into social and cultural ceremonies among serveral million people, especially in Southern or Southeastern Asia. Safrole is one of the major risk compunds for development of oral squamous cell carcinoma and hepatocellular carcinoma via DNA adduction. In innate immunity, macrophages are the predominant cells for non-specific first line defense against pathogens in oral tissue. Up to now, there is no evidence to implicate the potential toxicological effect of safrole on macrophages. In this study, we found safrole induced the generation of reactive oxygen species (ROS) and myeloperoxidase (MPO) in RAW264.7 macrophages in a concentration-dependent manner. Furthermore, cytotoxicity, DNA damage, and apoptosis were caused by safrole in a concentration-dependent manner. While the activation of antioxidative enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx) was reduced, the phosphorylation of Akt was induced by safrole in a concentration-dependent manner. These results indicated that the induction of cytotoxicity, DNA damage, and apoptosis in macrophages by safrole was through generation of ROS and inhibition of antioxidative enzymes possibly via Akt phosphorylation.
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- 2018
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50. Zerumbone from Zingiber zerumbet Ameliorates Lipopolysaccharide-Induced ICAM-1 and Cytokines Expression via p38 MAPK/JNK-IκB/ NF-κB Pathway in Mouse Model of Acute Lung Injury
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Chien-Ying Lee, Shih-Pin Chen, Ming-Ling Yang, Chun-Hung Su, Yu-Hsiang Kuan, Shiuan-Shinn Lee, Rosa Huang-Liu, Ching-Ping Yang, Chun-Jung Chen, and Yung-Chyuan Ho
- Subjects
Lipopolysaccharides ,Male ,0301 basic medicine ,MAPK/ERK pathway ,Physiology ,p38 mitogen-activated protein kinases ,Acute Lung Injury ,Chemokine CXCL2 ,Interleukin-1beta ,Anti-Inflammatory Agents ,Pharmacology ,Lung injury ,p38 Mitogen-Activated Protein Kinases ,Proinflammatory cytokine ,Capillary Permeability ,03 medical and health sciences ,chemistry.chemical_compound ,Zingiberaceae ,Physiology (medical) ,Animals ,Phosphorylation ,Protein kinase A ,Lung ,Macrophage inflammatory protein ,Mice, Inbred ICR ,Plants, Medicinal ,Dose-Response Relationship, Drug ,Plant Extracts ,Chemistry ,Kinase ,JNK Mitogen-Activated Protein Kinases ,NF-kappa B ,NF-κB ,Intercellular Adhesion Molecule-1 ,Disease Models, Animal ,030104 developmental biology ,Neutrophil Infiltration ,Cytokines ,I-kappa B Proteins ,Sesquiterpenes ,Phytotherapy ,Signal Transduction - Abstract
Acute lung injury (ALI) is a clinical syndrome with high morbidity and mortality rates mainly caused by Gram-negative bacteria. Nevertheless, an effective treatment strategy for ALI is yet to be developed. Zerumbone, a sesquiterpene isolated from Zingiber zerumbet Smith, possesses several advantageous bioeffects such as antioxidation, anti-inflammation, and antiulcer. Pretreatment of zerumbone inhibited lipopolysaccharide (LPS)-induced arterial blood gas exchange, neutrophils infiltration, and increased pulmonary vascular permeability. LPS-induced expression of intercellular adhesion molecule-1 (ICAM-1) was inhibited by zerumbone at a lower concentration than that of vascular cell adhesion molecule-1 (VCAM-1). In addition, proinflammatory cytokines, such as interleukin (IL)-1β and macrophage inflammatory protein (MIP)-2 were suppressed by zerumbone. The phosphorylation of nuclear factor (NF)-κB, a proinflammatory transcription factor, and degradation of inhibitor of κB (IκB), an inhibitor of NF-κB, were also reduced by zerumbone. Furthermore, we found the inhibitory concentration of zerumbone on phosphorylation of p38 mitogen-activated protein kinase (MAPK) and c-Jun NH2-terminal kinase (JNK) was lower than that of extracellular signal-regulated kinase (ERK). In conclusion, zerumbone could be a potential protective agent for ALI, possibly via expression of ICAM-1, IL-1β, and MIP-2. The protective mechanism of zerumbone was by reversing the activation of p38 MAPK/JNK-IκB/NF-κB pathway.
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- 2018
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