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Search Results: 1 - 10 of 3053 matches for " Steve Leu "
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Effect of erythropoietin therapy on clinical outcome in patients after acute ischemic stroke: a debatable issue
Chun-Man Yuen, Cheuk-Kwan Sun, Steve Leu, Hon-Kan Yip
Critical Care , 2011, DOI: 10.1186/cc10145
Abstract: We thank Minnerup and colleagues [5] for their comments in the previous issue of Critical Care. These authors suggested that, for evaluating 90-day neurological outcome, the modified Rankin Scale or the Barthel Index could be superior to the National Institutes of Health Stroke Scale (NIHSS) that was used in our study [5]. They also mentioned that, when the components of the composite endpoint in our study protocol are considered, the significantly higher number of patients with an NIHSS score of at least 8 after placebo treatment is also likely to be caused by the high rate of recurrent strokes and does not necessarily reflect improved neurological function in the EPO group [5]. However, NIHSS is widely accepted as one of the most efficacious tools for evaluating neurological outcome after acute IS. Additionally, the trial in our study was prospective, randomized, and placebo-controlled - this is the best design to minimize the selection bias between the study group and the control group. Accordingly, we suggest that the significantly lower number of patients with an NIHSS score of at least 8 in the EPO group in comparison with the placebo group could reflect simply the therapeutic benefit of EPO therapy in improving the 90-day neurological outcome rather than a mere speculation of a higher rate of recurrent strokes in the placebo group.The optimal dosage of EPO and duration of treatment for patients after IS remain uncertain. This may account for some inconsistency in improvement of neurological outcome after IS in clinical trials [1-4]. Accordingly, we disagree with Minnerup and colleagues [5] that 'the potential side effects and the failed efficacy in large clinical trials will presumably prevent the use of EPO as a therapy to increase EPCs after stroke'.Minnerup and colleagues also underscored that the study was first assigned to a trial register (ISRCTN 96340690) in January 2011, which was 10 months after the inclusion of the last patients in March 2010 [5]. W
Impact of apoptotic adipose-derived mesenchymal stem cells on attenuating organ damage and reducing mortality in Rat sepsis syndrome induced by cecal puncture and ligation
Chang Chia-Lo,Leu Steve,Sung Hsin-Ching,Zhen Yen-Yi
Journal of Translational Medicine , 2012, DOI: 10.1186/1479-5876-10-244
Abstract: Background We tested whether apoptotic adipose-derived mesenchymal stem cells (A-ADMSCs) were superior to healthy (H)-ADMSCs at attenuating organ damage and mortality in sepsis syndrome following cecal ligation and puncture (CLP). Methods Adult male rats were categorized into group 1 (sham control), group 2 (CLP), group 3 [CLP + H-ADMSC administered 0.5, 6, and 18 h after CLP], group 4 [CLP + A-ADMSC administered as per group 3]. Results Circulating peak TNF-α level, at 6 h, was highest in groups 2 and 3, and higher in group 4 than group 1 (p < 0.0001). Immune reactivity (indicated by circulating and splenic helper-, cytoxic-, and regulatory-T cells) at 24 and 72 h exhibited the same pattern as TNF-α amongst the groups (all p < 0.0001). The mononuclear-cell early and late apoptosis level and organ damage parameters of liver (AST, ALT), kidney (creatinine) and lung (arterial oxygen saturation) also displayed a similar pattern to TNF-α levels (all p < 0.001). Protein levels of inflammatory (TNF-α, MMP-9, NF-κB, ICAM-1), oxidative (oxidized protein) and apoptotic (Bax, caspase-3, PARP) biomarkers were higher in groups 2 and 3 than group 1, whereas anti-apoptotic (Bcl-2) biomarker was lower in groups 2 and 3 than in group 1 but anti-oxidant (GR, GPx, HO-1, NQO-1) showed an opposite way of Bcl-2; these patterns were reversed for group 4 (all p < 0.001). Mortality was highest in group 3 and higher in group 2 than group 4 than group 1 (all p < 0.001). Conclusions A-ADMSC therapy protected major organs from damage and improved prognosis in rats with sepsis syndrome.
ASEAN’s Preferential Trade Agreements (PTA) Strategy
Guanyi Leu
Journal of Current Southeast Asian Affairs , 2011,
Abstract: This paper provides a diversification explanation in order understand the development of PTAs in Southeast Asia. I argue that an important reason why ASEAN states participate in PTAs has been to diversify existing trade ties and to reduce overdependence on a narrow range of export markets. Southeast Asian countries have formed PTAs with markets with which they had weak or unexplored economic relations, as demonstrated by three case analyses: the ASEAN Free Trade Area (AFTA), the ASEAN-China Free Trade Agreement (ACFTA) and the ASEAN-Japan Comprehensive Economic Partnership Agreement (AJCEP). To maximise the economic gains and the diversification effects of PTA participation, ASEAN countries have pursued a strategy of strengthening economic unity while keeping external economic linkages as diversified as possible. Although East Asia, and especially China, was an important alternative market to reduce ASEAN’s dependence on trade with America, ASEAN countries have also pursued PTAs with a number of other trading partners. This paper explains how PTAs have helped ASEAN states to develop more policy autonomy in their trading environment.
Adipose-derived mesenchymal stem cells markedly attenuate brain infarct size and improve neurological function in rats
Steve Leu, Yu-Chun Lin, Chun-Man Yuen, Chia-Hung Yen, Ying-Hsien Kao, Cheuk-Kwan Sun, Hon-Kan Yip
Journal of Translational Medicine , 2010, DOI: 10.1186/1479-5876-8-63
Abstract: Adult male Sprague-Dawley (SD) rats (n = 30) were divided into IS plus intra-venous 1 mL saline (at 0, 12 and 24 h after IS induction) (control group) and IS plus intra-venous ADMSCs (2.0 × 106) (treated interval as controls) (treatment group) after occlusion of distal left internal carotid artery. The rats were sacrificed and brain tissues were harvested on day 21 after the procedure.The results showed that BIA was larger in control group than in treatment group (p < 0.001). The sensorimotor functional test (Corner test) identified a higher frequency of turning movement to left in control group than in treatment group (p < 0.05). mRNA expressions of Bax, caspase 3, interleukin (IL)-18, toll-like receptor-4 and plasminogen activator inhibitor-1 were higher, whereas Bcl-2 and IL-8/Gro were lower in control group than in treatment group (all p < 0.05). Western blot demonstrated a lower CXCR4 and stromal-cell derived factor-1 (SDF-1) in control group than in treatment group (all p < 0.01). Immunohistofluorescent staining showed lower expressions of CXCR4, SDF-1, von Willebran factor and doublecortin, whereas the number of apoptotic nuclei on TUNEL assay was higher in control group than in treatment group (all p < 0.001). Immunohistochemical staining showed that cellular proliferation and number of small vessels were lower but glial fibrillary acid protein was higher in control group than in treatment group (all p < 0.01).ADMSC therapy significantly limited BIA and improved sensorimotor dysfunction after acute IS.Stroke, a growing epidemic, is the third most frequent cause of mortality in industrialized countries [1-3]. Despite state-of-the-art therapy, clinical outcome after stroke remains poor, with many patients left permanently disabled [4]. Recently, thrombolytic therapy, a more aggressive treatment strategy, has been reported to be effective for some acute ischemic stroke (IS) patients [5,6]. However, its liberal use is hampered by a lot of limitations, including
Why Can’t Canada Spend More on Mental Health?  [PDF]
Steve Lurie
Health (Health) , 2014, DOI: 10.4236/health.2014.68089
Abstract: The World Health Organization (WHO) notes that mental illness accounts for 13% of the world’s disease burden, yet most countries under invest despite the social and economic costs of mental illness. It has been suggested that this lack of investment may be a result of stigma. A number of high income countries invest 10% or more in their mental health services. Although Canada is a high income country, its mental health spending is 7.2% according to the WHO Mental Health Atlas. This article will review the factors influencing Canada and its provinces’ under investment in mental health, compare its performance with other countries and make the case on why and how this could change.
Biomass Power Generation through Direct Integration of Updraft Gasifier and Stirling Engine Combustion System
Jai-Houng Leu
Advances in Mechanical Engineering , 2010, DOI: 10.1155/2010/256746
Abstract: Biomass is the largest renewable energy source in the world. Its importance grows gradually in the future energy market. Since most biomass sources are low in energy density and are widespread in space, small-scale biomass conversion system is therefore more competitive than a large stand-alone conversion plant. The current study proposes a small-scale solid biomass power system to explore the viability of direct coupling of an updraft fixed bed gasifier with a Stirling engine. The modified updraft fixed bed gasifier employs an embedded combustor inside the gasifier to fully combust the synthetic gas generated by the gasifier. The flue gas produced by the synthetic gas combustion inside the combustion tube is piped directly to the heater head of the Stirling engine. The engine will then extract and convert the heat contained in the flue gas into electricity automatically. Output depends on heat input. And, the heat input is proportional to the flow rate and temperature of the flue gas. The preliminary study of the proposed direct coupling of an updraft gasifier with a 25?kW Stirling engine demonstrates that full power output could be produced by the current system. It could be found from the current investigation that no auxiliary fuel is required to operate the current system smoothly. The proposed technology and units could be considered as a viable solid biomass power system. 1. Introduction Annual production of biomass energy in the world is estimated at about 100 billion tons coal equivalent. This abundant biomass energy exceeds the annual world energy consumptions by a factor of 7 [1]. Biomass energy, from plants (chiefly from forests but not exclusively), is therefore by far the largest category of renewable energy application, particularly in developing countries, with both traditional (fuel wood) and modern (e.g., ethanol and cogeneration) utilizations. Moreover, new technologies can greatly increase the efficiency of biomass energy application, and many in the field of sustainable energy developments predict a huge growth of biomass energy to contribute a quarter of global energy supply by 2025 [2]. Biomass is low in energy density and is widespread in space. Small scale biomass conversion system is therefore more competitive than a large stand-alone conversion plant since small-scale systems can be brought to the source of the biomass rather than incurring transportation costs to bring biomass to a large centrally located plant. In addition, small-scale biomass power system possesses benefits in terms of environmental impacts and distributed
Crafting a Real-Time Information Aggregator for Mobile Messaging
Jenq-Shiou Leu
Journal of Computer Networks and Communications , 2010, DOI: 10.1155/2010/209617
Abstract: Mobile messaging is evolving beyond SMS (Short Message Service) text messaging with the introduction of MMS (Multimedia Messaging Service). In the past, such a scheme is used for peer-to-peer communication. Messages are generally displayed on a cellular phone with a limited-sized screen. However, such a visualizing process is not suitable to broadcast real-time SMS/MMS messages to people in public. To facilitate the instancy and publicity, we develop a real-time information aggregator—Visualizing SMS and MMS Messages System (VSMMS)—to realize the concept by integrating SMS and MMS messaging over GSM/GPRS/UMTS onto a remote display device. The device exhibits messages on a larger display device in public. VSMMS features a revolutionized variation of mass media broadcasting. In this paper, we practically illustrate how to design and implement VSMMS and use a M/M/1 model to conduct a theoretical analysis about the message delay in the system queue. Meanwhile, we make an empirical performance evaluation about the message transmission time over different networks.
Comparison of acute versus convalescent stage high-sensitivity C-Reactive protein level in predicting clinical outcome after acute ischemic stroke and impact of erythropoietin
Kuo-Ho Yeh, Tzu-Hsien Tsai, Han-Tan Chai, Steve Leu, Sheng-Ying Chung, Sarah Chua, Yung-Lung Chen, Hung-Sheng Lin, Chun-Man Yuen, Hon-Kan Yip
Journal of Translational Medicine , 2012, DOI: 10.1186/1479-5876-10-6
Abstract: Totally 160 patients were prospectively randomized to receive either EPO therapy (group 1, n = 80) (5,000 IU each time, subcutaneously) at 48 h and 72 h after acute IS, or placebo (group 2, n = 80). Serum level of hs-CRP was determined using ELISA at 48 h and on day 21 after IS and once in 60 healthy volunteers.Serum level of hs-CRP was substantially higher in all patients with IS than in healthy controls at 48 h and day 21 after IS (all p < 0.001). Levels of hs-CRP did not differ between group 1 and 2 at 48 h and day 21 after IS (all p > 0.5). Multivariate analysis showed that hs-CRP levels (at 48 h and day 21) were independently predictive of 90-day major adverse neurological event (MANE) (defined as recurrent stroke, NIHSS≥8, or death) (all p < 0.03), whereas EPO therapy was independently predictive of reduced 90-day MANE (all p < 0.02).EPO therapy which was independently predictive of freedom from 90-day MANE did not alter the crucial role of hs-CRP levels measured at 48 h and 21-day in predicting unfavorable clinical outcome after IS.Numerous studies have already shown that inflammation plays a crucial role in the initiation of endothelial dysfunction, atherosclerosis and plaque formation, propagation of plaque burden, and finally, rupture of the vulnerable plaque and acute arterial obstructive syndrome (AOS) [1-4]. Although a myriad of inflammatory biomarkers have been reported to be useful in predicting endothelial dysfunction and the likelihood of AOS, high-sensitivity C-reactive protein (hs-CRP) remains one of the most extensively studied and widely accepted inflammatory biomarkers in our daily clinical practice [4-10].Indeed, not only is hs-CRP an inflammatory biomarker, but it has also been proved to directly participate in the inflammatory process contributing to acute AOS [3,4,7]. Besides, immense clinical observational studies have demonstrated that serum level of hs-CRP is a useful and powerful inflammatory marker in predicting future cardiovascular a
Myocardium-derived conditioned medium improves left ventricular function in rodent acute myocardial infarction
Steve Leu, Ying-Hsien Kao, Cheuk-Kwan Sun, Yu-Chun Lin, Tzu-Hsien Tsai, Li-Teh Chang, Sarah Chua, Kuo-Ho Yeh, Chiung-Jen Wu, Morgan Fu, Hon-Kan Yip
Journal of Translational Medicine , 2011, DOI: 10.1186/1479-5876-9-11
Abstract: Adult male Sprague-Dawley (SD) rats (n = 36) randomized to receive either left coronary artery ligation (AMI induction) or thoracotomy only (sham procedure) were grouped as follows (n = 6 per group): Group I, II, and III were sham-controls treated by fresh medium, normal rat MDCM, and infarct-related MDCM, respectively. Group IV, V, and VI were AMI rats treated by fresh medium, normal MDCM, and infarct-related MDCM, respectively. Either 75 μL MDCM or fresh medium was administered into infarct myocardium, followed by intravenous injection (3 mL) at postoperative 1, 12, and 24 h.In vitro studies showed higher phosphorylated MMP-2 and MMP-9, but lower α-smooth muscle actin and collagen expressions in neonatal cardiac fibroblasts treated with MDCM compared with those in the cardiac fibroblasts treated with fresh medium (all p < 0.05). Sirius-red staining showed larger collagen deposition area in LV myocardium in Group IV than in other groups (all p < 0.05). Stromal cell-derived factor-1α and CXCR4 protein expressions were higher in Group VI than in other groups (all p < 0.05). The number of von Willebrand factor- and BrdU-positive cells and small vessels in LV myocardium as well as 90-day LV ejection fraction were higher, whereas oxidative stress was lower in Group VI than in Group IV and Group V (all p < 0.05).MDCM therapy reduced cardiac fibrosis and oxidative stress, enhanced angiogenesis, and preserved 90-day LV function in a rat AMI model.Although transplantation of a variety of stem cells has been reported to be beneficial in improving infarct- and ischemia-related LV dysfunction [1-5], the underlying mechanisms are still poorly understood [3-5]. It has been proposed that implanted mesenchymal stem cells (MSCs) differentiated into functional cardiomyocytes to replace the lost myocardium, thereby improving heart function [6]. However, accumulating evidence has shown that only a few implanted stem cells subsequently express myogenic cell-like phenotype in ischemic z
Autologous Transplantation of Adipose-Derived Mesenchymal Stem Cells Markedly Reduced Acute Ischemia-Reperfusion Lung Injury in a Rodent Model
Cheuk-Kwan Sun, Chia-Hung Yen, Yu-Chun Lin, Tzu-Hsien Tsai, Li-Teh Chang, Ying-Hsien Kao, Sarah Chua, Morgan Fu, Sheung-Fat Ko, Steve Leu, Hon-Kan Yip
Journal of Translational Medicine , 2011, DOI: 10.1186/1479-5876-9-118
Abstract: Adult male Sprague-Dawley (SD) rats (n = 24) were equally randomized into group 1 (sham control), group 2 (IR plus culture medium only), and group 3 (IR plus intravenous transplantation of 1.5 × 106 autologous ADMSCs at 1h, 6h, and 24h following IR injury). The duration of ischemia was 30 minutes, followed by 72 hours of reperfusion prior to sacrificing the animals. Blood samples were collected and lungs were harvested for analysis.Blood gas analysis showed that oxygen saturation (%) was remarkably lower, whereas right ventricular systolic pressure was notably higher in group 2 than in group 3 (all p < 0.03). Histological scoring of lung parenchymal damage was notably higher in group 2 than in group 3 (all p < 0.001). Real time-PCR demonstrated remarkably higher expressions of oxidative stress, as well as inflammatory and apoptotic biomarkers in group 2 compared with group 3 (all p < 0.005). Western blot showed that vascular cell adhesion molecule (VCAM)-1, intercellular adhesion molecule (ICAM)-1, oxidative stress, tumor necrosis factor-α and nuclear factor-κB were remarkably higher, whereas NAD(P)H quinone oxidoreductase 1 and heme oxygenase-1 activities were lower in group 2 compared to those in group 3 (all p < 0.004). Immunofluorescent staining demonstrated notably higher number of CD68+ cells, but significantly fewer CD31+ and vWF+ cells in group 2 than in group 3.ADMSC therapy minimized lung damage after IR injury in a rodent model through suppressing oxidative stress and inflammatory reaction.The lung maintains its unique function of effective gaseous exchange because of its remarkably large alveolar surface area, its rich and delicate alveolar capillary network, as well as its physical properties (i.e. elasticity and compliance). On the other hand, it is vulnerable to acute ischemia-reperfusion (IR) injury in situations such as resuscitation from hemorrhagic/septic shock and recovery from cardiac surgeries where pulmonary blood supplies have to be clamped,
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