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Search Results: 1 - 10 of 168088 matches for " I-Chuan Chen "
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The microbiological profile and presence of bloodstream infection influence mortality rates in necrotizing fasciitis
I-Chuan Chen, Wen-Cheng Li, Yu-Cheng Hong, Shian-Sen Shie, Wen-Chih Fann, Cheng-Ting Hsiao
Critical Care , 2011, DOI: 10.1186/cc10278
Abstract: In this retrospective study, we analyzed 323 patients who presented with necrotizing fasciitis at two different institutions. Bloodstream infection (BSI) was defined as a positive blood culture result. The patients were categorized as survivors and non-survivors. Eleven clinically important variables which were statistically significant by univariate analysis were selected for multivariate regression analysis and a stepwise logistic regression model was developed to determine the association between BSI and mortality.Univariate logistic regression analysis showed that patients with hypotension, heart disease, liver disease, presence of Vibrio spp. in wound cultures, presence of fungus in wound cultures, and presence of Streptococcus group A, Aeromonas spp. or Vibrio spp. in blood cultures, had a significantly higher risk of in-hospital mortality. Our multivariate logistic regression analysis showed a higher risk of mortality in patients with pre-existing conditions like hypotension, heart disease, and liver disease. Multivariate logistic regression analysis also showed that presence of Vibrio spp in wound cultures, and presence of Streptococcus Group A in blood cultures were associated with a high risk of mortality while debridement > = 3 was associated with improved survival.Mortality in patients with necrotizing fasciitis was significantly associated with the presence of Vibrio in wound cultures and Streptococcus group A in blood cultures.Understanding the mechanisms underlying the pathophysiology of an infectious disease and characterization of the causative organism are key to providing better medical or surgical care, preventing complications and initiating early, appropriate antimicrobial treatment. Necrotizing fasciitis (NF), a life-threatening infectious disease with mortality rate ranging from 17% to 34% [1-6] actually refers to a spectrum of diseases where necrosis of deeper soft tissue is driven by an infective microorganism [7]. NF primarily involves the
Serum leptin is associated with cardiometabolic risk and predicts metabolic syndrome in Taiwanese adults
Wen-Cheng Li, Kuang-Yu Hsiao, I-Chuan Chen, Yu-Che Chang, Shih-Hao Wang, Kuan-Han Wu
Cardiovascular Diabetology , 2011, DOI: 10.1186/1475-2840-10-36
Abstract: In 2009, 957 subjects, who underwent a routine physical examination and choose leptin examination, were selected to participate. Participants (269 females and 688 males) were stratified according to leptin level quartiles. Metabolic syndrome was defined by NCEP ATP III using waist circumference cutoffs modified for Asian populations, and CVD risk was determined using the Framingham Heart Study profile.Leptin levels were correlated with CVD risk in men and women. With the exception of fasting plasma glucose, increased leptin levels were observed as factors associated with metabolic syndrome increased in both males and females. After adjusting for age, an association between leptin levels and metabolic syndrome was observed. After adjusting for age alone or with tobacco use, subjects in the highest leptin quartile had a higher risk of having metabolic syndrome than those in the lowest quartile (OR = 6.14 and 2.94 for men and women, respectively). After further adjustment for BMI, metabolic syndrome risk remained significantly increased with increasing leptin quartiles in men. Finally, increased leptin levels were a predictor of metabolic syndrome in men and women.Serum leptin levels are correlated with CVD risk and metabolic syndrome. Analysis of leptin as part of routine physical examinations may prove beneficial for early diagnosis of metabolic syndrome.Metabolic syndrome is a major risk factor for type 2 diabetes mellitus and cardiovascular disease (CVD). Specifically, a three-fold increase in the prevalence of metabolic syndrome is associated with a two-fold increased risk of cardiovascular disease fatality, 150% increase in total mortality, and a five-fold increased risk of diabetes mellitus [1]. Because metabolic syndrome is associated with increased risk for CVD and diabetes mellitus [2-5], early diagnosis of metabolic syndrome and resultant intervention strategies may help reduce the incidence of these associated diseases.Leptin is important for body weight re
Novel Nanohybrids of Silver Particles on Clay Platelets for Inhibiting Silver-Resistant Bacteria
Hong-Lin Su, Siou-Hong Lin, Jiun-Chiou Wei, I-Chuan Pao, Shu-Her Chiao, Chieh-Chen Huang, Shinn-Zong Lin, Jiang-Jen Lin
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0021125
Abstract: We develop a novel nanohybrid showing a strong antibacterial activity on all of the tested pathogens, including methicillin-resistant Staphylococcus auerus and silver-resistant E. coli. The nanohybrid consists of silver nanoparticles (AgNPs) supported on 1 nm-thick silicate platelets (NSPs). The AgNP/NSP nanohybrid enables to encapsulate bacteria and triggers death signals from the cell membrane. The geographic shape of the NSPs concentrates AgNPs but impedes their penetration into attached cells, mitigating the detrimental effect of silver ion deposition in applied tissues. Moreover, the tightly tethered AgNPs on NSP surface achieve a stronger biocidal effect than silver nitrate, but bypassing Ag+ mechanism, on silver-resistant bacteria. This nanohybrid presents an effective and safe antimicrobial agent in a new perspective.
Surgical Outcomes of Short-Segment Fixation for Thoracolumbar Fracture Dislocation
Shang-Won Yu,Kuo-Feng Fan,I-Chuan Tseng,Yi-Lee Chiu
Chang Gung Medical Journal , 2002,
Abstract: Background: Currently long-segment pedicle instrumentation for a thoracolumbar (T-L)fracture-dislocation is gaining in popularity. Otherwise, short-segment fixationmay be chosen as an another treatment method. This article evaluatesthe efficacy and complications of short-segment fixation for the treatment ofthoracic or lumbar spine fracture-dislocation.Methods: Twenty patients with thoracic or lumbar spine fracture-dislocation wereincluded in the study. The mean follow-up period was 3 years. Clinical,neurologic, radiologic (angle of deformity, displacement percentage, fusionrate), and complication outcomes were analyzed retrospectively.Results: The rate of failure, defined as an increase of 10o or more in local kyphosis, anincrease of 10% or more in displacement percentage, the development ofpseudarthrosis, and/or implant failure, was analyzed. Short-segment instrumentationhad a higher failure rate in the lower lumbar region (L3-L5) and alower rate at the thoracolumbar junction (T11-L2).Conclusion: Thoracolumbar fracture-dislocation required firmer fixation especially in thelow lumbar region, and short-segment fixation resulted in a high failure rate.Circumferential anterior and posterior fusion often played a role in certainseverely injured cases. Good postoperative spinal alignment is crucial to agood outcome.
Higher Complication Rate Following Hip Fractures in Uremic Patients Undergoing Maintenance Hemodialysis: A Cohort Study  [PDF]
Yi-Hsun Yu, Yung-Heng Hsu, Ying-Chao Chou, I-Chuan Tseng, Wen-Lin Yeh, Chi-Chung Wu
Open Access Library Journal (OALib Journal) , 2018, DOI: 10.4236/oalib.1103986
The current study retrospectively reviewed the surgical outcomes following hip fractures in uremic patients undergoing long-term hemodialysis and compared the results with those of geriatric patients with osteoporotic hip fractures during 1-year period. Thirteen complications occurred among the 21 uremic patients who underwent surgical intervention for a hip fracture. Two complications were related to the failure of osteosynthesis procedures after femoral neck fractures. While comparing perioperative parameters between the 2 groups, patients in the uremic group had younger age, more comorbidities, lower preoperative hemoglobin levels and platelet counts, and an increased requirement of perioperative blood transfusion. Statistical analysis revealed a significant increase in incidence of postoperative complications in the uremic patients; however, the incidence of surgery-related complications was unchanged. In conclusion, the present study shows that the incidence of perioperative complications in hip fracture surgeries is higher in uremic patients than those in geriatric hip fractures, mainly resulting from their comorbidities. In addition, we recommend hip prosthesis replacement surgery for femoral neck fractures in uremic patients due to the high rate of implant failure.
Intramuscular electroporation with the pro-opiomelanocortin gene in rat adjuvant arthritis
I-Chuan Chuang, Chien-Ming Jhao, Chih-Hsun Yang, Hsien-Chang Chang, Chien-Wen Wang, Cheng-Yuan Lu, Yao-Jen Chang, Sheng-Han Lin, Pao-Lin Huang, Lin-Cheng Yang
Arthritis Research & Therapy , 2004, DOI: 10.1186/ar1014
Abstract: We are now in an era of molecular medicine in which increasing focus is being placed on gene therapy as a potential approach for the treatment of several disorders in various types of patients. Several previous studies have reported that multinucleate and post-mitotic myofibres in skeletal muscle are capable of both long-term transgene expression and systemic delivery of proteins to the blood circulation. Gene delivery to skeletal muscle has therefore been investigated as a method of creating a tissue reservoir for the secretion of non-muscle proteins such as growth hormone. Different functional genes, including those that encode factor IX [1-3], erythropoietin [4], kallikrein [5] and interleukin-12 [6], have been delivered to skeletal muscle for potentially therapeutic purposes.It has been shown that endogenous ligands, and especially the opioid peptides, are expressed by resident immune cells in inflamed peripheral tissue. Environmental stimuli and endogenous substances such as corticotropin-releasing hormone and cytokines can stimulate the release of these opioid peptides, resulting in local analgesia and suppression of the immune system [7]. A therapeutic 'pain-killer gene', encoding pro-opiomelanocortin (POMC), produces the opioid peptides β-endorphins, other shorter endorphins, adrenocorticotropic hormone (ACTH) and α-melanocyte stimulating hormone. Injection of POMC cDNA with a gene gun has produced analgesic effects in phase 2 of the formalin test [8]. The possibility exists that this exogenous POMC-mediated analgesia could be used for the control of chronic inflammatory pain such as rheumatoid arthritis or osteoarthritis.Various studies have focused on the application of gene delivery using viral vectors such as adenovirus, retrovirus and herpes simplex virus for muscle-based gene therapy. However, the use of these viruses as vectors has been hindered by viral cytotoxicity, host immune rejection after repeat dosing, and limited transient transgene expressio
Analysis of Studies from 2000-2010 in Real Option Theory and Application to OM  [PDF]
Hui-Chuan Chen
American Journal of Operations Research (AJOR) , 2011, DOI: 10.4236/ajor.2011.11003
Abstract: Traditional project investment methods, such as the discounted cash flow (DCF) with a fixed static plan, are no longer sufficient to assist the corporate strategies of seizing opportunities and profitability. The option pricing formula includes a theoretical framework for pricing financial options, assuming that the risk in a financial hedged position is zero, if the option is adjusted continuously in a short position. Hence, the real options revolution arose in response to the dissatisfaction of corporation practitioners with traditional capital budgeting techniques, such as standard discount cash flow. This paper analyzes relevant articles from the “Journal of Operations Management” and “Management Sciences” as related to real options theory in the field of operations management. The goal of this study is to review and identify the gaps in application to real option theory in their studies. Finally, this paper provides suggestions for future researchers.
Newborn screening for citrin deficiency and carnitine uptake defect using second-tier molecular tests
Wang Li-Yun,Chen Nien-I,Chen Pin-Wen,Chiang Shu-Chuan
BMC Medical Genetics , 2013, DOI: 10.1186/1471-2350-14-24
Abstract: Background Tandem mass spectrometry (MS/MS) analysis is a powerful tool for newborn screening, and many rare inborn errors of metabolism are currently screened using MS/MS. However, the sensitivity of MS/MS screening for several inborn errors, including citrin deficiency (screened by citrulline level) and carnitine uptake defect (CUD, screened by free carnitine level), is not satisfactory. This study was conducted to determine whether a second-tier molecular test could improve the sensitivity of citrin deficiency and CUD detection without increasing the false-positive rate. Methods Three mutations in the SLC25A13 gene (for citrin deficiency) and one mutation in the SLC22A5 gene (for CUD) were analyzed in newborns who demonstrated an inconclusive primary screening result (with levels between the screening and diagnostic cutoffs). Results The results revealed that 314 of 46 699 newborns received a second-tier test for citrin deficiency, and two patients were identified; 206 of 30 237 newborns received a second-tier testing for CUD, and one patient was identified. No patients were identified using the diagnostic cutoffs. Although the incidences for citrin deficiency (1:23 350) and CUD (1:30 000) detected by screening are still lower than the incidences calculated from the mutation carrier rates, the second-tier molecular test increases the sensitivity of newborn screening for citrin deficiency and CUD without increasing the false-positive rate. Conclusions Utilizing a molecular second-tier test for citrin deficiency and carnitine transporter deficiency is feasible.
The Heat Transfer Characteristics of an Insulated Circular Duct Considering and Neglecting the Influence of Heat Radiation
Yen Hsun Chen,King Leung Wong,I Pin Kuo,Chuan Huang Lin
Lecture Notes in Engineering and Computer Science , 2009,
Accelerating Computation of DCM for ERP in MATLAB by External Function Calls to the GPU
Wei-Jen Wang, I-Fan Hsieh, Chun-Chuan Chen
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0066599
Abstract: This study aims to improve the performance of Dynamic Causal Modelling for Event Related Potentials (DCM for ERP) in MATLAB by using external function calls to a graphics processing unit (GPU). DCM for ERP is an advanced method for studying neuronal effective connectivity. DCM utilizes an iterative procedure, the expectation maximization (EM) algorithm, to find the optimal parameters given a set of observations and the underlying probability model. As the EM algorithm is computationally demanding and the analysis faces possible combinatorial explosion of models to be tested, we propose a parallel computing scheme using the GPU to achieve a fast estimation of DCM for ERP. The computation of DCM for ERP is dynamically partitioned and distributed to threads for parallel processing, according to the DCM model complexity and the hardware constraints. The performance efficiency of this hardware-dependent thread arrangement strategy was evaluated using the synthetic data. The experimental data were used to validate the accuracy of the proposed computing scheme and quantify the time saving in practice. The simulation results show that the proposed scheme can accelerate the computation by a factor of 155 for the parallel part. For experimental data, the speedup factor is about 7 per model on average, depending on the model complexity and the data. This GPU-based implementation of DCM for ERP gives qualitatively the same results as the original MATLAB implementation does at the group level analysis. In conclusion, we believe that the proposed GPU-based implementation is very useful for users as a fast screen tool to select the most likely model and may provide implementation guidance for possible future clinical applications such as online diagnosis.
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