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Biomedical subjects

Shu-Ching Chen

Publications and source records attributed to Shu-Ching Chen.

11 recordsLinked to original sources

Selective transmission of hepatitis C virus quasi species through a needlestick accident in acute resolving hepatitis.

BACKGROUND: Little is known about the transmission of variant hepatitis C virus (HCV) genome through needlestick injuries. METHODS: To demonstrate how HCV quasi species are transmitted and adapt to the new host in acute resolving infection, we analyzed the nucleotide and deduced amino acid sequences of the hypervariable region 1 (HVR-1) in the E2 domain of HCV in both the source of the virus ("donor") and the person who received the virus through a needlestick accident ("recipient"). In addition, we also performed phylogenetic analysis of HCV quasi species in these patients to document the viral transmission. RESULTS: We obtained a total of 33 clones at different time points by using polymerase chain reaction amplification and cloning and sequencing of HVR-1. A predominant HVR-1 variant (in 4 of 10 isolates) in the donor was not present in the recipient 6 and 14 weeks after the accident. In contrast, a minor variant (in 1 of 10 isolates) in the donor became the predominant strain in the recipient 6 weeks (in 10 of 12 isolates) and 14 weeks (in 6 of 11 isolates) after the accident. Additional phylogenetic analysis showed high homology of nucleotide sequences between isolates obtained from the donor and isolates obtained from the recipient. In addition, the variants in the recipient's virus showed substantial genetic preservation in the course of acute resolving hepatitis. CONCLUSIONS: These data suggested that a minor HCV variant from a donor was transmitted to the recipient through a needlestick injury and that it prevailed as the dominant species. The preserved genetic homogeneity of the transmitted viral variants in patients with acute HCV infection may account for their clinical outcomes of resolving hepatitis.

Adult↗

Psychometric testing of the Impact of Event Scale-Chinese Version (IES-C) in oral cancer patients in Taiwan.

GOALS OF WORK: No culturally relevant instrument exists to assess the impact of cancer on patients in Taiwan. Therefore, this two-phase study was undertaken to (1) develop a Chinese version of the Impact of Event Scale (IES), (2) examine its psychometric properties, and (3) use the IES-Chinese version (IES-C) to assess the impact of cancer in newly diagnosed oral cancer patients in Taiwan. PATIENTS AND METHODS: The psychometric properties of the 15-item IES-C were tested in 106 newly diagnosed oral cancer patients and analyzed by descriptive statistics, test-retest reliability, Pearson's correlation, and principal component analysis. MAIN RESULTS: The results showed that (1) the IES-C has satisfactory content validity and feasibility; (2) overall internal consistency (Cronbach's alpha) was 0.91 with values of 0.91 and 0.81 for intrusion and avoidance, respectively; (3) overall test-retest reliability (3-day interval) was 0.97; (4) two clearly identified factors explained 55.97% of the variance; (5) satisfactory construct validity was supported by both factor analysis and theoretically supported correlation analysis (significant correlations between the total IES-C and its subscales as well as anxiety and depression); and (6) oral cancer patients had relatively higher IES-C scores than previously reported. CONCLUSION: These results support the IES-C as an instrument with satisfactory psychometric properties and ease of use in clinical settings. They also suggest that more attention should be paid to the impact on patients of a new diagnosis of oral cancer. Further testing of the IES-C in different cancer populations is suggested to validate its psychometric properties.

Adult↗

Cross-linking of P-selectin glycoprotein ligand-1 induces death of activated T cells.

Increasing evidence has shown that death signaling in T cells is regulated in a complicated way. Molecules other than death receptors can also trigger T-cell death. Here, we demonstrate for the first time that P-selectin glycoprotein ligand-1 (PSGL-1) or CD162 molecules cross-linked by an anti-PSGL-1 monoclonal antibody, TAB4, can trigger a death signal in activated T cells. In contrast to classic cell death, PSGL-1-mediated T-cell death is caspase independent. It involves translocation of apoptosis-inducing factor from mitochondria to nucleus and mitochondrial cytochrome c release. Ultrastructurally, both peripheral condensation of chromatin and apoptotic body were observed in PSGL-1-mediated T-cell death. Collectively, this study demonstrates a novel role for PSGL-1 in controlling activated T-cell death and, thus, advances our understanding of immune regulation.

Animals↗

The use of bispectral index to monitor unconscious children.

The use of the Glasgow Coma Scale may be limited by the experience of physicians, errors resulting from subjectivity, the inability of patients to respond, and discontinuity. This study demonstrates that the Bispectral Index scores correlate well with scores from the Glasgow Coma Scale and that Bispectral Index scores can provide real-time, objective, and continuous monitoring of the consciousness level of critically ill children. Sixteen patients with consciousness disturbance, who were admitted to a pediatric intensive care unit of a tertiary university-affiliated children's hospital, were enrolled in this study. The patients received 34 Glasgow Coma Scale assessments and Bispectral Index scores. The age of patients ranged from 10 to 192 months (mean +/- S.E. = 68.4 +/- 12.3 months). Glasgow Coma Scale ranged from 3 to 11 (mean +/- S.E. = 6.3 +/- 0.4), and Bispectral Index score ranged from 0 to 100 (mean +/- S.E. = 55.4 +/- 5.6). A positive correlation was found to exist between Glasgow Coma Scale and Bispectral Index score (r = 0.76, P < 0.001). In conclusion, the Bispectral Index score correlates well with the Glasgow Coma Scale in critically ill children who score between 3 and 11 on the Glasgow Coma Scale.

Adolescent↗

Stochastic clustering for organizing distributed information sources.

The number of information sources and the volumes of data in these information sources have greatly increased, which may be attributed to the ever-increasing complexity of real-world applications. The enormous amount of information available in the information sources in a distributed information-providing environment has created a need to provide users with tools to effectively and efficiently navigate and retrieve information. Queries in such an environment often access information from multiple information sources. This may be attributed to navigational characteristics. Clusters provide a structure for organizing the large number of information sources for efficient browsing, searching, and retrieval. This paper presents a stochastically-based clustering mechanism, called the Markov model mediator (MMM), to group the information sources into a set of useful clusters. Each information source cluster groups those information sources that show similarities in their data access behavior. Information sources within the same cluster are expected to be able to provide most of the required information among themselves for user queries that are closely related with respect to a particular application. This can significantly improve system response time, query performance, and result in an overall improvement in decision support. Empirical studies on real databases are performed and the results demonstrate that our proposed mechanism leads to a better set of clusters in comparison with other clustering methods. This serves to illustrate the effectiveness of our proposed MMM mechanism.

Artificial Intelligence↗

Development and testing of the pain opioid analgesics beliefs scale in Taiwanese cancer patients.

The purpose of the study was to develop and preliminarily test the feasibility, validity, reliability, and factor structures of the Pain Opioid Analgesics Beliefs Scale-Cancer (POABS-CA) in hospitalized adults diagnosed with cancer in Taiwan. This scale was developed in three phases. In Phase I, item development was based on qualitative analysis as well as a review of the literature. Face validity, content validity, and feasibility were also evaluated. In Phase II, internal consistency reliability was further tested in 42 subjects with pain. In Phase III, test-retest reliability, internal consistency, and essential construct validity were further assessed in a sample of 361 hospitalized cancer patients with pain. The POABS-CA evolved from testing as a 10-item 5-point Likert-type instrument. Higher scores indicated more negative beliefs regarding opioids and their use in managing pain. Satisfactory face validity and content validity were found. The POABS-CA was also shown to be a reliable and stable pain belief scale, with Cronbach's alpha and test-retest reliability of 0.70 and 0.94, respectively. Two factors, namely pain endurance beliefs and negative effect beliefs, were extracted from the principal component factor analysis to support the construct validity. In conclusion, preliminary evidence indicates the POABS-CA is a reliable, stable, valid and easily applied scale for assessing beliefs regarding opioid use for cancer pain. Further studies should test this scale in different populations to increase its applications in cancer pain management.

Adult↗

Are nurses prepared to manage cancer pain? A national survey of nurses' knowledge about pain control in Taiwan.

Nurses play a crucial role in cancer pain control, but little is known about how well-prepared nurses are to manage cancer pain in Taiwan. The purpose of this study was to examine the level of knowledge about pain management among Taiwanese nurses with different background characteristics and to determine the predictor(s) of nurses' pain management knowledge. Nurse subjects were recruited by a cross-sectional nationwide survey with stratified sampling from nine hospitals distributed in the four major geographic regions of Taiwan. The Nurses' Knowledge and Attitudes Survey-Taiwanese version (NKAS-T) and a background information form were used to collect the data. Of 1900 surveys distributed, 1797 valid questionnaires (94.5%) were analyzed. The average correct response rate was 50.5%, with rates ranging from 7-86% for each survey question. Results from stepwise regression showed that nurses with higher mean correct answer scores had BS or higher degrees, had received pain education at professional conferences, had more prior hours of pain education, had longer clinical care experiences, and always worked with cancer patients. Nurses who worked in intensive care units, however, had significantly lower mean correct scores. The results strongly suggest an urgent need to strengthen pain education in Taiwan. The results also provide the direction for developing pain education.

Data Collection↗

Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients.

The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N = 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.

Adaptation, Psychological↗

The roles of interleukin-1 and interleukin-1 receptor antagonist in antigen-specific immune responses.

Despite evidence that interleukin (IL)-1 promotes the proliferation of some T helper 2 (Th2) cell clones in vitro, the physiological role of IL-1 in the regulation of antigen-specific immune responses remains undefined. Using a liposome-DNA delivery system, we transiently expressed IL-1 receptor antagonist (IL-1Ra) to suppress IL-1 functions at the site of the antigen-specific primary immune response. Our data indicate, for the first time, that IL-1Ra downregulates antigen-specific IL-4 and IgE responses, with concomitant enhancement of interferon-gamma and IgG2a responses in vivo. In addition, IL-1 can promote Th2 development in an IL-4-independent manner in vitro. Thus, the balance between endogenous IL-1 and IL-1Ra during the primary immune response can be an important factor in determining the antigen-specific effector function of T cells.

Animals↗

Effects of maternal nicotine exposure on branching morphogenesis of mouse fetal lung: in vivo and in vitro studies.

Epidemiological evidence suggests that premature infants born to mothers who smoke have a lower incidence of neonatal respiratory distress syndrome. The mechanism has been proposed to be due to increased lung maturity. This in vivo study investigated the effect of maternal nicotine on lung development by evaluating the airway branching morphogenesis (ABM) in mice fetuses. Nicotine (0, 2 and 3 mg/kg/day) was administered intraperitoneally to pregnant mice from gestation day 9 to day 12 (4 days). ABM was determined on day 13 by photomicrographic analysis. The results revealed a significant reduction in ABM in the higher dose nicotine group. The mean number of airway branches was 3.7 +/- 0.1/lobe for the 3 mg/kg/day group, which was smaller than 4.6 +/- 0.2/lobe for the 2 mg/kg/day nicotine group, and 4.4 +/- 0.1/lobe for the control group (F = 9.4, p < 0.001). The mean number of buds was significantly smaller in both the 2 mg/kg/day group and the 3 mg/kg/day group (8.7 +/- 0.5/lobe, 9.0 +/- 0.4/lobe vs. 12.3 +/- 0.4/lobe in the control group, F = 20.3, p < 0.001). For the in vitro study, fetal lung lobes were isolated at the 12th gestation day. The lung explants were cultured in nicotine (0, 30, 60 ng/ml) for 48 hours; there were no differences in all the groups. The results do not support the hypothesis that nicotine stimulates fetal lung ABM either in vivo or in vitro.

Animals↗