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ABSTRACT: To evaluate the functionality of the telehealth system in poorly controlled type 2 diabetic (T2D) patients receiving insulin injections.
Sixty-four patients with glycosylated hemoglobin (HbA(1c)) values > 7% for more than 1 year were included. All patients underwent an intensive diabetes management program, including titration of insulin, blood glucose-self monitoring, and nutritional review, and 32 participated in the telehealth system. The major outcome was to evaluate the change of the HbA(1c) and body weight, the incidence of hospitalization, and hypoglycemic events.
After 1-year management, patients receiving telehealth care had significantly improved HbA(1c) levels (9.5% ± 1.8% to 8.1% ± 1.2%; p < 0.01) without significant body weight gain. In contrast, the control group patients had no significant improvement in HbA(1c) levels but showed significant increase in body weight (66.8 ± 9.8 to 67.3 ± 10.0 kg; p < 0.01). No patient in the telehealth group was hospitalized during the follow-up period, but six patients in the control group were. Intergroup differences in hypoglycemic events were absent.
The intensive diabetes management program with the telehealth system is a useful education method to improve blood sugar control and prevent hospitalization in poorly controlled T2D patients receiving insulin injections.
Telemedicine and e-Health 09/2011; 17(9):683-7. · 1.42 Impact Factor
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Chih-Hung Chen,
On Lee,
Chung-Niang Yao,
Meng-Yun Chuang,
Yow-Lone Chang,
May-Hua Chang,
Yen-Fang Wen,
Wan-Hsu Yang,
Ching-Huai Ko,
Nien-Tzu Chou, [......],
Hsiang-Wen Tseng,
Chih-Peng Liu,
Chia-Mu Tu,
Tsan-Lin Hu,
Yuan-Jang Tsai,
Ting-Shou Chen,
Chih-Lung Lin,
Shu-Jiau Chiou,
Chung-Cheng Liu,
Chrong-Shiong Hwang
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ABSTRACT: A series of azulene-based derivatives were synthesized as potent inhibitors for receptor tyrosine kinases such as FMS-like tyrosine kinase 3 (FLT-3). Systematic side chain modification of prototype 1a was carried out through SAR studies. Analogue 22 was identified from this series and found to be one of the most potent FLT-3 inhibitors, with good pharmaceutical properties, superior efficacy, and tolerability in a tumor xenograft model.
Bioorganic & medicinal chemistry letters 10/2010; 20(20):6129-32. · 2.65 Impact Factor
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Rahul R Khanwelkar,
Grace Shiahuy Chen,
Hsiao-Chun Wang,
Chao-Wu Yu,
Chiung-Hua Huang,
On Lee,
Chih-Hung Chen,
Chrong-Shiong Hwang,
Ching-Huai Ko,
Nien-Tzu Chou, [......], Hui-Chun Hsu,
Hui-Chi Lin,
Ying-Chu Shih,
Shuen-Hsiang Chou,
Hsiang-Wen Tseng,
Chih-Peng Liu,
Chia-Mu Tu,
Tsan-Lin Hu,
Yuan-Jang Tsai,
Ji-Wang Chern
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ABSTRACT: A series of new ureidoindolin-2-one derivatives were synthesized and evaluated as inhibitors of receptor tyrosine kinases. Investigation of structure-activity relationships at positions 5, 6, and 7 of the oxindole skeleton led to the identification of 6-ureido-substituted 3-pyrrolemethylidene-2-oxindole derivatives that potently inhibited both the vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR) families of receptor tyrosine kinases. Several derivatives showed potency against the PDGFR inhibiting both its enzymatic and cellular functions in the single-digit nanomolar range. Among them, compound 35 was a potent inhibitor against tyrosine kinases, including VEGFR and PDGFR families, as well as Aurora kinases. Inhibitor 36 (non-substituted on the pyrrole or phenyl ring) had a moderate pharmacokinetic profile and completely inhibited tumor growth initiated with the myeloid leukemia cell line, MV4-11, in a subcutaneous xenograft model in BALB/c nude mice.
Bioorganic & medicinal chemistry 07/2010; 18(13):4674-86. · 2.82 Impact Factor
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ABSTRACT: To address the possibility that sennoside B inhibition of cell proliferation is mediated via interference with platelet-derived growth factor (PDGF) signaling.
Human osteosarcoma MG63 cells were treated with PDGF in the presence or absence of sennoside B. Activation of the PDGF signaling pathway was monitored using western immunoblotting with specific antibodies against the PDGF receptor, phosphotyrosine and components of the downstream signaling cascade. Activation of cell metabolism and proliferation was assessed by chromogenic reduction of MTT.
Sennoside B was found to inhibit PDGF-BB-induced phosphorylation of the PDGF receptor (PDGFR) in human MG63 osteosarcoma cells. Downstream signaling was also affected; pre-incubation of PDGF-BB with sennoside B inhibited the phosphorylation of pathway components including Ak strain transforming protein (AKT), signal transducer and activator of transcription 5 (STAT-5) and extracellular signal-regulated kinase 1/2 (ERK1/2). Further, we found that sennoside B can bind directly to the extracellular domains of both PDGF-BB and the PDGF-beta receptor (PDGFR-beta). The effect was specific for sennoside B; other similar compounds including aloe-emodin, rhein and the meso isomer (sennoside A) failed to inhibit PDGFR activation or downstream signaling. Sennoside B also inhibited PDGF-BB stimulation of MG63 cell proliferation.
These results indicate that sennoside B can inhibit PDGF-stimulated cell proliferation by binding to PDGF-BB and its receptor and by down-regulating the PDGFR-beta signaling pathway. Sennoside B is therefore of potential utility in the treatment of proliferative diseases in which PDGF signaling plays a central role.
Life sciences 05/2009; 84(25-26):915-22. · 2.56 Impact Factor
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ABSTRACT: Guidelines for prescribing antibiotics for uncomplicated urinary tract infection (UTI) were established in Taiwan in 2000. This study investigated the extent of physicians' adherence to the guidelines for treating ambulatory women with UTI.
National Health Insurance claims data were used to evaluate antibiotic prescription behavior for UTI among physicians serving in hospitals across the range of accreditation levels in Taiwan, including medical centers, regional hospitals, district teaching/non-teaching hospitals and community clinics. A random sample of 5047 female ambulatory care visits during 2001 and 2003 was analyzed.
Sulfonamides (trimethoprim and trimethoprim-sulfamethoxazole), first-generation cephalosporins and quinolones were the most commonly prescribed drugs. The overall guideline adherence rate for physicians was 72.1%. The differences in guideline adherence rates for physicians in medical centers (86.6%), regional hospitals (81.3%), district teaching/non-teaching hospitals (76.9%) and community clinics (69.5%) were statistically significant (chi-squared test; p<0.0001).
Physicians in community clinics were less likely to adhere to guidelines in the treatment of ambulatory cases of UTI than physicians in any of the different levels of accredited hospitals in Taiwan.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 12/2007; 40(6):532-6. · 0.99 Impact Factor
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ABSTRACT: Steam distilled essential oil from the aerial parts of Pogostemon cablin was analyzed by gas chromatography-mass spectrometry (GC-MS). Forty one compounds were identified of which alpha-guaiene (20.62%) and alpha-bulnesene (16.18%) were major constituents. Furthermore, fractionation of the essential oil from P. cablin guided by inhibitory activity against PAF-induced platelet aggregation led to the isolation of the sesquiterpene, alpha-bulnesene.
Fitoterapia 02/2007; 78(1):7-11. · 1.85 Impact Factor
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ABSTRACT: Alpha-bulnesene is a sesquiterpenoid isolated from the water extract of Pogostemon cablin. It showed a potent and concentration-dependent inhibitory effect on platelet-activating factor (PAF) and arachidonic acid (AA) induced rabbit platelet aggregation. In a radioligand binding assay for the PAF receptor, alpha-bulnesene competitively inhibited [(3)H]PAF binding to the PAF receptor with an IC(50) value of 17.62+/-5.68microM. alpha-Bulnesene also dose-dependently inhibited PAF-induced intracellular Ca(2+) increase in fluo-3/AM-loaded platelets (IC(50) values of 19.62+/-1.32microM). Furthermore, alpha-bulnesene inhibited AA-induced thromboxane B(2) (TXB(2)) formation and prostaglandin E(2) (PGE(2)) formation. These results indicate that the inhibitory effect of alpha-bulnesene on platelet aggregation was due to a dual activity; specifically the chemical blocked PAF-induced intracellular signal transduction and interfered with cyclooxygenase activity, which resulted in a decrease in thromboxane formation. This study is the first to demonstrate that alpha-bulnesene is a PAF receptor antagonist as well as an anti-platelet aggregation agent.
Biochemical and Biophysical Research Communications 08/2006; 345(3):1033-8. · 2.48 Impact Factor
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ABSTRACT: To explore more possible roles for GSK3beta function, the yeast two-hybrid screening using GSK3beta as a bait protein was performed. In this study, we demonstrated that two variants of CABYR (281 and 379) interacted with GSK3beta in the yeast two-hybrid and GST pull down assay. Molecular characterization showed that CABYR variants formed a dimer with a proline-rich extensin-like domain, which slightly overlapped with GSK3beta-binding site. In kinase assay, we also showed that CABYR variants act as an ideal substrate for GSK3beta within the extensin-like domain and phosphorylation sites on CABYR were mapped. Interestingly, Northern blot showed that CABYR transcripts were expressed more distinctly in the fetal brain than in the adult brain, suggesting that this protein may play a role during brain development. Moreover, differential expression of CABYR variants may exhibit aberrant expression in brain tumors and cancer cell lines.
Biochemical and Biophysical Research Communications 05/2005; 329(3):1108-17. · 2.48 Impact Factor
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ABSTRACT: To explore more hNinein interacting proteins, the yeast two-hybrid screening using ninein C-terminal domain as bait protein was performed. One novel gene, CGI-99, was demonstrated to associate with hNinein in the yeast two-hybrid method and in vitro GST pull-down assay. Molecular characterization also showed that CGI-99 possessed a transcriptional activity at the N-terminal. In addition, CGI-99 formed a dimer with the C-terminal, which overlapped with hNinein binding site. In kinase assay, CGI-99 binds to hNinein and completely blocks the phosphorylation of hNinein by GSK3beta. Moreover, CGI-99 was highly expressed in all brain tumors which is in agreement with the Northern blot analysis. Taken together, we have isolated a novel protein CGI-99, which may be involved in the functional regulation of human ninein in the centrosome structure and may also be important in brain development and tumorigenesis.
FEBS Letters 06/2004; 566(1-3):162-8. · 3.54 Impact Factor
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ABSTRACT: Cost-benefit analysis was conducted to determine whether it is worthwhile to initiate a routine varicella vaccination program in Taiwan from different perspectives. Using the human capital approach, the discounted net cost for vaccination program was New Taiwan Dollars (NTD) 281 million from health care payer's perspective. Taking indirect costs into account, the net saving due to vaccination program was NTD 425 million from the societal perspective. In terms of benefit-cost ratio, a mass varicella vaccination program could only save NTD 0.34 in discounted costs for each dollar incurred in a vaccination program from health care payer's perspective whereas save NTD 2.06 from the societal viewpoint. Results based on the willingness-to-pay (WTP) method showed the Net Present Value (NPV) of the vaccination program was estimated as -NTD 272 million. We conclude that a routine varicella vaccination program is worthwhile from the societal perspective but neither from health care payer's nor from consumer decision based on the perspective of WTP.
Vaccine 10/2003; 21(25-26):3982-7. · 3.77 Impact Factor
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ABSTRACT: To explore more possible roles for GSK3β function, the yeast two-hybrid screening using GSK3β as a bait protein was performed. In this study, we demonstrated that two variants of CABYR (281 and 379) interacted with GSK3β in the yeast two-hybrid and GST pull down assay. Molecular characterization showed that CABYR variants formed a dimer with a proline-rich extensin-like domain, which slightly overlapped with GSK3β-binding site. In kinase assay, we also showed that CABYR variants act as an ideal substrate for GSK3β within the extensin-like domain and phosphorylation sites on CABYR were mapped. Interestingly, Northern blot showed that CABYR transcripts were expressed more distinctly in the fetal brain than in the adult brain, suggesting that this protein may play a role during brain development. Moreover, differential expression of CABYR variants may exhibit aberrant expression in brain tumors and cancer cell lines.
Biochemical and Biophysical Research Communications.
